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Re-lactation: One Mother’s Journey

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By Jacquelyn Ordner BSN, RN, IBCLC, RLC

I had met my breastfeeding goals with three out of my four children, with the fourth still nursing once or twice a day.  Number four was about 2.5 years old and had decided he only needed “milkies” at naptime and bedtime.  I was comfortable with this, and we were moving through this transition happily.  But, when my husband and I decided we were going to adopt, my thoughts around weaning began to change. What if my next child needs my milk too?

As we completed the international adoption application process and began the home study process, we really began to think about the little person who would be joining our family.  We had told the agency that we’re open to parenting a child with significant medical needs. Our child could need a myriad of medical interventions, and I immediately began thinking that I needed to store breastmilk to help support him or her.  I’m an RN and IBCLC, so that’s just how my mind works. I KNOW that just 15 ounces of breastmilk can provide up to:

29% of a toddler’s energy requirements

43% of their protein requirements

36% of their calcium requirements

76% of their folate requirements

75% of their vitamin A requirements

94% of their vitamin B12 requirements

And 60% of their vitamin C requirements (Dewey 2001).

Breastmilk does not suddenly become non-nutritious or suddenly lose its bioactive and immune boosting components at a certain age! So, in the waiting and through the mountains and mountains of paperwork, I could be working toward making more milk to save for our fifth child! 

I began with the basics…..pumping! In an effort to store every ounce, I gently encouraged our current youngest to cut back to nursing just once a day.  This was easy at first, and he didn’t even seem to mind me pumping. I was double pumping with the Spectra S2 just 3-4 times a day to start. Let me tell you, this wasn’t very encouraging!  I was only yielding a total of 1-1.5 oz per DAY! That’s when I hit the first major setback….my toddler became jealous of my pump! He cried when he saw me pumping and asked for “milkies” multiple times per day.  I felt so conflicted at this point because my natural instinct was to scoop him up and provide that loving comfort as we had done thousands of times before. However, I also knew my goal was to collect and store as much milk as possible before we brought kiddo #5 home.  Knowing that an effectively nursing baby (or toddler in my case) was far more efficient at stimulating milk production than my pump, I allowed him to nurse up to three times per day while I continued to pump 3-4 times per day. 

We were hitting our stride, and my pumping output was SLOWLY increasing, when we had another setback.  My work schedule changed, and this put stress on the whole family. My little guy had to start a new daycare during at this time as well.  So, I took a break from pumping for a couple of weeks. I could kick myself for this now, but I can’t go back to change it. That two week break set me all the way back to the beginning. Still, once we found our new rhythm, I was determined to get my production up.  I began faithfully pumping 5-6 times per day and VERY SLOWLY started to see an increase! Over the course of 4 weeks, my pumping output went from 1-1.5 oz per day to 3 oz per day in addition to the milk I was providing to my nursing toddler. Though my output is small, I’m confident that I can continue to increase my supply with dedicated pumping. Re-lactation takes time!   If you are considering starting the re-lactation process, there are a few things to keep in mind:

  •  Milk supply is easier to influence in the first 4-6 weeks postpartum.
  • The amount of time and pumping needed to re-lactate depends on many factors such as how long you were nursing or pumping before stopping, how long it has been since you stopped nursing or pumping, and how much milk you were producing at the time you stopped.
  • Pumping alone can be an effective way to stimulate re-lactation.  The use of galactagogues should only be done so with the help of a knowledgeable practitioner.
  • An effectively nursing baby is the MOST efficient way to stimulate milk production.  If your baby will latch, this is very helpful to the re-lactation process. The use of an at-breast-supplementer can be significantly helpful as well.
  • The knowledge and expertise of an International Board Certified Lactation Consultant, who has experience with re-lactation, can be extremely beneficial for a mother who is pursuing this goal!

Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1).

Which Spectra Pump is Right for Me?

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Jacque Ordner BSN, RN, IBCLC 

With so many breast pump options, it can be overwhelming to make a final choice.  We’re known for our innovative closed system pumps that make pumping more hygienic while also preventing milk from making its way to the pump motor. While all of our spectra pumps offer high quality and amazing comfort, we’ve put together a guide for choosing the best Spectra pump for your specific needs. 

Handy Manual Breast Pump 
This manual breast pump is a convenient, no fuss option for moms who only need to pump occasionally.  It is also a fantastic backup to carry in your diaper bag for those oh-so-inconvenient pump emergencies! No outlets, no problem!  Stuck away from your pump unexpectedly, the Handy Pump has you covered!  Many women are surprised at how much milk they can express with a manual pump.  This BPA free pump holds up to 150ml and provides up to 350mmHg of suction all controlled by the user!  This affordable and versatile pump also makes a great baby shower gift! 

Spectra S2 Plus Electric Breast Pump 
If you’re looking for a workhorse of a pump that is often covered by insurance, the Spectra S2 Plus is it!  This hospital strength, closed system pump allows for single or double pumping, along with loads of additional features, all in a pump unit that weighs in at under 3lbs.  Boasting up to 270mmHg of suction via 12 vacuum levels and 5 Expression Cycles, this pump is perfect for moms who regularly express their milk.  This pump has strength and customization suitable for Exclusive Pumping as well! The multi-phase “suckle” makes pumping with the S2 feel comfortable and natural. The Massage Mode is also customizable with up to 5 levels of suction to help effectively elicit let-down.  The BPA free accessories, LCD screen display, built-in night light, timer, and 2-year warranty make this pump a top choice for many moms! 

Spectra S1 Plus Electric Breast Pump 
A favorite among Exclusive Pumpers, the Spectra S1 Plus includes all the features and functions of the S2 Plus in addition to a rechargeable battery!  The freedom of outlet-free pumping is often offered as an “upgrade” through health insurance plans.  Countless moms have reported the additional cost of the S1 as being “worth every penny”.  It’s no doubt that the 3-hour battery life delivers convenience that can make a pumping mom’s life easier, and when you’re already juggling a thousand things CONVENIENCE MATTERS!  Unplugging this pump doesn’t compromise suction like some other battery powered pumps…….say what?! You still get up to 270mmHg of suction whether plugged or unplugged! And let’s not forget that this amazing pump comes with Spectra’s generous 2-year warranty as well. If a rechargeable pump with the customization of 12 vacuum levels, 5 Expression Cycles, and an adjustable Massage Mode sounds like a dream, then the S1 is for you! 

Spectra S9 Plus Electric Breast Pump 
The S9 Plus is Spectra’s smallest pump, weighing in at only ½ a pound!  This tiny, but mighty pump offers the ultimate in on-the-go single or double pumping.  The rechargeable battery allows for convenient pumping in almost any location.  Though this pump is small, it isn’t lacking in features!  It provides up to 260mmHg of suction and is still considered hospital strength…..wow!!!  The S9 Plus also offers an adjustable Massage Mode along with 10 levels of vacuum in Expression Mode and a convenient timer. The backlit LCD screen is an added feature that moms love as well. Pair this little powerhouse with the hands-free CaraCups and you have a convenient hands-free pumping setup without sacrificing effectiveness! This pocket-sized pump also comes with a 2-year warranty. 

Spectra Synergy Gold (SG) Dual Powered Electric Breast Pump 
The Spectra Synergy Gold is a game changer in the pumping world!  Never before have we seen a pump with so many features and customizable options!  The dual controls allow for independent vacuum settings at 0-270mmHg PER BREAST!  It’s also offers a mute mode for even more discreet pumping. The convenient night light has 3 levels for easy middle of the night pumping, and the touch screen LCD makes selecting your cycle and vacuum a breeze! With 5 cycles in both Massage and Expression Modes, this pump has something for everyone.  Where the S1 and S2 have 12 vacuum levels, the SG has 15 and each breast can be independently adjusted! The possibilities really are endless with this incredible dual pump.  The SG maintains the same high standards as other Spectra models with its closed system and 2-year warranty. 

Remember that no matter which pump you choose, flange size, settings, pumping environment and several other factors can make a huge difference in your pumping experience.  Our specially trained International Board Certified Lactation Consultants (IBCLCs) can optimize pumping!  Schedule your FREE CONSULTATION today or email us at ibclc@spectrababyusa.com for more help. 

 

Finding Your Flange Size

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Melissa Portunato MPH, IBCLC, RLC

Pumping should never hurt. Whether a mom is exclusively breast pumping or will be away from her baby for any reason, it will be significantly more efficient when the pump is set up correctly.  This includes proper flange sizing. If you are experiencing pain, discoloration, or rings around the areola when pumping, it is likely coming from your flange size. Having a poorly sized flange can cause breast damage, pain, and low milk supply, leading to premature weaning. 

Here are some quick tips to follow to find the perfect flange fit! 

Accurately Measure 

Finding the proper size for a breast flange is based on the diameter of the nipple, not the areola (the softer pigmented skin around the nipple).  When your nipple is centered inside the flange tunnel, it should only have a few millimeters (3-5) of wiggle room around the nipple. The entire nipple should fit comfortably without much, if any, of the areola entering the tunnel before pumping. But measuring only tells us a piece of the story. Some moms feel comfortable sizing up or down and changing sizes throughout their breastfeeding journey. Nipple size can fluctuate and can vary from side to side. We recommend measuring before pumping or nursing then adding 3-5mm to the diameter. Here’s our helpful fitting flange guide. 

How should it look when pumping?

For the most part, the nipple should stretch a little less than halfway down the flange when pumping. If it’s way past that – like hitting the backflow protector or end of the flange and you’re experiencing pain or low milk output, then it’s time to troubleshoot. The nipple should move freely with no rubbing against the sides, which could be mean it’s too tight. If the areola is being pulled inside the tunnel (more than 3-5mm), suction is breaking while pumping, or milk starts to drip from under the flange, these could be indicators the flange is too large. Typically a flange that’s too big will cause the areola to be pulled farther into the tunnel, but if a flange is restrictive, the nipple will rub inside the tunnel and stretch it farther too. It’s normal for nipple size to fluctuate or to use different sizes on each breast. Both too small or too large of a flange can be accompanied by pain, discomfort, discoloration, or low milk output.

Sizing options 

The Spectra Baby USA S1/2 and SG come with two sets of flanges – 24mm and 28mm.  Spectra Baby USA flanges come in 20, 24, 28, and 32 mm. Flanges are relatively inexpensive and completely worth the purchase to ensure you have the highest comfort level when pumping. 

What about “elastic nipples”? You can read more about them here. 

Several factors go into finding the perfect flange fit. It’s essential to assess how the flange looks, feels and whether you are pumping an adequate amount of milk. Expected milk output is 2-4oz combined every 2-3 hr if you are exclusively pumping or about half if also nursing your baby at the breast. A higher vacuum does NOT mean more milk. Lowering the suction vacuum can help if you are having pain or your nipple is pulling significantly through the flange tunnel. 

If your nipples are sore from pumping, treat your nipples by letting your very own breastmilk air dry over the area. Applying moist wound healing with a cool hydrogel over the nipple can effectively treat pain and soreness. Even after troubleshooting flange sizing, if pain continues, contact your local International Board Certified Lactation Consultant (IBCLC) or healthcare practitioner for help. 

Have questions on flange sizing or simply want to be sized by our IBCLC Team of flange sizing experts? Schedule here. Follow us on social media at Spectra Baby USA on IG and Facebook for weekly educational videos, support, and guidance. Let us make your pumping experience more enjoyable and help you achieve your breastfeeding goals! We believe in you, and we support you! 

 

What To Do When The Witching Hour Hits

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The witching hour is a phrase used for an inconsolable baby typically between the hours of 6pm and 10pm, despite every effort to calm them.  It was originally a phrase used in the middle of the night when paranormal activity was most expected. For any mom that has experienced their baby during “witching hour”, this original idea isn’t far-fetched!  This can be a very trying time of day for mom, baby, and family when everyone is returning home from their busy days and everyone could use some relaxation time.

Tips for Dealing with ‘Witching Hour’

    1. Decrease baby’s stimulation.   By the end of the day, baby might just need a rain check from all the excitement. Put them in a nearby dim or quiet room and try to play soothing music or white noise.
    2. Feed on demand or cluster feed. Milk supply is lowest in the evenings.  The best way to make sure your breasts are keeping up with baby’s demand is to try to feed them whenever they are giving you hunger cues.   This will help boost your supply for the evening times in the future, keeping them well fed and happy.
    3. Put them to bed earlier.  Your baby may simply need to go to bed as early as 6 pm to prevent getting overtired.  Keeping them awake to get them to sleep through the night can backfire since it leaves them fussy and unable to calm themselves down for the night.
  • Let them nap more during the day.  Again, trying to keep babies awake to sleep better later does not typically work.  Putting them down for more frequent naps during the day may help combat end of the day overstimulation.  Since witching hour most commonly starts at 6 weeks, remember that most babies this age still need up to 16 hours of sleep per day!  
  1. Ask for help.  If you are feeling stressed, either directly from a fussy baby or from outside stressors (work, family life, etc.), make sure you’re asking for help.  Chances are if you’re feeling stressed your baby is picking up on that and making (or maybe even causing) the situation worse. This might mean getting help around the house so you can focus on baby more at the end of day or getting some personal time away from baby.  Do what will help you manage your own stress and recharge!
  2. Try soothing techniques. Find what works for your baby such as a warm bath, magic hold, a warm bath,  skin to skin snuggles, pacifier, singing, walking, rocking, vibrations and white noise.
  3. Talk to a specialist about your milk supply.  On average, breastfed babies need about 25 ounces of milk per day.  This can be hard to judge if you’re exclusively breastfeeding but totally feasible if you are pumping by tracking their intake.  If you’re concerned your baby is truly frustrated due to low milk supply, try boosting it. Start with these basic tips here.

If you are concerned there is something more going on talk to your pediatrician to rule out other potential issues like reflux or allergies. It can be hard to imagine while in the thick of it, but remember this is just a phase.  Try not to wish away those first few months because of witching hour and enjoy all the little moments. Before you know it, baby will be grown and you’ll be an empty nester. For more baby and mom support check out Spectra Baby USA’s blog here.  

How to Build Up a Freezer Stash Before Going Back to Work

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by Amanda G

Not every mama has the option to work from home after she brings that bundle of joy into the world.  This truth makes feeding baby challenging for those of us who are pumping and working.  The question then becomes, “what am I supposed to do and how do I do it”?  Before you go crazy, make sure you know your legal rights on pumping at work and what is supposed to be offered by law to you.  

Once you are no longer cross-eyed from the legal jargon, you can now focus on the How- To of building your stash.  A freezer stash can be really helpful when you’re preparing to go back to work and dealing with that anxiety of how do I feed my child!?  Many nursing moms pump while they’re at work and then have the baby’s caregiver feed the milk they pumped the following day. However, for the first day back at work, you’ll need to have some milk stored up ahead of time for your baby. Here are some ways on how to get started.  

 

What’s the best way to start building up a freezer stash?

When you’re nursing, it can be hard to know when you should pump for your freezer stash, because you still want to have enough milk in your breasts to feed your baby at his next feeding.

Your best bet is to start pumping within 30 minutes after your baby finishes nursing, giving you enough time to get your baby down for a nap or situated with tummy time, but also plenty of time before baby’s next nursing session to give your breasts time to fill up again.

When you sit down to pump, you’ll want to pump for about 10-15 minutes on each side. A double electric pump like the Spectra S1 or S2 will be most efficient.

 

How do I store the milk when I’m done pumping?

The best way to store breast milk in the freezer is in a breast milk storage bag.

When you’re done pumping, use your breast shield as a funnel – put it in the breast milk bag and pour the milk from the bottle into the funnel. This will help make sure that you don’t spill any precious milk when you transfer it. Label the milk with the date, and if you’re going to be bringing frozen milk to a daycare setting, make sure to put your baby’s name on the breast milk bag.

To freeze the milk, lay it flat in the freezer; this way, the frozen milk takes up less room and you can stack the breast milk bags easily.

 

How long can you store breast milk in the freezer?

This depends on the type of freezer that you have – with most normal freezers (where you’re opening and closing the doors to get ice cream and frozen pizza and other essentials out), breast milk is good for 3-6 months. Deep freezers (which are opened less frequently) will keep breast milk up to a year. A small freezer inside a mini fridge only keeps breast milk for two weeks.

If you have a large stash of frozen milk, it’s a good idea to rotate it (using the oldest milk first) so you don’t waste any.

 

What do I do with frozen milk when I’m ready to use it?

If you or a caregiver is thawing milk to use immediately, remember that warm water is always best.  You can put the bag of frozen milk in a bowl of warm water, which will thaw and heat it at the same time. Be careful not to burn yourself when you reach in to get the milk. (I’ve done this a few times.) Keep in mind that hot water can kill the live cells, so warm water is best and not above 37 degrees C or 98.6 F.

If you’re preparing bottles to be given to your baby the next day, you can thaw the milk in the refrigerator or by putting it in a bowl of cold water. (The cold water will be faster.) Once it’s defrosted, you can put it in bottles and store overnight in the fridge. Thawed milk should be used within 24 hours.

Remember mamas, don’t expect to pump A LOT at once; approx. 2oz combined sides is “normal output”.

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