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Nursing Positions To Try With Your Newborn

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Melissa Portunato MPH, IBCLC, RLC

Mothers and babies learn to breastfeed by breastfeeding. Exploring different nursing positions can help lessen nipple pain, improve milk transfer and allow you to get more rest. Read on to discover some of our favorite breastfeeding holds to try with your new baby. 

First things first, start every feeding with skin to skin. Remove all pillows, blankets, and comforters nearby; this can make latching more cumbersome and difficult. Baby should only have a diaper and bare chest for the parent. Skin to skin helps engage baby’s inborn feeding behaviors and reflexes while contributing to a powerful hormone feedback system between mom and baby. Skin to skin is powerful! 

Laid – back
Breastfeeding in a reclining or laid-back position relaxes and stimulates reflexes in both mother and baby. Research shows mothers and babies have innate physical responses that are triggered with laid-back breastfeeding. Interestingly, mothers were found to stroke their baby’s feet at just the right time during latching and feeding, which triggers the release of the lip and tongue for a deeper, more nutritive latch. Babies feed using their whole bodies, not just their heads and mouth. Your nurs-ling is looking for a place to anchor their chin, push with their toes, and feel the warmth of their natural environment – mommy’s chest! 

Side-lying 
Mastering the Side-Lying Breastfeeding position can help you recover from a difficult labor or cesarean delivery and can naturally improve blood circulation as you recover from childbirth. Start lying down side by side with your baby. You should be facing each other – belly to belly. Your baby’s mouth should be even with your nipple. Next, lift your arm under your head and, with your other arm, cradle your baby on the back of the neck to assist them to the breast if needed. Cradling your baby with the opposite arm can keep your newborn close, preventing turning and unlatching from the breast. Baby’s arm should always be hugging the breast. 

Football 
Cradle your baby by supporting the back of the neck with the same arm you will be latching to the breast. With the opposite hand, lift your breast to aim your nipple above the baby’s nose. Wait for your baby to “gape” or open wide and quickly bring your baby towards you. Pillows should be used only to support YOUR arms and back, not the baby. 

Koala
Feeding your newborn in an upright position can lessen reflux and manage an overactive or forceful letdown. Sometimes called the koala hold, your newborn will latch to your breast, sitting up while straddled on your thigh or knee. Baby’s spine and head should remain upright throughout the feeding. With proper support, this position can easily be done with newborns and can be a convenient way to nurse older babies too! 

Practice these four simple to-do nursing positions that will ensure your baby is growing and thriving from your super milk. Remember that breastfeeding doesn’t have to be “all or nothing.” No matter if you are nursing at the breast, exclusively pumping or supplementing with formula – it’s still breastfeeding! We’re here to support you and offer any help we can as you navigate your breastfeeding journey. 

Email us at ibclc@spectrababyusa.com or set up a free consultation with one of our IBCLCs at www.spectrababyusa.com/lactationservices. 

 

Sources

Milinco, M., Travan, L., Cattaneo, A. et al. Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial. Int Breastfeed J 15, 21 (2020). https://doi.org/10.1186/s13006-020-00261-4

Positioning. La Leche League International. (2020, August 6). https://www.llli.org/breastfeeding-info/positioning/. 

Milk Supply: What’s Normal?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

Moms want what is best for their babies and are often concerned they won’t make adequate milk throughout the breastfeeding process.  Couple that concern with daily social media posts about huge freezer stashes and 10+ oz. pumping sessions and moms can get full on anxiety about whether their production is “normal”.  Don’t worry mamas!  We’re here to let you know what a full milk supply looks like and to hopefully calm your fears about just how much milk you’re likely going to need. 

THE AVERAGE BREASTMILK INTAKE FOR A BABY FROM 1 MONTH TO 6 MONTHS IS 25oz. PER DAY.  Research tells us that the range is from about 19oz to 30oz. per day.  Milk production usually peaks at around 40 days postpartum as well. Medically speaking, a full milk supply ranges from 750ml –1035ml per day. It’s also normal for this amount to fluctuate from day to day.  It’s normal to see pumping output fluctuate from session to session as well.  

FOR MOMS WHO ARE PRIMARILY DIRECTLY NURSING THEIR INFANTS, TYPICAL PUMPING OUTPUT CAN RANGE FROM 0.5 oz to 2 oz. PER SESSION. We talk to so many moms whose babies have been growing and thriving while nursing at the breast, but then mom becomes concerned when her first pumping session only yields about an ounce from both breasts combined.  We can literally hear the relief in their voices when we tell them that THIS IS NORMAL!  Mamas, you don’t have to be pumping 5-10 oz per session to be successful at breastfeeding!  The amount you can pump is not necessarily an indicator of the amount your body is making.  Pumping is a learned skill that takes time to develop for many moms. Take cues from your baby….if they’re growing well and making adequate wet and dirty diapers, chances are you’re making the perfect amount of milk for them.   

EXCLUSIVELY PUMPING MOMS TYPICALLY SEE A PUMPING OUTPUT OF 2oz. – 4oz. EVERY 2-3 HOURS. Pumping is a learned skill and can take some time to get used to.  The above output range is for moms whose supply is established (after 40 days postpartum).  Unfortunately, some moms have been told that exclusive pumping will not allow them to make a full milk supply.  This is just not true, mamas!  With a high-quality, hospital strength pump, a consistent pumping schedule, and well fitted flanges, moms can make a full milk supply (and more) with exclusive pumping. 

While it’s true that most women can make a full milk supply, it’s also true that a small percentage cannot.  If you suspect you have low milk supply or just need reassurance that things are going well, don’t hesitate to reach out to an IBCLC. Our Spectra Baby USA IBCLCs are here to help with free virtual consultations.  Click HERE to schedule. We can also help via email at ibclc@spectrababyusa.com  Happy pumping, mamas! 

 

Sources: 

Bonyata, K. (2018, January 02). Exclusive Pumping • KellyMom.com. Retrieved July 27, 2020, from https://kellymom.com/mother2mother/exclusive-pumping/ 

Bonyata, K. (2018, January 16). I’m not pumping enough milk. What can I do? • KellyMom.com. Retrieved July 27, 2020, from https://kellymom.com/hot-topics/pumping_decrease/ 

Lawrence, R. A., & Lawrence, R. M. (2016). Breastfeeding: A guide for the medical profession. Philadelphia, PA: Elsevier. 

Mohrbacher, N. (2012, November 27). How Much Milk Should You Expect to Pump? Retrieved July 27, 2020, from http://www.nancymohrbacher.com/articles/2012/11/27/how-much-milk-should-you-expect-to-pump.html 

 

Breastfeeding and Sibling Support

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Breastfeeding and Sibling Support
Melissa Portunato MPH, IBCLC, RLC

We know moms reach their breastfeeding goals when they feel loved and supported. We know moms learn to breastfeed while watching their moms, aunts, and sisters breastfeed. Sibling support can make all the difference to a new mother’s breastfeeding journey. Studies show, when mothers are supported, they are more confident and empowered, leading to more successful breastfeeding outcomes. Breastfeeding is not always easy, and a kind word from a sibling can encourage us and breathe life into us when we need it most. 

This week we are celebrating sibling support in honor of National Sibling Day on April 10! Melissa’s Spectra Baby USA IBCLC, younger sister Natalia, was asked about her thoughts on sibling support throughout her breastfeeding journeys. “There’s an incredible feeling of comfort that comes from the support of a sibling. No matter your struggle with breastfeeding, having a sibling to lean on when you feel so overwhelmed makes you feel like you can conquer anything. The comfort comes in knowing you’re not in this alone.” said Natalia. 

Natalia is currently nursing her youngest and tandem nursed her children for one year. You might recognize her as a Spectra baby USA real mom model tandem nursing her children and pumping with the Spectra baby USA pumps! 

What is Tandem Nursing?
Tandem nursing means nursing two or more children of different ages at the same time. Twins and multiples can also tandem feed when nursing simultaneously at the breast.

Are there benefits to Tandem Nursing?
Continuing to nurse an older child after a new baby has arrived can be a way to offer emotional security and extra attention to the sibling. It can sometimes be temporary, while the older sibling adjusts to the new baby or can continue until both the child and mother desire. Tandem nursing can also help lessen engorgement and create an adequate milk supply. 

What can be expected in the early days?
During the first few days, colostrum will be produced for the newborn baby even if breastfeeding continued throughout pregnancy. Since colostrum is packed with immune properties and prepares the infant gut for mature milk, the newborn should have priority at the breast during the early days after delivery. 

Are you interested in learning more about tandem nursing or needing breastfeeding support? Catch our LIVEs every Wednesday at noon et on Facebook and IG for evidence-based breastfeeding education and support! It truly takes a village. You are not alone. Spectra Baby USA is honored to be part of this beautiful journey with you. Schedule a complimentary consultation, and we can help you reach your personal breastfeeding goals. 

Happy Breastfeeding! 

Sources:

Kornides, M., & Kitsantas, P. (2013). Evaluation of breastfeeding promotion, support, and knowledge of benefits on breastfeeding outcomes. Journal of child health care : for professionals working with children in the hospital and community, 17(3), 264–273. https://doi.org/10.1177/1367493512461460

Mohrbacher (2010) Breastfeeding Answers Made Simple, Hale Publishing, ISBN-10: 0984503900

Flower H. (2016) Breastfeeding during pregnancy and tandem nursing: is it safe? Recent research, Breastfeeding Today, 11 April 2016

 

 

 

Night Weaning

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Jacque Ordner BSN, RN, IBCLC, RLC 

Sleep is a sensitive and often sensationalized topic among so-called parenting gurus, authors, and creators of online sleep courses.  However, let me reassure you that if your baby nurses or takes a bottle to drift off and wakes to feed through the night, they are not broken….THEY ARE NORMAL!  In fact, research tells us that babies who sleep through the night at less than one year of age are closer to the exception than the rule.  New parents are often asked, “Is he a good sleeper?” or “Is she sleeping through the night yet?” when babies are barely out of the newborn stage. This helps perpetuate the myth that there is something wrong if babies under one are not yet giving their parents 6-8 hours of uninterrupted sleep.  Well-meaning advice givers often tell parents that their babies will magically stop waking if night feedings are cut-off.  In reality, early night weaning can lead to decreased milk supply and put baby at risk of receiving inadequate intake. At somewhere around six months of age,  you may begin to notice that your little one naturally stretches out the time between feedings and perhaps even stretches the time spent sleeping at night. While I recommend waiting until baby is closer to age one to start actively night weaning, there are some tips that parents can employ to encourage healthy sleep for their babies.  Since sleep is developmental, I recommend following your baby’s cues while eliminating obstacles to good sleep.  Find out more in our blog post, Newborn and Infant Sleep – What is Normal? 

While night weaning can help encourage an older baby or toddler to sleep longer at night, it’s not a guarantee of reduced night waking. This is because sleep is primarily developmental, and children wake for other reasons besides just hunger.  We, as parents, can help shape our children’s environment and behaviors to encourage sleep, but it is important to keep in mind that waking at night is normal even through toddlerhood.  Keep in mind that your child will eventually sleep through the night all on their own! 

Keep reading for our top tips for night weaning. 

Increase Daytime Intake 
When considering night weaning, it’s important to ensure your child is still receiving adequate calories.  Older babies and toddlers will often naturally shift to longer periods of sleep when their daytime intake increases.  Simply offering more nursing sessions or a greater volume of breastmilk via cup or bottle can be enough to encourage less need for night-time feedings.  Increasing solids is another way to get in more daytime calories.  Toddlers often do well with a bedtime “snack” that is nutritionally dense.  Foods that provide fiber, fat, and protein are often most satiating. 

Dream Feed Just Before Bed 
If your little one generally nods off before you’re ready to hit the sack, consider offering a dream feed to “top them off” just before you go to bed.  Babies will often rouse just enough to nurse or bottle feed without becoming fully awake.  This can give you a longer stretch before baby wakes for the next feed. 

Enlist Help 
If possible, ask your partner or another trusted caregiver to assist through the night during this transition.  This is especially helpful for nursing mothers.  If a non-lactating caregiver is present to comfort and soothe during night waking, baby may be less likely demand a feeding.  The old motto holds true…..Out of sight, out of mind! 

Increase Cuddles and Communication 
It’s not uncommon for toddlers to be anxious about weaning of any sort.  Reassure them with extra cuddles and clear communication about the night weaning process. Toddlers are perceptive and the often understand far more than we adults give them credit for!  Talk about night weaning during waking hours and let your child know when the process will start.  It’s ok to tell your toddler “no” when they ask for a night-time feeding, but follow it up by also letting them know when they can nurse again. For example, “We can’t nurse now, but we can nurse again when the sun is up”. Or “I’m just going to rock you for now, but we’ll get milkies when it’s time for breakfast”. Knowing when they will be allowed to nurse again, can bring an immense amount of peace to a worried toddler. 

Set Limits 
The counting method is often very effective with toddlers!  Let your little one know that they can nurse until you reach a certain number (whatever you are comfortable with).  For example, “You can nurse until Mommy gets to 20”.  Count out loud, going slowly for the first several nursing sessions.  After a few nights, begin to count a little faster.  As your toddler adjusts, you can reduce the number until there is no nursing.  If this approach is taken slowly and gently, it is not uncommon for toddlers to become uninterested in nursing at night. 

Don’t Be Afraid to Stop 
If you begin the night weaning process only to find that your baby or toddler is greatly distressed by it, don’t be afraid to stop and start again later.  If your child is hysterical each night and shows no signs of adjusting to night weaning, try again in a month or two.  There is no one-size-fits-all prescriptive timeline for any sort of weaning and it is rarely a linear process!  

Patience, reassurance, and planning are the keys to night weaning success! 

Tried all the tips and still struggling with night weaning?  You’re not alone!  Our International Board Certified Lactation Consultants (IBCLCs) have years of experience helping families navigate night weaning and many other sleep concerns.  We’re available 7 days a week for FREE CONSULTATIONS.  No matter where you are in your breastfeeding journey, we’re here to support you! 

 

Sources: 

Burnham, M., Goodlin-Jones, B., Gaylor, E., & Anders, T. (2002, September). Nighttime sleep-wake patterns and self-soothing from birth to one year of age: A longitudinal intervention study. Retrieved January 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201415/  

Galbally, M., Lewis, A. J., McEgan, K., Scalzo, K., & Islam, F. A. (2013). Breastfeeding and infant sleep patterns: an Australian population study. Journal of Paediatrics and Child Health, 49(2), E147–E152. https://doi.org/10.1111/jpc.12089 

Kent, J., Mitoulas, L., Cregan, M., Ramsay, D., Doherty, D., & Hartmann, P. (2006, March). Volume and           frequency of breastfeedings and fat content of breast milk throughout the day. Retrieved January 4,        2021, from https://www.ncbi.nlm.nih.gov/pubmed/16510619

To Sleep Or Not To Sleep?

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by: Bonne Dunham, IBCLC, RN

That is the question that so many new breastfeeding Mothers will ask when their babies start sleeping through the night, yet their breasts are overflowing with milk.

Of course, as mothers, we spend those first few months of motherhood dreaming about the day more sleep will arrive.  Yet, when that shift comes, we often start to worry about how this chunk of hours when baby is not breastfeeding will affect our milk supply. We put so much time into building and protecting that milk supply, nursing every two to three hours around the clock, even when our heart and soul and body would love to be sleeping, in the wee hours of the night. Rest assured (no pun intended!), that with a little understanding of how milk production works and adjusts to your baby’s growth and development, you can both have a sound sleep at night and plenty of milk to meet your child’s needs.

It may take a few weeks for your body/breasts to adjust to your baby’s new sleeping pattern, but it will.  Initially, most women will wake to find themselves in a pool of breast milk, or hard, swollen breasts, only to find that their baby is sound asleep and not in need of a breastfeeding snack at this moment. Most women will find that they wake naturally in those first few weeks, either because of the sensation of very full breasts, or just because their body rhythm has been doing so for several weeks or months.  To help your body adjust, to protect your milk supply, and reduce the risk of getting a plugged duct or mastitis, it is a great idea to relieve that pressure by pumping or hand expressing. The following tips will help you through this new stage of breastfeeding your baby.

1.)   It’s ok for you to harvest a little more sleep during this transition. If you are accustomed to feeding your baby every 3-4 or so hours at night, it is fine to sleep a couple of more hours before you relieve some of that milk by pumping or hand expression.  Keep in mind that going longer than 4-5 hours does result in the milk making hormone (prolactin) to lower in your blood which can result in less milk produced. What you remove from your breasts is what you will make. So, ultimately when you stop nursing or pumping at night your body starts the weaning process.

2.)   To help your body make this adjustment to producing less at night, you need only to express milk until your breasts are soft if your baby is not nursing during this time. Often, this looks like about 2-5 minutes of expression.  Longer than this time does result in elevating your amazing milk making hormones to continue to produce. Remember, after just two to three weeks of doing this, you will likely not experience swollen or leaking breasts at night, and can, therefore, stop expressing and start sleeping!

3.)   Babies are amazing creatures, and will adjust themselves by either nursing more frequently during the day, or taking in more milk per breastfeeding session. Starting around 3-6 weeks postpartum, babies drink an average of 30 ounces of milk per day, right up until solids are introduced. This average doesn’t really change much during those months, however, babies do become more efficient feeders as they grow, taking in more ounces per feed, and may space the feedings out depending on their needs.

4.)   It is wise to keep a watchful eye on your baby and your perception of your milk supply as you make this adjustment to less breastfeeding at night. If you suspect that your milk supply has decreased, there are ways to balance it out during your waking hours. You may benefit from speaking to a lactation consultant about your concerns, or to get extra stimulation on your breasts from a daily pumping session.

5.)   You got this!!!

 

If you missed the Live Q&A, don’t worry!  We got you covered.

…Sweet Dreams

Returning to Work: Planning and Pumping

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by Bonne Dunham, IBCLC

The prospect of returning to work after your baby is born can be a very frightening and overwhelming prospect for some Mothers, but with a little extra planning and knowledge about how to do this, you can smooth out this transition quite a bit.

In case you didn’t already know, there are several benefits to combining work and breastfeeding.  Knowing this might help give you a little bit of extra strength to leap over some of the more common hurdles that women face when re-entering the workforce AND taking care of a baby!  It’s not easy, but you got this!

Here are some benefits of combining work and breastfeeding:

Benefits to Baby:  Making the decision to supply breastmilk to your baby while you are working provides protection from ear infections, respiratory infections, allergies, colds, viruses and diabetes to name a few.

Benefits to Mother: Reduced risk of breast, uterine and ovarian cancer; decreases the risk of osteoporosis and allows for precious time to reconnect with baby.

Benefits to Your Wallet: One-day absences to care for an ill child occur more than twice as frequently for women who formula feed their infants as compared to those who breastfeed. And if you haven’t checked out the cost of formula…it isn’t cheap!

Setting Goals and Planning Ahead Will Reduce Stress

  •    Speaking with your supervisor about your plans for pumping at work BEFORE maternity leave is a great idea. If not before, than as soon as possible.
  •    Locate the lactation room in your workplace; does it have a fridge to store your pumped milk or will you have to bring a small cooler?
  •    Order you pump BEFORE your baby is born and understand how it works. While you are at it, gather your other pumping supplies ahead of time; collection bottles, storage bags and cleaning supplies.
  •    Plan your day: how will pumping fit into your workday? Consider making a mock-up of what your day will look like, from the moment you get up to when you step back through your doors. When and where will you pump? For most moms, pumping every 3 hours or so when separated from baby, for much of the first year, will help to keep your milk supply up and running.

Introduction of Pumping & Bottles

Week 1-4: Avoid pumping. Take this time to be with your baby! Allow the infant to naturally ‘program’ and establish your milk supply.

Week 4-6: Begin pumping once a day for 10-15 minutes and introduce a bottle. Adding this pumping session in during the morning or evening can be the best for when your milk supply is at its peak.

Weeks 6 and Beyond: Pump daily to store your milk or to have ready for your workday.

Milk Storage Strategies…The best tip I ever received!

The freshest is the bestest! Ok, bestest is not really a word, but I bet you get the picture: Always try to give your baby the freshest milk you have on hand, it will be highest in nutritive quality and deliver the most health benefits. Think “first in, first out”.

However, it’s also a good idea to rotate your frozen stash a bit too. Here is a way to do that: On Sunday night, take a days’ worth of frozen milk out of the freezer to thaw overnight in the fridge to feed baby on Monday. The milk you pump for Monday while at work will feed baby on Tuesday; Tuesdays’ pumped milk feeds baby on Wednesday, etc. No need to freeze this milk in-between, just keep it cool in the fridge.

Remember: Take a deep breath, take care of yourself too, and ask others for help. Leave us a comment about how you returned to work while breastfeeding and pumping.

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