Breastfeeding Basics

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By Jacque Ordner BSN, RN, IBCLC 

Breastfeeding is natural and the biological norm for feeding babies, but that doesn’t mean it’s easy! We’ve got you covered with top tips for getting started and avoiding common pitfalls. 

The human breast continues to develop milk-making glands, ducts, and other structures involved with lactation throughout pregnancy. For this reason, it is normal to experience breast changes including an increase in size, increased sensitivity, darkening of the areola and nipple, and even leaking of colostrum in late pregnancy. These are all great signs that your body is getting ready to feed your baby! 

After baby is born (more specifically, after the placenta is delivered) mom’s body experiences a hormone shift that triggers the production of breast milk.  For the first few days, women’s bodies make a thick, sticky liquid called colostrum.  Colostrum is a POWERHOUSE of nutrients and bioactive immune factors the help seal up your baby’s gut and protect him or her from illnesses.  Colostrum is small in volume but is just what baby needs in the early days.  Due to its thick, sticky consistency, colostrum can be difficult to express with a breast pump.  Many moms have more success using hand expression.  Here’s a great video with more information on hand expression in the early days:  https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html  Newborn tummies are tiny and are made to stretch as mom’s milk supply increases in the initial postpartum period. 

Placing baby skin to skin with mom and offering unlimited access to the breasts can have a huge impact on later breastfeeding success.  Latching baby within the first hour is ideal.  However, not latching in the first hour doesn’t mean breastfeeding will be unsuccessful!  Breastfeeding is a new sensation but shouldn’t be painful.  If you’re experiencing pain with latching or pumping, reach out for help from an IBCLC.  Frequent nursing helps mom’s milk supply increase faster.  Mothers make transitional milk (often somewhat yellow, very nutritious breastmilk) until about 6 weeks postpartum when transitional milk becomes mature milk (often whiter and more abundant breastmilk). If baby is unable to latch or is not nursing effectively, it is imperative that mom begin pumping with a high quality, hospital grade breast pump.  Studies show that 120 minutes/24 hours of good quality nipple/breast stimulation is needed to bring in and maintain a full milk supply. A full milk supply (after about 6 weeks postpartum) is between 750ml and 1035ml. 

Newborns nurse often!  We often hear that babies should nurse at least 8-12 times in 24 hours, but it is also normal for them to nurse even more.  If your newborn is producing 6-8 wet diapers in 24 hours and 3-4 dirty diapers in 24 hours, along with maintaining appropriate growth, then breastfeeding is likely going well! Remember, painful latching is a sign that something isn’t quite right even if baby is gaining weight well.   

If nursing is going well, there is no need to pump right away!  Many moms stress over when to add in pumping once they bring baby home.  In general, if nursing is going well, there is no need to add in pumping until around 4-6 weeks postpartum.  Pumping and nursing can lead to an oversupply of milk, and in-turn, increased risk of clogged ducts and mastitis.  However, many moms choose to introduce pumping as they anticipate returning to work soon after delivery.  If your baby requires a supplement, or if you are pumping milk for bottle feeding, Paced Bottle Feeding is key!  Check out this great demonstration for tips on avoiding overfeeding and helping baby transition from breast to bottle and back: https://www.youtube.com/watch?v=2K3O3grKusA 

Confidence is key!  Moms and babies are made to breastfeed!  If you are struggling with breastfeeding (pumping is breastfeeding too) or just need reassurance that things are going well, don’t hesitate to reach to an IBCLC for help!  Our IBCLCs are available to support you as well.  Email us at ibclc@spectrababyusa.com or set up a virtual consultation at www.spectrababyusa.com/lactationservices .   

 

Sources: 

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 

Unboxing the S1 and S2

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With so many breast pump options, it can be overwhelming to make a final choice to meet your specific breastfeeding needs. Before you decide on the perfect breast pump for you and your baby, you’ll need to consider a couple of factors like where and how often you will be pumping. No matter your breastfeeding journey, all Spectra baby USA Electric Breast Pumps offer high quality and amazing comfort. Read on to learn more about Spectra’s most popular breast pumps, the S1/S2 Plus! 

Spectra S2 Plus Electric Breast Pump

The Spectra S2 Plus is a hospital-strength, closed system pump that allows for single or double pumping. With a suction strength of 270mmHg, it has 12 adjustable expression vacuum levels and 5 cycle speed settings. Massage Mode is also customizable with up to 5 levels of vacuum suction to help effectively elicit let-down. The S2 Plus is the perfect pump for moms who regularly express their milk or exclusively pump.  The multi-phase “suckle” makes pumping with the S2 feel comfortable and stimulates a more natural milk flow. The Spectra S2 Plus is a top choice for many breastfeeding moms and is covered by most health insurance plans. 

The Spectra S2  Plus Features include: 

  • Closed Pumping System with Backflow Protection
  • Single or Double Pump capability
  • Customizable Dual-Phase Settings with Adjustable Suction 
  • Hospital Strength at 270 mmHg
  • Weighs 2.5 lbs
  • Soothing 2 level illumination light 
  • Touch screen LCD with timer control 
  • ( 2 ) Years Warranty

Spectra S1 Plus Electric Breast Pump 

A favorite among exclusive pumping moms, 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 with a reasonable upgrade charge 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 really does matter. Unplugging this pump doesn’t compromise suction like some other battery-powered pumps. You still get up to 270mmHg of suction, whether plugged or unplugged! If you want a portable and discreet pumping experience anywhere, the Spectra S1 Plus is the way to go! 

The Spectra S1 Plus Features include: 

  • Closed Pumping System with Backflow Protection
  • Single or Double Pump capability
  • Customizable Dual-Phase Settings with Adjustable Suction 
  • Hospital Strength 270 mmHg
  • Weighs 3 lbs
  • Soothing 2 level illumination light 
  • Touch screen LCD with timer control 
  • Rechargeable 3-hour battery life
  • ( 2 ) Years Warranty 

The Spectra S1 / S2 Plus Electric Breast Pump BPA Free Accessories:

  • Two (2) 24mm Spectra Breast Flanges
  • Two (2) 28mm Spectra Breast Flanges
  • Two (2) Spectra Tubing
  • Two (2) Spectra Duckbill Valves
  • Two (2) Spectra Backflow Protectors. Includes silicone membrane, uppercase, and lowercase for each Backflow Protector
  • Two (2) Spectra Wide Neck Storage Bottles. Includes nipple, cap, disc, and lid for each bottle
  • One (1) Spectra 12-Volt AC Power Adapter 

Does your health insurance plan cover a Spectra pump? Learn more here. Can’t decide on which Spectra Breast Pump is right for you? Schedule a complimentary virtual consultation with one of our International Board Certified Lactation Consultants today! We’re here for you and we support you! 

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 

 

All About the Snergy Gold (SG)

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The Spectra Synergy Gold Dual Electric Breast Pump is a game-changer in the pumping world! The SG dual-motor advanced technology promotes more productive pumping sessions that can save time with comfort and ease. Double the motors mean more customizable features and pumping options. The Spectra Synergy Gold has 15 vacuum levels on expression mode and 5 on massage mode that can be independently adjusted at 0-270mmHg per breast. With so many variations to choose from, this pump has something for everyone – part-time and exclusive pumpers alike. Benefits to having a breast pump with dual motors includes increasing milk supply on lower producing breast, treating and preventing clogged ducts, and creating a healthy milk supply for premature infants. The Spectra Synergy Gold Dual Breast Pump maintains the same high standards as other Spectra models with its trusted closed system and 2-year warranty. 

Unique features of the Spectra Synergy:

  • First of its type in the USA
  • Newest technology, dual independent motors, hospital strength (270+) per breast 
  • Spectra true closed pumping system
  • All current model Spectra accessories are compatible, including CaraCups
  • 15 vacuum settings and 5 cycles for expression
  • 5 vacuum settings and 5 cycles for massage mode
  • Vacuum levels adjustable on each side
  • Quiet and discreet with mute button option
  • 3 level soothing nightlight feature
  • Comfortable carrying back handle 

No matter which Spectra breast 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 can optimize pumping!  Schedule your complimentary consultation today or email us at ibclc@spectrababyusa.com for more help. 

 

Storing Breastmilk: Tips and Guidelines

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Melissa Portunato MPH, IBCLC, RLC

Every breastfeeding journey is special and filled with love. For you, it might include occasional pumping or only pumping when at work. Others choose to exclusively express breastmilk around the clock. It’s all breastfeeding! No matter how often you express your milk, you always want to ensure your liquid gold is handled with care and stored properly. Following proper milk storage guidelines will guarantee your breastmilk continues to support your baby’s health, growth and development. 

Read below frequently asked questions, tips and guidelines on breast milk storage. 

Breastmilk Storage Guidelines
How long is breast milk really good for? Remember the RULE of 4! According to the CDC, breastmilk is optimal for 4 hours at room temp, 4 days in the fridge, and 4-6 months in the freezer. If you will be freezing your breastmilk, it’s best to freeze it right away. Refrigerated breast milk can be frozen within 4 days of expression. 

Keep your breast milk cool when a refrigerator is not available. Transport refrigerated/frozen milk by placing breastmilk in an insulated bag or cooler with a frozen cold pack. Milk should be refrigerated or frozen within 24 hours. 

Proper Storage Containers 
Breastmilk should be stored in clean food-grade containers such as BPA-free plastic, glass, or silicone as well as disposable milk storage bags. Never use regular disposable kitchen bags or plastic inserts made for bottle feeding because freezing may cause these to leak and break down. 

Looking for a quick and effective way to pump, store and feed your baby? Check out the new Spectra Simple Storage Kit! Keep your milk clean, safe, and always ready to use with this new line of Spectra Baby USA products that lets you pump, store, and feed all from the same bag. This innovative storage solution also features a temperature sensor to ensure that breastmilk is just the right temperature for feeding. 

Fresh or Frozen? What’s Best?
All breastmilk is best! Fresh breastmilk contains the highest concentration of anti-infective properties, next in line refrigerated milk and then frozen milk. Give your baby freshly pumped milk whenever available. Fresh, frozen, and refrigerated milk can be combined. It’s best to mix breast milk at the same temperature to keep the immunological properties intact. 

Breastmilk should never be microwaved because it can heat unevenly and hurt your baby. In addition, microwaving can destroy valuable bioactive components found only in human milk. Gentle thawing of breast milk is best to preserve the quality. Thawing can be done in the refrigerator overnight or placed in a bowl of warm water. 

The Pitcher Method
The Pitcher Method is a popular method of collecting pumped milk from several pumping sessions throughout the day into one container and then using that milk to prepare the next day’s bottles. So easy to do, The Pitcher Method can save space and valuable time for breastfeeding families! 

Learn more about The Pitcher Method here. 

Cleaning Pump Parts
It’s recommended that you wash all your pumping parts (except tubing) after every use in a designated basin with warm soapy water. The CDC recommends, sanitizing parts once daily for extra germ removal. If you know you won’t have access to a sink, bring enough sets of pump parts to get you through the day. Placing pumping parts in the refrigerator in between uses is not recommended. 

Expert Tips

✔ Remember to start every pumping session by washing your hands for 20 seconds. 

✔ Store breastmilk in 2-4 ounce increments to prevent milk from being wasted. 

✔ If using breastmilk storage bags, squeeze the air from the top before sealing tightly.

✔ Freeze breastmilk bags flat to save space.

✔ Once frozen breastmilk is defrosted, it’s good to use within 24 hours and shouldn’t be refrozen. 

✔ Use leftover breastmilk from a feeding within 2 hours of finishing. 

✔ Warm breastmilk first, then gently shake. This technique will mix the fat which may have separated. 

✔ Breastmilk can be given cool, warm or room temp to healthy full term babies. 

For more information on breastmilk storage and preparation, download a printable sheet here to share with your family and caregivers.

Do you have a question about breastmilk storage? Email us at IBCLC@spectrababyusa.com! Our International Board Certified Lactation Consultants are happy to assist you along your breastfeeding journey. 

Sources:

Proper Storage and Preparation of Breast Milk. (2020, January 22). Center For Disease Control. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

Heating Human Milk. La Leche League International. (2020, August 6). https://www.llli.org/breastfeeding-info/heating-human-milk/. 

 

 

Do I Have Elastic Nipples?

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Do I Have Elastic Nipples

By: Melissa Portunato MPH, IBCLC, RLC

There’s been quite the buzz on “elastic nipples” lately. Whether you’re on social media or part of a virtual mommy group you’ve likely heard the term. It’s probably left you wondering if YOU have elastic nipples and if you’re even using the correct flange size. Don’t worry mama! We’ve got you covered. Read on to get the real 411 on elastic nipples. 

Here’s the deal. The skin on and around your nipple (areola) was intended to be stretched by breastfeeding. The nipple stretching is actually a good thing! Moms with truly inverted nipples or skin that is less elastic, are at an increased likelihood to experience issues with low milk supply, soreness, and nipple discomfort. Now if nipple elasticity is associated with low milk supply, pain, redness, or discomfort then it definitely needs to be addressed. Pumping shouldn’t hurt.

But how much should the nipple stretch when pumping to be experiencing “elastic nipples?” For the most part, the nipple should stretch a little less than half way 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. Otherwise, elasticity itself is no cause for concern. 

Check out these 4 tips on how to get relief if you have “elastic nipples” and pain when pumping:

#1) Lower The Vacuum Strength

Please don’t think you have to work up your nipple tolerance to level 12 vacuum. Vacuum strength should always be set to comfort. Moms are surprised to see they pump the same amount whether pumping on a high suction or medium / low suction. Every mom is different. Keeping the cycle steady and lowering suction strength can help lessen the elasticity of the nipple. Pumping with your S1/S2 steady on the expression cycle 54 vacuum between 5-6 for 15-20 min can help minimize discomfort. 

#2) Check Your Flange Size

This part could be tricky. 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. That’s why it’s important to work directly with an International Board Certified Lactation Consultant. It’s normal for nipple size to fluctuate. Measure to know your nipple diameter. But this only tells us a piece of the story. Some moms will benefit from going up a size or changing sizes throughout their breastfeeding journey. 

#3) Lubricating Before Pumping 

Hand express a few minutes before pumping and squeeze a few drops of breastmilk to lubricate the inside of the tunnel. This can help keep your nipple in place and help with soreness too. You can do this with lanolin or a few drops of olive oil too! Reposition your flanges every few minutes while pumping if needed. Hand express for a few minutes after pumping and let breastmilk air dry on them to help heal and keep them healthy. Bonus – hand expressing before and after pumping can trigger more milk production. 

#4) Silicone Inserts / Massagers 

A massager or silicone insert can offer relief sometimes but not always. Spending a ton of cash on accessories that either don’t work or fit properly can be frustrating.Too often moms find these products can actually decrease suction and they find them hard to keep in place. If you’d like to try one of these, go for it! But it’s best to look for an insert that offers a money back guarantee or can send you multiple sizes to find the best fit. If you do find it hard to keep an insert in place, try moistening it with a few drops of water or breastmilk. Moisture can help create a better seal. 

Correct flange sizing and lower suction can usually be a quick fix to get relief from elastic nipples. But what if you’ve tried it all. You have the correct size, low suction and still have your nipple stretching way past the halfway mark but don’t have any pain? Then you’re good mama! Pump on! Your body is doing exactly what it was intended to do. 

Schedule a virtual consultation with us and we can help with tips to manage pain and discomfort associated with elastic nipples. We can help with flange sizing and troubleshoot your pump too. You’re doing really great at breastfeeding mama. We’re proud of you! 

 

 

HypnoBirthing for Childbirth, Breastfeeding & Beyond

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By Patty M. Castellanos, LMHC, CHT, HBCE

You’ve heard the stories from your mother, sister, friend, or even that mom you don’t know, but she’s in a Facebook group you’re a part of. You’ve seen the movies; Hollywood loves dramatic birth scenes. Your provider may have even talked to you about what birth is like. Perhaps you have even had a birth experience yourself, which left you wondering if pregnancy and birthing could be different.

Mothers have been conditioned to believe that excruciating pain is associated with labor, and because of this, women often hold a deeply rooted fear of giving birth. This intense fear may cause their bodies to become tense, and that tension prohibits their bodies from quickly allowing the body to function as it is intended to. This leads to what many fear most – long, painful birthing, unnecessary interventions, and feelings of failure or inadequacy.

I became a HypnoBirthing educator after experiencing an empowering birth experience with my daughter, as a  Vaginal Birth After a Cesarean. This led me to believe that our bodies were designed to release, heal, relax, focus, surrender, and trust that my baby and body work together in harmony for birth.

HypnoBirthing is a childbirth education method that emphasizes the use of self-hypnosis,  guided imagery, and relaxation techniques to reduce fear, anxiety, and childbirth discomfort. HypnoBirthing is a method for all mothers and birthing couples, those seeking the calm confidence to give birth as calmly, safely, and gently as possible, in a hospital, a birthing center, or at home. This method is beneficial for mothers seeking natural unmedicated birth, medicated birth, cesarean section birth, or elective or non-elective. Mothers of all walks of life, birthing alone or with a birth companion, benefit from dispelling deeply rooted myths of birthing and discovering that they are capable of giving birth in a very different and empowered way. From healthy, low-risk women to women who need medical assistance or interventions due to particular circumstances, they learn to eliminate the fear-based stories, myths, and the words of well-intentioned people, and they are guided to see birth as normal, learn to trust that their bodies how to birth in a calm and gentle way.

 So now you may be wondering what this really looks like in practice:

 ✔ Confidence-building classes are hosted in a series of five, 2.5-hour classes, once a week, providing a thorough yet simple to follow program of guided relaxations, hypnosis, and education.

 ✔ The five-week series includes a HypnoBirthing® the Marie Mongan Method book, Spiral Workbook, Relaxation Audios, and everything you need to know to create an amazing birthing experience.

✔  When giving birth with HypnoBirthing, just as with the practice, a mother is not in a trance or asleep but instead in a state of deep focused relaxation—awake, aware, and fully in control, as she impacts her subconscious mind towards release and trust.

 ✔  Mothers and birth companions learn through a process of special breathing, relaxation, visualization, deep intentional bonding practice, attention to nutrition, and positive body awareness. Through this, it encourages communication, mutual respect, and understanding for the mother, the birthing family, and the care provider. This, in turn, allows the mother to remain in complete trust and confidence.

✔  Mothers and the birth companion are encouraged to bond with their babies. For some, this time is the first time in their pregnancy that they deeply connect and communicate with their baby and a team.

 ✔ Mothers learn what makes labor hurt, or what’s called the cycle of Fear-Pain-Tension, but more importantly, they learn the reasons behind why labor doesn’t have to hurt and what they can do about it.

 ✔ Mothers and their birth companions learn how past learning, programming, fear, and anxiety affect their mindset and how it affects the body’s physical and chemical processes. In other words, we break down the fight, flight, or freeze response and replace it with calm, confident relaxation.

✔ The HypnoBirthing techniques are practiced in class. Then they continue the practice in what I call the white space of change between classes, where the deep transformation and mindset shifts occur. As they listen to the Affirmations and Relaxations, their subconscious mind shifts limiting beliefs or negative thinking to thinking that is calm, confident, and surrendering to the breath and purpose of birth.

This mindset and practice extends to breastfeeding and the bond of a mother and child through their feeding relationship. Mothers receive basic breastfeeding education and are guided to understand how relaxation supports milk production and a mother’s bond to her baby using the same calm breathing exercises they learned for birthing combined with Breastfeeding Affirmations.

The overall effect of practicing the HypnoBirthing techniques is that the birthing mother and others supporting her can better appreciate the benefits of calm, gentle birthing, clear open communication, and instinctive bonding. HypnoBirthing can make the childbirth experience a more trusting, relaxed, and joyful one for mother, baby, and others involved—benefits that can last a lifetime. 

You are Greater than your Story…

Connect with Patty at www.theexpressioncenter.com to inquire about HypnoBirthing virtual classes and to learn more on how this affirming relaxation technique can support your individual goals for birth and journey through motherhood. 

Source:

Victoria J. Madden, BSc, Daniel S. Harvie, PhD, Romy Parker, PhD, Karin B. Jensen, PhD, Johan W.S. Vlaeyen, PhD, G. Lorimer Moseley, PhD, Tasha R. Stanton, PhD, Can Pain or Hyperalgesia Be a Classically Conditioned Response in Humans? A Systematic Review and Meta-Analysis, Pain Medicine, Volume 17, Issue 6, June 2016, Pages 1094–1111, https://doi.org/10.1093/pm/pnv044

Hands on Pumping

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Melissa Portunato MPH, IBCLC, RLC

“Hands on Pumping” is a technique that uses breast massage to drain the breast better and stimulate healthy milk production. Studies tell us combining hand expression and breast massage can increase milk volume by 48%. That’s a considerable amount of more liquid gold to store or give fresh to your baby! Benefits of Hands on Pumping is higher milk volumes, increased fat content, less time pumping, preventing and treating clogged ducts. Every breastfeeding mom should use Hands on Pumping because it’s simple to do and maximizes pumping sessions!

Check out this easy to follow routine to get started with Hands on Pumping:

Step 1
Start with hand massage and expression! Use two fingers to gently massage around each breast in a circular motion for 3-5 min. This will begin to stimulate your first letdown.

Step 2
Wear a hands-free bra and double breast pump for 15 – 20 minutes. As you’re pumping, apply pressure on both breasts. Position your hands above the flanges. Move your hands around the breast throughout your pumping session, concentrating on areas that feel full. Cup your hands and apply pressure under the breast and on the sides of your breasts with the traditional “C” hold.

Step 3
Finish with hand expression or single pumping for 3-5 minutes on each breast.

Spectra IBCLC Bonus Tip – Start with the letdown mode (three-wave button) for 5 min. When milk slows down, press the three-wave button and switch to the expression mode—swapping modes when milk flow decreases is called Cycle Pumping. These settings closely mimic a newborn’s feeding pattern and can be an effective tool to make pumping more productive. Keep suction set to your comfort level. Higher suction DOES NOT mean more milk!

Instead of only relying on the pump for milk removal, use your hands in combination for more productive pumping sessions! To learn more, check out these videos on Hands on Pumping. Watch it while pumping for the best results! 

Hands on Pumping: https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html

Hand Expression: https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html

Source

Combining hand techniques with electric pumping increases milk production in mothers of pre-term infants. J Morton, JY Hall, RJ Wong, L Thairu, WE Benitz, and WD Rhine: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA: Journal of Perinatology (2009) 29 757-764

What is Power Pumping?

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By Melissa Portunato MPH, IBCLC, RLC

Power pumping is a strategy used to increase milk supply by mimicking a baby cluster feeding at the breast. Cluster feeding is normal newborn behavior associated with short, frequent feeding patterns at the breast. Power pumping is intended to recreate this behavior, stimulating healthy milk production. 

Do I really have a low milk supply? 

Before starting power pumping, first, evaluate if you truly have a low milk supply. The average milk output for mothers exclusively pumping is 25-30 ounces per day, and if baby is brought to the breast as well, expect about half the amount. Working closely with an International Board Certified Lactation Consultant can determine the root cause and help you successfully meet your breastfeeding goals.

When’s the best time to power pump?

Most mothers find the evening is a great time! Baby is sleeping, you have extra hands on deck ready to soothe baby if needed, and you can relax. Ideally, find the time that works best for you when you can have an uninterrupted full hour of on and off pumping. 

How often should I power pump?

It’s not recommended to power pump long term but rather 1-2x a day for four consecutive days. There’re many different ways to power pump, but the main idea is on and off breast stimulation for one full hour. In most cases, it should be done in addition to your regular pumping sessions, even though sometimes it can be used to replace a pump session mostly for moms exclusively pumping. Remember, every mom is different, but power pumping every 3-4 weeks can be an easy tool to apply and kick start milk production. 

Power Pumping Quick Guide 

Power pumping can be done on one breast or both breasts with a hospital strength electric pump or a manual hand pump. See the easy-to-follow guides below to get started. 

Single breast power pumping:

  • Pump left breast for 10 minutes
  • Pump right breast for 10 minutes
  • Pump left breast for 10 minutes
  • Pump right breast for 10 minutes
  • Pump left breast for 10 minutes
  • Pump right breast for 10 minutes

Double breast power pumping:

  • Pump 20 minutes
  • Rest 10 minutes
  • Pump 10 minutes
  • Rest 10 minutes
  • Pump 10 minutes

Don’t watch the clock as much as letting your body take the lead. If you have a letdown, wait before stopping again to rest. Don’t get discouraged if you don’t see an increase right away. The extra stimulation is signaling your body to make more milk. Be patient. It can take about a week after you have stopped power pumping to see an increase. 

Do you have more questions about power pumping? 

Spectra Baby USA is happy to help! Schedule a virtual consultation with one of our IBCLCs today and get the support you need to meet your breastfeeding goals successfully! We’re here for you, and we support you! 

Sources: 

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 

Bonyata, K. (2018, January 3). Cluster Feeding and Fussy Evenings • KellyMom.com. KellyMom.com. https://kellymom.com/parenting/parenting-faq/fussy-evening/. 

 

Top Breastfeeding Challenges and How to Overcome Them

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By Melissa Portunato MPH, IBCLC, RLC

You had envisioned yourself latching your beautiful new baby to your breast, and it would instantly be magical. Pure bliss! But breastfeeding didn’t come as easy as you thought it would, and it feels far from magical. Instead, you feel frustrated, disappointed, and feel like giving up. The truth is, for most of us, breastfeeding is not what we thought it would be like at all. Just like with anything worthwhile in life, breastfeeding takes hard work and commitment. Let us help you get past those pesky common challenges so you can begin to truly bond with your baby.

Here are the Top 10 most common breastfeeding challenges and solutions to get you through those tough times and into a happy place with breastfeeding. 

#1 Painful Latch

Every time you know feeding time is coming around, your toes curl, and you start to get major anxiety because it hurts to latch your baby to your breast! Most likely, it’s because your nipple is rubbing on the roof of your baby’s mouth, causing discomfort. So how can you work on perfecting the latch to get rid of this dreadful feeling? Adjust your body, adjust your baby, and adjust your breast to what feels comfortable and relieves tension. Do this by practicing  “natural breastfeeding,” or also called “laid-back breastfeeding.” If you are using a traditional hold like the cradle or football hold, start the feeding with your nipple above baby’s nose, wait for baby to open wide, and then bring baby quickly (chin first) towards you. This technique can help aim your nipple deeper into your baby’s mouth. When done correctly, you should instantly feel a difference. Phew!

#2 Sleepy Baby at Breast

You changed baby’s diaper, tickled their toes, got them all undressed, and still can’t seem to wake baby from dreamland. A newborn baby should be nursing a minimum of 8 to 12 times per day. If baby is still not at their birth weight, they most definitely need to be woken up to feed throughout the night. For the first six weeks, try NOT to swaddle baby or offer a pacifier. This can interfere with nursing cues and cause baby to feel full and cozy and not want to nurse. Hand express for a few minutes before offering the breast to soften the breast, allowing for baby to latch easier. Sometimes, just a few drops of breastmilk on a sleepy baby’s lips will get them to want to nurse. Use breast compressions while you nurse. This can help keep your baby stay awake because of the steady flow of milk.

If your chubster is already back up at their birth weight, talk to your pediatrician. It’s most likely OK to hit the snooze button on that alarm. Finally rest!

#3 Cluster Feeding 

You feel your baby is practically attached to you morning, noon, and night. You can’t catch a break and you’re tapped out! Cluster feeding is when baby bunches nursing sessions close together about every 45-60 minutes. This feeding pattern is typical for young babies and coincides with growth development, but cluster feeding can be exhausting. Wearing your baby in a wrap or sling will allow you to be hands-free and get work done around the house or on the go! Check out more tips on our baby-wearing blog post here. 

We promise, there is hope! These marathon feedings will increase your milk supply and are typically followed by long sleeping stretches for baby. Sit back, relax, and scroll through your favorite newsfeed. Sleep is on the horizon. 

#4 Baby Refusing the Breast

If your baby was nursing and suddenly refuses the breast, you could be experiencing a nursing strike. Nursing strikes will typically last from just a few short days to over a week. They can be caused by various factors like an illness, teething, significant changes in routine, or long periods of separation from your baby.

Take it back to the basics! Dim the lights and do skin to skin with baby on your bare chest with only a diaper. Offer the breast frequently but, don’t ever force baby! It should be a gentle “wooing” back. You can even have baby gently wake up next to your bare breast. Often, babies will be more willing to nurse when just waking up. Limit bottles as much as possible and offer the breast first. Don’t wait until baby is too hungry. Try to have someone else give the bottle besides mommy.

#5 Sore Nipples

Your nipple is elastic, and as it begins to stretch, you can experience soreness. Soreness in the first few weeks is normal but should subside after about two weeks. Continued soreness, pain, cracking, and bleeding are not normal. It’s best to work closely with an International Board Certified Lactation Consultant to ensure baby is latched on properly. The best way to treat sore nipples is with your very own breast milk! Yep, pretty incredible, huh? Studies show the antibacterial properties in breastmilk make it the perfect substance to heal nipples and keep them healthy. Hand express breast milk on your nipples after every feeding and apply a cool hydrogel. Make sure you are changing your breast pads frequently. This will help prevent any infection and allow your nipples to heal faster. Your nipples will be feeling better in no time! 

#6 Engorgement

It’s been a few days, and your milk has officially made its grand entrance. HELLO! Engorgement can make it difficult for baby to latch. To help, you can apply a warm cloth and softly massage your breasts a few minutes before nursing. It’s crucial during this time to nurse frequently! Offer the breast often and use Reverse Pressure Softening, a technique that moves swelling upward and into the breast, providing relief from engorgement. If after nursing or pumping you still feel engorged, fill up a large basin with warm water and lean over it to let gravity naturally drain any excess milk from your breasts. After you’re done, you can ice or use a cold compress for 10 min to help bring down any swelling.

Call your healthcare practitioner if you have redness on your breasts; they feel hot to the touch; you have a fever or chills because it could sign an infection.

#7 Clogged Ducts

Ouch! Clogged ducts can be extremely painful but completely treatable. How did you even get them in the first place? A blocked duct can be caused by various reasons, from prolonged time without milk removal, shallow latch, restrictive clothing, or even stress. The fastest way to treat clogged ducts is by frequently nursing or pumping. Try nursing in the “dangling feed” position or “dangle pumping.” Practice massaging your breasts while nursing or pumping, no matter what position you use each time. You want to start massaging above where you feel the clog and gently move towards the nipple. You can use a warm compress before you nurse or pump to help with milk removal.

Alternate heat and cold on the area affected. If you find you have a milk blister or bleb, avoid trying to squeeze because it can make things worse. The milk blister or bleb will naturally draw out as the clog subsides.

The most important thing to remember with clogged ducts is that they should progressively get better, not worse. Most clogged ducts subside within 48 hours. If pain continues or other symptoms appear, give your doctor a call.

#8 Tongue Tie

You’ve spent countless hours looking under your baby’s tongue and upper lip, comparing it to pictures you found on the internet to try and assess. A tongue-tie is when the connective tissue under your baby’s tongue is too tight, too thick, or both. A tongue-tie is commonly accompanied by a lip tie – the upper lip tissue connecting to the gum can be tight or too thick. Both tongue and lip ties can restrict mobility in oral function, causing issues with breastfeeding.

Unfortunately, ties often go undiagnosed. Signs of a tongue or lip tie can include loud clicking when baby is nursing, baby is not gaining weight, has reflux, or you continue to experience nipple soreness. A specialist such as an International Board Certified Lactation Consultant or a Pediatric Dentist can evaluate your baby and provide effective treatment to ensure the breastfeeding relationship can continue. 

#9 Thrush

Stabbing nipple pain, itchiness, and shiny or flaky skin on the nipple or areola can all be signs of thrush. Thrush is a common fungal infection caused by the overgrowth of yeast or “candida.” Candida can be found in its natural environment pretty much all over the human body, but when it starts to multiply, it can cause an infection. Thrush can be a side effect of antibiotics too!  Talk to your doctor if you are experiencing any of the above symptoms and suspect you have thrush. Both you and the baby will need to be treated. Ask about starting probiotics for the both of you, which can help replenish the healthy bacteria in the gut for a quicker recovery and, most importantly, prevent thrush from recurring. 

Rinsing your nipples with a vinegar and water solution (1 tablespoon apple cider vinegar preferred to 1 cup water) or baking soda in water (1 tablespoon per cup) can help stop the spread. Use a fresh cotton ball for each application and mix a new solution every day. Limiting sugar can also help! Make sure you wash and sanitize your pumping parts after every use. 

#10 Mastitis

Last but not least, you think you might have the most dreaded condition in the whole breastfeeding universe; Mastitis. Mastitis is an inflammation of the breast tissue. Symptoms of mastitis include redness of the breast, hard lumps, hot to the touch, and feeling like you’re catching a nasty flu bug. If symptoms persist or get worse after a few days, call your doctor to ensure infection is not brewing. 

There are many causes of mastitis, including lack of breastmilk removal, worsening clogged ducts, change in breastfeeding patterns, and even a tight bra! It’s essential to continue to breastfeed during this time and keep your milk flowing. Make sure you REST and get plenty of fluids, as this often can occur due to a suppressed immune system. You need to take care of yourself so that you can take care of your little one!

Tips for relief are the same as when treating a clogged duct. See tip #7.

If you are experiencing any one of these common breastfeeding issues and still can’t seem to find relief, trust your mommy instincts and seek professional help from an International Board Certified Lactation Consultant. Never quit on your worst day! Always remember why you wanted to breastfeed in the first place. Surrounding yourself with breastfeeding support will make a world of difference. Join our online community on Facebook and connect yourself with other moms who will meet you exactly where you are on your breastfeeding journey. You’re not alone in your struggles, and you’re doing the very best you can!

 

Sources:

Colson, S. D., Meek, J. H., & Hawdon, J. M. (2008). Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Human Development, 84(7), 441-449.

Newman, J., & Newman, J. (n.d.). Are you worried your baby’s not getting enough breastmilk? International BreastFeeding Centre. https://ibconline.ca/breastcompression/. 

Thrush. La Leche League International. (2020, August 6). https://www.llli.org/breastfeeding-info/thrush/#:~:text=Rinsing%20your%20nipples%20with%20a,Wash%20your%20hands%20thoroughly. 

 

 

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! 

 

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

 

 

 

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