Bringing Baby Back to the Breast

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Jacque Ordner BSN, RN, IBCLC 

There are scores of reasons why nursing at the breast may have gotten off to a rocky start or, perhaps, didn’t get off to a start at all.  Many mothers desire to bring their babies back to the breast after a period of bottle feeding.  While returning baby to the breast can be emotional, having the right tools, appropriate expectations, and the right support is essential for giving you and baby the best chance of achieving a successful latch. The following tips can help get you started. 

    1. Find a skilled International Board Certified Lactation Consultant.  An experienced IBCLC can help guide you and let you know what interventions to incorporate when.  Don’t be afraid to ask your potential IBCLC if they have experience with exclusive pumping and getting baby back to the breast.  It’s okay to be choosy when lining up your support team! This Find a Lactation Consultant directory can help put you in touch with IBCLCs in your area. 
    2. Consider the age of your baby and the potential reasons latching was difficult. Babies under 4 months of age tend to have a much easier time learning to nurse after a period of bottle feeding.  Older babies have been known to begin latching after having only bottles, but this is less common and often requires considerably more time. In many cases, the initial cause (or causes) of latching difficulty have been eliminated or reduced.  For example, moms and babies often pursue nursing after oral ties have been revised, low milk supply has been increased, baby has been discharged from the NICU, etc.
    3. Skin to skin is powerful! One of the first ways to help ease into latching is to soak up as much skin to skin time as possible.  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 results in the release of Oxytocin, creating a bonded feeling and encouraging mom’s milk to let down.  Many moms and babies find latching success while taking a warm bath skin to skin.  Don’t underestimate the effects of skin to skin! 
    4. Paced Bottle Feeding is key. Many nursing relationships have been halted due to baby’s preference for the faster flow and ease of the bottle.  Paced Bottle Feeding is a technique that helps mimic the slower, less consistent flow of the breast while feeding from a bottle. Check out our blog post for Paced Bottle Feeding tips. Implementing Paced Bottle Feeding can help your baby transition to nursing at the breast by setting the expectation for a realistic flow rather than fast, immediate gratification.   
    5. Keep the experience positive.  Attempting to latch an already ravenous baby is not likely to go well.  In fact, doing so can lead to a negative association with the breast.  Choose a time to offer the breast when baby is calm and not excessively hungry.  Watching for early hunger cues like sucking on hands and fists, smacking lips, sticking out the tongue, rooting, and restlessness can help.  Many moms find great success in offering the breast while baby is sleepy.  If baby becomes upset, stop and comfort baby before attempting to offer the breast again.  It may also be helpful to allow for a small feeding from the bottle before finishing at the breast. This can “take the edge off” of baby’s hunger and help ease tensions.  Skin to skin before offering the breast is another great way to put baby in a calm state. 
    6. Make sure baby is well fed.  Intake from a nursing session can’t be precisely measured as intake from the bottle can.  For this reason, it is especially important to continue supplementing until you are confident baby is nursing successfully.  A well trained IBCLC can help assess baby’s nursing abilities and weight checks and diaper counts can help put mom’s mind at ease. 
    7. Consider the use of nursing tools. Many babies transition back to the breast by use of a nipple shield.  The texture of nipple shield feels similar to that of a bottle nipple, and many reluctant babies are much more likely to take a nipple with a shield over a bare nipple to start.  Squeezing a small amount of breastmilk onto the tip of the shield can also help entice baby to latch. Another tool that can be used with or without a nipple shield is a Supplemental Nursing System (SNS).  An SNS is a tool that helps deliver a supplement of breastmilk or formula via a thin tube placed alongside the nipple and connected to a bottle.  This is especially helpful for moms with low milk supply and for babies who struggle to transfer milk at the breast.Click here for a video demonstration of feeding with an SNS.  *We highly encourage working with and IBCLC if you plan to incorporate a nipple shield or SNS. 

Remember that nursing doesn’t have to be “all or nothing”.  Many moms and babies find feedings work best when they do a combination of nursing and bottle feeding.  Many bottle fed babies still like to nurse as much for comfort and closeness as they do for nutrition.  Breastfeeding looks different for different families, and PUMPING IS 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. 

Breastfeeding and Benefits For Mama

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By Melissa Portunato MPH, IBCLC, RLC

You’ve likely heard all the amazing benefits of breastfeeding for your baby and how it can give them the very best start at life. Less risk of allergies, asthma, ear infections, obesity, a strengthened immune system, and so much more. But did you know that the benefits of breastfeeding are not only for your nursling but for you too? Read on to learn more! 

Reduces Risk of Breast and Uterine Cancer 
Breastfeeding can help shed cells with potential DNA damage which can reduce the chances of pre and post menopausal breast cancer. Estrogen can promote cancer cell growth and since breastfeeding delays ovulation this means less lifetime exposure, significantly reducing the risk of ovarian cancer. Studies tell us the longer you breastfeed for, the more protection you will have against both breast and ovarian cancer so nurse on mamas! It’s good for you! 

Less Osteoporosis With Age
Osteoporosis is a disease that weakens the bones and can make fractures sudden and easier to happen. Women are four times more likely to suffer from osteoporosis. By age 50, 1 out of 2 women will break a bone due to the disease. It’s known that while a mother is breastfeeding her bone density will be reduced by up 10% because ovulation is delayed. But when menstruation once again returns, her bones will regain strength. A review of 911 articles relating to breastfeeding and osteoporosis calculated a 0.9% reduction of any fracture from osteoporosis for each month of breastfeeding. More specifically, there is a 1.2% decreased risk of hip fracture for every month of breastfeeding! Breastfeeding can help keep mamas bones healthy and strong! 

Less Chance Type 2  Diabetes
A 30-year study published in 2018 showed the effects breastfeeding can have on diabetes incidence in women of child-bearing age. The study concluded breastfeeding for 1 year can lower your risk of type 2 diabetes from as much as 47%. But how does that all work? Lactation results in lower circulating glucose levels, which in turn lowers insulin secretion. Prolactin (milk making hormone) has also been linked to preserving the function of pancreatic cells. In conclusion, the duration of breastfeeding shows an independent relationship to lower incidence of diabetes, even when other risk factors are considered. 

Less Hypertension Decreases Blood Pressure
High blood pressure is often referred to as the silent killer because it can be present with no known symptoms. Alison Stuebe, a lead researcher at the University of North Carolina, Chapel Hill has studied the correlation between high blood pressure and breastfeeding mothers and stated, “Women who never breastfed were more likely to develop hypertension than women who exclusively breastfed their first child for six months or more.” Stuebe and her team analyzed the correlation between breastfeeding and later risk of high blood pressure among  56,000 U.S. women that had at least one baby. Though, the study does not indicate breastfeeding has a direct correlation with healthier blood pressure, it did depict the odds for developing high blood pressure were 22 percent higher for women who did not breastfeed their first child, versus women who exclusively breastfed for six months. The best way to protect yourself is to know the risks associated with high blood pressure and routine monitoring with your medical practitioner. 

In general, experts recommend that mamas and babies breastfeed exclusively for the first six months to receive the optimal benefits, but the longer a mama can breastfeed for the better. Breastfeeding is a mutually exclusive relationship and there is no need to stop if mom and baby are happy and desire to continue. Breastfeeding provides overall health benefits for mom and baby that will last a lifetime. 

Sources:

Lancet 2002 Jul 20;360(9328):187-95. doi: 10.1016/S0140-6736(02)09454-0. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease

Collaborative Group on Hormonal Factors in Breast Cancer, PMID: 12133652 , DOI: 10.1016/S0140-6736(02)09454-0

Gunderson, Erica P., et al. “Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years.” JAMA Internal Medicine, 16 Jan. 2018, pp. 1–10., doi:10.1001/jamainternmed.2017.7978.

Gunderson, Erica P., et al. “Lactation and Progression to Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus.” Annals of Internal Medicine, vol. 163, no. 12, 15 Dec. 2015, pp. 889–898., doi:10.7326/m15-0807.

American Journal of Epidemiology, Volume 174, Issue 10, 15 November 2011, Pages 1147–1158, https://doi.org/10.1093/aje/kwr227 Published: 12 October 2011

https://www.cdc.gov/breastfeeding/data/healthstyles_survey/

https://my.clevelandclinic.org/health/diseases/4443-osteoporosis

https://lacted.org/blog/questions/breastfeeding-osteoporosis-fractures-females/

 

Paced Bottle Feeding

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Jacque Ordner BSN, RN, IBCLC, RLC 

Are you worried your precious little one will grow to prefer the bottle over your breasts?  Are you concerned you might not be able to keep up once baby begins taking bottles regularly while you’re away? Are you exclusively pumping and looking for tips on bottle feeding?  We’ve got you covered with our full guide on Paced Bottle Feeding.  

Research indicates that infants will take more from a bottle than they would when nursing.  This can result in overfeeding, mom losing confidence in her milk supply, and can even contribute to later obesity.  One large study compared formula fed infants (via bottle) and breastfed infants (via direct nursing) and found that the bottle-fed infants consumed 49% more milk at 1 month, 57% more at 3 months, and 71% more at 5 months. In comparison, we know that directly breastfed infants do not increase the volume of breastmilk intake from one to six months of age.  The average daily intake for a breastfed infant from one to six months remains about 25 ounces per day.  

 Why do bottle-fed infants tend to consume more?  

  • The flow from a bottle can often be initiated by gravity alone, triggering innate sucking reflexes present in babies under 4 months old.  In other words, baby will often continue to suck and swallow milk from a bottle long after they’ve reached “fullness”.  In contrast, the flow of milk from the breast requires a coordinated suckle and does not flow consistently.  An infant can pause, breathe, relax, and reassess before initiating additional flow from the breast.  This puts the baby in greater control of the feeding.  
  • Formula fed infants regularly consume more than their breastfed counterparts because more formula is required to meet their nutritional needs.  Formula also does not contain hormones such as leptin and adiponectin which regulate hunger and metabolism.  It’s especially important to keep this in mind if your baby receives breastmilk and formula or if you are tempted to compare your breastmilk fed baby’s intake with that of a formula fed infant.  

 What are the benefits of Paced Bottle Feeding? 

  • Paced Bottle Feeding allows infants to develop and practice their innate feeding cues and skills rather than only responding to the consistent flow of the bottle over which they have no control.  This is especially important for newborns (particularly pre-term newborns) who require supplementation early.  Allowing newborns to develop natural feeding cues and skills can be instrumental in helping them return to the breast or to transition from breast to bottle and back.   
  • Babies often develop a preference for the fast and continuous flow from the bottle. In the past, this might have been labeled as “nipple confusion”, but we now call it flow preference.  We now know that when baby prefers the bottle over the breast, it’s almost always due to the preference and ease associated with the faster flow of the bottle.  Babies are smart, and once they learn that they don’t have to wait for milk from the bottle they may start to refuse or become frustrated at the breast. Paced Bottle Feeding helps to mimic the slower and non-continuous flow of milk that occurs during nursing.  
  • Paced bottle feeding allows time for baby’s satiation signals to be recognized.  Most of us know the experience of scarfing down a big holiday meal in 10 minutes or less only to realize we’re painfully full.  Similarly, a baby can often take copious amounts from the bottle, due to its rapid and persistent flow, before the brain has had a chance to realize the belly is full.  This can lead to a gassy, fussy, spitty baby. Over time, baby’s tummy can come to expect those large feeds even if the volume isn’t necessary for baby’s complete nutrition.  Additionally, the same large study mentioned above found that caregivers often encourage baby to finish a bottle even when they’re displaying signs of satiety. Caregiver pressure to empty the bottle is another contributing factor to overfeeding. This can also lead mom to believe her supply is inadequate when baby is actually being overfed. 

 What are the principles of Paced Bottle Feeding? 

  • Feed on demand following baby’s hunger cues (rooting, sucking on fists, smacking lips, restlessness, etc.) Remember crying is a LATE sign of hunger.  
  • Choose a slow flow nipple.  Not all slow flow nipples are as slow as they claim.  Click HERE for to check the flow rate of many popular brands.  
  • Feed baby in a nearly upright position. 
  • Allow baby to “latch” onto the nipple rather than inserting it into his or her mouth. 
  • Hold the bottle parallel to the ground so that milk just enters the nipple. 
  • Provide frequent breaks by tipping the bottom of bottle down or completely removing the nipple from baby’s mouth. This is especially important if baby begins to gulp. Watch baby’s cues! 
  • Switch sides halfway through the feeding to mimic a nursing session. This also provides cross-connectivity in the brain. 
  •  Feedings should take 15-30 minutes.  
  • Don’t force baby to finish the bottle.  Allow baby to determine when he or she is full rather than encouraging them to finish a specific amount.  

*These techniques are appropriate for babies under 6 months of age.  

Click HERE for a video demonstration of Paced Bottle Feeding. 

Paced Bottle Feeding helps protect the nursing relationship, reduces the risk of overfeeding, and gives baby control of their feedings.  Have concerns about bottle feeding?  We can help!  Our Board Certified Lactation Consultants can develop a plan to help you introduce or manage bottle feeding.  Click HERE to schedule your free virtual consultation or email us at ibclc@spectrababyusa.com.  We’re here to support you! 

References 

 Arenz, S., Ruckerl, R., Koletzko, B., & von Kries, R. (2004). Breast-feeding and childhood obesity–a systematic review. International Journal of Obesity and Related Metabolic Disorders, 28(10), 1247-1256. 

 Dewey, K. G. (2009). Infant feeding and growth. In G. Goldberg, A. Prentice, P. A., S. Filteau & K. Simondon (Eds.), Breast-Feeding: Early influences on later health (pp. 57-66). New York, NY: Springer. 

Kramer, M. S., Guo, T., Platt, R. W., Vanilovich, I., Sevkovskaya, Z., Dzikovich, I., et al. (2004). Feeding effects on growth during infancy. Journal of Pediatrics, 145(5), 600-605. 

Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics, 117(3), e387-395. 

Li, R., Fein, S. B., & Grummer-Strawn, L. M. (2008). Association of breastfeeding intensity and bottle-emptying behaviors at early infancy with infants’ risk for excess weight at late infancy. Pediatrics, 122 Suppl 2, S77-84. 

Doneray, H., Orbak, Z., & Yildiz, L. (2009). The relationship between breast milk leptin and neonatal weight gain. Acta Paediatrica, 98(4), 643-647.

Everything You Need To Know About Biting and Breastfeeding

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Melissa Portunato MPH, IBCLC, RLC

Not all babies bite and the ones that do learn pretty quickly that mama does not like it and stop. If you’re part of the lucky few that does have a baby shark don’t worry mamas! Biting down at the breast is almost always temporary. With patience, time and support your breastfeeding journey doesn’t have to come to an end. Check out our expert tips to keep your baby from chomping down and get you back on track with breastfeeding pain free! 

Why does my baby bite down when nursing? 

Teething 
Every baby is different, but generally babies will start to cut their first tooth between 3 months and 12 months. During this time, baby’s gums can get sore and the pressure of biting down can bring them relief. Freeze a washcloth dipped in breastmilk and before nursing let baby chew on it. Breastmilk triggers the production of endorphins, a natural pain numbing effect. The anti inflammatory properties in breastmilk may also help reduce soreness and pain. Wrap your finger around the cold washcloth and softly massage the gums providing counter pressure before nursing. Massaging the cheeks and ears from the outside can also help soothe pain. These techniques can relax baby before nursing and they will be less likely to bite down. 

Sometimes teething can result in a shallow latch which overtime can make nipples tender. Try “breast shaping” and compression when nursing to better position the baby on the nipple. Using lying back breastfeeding and dangle feeding can help your nipple go deeper into the baby’s mouth. 

Baby not feeling well 
Other reasons babies might bite down when nursing could be because of a sickness like a cold, ear infection, sinus pressure, headache, or a stuffy nose. If baby has nasal congestion, use a mucous removal tool, like a nasal bulb or the NoseFrida, to clear baby’s nasal passage before nursing. Use breastmilk or saline water to moisten the inside of the nostrils before suctioning to make the process less irritating. Nursing your baby in an upright position, straddled on your lap, or using a sling or carrier can help make the airway stay clear and make breathing easier.

Oral Restriction
Sometimes newborns will clamp down when nursing at the breast. It doesn’t always mean there are oral restrictions but it could be an indicator. Oral restrictions can vary and can come in the form of a tongue tie, lip tie, and buccal tie (these ties can be found on the inside of the cheek). The shape of the palette and tongue can also influence how a baby will nurse at the breast. If your baby continues to clamp down when nursing, work closely with your pediatrician and connect with your local International Board Certified Lactation Consultant, IBCLC for a thorough breastfeeding consultation to determine the cause of the issue and develop a plan for resolution. 

Forceful Letdown 
If mom has a forceful letdown this can also cause a baby to clench down on the nipple. Using nursing positions that are counter gravity can slow the overactive letdown and baby will be able to manage milk flow easier. Nursing lying back with baby’s body flat directly over you or sitting baby upright to nurse can slow the flow, allowing baby the rhythmic suck and swallow necessary for nutritive feeding. In addition, hand expressing first or pumping for 5 min prior to nursing sessions can help baby latch on easier and slow forceful letdown too! 

What else can I do to make baby stop biting? 

No matter the reason for biting it can be painful. Try not to scream! Instead, put your baby down in a safe place and leave the room. It’s important to know a baby that is actively nursing can not physically bite down on the breast. Babies tend to bite down towards the end of a feeding, when distracted, or not interested. Watch your baby closely when nursing and end the nursing session before baby has the opportunity to bite down. Babies are pretty keen at sensing our body language and behavior. Talk to your baby often when nursing. Tell your baby things like “we don’t bite mama” or “biting hurts mama, outchy.” Babies look for facial expressions to communicate. Be expressive with your emotions when you talk to your baby. Smile and positively reassure your baby when latch on happens carefully and smoothly. 

Managing Nipple Pain and Milk Supply
If baby’s biting has your nipples sore, caused abrasions, or cuts be sure to treat them to prevent infection. Air dry as much as possible and wash with non antibacterial soap in the shower. Applying a cool hydrogel can soothe sore nipples and keep them healthy. For deeper cuts and abrasions temporarily applying a mupirocin, prescribed by your doctor, can help speed up healing and avoid infection. Small amounts on the nipples do not need to be wiped away before nursing. Always remember mamas! Your doctor is always a quick call away if something doesn’t seem right. 

If nursing directly at the breast has become too painful, pump to maintain your milk supply. Use the slow 38 cycle steady with the Spectra breast pump S1/S2 and lubricate the tunnel well with breastmilk or olive oil to prevent friction and further discomfort. Be gentle on your breasts and nipples. Use massage and compression to stimulate more effective letdowns allowing for less time on the pump. 

Remember you and your baby are a dyad. You are one. Your baby will learn quickly biting hurts mama and they will stop. Your baby loves you and doesn’t want to knowingly hurt you! You’re an amazing mom and your baby thinks so too.

References

Nishitani S, Miyamura T, Tagawa M. et al. The calming effect of a maternal breast milk odor on the human newborn infant. Neurosci Res (2009) 63(1): 66-71

In: Drugs and Lactation Database (LactMed). Bethesda (MD): National Library of Medicine (US); 2018 Oct 31.

http://www.nancymohrbacher.com/breastfeeding-resources-1/2016/6/10/your-breastfeeding-baby-is-biting-you

What Do I Really Need to Buy for Breastfeeding?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

It’s no secret that having a baby is expensive!  With all the buzz around certain products, we thought it would be helpful to break down what is a must-have and what might not be necessary (at least at first). 

 Must Haves: 

  1. A good quality, hospital strength, double electric breast pump- It’s true not every breastfeeding mom needs a pump, but it is estimated that 85% of breastfeeding mothers use a pump at some point in their breastfeeding journey. Even if you don’t plan to be separated from your baby for work, you may desire a night out or have to be separated due to other circumstances.  If your baby has trouble latching or you need to boost your supply, already having your pump will help prevent added stress. 
  2. An extra set of pump accessories- Duckbill valves, backflow protectors, flanges, tubes, and collection bottles are essential to your pump’s function. Having an extra set can save you or your partner from a midnight run to Target if one of your pieces gets lost or broken.
  3. Hands-free pumping bra – If you plan to pump, even just occasionally, a hands-free bra can be a game-changer!  Going hands-free gives you more freedom and allows for hands-on pumping to help increase pumping output.  
  4. Nursing bras – Many moms find the support of a nursing bra to be comfortable once their milk production ramps up.  The convenience of fold-down flaps can lead to reduced frustration when trying to get little one to latch.
  5. Hydrogel Pads – Your own breastmilk can be helpful for soothing and healing sore nipples, but hydrogel pads offer an added soothing coolness that many moms love.  Even if you don’t experience cracked nipples, hydrogel pads can be great to keep on hand for any nipple soreness that might occur. 
  6. A FEW milk storage containers/bags– While it’s tempting to stock up when those nesting urges hit, we recommend only purchasing a few milk storage containers or bags.  This gives you the opportunity to try different brands to find what you like before purchasing in bulk.  
  7. Bottles – Breastfed babies can be finicky when it comes to bottles.  For this reason, we recommend purchasing only a few to have on hand until you know what works best for your little one.  Registering for one of each of a few different brands is a great way to have a few to try when the time comes. 
  8. Water bottle – Staying hydrated is key when making milk!  Having a cute water bottle that you enjoy drinking from can be extra helpful when you’re stuck on the couch nursing or pumping. Have a water bottle that you like also encourages you to take it with you to get your water in on the go! 

While there are hundreds of products marketed to breastfeeding moms, the above list focuses on the basics to help get you started.  With this list, you can avoid expensive purchases that end up going unused.  If you find you desire extras like nursing tops, a pumping cart, breast massager, etc, there will be plenty of time to shop online while you’re nursing or pumping for your sweet bundle of joy!  
 
Have pumping or breastfeeding questions?  Schedule a free consultation with one of our 
Spectra Baby USA IBCLCs HERE.  

Working From Home and Breastfeeding

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By Melissa Portunato MPH, IBCLC, RLC

Your maternity leave might be coming to an end soon and instead of doing your typical trek to the office you now find yourself prepping for a new normal...working from home. Will your baby be home while you’re working? Will you be pumping during your work day? No matter your situation, with some flexibility and planning you can continue to meet your breastfeeding goals. 

Childcare
Let’s start with the most important question. Who will be caring for your baby? Will you be home alone and caring for your baby while you work? Will your baby be going to daycare? Depending on your childcare options pumping and nursing can look a little different. If baby will be home with you and nursing at the breast has been going well so far, holding off on a pumping schedule all together may be your best bet! If nursing at the breast is not an option, double pumping every 2-3 hours while you are working is going to help keep up your milk supply to meet the needs of your growing baby. 

Prioritize Your Pumping Schedule 
Juggling back to work and mommy-ing can be hard at first but it’s all about routine! Make sure to plan your pumping breaks. Set alarms and block out times on your calendar to allot for pumping. It can be tempting to tame the laundry monster during breaks but stay focused and reserve this time for ONLY pumping. Keep a pretty nursing cover nearby, so if you do need to take a virtual call or meeting while pumping you’re ready to go! Our pumps are quiet and discreet. Your co-workers will never know you are multitasking. 

Setup a Mobile Pumping Station
If you will be pumping from home during your work day, creating a mobile pumping station can help you stay organized and make pumping a lot easier to squeeze into your busy day! An art cart or portable plastic drawers will work well. Load up your mobile station with all your pumping essentials: Spectra baby USA pump, parts and accessories, milk storage bags, and even a small cooler kit to temporarily store your pumped milk. Add yummy dry snacks and remember to stay hydrated. Creating a mobile pumping station will save you time and allow you the mobility to move around the house to find a quiet place to help you relax while you pump. It especially comes in handy if you have others working from home or in virtual school, where space is sometimes limited and working areas can change throughout the day. 

Caring For Your Accessories 
Take advantage of your clean personal pumping space! It will be pretty sweet to not worry about where to clean your pump accessories or having to store your milk in a stinky work fridge. CDC recommends washing all pump parts that come into contact with your breast milk in warm soapy water after every use. It will be easy to keep them squeaky clean and ready for your next pumping sesh! Keep extra accessories on hand especially duckbills and backflow protectors. We recommend replacing these accessories every 6-8 weeks depending how often you are pumping. Bonus tip: Assembling your accessories in advance can save you precious time!

Communication 
During these strange pandemic times, something positive that has surfaced is employer flexibility. Companies have had to adapt to unlikely conditions like employees virtually schooling and caring for children at home while working. Employers are now more likely to accommodate flexible and even non traditional working hours. Start the communication now with your employer if you think a different schedule will make you more focused and productive. You’re a valuable asset to your organization mama! Speak up! You might be pleasantly surprised at the response. 

Staying Connected 
Working from home definitely has its perks and can help make the transition back to work easier but it can be lonely at times. Be kind to yourself and care for your physical, mental and emotional well being. Ask for help if you need it mamas and if you need breastfeeding advice reach out to our team of Spectra baby IBCLCs. Join our virtual support groups on Facebook and keep yourself engaged with other breastfeeding mamas just like you! 

We believe in you and we know you are totally going to rock working from home and breastfeeding! 

 

Have You Heard of Reverse Cycling?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

Reverse cycling is the term used when baby is nursing more at night and less during the day.  You may have heard someone refer to this as baby having their “days and nights mixed up”.  While many moms do their best to avoid Reverse Cycling, others choose to encourage it.  Reverse Cycling can be great for moms who wish to reduce the number of pumping sessions while they’re separated from baby during the day, for distracted babies who don’t seem to nurse well during waking hours, for busy toddlers who just don’t want to be still long enough to nurse, or for any reason that benefits mother and baby’s nursing relationship.  The goal is to keep baby’s intake the same despite feeding in an altered pattern. 

What you should know if you’re considering Reverse Cycling: 

-If your baby seems to be on a “nursing strike”, offering the breast during periods of sleepiness or through the night can often help preserve the nursing relationship until the strike is over.  

-Toddlers who are constantly on the move may not nurse well during the day.  Sometimes, this is perceived as an indication of weaning.  Offering the breast in the evening and overnight times can prevent weaning before mom and toddler are ready. 

-You can encourage Reverse Cycling by waking your little one to nurse.  It is important to keep baby’s intake the same, so be sure that he or she maintains the same number (or more) of nursing sessions despite changing to a reversed cycle. 

-Sharing a room with baby can make Reverse Cycling more convenient.  Nursing in a side-lying position can also help.  

-Studies show that moms and babies experience quality rest when breastfeeding overnight because their sleep cycle sync up. 

-Reverse Cycling can even be good for them milk supply!  Prolactin levels peak at night, which means night nursing sessions contribute to increased milk production. 

-If you choose to Reverse Cycle, consider adjusting your sleep schedule to allow for adequate rest.  If possible, go to be early, sleep late, and nap when baby naps.  

-If your child is with another care giver during the day, be sure to communicate that you are using a Reverse Cycle feeding pattern.  Informing your childcare provider about Reverse Cycling will help him/her feel more comfortable if baby takes less milk than expected throughout the day. 

Does Reverse Cycling sound like a good option for your family?  We can help make a plan to incorporate this feeding schedule into your routine.  Click HERE to schedule a free consultation with one of our Spectra Baby USA IBCLCs.    

  

 

 

Weaning From the Pump

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By Jacque Ordner BSN, RN, IBCLC, RLC 

 

It’s relatively easy to find information on increasing milk supply and maximizing pumping, but what happens when it’s time to pack the pump away?  Weaning from the pump can be confusing and scary for some moms.  With our step by step method, you can make a plan to wean from the pump safely and comfortably! 

There are many reasons a mom would wish to wean, but if you are considering weaning due to breastfeeding problems, an IBCLC can help! If your desire is to continue providing breastmilk for your baby, but things aren’t going well, reach out for help!  You can schedule a free consultation with one of our Spectra IBCLCs HERE.  

Step 1:  Determine what your goals are.  Do you want to get down to just one or two pump sessions per day? Do you just need to eliminate the middle of the night sessions?  Or, do you want to wean completely?  Knowing your end game will help you make the best plan for you! It’s also important to remember that reducing pump sessions will result in a reduced milk supply.  

Step 2:  Determine when to start. Now that you know what your goals are, you can evaluate when to start the weaning process.  The more milk you’re making and the more sessions you need to eliminate, the longer the process will take.  Plan for at least one week per session. 

Step 3: Pick a session to eliminate first.  Weaning S L O W L Y is the best way to ensure you don’t end up with clogged ducts and mastitis.  For this reason, we just want to pick one session to focus on at a time.  Do you loathe pumping over your lunch hour?  Are you gleefully daydreaming of cutting out that middle of the night pump?  Think through your pumping schedule and settle on one session to whittle away first.  

Step 4:  Cut back slowly!  Reduce the pumping session of your choice by just a few minutes.  In general, reducing by 5 minutes is effective. You can keep all other sessions the same. 

Step 5: Evaluate.  How is your body responding to the reduced pumping time?  If things are going well, continue with the next steps. Conversely, if you’re experiencing clogs or uncomfortable engorgement, consider going even slower.  You can reduce by just 3 minutes and even allow a few days for adjustment before continuing to reduce. 

Step 6: Repeat.  If your body is adjusting to the reduced pumping time, repeat steps 4 and 5 until the session has been fully eliminated.  Then, review your overall pumping schedule to determine if you need to space out your remaining sessions before choosing another one to eliminate.  

Ready to tackle weaning?  Need to wean faster?  Schedule a free consultation with one of our IBCLCs to make a custom weaning plan.  Click HERE to schedule.  

Breastfeeding 101

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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 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 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 expressing 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 

Milk Supply: What’s Normal?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

The number one concern I hear from breastfeeding moms is worry over not making “enough”.  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.  If you’re conditioned to letting down to your warm, squishy baby, it can take a while to train your body to let down to the cold, plastic pump. 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. As I mentioned before, 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 

 

Summertime With Your New Baby

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Summertime With Your New Baby
Melissa Portunato MPH, IBCLC, RLC

Summer is finally here! Time to hit the road, spark up the grill or hit the beach with the family for some fun in the sun. Check out our best advice on keeping baby happy and healthy while enjoying the outdoors this summer. 

Will I need to bring along drinking water to give my baby?
Did you know that breastmilk is 80% water? Yep! It’s not necessary to give an exclusively breastfed baby water as long as mama is hydrated and they have free access to the breast or breast milk. Your baby will get all the hydration they need just from your breast milk! Infants less than 6 months should receive their nutrition exclusively from breastmilk, which means no other fluids should be given even in hot climates. 

Can I put sunblock on my baby? 
Your best defense will be to keep your baby in the shade and covered up. The general recommendation is to wait until your baby is 6 months before lathering them up in sunscreen. There are some sunscreens that are safe for younger babies. Check with your pediatrician before you’re ready to be in the summer sun with your baby. The majority of sunscreens on the market have toxic chemicals that are harmful to your baby and the environment. Look for a baby sunscreen with the active mineral ingredients of zinc oxide and titanium dioxide, these are ingredients the FDA recognizes as safe. 

What about bug repellent? Is it safe for my baby? 
The skin of a baby is so tender. It can be scary spraying it with bug spray and wondering if the ingredients are safe or will cause an allergic reaction. Most insect repellents are safe for babies over 2 months old. The American of Pediatrics recommends not to use DEET (N, N-diethyl-3-methylbenzamide) on babies less than 2 months old and not to use more than 10% DEET on a child of any age. It’s best to spray first on your hand and then on your baby. Natural repellents that contain essential oils from plants like citronella and lemongrass can be quite effective and will be the safest route to keep your little one bite free. You might want to consider mosquito netting around your baby’s stroller or bassinet to help keep those blood suckers out too! 

Keep You and Your Breastmilk Cool
You will get extra thirsty breastfeeding, caring for your baby, and lugging around all the outdoor props. Remember to stay hydrated mama! Carry a refillable water bottle with you and drink to thirst. If you are pumping on the go, keep your milk cool up to 24 hours with our pretty pink cooler. Check out the CDC guidelines for milk storage guidelines here. 

Hitting the road this summer with your baby? Do you have questions about pumping on the road? Schedule a one on one consultation with a Spectra IBCLC today. We can help you better plan! Less stress means more summer fun with your baby. 

Sources:

Academy of Breastfeeding Medicine Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med. 2017;12(3). DOI: 10.1089/bfm.2017.29038.ajk

https://www.fda.gov/drugs/understanding-over-counter-medicines/sunscreen-how-help-protect-your-skin-sun?gclid=EAIaIQobChMI0JO4l7KY6gIVCbSzCh17DgLzEAAYASAAEgJJhfD_BwE

American Academy of Pediatrics: Choosing an Insect Repellent for Your Child, July 2018.

Milk Storage: Have you heard of the Pitcher Method?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

Pumping can be time consuming and difficult for so many mothers.  In our opinion, anything we can do to make it easier is a must!  That’s where the Pitcher Method comes in.  

What is the Pitcher Method? The Pitcher Method is a general name given to the 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.   

What are the benefits? One of the major benefits of using the Pitcher Method is that it can save valuable time and space!  Pumping into one set of collection bottles, then transferring directly into the pitcher means less bottles to wash and less bottles to store in the refrigerator.  You can also easily fill bottles, for the next day, with the desired amount for each feeding or divide milk up for freezer storage.  Using the pitcher method can also eliminate worry over dating separate bottles and remembering to get them in the freezer in time if they’re not used. This can be especially helpful for moms who make more milk than their babies typically eat. 

How to get started with the Pitcher Method: The first step is to collect the needed supplies. You’ll need a pitcher or other container made of food grade plastic or glass that is large enough to store the milk you pump in a day.  Pro tip:  glass Mason jars can work well for this method as the fat doesn’t tend to stick to the glass quite as much as it does to plastic.  You can even find half gallon Mason jars! Once you’re ready to collect your milk, add the yield from your first session to the pitcher and store it in the refrigerator.  At your next pumping session, cool your collected milk in the refrigerator then add it to the pitcher along with your previously collected milk.  Continue this process at the next pumping session and so on.  Once you’ve collected milk for the day (or other specified time), you can then pour it from the collection pitcher into bottles for the next day’s feedings or separate it into appropriately sized portions for freezing.  

Are there any drawbacks? It’s important to cool freshly pumped milk before adding it to previously cooled milk, so keep that step in mind!  There is a study that suggests that newborn’s circadian rhythms are affected by breastmilk.  This implies some correlation to the time of day milk is expressed and its effect on newborn sleep patterns. It’s important to note that this study did not investigate expressed milk, but rather looked at directly breastfed infants and formula fed infants.  In our opinion, this evidence is not strong enough to warrant extra stress over making sure baby receives milk collected at night for night-time feedings or milk collected in the morning for morning feedings, etc. No need to complicate things, mamas! 

Is the Pitcher Method right for you?  We hope we’ve given you enough information to help answer that question!  We’re all for anything that makes pumping just a little bit easier! If you have questions about pumping and storing milk, email us at ibclc@spectrababyusa.com  You can even schedule a free pumping consultation with one of our IBCLCs here.  

 

Sources 

Cubero J;Valero V;Sánchez J;Rivero M;Parvez H;Rodríguez AB;Barriga C;. (n.d.). The Circadian Rhythm of Tryptophan in Breast Milk Affects the Rhythms of 6-sulfatoxymelatonin and Sleep in Newborn. Retrieved June 16, 2020, from https://pubmed.ncbi.nlm.nih.gov/16380706/