Jacque Ordner BSN, RN, IBCLC 

If you’re nursing or pumping for your little one, it can be months before your period returns.  Many moms consider this a bonus of breastfeeding!  However, every mother is different and that means some moms can experience the return of ovulation and their period just a few short months (or sooner) after delivery.  Maybe you’ve heard of the dreaded supply dip that commonly occurs with the return of menstruation.  Fear not! Our tips can help you adjust and adapt with hormonal changes and their effects on your supply.  

Tip #1. Don’t assume you can’t get pregnant before your period returns! Current evidence tells us that fertility returns in stages, and this means a postpartum mother can ovulate well before her period has returned.  For moms not looking to become pregnant just yet, it’s important to take necessary precautions.  Non-hormonal types of birth control are the least disruptive to milk supply, so talk with your IBCLC and your doctor to determine which option is best for you.   

Tip #2 Keep calm and nurse or pump on! A period related supply dip might be enough to keep you up at night, but the best thing you can do is keep nursing or pumping frequently! Some babies will nurse less enthusiastically during this time.  This could be due to subtle changes in milk flavor.  Breastmilk becomes a bit saltier and less sweet during mom’s period.  If your baby is nursing less, it’s important to pump in order to provide adequate stimulation and drainage of the breasts.  This helps safeguard against the dip in supply becoming permanent.  If baby seems dissatisfied with the flow, try switching back and forth between breasts multiple times during a nursing session.  This triggers multiple let-downs and can help boost supply! Pumping moms often get discouraged during this monthly dip and will shut the pump off early or skip sessions altogether.  Avoid this pitfall!  Any reduction in stimulation or milk removal can lead to milk supply decrease.  Keep pumping on your normal schedule even if the milk stops flowing earlier than usual and even if you’re getting less than your typical output.  Consider adding in a power pumping session or even mini pumping sessions to help your supply bounce back once your period is over. 

Tip #3 Address nipple tenderness. It can be shocking to experience new nipple tenderness when you were previously nursing and pumping comfortably.  This new pain can lead to reduced pumping and nursing. Nipple soreness is commonly associated with hormone changes once a mom’s cycle returns, but it doesn’t have to be a deal breaker. Consider trying new nursing positions like koala or laid back.  If nursing is too painful, consider pumping every other feeding to provide some relief.  If pumping is painful, a temporary change in flange size might help.  Some moms find pumping with a larger size to be more comfortable during this time of their cycle. Lowering the vacuum can help too!  If you haven’t tried a slower cycle like cycle 38 on your S1 or S2, we highly recommend it! Don’t forget to use hands on pumping techniques to improve the effectiveness of your pump sessions. Hydrogel pads are also super soothing and can get you through until the temporary tenderness subsides. 

Tip #4 Nourish yourself well. Eating well and staying hydrated are keys to good health in any situation, but even more so for lactating mothers during their period! Iron is an important component of red blood cells.  Choosing iron-rich foods can help replace iron lost during your period.  Pairing those iron-rich foods with foods rich in vitamin-C for will further enhance absorption. Wash down those iron and vitamin-C rich foods with at least 3.8 liters of water as recommended by The Institute of Medicine (USDA) for lactating women. Consuming adequate fluids not only supports milk making, but can also help relieve symptoms of bloating and constipation often associated with menstruation. Concerned about a dip in supply?  Talk with your doctor about adding in a calcium/magnesium supplement starting at the time of ovulation and continuing through the first few days of your period.  

Are you experiencing a dip in supply?  Nipple tenderness got you down?  We can help! Schedule your free consultation with one of our International Board Certified Lactation Consultants HERE.  You can also reach us by emailing ibclc@spectrababyusa.com  We’re here for you!!! 

References 

Bonyata, K. (2020, April 08). Natural treatments for nursing moms • KellyMom.com. Retrieved December 04, 2020, from https://kellymom.com/bf/can-i-breastfeed/herbs/natural-treatments/ 

Dullo, P., & Vedi, N. (2008). Changes in serum calcium, magnesium and inorganic phosphorus levels during different phases of the menstrual cycle. Journal of Human Reproductive Sciences, 1(2), 77. doi:10.4103/0974-1208.44115 

Hartmann, P. E., & Prosser, C. G. (1982). Acute changes in the composition of milk during the ovulatory menstrual cycle in lactating women. The Journal of Physiology, 324(1), 21-30. doi:10.1113/jphysiol.1982.sp014098 

Jackson, E., & Glasier, A. (2011). Return of Ovulation and Menses in Postpartum Nonlactating Women. Obstetrics & Gynecology, 117(3), 657-662. doi:10.1097/aog.0b013e31820ce18c 

Read “Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate” at NAP.edu. (n.d.). Retrieved December 04, 2020, from https://www.nap.edu/read/10925/chapter/1 

Jacque Ordner BSN, RN, IBCLC 

Holiday weaning can occur accidentally when we unintentionally nurse or pump less as a result of the busy-ness of the season.  Parties, family gatherings, travel, passing baby around, and more can result in changes in baby’s overall feeding behavior and can also mean fewer successful pumping and nursing sessions. Don’t worry, mamas!  We’ve got your guide for how to avoid holiday weaning! Check out our top tips below:  

#1 Wear your baby. Wearing keeps baby passing to minimum and also insures you’re able to observe and respond to baby’s early hunger cues.  Get baby comfortable in your wrap, carrier, or sling of choice BEFORE entering the holiday gathering.  Your fellow party goers will be less likely to ask to hold baby if he or she is being worn. BONUS:  This also reduces the risk of others sharing their germs with your precious little one.  

#2 Make feedings a priority.  Whether you’re travelling across the country or just across town, make a plan to allow for on demand feedings. Call ahead to your hosts and let them know you’ll be feeding on demand. If your baby is easily distracted, consider asking for a quiet place to feed so baby can focus on the task at hand. If you’re pumping, be sure to make a plan to pump on your regular schedule.  Most airlines and other transportation companies have policies in place to protect nursing and pumping mothers.  If you have questions, don’t hesitate to call them and ask! Talk with your partner about ways they can support you in this as well! 

#3 Avoid overstimulation. Some babies respond to overstimulation by “checking out” or sleeping most of the day.  This is especially common when babies are continually passed from one admirer to another during gatherings. Other babies respond to overstimulation by becoming fussy and irritated.  They know they need some snuggly, calm moments, and the only way they can communicate this is to cry. Wearing baby can limit the requests to pass the baby without forcing you to continually tell others “no”.  It’s okay to be your baby’s voice and let others know if he or she needs a break. Sneaking off to a quiet room, even for just a few minutes, can help baby relax and reconnect with you. 

#4 Be prepared for unsolicited advice. It’s not uncommon for well-meaning family and friends to offer their two cents when it comes to baby care.  Remember that YOU get to decide what is right for your baby! Mentally prepare yourself to shrug off unwanted advice. It’s a good idea to be prepared with a few responses for nay-sayers.  Here are some of our favorites: 

Aunt Hilde: “Is he a good baby?” 

You: “Of course!  ALL babies are GOOD babies!” 

Uncle Bert: “Do you have to do that in here?” 

You: “My baby is hungry.  If you’re uncomfortable with me feeding my baby, you’re welcome to step into the other room until we’re finished.” 

Neighbor: “Is she sleeping through the night yet? If not, some formula might help.” 

You: “She still wakes to eat at night and that’s okay because it is completely NORMAL for babies to wake frequently at night. Did you know it’s actually developmentally normal for babies and toddlers to wake up at night until sometime around 2 or more years old?” 

Cousin Mel: “Are you still breastfeeding? How long are you going to let him do that?” 

You: “My doctor has encouraged us to continue breastfeeding as long as we are both still interested.  Breastmilk provides amazing nutrition and immune factors so I don’t want to limit it!” 

And mamas, don’t forget that PUMPING IS BREASTFEEDING! 

It’s still very possible to enjoy the holidays while also protecting your breastfeeding relationship!  If you need help preparing to breastfeed through the holiday season, reach out for a FREE consultation with one of our specially trained International Board Certified Lactation Consultants. You can also email us at ibclc@spectrababyusa.com . From all of us here at Spectra Baby USA, “Happy Holidays! 

Melissa Portunato MPH, IBCLC, RLC

Breasts are asymmetrical which means they can come in different shapes and sizes. They can also vary from side to side too! They’re sisters not twins. In fact, it’s pretty common for breasts to be uneven by a cup size or less, and more than half of women have some variation between breast size. No matter the size and shape of your breasts and nipples, rest assured mamas they are perfect for your baby. 

Factors that contribute to shape and size
During puberty, a girl’s breasts will begin to bud right under the nipple. It’s not unusual for one breast to start to develop first. Breast unevenness during puberty is normal and usually improves over time. A person’s genetics, body fat, and age can all influence the shape of the breasts, areolae, and nipples. A few of the most common breast shapes include: bell shaped, athletic, slender or tear dropped shaped. Nipples can be elongated, short, wide, flat or inverted. Moms can even have a supernumerary or extra nipple! Breasts / nipples types can vary from side to side and can have a combination of types and features. 

Changes in Pregnancy and Breastfeeding 
The response to fluctuating hormone levels such as with pregnancy and breastfeeding can influence changes in breast characteristics. During the first trimester (1-12 weeks), as a mother’s body starts to prepare for breastfeeding, breasts can become tender and sensitive. This is usually the first indication a mom might think she’s pregnant…sore breasts. As estrogen and progesterone levels continue to rise, the size of the breasts will increase and moms can sometimes continue to feel tenderness and swelling as the months progress. Pregnant moms will notice as they get closer to delivery their nipples and areolae will begin to darken. Why does this happen? Pregnancy hormones can cause skin pigment to darken making the areola a direct bullseye to baby’s food source! Your breasts! 

The size of your nipples will also change when you begin to breastfeed. We recommend sizing your nipples about 1-2 weeks after delivery to find the right flange fit. Check out our sizing guide! It’s normal for nipple size to fluctuate throughout your breastfeeding journey especially when there are changes to your routine. Skipping the middle of the night pump, returning to work, or transitioning to exclusively pumping can be some examples that can impact the shape of your nipples. The return of menstruation can also cause tender or swollen breasts / nipples as well as temporary dips in supply. Resizing your nipple diameter and switching flanges sizes can be helpful to keep you pain free. 

But what about milk output? What’s normal? 
Babies between 1-6 month old will consume between 25-30 ounces per day of breastmilk. This is a great goal for moms exclusively pumping and wanting to keep up with baby’s intake. Moms who exclusively pump or pumping for a missed feed will see about 3-4 ounces (combined, both breasts) each pumping session. While moms who pump in addition to nursing at the breast will see about half (.5-2 oz , combined both breasts).

Pumping and Flange Sizing 
Breast and nipple size can vary on each side and it’s quite common for moms to respond differently with adjusting cycles on each side. It can be frustrating but quite common for one breast to produce more milk than the other. Do you notice one breast is producing significantly more than the other? Check out our previous blog When One Breast Produces More Than The Other. Sometimes moms will need to use different flanges on each side to accommodate and that’s OK! Maybe one side is more prone to clogged ducts or one nipple is more elastic. Troubleshooting the flanges can help! Lubricating with coconut oil can ease discomfort and create a better seal. Repositioning flanges while pumping may also be necessary to keep the nipple centered and milk flowing freely. Tip: Instead of double pumping, try single pumping for 15 minutes on each side while keeping it steady on expression 54. Try the other breast steady on expression 38. Vacuum is always to comfort. Is there a side that responded better? Single pumping allows for more concentration on one side and can help find your “magic Spectra number.” Don’t forget to use your hands before, during and after! 

It’s important to know the signs when something isn’t right. Perform routine self breast examinations and keep up with your yearly well checkups. Studies tell us, breast / nipple shape and size typically return back to normal after breastfeeding. Phew! That’s encouraging news! Remember mamas your breasts are sisters not twins! Your body is perfectly designed to create, birth and feed your baby. 

Got questions about flange sizing? Are you having pain when pumping? Connect with our free lactation services hosted by an International Board Certified Lactation Consultant. You’re not alone on your breastfeeding journey. We’re here for you and we support you! 

Sources:

de Holanda AA, Gonçalves AK, de Medeiros RD, de Oliveira AM, Maranhão TM. Ultrasound findings of the physiological changes and most common breast diseases during pregnancy and lactation. Radiol Bras. 2016;49(6):389-396. doi:10.1590/0100-3984.2015.0076

Butte NF, Garza C, Smith EO, Nichols BL. Human milk intake and growth in exclusively breast-fed infants. J Pediatr. 1984 Feb;104(2):187-95. doi: 10.1016/s0022-3476(84)80990-7. PMID: 6694010.

https://www.healthline.com/health/breast-shapes

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. 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. 

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.