Monthly Archives: June 2013

Foremilk And Hindmilk

Foremilk And Hindmilk: The Two Types of Breast Milk (Sort of)

Foremilk and Hindmilk samples of human breast milk

Foremilk (left) and Hindmilk (right)  (Photo credit: Wikipedia)

Foremilk and hindmilk are the names given to the two “types” of breast milk, however the breast does not make different kinds of milk. Foremilk simply refers to the milk that first is pumped or breastfed and hindmilk refers to the milk that is pumped or breastfed after the breast has been somewhat emptied. While the breast only makes one kind of milk, foremilk and hindmilk do have different qualities:

The Qualities of Foremilk

Foremilk is the breast milk that first is expressed from a full breast. It tends to be:

  • More watery
  • Lower fat content
  • Lightish blue in color

This type of milk is hydrating for the baby but contains less calories than hindmilk.

The Qualities of Hindmilk

Foremilk gradually changes into hindmilk as the breast is emptied. Hindmilk is the milk that is expressed after the breast has been somewhat emptied. Hindmilk tends to be:

  • More creamy
  • Higher fat content
  • Yellow in color

Because Hindmilk contains more fat and so it contains more calories than foremilk.

How to Apply Your Knowledge of Foremilk and Hindmilk To Get A Better Sleeping Baby

You’ve learned that hindmilk is more fatty and contains more calories than foremilk. This is important for a number of reasons. Imagine you have just woken up in the middle of the night and you are hungry. Do you grab a glass of water or do you get something to eat? In the same way, you want baby who wakes up hungry in the night to get the higher calorie hindmilk, therefore don’t be in a hurry to rush the nighttime breastfeeding sessions and be sure baby has emptied one breast completely before switching to the other one. This makes sure baby gets as much calorie-rich hindmilk as possible which will allow baby to sleep for a longer stretch.

Switching sides too quickly at night might leave baby with a tummy full of watery foremilk and baby will wake again sooner because he will get hungry faster.

How to Apply Your Knowledge of Foremilk and Hindmilk To Help A Baby Gain Weight

If your baby is struggling with gaining weight, follow the same advice above and breastfeed baby on one side until that breast is completely empty before switching sides. Whenever baby is not gaining enough weight be sure you are giving baby as much hindmilk as possible.

Another strategy for a baby who is not gaining weight is to breastfeed more often. The less amount of time that passes between breastfeeding sessions, the less chance foremilk has to form. When you breastfeed more often, more of the milk will be calorie-righ hindmilk.

Foremilk and Hindmilk Recap

While we use the names foremilk and hindmilk, really a breastfeeding mother only makes one type of milk but due to the sticky nature of fat, it tends stay further back in the milk ducts and this creates the phenomena of foremilk and hindmilk. Foremilk is a blueish, watery, quick-flowing milk that is great for hydration. Hindmilk is a yellowish, creamy, slower-flowing milk that’s packed with fat and calories. heart-logo

Breast Milk Storage

 

breast-milk-pumpBreast milk storage is easy and straightforward because even though breast milk does not contain  preservatives, it is all-natural and exceptionally fresh. Even in a warm room that’s 78°F breast milk will not expire for 4 hours and simple refrigeration will keep the milk fresh for 8 days. This article covers everything you need to know about breast milk storage.

A Simple Breast Milk Storage How To Guide

First, how long will you need to store the breast milk?

Breast milk storage for 6 days or less

For 6 days or less of breast milk storage simply put the breast milk in a covered glass or plastic bottle in the refrigerator. Breast milk will not expire in the refrigerator until after 8 days. Put a strip of masking tape on the bottle and label it with the date the breast milk was pumped or hand expressed. If you have not used the breast milk by day 8, either dispose of it or freeze it.

Breast milk storage for 7 days or more

For 7 or more days of breast milk storage, you will need to freeze the breast milk. The best way to do this is with breast milk storage freezer bags which are available online and from baby stores or baby sections in most big box stores.

Breast milk storage bags usually have a measurement scale that shows how much milk is in the bag. Fill the storage bag between 3 and 5 ounces full. It is okay to combine the milk from two or more pumping or hand expression sessions in one bag as long as the older breast milk has been refrigerated and is not more than 8 days old.

Once the breast milk storage bag is filled, write the number of ounces as well as the date of the milk was pumped. Before you put the storage bag into the freezer, here is a breast milk storage tip: put the storage bag into a one gallon freezer bag and label the freezer bag with the current month. Put all breast milk storage bags that you freeze during this month into this freezer bag. This keeps your freezer stash of breast milk organized by month, which will make finding the oldest milk very easy when it comes time to unthaw and use your stored breast milk.

Breast Milk Storage Bags

To store breast milk in the freezer, the simplest and most convenient way is to use breast milk storage bags. These are typically zip top bags that have a scale that measures the amount of breast milk in the bag as well as a section that can be written on to indicate the date the milk was pumped.

Breast milk storage bags are available from a wide ranges of manufacturers including; Dr. Brown’s,  Simple Wishes, Medela and Lansinoh. They can be purchased online or from local baby stores / departments and typically cost about 25 cents each.

Breast Milk Storage Guidelines

The length of time that breast milk will remain fresh depends on the temperature at which it is stored. The colder the storage temperature, the longer the breast milk will stay fresh. Click the image or the link below for a handy printable version of our breast milk storage guidelines you print then hang on your refrigerator or freezer.  heart-logo

breast milk storeage guidelines

Printable breast milk storage guidelines

Breastfeeding and Caffeine

Does A Typical Amount Of Caffeine Affect A Breastfeeding Baby?

In most cases, one or two cups of coffee or an equivalent amount of caffeine will not affect a breastfeeding baby in any way.

How Much Caffeine Is Transferred To Breast Milk?

About 1% of the caffeine a breastfeeding mother drinks is transferred to her breast milk. So if a mother drinks coffee with 300 mg of caffeine in it about 3mg of caffeine will end up in her breast milk during the peak timeframe. That’s about the same amount of caffeine in a 4oz glass of chocolate milk.

When Does Caffeine Peak In Breast Milk?

caffeine and breastfeeding info

Photo credit: epSos.de via flickr.

Caffeine concentrations peak in a breastfeeding mothers milk about 60 to 90 minutes after drinking the caffeinated beverage. This time can be shortened by:

  • Consuming the caffeinated beverage quickly
  • Drinking caffeine on an empty stomach
  • Below average body weight

The 60 to 90 minute timeframe can be increased by

  • Consuming the caffeinated beverage slowly
  • Having the caffeinated beverage along with a lot of food
  • Above average body weight

About half of the caffeine is removed from the mother’s body after 4 hours has passed.

When Breastfeeding, What Is The Best Time To Have Caffeine?

Because caffeine does not have a noticeable effect on breastfeeding babies, it is not crucial to carefully schedule breastfeeding around caffeine consumption. However if you want to minimize the amount of caffeine that is passed along to your breastfeeding baby, avoid breastfeeding for several hours starting one hour after you have the caffeinated beverage.

The best time to have caffeine when breastfeeding is while breastfeeding! Be sure to keep hot liquids well away from baby, but drinking your morning cup of coffee or tea while breastfeeding does not give the caffeine a chance to get into your breast milk and it fills baby so that baby is less likely to want to breastfeed during the following time when the concentration of caffeine will be the highest in the breast milk.

How Can I Tell If Caffeine Is Affecting My Breastfeeding Baby?

Watch for these warning signs that your breastfeeding baby may be sensitive to caffeine:

  • Trouble falling asleep
  • Restless sleeping / frequently waking up
  • Wide eyed and very alert
  • Fidgety or jittery
  • Fussiness

These symptoms can occur at any time during the day because a baby’s digestive system is immature and can not breakdown caffeine as quickly as an adult.

How Long Will Caffeine Stay In My Breastfeeding Baby’s System?

While the mother can remove half of the caffeine she consumed in as little as 3 hours, newborns can take up to 5 days to remove half the caffeine from their bodies they received through breastfeeding! By the age of three months, a baby can remove half the caffeine in about 14 hours and by the age of 6 months they can remove half the caffeine in about as quickly as an adult can.

What To Do If You Suspect Caffeine Is Affecting Your Breastfeeding Baby.

If you have caffeine at a specific time, only once each day, you can try to schedule your breastfeeding so that you are breastfeeding while you are drinking caffeine. Then try to go as long as possible before breastfeeding again, however you may need to pump for comfort or to maintain breast milk production.

Pumped milk should not be given to baby (since it likely contains caffeine) however it can be frozen and saved until baby is older and less likely to be affected by caffeine.

The other option is to abstain from caffeine and see what happens. Be aware that you may be withdrawal symptoms such as: headache, tiredness and fatigue.

The amount of time you will need to wait for the caffeine to clear from baby’s system depends on the age of the baby.

Time to clear caffeine from a breastfeeding baby’s body:

  • Newborns to 1 month olds: 20 days
  • 1 to 2 month olds: 14 days
  • 2 to 3 month olds: 8 days
  • 3 to 5 month olds: 3 days
  • Older than 5 months: 2 days

After the required amount of time has passed reevaluate baby. If baby is no different then it is likely caffeine is not the cause of the symptoms. If baby’s symptoms are improved, caffeine may be the cause. Wait for baby to get older (especially older than 3 months) and then try caffeine again and watch how baby reacts. Often as a breastfeeding baby’s digestive system matures, caffeine posses less of a problem.

What Are The Common Sources For Caffeine?

  • Caffeine is not just found in coffee! Check your diet against these common sources of caffeine:
  • Coffee (percolated, drip, instant, espresso, etc)
  • Tea (Black, green, etc, but usually not herbal)
  • Chocolate (Milk chocolate, dark chocolate, chocolate milk, etc)
  • Soda (Coke, Pepsi, Mountain Dew, Jolt, etc)
  • Energy Drinks (Red Bull, Monster, Full Throttle, etc)
  • Certain medications (Excedrin, Day Time formulas, weight loss pills, NoDoz, etc)

Have a question about breastfeeding and caffeine? Post it in the comments! heart-logo

Breastfeeding and Alcohol – All Questions Answered

Is Breastfeeding and Alcohol Consumption Safe Together?

breastfeeding and alcohol

Alcohol can be enjoyed in moderation by responsible breastfeeding mothers

In moderation, yes.

Only about 2% of the alcohol that’s consumed ever reaches a breastfeeding mother’s milk. That means if you have a margarita that has 2 ounces of tequila in it, only 1/25 of an ounce (about a quarter of a teaspoon) will reach your milk. Additionally alcohol leaves the milk supply in the same way and in the same timeframe that it leaves the bloodstream.

Abstaining from alcohol is the only sure way to avoid passing alcohol to your breastfeeding baby, however a single drink, or possibly two, should have no negative effects provided you avoid breastfeeding when alcohol concentrations are highest in breast milk and you take into account baby’s age.

Basically if you are a responsible drinker and take some simple precautions, there is nothing wrong with enjoying the occasional glass of wine, beer or cocktail while breastfeeding. If you are not a responsible drinker, you should avoid all alcoholic beverages.

When Is Alcohol Strongest In Breast Milk?

For breastfeeding mothers, the concentration of alcohol is strongest in breast milk 60 to 90 minutes after the alcoholic beverage is consumed. This timeframe can be decreased by:

  • Consuming the alcoholic drink quickly
  • Drinking on an empty stomach
  • Below average body weight

The 60 to 90 minute timeframe can be increased by

  • Consuming the alcoholic drink slowly
  • Having the alcohol along with a lot of food
  • Above average body weight

To pass along the least amount of alcohol to your breastfeeding baby, it is best to avoid breastfeeding (or pumping) during this timeframe as much as possible.

What Is The Best Timing For Breastfeeding And Alcohol Consumption?

The best timing of breastfeeding is any time outside the 60 to 90 minute timeframe when alcohol concentration is greatest in breast milk. As odd as it may sound, one of the best times to breastfeed is while you are drinking the first alcoholic beverage. The alcohol will not have had enough time to reach your milk supply and breastfeeding now will fill baby so that baby will not need to breastfeed during the highest alcohol concentration timeframe.

Of course sipping a martini while breastfeeding is sure to get some questioning looks, but it is good timing.

What is an Easy Rule Of Thumb For Breastfeeding And Alcohol?

Because alcohol leaves breast milk at the same time that it leaves the bloodstream you can tell how much alcohol is in your breast milk by how you feel. If you feel sober and feel confident you could drive a bulldozer or car, then you are safe to resume breastfeeding.

What Is Moderation When It Comes To Breastfeeding And Alcohol?

The expert consensus is that moderation for the breastfeeding mother is no more than two alcohol drinks per day and no more than two days per week when alcohol is consumed.

Does The Type Of Alcohol Matter?

In general, there is no difference between hard alcohol and wines and beers. There is roughly the same amount of alcohol in one cocktail, one beer and one glass of wine.

Do You Have To “Pump And Dump” To Be Safe?

Provided you are drinking alcohol in moderation, no. Because only 2% of alcohol consumed ever reaches breast milk and because the body will naturally and automatically remove alcohol from breast milk it is never “contaminated.” Just be sure to wait until you feel sober, before resuming breastfeeding.

How Does Baby’s Age Affect Breastfeeding And Alcohol Consumption?

Baby’s are born with immature livers (the organ that removes alcohol from the body) and until baby is over three months old the baby can’t remove alcohol as quickly from its body as an adult can. Therefore be extra cautious with alcohol while the breastfeeding baby is younger than three months old.

What Are The Risks Of Alcohol Consumption When Breastfeeding?

Provided alcohol is consumed in moderation there are no significant risks to the breastfeeding mother or her baby. However if alcohol is not consumed in moderation there are many risks to baby and mother including, slow weight gain, lower milk production, developmental problems and delays, poor sleeping and so on.

Breastfeeding and alcohol can go together provided the mother is responsible and is knowledgeable about the factors in this article. heart-logo

Breastfeeding and Jaundice

What is Jaundice?

breastfeeding-and-jaundiceJaundice is a yellowing of the skin and possibly also a yellowing of the whites of the eyes. It is caused by a orangish-yellow pigment called bilirubin that results when red blood cells are broken down. Newborns often have more red blood cells than adults and their immature livers can’t breakdown the bilirubin fast enough, so the yellowish pigment begins changing the skin, usually on the face first then spreading down the chest and to the rest of the body.

Jaundice and Breastfeeding

Jaundice is slightly more common in breastfeeding babies than formula-fed ones and the length of jaundice can be increased because of breastfeeding (see breast milk jaundice, below) however the vast majority of Jaundice cases are not harmful to the baby in any way. An adult getting a slight tan is usually more harmful to the adult than jaundice is to the breastfeeding baby.

Types of Jaundice in Breastfeeding Babies

There are three types of Jaundice that appear in breastfeeding babies. They are:

  • Physiologic Jaundice – Affects 60 out of 100 newborns
  • Breast Milk Jaundice – Affects 1 out of 100 newborns
  • Breastfeeding Jaundice

Physiologic Jaundice

This type of Jaundice is the most common type of jaundice and affects breastfeeding and formula-fed babies alike. It often appears in the first 2 or 3 days after birth and begins with a yellowing of the face that spreads down the chest and to the rest of the body. It can be treated by increased breastfeeding and light therapy but will often go away on it’s own with little intervention as the baby’s liver becomes efficient at processing the yellowish pigment, bilirubin.

Breast Milk Jaundice

Breast milk jaundice affects only breastfeeding babies and is believed to be caused by a component of the mother’s breast milk that causes the baby’s liver to more slowly process bilirubin.

This type of jaundice usually doesn’t start until 7 days after birth and may continue until 6 weeks after birth. Often an otherwise healthy breastfeeding baby will not need any treatment and breastfeeding should not be interrupted.

Breastfeeding Jaundice

Breastfeeding jaundice is caused by a breastfeeding baby not getting enough breast milk. If a mother’s milk is slow to come in or if baby is not getting a proper latch and therefore is not able to remove milk effectively, breastfeeding jaundice can occur. In this type of jaundice the lower levels of breast milk consumption result in fewer pees and poops, which is how baby gets rid of the bilirubin.

Damaged, bleeding nipples and low diaper output are warning signs that your baby may develop breastfeeding jaundice.

Treat All 3 Types of Jaundice with More Breastfeeding

Jaundice (any type, even breast milk jaundice) is not a good reason to stop, reduce or interrupt your breastfeeding! In fact, the opposite it true: don’t slow or stop breastfeeding the jaundice baby, increase breastfeeding!

No matter which type of jaundice your breastfeeding baby has, you can help treat the condition with an increase in breastfeeding sessions! Encourage as many breastfeeding sessions as you and let no more than 2 hours pass between the start of one breastfeeding session and the start of the next. Aim for 12 breastfeeding sessions each 24 day. The increase in breast milk will help flush baby’s system of the extra bilirubin.

Jaundice Treatment

If your baby develops jaundice, tell your health care professional who may want to do blood work to determine bilirubin level. In cases of high bilirubin, your baby may need to do phototherapy which involves wrapping the child in a special blanket outfitted with lights that help lower bilirubin levels.

Breastfeeding and Jaundice Final Thoughts

While breastfeeding can be a cause for jaundice, it can also be part of the solution and the benefits of longterm breastfeeding far outweigh the condition of jaundice. As long as your baby is under competent medical care, keep breastfeeding and the jaundice will resolve in time. heart-logo

Breastfeeding and Birth Control

Breastfeeding and Birth Control: What affects what?

Different kinds of birth control pills.

Different kinds of birth control pills: some affect breastfeeding more than others. (Photo credit: Wikipedia)

Some types of birth control can affect breastfeeding by lowering breast milk production, while other types of birth control do not affect breastfeeding in any way. We explore both categories in this article to help you make the best choice for your situation.

You can also look at the relationship between breastfeeding and birth control from the other direction. Birth control can affect breastfeeding and breastfeeding can affect birth control because, done correctly it can act as a very effective birth control method. Let’s look at this first:

Breastfeeding as Birth Control

Exclusive breastfeeding can be used as a successful birth control method with up to a 98% effectiveness rating. Why does it work? In simple terms the hormone that controls breastfeeding and lactation (prolactin) is suppresses the fertility hormone (estrogen). When prolactin is running the show, estrogen takes a back seat and monthly menstruation cycles and fertility are suppressed.

The key point to remember if you are using breastfeeding as birth control is to keep prolactin running the show. You do this by making sure prolactin is being produced in your body consistently and frequently. How? Prolactin is produced when your baby breastfeeds; therefore you need to breastfeed consistently and frequently.

All of baby’s sucking should be done at the breast so you should avoid giving pacifiers and bottles of any kind. Be sure to breastfeed consistently throughout the day about every three hours. Do not go long stretches at night without breastfeeding. No more than 5 hours is recommended. Any longer than that and you risk estrogen resurging and taking control.

Warning Signs When Using Breastfeeding as Birth Control

As long as you are breastfeeding consistently and frequently, breastfeeding can be an effective form of birth control however be mindful of these warning signs:

  • Return of your monthly cycle: If you’re monthly cycle has returned, it means estrogen – the fertility hormone – has taken over the driver’s seat. You are now fertile again and will need to begin a new method of birth control to prevent pregnancy.
  • Baby starting on solid foods: Around six months of age, babies usually begin the journey of solid foods and they began replacing the calories they start taking less calories through breast milk as they take more calories with solid foods. This decrease in breastfeeding is often enough to allow estrogen to take control and return your body to a fertile state. Once baby begins eating solid food, you should begin a new method of birth control to prevent pregnancy.

The Effects of Birth Control on Breastfeeding

When considering the effects of birth control on breastfeeding there are two broad categories:

  • Birth control methods that don’t affect breastfeeding
  • Birth control methods that do affect breastfeeding

Let’s look at each of these:

Birth Control Methods That Don’t Affect Breastfeeding

There are several methods of birth control that do not affect breastfeeding in any way. They are:

  • Condoms
  • Vasectomy / Tubal ligation
  • Natural Family Planning / Fertility Awareness
  • Diaphragms / IUDs
  • Spermicides

If one of these birth control methods works for your situation, you can rest assured that they will not interfere with breastfeeding or the quality of your breast milk.

Birth Control Methods That Do Affect Breastfeeding

Hormone-based birth control methods can affect breastfeeding. The good news is that hormonal birth control when taken in prescribed doses not pass through breast milk in a significant amount to affect the baby. However a very real risk to breastfeeding remains: lower milk production.

If you read the first part of this article you learned that lactation is governed by the hormone prolactin. Prolactin plays a sort of “King of the Hill” game with the fertility hormone, estrogen. While prolactin is the king of the hill, lactation is emphasized and fertility is suppressed. However when you take hormone-based birth control, especially one that contains estrogen, you’re kicking prolactin off the hill and lactation, milk production and breastfeeding will all suffer.

Your milk production is still at risk if your birth control pill does not contain estrogen, but the risk is far less. Here are the specifics:

Birth Control Methods That Will Almost Certainly Harm Breastfeeding Through Lower Milk Production

  • Oral birth control pills that contain estrogen (aka: combination pills): such as Ortho Tri-Cyclen, Alesse and Desogen.
  • Birth control patches containing estrogen, such as Ortho Evra
  • Birth control injections contain estrogen, such as Lunelle

Birth Control Methods That May Harm Breastfeeding Through Lower Milk Production

  • Oral birth control pills that contain only progestin (aka: the mini pill)
  • Birth control injections that contain only progestin, such as Depo-Provera
  • Patches or implants that contain only progestin, such as Nexplanon
  • Progestin-based IUD, such as Mirena IUD

If you have had any struggles with low milk supply (with this child or with a previous child) you should carefully consider the risk to your milk supply when thinking about this type of birth control. However if you have always produced enough milk, progestin-only contraceptives pose little risk to your milk production. However, little risk, is not the same as no risk and you should always keep tabs on your milk production and baby’s weight gain.

Breastfeeding And Birth Control: Final Thoughts

Breastfeeding and birth control are linked through the interaction of competing hormones. Changes in one, often affect the other. However you are now aware of how the hormones affect each other and you can use that information to for successful birth control and breastfeeding! heart-logo

Low Milk Supply And Your Next Baby

Preparing For Your Next Baby When You Have Struggled With Low Milk Supply In The Past

If you have struggled with low milk supply with one or more previous babies, you probably know there is a good chance you might have low milk supply problems with your next baby. Rather than hope for the best, take maters into your own hands so that breastfeeding can get off to the best start possible. This article is all about what you can do to ensure breastfeeding success for your next child.

Before Baby Is Born

The first step is to review the 27 causes of low milk supply. If your low milk supply is caused by any of these, the fix can be fairly easy and quick. If hyperthyroidism was the cause, your doctor can treat it with medication throughout your pregnancy. If inverted nipples was the cause, you can use the Avent Niplette. Or if PCOS was the cause, your doctor can prescribe metformin.

There are many, many more causes of low milk supply and information about how to fix them is in the linked article above.

Next, if you took herbs to increase your milk supply with an earlier child, you should consider planting an herb garden of those herbs you took last time. The best herbs are often those you grow yourself because you have complete control over the soil, planting, fertilizing and harvesting. If you’re not due for 2 or more months, consider starting your own personal lactation herbal garden or if gardening is not your thing, order an herbal blend, such as Lactiful Supply Max, so it is on hand.

?Once you’re pregnant with your next child and have reviewed the causes of low milk supply and considered starting your own herb garden, it’s time to be proactive and take herbs that help prepare your milk supply. Here are the herbs that will get your supply off to the best start:

Alfalfa
Use: General milk increase
Contraindications: Lupus and other autoimmune disorders
Sources: Health food stores, online

Saw Palmetto
Use: Hormone balancing, increase breast tissue
Contraindications: None
Sources: Some health food stores, online

Goat’s Rue
Use: General milk increase, glandular tissue generation
Contraindications: Diabetics
Sources: Some health food stores, online

In the second and third trimesters take Alfalfa and Saw Palmetto:

Alfalfa – Take 1 tablet (500 Mg) three times a day with meals.
Saw Palmetto – Take 1 capsule (540 Mg) in the morning and 1 capsule at night.

In the third trimester also take Goat’s Rue.

Goat’s Rue – Take 1 capsule (500 mg) 4 times per day but with only a small amount of water (1 to 2 ounces). Additionally, avoid all liquids 20 minutes before and after each dose.

Next, prepare your home, your mind and your life for your new baby. Are there any home projects you should finish before baby arrives? Getting any projects done before baby arrives will give you more time to breastfeed the new baby. Preparing and freezing meals reduces stress and workload after baby arrives.

If you work, are you able to bank up hours at work and extend your maternity leave? Can you set up a work-from-home agreement with your employer and have more time to spend with baby?

If you have a pump, consider if you need to buy a new one. Often suction power decreases after a year of average use. If you don’t own a pump, perhaps now is a good time to purchase one.

Once you reach week 36 in your pregnancy, begin pumping once a day for 10 minutes (as long as this is okay with your health care provider). Each week add a new 10 minute pumping session. Spread out the sessions as much as you can. For instance in week 38 pump once in the morning and once at night. In week 39 pump morning, afternoon and night. Don’t worry if no milk is expressed during these pumping sessions. The purpose of this pre-birth pumping is not to generate milk but to stimulate the breasts and let them know it’s almost showtime. Early stimulation increases the number of breastfeeding hormone receptors that are established which sets your milk production ceiling or maximum milk production. We want your maximum milk production set as high as possible.

After Baby Is Born

Once baby is born breastfeed as soon as possible. Within 30 minutes is ideal, but it should be no more than an hour. Put this in your birth plan so your medical team knows your wishes.

Be sure to breastfeed every time baby cries and let no more than 3 hours pass from the start of one breastfeeding session to the start of the next. Treat 3 hours as the maximum allowed time between the start of one session and the start of the next, even if you have to wake baby. Better yet, aim to breastfeed every 2 to 2 and a half hours to better your chances of maximizing your milk supply. Continue this strategy until baby is at least 6 weeks old.

Every time you breastfeed be sure baby breastfeeds on both breasts. Alternate which side you start on with each nursing. Aim for 10 minutes of active nursing before switching to the other side. Tickle baby’s cheeks and toes to keep him alert and really actively nursing for a minimum of 10 minutes, then switch to the other side (if baby is still actively nursing continue to nurse on the same side until baby settles into comfort sucking – do not automatically switch at 10 minutes – that’s a minimum, not a maximum). See our article on not allowing a sleepy baby to leave milk in your breasts for tips to encourage a sleepy baby to breastfeed actively.

After each time you breastfeed, pump for 7 minutes on each side or until milk stops flowing.

On day four, begin taking your herbal supplement. You may wish to start with a lower than recommended dose and build up to a full dose over the course of a week so that you can gently ease your body into the herbs.

If you suffer from engorgement when your milk comes in do not use cabbage leaves to relieve the symptoms as this can also reduce your milk supply.

And finally, see our article index for many, many helpful articles about low milk supply, pumping and breastfeeding.

The good news is that breastfeeding and milk supply generally get better with each successive child. That coupled with these recommended preparations are sure to give you a much better breastfeeding experience with your new baby! Best of luck to you and your family and congratulations on your pregnancy! heart-logo

Coping With Low Milk Supply

Breastfeeding is difficult for some mothers. I know. At times I’ve felt jealous, inadequate, overwhelmed, angry, lonely, afraid and even depressed. If you have been struggling with low milk, only to have to give up in the end, can be heartbreaking. This article is all about strategies for coping.

Before my first child was born, I knew that I wanted to breastfeed exclusively. I read a few books, such as The Womanly Art of Breastfeeding and expected breastfeeding to be fairly easy.

Was I ever wrong.

The trouble wasn’t so much what happened or how it happened. The trouble was my expectations. Had I expected breastfeeding to be difficult and known in advance that I’d have to pump a lot and take herbs, eat a special diet, breastfeed frequently and so on I’d have handled the whole situation a lot better.

Expectations, either yours or your family’s, are often very hard to live up to. So the first step in coping with low milk supply is to adjust your expectations. Accept that life is not fair and that at times, you’re dealt a really crummy hand. Just remember, you’re in control of how you play that hand.

I’ve known plenty of moms that threw in their cards and gave up breastfeeding. That’s one option.

I’ve known other moms who became obsessed with increasing their milk supply and saw their doctor for hormone screening, supplemented nursing by using a periodontal syringe.They completely changed their diet, took herbal supplements, pumped and nursed like mad and found a way to bring their supply back.

I’ve known other moms who gave it their best shot, but still had to supplement. They found a way to be happy with breastfeeding as much as they were able. For them, some breast milk was better than none. And simply being able to continue the loving connection of breastfeeding was priceless and something they’ve treasured for years.

How you choose to play your cards is your own decision. And I know you’ll make the right decision for you, your baby and your family. How can I say that? By simply finding this article, I know a bit about you. I know you have courage, perseverance and tenacity because that’s what it takes to fight low milk supply. I know how deeply you are committed to giving the very best to your baby.

I know some days it may be hard to believe it, but these qualities make you an amazing mom and a wonderful human being. I have no doubt that you will raise your baby into a delightful child and guide him or her successfully into adolescence and adulthood. You already have all the tools. Love. Courage. Compassion. Tenacity.

Someday, probably before you’re ready, you’ll be putting this baby on the bus for his or her first day of school. And in the blink of an eye you’ll watch as your baby graduates from high school. And then college. There as so many joys on their way to you, so try to not dwell on the difficulties of today.

Don’t think about what you could not do, think about what you have done. You have breastfed. You have fought for your child. And while there are many sources of nutrition for your baby, there’s only one mother who will love him, hold him when he scrapes his knee, provide guidance, and care for him in every way.

In the long run, it’s not about how many ounces of milk flow out of your breasts. It’s about how much love flows from your heart. heart-logo

Exclusively Pumping

Exclusively Pumping – An Abstract Way Remove Breast Milk

I found it fascinating to watch my two year old, who had struggled to use an educational computer game in the past, play with an iPhone for the first time. With the computer she had to learn that the arrow on the screen was what made the objects in the game move. She had to learn how to hold the mouse in the right orientation, how to move her hand to get the arrow to move, what to do when the mouse hit the keyboard or fell off the mouse pad, which button on the mouse to push and so on. It was all very abstract and difficult for her to grasp.

When I handed over the iPhone, all the barriers were removed. She used her finger to swipe through family photos. She used her finger to launch apps. She used her finger to open a barn to see and hear the animals inside. In just a few minutes she grasped how to use it. An entire level of abstraction was removed and it made everything so much easier.

Breastfeeding is a lot like using an iPhone and exclusively pumping is a lot like using a traditional computer. Breastfeeding and the iPhone are intuitive, natural and intimate. While exclusively pumping and the computer are abstract, analytical, cold and complicated.

This is not to say that exclusively pumping is “bad” or “wrong” or “difficult.” But it is important to acknowledge that our bodies are wired to release milk to a breastfeeding baby. It’s not just about nipple stimulation. The feel of baby’s soft skin, his unique smell, the movement of his hands, the way you feel when you look into his eyes as he breastfeeds, his sounds and expressions, his cry of hunger – all of these play a role in encouraging milk to letdown. When baby is replaced with a “cold” machine all those cues are abstracted away.

To Be Successful At Exclusively Pumping:

  • You’ll need to find a way to get your body to easily and frequently letdown for the pump. You need to reconcile this level of abstraction because when you are exclusively pumping you don’t have access to al the cues your body normally relies on to release milk. Some exclusively pumping women, pump while near baby, or look at photos of their baby while pumping. Others listen to baby sounds they have recorded. Other exclusively pumping moms find it better to distract themselves by talking on the phone, reading or engaging some other distracting activity. You may need to experiment to find what works best for you.
  • You’ll need to select a good, high-quality pump and monitor it and keep it in good working order. We have written an article specifically about selecting the best pump for exclusively pumping moms.
  • You’ll need a pumping strategy and exclusively pumping schedule that gets your breast milk supply off to a good start and maintains it with as few hassles as possible. This topic also deserved its own article.
  • And finally you need to know what to do if your milk supply drops. There are many ways to bring your milk supply back up and you can read about them in this article targeted at exclusively pumping moms.

Follow these suggestions and you will be well on your way to providing the best nutrition your baby can get by exclusively pumping. heart-logo

How To Increase Milk Supply While Exclusively Pumping

The most common reason for milk supply to drop when exclusively pumping is not pumping enough. Sometimes moms who are pumping more milk than is needed by baby feel like they’re wasting time by pumping too much and they cut back dramatically on pumping.

However an oversupply of milk can quickly turn into an undersupply. Whenever you have an oversupply, keep storing the milk in the freezer and make slow, deliberate adjustments to your exclusively pumping schedule. I recommend to either pump one minute less at each session or drop one session per week – until your output matches your baby’s intake.

If you’ve recently cut back on pumping any more dramatically than that, it may have caused your milk supply to plummet. Return to your prior pumping schedule and your milk supply should rebound.

If you haven’t cut back on pumping, be sure you are pumping at least 8 times in 24 hours with at least one time in the middle of the night.

Here’s some additional things to try:

  • Review the 27 common causes of low milk supply. Perhaps you have become pregnant or have started birth control pills, both of which will cause your supply to drop. If none of those causes make sense:
  • It could be your breast pump. Even new pumps are occasionally defective and older pumps wear out over time and while they may seem to work, the power of the suction may have dropped so low that it’s not effective. Be sure to check all connections for a good fit. Also check the tubing for kinks or punctures. Look at the membranes – are they soft, flexible and not clogged? If everything checks out with your breast pump but you have a suspicion that it may still be the problem, you can rent a hospital-grade pump for a week. If your supply comes back up you’ve found the problem. If not:
  • Are you frequently eating health food? If the busyness of daily life is causing you to skip snacks and meals this can cause lower milk supply. Be sure you’re getting at least 1800 calories each day, preferably spread out over 3 meals and 3 snacks. If you have been eating well then:
  • Perhaps you are wore out, run downed or stressed. Managing all the demands on your time and maintaining a commitment to exclusively pumping may be taking its toll. Do not hesitate to ask for help from family or friends. A bit of help with cooking, cleaning, errands or childcare can go a long way toward relieving stress and can help your milk supply to rebound. Next, be sure to:
  • Take Lactiful Supply Max or your own herbal blend that increases milk supply and stimulates multiple letdowns. Then be sure you:
  • Check out the 11 ways to increase milk supply or see our article index for many articles on the causes and solutions for low milk supply.  Also consider:
  • Marathon weekends. I don’t mean go running, I mean pump as much as possible over the weekend to kick your production into high gear going into the next week. And finally:
  • Dip into your frozen milk reserve. If you’ve built up a freezer bank of stored milk, now is the time to use it so that baby is getting the best nutrition possible. After all, maybe baby is simply going through a growth spurt and can’t be filled up or maybe there’s a new stress in your life that’s negatively affecting your pumping performance. While any drop in milk production can cause panic, sometimes these things just work out in a few days time.

One of the great things about exclusively pumping is that you can measure and closely monitor exactly how much milk your body is producing each day. Follow the advice in this article and you will see your milk supply increase! heart-logo