Making More Milk

It is so disheartening and crushing to feel that you might not be making enough milk to nourish your baby. Take comfort in knowing that the majority of healthy mothers are able to increase their milk supply and make enough milk to feed their little ones. The first step is to determine whether or not you have a low milk supply to begin with. Many mothers are concerned that they do not have enough milk, when in fact they are producing the perfect amount for their child. A few things to realize when you are evaluating your milk supply:

  • It is perfectly normal for newborns to breastfeed frequently. Just because your baby wants to nurse 30 minutes after you fed her does not mean that she is not receiving enough milk.
  • Milk production is a system of supply and demand. When your baby is able to nurse whenever she needs to, most often this will let your body know exactly how much milk to produce(don’t worry, you are not going to spoil your baby).
  • Breastfeeding should not be painful. If it is painful to nurse your child then please check her latch, and if it is still painful then consider visiting a Lactation Consultant. A poor latch will effect how much milk your baby is receiving as well as the supply and demand process taking place between your child and your body.
  • After mature milk comes in, a few days after childbirth, your breasts will probably feel very full. As your milk supply regulates and your breasts feel less full, it may seem that you are not making enough milk. More than likely you are now making the perfect amount of milk!
  • Your baby is much better at removing milk then a pump; so how much milk you can pump is not necessarily indicative of how much milk you are producing(and your baby is receiving).

So how are you supposed to know if your baby is getting enough milk? Well…what comes in must come out!

  • A baby between the ages of 4 days and 6 weeks will usually have about 4 wet diapers and 3 stools during a 24 hour period.
  • It can be difficult to determine when a disposable diaper is wet with a young baby. Compare the small weight difference between a wet diaper and a dry diaper side by side so you know what to look for.
  • It is typical for a baby to lose some weight during the few days after birth. After the first few days most babies gain at least one ounce a day – be sure that you are using the same scale every time you weigh your baby.

If you still do not feel like you are producing enough milk, there are a few things that you can try(please also make contact with a La Leche League Leader or an IBCLC).

  • Nurse Nurse Nurse! Nurse your baby as often as possible. Consider crawling into bed with your baby for a day or two of skin-to-skin contact, cuddling, and nursing.
  • When your baby starts to nod off or when sucking slows down during a feeding, switch to the other side. You can do this multiple times if your baby is happily nursing.
  • Rent a hospital grade breast pump. If you are feeling like you are not removing enough milk, or if baby is not wanting to nurse frequently, then try pumping between nursing sessions.
  • Avoid pacifiers, if your baby wants to suck on something it might as well be your breasts so that your body is signaled to make more milk!
  • If supplementing  becomes necessary, consider using a device that allows baby to nurse at the breast while receiving extra milk via a tube running next to the nipple. Finger feeding(with a tube attached to your finger) is also a great option; early bottles can lead to nipple confusion which may make the situation worse.
  • Take care of yourself by resting, eating a balanced diet, and drinking enough fluids.
  • An herb called Fenugreek is helpful to many mothers who are trying to increase their milk supply. More information on the herb, and suggested dosage can be found here.

Remember to call a La Leche League Leader or an IBCLC if you are still concerned about your milk supply, as early intervention is a key component of successful breastfeeding. If you have had something specific that has worked for you please leave a comment!

Visiting the New Mom

As a Postpartum Doula I have spent countless hours in the homes of new mothers. In those homes I often see family and friends come and go; some of these visitors are extremely helpful and some….not so much. It is hard to know what to do to help a new mother, especially if you do not have children yourself(or maybe it has been awhile). The following is a guide for visiting the new mother:

  • Let Her Know You are Coming – Do not drop by unexpected! Imagine sleeping no more than an hour at a time for a week straight, finally you have an opportunity to lay your head down on a nice comfy pillow to get some rest, then someone knocks at your door(waking not only you but your sleeping baby as well).
  • Ask What You Can Bring- For a new mom, a chance to run to the grocery store is a rare occurrence. When you are calling to ask when to visit, also ask what you can bring. Rest assured, there is most likely something that she needs. Use open ended phrasing that invites an honest response (example: “I am headed to the store on my way, what can I bring you?” instead of “do you need anything from the store?”.
  • Feed Her a Home Cooked Meal– If you are visiting during a meal time, do not expect her to feed you! If at all possible, bring a home cooked meal to share with her and her family. Even if you are not visiting during a meal time, a covered casserole that they can heat up later is sure to be appreciated.
  • Wash Your Hands– Wash your hands when you walk in the house, especially if you are wanting to hold the baby. It will be much appreciated.
  • Clean – If you share a meal together, please clean up afterwards. If you notice a sink full of dishes, wash them. If you see that there is laundry piled on the couch, sit and fold it while you talk. She may not ask you to help out but I am guessing she wont stop you, and she will be grateful.
  • Be Breastfeeding Friendly– New moms need to feed their babies very frequently. A new mother may feel uncomfortable nursing around other people, as it is a new learning process for her and her child. A simple statement such as “don’t hesitate to let me know when you need to nurse and I can step out of the room if it will make you more comfortable” goes a long way at relieving tension. Now she will not feel awkward when her baby needs to breastfeed and she doesn’t know how to ask you to leave. She might even invite you to stay while she nurses.
  • Play With Older Children – If mom has another child(or more), be sure to give them a lot of attention. It is hard for siblings to see many people come and go, gushing over a new baby while they receive no more than a pat on the head. Bring a toy or a project for siblings and engage with them. Mom will get some alone time with the baby and she will be so grateful that her older child/children are receiving some focused attention.
  • Pay Attention to Body Language – If you are wanting to hold the baby then pay attention to moms body language when you are doing so. You may notice that she appears a little tense and does not take her eyes off of you when you are holding her baby; this may be a sign to give the baby a quick cuddle and hand her back over. On the other hand, you may notice that her whole body relaxes as she embraces the break and grabs some food to enjoy with both of her hands or runs off to use the bathroom by herself; guess you get to enjoy holding baby for a bit longer!
  • Make it a Short Visit – Being a new mom is exhausting and as much as she is probably happy to see you, a short visit is almost always better. Enjoy the new family, help out a bit, but plan on leaving before she has to ask you to.

Breastfeeding During Pregnancy

If you have a nursing toddler and you are pregnant, or are trying to become pregnant, you may be wondering what you should do now. I have known many mothers who continued to breastfeed during pregnancy and went on to tandem nurse their toddler and the newest addition to their family.  Whatever decision you make about breastfeeding during pregnancy will depend on your unique situation and what you feel is best for you and your family. Below are a few questions that you might like to consider:

 

  • How long would you have liked to nurse your older child if you were not pregnant(or planning to become pregnant)?
  • Is your child showing signs of weaning already?
  • How old is your child?
  • If you are already pregnant, is nursing painful and/or is your milk supply decreasing?
  • How often is your toddler breastfeeding?
  • Are you open to tandem nursing?

 

The answer to these questions might begin to help you to get an idea of the direction you are wanting to go. What does your gut tell you? Does the thought of weaning your child bring tears to your eyes, or is it the thought of nursing through morning sickness? If you are planning a pregnancy, you might like to wait until your child is at an age where you would be comfortable with them self-weaning(if your milk supply does decrease during pregnancy). If you do decide to continue nursing throughout your pregnancy, hopefully some of the following information will help you prepare:

  • Many children will wean during pregnancy – some show renewed interest in breastfeeding once the baby comes and go back to nursing, others have interest but forget how to latch correctly, and others have lost interest.
  • Breastfeeding during a healthy pregnancy is typically safe for you, your toddler, and your unborn baby.
  • You may find that breastfeeding is less enjoyable during pregnancy(due to nausea, fatigue, or sore nipples) or you may find that you don’t experience these symptoms.
  • Breastfeeding during pregnancy may help you get more rest as you can take breaks to lay down and nurse your toddler.

If you have had nursed a child during a pregnancy, please share your experiences!

Check out Plugged ducts!

Plugged Ducts

There is no easy way to say it, plugged ducts are a royal pain in the you know what. Hopefully you have stumbled upon this page because you are experiencing your first and last plugged duct. A plugged duct can be recognized as a hardened lump in a portion of your breast. If you have a fever or other symptoms you may have mastitis. For a few of us unlucky ones, plugged ducts can be an annoying, uncomfortable, and reoccurring problem.

If you are suffering from plugged ducts fairly often, the first thing you should do is check your babys latch to make sure that he is removing milk effectively. A few other precautions that you can take include:

  • Don’t wear tight bras or clothing that applies consistent pressure to any spot on your breast.
  • Nurse your baby on demand.
  • Avoid sleeping on your stomach or in any position that applies pressure to your breasts.
  • When wearing a purse, drape it over your shoulder instead of across your chest.

Okay now for what to do when you have a plugged duct:

  • Nurse, nurse, nurse, nurse, nurse!
  • Massage the breast over the plug and toward the nipple while nursing.
  • Soak your breast in warm water or take a hot bath and lie on your side.
  • Vary your nursing position so that your baby has their nose or chin is pointing toward the plug.
  • Try to relax, the plug will usually come out with time.
  • Check for any hardened milk on your nipple that may be the cause of a plug. Try removing the milk with a wash cloth.

Many moms, myself included, have found taking supplements of Lecithin to be a huge help. Lecithin can be taken as a precautionary measure or after a plug is present. More information about lecithin can be found here:

If you are concerned about reoccurring plugged ducts or your baby’s latch, please contact an IBCLC or a La Leche League Leader. I would love to hear what tricks have worked for other mamas out there!

Seasonal Allergies While Breastfeeding

The sun is finally out in Oregon and my allergies are attacking with full force this year. As a breastfeeding mama I often have to do a little digging to find suitable remedies for my different ailments. Although many medications are fine while breastfeeding(it’s still a good idea to try to find a natural remedy if possible), antihistamines have been shown to lower a mothers milk supply. So I thought I would present a few alternatives for those of us that just need a little help getting through the beginning of the season:

  • Nettle Tea– Many people swear by Nettle Tea for seasonal allergy relief. Drink 3-4 cups a day. Tea can be made using loose leafs or, if you are like me and have never gotten in the swing of making loose leaf tea, you can try an already bagged brand such as Alvita or Traditional Medicinals.
    • Local Honey – If your allergy is to pollen, ingesting honey that is made from local bees can be quite effective at combating allergies. Try to find honey that was made as close to your home as possible. Honey is often available this time of year at a local farmers market.
    • Netti-Pot – Oh the sinus pressure! Netti-pots are small containers shaped like a tea kettle with a longer stem.To use the netti-pot you fill it up with warm water with a bit of salt, stand over a sink, pour the water in one nostril and let it drain out of the other. Although it is not the most pleasant experience, it really works to help clear out sinuses.
  • Spicy food – I’m sure many of you have noticed that when you eat food that is spicy, your nose starts to run. Eating spicy food every so often will help to keep your sinuses from getting too backed up; just make sure to have some tissues handy!

It is not the most comprehensive list but I only wanted to speak to the remedies that I have tried. I would love to hear what has worked for you; perhaps together we can offer several natural and safe allergy remedies for breastfeeding mamas to try!

Getting a Good Latch Checklist

If you are experiencing pain while nursing, or if your baby does not seem to be gaining weight well, the first thing that most breastfeeding professionals will examine is your latch. Getting a good latch is essential for your comfort and your baby’s milk intake. Below is a simple checklist that any mom can perform to check for a good latch. If pain or other concerns persist, please contact a Board Certified Lactation Consultant.

  1. Is nursing comfortable for you? Pain is a big sign that you’re baby is not latching correctly. In order for you to be comfortable, baby must be “latched on” to the breast (not the nipple). Although there may be some breast and nipple tenderness during the early days, breastfeeding should not be painful.
  2. Is your baby’s head tilted back? Your baby should latch on to your breast chin first (with his head slightly tilted back) so that he takes an adequate amount of breast into his mouth. Try bringing your baby’s body closer to you so that his head naturally tilts up.
  3. Is your baby opening his mouth wide? Your baby needs to open his mouth wide to prevent from only latching on to the nipple. Try tickling your baby’s lips with your nipple to encourage him to open wide.
  4. Can you see your baby’s lips? The upper and lower lip should be flanged outward so that you can see both of them. It is common for the lower lip to become tucked in, often a soft press on the chin is enough for the lower lip to turn outward.
  5. Can you hear your baby swallowing? In the beginning of a breastfeeding session you will usually see your baby sucking quickly until the letdown occurs. After letdown, you should notice baby swallowing after every one or two sucks.
  6. Is your baby’s body facing yours? No matter which breastfeeding position you choose, your baby’s tummy, chest, and legs should be facing and tucked in close your body.

Babies who are given opportunity to self-latch, by using a breastfeeding position such as the biological nurturing position, will often surprise us with a perfect latch!

Mastitis

When my son was about three weeks old I woke up with an extremely sore breast and began feeling like I had come down with a nasty flu. As I tried to get ready for the day I felt extremely cold and proceeded to put on my heaviest sweatshirt and climb back into my bed as I asked my husband to bring me some tea and an extra blanket. Luckily, because of my experience with breastfeeding mothers, I recognized my ailment right away. My sympathy goes out to anyone who has experienced mastitis, it is truly miserable. Thankfully mastitis is not always as severe as it was in my case. The term “mastitis” refers to any inflammation of the breast and there are various causes including:

 

  • infection
  • ineffective draining of the breast caused by a poor latch
  • damage to the nipple
  • scheduled feedings
  • limiting the length of feedings
  • supplementation
  • nursing strikes
  • pressure on the breast (such as a tight bra, or sleeping on stomach)

I am pretty sure that stomach sleeping was the cause of my mastitis, it’s so hard to resist when you had been forced to sleep on your back or side during pregnancy! Most cases of mastitis begin with a plugged duct that escalates into an infection; so it is important to recognize plugged ducts and begin to combat them right away (I will be posting information on plugged ducts soon!)

So now you might be thinking “Okay this is all great, but I think I have mastitis so what do I do about it?” There are several things that can be done to help you get on your way toward recovery:

  • Nurse, Nurse, Nurse! You need to get that breast drained; so climb into bed and nurse your baby as often as you can. If you can power through the pain, always begin with the infected breast as your baby’s suck will be strongest during the beginning of the feeding. Aim to breastfeed at least every 2 hours.
  • Get Comfy – You are not feeling well and need to rest. So put on some loose clothes(or go topless) and get as much rest as you can. Get some help if at all possible; if ever there was a time to call in a favor – now is it.
  • Check the latch – Your baby needs a good latch to be removing milk effectively. If you feel like your baby’s  latch might need some help then call a La Leche League Leader or an IBCLC. They will also be able to give you some more tips for dealing with mastitis that are relevant to your specific situation.
  • Massage – Massage your breast down toward the nipple while your baby is nursing, this may help to loosen any plug.
  • Soak – Soak your breast a few times a day to loosen any milk that may be dried to the nipple. You can do this by placing your breast in a warm basin of water for a few minutes, or take a nice relaxing bath and lie on your side. Try massaging your breast in the bath tub (I have gotten more plugs loose this way than any other).

An antibiotic may be needed if a fever is present for longer than 24 hours or if you are showing signs of a bacterial infection such as a cracked nipple, blood in your milk, or red streaks at the infection site.  Remember to call an IBCLC if you are feeling concerned about the severity of your symptoms. I hope you feel better soon!

Birth Control While Breastfeeding

The baby has been here for a few months, breastfeeding is finally going smoothly, and you are starting to get in your groove…..but what about birth control? If you are exclusively breastfeeding your baby, nature has given you a built in birth control option for the first 6 months or so. Lactational Amenorrhea refers to the delay of fertility during breastfeeding. In order for the Lactational Amenorrhea method to be effective (and it can be as high as 98% effective), the following must be true:

  • Your period has not returned
  • You are exclusively breastfeeding(baby is not receiving any other form of nourishment)
  • You are going no longer than four hours during the day and six hours at night between feedings
  • Your baby is younger than 6 months old.

The wonderful thing about breastfeeding as birth control is that it gives a new mom a nice long window before she needs to worry about other options. Once baby is a little older and you are considering other forms of birth control, you do have a few methods to choose from:

Natural Family Planning – If you tend to have pretty regular cycles then Natural Family Planning might be perfect for you. With NFP, you learn to chart your cycles so that you know when you are fertile, and abstain from intercourse during that time. If you decide to go this route, I strongly recommend the book Taking Charge of Your Fertility by Toni Weschler.

Barrier Methods– Barrier methods such as condoms, cervical caps, and diaphragms are definitely compatible with breastfeeding. Barrier methods can be used alone or combined with other methods for extra protection. Diaphragms are effective approximately 88% of the time with typical use. If used correctly, condoms are about 98% effective. A cervical cap is only about 71% effective for women who have given birth vaginally.

Intrauterine Devices (IUDs) – IUDs are devices that are inserted through the cervix and into the uterus to prevent pregnancy. IUDs are available in both hormonal and non-hormonal forms. Both forms are considered compatible with breastfeeding. IUDs are extremely effective, with a failure rate of less than 1%. I have heard stories of unpleasant side effects with IUDs, so make sure to do your research if this is something you are considering.

The Mini-Pill- A Progestin-only birth control pill is considered compatible with breastfeeding. In order to be effective, the mini-pill needs to be taken at the same time every day.

Forms of birth control containing estrogen can affect a mothers milk supply and are not the best choice during breastfeeding. The above information is meant to give an overview of the choices available but does not include all of the advantages, side effects, and risks of each option.

Breastfeeding Myths

From the moment a mom develops a visual “baby bump”, she will usually find herself on the receiving end of endless advice from friends, family, and well-meaning strangers. When it comes to breastfeeding, everyone seems to have some input. With all of the contradictory information coming in from various sources, it can be hard for a new mom to know what to believe. Although most advice givers only want to help, there are many breastfeeding myths floating around that can be detrimental to a new breastfeeding relationship. Below are 10 common breastfeeding myths that I’m sure most moms have heard at least a few of:

 

  1. Your breasts are too small to breastfeed – women with all size breasts are able to breastfeed just fine!
  2. If your baby is nursing more than every two hours, you don’t have enough milk – It is perfectly normal for your baby to breastfeed often during the first few months and beyond. Remember that breastfeeding is also comforting so your baby may nurse often during times of stress or after a tumble.
  3. You have to give baby a bottle when you are sick – The best thing that a mom can do when she is sick is to keep baby close and nurse as much as possible. By nursing your baby when you are sick you are making sure she is getting the antibodies that she needs to protect herself from getting sick as well.
  4. You have to give baby a bottle when you have had any alcohol – It is okay to have one or two drinks and still breastfeed.
  5. If your baby is still waking up at night he needs to eat solid foods- It is perfectly normal for babies to wake during the night to breastfeed; and babies do not need anything other than breast milk until at least 6 months of age. Try to enjoy these night nursing sessions and special nighttime cuddles with your baby. It goes so fast! Sleeping with your baby often makes nighttime parenting easier.
  6. Breastfeeding is purely instinct- Although breastfeeding is natural, it is also learned. If you run into problems please contact a Board Certified Lactation Consultant or call your local La Leche League Leader.
  7. You need to toughen up your nipples to prepare for breastfeeding – Babies who are latched correctly will nurse from the breast, not the nipple. Although some mothers experience mild tenderness during the early days, nursing should not be painful.
  8. You need to wean when your baby gets teeth – Simply not true. The World Health Organization recommends exclusive breastfeeding for 6 months of age with continued breastfeeding (along with appropriate solid foods) for up to two years of age or beyond.
  9. Your baby needs to be on a schedule – Breastfeeding is a process of supply and demand and in order for your body to produce the right amount of milk for your little one, she needs to be able to eat when she is hungry.
  10. Your baby gets all of the benefits of breast milk in the first 3 months, there is no point in breastfeeding past that time – Your baby will continue to receive benefits from breastfeeding for as long as it is continued.

You might be interested in this article about mastitis.

Biological Nurturing – Laid-Back Breastfeeding

With the overwhelming flow of emotions that comes with welcoming your new baby to the world, figuring out the perfect cross-cradle breastfeeding hold might be low on your list of things to master. You probably just want to snuggle your baby close on your chest and take in his wonderful scent. Fortunately, breastfeeding babies do not typically need special positions. A technique often referred to as Biological Nurturing, or laid-back breastfeeding, can help baby and mom find their natural rhythm.

To hold your baby in a Biological Nurturing position: lay back in a semi-reclined position, with pillows supporting your lower back and body, so that you are comfortable.

Place your baby tummy down so that all of their weight is resting on your chest.

Your hands are now free to caress and touch your baby!

Your baby may begin rooting around trying to find your breast; guide your baby to your breast and help them latch on (if they do not amaze you and do it by themselves!).

Some wonderful benefits to Biological Nurturing include:

  • Gravity helps ensure a wide and close fitting latch.
  • Your baby has their entire body is supported, as opposed to other holds which often leave their feet dangling.
  • Promotes your childs natural ability to self-latch.
  • You are able to fully relax and caress your baby while nursing.