Tag Archive for "nursing"

How to Pump at Work

by Melanie Venuti, IBCLC, RLC • September 27th, 2016

Heading back to work with a nursing baby? Read our tips on how to pump at work!

How Often? – When returning to work with a baby at home who is 6 months or younger, I would encourage mom to express milk approximately every 3 hours. For example, if you are separated from baby for 10 hours, it is recommended that you pump at work at least three times. Pumping often while away from baby will ensure that your body continues to be stimulated and will keep production up.

How much will my baby drink? – Breastfed babies are typically eating every 2 to 3 hours throughout the day, some more, some less. On average, they may consume 1 to 1.5 ounces of breastmilk for every hour they are separated from Mom, in increments of 2 to 4 ounces offered in a bottle. For example, if baby is separated from mom for 10 hours, baby will likely be consuming between 10 to 15 ounces of milk. The first few weeks back to work can be trial and error. Communicate with your care provider about your baby’s typical hunger cues so that milk is not offered with every cry. Ask them to offer feedback so that you can plan to leave the amount that works best for your baby.

Nursing and pumping at home – Most of the mothers I work with hope to continue to nurse their baby while they are home in the morning, evening, and on the weekends. While continuing to nurse your baby during the hours that you are home, mothers may find it helpful to pump one more time in addition to feeding their baby at the breast, and pumping at work. Pumping perhaps before you go to bed or before you leave for work, or both, will assure that you keep your supply up, and collect milk to save for times in need.

Some tips for better pumping

Always pump both breasts at each session for 15 minutes. You will be able to get more milk in less time when pumping both breasts and your body releases hormones more freely when both breasts are stimulated at the same time

Play around with the settings on your pump. Put the vacuum/suction strength to the max that is comfortable for you. When using a 2 phased mode pump, keep the cycling speed on stimulation mode for 2 minutes and then change into a slower phase, the expression mode (Some pumps automatically change phases after 2 minutes). After about 6-8 minutes, you may toggle back to stimulation mode for another 2 minutes to trigger additional let downs (some pumps have a “let down button” and some have a dial to increase speed). This will simulate baby being at the breast and offer more hormonal response.

The flange (cone) size is key to comfort and successful milk expression. The flange is what puts pressure on the nipple and areola tissue for successful output. If it is too big, it may cause swelling of the nipple and areola, constricting the ducts and milk output. If it is too small, it can cause discomfort and restriction of the ducts which would therefore also effect expressing milk. *lubricate the flange with a little bit of olive or coconut oil to allow for the nipple to move more freely and gently.

Get hands-on. Massage and compress the breast throughout the pump session. This helps increase stimulation (skin to skin contact) and also the volume of breastmilk output eventually, especially in the areas that you are feeling bumps.

Take a short cut for cleaning: after each pumping session, put all parts in the fridge in a bag or a bowl. Continue to use those pump parts throughout the day, continuously putting the back in the fridge between pump sessions. At the end of the day, you can wash everything in warm soapy water and allow to air dry for the next day. Sterilizing is not necessary daily, you can boil for 3-5 minutes or use a steam bag 1 or 2 times per week.

Sample Schedule for a mom working 9AM – 5 PM:
6 AM – Breastfeed
8 AM – Breastfeed at “drop off”
10 AM – Pump at work
1 PM – Pump at work
4 PM – Pump at work
6 PM – Breastfeed
Breastfeed at Bedtime (time may range)
10:30 PM – Pump
Breastfeed during the night as needed

Need more help! Drop in to our free weekly drop-in breastfeeding group or take a breastfeeding class!

Helpful Resources:
Free Breastfeeding Hotline Sponsored by MV Breastfeeding Support: 857-400-0897
www.workandpump.com
www.kellymom.com/bf/pumpingmoms/pumping/bf-links-pumping/

Tags: breast milk, breast milk storage, breastfeeding, feeding, nursing
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Starting Solids

by Cheryl Donahue • April 4th, 2016

Up to four to six months, your baby only needs breastmilk or formula to grow and thrive. When she’s ready for solids, she will tell you! Can she sit with support and hold her head up steady? Does she mouth her hands and toys? Does she look interested in what you’re eating?

If your answers to the above questions are “yes,” and your pediatrician gives you the go-ahead, you can start introducing solids. How fun!

Before you even start, you may want to enroll in an infant CPR class if you haven’t already taken one. That will make your baby’s adventures into food all the more safe.

The first food is often rice cereal, but more parents today are opting for more nutritionally rich brown rice, oatmeal or barley. Some caregivers will even offer avocado or meat as a first food.

The most important thing to remember in the first year is to always breastfeed or offer formula before giving solids because breastmilk or formula is the most important source of nutrition.

You may want to breastfeed or give your baby a bottle and then wait a half hour before offering the solid food. Mix 1 tablespoon of a single-grain, iron-fortified baby cereal with 3-4 tablespoons of breast milk or formula. Soupier consistencies might be easier for baby to swallow, but they will also be messier, so grab a bib or three! Try a plastic bib with a pocket for easy cleanup. Resist the temptation to give cereal via a bottle. During the first year, food is for fun, and she won’t learn good eating habits without the chance to practice.

It is important to introduce new foods one at a time, every three days, so you can easily identify any adverse reactions to each food. Look for rashes, vomiting, or diarrhea in the cases of food allergies. Once baby has accepted the food without a problem, you may give another food.

I recommend that you start with the “less sweet” foods, such as green beans and peas before the sweet foods like sweet potatoes and fruits. This gives you the opportunity to mix sweeter foods with the foods baby may not want after exposure to “the good stuff!”

If you have been breastfeeding, your baby has already been given a taste of all the spices you are eating as a family. You can eventually give baby spices as well, following the one-new-food-per-three-days rule. Try adding cinnamon or nutmeg to apples and sweet potatoes. Before a year, stay away from honey, which might contain dangerous spores that cause infant botulism, and don’t substitute cow’s milk for breastmilk or formula because it doesn’t fulfill your baby’s nutritional needs.

When making your own baby food, make sure you use only organic root vegetables, and wash all produce thoroughly. Freezing small portions in a covered ice cube tray will give you the perfect portions for baby!

By eight to ten months, your little pumpkin will be ready for finely chopped finger foods like fruits, soft cheese and pasta. Mash up whatever the family is eating for dinner and let baby share in the meal!

To prevent choking, stick to foods that are soft or break apart easy. Hot dogs, cheese, larger chunks of meat, candy, grapes and nuts can be dangerous for tots.

To make solids a smoother experience for both of you, feed baby only in a high chair or infant seat. Toss down a drop cloth to catch tossed tidbits – and try to let her explore her food with her hands without getting worried about a mess. She is learning! Offer a spoon once baby starts mastering finger foods, and begin to offer a cup at about 6-8 months to help her get used to drinking from a sippy. Last, when you baby turns away at a food or seems uninterested, don’t try to push it. Her bottles or breastmilk gives her the nutrition she needs and trying to force one last bite is a power struggle no one will win.

Have fun with this new adventure in parenthood, and we hope to see you in our infant safety classes and child development classes.

Tags: allergies, baby food, breastfeeding, feeding, formula, nursing, sippy cups, solids
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How to Store Breast milk

by Margaret Breen • March 14th, 2016

Happy St. Patrick’s Day! We feel lucky to have YOU, so we put together a guide to pumping “liquid gold” for your wee ones. Enjoy!

Remember: The more you take, the more you make!

How to get started:

3-4 weeks after birth, incorporate pumping into your breastfeeding schedule and introduce a bottle once a day.
Store breast milk in the refrigerator or the freezer.
The best time to pump is first thing in the morning or right before bedtime. Or, if the baby only feeds from one breast, you can pump the other side.

Tips:

Relax and make yourself comfortable. Get some tea, eat a snack, and put your feet up.
Look through photos of your baby or hold one of their blankets. You’ll make more milk just thinking of them!
Avoid watching the collection bottles.
Double pump.
Use a hands-free bra. If you don’t have one, make your own by cutting two nickel-sized holes in an old sports bra where your nipples are.

What expressed milk looks and smells like:

It may separate in the refrigerator where the fat floats to the top. Foremilk comes from the front of the breast, is meant to quench the thirst of the baby, and therefore has more water. Hindmilk, which comes from the back of the breast, satisfies the hunger and has more fat.
Freshly expressed milk may appear white.
Frozen, thawed milk has a slightly metallic sent and smell, which is completely safe and normal.
The soapy smell comes rom the Lipase enzyme that helps the baby metabolize fat.

To Store Breast Milk:

You can use bottles or bags. Or, for convenient one-ounce single-serves that mix great into baby food, fill ice cube trays with milk and freeze them. Then, drop the frozen cubes into a ziplock and keep it in the freezer.
When freezing milk in bottles, leave room for frozen liquid to expand.
Label “BREASTMILK” and note the date and time.
Lie bags down and freeze them flat to stack them.
Place newer milk to the bottom of the pile or towards the back in the freezer.
Freeze in 2-5 oz. portions, or 1 oz. portions for younger infants.
Transport milk in an insulated cooler with a frozen ice pack.

NAE Breastmilk Storage Chart:

Defrosting and Warming Breast milk:

Warm refrigerated breastmilk in a bowl of warm tap water.
Place frozen breastmilk in the refrigerator overnight to defrost. Do not refreeze.
NEVER boil or microwave breastmilk as it kills nutrients and can create hot spots.
Bottle warmers are safe to use.
ALWAYS test the breastmilk temperature on your inner wrist before feeding baby.

Want to learn more? Check out our breastfeeding classes, lactation consultant classes, or come to a drop-in breastfeeding group! Good luck, mamas!

Tags: breast milk, breast milk storage, breastfeeding, milk storage, nursing, pumping
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Supplemental Nursing System

by Melanie Venuti • February 8th, 2016

A supplemental nursing system (SNS) involves the use of a container or bottle, and a tiny tube leading from the container to the mother’s nipple. An SNS is used for supplemental circumstances when a baby either is not able to transfer milk from mother’s breast, or mother’s milk is in short supply. An SNS can be filled with expressed breast milk from the mother or a donor, or with infant formula.

An SNS may be recommended for a mother to use by a lactation consultant for specific reasons concerning the baby, or reasons concerning the mother. Some circumstances that may affect a baby’s latch including a premature baby, a baby with a cleft lip or palate, or a baby with Down Syndrome, would be perfect examples of when an SNS would be appropriate. A mother adopting a child who either wishing to induce lactation or create an intimate bond by breastfeeding their baby, a mother who has had previous breast-related surgeries, including augmentation, reduction, or removal of breast tissue for medical reasons, or a mother who congenitally has insufficient glandular tissue, would also be examples of which an SNS would offer a positive breastfeeding option.

The benefits of using an SNS versus a bottle for supplementation in the above situations, are both for the mother and baby. When a baby suckles directly on the breast, the baby is receiving nutrition from the mother’s milk supply directly, in addition to the tube. In this circumstance, the mother’s milk supply is stimulated hormonally by the infants suckling, and therefore helping increase her supply. In the event where mother either hormonally or congenitally is not able to produce a full milk supply for their baby, we must remember that breastfeeding is not only about providing mother’s milk to baby, it is just as much about creating and intimate bond, providing comfort, providing a safe place for baby and offering mother and baby a way to feed in the most natural approach.

Some quick tips:

Before deciding to use a SNS, talk with an Internationally Board Certified Lactation Consultant (IBCLC). She/he will be able to give you advice on which system to use, and may be able to assess and improve position and latching. This will ensure that your breast is being stimulated properly, and will avoid sore and damaged nipples.
If you have milk, use it! Talk with your LC and figure out when pumping is possible in your day to use your own milk in the device.
Donor milk is available, but formula is ok too!
Create a consistent routine with using your SNS. Decide what positioning is most comfortable for you (IE: placing in a pocket, hanging around your neck, having a partner or helper hold it), have a feeding area with all of your supplies (tape, water, cell phone) so that each feeding may happen with ease.
Make sure the tube is positioned in baby’s mouth towards the roof of their mouth for consistent flow and comfortable swallowing. If your baby seems to be gagging or coughing or coming off the breast, slow the flow of the SNS and re-position the tube.
Some mothers find it helpful to feed their baby with mittens or swaddled. This will prevent baby from tugging or pulling the tube out of their mouth. This is not the case in every circumstance, so make your best judgment during your feedings.

Remember that every task takes time to progress into ease. Take a deep breath, and remember that you are doing the best for you and for your baby. Reach out to your local LCs with all questions and concerns.
When you are beginning your journey of breastfeeding, remember that it is a special gift that only you can provide to your baby. If you need more support, take a breastfeeding class, come for a drop-in breastfeeding group, or talk to a lactation consultant on the south shore.

Tags: breastfeeding, nursing, sns, sns system, supplemental nursing system
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5 tips for nursing mamas

by Melanie Venuti • February 1st, 2016

1.) Breastfeeding can HURT…but it shouldn’t.
After your baby is born, and you and your baby are learning to breastfeed together. Sometimes it can be a little bit uncomfortable, and this is when you want to ask for help. When breastfeeding is painful, it typically means that something isn’t right with positioning, latch, engorgement, or even water retention or swelling. A Certified Lactation Consultant (IBCLC) has knowledge and experience working in the field of maternal and child health and has specialized skills in breastfeeding management. IBCLC’s use a problem solving approach and provide evidence-based information to breastfeeding women and make appropriate recommendations as needed to ensure breastfeeding success. Breastfeeding help is available!

2.) “It Takes a Village to Raise a Child.”
You can read books, take classes, and talk to friends and family to prepare for the arrival of your little one, but it’s also a great idea to take advantage of this community when your baby is born. Don’t be afraid to ask for help! Send an email with questions to the instructor of your newborn care or breastfeeding class. Reach out to friends and coworkers who have children for tips. Allow family to cook, clean and do laundry so you can rest.

3.) To make milk, you have to feed your baby.
Breast milk production starts during pregnancy. At about 18-20 weeks a woman’s body starts to produce colostum, baby’s first milk. After delivery, the endocrine control system continues to drive milk production, meaning that milk starts to increase by volume at about 36 hours due to changes in hormones. After milk has come in, production works via supply and demand. The more milk the baby takes the more the mother makes. So, feed your baby early and often!

4.) Some women have TOO MUCH milk.
Oversupply is a very real situation for some women. If your baby gags, chokes or pulls off the breast during the feeding or seems to have an uncomfortable gassy tummy, or if you are feeling “full” all the time or see sprays of milk coming from the breast upon stimulation, it is possible you have an oversupply. Talk to your IBCLC for what to do.

5.) You can enjoy your much-needed cocktail.
Alcohol does pass into breastmilk, and after one drink (1 beer, glass of wine, 1 mixed cocktail) typically peaks at about 30-60 minutes after consumption. Alcohol also passes out of a mother’s milk and her system, within 2-3 hours, making it safe to resume breastfeeding. Just like blood alcohol level, of course, the more alcohol that is consumed, the longer this process takes. “An occasional celebratory single, small alcoholic drink is acceptable, but breastfeeding should be avoided for 2 hours after the drink” as stated by the American Academy of Pediatrics.

Looking for Breastfeeding Support? Take a breastfeeding class, talk to one of our lactation consultants in the boston area or drop in to our breastfeeding group.

References:

http://www.lalecheleague.org/faq/alcohol.html
http://pediatrics.aappublications.org/content/115/2/496.full

How does milk production work?

Tags: breastfeeding, IBCLC, nursing
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