Archive for the ‘Breastpumps’ Category

Nipple Confusion…Really?

September 7, 2011

I have never, in all my years of breastfeeding help, seen a case of nipple confusion. There, I said it. For many years I thought I saw it. I bought the whole concept that introduction of bottles too early would cause a baby to reject his mother’s breast. That somehow the baby would get “confused” and suddenly not know how to breastfeed.

So what made me change my tune? The babies themselves. They proved to me over and over again that the idea of nipple confusion is nonsense. They showed me that they are infant mammals and that mammals are hard-wired to do this thing we call breastfeeding. And they showed me that they are born to be adaptable and perfectly capable of adjusting to a wide variety of challenges that life doles out on a daily basis.

But, please… don’t listen to what I have to say about this. Listen to the babies. They taught me. Maybe they can teach you too!

Here are the stories of just a few of the many, many babies who teach me every day:

Case 1–Baby could not latch on to breast. Nipple shield was given to mom to help with latch and milk transfer. Baby used nipple shield for 4 months. By 5 months of age she had completely transitioned from the shield and was happily breastfeeding all by herself.

Case 2– Twins born prematurely. Neither could breastfeed at birth and needed a lot of help to suck at all. Eventually they learned to bottle feed well. Mom pumped for 3 months so these babies could have her milk. At 3 months, as mom was bathing with one of the babies, he rooted and latched and suckled. Encouraged, she tried to nurse the other twin and he did the same thing. They never looked back.

Case 3– Mom pumped and bottle fed for 3 months because baby was unable to breastfeed after birth. She was told the baby probably never would. She called me as a last resort. I showed her how to hold the baby and support her breast, and baby latched on and breastfed like she’d been doing it all along.

Case 4—Baby born tongue tied and unable to latch. The parents were referred to a Dr. who clipped the frenulum, but didn’t clip enough so the tongue was still restricted. By the time the mother had called me, her milk supply was severely compromised. She worked on her milk production, finally got her son’s tongue properly released and continued to pump and bottle feed. Another lactation consultant told her “your baby has learned to like the bottle better” and he would never breastfeed. The baby and mom had other ideas. At 11 weeks this baby was 100% breastfed.

Case 5–(My favorite). This baby girl had been born with a cleft palate so she was unable to breastfeed or even use a regular bottle. Mom pumped for 4 months until the palate was repaired, hoping to breastfeed after her baby had healed from surgery. But she wasn’t successful. Finally, she called me at 7 months. When baby was sleepy, mom was able to coax her baby to the breast using a nipple shield. She suckled a bit then came off. I suggested she keep trying—that she had proved to us she could do it. A few months later I received an email from an elated mom telling me her baby had figured it out and at long last really breastfeeding!

I have many more stories of mothers and babies who persisted and triumphed. What about you? Do you have a story to share? Feel free to let us know by commenting here!

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Breastfeeding and Work: New Research

July 27, 2011

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

It is commonly understood that breastfeeding mothers returning to work face multiple challenges. Balancing work and motherhood, carving out time to pump at work and maintaining adequate milk production are all topics that any employed, lactating mother can discuss at length. Studies have shown over and over again that employment outside the home reduces breastfeeding duration.

A new study just published in the Journal of Human Lactation (August, 2011) has shed some new light on this topic. It sought to understand the relationship between breastfeeding and occupational type (professional, administrative, service, sales, etc.) and postpartum employment status. The researchers asked about initiation of breastfeeding as well as duration of breastfeeding. The subjects in the study included thousands of women in the U.S. from all walks of life.

Instead of boring you with all the statistics and methodology, I’ll just summarize the results. This study found that neither postpartum employment status or occupational type was a significant predictor of duration of predominant (mostly) breastfeeding. However, and this is big, full time workers were less likely to initiate breastfeeding in the first place! There was no significant difference in breastfeeding initiation between part time workers and mothers with no postpartum employment.

Mothers who were employed full time and chose to continue breastfeeding were also less likely to continue breastfeeding beyond 6 months compared to part time workers and “stay at home” mothers. Again, there was no difference in breastfeeding duration between part time workers and non-employed mothers.

Even when mothers have part time jobs that enable pumping breaks, access to lactation consultants, and other amenities, milk production can still be a problem when relying on a breast pump for a large part of the day. Other research has demonstrated that the strategy associated with the longest duration of breastfeeding after returning to work was breastfeeding the baby during the work day. Access to the baby is the number one strategy for maintaining breastfeeding for the longest amount of time.

How does all this relate to you? If you’re breastfeeding and plan to return to work, the following strategies will help you continue your breastfeeding relationship until you and your baby are ready to wean.

  • Don’t go back to work for as long as possible.
  • When you start back to work, just work part time if possible. Even if it’s only for the first year. Consider job sharing.
  • If you must go back full time, find a way to work from home part of the day or a day or two per week.
  • Does your employer offer onsite day care? If so, go for it!
  • Get childcare close to your job so you can have access to your baby.
  • Find a care provider who will bring your baby to you at lunch so you can breastfeed.
Obviously not every mom can enjoy all of the above options.  You can only do what you can do! But if you apply some creativity to your work situation, you may be able to improve your situation somewhat–which may be just enough to make long-term breastfeeding easier!

Breast Engorgement and Cabbage Leaves?

July 25, 2011

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Let’s be honest. Overly full, engorged breasts are uncomfortable and sometimes downright painful. Fortunately, under normal circumstances true engorgement can be prevented with frequent breastfeeding in the first few days/weeks after the birth of your baby. Some breast fullness and tenderness is to be expected in the first week postpartum as your breasts prepare to provide nourishment for your baby or babies. It may feel like you have enough milk to feed the entire neighborhood, but keep in mind that much of the swelling you are experiencing is simply that—swelling. It’s not just milk “coming in” that is making your breasts feel so full. After the birth of your baby; water, blood and lymphatic fluid rush to your breasts in preparation for breastfeeding. With adequate breastfeeding, the discomfort usually passes in a day or 2. Many mothers don’t experience anything but mild fullness.

Currently, however, many mothers in the U.S. experience births that are anything but “normal.” Epidural anesthesia requires that mother receive an IV of fluids. Inducing labor with pitocin requires extra fluid. C-sections require IV’s. If a mother receives any extra fluids via IV, she will continue to retain the fluid for some time even after the birth of her baby. That extra fluid often results in swollen ankles, fingers and even breasts!

The edema in the limbs may be noticeable right away; but the breast swelling will probably not be apparent until day 3-5. When breasts are full in a normal way as the milk “comes in,” your baby will still be able to latch on and breastfeed. The breasts will feel full, but the areola will be soft and compressible. True engorgement is very different. Your breasts are hard. The skin is stretched and shiny. The areola is hard and taut. There is no way a baby can latch on to your breast. Pumping is usually ineffective since the tissue is not malleable. It’s like trying to use a pump on a wall!

So what can you do if your breasts become so engorged that you feel like you have 2 bowling balls on your chest? Try using cabbage leaves to relieve the swelling so that milk can be removed by the baby or a pump. Cabbage? Really? Yes! This is one of those times when folk wisdom can be helpful.

Green cabbage contains sulfa compounds which pass through the skin, and constrict vessels–relieving inflammation. This reduction of inflammation and swelling allows the milk to flow. To use the cabbage to relieve engorgement, rinse the leaves thoroughly in cold water (leaves should not be cooked). Place a leaf or two on your breasts under your bra. Change the leaves as they wilt. Most mothers notice immediate relief using this method.

A couple words of caution: This technique is not recommended for women who are allergic to sulfa or cabbage. It’s also important to not over-do the cabbage cure. There are reports of decreased milk supply with excessive cabbage use.

If you find yourself in the difficult situation of clinical engorgement, you need help! Contact an experienced lactation consultant right away. In the meantime…try some cabbage!

Breastfeeding Myths Galore!

June 19, 2011

These are things that I see or read every day: From my clients, from professionals and websites focusing on newborn issues. I know that one post cannot squash these myths completely, but if this helps just a few moms obtain correct information, I’ll be very happy! Each one of these statements could be an entire post. As time goes on, I hope to link each myth with a thorough explanation as to why it’s a myth. But for now, read these and remember they are MYTHS!

Breastfeeding is painful for the first few weeks.

Engorgement is normal and is a sign that everything is going well.

There is not enough milk during the first few days after the birth, so most babies need some formula until the milk “comes in.”

Many women do not produce enough milk.

A baby should be on the breast for a certain amount of time.

A mother should wash her nipples with soap before feeding the baby.

Pumping is a good way of knowing how much milk you have.

If your breasts don’t feel full, that means your milk supply is inadequate.

If a mother is planning to breastfeed, she should buy a pump.

Infant formulas are almost the same as breast milk.

Doctors know a lot about breastfeeding.

Some babies are lactose intolerant.

Nipples need to “toughen up” in order to breastfeed.

If you give a baby a bottle, he will not like the breast any more.

If you breastfeed you will sleep less than if you bottle feed.

You can’t eat your favorite foods if you breastfeed.

You can’t have a glass of wine if you breastfeed.

Breastfeeding makes your breasts sag.

Breastfeeding takes a lot of time.

Dads can’t bond with the baby if baby is breastfed.

If you breastfeed, everyone can see your breasts.

After 6 months, breast milk provides no more benefit to the baby.

If you have twins or more, you will definitely need to use formula.

If your baby is gassy or cries a lot, it means he is allergic to your milk.

Your baby will sleep longer at night if you give her a bottle of formula.

If your baby doesn’t breastfeed in the first week, he probably never will.

If you have flat nipples, your baby won’t be able to breastfeed.

If your nipples are too big, your baby won’t be able to breastfeed.

If your breasts are too small, too big, too (fill in the blank), you won’t be able to breastfeed.

Have you encountered any myths about breastfeeding? Have you heard some things that just don’t sound right? Please, post them here in the comments box. I would love to hear from you!

Important notice:  This blog and all its content and subsequent content is now at www.second9months.com.  Please visit there often for updates and new posts!

Sharing Breastpumps: Is it Safe?

April 26, 2011

Please note:  This blog and all its content and subsequent content can now be found at www.second9months.com.  Please visit often.  Your comments are always welcome!

Smart moms shop around and look for bargains. And when we’re talking about items for the nursery and other new baby gear, hand-me-downs are often as good as new and can save you a lot of money. When it comes to purchasing a breast pump, however, think twice about buying used or sharing with a friend.

The FDA defines breast pumps as single-use devices —not designed for sharing. Most professional-grade pumps are “open systems.” This means that there is no barrier between the milk collection kit and the pump motor. (Rental pumps are “closed systems” and designed for multiple users.) If a mother has used the pump when she has had cracked or bleeding nipples, or mastitis, it is possible that blood or bacteria may have entered the motor. According to the FDA, …”a breast pump should only be used by one woman because there is no way to guarantee the pump can be cleaned and disinfected between uses by different women.”  

In addition, pathogens from some infectious diseases can be found in human milk. Diseases such as hepatitis and cytomegalovirus (CMV) have serious health implications for you and your baby—but a mom may be unaware that she is infected. So even if you know and trust the previous owner of the pump, there is a risk that it is unsafe.

When my clients purchase used pumps, they always assure me, “I bought a new pump kit so I know it’s safe.” Unfortunately, buying a new kit is not the answer. It’s possible for tiny droplets of milk or air-born pathogens to get into the motor and cause cross contamination to the next user. Even though there are no documented cases of mothers or babies being infected via a second-hand pump, why take a risk? “You should never buy a used breast pump or share a breast pump…. The money you may save by buying a used pump is not worth the health risks to you or your baby. Breast pumps that are reused by different mothers can carry infectious diseases…” (FDA website)

Here’s the good news: All Hygeia breast pumps have FDA clearance as multi-user pumps. There is a filter between the pump kit and the motor that eliminates the risk of cross-contamination. Hygeia pumps are effective, affordable AND shareable! If you’re interested in purchasing a Hygeia pump, or have questions, contact me via phone or email.  

See also: “Are Used Breast Pumps a Bargain?”

Breastfeeding and Work-Clothing Crisis?

March 30, 2011

My friend and teaching partner, Holli Harris,  generously shared the following article.  Thank you, Holli, for your contribution and insight!

If you plan to combine breastfeeding with a job, double the need for breastfeeding and pump-friendly clothes. It’s one thing to not want to bare your breasts to your family and friends, and/or want to retain your sense of pre-motherhood style, but it’s another situation completely when you require combining the need for looking professional with quick and discreet access to breasts for pump (or breastfeeding) breaks in often semi-private locations…and in a situation where every minute away from work counts.   It’s no wonder there is a steep decline in breastfeeding when women return to work.

I think it was while pumping in a hotel room naked because I was wearing an impenetrable wool sheath dress/suit, that the inkling of HadleyStilwell was born. No wait, maybe it was the time I was sitting in a parked car with an unbuttoned blouse and a shawl for a semblance of privacy. I can’t remember anymore. At any rate, if you plan to breastfeed for a year,  you will get more mileage out of investing in wardrobe staples that mix and match with your current wardrobe and with each other than you did with maternity clothes that you wore for about six months.  And my goal with HadleyStilwell designs is that you will want to wear them whether or not you are still breastfeeding. Lately I’ve been wearing the Signature Tunic with the matching skirt and either the Signature Jacket for more formal situations, or dress it down with a denim jacket, or switch out the skirt altogether for leggings or wide bottom pants. The other piece I’ve been living in this winter is the Fleece Cowl Neck Nursing Tunic.   It’s like wrapping a blanket around yourself except that it’s also tres chic…

HadleyStilwell designs help busy moms breastfeed or pump outside the home, not to mention provide quick pulled-together looks, but it’s not just about the clothes. Read Milk Notes for detailed guidance on combining breastfeeding with work, and watch for guest posts from various experts.–Holli Harris

Do you need help preparing to return to work?  Wondering how to combine breastfeeding with your work life? You don’t have to live in Seattle to receive expert guidance from a lactation consultant. I am available for phone consultations for moms anywhere. You may reach me at www.second9months.com.  Send me an email and I’ll call you the same day to set up a “meeting.”

Is Breastfeeding Good for Business?

March 21, 2011

Are you wondering if health care legislation that includes provisions for breastfeeding is a good idea?  How do you feel about requiring businesses to accommodate mothers who want to pump at work? Consider the following:

Every year, more than 3 million mothers in America breastfeed. These provisions are good public policy for not only the baby and the mother, but also for the business community and our overall economy. Breastfeeding can improve more than 10% of the Healthy People 2020 health goals for the nation.

Promoting and increasing the rate of breastfeeding in the United States can provide upwards of $14 billion per year in cost savings related to just the treatment of several childhood ill- nesses seen in higher rates in those infants who are not breastfed. Research shows that breastfeeding lowers the baby‘s risk of infections, diarrhea, SIDS, obesity, diabetes, asthma, and childhood leukemia. A 2009 study of nearly 140,000 women found that women who breastfed for at least one year were 10-15% less likely to have high blood pressure, diabetes, high cholesterol, and cardiovascular disease compared to mothers who never breastfed. Breastfeeding also lowers the mother‘s risk of breast cancer, ovarian cancer and osteoporosis.

Companies providing lactation accommodations reap a 3 to 1 return on investment and can save hundreds of thousands of dollars every year on reduced health claims, lowered employee turnover, decreased absenteeism, and less money spent on recruitment and training of new employees. At the same time, The Business Case for Breastfeeding, a program created in 2008 by the Department of Health and Human Services, showed that employees whose com- panies provide breastfeeding support consistently report improved morale, better satisfaction with their jobs, and higher productivity.

Excerpt from the United States Lactation Consultant e-newsletter.

Breast Milk Storage Guidelines

February 13, 2011

Your milk is a living thing! It is rich in antibodies that are constantly killing off nasty bacteria. For that reason, it is very stable and remains nutritious and safe even after it’s been expressed.

You may find a wide spectrum of guidelines written about the safety of breast milk at various temperatures. It can be confusing to try to figure out which source is correct. Why is there so much variability? The simple answer is that research is conducted in controlled situations and different populations have different needs. For example, pumped milk will last longer in a refrigerator that is never opened. A hospital environment with fragile, premature babies requires that milk be handled much more carefully than a home environment with a healthy baby.

What follows is a middle-of-the-road approach that considers the research as well as the less than perfect conditions that are found in our homes. The guidelines below assume that your baby full term and healthy.

Room temperature: 4 hours or until the next feeding. (No need to warm it up!)

Refrigerator: 5 days

Freezer: 3 months

Deep Freeze: 6 months

Whenever possible use fresh, refrigerated milk. Just as a freshly picked apple is more nutritious than an apple that’s been in cold storage for 3 months; your milk is most nutritious immediately after it’s been expressed. In addition, freezing destroys some of the live cells in your milk. So, if possible, store your precious milk in the fridge, leaving the frozen stash for emergencies.

Are you having a hard time creating a system for storing your milk for your return to work?  I can help! Call or email for a personalized phone consultation.

Breastfeed Twins? Yes!

January 12, 2011

If you’re expecting twins, you may be wondering…Is it possible to breastfeed twins? Can my body make enough milk for two babies? Can I really nourish my babies without using formula? The answers are yes, yes and yes!

Your Dr., your doula and your childbirth educator may all have told you, “Most women can’t make enough milk for 2 babies.” Don’t believe them! If your body is equipped to breastfeed one baby, it is highly likely that you will have sufficient milk for 2.

Arnie and Ashley

Last week I met with the parents of these 2 babies to help them with breastfeeding. They told me I was the first professional to say that they could expect to fully breastfeed their twins. They attended a prenatal twins class and the instructor told them “…hardly anyone is able to breastfeed twins without supplementing…” Immediately after giving birth, the nurses in the hospital told the mom, “you are going to have to supplement. They will starve if you only breastfeed.” The next day the pediatrician saw them in the hospital and told the mom, “Your milk isn’t in yet. You need to supplement.” Their doula who considers herself an expert on twins said, “I have never seen a mom 100 percent breastfeed twins.” Well, guess what! After some guidance and adjustments to their routine, these babies are now breastfeeding with no supplementation.

You body is made to breastfeed! It expects to breastfeed. And when you are carrying twins, your body knows you have twins and transmits the information to your breasts. Before you even give birth, your breasts are gearing up for double duty! In fact, research shows that moms of twins produce more than twice as much milk as moms of singletons. Now that’s preparation!

Remember the concept of supply and demand. The more your babies breastfeed, the more milk you produce. If your babies can’t breastfeed immediately after birth (or if one baby can’t breastfeed), use a hospital-grade pump to encourage and maintain milk production.

Will breastfeeding twins be challenging? Of course! Having twins is not easy. You will be learning about 2 babies at once and learning about breastfeeding at the same time. Without a doubt, there will be a steep learning curve. Once you and the babies have figured it out, however, breastfeeding two will be as easy as breastfeeding one!

Working and Breastfeeding

April 11, 2010

Women have been combining work with motherhood for thousands of years. Since babies get their nutrition directly from their mothers, society expected moms and babies to be literally joined at the hip for the first year or more. It’s only been in recent history that “going back to work” has been a potential roadblock to continuing to breastfeed. Although it is normal to work while caring for baby, our modern world and societal expectations often requires moms to be separate from baby while working.

So, is it really possible to continue breastfeeding while working away from baby? Absolutely! It takes some planning and commitment, but as a mother,  you’re already committed to your baby and you’re probably a master planner and multi-tasker! Just make sure you have the tools and information you need to be successful.

If you are working more than 20 hours a week, you will need a professional-grade breastpump that is designed to be used every day, several times a day for a year or more. Expect to pay 200 to 300 dollars. Some very good brands include: Medela, Hygeia and Ameda.  (Hygeia is a new company. Check them out at www.hygeiababy.com)

Talk to you employer and colleagues about your plan to continue breastfeeding while working. Find other mothers in your workplace who have pumped at work.  Remember you only need a small, private space and a chair.  You don’t even need an outlet if your pump has a battery pack!

Before you return to work, make sure your baby knows how to take your milk from a bottle or cup. Give your baby at least 2 weeks to learn this new skill.

Store a few bottles of milk in the freezer just in case! Accidents happen—milk gets spilled, milk gets left at work, etc. You don’t need a whole freezer full of milk! Remember you’ll be replacing what your baby drinks every day!

If possible, visit your baby at lunch. Or arrange for your baby to be brought to you. Mothers who have access to their babies breastfeed longer.  This practice will also do wonders for your milk supply!

Most importantly, take care of yourself. Learn to delegate! Make sure you eat well and sleep whenever you can. Remember, you have two jobs now!


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