Breastfeeding information and tips

1) BREASTFEEDING MYTHS

Myth 1: “It’s not that popular, only a few women do it in this country”

Fact: 78% of women in England start breastfeeding.

Myth 2: “Breastfeeding will make my breasts saggy”

Fact: Breastfeeding doesn’t cause your breasts to sag, but the ageing process and losing or putting on weight can all have an effect.

Myth 3: “Infant formula is basically the same as breast milk”

Fact: Infant formula isn’t the same as breast milk. It's not a living product so it doesn’t have the antibodies, living cells, enzymes or hormones that protect your baby from infections and diseases later in life.

Myth 4: “People don’t like women breastfeeding in public”

Fact: Surveys actually show that the majority of people don’t mind women breastfeeding in public at all. The more it’s done, the more normal it will become.

Myth 5: “Breastfeeding is easy for some women, but some don’t produce enough milk”

Fact: Almost all women are physically able to breastfeed. It’s a skill that every woman needs to learn and practise before it becomes easy. It happens more quickly for some women than others, but nearly all women can produce the amount of milk their baby needs.

Myth 6: “If I breastfeed I can’t have a sex life”

Fact: After you've had your baby you'll decide when it's time to have sex with your partner. The same hormone that helps to release your milk for the baby (oxytocin) is also made when you have sex. When having sex you may leak a little breast milk. This is normal.

(source: netmums)

2) BREASTFEEDING FAQ

How can I tell my baby is getting enough milk?

Signs that your baby is feeding well are:

◾Frequent wet/dirty nappies

◾Taking regular feeds - (average 8-12 feeds in 24hrs)

◾Baby is active, alert and has a good colour and firm skin

If you look in your red book you will find the guidelines from the World Health Organisation (WHO) which outline the optimal growth for breast-fed children. These are the standards your health visitor will use to make sure your baby is thriving.

The following are not good ways of judging

◾Your breasts don't feel full

◾Your baby starts sleeping through the night

◾Your baby cries after feeding

◾Your baby suddenly starts feeding more often

◾You can only express half an ounce of milk

If you are at all concerned speak to your health visitor or GP

Why does my baby want to feed constantly?

You may find that after settling into a fairly steady pattern of feeding, your baby suddenly starts feeding much more often - even every hour! This could be for a variety of reasons - maybe your baby is getting a cold. Increased breastfeeding can provide valuable protection from illness, as your baby will be receiving antibodies and immunities that your body has made especially for your baby during this time.

Some babies also pick up their breastfeeding for other reasons. Are there significant changes in your life, for instance a move or a vacation or visitors in the house? Have you been away from your baby more than usual recently? Is your baby starting to teethe? Often changes in routine or new stages of development in the baby trigger increased desire to breastfeed for comfort and reassurance.

More often than not however, an increase in feeding is due to a growth spurt. These can generally be expected when your baby is about 3 weeks, 6 weeks, 3 months and 6 months and may last several days. Respond to your baby's additional demands and this will maintain your milk supply - as well as giving opportunities for extra cuddles! Ensure that you are eating enough, drinking plenty of water and getting extra rest so your body can cope with the extra demand.

Can I take medication while breastfeeding?

Most drugs that you take will enter your breastmilk so it is best if you ask the advice of your GP or pharmacist before taking any over the counter medicine. Generally paracetamol and ibuprofen are safe pain killers.

Postnatal depression is something more that 50% of mums face and you may find that your GP will tell you that you need to stop breastfeeding to take antidepressants, this is not true. Stand your ground and ask your GP to research this thoroughly. If you look on our PND forum you will find many mums who can give you advice on this.

What can my partner do to be involved?

Many new dads feel left out when a new baby enters the family because the mum needs to spend a lot of her time caring for their new baby, when a mum is breastfeeding it feels like there is even less a dad can do. This is not true at all, there are plenty of things a dad can do to bond with his new baby - in fact it is a well known fact that a baby can be lulled to sleep much quicker tucked in against her dads chest listening to the deep relaxing rumble of his voice.

Many dads find it lots of fun to give their baby a bath, this gives them important skin to skin contact and gives the new mum a rest.

Will a dummy interfere with breastfeeding?

Don't give your baby a dummy in the first four weeks if you're trying to establish breastfeeding, as it may interfere with her ability to suck well at the boob.

Be very careful not to give your crying baby a dummy/soother when what she really needs is a feed - this is especially important if you're breastfeeding, as you could affect your milk supply.

3) BREASTFEEDING TIPS FOR HUNGRY BABIES

When you have a new baby it can sometimes feel as if feeding is non stop and you barely finish one feed before the next starts, leaving you to worry that your baby is "always hungry". It can seem that your baby is "demanding" and that he never has enough. It's important to realise that this can be entirely normal and that your tiny baby has a very small stomach so needs these frequent feeds.

>Frequent feeding

A small baby can feed up to 12 times a day in the early days and the process of snuggling up and being close is important to mum and baby too. In the first days a routine is not really possible and it does take time for some sort of pattern to emerge.

Although every baby is different, a good indication your baby is still hungry is if they cry for a feed more often and feed for longer when you do offer them the breast. However, if your baby is having several wet nappies a day, is gaining weight and generally happy then its unlikely that he is going hungry. Just try to feed her as often and as long as she wants.

>Growth spurts

All babies are unique and have growth spurts at different times. Some of the common times that newborns and infants may have a growth spurt are at approximately 10 days, 3 weeks, 6 weeks, 3 months, and 6 months of age. During a growth spurt, the baby will often want to nurse more often.

The good news is that these usually only last a few days and will stimulate your body to produce more breast milk to meet your baby's growing nutritional needs.

>Managing weight gain

It is normal for a baby to lose up to 10% of his or her body weight. After the first few days though a consistent weight gain coupled with frequent wet nappies and a happy disposition is the best way to confirm that your baby is getting enough nutrition.

>Is it really hunger?

Your baby may be too young to differentiate between their need for food and their need for comfort. Some experts believe that it's ok to offer the breast whether for food or comfort, but have a look at our sleep pages once your baby is a little older and you want to avoid feeding them to sleep at night. Getting close to your baby, perhaps with skin to skin or snuggled up may be enough to comfort them before offering another feed. The process of breastfeeding helps regulates your baby's temperature and heart rate and also lowers her blood pressure, plus the process of being comforted is an important social and emotional factor.

>Is she getting enough milk?

If you are worried the most important thing to check is the latch on. This may look good but a good breast feeding supporter will be able to show you if you can do anymore to ensure that baby is well latched on.

4) BREASTFEEDING PROBLEMS

>My baby won't latch on properly

Is he well in himself? Does he have any white patches on his gums or tongue that either won't come off or may bleed if you rub them? If so, these are symptoms of thrush which can cause difficulties with feeding.

It may help to try different positions and also to try to latch him on as soon as he shows any signs of hunger - it can be more difficult if your baby has already become distressed before trying to latch on.

We also recommend getting some support from a local breastfeeding advisor group or your Health Visitor.

>Inverted nipples

Flat and inverted nipples are very common and midwives are trained to help you get the most from breastfeeding and will in no way make you feel embarrassed or inadequate in terms of being able to breastfeed.

The baby feeds from the breast and not the nipple and in most cases is able to draw out the nipple through breastfeeding.

However there are breast shells you can wear for a period each day from the 3rd trimester onwards that can help to draw out the nipple. It is often recommended that you express briefly by machine before offering the baby the breast as this can help draw out the nipple.

>Breast pain

There are several reasons why you may have breast pain whilst breastfeeding. The most common reason is that your baby is not latched on properly, Even though you may think your baby looks latched on ok if you are in pain then double check your latch as this is most likely to be the cause of the pain. Try to find a local breastfeeding support group. It is a good idea if they see your baby feeding.

If you have sudden onset of pain in the middle of your breast and it is accompanied by heat or redness then you may have a blocked duct or mastitis.

>I don't think I have enough milk

It is very unlikely that you won’t produce enough milk for your baby. You can increase your supply by feeding your baby more often and offering the breast as often as your baby would like. You should try to ensure your baby feeds well on each breast to reach the hind milk rather than offering a little from each breast.

Do make sure you are looking after mum too. Regular rest and food and drink can really help especially in the early days when you are feeding more often.

>It seems to take too long

If you have a new baby and you seem to spend all day feeding then keep going with the good work. Frequent feeding is very common in the early days, babies can feed up to 12 times a day and this is absolutely normal if your baby has frequent wet nappies, is gaining weight and is generally happy in themselves. Mums generally feel like it takes too long because they can’t get on with other things. In the early days it helps to have a laid back attitude to house chores, or to get someone else organised to help you, even those guests who arrive can be asked to do something whilst you feed the baby. Most mums would be happy to help out.

It can also help to be organised before you start feeding: have a comfy chair, an MP3 player or the tv remote, cushions, a drink and anything else you need before you start. Once you get breastfeeding established some mums find they can feed whilst the baby is in a sling and this can be a great help to get a few things done whilst you feed.

>My baby is suddenly feeding all the time

This could be the sign of what is often referred to a growth spurt, for some reason you baby just seems to want to feed more. Simply put for the time being you are going to have to offer your baby more time on the breast as and when she needs it.

>My baby is crying and pulling off

The most common reason for this is ironically too much milk, sometimes it all spurts out so that there is too much for baby to cope with. You will find that changing position will help, as well as expressing the first fast flowing milk off. If this continues you may have a condition called hyperlactation and its recommended that you see a local breast feeding supporter from some specialist support.

>My baby isn't gaining enough weight

Firstly don’t compare your baby to other babies and certainly not to their formula fed friends as breastfed babies tend to gain weight more slowly and steadily than formula fed babies. The most obvious advice is to feed your baby more often and also to make sure that your baby is getting down to the hind milk. This is not a precise science as your breasts arn’t see through, but you should try to ensure that your baby feeds until they want to come off the breast of their own accord.

The following advice from the NHS shows what you should be looking for to ensure your baby is feeding well:

◾Your baby has a large mouthful of breast.

◾Your baby's chin is touching your breast.

◾It doesn't hurt you to feed (although the first few sucks may feel strong).

◾If you can see the dark skin around your nipple, you should see more dark skin above your baby's top lip than below their bottom lip.

◾Your baby's cheeks stay rounded during sucking.

◾Your baby takes rhythmic, long sucks and swallows. It's normal for them to pause sometimes.

◾Your baby finishes the feed and comes off the breast on their own.

Another indication of good feeding is the contents of the nappy! Is your baby wetting his nappy regularly, and doing a dirty nappy at least once a day? This can show you how much milk your baby is taking in these early weeks.

Sorry if a few of these are repetitive..

5) MASTITIS

Mastitis is a common condition that causes a woman's breast tissue to become painful and inflamed. About 1 in 3 breastfeeding women may be affected by mastitis, often occurring in the first three months after giving birth. Sometimes a mums milk supply may drop a little but please try not to worry about this, continue to feed your baby or express and once the infection has cleared it should pick up again.

It is not always possible to determine if a mum's breast inflammation is due to an infection or a plugged milk duct.

A plugged duct:

◾comes on gradually

◾may shift in location

◾the mother feels little or no warmth in the area

◾the pain is mild and localized

◾the mother feels generally well

◾the mother may have a mild temperature

A breast infection (mastitis):

◾comes on suddenly

◾is localised

◾the mother's breast is red, hot and swollen

◾the pain is intense but localised

◾the mother has flu-like symptoms' (feels tired, run-down, achy etc)

◾she has a high temperature.

What causes Mastitis?

Mastitis can be caused by a number of reasons including an infection, poor latch-on or milk remaining in the milk tissue. Also, many studies have shown that mums who have nipple damage or pain during feeding are more at risk of mastitis developing.

LaLeche (2003) have highlighted other causes of mastitis to include:

◾poor fitting bras

◾breast shells that cause the bra to become too tight

◾mum sleeping on her tummy as it can put consistent pressure on her breasts

◾shortened feeds (breast may not drain well

◾irregular feed patterns (may leave a mum with overly full breasts)

◾babies who have a short frenulum or high palate (fetherston 1998)

◾a mum who feels run down or stressed

Treatment of Mastitis

Your doctor will choose an antibiotic that is safe to give to breast-feeding women and which will not harm the baby. Alongside antibiotics there are a number of things that a mum can do to help clear the mastitis. This includes:

◾taking regular painkillers such as paracetamol or ibuprofen

◾have as much rest as possible as it is an important part of her recovery

◾drinking plenty of fluids

◾possibly adjusting breastfeeding technique or position

◾feed more often, ensuring breasts no longer feel full: expressing may be needed

◾wear properly fitting bras

◾continue to feed on the affected side- if baby refuses, you will need to express your breastmilk

◾gently massage your breasts, especially area the affected area, by using the palm of your hand

◾apply hot or cold flannel over your breasts: even have a bowl of warm water and by leaning over, let your breasts soak for around 10-15 minutes.

◾try using a hot water bottle, heat pad etc

◾dont miss any feeds- if running late feed at the earliest opportunity or the mastitis may begin to feel even worse.

◾Some women say putting chilled, or room-temperature, cabbage leaves on their breast helps with the pain. But there’s no research to say that this will help to get rid of the mastitis (BMJ 2013).

When breastfeeding your breasts should feel softer and lighter after the feed but there may still be a small amount of milk left over. In some cases it may be necessary to:

◾feed more frequently

◾express any remaining milk after a feed

◾express milk between feeds

Breastfeeding with mastitis

Although the symptoms of mastitis may discourage you from breastfeeding, it is important that you try to continue. Regular breastfeeding will help:

◾remove any blocked breast milk from your breast

◾resolve symptoms of mastitis more quickly

◾prevent mastitis from becoming more serious

The milk from the affected breast may be a little saltier than normal, but it is safe for baby to drink. Any bacteria present in the milk will be harmlessly absorbed by the baby's digestive system and will not cause any problems.

Mastitis and abscesses

Unfortunately, in severe cases of mastitis, an abscess may develop in your breast.

The main symptoms include:

◾a painful lump

◾a reddened area

◾area feels hot to touch

◾area may become swollen

◾you may feel unwell and have a high temperature

The NHS suggest that the abscess can be treated using a needle or a small incision to drain the pus out of your breast. Be very careful with this though - it may be best left to a health professional.

One study found that 3 out of 100 women who were treated for mastitis with antibiotics developed an abscess. Some different research estimated that 1 in 10 women who develop an abscess may be unable to breastfeed again.

Yeeeeey!! I'm glad my efforts are appreciated! My LO is fast asleep and I'm really a geek! Much prefer reading and researching than watching telly!

6) BREASTFEEDING AND THRUSH

Thrush is an infection caused by the fungus candida albicans. Thrush can sometimes occur if you or your baby are taking antibiotics or if you have had any damage to your nipple. More often though, there is no cause.

Therefore, the main symptoms of nipple thrush include:

◾severe shooting pain in the nipples, often after there has been no problems breastfeeding

◾burning or itching sensation in one or both breasts

◾some mums describe a deep pain within one or both of her breasts

◾normally this pain is continuous, even when feeding baby

◾loss of colour, increased sensitivity, redness or flakiness of the nipple and areola

◾areola that is red or shiny

◾cracked nipples which do not heal

It has become apparent that sometimes a mum is being diagnosed as having thrush, when infact she doesnt. If your baby has a white tongue but you are not experiencing pain, be aware of the risk of thrush but do not treat either of you immediately. Some babies have white tongues in the first few weeks after birth or this may be associated with tongue tie where the milk is not thrown to the back of the mouth.

Treatment for mum

The NHS recommends that if a mum has no symptoms then she is unlikely to need treatment, for instance if baby has it and she doesn’t.

◾if treatment is recommended, a GP may prescribe an antifungal cream such as miconazole which is normally used for 14 days. This cream should be applied to each nipple after feeding - taking care to remove all traces just before breastfeeding baby.

◾occasionally, antifungal tablets may be prescribed if the infection is severe, for example if it has travelled deeper into your breasts or spread to your milk ducts. If your GP prescribes antifungal cream or tablets for you, your baby will probably be treated at the same time, to prevent re-infection.

◾you may find that you need to take regular painkillers such as paracetamol.

◾good handwashing techniques - wash your hands well after each application of cream or going to the bathroom.

◾use separate towels for each person in the family and change daily.

◾showering may be better than bathing so that you can ensure your nipples are gently washed with warm water - ensure that you also gently dry your nipples as this fungus thrives in warm moist environments.

◾wear clean bras each day and ensure they are washed at the highest possible temperature that the fabric can take.

◾anecdotally some mothers find reducing the level of sugar and yeast in their diet helps (BNF 2013).

◾you could try eating probiotic yogurts to see if the ''friendly bacteria'' that are in these yogurts help to destroy the thrush.

◾revisit how baby is latching on and check your positioning as well.

Baby oral thrush

It is possible for a baby to give his mum nipple thrush and for a mum to give her baby oral thrush.

Symptoms of oral thrush can include one or more white spots or patches in and around the baby's mouth. These may look yellow or cream-coloured, like curd or cottage cheese. They can also join together to make larger plaques. You may see patches -

◾on your baby's gums

◾on the roof of their mouth (palate)

◾inside their cheeks

The main symptoms of oral thrush within a baby includes:

◾he may have white plaques in his mouth which can't be gently rubbed off

◾be less keen to feed

◾have a sore bottom

◾have more wind than usual

◾be difficult to settle

◾baby’s tongue/lips may have a white gloss

◾clicking sounds during feeding

◾poor weight gain

◾nappy rash

◾some babies may dribble more saliva than normal if they have an oral thrush infection

◾a whitish sheen to their saliva

Treatment for baby

The NHS recommends that if thrush is diagnosed then both "you and your baby will need treatment. You can easily give thrush to each other, so if your baby has it in their mouth you will still need some cream for your nipples or an oral thrush tablet to stop it spreading to you. You may want to ask your pharmacist for information. Some anti-fungal creams can be bought over-the-counter from a pharmacy."

Your GP may, according to the NHS prescribe one of these treatments:

Antifungal medicine

If your GP decides your baby needs treatment, they will probably prescribe an antifungal medicine.

◾if your baby is less than four months old, a medication called nystatin may be recommended.

◾in babies older than four months, a medication called miconazole is likely to be recommended. This is because there is a small risk of miconazole causing choking if it's not applied properly.

Nystatin

Nystatin comes as a liquid medicine (suspension). You put the liquid directly on the affected area using a dropper (oral dispenser) supplied with the medicine. Nystatin does not usually cause any side effects and most babies will have no trouble taking the medication.

Miconazole

Miconazole is available as a gel. You apply the gel to the affected areas using a clean finger. It's important only to apply a little at a time and to try to avoid the back of your baby’s mouth to reduce the risk of choking. A small number of babies are sick after being treated with miconazole. This side effect usually passes and is not cause for concern.

General advice on treatment

◾medication is most effective if you use it after your baby has had a feed or drink

◾continue to use the medicine for two days after the infection has cleared up as this will help prevent the infection from coming back.

If treatment hasn't cleared the thrush after seven days, contact your GP for advice.

In addition to this there are a few things that you can do to help the thrush clear, including:

◾sterilizing of any items such as dummies, teats and teething rings

◾washing all toys in hot soapy water - make sure that you rinse all the soap out as it may taste unpleasant for your baby

◾continue to maintain your good hand washing practices, especially after every nappy change

◾ideally wash baby's clothes at a higher temperature to ensure that the infection is destroyed

◾when changing baby's nappy, take care when cleaning his bottom as you need to avoid spreading the infection.

7) ENGORGED BREASTS FROM BREASTFEEDING

A few days after you have had your baby your breasts will feel very full and heavy, as the breast tissues enlarge and start fully producing your breast milk. This should ease within the first 2 or 3 weeks of breastfeeding as things become established.

If your breasts become hard again whilst you are feeding and you have a feeling that they are very heavy, hard and tender to touch then it’s likely that you have engorged breasts.

The main reason for engorgement is because you are not feeding your baby as often as your breasts need in order to empty them fully. It can also be a symptom that you have a blocked or obstructed duct.

The key thing to do to improve the situation is to get your baby to feed from your breasts. This can be difficult if they are very hard so you might need to express a little, even the tiniest amount can make a difference. Try not to express for too long, as the aim should be for your baby to get the majority of the milk, also you want to avoid stimulating more milk production so ideally you only want to produce what your baby needs.

You can also use hot water bottles or warm flannels in a compress on the breast, try just before or when you are expressing. Some mums find that doing the expressing in the shower or in a bath also help. Don’t overdo the heat though as this can increase the tender feelings.

Once you have expressed a little try to latch baby on and feed until the hardness disappears, sometimes you can almost see the breast change as you feed. The aim should be to feed as often as possible, about every 2 to 3 hours. You can also encourage more milk to flow by gently massaging the breast with your hands as you are feeding baby.

As your breasts are hard and tender you might find that you want to wear your nursing bra at night too, just make sure you have no seams or wires that could cause a blocked duct.

Some mums have used cabbage leaves in their bras to help with engorgement, it’s not known if there is a special ingredient in them that helps or whether it’s just the fact they are the right shape and have been in the fridge that helps sooth your breast. Obviously you should give them a wash before you decide to try this at home!

8) CRACKED NIPPLES FROM BREASTFEEDING

Some mums find that they experience sore nipples at some time during breastfeeding but it is not usual to have painful and cracked nipples when breastfeeding. Normally, nipples become damaged and sore if a baby isn't attached correctly. In some cases, baby may not be sucking effectively, for example if they have tongue tie.

Unfortunately, for the mum who does have sore cracked nipples, she may begin to dread feeding times.

There does seem to be some confusion between researchers over what could be called ''expected/normal' soreness - in particular during the first few weeks or in the few moments at the beginning of a feed. Heinig (2001) believes that sore nipples for the first few weeks may be normal for some mums - so long as mums nipples are healthy and have no cracks or bleeding.

LaLeche (2003) state that although there may be some early tenderness, breastfeeding should not hurt. Furthermore a mum needs to contact a breastfeeding counsellor, or health visitor if she has sore nipples and:

◾she feels intense toe-curling pain at any time

◾she has a burning sensation in her nipples during, between or at the end of feeds

◾the soreness doesn't improve after 3 days of consistently working to correct the cause

◾cracks, bleeding or other nipple trauma

If feeding is painful and a mums nipple seems flattened or pinched then the position baby is in needs to be adjusted and improved. Ineffective position may result in baby not taking enough breastmilk, which in turn will result in a baby who is unsettled after feeds. Also, the time it takes for baby to feed could be longer, resulting in a mum being at risk of developing engorgement, blocked ducts and mastitis. Sore nipples can also be caused by thrush.

How to relieve the pain

If your nipples hurt, take your baby off the breast and start again. To do this you can slide a finger gently into the corner of your baby’s mouth until their tongue releases. Putting up with the pain could make things worse. If the pain continues or your nipples start to crack or bleed, ask a breastfeeding supporter to help you get your baby attached effectively. Asking for help and support is important.

The following may also help:

◾Squeeze out a drop or two of your milk at the end of a feed and gently rub it into your skin.

◾Let your nipples dry before getting dressed again

◾Change your breast pads at each feed (if possible use pads without a plastic backing).

◾Don't use soap, as it dries out your skin.

◾Wear a cotton bra so that air can circulate.

How to treat cracked nipples

◾Treat any cracks or bleeding with a thin smear of white soft paraffin or purified lanolin. Put the ointment on the crack (not the whole nipple) to help it heal and prevent a scab forming.

◾Its worth mentioning that although there are many creams and sprays available, care should be taken – as they will not work unless the cause is treated. Also, some can cause allergic reactions in the mother or baby.

◾There's no need to stop feeding. With skilled help you should find that breastfeeding quickly becomes more comfortable again

◾Very gently hand express a few drops of your break milk and gently rub into your nipples. Breastmilk contains substances which aid healing and counter infection.

◾Some women say putting chilled, or room-temperature, cabbage leaves on their breast helps with the pain. But there’s no research to support this (BMJ 2013).

◾Have times during the day when you can sit, braless and let your nipples be exposed.

Remember, you can have sore nipples at any stage of breastfeeding. If you find that you do....go back to basics which include:

◾Checking position and attachment of baby.

◾Looking for any signs of nipple thrush.

◾Checking to see if baby has teeth coming through.

◾Checking that your bra isnt irritating your nipple and that it is the correct size.

◾Remembering if you have used any new products, eg washing powder, shower gel etc.

9) BREASTFEEDING SUPPORT

Breastfeeding can sometimes be challenging, and things don't always go as smoothly as planned.

If you find yourself in need of a little support or advice, there are plenty of options available, so don't struggle on alone.

There are nationally-run organisations you can contact, some of which may visit you in your home. There may also be breastfeeding support groups in your area - find your local breastfeeding groups.

National breastfeeding helpline

NBH 0300 100 1212

The National Childbirth Trust

NCT

La Leche League

0845 120 2918

www.laleche.org.uk

Association of Breastfeeding Mothers

Abm 0300 330 5453

www.abm.me.uk

The Breastfeeding Network

The BFN 0300 100 0210

breastfeedingnetwork.org.uk

Thank you lovely ??? how do we make this a sticky again? :)

10) BREASTFEEDING POSITIONS

Successful breastfeeding relies on finding a position that works for you and your baby. There are various breastfeeding positions you can try and if one position proves tricky and you're experiencing breastfeeding problems, don't give up - you might simply need to try another method.

Sometimes you or your baby may have a preference for feeding from a particular side, as you can read about on the Kellymom website.

Just before feeding, it's important that your body feels supported and comfortable when breastfeeding so find the best position that prevents you from straining any muscles, in particular those in your back.

You may be more comfy in a chair, sofa or in bed. Pillows, cushions, V-Shape pillows etc. can help you to find the best position for you to feed baby.

Some mums find that they need to use a stool or low table to help support their legs.

>The cradle-hold position

This is a popular position that works for lots of mums. Some mums feel that this position works best if they have delivered vaginally.

Occasionally, mums may find that this position is difficult when helping baby move their mouth towards your nipple.

Place your baby's head in the crook of your arm and ensure her arm is tucked under her body. Your baby should be facing you, your tummies turned to each other. Take your right breast in your left hand or vice versa.

Draw your baby to the breast and ensure she takes the whole nipple and most of the areola into her mouth. To check your positioning is correct make sure baby's ear, shoulder and hips are in a straight line.

>The cross cradle position

A slight variation on the cradle-hold position and this position may work well for babies who have difficulty latching on or babies that are small. This position requires a pillow. Place the pillow on your lap and ensure your baby is resting at nipple level. Make sure your elbows are supported. Cup your breast in a 'U' shape - if you're feeding from the left side, use the left hand and vice versa.

Support your baby with the fingers of the hand - place your hand behind your baby's ears and neck, with your thumb and index finger behind each ear. This cradles your baby's neck and keeps his head secure while you feed.

The palm of your hand should be placed between your baby's shoulder blades. Draw your baby towards the nipple. When your baby has opened his mouth wide, gently push him towards the breast using the hand that is placed between the shoulder blades.

>Side-lying position (a god-send if you're sore down below, this is the position I used as it least aggrevated my coccyxdynia, it's also great for cluster feeding if you're lazy like me - you can lay on the couch and watch the soaps the same time! Result!)

If you prefer to lie down for breastfeeding or are looking for a restful position for night-time breast feeding, you could try a side lying position. This position is particularly good for mums who have had a c-section delivery. Lie facing your baby, using pillows to support your back or between your knees. You can also use a pillow behind baby's neck to keep him in a secure position facing you. Cradle your baby in your arm, with his back along your forearm. Ensure your baby's ear, shoulder and hip are in line to ensure your baby gets their milk easily.

It's important to exercise caution when feeding your baby in this position, particularly at night-time. Don't lie underneath your duvet when feeding to avoid the possibility of falling asleep and possible suffocation. Furthermore, do not feed in this position on a sofa where your baby could roll between a cushion and suffocate if you fall asleep.

>Clutch or football position

This is a useful position for mothers recovering from a c-section as it keeps the baby well away from your cut. It's a position many babies find comfortable, so you might like to give this one a try if other positions aren't working for you. Place a pillow underneath your baby and support baby's head in your hand, facing upwards and towards you.

Nestle your baby's side closely to your side so they are well secured and comfortable, with their feet tucked under your arm.

Bring baby towards your breast gently and place them on the nipple.

>Laid-back breastfeeding or biological nurturing

Nurturing, encourages closeness between you and your baby. Baby is laid ''tummy to mummy'' and encourages baby to find their way to your breast. This position promotes you and your baby’s natural breastfeeding instincts.

Start by getting yourself comfortable, and leaning back into pillows, cushions etc. In this laid back position, gravity will help to hold baby in place. You may want to cover baby with a blanket to keep him warm. With your back, head and shoulders supported lie baby ''tummy to mummy'', with his cheek resting on your naked breasts. Some mums place their arm behind baby. You may need to help by guiding him towards your nipple. Baby will probably do lots of head bobbing which is helping him to move to where he needs to be. Once baby is latched on, relax and enjoy this close feeling.

Hope you don't mind Toggy, just thought we need something on here to help new mums or mums-to-be with bf. The sticky post was great and contained lots of invaluable advice about bf.

You have to email the mods. I'll let someone else do that. I don't want to ask them to make my own post a sticky (lol).

11) STORING BREASTMILK

If you're breastfeeding, there may be times when you may decide to express your milk. This could be for a number of reasons including your return to work, or simply so your partner can do some of the night feeds.

When expressing milk, it is important to store it correctly and safely - here are our guidelines on how to do this.

>Containers for storage

Obviously everything should be well cleaned before you start expressing this also applies to breast milk storage containers. Read about sterilising options.

There are several options for storing your breast milk:

◾Bottles made from glass

◾Normal plastic babies bottles with lids that fit well

◾Disposable plastic milk storage containers

◾Freezer breast milk bags

Ideally the bottles should be made without bisphenol A (BPA). Find out more about bisphenol A.

>Filling the bottles/bags

Only put two to four ounces of milk in, as this is the amount your baby will use at one sitting and avoids wasting your milk. Also leave a gap of about 1-2 cms at the top of the container as the milk will expand when it's frozen. Mark the date and time on the container and add your baby’s name if you will be sending the bottle to your childminder or nursery to use.

>Newly expressed milk

Firstly, always try to store the milk towards the back of the fridge and not in the door as the temperate is lower at the back.

You should try to refrigerate or freeze this as soon as possible and definitely within 3 to 8 hours. If you are not able to refrigerate, use it or freeze it in this time, you should discard it because of the risks. If you are expressing at work, refrigerate it as soon as possible (making sure you label it clearly to avoid any coffeebreak confusion!) and then transport it home in a cool bag, and refrigerate or freeze as soon as you can.

>Using refrigerated milk

Once you have refrigerated the milk you should use it ideally within 3 days, there is some advice that you can use it up to 8 days later.

If you are refrigerating previously frozen breastmilk then you can only store it in the fridge for a day.

>Freezing breastmilk

You should freeze milk as soon as possible keeping to the guidelines for newly expressed milk above.

You can freeze milk for around 6 months, if you have an old style freezer within your fridge the maximum storage time is much less and only around 2 weeks.

To use frozen milk you should remove it from the freezer the night before you need it and keep it in the fridge to defrost it. Be careful about defrosting at room temperature as you could end with breastmilk at room temperate for longer than advised. You may find it quicker and easier to thaw it under a warm running tap, moving it about so that you don’t end up with one part boiling hot and the other still frozen. Previously frozen milk can be kept in the fridge for up to 24 hours after it has thawed. Do not refreeze it.

Don't use a microwave to defrost or warm breast milk - it could cause 'hot spots' and you may lose more of its beneficial properties.

Give the bottle a gentle shake before you offer it, so the foremilk and hindmilk are mixed (you'll probably notice that they've separated).

If your baby does not drink all the milk when you offer it, you should use it within 1-2 hours before discarding it.

How long can I keep expressed breastmilk?

◾At room temperature - use within 3-8 hours

◾In the fridge - use within 3-8 days

◾In the freezer - use within 6 months (or 2 weeks in an older style freezer compartment of a fridge)

Can't see the full title - what is it?

I'll email them now.

12) GETTING BREASTFEEDING ESTABLISHED

With breastfeeding it is best to get off to a good start. Here are our top tips for those first special moments

First Feed

It is important that your baby latches on as soon after birth as she wants to, in fact if you have had a normal, drug-free delivery and your baby is delivered directly onto your stomach, she should instinctively make her way up your body and latch herself onto your left nipple - the left because she will follow the sound of your heartbeat...amazing isn't it?!

The first feed will be made up of colostrum - this special milk is low in fat, and high in proteins and carbohydrates. It is also your baby's first immunisation as it contains antibodies your body has produced to help keep your baby healthy. It is extremely easy to digest, and is therefore the perfect first food for your baby. It is low in volume but high in concentrated nutrition for the newborn. Colostrum has a laxative effect on the baby, helping him pass his early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice.

If you had medication during your labour, it could be that your baby is drowsy and unresponsive and this may last for a few days. Do not worry unnecessarily that your baby isn't feeding lots - ask your midwife or the infant feeding co-ordinator of the hospital for advice.

Early Days

Breastfeeding isn't easy, it is something you and your baby will need to learn how to do together. The most important thing you will need in these early days is support, that could come from your partner, your mum or a local breastfeeding counsellor. It might be a help if you talk to the people you are close to before you have your baby and make them aware that you will be feeding her yourself - though feeding your baby is the most natural thing in the world there are some people who find the thought uncomfortable, mainly because it is an unknown thing to them. If you talk about it beforehand there won't be any unnecessary upset. Tell them you are giving your child the best start in life - no-one can argue with that.

Your baby will make her own routine, there is not a right and wrong time to feed and no set time to say how long a feed will last. It can be really hard as - unlike a bottle - your breasts don't have quantity markings to tell you how much your baby has fed. Try to remember your baby's stomach is as big as its tiny curled up fist so it can't hold much, and because your milk is so easy for your baby to digest, your baby will process it quickly and be ready for more.

You may find that one day she is feeding every 30 minutes and the next going four hours without waking up. This is normal and when she is asleep try to catch up on some rest yourself - leave the dirty pots in the sink for your partner, ask your mum to put the washer on and your mother in law to do the hoovering - they really will be glad of something to do to help you out. And if there isn't anyone to help, just leave things - your baby doesn't care if the house is a bit dusty or if your breakfast pots are still on the coffee table. All she needs is a mum who is well and has enough energy to cope with her demands (and there will be plenty!)

Within three to four days your milk will come in and your breasts will be heavier and swollen. The early thick colostrum reduces and your milk now looks thin and watery - this is normal don't expect it to look like the stuff you buy at the corner shop! If your baby finds it hard to latch on at first, try expressing a small amount of your milk which will make your nipple softer and easy for your baby to latch on to.

You might experience a few moments of toe-curling pain which will make your entire body clench tight as your mum breastfeedingbaby first begins to suckle. This should pass and you'll feel what is known as the 'let down reflex' when your milk comes through. It is not normal to feel pain or discomfort throughout the feed. If you do it could be due to your baby not being latched on correctly - put your clean finger into the corner of your baby's mouth to break the seal and try again. When your baby is latched on correctly her lips will be turned outward, her nose is almost touching your breast and at least half an inch of your breast around the base of your nipple is in her mouth. When she is suckling you will be able to see the jaw working all the way back to her ears, you'll hear quick sucks at first and then slower swallowing.

If you still feel pain you can ask your midwife or a breastfeeding counsellor to check your positioning and if they feel anything is out of the ordinary they may suggest you see a GP to rule out any other problems.

It's called breastfeeding information and tips

I've emailed them now xxx

Thanks! Remember to include your own tips or experiences Toggy! :-) xxx

13) RAYNAUD'S SYNDROME

Raynaud's phenomenon (syndrome) is now felt to be common, affecting up to 20% of women of childbearing age. It affects the nipples of breastfeeding mothers and is recognised by many lactation experts as a treatable cause of painful breastfeeding (Anderson, 2004).

Raynaud's of the nipple in breastfeeding women is often misdiagnosed as poor latch, thrush or milk blisters, which may cause a mum to stop breastfeeding due to the amount of pain she is experiencing. It is important that you let your health visitor or breastfeeding counsellor know if you are experiencing severe pain. It is caused by the abnormal spasms of arteries that supply blood to your nipples, causing the restriction of blood flow to this area. Raynaud's of the nipple appears to be triggered by the increased levels of oestrogen during pregnancy and in the postnatal period. Whilst Raynaud's affects breastfeeding, it is not breastfeeding itself which causes it - the trigger is cold temperature.

Occasionally if a woman already has this syndrome existing prior to pregnancy in her fingers and toes she is at greater risk of developing this during pregnancy or if she breastfeeds. For those women who already have this, breastfeeding can sometimes be more challenging, as it is thought that when she exposes her nipple to the cold air, especially just before feeding it can trigger it.

Signs

• severe breast pain which can feel throbbing

• nipple changes colour. Kellymom says ''the nipple turns white, then there is usually a noticeable triphasic color change – from white to blue to red – as blood flow returns. The color change may also be biphasic – from white to blue''

• numbness of the nipple

• areola may change shape

• breast milk supply might be affected

Treatment

Once diagnosed, this syndrome can be treated with a wide range of treatments, including

• nifedipine (check with your gp first though)

• Vitamin B6 (check with gp and breastfeeding counsellor)

• keeping breast and nipples warm is important as it can help with the pain

• avoid over exposing your nipples to the air - ideally time should be kept to a minimum.

• any creams applied, eg. lanolin, should be kept at body temperature so that your nipples don't become cold, increasing your pain.

• try warming up your nipple with a warm flannel or breast warmers. Care should be taken when attaching your baby to your breast after warming; consider the risks for baby if your nipple/breast is too warm

• simple painkillers eg. paracetamol or ibuprofen

If you want to talk about Raynaud's, call

NHS Direct: 111

National breastfeeding helpline: 0300 100 0212

NCT breastfeeding helpline: 0300 330 0771

(source: mumsnet)

14) FOODS TO AVOID WHILE BREASTFEEDING

What you eat and drink fuels your breastmilk production and small amounts of what you eat and drink can pass through your breastmilk to your baby. Sometimes, foods you eat can disagree with your baby.

Your diet can also affect the taste of your milk and your baby might like some tastes more than others. Your baby probably became used to most of the things you eat regularly while you were pregnant, but there still may be some foods he or she just doesn't like when they appear in your breastmilk.

All babies are different and where one baby will get terrible wind after their mum has eaten a load of lentils, another will glug away with no problems at all.

How can I tell if my baby has been affected by food I've eaten?

If you notice any of these symptoms, you might want to think about what you have been eating and whether it has been affecting your baby:

•Diarrhoea or constipation

•Windiness or bloating

•Colic symptoms (a lot of crying)

•Discomfort

•Being extra fussy or out of sorts

•Runny nose

•Eczema or rashes

•Milk rejection

Try eliminating the foods you think are causing the problems and see if he or she then settles.

Common foods that may cause problems

•Wheat

•Dairy products

•Fizzy drinks

•Cabbage, brussels sprouts and other wind-producing food

•Citrus fruits

•Foods with a laxative effect

•Too much sugar

•Large quantities of fruit

Food to avoid or limit when breastfeeding

•Any foods that cause allergic reactions in members of your family

•Limit oily fish to two portions a week

•Stick to one portion of swordfish, tuna, marlin or shark a week because of the mercury content

What about caffeine when I'm breastfeeding?

Caffeine will pass through your breastmilk to your baby and may interfere with his sleep or make him fussy and a bit 'wired' ie wide-eyed and overactive.

Stick to a couple of cups of tea or coffee a day if your baby is sensitive to caffeine and remember that chocolate and fizzy drinks have caffeine in them, too.

Some babies will be more sensitive to caffeine than others and it is thought that younger babies (up to six months) are more affected than older ones. If you do have to limit your intake, you can try and increase it when your baby gets a bit older. There is no evidence to support the idea that caffeine reduces your milk supply.

Can I drink alcohol when I'm breastfeeding?

There is conflicting advice about alcohol and it is difficult to find any solid guidance. Alcohol does pass to your baby through breastmilk but in low levels it is not particularly harmful. It may make your baby more sleepy or conversely agitated and less likely to sleep. It can also interfere with the amount of milk your baby gets during a feed, and they may need to feed more often.

One unit is roughly equivalent to half a pint of normal beer, a 25ml (pub) measure of spirit, or a small (125ml) glass of wine.

It takes two to three hours after drinking for alcohol to stop being present in your breastmilk, so if you're worried about the effects of alcohol on your baby, or they seem sensitive to it, time your drinking around feeds. One or two units occasionally are not going to have a big impact though. The general consensus is that drinking within reason and not having binges or drinking heavily is compatible with breastfeeding.

And if you do drink a bit too much...

Advice from Dr Wendy Jones, a pharmacist associated with the Breastfeeding Network says: "If you feel drunk and particularly if you have drunk enough to vomit, it is better not to breastfeed for 12 hours."

There is no need to do the 'pump and dump' (expressing milk and discarding it) as the levels of alcohol in your milk drop at the same rate as the alcohol levels in your blood.

15) MEDICINES TO AVOID WHILE BREASTFEEDING

The good news is there are medicines you can take when breastfeeding. It's not always necessary to suffer in silence (or even while moaning loudly).

Most over-the-counter medicines will advise caution when breastfeeding, mainly because they have not been specifically licensed for breastfeeding women. This will often be because there has not been enough research into the effects of the medicine on breastfed babies. The Breastfeeding Network says that some of these warnings can be based on just one report of an adverse reaction.

If in doubt, it's best to talk to your doctor (and always to make them aware that you're breastfeeding when they prescribe you anything). In general though, if you can avoid taking a drug, it is best to do so.

Medicines do pass to your baby via your breast milk - about 1% of a drug. But this doesn't necessarily mean they will do your baby any harm. You have to weigh up the benefits of taking the drug for your own health versus the possible risk of any damage to your baby, however slight. Again, discuss it with your GP if you need more information.

Before taking any medication while breastfeeding consider:

•How old your baby is and whether they were born prematurely. The liver and kidneys of younger babies are still developing and are less likely to cope with any harmful effects of any drugs.

•Whether your baby is breastfeeding exclusively or also taking solids and and having less frequent feeds - this will lessen the impact of any drug.

•Any research into the safety of the particular drug.

•The benefits of taking the drug: do you really need to take it and are there any alternatives you could try?

If you take medicine while breastfeeding try to:

•Choose single-ingredient options rather than ones that cram a variety of active ingredients into one pill.

•Take your medication after feeding and try to leave two to hours hours before feeding again.

•Use drops and sprays rather than pills and choose non-drowsy options to avoid any unnecessary adverse risks.

What common over-the-counter drugs should be avoided while breastfeeding?

•Aspirin (because of an increased risk of Reye's syndrome)

•Codeine (as it can cause sedation)

•Pseudoephedrine - a decongestant that can reduce milk supply

•Phenylephrine and phenylpropanolamine - both decongestants found in some cold medicines

•Guaifenesin: an expectorant (to bring up phlegm) found in some cough medicines

•Medicines that may cause drowsiness

Explore alternatives. There are safe painkillers you can take and you can find softer options for coughs and colds. Kellymom has information on cold and allergy remedies compatible with breastfeeding.

Recreational drugs should be avoided as they can have a negative impact on your baby and may make you less able to look after your child. There have been some studies into the effect of cannabis passed on through breastmilk that suggest it could effect a child's motor skills development at one year. The research isn't extensive, but why risk it?

What medicines are OK to take while breastfeeding?

•Most antibiotics

•Painkillers such as paracetamol and ibuprofen (but not aspirin)

•Hayfever medicines (choose non-sedating antihistamines)

•Cough medicines - linctus is fine but decongestants should be avoided as they can greatly reduce your milk supply

•Asthma inhalers

•Normal doses of vitamins but not the mega-level vitamins

•Most antidepressants are OK to take, but check with your GP first

•Anticoagulants for DVT

•Domperidone, but only in low doses

•The flu jab and other immunisations will also benefit your baby

•Corticosteroid injections

•Drugs that have also been formulated for children are usually safe for breastfeeding mums; this includes loratadine and cetirizine for hayfever

•Warfarin and Heparin anticoagulants are protein-bound in the blood and so less likely to enter breastmilk (but if you need to take these drugs make sure your baby has vitamin K at birth, as the anticoagulants may deplete your milk supply)

What about the pill?

Not all contraceptive pills are recommended while you're breastfeeding, especially those that contain oestrogen. Check with your GP which ones are safe to take.

Don't believe the 'you can't get pregnant while breastfeeding' myth. Oh and if you should need to, it is possible to take the morning-after pill without stopping breastfeeding.

Thank you Toggy! xxx

(source: Mama Natural)

16) TOP TEN FEEDING TIPS

1. Be sure you get the right latch

This is KEY. If we don’t have the right latch, we end up with really sore and perhaps damaged nipples. There’s a TON of great resources online that will literally show you what the right latch looks like but in a nutshell it’s about getting the lower part of the breast and areola into baby’s mouth so that the nipple hits their high palette which stimulates sucking.

2. Experiment with different breastfeeding positions

I read in my Hypnobabies literature that the cross-cradle is the best position for newborns and I couldn’t agree more. My little guy needed my hand on his neck to guide him to the nipple, help establish the right latch, and keep him in the right position as he nurses. We STILL use this position if we’re having troubles.

I also have heard that the football hold is really helpful for sore nipples and establishing a good latch. The sideline position, which you can do in bed, is nice for sleep-deprived mamas, but it is a bit advanced for some newborns to get the hang of right off the bat.

With my fast milk letdown, we also use the position where I’m laying back and baby’s body is on top of mine. This way his head is upright and the milk has to work against gravity, helping slow the flow.

While I tend to rely on cradle hold, I know that rotating positions helps with sore nipples since baby’s latch will hit different parts of breast depending on angle.

3. Get help early

Habits form fast so it’s VITAL to get the latch right at the beginning. (Don’t despair if you didn’t, as babies are adaptable.) It will help you and your baby immensely if you start off on the right foot.

If you can afford it, I highly recommend hiring a Lactation Consultant. Even if you are breastfeeding just fine, it can be a worthwhile investment. Think of them as Breast Whisperers, experts in the field of palettes, latching, positions, and intake volume. I was AMAZED at how helpful and empowering my consultations were.

If seeing a consultant isn’t for you, check out some of these free resources online:

General breastfeeding sites

•www.llli.org The international La Leche League website, a phenomenal resource for breastfeeding families.

•www.bfmed.org The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection and support of breastfeeding and human lactation.

•www.kellymom.com Awesome site. Created by a lactation consultant and mother of three, this site provides evidence-based information on breastfeeding, sleep and parenting.

•www.breastfeeding.com This site has a ton of resources including videos, forums, etc.

•www.drjacknewman.com One of the great advocates for breastfeeding, Dr. Jack Newman’s site has a plethora of breastfeeding including videos, articles and troubleshooting information.

Milk production resources

•www.lowmilksupply.org This site gives information, support and solutions for mothers struggling with low milk supply.

•http://milkshare.birthingforlife.com/ A great site for moms looking to give or receive breast milk.

4. Use props

We are lucky to have all of these great tools to help us breastfeed well. Some of my favorites include:

•The Boppy. My favorite nursing pillow… so comfy… so supportive… I never wanted to nurse without it!

•My Breast Friend. Another nursing pillow that’s great if you’re having a hard time getting the latch and positioning right. It’s very firm and you can even nurse while standing up! (with support from my hands, of course).

•Motherlove Nipple Cream. This stuff is wonder cream for sore nipples, creating a healing “moisture seal” in-between feedings. Made with extra virgin olive oil, beeswax, shea butter, marshmallow root, and calendula, it’s non-toxic and safe for the baby to ingest, so no need to rinse off before feeding.

•Nursing Pads. At the beginning, while you are establishing your milk supply, nursing mamas tend to leak. Using these pads, you prevent the embarrassing ring-around- the-nipple phenomenon.

5. Expect that it will be challenging.

Call me twisted but I find if I know the worst right off the bat it helps me to stay positive. It is easier for me to find joy in the small successes along the way and not get discouraged if it doesn’t click right away. I also found that despite the right latch, I do have some tenderness from time to time, and that is perfectly normal.

6. Be sure to burp ‘em

If you don’t want your precious milk regurgitated onto the back of your couch, be sure to burp your baby well! This will also help ease painful gas bubbles that often accumulate in baby’s belly since their digestive system is still so delicate.

7. Get an eyewitness

My husband was a HUGE help in making sure I got the right latch with Griffin. From his perspective, he could see things that I couldn’t. He also was supportive in terms of getting me water each time I fed, inserting extra pillows for support, and changing Griffin’s diaper once I finished. He will also be the one who feeds Griffin a bottle at some point so it’s good for him to get involved early!

8. Use a breast pump if needed

I found pumping at 3 weeks was helpful so I could literally *see* milk coming out of my breast. While not always a good indicator of supply, it did give me peace of mind that things were working as a first-time breastfeeder.

I also liked having a bit in the freezer so that if I had to leave town unexpectedly or, God forbid, be hospitalized, my child would have some nourishment on hand. Pumps can also be great to help regulate or increase milk supply if needed. My lactation consultant recommended pumping each breast once a day in the morning when supply is usually higher and baby’s appetite is smaller.

9. Keep it pure

For the first month, try to just breastfeed without introducing a bottle or pacifier. This will help to establish a strong breast bond so that the baby doesn’t experience nipple confusion and start preferring artificial nipples.

10. Think peaceful thoughts

^I personally agree with these top ten tips :-D

Wow?!

(source: Babycentre)

17) 24 TIPS FROM BREASTFEEDING VETERANS

Nursing is a different experience for every mother and baby, so what works for one woman may not work for the next.

That said, there are plenty of time-tested techniques for improving milk flow, clearing blocked milk ducts, and more. Read on to find out how BabyCenter moms faced, and overcame, some of the most common breastfeeding challenges.

I attended a class offered at the hospital. It gave a lot of the basics along with the encouragement that if breastfeeding wasn't easy at first, baby and mom eventually would find their rhythm.

— R.L., Racine, Wisconsin

Don't watch the clock to see how often or how long your baby is nursing. Instead, go with your instincts. If your baby is rooting around or crying, then feed him or her — even if you just did.

— Gina Locke, Grapevine, Texas

Make sure your baby's mouth covers a large part of the underside of your nipple. I spent the first few weeks in a lot of pain because my baby wasn't latching on properly. What a difference the correction made!

— Heidi Hudson, Oakland, California

I'm a pediatrician mom of a 3-year-old whom I breastfed for eight months. My son was extremely hard to start: Despite making our first attempts (unsuccessful) in the first hour and knowing what to do, it took almost two days to get him latched on. In the interim, we finger-fed with an SNS (supplemental nursing system) and glucose water while I pumped to get my milk supply going. The SNS was a lifesaver. We finally hooked it to my breasts and were able to get him latched on by the third day.

— Dara Hogue, Cupertino, California

I used lanolin ointment on my nipples faithfully morning and night and never experienced any cracking or bleeding when I started nursing. My soreness was minimal, and the ointment soothed my skin when it was chafed. I have very fair, thin skin, so that was a wonderful tip for me! I included a tube with my shower gift to a friend.

— Rachel L. Sarantopoulos, Dayville, Connecticut

I've been solely nursing my baby since birth and now, at 9 weeks, she's a big healthy baby. I had very sore latch-ons at the start, and I found that if I stayed ahead of her intense hunger I was better off. I would check on her around the time I thought she would be waking to eat and watch for tongue-sucking and lip-smacking in light sleep. If I put her to the breast when she showed early signs of hunger, she wouldn't suck as hard as when I waited until she was fully crying and really hungry.

— Kathy Kent-Knurek, Chicago

The best — and probably hardest — breastfeeding advice is to relax! Remember that you and your baby are learning.

— Sandy Kenniston, Green Bay, Wisconsin

When I had my daughter, I knew I wanted to breastfeed. Unfortunately, she didn't latch on right away, so I began supplementing with formula. Hospital staffers tried everything from round-the-clock attempts to pumping and inserting feeding tubes in the baby's mouth while I tried every nursing position known. The baby knew how to suck, but she just wasn't getting the knack of it. Finally, we tried the plastic breast shield. My baby was able to suck the large plastic nipple and draw the milk rather than search for my small nipple.

I had visions of using the shield from then on, but luckily I lost it and was forced to teach the baby to take my own nipple. I had to use a syringe to "pull" the nipple larger, but in time, thanks to the baby's suckling, my nipples conformed. The rewards for not giving up have been great!

— Alison O'Donnell, Pawtucket, Rhode Island

I've had a real problem with leaking breasts. The nursing pads never worked well enough for me, so I came up with my own solution — sanitary napkins! I buy the ultra-thin kind and fold them in half. I can wear them all day and they never leak. It's cheaper, too.

— Cindy Brown, McKinney, Texas

For me, preparing for nursing meant reading all I could. I had several magazine subscriptions going while I was pregnant and almost every issue had an article on breastfeeding. I found new facts and ideas in each, but the bulk of the article was the same. Every time I read these articles, it reinforced all the information I had previously read. When the time came to put it all to use, I felt pretty confident. I felt like I really understood what was coming next and as a result, breastfeeding seemed relatively easy.

— Ginger Renae Koontz, Pasadena, Maryland

I didn't "ease" into breastfeeding. It was one of the hardest, most frustrating, heart-wrenching things I've ever done. I stuck with it though, and four months later I have a healthy, entirely breastfed baby boy. With all the talk about how it is so good for you and the baby, and what a great bonding experience it's supposed to be, a new mother feels guilty if she dreads each feeding and wonders if perhaps she doesn't love her baby enough. Eventually she'll get the hang of it, but the odds are pretty good that she'll actually hate it the first couple of days — or even longer.

— Libby Bollino, Abbeville, Louisiana

When I started breastfeeding, I felt like I needed two or three extra hands. I was so nervous about holding my newborn and supporting his head properly that trying to get him in the right position to latch on seemed impossible. It wasn't until several months later that I got a breastfeeding pillow as a gift. It's amazing. It props the baby up into the perfect spot so I can concentrate on the latching-on, which is the hardest part when you're new to nursing. I wish I'd had one of these when I was learning to nurse and fumbling around with ordinary pillows and blankets and propping and leaning.

— Laura Jaglowitz, Hedley, British Columbia

The single most beneficial thing I did was to attend a La Leche League meeting while I was pregnant. I learned a tremendous amount and got to see other women nurse their babies, which I had never really seen before. After my baby was born, I continued to attend LLL meetings and have received a great deal of knowledge, support, and encouragement from the leaders and the other mothers. I also made some terrific friends.

— Debbie Strelevitz, Rock Tavern, New York

My mother gave me a great tip for getting through those first couple of weeks when breastfeeding hurt: Drink very cold water through a straw as the baby is latching on. The cold water will help defer the pain. Other things that help include listening to relaxing music and minimizing distractions so that you can relax and focus on the task at hand.

— Wendy Katzman, Seattle

When my daughter was born, I told my lactation consultant about my horrible experience with mastitis and bleeding nipples when I breastfed my first child. She recommended some products that have worked great: lecithin, for avoiding clogged milk ducts; blessed thistle, for increasing milk flow when I return to work and need to pump; and alfalfa, for enriching my milk. I haven't had any episodes of mastitis. I swear by the herbs – they've made all the difference!

— Ruth Tutterow, Greensboro, North Carolina

Take all the help and support you can get. The lactation consultant got my husband involved in the learning process so he would know how to help me get the baby latched on until I was able to do it by myself.

— Candice Gray, Paulina, Louisiana

>p>The best advice I got for dry and sore nipples came from my doctor. She said not to bother buying those expensive ointments but instead, after breastfeeding, express just enough milk to spread on the nipples. It really does work with the dryness and cracking.

— Anonymous<

During those early stages, I frequently got blocked milk ducts. When I could feel the full duct even after Doug had fed, I'd put on the warming bag (the kind that you heat in the microwave). I'd also take one ibuprofen tablet. The next time I fed him, I'd start with that breast and massage and "milk" the duct as he sucked. Sometimes I'd keep the warming bag on as he sucked. Usually after three or four feedings it would clear.

— Laurie Reid, Toronto

I'm a mom of five breastfed babies, expecting the sixth this month. I think one of the hardest things is the constant demand on your time and body. It helped me to look at nursing as our special time together. You'll have bumps in the road, but don't give up.

– eatonmem

Make a nursing tool kit. Get a basket or tote bag and fill it with things you'll want on hand while nursing: a refillable bottle of water (one with a pop top spout is great for one-handed maneuvering); an energy bar; something to read; baby nail clippers (it's a great time to get those nails, especially if your baby dozes off); a pad of paper and pen (for jotting down all the things you want to do if you ever get a chance); your cell phone; lanolin for sore nipples; a burp cloth; and so on.

– angelinasol

Relax. I continued to pump after I went back to work and was able to breastfeed my firstborn for almost a year. One day at lunch, I came home to pump and my husband was also there. We got into an argument while I was pumping. Normally I would produce plenty of milk in ten to 15 minutes. Apparently I was so emotionally distressed, my milk would not let down. After 20 minutes, I had less than 2 oz, and it was time to go back to work. When I explained to my husband why we didn't have enough milk the next day, he was much more supportive during pumping time. I never would have noticed this unless I was pumping, so I wanted to share with all the breastfeeding moms out there.

– Anonymous

When my son was born, we were told he was tongue-tied but his pediatrician said it wasn't a big deal. I started breastfeeding, and soon I had sores on my nipples. It hurt the whole time he nursed, every time he drew milk out. A week after I left the hospital, I went back to see the lactation consultant, and she reiterated that my baby was tongue-tied. She said that he couldn't extend his tongue far enough to suck properly, and that instead, he was chomping on my breast to get the milk. The next day, we had his frenulum clipped a little (he was fine right afterward, no lasting pain), and now he sucks just fine.

– Sheri

My son was born rooting! But he was also born with a teeny tiny mouth and I have large breasts and large nipples, so we had a rough time getting started. I figured out that if I squish my nipple down, much the same way you squish a cheeseburger, he can latch on and eat to his heart's desire! He is 3 weeks old and growing like a weed. I'm so glad I stuck with it and figured out what works best for us.

– Molly, Goshen, Indiana

Expect the best. While these comments are wonderfully helpful in terms of tangible tips and support, I imagine that some readers who haven't yet breastfed might read them and expect all kinds of difficulties if they choose to nurse. I just want to say that I delighted in breastfeeding for ten years straight (four babies in a row, each into toddlerhood) without a single snag. I'm not boasting – just reassuring readers that they won't necessarily have problems breastfeeding!

– Karen, Iowa

Tongue tie is a VERY common yet very misdiagnosed problem!

So much so it is worth reading about it/checking for it even if things seem to have a different explanation as it can cause reflux, colic, gas and pain.

http://www.mommypotamus.com/a-step-by-step-guide-to-diagnosing-tonguelip-ties/

http://milkmatters.org.uk/2011/04/15/hidden-cause-of-feeding-problems-however-you-feed-your-baby/

http://www.tonguetie.net

Other similar problem is lip tie.

For inverted nipples, AVENT nipplette is supposed to be good!

And dr jack newman is amazing! You can follow him on fb or even email him and he will help!

Just start putting him on the breast hun, as often as you can! Gradually you will be able to replace feed by feed. Is his latch ok?

To increase your supply, take fenugreek, eat oats (good excuse to eat biscuits!), dark chocolate, mothers milk tea, lots of water, can even try non alcoholic beer! Avoid sage, rosemary and various types of mint.

Sounds silly but try putting a bit of his saliva on your nipple even when not feeding as it will send the right messages to your brain to produce more and the right type of milk.

Good luck and do ask more questions! Xxx

VickAHolt is also a good person to ask as she has relactated recently! Xxx

18) RELACTATION TIPS

1. Do not forget the importance of drinking water and resting.

2. You are going to need supportive family, friends and healthcare professionals.

3. Galactagogue medication (Domperidone aka Motilium) helps your breastmilk production immensely. In some countries, this is not available anywhere but online.

4. Galactagogue supplements such as Fenugreek and Blessed Thistle can increase your supply.

5. Get a hospital grade double breast pump.

6. Speaking of pumping, remember the #1 rule of breast milk production: supply = demand. Therefore, you need to pump more frequently than your baby is feeding and pump through the night (yes, really)

7. Skin on skin time with baby has been shown to be effective in helping breast milk production.

8. You can consider purchasing a Supplemental Nursing System (SNS, or Lactaid in the US). This is a device that feeds the baby extra milk at the breast (rather than by bottle) through fine tubes connected to a container worn on a cord around the mother’s neck. This adds stimulation for milk production as the baby sucks and can help bring a baby back to the breast.A Supplemental Nursing System can be used with either formula or breast milk (including donated breast milk*)Ensure you get the help of a lactation consultant, as it can be fiddly and hurt the babies mouth if used incorrectly.

9. Make some lactation cookies. At the very least, they are delicious! The cookies are high in omega 3 (through the eggs and the linseed/flaxseed meal) which is proven to boost breast milk supply. Brewers Yeast is also meant to be a milk supply helper, and is high in protein.Brewers Yeast and Flaxseed/Linseed meal can be found at health food stores. Add your own subsitution for chocolate if you wish – e.g dried apricots, mashed banana, almonds/cashews, coconut, etc.

10. Don’t be afraid to ask for help. Relactating takes time and effort out of an already exhausting day of raising a baby. Accept help! Anyone supporting a relactating mama should consider: baking a batch of lactation cookies, bringing over a meal, offering to help with other children and/or baby. Every bit helps.

Keep in mind: It is difficult, but it may be so worth it!

(source: Kellymom)

19) RELACTATION OR INDUCED LACTATION

Relactation or induced lactation (for those who did not give birth to their baby) is essentially a two-fold process:

You will be teaching (or re-teaching) baby to nurse at the breast, and to equate nursing with comfort.

At the same time you will be developing (or re-developing) a milk supply. Developing a milk supply requires nipple stimulation (via baby nursing, hand expression, pumping or a combination) and milk removal (once there is milk to remove). If your baby will nurse, regular and frequent nursing sessions (even if baby is just learning in the beginning) will be very helpful.

If your baby is 4 months old or younger it will generally be easier to relactate. It will also be easier if your milk supply was well established (frequent and effective nursing and/or pumping) during the first 4-6 weeks postpartum. However, moms with older babies, moms who did not establish a good milk supply in the beginning, and adoptive moms who have never breastfed can also get good results. Keep in mind that breastfeeding is not just about the milk. Your child will get numerous benefits from breastfeeding even if you do not have a full milk supply.

If baby is willing to latch on, then nurse often (at least every 2-3 hours). Also, offer baby the breast for comfort any time you see a chance- at the end of a feeding when he is not hungry, when he is going to sleep and just waking up, and whenever he needs to comfort suck. Even if baby is not getting any milk at first, the nursing will be signaling your breasts to make milk.

What if baby will not latch? Keep working at it – some babies have gone back to the breast after many months of bottle feeding. Even if you are not able to persuade baby to latch, you have the option of re-establishing your milk supply via pumping and giving baby your milk via bottle or cup (this is called exclusive pumping).

If baby is not nursing well (or not yet latching at all), pumping will make a big difference in increasing your milk supply. Even if baby appears to be nursing well, additional pumping will speed up the relactation process.

Consider giving your baby his feedings via an alternative feeding method (rather than a bottle), such as a nursing supplementer, feeding syringe, finger feeding setup, flexible cup, spoon, medicine/eye dropper, etc. If your baby is latching well, a nursing supplementer can be a big help: it will encourage your baby to nurse at your breast by giving him a constant flow of milk (expressed milk and/or formula) while he stimulates your breasts to produce more milk. Read more about nursing supplementers in Notes from “Induced Lactation and Adoptive Nursing”.

Some mothers use herbal supplements, such as fenugreek or blessed thistle, to stimulate milk production. You can usually buy these at health food stores or herb shops and occasionally at some large supermarkets or pharmacies. There are also several prescription medications that increase milk supply. These herbal and pharmaceutical methods for stimulating milk supply will not be particularly effective unless combined with frequent nursing and/or pumping.

Finally, get in touch with a La Leche League Leader or Lactation Consultant/IBCLC (in person if at all possible) who has experience with relactation. It’s great to have one-on-one support as you work through this.

20) EXCLUSIVELY PUMPING

How often to pump and when?

First and foremost – one should have a good quality, double electric pump. Some mothers rent them, others buy pumps. The quality of the pump can make all the difference in the world!

A normal newborn baby nurses on average 8 to 12 times in a 24 hour period. Most experts suggest it is best if mom can come close to matching what the normal nursing baby would do at the breast, and recommend she pump about every two hours, not going longer than three hours between sessions. Understanding how milk production works can help moms in their efforts to establish good milk supply. The more frequently the breasts are emptied, the more milk mother should have. Therefore, if she were to pump at least every 3 hours, for about 20 minutes, she should establish and maintain a good milk supply. In the first couple of weeks, she may also want to pump at least twice at night, but not all mothers do this.

“It’s insanely hard in the beginning but you need to pump every 2 to 3 hours around the clock. Prolactin levels (the hormone that tells your body to make milk) are highest in the early morning hours so mom would want to make sure she is pumping then as well. This is like the 1am to 5am stretch of time. If mom can at least get one pump in during this time, it will really help.

The main concern is to get enough pumps in per day – a minimum of 7 pumps per day. I will say from experience that when I pushed myself to get in 8 pumps per day, my supply REALLY increased. Most of the time, I just couldn’t push myself and ended up with 7 times. And to create a little bit of sanity, it is the number of pumps per day that you get in and not necessarily the amount of time you wait in between pumps that counts. So, if I needed to run an errand or just wanted to get out of the house without dragging my pump along, I would pump every 2 hours in the morning and then have a window of about 4 or 5 hours in the afternoon to do everything and would then pump again every 2 hours in the evening to get my total of 7 pumps in for the day.

That being said, I did NOT get up to pump in the middle of the night if my baby wasn’t awake. I thought that was cruel and couldn’t do it! Ha! The sleep was more important to me (especially after the c-section). A lot of pumping is trial and error and this is why keeping info in a spreadsheet (or journal) is helpful. If you start sleeping through the night or going longer stretches and see a huge decline in your volume, you can always set you alarm to add another pump back in. I never had to but this can vary from mom to mom. I did the early morning pump as long as I was up feeding the baby, but if she slept 5 hours through the night, so did I! ”

Pumping - how long?

Most experts agree that whatever the reason for pumping, moms should pump for about 20 minutes. Most agree its best to pump at least 15 minutes, and to avoid going much longer than 20 minutes. Experts also encourage pumping about five minutes past when the milk stops flowing, often by doing so mom will elicit another letdown, and at the very least will maintain production as well as encouraging increase in supply if needed.

“The standard advice is to pump for 15-20 minutes. Even if you don’t have milk flowing that entire time, you need to pump that long to get enough nipple stimulation. Also pumping at least 5 minutes after your milk stops flowing will tell your body that you need more milk; thus increasing your supply. 15 minutes should absolutely be the minimum pumping time. I’ve talked to women who only pumped for 10 minutes and eventually started losing their supply. They had to work really hard to rebuild it.”

Thanks for the info on expressing! I'm seriously considering doing it this time (had to give up and ff after 6 weeks before) and its great to see advice x

Pump Settings

“More is not better” when it comes to the suction settings on the breast pump. Most experienced moms do not set the pump speed on high, but rather keep it on lower setting for comfort.

“This one was a BIGGIE for me and I want to definitely pass this one on! There should be a suction setting on your pump and a speed dial. This is very important, the higher the suction does NOT mean the more milk you make. Your pump will probably have a suction setting of minimum, medium, and maximum. I had mine set on medium when I developed a blister. Once it healed, I turned it down to minimum and have never had another blister or pain again. I keep the speed at 3 but if you feel like too much areola is being sucked into the horn, then turning down the speed will remedy that. If you are in a lot of pain and turn down the settings, you might actually get more milk because you are more relaxed!”

How much milk per bottle?

Moms may find it surprising that the breastfed baby often takes less milk in the bottle than formula babies take in. This is because breastmilk is so well utilized by the baby’s body that less is needed. Since breastmilk is so easily and completely digested, the breastfed baby needs to eat more often, but they don’t need as much per bottle.

When a baby is nursed from the breast, research shows us that baby will vary their intake of milk from feeding to feeding, and the length of time at the breast doesn’t always correlate with the amount of milk taken from the breast. Overall, the average bf baby takes in between 19 and 30 oz (or 570 – 900 mL) per day (24 hrs), but the amount taken per bottle may vary somewhat from feeding to feeding, just as it does at the breast, depending on baby’s need at the time.

” According to the most current breastfeeding research, exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months. This may vary a little from baby to baby, but the average range of milk intake is 19-30 oz per day (570-900 mL per day).

To estimate the average amount of milk baby will need at a feeding:

Estimate the number of times that baby nurses per day (24 hours).

Then divide 25 oz by the number of nursings.

This gives you a “ballpark” figure for the amount of expressed milk your exclusively breastfed baby will need at one feeding.

Example: If baby usually nurses around 8 times per day, you can guess that baby might need around 3 ounces per feeding every 3 hours when mom is away. (25/8=3.1).

How to bottlefeed with expressed breastmilk

It is important to remember that it is very easy to overfeed a baby using bottles. This is because the way a baby drinks from a bottle is very different than how a baby would nurse from the breast. A baby cannot control the flow of milk from a bottle thus experts recommend using slow flow or “newborn” type nipples, to reduce the risk of overfeeding.

The breastmilk should never be warmed in the microwave, since doing so not only creates hot spots that cannot fully be distributed evenly even when the milk is mixed (the heat adheres to the fats which “glob” together, and can result in scalding of a baby’s mouth and throat), but it actually alters the composition of the breastmilk, damaging some of the nutrients. Shaking breastmilk is also not recommended (gently swirl to mix, instead).

Ideally bottlefeeding the baby should mimic how a mother breastfeeds her baby. The baby should be fed on cue, or demand, and not according to a rigid schedule. Breastmilk digests in about 90 minutes, so one would expect the feedings to be anywhere from 1.5 hrs to 3 hours apart. (younger babies often need to eat more frequently than older babies).

The bottle should be offered gently, in a non-stressful manner, with the baby drawing the nipple into the mouth. The type of bottle or nipple is not as important as the manner in which the bottle is offered. A typical nursing session lasts about 15 to 20 min, and care should be taken to allow baby to take his/her time to drink the bottle, not “rushing” through a feeding as quickly as possible. Changing position mid-way through a feeding is often recommended, as is holding baby is a more upright position. Propping a bottle is also not recommended.

Increasing your supply

There are wonderful tips on increasing milk supply below – those that work for nursing mothers also work for mothers who exclusively pump, the biggest “difference” is that nursing mothers are encouraged to put baby to breast often, and pumping mothers are encouraged to pump often. Probably THE most important thing to remember is to pump often and pump long enough to soften (or “empty”) the breast.

“Some little tips to help increase your supply if you really need it. It’s nice to have these on hand just in case:

First drink plenty of water. I don’t drink a ton but I make sure to stay hydrated. Check your pee when you go (I know, sounds funny!). If it is light yellow to clear, you are plenty hydrated.

Make sure you eat! While you are pumping, you will keep the weight off, I promise! It can make you hungry as a horse and it does that for a reason. You need the extra calories because you are burning so much off! When I didn’t eat enough, I would get really light headed and feel like I was going to drop my baby…not good! Eventually, your hunger should taper off (mine has).

Eat REAL oatmeal, not the instant. You can eat the quick oats (the ones that cook in 1 minute) or the old fashioned oats (that cook in 5 minutes). You can also make cookies that have oatmeal in them and get oatmeal that way (I prefer this way! Ha!). The way they process the instant oatmeal, it doesn’t give you the same results. No one is sure how the oatmeal works but it does!

Get some rest (yeah, I know easier said than done!) If you are exhausted and have the opportunity to take a nap (even if it pushes your pump back) do it! You will actually get more milk that way! Even if you’re not sleeping, rest by sitting down a lot. Conserving energy is important.

Don’t stress too much. This all depends on how you personally handle stress. I tend to be a thinker, so I think things out a lot. It has to be some MAJOR stressful situation for it to hurt my supply.

Some suggest drinking dark beer, with or without alcohol. Some say it’s the barley in it or something, that helps to increase supply. Plus some women just swear by the relaxation it gives them! You can have 1 or 2 beers without much crossing into your milk. (Note: Most breastfeeding experts do not routinely recommend using alcohol to boost milk supply. More on alcohol and breastfeeding here.)

There is a tea called Mothers Milk Tea and it is supposed to increase your supply if you drink it.

There are herbs like Fenugreek and also prescription medications that will increase your supply if you really need it. I would use these as a last resort but they can be effective and are available!

how you personally handle stress. I tend to be a thinker, so I think things out a lot. It has to be some MAJOR stressful situation for it to hurt my supply.

Some suggest drinking dark beer, with or without alcohol. Some say it’s the barley in it or something, that helps to increase supply. Plus some women just swear by the relaxation it gives them! You can have 1 or 2 beers without much crossing into your milk. (Note: Most breastfeeding experts do not routinely recommend using alcohol to boost milk supply. More on alcohol and breastfeeding here.)

There is a tea called Mothers Milk Tea and it is supposed to increase your supply if you drink it.

There are herbs like Fenugreek and also prescription medications that will increase your supply if you really need it. I would use these as a last resort but they can be effective and are available!

Most importantly, good pumping habits will keep your supply up and increase it!”

21) EXPRESSING TIPS

“Go hands free! This was the best trick I learned!! I went hands free and set my pump up by my computer and read my pumping board while I pump. It keeps me from looking down into my bottles wondering how much I’m getting, being bored out of my mind, and makes time FLY by! You can use an old nursing bra and just cut slits in the flap. Then you just slide the horns through. I did this for a while but I didn’t want to wear the cut up bra all day long so that meant I had to literally change bras before each pump. At 7 times a day, that was a bit much!! So, I bought a pumping bra and LOVE it! It’s the Easy Expressions bustier.

The best thing about this bustier is that it can be worn over any nursing bra. So, when it’s time to pump, I put the flaps down on my nursing bra, wrap the bustier around, slide the horns through the holes, position them and zip it up. That’s all!”

“The refrigerator trick. This is where you rinse your horns and/or collection bottles after each pumping session. You put them in a ziplock bag (or not, this is optional), and put them in the refrigerator. The idea is that since breast milk is good in the fridge for 5-8 days, any residue left on the horns won’t matter. Then you can wash the horns/bottles once at night. I throw mine into the dishwasher (all except the white membranes) and it’s easy, easy, easy!”

“Storage bags. Many of us started out using the Gerber Seal-N-Go bag but they get very pricey quickly. They are like $5.50 for a box of 25 bags. After researching it online, I found many other women were using regular freezer bags for freezing the milk….MUCH cheaper! Everything I’ve read shows that they are safe to use. From what I have found, I only buy Glad and not Ziploc. Ziploc seems to have a much higher rate of leaks. I write the date and amount of ounces on the label with a sharpie and put the milk in and freeze flat. I then take several of them and put them into a gallon size freezer bag and write the dates that are enclosed on the gallon bag. This helps by double bagging and keeping them grouped. This way the corners on the bags won’t get poked and possibly cause the bag to leak. Also, whenever I want to get a bag, I can just dig through gallon size bags instead of tons of little bags floating around! : I usually put one or two days worth in a gallon bag.”

“Lube Up! It is perfectly safe to put the lansinoh on before pumping and still use the milk. Putting it on before and after pumping really helps to keep you from getting too sore. Purelan100 is also good (and cheaper). I’ve used this from the beginning. You can also rub Olive Oil on the horns and inside the nipple chamber to reduce friction. Olive Oil is antibacterial so it is helpful. This is also safe to use and pump milk with. I’ve done both of these and hadn’t had a problem. There are times when I seem to get sorer than other times with no real explanation. But, it then goes away as quickly as it came! Who knows!”

“Taking Care of Baby When Pumping. Once I went hands free and had to do those early morning feedings by myself, I would sit on the floor and prop my baby up in her boppy pillow on the floor. I would get hooked up to the pump and start it and pump while I fed her. About the time she was done eating, I was done pumping and I would put her back in bed and go to sleep myself. This will cut down on your time tremendously! It also helps to do this if your pumping time happens to correspond to your baby’s feeding time during the day. The bouncy seat is my best friend! I would put her in the bouncy seat and bounce it with my foot while surfing the net and pumping. It made time fly by and she was content. You may find other solutions if you have older children, or extra help.”

“Taking Care of Older Children, and Pumping. You may not need a lot of tricks for this one depending on the age of the child, or children. They will probably understand if you just explain that while you are pumping, they can’t get up and get things without help. Some tricks other moms had mentioned to keep their other child entertained and kind of reward them would be to go shopping and let your child pick out a special toy or video that she really wants. Then when ever it comes time for you to pump, she can play with it. But, she ONLY gets to play with it when you pump. This helps to make pumping time special for her as well and can help prevent any resentment she might begin to feel.”

things without help. Some tricks other moms had mentioned to keep their other child entertained and kind of reward them would be to go shopping and let your child pick out a special toy or video that she really wants. Then when ever it comes time for you to pump, she can play with it. But, she ONLY gets to play with it when you pump. This helps to make pumping time special for her as well and can help prevent any resentment she might begin to feel.”

Warnings

Excessive caffeine may cause problems (like keeping the baby wired!). I avoid caffeine completely (except chocolate) but even if you have 1 drink a day, it won’t hurt. Just don’t go over board. (More on caffeine here.)

Medications that have Sudafed (pseudoephedrine HCl) in them can affect milk supply! Be careful!

Regular birth control pills will impact milk supply, and some women even have a problem with the mini pill. Breastfeeding (and yes that’s what you are doing even if it’s not from “the tap”) is a good deterrent for ovulation but not 100% so be careful! However, you may find you get hot flashes and things like that. It is normal because your body is acting like it’s going through menopause. This suppresses ovulation and allows you to make milk. I thought I was going crazy until I learned this! Ha! Sometimes if you get your period back while pumping, it can decrease your supply. This can be fixed by taking a calcium/magnesium supplement. (I don’t have mine back yet and loving it!).

When does this get easier?

Around 3 months your supply will probably be established. This is when you can begin to drop the number of times per day that you pump and not see too much of a decrease in total output (this is again, where the spreadsheet comes in handy). That’s why if you do the hard work in the beginning, I promise it will pay off when this time comes! If you don’t keep up the number of pumps per day in the beginning, you may continue to have to pump a high number of times per day just to maintain a small supply. Of course, this is all dependent on how each woman produces milk. So, you may have such a great supply and so much frozen that you can drop pumps earlier. I began dropping pumps at 10 weeks and by 3 months I was down to 4 pumps per day! I lost a little with each drop but am currently at 50 ounces per day. There’s no way my baby will ever eat that much so I see no reason to pump more. You will have to decide for yourself. Once you start dropping pumps, you will need to pump longer at each session (because you’ve gone longer in between pumps and need longer to empty your breasts). This is also dependent on the woman. I pump about 35-40 minutes per pump now on 4 times because I get another let down at about 36 minutes into it!”

“YOU CAN DO THIS!!!

I firmly believe that pumping is 10% physical and 90% psychological. If you try to view this as positively as possible, I think you will have a better outcome. That’s why going hands free and doing everything to minimize your stress about pumping is important.

A lot of people don’t understand pumping. I still get stupid questions like, “Why don’t you just nurse?” Well, DUH! She won’t nurse! Ha! You should do whatever makes you comfortable. Sometimes strangers ask me if I’m breastfeeding and if I don’t feel like dealing with anything, I just say yes. I am after all! She’s just getting it “to go” instead of from “the tap”! Ha!

Mostly though, I do all I can to educate. I know many women who didn’t know this option was even possible and wished they had when breastfeeding didn’t work out. Don’t listen to doctors or nurses who tell you this isn’t possible. There just isn’t enough wide spread info out there and unfortunately most health care professionals give really bad advice (like only pump for 10 minutes). So, when they hear back from their patients on how they had supply problems or dried up, they just assume it’s not possible to pump long term. On my online group, there are women who have been pumping for a year or longer! It is DEFINITELY possible!

22) GROWTH CHARTS AND BREASTFED BABY GROWTH

I have heard of many breastfed babies whose doctor was disturbed at some point because the baby wasn’t gaining weight quickly enough, even though the baby was well within the parameters for weight gain of breastfed babies. The problem is that many doctors are not familiar with the normal weight gain patterns of breastfed babies, and rely too much upon older growth charts that are based upon the growth of artificially fed babies. In 2006, the World Health Organization released revised growth charts that are representative of healthy breastfed babies throughout the world. Until doctors are familiar with them, we need to keep ourselves informed so that doctors don’t undermine our confidence to breastfeed our babies.

Healthy breastfed infants tend to grow more rapidly than their formula-fed peers in the first 2-3 months of life and less rapidly from 3 to 12 months. All growth charts available before 2006 (which are still used by many health care providers in the US) included data from infants who were not exclusively breastfed for the first 6 months (includes formula-fed infants and those starting solids before the recommended 6 months). Because many doctors are not aware of this difference in growth, they see the baby dropping in percentiles on the growth chart and often come to the faulty conclusion that the baby is not growing adequately. At this point they often recommend that the mother (unnecessarily) supplement with formula or solids, and sometimes recommend that they stop breastfeeding altogether. Even if mom realizes that her baby is perfectly healthy and doesn’t follow these unnecessary recommendations, she ends up worrying for no reason (and moms don’t need anything extra to worry about!).

A note about growth charts

A growth chart isn’t a test, where you are striving to get your baby into the 100th percentile. The growth charts show us the statistical distribution of weight, height , etc. in a particular set of babies (or children or adults). So if a baby is in the 50th percentile for weight on the CDC charts, it means that half of the healthy babies of the same age in the US are heavier and half are lighter; if a baby is in the 10th percentile for height, then 90% of babies of the same age in the US are taller and 10% are shorter. Healthy babies, just like adults, can come in all shapes and sizes – a baby in the 3rd percentile can be just as healthy and normal as a baby in the 97th percentile. What doctors are generally looking for on a growth chart is that baby stay relatively consistent in their growth pattern (see above for why this may not happen with earlier growth charts). Growth charts are only one part of the puzzle, however, and must be evaluated along with other factors, including:

◾What size are baby’s parents? What were their growth patterns as babies? What about baby’s siblings or other family members? Genetics plays a large part in baby’s size, so don’t ignore it.

◾Is baby gaining consistently, even if it’s not on a curve?

◾Is baby meeting developmental milestones on or near target?

◾Is baby alert, happy, active?

◾Is baby showing other signs of adequate milk intake?

I don't know if it's been mentioned but if you have a fast let down sometimes the milk can come out a bit too quickly for baby. When your milk is let down take baby off the boob and let the milk flow into a muslin until the flow slows down.

Poo: It's normal when the baby gets a bit older to go up to 10 days without having a dirty nappy. But it's just as normal for baby to go daily or several times a day still. If the poo is green it could be a sign of too much foremilk. If this happens try keeping baby on the same boob for a bit longer.

23) HERBS THAT MAY DECREASE MILK SUPPLY

Using large amounts of the following herbs and other natural remedies should be avoided while nursing because they have been known to decrease milk supply. The amounts of these herbs normally used in cooking are unlikely to be of concern; it’s mainly the larger amounts that might be used therapeutically that could pose a problem. However, some moms have noticed a decrease in supply after eating things like dressing with lots of sage, sage tea (often recommended when moms are weaning), lots of strong peppermint candies or menthol cough drops, or other foods/teas with large amounts of the particular herb. These herbs are sometimes used by nursing mothers to treat oversupply, or when weaning.

◾Black Walnut

◾Chickweed

◾Herb Robert (Geranium robertianum)

◾Lemon Balm

◾Oregano

◾Parsley (Petroselinum crispum)

◾Peppermint (Mentha piperita)/Menthol

◾Periwinkle Herb (Vinca minor)

◾Sage (Salvia officinalis)

◾Sorrel (Rumex acetosa)

◾Spearmint

◾Thyme

◾Yarrow

Herbs that may be harmful to mom and/or baby

Other herbs should be avoided while nursing due to their potential for harming mom and/or baby. Here are a few herbs that are generally considered to be contraindicated for nursing mothers. This is by no means a complete list.

◾Bladderwrack

◾Buckthorn

◾Chaparral

◾Coltsfoot (Farfarae folium)

◾Dong Quai (Angelica Root)

◾Elecampane

◾Ephedra / Ephedra sinica / Ma Huang

◾Ginseng (Panax ginseng)

◾Indian Snakeroot

◾Kava-kava (piper methysticum)

◾Petasites root

◾Phen-fen, herbal

◾Rhubarb

◾Star anise

◾Tiratricol (TRIAC)

◾Uva Ursi

◾Wormwood

24) FOREMILK AND HINDMILK

Foremilk is the milk (typically lower in fat) available at the beginning of a feeding; hindmilk is milk at the end of a feeding, which has a higher fat content than the foremilk at that feeding. There is no sharp distinction between foremilk and hindmilk – the change is very gradual. Research from Peter Hartmann’s group tells us that fat content of the milk is primarily determined by the emptiness of the breast — the less milk in the breast, the higher the fat content.

A woman’s breast really only makes one type of milk, the higher-fat milk that we typically think of as hindmilk. As milk is produced in the breast, the fat globules in the milk tend to stick to each other and to the walls of the alveoli (where the milk is made). Between feedings, milk collects in mom’s breasts and gradually moves out toward the nipple, leaving more and more of the fat “stuck” further back in the milk ducts. The more time between feedings, the lower the fat content of the foremilk available to baby at the beginning of the feeding.

Once the let-down (or Milk Ejection Reflex/MER) is triggered (by baby’s nursing, pumping, etc.), the milk is squeezed down the ducts until it becomes accessible to the baby. Milk production is not faster during letdown – the flow is simply faster. There are several let-downs per feed, although most mothers only sense the first one.

As the breast starts to empty, the fat globules begin to dislodge and move down the ducts (let-down facilitates this process). So the further into the feed, the higher the fat content of the milk, as more and more fat globules are forced out. The end result is that the milk gradually increases in fat as the feeding progresses.

! Your breasts don’t “flip a switch” at some arbitrary point and start producing hindmilk instead of foremilk. Instead, think of the beginning of a nursing session as being like turning on a hot water faucet.

The first water you get out of the tap isn’t usually hot, but cold. As the water runs, it gradually gets warmer and warmer and warmer. This is what happens with the fat content in mom’s milk – moms’s milk gradually increases in fat content until the end of the feeding.

Since fat content is is directly related to the degree of emptiness of the breast, it is possible, depending upon nursing pattern, for fat content to be higher at the beginning of a particular feeding than it is at the end of some other feeding.

! Now think about the hot water faucet again. If there is a long period of time before the faucet is used again, then you go through the “cold to hot” process once more, but if you turn the water on fairly soon after it was used then the water is either pretty warm or still hot, depending upon how long it’s been since the faucet was last on.

This is how it works with mother’s milk too – the longer the time between feedings, the lower the fat content at the beginning of the next feeding. If feedings are closer together, you’re starting off with a higher fat content.

As a particular feeding progresses, fat content increases, milk volume and flow decrease, and milk synthesis speeds up. Because every baby varies in the amount of time it takes him to receive his fill of the higher-fat milk at the end of the feeding, it is important not to switch breasts while baby is actively nursing.

25) GALACTORRHEA (UNEXPECTED MILK PRODUCTION) AND OTHER NIPPLE DISCHARGE

Per Breastfeeding and Human Lactation (Riordan, 2004, p. 80), “Small amounts of milk or serous fluid are commonly expressed for weeks, months, or years from women who have previously been pregnant or lactating.” The amount is most often very small, however, and spontaneous flow (leaking) generally stops within 2-3 weeks. Mothers who have breastfed for a longer duration may be able to express milk for a longer time after weaning. Any stimulation, e.g. checking to see if milk is still there, frequent breast self-exams, friction from a bra , stimulation during intercourse, etc., can cause further production.

If you stop producing milk after weaning and then start again, it could be due to a new pregnancy (or a recent miscarriage).

Schedule a visit with your physician if…

◾you are still producing a significant amount of milk at 6 months after weaning or re-start milk production spontaneously (not associated with pregnancy).

◾you start producing milk and have never been pregnant.

◾you have breast discharge that does not appear to be milk. Discharge may be multicolored and sticky (color is generally green; this is usually a benign condition called duct ectasia), purulent (containing pus; this is generally due to mastitis or an abscess), clear/watery, yellow/serous, pink/serosanguineous or bloody/sanguineous.Per Breastfeeding: a guide for the medical profession (Lawrence & Lawrence, 2005, p. 602), “Most nipple discharges are caused by benign lesions, and many do not require surgical intervention. They could, however, represent a malignant condition and deserve careful investigation. Nipple discharges associated with lactation have a different etiologic incidence profile, but are no less significant.” Per Monica Morrow, MD in “The Evaluation of Common Breast Problems” (2000), “Nipple discharges are classified as pathologic if they are spontaneous, bloody or associated with a mass. Pathologic discharges are usually unilateral and confined to one duct.”

Per Breastfeeding: a guide for the medical profession (Lawrence & Lawrence, 2005, p. 570), “Galactorrhea is characterized by spontaneous milky, multiduct, bilateral nipple discharge. It is thought to result from increased prolactin production, either by the pituitary or by removal of hypothalamic inhibition.” It is not usually a serious problem, but you should always have your health care provider check it out carefully. Galactorrhea can have various causes:

◾Any type of frequent breast stimulation can induce lactation. Other types of nerve stimulation can also cause galactorrhea, including chest surgery/trauma/burns, herpes zoster that affects the chest wall or chronic emotional stress. Per Lawrence & Lawrence (2005, p. 571), “In susceptible women, a visit to the doctor, stress, a pelvic examination, venipuncture, or surgical procedures can produce elevated serum prolactin” which can result in galactorrhea.

◾Galactorrhea can be a side effect of certain drugs including some H2 blockers (cimetidine/Tagamet), oral contraceptives, metoclopramide (Reglan), sulpiride, psychotropic medications (SSRIs, tricyclic antidepressants, benzodiazepines, phenothiazines, thioxanthenes), antihypertensives (methyldopa/Aldomet, reserpine/Serpasil, verapamil/Calan, atenolol), rauwolfia alkaloids, theophylline, marijuana, opiates or amphetamines. It has also been seen as a copper IUD side effect. See also: ◾Some Medications Associated with Galactorrhea (Table 1 from Diagnosis and Management of Galactorrhea by A.K.C. Leung, MBBS & D. Pacaud, MD)

◾Pituitary tumors are the most common pathologic cause of galactorrhea. The most common type of pituitary tumor is a prolactinoma – this is a benign (non-cancerous) tumor. Hypothalamic lesions or disfunction, or pituitary stalk lesions can also cause galactorrhea.

◾Rarely, galactorrhea is a side effect of primary hypothyroidism or thyrotoxicosis.

◾Galactorrhea is sometimes associated with chronic renal failure due to elevated prolactin levels.

26) FORCEFUL LET DOWN (MILK EJECTION) AND OVERSUPPLY

Is forceful let-down the problem?

Does your baby do any of these things?

◾Gag, choke, strangle, gulp, gasp, cough while nursing as though the milk is coming too fast

◾Pull off the breast often while nursing

◾Clamp down on the nipple at let-down to slow the flow of milk

◾Make a clicking sound when nursing

◾Spit up very often and/or tend to be very gassy

◾Periodically refuse to nurse

◾Dislike comfort nursing in general

If some of this sounds familiar to you, you probably have a forceful let-down. This is often associated with too much milk (oversupply). Some mothers notice that the problems with fast letdown or oversupply don’t start until 3-6 weeks of age. Forceful let-down runs the gamut from a minor inconvenience to a major problem, depending upon how severe it is and how it affects the nursing relationship.

What can I do about it?

There are essentially two ways you can go about remedying a forceful let-down: (1) help baby deal with the fast flow and (2) take measures to adjust your milk supply down to baby’s needs. Since forceful let-down is generally a byproduct of oversupply, most moms will be working on both of these things. It may take a couple of weeks to see results from interventions for oversupply, so try to be patient and keep working on it.

Help baby deal with the fast milk flow

◾Position baby so that she is nursing “uphill” in relation to mom’s breast, where gravity is working againstthe flow of milk. The most effective positions are those where baby’s head and throat are above the level of your nipple. Some nursing positions to try: ◾Cradle hold, but with mom leaning back (a recliner or lots of pillows helps)

◾Football hold, but with mom leaning back

◾Elevated football hold – like the football hold, but baby is sitting up and facing mom to nurse instead of lying down (good for nursing in public).

◾Side lying position – this allows baby to dribble the extra milk out of her mouth when it’s coming too fast

◾Australian position (mom is “down under”, aka posture feeding) – in this position, mom is lying on her back and baby is on top (facing down), tummy to tummy with mom. Avoid using this positioning frequently, as it may lead to plugged ducts.

◾Burp baby frequently if she is swallowing a lot of air.

◾Nurse more frequently. This will reduce the amount of milk that accumulates between feedings, so feedings are more manageable for baby.

◾Nurse when baby is sleepy and relaxed. Baby will suck more gently at this time, and the milk flow will be slower.

◾Wait until let-down occurs, then take baby off the breast while at the same time catching the milk in a towel or cloth diaper. Once the flow slows, you can put your baby back to the breast.

◾Pump or hand express until the flow of milk slows down, and then put baby to the breast. Use this only if nothing else is working, as it stimulates additional milk production. If you do this, try to express a little less milk each time until you are no longer expressing before nursing.

Adjust your supply to better match baby’s needs

◾If baby is gaining weight well, then having baby nurse from only one breast per feeding can be helpful.

◾If baby finishes nursing on the first side and wants to continue nursing, just put baby back onto the first side.

◾If the second side becomes uncomfortable, express a little milk until you’re more comfortable and then use cool compresses – aim for expressing less milk each time until you are comfortable without expressing milk.

◾Avoid extra breast stimulation, for example, unnecessary pumping, running the shower on your breasts for a long time or wearing breast shells.

◾Between feedings, try applying cool compresses to the breast (on for 30 minutes, off for at least an hour). This can discourage blood flow and milk production.

◾If nursing one side per feeding is not working after a week or so, try keeping baby to one side for a certain period of time before switching sides. This is called block nursing.

◾Start with 2-3 hours and increase in half-hour increments if needed.

◾Do not restrict nursing at all, but any time that baby needs to nurse simply keep putting baby back to the same side during that time period.

◾If the second side becomes uncomfortable, express a little milk until you’re more comfortable and then use cool compresses – aim for expressing less milk each time until you are comfortable without expressing milk.

◾In more extreme cases, mom may need to experiment a bit with time periods over 4 hours to find the amount of time per breast that works best.

◾Additional measures that should only be used for extreme cases of oversupply include cabbage leaf compresses and herbs.

Even if these measures do not completely solve the problem, many moms find that their abundant supply and fast let-down will subside, at least to some extent, by about 12 weeks (give or take a bit). At this point, hormonal changes occur that make milk supply more stable and more in line with the amount of milk that baby needs.

Sometimes babies of moms with oversupply or fast let-down get very used to the fast flow and object when it normally slows somewhere between 3 weeks to 3 months. Even though your let-down may not be truly slow, it can still seem that way to baby.

27) TOO MUCH MILK: SAGE AND OTHER HERBS FOR DECREASING MILK SUPPLY (if you are weaning your baby off bm)

Sage

This is best used only if you are in the process of weaning, though it may also be used in extreme cases of oversupply when the usual measures are not effective. Be careful with this if you are not in the weaning process! Don’t overdo it once you’re seeing some results.

To use dried sage (Salvia officinalis) for reducing milk supply, take 1/4 teaspoon of sage 3x per day for 1-3 days. You can mix the sage in vegetable juice (for example, V-8), but it won’t mix well into other juices. You can also mix it into other foods. If you don’t like the taste of sage, try putting it into a tiny piece of sandwich and swallowing it whole – peanut butter or something else a bit sticky seems to work best for holding the sage in place. Tear off the corner of the sandwich containing the sage (it should be a very small section) and swallow it without chewing (that’s why you need a very small section).

To use sage tea for decreasing milk supply, infuse 1 tablespoon of dried sage in 1 cup of boiling water (or 20g dried sage in 50 ml boiling water). Steep for 5-15 minutes. Drink 1 cup, 2 – 6 times per day.

You can use a tincture of sage instead: 30-60 drops of tincture, 3-6 times a day.

See Sage for additional safety information for nursing moms.

Cabbage

Green cabbage leaves can also be used topically on the breast to reduce milk supply. Again, be careful with this if you are not in the weaning process.

Jasmine

Another effective treatment is to apply fresh, crushed jasmine flowers (Jasminum sambac) to the breasts to decrease milk flow. A study has shown this to be effective: Shrivastav P, George K, Balasubramaniam N, Jasper MP, Thomas M, Kanagasabhapathy AS. Suppression of puerperal lactation using jasmine flowers (Jasminum sambac). Aust N Z J Obstet Gynaecol. 1988 Feb;28(1):68-71.

Other herbs

Other herbs that can decrease milk supply: Peppermint (Mentha piperita), Spearmint, Parsley (Petroselinum crispum), Chickweed, Black Walnut, stinging nettles (not nettle – that increases milk supply), Yarrow, Herb Robert (Geranium robertianum), Lemon Balm, Oregano, Periwinkle Herb (Vinca minor), Sorrel (Rumex acetosa).

Sage, peppermint, spearmint, lemon balm, oregano, and cabbage leaves can all be incorporated into a pressed oil (cold pressed or hot) to make massage oils for milk suppression.

Peppermint essential oil has been used traditionally for decreasing milk supply. Peppermint tea is a very weak form of peppermint and only large amounts (quarts) would be expected to decrease milk supply. Some women have successfully used the strong peppermint candies (for example, Altoids® Curiously Strong Peppermints) for decreasing milk supply (a few per day aren’t likely to affect supply, though).

28) FAQ ABOUT MILK PRODUCTION

How does milk production change over the course of lactation?

For the first few days, up to and including the point at which mom’s milk “comes in,” milk production does not depend upon milk being removed from the breast. After those first few days, it is necessary for milk to be regularly removed from the breast (via baby or pump) to continue milk production. The breasts will begin to shut down milk production within several days if milk is not regularly and effectively removed.

During the early weeks, assuming nursing is going well, a mom will often have more milk than baby needs. Many moms also experience varying degrees of leaking and/or breast fullness/engorgement in the early weeks — this is not the norm for the entire breastfeeding experience but simply a period of adjustment as mom’s body determines and adjusts to the amount of milk her baby (or babies) actually needs.

In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts). Current breastfeeding research does not indicate that breastmilk intake changes with baby’s age or weight between one and six months. Sometime between six months and a year (as solids are introduced and slowly increased) baby’s milk intake may begin to decrease, but breastmilk should provide the majority of baby’s nutrition through the first year.

After the first 6 weeks to 3 months (or sometimes later – this varies for different mothers), the high baseline prolactin level that is the norm in the early weeks gradually decreases to the lower baseline that is the norm for later lactation. Around this time, mom’s breasts may feel less full, leaking may decrease or stop, let-down may become less noticeable, and pumping output may decrease. These are all normal changes and, on their own, do not mean that milk supply has decreased.

I’m confused about foremilk and hindmilk – how does this work?

Foremilk is the milk (typically lower in fat) available at the beginning of a feeding; hindmilk is milk at the end of a feeding, which has a higher fat content than the foremilk at that feeding. There is no sharp distinction between foremilk and hindmilk – the change is very gradual. Research from Peter Hartmann’s group tells us that fat content of the milk is primarily determined by the emptiness of the breast — the less milk in the breast, the higher the fat content.

What happens between feedings?

Milk is produced at all times, not just between feedings. Between feedings, milk collects in mom’s breasts. Volume of milk stored in the breast is greater when there has been a greater amount of time between feeds. The amount of milk that can be stored in the breast between feedings (milk storage capacity) varies significantly from mom to mom and is not determined by breast size (although breast size can limit storage capacity). For most women there is not a lot of storage room. Although mothers with both low and high milk storage capacities produce enough milk for their babies, mothers with a greater milk storage capacity may be able to go longer between feedings without impacting milk supply and baby’s growth.

Do breasts need time to refill?

Many people mistakenly think of a mother’s milk supply as being like “flesh-covered bottles” that are completely emptied and then need time to refill before baby nurses again. This is simply not how we understand milk production to function.

First of all, milk is being produced at all times, so the breast is never empty. Research has shown that babies do not take all the milk available from the breast – the amount that baby drinks depends upon his appetite. The amount of milk removed from the breast varies from feed to feed, but averages around 75-80% of the available milk.

! Trying to completely empty a breast is like trying to empty a river — it’s impossible, since more milk will keep flowing in while milk is being removed.

Research also tells us that the emptier the breast, the faster the breast makes milk. So when baby removes a large percentage of milk from the breast, milk production will speed up in response.

! Rather than thinking of nursing or pumping as “pouring milk out of a container” think of it as flipping on the “high speed production” switch!

! Yet another analogy: Imagine you are using a straw to drink from a glass of water. As you drink, a friend is very slowly pouring water into your glass. The emptier the glass, the faster your friend pours the water. Would you be able to drink all the water in your glass?

Waiting a set amount of time to nurse your baby (under the mistaken belief that breasts need time to “refill”) is actually counterproductive. Consistently delaying nursing will lead to decreased milk supply over time because milk production slows when milk accumulates in the breast.

29) BREASTFEEDING AND FERTILITY

How can I use breastfeeding to prevent pregnancy?

The Exclusive Breastfeeding method of birth control is also called the Lactational Amenorrhea Method of birth control, or LAM. Lactational amenorrhea refers to the natural postpartum infertility that occurs when a woman is not menstruating due to breastfeeding. Many mothers receive conflicting information on the subject of breastfeeding and fertility.

Myth #1 – Breastfeeding cannot be relied upon to prevent pregnancy.

Myth #2 – Any amount of breastfeeding will prevent pregnancy, regardless of the frequency of breastfeeding or whether mom’s period has returned.

Exclusive breastfeeding has in fact been shown to be an excellent form of birth control, but there are certain criteria that must be met for breastfeeding to be used effectively.

Exclusive breastfeeding (by itself) is 98-99.5% effective in preventing pregnancy as long as all of the following conditions are met:

1.Your baby is less than six months old

2.Your menstrual periods have not yet returned

3.Baby is breastfeeding on cue (both day & night), and gets nothing but breastmilk or only token amounts of other foods.

How can I maximize my natural period of infertility?

Timing for the return to fertility varies greatly from woman to woman and depends upon baby’s nursing pattern and how sensitive mom’s body is to the hormones involved in lactation.

◾Breastfeeding frequency and total amount of time spent breastfeeding per 24 hours are the strongest factors leading to the return of fertility: a mother is more likely to see the return of fertility if baby’s nursing frequency and/or duration is reduced, particularly if the change is abrupt.

◾In some populations, research has shown that night nursing slows the return to fertility.

◾One study showed that mothers who were separated from their infants (but expressed milk to provide 100% breastmilk for baby) had a higher pregnancy risk (5.2%) during the first 6 months (Valdes 2000).

◾The introduction of solid food can also be a factor in the return of fertility. Once baby starts solids (if mom’s cycles have not returned), the natural period of infertility may be prolonged by breastfeeding before offering solids, starting solids gradually, and not restricting nursing.

You can achieve higher effectiveness by practicing ecological breastfeeding:

◾keeping baby close

◾breastfeeding on cue (day and night)

◾using breastfeeding to comfort your baby

◾breastfeeding in a lying-down position for naps and at night

◾using no bottles or pacifiers

If you practice ecological breastfeeding:

◾Chance of pregnancy is practically zero during the first three months, less than 2% between 3 and 6 months, and about 6% after 6 months (assuming mom’s menstrual periods have not yet returned).

◾The average time for the return of menstrual periods is 14.6 months.

◾Moms whose cycles return early tend to be infertile for the first few cycles. Moms whose cycles return later are more likely to ovulate before their first period.

While it is possible for a nursing mom to become pregnant while she is breastfeeding and before she has her first menstrual period, it is rare. Most moms do not get pregnant until after their first period (often referred to as the “warning period”). Even after that, while some can become pregnant the first cycle, others will require months of cycles before pregnancy can occur. Still others (this is quite uncommon) may not be able to become pregnant until complete weaning has occurred.

The transition to full fertility

Several studies have indicated that fertility and ovarian activity return step by step (Ellison 1996, p. 326-327):

1.Follicular activity without ovulation (No chance of pregnancy.)

1a. Menstruation without ovulation (This does not always occur–see below.)

2.Ovulation without luteal competence (After the egg is released, fertilization may take place. During the luteal phase, the uterine lining is prepared for implantation as the egg travels down the fallopian tube and into the uterus. If the uterine lining is not adequately prepared for implantation, the implantation will probably not be successful.)

3.Full luteal competence (Full fertility — at this point breastfeeding no longer has any effect on your chance of pregnancy.)

It is possible to have one or (occasionally) more periods before you start ovulating. In this case, menstruation begins during the first stage of the return to fertility –before ovulation returns. Cycles without ovulation are most common during the first six months postpartum. For other mothers, the first menstruation is preceded by ovulation – a longer period of lactational amenorrhea increases the likelihood that you will ovulate before that first period.

A very small percentage of women will become pregnant during their first postpartum ovulation, without having had a postpartum period. Per fertility researcher Alan S. McNeilly, this “is rare and in our experience is related to a rapid reduction in suckling input.”

It is not uncommon for breastfeeding mothers to report cyclical cramping or PMS-type symptoms – symptoms of an oncoming period without the period – for weeks or even months before their period returns. When this happens, the body is probably “gearing up” for the return of menstruation, but breastfeeding is still delaying the return of fertility.

The amount of time that it takes for the transition to full fertility varies from woman to woman. In general, the earlier that your menses return, the more gradual the return to full fertility.

Do I need to wean to get pregnant?

Probably not. If you are still transitioning to full fertility (as discussed above), breastfeeding may affect the success of implantation. Once implantation is successful, breastfeeding should not affect a healthy pregnancy (see A New Look at the Safety of Breastfeeding During Pregnancy for more information). If your periods have come back and settled into a regular pattern, it is likely that breastfeeding is no longer affecting your fertility.

Many moms can conceive without deliberately changing their toddler’s nursing patterns. There is no “magic” threshold of breastfeeding that will allow you to conceive — every mother is different. Some moms need to stretch out nursing frequency and/or shorten nursing sessions to make it easier to conceive — babies naturally do this themselves as they get older, so one of your options is simply to wait a bit.

Changes that are more abrupt tend to bring fertility back faster (e.g., cutting out one nursing session abruptly, rather than gradually decreasing nursing time at that session) –even if you continue to breastfeed a great deal– this is why many mothers experience the return of fertility when their child sleeps through the night or starts solid foods. If you decide to make changes to your nursing pattern, the time of day that you make the change (e.g., cutting out or shortening a nighttime nursing session as opposed to a daytime nursing session) should not make that much of a difference. Current research indicates that nursing frequency and total amount of time at the breast per 24 hours are the most important factors, rather than the time of day that the suckling occurs.

A few moms do find it impossible to conceive while nursing, but this is not at all common.

Many mothers wonder whether breastfeeding will affect the reliability of pregnancy tests. It does not — pregnancy tests measure the amount of the hormone hCG (human chorionic gonadotropin) in blood or urine, and hCG levels are not affected by breastfeeding. The developing placenta begins releasing hCG upon implantation; a pregnancy can generally be detected with a pregnancy test within 7-14 days after implantation.

30) HUNGER CUES - WHEN DO I FEED BABY?

Babies should be fed when they indicate hunger. Crying is a late indicator of hunger – breastfeeding is much easier for both mom and baby if mom is able to pick up on baby’s earlier hunger cues.

Common infant hunger cues include:

Early

◾Smacking or licking lips

◾Opening and closing mouth

◾Sucking on lips, tongue, hands, fingers, toes, toys, or clothing

Active

◾Rooting around on the chest of whoever is carrying him

◾Trying to position for nursing, either by lying back or pulling on your clothes

◾Fidgeting or squirming around a lot

◾Hitting you on the arm or chest repeatedly

◾Fussing or breathing fast

Late

◾Moving head frantically from side to side

◾Crying

“My newborn wants to sleep all the time! Should I wake him to nurse?”

Yes, if he doesn’t wake on his own. Many newborns are very sleepy in the early days or weeks and may not exhibit hunger cues as often as they actually need to eat. Newborns should be nursed anytime they cue hunger, but at least every 2 hours during the day and at least once during the night. Once your baby has established a good weight gain pattern (at least 4 ounces per week, for babies under 4 months), you can stop waking baby to nurse and let him set his own pattern.

“My baby just started sleeping longer at night. Do I need to wake him to nurse?”

If your baby is younger than 4 weeks, then it is a good idea to wake baby at least every 4-5 hours at night to nurse if he does not wake on his own. If your child is older than 4 weeks, you can allow baby to sleep as long as he wants at night as long as he is peeing, pooping, and gaining weight within normal parameters.

“My baby frequently sucks on his hands. Does this always mean that he’s hungry?”

After the newborn period, hand sucking is not as reliable an indicator of hunger. Starting at around 6-8 weeks, baby will begin to gain more control over his hands and will soon begin to explore his hands and everything else using his mouth. It is also common for babies to suck on their hands when their gums become tender in preparation for tooth eruption. Symptoms of teething can sometimes occur weeks and even months before the first tooth erupts.

31) HANDLING CRITICISM ABOUT BREASTFEEDING

Introduction

Unfortunately, many mothers end up having to deal with criticism about their choice to breastfeed at one point or another. Criticism from strangers happens occasionally, but tends to be easier to deal with since you’re unlikely to see those people again. Criticism from family members and others close to you can be much harder to handle.

Sometimes the people close to you – particularly your parents – feel that when you make parenting choices that are different from their own, it is a personal attack on their own parenting choices. They may truly feel that accepting your parenting choices is the same thing as admitting that their own parenting choices were wrong. It may be helpful to make it clear that your choices are not a judgment on their parenting, but a result of having different information available that you are using to make choices for your own unique child and family.

Always keep in mind that family members and close friends who make negative comments about breastfeeding generally do so because they care for you and your child, even if their comments are uninformed or inappropriate.

Although this information is aimed at responding to criticism about breastfeeding, it can be applied to other parenting decisions as well.

Educate

Many people simply aren’t aware that there are continuing benefits of breastfeeding for mother and child. They do not know that there is a huge amount of research data that supports sustained breastfeeding– particularly regarding the health benefits. State the scientific facts about why breastfeeding is beneficial. Print off some written material and leave it around your house –the bathroom is always a good place! Gently ask the person who is criticizing you to read through it–not for the sake of argument, but for the sake of considering what is beneficial for your child.

Respond to specific concerns

Try to find out exactly why they feel nursing is a problem – this way you can respond to specific concerns and correct any misinformation. Do they think that there are no benefits to baby? Are they worried what others will think? Have they read the research? Have they met other families with children who were breastfed for an extended time?

Let them know how their comments make you feel

It may be helpful to have a heart-to-heart talk with someone who has too many negative things to say about breastfeeding. This unsupportive person may need to hear you say how these comments hurt you and your child (particularly if your child is older), and that you need them to stop. Children often understand a lot more than you realize, and negative comments and actions can be confusing and upsetting to them. Your words may get through, or at least prevent this person from criticizing breastfeeding in your or your child’s presence.

Quote an authority

Some people who will not listen to you will listen to a doctor or other professional. Say that your child’s doctor recommends continued nursing. If your doctor is firmly pro-breastfeeding, take the unsupportive person with you to a doctor appointment so they can hear it for themselves. The American Academy of Pediatrics recommends that “breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired.” The World Health Organization recommends that babies be breastfed for at least two years.

Laugh it off

Some have found humour to be an effective way to hush others. You might come back with something like, “Don’t worry. I don’t think I’ll have to room-in with her when she moves into the dorm at college!”

Avoid the issue

Another way to handle criticism is to do your best to avoid the issue. If the subject of breastfeeding comes up, politely change the subject. Try to go into a different room to nurse to avoid or minimize any direct comments to your child.

Make the subject completely off-bounds

Some parents (particularly when others are very opposed to continued breastfeeding) find it most effective to refuse to argue or discuss the matter at all. It’s sometimes necessary to be nice but firm: “This is my child and my parenting choice and I will not discuss it anymore.” If they DO bring the subject up, answer with the exact same phrase every time (for example, “This is what works for our family”) until they realize that the matter is not up for discussion. If that doesn’t work, then leave.

What if nothing is working?

When you are willing to debate the matter, some people will feel that they have a good chance of convincing you that you are wrong–and thus will continue with their objections ad infinitum. Sometimes a person is not really interested in hearing your reasons, but only wants to keep “wearing you down” until you do things their way. If it’s just an emotional response that they are having, and they can’t give any reasons for it (or keep giving ‘bad’ reasons one after another as soon as you answer, without any intention of stopping or listening to you), then you might be better off with doing things like using humor, avoiding the issue or making the subject off-bounds.

Express confidence in your decision while being as diplomatic as possible (depending upon who you’re talking to). Once they realize that there is no chance of dissuading you, then they may give up the argument, or at least tone it down. Repeat the same statement every time the issue comes up. Eventually it will get through.

“In some cultures it is considered a child’s birthright to be nursed until the age of two. It is believed all your sins are forgiven when you nurse your baby, and an angel stands behind you and pats you on the back when you are done. I like to think of an angel standing behind me every time I nurse. It is a very comforting thought when things aren’t going well. If you can’t get support from your family, at least the angels are behind you.”

– Diane

Responses to criticism that other parents have used

◾“That’s interesting. What makes you think that?”

◾“I’m parenting the way that feels right to me.”

◾“I respect your opinion and value your advice, but I have thought this out carefully and done a lot of research, and my mind is made up. I will be happy to respect your opinion and listen to what you have to say, but you have to respect my decision–and it is MY decision.”

◾“As the mother of this baby, and because of all I’ve learned about the importance of breastfeeding, in my heart of hearts this is what I want – and need – to do for my child right now. If you love us both, you need to support me in this decision.”

◾“You know how the medical community is always changing their recommendations. Well, this is what they recommend now–this is the best I have to go on, and I feel good about breastfeeding.”

◾“We’re working on weaning now.” [Once solids are introduced, you're technically in the process of weaningthough it may take a few years.]

◾“This is what works for our family. Unless it becomes a problem, we’re not going to change things.” [Case closed- -save the arguments for someone who is truly interested in listening to them.]

◾“Why would I want to replace nursing with something that costs money and is nutritionally and immunologically inferior?” [This one is not exactly tactful, so consider who you're talking to before you use it.]

◾Responses to your parents: ◾“Now that I’ve become a mother, I have a new appreciation for what you went through for me, and I’m so thankful to be able to come to you for advice. It especially helps to know that you’re going to support me in my decision to breastfeed, because that means so much to me.”

◾“It’s not that I resent you for not breastfeeding me – I don’t. You made the decision that was right for you and your baby (me). I am making the decision that is right for us.”

◾The “sandwich” technique sometimes works: ◾Say something complimentary first: “I’m so glad you are here to be with my children; Having a loving grandma like you is so important; You are such a wonderful grandma, just like I knew you would be.”

◾Then make the point you are trying to make: “It really upsets me when you criticize my choice and my pediatrician’s recommendation to breastfeed to the degree that I feel I might start to avoid visiting with you.”

◾Then say something nice again: “That would make me sad because I know you love the children and I want them to have you in their life because you are so special.”

khoset - Thanks for your comment hun! Now I see this!! Too busy copying and pasting! Haha xx

Thanks Emily! xx

Great post foulky, sorry my laptop is out of action at the moment otherwise I'd do this myself but can you put some info on about nursing strike please? Both of mine did this and I actually gave up with my first as I couldn't find info or support. There's a good piece on Kellymom about it x

Of course I will, anything to help :-) I'll have a look now. I have a list of things I need to find. I'll put in on the top of my list :-)

32) NURSING STRIKE

The following techniques have proven helpful for a wide range of problems with baby refusing the breast. Some of the babies who might benefit include:

*a newborn (or older adopted baby) trying to figure out how to breastfeed

*a previously-weaned baby whom you wish to breastfeed again

*a baby who seriously resists nursing (or even being placed in a nursing position)

*a baby with nipple confusion

*a baby who is a fussy nurser (but does not completely refuse the breast)

*a baby on a nursing strike

Even if you have a baby who adamantly resists nursing, getting your baby to breast is very possible but it will probably require time, patience, and kangaroo-style frequency. Expect “two steps forward and one step backward.”

If you have a newborn who is not latching on, do keep in mind that almost all reluctant nursers will start latching by four to eight weeks of life.

The Basics

Follow the Rules

The two primary rules when you have a baby who is having problems nursing are:

Feed the baby. A baby who is getting the right amount of calories and nutrition is best able to learn how to nurse. First choice for what to feed a non-nursing baby is mom’s own milk, second choice is banked milk from another mom, third choice is infant formula.

Maintain milk supply. If mom’s milk supply is being maintained with an appropriate frequncy and amount of milk expression, more time is available for baby to learn to nurse, and baby’s efforts will be better rewarded (with more milk).

Suggestions for a typical nursing session

Very careful, supportive positioning can be very helpful when baby is having problems breastfeeding; for example, a cross-cradle hold or a modified football hold can be useful.

If your baby is tolerating it, then work on latching for up to 10 minutes or so. If baby is getting upset, then go with shorter sessions. It’s not a good idea to keep trying for more than about 10 minutes – after this baby will be tired, latching will be harder, and there is a risk of baby developing an aversion to the breast if you persist too much.

Don’t continue trying to get baby to take the breast after major frustration (either mom’s or baby’s) sets in; stop for a bit and calm baby (and/or give mom a break) before continuing – let baby suck on a finger, or snuggle baby high up between mom’s breasts, or hand baby to dad.

Sometimes it can be helpful to offer a little supplement at the beginning of a feeding; this can take the edge off baby’s hunger so he has more patience to work on the breastfeeding. If you’ve been working on latching and hunger is getting in baby’s way, go quickly to whatever alternative feeding you’re using.

If you’re both totally frustrated, give a whole feed, but if you think your baby is up for it (and you are too), only offer enough supplement to calm him and go back to working on breastfeeding.

If baby does not latch or does not suck effectively (or won’t sustain a suck for more than 3 sucks even with breast compressions), then either try supplementing at the breast (see below) or stop and offer baby a little supplement (1/2 ounce or so of expressed milk or formula), and then have another try at nursing. If the second try is unsuccessful, then go ahead and finish up the feed with whatever method of supplementation you are using.

Any time that baby does not nurse at all, or nurses but does not soften the breast well, pump after feeding baby. This will help to maintain your milk supply, plus you will have some “liquid gold” available the next time baby needs a supplement.

Feed the Baby!

Do not try to starve your baby into nursing. Your baby is not refusing to nurse just because he doesn’t want to and is being stubborn, so ignore anyone who tells you that “baby will nurse when he gets hungry enough.”

In general, a baby who won’t nurse, can’t nurse. Your goal is to (hopefully) identify why baby can’t nurse and either remedy the problem, work around the problem, and/or preserve your milk supply until the problem remedies itself (sometimes necessary for ill, small or premature babies). A board-certified lactation consultant is a great partner to have in this process.

Keep baby as full and happy as possible, i.e. continue to offer expressed mother’s milk, banked milk, formula or solids (if baby is old enough), but gradually get closer and closer to the nursing position, skin-to-skin, etc. Click here for tips for weaning from formula supplements.

Maintaining milk supply when baby is not nursing

It is important to express your milk to maintain milk supply while baby is transitioning to full breastfeeding.

Coaxing baby to the breast

General tips

Your goal is to coax baby to the breast. Do not attempt to force your baby to breastfeed. Forcing baby to the breast does not work, stresses baby, and can result in baby forming an aversion to the breast. As baby gets better at nursing and is able to get more milk via nursing, he will grow to trust that breastfeeding works and will have more patience when latching.

Wear clothing that allows very easy access to the breasts. Baby may get very impatient in the split-second it takes for mom to lift the blouse and undo the bra. Spend time, if possible, in a warm place that allows both mom and baby to be naked from the waist up.

Lots of skin-to-skin contact can help your baby nurse better and even gain weight faster. Keep your baby with you as much as possible, and give him lots of opportunities to nurse (even if you’re not successful). Get skin-to-skin with him, first when he is sleepy, right after a bottle feed (or however you’re supplementing). This way baby has the opportunity to sleep and wake up happily, skin to skin at mom’s chest, and mom is right there to catch the earliest hunger cues. If baby moves toward the breast and then falls asleep before even mouthing the nipple, or after sucking twice, then these are positive baby steps, not failures. (Read more about kangaroo care or take a look at the book.)

Offer the breast often. Try breastfeeding in baby’s favorite place, in his favorite position, in the bath, while walking around, while lying down, with baby upright, baby flat on his back, in his sleep, just as he is waking, any time baby looks as if he might be interested, or any other way you can think of, i.e. any time, anywhere.

Avoid pressuring baby to nurse. Offer in an ultra-casual way and pretend you don’t mind if he refuses (easier said than done, but try not to show any frustration – your aim is to avoid pressuring baby to nurse). Don’t hold the back of baby’s head or push or hold baby to the breast. If baby pulls off the breast, then don’t try to make him go back onto the breast at that time – simply try again later. If baby seems frustrated with your offering the breast, then turn the pressure down and simply make the breast available (lots of skin-to-skin!) without offering. It can be helpful to have lots of skin-to-skin time with baby where he is cuddled at the breast with no pressure to nurse – give control over to your baby, so that baby decides if and when to nurse and when to stop nursing.

Carry your baby close to you (a sling or other baby carrier can help with this). “Wear,” carry, hold and cuddle your baby as much as possible; carry baby on your hip while doing other things, play with baby, and give baby lots of focused attention.

Sleep near your baby. If baby sleeps with you, you’ll get more skin-to-skin contact, plus baby has more access to the breast (see this information on safe co-sleeping). If baby is not in the same bed, have baby’s bed beside your bed or in the same room so that you can catch early feeding cues, breastfeed easier at night, and get more sleep.

Nipple shields can be helpful at times for transitioning baby to the breast. Talk to your lactation consultant about using this tool.

Comfort nursing is often the first to come, followed by nutritive nursing. Offer the breast for comfort any time you see a chance- at the end of a feeding when baby is not hungry, when baby is going to sleep or just waking up, when baby is asleep, and whenever he needs to comfort suck If your baby is actively resisting nursing, then try encouraging comfort nursing after baby is comfortable with skin-to-skin contact. After baby is willing to nurse for comfort, you can then proceed to working on nursing for “meals” as well.

“Instant Reward” techniques

For a newborn who is not latching or an older baby who does not want to wait for letdown, try these techniques that help to teach (or re-teach) your baby that nursing is a way to get milk:

Hand express or pump until let-down, just before trying to latch baby, so that baby gets an instant “reward” for latching on.

Another way to elicit let-down is by doing reverse pressure softening.

If you are using a nipple shield to transition to nursing, try filling the tip of the shield with expressed milk prior to applying the shield and latching, so that baby gets some milk first thing as he latches.

Drip expressed breastmilk (if you have it) or formula onto the tip of the nipple as you’re latching (use an eyedropper or a bottle). You can continue this while you’re breastfeeding: Just drip milk toward the center of baby’s upper lip; let the drop start on the breast and roll down toward the center of the upper lip (12 o’clock position if you’re using the football/clutch hold), one drop at a time. A curved tip syringe can also be used to drip milk into baby’s mouth.

Use a nursing supplementer to increase milk flow at the breast.

If baby starts breastfeeding but stops sucking as soon as the milk flow slows, breast compressions can speed the flow of milk. If this is not sufficient, the last two methods above can also be used.

Thanks foulky!

And just to reassure anyone who experiences nursing strike, I know how upsetting, depressing, distressing and frustrating it is but with the tips above and patience it will pass :-) x

Skin to Skin/Laid-Back Breastfeeding

Keeping baby skin to skin with mom and “laid-back” breastfeeding techniques can both be very helpful when encouraging baby to breastfeed. One technique used to get babies to accept the breast has been called rebirthing, but this is essentially just laid-back breastfeeding in the bath. Mom gets into the bathtub, full of warm (not hot) water with baby.

Place baby on mom’s tummy, in the water. Stroke baby, talk to baby. This may take time, but baby may begin to work his way up to the breast, search it out, and begin to suckle. It’s important to have a support person with mom when doing this, for the safety of the baby.

Working with a baby who is actively resisting nursing

Make sure that a physical problem is not causing baby to resist nursing. Could baby have a birth injury or other condition that makes positioning for nursing painful? Is baby having problems with breathing while nursing or coordinating sucking and swallowing? Does baby have an overactive gag reflex that makes nursing uncomfortable? Does baby have severe reflux that makes feeding painful? Does baby have a sore throat from suctioning or other medical interventions? These are just some of the things that might interfere with breastfeeding.

Sometimes a baby will aggressively refuse the breast for no discernable reason – this baby will often resist being held, and may also be easily overstimulated. These babies can be transitioned to breastfeeding, but it should be done very gently so that baby becomes comfortable with being at the breast.

La Leche League’s Breastfeeding Answer Book lists the stages that these babies go through as they transition to breastfeeding:

* The baby aggressively fights the breast.

*The baby cries more while being held than when he’s put down.

*The baby is willing to be held in some positions, even if not in a cradle hold.

*The baby tolerates being held in the cradle hold.

*The baby will attempt to root.

*The baby will lick at the milk on the nipple.

*The baby will attempt to suck, using and in-and-out movement.

*The baby will take milk at the breast.

*The baby nurses well, even before the let-down occurs

Some babies will become more resistant the more you press the issue of nursing. If you’ve been working hard to get baby to latch and baby is resisting nursing, it can be helpful to step back for a bit, take the pressure off both yourself and baby, and not try to latch baby at all for a few days. Then slowly and gently work on moving baby through the above stages.

Start out by bottle feeding (or using whatever form of alternative feeding you prefer) in the feeding position you usually use, without trying to nurse. If baby resists being held in the beginning, it might be helpful to feed baby in an infant carrier or perhaps while holding baby so he is facing away from you.

Work with baby until he becomes comfortable being held in any position, then being held in a nursing position.

Once baby is comfortable being held in a nursing position, start trying more skin-to-skin contact.

Don’t actively try to get baby to latch before he is comfortable with skin-to-skin. You want baby to be able to trust being at the breast and cuddling at the breast without the stress of trying to latch.

When baby is comfortable cuddling at the breast, try feeding (bottle, etc.) at the breast. You’re working to get him comfortable with feeding in a breastfeeding position, skin-to-skin.

Next step, start offering the breast for comfort when he’s really relaxed and sleepy, or even asleep. Nursing in the side lying position might be helpful, as this positioning allows for less body contact. Some babies will take the breast after bottle-feeding or partway through a bottle-feeding.

Once baby is willing to take the breast for comfort, begin to work toward full breastfeeding.

Bottles – yes or no?

Many experts suggest that baby not get bottles or pacifiers while he is learning to nurse correctly, with the idea that his need to suck will help the process along (nursing will satisfy the need to suck). Of course, if you’re working with a baby who has nipple confusion, it’s best to avoid bottles (when mom and baby are together, in particular) until nursing is going well again. If baby is not latching on at all, you do need to balance this with your baby’s need to suck and comfort level.

Do consider giving your baby his feedings via an alternative feeding device other than a bottle, such as a nursing supplementer, feeding syringe, finger feeding setup, flexible cup, spoon, medicine/eye dropper, etc. A nursing supplementer can be a big help if baby is latching well: it will encourage your baby to continue nursing by giving him a constant flow of milk (expressed milk or formula) while he stimulates your body to produce more milk.

If you prefer to use a bottle for supplementing baby, it’s not the end of the world (or your breastfeeding relationship). For some moms, using a bottle is easier and more familiar. If you feel that using a specialized feeding device (like a finger feeder or SNS) is simply too overwhelming and other methods (cup, dropper) are not working for you, using bottles may make it easier for you to continue working on the breastfeeding. Although bottles can certainly have their disadvantages, a good lactation consultant should be able to help you to transition to breastfeeding with or without the bottles.

When using a bottle, encourage baby to open wide prior to giving the bottle. Stroke baby’s lips from nose to chin with the bottle nipple, and wait until baby opens wide like a yawn. Allow your baby to accept the bottle into his mouth rather than poking it in. This will teach your baby to open wide for feedings, which is a good start to getting on the breast effectively.

Nursing Strikes

When babies abruptly stop nursing, it’s a nursing strike – not weaning. Babies rarely wean on their own before 18-24 months, and self-weaning is almost never abrupt.

Will baby nurse while asleep or just waking up? This is usually one of the best times to try. You also might try nursing lying down or while walking around. See also the tips at the top of this page for persuading baby to nurse.

As long as baby is not nursing as often as before, you’ll want to express milk to maintain your supply, stay comfortable, and reduce the risk of plugged ducts and mastitis.

This is a great post, you've been working hard! I thought bf for 16months I knew quite a bit, but I've come across a lot of new info, defiantly helpful for this time around! Defiantly love the promotion of bf it's such an amazing thing that I would love to see become more normalised especially amongst younger mums where the concept can seem even more strange. I was the only one amongst my friends that bf and got a lot of negative comments but I do not regret my decision in the slightest, I did what was best for my baby and for that feel proud! For me it was without doubt one of the best parts of becoming a mother.

Whoa! Have you read it all?! Fair play to you :-) thanks for sharing that Jada! :-) I agree about the fact that bf should be normalised. I'm going to look for info regarding the laws on bf next as I have read somewhere that it's illegal to ask a bf mother to leave the premises to bf. Hopefully knowing where women stand with the law will help normalise bf too. All bar one of my friends breastfeed. So it's quite 'normal' in our group. I think I still would have bf anyway because it's the norm in my family too. My brother and I were bf for a year, so were my parents, their siblings, my cousins etc. When I had a doll as a child I would put her on my chest under my jumper! Hehe. Looking back now I think that's so funny! And so innocent! ?

Haha yeah about 85% of it! I do like a read :) it's a lot easier when all the information is on one page to so this is going to be extremely helpful to any one with bf problems or wondering where to begin!

That's what I thought! We're similar, I love to read too. :-) I've read it all at least 3 times (sad aren't I?) lol. But I thought at least people can skim read it? The main headings are clear I think? If only I had an index.... Sigh

It's definitely helpful having it all in one place. I haven't read it all but what I did read was very informative and I've also learnt something new after bf my first for a year and now nearly 12 weeks into bf my second.

Definitely the norm in my family to bf, I'm from Norway and you very rarely see a ff baby there so for me it was really a no brainer how I wanted to feed my kids.

33) BREASTFEEDING AND THE LAW

What does the law say?

The new EQUALITY ACT 2010 says that it is SEX DISCRIMINATION to treat a woman unfavourably because she is breastfeeding. It applies to anyone providing services, benefits, facilities and premises to the public, public bodies, further and higher education bodies and association. Service providers include most organisations that deal directly with the public. Service providers must not discriminate, harass or victimise a woman because she is breastfeeding.

Discrimination includes refusing to provide a service, providing a lower standard of service or providing a service on different terms. Therefore, a cafe owner cannot ask you to stop breastfeeding or refuse to serve you.

(IF THEY ASK YOU TO STOP OR ASK YOU TO LEAVE THEY ARE BREAKING THE LAW!! YOU ARE LEGALLY PROTECTED TO BF IN PUBLIC!! QUOTE THE EQUALITY ACT AND TELL THEM IT'S SEX DISCRIMINATION TO ASK YOU TO STOP AND IF THEY ASK AGAIN YOU WILL BE SEEKING LEGAL ADVICE!!

STAY PUT AND CARRY ON MAMA)

How long does protection apply for?

There is no age restriction, the law protects you for as long as you wish to breastfeed your baby.

Where can a woman breastfeed?

You are protected in public places such as parks, sports and leisure facilities, public buildings and when using public transport such as buses, trains and planes. You are protected in shops, public, restaurants and hotels regardless of how big of small. You are also protected in places like hospitals, theatres, cinemas and petrol stations.

That's definitely useful to know. I knew there was a law protecting bf women but never actually seen it in writing.

You're welcome :-)

Additional protection in Scotland

In Scotland a person has a right to breastfeed or bottle feed a child under two and it is a criminal offence to try to stop or to prevent a woman from feeding a child under two in any place in which the public has access and in which a child under two is entitled to be. Anyone who tries to stop or prevent a person feeding milk to a child under the age of two can be prosecuted and can face a claim under the Equality Act.

Employers are responsible for ensuring that their staff are fully aware of the law. If an employee tries to stop or prevent a woman from breastfeeding in the course of their employment, the employer may also be liable even if they were unaware of the incident. You should complain to the employer in the first instance and, if necessary, you can report the matter to the police.

Does the law change once the child is over 2?

Are there some places where I cannot breastfeed in public?

Yes, it is not against the law to prevent a woman breastfeeding in a service which is a SINGLE SEX SERVICE FOR MEN. This single sex service must be JUSTIFIED, for example, where only one sex needs it or one sex needs the service more than the other. Voluntary groups or charities set up specifically to benefit one sex may be acting lawfully if they exclude women. Religious organisations may offer services to one sex if it is in line with the doctrines of that religion. In some cases, where single sex services are justified, it would be reasonable to object to members of the opposite sex being there.

It is not against the law to prevent a woman breastfeeding where there are LEGITIMITE HEALTH AND SAFETY REASONS, for example, near to certain chemicals or radiation.

Good question Jada, I'll find out now. My understanding at the minute is that the Equality Act 2010 applies to England and Wales but there is also an Equality Act in Scotland which covers children up to two - where they can't ask anyone to stop giving a child under 2 milk - if it's from breast or from a bottle.

I'll correct myself if I find otherwise and if I can't find the answer I'll ask my cousin's husband who is a solicitor - he may know.

Tbh I think people would be scared once educated to ask anyone to stop bf plus how can they know/prove the child is 2 or older?

I found this in the midst of researching, thought it would be good to share.

Source: BBC news (2005)

Law ensures breastfeeding rights

The Breastfeeding (Scotland) Act has come into force

A new law giving mothers the right to breastfeed in public has come into effect.

The legislation makes it an offence to stop nursing mothers from feeding their babies in places like bars, buses and shopping centres.

Businesses who break the law risk a fine of up to £2,500.

The new rights were intially proposed by the Labour MSP Elaine Smith, who hopes to increase breastfeeding rates, and passed by parliament in November.

MSPs voted by 103 to 13 to bring the Breastfeeding (Scotland) Bill into force last year.

The new law covers breastfeeding women as well as anyone feeding milk to toddlers in licensed premises where children are already allowed to enter.

Conservative politicians (SURPRISE SURPRISE) voted against the proposals and were in favour of a voluntary code of practice, branding the move an example of "the nanny state taken to the extreme".

The closest I came to find the answer was this (it's from a woman named Sandra who posted about it on netmums)

In Scotland babies up to the age of two now have the legal right to be breastfed in public, as long as the baby has a right to be in that place ( ie the law would not extend to a club for instance that does not admit under 18s)

If a baby is being fed and a member of staff asks the mother to stop or leave then the owner of the establishment can be prosecuted.

This does not mean that it is illegal to breastfeed a child over the age of 2 in public, simply that the older children do not have the same protection. An age had to be stipulated legally for the actual substance of the bill, Elaine Smith the politician who worked this bill through parliament really would have preferred no limit - but for legal reasons a limit had to be defined- or perhaps 5 years, but there was a lot of opposition in the house ( PROBABLY FROM CONSERVATIVES!) which meant the bill may not have been passed at all. 2 years was chosen to fit in with the WHO recommendations that this is the minimum duration of breastfeeding for optimum health.

How are things progressing in England over legal changes? I believe a slightly different tack is being taken, in that the law is being pressed under gender discrimination.

In Scotland we had to take this law forward under the child health legislation, as gender laws are non-devolved, ie the Scottish Parliament can't change them.

In any case it actually proved to be much simpler the way we did it up here, you may notice the the wording of the law says that it is a "child's " right to be breastfed in public, rather than a "mother's right " to feed in public. This is because the bill has been passed to improve babies health rather than women's rights.

Ahh your good!! It's a shame it can't be more straightforward really, it would just be nice if it was accepted as the norm even beyond 2 like it is in a lot of cultures.

Chances are the bosses have told them to let bf/ff mums be full stop! It's serious stuff!

Ooohh Jada, you've reminded me! I need to post about self-weaning! And bf norms around the world. Off the top of my head I believe the world-average age of self-weaning is 4.5 years! In the west we tend to frown upon babies older than 6 months being bf, unfortunately! My son is nearly 14 months and we're still going strong! I questioned a treatment I was offered by a consultant a while back as I couldn't bf on it. I refused to use it and demanded another treatment! We do need to stick up for ourselves and for our babies more when it comes to breastfeeding! I'm going to let my son self-wean. I'm all for extended breastfeeding myself.

34) WEANING (stopping bf)

Child-led Weaning

Child-led weaning occurs when a child no longer has a need to nurse – nutritionally or emotionally. A baby who self-weans is usually well over a year old, is getting most of his nutrition from solids, is drinking well from a cup, and cuts down on nursing gradually. If children are truly allowed to self-wean in their own time, most will do so somewhere between the 2nd and 4th year. Obviously, some will wean before this time and some will wean after this time, too.

Mother-led Weaning

If you feel that you need to encourage weaning before your baby is truly ready, it is possible to gently and lovingly “help” your child along the way, while at the same time remaining as flexible and as respectful to his needs as possible. Some children, even though they’re not truly ready, can be gently weaned without too much of a protest. It’s important to always conduct mother-led weaning in a way that is gentle, gradual, flexible, patient, and as respectful to your child’s needs as possible. Be aware of any signs that the weaning process is going too quickly for your child and be ready to slow things down some if necessary.

If you want to take an active approach to weaning before baby show signs on his own, you might consider waiting until at least the age of 18 months. At this age most children can be told “no” and asked to wait on nursing more easily than a younger child can.

Sudden Weaning

Stopping breastfeeding abruptly, or “cold turkey,” can be very distressing for both mother and baby and can cause plugged ducts, breast infection, or even a breast abscess. Hormone levels are also more likely to take a drastic plunge, causing mood swings, depression, etc. It’s very rare that sudden weaning is truly necessary. If someone suggests to you that this is required, get a second opinion. It would also be helpful to talk to a lactation consultant and/or a La Leche League Leader, who will be able to suggest alternatives and, if necessary, help you to wean with as little distress to mom and baby as possible.

Gradual Weaning

Gradual weaning allows you to gradually substitute other kinds of nutrition, affection and attention to compensate for the loss of nursing. Gradual weaning also allows the immunity levels in your breast milk to increase (as overall milk supply decreases) and thus give your child a last bit of extra protection against infection. Weaning should occur as slowly as your situation permits to make it easier on both you and your child.

How long weaning takes depends upon too many variables to predict. Be as patient and as flexible as you possibly can. Weaning will happen, but you may feel at times that you’re taking one step forward and two steps back. When you’re actively weaning, be sure to offer lots of cuddling and extra affection during the day. As your child grows older, nursing becomes much more than a way to satisfy hunger and thirst. It provides him with much comfort, security and closeness, so be as sensitive to his needs as you possibly can be throughout the process.

Partial weaning

Weaning is not an all-or-nothing process. You can always keep one (or more) feedings per day and eliminate the rest.

Yeah I've read that and I was shocked at the age as in western society you get so much negativity when ur baby is no longer 'small', it does put it into perspective that extended bf is not as uncommon as people would think, this is how it would of been before civilisation came about and is I believe a part of our make-up as humans as every other mammal 'self weans' at different stages.

35) TIPS FOR AVOIDING PREMATURE WEANING

Keep breastmilk primary in baby’s diet during the first year

If you feel that your milk supply is low, take measures to increase it.

Offer breastmilk first, before any solids, through at least the first year. Don’t let solids become more important than breastmilk during the first year.

Increase solid foods gradually. An example of a gradual increase in solids would be 25% solids at 12 months, 50% solids at 18 months, and 80% solids at 24 months.

Sugared drinks (and juice, too) are “empty calories” and will keep baby from feeling really hungry – limit or eliminate these.

Water can also fill baby up and decrease nursing frequency.

Minimize the risk of baby developing a preference for the bottle or cup

Limit (or eliminate) bottles. If baby must be supplemented due to separation from mom, then only use bottles when you are physically separated from baby. Use a newborn-flow nipple, no matter how old your baby is, to reduce the risk that baby will grow to prefer the fast flow of a bottle. If baby is older than six months, seriously consider using a cup rather than a bottle.

Limit or eliminate pacifier use when you are with baby, so that your baby’s desire to suck encourages him to nurse more often.

Avoid allowing baby to walk around with bottles or sippy cups.

If baby is very busy and doesn’t want to stop and nurse

Try different and novel nursing positions in which he can have more control and perhaps see what’s going on around him – baby standing up, sitting on your lap facing you, etc.

Try singing, talking, telling stories, playing finger games, reading, etc. while nursing.

Try wearing a nursing necklace or bright colored scarf to help hold baby’s attention when nursing.

Give baby a small toy to hold and play with when nursing.

Be aware of your own subtle cues that encourage weaning

Offer baby the breast often; don’t wait until he “demands” to nurse. Be aware that the “don’t offer – don’t refuse” method of breastfeeding is a weaning technique.

Be available to nurse when baby wants to. Saying “not now, but later” is certainly part of the natural give and take of a nursing relationship as your child gets older, but don’t overuse it and don’t forget the “later” part – offer to nurse later, rather than waiting for baby to ask.

Diversion/distraction by mom is a weaning technique, particularly if used frequently.

Avoid limiting times or places for nursing. This is another weaning technique.

Allow baby to nurse at night if he wishes. Baby will nurse more often if he is in your room and/or bed, and many families get more sleep this way.

If you feel you need to phase out night nursing before baby does it on his own, then it may be helpful to make a conscious effort to increase daytime nursing.

Keep in close contact – carry and hold your child often. This will make breastfeeding more accessible to baby. Restricting access to nursing is a weaning technique.

Does anyone know if there's a formula feeding information thread?

Not as far as I know hun, maybe someone will start one? What would you like to know about formula feeding? I could try to answer or look for the answer for you? Or, I'm sure you could post a question in this forum as there are many ff mums on this forum? Good luck! :-)

I've just had a look for you now there's TONS of tips on ff in the 'tips' post, which is the other sticky on here.

Daisysmummy has created a group for ff feeding UK a while ago xxx

36) BREASTFEEDING FACTS (that haven't already been mentioned)

>Breastfeeding aids in the uterus returning to original size after birth.

>Breastfeeding causes the release of a hormone called Oxytocin. Oxytocin is also responsible for the contraction of the uterus and therefore helps to decrease the size of the uterus after birth.

>An average breastfeed lasts 16 minutes.

>You only produce a small amount of milk in the first few days

>This milk is called colostrum

It is only produced in small amounts because that is all your baby needs. He only has a very small tummy and only needs a small amount to fill it.

>This milk is rich in special goodies to help your baby's immune system and provides an excellent start in life

>After around day 3 or 4 you gradually produce more milk and the production adapts to your baby's demands.

>Almost three-quarters of mums produce more milk with their right breast.

>Babies instinctively know how to get your milk quickly and efficiently - they start breastfeeding with a faster suck for stimulation until you let-down. Then when your milk is flowing, they switch to a slower, deeper suck and eat until they’re full.

>Breastfeeding reduces the exposure to sugar - the only sugar a baby should have or even needs, is lactose. This is the harmless sugar found in breastmilk. sucrose is the alternative and can cause damage to erupting teeth.

>About a third of moms can’t sense 'let-down' -'let down' is when your milk starts to flow

it can also be called milk ejection

>The average time it takes for let down to happen is 56 seconds.

>Your baby controls your breastmilk flow with an instinctive action that includes sucking, swallowing and breathing - milk flows only when your baby moves his tongue a certain way whilst holding onto the breast. He is able to pace himself and only sucks and swallows when he wants.

Your baby can also pause and breathe regularly without letting go of the breast!

>Babies breastfeed until they’re full not until they 'empty' your breast. On average, babies remove 67% of the milk you have available – this amount can vary widely among moms.With bottle feeding, a baby will generally feed until the bottle is empty

>Breast size is not important! No matter what size you are, you’ll make enough milk for your baby - A cups rejoice!

>Your milk sprays out of many holes, not just one. The average amount of openings in the nipple is 9, with some even up to 18

>73% of mothers get outside help for breastfeeding problems

it is so important to ask for advice or help if you need it.

>82% of mothers use a breastpump - whether it is because of going back to work or to help overcome a temporary separation or problem, a breastpump is a valuable tool

>Breastfeeding exposes your baby to many different tastes and smells. Early exposure to different flavours can influence a child's acceptance of food when weaning

>Breastfeeding can help prevent cancer and reduces risk of osteoporosis. In countries were breastfeeding rates are higher, the commonest female cancers, ovarian, uterine and breast, are reduced.

>Breastfeeding also helps reduce the risk of osteoporosis later in life

>Breastfeeding contributes to a better environment. Breastfeeding is energy efficient - no need to boil water/ wash/ sterilise

-less wastage with breastfeeding

I'm still in the early stages but this is very helpful. Thank you xxx

I'm glad you find it useful :-) xxx

37) EXTENDED BREASTFEEDING FACTS (bf over the age of 1)

Breastfeeding contributes to your child’s NUTRITION

>“Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant.”

– Mandel 2005

>In a study of 250 toddlers in western Kenya, breastmilk provided, on average, 32% of the child’s total energy intake. “Breast milk made an important contribution to the fat and vitamin A intakes of toddlers in this community.”

– Onyango 2002

>“Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.”

– Dewey 2001

>In the second year (12-23 months), 448 mL of breastmilk provides:

29% of energy requirements

43% of protein requirements

36% of calcium requirements

75% of vitamin A requirements

76% of folate requirements

94% of vitamin B12 requirements

60% of vitamin C requirements

– Dewey 2001

>Studies done in rural Bangladesh have shown that breastmilk continues to be an important source of vitamin A in the second and third year of life.

38) ALCOHOL AND BREASTFEEDING

Current research says that occasional use of alcohol (1-2 drinks) does not appear to be harmful to the nursing baby.

Per Hale (2012), “mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal.”

The American Academy of Pediatrics Section on Breastfeeding notes: “ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g alcohol per kg body weight, which for a 60 kg mother is approximately 2 oz liquor, 8 oz wine, or 2 beers.

Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.”

Many experts recommend against drinking more than 1-2 drinks per week.

There is no need to pump & dump milk after drinking alcohol, other than for mom’s comfort — pumping & dumping does not speed the elimination of alcohol from the milk.

Alcohol does not increase milk production, and has been shown to inhibit let-down and decrease milk production (see below).

If you’re away from your baby, try to pump as often as baby usually nurses (this is to maintain milk supply, not because of the alcohol). At the very least, pump or hand express whenever you feel uncomfortably full – this will help you to avoid plugged ducts and mastitis.

In general, if you are sober enough to drive, you are sober enough to breastfeed. Less than 2% of the alcohol consumed by the mother reaches her blood and milk. Alcohol peaks in mom’s blood and milk approximately 1/2-1 hour after drinking (but there is considerable variation from person to person, depending upon how much food was eaten in the same time period, mom’s body weight and percentage of body fat, etc.). Alcohol does not accumulate in breastmilk, but leaves the milk as it leaves the blood; so when your blood alcohol levels are back down, so are your milk alcohol levels.

Always keep in mind the baby’s age when considering the effect of alcohol. A newborn has a very immature liver, so minute amounts of alcohol would be more of a burden. Up until around 3 months of age, infants detoxify alcohol at around half the rate of an adult. An older baby or toddler can metabolize the alcohol more quickly.

Effects of alcohol on breastfeeding and the breastfed baby:

Alcohol does not increase milk production. In fact, babies nurse more frequently but take in less milk in the 3-4 hours after mom has had a drink, and one study showed a 23% decrease in milk volume with one drink (Mennella & Beauchamp 1991, 1993; Mennella 1997, 1999).

2+ drinks may inhibit let-down (Coiro et al 1992; Cobo 1974).

One study showed changes in the infant’s sleep-wake patterning after short-term exposure to small amounts of alcohol in breastmilk — infants whose mothers were light drinkers slept less (Mennella & Gerrish 1998).

Daily consumption of alcohol has been shown in the research to increase the risk for slow weight gain in the infant.

Daily consumption of alcohol (1+ drinks daily) has been associated with a decrease in gross motor development (Little et al 1989).

This is a fab idea as with my first son who is now 3, I was adamant I was going to breast feed but I just couldn't get him to latch on properly, this could have been because I was never really shown at the hospital I tried and tried at home and I just couldn't get it right, I figured it wasn't as easy as I thought it would be, I tried for about a month obv giving formula too but it got to the point where I was stressing out about it so much thinking Logan wasn't being fed properly that I gave up and just kept him on formula which did no harm To him at all. However I will be trying to breast feed our second son when he Is born but if he does not latch on or take tout then i will to be worrying as much as I did with my first and formula milk it will be.

Any tips on breast feeding would be great xxx

The main tip is to treat everything as a symptom not a "sentence", ie if there are any issues, see a bf specialist and demand help, dont have to do it on your own xxx

Following

This post has been the most useful thing i've read on breastfeeding! I had a bit of trouble with bf my son, through lack of knowledge & ill advice causing me to quit early on so I'm preparing for the new arrival. I'm so grateful for this post! Great idea!! xx

Thanks!! I'm glad it's appreciated :-)

Any reviews on breast feeding vitamins? Iv just bought pregnacare breast feeding vitamins. Just wanted to know if anyone has took any and felt more energetic etc?

Love this so informative

You don't need any special vitamins when you are bf, unless you want to take them for yourself. Your body is very clever at making the child a priority and will provide your baby with everything they need :) x

Sorry if this been asked before but there are so many comments ! :)

What's the deal with nipple shield ? I've never heard about them until now (new mummy to be ) x what are your thoughts/ experiences x

Also should I get manual or electric breast pump ? Xx

Breast pump is a very personal choice.. Maybe someone else can share their experiences? I had an electric, which was fine, but didn't like expressing much anyway.

Nipple shields can be helpful as a temporary measure to feed whilst nipples are healing, however, the experts don't recommend them. A few reasons for this. Firstly, sore nipples are usually a result of a bad latch, and since nipple shields are not exactly like nipples, the latch on them would be different, so it's confusing for Los. It can also affect supply and the type of milk produced because the brain gets a lot of the information about the baby's needs (including immunity) from the saliva on the nipple. However, I know people who suffered from a bad latch, used the nipple shield, then slowly weaned from the nipple shields, successfully. But I would say tackle the problems causing the issues first, like new positions, or tongue tie. Xxx

Thank you Toggy :)

Sorry if this has been asked further up the post, I scanned but couldn't see it!

I'm planning on bf, all going well, but would like to try expressing just so OH can help. Can you recommend bottles that won't confuse LO? I've seen some on mothercare but didn't want to splash the cash without some recommendations! X

Thanks Toggy only just seen your reply.

I feel so much better now I'm taking these vitamins. I know he is getting everything but I really don't think I was getting enough. But (tmi) number twos are much better, less constipated, skin is better and my hair feels better. I would definitely recommend xx

Try this link:

http://mama-milk.co.uk/best-bottles-for-breastfed-babies/

I personally never found a bottle I was completely happy with (lo refused them at one point!) but found dr brown ok. X

Have a search on Facebook, there might be a local group on there you can join.

Agree with local bf groups on fb. You could also phone the la leache league and see if they could send a consultant over to you it just speak to someone on the phone. You could also email dr jack newman, he is ace and answers free of charge as far as I know! It sounds like you are doing it right, just give it time hun and well done!!! Maybe look into getting fenugreek and domperidon?

Any advice how to get them off 20 month and he is very attached xx

That's great! ?

Should only last a few days and I personally think cosleeping (safely) is the easiest way to survive this :)

But some people find that breast compression works too as it fills the baby up a little more, YouTube it xxx

Great help here thanks

Great post so helpful. Any way to print it out??

☝☝☝

Bump

What's with alt12 unstickying this and my movements post!!

Your movement post won't even bump up anymore? X

Yep I know ? I tried to edit it to put a disclaimer on it and I can't even edit it now! (They said they unstickyed it because someone might sue them because I'm not medically trained or something) xx

No the posts don't have to be medical - they can't be medical, because the people who wrote them aren't medically trained so if someone takes them for gospel and something goes wrong alt12 are worried they would get sued, load of crap if you ask me but that's their reasonings

Who the hell would sue alt12 that is ridiculous

Well, I'm a qualified breastfeeding peer supporter, does that count lol I can quite confidently say I know more about breastfeeding than midwives and health visitors, simply because I've had more training, read up more and have had quite a bit of experience of dealing with issues (including helping others of course). Since qualifying, I never say things about bf as facts unless I'm 100% sure it's facts, for the sane reasons as alt12. I haven't read this post recently but as far as I remember, this is extracts from kellymom which is a scientific website, and has correct and up to date information..

They have said it's basically for the same reason. And because people keep bumping them both up/ protesting it then it won't get bumped it will stop. Posts with loads of attraction comments etc will get notified to the mods and if your b**** ing about it etc they can stop it getting bumped because it then becomes down thing else other than a breastfeeding/ movements thread. I understand there reasoning. It does make sense. And someone can take it as medical advice so they have to protect themselves at the end of the day. It's not their fault they have had to do this it's been done with legal advice

They have said if you need this info just favourite them both. In the U.S. US law prohibits their company and its app from providing information that can be taken as medical advice which again I agree with cause some people will..

They have said tho that you can make our own group and have them stickys in there if you want too.

I suggest everyone favourite them both and if you need them or someone asks for them then bump it up when someone wants/needs/asks for it because keep bumping it up all the time all day long is just going to result in it going forever or like the movements post won't bump up.

Bump

This one Fiona?