Breastfeeding information and tips

This one Fiona?

Bump

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.

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..

Who the hell would sue alt12 that is ridiculous

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

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

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

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

Bump

☝☝☝

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

Great help here thanks

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

That's great! ?

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

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?

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

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

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

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

Thank you Toggy :)

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

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

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

Love this so informative

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?

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

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

Following

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

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

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).

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.

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

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

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

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.

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! :-)

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

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.

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.

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.

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.

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.

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.

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.

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.

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".

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?

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.

Does the law change once the child is over 2?

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.

You're welcome :-)

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

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.

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.

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

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!

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! ?

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.

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.

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.

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

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

“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.

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.

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.

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.

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 :-)

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

Thanks Emily! xx

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

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.”

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

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.

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.

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.

“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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

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

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.

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?

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!).

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!