All the most commonly answered questions about working and pumping.Pumping is one of the most commonly addressed issues by working and non-working mothers alike. So, let's talk about it. Warning: This subject has been tackled many times by those who have already written great articles about it, so there will be a lot of links. We don't need to rewrite the manual, just say where that information can be found. So think of this also as a good reference page.
Here we go. Below are some of the most common questions we see: Do I need a pump? And if so, what is the best kind? Well, let's break that down. Do you need a pump? If you are planning on being a stay at home mom, then the answer is, not really. If you would like to pump a bottle to go out on a date occasionally, then sure, go ahead and get yourself a decent hand pump, though some mothers get just as much as hand expressing, if they do it correctly. But if you aren't really going to be separated from the baby, then a pump can cost a lot of money (if you are looking for an electric one), and can cause a lot of extra stress that as new mothers, we really don't need. We may look to pump to try to 'measure' how much a the baby gets, but that is not actually an accurate measure, since a pump operates VERY differently than a baby. On average, what we pump is about 60-70% of what a baby may get when they nurse. No matter how wonderful your pump is, a baby who is feeding well is ALWAYS more efficient than any pump. Jack Newman has a great article on Hand Expression here: http://www.breastfeedinginc.ca/content.php?pagename=doc-EBM If you are planning on returning from work, or are separated from baby due to medical or personal reasons, then absolutely, get a pump. What kind can remain a debate, since mothers respond differently to different devices. The best kind of pump is the one that works. Some mothers who feel like a cyborg by being attached to a machine won't relax, therefore, their body won't respond well to an electric pump. LLL has a great article that breaks this all down right here: http://www.llli.org/llleaderweb/lv/lvjunjul04p51.html No matter what kind of pump you are using, it should NOT be painful! So, what do to if pumping hurts? Read this to find out: http://www.nancymohrbacher.com/blog/2010/8/30/ouch-what-if-pumping-hurts.html This invariably leads to the next question: Is it OK to buy a used pump? Again, LLLI has a great article on what to consider when looking at a used pump: http://www.llli.org/llleaderweb/lv/lvjunjul04p54.html They address Open Vs Closed Systems, Health and Hygiene Issues, and Legal and Liability Issues, as well as what if a used pump breaks. I highly encourage you to read this article if you are considering buying a used pump, or if someone gave one to you as a gift. How long can I store breastmilk? According to LLLI: This information is based on current research and applies to mothers who:
All milk should be dated before storing. Storing milk in 2-4 ounce amounts may reduce waste. Refrigerated milk has more anti-infective properties than frozen milk. Cool fresh milk in the refrigerator before adding it to previously frozen milk. Preferably, human milk should be refrigerated or chilled right after it is expressed. Acceptable guidelines for storing human milk are as follows. Store milk:
A really great suggestion was to freeze the milk in ice cube trays, which ammount to approx 1 oz per ice cube, then you could put the ice cubes in a food safe freezer container. This can help keep you from having to thaw a full 4 oz when your baby only drinks 2 of them, and you end up having to toss the rest (with many tears included, because it always hurts to see what we have worked so hard for tossed down the drain). Can I continue to breastfeed when I go back to work? Well, some of that depends on where you work. There are new laws in place to protect breastfeeding mothers at the workplace, but only companies with over 50 employees that have to ahdere to Labor Laws are required to comply. Basically, they are required by law to give you as many breaks as you need in order to pump (though they are not required to pay you for those breaks), and they are required to provide you with a clean, private place to pump that is NOT a bathroom. To get all the information on that to share with your employer, please go here: http://www.dol.gov/whd/regs/compliance/whdfs73.htm#.UO9ZDOSx9ic There are instances, of course, when the employer is required by law to do something that they don't want to do, or may dock you or not schedule you or give you a hard time. This is illegal. But what new mother wants to deal with getting fired or not scheduled and launching a complaint and dealing with all of that with a new baby? Not many. So use your advocates, such as WIC to fight for you if you need. There are resources to help you, use them. Another common issue is a willing employer, but a job that doesn't necessarily allow a lot of breaks, such as working in a restaurant. In these cases, we recommend taking shorter, more frequent type of breaks. Instead of taking a 20 minute break every 2-3 hours, take a 5 minute one at least once an hour. If nothing else, use a bathroom to do hand expression or use a hand pump for 5 minutes. Even this will stimulate milk flow and production even if you don't sit with an electric pump for 10 minutes. It will help and be better than nothing. As always, it helps to discuss your BF plans with your employer before you go on maternity leave, or before you go back to work so they have time to accomodate you. Springing it on them the day you get back does not really make them want to bend over backwards to help you. As far as how often you should pump, that sort of depends on how often the baby nurses. Nancy Mohrbacher wrote a great article on this, what she calls "The Magic Number". Basically, how many times a baby feeds in a 24 hour period will determine how many of those feedings you are going to miss, and therefore need to pump out. If the baby nurses 12 times in 24 hours, and you are going to miss 6 of them, then you would need to pump 6 times while you are away from baby. This will keep your production going at the same rate, so you don't start to make less because you are away from the baby. To read her whole article on it, go here: http://www.nancymohrbacher.com/blog/2010/8/13/the-magic-number-and-long-term-milk-production-part-1.html Here is one from LLLI on pumping frequency at work as well: https://www.llli.org/faq/pumpfreq.html And here is a great one about facts every working mother needs to know: http://www.nancymohrbacher.com/blog/2010/8/10/facts-every-employed-breastfeeding-mother-needs-to-know.html And a compilation of Working and Breastfeeding questions and articles: https://www.llli.org/nb/nbworking.html My baby seems hungry all the time, and when I pump, I only get out an ounce! Am I starving my baby? First, take a deep breath. Then let it out. Do it again a couple more times. This tackles a couple of different issues. The first one: Baby hungry "all the time". First of all, what is "all the time" to you? We all have different perceptions, especially when we are used to our bodies belonging only to ourselves, AND we are in a sleep deprived exhausted state. ANYTHING seems like "all the time" when you're exhausted and just want to sleep. And we are pretty much functioning with only the right side of our brain, BTW, which does not guage time well, or do anything logical, really. There is a biological reason for that, so just know that "mommy brain" is normal and serves a survival purpose. Get used to looking for your car keys in the refrigerator for the next year or so (or 5). It is normal for breastfed babies to want to nurse every 2 hours, or more often than that. It's not all about the food, either. Do YOU only eat when you are hungry? Or when you're bored, or upset, or need comfort, or just because it's sitting in front of you? What if it was the only thing on this earth you knew was safe and could make you feel better, even if you didn't know what was wrong? Yeah, you'd eat "all the time", too. If you are bottle feeding and nursing, and feel like your baby "still seems hungry" after taking a bottle or is at the breast, it's not necessarily that it is hunger driving them. When babies get a bottle, it seems as though they take more. Usually, this is true. But for different reasons than hunger. One reason is because the flow of a bottle is faster than a breast, and they do not have to work very hard to get it out. In fact, if they are laying down while taking a bottle, then they are being flooded and it's swallow or drown time, so of course they are going to gulp it down. Then they may also get lazy at the breast because they get used to this new 'fast flow', but that is a whole different topic that we can discuss at a different time. The other thing that happens with bottles is that is bypasses an important signal in the brain (sugar does this as well), that alerts them that they are "full", so they don't necessarily feel "full". If you have ever eaten a lot of sugar, you can probably relate to that feeling. ;) To get mroe information on the difference in how much a baby takes breast vs bottle, see this article here: http://www.nancymohrbacher.com/blog/2010/7/12/breast-versus-bottle-how-much-milk-should-baby-take.html And a great article explaining the whole: "It's Not Really About The Milk", check this out: http://www.normalfed.com/Why/notreally.html I loved what Jack Newman said once, which was that Breastfeeding was really 90% about brain development and only about 10% about the milk, and we all know how awesome the milk is. So much more happens at the breast than simply feeding that allows the brain (and we now know oral and facial) development, that it's really wonderful for babies to feed at the breasts as often as possible. Basically, if your baby has the energy to nurse all the time, is gaining weight, and peeing and pooping for just about every time they feed, you guys are good. And they are doing wonderful things for your milk production, so hang in there and know that their nursing behavior and patterns will change. Some sooner than others. However, IF your baby is NOT gaining weight, is constantly sleeping, isn't having many dirty diapers, seems otherwise lethargic when awake (not alert), and/or you have nipple trauma (cracked or bleeding nipples), then see an IBCLC right away. Do not pass go, do not collect $200, simply make an appointment and get help. Now. For more info on how to tell if your baby is getting enough milk, check out this article by Jack Newman: http://www.breastfeedinginc.ca/content.php?pagename=doc-IMB OK, now to tackle the pumping 1 ounce issue. Or not pumping as much as your friend, or getting as much as you think you should. READ THIS ARTICLE about how much you should really be EXPECTING to get, and why it varies from woman to woman: http://www.nancymohrbacher.com/blog/2012/11/27/how-much-milk-should-you-expect-to-pump.html It covers all the things that can expect milk supply:
How can I increase the amount that I am pumping? (and variations on the same question) First, are you doing Hands On Pumping? The absolute BEST video to watch on how to get the MOST out of your pumping session as well as HOW to do hand expression can be found here: http://newborns.stanford.edu/Breastfeeding/MaxProduction.html Women who practice HOP can get an average of 50% more when pumping and using this technique. Here are some other pumping tips: "Forget all the rules—Let comfort guide you.You do NOT need to pump on a set schedule (Forget “every 2 or 3 hours” or whatever).And you do not need to pump a set number of minutes, either! 1. Relax and enjoy! This is a break from all your housework and baby chores. Relax and enjoy it.Milk flow is hugely psychological. Love, laughter and pure pleasure in your baby are what make the milk flow best. Don’t watch the pump. (No love, laughter or pleasure there!) Don’t watch the clock. Take off your watch! 2. Interruptions help! No need to feel chained to the pump, or chained to the sofa! Anytime you want, set the pump aside, and go off and do something else.It’s time to take a break… As soon as you start wondering what time it is, or how much milk you have; Or you remember something you need to do; Or someone asks you to find something; Or your baby is squirming: Just put the pump aside, and go take care of whatever’s on your mind. Don’t put the milk in the fridge, or wash out the pump… Leave the milk right where it iso You might be gone 5 minutes or a half hour. The break SPEEDS your milk. Then come back, and pump right into the milk that’s been waiting there. 3. Hands on the breasts, before, during, and after pumping The pump only vacuums the milk out, so it can’t do a great job by itself. Your hands are crucial! BEFORE: No skill involved—just use your hands to push and mush on the breasts for a bit, a few seconds each, just to warm them up a bit, and get the milk moving. DURING: While pumping, use your hands to press and massage on any lumps or full areas. As the breast gets softer, continue massaging toward the pump. Hint: Sacrifice an old bra that’s too small—cut holes for the pump flanges (shields), to pump hands-free. AFTER: If your aim is increasing milk production:Your hands can press the milk out that the pump can’t vacuum. Getting a bit more milk out is especially important to increasing milk production. If you have plugged ducts:If you have plugged ducts, or a tendency to get them, use your hands to look for any lumps of milk the pump didn’t get. Which pump?Not everyone needs a pump. The hands often work better than a pump, once you get the hang of it.There is no one best pump that’s right for everyone. The best pump for you is the one you like-- milk flows best when you are comfortable. Many women prefer a manual pump over an electric pump. Good manual pumps are the Avent ISIS or Medela Harmony. For round-the-clock pumping, many women prefer an electric double pump (Ameda (Purely Yours), Bailey,or Medela (PumpNStyle or PumpNGo); Others prefer one of the manual pumps. If pumping hurts… Use electric pumps on the lowest pressure that just pulls comfortably on the breast. Hand pumps are always comfortable unless you pull the handle too far. You do NOT have to pull it all the way, only to the point of gentle pressure. Be sure you have a flange (shield) that fits comfortably. Ameda and Medela offer several sizes. If your baby isn’t nursing; If you are not nursing, and if you want to minimize or eliminate formula use, You can keep up with your baby’s needs if you pump about as often as the baby feeds, and in the same rhythm as your baby feeds. Easiest is after feeding, after your baby is asleep, so you aren’t pumping under pressure. At first, you will probably start out by pumping about 6 - 7 short (interrupted) times in the daytime, and once at night. You may be able to drop this to more like 5 or 6 times in the daytime, and once at night. At first, keep intervals between pumping no longer than about 3-4 hrs in the daytime with no longer than one 5 hour stretch at night. If you’re increasing your milk production: It’s helpful to pump after most of your baby’s feeds, whether the baby feeds at breast or bottle, at least 5-6 times a day, followed by hand expression. If you’re pumping for work: Pump both sides each morning, before or after the baby feeds. This helps maintain your milk production. Everyone has more milk in the morning, so it’s an easy time to pump. You don’t have to pump everything the baby needs while you’re at work. Pump during your work day often enough too keep your breasts comfortableo get enough milk for the next day. You do NOT have to pump on a set schedule at work. You can be quite regular, every 3 or 4 hours, if your work schedule allows/demands. But if your work routine is erratic, that’s OK—You might pump twice an hour apart when you have a chance, knowing that you might not get another chance for five hours! If your schedule is very unpredictable, and you get over-full, you may occasionally need to take a one minute break to hand express just enough off to prevent leaking or plugged ducts, until you have a chance to pump for real." -Brought to you by: .Christina M. Smillie, MD, IBCLCBreastfeeding Resources, 2505 Main Street, Stratford, CT 06615© 2010 Christina M. Smillie, MD. All rights reserved. OK, other suggestions. You may hear about galactogogues. These are things you can take to increase your milk supply, but they all only effect ONE of the hormones in milk production. The other is stimulated by emptying the breast, so the more you use, the more you will make. Jack Newman has a great article on Herbal Remedies for Milk Supply: http://www.breastfeedinginc.ca/content.php?pagename=doc-HRMS There are also a number of members of our own group who either make Lactation Cookies, or have helpful tincures or suggestions for herbal galctogogues as well. I will include them in the next section of "Members Advice and Suggestions". There are also non-herbal galactogogues, though the one that is used most widely around the globe has not been approved by OUR FDA, for some crazy reason. Jack Newman also actually addresses this if you want to read more about it: http://www.breastfeedinginc.ca/content.php?pagename=doc-OFDA. If you have more questions about galactogogues, you can find information on them on www.kellymom.com, www.llli.org, www.breastfeedinginc.ca, or please speak to an IBCLC, or maybe your doctor, though I can't promise they will know what you are talking about. :P Additional Pumping Information Links: http://www.llli.org/nb/nbpumping.html http://kellymom.com/?s=pumping http://www.normalfed.com/Starting/work.html http://www.normalfed.com/Starting/pumps.html http://www.normalfed.com/Starting/pumpinghints.pdf If you did not find your question or answer on this page, check out the File: Pumping Q&A by Members. There we have compiled any and all pumping questions and answers by the moms on this page. We spent time doing that so that mothers didn't need to spend their premium time repeating the same answers for the same questions that seem to always come up at different stages. If you STILL have questions after reading this file and that file, then please post, as we all love new situations to talk about. Or if you simply need support, because that is why we are all here! Happy Pumping!
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The 9 Month Challenge There are always challenges in Breastfeeding. Because there are always challenges in parenting. But do we give up?? NO!! (well, sometimes) There are some phases that are typical, though. And I have been kind enough to walk you through them. General rule of thumb for children of any age: When they are going through a growth spurt, they will eat more, sleep less, and be generally disagreeable. Be patient. They don't know what's going on, either. Congratulations!! You made it through those tough few days of figuring out ‘The Latch’ and ‘Positioning’, you soldiered through Engorgement, you have even fought your way through the 4 Month Hump! How amazing are you?!
By this time, you have nursed through a minimum of 5 growth spurts, teething, and countless sleep deprived nights. (Maybe even a little illness or two for your little one.) You have provided comfort and nourishment that will benefit your baby their entire life. Take a moment to congratulate yourself on those accomplishments! So why is this new growth spurt so challenging? Many mothers find themselves faltering around 8-10 months (give or take a month or two) with breastfeeding as baby’s behavior changes, and they find themselves simply exhausted and frustrated (and maybe not a little bit resentful). You are not alone. There are quite a few things going on right around this time. The biggest changes going on with your baby with this particular growth spurt may be ones that you can’t really see physically. They are going through an enormous emotional and mental growth spurt at this age. This is the age where they finally start to realize they are separate beings from you. That they are not an extension of you, and to be honest, that can totally freak them out. Up until this point, you are them and they are you. You are the center of not only their Universe, but their being. Now they realize that their bodies are their own, and there is a point where you end and they begin. Not only that, but there are THINGS out there. Things they must explore. But are they safe? They look to you to be their touchstone, sometimes crawling away to chase something, then coming back to nurse for a minute, then leaving again and repeating the process. “Wow, that thing looks awesome over there! I gotta go check that out! MOM!! Where’s Mom?! Oh, there you are, OK, just have to make sure……. OK, I’m gonna go check that thing out again….. MOM! Where’s Mom!! Oh, there you are….” There is a reason we play peek-a-boo with them and they are actually surprised. If they don’t see us, we are simply gone. And since they have no concept of time, 2 minutes can be an eternity of despair. Plus, if they are developing a new skill (crawling, walking, etc), know that with each new skill comes a new fear as well. You are their touchstone to know that everything is OK and all is well. Your crawling and moving (and distracted) little bundles are showing you their own unique personalities as well. Up to now, maybe they have just been cute little babies. Now they are babies with personality, whose will can sometimes clash with yours. Let me be perfectly clear: if you enter into a battle of wills with a baby (or child under 7 years old), you have already lost. They ARE will. This does not mean that you can’t teach them and guide them. It means that we need to realize that we are adults and it is futile to get into a fight with a 9 month old, because there is simply no way for us to “win”. It does not mean we can’t be in control and help guide baby’s behaviors a bit (especially that fun acrobatic nursing/biting/pinching/hitting). In fact, this is a wonderful age to begin teaching “Nursing Manners”. You can check out the link to help curb unwanted nursing behavior here: http://kellymom.com/blog-post/nursing-manners/ While it is important to know that battling wills will only lead to frustration for both parties, it is also vital to know that they are not manipulating you. Babies don’t manipulate. They communicate. And they learn. They learn what your responses will be to their attempts at communicating. Will you be responsive and loving? Or will you withhold from them what they are telling you they need? This is the time when the brain pathways are being built learning cause and effect. (The ‘dropsy’ game might be really popular right about now.) Neuropathways are not built upon one response. They are built with continual and consistent responses over time. You are not ‘spoiling’ your baby by responding to their needs. You are listening and responding, teaching them that you WILL be there for them when they need you. Studies have shown that the quicker you are to respond to your baby, the less fussy they may be, and the more secure they will feel. For more information about “spoiling”, you can click here: http://kellymom.com/parenting/parenting-faq/fussybaby/ What does all this have to do with Breastfeeding? Besides the acrobatic part, that is.. Well, babies around this age (as will most growth spurts) tend to sleep less, and nurse more at night. This can be really frustrating to us Mommies who thought we had that sleeping thing down pat. Just when we thought we had them on a ‘schedule’, they turn around and start nursing a ton at night. Many mothers are tempted at this time to try ‘sleep training’. Unfortunately, the timing is not the best for that. As distracted as babies can get around this age during the day, they tend to snack a lot, come on and off the breast, and not really get good solid feedings in during the day. They get a lot of their nutrition at night during this stage. They also often need that extra comfort during this exciting, yet frightening, time. It can be particularly difficult or emotionally traumatic for them during this stage to do any kind of ‘crying it out’ method (which research has shown to be emotionally and mentally harmful at any time). This can be additionally frustrating, because the first few times they went through this, they were much smaller and we were still in that ‘newborn bliss’ hormonal phase. Around 9 months, we just want to friggin sleep. And our babies have personalities, which (incorrectly) makes us assume that they understand logical things. Sadly, no matter how ‘advanced’ they are, they don’t really get until they are almost 7 (that’s years), no matter how much they seem to understand. A difficult thing to remember as they get older and more vocal as well. In short, all of these behaviors are normal for your 8-10 month old: - Disrupted sleep - “Clinginess” (If mom is here, she needs to be holding me NOW) - Acrobatic nursing - Pinching, pulling, biting (these you can help curb) - Doing things over and over again - More moving around and exploring (yet some fear or anxiety when they do so) - Nursing strikes (sudden refusal of the breast or to nurse: https://www.llli.org/faq/strike.html) - Sore nipples all over again (this often has to do with re-visiting proper positioning of your baby, we get less diligent over time, but our nipples won’t tolerate that for long) As a mom, I can promise that this phase will too, pass. All developmental stages for our babes are temporary. There are things you can do to help teach nursing manners: offering something else soft for them to pinch and knead while nursing, or getting a nursing necklace. Being consistent with your reactions to things, and hopefully reacting in a gentle and supportive way (as much as our sleep deprivation will allow, that is). And getting help when we need it. It’s not uncommon for post-partum depression to rear its ugly head around this time, either. If you find yourself experiencing these symptoms to an incapacitating degree, please seek the help of your physician:
For more information on PPD, you can go here: http://www.9monthsin9monthsout.com/is-it-just-the-baby-blues-or-postpartum-depression/ and here on how to treat it safely: http://blog.oncloudmom.com/2010/03/how-to-treat-depression-safely-while.html So now you know what is normal, what you can expect, and some tools on getting through it. Support from other BF moms is essential, especially during difficult times as this. Don’t let your friends or family members tell you that you are spoiling your baby, or that they would be better off with formula, or you just need to teach that baby who is boss. You know your baby better than anyone else. Listen to them, listen to yourself, and listen to your heart. You are doing an amazing job, and don’t let anyone tell you any differently. Difficult times will pass with time, and honestly, you won’t really remember much of that first year anyways. It’ll all be a sleep deprived blur. But you will survive. And your baby will thrive. Just continue to listen to them, and follow your heart. You can’t go wrong. RESOURCES: http://kellymom.com/ages/after12mo/ebf-links/ http://www.naturalchild.org/guest/norma_jane_bumgarner.html http://kellymom.com/parenting/velcrochild/ http://kellymom.com/ages/older-infant/ebf-benefits/ http://kellymom.com/bf/normal/comfortnursing/ http://kellymom.com/blog-post/nursing-manners/ http://kellymom.com/bf/normal/babyselfwean/ http://kellymom.com/parenting/parenting-faq/fussy-evening/ http://drjaygordon.com/breastfeeding/growthspurts.html http://kellymom.com/fun/trivia/bf-rates-2004/ http://kellymom.com/bf/pumpingmoms/pumping/maintainsupply-pump/ http://kellymom.com/bf/normal/toddlernursing/ http://www.breastfeeding.org.sg/comfort-versus-nutrition-by-kathryn-orlinsky.html http://kellymom.com/health/baby-health/tooth-decay/ http://www.llli.org/nb/nbextended.html http://kellymom.com/bf/concerns/mother/criticism/ http://kellymom.com/bf/concerns/child/back-to-breast/ http://www.health.wa.gov.au/docreg/Education/Population/Child_Health/Growth_and_Development/HP3420_child_dev6-9months.pdf http://www.babycentre.co.uk/x558330/how-can-i-function-at-work-without-enough-sleep http://www.babycentre.co.uk/a558733/10-ways-to-get-more-sleep http://www.babycentre.co.uk/a1011765/parents-tips-coping-with-tiredness http://www.9monthsin9monthsout.com/is-it-just-the-baby-blues-or-postpartum-depression/ http://www.naturalchild.org/guest/missy_willis.html http://www.naturalchild.org/jan_hunt/babyspeaks.html http://www.naturalchild.org/research/emotional_learning_infants.html http://www.naturalchild.org/james_kimmel/human_baby.html http://www.naturalchild.org/robin_grille/post_natal_depression.html https://www.llli.org/nb/nbnovdec92p173.html https://www.llli.org/nb/nbjanfeb06p4.html http://www.llli.org/nb/lvaprmay98p21nb.html http://www.llli.org/cbi/journal9.05.html https://www.llli.org/ba/may06.html http://www.llli.org/nb/nbmayjun06p100.html http://www.llli.org/nb/nbiss56-09p38.html http://www.llli.org/llleaderweb/lv/lvfebmar00p10.html There are always challenges in Breastfeeding. Because there are always challenges in parenting. But do we give up?? NO!! (well, sometimes) There are some phases that are typical, though. And I have been kind enough to walk you through them. General rule of thumb for children of any age: When they are going through a growth spurt, they will eat more, sleep less, and be generally disagreeable. Be patient. They don't know what's going on, either. The 4 Month HumpWe commonly see a sharp drop in breastfeeding around 4 months of age. There are quite a few different things that we believe contribute to this, and thought I would take a moment to address some of them.
Hormonal Around this time, many women start going back on hormonal birth control, if they haven't already. The estrogen based hormones in some birth control can interfere with your body's ability to produce milk. For more information on this, and to see which types of BC are better for BF moms, check out this link: http://www.kellymom.com/health/meds/birthcontrol.html Teething / Growth Spurt Around this age, babies also start showing signs and symptoms of teething, as well as going through a fairly large growth spurt. For this reason, their feeding habits, sleeping habits, and behaviors often change. They might want to nurse constantly, cry all the time, spit up more, and have disrupted sleep. They may "act angry" at the breast, making moms think that their milk supply is dropping. If the teething and growth spurt are truly the only things going on right now, then the opposite is true. Baby knows that he/she is growing, and going to need more food, so they will nurse more to create more milk. Babies can increase your milk supply in about 24 hours to what they need it to be for those growth spurts. The same is true for growth spurts at any age. If it is teething, here is a very helpful link on teething symptoms and remedies: http://www.kellymom.com/babyconcerns/teething.html Early Introduction of Solids / Baby getting bottle Introducing solids before 6 months is not recommended by the AAP, as baby's digestional tract is not quite matured enough for anything besides breastmilk. Many doctors are of the old school beliefs that babies need to start rice cereal at 4 months. This is a slightly controversial subject, but according to Nancy Mohrbacher in Breastfeeding Made Simple: "Research found that this practice (introducing solids @ 4 months) is associated with an increased risk of atopic disease and other health problems." And that "in 1997 the AAP Section on Breastfeeding issued is revised policy statement, recommended dealying solids until 6 months of age." (And in case you were wondering, rice cereal is a solid.) She goes on, "In 2001 the WHO published a report by its expert panel, which reviewed over 3,000 studies and concluded that starting solids before 6 months had health drawbacks for both mothers and babies: -Babies are at a greater risk of gastrointestinal infections and diarrhea in both developed and developing contries. -Mothers lose less weight and return to fertility sooner. There was also some evidence that babies who are not exclusively BF for 6 months are at an increased risk for delayed motor development. The WHO expert panel agreed that in most cases exclusive breastfeeding for 6 months results in normal growth and that the benefits of waiting until 6 months to start solid foods outweighed the risks." There is a lot more information out there about the introduction of solids, which will probably end up in another post. But you may ask "What does that have to do with my milk supply?" Well, I'll tell you. It all goes back to those early days of nursing, and the perils of "Negotiated nursings" and "contract feedings". The Womanly Art of Breastfeeding puts it like this: "The underlying reasons are often negotiated nursings ("You'll have to persuade me that you really need to nurse") and contract nursings ("the clock says it isn't time yet") - both recipes for a faltering milk supply or premature weaning. If you want to nurse your baby according to a schedule (if it's 2:00 then we nurse), it's like nursing by contract. If your baby has to convince you, maybe by workig up to full-blown crying, that she really does want to nurse, she's having to negotiate her nursings. It's like she's saying, "If I cry, will you let me?" Neither one is very much fun for either of you....and both are hazardous to breastfeeding. Imagine that you have to have lunch at your workplace cafeteria every day. But when you step up to the counter, you're always quizzed as to why you want to eat and why you want, say, a hamburger instaed of a veggie burger. You put up with it because the food is really good and it's the only place you can eat lunch. But then one day they expand the cafeteria and put in a second counter. At the other counter, you ask for food and you get all you want, with a smile, no questions asked. Which counter will you go to? It's the same for a baby who's always been asked why he wants to nurse. "You can't be hungry yet; it's only been an hour and half," or "You're probably just tired. Let me rock you to sleep," or "Not now. Here's a pacifier." Then one day he starts getting a bottle to hold onto, or a spoonful of solids that he's encouraged to eat, even praised for eating. Now he feels as if he and his mother on the same side. Nursing - and the milk supply that goes with them - start to fade away until it's just easier to give the bottle or offer the crackers than it is to fight about nursing. If you feel you're losing your nursing relationship to negotiations and contracts, it's not too late. Make nursing fun and spontaneous again: nurse in the bathtub, take naps together, offer to nurse for no reason at all, make it silly, play with his toes and hands. It can take some time and patience to conince your baby that the rules are gone, but many mothers have turned a faltering nursing relationship into something they enjoy for many months or years to come. Make yours the lunch counter with the welcoming smile." Hopefully this will help you identify some of the reasons why you may experience some difficulties around 4 or 6 months of age. Know that your milk supply was well established by 6 weeks, and short of baby stopping nursing, or skipping feedings, or taking medication (such as hormonal BC), it won't suddenly "disappear". As long as baby is nursing actively, you will have milk. The baby makes the milk by nursing. Your body, in healthy BF relationships, will continue to make milk as long as baby wants it. Only about 1% of mothers have an actual medical reason for their bodies not manufacturing milk. The rest who have production issues are a result of outside factors. Again, milk supply is another larger question that will warrent it's own post. But hopefully, by the end of this, you will have some ideas about why your 4 month old is acting differently, and you can be confident that they are growing, and just help them work through those difficult spurts. And pat yourself on the back, Mama; you are doing a great job! Yes, Breastfeeding has benefits. Haven't you heard?! Of course you have. There are literally over 100 benefits of breastfeeding, and more websites than that dedicated to telling you what they are. If you don't already know, I won't bog this page down with them individually, but I WILL say that you can read about the benefits here, here, here, here, and here. To name a few.
There are always challenges. I will let you in on a secret that most Lactavists don't want you to know....... Breastfeeding. Is. Hard. For many women. At least at first, and sometimes during the first few months even. It does not always come naturally. Help is often needed. And NOT from your Mother/Mother-In-Law/Sister/Aunt/Grandmother/RudeLadyAtTheStore. But from a professional Lactation Consultant (IBCLC), La Leche League Leader, or Breastfeeding Counselor. I have been 2 out of the 3 of those things, and have a local IBCLC I refer to for the ones that need a little more expertise than I have. There is so much information about positioning, diet, sleeping issues, tongue tie, expected behaviors, and more, that this page could take you all night to read. Instead, I will share with you the resources I go to for all things breastfeeding: Nancy Mohrbacher - www.nancymohrbacher.com She literally wrote the book on Breastfeeding. Her blog covers EVERYTHING you need to know. First days, skin to skin, pumping, problems, sleeping, swaddling, pacifiers, you name it. She co-wrote the La Leche League Book, The Womanly Art of Breastfeeding. She also wrote the enormous manual for IBCLC's and health care providers, as well as the best book I have read for new mothers yet - Breastfeeding Made Simple - 7 Natural Laws for Breastfeeding Mothers. Jack Newman - www.nbci.ca Otherwise known as the Grandfather of Breastfeeding Medicine, he is another definitive source for all breastfeeding questions and information. He has wonderful videos and articles on everything from positioning to SNS nursing systems, starting solids, common questions and problems, you name it. Takes a slightly more clinical approach than Nancy, he is nonetheless incredibly respected in the field, and an excellent resource. La Leche League International - www.llli.org Of course, we can't leave out the oldest international breastfeeding support organization!! With meetings and groups all over the world, their website has a plethora of articles and resources to help any breastfeeding mother. If you live in the Verde Valley, there is a local LLL Group that meets monthly. You can find information for them HERE. KellyMom.com A great resource for all things breastfeeding, and easy to search. |