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Don’t Cry Over Spilled Milk. Unless …
Kelly Ochoa, MD
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Breast Feeding Basics
Don’t cry over spilled milk! Unless it is breast milk, that is, then that deserves a few tears. Breast milk lives up to its nickname of “liquid gold”. As a pediatrician, I am an unwavering advocate for breastfeeding your baby for oh so many good reasons. I cannot encourage new mothers enough to at least try exclusive breastfeeding if they have the option. As a mother of 4 nursed babies, I completely get that it can be hard and tiring, and even painful (well often painful) at first, but it will become much easier after time. Stick with it and it is completely worth it – for both you and your baby!
What are the Benefits of Breastfeeding?
Well, first off for you, mom, you will lose your baby weight much faster, and won’t get your period back nearly as quickly, bonus and bonus! Did you know it also decreases your risk of ovarian and breast cancer? Breastmilk is very easy for your baby to digest, and, in my experience I see WAY less colic in breastfed babies, and almost never see a constipated breast fed infant. Formula can get expensive, and when breastfeeding you don’t have to worry about constantly cleaning bottles and nipples. Amazingly, breastmilk also passes on disease fighting parts of your blood to your baby, so your child gets less colds and less ear infections, among other more serious infections. And moreso, breastfeeding has been shown to decrease your child’s chance of getting diabetes and some types of cancer later on in life. Some studies show that breastmilk can even increase your child’s IQ! Breastfeeding is surely the smart choice!
Am I Making Enough Milk?
Too many new mothers quit breastfeeding or add formula too soon because they think they’re not producing enough milk. While this can be the case, it is often not. A new breastfeeding mother should nurse her baby frequently on demand, and start immediately after birth. The foundation for a terrific milk supply later on is actually in the first week of the baby’s life. It is pretty amazing if you think about it, (well I think EVERYTHING about your body growing a baby is amazing, but that is for another day), your breast milk actually changes in amount and content to meet your growing baby’s needs. A full term newborn’s stomach is only the size of a marble at birth and can handle less than 1 teaspoon of milk at a time. By day 3, it can hold up to 1 ounce. By one week old, 1.5 – 2 ounces, and at one month old 2.5 to 5 ounces. Drinking plenty of water and nursing often are key to milk production. You can tell if your baby is getting enough nutrition by weight gain, and keeping track of wet and dirty diapers.
How Do I Increase My Milk Supply?
Your body produces milk in response to your baby suckling. It is basically a supply and demand relationship. The more your baby nurses, the more milk you will produce. If you aren’t producing enough milk, don’t fret. Even if your doctor or lactation consultant advises to supplement with formula for your baby’s weight gain, you can still get your milk supply back up to exclusively breast feed, and then ditch the formula when your supply increases. You need to “trick” your body into making more milk. To do this, I often suggest pumping for 15minutes after you breastfeed. This will stimulate your body to make more milk. It is also important that your baby is emptying your breasts efficiently, so make sure his/her latch is good during each feeding. If you have milk leftover in your breast, then your body thinks you already have too much, and production will go down to match the perceived baby’s needs. Also, make sure you are drinking plenty of water. Personally, I found mixing 1/3 Gatorade with 2/3 water helped me, but maybe it was just because I drank more water if it was flavored. There are various herbal supplements, such as fenugreek, and prescription medications that can increase milk supply. If pumping and frequent nursing are not enough, you can talk with your doctor or lactation consultant about these options. Herbal supplements are typically used in combination with increased breastfeeding frequency, pumping, and maximizing milk removal.
Can I Take Medications While Breastfeeding?
Some medications do pass through breast milk, but the list is smaller than during pregnancy. Many common medications are safe, but consult your doctor prior to taking any medication while breastfeeding. Alcohol also passes through breast milk, so if you want that glass of wine with dinner, you should consider “pumping and dumping”.
Back to Work and Pumping Basics
Maternity leave over? I know, it is sad, I did it four times. Now time to figure out the pumping and the storage of your liquid gold.
When going back to work, you will need a good pump, a cooler to keep your milk cold, BM storage bags and a permanent marker for labeling your storage bags, scotch tape for the door sign, and something to clean your pump supplies between each pumping session. Also, don’t forget an extra top/blouse just in case you leak a bit of breastmilk onto your clothing, and nursing pads for inside your nursing bra. You may also find that a pumping bra (which is basically a tight elastic strapless bra that has little slits for the pump parts to go through) could be helpful for handsfree pumping if you really need to get some work done while pumping. I did not know these existed with my first, but discovered their necessity by the 4th! Ask your supervisor ahead of time where you can pump. Most workplaces should have an area that is clean, quiet, and private for this. Have a sign ready that you have in your bag with tape that you can tape to the door so no one disturbs you. I have pumped in all sorts of places at work, including many bathroom stall pumping sessions, but hopefully you have better accommodations than this!! Carry a water bottle around with you and drink frequently at work. You need more liquid than normal when nursing, and it can be easy to forget to drink while at work. Lastly, if you are stressed and uncomfortable, this will make it harder for your milk to let down. Some moms record on their phone their baby’s hunger cry from a previous nursing time, and play it to help with milk letdown.
First off, try to pump immediately before work. Get to work early, pump for 20minutes before your workday starts so that you can maximize the break time you have during your workday. Have the timing of pumping built into your schedule ahead of time, either in your mind, or actually scheduled if you can. Things ALWAYS come up – if you keep postponing pumping until tasks are done, pretty soon it is an hour later. Eventually your supply will diminish if you keep doing this. Believe me, I know. Just go pump – those tasks can wait 15 minutes. Prioritize timing your pumping so that you can get away every 3 hours or so when your child is very young, and every 4 hours as they get a bit older. Let your colleagues know you’re unavailable for the next 15min. so they can cover for you if that is needed. When pumping make sure to empty both breasts entirely. If you are rushed and stop 5 minutes early without emptying your breasts, you will see that your supply starts to diminish – not worth the extra 5 minutes you get. At first, sessions may take you more than 15 minutes, but as this becomes part of your routine, and more comfortable, you should be able to finish in 15 minutes.
Now For Storing Your BM:
Bring a cooler to put your bottles of milk into – although clean and natural, most colleagues don’t appreciate bottles of breast milk in the employee fridge. If you will be home within 4 hours, you don’t even need to put the milk in the cooler! Expressed breast milk is fine at room temperature (<77degrees) for up to 4 hours. I actually just put my pump supplies in the cooler bag with the bottles since I didn’t have time to thoroughly clean them between pumping, but hopefully you wouldn’t be as rushed and could store your cleaned pumping supplies out of the cooler. You can purchase breast milk freezer bags. I then labeled the bags with the date and amount (before filling). It is helpful to know the amount for when you need to thaw out milk for the babysitter. I pumped into bottles, then transferred to storage bags right away. Do not fill them too full – BM expands when frozen! Then when I got home I could easily slip the storage bags in the freezer (lay them flat until frozen, then you can pack the frozen bags one after the other standing up to conserve room) and wash the supplies so they would air dry by the next morning. Do not cheapen out on freezer bags – I bought the discount ones figuring they were just bags, and they leaked more than once! Not again. Also, when thawing out from the bag make sure to put the bag in a bowl to collect any milk that leaks out. A frozen bag rips somewhat easily after weeks of being moved around in the freezer. You can store BM in the fridge for 4 days, and up to a year in the freezer. If you won’t use it soon, freeze it to protect the quality of the breast milk contents.
Don’t get Overwhelmed – YOU CAN DO IT!
I know this is a lot to take in and pumping is such a pain, but know that all of this effort is so worth it for your baby! With time pumping becomes easier, more efficient, and just part of the routine. You can do it – keep feeding your baby the absolute best nutrition their little growing body can get!
How do I find lactation help?
Do not feel like you are alone. There are many good resources out there to help you successfully breastfeed. Check out La Leche League International to find a lactation consultant near you. Your child’s pediatrician and your OB are also great resources.