Tuesday, July 26, 2016

Comprehensive Guide to Increasing Breast Milk Supply

Your body makes milk on a supply and demand basis. Although we don't need ounce markers on the side of our breasts to know the baby is getting enough, we tend to fret over milk supply.   Here is a comprehensive guide to easy your worries and address your concerns.

Is my baby getting enough?
When your baby is first born, his wet diapers should increase daily. On day one, he should have at least one, day two, he should have two, up until day six. After six days of age, they have six to eight pale wet diapers daily and three to four "cottage cheese and mustard" stools. Other ways we can tell the baby is getting enough milk is that he makes quiet swallowing sounds at the breast. The breast feel full before the feeding and softer afterward. The baby seems satisfied after twenty minutes of swallowing. Babies may loose 7-10% of their birth weight, but begin regaining at day 6 and gain 5-7 ounces per week on the average until 6 months of age. The stools can change at 4-6 weeks of age. Only if your baby is not gaining well, invest in a good baby scale that you can use to monitor breast milk intake and growth.
Do I need to drink more water?
Water does not make milk, but make sure you are drinking to thirst. If you are dehydrated your body does not function optimally.  
Can I increase my milk supply with supplements?
If you want a boost increasing milk supply, there are several galactagogues on the market. Fenugreek is safe and effective and can be found in most areas. Make sure you are talking a quality brand like Nature's Herbs or Natures way in an appropriate quantity.  You should take 600-626 mg capsules that only contain Fenugreek.  This normally increases milk supply in about 48 hours.  If you are an average size mom, you should take three capsules, three times daily so 9 per day.  Plus size moms can take up to 5  600-626 mg capsules per dosage for a total of 15 per day.  Make sure you are not getting loose stools and check milk supply after 3 days by nursing the first session in the morning and then double pumping with a good quality double pump like the Hygeia EnJoye LBI, Spectra S2, or the Ameda Purely Yours breast pump for 15 minutes. If you don't own a quality pump, hospital grade breast pump rentals are available monthly for delivery nationwide.

How much is enough?
You should be yielding 2.5 oz per lb of baby's body weight per day.  To calculate if you are making the appropriate amount take your baby's weight for example 8 lb multiply by 2.5 which in this case would equal 20 oz per day.  Then divide by 8 times per day for a baby under 6 months.  This means from both breasts you should be making 2.5 oz for an 8 lb baby.  Here is a link to a page where you will find to an easy to read milk intake feeding supply chart.
Can I increase my milk supply with a breast pump?
Yes!  If your baby will nurse frequently even if milk supply is low, use the baby; but if your baby will not latch or will not stay latched long enough for you to get adequate stimulation, by all means use a quality pump like the Hygeia EnJoye LBISpectra S2Ameda Purely Yours or the Ameda Platinum Breast Pump.  If your baby is under six months old, you should be pumping or nursing at least 8 times per day for 10-15 minutes of double pumping.
If you are already nursing eight times per day, use your breast pump to simulate a growth spurt.  Studies show that you need one hour of additional stimulation per day to increase milk supply.  Pump an additional 10-15 minutes three times per day for five days in a row to simulate a growth spurt and increase milk supply.  If you miss a day, start the process over. You can accomplish this by moving feedings and or pumping to every 2 hours instead of every three or pump.  Frequency is better than duration for increasing milk supply so don't cheat by making pumping times longer.  They need to be more often.
Are there other supplements that help with maintaining milk supply?
There are several other supplements that I would recommend substituting for snacks. Instead of a candy bar, grab a Boobie Bar.  Instead of a cookie, grab a Milkmakers Lactation Cookie.  Moms do need an additional 500 calories per day to make milk.  Most of us get them instinctively, but if you are already over your calorie limit, a good mothers milk tea is a good option.  Nursing Mama Tea now even comes in kcups!

Are there other tips for maintaining a healthy milk supply?
Busy moms can sometimes miss feeding and or pumping.  Don't just forget them, make up for missed pumping times at work when at home or put later in the day pumping closer together if you have a meeting.  If you are out for a short time and someone else is fed the baby before you could make it back, make sure to pump immediately upon return.  This helps milk supply as well as restocking your freezer.
Is my body capable of making enough milk?  
Insufficient milk supply syndrome is actually very rare.  A mother with a complete mastectomy on one breast can still nourish a baby just as a mother of twins can nourish two. Most milks supply issues are about mismanagement of stimulation of the breast and insufficient extraction of the milk, making your body think it doesn't need to make more.  
What other tips do you have for managing milk supply?

  • Nurse within the first 30 min to 1 hour after birth, delaying the bath for skin to skin contact.
  • Try to minimize engorgement and don't leave engorgement unresolved.  Nurse often, waking the baby every 2-3 hours.  Use warm compresses and a breast pump if the breasts are too hard for the baby to latch on.  The first day, the baby tends to sleep longer after the initial hour after birth, but continue to try and after that 6-10 hour period increase your efforts.
  • Don't miss feeding unless you are pumping.
  • Don't forget about growth spurts when you are working.  If you are away from your baby at the 3 week, 6 week, 3 month or 6 month time period, pump every 2 hours instead of every 3 for a total of 11-12 nursing or pumping sessions per day.
  • Delay solid foods until the baby had not only double his birth weight but is sitting alone unassisted.  Sitting without help (even from a Boppy) coincides with the loss of a tongue thrust reflex that indicates readiness for solids.
  • Feed solids only after breastmilk.  Breastmilk is still the main source of nutrition for at least the first year so do not fill the baby up on inferior food.  Nurse or give breastmilk first.  Besides, who wants green beans on your breast?

Here's to a healthy milk supply!

Fenugreek: One Remedy for Milk Production by Kathleen Huggins, RN, MS
Fenugreek: Overlooked but not Forgotten by Rima Jensen, MD

Thursday, July 14, 2016

Breast Milk Intake Scale

One of the top questions we get, is how much do I leave for my baby in a bottle when I am away at work?  After all, your breasts don't come with ounce markers because your baby feeds on demand.  But for moms who are working or away from their baby short term, it is important to know how to determine how much milk is appropriate to leave.  For infants up to six months old, the quickest way to determine this is to take your baby's current weight rounding up to the nearest half pound and multiply by 2.5.  For example, a baby who is 10 lbs will need 25 ounces per day.  Then divide by the number of feedings per day, normally 8 for an infant under six months of age.  Therefore 25 ounces divided by 8 feedings is 3.12 ounces per bottle which we will round up to the nearest quarter ounce.  In other words, leave 31/4 ounces for a 10 lb baby for every 3 hours that you will be away.  Also leaving an extra frozen bottle is a good idea for emergencies.  Here is a link to a breast milk intake chart for those of you who are like me and have a mental block when it comes to math.
Breast Milk Intake Chart
If you are trying to determine breast milk intake in those early days for your peace of mind or if your baby doctor is indicating that your baby is slow to gain weight, an affordable accurate baby scale with memory is a great tool.  The Hygeia Baby Weight Trending Scale is a great option. Because of  the price value and accuracy within .18 of an ounce, this makes a great breast milk intake scale for home use and for visiting lactation consultants.
Remember, diapers are a great indicator that your baby is getting enough.  Infants from day 6 through 6 weeks should have 6-8 wet diapers per day and 3-4 dirty diapers larger than a silver dollar.  Also note that older babies who are on solid food do not use this chart.  At that age, they take an average of 24-32 oz per day in addition to three solid meals per day.  When feeding solid foods, breastfeed first as breastmilk is still the main source of nutrition.  

Best wishes!

Monday, July 11, 2016

World Breastfeeding Week 2016

World Breastfeeding Week is upon us! The theme for World Breastfeeding Week 2016 is Breastfeeding:  A Key to Sustainable Development.  Breastfeeding has so many benefits, but this year the focus is sustainability.  A few of the key points that are being used as the focus for this year are:

No Poverty - Breastfeeding is naturally a low-cost way of feeding babies that does not put an economic burden on the household.

Zero Hunger - Breastfeeding is food security for infant through age two and helps prevent hunger, malnutrition and obesity.

Health & Well Being - Breastfeeding improves the development, health and well being of the infant as well as improves health of the mother.

Education - Breastfeeding improves mental and cognitive development and therefore improves learning.  Educating our children help sustain the future of society as a whole.

Many breastfeeding coalitions will be hosting World Breastfeeding Week events during August 1st-7th.  Lactation Connection supports these endeavors such as the Big Latch On with donated Amamante Nursingwear auction items for these events.  If you know of an event in your area, please comment with a link to the event so local moms can attend.

Our company, Lactation Connection has been promoting breastfeeding since 1993 and provides quality affordable products to nursing mothers as the need arises.  In honor of World Breastfeeding Week, we will be offering our lowest prices of the year on nursing bras, nursing gowns and nursing pajamas.  Nursingwear is more than a luxury, it helps mothers feel comfortable promoting sustained breastfeeding past the first year.  So take advantage of our $10 nursing bras, $15 nursing gowns, and $20 nursing pajamas during our World Breastfeeding Week flash sale!  When sharing this sale, don't forget the #wbw2016 hashtag.

Believe it or not, new couples and new mothers still do not all know about the benefits of breastfeeding.  Spread the word!

Happy #wbw2016

Thursday, June 16, 2016

Pump Up Your Production: Milk Supply and the Pumping Mama

With today's easy to use breast pumps, moms sometimes think they just need to pump at work at lunch and break and then just go about their business.  Pumping, just like breastfeeding should be intentional.  We don't choose to breastfeed because someone said it is better for your baby.  We breastfeed because we educate ourselves to want the best for our child.  Pumping should also not be so haphazard.

First choose a quality hygienic breast pump.
There are many breast pump out there that while commonplace, are not the best choice.  You need an auto-cycling breast pump that does at least 60 cycles and has a closed system like Hygeia, Ameda and Spectra offer.  Double pumping increases the prolactin levels as well as save you time. Prolactin is the milk producing hormone.

Next determine your pumping schedule.
A mother of an infant under six months should pump at least every 3 hours that she is away from her baby.  That time frame is from the beginning of one pumping or nursing session to the beginning of the next.  If your schedule is erratic, you should still pump 3 times per day on an 8 hour work day. Just put some of them closer together if needed to get this time in.

Allow enough time for pumping.
You should allow a full 10-15 minutes for double pumping and then an extra few minutes to rinse your parts and put them away.  Do not stop pumping if milk stops flowing unless the time on the clock has passed.  Otherwise your body will think you don't need as much milk.  A good rule of thumb is that if milk is flowing for less than 10 minutes, pump for 10. If it is flowing past the 10 minute mark, pump for 15.  These extra few minutes simulate the non-nutritive sucking your baby does when nursing and is imperative for milk supply.

Don't forget about growth spurts.
Infants nurse more frequently during growth spurts.  At 10 days to 3 weeks, the first growth spurt is evident with the baby asking to be fed more frequently.  Breast pumps don't cry to be used so we have to intentionally pump more often during this 5 day period.  Pumping every 2 hours is best during the baby's third week, sixth week and three month milestone.  If this is not possible at work, pump at home after feeding the baby at least three extra times per day.  Don't worry about the amount of milk you are extracting.  This is more for stimulation than extraction, indicating to your body that your baby is about to grow and will need more milk.

Maintain your breast pump.
Professional grade breast pumps like the Hygeia EnJoye, Spectra S2 have systems that are dependent on maintaining suction.  Replacing breast pump valves and filters every six to eight weeks is essential for keeping your breast pump working at it's optimal level.  Keep breast pump parts on hand and replace on schedule or more often if you notice evidence of decreased suction or damage to your parts.

With good information prior to embarking on full time pumping or working and breastfeeding it is entirely possible for you to maintain a healthy milk supply.

Happy Pumping!

Wednesday, June 15, 2016

Nursing Nightgown: Nursing Gown Review

What are moms looking for in a nursing nightgown?  Soft breathable fabric, easy nursing access and something made right here in the USA that won't fall apart before you can use it again with the next baby!
The Amamante Nursing Gown collection offers something for every mom.  We love the Signature Nursing Gowns because they have a built in sleep bra that just pulls down to nurse.  So when that bilateral let-down occurs (nursing on one side and leaking on the other), your nursing pad is held in place by the soft sleep bra style cups that are contoured to your curves.
Amamante Signature Nursing Gown in Plum

What else should you be looking for?  Soft, breathable fabric that doesn't show wear prematurely and comes out of the dryer looking as good as new.  Amamante is right on point with 96% rayon and 4% spandex offering a two way stretch that moves with you.  In addition, the straps are top notch because they are made with fold-over trim to stay in place and not all all too common cheap substitute that the ones made in China offer.
Finally, we all want value.  You are not going to buy a $20 gown that will keep its shape for the long haul, so Amamante are priced in the mid-range making them accessible for all moms, a great gift for the mom on a strict budget and a great value for the moms who wear them well after weaning.
Hands down, we think this is the best nursing nightgown on the market today!
Most recently, Amamante has come out with the Belleza Nursing Nightgown.  It offers the same empire waist usable for both maternity and nursing, but with a soft lace inset instead of the elastic bra band that comes with the Signature Nursing Gowns.  The Belleza nursing gown is also a couple of inches shorter for moms who prefer a shorter nightgown.  Amamante's designes are made with mothers in mind and babies at heart, but they didn't forget daddy with this feminine flattering nursing nightgown!

Monday, April 18, 2016

Pumping Schedule: Working and Breastfeeding

We get this question often as to how to ensure a healthy breast milk supply while working and breastfeeding.  Just as in raising kids, consistency is essential.  Most moms return to work when the baby is 4-8 weeks old so we will give you a typical schedule to keep you on track as well as a schedule for the early growth spurts.

This schedule is for a 24 hour period on any given 9-5 workday and can be modified to your changing schedule.  The imperative is to nurse or pump every 2-3 hours for a total of 8 times per 24 hour period when your baby is under 6 months old.  If you choose to delay solids past 6 months, then continue this schedule until solids are introduced.

Please note that we are not advocating scheduling a baby's every feeding.  Feeding on demand is best for milk supply so if your baby asks to be fed earlier that your normal "schedule" by all means, feed your baby.  We do however find that working mothers benefit from a routine when it comes to pumping to ensure that they do not miss feedings and therefore do not adequately stimulate the breast which lowers milk supply.

Sample Feeding - Pumping Schedule for Infants who Night Feed

6:00 am feeding

8:30 am feeding

11:30 am pumping

2:30 pm pumping

5:30 pm feeding

8:00 pm feeding

10:00 pm feeding

3:00 am feeding

Once the baby begins sleeping through the night, put daytime feedings/pumping closer together so that you still meet the 8 times per day minimum feedings.  

Sample Feeding - Pumping Schedule for Infants who Sleep Through the Night

5:00 am feeding

8:00 am feeding

11:00 am pumping

1:00 pm pumping

4:00 pm pumping

5:30 pm feeding

8:00 pm feeding

10:00 pm feeding

This schedule will vary when your baby is going through growth spurts.  PLAN on feeding or pumping every 2 hours for a total number of 11-12 times per day during the week that your baby is 3 weeks, 6 weeks, and the week that your baby turns 3 months old.  This will help ensure that your milk supply grows with your infant's needs.  For at least 5 days during that period, you will want your feeding and pumping schedule to look something like the one below:

Sample Feeding - Pumping Schedule for Infants During a Growth Spurt*

3:30 am feeding

5:30 am feeding

7:30 am feeding

9:30 am pumping

11:30 am pumping

1:30 pm pumping

3:30 pm pumping

5:30 pm feeding

7:30 pm feeding

9:30 pm feeding

11:30pm feeding

As a working mother, you should choose a quality closed system double breast pump such as Spectra, Hygeia or Ameda make.   The convenience of a hands-free pumping bra is nice.   Make sure that you are changing your breast pump valves and filters or backflow protector to keep your breast pump working at it's optimal suction levels.  Do not risk low milk supply by not replacing your breast pump parts.  Use a phone app timer or equivalent to make sure you pump for a full 10-15 minutes of double pumping whether milk is coming out or not.  The law of supply and demand when it comes to breastfeeding is more like DEMAND and then the SUPPLY will come!  

Happy Pumping,

*Growth spurts typically occur either at 10 days or 3 weeks, and then recur at 6 weeks, and 3 months and last for 5-7 days.

Tuesday, March 29, 2016

Getting Ready for Breastfeeding: Nursing Bras & Nursing Gowns

One of the questions we get most often in the last trimester of pregnancy is what do I need for breastfeeding?  Moms may need a breast pump to return to work, but most often the real question is what clothes do I need.  You don't need to have a full on wardrobe for breastfeeding, but a few essentials will make your life easier, and even help you succeed at breastfeeding.  We see moms get frustrating trying to pull up a non-nursing gown to access the breast or even get plugged milk ducts from pulling a tight sports bra up from the bottom or an under wire bra down from the top.  Even when moms are not on a strict budget, they sometimes don't buy a nursing bra simply because they just don't know what size to get.  Here is some advice to make thing simpler:

1.  Sleep Nursing Bra - These are usually under $20 and are a must-have to keep your nursing pads in place.  During the first 6-8 weeks postpartum moms normally leak breastmilk, especially at night. Bilateral let-down also causes leakage so when the baby is nursing on the first breast, the second breast starts to leak.  We all know that new moms don't always get dressed until later in the day so wearing a sleep bra ensures you have some support and a place to hold your nursing pads until you change into your daywear.  By the way, using cotton nursing pads instead of disposable nursing pads will save enough money to pay for everything we mention in this article!  You will want 2-3 sleep bras.  We recommend buying them in the last month of pregnancy. Buy 2 in the bra size you wear at that time and a 3rd one size larger to accommodate for engorgement.

2.  Transitional Nursing Bra - It is futile to try to guess your breastfeeding bra size while you are still pregnant, but you need a nursing bra immediately after delivery.  We have seen too many husbands come in and ask for a bra for their wife.  It is sweet, but pretty comical as they usually have no idea of even what band size she is.  The best course of action is to get a nursing bra with a multi-cup fit.  This will allow you a wider range of sizes with stretch fit comfort which is essential because you are larger during the engorgement period, visibly fuller before and after feedings during the first 6-8 weeks, and regulate down at about 8 weeks when your ribs go back into place.  For example, the Amamante Caress & Contour Nursing Bra in size small/medium fits 32B all the way through 36D.  Other examples of this type of bra are the Bravado Double Plus Nursing Bra.  These type of bras usually range between $30-$35.

3.  Nursing Gown - You will definitely want to invest in a nursing gown or pajama set that easily accesses the breast.  One with an integrated sleep bra can also reduce the number of sleep bras that you purchase.  Amamante Signature Nursing Gown and Serenity Nursing Pajamas have a full sleep bra built in.  Other crossover styles or other styles of nursing sleepwear will need to be worn with a sleep bra to keep your nursing pads in place.  A quality nursing gown or pajama set will run between $30-50.  When creating a budget for nursingwear, keep in mind that artificial infant formula costs between $150-$170 per month.  Use that as a guideline to invest in breastfeeding instead.  

For under $170, you can build a postpartum nursing wardrobe
2-3 Nursing Sleep Bras
2 Transitional Nursing Bras
1-2 Nursing Gowns or Pajamas

Happy Breastfeeding!