Monday, April 9, 2018

Breastfeeding Diet: Do Lactation Cookies Boost Milk Supply?

Breast milk supply is the number one issue on the minds of most nursing mothers and the busy working mom is no exception.  Whether she works in the office or from home, feeding everyone but herself is often an issue.

When considering milk supply, the first consideration is always supply and demand.  Are you getting the proper stimulation of nursing or pumping each day?  The average number of nursing or pumping sessions for a mom whose baby is under 6 months is 8 times per day, but often jumps to 11-12 times per day during typical growth spurt periods at 3 weeks, 6 weeks and 3 months.  So if you are not getting at least 15 min of double pumping or 20 minutes of swallowing the number of times mentioned here, that is the first thing to fix.

The next is fairly simple.  It takes 500 extra calories per day to make milk.  If you choose to grab a candy bar for your extra calories, you are not doing yourself a favor as these empty calories will cause you to have less energy later on.  When you body is fueled properly, your body functions optimally.

Having said that, we know in a mom's busy day, shopping and preparing healthy meals and snacks is not always going to happen.  One easy wasy to give your body the fuel it needs for breastfeeding is to choose snacks that not only have healthy ingredients, but these ingredients are glalactgogues that actually boost milk supply.  For you morning breakfast on the run, grab a Boobie Bar as you head out the door.  In addition to whole grain oats, you are getting tumeric to help your imune system, moringa which is high in calcium, iron, pretein, potassium, coconut oil a good source of fat and shatavari for hormone balance and milk production.  These lactation bars come individually wrapped, making it a great grab and go breakfast.

If you are anything like me, the mid afternoon rolls around and you want a sweet snack.  Trust me, there is nothing good in the vending machine.  Milkmakers offers individual packs of lactation cookie bites that hit the spot.  They come in salted caramel and oatmeal chocolate chip and contain oats, brewers yeast and flax seed for milk supply as well as lecithin which actually helps the breast milk fat slide off the lactiferous sinuses for better milk transfer.

And coincidentally, eating one Boobie Bar per day at 240 calories plus one MilkMakers Lactation Cookie Bites at 260 calories add up to the extra 500 calories you need per day!

In summary, lactation cookies and bars can help milk supply.  Many moms report a boost in their milk supply with the addition of these products.  The Boobie Bar company reports the average increase a mom sees is 1.5-4.6 ounces daily and Milkmakers report that in at least one focus group 100% of moms reported positive results.  I am more of a skeptic as I have been serving nursing mothers since 1993 so I would say that you can't please all of the people all of the time, but the odds are definately in your f(l)avor!

Happy Snacking!

Friday, April 6, 2018

Breastfeeding Pain Diagnosis: Yeast Infection and Thrush

I would love to tell you that breastfeeding is always easy, but unfortunately that is not always the case.  When you look up the word tenacious (te·na·cious) in the dictionary, I picture the nursing mother who has been tried by the challenges that sometimes come with breastfeeding.

Today, I am addressing a challenge that literally tries a mom by fire, yeast infections.  Yeast on nipples often exhibits itself as a burning sensation and sharp shooting pains in the breast even in-between feedings.   If you have pain only during the feeding, you need to address the latch.  Yeast naturally occurs in our bodies, but the overgrowth of yeast often as a result of oral or IV antibiotics can be a real challenge.  The good news is that it is fairly easy to diagnose and curing the overgrowth is manageable, especially if you know how to avoid a recurring incidence.

Lets start with the diagnosis.  As I said, the mother with yeast will normally have burning sensation on her nipples and sharp shooting pain in her breast during and in-between feedings.  Yeast is highly contagious so if you are experiencing these symptoms, check your baby for thrush in the mucosa lining of the mouth, not just white patched on the tongue which could be milk.  The baby might also have a bright red diaper rash.  NOTE:  Mom's nipples might not be red nor have a white spot and baby may have absolutely no symptoms and mom can still have a yeast infection if she has the burning, sharp shooting pain.  In either case if yeast is diagnosed, both mom AND baby must be treated simultaneously even if baby is asymptomatic otherwise the pair continue to pass the yeast infection back and forth and curing it becomes extremely difficult.

There are a few ways to diagnose yeast.  Initially the visual and pain cues I described before can lead you to suspect yeast.  Second, you can see your doctor: but if the thrush is not visible, he may have to test for the fungal bacteria which could delay your treatment.  The easiest way to check for a yeast infection on the nipples is to wash your hands and apply Gyne-lotrimin (clotrimazole) or Monistat (miconazole nitrate) to dry nipples after each feeding for 24 hours to see if your pain is starting to diminish.  You will find this with the vaginal yeast treatment in most drug store and heath and beauty section of grocery stores.  Make sure that the one you are purchasing is not just in suppositories, but has a tube that you can use like a breast cream.  If the pain is beginning to diminish (you are not yet cured) within 24-48 hours, it is most likely a yeast infection.

You have a yeast infection on your nipples.  What's next?

1.  After each feeding, air dry or sun dry nipples before applying the clotrimazole or miconazole with clean hands.  You can air-dry nipples by fanning them with your nursing pad, allowing them to dry naturally or use the sun or even a blow dryer on a cool setting if you are in a hurry.  These anti-fungals absorb in the skin within 15 minutes, so there is no need to wash them off before the next feeding.  It is not advisable to wash your nipples with a washrag when you are breastfeeding as you can actually remove the protective keratin layer on your nipples.

2.  Seek treatment for the baby.  Remember that mom and baby must be treated simultaneously even if one or the other does not have symptoms.  There are over the counter treatments for thrush in the baby such as gentian violet, but it quite messy so I recommend calling the pediatrician for oral Nystatin and following the directions.

3.  Change habits to promote healing.  Always use nursing pads to avoid contaminating your bras and only breathable disposable nursing pads.  We do not sell them, but we recommend Lansinoh and Ameda Nursing Pads as they do not harbor yeast.  Some pads have a plastic lining or are made with products that do not promote breath-ability, so stick to these brands to be safe.  You can find Lansinoh in most stores.  Wash hands frequently and sterilize breast pump parts, bottles, nipples, nipple shields, feeding syringes with each use.  Normally due to the anti-fungal properties of breast milk, you only have to sterilize breast pump parts once per day, but better safe than sorry!
In addition eating habits needs to be curved during a yeast infection.  Mom should eliminate wheat, refined sugar, alcohol and honey to promote a healthier intestinal flora instead of feeding the overgrowth of yeast.

4.  Complete treatmentGive the Nystatin and Gyne-lotrimin or Monistat a full week to 10 days for treatment.  If both mom and baby are now symptom-free, treat for 3 additional days to know out any residual infection and remove any items that may be prone to harboring yeast.

What do I need to discard to avoid re-occurrence of yeast?

- breast cream 
Moms usually will put breast cream on the second nipple with the same finger they used to apply to the first nipple.  So unless you washed you hands between applications, the breast cream or coconut oil has go to go!
- washable nursing pads
You cannot kill yeast by washing or boiling.  The only thing that will kill yeast is an anti-fungal so pitch the washable nursing pads you used while you had symptoms!
- breast pump parts
Any breast pump parts that have come into contact with the breast milk must be scratch-free or non-porous.  If you used a bottle brush to clean your parts, pitch everything.  If you washed them carefully, get rid of valve membranes, duckbill valves, bottle nipples and replace any filters or back-flow protectors as well.
- feeding supplies
If you used a bottle brush to clean your bottles, pitch everything.  If they were washed with a soft cloth or in the dishwasher, you can just discard bottle nipples and some brands have rubbery sealing discs.  Even baby feeding syringes have a rubber plunger, so if you used one to feed breastmilk or give medicine, discard it and replace.
- breast milk
Any breast milk that you pumped during your yeast infection must be given to the baby during the first week of treatment.  During the three days that you are treating the yeast to avoid recurrence, only feed the baby directly from the breast, freshly expressed breast milk or milk frozen prior to the initiation of the yeast symptoms.

Here is to putting out the fire!

Monday, April 2, 2018

Pumpin' Pal - Getting the Most out of an Angled Breast Pump Flange Size

Finding the right breast pump flange size is your first concern when starting to pump, but as you continue to pump exclusively or for working and breastfeeding, investing in a more comfortable flange can help not only your body, but your baby's milk supply.  Pumpin' Pal Super Shields offer a multitude of benefits including:

  • Eliminating constriction of milk ducts that can be cause by traditional flanges
  • Promoting better milk flow
  • Helping prevent plugged milk ducts and mastitis
  • Reducing nipple irritation
  • Saving mom from back aches caused by leading forward
While Pumpin' Pal Super Shields are effective in most cases, you will want to know if and how they fit with your breast pump before you invest in these breast flanges.  Pumpin' Pal M-XL work best with breast pump brands that have two piece breast shields such as Medela, Lansinoh and Hygeia.
Pumpin' Pal Small and X-Small include an adapter to work with two piece breast shields, but also fit into the following one piece breast shields very nicely:  Spectra 24 mm and Ameda 25 mm Breast Flange.

The Pumpin' Pal company also recommends use of these Super Shields with other breast pump flanges, but in our experience layering the hard flanges into another hard flange can be a bit awkward.  We have pictured some Pumpin' Pal Super Shields below so you can see how they will fit.

Again, start with finding your correct breast flange size.  Then work with making pumping the most comfortable experience possible because not only does flange size matter, but tension from pumping in an uncomfortable position can reduce oxytocin and therefore reduce milk supply.
On a concidental note, getting a discount actually increases oxytocin in most people including nursing mothers, so we are offering 25% OFF on Pumpin' Pal you can use during the month of April 2018!  If you are reading this blog at a later date, check out our breastfeeding coupon code  o breastfeeding sale page for another boost of!

Here is to more comfortable pumping!

Tuesday, March 27, 2018

How to Use a Baby Feeding Syringe for Breastfeeding

It is recommended that breastfed infants are fed exclusive of a bottle for at least 6-8 weeks while learning to breastfeed.  Bottle feeding greatly changes the way the infant sucks and their expectations for immediate gratification while feeding.  Feeding from a bottle provides immediate gratification because bottle drips even when sucking does not occur.  This causes the infant to thrust their tongue to the end of the nipple or to arch their tongue to collapse the nipple on the roof of their mouth to control the flow.There are several methods of supplementing a newborn with breast milk during the early days.  For short term feeding solution, we recommend finger feeding with a syringe.  This method is tried and true and can be learned by both parents and baby in a matter of minutes.


Wash your hands.

Sit with your feet on a stool or anywhere you can raise your knees.

Place the baby in your lap facing you so they are in a reclined with their head above their body.

Draw the breastmilk into the syringe from an open container.  This can be done with one hand once you learn to pull the plunger up with your thumb.

Allow the baby to suck on the index finger of your non-dominant hand.  Your finger should be in far enough that the infant's tongue is attempting to draw it in with a peristaltic wave motion.  If Dad is feeding and has large fingers, he may want to turn his hand and use his pinky finger.

Using your dominant hand, place the syringe full of breast milk in the corner of the baby's mouth.

Wait 30-60 seconds before tapping the plunger so that the baby understands that they need to suck before the milk lets down when they return to the breast.

Tap the plunger every 3 sucks, but not every suck so they establish a breastfeeding pattern of suck, suck swallow.

Remember that a newborn's stomach is the size of a cherry when they are born so during the first few days, the teaspoons of colostrum are all that is necessary.

If there is a reason to syringe feed beyond day 5, refer to the infant feeding chart for ounces needed.  A 10 cc or 10 ml baby feeding syringe is 1/3 of an ounce so it is easy to know that re-filling this syringe 3 times is 1 ounce.

Attempt burping after 1-3 times of re-filling the syringe.  If the baby is spitting up or taking the milk too quickly, burping is a good way to slow the feeding and eliminate excess air.

Syringes are an inexpensive way to supplement a newborn without interfering with breastfeeding.  This lactation aid may be a tool you will want to have in your arsenal in case your baby has latch or suck difficulties such as the ones that can arise from tongue tie.  A sleepy  baby can also become more lively if breast milk is supplemented correctly so they will have enough energy to stay awake at the breast.

Best wishes for a bottle-free start to breastfeeding!

Saturday, March 10, 2018

Ameda Finesse Breast Pump Comparison

The Ameda name is synonymous with breast pump innovation.  Long before Medela was on the scene, Einar Egnell created the first breast pump that mimicked sucling in infants and set the standards for cycling and suction we use today and founded the Ameda Egnell company 75 years ago.  Ameda has been a consistent force in helping nursing mothers reach their goal.

As lactation consultants, we watched other companies pull ahead in innovations; but when Ameda came out with the Platinum breast pump, Ameda surpassed them all!  The Ameda Platinum Breast Pump far exceeds the other hospital grade breast pumps including the Medela Symphony in it's performance, efficiency, comfort and adaptability with more speed and suction settings than any other breast pumps on the market today.  Ameda has created the Finesse Double Electric Breast Pump with the same waveform technology that it in the Ameda Platinum.  Waveform is what is measured when you study an infant's suckling at the breast as shown below.

The Ameda Finesse mimics the Ameda Platinum's natural rhythmic waveform in a personal breast pump.  The Finesse offers a long life with a 2 year warranty and reliable performance throughout the life of the pump.  What does this mean for the mom?  She doesn't have to worry about the motor weakening as she uses the pump month after month or even year after year.  Having said that, in any breast pump suction will decrease if crucial breast pump parts such as the Ameda valves and Ameda diaphragms are not replaced.  Frequency of replacement depends on the mothers use, but for the full time working mother these two pump parts should be replaced every six to eight weeks.  Unlike other manufacturer's Ameda's parts are interchangeable with all their other breast pump parts so the same Ameda Hygeinikit Double Collection Kit that works for the Ameda Platinum and Ameda Purely Yours works with the Ameda Finesse Breast Pump.  The collection kit for the Ameda Finesse Breast Pump includes the standard Ameda 25mm breast flange plus the additional 30.5mm larger flange for a CustomFit breast flange.

The Finesse Breast Pump is quiet at only 41 decibels quieter than most pumps and far superior than the Medela Sonata which tests at 43.8 decibels.  We do not recommend Medela personal breast pumps since they do not offer closed systems to protect the mother and the milk from bacteria.  Ameda breast pumps have a proven airlock protection and an FDA approved viral and bacterial barrier which is the Ameda diaphragm.  

The Ameda Finesse Breast Pump is portable and lightweight.  The motor itself weighs only 1 lb and is 6.7" long, 4 4.5" wide and 3" tall which is slightly smaller than the Ameda Purely Yours Breast Pump.  As with the Purely Yours, the Finesse still offers custom control with 4 speed settings and 8 suction settings.  Power sources available are still AC, AA batteries (not included) and car adapter (sold separately).  

In my 25 years of experience, the Ameda Finesse is at the top of the list when choosing a personal portable electric breast pump.

Happy Pumping!

wedish engineer, Eiwedish engineer,Einar Egnell made it his life’s work to help breastfeeding moms. After years of research, Egnell created the first comfortable and effective breast pump that closely mimics the suckling rhythm of nursing infants. In the process, Egnell also created the vacuum and cycling standards that have since become the industry benchmark.nar Egnell made it his life’s work to help breastfeeding moms. After years of research, Egnell created the first comfortable and effective breast pump that closely mimics the suckling rhythm of nursing infants. In the process, Egnell also created the vacuum and cycling standards that have since become the industry benchmark.

Friday, March 2, 2018

Troubleshooting: Breast Pump Replacement Parts for the Hygeia Breast Pump

If your Hygeia Breast Pump is not suctioning the way it used to, the culprit is usually one of two parts, the duckbill valve or the bacteriostatic filter.

The number one cause of low suction is a torn or worn out valve. The tip of the Hygeia duckbill valve must be able to close completely.  If it remains open, the amount of pressure your pump can provide is decreased.  As a rule, if you are pumping three times per day or more, replace duckbill valves every six to eight weeks at minimum.  If you are like most moms and you have multiple valves that you interchange and you notice a decrease in suction and want to determine which part needs to be discarded, switch to single pumping.  To do this, you will remove the tubing from one side and cover the opening with the port cover attached to the bacteriostatic filter.  Place the remaining breatshield still attached to the pump on one breast and test the suction.  If the nipple is being drawn in normally, remove the breast shield from your breast and remove the bottle from the breast shield.  Then remove and replace the duckbill valve to test the next one.  Continue to do this which each valve you have in your stash and discard any valves that are not performing well.  This way you don't use valves that may compromise your milk supply with inferior suction.

It is harder to visually determine when the Hygeia bacteriostatic filter needs to be replaced, but the rule of thumb is that whenever you replace a valve, replace the filter.  At the very least, if you are a working mother or an exclusively pumping mama, replace the filter every 2-3 months whichever comes first.  

Buying replacement parts is a small price to pay when the reward is a healthier milk supply.  Lactation Connection makes this easier with their subscription service.  With the Hygeia Replacement Parts Program, moms can choose to get parts delivered to you every 3 months for 2 shipments, 3 shipment or 4 shipments.  Each shipment arrives with free shipping and an option to add additional items that ship free along with your subscription in case you need more bottles, milk bags or any other breastfeeding supplies.  The subscription service takes the guesswork out of  replacing breast pump parts.  

During the month of March 2018 in honor of our 25th year in business, Lactation Connection has partnered with Hygeia to offer moms some exclusive deals.  We are really excited about the March Hygeia sale!  All Hygeia breast pumps and accessories products are 25% off, all month long with no coupon code needed.  Every order that includes Hygeia products during the month, will receive a free gift of a breastmilk storage guide magnet, samples of milk bags and nursing pads and a coupon for a future Hygeia order.  In addition, every mother who places any order at Lactation Connection during March 2018 has a chance to win a Hygeia Nursing Stool.  It is so simple!  If your order number ends in the number 25, you win and your stool will be shipped with your order.  That is a 1 in 100 chance of winning, so the odds are pretty great!

Best wishes for a healthy milk supply and good luck on winning a nursing stool!

Tuesday, February 27, 2018

Milk Supply: How Do I Know if My Newborn is Getting Enough Breast Milk?

Once your newborn is at least 6 days old, there are some guidelines to help you be sure of your milk supply.  Note that insufficient milk supply is rare.  What is more common are practices that can hinder your milk supply or baby's feeding which I will detail at the end of this post.

To assess good milk transfer, answer the following:

  1. Is the baby wetting 6-8 diapers in 24 hours? (Disposable diapers are so absorbant, that it might be hard to tell.  If you are unsure, take a clean diaper in one hand and the removed diaper in the other and you should be able to tell by the slight weight difference.)
    Yes  |  No
  2. Is the baby having 3-4 bowel movements in 24 hours that are mustard yellow with curds in them? (These shold be silver dollar size or larger, not just a stain.)
    Yes  |  No
  3. Do the breasts feel full before feeding and softer after feeding
  4. Yes  |  No
  5. Do you hear swallowing when the baby is breastfeeding?
    Yes  |  No
  6. Is the baby eating at least 8 times in 24 hours?
    Yes  |  No
  7. Does the baby seem satisfied after a feeding?
    Yes  |  No
  8. After the initial weight drop, has your baby started gaining 3/4 - 1 ounce per day?
    Yes  |  No                                                               
  9. If tyou had some nipple soreness, is gone?                                                                                    Yes  |  No
Practices that hinder milk supply include "scheduling".  Making an infant wait for feedings, lowers milk supply and slows weight gain.  Infants may need to eat at 1-3 hours apart during the day, especially between day 10 and three weeks when the first grown spurt occurs.  The only scheduling that should occur is if the infant has not asked to be fed at the 3 hour mark from the beginning of the last feeding, it is time to nurse.  A mininum of eight times a day is normal for a newborn.  The longest stretch you could hope for is one 5 hour stretch.  It is common for newborns to feed up to 12 times per day during a grown spurt.  This practice ensure a healthy milk supply for a growing baby as milk supply follows a demand and supply principle.

Other practices that can hinder milk supply are the use of a nipple shield.  While they have a time and place to assist in latch.  They are not a cure for sore nipples and should not be used unless necessary and discontinued as soon as possible.  When using a nipple shield, a cut out ultra thin silicone nipple shield is best.  Place the cut out at the baby's chin so that the skin to skin can elevate your hormone response which increases milk supply.

Another practice than can reduce milk supply is unresolved engorment.  When the milk first comes in 3-5 days postpartum, softening the breasts with warm moist heat from a compress or disposable diaper doused with hot water and warmed in the microwave is essential before nursing or pumping so that milk is more effectively extracted.  Milk that is not extracted actually reduces milk supply as your body is being signaled that you do not need the milk.  That is why the practice of waiting for an insurance pump is not the best idea.  If your insurance company will not allow you to get a pump until after the birth, go with a private pay DME.  That way, you can order the breast pump on the day of the baby's birth and it will be at your doorstep between 3-5 days when you need it most.  You then have to file for reimbursement with your insurance company, but it beats waiting around for a company to bill your insurance and you may not have your pump when you need it most. 

Here is to a Healthy Milk Supply, Mamas!