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Showing posts from 2013

Ringing in the New Year: Breastfeeding and Alcohol

As the New Year and New Year's Eve parties are approaching, this is a question that Lactation Consultants get asked repeatedly.  While the advice has changed from a pump and dump approach to a you can have as much as you want mentality, the truth is really somewhere in the middle. 
     It is safe to have a New Year's toast after your baby has gone to bed.  It is also safe to have an occasional glass of wine.  The key is moderation and timing.  Alcohol does enter the blood stream and your breast milk.  It is also metabolized quickly.  So one glass of wine or beer or an alcoholic drink that contains one shot of liquor is metabolized in one hour.  If you baby nurses every 2-3 hours and you have one drink, there is no need to pump and dump.  If you have multiple drinks, you should pump and dump.  This is not to get rid of the alcohol as time will do that, but to keep you from getting plugged milk ducts if you do not pump or nurse.  Use the same rule of thumb you would for d…

Breastmilk: It's just not that important!

Although I have advocated for breastfeeding for over 20 years, breastmilk is not that important. I personally was not a breastfed baby. My mother had difficulty nursing her first child and was told she did not make enough milk. She was too discouraged to try to nurse her subsequent children so I did not get a drop of this precious substance.


      What my mother did give me was my upbringing. She raised me to know the truth about who I was. I am not an entitled human being who can do no wrong. Nor am I perfect in the eyes of my parents. I am flawed. I have a broken relationship with my creator and a deep need for healing. This I learned from my parents.       My mother taught me to trust with every time she picked me up while I was crying.  My mother taught me about Jesus from the first time she sang to me. When she rocked me to sleep, she taught me of His love for me. 

      It amazes me that God could have created us, knowing full well that we were going to destroy …

Breastfeeding Secrets Revealed: Position, Hold and Proper Latch

New moms have told me that they wish they had been given more information on positioning and latch as well as the various holds associated with breastfeeding.  So I have decided to reveal these breastfeeding "secrets" here. 
1.  What is the secret to preparing for breastfeeding?
Holding the breast properly!  The c-hold is the proper way to support the breast when learning to breastfeed and should be practiced by expectant and new mothers because almost every new mom does it incorrectly.  How?  Moms tend to place the thumb on top (correct) but place the bottom fingers in the wrong place.  The bottom fingers need to be near the chest wall.  The index finger usually ends up on the bottom of the areola preventing baby from getting a deep latch.  Whether you are already breastfeeding or still expecting, check your c-hold in a mirror to make sure your fingers are out of the way. Also make sure the flap of your nursing bra is not in the way.  Remember, a new baby cannot suppo…

Breast Milk Allergy: Breastfeeding Myth Busted!

The breastmilk allergy myth was further perpetuated on the TODAY show's #bornTODAY series this morning causing me to have to speak out against irresponsible and incomplete journalism. 
The Myth: Some babies are allergic to their mother's milk.
The Facts: Human milk is the most natural physiological substance that baby can ingest which is why breast milk can be used as a "clear liquid" if a baby is ill with a stomach virus and it is also why breast milk does not sting when placed in the eye as a remedy for conjunctivitis.  
     If a baby shows sensitivities related to feeding, it is usually a foreign protein that has been consumed by the mother and entered into mother's milk, and not the breast milk. The remedy for this is to remove the offending food from mother's diet for 3-4 weeks.  One example is dairy.  Dairy is difficult to digest and can take 10 days to two weeks to leave the mother's system and another 10 days to two weeks to leave the nursin…

Why Fenugreek Isn't Working for Breastfeeding

The truth is fenugreek is a great tool to boost milk supply in most moms.  However, in the two decades that I have been helping nursing moms, I get this comment a lot, "Fenugreek didn't work for me."  How can it be that an herb with such great success stories doesn't work for a large number of mothers.  In most cases, the answer is in the quality, dosage or delivery method.

     Many moms buy Fenugreek at a local health food or grocery store in brands that are not stored or bottled in the best way to keep them at full potency.  Also, shelf life factors into this so buying from a store that doesn't cater to the largest market for Fenugreek, nursing mothers, will not have the best turn-around.  It is always a good practice to check the expiration date on any herb before using.  Fenugreek capsules work best when taken in a quality brand like Nature's Herbs or Nature's Way Fenugreek and in the appropriate dosage or combination.   The correct dosage is es…

7 Stages of Breastfeeding: A Baby's Perspective

Just for fun in honor of World Breastfeeding Week 2013, I thought I would write something from baby's perspective as a breastfeeding tip for mom.  Here is one tip for every day of this week!
1.  Birth-day Initiation:  My stomach is the size of a marble.  I am loving being skin to skin with Mama and the reward of a swallow of golden colostrum!
2.  10-Day-itis:  After 10 days, I start my first growth spurt.  I want to eat every hour or two and can't get enough of this liquid gold.
3.  6 weeks:  Breastfeeding is easier for me, but pooping is harder.  I am going through another feeding frenzy and things seem to be changing!  I was pooping all the time, but now only once in a while!
4.  3 months:  Another growth spurt.  Love it!  I get to eat as often as I like and no one complains, but I do get a little distracted 'cause there is so much to see while I'm eating.
5.  6 months:  I'm learning to sit up and trying solid foods just for fun.  My mom always lets me nurse fir…

Free Breastpump! How to Get your Breastpump Covered by Insurance

When the Affordable Care Act was enacted, insurance companies were required to cover breast pumps for new moms at 100%.  There are a few grandfathered policies that are exceptions, but this is a very small percentage so it would benefit any new mom to use this information to pay for her breast pump. 
     This coverage is under preventative care so you should not need a prescription from your doctor.  There may be some stipulations mandated by your particular insurance company so you will want to get that information from them.  For example, some insurance companies are stipulating that only one breast pump will be covered every three years.  In that case, you will want to purchase a pump like the Hygeia EnJoye Breast Pump that has a three year warranty over a Medela Pump In Style that only has a one year warranty.

Use these steps to get started:
1.  Call your insurance company and ask the following questions:
     A.  Is a breast pump covered under my policy?  What type?  Is the…

Supplementing the Breastfed Baby: Lactation Aid Feeding Tubes vs Supplemental Nursing System & Lact-Aid Nursing Trainer

In my practice as a board certified lactation consultant, there were times when it was medically necessary to supplement.  Whether it was due to a poor suck or mismanaged milk supply, we need options when recovering from these issues and getting back to breastfeeding.  Many times, I would recommend finger-feeding with a syringe to keep moms from using a bottle nipple.  I would have rather recommended a Supplemental Nursing System which has a container with tubes that runs to the breast; but I didn't want to see mom spending the extra money when her budget was so tight.  At that time, the only options were the Supplemental Nursing System (SNS) by Medela and the Lact-Aid Nursing Trainer.   These cost mom $50 or more and had small tubes to be cleaned which were cumbersome.   Now, with more options available, Moms can use a short-term feeding tube which accomplishes the same thing and can be cleaned for a few days before disposing of it.  It is a small investment in comparison to…

Breastfeeding Decreases Chances of ADHD

I know the title is a bold statement, but there is reseach to back this up which I will provide below.  The reason I state that breastfeeding decreases ADHD (attention defecit hyperactivity disorder) so emphatically is that I saw this in my own children who are now 24, 20 and 18.  Twenty-four years ago, professional grade personal breast pumps were not on the market and my doctor gave me very little information about breastfeeding.   When I told him that I had to go back to teaching and coaching when my firstborn was only 4 1/2 weeks old and asked him if I could breastfeed for just that duration, he said yes.  Period.  No further explanation.  There were hospital grade breast pumps that I could have rented.  I didn't know.  I also didn't know that I would be going back to work with bowling balls instead of breasts because I tried to wean over a weekend.  When my second and third were born, I sought out more information and nursed for 15 months and 18 months repectively.  …

Breastfeeding, Co-Sleeping and The Family Bed: Safe Sleep

There is much controversy associated with co-sleeping.  My opinion may be less biased than others because although my husband and I slept with our babies, we started them out in their crib and then when they awoke to feed brought them into bed with us for the rest of the night.  This gave us time alone before the baby came to bed with us and also alowed them to sleep though the night without feeding when they were ready. 
     What I am passionate about is the myth that co-sleeping is more dangerous than crib sleeping. 
The Chicago Infant Mortality Study reveals that Breastfeeding Infants have 1/5th the Rate of SIDS. They report a nearly doubled SIDS rate for cosleeping, but this study does not remove the powerful effect of smoking parents from their statistic. When other studies remove this behavior, they find the remaining infants enjoy a greatly lower rate of SIDS for cosleeping versus isolated crib sleeping.There are two kinds of cosleep…

Breastfeeding Essentials: Budget for Breastfeeding

We all know that all you really need for breastfeeding is a boob and a baby, but I often get the question, "What do I need for breastfeeding?".   The answer is that it really depends on your situation and your budget.  Are you going to be working outside the home?  If you are mostly working in the home, do you have times that you need to be away from your baby for conferences, etc? 
     Formula costs about $150 per month so you budget for breastfeeding could be over $1000 and still be ahead, but most most do not spend that much.  If you work inside the home and are not separated from the baby, you can spend very little.
     The following is a checklist and depending on whether you are work at home mom or a mom who works outside the home, you will want to pick and choose the type of breast milk collection product you will need based on your situation.   I have been in the business of breastfeeding for 20 years and am very familiar with the major brands and products as…

Nursing In Public: To Cover or Not to Cover

There is an ongoing debate in the breastfeeding community about covering up while breastfeeding.  Many lactivists insist on nursing without a cover.  Others may even be rude to a nursing mother who is nursing in public.  A cover is a personal choice.  Nursing in public may be more comfortable to you while you are learning to latch on discreetly with a nursing cover.  Once you and your baby learn to latch well, a nursing top or other discreet top may work for you.  If you are in a group of women, it is actually helpful to nurse without a cover so that other women can learn from you.  One of the reasons our culture has a difficult time with the early days of breastfeeding is that we have never seen it done.  Although Spanish is my second language, in my 20 years of counseling nursing mothers I have had less Hispanic clients who needed help with latch due to the culture of women helping women. 
      If you choose to cover, the Bebe au Lait or Hooter Hider is an excellent nursing c…

Introducing a Bottle to the Breastfed Baby

Waiting to offer a bottle is essential for initation of lactation.  Experts tell us that we should wait at least 3-4 weeks.  I believe it should be at least four weeks because even a bottle of breastmilk can interfere with stimulation during the three week growth spurt period. It can undermine moms confidence when baby gulps a bottle down during the hunger games of growth spurts.  When you offer a bottle of expressed milk, it is essential to pump to replace that feeding or it can interfere with milk supply or cause plugged milk ducts. 
     Most moms begin a bottle because they want the freedom of allowing someone else to feed or out of necessity because they are going back to work.  If you choose to nap and let Dad feed make sure to fully empty the breasts by nursing first.  If a bottle has been given while you were asleep or running errands, pump when you return even if you have nursed immediately when you came through the door.  Anytime a bottle was given, baby will not be as…

Breasfeeding: When and How to Supplement a Breastfed Baby

Although breastfeeding is natural and a full milk supply is available in almost all women, there are times that milk supply is down for reasons that we can usually trace to supply and demand issues.  These issues include mother baby separation, scheduling, good baby syndrome, and birth control prescriptions. 
     Many times, however supplementation occurs because of perceived low milk supply.  Just because a baby gulps down a bottle of formula when offered doesn't mean moms milk supply is low.  If you feel your milk supply is low, stop and calculate.  First, check your baby's wet and dirty diapers.  Your baby should have at least 8 diapers.  The number of dirty diapers is age dependent.  If your baby is 6 days to six weeks, he should be having 3-4 silver dollar sized stools per day or more.  If your baby is over six weeks as little as one stool every 3-5 days can be normal.  Your baby's stool schedule changes at about six weeks so if additional changes occur, check …

Breastmilk: The Perfect Food

Breastmilk varies in composition from colostum to transitional milk to mature milk and each stage is perfect for your baby's stage of development. 

Colostrum can begin leaking during the last trimester of pregnancy and is produced during the first few days (1-7 days) after birth.  It contains a higher amount of protein and less fat than transitional or mature milk. It is thick and sticky and coats and protects the infant's stomach.  It is high in antibodies and acts as the first immunization for your baby. Colostrum has a laxative effect on the newborn, helping your baby pass the meconium stool.  It also comes in teaspoons and not ounces, making it the perfect amount for a newborn whose stomach is the size of a walnut.

Transitional milk is the breast milk that transitions from colostrum to mature milk.  Transitional milk is produced from approximately day 8 through the second or third week in most women.  However, when moms deliver a baby prematurely, transitional milk can las…

Sleep Training and Breastfeeding

Sleep training is understandably a popular subject among sleep deprived new mothers.  Unfortunately popular methods like BabyWise and the Ferber method can decrease milk supply dramatically.  I recently had a mother contact me who was using the Ferber method.  Her 5 month old baby who was previously gaining weight well had only gained 3 ounces in six weeks after starting the Ferber method*.  This can occur because a baby is not feeding frequently enough during the day and then is not being fed when he wakes in the night.  Please know that sleep should take a back seat to weight gain.  And waking at night is not only healthy for milk supply, but there may be other benefits as well.  Breastfed babies have a lower incident of SIDS.  We do not know whether that is due to the superior nutrition in breast milk or whether it is because they wake more frequently at night.  Breast milk is more easily digested than formula so it is normal for the breastfed baby to feed more frequently than…

Breast Pump Insurance Coverage & Reimbursement

As the Affordable Care Act is enacted and more and more moms are becoming aware of the benefits of it, we are learning more and more about getting insurance to cover your breast pump.
 First, don't take "no" for an answer.  Call your insurance company.  If the representative tells you that a breast pump is not covered ask why.  Some insurance companies are still classifying breast pumps as "personal comfort" items.  According to the US Government Department of Health & Human Services, " Non-grandfathered plans and issuers are required to provide coverage without cost sharing consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012."
The Affordable Care Act covers Breastfeeding support, supplies, and counseling.  Some insurance companies are covering hospital grade breast pump rentals, but others are covering quality personal use pumps sold by DME supplies lik…

Breastfeeding Herbs: Is it all Fenugreek to You?

Herbs can be confusing because not all herbs are created equal. Cheaper herbs can loose their efficacy quickly.  For increasing milk supply you want a high quality brand Fenugreek in a trusted brand  like Nature's Way Fenugreek for maximum freshness and potency if taking in capsule form. You also need to take the appropriate dosage for your weight.  If you are an average weight and taking  610-626 mg capsules, you should take three capsules three times daily which is a total of 9 capsules per day.  If you are a plus sized mom, you should take 5 capsules three times daily for a total of 15 capsules per day.  Below is a height and weight chart for the average women 18-34 for the purposes of dosage:
4'10"-5' 90-128 lbs
5'1"-5'3" 101-141 lbs
5'4"-5'6" 111-155 lbs
5'7"-5'9" 111-169 lbs
5'10"-6'   132-184 lbs
Fenugreek can also be taken in the form of tea.   Traditional Medicinals Organic Mother's Milk Tea c…

Comparing Hygeia Breast Pump Models

The Hygeia EnJoye Breast Pump has become our most requested pump of 2013, but the different models can be confusing.  First, all EnJoye pumps have the same motor with the same three year warranty. All three are "green" pump so they are approved by the FDA for multi-person uses so can be resold.  If you are purchasing a used Hygeia EnJoye you will need your own sanitary double pumping kit which includes the tubing, filters bottles and valves. And all three have the CARE function witch is an audio recording device to record your baby's coos or cries and play them back to assist with let down while pumping.  The distinctions are below:
Hygeia EnJoye EPS Breast Pump has an external power supply (AC adapter) only and can be purchased on our site with or without a tote.
Hygeia EnJoye EXT Breast Pump has both the AC adapter and an external AA battery pack.  You can purchase these with a brown or black tote which makes a very nice diaper bag as well.
Hygeia EnJoye LBI Breast P…