Pumping: Increasing Volume of Breastmilk

Our previous post gave information on how to increase your milk supply while pumping,  In addition, there are ways to increase the milk output from the supply mothers already have. 

1.  Massage While Pumping.  Using a hands-free pumping bra or using the pledge of allegiance hold pictured here can give you the freedom to massage your breast while pumping.  This can assist your milk output provided that you are doing it in a relaxed manor and not watching the bottles anxiously.

Mother using pledge of allegiance hold with Ameda Elite Breast Pump.



2. Reposition Breast Flanges.  Instead of just sitting and double pumping for 10-15 minutes, take advantage of the anatomy of your body.  You can engage more milk ducts if you re-position your breast flanges a.k.a. breast shields every 3-5 minutes during your pumping session.

3.  Pump Up the Volume.  Studies on mothers of premature babies show that listening therapy increases their output by 2-3 times. The most effective form of listening therapy includes verbal encouragement plus music.  One way to accomplish this is to have hubby record encouraging words and/or relaxing music.  It doesn't have to be elevator music, just music that is relaxing to you.

Study published in Advances in Neonatal Care, Douglas Keith, April 2012. 



4. Visualize the Prize.  Have a picture of your baby taped to your breast pump bag, on your desk or table by where you are pumping.  This will help milk output much more than staring at the bottles.

5.  Sense of Smell.  Another way to aide with let-down is to have a receiving blanket that has been on the baby or nursing scarf to drape around your neck or even to cover the bottles while you are pumping.

Remember, your expressed milk is liquid love.  You are leaving a part of yourself when you can't be with your baby and you are doing a great job, mama!

Happy Nurturing,
Tanya

Pumping: Increasing Milk Supply

Every Lactation Consultant will tell you breast milk quantity is based on supply and demand, but with today's busy mom taking the baby to bed with you all day to suckle is not an option.  You can increase your milk supply while at work or with your breast pump at home.

First make sure you are already getting the appropriate stimulation for your baby's age.  If your nursling is under 6 months, you should be nursing and/or pumping at least 8 times per day while using a quality double electric pump such as the Hygeia EnJoye or Ameda Purely Yours or Ameda Platinum breast pump for a full 10-15 minutes per session.  If your nursing is 6-12 months, you should be stimulated at least 5 times per day.  For over 12 months at least 2-3 times per day. 

If you are already following the above protocols for sufficient stimulation of the breast, you will need to increase the number of pumping sessions to increase milk supply using a breast pump.  Research indicates that you need an hour of additional stimulation to increase milk supply.  Nature dictates that the average growth spurt where a baby is increasing their nursing sessions lasts about 5 days.  taking these two things into consideration, you should add 3 double pumping sessions of at least 10 minutes for 5 days in a row.  Each breast is stimulated for 30 minutes totaling the 1 hour of stimulation you need. For example, if you are nursing/pumping 8 times a day, you need to increase it to 11-12 times per day.  If you are nursing/pumping 5 times a day, you need to increase it to 8. 

Growth spurts are just that, spurts.  You need to increase your pumping sessions for a full 5 days in a row for this to be effective.  If life interrupts that, you will need to start over and do another 5 days in a row to simulate the growth spurt.

You can also use breastfeeding supplements during this time for additional increase if you prefer.



Happy Pumping!
Tanya

Free Breast Pumps: Insurance Company Breast Pump Review from the Experts

     After the Affordable Care Act took effect more moms are getting a "free" breast pump.  We get a lot of phone calls asking us which pumps on their insurance are best so we thought we would give you a review of the common ones out there.  After all, I personally have over 20 years experience using and selling different breast pumps and have seen breast pump companies come and go so you may benefit from my experience.

1.  Hygeia EnJoye Breast Pump - This is the number one choice for insurance company breast pumps because even the least expensive Q model has higher suction than most pumps at 250 milligrams of mercury and faster speed at 80 cycles per minute on it's highest settings.  Hygeia offer a closed system with a bacteriostatic filter so no bacteria can reach the milk and qualifies it for multi-person use.  So in that regard, you get a quality breast pump for free.  What you don't get.  Insurance companies do not give you the Hygeia EnJoye LBI which is the best model due to its integrated lithium ion battery pack.  You can add a Hygeia External Battery Pack to the Q and Hygeia EPS breast pump models, but this is a AA battery pack and not the lithium ion battery.  As with any insurance company breast pump pump, you either do not get a tote bag, or you get a cheaply made version of the deluxe tote that comes when you buy retail.  Another item that is not included in the insurance pump are the Hygeia bottle adapter rings to allow you to pump into standard size bottles instead of the Hygeia wide mouth bottles, but these are sold separately as well.  Large and X-Large Hygeia flanges are available.

2.  Ameda Purely Yours - This would be the second pump I would recommend because it does what most pumps do which is 220 milligrams of mercury and faster speed at 60 cycles per minute on it's highest settings.  It is a closed system with an Ameda diaphragm for protection against bacteria, but since this is not a filter it does not qualify as a multi-user breast pump.  This is most likely the case because if the bottle of expressed milk fell over, milk could theoretically enter the Ameda tubing.   Ameda Custom Size Flanges are available.

2.  Spectra S2 Breast Pump - New to the marketplace, the Spectra S2 breast pump is a good pump for moms who have never pumped before or who felt more comfortable with their previous breast pump at lower settings.  While it will do the higher 220 milligrams of mercury, it functions better on lower settings because the suction is not a constant pull and release, but more of a succession of short draws much like the peristaltic wave of the baby’s tongue.  The company's slogan is "Our pumps don't suck, they suckle!".  It is also easy to use because you just turn it on, put the massage setting on to get your milk flowing and then change the suction or speed to your liking.   I would recommend this pump for moms who have had nipple abrasion, for those who don’t use their pump on the high setting, and for those looking for something with a more natural feel than the traditional pump.  It offers the very effective Spectra Backflow Protector filtration so it is a closed system and approved for multi-person use.  I love the night light feature on this pump form moms pumping at night.  It offers a the light right where you need them, on the controls at the pump and includes two settings for additional lumination.  Additional flange sizes are available to custom fit every mom.    

3.  Ameda Purely Yours - This would be the third pump I would recommend because it does what most pumps do which is 220 milligrams of mercury and faster speed at 60 cycles per minute on it's highest settings.  It is a closed system with an Ameda diaphragm for protection against bacteria, but since this is not a filter it does not qualify as a multi-user breast pump.  This is most likely the case because if the bottle of expressed milk fell over, milk could theoretically enter the Ameda tubing. This pump is slightly louder than the Spectra and Hygeia pumps, but still a quality efficient breastpump.  Ameda Custom Size Flanges are available.


4.  Medela Pump In Style - This is by no means my first choice for several reasons.  It is not a closed system and can and does harbor bacteria and mold.   While the pump does offer 220 milligrams of mercury in the strength of suction and 60 cycles per minute for speed, the insurance company version does not come in any type of tote that can hold your milk or even your breast pump part.  While good cooler tote bag are available from various companies, they can cost as much or more than a good breast pump.  It is important that the cooler tote you choose is one that keeps the milk cold for a minimum of 10-12 hours which makes them harder to come by.  On the upside, Medela PersonalFit breast shields are available to accommodate various nipple sizes.  And finally, the Medela company does not support the World Health Code or the International Lactation Consultants Association standards. 

5.  First Years Breast Pump - No, no, no.  Just NO! 

If your insurance company has pumps on their list that we have not reviewed here,  please let us know and we will do our best to review it.  What if you want a better pump?  An alternative to getting an insurance pump on a list, check with your insurance company to see if they allow you to purchase from an alternative DME and file for reimbursement.  Or if you have an HRA or HSA credit card, breast pumps qualify as a medical expense.  This way you can get a pump like the Hygeia EnJoye LBI Breast Pump with the deluxe tote, bottle size adapters and the lithium ion rechargeable battery making pumping on the go much easier.

Best wishes in your search for a breast pump,
~Tanya

Buying a Nursing Bra on Sale Online

Sometimes, buying a nursing bra can be difficult.  Unless you live in a big city, there may not be a boutique where you can be professionally fitted for a bra.  Here are some tips on getting the best size and the best deals:

1. Invest in a tailors measuring tape and use instructions with three nursing bra measurements and not just two fro a better fit.

2. Measure for and order your nursing bras 3-4 weeks before delivery.  You will already have grown to the largest cup size you will be other than the few days of engorgement.  This will allow for any back orders or delay for specialty sizes.

3.  Don't just order one bra.  You never go into a dressing room with just one swimsuit to try on and have success.  Bras are not any different.  Check that the nursing bra return policy is 30 days and try a few styles or sizes to get the best fit.  Bras are usually only about $3 each to return by mail and a great fit is well worth the extra cost.

4.  Take advantage of a nursing bra sale to like the 4th of July sale shown below to try new styles, but don't try an underwire until you are at least 8 weeks postpartum and have had no difficulty with plugged milk ducts.

Happy Shopping!
Tanya
http://www.lactationconnection.com

Packing Your Hospital Bag for Breastfeeding

In addition to the things you will want during labor and the cute coming home outfit you will want to pack for baby, there are specific things you will want during your hospital stay for breastfeeding:

• Disposable Nursing Pads - Not all disposable pads are created equally.  Choose a brand that is completely breathable such as the Ameda NoShow Nursing Pads or the Hygeia Custom Nursing Pads that are available in two sizes to accommodate moms who are more endowed.  Lansinoh Nursing Pads are another good brand for breathability.  Washable nursing pads are a great money saver, but you may still want disposable as a time-saver for the first week while you are adjusting to caring for a new baby. 
• Sleep Nursing Bra - This bra needs to have no hooks with which to fumble and it needs to room for your breasts to expand as the milk comes in.  The Amamante Night & Day Nursing Bra just pulls down to nurse and is perfect for B-DD cups.  The  Amamante Comfy & Curvy Nursing Bra has a hidden inner support to keep moms in the E-H cup supported while offering easy access.
• Nursing Gown or Pajamas -  The Amamante Signature Nursing Gown and Serenity Nursing Pajamas offer a built in sleep bra for B-DD cups so this can save you money over buying a gown and a separate sleep bra.  If you are not using a standard hospital gown for labor because you purchased a nursing gown for labor and delivery, you will still want to pack another nursing gown as the gown used for labor is likely to be soiled in the process.
• Nipple Cream - This can help in the babymoon period while you and your little nursing are learning to latch.  Just remember to use it sparingly on the affected area and not on the entire areola.  Also, you will want to use your nursing pads with it as many brands tend to soil your garments.  Lanolin is a time tested effective breast cream which can be found in the Ameda ComfortLan brand.
• Nursing Bra or Nursing Tank - You will either want  a daytime nursing bra or a nursing tank with built in nursing bra to wear home.  We recommend the Bravado BodySilk Nursing Bra for most moms because each size fits a range of sizes to accommodate your changing shape. The BodySilk Nursing Bra also has removable foam cups for extra room and memory fabric so as your breasts regulate it goes back to it's original shape.  If you are larger busted, the Bravado Essential Nursing Tank is available in up to FG cup sizes.  The Bravado Nursing Tank runs a little large making it perfect for when your milk comes in.  The bra that is built in to the Essential Nursing Tank is supportive unlike the shelf bra in most nursing tanks.  If these two styles do not offer your cup size, shop by nursing bra size on our website for more options.  Measure for your nursing bra size 3-4 weeks before you deliver and order early so you have your bag packed in plenty of time.

You should begin packing your hospital bag at least 4-6 weeks before delivery just in case your baby decides he or she can't wait to meet you!  If you don't have an overnight size bag, consider using your breast pump bag like this affordable Breast Pump Cooler Bag by Hygeia.  It has a removable bottle cooler so you will have extra room for your personal items.





The Real Deal on Co-Sleeping and Breastfeeding

Whenever moms are given contradictory information, there is always controversy.  Hopefully, this article will help you understand why lactation consultants and breastfeeding advocates recommend co-sleeping.  In over two decades of helping nursing mothers, my philosophy has always been that the same instincts that keep you from rolling off the bed, keep you from rolling onto the baby.  Having said that, there are precautions that you should take when co-sleeping such as not using a couch that has deep crevices where a baby could have their airway restricted.  The best place for co-sleeping is on a firm mattress.  Scare tactics showing a tombstone headboard on the bed, are just not accurate.  There are times you should not co-sleep however and those are if the mother's natural systems are compromised in any way such as drugs or alcohol.  Using sleep aides or other over-the-counter or prescription medications would also not be advisable when co-sleeping. 

There are many benefits of co-sleeping but the most significant is that co-sleeping promotes breastfeeding and breastfeeding reduces SIDS.  Perhaps it is because that the bed-sharing nursing mother is more aware of her baby's sleep patterns.  Possibly it is because the nutrition on breastmilk decreases illnesses including respiratory illness.  Or it could even be that skin to skin contact regulates heart rate, breathing patterns and temperature.  Whatever the reason, night nursing increases milk supply.  And increased milk supply translates to reduced incidence of early weaning and increased rates of breastfeeding success.

If you are still conflicted regarding bed-sharing with your nursling, there are alternatives. A co-sleeper crib attached to mom's side of the bed is an excellent alternative.  The benefits of these are that you have more room and less separation between you and your husband.  Also, when the baby is ready to sleep through the night, he is already in his own bed.  The Arm's Reach company has a long-standing track record of safe and affordable co-sleeper bassinets.

The mother who feeds on demand whether it is during the day or at night, has a greater chance of breastfeeding success.  Longer breastfeeding rates translate to healthier children even beyond infancy.  Remember, it is much safer to nurse in a familiar environment than for the mom who is trying not to co-sleep to fall asleep on an unsafe piece of furniture such as a couch or recliner. 

Happy Nurturing!
Tanya

     

McKenna, James J., and Thomas McDade. "Why babies should never sleep alone: a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding." Paediatric respiratory reviews 6.2 (2005): 134-152.

Birth and Breastfeeding: Choosing to Use a Doula

     In honor of World Doula Week, we wanted to give you some information to help you if you choose to use a Doula.  DONA international is the official certification organization for a professional doula.  According to DONA, the word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.
   Here are some tips for questions to ask a potential doula:
1.  Are you certified by DONA?  This is the official organization certifying doulas.
2.  What are your professional credentials?  They should be CD or PCD
3.  Are you affiliated with a hospital?  This is a red flag as you want the doula on your side and not siding with the hospital or birth facility if  your birth plan comes into question.
4.  Do you help with the postpartum period such as learning to breastfeed?  If your doula is PCD, she is certified to work with you in the postpartum period.  She may also have credentials such as CLE, certified lactation educator or IBCLC, international board certified lactation consultant which offers the highest degree of education in breastfeeding.
5.  What are your gifts?  A good doula needs to be an encourager  and have a servant heart so this question may reveal a lot about her personality.
    Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.  Use your instincts and these questions to help you find the doula that is right for your family.

To locate a doula in your area, visit the DONA website.

May you have a Blessed Childbirth!
Tanya