Are you Mom Enough: Time to Speak Out!

Unfortunately, the Time Magazine article picture did not help to promote breastfeeding.  This photo was shot to sell magazines, not to help make breastfeeding the norm.  While I personally nursed my children for up to 18 months, there is no doubt that breastmilk is beneficial for much longer.  The controversy comes in with the child standing and the captioning challening moms to nurse their older child.  As a retired lactation consultant, I always tried to help moms meet their personal goals and encourage them to nurse at each stage of breastfeeding.  Whether it was the first month, three months or hopefully at least a year.  I gave advice on partial weaning when a mom did not want to pump when returning to work and advice on gradual and baby led weaning when asked about weaning.  The caption depicts all who promote breastfeeding as breastfeeding Nazis and not the supporters of mothers and babies who we are.  It makes nursing mothers look radical instead of impassioned.  While I support the mother on the cover and her personal decision to nurse her toddler, I reject the notion that we are all out there screaming that if you don't nurse for over a year, or at all, that you aren't mom enough!  Breastfeeding can take tenacity.  Tenacity which you need when you are parenting teenagers later on, but moms should be encouraged, not called out in a confrontational manner for not breastfeeding.  Having said that, I personally have been atacked for statements such as "breast milk has never been recalled".  Proponets of breastfeeding should be allowed to speak the truth without it being perceived that we are attacking the other side.  Truth is truth whether you believe it or not and whether you choose it or not.

Breastfeeding Diet: How to Lose Weight While Breastfeeding

      As a retired lactation consultant, mother of 3 and grandmother of one, I get asked this question quite often:  "How do I loose the baby weight?"  More recently I was asked about diet pills, which are unsafe for the nursing mother.  That caused me to take action so I am giving you a guideline below based on two decades of experience and the additional 500 calories per day needed by nursing mothers or 1000 extra calories if you are nursing twins.  As with any diet, consult your doctor before beginning this and do no begin until the baby is at least 3 months old. 

     Losing weight is not necessarily how much you eat, but what combination of foods you eat in order to jump start your metabolism.  Start by measuring yourself and not just weighing yourself because you begin to lose inches faster than pounds so it is encouraging to see the smaller waistline, etc.  An inexpensive food scale and measuring cups is helpful for this process.  Do not “cheat” by exchanging servings and eat everything recommended in the course of the day.  Serving size for veggies is 1 cup and fruit 1 apple, orange, etc. 

7 oz meat (nothing fried; cheese is included in this category)

3 fruit

2-3 non-starchy vegetable (not peas or corn)

4 bread (1 cup pasta, regular sliced bread  = 1, but a muffin or biscuit = 2)

3 cup dairy (1% milk or yogurt, not Yoplait or any brand with corn syrup, no ice cream)

1 fat = (1 TBS salad dressing or peanut butter or low-fat mayonnaise)

Weight loss varies depending on how much weight you gained during the last pregnancy ad this weight comes of faster than extra pounds that have been there for years.  Typical weight loss after you reach pre-pregnancy weight should be 1-2 lbs per week, do don't skimp on food to make it go faster. You are better off keeping weight off than loosing too quickly!  Please don't make your goal getting back into your favorite jeans from high school, that is unrealistic.  You goal is a healthy weight, womanly curves are not your enemy.  After all, you need hips to carry your toddler around!

For additional breastfeeding tips, visit our website!

Happy, healthy eating!

Tanya Roberts
Lactation Connection

Exclusive Pumping: Keeping Up Breast Milk Production While Pumping

I often get moms who want to exclusively pump instead of breast feed directly.  If you choose to pump exclusively, it is very important that stimulation starts in the hospital within 1 hour of the baby's birth.  Moms should double pump with a hospital or professional quality pump like the Ameda, Medela or Hygeia hospital grade rental pumps or a brand new (not used) professional quality pump like the Ameda Purely Yours,  Hygeia EnJoye Breast Pump or Spectra S2 Breast Pump. 



To initiate milk supply, pump every 2-3 hours with a 5 hour stretch at night for a total of at least 8 times per day of 10-15 minute double pumping sessions.  Many pumping moms get discouraged during the first 3-5 days as it is hard to see much going into the bottles as colostrum comes in teaspoons, not ounces.  Do not let this dissuade you, but draw this liquid gold up in a syringe and give it to the baby as it is chalked full of antibodies.  This schedule goes on for the first six months for the most part, but there are times when normal babies go through growth spurts that you will have to simulate with a pump.  When the baby is 2-3 weeks old and again when the baby is 3 months old, set aside a 5 day period that you will step up the pumping schedule to every 2 hours for a total of at least 11-12 times per day.  This must be 5 days in a row.  If your schedule gets interrupted, start over.   As you can see, this is a lot of pumping and cleaning of pump parts.  You will want at least 2-3 sets of breast flanges to use.  Some moms start this because it only takes 10-15 minutes to pump and a newborn baby takes 45 minutes to nurse, but as the baby gets older breastfeeding directly is much easier.  No bottles or pump parts to clean and most 2-6 month old babies will nurse in 20 minutes so you may want to reconsider your decision.  Pumping is great for the working mother, but if you choose to exclusively pump, experience shows me that these moms do not nurse as long as their direct breastfeeding counterparts.  If you breastfeed directly, it gets much easier by 6 weeks and by 3 months you feel sorry for moms who mix formula.   After all, have milk will travel!

If you do choose to exclusively pump, in addition to a quality breast pump a few key accessories will make your life easier.  These include a hands-free pumping bra so that you can multi-task while you are pumping, a breast pump cooler bag for transporting your pump and breast milk, an air dry bag to store and dry your breast pump parts on-the-go, and re-usable sterilizer bags to keep your parts sanitary anywhere you pump that you have access to a microwave.

Happy Traveling,
Tanya
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Every Ounce Counts!

Recently, I was asked to be the guest speaker for a breastfeeding reception at our local WIC clinic. August is always an exciting time to be in the business of breastfeeding because the first week is officially World Breastfeeding Week. Many cities and government agencies promote breastfeeding during this week and I am honored to be a part of the celebration in Granbury, TX.

As I was preparing, I researched the WIC theme, "Every Ounce Counts". What a great slogan! I encourage you to check out the WIC website because their campaign rivals those of major companies. Not only do they have great pictures of babies and what they might be when they grow up, but a song that can only be an encouragement to any nursing mother. The WIC ads include babies that want to grow up to be firefighters and doctors because breastmilk makes you stronger and smarter, which is very true! Breastfed babies develop better with fewer health problems and their IQ scores and performance in school is markedly better than their formula-fed counterparts. The next thing that came to my mind, was the composition of breast milk and how many moms are fooled into thinking that their milk isn't good enough or that the time they breastfeed isn't important. Collostrum comes in teaspoons, not ounces and yet it is the baby's first immunization against the world's diseases. Moms are also fooled into thinking that a bottle of formula occasionally doesn't affect anything, but supplementing even once per day before the age of 3-4 months, can cause early weaning. Babies who are breastfed just three months already have a reduced risk of juvenile diabetes, multiple sclerosis, heart disease and even childhood cancer!  The breast milk made the difference and the longer you nurse, the better. Babies who are breastfed for four months are less likely to be hospitalized for respiratory illness.

Those are some great benefits of breastmilk, but lets look at the flip-side. Diarrheal disease is four times more likely in formula-fed infants and formula-feeding increases risk of childhood obesity by 20-30%. Those are some statistics you can't argue with. And did you know that breastfed babies have fewer cavities than their artificially fed counterparts?

So many moms are discouraged from breastfeeding because they think their milk is not good enough or they
think that after a certain age, the benefits are gone. Nutritional content of breastmilk is consistent from mother
to mother even in third world countries. Between the ages of 12-24 months, toddlers can still get about 15 oz per day from nursing. These 15 oz provide the following RDA: 29% of energy, 43% protein, 36% calcium, 75% vitamin A, 76% folate, 94% vitamin B12, and 60% of Vit C. That is a lot more nutrition than they can get from chicken nuggets!

So moms, take heart. Every ounce does count and not just for your baby, but for you too. Not only does making breastmilk burn calories, but if you nurse for a total of 2 years, even if that is 3 babies for 8 months each, your reduce your risk of breast cancer, uterine cancer and ovarian cancer. Do remember, whether you nurse for 2 weeks or 2 years, any breast milk is good for your baby.

My Dad always had a saying, plan your work and work your plan. Most moms plan how to feed their baby, so there are a few things that are need to know. First, supplementing early causes early weaning. Moms who think they can nurse and feed formula early on, loose their milk supply. To keep up milk supply, partial weaning which is what we call it when moms choose to nurse at home, but not at work, can be accomplished only after your milk supply is well established. This happens when your baby is 4 months old. Full milk supply is best achieved when moms do not supplement solids until the baby is 6 months old and even then after the nursing, not before. Next, watch for growth spurts. Babies are supposed to act like they are hungry all the time at 3 weeks, 6 weeks, 3 months and 6 months. This is normal, don't schedule them, just use it or loose it!

For more answers to breastfeeding questions, check out our Q & A:
http://www.lactationconnection.com/breastfeeding_questions.aspx

Induced Lactation: Protocols for Adoptive Breastfeeding Mothers

Motivation as in anything is extremely important in breastfeeding and even more important is tenacity when inducing lactation.  The success rate for the following protocols according to Nemba in the 1994 Journal of Trop Pediatrics was 89%.  In this study 33 of the 37 women nursed their babies for 9 months or longer.
These mothers began with a 100 mg single priming dose of medroxyprogesterone (Depo Provera).  After 7 days, they began 25 mg of chlorpromazine 4 times daily or 10 mg of metoclopramide (Reglan) 4 times daily until adequate lactation was established.  Frequent pumping before infant's arrival and/or frequent suckling afterward is encouraged.  A supplemental feeding device is necessary until adequate lactation is established.  Inducing lactation is a gift of time and love!
Breastfeeding an adoptive baby is more than about breastmilk.  It is about bonding.  Skin to skin contact is essential.  Use a lactation aide to feed donor milk or formula at each feeding.  This is essential for stimulation of the milk production, bonding and success.

Best wishes for nurturing and nourishing your baby,

Tanya Roberts, BSEd, IBCLC

www.lactationconnection.com 

Engorgement: Bowling Ball Breasts

If you are experiencing difficulty with breast pain or latch-on 3 to 5 days postpartum, it is probably due to engorgement. Your breasts can feel as hard as bowling balls making it difficult for your baby to get a good latch.  Most of the time severe engorgement can be prevented by nursing the baby immediately upon delivery and putting the baby to breast every 2-3 hours.  If your baby is sleepy or there is a delay in breastfeeding, engorment can set in heavily.  Advil is safe for breastfeeding and contains an anti-inflammatory that may reduce some swelling and discomfort. Your best friend during this time is a hot compress. Turn the tap water and let it run until hot. Take two disposable baby diaper and swipe it under the tap three or four times. Mold the diapers around your breast. Repeat this procedure before each feeding. Commercial hot packs are also available, but the diapers work just as well so you may want to save your money for a good breast pump. If the areola is still too hard for the baby to grasp, use a quality breast pump for three to five minutes before latching the baby on. If the baby goes to sleep before emptying the breast, finish pumping afterward. Take heart! Engorgement only lasts for 48-72 hours.

Milk Intake: Your Breastfed Baby at 12-36 months

As a Lactation Consultant, my main clients are mothers whose babies are under 12 months of age, so when looking for information for my daughter-in-law, I found it hard to find anything on milk intake for babies older than 12 months.  After doing some research, I have come to the following conclusion that I thought I would share with all moms.

Babies who are 12-24 months of age and weigh 20 lbs or more should take in 16-20 oz of milk; more if they are underweight. Normal weight gain during this period is 2 oz per week. A typical schedule would be nursing or feeding expressed milk 4 x daily, feeding solids 3 x daily with one or two healthy snacks in between. If you are weaning to cows milk, it should be whole milk unless advised otherwise by your pediatrician.  For toddlers 2-3 years or age, typical milk intake is 3 servings or nursings per day. After 24 months, most pediatricians recommend switching to 2% milk if you have weaned from breast milk. Toddlers 24-36 months should gain approximately 1 oz per week and eat 3 meals per day with one healthy snack.

Between the ages of 12-24 months, toddlers can still get about 15 oz per day from nursing. These 15 oz provide the following RDA: 29% of energy, 43% protein, 36% calcium, 75% vitamin A, 76% folate, 94% vitamin B12, and 60% of Vit C so if you are pressured to wean before you or your baby is ready, stand your ground, even if it is in the snow!

Happy Nurturing,
Tanya
www.amamante.com