Blog Category: Breastfeeding support and Information

The first few weeks of breastfeeding can feel quite overwhelming. It’s a learning time for both you and your baby, each of you getting a feel for each other. Your baby is slowly discovering how to breastfeed and find comfort outside the security of your womb. You are learning how to communicate with your baby and offer comfort and nourishment.  Be patient with yourself and your baby; it will get easier, particularly once your milk supply becomes established. Having questions is normal. Trust your instincts, but also try to prepare yourself by understanding what to expect in the first few weeks. Below we’ve compiled some breastfeeding basics and tips from Day 1 to Week 6. What to Expect Your milk production grows from about 1 ounce (30 mL) to about 30 ounces (900 mL) between Days 1 and 40. Most mothers start to make noticeably more milk starting around Day 3 or 4. Your baby should be back to birth weight by 2 weeks. You can then expect baby to gain about 7 ounces (210 g) per week or 2 lbs (900 g) per month. Most babies feed 8-12 times per day, but not at set times. They may bunch feedings close together for part of the day (cluster feed). Your baby may want to feed again soon after breastfeeding. This is normal in the beginning. By Day 3-5, baby’s black stools (meconium) turn first green, then yellow. You can then expect 3 or more yellow stools every day. Also, expect 5-6 or more wet diapers a day by Day 5. If your breasts feel very full, breastfeed more or express milk. This will make you feel better, not worse. Most babies sleep for one 4-5 hour stretch each day. This may not happen at night, unfortunately. Fun Facts A baby’s stomach stretches from the size of a shooter marble on Day 1 to a chicken egg by Day 10. Babies may take one breast at a feeding, or they may need to feed on both breasts. Let your baby decide. Drained breasts make milk faster. Full breasts make milk slower. Breastfeed only if possible. Avoid pacifiers and any other liquids General Breastfeeding Tips Breastfeed whenever your baby wants to. You’ll know it’s time when your baby’s head turns from side to side with an open mouth. Or when she puts her hand to her mouth. Ideally, don’t wait until your baby fusses or cries. When upset, it’s harder to feed well. Use a position that feels good for you and your baby. Learn to sleep while you breastfeed. Practice during the day. If breastfeeding hurts, get help. A small change in how your baby takes the breast may be all you need to feel better. Find a mother’s group near you and spend time with other breastfeeding mothers. We are stronger together! You Know You Have Plenty of Milk When Baby is gaining weight well on breast milk alone. 0-4 months: 7 ounces (210 g) a week or 2 lbs. (900g) a month When to Seek Help If breastfeeding hurts. If your baby loses more than 10% of birth weight or after Day 4, gains weight too slowly. Even when breastfeeding is going well, you may experience some of the following: Your baby has fussy times – Most babies do. She wants to feed again soon after breastfeeding -Most babies do. She wants to feed more often – This adjusts your milk production Your breasts no longer feel full – Usually at about 3-4 weeks She wants to feed less often or for a shorter time – Babies get faster with practice Frequent night feedings – Babies need to do this to get enough milk She will take a bottle after breastfeeding – Babies like to suck, this might not be related to milk supply You can’t express much milk – This skill takes practice One thing that we can not stress enough is, be patient with yourself. Breastfeeding is natural but it’s also a skill, and like all skills there is a learning curve involved. You are not expected to know it all and there is no shame in asking for help and reaching out. Seek out the support you need. Nancy Mohrbacher, IBCLC, FILCA, Lactation Consultant, Ameda Breastfeeding ProductsCoauthor of Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers

There are countless articles, books, and websites that explain everything you need to know about how to breastfeed. These instructions, however, often ignore the fact that breastfeeding is an interactive experience, dependent on the communication between you and your baby. It’s not a matter of placing Point A (baby’s mouth) over Point B (mother’s breast) and commencing breastfeeding. It’s much more like a dance that engages the whole body. Each breastfeeding duo sets its own rhythm and pace. Instinct is still the key. There are some things in life that are best learned by tapping into our left-brain, the analytical, rational hemisphere where logic is king. Then there is the right brain, a more holistic and intuitive way to learn. Some things you process best by intellect, others by experience. Breastfeeding falls under the latter. Mothers and babies have physiological responses that draw them to each other, encourage them to look at each other, touch each other, and interact. Much of this behaviour is guided by the right side of the brain. We need to listen to and trust this more. It’s time to take a right-brained approach to breastfeeding. How exactly do you use a right-brained approach to learning to breastfeed? First, take some deep breaths and let go of those worries about doing things “wrong.” Instead of thinking of breastfeeding as a skill you need to master, or a measure of your worth as a mother, think about breastfeeding as an expression of you and your baby’s relationship. As you spend time with your baby, you’ll become more adept at reading their cues. As you hold your baby, they will become more comfortable seeking your breast. Breastfeeding will flow naturally out of your affectionate relationship. And your body dynamics can make breastfeeding easier or harder. Here are some specific things you can do to help: Watch for early feeding cues. These cues could include turning their head when someone touches their cheek or a hand-to-mouth motion. Take note of when baby starts smacking their lips or putting their hands to her mouth. This is an ideal time to try breastfeeding. Start with a calm baby. One mistake that many women make is waiting until their baby is screaming to try breastfeeding. Do you learn best when you are upset? Probably not. The other reason to start with a calm baby comes down to physics. When a baby is screaming, their tongue is on the roof of her mouth. You will never get your breast in their mouth when their tongue is there. Unfortunately, it may not always be possible to catch your baby in the early hunger stages (such as when you’re sound asleep!) and you will have to deal with an upset baby. Some babies go from slightly hungry to very hungry in the blink of an eye. Sometimes offering your breast will work to calm your baby. But if this doesn’t work, don’t force the issue. First, try soothing your baby by holding, swaying, rocking, or walking. Then try these suggestions: Lean back in a comfortable position. Semi-reclined positions in which your back, neck, shoulders, and arms are well-supported are sometimes referred to as laid-back. breastfeeding. These may be the same position you use to watch your favorite TV show. Lay your baby, tummy down between your breasts. Your baby can be either dressed or stripped down to her diaper. Then make your breast accessible. Your chest is a very calming place for your baby. She can hear your voice and your heartbeat. She can smell you and get the feeling of your skin. Talk with her and make eye contact to bring you closer to your baby. Follow your baby’s lead. When a calm baby lies tummy down on her mother’s laid-back body, this triggers instinctive feeding behaviours such as head-bobbing and movements toward the breast. If she is lying between your breasts, she probably won’t need much help. Encourage her with your voice. Babies can’t understand your words at this age, but they can understand your tone of voice. And feel free to touch and stroke her as the spirit moves you. Play while you learn to breastfeed. Rather than worrying about doing things wrong, focus on your relationship with your baby and think of breastfeeding as a part of this larger whole. Breastfeeding often flows naturally from this attitude. Sometimes your baby may try to take the breast even when they’re not really hungry, just to try out this new behaviour. Practice times are good and will help them breastfeed better when they are hungry. Try out different latching and breastfeeding positions and feel out which ones work best for you and your baby. Remember, instinct is key, trust it. Adapted from the book Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers by Nancy Mohrbacher, IBCLC, FILCA and Kathleen Kendall-Tackett, PhD, IBCLC Related Products

The pain experienced during labour is different for every woman and can vary pregnancy to pregnancy. Preferences on how to manage that pain also differ, and each expecting mom will have her own ideal plan. Researching the available options is an important step in preparing for your labour. What is TENS for Labour? If you would prefer to avoid drugs or other medical interventions and are opting for natural labour pain relief, a TENS machine may be just the thing for you. TENS stands for transcutaneous electrical nerve stimulation. The machine itself is a small box with a clip on the back that you can attach to your clothing. It releases little pulses of electrical energy. How does a TENS machine work? Leading out of the box are four wires connected to sticky pads. Ideally, your birth partner will place the pads on your back for you. Put one pad on each side of your spine, at about bra-strap level. The remaining two pads should be placed further down your back, near the base of your spine. The pads are covered in a gel to help the electrical pulses pass through your skin more easily. There are dials that allow you to adjust and control the frequency and strength of the pulses. There’s also a boost button for you to hold in your hand and press when you want maximum output from the machine to help you with a difficult contraction. Always follow the instructions that come with your TENS machine. How does a TENS machine reduce pain? There are several theories on what makes a TENS machine effective. One is that the electrical pulses prevent pain signals from reaching your brain. Another is that the pulses stimulate your body to release its own natural, feel-good substances, called endorphins. It’s most likely that various factors interact to make TENS work. It may give you a feeling of control over your contractions, it may help you to feel less anxious, and it also may provide a distraction from your contractions. When and how should I use TENS? TENS seems to work best and give you the most effective pain relief when you start using it at the very beginning of your labour. TENS machines are available to rent or buy, so will be able to use it at home before you transition to the hospital (if you’re having a hospital birth). It generally takes about an hour for your body to respond to the electrical impulses by releasing endorphins, so start using it when you’re getting regular contractions or backache. You may find your machine works better at relieving your back pain rather than abdominal pain. Start with the controls at their lowest settings and gradually turn them up as your contractions or back pain gets more intense. You can use the boost button at the peak of your contractions for a little extra relief. What are the advantages? It’s portable and non-invasive. It’s under your control. It’s easy to use. You can keep moving while using it. You can use it for as long as you want and then take it off. There are no lasting side-effects. It’s safe for your baby. You don’t need an anesthesiologist, doctor or midwife to administer it, so you can start using it as soon as you want to. It can be used for a home birth. What are the disadvantages? You will need someone to help you put the pads on. It may only help in the early stages of labour. It may be difficult to find a TENS machine in your area. (http://www.motherschoiceproducts.com/) you can purchase or find a store. It may have to be removed if your baby’s heart has to be monitored electronically. If you want to use a birthing pool or have a bath, you can use TENS before you get in the water, but not when you are in the water. It can make it more difficult for your birth partner to massage your back, which can be an effective form of pain relief. Useful tips · Don’t give up right away if you think your TENS isn’t doing anything. It usually takes at least an hour of using it for your body to build up endorphins in response to the stimulation. · Take the pads off every three hours and reapply the gel to ensure good contact with your skin. · Keep mobile. Moving around during labour helps women feel more in control and should, therefore, enhance the effect of TENS. · If you don’t feel like it’s helping you, take it off and don’t feel bad. You’ve lost nothing. All other forms of pain relief, both medical and non-medical, are still open to you. Where do I find a TENS machine? You may need to call a midwife clinic to track a TENS machine down. Or if you are lucky enough to have an obstetrical physiotherapist in your town, try calling her office. Your doctor or midwife should be able to help you track one down; ask for their help during a prenatal appointment. Once you find a TENS machine, the midwife will show you how to use it during your labour. Prices will vary but generally hang around $100. You can usually find TENS machines at midwife clinics, select pharmacies, or online.

Have you been told that your baby doesn’t need, or shouldn’t be breastfeeding at night past a certain age? The age in question tends to vary depending on the well-meaning advisor. However, science tells us that in many cases, this simply isn’t true. All babies and mothers are unique, and your differences affect your baby’s need for night feedings. Some babies need to breastfeed at night, whether they’re six months, eight months, or beyond. Night feedings are particularly common for moms with small “breast storage capacity”. Understanding the basics of how milk production works will help clarify what this means and if it applies to you. The two basic dynamics that influence your milk production Degree of Breast Fullness The first, “degree of breast fullness,” refers to a simple concept: drained breasts make milk faster and full breasts make milk slower. Whenever your breasts contain enough milk to feel full, your milk production slows.1 The fuller your breasts become, your body receives the signal to slow down milk production. This is why pumping can help increase milk supply. How quickly your body produces breast milk is directly related to whether your breasts are full, or drained. When your breasts contain enough milk to feel full, your milk production slows.1 If they are fully drained, your body then increases milk production. This concept explains how pumping helps increase your milk supply. Breast Storage Capacity The second dynamic refers to a physical characteristic known as breast storage capacity, which varies among mothers. This biological difference is the reason why feeding patterns among mothers differ, and why some breastfed babies do not need to breastfeed at night while others do. Breast storage capacity is the amount of milk your breasts contain in your milk-making glands at their fullest point of the day. Storage capacity is not related to breast size. Breast size is mainly determined by how much fatty tissue is in your breasts, not by your milk-producing glands. So smaller-breasted mothers can have large-capacity storage, and larger-breasted mothers can have small-capacity storage. Whichever amount of storage your body has, it will produce plenty of milk for your baby. But babies will feed differently to get the daily volume of breast milk they need.3 Large Storage Capacity If you have large storage capacity, you may notice that after the first month of breastfeeding, your baby: • Is satisfied with one breast at most or all feedings • Is finished breastfeeding much sooner than other babies (sometimes just five minutes • Gains weight well on fewer feedings per day than the average eight or so • Sleeps for longer-than-average stretches at night If this describes your breastfeeding experience, your baby may already be sleeping for longer stretches at night than other babies you know. Small Storage Capacity Alternately, you most likely have a storage capacity on the small to average side if after the first month of breastfeeding you notice that your baby often: • Takes both breasts at feedings • feeds on average longer than about 15 to 20 minutes total • typically takes eight or more feedings per day • wakes at least twice a night to breastfeed How storage capacity affects breastfeeding patterns The most important factor contributing to your baby’s healthy growth is not how much milk he receives at each feeding, but rather how much milk he consumes in a 24-hour day. Breastfed babies of both large and small-capacity mothers receive plenty of milk, but their breastfeeding patterns will differ to gain weight and thrive.4 For example, a baby whose mother’s breasts holds six ounces or more (180 mL) may grow well with as few as five feedings per day. Whereas, if the mother’s breasts hold three ounces (90 mL), their baby will need to feed ten times each day. Breast storage capacity is much less of a factor if you are pumping. You can measure pumped milk much easier as bottles and storage bags all have markers to indicate the number of ounces (mL’s) a baby is taking. How These Dynamics Affect Night Feedings How does this all apply to night feedings? A mother with a large storage capacity has the room in her milk-making glands to comfortably store more milk at night before it exerts the amount of internal pressure needed to slow her milk production. On the other hand, if the baby of the small-capacity mother sleeps for too long at night, her breasts become so full that her milk production slows. In other words, if you have average or small breast storage capacity, night feedings may need to continue for many months for your milk production to stay stable and for your baby to thrive. Also, because your baby has access to less milk at each feeding, night feedings may be crucial for them to get enough milk overall. What’s important is not how much milk a baby receives at each feeding, but how much milk he consumes in a 24-hour day. Note: If you have small storage capacity and are using sleep training strategies to encourage baby to go for longer stretches between feedings, this can result in decreased milk production and slower growth for your baby. There is no standard to follow Each mom and baby duo is unique, and babies will outgrow the need for night feedings at different ages. Trying to apply a standard rule of thumb doesn’t take into consideration the emotional needs of the baby nor their physical need for milk. Adapted from Nancy Morbacher, the Breastfeeding Reporter References1Daly, S. E., Kent, J. C., Owens, R. A., & Hartmann, P. E. (1996). Frequency and degree of milk removal and the short-term control of human milk synthesis, Experimental Physiology, 81(5), 861-875.2Cregan, M. D., & Hartmann, P. E. (1999). Computerized breast measurement from conception to weaning: clinical implications. J Hum Lact, 15(2), 89-96.3Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). Volume and frequency of breastfeedings and fat content of breast milk throughout the […]

Whether you are an exclusive pumper or you only pump occasionally, it’s important to know the do’s and don’ts of properly storing, freezing, and thawing your breast milk. What do I need to know about storing my breast milk? Here we’ll answer some frequently asked question as well as offer a few tips and tricks for storing and making the most out of your breast milk. What container should I use? • Glass bottles with a leak proof lid or hard BPA-free plastic bottles work really well. • Breast milk freezer bags are great if you’re travelling or have limited storage space available. Ameda Store n’ Pour bags are an excellent option and compatible will all Ameda kits. They allow you to pump directly into the bag, write the date, and pop it into your fridge or freezer. Avoid thin bottle liners. These are meant to be used as feeding bags, but not for freezing milk. The liners will often split when frozen. How much breast milk should I store? • Divide your milk into the smallest amounts your baby might take (e.g. snack size). You can always add milk if needed, but don’t save leftover milk after a feeding. When your baby takes a bottle, their saliva mixes with the milk which makes it unusable for future feedings. Storing smaller portions will reduce the possibility of having to discard any breast milk.   How long can I store my breast milk? • If you follow the times on the chart below, you can keep your milk at room temperature, refrigerate it, then freeze it. • Write the date and time on your milk container with a sticky label or non-toxic marker. Add your baby’s name if they are in daycare or in the hospital. • You can combine milk pumped at different times. When combining milk from different days, write the date of the oldest milk on the container. • If you plan to use your milk within 8 days, you can keep it in the fridge. Otherwise, freeze it in the coldest part of the freezer. Avoid storing in the door, the deeper into the freezer the better. • Fresh is best. If you have just finished pumping, give your freshly pumped milk to your baby before thawing a previously frozen milk. • Fresh milk  can be added to cooled milk. If you are using frozen milk, you can add to it but be sure it’s cooled first and there is less fresh than frozen. • Before freezing large amounts of milk, start with just a batch or two, thaw, and smell it. Some moms make milk high in lipase, an enzyme that digests fat. This type of breast milk has a strong, soapy smell when thawed. If this happens and your baby refuses the milk, you can deactivate the lipase before freezing by scalding the milk first. To scald your milk, heat it in a pot on the range until bubbles form at the edges, cool, and freeze. Why do some milk storage guidelines differ? Why can’t the experts agree? First, research confirms that your milk will not spoil before the times in the table below. But the longer your milk is stored, the more vitamins and antioxidants are lost. That’s why some breastfeeding books list shorter storage times. Those experts prefer you to use your milk sooner rather than later. But this doesn’t mean that your milk will spoil if you wait longer. It’s never a bad idea to give your milk as soon as you can after pumping. But what should you do if you find some stored milk in the back of the fridge that has been there for up to eight days? When in doubt about the freshness of your milk, smell or taste it. Spoiled milk will usually smell spoiled. Why do I need to warm my milk before feeding it to my baby? An older, larger baby can handle drinking chilled milk. But milk needs to be warm for a tiny baby. If a newborn is fed cold milk, it can bring down their body temperature. Younger babies need their milk warmed to between room and body temperature.   What should I know about warming and thawing my milk? • Whether you’re warming chilled milk or thawing frozen milk, keep the heat low. High heat kills the live cells in your milk that help keep your baby healthy. • Warm your milk to between room and body temperature under cool then warm running water. Be sure to keep the water away from the lid of the bottle so that it doesn’t mix with the milk. One method is to put the bottle in a bowl with sides lower than the bottle’s lid. Run warm water in the bowl. The warm water against the sides of the bottle warms the milk. • Frozen milk can be thawed in the refrigerator. • Your milk is not “homogenized” like the milk you buy at the supermarket so it may separate into layers. This is a natural occurrence and if it happens, simply give it a gentle swirl to mix. HERE ARE SOME “DON’TS” TO KEEP IN MIND: • Don’t warm breast milk in the microwave. It changes the composition of the milk and causes hot spots that can burn your baby’s mouth and throat. • Don’t heat the milk in a pot on the stove. High heat can make your breast milk too hot for your baby, and it destroys the antibodies your baby needs.