Returning to work with the breast pump

Not too long ago, it was almost unheard of for a mom to breastfeed and work full time. Formula feeding was the standard for working moms but now many moms are breastfeeding and working full time. Choosing to breastfeed no longer means sacrificing your career. Breast pumps are more affordable and easier to purchase. You can purchase a breast pump for as little as $40 that is suitable for using at work. With more and more women choosing to breastfeed and work, the tide is turning in the workplace. More companies are accommodating moms and even providing nursing stations for their employees to pump while at work (1a).

To figure out how much breast milk your baby needs multiply your baby’s weight times 3 oz. This will tell you approximately how much breast milk your baby needs over a 24-hour period. You can start pumping as soon as your milk comes in. You probably want to wait for a week or so until you are no longer producing colostrums. Don’t be surprised if the first time you pump you produce nothing or very little. Milk production works by supply and demand. It takes several days before your body will get the signal to make more milk for your pumping session. The best advice would be to pump around the same time each day, preferably in the morning when your body’s milk production is the best. Once you have been pumping consistently you should start to produce milk for your freezer stash (1b).

Before you return to work you should talk to your employer and tour your workplace. You will want to have a place where you can pump that is clean and private. Talk to your employer about possibly places that you can pump. Be confident and don’t worry about what your boss will think. Most of the time this is no big deal. You may spend time unnecessarily worrying about this and your boss may not think anything about it. Usually this goes over better than expected. Sometimes moms settle for pumping in the bathroom without even having a conversation with their employer. Pumping in the bathroom is not a good solution. Once you have found a few options for places to pump talk it over with your employer and see how it goes. If for some reason your direct supervisor is not cooperative, check with your company’s human resource manager or state labor department for options. Most employers are cooperative with breastfeeding moms (1c).



Weaning Night Feeds

We often heard that having a baby comes sleep deprivation. Your infant waking up in the middle of the night, crying till your ears bleed, needing your attention to survive. It’s a labor of love, but in an adult human’s daily life, sleep is something that is cherished. Though there are ways to wean your baby off of night feeding.

First, you need to make sure your baby is developmentally ready to start sleeping for longer stretches without the extra nourishment. Most babies between 4 and 6 months of age get enough nutrition during the day that they don’t need to feed at night (1a).

Once your baby is ready, you can try a number of different strategies to help your baby sleep for longer stretches through the night.  You could give them a lot of loving attention. Babies need lots of this, and a full night is a long time for them to go without it, especially if they’re not getting enough during the day.

Make sure that they get full feedings during the day and right before bedtime.  If your baby is breastfed, you can try cluster feeding right before bed, which is multiple feedings spaced closely together.  By spacing the feedings close together, your baby will be able to go for longer stretches without needing to nurse (1b).

Make sure that the room is dark and warm and quiet. Use black-out shades on the windows and a white noise machine if necessary. Also make sure that the baby is not waking up because of a wet diaper and/or pajamas. If he needs a change, do it as quickly and quietly as possible.

You may think that having the baby sleep with you will lessen the chance of it waking up, but actually your smell and sounds will give it more reason to wake at night, than if it were by itself (1c).

If you are bottle-feeding, gradually water down the formula until the baby is getting mostly water. Many babies decide at this point that the water isn’t worth waking up for.

This will take some time for your baby to get used to. You can expect two steps forward, one step back kind of progress. Just be patient if you help your baby establish good sleep habits early, he or she will be more likely to return to a good sleeping pattern once the latest distraction has passed. Before you know it you, your baby, and the rest of your household will be sleeping peacefully through the night.


Breastfeeding Position Overview

Learning how to hold and support your baby in a comfortable position for you calls for coordination and patience. Yet finding a nursing hold that works for you and your infant is well worth the effort. After all, the two of you will spend hours breastfeeding every day.

This classic breastfeeding position requires you to cradle your baby’s head with the crook of your arm. Sit in a chair that has supportive armrests or on a bed with lots of pillows. Rest your feet on a stool, coffee table, or other raised surface to avoid leaning down toward your baby. Hold her in your lap so that she’s lying on her side with her face, stomach, and knees directly facing you. Tuck her lower arm under your own. If she’s nursing on the right breast, rest her head in the crook of your right arm. Extend your forearm and hand down her back to support her neck, spine, and bottom. Secure her knees against your body, across or just below your left breast. She should lie horizontally, or at a slight angle. d a cesarean section may find it puts too much pressure on their abdomen (1a).

Another position is the cross-cradle hold. This position differs from the cradle hold in that you don’t support your baby’s head with the crook of your arm. Instead, your arms switch roles. If you’re nursing from your right breast, use your left hand and arm to hold your baby. Rotate her body so her chest and tummy are directly facing you. With your thumb and fingers behind her head and below her ears, guide her mouth to your breast (1b).

Next is the clutch or football hold. As the name suggests, in this position you tuck your baby under your arm, on the same side that you’re nursing from like a football or handbag. First, position your baby at your side, under your arm. She should be facing you with her nose level with your nipple and her feet pointing toward your back. Rest your arm on a pillow in your lap or right beside you, and support your baby’s shoulders, neck, and head with your hand.  Guide her to your nipple, chin first (1c).

Finally is the lying position. Ask your partner or helper to place several pillows behind your back for support. You can put a pillow under your head and shoulders, and one between your bent knees, too. The goal is to keep your back and hips in a straight line. With your baby facing you, draw her close and cradle her head with the hand of your bottom arm. Or, cradle her head with your top arm, tucking your bottom arm under your head, out of the way (1d).


All About Lactation Consultants

A lactation consultant is a health care professional who is knowledgeable, skilled, and experienced in lactation, or breastfeeding. The lactation consultant’s primary focus is to provide education, assistance and support to breastfeeding women (1a).

Lactation consultants work in a variety of settings, including hospitals, clinics, physicians’ offices, and private practices. Many consultants are Board Certified, using the initials IBCLC (International Board of Certified Lactation Consultants) after their name. This designation is a valuable credential for identifying a member of the health care team who has demonstrated advanced knowledge and experience and who can provide breastfeeding assistance and skilled technical management of breastfeeding problems (1b).

Your first encounter with a lactation consultant may be during a prenatal breastfeeding class, where you will learn benefits of breastfeeding, basic anatomy, proper positioning and latch-on, prevention and management of potential problems, and more (2a).

A class is a great way to begin your breastfeeding experience. Ask the instructor if there is a lactation consultant on staff at the hospital or birthing center where you will deliver. Find out how to contact the lactation consultant. At some hospitals, lactation consultants see every breastfeeding mother before discharge. At others, mothers may make an appointment, or can be referred by their physician. Phone and/or personal consultations are generally available. Many hospitals offer these services to their patients free-of-charge, while others charge a fee. Still other hospitals do not have a consultant on staff, but will refer to a lactation consultant in private practice (2b).

During a consultation, the lactation consultant will gather information, which may include a medical history of the mother and baby, a breastfeeding history, and an observation of a nursing. This information will be used to formulate a plan of action. Depending on the situation, the consultant may also communicate with the primary health care provider or make referrals to other health professionals, community services, and support groups. With certain breastfeeding situations, a hospital-grade breast pump may be recommended as part of the mother’s plan of care (2c).





What is the Clutch Hold?

While breastfeeding your baby there are many ways to hold your baby. Each position has it’s own nuances that may be better suited for your needs.

In the clutch hold, baby is positioned to the side of mother during breastfeeding, tucked under her arm. It is especially helpful for babies who have difficulty latching on; babies who arch their back and squirm at the breast; babies who come off the nipple frequently during breastfeeding; and babies who are small or premature (1a).

In this position you get a good view of baby latching onto the breast, while your hand at the nape of his neck gives you control of his head. Baby is bent at the waist, which helps tense babies relax better. If his body is relaxed, he’ll latch on better.

To achieve best results, sit up in bed or in a comfortable armchair with your back and shoulders well supported. Position one or more pillows at your side to bring baby up to breast level. If you’re sitting in a chair, wedge the pillows between you and the arm of the chair.Place baby on the pillow, tucked under your arm, with your hand on that side supporting his neck and shoulders. Bend him in the middle, so that his legs are pointed upward and his bottom rests against the pillow supporting your back, or against the back of the chair. Be sure that baby does not push his feet against the back of the chair, causing him to arch his back (1b).

Cup the nape of his neck in your hand. Avoid holding the back of baby’s head, as this stimulates some babies to arch away from the breast. If baby finds your touch too stimulating, put a cloth diaper or a receiving blanket between your hand and his skin.Pull baby in close to you. Once baby is sucking well, wedge a pillow under the hand and wrist that are supporting baby at the breast to help hold him close. Lean back into the pillows behind your shoulders, rather than hunching forward over your baby. Remember, bring the baby to the breast, not the breast to the baby (1c).




Life After Breastfeeding

After nursing ends, mothers and their children experience a mix of reactions, both physical and emotional. These reactions vary greatly in kind and intensity, depending on the age and temperament of the child, how fast weaning has occurred, and how the mother has felt about breastfeeding (1a).

Unless your milk production has stopped before weaning is complete, you will probably experience some decrease in appetite when you stop breastfeeding. Some women report losing weight and feeling restless for a week or so after weaning. Others, perhaps because they eat according to habit rather than appetite, gain weight after weaning (1b).

After any post-weaning engorgement and breast lumps dissipate, you will probably find that your breasts are smaller even than they were before pregnancy. The areola may look shriveled, from being stretched in the baby’s mouth, particularly after several years of nursing. After six months or so, new fat stores may make your breasts fill out a little (1c).

Your breasts will probably continue to produce some fluid, if you try to express it, for months after complete weaning. Some women notice continued milk production for as long as two years after nursing ends. And, for months after the last nursing, some mothers occasionally notice the tingling sensation of milk letting down. One mother, whose breasts had never leaked while she was nursing, said milk dripped from them one night when she was very worried about her child’s cough, three months after she had stopped nursing (2a).

If your periods didn’t resume before the last nursing, they probably will within a few weeks — and so, probably, will your fertility. If you began menstruating before weaning was complete, expect that your next period may be early and heavy. Heavy periods may continue for several months as your body adjusts to the hormonal changes of weaning (2c).

With the resumption of menstruation may come an increase in sex drive and vaginal lubrication. If your periods started while you were still nursing, your sex drive may still increase at weaning, though this may be partly due to the decrease in tactile stimulation from your child. Some mothers find, however, that their breasts are less sensitive to erotic stimulation after weaning than before (2d).

In a few women who have personal or familial histories of depression, rapid weaning in the first year may precipitate severe depression or even psychotic behavior. This may result from the hormonal changes at weaning, perhaps in combination with feelings of loss of the symbiotic mother-baby bond. Extreme anxiety, fears, frequent tearfulness, insomnia, and loss of appetite are signs that medical help is needed (2e).





Periods During Breastfeeding

 All women experience a time of postpartum bleeding following birth which is not considered a menstrual period. If bottle feeding, most mothers will have their first real period not long after this. Breastfeeding, however, suppresses menstruation at least for a while. For some mothers, there may be an absence of menstruation for weeks, months, and even years while still breastfeeding. Some mothers report needing to completely wean before they see their first period. Others begin menstruating as soon their babies begin taking supplemental foods or sleeping through the night. Once menstruation returns it may continue to be irregular during lactation. It’s not uncommon to have a shorter or longer than normal period while breastfeeding. It’s also not abnormal to skip a period or see the first period return and then find that months pass before the next one (1a).

When the first period returns depends upon several factors: how frequently the baby is nursing, how often the baby is supplemented with bottles, whether or not the baby takes a pacifier, how long the baby is sleeping at night, whether or not solids have been introduced, and the mother’s own individual body chemistry and the way it responds to hormonal influences associated with breastfeeding. Any time the stimulation to the breast is decreased, especially at night, menstruation is likely to return soon after (1b).

When menstruation does return, you should consider yourself fertile and take precautions against pregnancy if desired. Some women consider their first period as their “warning period” that they are now capable of becoming pregnant. However, it is possible to become pregnant before the first period returns, although quite rare (1c).

The return of menstruation does not mean the end of breastfeeding. The milk does not sour or “go bad” when you are having a period. The milk is no less nutritious when you are menstruating than when you are not. Some women do notice a temporary drop in milk supply in the days just prior to a period and for a few days into one. This is due to hormonal fluctuations. Once the period begins and hormone levels begin to return to normal, the milk supply will boost back up again. Most babies can compensate well for this temporary drop in supply with more frequent nursing (1d).

Nipple tenderness occurs for some women during ovulation, during the days before a period, or at both times. Some mothers report feeling antsy while nursing at these times, too. As with the drop in supply this is also hormonally influenced and therefore temporary (1e).

Some babies may detect a slight change in the taste of the milk just before a period, again, due to hormonal changes. These same babies may nurse less often or less enthusiastically during this time as a result. Almost anything is considered normal when it comes to your periods while breastfeeding (1f).



The Let Down Reflex

The let down reflex is when the nerves in your breasts send out signals that releases the milk in the milk ducts when the baby begins to nurse.It is normal for let-down not to feel as strong as your baby gets older. Some mothers never feel let-down, and some stop feeling the let-down sensation as time goes by. This does not necessarily indicate that let-down is not taking place (1a).

Reliable signs of a healthy, functioning let-down include: (1b)

  • In the first week or so, mother may notice uterine cramping during letdown.
  • Baby changes his sucking pattern from short and choppy (like a pacifier suck) at the beginning of the feeding to more long, drawing, and rhythmic a minute or so into the feeding.
  • Mother may have a feeling of calm, relaxation, sleepiness or drowsiness.
  • Mother may have a strong sensation of thirst while breastfeeding.
  • Baby is swallowing more often. A swallow sounds like a small puff of air coming out the baby’s nose and you can usually see the muscle moving in front of the baby’s ear, giving the baby the appearance of his earlobes subtly wiggling.

Occasionally, mothers will also experience other symptoms during let-down, including itching, nausea, headaches, or negative emotions. It’s quite normal for a mother to have a harder time letting down when pumping than when nursing. The milk may be there, but you may have a hard time letting down and “releasing” the milk. Some mothers also have a let-down which is not functioning properly when baby is nursing. (2a)

Many things can be the cause of a slow or inhibited let-down: anxiety, pain, embarrassment, stress, cold, excessive caffeine use, smoking, use of alcohol, or the use of some medications. Mothers who have had breast surgery may have nerve damage that can interfere with let-down. In extreme situations of stress or crisis, the release of extra adrenaline in the mother’s system (the “fight or flight” response) can reduce or block the hormones which affect let-down (2b).

Sometimes a cycle is created, where baby fusses and pulls off because the let-down is slow, which makes mom tense up, which makes the let-down even slower, etc. You can use relaxation techniques and let-down cues to break this cycle (2c).




Cow’s Milk Causes Colic

Colic is an attack of crying and what appears to be abdominal pain in early infancy. Colic is a common condition and is estimated to affect at least 20% of babies during their first few months. Colic usually appears a few weeks after birth and carries on until the baby is about three to four months old. Even though the baby may scream for all he/she is worth, colic is not dangerous or harmful. Experts say colic has no long-term effects and a baby with colic will gain weight and feed normally (1a).

Many times, colic in a breastfed baby can be traced to something in the mothers diet.The worst dietary offender is cow’s milk. Many times, a baby’s digestive tract isn’t mature enough to handle the proteins in cow’s milk which causes a gas builds up in the intestines. When this happens, your baby’s will scream in pain as his intestines go into spasms.Eliminating dairy from your diet can make a tremendous difference in the level of colic your baby experiences.Cow’s milk takes many forms and you need to be vigilant in reading the labels of food you consume (1b).

Many prepared items in the supermarket include some form of milk product. These include, but are not limited to: (1c)

  • Batter Products: Waffles, Pancakes, Cakes, Cookies, Biscuits, etc.
  • Chocolate: Both milk and white varieties
  • Processed Foods: Bologna, hot dogs, pepperoni, salami, sausage
    (The exception to this is Kosher meat products because they are milk free)
  • Butter
  • Cheese

When you are trying to eliminate dairy from your diet, allow at least two weeks for your body to be dairy free. If after two weeks, you aren’t seeing a marked improvement, you can safely assume that your child is not sensitive to dairy products.If after two weeks, you don’t see a significant change in your baby’s colic, you can pretty much assume that it isn’t the dairy products that are causing the colic (2a).

The foods listed below can also cause reactions in your baby, but if you are eating a balanced diet and not eating too much of any one of these foods, they are probably not the cause of your baby’s colic. Every baby is different and what may cause a reaction in one baby, may be perfectly fine for another baby. If you notice that your baby’s colic acts up after eating a particular food, there is most likely a sensitivity issue for your baby. Avoiding consumption of this food in the future may be a good idea (2b).

Other potentially colic inducing foods for breastfeeding moms include onions, chocolate, eggs, peanuts, citrus fruits, wheat, corn, soy, tomatoes, strawberries, highly spiced foods, legumes, artificial sweeteners, caffeinated beverages, licorice, beet greens, bok choy, broccoli, brussel sprouts, cabbage, cauliflower, Chinese cabbage, collard greens, garden cress, horseradish, kale, mustard greens, radishes, rutabaga, Swiss chard, and turnips (2c).


Cluster Feeding Babies

Breastfeeding Question: What Is Cluster Feeding?

Cluster feedings are apparent when a baby has periods where he constantly breastfeeds for about three hours or so. Sometimes baby might fall asleep on the breast, refusing to let go and wanting to nurse more when waking. These babies are usually cranky and fussy and extremely demanding. Cluster nursing usually happens in the evenings, but can happen any time during the day or at the middle of the night. Cluster breastfeeding is very common in newborn babies. Cluster feeding at night can become very tedious, mom and baby will usually end up sleeping in the same bed. During the day, the baby might breastfeed a few times and sleep in-between, in the evenings they catch up with a period of constant feeding.

Cluster feedings do not mean that the mother has a low milk supply. Supplementing baby with formula will cause the body to produce less milk, continuing with the cluster feeding will make sure the body is making just the right amount of breast milk for baby.

hungry baby, grey eyed baby,Newborn cluster feeding is a temporary thing and learning to work around it and accept it will help you enjoy your breastfeeding experience more. Infant cluster feeding can actually work to the advantage for moms who are returning to work, as babies who cluster feed usually sleep longer at night. Moms can also use this time as a time to relax and bond with baby.

Possible causes for cluster feedings are growth spurts, acid reflux, breast milk supply is generally lower in the evenings and evening feeds are not as rich as morning breast milk, baby having extra sucking needs in the evening, colic, slower milk flow in evenings, or baby wanting more attention in the evening.

Some tips for mothers whose babies are cluster feeding are taking the baby to the pediatrician to make sure that the problem is not caused through acid reflux. Prepare for a cluster feed if you know the baby usually cluster feeds at a certain time of the day. Get baby to breastfeed while in a sling , this will be helpful in doing whatever you want to do while baby is breastfeeding. This also helps if baby is fussy. Try doing something while baby is breastfeeding like reading your favorite magazine, watching a movie or chatting on the phone. And finally, try feeding the baby on demand, not on a schedule.

Read More:

How Long Does it Take to Nurse?
When Is It Time To Stop A Breastfeeding Session?

Is It Okay To Let My Baby Breastfeed For Comfort?
Common Misconceptions about Breast Milk Supply
More On Cluster Feeding