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The content on this website (http://sdbfc.com) is the property of Robin Kaplan, M.Ed., IBCLC, except in the case of guest blog posts, which have been posted with permission of the authors credited.

The information and opinions provided on this blog are not a substitute for medical advice or consultation with a qualified medical professional; nothing contained on this website shall be presumed or shared as medical advice at any time.

Links to other websites and blogs that may be of interest to you, the reader, are provided; this does not imply endorsement of or collaboration between Robin Kaplan and the owners/authors of those websites and blogs.

Wednesday
May202015

Top 6 Tips for Protecting Your Milk Supply While Traveling for Work

We had this terrific question posted on our Facebook page:

“Dear Robin,

I leave tomorrow for a four day work trip and I can't take my baby with me. She has 6 feedings a day (one of those at night) so I'll be doing a good amount of pumping while I'm gone. Do you have any tips, specifically for pumping at airports and/or on planes? I'll be on a red eye there and a direct flight on the way back.”

 

Absolutely!  Just because you have to travel for work doesn’t mean that you can’t protect your milk supply while you are gone.  

 

Here are my top 6 tips for protecting your milk supply while travelling for work:

1. Pick up a few insulated cooler bags with a zipper, like this one from Trader Joe's, with several blue ice packs, from Rubbermaid, to bring with you in your check-on luggage.  When traveling for more than a day or so, you may have a lot of pumped milk to bring home with you.  Using insulated cooler bags with ice packs will allow you to bring all of that liquid gold home with you, without having to lug it through security.

 

2. Call your hotel before you leave home to ask if there is a fridge in your room.  If not, you can request one and that is where you will place all of your pumped milk while on the trip.  Store your milk in breast milk storage bags so that you can fit a lot of them in the insulated cooler bags on the way home.  Also bring a small cooler with ice packs to store pumped milk when you are away from your hotel room.

3. Depending on the length of your flight, you could either skip the pumping session and just make sure to pump extra long when you arrive in at your destination.  Or, you could bring a nursing cover, your pump pieces, and a battery pack and pump while on the flight.  On the red eye, this should be easy, since it will be dark.  On the daytime flight you might ask the flight attendants if you could sit in the back in one of their seats so that you have a bit more privacy.  If you are going to pump on the flight, bring a small cooler with you with blue ice so you can save your pumped milk.  You could also just pump right before you get on the plane and then completely forget about pumping while on the flight.

Freemie Collection Cups4. Invest in some Freemie collection cups.  These cups are amazing!  You can pump with your shirt on and no one will know what you are doing!  They are incredibly discreet and hold up to 8oz per cup.  These are great for on the plane, in the cab, and in between meetings.  

 

5. Try to pump every few hours, and once at night if your baby is still breastfeeding in the middle of the night, to keep up your milk supply for when you get home.  If your meetings are in a conference center or hotel, ask the concierge if there is an open room that you can use (NOT A BATHROOM) to have some privacy while pumping.  Aim for pumping for about 15 minutes, which is about as long as it will take your co-workers to enjoy a coffee break.

Mamava Lactation Suite6. Do some research ahead of time to see if the airport you are spending time in has a Mother’s Room, Nursing Room, or Pumping Room.  Download the Mamava app to find publicly placed Mamava Lactation Suite in United States airports.  

 

Now it’s your turn!  What tips would you add to this list?

 

Wednesday
May062015

Support Group or IBCLC: What's the Difference?

When a mom is looking for breastfeeding assistance, it can often be difficult to know where to get this help and from whom.  There are so many options…. Facebook, breastfeeding support groups, lactation consultants… where to go can be confusing, especially if she feels like she needs to get help immediately!

So, what is the difference between the breastfeeding help you will get at a support group and at a private lactation consultant visit?

 

What you can expect at a breastfeeding support group:

Let me preface this by saying that not all groups are the same and it really depends on the level of expertise of the person running the group and how busy the group is.  There are different levels of experience and training in the field of lactation, depending on how many hours a person has spent in class and in an internship.  The level of expertise are demonstrated by the letters that follow the person’s name (IBCLC, CLC, CLE, etc), which is all explained in this fantastic article, What’s the Difference Between LC, IBCLC, CLE, etc?

At a breastfeeding support group, you will find a leader who is there to offer general breastfeeding assistance and support.  This leader can assist with positioning and latch (although often times this leader will not be able to actually touch you or the baby), basic information about normal breastfeeding/pumping strategies, normal baby feeding patterns, normal baby weight gain, breast and nipple care, and ways to maintain and protect your milk supply.  Often times there is a scale where you can weigh your baby before and after a feeding to see how much your baby is taking in (which is AWESOME!)  Attendance at the support group can range from a few moms to over 20, depending on how big the space is and how well attended the group is.  Support groups are often free, depending on where you live.  Support groups are fantastic for getting basic breastfeeding support, getting help while you wait for an appointment with an IBCLC, meeting other breastfeeding moms in your community, and practicing breastfeeding outside of your home.  

What you will not receive at most breastfeeding support groups is a personalized plan of care for difficult breastfeeding situations.  To create a personalized plan of care, a mother and baby’s medical history need to be discussed, as well as mom and baby both need to be assessed, which requires a consent form.  Therefore, most advice given at a breastfeeding support group is general, not specific for mom and baby’s personal situation.  

 

What you can expect at a private lactation consultant visit:

If you are meeting with an International Board Certified Lactation Consultant (IBCLC), you are now moving from general advice to a personalized assessment and plan of care.  The IBCLC should conduct a suck assessment on your baby, collect medical histories of both you and your baby, assess a feeding session, and offer guidance on how to improve your personal breastfeeding experience.  

 

Reasons you would want to see an IBCLC rather than just attend a support group:

  • Cracked, bleeding nipples

  • Painful latching that isn’t improved with positional changes

  • Baby not gaining weight well

  • Mom’s milk has not come in by day 3-5

  • You suspect your baby has a tongue tie and/or lip tie

  • Baby has signs of colic or reflux

  • Mom has a low milk supply/supplementing baby

  • Mom has an oversupply

  • Premature baby

  • Challenges with breastfeeding multiples

Each of these situations requires that someone provides a medical assessment and advice beyond what’s normal or typical with breastfeeding, therefore, it goes beyond what a mom can seek help for at a support group.  These private visits can take place in mom’s home, in the IBCLC’s office, at an outpatient clinic, at a medical practitioner’s office, or similar places.  Most of the time these visits have a fee associated and sometimes insurance will pay for these visits.

 

Where you can find an IBCLC in your area:

  • Ask your friends

  • Ask your baby’s pediatrician

  • Search for a local breastfeeding coalition

  • Call the breastfeeding warm line at the hospital or ask your midwife/OBGYN

  • Ask your WIC Peer Counselor

  • Search for an IBCLC in your area on the ILCA website

  • Google “IBCLC” and the name of your town or city

  • Ask for a recommendation on Facebook

  • Attend a support group led by an IBCLC

Where have you found breastfeeding support in your neighborhood?  

Was it easy to find this support?

Wednesday
Apr292015

Positive Breastfeeding in Public Stories 

Written by Ashley Treadwell, IBCLC

So much of what we hear about feeding our babies in public is negative - stories from women being harassed and shamed for breastfeeding in public.  While we believe that it is so important to respond to these incidents and educate people on the importance of normalizing breastfeeding, we also think that one of the best ways we can empower women is to share our positive experiences as well.  Below is one of many examples of wonderful responses women receive while feeding their babies in public - meet Briana!

 

 


"So I'm at Ross today with the toddler and baby when baby gets fussy and hungry. I let the kiddo try on big girl shoes in the ladies dept while I nursed baby. But a woman and her 'tween came down our aisle and hovered. I wasn't covered up and panicked for a second thinking that this may be my first altercation regarding NIP.

NOPE. The super sweet lady said I was doing a great job--and the most important one. She breastfed all 3 of her babies. I felt such a sense of connection and gratitude. I had a hard time not crying and hugging her.

I've never had anything but support from family, friends and strangers, but this was really touching today.

Just wanted to share a happy story, and write a little blessing to the wonderful woman who made my day. May she feel the love that I felt from her today, every day."

 

 

Do you have a positive breastfeeding in public experience to share?  Please send it to us at ashleytreadwell@sdbfc.com

 

 

Wednesday
Apr082015

Breastfeeding at 3-4 Months - It Can Look Very Different!

 

Written by Ashley Treadwell, IBCLC

 

 

Running two support groups every week, I get all sorts of questions from moms with concerns about their breastfeeding babies.  One of the questions/concerns I hear the most often is this: “My baby is suddenly not feeding for nearly as long as they used to and they aren’t interested in feeding as often.  They get fussy easily at the breast and pull off after just a few minutes.  I’m concerned that they aren’t getting enough milk from me!”  I can almost always predict the age of these babies - somewhere around 12-16 weeks.  And here’s why.

Many moms know that babies feed frequently in the early weeks.  They expect feedings around the clock that can last quite a while.  What many moms don’t realize is that this *can* change dramatically around the 3-4 month mark.  Babies who used to feed every 1 to 3 hours, for 30 minutes or more, babies who were always happy to breastfeed when offered - suddenly start refusing the breast at times, and when they do accept, may only feed for a few minutes before pulling off.  This can be a frustrating time for moms as they are often concerned that the baby may not be getting enough and are worried about this significant change in baby’s feeding patterns.  In this article, we’ll discuss why this happens, how to know if there is reason for concern, as well as how to manage this new behavior.

 

Why is this happening?


 While it’s great to know that this behavior is normal, many moms want to know why their baby’s breastfeeding behavior has changed so much.  Much of it has to do with developmental changes that occur as baby grows and matures.  One reason the length of a baby’s feeding may shorten significantly is simply that baby is becoming more efficient at the breast - meaning she/he can get more milk out in less time.  This can be hard for moms to believe, so visiting a support group where you can do a weighted feed to see how much baby is taking is a great way to confirm this!  I can’t tell you how many moms come to my groups and are amazed at how much their baby can take in only 5-10 minutes.  Another factor is baby is experiencing a huge developmental leap at this time...  awareness of his/her surroundings is exploding.  Suddenly, your baby will notice the plant in the corner, the dog chasing it’s tail, the freckles on mom’s nose!  Everything is so new and exciting, babies are often too distracted to breastfeed.  They may go hours between feedings, and when they do go to breast, they will often pop off frequently to look around and interact with their surroundings.  

 

Should you be concerned?

If your baby has breastfed well up to this new stage, if weight gain has been within normal limits (4-7oz per week), and they are having the appropriate amount of wet and dirty diapers, you can rest assured that this is all normal behavior and your baby will not go hungry.  It is very uncommon for a baby who has gained weight well to suddenly start to have difficulties.  Yes, your baby may take in less during the day if they’re distracted by all that goes on around them, but they will make up for it in other ways.  Baby may start to wake more at night, asking to feed, to make up for the milk he/she missed during the day. This is one of the reasons that we don’t recommend night weaning at this time - your baby might need those middle of the night feedings! But don’t worry, tired mama, this won’t go on forever.  

  • The signs to look for that will tell you that all is fine are as follows:
  • Baby is having the appropriate number of wet and dirty diapers
  • Baby is meeting the age-appropriate milestones
  • Baby is gaining at least 4oz per week.  

While you may not know what your baby’s weight gain looks like in between doctors’ appts, you can visit a weekly breastfeeding support group to monitor baby’s weight on a weekly or monthly basis and be sure that he/she is gaining appropriately.  

 

What can you do?

  • Offer your baby the breast when he/she shows signs of wanting it, but don’t worry too much if he/she don’t take it, or doesn’t feed for as long as she/he used to.  
  • A couple of times a day, try to feed your baby in a dark, quiet place with fewer distractions.  
  • Consider purchasing a nursing necklace so that your baby has something to play with while breastfeeding.  It will help keep your baby’s attention on you rather than the ceiling fan above your head.
  • Try nursing in a carrier, which provides a nice, quiet, distraction-less space on the go.
  • When your baby wakes at night, respond to him/her and breastfeed, as he/she may need these feedings now more than ever.  
  • But mostly, relax!  Enjoy the shorter feeding periods and longer stretches between them.  Have fun with your baby as he/she explores his/her surroundings and learn about the world. Trust that your baby will let you know when he/she is really hungry and follow his/her lead!

 

 Here are a few more resources about breastfeeding a 3-4 month old:

Help a Mama Out: Tips for Breastfeeding the Distracted Baby

I've Had My Baby - Now What? Breastfeeding During Months 2-6

The Boob Group: New Mom Breastfeeding Manual 2-6 Months

Thursday
Mar262015

Do's and Don’ts of Using the Nipple Shield

Written by Robin Kaplan, M.Ed, IBCLC

Is your baby having a difficult time latching?  Is breastfeeding incredibly painful?  Do you have a cracked nipple that just won’t heal?  Then most likely you have been recommended to try a nipple shield.  While the nipple shield can often be a terrific temporary tool to help with these situations, it is important to know how to use them correctly, as well as have an exit strategy for how to discontinue usage as soon as possible.

 

What is a nipple shield and why is it used?

 

Nipple shield

A nipple shield is a thin piece of silicone that is placed on your nipple so that your baby can feed at the breast.  For the baby who cannot latch on easily (due to prematurity, difficult birth, tongue tie, etc) the nipple shield provides a definitive shape for mom’s nipple, making it easy to latch onto.....all baby has to do is open his/her mouth and start sucking.  For the baby who is compressing mom’s nipples while breastfeeding (due to a tongue tie, lip tie, torticollis, receded chin, difficult birth, etc.) causing pain and cracked nipples, the nipple shield provides a temporary barrier so that the baby can still breastfeed while allowing mom’s nipples some relief and time to heal.  Sometimes the nipple shield is offered to a mom just because she has flat nipples.  In most cases, this isn’t really necessary, since a baby who latches on deeply doesn’t care whether mom has flat or erect nipples.

 

Is there a correct way to use the nipple shield?

YES!  Just as with the baby who latches on to the bare breast, when a baby is latched on with the nipple shield, he/she will only be able to stimulate mom’s milk, keep up her milk supply, and effectively transfer milk if he/she has the entire nipple shield in his/her mouth.  If the baby is sliding off and on the nipple shield while feeding, the baby will not be able to transfer milk well and can also cause mom a lot of nipple pain.  

 

Depending on how long your nipple is, you might have to invert the shield before putting it on, so that your nipple goes further into the shield before latching your baby.  Our DIY Breastfeeding YouTube Video, Latching: Using a Nipple Shield, demonstrates how to do this.

 

 

What are the pros and cons of using the nipple shield?

Pros:

  • Mom’s nipple has an opportunity to heal without having to introduce a bottle too early to her baby.
  • Premature babies who have not yet become super coordinated at latching on to mom’s bare breast and who tire quickly are able to breastfeed more easily.
  • Babies who are unable to latch onto mom’s bare breast, for a variety of reasons, are able to breastfeed while the underlying challenges are addressed.

Cons:

  • Babies may not be able to effectively transfer milk using the nipple shield, so baby might need supplementation even if mom’s milk supply is able to meet his/her need.
  • Mom’s milk supply could potentially decrease if baby isn’t effectively stimulating her milk supply.
  • Mom might get recurrent plugged ducts and/pr mastitis due to ineffective milk drainage.
  • Babies can become very dependent on the nipple shield, which can make it difficult to wean from.  This can make breastfeeding in public a bit of a challenge.

 

How can I wean my baby from the nipple shield?

Babies can become very obsessed with the nipple shield, so sometimes it can be challenging to wean them from it.  This is why you always want to have an exit strategy.  

  • If you are using the nipple shield as a temporary band-aid while your nipples heal, try to use it for only a few days and maybe not for every feeding.  If one side is less damaged than the other, only use the shield on the more damaged nipple.  
  • If you are using the nipple shield to help with latching difficulties, attempt each day to latch your baby without it.  You never know when he/she is going to figure out how to latch without it and the daily practice should help speed up that process.  Sometimes moms find it helpful to latch the baby with the nipple shield at the beginning of the feeding and then try the ‘bait and switch’ move to encourage the baby to latch back on without it once he/she has a little milk in the belly.
  • If you are using the nipple shield due to baby’s inability to breastfeed well because of a tongue tie, lip tie, general chompiness, torticollis, etc., you absolutely want to schedule an appointment with a lactation consultant to help remedy these underlying issues.  The use of the nipple shield might help temporarily, but it may increase your risk for breastfeeding challenges later on, which can be more difficult to fix as the baby gets older.  A great IBCLC should be able to assess what is causing these breastfeeding challenges, as well as provide you with other practitioners who can help remedy the situation, such as an ENT, pediatric dentist, chiropractor, craniosacral therapist, etc.

 

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