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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.

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Monday
Jun232014

I’ve Had My Baby - Now What? Breastfeeding During months 2 through 6.

Written by Ashley Treadwell, IBCLC

 

Welcome back to our series, I’ve Had My Baby - Now What?   This is a guide with basic information to help you navigate the first days, weeks, and months of breastfeeding your new baby.  

Today we’d like to talk about months 2 through 6 of your baby’s life, and what breastfeeding looks like.  What can you expect for normal behavior from your new baby, and when do you know there’s a problem that you should seek professional help for?

 

What does normal breastfeeding look like in months 2-6?  How often should my baby be eating, and how long should feedings take?

This can vary from baby to baby - the most important thing is that your baby is having lots of wet and dirty diapers and gaining weight appropriately.  Some babies may have started taking in more at each feeding, and spacing them out more, while some may still be eating every 2-3 hours.  If you’re lucky, your baby may have dropped a feeding or two at night, and may make up for it during the day.  Other babies become much more distracted during daytime feedings around 4 months, so continuing those nighttime feedings are crucial for baby to get enough over a 24 hour period.

 

How much weight should my baby be gaining at this age? Is their weight gain expected to slow during this time?

Around 4 months, babies weight gain does start to slow down.  Up until 4 months, we like babies to gain 4-7 ounces a week.  At 4 months, this drops to 4-5 oz per week, and again at 6 months, when we expect baby to gain about 2-4oz per week.  This is important for parents to know so that they don’t worry if they see their baby’s weight gain slow around 4 months of age.  Make sure that your pediatrician is using the WHO charts for weight gain, which is for breastfed babies.  

 

Suddenly my baby seems too distracted to eat!  Is this normal, and what can I do to get my baby to feed better?

At around 4 months of age, babies start to learn that there is a whole big world out there - and suddenly, *everything* is more exciting than breastfeeding!  Dogs barking, a ceiling fan, dad sitting next to them on the couch.  It can be really worrisome for moms as they may worry that baby isn’t getting enough.  Some things you can do to help your baby focus on breastfeeding during the day: feed baby in a quiet and dark room, or learn how to nurse in a carrier - this can really help cut down on distractions.  Also, this is definitely NOT a time to start night weaning or sleep training, as these distracted kiddos often need those nighttime feedings to keep gaining weight appropriately.  Also, it’s important to remember that this is really normal behavior - and usually fades around 6 months of age.

 

I’m getting ready to go back to work - how can I make sure that I’ll be able to pump what my baby needs when I’m away from him/her?

This can be a stressful time for moms - there are definitely some things you can do to help protect your breastfeeding relationship when you return to work. The first thing you can do is to know your rights!  Know that the federal law protects your right to pump at work for a reasonable amount of time and in a private space.  Do some research ahead of time and talk to your human resources department - find out where the pumping area is, how close it is to your desk or workspace, what equipment you’ll need.  This is also a good time to talk to your caregiver - help them understand how best to bottle-feed a breastfed baby.  There are also some ways to help maximize your output while you’re pumping at work.

 

My baby still wakes often to eat at night, even at 6 months of age - is this normal behavior?

It is absolutely normal behavior!  By this stage, babies may be sleeping for longer stretches in the first part of the night, but may still wake after that to feed.  By this age, a baby needs anywhere from 28-35 oz in 24 hours and if your baby is too distracted to feed well during the day, they may wake more at night to make up for it.  If you hear your baby gulping during feedings at night, or your baby won’t settle without nursing, it is very likely that they still need the feedings throughout the night.  If the frequent wakings are taking a toll on your mental sanity, co-sleeping and side-lying breastfeeding is a great way to get some extra rest.  If you are uncomfortable with co-sleeping, you can set your alarm for 30 minutes after beginning to breastfeed your baby, and then wake up and place your baby back into their own bed.  If your baby is waking up *very* frequently, every hour, and is very uncomfortable and difficult to soothe, it could be something else that’s causing the restlessness - possibly gut discomfort and/or a sensitivity to something in your diet.

 

My 4-month-old baby will not sleep!  What’s happened to my baby that used to sleep??

The 4-month-sleep regression is a real thing and can wreak havoc on a mom’s sanity.  At 4 months, babies are going through huge developmental milestones.  They have suddenly become aware of all that is going on around them and their excitement about this can interrupt their sleep.  It’s important to keep in mind that this is temporary stage, you will sleep again…. we promise!

 

My baby is approaching 6 months and I’m starting to think about solids.  How will I know that my baby is ready?

It is definitely recommended to wait until your baby is at least six months of age before offering solid foods – even longer if your baby doesn’t seem ready.  Some of the signs of readiness are being able to sit up on their own unassisted and losing their tongue thrust reflex, so that they don’t automatically push food out of their mouth.  Another sign is when the baby has developed their “pincer grasp”, which is when they can use their fingers to pick up objects.

 

When I do start solids, what is an appropriate amount to start out with?

Your baby will need a very small amount at the beginning - only about a tablespoon once per day.  The first food doesn’t have to be a grain cereal, either - as many doctors have previously recommended.  Avocados are a perfect first food for your baby.  Remember the saying “food before one is just for fun” – your baby should be getting their total nutrition from breastfeeding – so the solids you offer them now are just for practice.   As the baby gets older, you can start to add in other meals and snacks.

 

How can I be sure that my milk supply won’t suffer once I start feeding my baby solids?

The rule for solids is always – milk first, then food.  You should always breastfeed first and then offer your baby solids.  You want to be sure that baby is still taking a full feeding at breast to both ensure he/she is getting all the calories and nutrition he/she needs, as well as maintaining your milk supply.  If you start to replace breastfeeding sessions with solid meals, you most likely will notice a dip in your supply.

 

What did breastfeeding look like for YOU during months 2-6?

How did YOU survive those distracted breastfeeding sessions?

 

Wednesday
Jun182014

You Know You Are a Breastfeeding Mother of a Toddler When....

Jenn: You can have a conversation with him WHILE he has a mouth full of boob!

Julie: Your boob is visibly lopsided because it’s full and you’re at the park so your kids is too distracted to nurse.

Tiffany: Your nipples start reminding you of Stretch Armstrong. 

Stacy: Your lap is full of toys and your toddler is dangling off the furniture while he eats.  You have to tell your utensil-obsessed kiddo that spoons are for the table, not mommy’s milk.  You laugh when people say that nursing a toddler is for YOUR benefits and not for the toddler.  They have obviously never tried to get a toddler to nurse who didn’t want to, or stop one who does.

Lindsay: Your toddler offers her mommy milk to her teddy bear, dolls, toy animals, and daddy.  It’s so nice she is willing to share!

Cat: They ask you to hold their cracker.

April: When he/she is hurt, the first words are, “Boob! Mommy! Boob!”

Julia: They announce, “That kid needs boo-boo” every time they hear a kid crying.

Laura: He’s dancing all over your chest, tummy, chair, the floor, the walls, the dog, WHILE nursing!

Colina: Nursing begins to feel more like a Cirque du Soleil performance.

Sarah: You see nothing wrong with sittin on the couch with your boobs hanging out for the quick ‘run by milking!’

Paula: After nursing you find gum on your nipple!

Laura: You are simultaneously a food source and a raceway for Matchbox cars.

Ariel: You get bras that are specifically padded to hide your nipples from twiddling hands.

Elisa: Your aren’t phased by nursing with a baby standing up!

Shannon: When you actually pray that he will sit and nurse longer than 4 minutes at a time so that you can rest for just a minute!

Cindy: You have to remind your kid to unlatch BEFORE walking away from you.... or jumping on the bed!

Ariel: When they know you’re touched out, so they ask for ‘just a little bit’ oh, so sweetly.

Kristin: They are constantly upside down.

Jamelle: Sometimes they just want to hug their boobies.  They play ‘Tune in Tokyo” on whichever one is not being used.

Lisa: When you can’t make it from the dining room table to the shower without a nursing break.

Maryjane: When they put your boobs away after nursing! (I actually really appreciate this one!)  When they tell YOU having milk (just a tiny little bit) will make them feel better.

 

Check out some of our fantastic articles about breastfeeding a toddler:

Toddler Nursing Part 1: How it Helped Me Manage My Circus

Toddler Nursing Part 2: Toddler vs. Breastfeeding

Toddler Nursing: Part 3: Super Breastfed Baby!

 

Check out some of our awesome podcasts about breastfeeding a toddler:

Breastfeeding Beyond Two Years

Breastfeeding Toddlers: Frequency, Biting, and Staying Motivated

Breastfeeding Toddlers: Night Nursing and Weaning

 

How would you finish the following sentence: You know you are a breastfeeding mom of a toddler when....

Wednesday
Jun112014

Was it Something I Ate? Food Sensitivities in the Breastfed Baby: Part 2

By Lindsey Hurd, MS, RD, LDN, IBCLC and Owner, Angel Food Lactation & Nutrition, LLC

Last month, we talked about the prevalence of food allergies, how a baby’s immune system is established, and how maternal immunity plays a role.  This month, we are diving a little deeper into understanding how mom’s gut influences baby, what causes an unhappy digestive system, and what we can do about it.  

 

Are You Being A Good Host?

Deep within the crevices of our gut we are hosts to billions of microorganisms, or bacteria that make up our Microbiome. These gut dwellers are such an important part of our body. They kill ‘bad’ germs that make their way into our digestive system, establish and maintain our immune system and even help digest our food. We need them to be happy, healthy, hard workers! Certain aspects of our American lifestyle cause many people to lack the hospitality necessary to keep these good bacteria alive. Behaviors such as being overweight/obese, an excessive use of antibiotics, a highly processed diet low in fiber, poor intake of fruits and vegetables, chronic stress, and poor bowel habits are a few examples. The key outcome from each of the offenders listed above is inflammation. A number of chronic health concerns have been linked to inflammation such as autoimmune diseases, arthritis, Ulcerative Colitis, IBS, chronic fatigue, and even heart disease. Some may say, “You mean if I am overweight and have symptoms of IBS,  I have inflammation... the same inflammation that could lead to other chronic conditions?” The answer is yes! 

Take a look at this image to find out how this affects our digestive system. 

 

Image found at: http://lyndabuitrago.com/stress-and-your-gut-part-2/

 

Inflammation over time damages the lining of our gut. The folds of tissue you see in the healthy intestinal lining increase the square footage of our intestines, helping to absorb all the nutrients found in food. Notice how they are virtually gone in the damaged gut, leading to poor digestion and, over time, something called leaky gut syndrome. This is where the bad news enters the scene… when our cells become leaky, they allow particles, allergens, bacteria, and other offenders to pass through into our system where it can cause many unwanted side effects.  

 

How does this relate to lactation? 

The cells that line our gut are the same types of cells that make up our milk-making factory! How does this relate to allergy and sensitivity risk, you ask? For some women with chronic inflammation or leaky gut syndrome, this inflammation is present within their milk making cells, allowing whole proteins and antigens to pass through their milk to their baby. 

Now, let’s stop here and point out that even with this undesirable process, breastfeeding your baby is still the best choice to make for your little one. Know why? Some studies are linking maternal gut health with baby gut health, meaning that mom’s gut environment develops and establishes the baby’s gut en utero, as well as throughout lactation. So even before feeding your baby, his/her gut cells may be predisposed to this inflammation. 

But wait; don’t throw in the towel just yet. We have something on our side… the most amazing food known to man, one that’s easily digestible and equipped with anti-inflammatory, antibacterial, antiviral, and antifungal properties. What am I referring too? Breast milk! There is no other source of infant nutrition that can compare to the powers of breast milk, making it the best food to aid in the growth of a healthy immune and digestive system.

Still worried? Take a deep breath because all of this can be reversed. With good nutrition, you can make your way back to being the hospitality queen… renovating your gut environment to serve your microbial ‘guests’ the best food and provide the strongest cells for their home. Strengthening your microbiome and reducing inflammation will get you and your little one on the fast track to improving your gut health and overall wellbeing.

 

I am in! Now what do I eat? 

Improving your diet can begin with 3 simple steps. 

First, begin boosting your microbiome of good bacteria by consuming probiotics in the form of fermented foods such as kefir, kombucha, sauerkraut, tempeh, kimchi, and more. If these foods do not appeal to your palate, find a probiotic supplement that contains many strains and species of bacteria and take on a daily basis. Remember to check with your doctor before using supplements. 

Second, increase the fiber rich foods in your diet via fruits, vegetables, and whole grains. Why do you ask? First, fiber, also sometimes called prebiotics, is the ‘food’ that feeds your good bacteria. Once we place them in our digestive system, we must feed them! Additionally, fiber helps to regulate our digestive system, allowing bowel habits to improve and, therefore, reducing inflammation caused by constipation. 

Lastly, monitor the fats you are consuming on a daily basis. Focus on consuming healthy fats. Omega 3 fats are known to reduce inflammation and improve the health of our cells. This can be found in foods like salmon, walnuts, rice bran or olive oil, flax seeds, etc instead of the omega 6 and saturated fats found in the abundance of processed foods we find on our grocery store shelves.  Guess what? The fats you choose to consume reflect the fats found in your milk and en utero! That’s right, if you increase the omega 3’s found in your diet, you will directly increase the amount in your baby’s diet. This special perk can increase the retinal development in your baby’s eyes, as well as increase cognitive development for your baby’s brain! 

 

Next month, don't miss Lindsey's next article about elimination diets: when they are needed and how to do them. 

Want to find out more? Visit www.angelfoodlactationandnutrition.com to schedule a Skype consult with Lindsey and begin your journey toward better health and a happier baby today! 

Want to stay connected between posts? Find Angel Food Lactation & Nutrition on Facebook at www.facebook.com/angelfoodlactationandnutrition for current articles, events, fun discussions and more!

Does your baby react to the foods you are eating?  

Have you tried fermented foods and a high fiber diet to help heal your gut?

Wednesday
Jun042014

A Resolution to the LA Fitness Nursing in Public Harassment Incident

Last month I shared a story about how a breastfeeding mother had been involved in a nursing in public harassment incident at a local LA Fitness.  During this incident, Monique Golueke was told that her only option for breastfeeding in the Oceanside LA Fitness facility was in the Kids Klub restroom.  After some media coverage, a nurse-in, and several cordial email exchanges between the San Diego Nursing in Public Task Force and Jill Greuling (Vice President of Operations for LA Fitness), I am elated to report that we have come to an incredibly positive resolution!  

Today, I received an email from Ms. Greuling, stating that the following memo will pop up for every LA Fitness employee in California when they log on June 5th, requiring an acknowledgement that they read and understand the information contained in the memo:

"According to California Civil Code, section 43.3, “Notwithstanding any other provision of law, a mother may breastfeed her child in any location, public or private, except the private home or residence of another, where the mother and the child are otherwise authorized to be present.”  To accommodate breastfeeding women in LA Fitness facilities, staff members may recommend reasonable places for her to do so, such as the foyer, the sales area or in the Kids Klub. It is not reasonable to tell a woman that the only place she can breastfeed her baby is in the Kids Klub restroom."

The San Diego Nursing in Public Task Force would like to commend Monique Golueke and Ms. Greuling for having the initiative to take tangible, practical actions that will prevent any incidences like this from happening in the future.  We are thrilled we were able to collaborate with her to bring forth such a positive resolution.

 

Monday
Jun022014

Defining my Breastfeeding Experience: Inclusive Breastfeeding

Written by Aran Tavakoli

It has been nine months and I just put away my pump. Getting it ready for storage was bitter sweet. How many hours have I spent with that machine in the past 9 months? Its usefulness outweighed the annoyance.  Once again, at this point in time, I am redefining my breastfeeding relationship with my baby. 

 

 

Breastfeeding has been an extraordinary journey. I have experienced and learned so much. I keep searching for a word that captures and defines my experience, but I can’t find one. I believe the breastfeeding community is actually missing a term for mamas that fall into their own camp. There is the exclusively breastfeed group and the formula group. Research often distinctly divides mamas and babies into these two groups. But, there is an ever-growing group of mamas that breastfeed and give formula to support their breastfeeding relationship with their baby. The current words used to describe this group include combo feeding or more commonly, low supply needing supplementation. 

From the true definition, I do not "exclusively" breastfeed my baby. However, I do exclusively give my baby all the breast milk that I have.  But he needs more to be happy and healthy, so he also receives formula and when he was really little, he received donor milk. Honestly, I am so tired of the “low supply” conversation, I wish there was a different word for how I feed my baby. A word that matches the pride of the mamas who do exclusively breastfeed their little ones all that they produce.  

 


Per Merriam-Webster, ‘exclusive’ is defined as, “not shared: available to only one person or group.” ‘Inclusive’ is defined as, “covering or including everything: open to everyone: not limited to certain people.” 

Thinking about it, I have never been an exclusive type of person, so the opposite of exclusive is inclusive. I have inclusively breastfed my baby for 9 months (way longer than I would have thought in the beginning!). This is the word that I am using to define my breastfeeding experience. 

In the inclusive camp, mamas know the best and worst of both worlds. The best of breastfeeding includes that joys of nourishing your baby with your body and making personalized milk. Then there is the best of formula: the intervention that provides life saving nutrition to support healthy growth and development. The worst of breastfeeding includes the sometime difficulties: mastitis, plugged ducts, yeast, blebs and so on! On top of breastfeeding, there might also be pumping, all the equipment and time that is required. For formula, besides the cost, the worst includes the bottles to be cleaned, sterilized and cleaned again. 

In the inclusive camp, the mamas are incredible as they work so hard to maintain their milk supply for their little ones, while also accepting help in the form of formula or donor milk. It is not one way or the other, it is all the ways: the breastfeeding, the pumping, the supplementing, the love, the dedication, the tears and the sweat (especially on hot days)! The inclusiveness of the experience. 

 

 

 

I don’t want to use a breastfeeding definition that makes mamas feel bad that their milk supplies are low (I worked through that one) or that they feel badly for needing to use formula (I worked though that one, too). Saying that, 'I inclusively breastfeed" is so much more positive and empowering than saying, "I have low supply and need to supplement." My lactation consultant, Ashley, always said to me, “He is getting your milk.” That has become my motto. He’s getting my milk, the amount doesn’t matter, and he is getting my milk.

So...Mamas who Inclusively Breastfeed, shall we adopt a new term? 

 

 

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