Due to ongoing delays from TriWest in countersigning our contract, we are no longer able to provide insurance-covered appointments to Tricare families. To help bridge this gap, we’ve added a low-cost clinic option for Tricare families. This affordable clinic is also available to families with insurance we do not accept, such as Kaiser, HMOs other than UCSD Managed Care, or MediCal, who may be unable to afford the cost of our one-on-one consultations.
Let’s explore the liver’s role in lactation, how insulin helps prepare your body during pregnancy and postpartum, and practical ways to support your liver and overall health for the most robust milk supply possible!
Dealing with a plugged/clogged duct? While this condition is often painful and frustrating, it’s usually manageable with some self-care and support. So, what exactly are plugged (clogged) ducts, why do they happen, and what can you do to resolve them? Let’s break it down!
Battling a cold or flu while chest/breastfeeding can be overwhelming, especially if symptoms or dehydration cause a dip in your milk supply. Fortunately, there are safe remedies to help you recover while maintaining your chest/breastfeeding journey and milk supply.
Due to ongoing delays from TriWest in countersigning our contract, we are no longer able to provide insurance-covered appointments to Tricare families. To help bridge this gap, we’ve added a low-cost clinic option for Tricare families. This affordable clinic is also available to families with insurance we do not accept, such as Kaiser, HMOs other than UCSD Managed Care, or MediCal, who may be unable to afford the cost of our one-on-one consultations.
A few weeks ago, we sent out a call for Breastfeeding/Chestfeeding/Pumping memoirs. Our desire was to flood the Internet with beautiful breast/chestfeeding and pumping stories of triumph, overcoming challenges and struggles, and positive outcomes, regardless of the total amount of milk a parent was producing. We are thrilled to share these stories with you, our readers, and hope that they offer support and inspiration for you, wherever you are in your breast/chestfeeding or pumping journey.
Thank you to all of the parents who submitted their stories! If after you read these memoirs you are inspired to submit your story, feel free to send it to RobinKaplan@sdbfc.com.
This Memoir is from Casey
Our breastfeeding journey began in June of 2018, following a traumatic (for me, fortunately not my son) childbirth. Combating an unexpected c-section, magnesium treatments, dehydration from blood loss, and significant tongue and lip ties with a macrosomic baby (11lb7oz) was a rough start. For about 5 weeks, I nursed my son with a shield, then immediately supplemented with pumped milk and formula, pumping almost as often as I was nursing him. I was recommended to see an IBCLC, and met with her a few weeks later, as well as regularly attending support groups one to two times a week. Our son had his lip and tongue ties revised, and we were able to immediately drop the shield and successfully latch FINALLY when he was about 6 weeks old. I attended support groups regularly, even once we established a solid latch and experienced success, to support others who were struggling with similar issues and for the camaraderie.
As we continued to nurse, my original goal of at least 1 year came and I had a choice to make. To conceive, my husband and I require IVF. While there are some unknowns and potential risks associated with nursing through infertility treatments, I consulted an IBCLC as well as professionals who research medication interactions with pregnancy and breastfeeding and decided the potential that the treatment wouldn’t work was worth the risk of continuing to nurse my son.
In July of 2019, we transferred an embryo and became pregnant with my second kiddo. My son nursed throughout the pregnancy, dry nursing when my supply diminished from typical pregnancy hormones, and continued as my colostrum came back in shortly after. I worked through some nursing aversion that arose from those same hormones. In March of this year, literally the same day that the state of California started a stay at home order, I went to the hospital to be induced. This was my first and only time away from my first nursling overnight, as my original plan of having him come in and snuggle with me and nurse was thwarted by the pandemic. I gave birth to my daughter via c section on my second day at the hospital, and immediately began to nurse. She was much smaller than my son, only 7lbs1oz and had some temperature and blood sugar issues shortly following birth and wound up spending her first night in the NICU. (I need to say that those long term NICU moms are the bravest women I’ve ever met, and many of them were pumping day and night to provide for their babies, even as their stay was stretched over several months.)
I traveled slowly to and from the NICU every couple hours to nurse my daughter, but her sugars needed a bit of support and we supplemented with formula after nursing those first few days.
After 5 days in the hospital, we finally got to go home and see my son. I wasn’t sure if he’d still be interested in nursing after 5 days with nothing, but as soon as I sat down at home, he instantly latched as if nothing had changed. I tandem nursed both my babies for the first time- my son at 21 months old, my daughter at 3 days old.
It’s been 4.5 months and both of my children still nurse well. I’m grateful that my daughter didn’t have any ties or other latching issues and was able to gain weight well. My new breastfeeding goal is as long as each of them want to nurse, though we have scaled back the frequency for my toddler, so that I have time to function throughout the day. He was thrilled when my full milk came back in!
I will forever be grateful to all of the IBCLCs for helping me salvage my breastfeeding relationship with my son and for continuing to support me and numerous other nursing parents to provide our children with the best start possible.
Have you been asked this question: How is your baby sleeping? This is my least favorite question because it puts the parent in a position to evaluate or validate their parenting skills based on their child’s sleep. The reality is that your baby’s sleep habits may have everything to do with brain development and how the brain organizes sleep cycles and awake windows.
This is Part Two in our supplementation series. Don’t miss Part One: I’m Told that my Breastfed Baby Needs to be Supplemented…. What Should I Do?
One of the most challenging aspects of supplementing your breastfed baby is knowing when and how you can reduce or completely stop that supplementation. You will want to work with your pediatrician and an IBCLC to help fine tune this process for you and your baby, but here are some general guidelines.
Early supplementation in the first few days after your baby was born may have been recommended to help resolve a temporary medical situation, such as jaundice, hypoglycemia, or excessive weight loss. Typically, once your milk supply has fully ‘come in’ and baby is gaining well, supplementation can stop. Longer-term supplementation, such as for a premature baby, baby with feeding challenges, or a breastfeeding parent working to increase milk supply, will likely require a longer weaning process. In both cases, though, watching the baby for signs of effective breastfeeding will be an important part of baby's care.
There are quite a few ways we can tell that a baby is breastfeeding well
Baby actively feeds for 20-40 minutes, seems satisfied after eating, and can go about 2-3 hours between most feedings
Breastfeeding is comfortable and your breasts feel softer after your baby has fed
Diaper count - Babies in the first few weeks to months should pee/poop at least 5 times a day. As babies mature, so do their digestive systems. After the first few months, babies often continue to pee at least 5 times daily, but poop frequency may drop to 1-2 times daily
When you weigh your baby before and after a breastfeeding session (like with a gram-sensitive scale at a breastfeeding consultation or support group), your baby is taking in an appropriate amount for his/her age and weight.
Weight gain - Baby is gaining the appropriate amount of weight based on his/her age
As your baby begins to breastfeed more effectively and transfer more milk from you while breastfeeding, you might also notice that your baby begins to refuse supplements (or just takes less) after breastfeeding. If your baby is gaining weight well, then you might consider offering less of a ‘top off’ after breastfeeding and see if your baby continues to gain weight well. If your baby is gaining more weight than expected for his/her age, this is also a reason to pull back on supplementation.
To wean from supplementing your baby, you will want to either reduce the amount of supplementation after each breastfeeding session or cut back on how often you supplement during the day. Try this reduced supplement amount for a few days and see if your baby still seems satisfied after eating throughout the day and night, as well as check your baby’s weight to make sure he/she gained enough over that time period. If weight gain is still more than needed/expected and your baby seems satisfied after eating, continue to pull back on the amount of supplement per day until you reach a point where you have either cut supplementing completely or dropped down to your baby’s sweet spot.
While reducing the supplementation amount, this also means that you might be able to cut back on the number of times you pump per day, which is what every parent wants to hear, right? A lactation consultant can definitely guide you on this process so that your milk supply isn’t lowered with this decrease in pumping frequency.
There are some situations when a breastfeeding parent may not have a full milk supply and will need to supplement long term. Working with a lactation consultant can be very valuable during this process to help maximize your milk supply potential, as well as discuss options for long-term supplementation.
It is incredibly important for any parent needing to provide long-term supplementation to understand that EVERY drop of breastmilk you produce for your child is valuable. You are creating a perfect food for your child, as well as providing amazing immunity-boosting benefits that only YOU can create. Your milk was meant for your baby and breastfeeding does not have to be all or nothing. While it can feel absolutely heartbreaking to hear that exclusive breastfeeding may not be a possibility, I’d like to share a beautifully written breastfeeding memoir on our website. The author, Aran, brilliantly coins a new term, ‘Inclusive breastfeeding’, which helps put all of this breastfeeding and supplementation into perspective.
And, if you need some guidance on how to navigate your supplementation journey, book an appointment with us, as we would love to help!
To book an appointment at the San Diego Breastfeeding Center, click here!
If you don’t live in San Diego and would like to book a virtual consultation, email Robin at robinkaplan@sdbfc.com
If you are looking for a lactation consultant in your area, click here for ILCA’s Find a Lactation Consultant Directory
