Breastfeeding Truly Takes a Village!

A few months ago, we sent out a Call for Breastfeeding Stories.  Our desire was to flood the Internet with beautiful breastfeeding stories of triumph, overcoming challenges and struggles, and positive outcomes, regardless of the total amount of milk a mom 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 breastfeeding journey. 

Thank you to all of the mothers 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 Breastfeeding Memoir is from Natalie

Before my son was even born, I knew I wanted to breastfeed him. I attended multiple classes on breastfeeding, stocked up on nursing pads, nipple butter, and felt as prepared as I could be prior to his arrival. After a precipitous labor/delivery, he ended up being born in front of the hospital! One benefit was that I got to hold him immediately, so we had lots of skin to skin time which was emphasized in the classes. We tried breastfeeding within one hour of his birth, and he immediately latched! We had a lactation consultant visit at the hospital, and she said everything looked great! I even scheduled my first lactation appointment at SD Breastfeeding Center when my son was 4 days old. We weren't having issues, but I quickly learned that breastfeeding my son was way different than the practice doll we used in the class! During that visit, I learned my son had lip and tongue ties. Nobody else evaluated him for these, but being tongue tied myself it didn't come as much of a surprise. Fortunately, he was transferring well and the ties did not seem to be interfering with his feeding.

Fast forward 2 weeks, and my son was not at his birth weight. He was feeding for over an hour, falling asleep, and seemed very irritable and unhappy. As a new mom, I assumed this was normal. I pushed on for another week and then decided to schedule another visit with the LC for an evaluation. There, I did a weighted feed and learned that he wasn't transferring effectively. The LC explained how he was being restricted by his lip and tongue ties, and this could potentially decrease my supply. She recommended I consider a release of his ties, so I immediately called a provider and had them addressed the next day.

I read how many mothers noticed instant results and symptom relief post release. I didn't notice immediate results, but was confident that things would improve over the next few weeks. When they didn't, I followed up with Melanie, our LC. She assessed him and noticed that he still seemed restricted, wasn't transferring adequately, and recommended we take him for body work. Due to his poor weight gain (6 oz in 2 weeks) she taught me how to use my breast pump and implement an SNS (supplemental nursing system). She also recommended a galactagogue supplement. Things weren't moving in the direction I wanted, but I was committed to do everything I could to continue breastfeeding.

At this point, I was feeling very defeated and inadequate. I felt like I was doing everything I could, and was so sad that my little baby was not growing at the rate he should. My pregnancy and delivery were so natural and without issue that I naively thought breastfeeding would follow. I called my sister in law, who happens to be a breastfeeding mother.  She immediately came over with galactagogue-rich foods and tea, and even pumped for my son while I built up my supply!

After additional LC visits, support groups, and the implementation of bodywork, I made the decision to have a second release for my son. Even though we are still post op and performing stretches, I already am seeing results. My son is happier, and I no longer have to use the SNS system. I have a nice freezer stash of my milk, and he is thriving with weight gain. He's not even three months old, so I don't know how this journey will end. I do know, however, that I'll do everything I can to preserve our nursing relationship. Without the help of multiple providers, I'm not sure where we would be. "It takes a village" is such an appropriate phrase for this season of my life. I am so thankful to live in a community that has SO much support for breastfeeding mothers.

Help Us Make A Difference on Giving Tuesday!

Happy #GivingTuesday!

Breastfeeding is not always easy!  Having personally experienced breastfeeding challenges with both of my kids, I know firsthand how critical breastfeeding support is for a mom in those first few weeks after her baby is born.  Critical, both physically and emotionally.

Join me in helping local low-income women gain access to critical breastfeeding support on this #GivingTuesday.

 

Wondering how to do this?

We are asking you to help us #SupportSDMoms by donating your weekly coffee money!  It’s that simple!  If everyone on this email list donated $10-$20 today, the amount they would spend at a coffee shop this week, we would be able to raise over $40,000 on #GivingTuesday.  

 

Can you help us reach this goal?

All you have to do is click on this Paypal link to donate this week’s coffee allowance and help bring affordable breastfeeding support to hundreds of local low-income moms.

After a fairly smooth pregnancy and birth, breastfeeding presented me with the greatest challenges in my journey to motherhood. Tula had a tongue tie that caused her latch to be shallow and excruciatingly painful for me. After the revision, she had trouble re-learning how to latch with the new mobility and ended up losing nearly a whole pound one week postpartum. That's when robin and the team at the San Diego Breastfeeding Center swooped in to the rescue.

Realizing our baby had been starving, we were wrought with concern and exhaustion. Robin was kind, supportive, and professional. She came to our home and was affordable, which was such a relief! She created a plan with us and she reassured us that we could reach our goals and get our baby healthy.

Five months later and we are going strong halfway towards our goal! Robin remains an essential source of support and guidance. Having access to these invaluable services, at the incredibly reasonable price point of $25, made all the difference.

- Lauren

DID YOU KNOW….

• While 93% of moms start breastfeeding exclusively at birth in San Diego, only 56% continue doing so at 3 months, largely due to a lack of access to ongoing lactation support.

• Lack of financial resources is reported as one of the main barriers for women to receive qualified breastfeeding support to help feed their babies.

Please join us today, on Giving Tuesday, to help more local families like Lauren's gain access to critical breastfeeding support!

To donate to the San Diego Breastfeeding Center Foundation, please send checks to:

San Diego Breastfeeding Center Foundation (3355 4th Ave., San Diego, CA 92103)

Breastfeeding After Breast Reduction - A Memoir

A few months ago, we sent out a Call for Breastfeeding Stories.  Our desire was to flood the Internet with beautiful breastfeeding stories of triumph, overcoming challenges and struggles, and positive outcomes, regardless of the total amount of milk a mom 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 breastfeeding journey. 

Thank you to all of the mothers 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.    

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This breastfeeding memoir is from Jenna

Ten years ago, eighteen-year-old Jenna was bouncing between San Diego and Los Angeles counties looking for a plastic surgeon. They had to be willing to do a keyhole incision and leave my nipple attached while they performed a bilateral breast reduction. I was a senior in high school and had my breast reduction surgery during spring break. 

Fast forward six years. I find out I'm pregnant the day my boyfriend gets to Djibouti, Africa, where he'll be deployed for the next 7 months. I sought out a natural birth provider in my network after reading the book, Defining your Own Success: Breastfeeding After Breast Reduction Surgery by Diana West. In this book, it encouraged mothers to birth as naturally as possible for the best chance at breastfeeding after a reduction and this book had become like a Bible for me, so I followed its every recommendation. After finding midwives, a doula and a baby-friendly hospital, I looked for an IBCLC and a Breastfeeding 101 class. I knew I needed to be prepared or I would succumb to all of the "boobie traps" within the first few days. My daughter was born on the much later end of normal, well past 42 weeks, was 9lbs 11oz at birth, and was born with a tongue tie and upper lip tie. I was given hell at the hospital for not wanting to give her formula, after requesting several times to be seen by the in-house IBCLC. The nurses and pediatricians said they'd never seen a mother be able to exclusively breastfeed after a reduction and feared that I wouldn't feed my baby because of my determination to nurse. 

At 6 weeks old, my daughter was diagnosed with life-threatening food allergies making even allergen-free, prescription-only formula not an option. The first six weeks I pumped after every feeding.  My husband spoon-fed, finger-fed, syringe-fed, cup-fed, & I used an SNS. At our 2 month pediatrician appointment, our doctor told me to quit trying and that what we were doing wasn't sustainable. I sought out chiropractic care, craniosacral therapy, multiple tongue tie revisions, continuous IBCLC care, breastfeeding support groups, homeopathic remedies, acupuncture, removed all allergens from my diet, quit my job, and somehow decided, breastfeeding was worth it all. From eight weeks old, we exclusively nursed through recurring tongue ties, vasospasms, low milk supply, mastitis, severe food allergies, thrush, and an abscess, for over 3 years, through a pregnancy and tandem nursing for a year and a half. Her younger sister is 28 months and we don't see an end in sight. 

We Were Not Meant to Mother Alone

A few months ago, we sent out a Call for Breastfeeding Stories.  Our desire was to flood the Internet with beautiful breastfeeding stories of triumph, overcoming challenges and struggles, and positive outcomes, regardless of the total amount of milk a mom 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 breastfeeding journey. 

Thank you to all of the mothers 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.    

_____

Our first breastfeeding memoir is from Michelle

I booked at least 2 vacations for my maternity leave, all on airplanes. I was going to wear my baby everywhere, nursing her as we went along. I had the organic breast pads purchased, all the nursing tanks, and the most breastfeeding-friendly bottles, but of course I wouldn’t need those for at least several months. I would see Mamas nursing their babes at the beach and I would find myself staring as I daydreamed about my nursling that was to come. December 2013, my sweet baby girl arrived.  She latched and we were a nursing team. 24hrs later I was told she was Coombs positive and her jaundice levels were high. She was sleepy, was losing too much weight and I needed to give her formula in a bottle. I cried lots of tears. "FORMULA? No way!", but I had no other options. Every time I fed her, and I wouldn’t let anyone else feed her.  I felt awful and felt like I was letting her down. 7 days later I was told, "your daughter is failure to thrive". Queue more tears, more formula, more guilt, and not a lot of milk being produced from me. 

Over the next month, my journey consisted of doctors’ visits, pumping 8x a day, a baby screaming at the breast due to bottle preference and low supply, tube feeding, domperidone, and yet my milk never fully came in. 5 weeks in, a friend asked me to go to a breastfeeding support group.  I went and hoped no one would notice me feeding formula to my sweet baby who wouldn't latch more than 5 minutes. Everyone noticed, yet no one judged me. 

3 months in, at the Breastfeeding Support group that I now attended weekly, a Mama who I hardly knew asked if I wanted her to pump for me, and then another offered to help, as well. This would begin my donor milk journey, and a mental shift in my head that allowed me to stop seeing what I wasn't capable of, and start enjoying the beauty that came from a community that would end up feeding both of my babes! I threw away my pumping and tube feeding schedule right along with the lies that told me I wasn't enough because I couldn't get my body to do what I needed to do to fully feed my baby. We kept nursing as much as possible until 10 months and she got half formula and half donor milk. 

A few months later, I was pregnant with my son. After my prenatal appointment at the San Diego Breastfeeding Center, I got permission from my doctor to start hand expressing at 37 weeks to collect colostrum to give my baby in the hospital through syringe feeding at the breast to help flush any jaundice he would have since he would be Coombs positive, as well. I started to collect donor milk and I had a community that donated enough breastmilk to supply him 9 full months as I only provided him about 30% of his needs with my own supply. He was born and I had a tiny bit more milk and a lot more confidence. I knew that no matter what, a nourished baby is a loved baby. I knew now that if I needed to give formula, I wasn't less of a mother.  If I fed my baby pumped milk, donated milk, only could nurse a few times a day, used a cover, didn't use a cover, nursed for 3 months or nursed for 3 years, no matter what, I WAS ENOUGH. Even after a 6 day stay in the hospital for his Coombs, a tongue and lip tie revision, and a micro supply, we nursed for 10 months with donor milk through the SNS tube feeding at the breast. We then fed formula in a bottle and nursed as often as he wanted. He nursed until 16 months. 

Today I am working towards my IBCLC, because of the non-judgmental support I received from the San Diego Breastfeeding Center community. They didn't sprinkle magic fairy breastfeeding dust on me that fixed all issues, but they gave me a plan that was doable. They gave me tools to accomplish the goals I set for myself.  They gave me hope and they provided me with a community that was there to cheer me on. When I think about my breastfeeding journey, it is less about feeding my children, and more about the discovery that we Mamas cannot mother alone; we were never intended to do so. It takes a village to raise a baby, and for me, it took a village to feed mine. I am forever grateful. 

Breastfeeding Memoirs: Persevering when Returning to Work

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Maggie.

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I had a long, stressful delivery that resulted in an emergency c-section, a tongue tie revision on day 2, followed by 48 hours in NICU. I was given a nipple shield, instructed to supplement with formula through an SNS and sent on my way. Breastfeeding was painful and difficult even with the shield, I went to many support group meetings and did weighed feeds and was able to stop supplementing. We were also dealing with a "colicky" baby until about week 8 . Then at week 10, I was able to get off the nipple shield with the help of an LC at Mary Birch. I was supposed to go back to work after 12 weeks but I was so exhausted and we were finally starting to turn a corner where we could actually enjoy our time with baby, I thankfully was able to extend my maternity leave to 16 weeks.

This prelude is to say that with all the struggles we went through in the beginning, I was very anxious about going back to work, whether I would make enough milk, whether he would get nipple confusion or a bottle preference. I worked so hard and suffered through so much literal blood, sweat, and tears to make breastfeeding work I started to really resent the fact that I had to go to work and interrupt our breastfeeding relationship.

Thankfully through my breastfeeding support group journeys I came to the San Diego Breastfeeding Center. She told me about the upcoming "going back to work" class. I was so excited! I had so many questions. I had scoured the internet, and learned a lot through websites, but still needed much more guidance and support. The information from that class helped me plan and feel prepared to go back to work.

Before I went on maternity leave, I worked out with my HR department where my lactation accommodation would be, but I didn't fully understand my needs until I returned. It was obvious that what we had planned was not going to be feasible long-term, so the first two weeks back were a challenge until they were able to give me my own office and make it private so that I could pump there. My pre-baby brain was trying to cause as little disturbance as possible to the rest of the office when planning my accommodations, but once I was back from maternity leave my only concern was making enough precious milk for my little guy! I'm grateful to have a supportive team at work that have had no issues whatsoever about giving me what I needed.

The first day back I barely pumped 9 oz. I was aiming for 12-15oz. I tried to keep calm and take it one day at a time. I still try to keep this mindset and not worry if I pump a little less some days. Gradually overtime I started consistently pumping 12 oz every day, and for a while was getting 16oz and was able to build a decent freezer stash. One of the LCs I met along my journeys suggested 5 minutes of hand expression after every pumping session, and that has worked wonders for me. It's amazing how much the pump leaves behind. The facebook group, "working moms who make breastfeeding work" has been also been an amazing resource.

We're now almost 4 months back at work and things are going smoothly. Bedsharing has been a saving grace...it helps my supply to let him nurse all night long, I don't worry about whether he is getting enough to eat or not, and I'm well rested for work each morning despite waking up every 2-3 hours all night. Plus its awesome snuggly bonding time that I miss out on while I'm working.

While I plan to breastfeed as long as baby wants to, I can't wait to break up with my pump in 4.5 months once he turns one!

Breastfeeding Memoirs: Third Time's a Charm

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Lilly Penhall.

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Being a freelance contractor has its benefits to a work-at-home mom, that’s for sure. Flexible schedule, control over your workflow, and a certain sense of freedom comes with working for your own business instead of someone else’s. However, when it comes to maternity leave, freelancers don’t have the advantage of six weeks of paid leave that some employers offer. I returned to work two weeks after the birth of my daughter, who is now 18 months old, and started working only ten days after my son was born in June. To complicate matters, I was determined to breastfeed my babies.

My first child, born over 10 years ago, was given formula in the hospital nursery (at the time I lived in a small Texas town where that was standard procedure) and only breastfed for about 6 days until we had such trouble latching that I, being young and uneducated about nutrition, decided to just continue to give her formula.

Many years and a cross-country move later, I started freelancing when I was six months pregnant with my second child, after having lost my sales job for lack of productivity. Sales wasn’t my field, but I was doing it because I needed to support myself; however, at that point my boyfriend and I were combining our finances and I was able to take some time to figure out what to do next. I had been volunteering my graphic design skills for years, but had not really tried to pursue it as a career, thinking my skills were not enough to make a living. Thankfully, having years of experience designing books for self-publication for family and friends, I started advertising myself as a book designer to fulfill that niche market. My business took off right away and I was able to start building a loyal clientele who loved my work and sent more clients my way.

After a full working day in labor at 41 weeks, we had a nearly tragic delivery and my daughter spent six hours in the NICU before I was able to see her, hold her and feed her. When I finally had her in my arms, she had the same troubles latching that her sister did—specifically, on my right breast. She was given a pacifier in the NICU, but whether that contributed to her breastfeeding issues is really hard to determine. I called the nurses at almost every feeding to help me latch her, but it was a frustrating routine that I continued at home, replete with many tears especially during the night when I was tired and couldn’t get her to latch.

I started pumping right away on the right side so that I could at least feed her breastmilk in the bottle. After two weeks, the (relatively) cheap single pump burned out and I was again struggling to get her to latch, which was more difficult now that she was used to the bottle. On top of that, a very demanding client who I had been put on hold when I went into labor, started calling daily and asking when I was going to finish her project. As much as I wasn’t ready to start working, I was guilt-tripped into it and started spending four or more hours a day on my client’s project which limited my ability to breastfeed even further.

At my child’s one month WIC appointment, I expressed my concern to my caseworker and was met with a blank stare and the reply, “You don’t think breastfeeding is easy? I think it’s easier than making a bottle.” She did not offer lactation consultant services or any help at all. My frustration turned inward into anger and depression because I felt incapable of providing nourishment to my baby that was supposedly so easy. I blamed my sagging breasts with nipples that pointed at my toes. I blamed my baby’s severe reflux that caused her to spit up half of what I fed her, leaving her still hungry and crying when I didn’t have any milk left.

I blamed the pediatrician we saw at her two week appointment because he misdiagnosed her thrush as “just dried milk” and it got so severe in her that her entire mouth was white and her skin broke out in rashes, while I had a full-blown candida overgrowth throughout my whole body that left me drained and deeply depressed, as well as an intense burning pain when my milk let down. I blamed my demanding client for taking up all my time, and further blamed myself for taking on the job when I should have been dedicated to my baby. I blamed myself for drinking too much on my birthday when she was one month old—a night when I really needed a break—and bought a can of formula to feed her, thinking my breastmilk was toxic.

Finally, I made an appointment with the lactation consultants at WIC and went in for some help, but by then it was almost too late. I was only producing a small amount of milk and my baby was constantly hungry. Still determined to breastfeed, I had clients write letters to WIC saying that I was working full-time so that they could supply me with a Medela double pump at no cost. When I finally got the pump at six weeks postpartum, even pumping every hour for days didn’t produce more than 2-3 oz of milk over the entire day, plus dry pumping was very painful. As hard as I tried, with all the tears I cried and all my efforts, I couldn’t continue breastfeeding my baby any longer. I remember when I put her to by breast for the last time, at six weeks old, and feeling the strangeness of her trying to drink from me when I was completely dried up. I felt useless and rejected by my own child, but I had to surrender to reality. If I couldn’t breastfeed, at least I would get her the best organic baby formula on the market.

Even with all the trouble I had with my girls, I knew I would try again with my next baby, and this time I would have more tools, more knowledge and more patience. I got pregnant again when my daughter was 7 months old, and we decided to be surprised as to the gender of our new arrival. I continued working from home and taking care of my baby at the same time until she was one year old, when I was offered a really well paying work-from-home job that would require more of my time. We put our toddler in daycare so that I could work full-time for my new employer, a university that needed web design work on a contractual basis.

I was working 40+ hours per week until I went into labor, at first from home, then I spent two months working at the university before I went back to working from home as my due date got closer. This time my baby decided to show up unexpectedly 2 weeks early and I was right in the middle of a project. I emailed my bosses from the hospital and told them I was having my baby and I would be back to work in a few weeks. This time, the delivery went more smoothly and my son was placed on my chest directly after birth, as nature intended. He latched right away on both sides and I can’t even express my relief and satisfaction at how easy it has been for him to breastfeed.  It’s the experience I always wanted, but never had. Even the clogged duct I got the first week when I was severely engorged didn’t stop us from breastfeeding; in fact, the colostrum-rich milk I pumped during that time was fed to my older child who had a cold when her brother was born (and it was the last time she got sick—coincidence? Perhaps…)

Although I had intended to wait at least three weeks before returning to work, we had gotten behind on our bills during my transition from contractor to employee back to contractor, so after just one week I requested another project and returned to work part-time at 10 days postpartum. This time, however, I have been able to successfully breastfeed my baby while working because of some things I did differently.

We established a good breastfeeding routine before I returned to work, and we didn’t introduce a pacifier or bottle until he was over one month old. I have been able to pump easily with the Medela and my nifty homemade pumping bra (an old bra with holes cut in the nipples to stick the pump shields through—works like a charm!). I have spent entire days not working when the baby has been more demanding, instead of sacrificing my time with my baby for a demanding client. My son is so easy to feed that sometimes I can hold him and feed him with one hand while working with the other, and when he’s milk drunk I put him in a wrap or carrier and wear him while I work.

I also put a lot less pressure on myself this time—pressure to work AND pressure to breastfeed. I have a more “que sera sera” attitude about it now, and instead of stressing over working while breastfeeding, I relax in knowing that any amount of time I am able to breastfeed my son is awesome and feel blessed that I am able to support my family on a part-time income for now. My boyfriend wants to put him in daycare already so I can work more hours, but he’s only six weeks old and I want to spend as much time with him as I can. I’m increasing my working hours this week, and some time in the next few months I might return to full-time work on-site, but I’m in no hurry.

Breastfeeding while working has not been an easy journey, but I realize that I have many advantages that others don’t. I feel for moms who have to return to work outside the home after maternity leave and all the struggles that brings: pumping in smelly bathrooms or uncomfortable closets for the sake of “decency,” eight hours of engorgement followed by two hours of traffic, bosses and/or coworkers who don’t understand why you get to take so many breaks as if it’s some sort of mommy privilege instead of your other full-time job, etc. I am so grateful for finally having the positive breastfeeding experience I dreamed of, while still able to work and support my family. My goal is six months of breastfeeding, which is much longer than I have been able to do in the past, and I really hope to make it over one year for my baby’s sake. And if I am blessed with one more child, I will breastfeed again for as long as I can, because I know it’s what’s best for all of us.

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?

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

Breastfeeding After Breast Reduction - It IS Possible!

Written by Ashley Treadwell, IBCLC

Many women wonder if they will have a full supply after having a breast reduction.  While the basic answer to this question is “we don’t know yet” - there are many factors, as well as things she can actively do, that can affect her ability to breastfeed successfully.  In this article, we will discuss what those activities are and how a mom can maximize her supply when breastfeeding after a breast reduction. We will also look at what long-term supplementation can look like, if it is necessary.

It is important to remind you that breastfeeding does not have to be an “all or nothing” endeavor!  We need to re-define what “success” means when it comes to breastfeeding after a breast reduction. Anytime a woman has a physiological factor that can affect milk supply, we always want her to understand that ANY amount of breastmilk is amazing. Whether she is able to provide 10% or 100% of what her baby needs, she is doing a fantastic job.

What Factors Will Affect My Ability to Breastfeed Exclusively?

An initial factor is how the surgery was performed.  Fortunately, surgeons are currently performing breast reduction procedures in a manner that protects as much of the lactation function as possible - increasing a woman’s chance for breastfeeding later in life.  If a large amount of breast tissue has been removed, or the ducts that deliver the milk to the nipple openings are severed, breastfeeding may be negatively affected. There are many different types of procedures and it isn’t always possible to tell which type was performed by simply noting the shape and placement of a woman’s scars.  If you have had a breast reduction surgery and don’t know the specific type that was performed, the best way to gather this information is to contact the surgeon who performed the procedure.  The most popular surgery performed in the United States is one that is also known to have the best implications for breastfeeding later in life. In this procedure, the areola isn’t completely removed and, therefore, connection between the nipple and breast tissue/ducts is partially protected.  If the procedure involves removing the nipple completely and then surgically reattaching it, your chances of exclusively breastfeeding can be decreased.

Another factor that will affect your milk production is when the procedure was performed.  The longer the time between the birth of your baby and the procedure, the better your chances will be to develop a full milk supply.  Also, your milk supply is likely to increase with each subsequent birth - so if you are not able to exclusively breastfeed a first baby, there is still a good possibility you will be able to with a second or third child!  These factors are each important because with both time and breast stimulation, breast tissue can actually re-grow and re-connect.  This can be very encouraging for first-time moms to hear - that even if they are not able to provide their first baby with 100% of their breastmilk needs, all the hard work they are putting in is likely to pave the way for a larger milk supply with later children.

What Can I do to Maximize my Milk Supply - Before and After my Baby Arrives?

Something ALL moms can do to best prepare to breastfeed a baby (those who have had reduction procedures and those who haven’t!) is to educate themselves prior to the baby’s arrival.  Take a breastfeeding class taught by an International Board Certified Lactation Consultant (IBCLC) and find out which resources are available in your area.  Free support groups are a wonderful place to get help and support, as well as connect with other moms who are currently breastfeeding.  We encourage women to attend our breastfeeding support groups while still pregnant - it’s a great way to familiarize yourself with breastfeeding women. A breastfeeding class will teach you what normal breastfeeding looks like in the first few weeks - this knowledge can help to reduce a lot of stress and anxiety.

Find an IBCLC who is knowledgeable about helping women breastfeeding after a breast reduction.  Most offer prenatal consults that will specifically address what you can do to maximize your milk production, including different herbs available to help with supply.  And even if you don’t meet with one prior to birthing your baby, she can be there as soon as baby arrives to help, if needed.

Once your baby arrives, the very best thing you can do is to breastfeed that baby constantly!  The more stimulation your breasts receive in the early days, the better your milk supply will be.  Babies feed frequently in the early days - knowing the signs that baby is getting enough are important.  We have great information in a blog post about how to know baby is getting enough in the first week - I’ve Had My Baby, Now What? Breastfeeding During the First Week.

Some signs that baby isn’t getting enough are: baby not gaining weight after the 5th day of life, baby not having the recommended number of pee and poop diapers per day, or baby is well under birth-weight by 2 weeks of age.  If you are experiencing any of these issues, it is important to seek out the help of an IBCLC.

If Long-Term Supplementation is Necessary - What are My Options?

It may be the case that some amount of supplementation is necessary for a woman breastfeeding after a reduction, especially for her first baby.  If this is true - there are many options available.  Whether mom has little to no supply, or close to a full supply, the best way to supplement a baby to establish a wonderful breastfeeding relationship is to feed the baby the additional milk at the breast.  There are supplemental nursing systems (SNS) available that are made for this specific situation - an IBCLC can help a mom learn how to use this.  If mom doesn’t want to supplement baby this way, but does want baby to have time at the breast, she can still feed the baby at the breast and then follow up with another feeding method - like a slow-flow bottle.  If having baby at breast is important to mom, we do recommend that a bottle isn’t introduced until baby is latching well at the breast - some time after week 3.  Prior to then, mom can supplement using a SNS, and then move to some combination of that and a bottle after the baby is 3-4 weeks of age.  Supplementation can either be with mom's pumped milk, donor milk from another breastfeeding mother, or commercial formula. Here is our YouTube video showing one way a mom can supplement her baby at the breast: Supplementation: SNS at Breast

What Resources are Out There to Help Women Who Want to Breastfeed After a Breast Reduction?

Having support and help both before and after the birth of your baby is crucial and can have a lasting effect on your breastfeeding experience.  We encourage all moms, whether they’ve had breast surgery or not, to look for breastfeeding support in their communities.  Women who are breastfeeding after a breast surgery may need additional support and information specific to their unique situation.  One of our favorite places for support is the website Breastfeeding After Breast and Nipple Procedures.  Here you can find links to health care providers in your area who specialize in helping women post breast surgery, as well as a community of women who are in your same situation.  Robin also interviewed Diana West for The Boob Group podcast episode: Breastfeeding After Breast Reduction Surgery.  

Additional Resources:

Defining Your Own Success. Breastfeeding after Breast Reduction Surgery by Diana West.

How Can I Pump Enough for my Baby When I’m at Work?

 Going back to work can be a very stressful time for many new moms.  It’s difficult to leave your baby for the first time.  You may feel nervous about returning to a job you’ve been away from for months.  Your schedule/routine may have changed due to child-care arrangements.  Plus, if you’re anything like me, none of your work pre-pregnancy work clothes fit yet!  A concern that often adds to this stress is the fear that you may not be able to pump enough for your baby’s bottles while you’re at work. Some moms find that they are constantly playing a game of catch-up, trying to keep up with their baby’s intake while with the caregiver.  Below are some things you can do to improve your ability to keep up with your baby’s needs.

Do some research before returning to work.

Most importantly, know your rights!  There is a federal law that protects your right to express milk for your baby while at work, in a private location, that is not a bathroom.  Speak to your Human Resources Department or direct supervisor (before you return to work) to find out where you will be able to pump.  Take note of where it is, how far it is from your work-space, and what equipment you’ll need to bring with you. Check to see if there are other breastfeeding moms using the space to express milk… that way you’ll know if you need to reserve the room or if you are free to use it as you please.  Take a look at your general work hours and responsibilities and create a plan for when you will be able to pump.  

Be sure your caregiver isn’t over-feeding baby!

Often, the issue isn’t the amount that mom is pumping (or not pumping), but the amount that baby is taking while in the care of someone else.  Many caregivers unintentionally offer too much breastmilk to babies, therefore “sabotaging” mom’s supply.  There are a number of reasons this may happen - your caregiver may allow the baby to finish the bottle too quickly and babies will take in more than they need when they eat too fast.  It’s similar for us when we sit down to a big meal.  If we eat very quickly, we often end up eating past capacity as our brain doesn’t have the chance to catch up with our stomach and tell us to stop eating.  A baby may finish a bottle and still show hunger signs, and the caregiver, wanting to soothe baby, will offer more milk when if given just a bit of time, the baby would have calmed on his/her own.  

Sometimes a caregiver may not understand the proper handling and storage of breastmilk and will treat it like formula, throwing any left in the bottle, when the milk could be placed back into the refrigerator for the next feeding.  Be sure to talk to your caregiver before returning to work to help them understand how to best bottle feed your breastfed baby.  Nancy Mohrbacher, IBCLC, wrote a wonderful article addressed to the caregivers of breast-fed babies that you can forward to your nanny/sitter/daycare worker to help them.  

Lastly, make sure your caregiver knows what time you will pick your child up and ask him/her to not feed the baby for the hour or so prior, so that baby will want to breastfeed when you are reunited.

Create a calm and relaxing space/routine for yourself while you express milk at work.

Trying to pump in a stressful environment can negatively impact the amount that you are able to express.  Take a good look at where you pump milk for your baby - is it a convenient, quiet, private space?  Are you able to lock the door so that you’re not worried about a co-worker unintentionally walking in on you?  

Here are some of our top tips for expressing milk at work: 

• Bring articles of clothing that your baby has worn, or a blanket he/she has used.

• Have a picture nearby of your baby, or even better, a video of him/her - perhaps of your baby showing hunger cues. These items can help to get your hormones moving which will help your milk to let down and flow more quickly and fully.

• Use a hands-free pumping bra so that you can do other things while you express - check your email, eat a snack, play scrabble on your smartphone!

• Bring a blanket or towel and cover the flanges while you pump, so that you can’t see the amount that is coming out. Hyper-focusing on how much milk you’re expressing can inhibit your body’s response to the pump.

• Listen to calming music, or a podcast you enjoy.

• Watch funny videos on YouTube - we have a few that are oxytocin inducing on our San Diego Breastfeeding Center YouTube Channel.

• Bring water and snacks to stay hydrated and satiated. Moms often see a dip in their milk supply when they are dehydrated or are not eating enough calories. (Breastfeeding women need about 2000 calories a day to sustain a robust milk supply.)

Engaging in activities that bring you joy or peace can help you relax and may increase the amount that you are able to pump.  You may find that you start to look forward to your pumping sessions!

Techniques that can help increase your output

There are a number of tips/tricks that can help you maximize your output when pumping.  

• Be sure that all of your pump parts are in working order - that there are no damaged pieces.

• Hands-on-pumping has been shown to help increase the amount of milk a woman expresses.

• Learn a combination of breast massage, hand expression, and electric pumping and practice it whenever possible.

• Apply a bit of organic olive oil to the inside of your flanges to help reduce any friction or discomfort.

• Play around with the amount of time that you pump, but remember that stronger and longer doesn’t always mean more milk!

• If you find that you are absolutely not able to express the amount of milk that your baby needs in a day, you can add an extra pumping session in at night before going to bed and on your days off.

Here are a few more tips from our Facebook friends: Help a Mama Out: Getting the Most Milk Out while Pumping

And MOST IMPORTANTLY, feel proud of the hard work you’re doing to provide your baby breastmilk while you’re at work!  Remember that breastfeeding is never an all or nothing endeavor.  Some women are not able to pump enough, some because of work situation or how they respond to the pump, but are still able to provide their baby as much breastmilk as possible, as well as breastfeed their baby while home with them.  Know that every drop of your breastmilk that your baby gets, whether it’s 1% or 100% of their total needs, is an amazing gift that only you can provide!

What are your favorite tips for pumping enough milk while at work?