Breastfeeding Memoirs: Returning to Work in the Navy

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

Today’s story was written by Cinda Brown.

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I’m an active duty Navy officer and mother of two girls. My journey to becoming a working, breastfeeding mother started almost 4 years ago with the birth of my first daughter. Breastfeeding was challenging in more ways than I could have imagined. I thought that it would just be easy and natural, not knowing that those two little words can mean so many different things.

My baby had a high palate combined with tongue and lip tie. I had no idea what this was. All I knew is that my nipple was damaged and cut from her very first latch and that it hurt each time there after. Soon I was scabbed and crying each time she latched. So much pain. I didn’t know where to get help and the nurses at the hospital told me it would get better with time. When my daughter was about 5 weeks old I finally met a nurse who promptly referred me to a pediatrician who was also an IBCLC. Her issues were diagnosed and we were then set up for a revision. I learned so much from this IBCLC. He taught my husband what to look for and we both were sent home with more knowledge that helped us on our road to success. My husband knew what looked wrong and was there to help me reposition. He supported me through all of the pain and sleepless nights. He did diaper changes and baths and allowed me to keep working on breastfeeding, instead of asking to bottle feed so he could bond. He found other ways to really bond with our baby girl while ensuring that our breastfeeding relationship would be preserved. Partners play such an important role and I can’t say this enough!

Once my daughter and I finally started to get the hang of breastfeeding, it was time for me to go back to work. I struggled with a very intense oversupply and was worried about how I was going to manage it when I was back at work. It had been difficult enough to manage it when I just had to take care of my baby at home, but now I was looking at adding in daycare, going back to work full time, and still trying to keep up with everything else that needed to be done at home. While many people I’ve encountered have told me how lucky I am to have oversupply, I also know that it’s very difficult to manage. It takes an extraordinary amount of time to pump, collect, freeze, and store the milk not to mention the washing of all of the pump parts. Adding this extra needed time into an already compressed day was overwhelming to think of, much less try to put into action.

We were very lucky to find a daycare teacher who was experienced with bottle-feeding breastfed babies. That was hurdle #1. She was an amazing communicator, which helped the process so much more. The day came to go back to work and I still remember it like it was yesterday because the experience is forever imprinted in my memory. Leaving my baby girl with someone new for the first time to go back to work was just devastating to me. And her. For me I felt like it absolutely went against my innate knowing to separate us. But yet I had no choice and my leave was over so it was time to go back. In that moment I would have given anything to stay home with her. Having a caring provider and making the most of the time that I did have with my baby while at home helped to ease the separation but it definitely took time before that ache started to subside. I really had no idea about the obstacles I was about to encounter and had no one to guide me along the way.

Day one back at work, I found myself in a land of cubicles, with no place to pump breastmilk. Over the next several months I improvised wherever I could to find a place to  pump when I needed to. I pumped in bathrooms, in my car in the parking lot, in my car on the way to and from meetings, basically anywhere I could find that would provide some sense of privacy and still allow me to complete work requirements. It was far from ideal and was super stressful, and mastitis and clogged ducts became more usual than unusual. I had to wake up super early before work so that I could pump since I would be so engorged. Wash parts. Try not to forget parts, bottles, or storage bags. Or the plug for the pump! So many things to remember!

My job had been so busy and intense before I had my baby and I knew that it was going to be no different when I returned. The biggest challenge was trying to coordinate pumping between meetings that for the most part I didn’t have a lot of control over scheduling. Many times meetings would come up at the last minute, or would be rescheduled right in the middle of when I’d need to pump. I had to figure out a way to talk to my supervisors about my need to pump, the importance of keeping a regular schedule, and at the same time keep my head held high.

In the military culture, it can be intimidating to ask your supervisor for permission to do things outside of the norm or what’s expected. I wanted to be able to show that I was able to handle it all: be a successful officer and a successful mother. But the reality is that each demands 100% or more of a person, and there’s only so much effort and time that can be allotted to each. Some compromises had to be made, and it was up to me to advocate for myself and my baby. I’m not going to say that the conversations were the most comfortable that I’ve ever had or the most easy, or that they were well received. They certainly were not. But I thought of all of the other more junior women going through the same journey and realized that if I couldn’t advocate and speak up for myself, then there’s no way that my example would set other women up for success.

I asked for what I needed and over time it became more normal for everyone I worked with. I did find out something very interesting in that most of the people I worked with were male, and that their wives/partners were full time stay at home parents. None of them were mothers who had breastfed and many of their wives had not breastfed. Education and communication with my male leadership helped them to realize the importance of breastfeeding and how it could in fact make the workplace better for everyone since breastfed babies tend to get sick less often. Mothers are able to get back into fitness standards more quickly since breastfeeding can help mothers lose weight. These are only a couple of examples amongst many. I know that the Navy is keenly interested in retaining females in order to have females rise in the ranks of leadership. Advocating for breastfeeding is one step in the right direction to retain mothers in the military. Mothers who are shamed or made to feel that they can’t fit in are not likely to want to stay as a part of an organization that can’t accept them for doing something that’s good for both their baby and themselves.

After several months of making do, a fellow military breastfeeding mother and I set out on a journey to have our commands come into compliance with current Navy breastfeeding instructions and guidance. This meant that our command was required to provide a room that wasn’t a bathroom space, with privacy, a locking door, a refrigerator/freezer, outlets, and furniture. It also allowed for time to pump milk that would accommodate what the mother would need to maintain her supply. It was a long process, but with diligence and help from many people, by the time I left my command there were 5 mother’s rooms set up for breastfeeding mothers to pump milk and an instruction that provided guidance so that mothers were protected in their ability to pump breastmilk.  Each room had a multi-user pump and pump kits donated by the San Diego County Breastfeeding Coalition. The command won the SDCBC Breastfeeding Friendly Workplace Award in 2014, which was such an amazing accomplishment given where it had started from. A monthly breastfeeding support group led by Sarah Lin, IBCLC, started in 2013 and continues to this day. She selflessly stepped up to donate her time to help countless mothers who have so benefitted from her expertise when there was a definite need.

I’m now a mother of two and I honestly thought that going back to work for the 2nd time with an infant would be easier since I had done it before, but it’s been just as challenging. I’m at a new command, so I have new people to interact with. Dynamics are different and the juggling act of timing pumping around work requirements is still as alive today, if not more than it was when I went back to work with my first daughter. Mastitis and clogged ducts continue to make their presence known, which was disappointing since I thought that I had them figured out. Goes to show that just because it worked last time doesn’t mean that it will work this time. Each baby is so very different, as is each pregnancy and postpartum period. I’ve been known to excuse myself from meetings with very senior personnel so I can go pump, which hasn’t been easy. I know that I need to take care of myself so that I’ll be at work tomorrow. Sacrificing today isn’t worth getting sick tomorrow and I keep telling myself that. Because there’s a part of me that still struggles to have a voice and speak up for what I need.

I pumped for 2 years for my first daughter. She will be 4 this fall and breastfeeds right along with my infant. I’m pumping for my infant at work and will continue to do so until it’s the right time to stop. I never thought that I’d make it this far in our breastfeeding journey, but now I can’t imagine it being any other way. There have been so many that I can attribute our success to in our San Diego community. The amazing support of IBCLCs and mothers has carried me when I needed to be lifted up too many times to count. I hope that through my efforts I can help other military mothers achieve the success that they envision for breastfeeding their children, whether it be for days or years.

Breastfeeding Memoirs: Trusting my Body 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 Georgina.

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When I had to go back to work I knew I wanted to keep providing my son with the very best I could offer and one of them was his dear breastmilk.  I was very confused with the whole pumping at work idea. I had done some research at work before delivering as to where the lactation room was and what the process was to reserve the room.  I work at a hospital and I thought that just by going to the L&D department everyone would know where our lactation room was and it was going to be very easy to find.  Well to my surprise, no one knew exactly what I was referring to, all the nurses looked at me with puzzled faces and confused as to why an 8 month pregnant employee was asking about this room and they didn't even know where it was!  When I finally found it, it was a rather disappointing, sad room that looked like a utility closet, but at least it was clean and it had the necessities: a chair, a desk and a fridge.  

I took the longest maternity time off I could take with and without pay and in the meantime I read and read and read everything I could about breastfeeding and pumping at work.  Breastfeeding had its challenges, but we quickly adapted to one another and it started to feel like a breeze.  It was near the end of my baby bonding time that I started to become stressed about the whole logistics about pumping at work. The  more I researched, the more confused I got. How many hours can breastmilk be in the fridge? What if he didn't finish the whole bottle?  Was it safe to use it again? How many ounces to feed? How often? What if I don't make enough milk? Ugh! Sooo frustrating! So many doubts! So many mixed emotions!!  I joined several breastfeeding support groups and would often go to baby weight-ins just to make sure baby was eating enough only through my breast.  But, how would I know if we were overfeeding him when using the bottle while I was at work? What about underfeeding him,? Would he prefer the bottle over me?   I decided to attend aBreastfeeding for the Working Mom class through the SD Breastfeeding Center by Robin Kaplan.  Even though I had already read what she said, it was extremely reassuring to hear it by a someone who had gone through it before. Robin was very patient.  She sat with me and we made a "pumping at work plan."  How many times and the estimated hours that I would be pumping.  I still remember my pumping schedule as if it was yesterday. Nurse at 5am,  pump at 8:30am,  pump at 11:45am and nurse at 3pm.  Slightly adjust schedule as breasts were engorged when I would feed the baby earlier than 5am. It worked like a charm!

It was definitely a learning curve for the nanny and our family members who were taking care of our little guy while we were at work.  We had to teach everyone not to shake breast milk - only swirl.  Fat particles in breastmilk are normal.  It’s normal to have different colors.  And never ever dump any breast milk that smelled fine... we could always make breastmilk soap, lotion and even use it for rashes and cuts.  Everyone, myself included, has been amazed about the little we knew about the amazing properties of breastmilk and how powerful it is.  We learned about paced feeding and growth spurts the hard way and we succeeded.

I pumped until little dude was about 11-13 months.  That was last year when our summer in San Diego was just extreme.  During the day while I was at work he was asking for more water than breast milk and shortly after he refused to drink breastmilk from his sippy cup only from the tap :)   He is past 2 years old now and we are still nursing strong.  It has been a marvelous, unexpected experience for both of us.  

Every once in a while I still pump to make our little dude some breast milk soap and I was very happy to find a beautiful bright freshly remodeled lactation room at the hospital where I still work.

If I could go back in time I would tell myself to trust my body to do its magic.  Eat oatmeal, drink lots of water, watch pictures/videos of baby while you are pumping, relax and watch your baby being nourished by your wonderful body.  Take advice with a grain of salt.  Everyone is different, trust the relationship you have with that amazing human creature your same body nourished for 9 months in your belly.  You can do this! You are meant to do this and you can!

Breastfeeding Memoirs: My Three Bs

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

Today’s story was written by Louanne Ferro.

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Prior to May 27th, 2014, the word baby meant something very different to me: my baby was my business. At the young age of 17, I entered the world of cosmetology. Knowing I wanted to strive and create greatness in my industry, I focused on building. In 13 year's time, I had nurtured my baby and created a small empire. One of the leading educators for the world's largest professional beauty company, I frequently traveled to teach my craft.  In the heart of North Park, I opened my very own salon. My baby was thriving and I was the proud mother, spending further countless hours tending to make it what it is today.  Then, May 27th, 2014 happened, changing everything I knew about babies.

The test was positive. To my shock, my work "baby" was going to be replaced with a real-life, micro-human! My pregnancy was something my husband and I had been hoping for and we were thrilled!

As the days went by and I soaked in the reality of this new chapter in our lives, I quickly realized that the acronym B.B. meant far more than a makeup product; my new "B.B." was Business and Baby! I started to prepare myself with all things human baby-related. In addition to the copious things on lists and registries, preparing for the physical exit of my child by way of my body required some serious consideration. My birth plan was short and extreme: 1. Do whatever you need to do to deliver a healthy baby, and 2. If baby and mom get separated, dad goes with baby. My preparations seemed both rational and thoughtful.

As the months crawled forward, I was asked, "Do you plan to breastfeed?" "Sure," I would state casually. I mean, doesn't everybody do it? The portrayal of happy mothers stroking their babies' heads seems the most natural and obvious choice. The commitment to breastfeeding tacked a third B on my list. Self-assured, I reiterated to myself, "Three Bs and three-step birth plan." Simple right?

As the ideas gestated, so did my little human. On February 1st, 2015 when most people seemed to be watching the Patriots win the Super Bowl after the controversial "Deflategate," I was in labor. I had no delusions of grandeur, and felt that the experience progressed well, or at least as well as it could. Literally dancing myself into labor, and thus, the hospital, I was celebrating my salon partner's thirtieth birthday only the night before.

In a lighthearted moment of somewhat inappropriate comedic relief, as I was pushing my sweet boy into the world, my husband, nurse staff, and I were laughing while Maureen, the midwife, styled my son's full head of hair mid-birth canal into a Mohawk for his grand exit. Ezra entered the world healthy and strong, with all the right parts and two healthy lungs. Things were great, that is, until they weren't.  Laying him on my naked breast, as I looked into his eyes for the first time, all I could say was, "I'm going to be sick." Those weren't the words I was expecting to first say to my baby.

Before I knew it, Ezra was being transferred to my husband chest and my birth plan, the one that everyone says won't be needed, became needed. Ripping itself from my uterus, the placenta dislodged, and I, unknowingly, quickly began to bleed out. Because the hospital staff was great, the bleeding quickly stopped and I was generally unaware of the severity my body endured. Before I fully understood what had happened, I was on the mend. So I thought...

Latching my son in the hospital, he seemed to latch well. We left the hospital feeling very supported and excited to start our new lives as parents, and I was eager to be a mother who could sustain life solely from my own body. This, too, proved that things could go well until again, they don't. Shortly after arriving to our home as a family of three, I noticed my son no longer wanted to latch. Unable to wake him for feeds, we were heading down a slippery slope at excruciatingly high speeds. With no formula in the house because it wasn't part of the "plan" and no idea what was wrong, helplessness took hold of me and rattled this new parent's head and heart. Breast feeding should be easy, right? Everyone does it! It's natural.

I held my baby through the night, the first night home, praying we'd make it until morning when I would seek professional support. There was no marveling over the beauty of childbirth or reveling in the moment that our chests rose and fell together. This was the worst night imaginable.  In the mean time, it was after midnight and my husband scoured for 24-hour stores, and finding none, finally sought out a NICU nurse at the hospital to get the formula an after-hours advice nurse suggested.  

As the sun rose, I ran into the Kaiser breastfeeding support group, crying my eyes out as I told the head lactation counselor that I was starving my baby and I didn't know why. I was failing, and failing was something I was never good at doing. Rose, this angel, this pinnacle of breastfeeding knowledge, sat with me most of the support group and promptly made me a one-on-one appointment following the support group that day. Ezra had lost over 20 percent of his birth weight and was comparable to a premature baby. She asked me to share my story leading up to that point, and as soon as I mentioned the hemorrhage, she exclaimed, "There's your road block. You're not broken, you're healing." Not fully understanding, I listened, captivated by what the angel was telling me. She explained to me that our bodies can almost always produce milk for our babies, but major blood loss was one hindrance that halts milk production in its track. My body was healing me so it then could support my baby.

A woman - a new mom, rather - on a mission, I spent 24/7 learning how to help kickstart my supply, all the while supplementing at the breast, and educating myself on how to properly feed my baby. This harrowing and hormonal journey took a couple weeks, but my milk eventually came in and I had a new routine. I referred to myself as "The Dairy Queen," and I was always open for sweet treats!

Realizing quickly, in order to be successful with breastfeeding, I also needed to be knowledgable. This, after all, was one of the most important jobs I'd ever had. My short eight-week maternity leave was filled with work, just not the type of work I was accustomed to. My 13-year-old older child, my business, was doing well, but still needed my care. Much like a regular teen, it seemed as though it could self-manage, but a true mother, I realized it needed me to continue to grow. A new balancing act had begun. My new baby and breastfeeding also needed my constant care, and as the weeks passed, I slowly figured out how to balance my three Bs.

The key to success in working and breastfeeding, I have found, is to set boundaries with myself, my clients, and colleagues. Making food for my baby was just as important as my business. My work schedule has a pump break every three hours and for no circumstance should that pump break be booked - after all, it is my most important appointment of the day. When traveling for my company, it's made known that pump breaks must be allotted in order for me to take the job. Compromising my need to feed is not an option. My hands-free pump bra and car adapter for my breast pump have become my best friends. They really do support me. The ladies at the drive through coffee shop now know me as the pumping, purple haired mom as I pull through for my iced coffee while pumping on my way to work. My friends on speaker often ask, "Is that noise I hear your pump?" I say, "Sure is" with a smile, knowing that I am finding balance.

My flanges might not be a Marc Jacobs accessory, and my black pump bag may not be Prada, but I wear them with the same sense of excitement because I'm doing something I thought I couldn't achieve. They are also symbolic reminders of a label I do wear: mother, maker of milk and master of the Three-B balance, business, baby, and breastfeeding. My journey has not been lengthy, but on August 1, the first day of World Breastfeeding Week, I will celebrate my six-month "nurse-iversary." I've always argued that you can't hold a driven woman back, and now I know another word synonymous with driven woman is "mom!"

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.

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.  

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

Freemie Collection Cups

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.
4.  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.
6. 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.  

Mamava Lactation Suite

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... It has to get easier, right???

When I started working with Galit 10 1/2 months ago, I knew immediately that she would be one of the most dedicated, hard-working, and comedic mothers I would ever encounter.  Her breastfeeding journey has been wrought with painful nipples, engorged breasts, and twins who had difficulties transferring milk.  It has also been blessed with sweet moments of tandem nursing, gaining an abundance of milk, and confidence to overcome any challenge that lay in her path.  Happy 1st birthday to your adorable boys, Galit, and happy 1st nursiversary to you!  You continually inspire me!  

Here is Galit’s story, in her own words!

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I had twins at 37 weeks 3 days who were 5.5 and almost 6 lbs (FRIGGING AMAZING) after preterm labor at 23 weeks and 4 months of bed rest!  I wanted nothing more than to provide for them and ensure their health. Breastfeeding started out pretty rough.  My colostrum was hard to obtain and milk took forever to come in.  We were told to supplement with formula to keep them out of the NICU (they lost weight after birth, as all babies do), so we obliged. We went home with two healthy boys after 4 days and they were with me the entire time!

For several weeks, we used a gloved finger-straw-tube thing to help the boys practice sucking.  Then, out of desperation and exhaustion, we switched to a bottle and for several months (yes, months), we had to pull their chins down to help them open their mouths wider and also tilt the bottle up and down to simulate the natural flow of breast milk. No one was really capable of helping my hubby and I because there was just too much to remember.

My schedule was: nurse one baby, nurse the other, supplement both with bottles with as much breast milk as I could pump, then another separate bottle with formula (we were told not to mix breast milk with formula.  We tried several organic versions before finding one that worked for us), then pump. Between pumping 8+ times a day and nursing 10-12 times a day, I had between 10 and 25 minutes to eat OR to sleep at a time, around the clock, for almost two months. Ugh. I was always hungry and tired. If someone didn’t put food in front of my face, I didn’t eat. Great diet plan, aside from the feeling of extreme hunger, lack of energy, and need to consume extra calories to help my body make milk! 

After a couple months of serious struggles with nursing, we were desperate. The boys both had extremely tight frenulums (tongue ties), hampering their sucking abilities and leaving them very inefficient (45 minute feeds to take in less than an ounce), and me in incredible pain due to their pinching. We were told to have them clipped to allow their tongues to work better (ouch, but not too bad). This didn’t do enough (the frenulums were posterior and thick), so several of our doctors recommended we have them lasered (under their tongues and under their upper lips). Holy hell, this sucked so hard!  Then, worse, for a month and a half after the laser (until they healed), we had to stretch their wounds every time they ate. They cried. I cried. It was a very hard decision and experience, but we did what we thought would be best for our babies, for nursing, and for other reasons. So we resorted to these “drastic” measures. They eventually healed and can do all sorts of things with their tongues now! Oh the trouble they will get into some day. 

When they were about a month old, I got mastitis. I thought I was dying. The pain, all over my body, was horrible. I cried all the way to the hospital (and I’m not a crier when it comes to physical pain) and got antibiotics.  It took about four days before I felt okay enough to try breastfeeding again. I was in so much pain I couldn’t handle the babies biting/pinching, so I was only pumping. So much pumping. My parents (and in-laws) came to help care for the boys, as I couldn’t even hold them. 

Then, thanks to the antibiotics, I think got thrush (a yeast infection in the nipples. I had never had a yeast infection before, thus I am conjecturing that antibiotics was the cause).  I didn’t show any symptoms, aside from what I called “fire needle nipples.” The pain went all the way up to my armpits.  This lasted for 3.5 months. AAACK!  We had to sterilize everything, including pump parts, bottles, bras, and even my boobs(!) all the time.  My attempt to destroy thrush was energy and time consuming, to put it simply. I continued to sterilize everything after each use until I stopped pumping (at over 9 months). I still change nipple pads several times a day.  I’m so very thankful the boys never showed any signs of thrush, as I probably would have gone cuckoo! 

I ended up getting mastitis again a few weeks later (OMG!).  Thankfully, Robin came to my rescue with her “mastitis protocol.”  I healed within 1.5 days, with NATURAL supplements, pumping, massage, heating pads, hot showers, etc. without antibiotics! YIPPEE!  In total, I’ve had mastitis 10 times (WTH?), 5 of them pretty bad, leaving me mostly dysfunctional. Damn you, Plugged Ducts!  I know how to deal with it now (phew!). I worked for months to restore my milk production to the level it was before infections and scar tissue hampered my supply. I still produce less on the left side, as compared to my right; however, I still made enough to feed both my boys! 

In addition to dealing with mastitis and thrush, I had severe breast (and surrounding area) pain, for several weeks.  I was mostly pumping and wasn’t nursing more than once or twice a day due to the intense discomfort (So. Many. Bottles.). I discovered I have vasospasms but, thanks to Robin’s protocol, the pain is now gone! Thank goodness for Robin.  Phew!  My daily supplements can fill an aisle at Sprouts, but at least they are all actually helping, homeopathic, and aimed at health rather than disease. 

Big milestone: at about 3 months, I realized the boys were only being bottle supplemented with MY milk. I was finally producing enough to feed two growing boys and we were off formula! HOORAY!  From 3 – 5 months, I was weighing the boys before and after each breastfeeding session to see how much they were taking in (as if I wasn’t doing enough already).  We rented a scale from a local hospital to make sure the boys were eating enough.  Then one day, at about 5 months, I looked at their thighs and BAM!  I noticed they were chunky monkeys!  We immediately returned the scale! SCORE!  

At 8.5 months, we were meeting and overcoming new “opportunities for growth.”  These “opportunities” have slowed greatly, but they still come.  With 4 new teeth, one of my boys bit me. Hard.  I instinctually yelped, so he cried. I soothed for 5 minutes and we tried again.  He bit again. Hard. I yelped (no self control) and he cried harder, longer.  15 minutes later we tried again. Guess what happened? He bit. Again. I yelped (OMG control yourself, Mama!) and he was hysterical, hungry, and absolutely refusing to nurse, for 45 minutes. I gave him a little bottle of my pumped milk to calm him and his belly and put him down for a nap.  I was sure he would never want to breastfeed again.  Thank the heavens, as my hubby suspected, when he awoke, our baby had forgotten the morning ordeal and all was normal again. PHEW!  

So, was all this craziness, horrible frustration, and extreme pain worth it? HECK YES!!! So far, my boys have always been healthy!  In their whole first year, they’ve never even had a sniffle! Holy cows!  I’ve had two colds and my hubby had three! Was it the breastfeeding?  I’d like to think so. In addition to their health being friggin amazing, we get some great bonding time. I pet their heads, they give me smiles, hold each others’ hands, and sometimes giggle while nursing. They eat 3 solid food meals a day now, and I nurse them 5 times a day as well. The enzymes, antibodies, and good stuff my milk provides for them is so important.  Breastfeeding is just the BEST and I’m SO grateful my body has provided. 

We’re learning, growing, and laughing so much every day. We’ve hit the latest “golden age” of our babies and are enjoying each moment.  It’s just amazing. 

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?

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.

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.