Why Does My Milk Smell Sour?

Dear SDBFC,

This weekend my hubby wanted to give our son a bottle, so I thawed some milk that was pumped mid-February (2 months ago). When I was putting it in the bottle it smelled sour like spit-up. Why is that? He still ate it and it didn't make him sick. Is my milk bad? That was the oldest milk I have so I thought it would be fine still.

Thank you!

Natalie

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Dear Natalie,

There are many reasons why your milk may smell sour.  

Storage

What are you storing your milk in?  Sometimes the breastmilk storage bags can let in smells from the freezer, which may make your milk smell less than desirable.  Try storing in air-tight glass containers to see if this helps.  Also, store your milk in the back of the freezer, rather than the door, so that the milk doesn't defrost as the freezer door stays open.  For terrific information about milk storage guidelines, check out Mother and Child Health's article: Storage and Handling of Breastmilk.  

Excess Lipase

Your milk may have excess lipase in it, which can cause stored breastmilk to smell sour or soapy.  Lipase is a beneficial enzyme found in breast milk that helps break down milk fat.  If your breastmilk has excess lipase, the longer the milk is stored, the stronger the smell becomes.  The milk is totally safe for the baby to consume, but some babies may reject the milk because of its strong scent and change in flavor.  To break the cycle of the excess lipase, you can scald your milk after you express it, so that you can store it and use it at a later date.  Here are two great resources, one by Christina Williams and one by Simply Rebekah,  about scalding breastmilk to get rid of excess lipase.

For a more detailed explanation of excess lipase, check out Kellymom's article: My Expressed Breastmilk Doesn't Smell Fresh.

Natalie, as long as you are following proper breastmilk storage guidelines, sour milk doesn't always equal spoiled milk.  Hope these resources help!

Warmly,

SDBFC

What Can I Do About My Fast Let-Down?

Dear SDBFC,

What are some good nursing positions if you have a fast let-down?

Sincerely,

Alanna

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Dear Alanna,

When moms have a very fast let-down, babies often have difficulties tolerating the fast and furious flow.  Some choke and sputter at the breast.  Some pull off and get sprayed in the face.  Others pinch down on the nipple, as if trying to put a kink in the water hose.  All of these can cause somewhat uncomfortable feedings for mom and baby.

So this is what you want to do.... Work with gravity!

Recline and lean back

When you lean back, it can slow down the flow a bit, making it more comfortable for your baby to feed. Place a pillow behind your back on the couch or your diaper bag behind you while nursing in public.  Then slide your bottom to the edge of your seat and you are now reclined.  

Position your baby in a diagonal or upright position

When your baby is laying on his side, it is hard for him to coordinate his suck, swallow, breath when the milk is pouring into his mouth.  Think about it... have you ever tried to drink a glass of water laying down on your back?  I'm choking just thinking about it!  So, sit your baby up a bit and let gravity help him as well.  This works well when the baby is facing tummy to tummy, either sitting in your lap or somewhat diagonal.

Sidelying

Now, I realize that this goes somewhat against the above two suggestions, since you are no longer reclined and baby is now on his side, but check this out.  When you feed in the sidelying position, any milk that cannot be swallowed by your baby can just slide out of his mouth, while he is feeding.  Sure, your bed or couch might get a little wet, but just place a towel under the two of you and nurse away!

For more information about this topic, check out our recent article: Foremilk vs. Hindmilk: The Unnecessary Controversy

For other terrific photos of laid-back breastfeeding, check out the Biological Nurturing Web site.

Do All Exclusively Breastfed Babies REALLY Need Iron Supplements?

When I read a policy statement from the American Academy of Pediatrics stating that exclusively breastfed babies need to be supplemented with iron starting at 4 months, I have to wonder…

Are they saying that my perfect nutrition for my baby is no longer PERFECT? 

Are they saying that what my body produces is suddenly SUB PAR? 

This caused me to do a little research.  What IS the deal with iron in breast milk? 

Does my 4 month old really need those nasty-tasting drops?

According to my research, I found that not all exclusively breastfed babies need iron supplementation.  In general, babies are born with enough iron in their system to last at least 6 months, of not until they have tripled their birth weight. (Riordan and Wambach, Breastfeeding and Human Lactation)  According to the Womanly Art of Breastfeeding, there is not a lot of iron in breast milk, yet there is not supposed to be, as it is more completely absorbed from breast milk than in supplements or formula.   Also, breast milk contains a protein, called lactoferrin, which binds to the extra iron that the baby cannot use, keeping it from feeding harmful intestinal bacteria.  Iron supplements, for a baby who is not iron-deficient, can often overwhelm the lactoferrin, causing an overgrowth of intestinal bacteria, resulting in diarrhea and possible microscopic bleeding.  WHAT???

And, my biggest RED FLAG went off when I found a Letter to the Editor of Pediatrics, called Concerns With Early Universal Iron Supplementation of Breastfeeding Infants.  In this article, the executive committee of the Breastfeeding Section of the AAP states that they have “major concerns about universal iron supplementation at 4 months in breastfeeding infants” and that the authors of the above policy “acknowledged that this report was submitted for review to the AAP Section on Breastfeeding, but they did not mention that we disagreed and provided our additional recommendations 2 years ago.”

HMMMMM!  So, clearly my breast milk is much more perfect than the AAP was trying to make it sound and universal iron supplementation of exclusively breastfed babies over 4 months is NOT ideal.

So, how would you know if your baby actually needs iron supplements?

Which babies are more at risk for iron-deficiency anemia? (according to www.kellymom.com)

• Babies who were born prematurely, since babies get the majority of their iron stores from their mother during the last trimester of pregnancy.
• In addition, there is evidence that babies whose birth weights are less than 3000 grams – about 6.5 pounds – (whether term or premature) tend to have reduced iron stores at birth and appear to need additional iron earlier.
• Babies born to mothers with poorly controlled diabetes.
• Theoretically, babies born to mothers who were anemic during pregnancy could have lower iron stores, however medical studies do not show this to be a problem. Babies born to mothers who are anemic during pregnancy are no more likely to be iron deficient than those born to mothers who are not anemic during pregnancy.
• Babies who are fed cow’s milk (instead of breast milk or iron-fortified formula) during the first year of life.

If your baby falls into one of these categories, you have the right to ask for your baby’s hemoglobin to be tested for anemia, rather than automatic iron supplementation.  And, if your baby does test positive for anemia, there are many Iron-only drops that you can give your little one.  No need for that multivitamin because your breast milk has all of those vitamins already in it!

In addition, when your little one is over 6 months and ready to start solid foods, consider those with a healthy dose of iron, like the ones listed on one of my favorite baby food sites, Wholesome Baby Food.  No need to try that boring white rice cereal, just because it is fortified with iron!

How Can I Respond to My Pediatrician Who is Not Supportive of Breastfeeding?

Welcome to our first edition of Help A Breastfeeding Mama Out!  Every Thursday, we will answer a question from one of our dear readers.  Do YOU have a burning question you would like answered on our blog Please email them to robinkaplan@sdbfc.com and we add it to our list!

Dear SDBFC,

Any advice for responding to doctors when they are unsupportive of breastfeeding past the first few months or uneducated about it (such as believing it causes cavities, etc.)?  Thank you in advance!

Sincerely,

Theresa

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Dear Theresa,

My first response would be, "Can I have my records, please?"  

I hope that doesn't sound too harsh, but pediatricians are supposed to be one of the main practitioners you can turn to with regards to the health of your child.  If your instincts are telling you that this professional is not up-to-date on one of the best ways to keep your child healthy (BREASTMILK!!!), then I would look for another practitioner who has read some research since 1970.  

Our family has changed doctors many times over the past few years, as I wanted to make sure that we were getting the best, most research-based care possible.  I was tired of explaining my preferences for vaccinations and antibiotics.  Now, going to the doctor is a pleasure, as I am respected participant in the decision-making for the health of our family.

Now, as for articles to share with any practitioner about the benefits of breastmilk past a few months, here are a few of my favorite:

Natural Resources Defense Council: Benefits of Breastfeeding

American Academy of Pediatrics: Breastfeeding and the Use of Human Milk

Kellymom.com: The Many Benefits of Breastfeeding (Resources)

Are New Moms Bombarded with TOO MUCH Information?

So I would like to take a virtual raise of hands to see how many of us have googled ‘sore nipples’ or ‘increasing milk supply’ on a random Thursday night at 11pm?  What about ‘when will my baby sleep through the night?’

Sure, we are blessed to live in a time when we can go online to find information on anything, yet, how legitimate and correct is this information we stumble upon?  If I search ‘sore nipples and breastfeeding’, I get over 327,000 hits… that is INSANE!  That many people have written an article about sore nipples?

And the information overload doesn’t end there.

Oh, Facebook….how I love and hate you at the exact same time.  

While I love seeing photos of my friends on Facebook, I also find myself feeling in competition with them for who is the BETTER mom.  Who plans the best art projects?  Who looks like she is the most relaxed?  Who always looks like she is enjoying her role as mom?  It can sometimes make me feel badly about myself.

Now don’t get me wrong.  I think my favorite aspect of the Internet is the way in which we can share our personal stories.  Personal stories are incredibly powerful.  When I read stories about what other moms are dealing with, it can often put my current situation into perspective.  I can relate to someone else, via the Internet, and feel like I actually know this woman, although I have never met her in real life.  The connections and support are empowering!

Yet, sometimes I think the Internet is a little too much of a good thing.  When my friends and clients are telling me about how they googled ‘reflux’ last night and now have 10 different diagnoses for their baby’s fussiness at the breast, I feel like their stress has elevated, rather than dissipated.  Their main questions were never answered.  Plus, while there is terrific parenting advice online, there is equally horrible, judgmental, and biased opinions that can really bring a mama down.

So what can an Information-Bombarded mom do to bring back her sanity?

This past week, I spent 4 days with my family, without Facebook and Google Reader.  Instead, I hiked, reconnected with my kids and my siblings, cooked nutritious meals, sat and watched my kids go on a scavenger hunt in a garden for an hour, and actually read a REAL book!  It was so therapeutic to purposefully ignore what everyone else was doing and what they were presently concerned about.  It was all about my family instead.

My favorite ways to actively become more present:

• Turn off my computer and phone…. I can instantly be in the moment.
• Spend more time outside….even writing this article was more relaxing as I sat on my outside couch with my feet up, soaking in the sun and the rustling branches.
• Take photos with a real camera, rather than my phone.  This way I can’t be interrupted by calls or emails.
• Bookmark my favorite sources of legitimate Internet information.  This way I spend less time weeding out the crappy articles and just read the beneficial ones.  For breastfeeding resources, I love Kellymom and Best for Babes.
• Hide my ‘perfect’ friends on FB.  It has saved me hours of thinking aggravating thoughts now that I don’t have to read their posts every day.
• Find time to decompress every day.  Parenthood, while rewarding, demands nonstop attention, which can really wear one down.  Sneaking out to throw the ball to my dog or hiding in the garage while I do my laundry can help quiet my mind and my stress during the times I need it the most.
• Find those few friends who can truly relate to you and will offer non-judgmental advice.... or even better, just listen when you need them to.
• If at all possible, take a small vacation.  While I try to decompress on a daily basis, I find that the stress of being a working mom just builds and builds until I explode.  This short vacation, spending time in nature and eating great food, with little contact with the outside world, definitely helped me hit my ‘restart’ button. 
• Find practitioners in my community that I trust.  Rather than googling ‘thrush’ or ‘vaccines’ online, I have someone that I can contact personally and get a straight answer based on my personal situation.  I recommend for my friends in other areas to check out ILCA's website for a list of qualified lactation consultants.

How about you?  What would you add to this list?

Advice for the New Breastfeeding Mom

Dear New Breastfeeding Mama,

All rights reserved by Rebeca CygnusAre you feeling completely overwhelmed by your new profession as Mother of a New Baby?  Are you googling sore nipples and how often should my newborn breastfeed while sitting awake at 3:30am?  Are you like me and only prepared for pregnancy and labor, but forgot to read the books about how to take care of a newborn?

Well, then look no further, my sweet friend!  Put the google search DOWN!

While I don't have all of the answers to breastfeeding and parenting  (let's be honest....who really does?), I do have some short and sweet resources that may be helpful for you in your time of need.  

And if you don't find what you are looking for on this list, add your question to the comments and I will do my best to provide you with the help you need!

Here are my Top 6 Advice for the New Breastfeeding Mom articles:

1. My Newborn is So Sleepy!

2. Laid-Back Breastfeeding: Physically and Mentally

3. Napping and Postpartum Sleep Deprivation

4. Common Concerns While Breastfeeding - Sore Nipple Therapy

5. Common Concerns While Breastfeeding - Help!  I'm Engorged!

6. How to Bring in Your Milk Supply More Quickly

Know Your Newborn's Rights After a Hospital Birth: What Are Your Choices?

Did you know that you don't have to cut your baby's umbilical cord immediately after he/she is born?

Did you know that you could hold off on standard hospital procedures after your baby is born, given he/she is healthy, until after the first breastfeeding session (and beyond?)

I am somewhat embarrassed to admit, but I was one of those mothers who walked into labor and delivery trusting everything my OBGYN said.  I had not done any extra research on the policies and procedures that took place during a hospital birth.  I had no idea how these medicalized birth practices could impact my delivery, my child's future well-being, my breastfeeding initiation, and my recovery.  

Now that I have been in the birth and postpartum professional world for over 3 years, I am shocked about how little I knew about my rights during birth and beyond.  And I have a masters degree, dammit! I am an educated woman about everything else in my life, so why didn't I learn more about birthing practices?  

Fortunately, there are many research-based articles on the web that will help you make a decision about whether these routine hospital procedures are for you or not.

So which procedures are under your control?

1. All initial evaluations can take place while the baby is resting on mom's chest.

2. Your baby doesn't need a bath in the hospital - the vernix helps fight infections and is moisturizing, so rub it in!

3. If you don't have chlamydia or gonorrhea, your baby doesn't need drops in the eyes after birth.

4. Vitamin K shots - does your baby really need this?  

And these are just a few....

For more information about your newborn's rights after a hospital birth, take the time to listen to this fabulous online radio show episode from Pregtastic called, Know Your Rights!  Routine Hospital Procedures for You and Your Newborn.

Also, while you are at it, make sure your hospital is breastfeeding-supportive.  In 2012, you would think they all are, but, again, I was shocked at how many of them are not.  Best for Babes has a great article that can help you figure this out: Top 10 Questions to Help You Find a Breastfeeding-Supportive Hospital.

Why TSA Needs Some Serious Professional Development Classes about Breastfeeding

I have to admit that I was completely dumbfounded when I read the article about how a TSA worker required a breastfeeding, working mom to pump in a public airport restroom to save her $200 pump from being confiscated.  Were the bottles filled with over 3.4oz of breast milk (which is completely legal) – NO!  Was her breast pump any different than a battery-operated computer or DVD player – Nope!  So, what was this man possibly thinking?  Apparently, he wasn’t thinking, which is an enormous problem when dealing with public safety.

Amy Strand, a breastfeeding mother of four, was forced to pump, next to the sink, in a public airport restroom.   Having just poured out her precious pumped breast milk, so that she didn’t have to justify carrying liquids in her carry-on luggage, a moronic TSA agent made the audacious request that Amy must pump her breast milk into the bottles to prove that this is what they were used for.  Otherwise, he would confiscate them.

As a breastfeeding advocate, I am mortified by this news story.  Why?

1. When society makes life more difficult for breastfeeding mothers, we see a decline in breastfeeding rates.
2. When breastfeeding mothers feel an increased risk for being humiliated in public for breastfeeding or pumping, we see a decline in breastfeeding rates and an increased risk for postpartum depression.

As an avid traveler, I am also disgusted by this news story.  Why?

1. What type of education level are we requiring for someone to work for TSA and protect my safety as a frequent flier?  Middle School diploma, perhaps?  Now that’s scary!

How many of you breastfeeding moms have flown, carrying pumped milk in your carry-on?    

Did you find that this was somewhat stress-provoking?

I remember when my son, Ryan, was 6 months old, I flew up to Northern California to visit my newly-born niece, leaving my son at home with my mom.  I wanted to bring my breast pump as a carry-on, just in case.  What if my luggage was lost?  How would I preserve my milk supply without my pump?  Standing in the security line, I began to panic.  What if I had to explain what the pump was used for?  What if they took away my freshly pumped milk?  Sure enough, I got pulled out of line to explain my pump to a kid that looked no older than 21.  While I was mortified as I took out all of the pump pieces and my bottles of breast milk, the TSA agent was obviously more embarrassed.  I explained what everything was and that the liquid in the bottles was breast milk that I planned to bring home to my exclusively breastfed son.  As I put all of my pump pieces and bottles back into the pump case, I remember thinking, “I bet this kid won’t bother another pumping mom again.”  I had hoped it was a little glimpse into the breastfeeding world for that kid.

Apparently, I was the lucky one.  At least I wasn’t required to demonstrate how my pump functioned in front of a bathroom full of complete strangers.  Amy Strand wins the Breastfeeding Mother of the Year Award in my mind.  Not only did she withstand utter humiliation, but she stood up for what she believed in. 

As for TSA, I think it is quite apparent that it is time to retrain your agents about your policies and procedures.  Moreover, maybe consider hiring the professional development staff from Nordstrom to teach the basics of customer service!

Know Your Rights!

Moms, here are the TSA Guidelines for Traveling with Children and Traveling with Formula, Breast milk, or Juice.  Maybe we should all print these out and pack them in our carry-on bag, just in case the TSA agent didn’t receive the proper training!

The Lactation Consultant Who Changed My Life

On March 7, 2012, International Board Certified Lactation Consultants (IBCLCs) globally will celebrate their 11th official Annual IBCLC Day.  The theme for this year’s celebration isIBCLCs Make an Impact and this powerful statement definitely rings true in my life.

Six and a half years ago, an amazing, gentle IBCLC entered my home and changed the course of my life forever.  My son, Ben, was 4 days old.  I had just returned home from the pediatrician’s office and breastfeeding was NOT going well at all.  My fuller milk had not ‘come in’ yet.  My nipples were completely torn to shreds.  My son wanted to eat non-stop and my sanity had started to wane. 

Then, enter Eve.  Eve brought a scale, a bag of tricks, and a calmness that enveloped my entire home.  She had a way about her that put everyone at ease, including my hungry baby boy.  Within 90 minutes, Ben had latched (with the temporary help of a nipple shield), transferred 2oz (apparently my milk decided to perform for Eve, as well), and had happily fallen asleep on my chest.  More than providing latching assistance, though, Eve helped me to feel more confident about myself as a new breastfeeding mother, which is what I needed more than anything.

Over the next few months, I would stop by Eve’s weekly breastfeeding support group, to ask breastfeeding/reflux questions, visit with other breastfeeding mothers, and get a quick dose of self-confidence.  No matter what breastfeeding challenges I was facing at the time, Eve knew how to calm my fears and encourage me to trust my instincts.  It was the best money I had ever spent.

As my milk supply started to dwindle when my son was about 5 months old, I don’t know why I didn’t think to contact Eve.  In retrospect, I guess I didn’t think it was her job to support me past those first few months.  These thoughts may have been quite ridiculous, but at the time made sense to me.  My milk completely dried up when my son was 8 months old, which meant that I wasn’t able to meet my final breastfeeding goal of nursing past 1 year.  I have always regretted not reaching out for help at that time; however, that was no fault of Eve’s.

Eve’s impact on my life has been boundless.  As a nursing mother, she reinvigorated my self-confidence, which helped me to become a better parent.  As a woman, she taught me the importance of supporting other women through the journey of motherhood.  As a teacher, she taught me that listening can be more powerful than solving a problem.  And as a business woman, she inspired me to change my profession so that I could offer similar caring postpartum support to new mothers.

Eve, my IBCLC, made an immeasurable impact on my life, and I will be forever grateful!  My life is infinitely better and more fulfilling having met her. 

Gentle Weaning: Techniques and Resources

In this third article in our Gentle Weaning series, we will start the conversation about different techniques you can try to gently wean your baby.  If you are wondering about how to pace the weaning process, check out our last article, Gentle Weaning: What is the Process?

Every breastfeeding mother eventually weans her child.  It is part of the evolutionary process.  Whether your baby is a few months old or a preschool-age child, there comes a time when the act of breastfeeding no longer occurs.   When the time is right for both you and your child to wean, there are quite a few techniques you can use to help make the process go more smoothly. 

 I have searched books and the Internet to find some of the best resources out there.  I would love if you would please share your own resources and experiences, as well, so that we can all benefit from them!

 Techniques for Gently Weaning your Breastfed Child

Choose one feeding per day to replace with something else.  If your child is not on solid foods yet, then this would have to be some other nutritionally-based liquid.  Consider using previously pumped milk, or donor milk, in a bottle or cup.  If you child is eating solids, replace this breastfeeding session with fruits, vegetables, protein, grains, etc.  Fill a cup with water, pumped milk, or another nutritional liquid to help keep your child hydrated.

When you replace this feeding session, don’t stimulate your breasts at that time.  Skipping this nursing session should help to slowly decrease your milk supply, without the discomfort of engorgement.  After a week or two of skipping that nursing session once a day, choose another feeding to drop.  Continue this process until you have completed weaned.  This process may take weeks or months…. It is completely up to you. 

Don’t offer, don’t refuse.  This gentle weaning technique is more appropriate for an older child, rather than an infant.  What it means is that you don’t offer to nurse your child unless he/she asks to nurse.  This process may take longer than the other, as your child is never denied a chance to nurse if he/she needs to or wants to breastfeed. 

Save naptime and bedtime as the last feeding sessions to wean.  Bedtime and naptime are often the most difficult nursing sessions to end for both emotional and convenience reasons.  Save these for last.  Attempt to drop all of the other feedings first before you attempt those associated with naptime and bedtime. 

Create a new routine.  If you and your child like to nurse before a nap or bedtime, replace this nursing session with another routine.  Here are a few ideas:

Have your partner put your child to bed

Read your child a story

Sing to your child and relax in a rocking chair or bed (somewhere that is a different location than where you nursed before.)

If your child is old enough, ask him/her to choose what he/she would like to do instead.

Distract your child or offer something else.  If you can anticipate that your child is going to want to nurse at a certain time, offer him/her something else to do.  Kellymom.com recommends distracting with a favorite snack, a playdate with a friend, playing outside, or reading a favorite book as a few ideas.

Attempt nighttime weaning and daytime weaning at different times.  Trying to daytime wean and nighttime wean at the same time can be extremely overwhelming.  It’s best to choose one or the other and start there.  Kellymom.com has some terrific suggestions for ways to nighttime wean.

Celebrate your breastfeeding accomplishments at the end.  Weaning can be a very emotional process for both mother and child.  I remember my last nursing session with my son like it was yesterday.  We had this cozy, green rocking chair in his bedroom and I just sat there, rocking his soundly sleeping body in my arms, for about an hour after he finished nursing that last time.  I reflected upon the breastfeeding challenges we had overcome and the joy it had brought to the both of us.   I felt so blessed to have shared those moments with my sweet boy.

Now, this is NOT an exhaustive list of techniques to help you gently wean your child…not in the least.  Here are a few of my favorite blog posts about this topic:

Natural Parents Network: Gently Weaning a Preschooler

PhD in Parenting: A Different Kind of Baby-Led Weaning

San Diego Breastfeeding Center: Our Breastfeeding Memoirs, Chapter Two