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

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

Do some research before returning to work.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Techniques that can help increase your output

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

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

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

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

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

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

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

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

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

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

Help a Mama Out: Dealing with the Biting Breastfeeder

Oh, that sweet infant gummy smile!  So serene.... so innocent.... so adorable.  But all toothless mouths must come to an end and teething starts another fun developmental stage for your little one.  Teething can also stir up some anxiety in the breastfeeding mama, which we are hoping to aleviate today.

Will my baby bite me?  

Do I have to stop breastfeeding?  

Most moms have felt a clamp down on their nipples from their teething babes once or twice, but it doesn’t mean that your breastfeeding relationship has to come to an end.  No need for those new teeth to be a deal-breaker!

We turned to the wise breastfeeding mamas on Facebook to offer some tips for dealing with a biting breastfeeder.  As always, your advice was amazing.  Here is what you had to say.

Top Tips for a Dealing with a Biting Breastfeeder

Stacy: Remember that your baby isn't malicious and isn't trying to hurt you. If baby bites at the beginning of a nursing session, try giving him/her something cold/hard to chew on beforehand. If it's at the end, pay close attention and break their latch as soon as they finish eating but before they are tempted to play with the new sensation of using their teeth.

Amber: Remember, it’s just a phase!

Michelle: I found that using a nursing necklace was really helpful.  Instead of pulling back on my nipple when he distracted, he would play with the nursing necklace while breastfeeding and focus on feeding.  I found that he mostly bit down when he was distracted.

Liz: Ugh. Cry? I do the "don't bite. That hurts." And set P on the ground for a few minutes. Then nurse again.

Katie Jo: What ultimately worked for me was to pay close attention and learn to recognize when he was finished eating. Then I would have to quickly unlatch him with my finger before he started to play/explore what he could do with his teeth. If I didn't catch that moment quickly enough, he would bite down the instant he sensed I was about to unlatch him, and my nipple turned into a rubber band chew toy for him. Sometimes he would bite my finger instead. I tried pressing him into my breast and telling him ouch in an upset voice, but he just laughed every time.

Julie: I bought my daughter an amber necklace to help relieve some of the teething pain she was feeling.  Less teething pain = less biting while breastfeeding.  I also wore one around my neck as well.

Jen: I tell P, "ouch, that hurts mommy." She stops biting/nursing and looks at me with concern. I let her know it hurts and to be gentle. Sometimes it takes a few reminders, other times she will stop.

Stephanie: If your child will take a cold teether, try offering that before or after a nursing session.

Tamara: Be patient, they may be in pain from teething and doing their best to find relief.

Jennifer: Keep your finger close by their mouth so if they go to bite, you can stick your finger in the side quickly to get them to unlatch!

Erin: I loved the Camilia teething liquid to help with teething pain.  I would use this a couple of times during the day when my baby was really teething badly and I thought it really cut down on the biting while breastfeeding.

Kat: My kids didn't start that nonsense until they were 10 and 8 months old respectively. So every time they bit, I would quickly unlatch them and set them down. I would say "no biting Mama" and ignore them for a minute or 2. My daughter figured it out after a couple of days, and my son took a week. I tried a couple of times to do that thing where you push their nose into your boob to make them open their mouth but it's so counterintuitive! The first instinct is "get it off me!"

Kim: My 9.5 month daughter got her first teeth at 4 months 1 week. She usually bit me when she was done eating or not hungry. I would tell her no biting and take her off my boob. I would make sure when she was done eating to immediately unlatch her or that's when the biting would begin. I could tell when she was about to bite. Now she is biting my shoulder.

Don't miss our article about why babies bite while breastfeeding and a few more tips and tricks to stop it from happening: Breastfeeding a Teething (or Toothy) Baby

Also, check out our Boob Group podcast episodes where we discuss biting babies and toddlers:

Breastfeeding A to Z: Sore Nipples and Biting

Breastfeeding Toddlers: Frequency, Biting, and Staying Motivated

Was it Something I Ate? Food Sensitivities in the Breastfed Baby: Part 3

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

Last month we probed a little deeper into understanding how mom’s gut influences baby, what causes an unhappy digestive system, and what we can do about it.  From leaky gut syndrome to food sensitivities in baby, maternal dietary modifications have become the first line of defense, despite the inevitable difficulties one may face when narrowing the focus of problem foods. A mom’s diet during pregnancy and during lactation is often a hot topic among anyone close enough to ask questions about her experience… even someone in the checkout line at Target! From your Aunt Sally to your Grandpa Joe, everyone seems to have an opinion about what a mom should and shouldn’t eat.

Often times we hear myths such as spicy foods, cruciferous veggies, beans, garlic, etc. cause excessive gas and GI upset in babies therefore moms should always avoid these foods. What about allergy risks? Shouldn’t moms avoid high allergen foods to reduce the risk of their baby suffering from allergies?  Most importantly for our discussion here, once an allergy or sensitivity in baby has been detected, many foods are considered to be a cause for concern and are encouraged to be eliminated all at once. This is often with no direction into the how, why, or to what capacity… so what’s a mama to do with all of this information? As a Registered Dietitian specialized in lactation related food sensitivities, below are tips and tricks I share with each client I see, via skype or in person, on how to make an elimination diet work for you. 

First Things First…

How do we know when our baby is showing signs of an allergy, sensitivity, or is just ‘being a baby’? Throughout the first few years of life, we go through many phases of maturation, growth spurts, improved function of the internal organs, and cognitive development that lead to variability in bodily functions. As our little ones grow, much like a child or teenager, these phases can be fast or slow, contributing to symptoms signifying the ease or difficulty in coping with such change. When infants have variations in their digestive habits, something many parents have held under strict observance, it can lead to a lot of anxiety and concern about the normalcy of what they see. Each infant’s stool pattern and appearance have individual variations of normal, similar to that of older children and adults. This could be a series of blog posts on its own! For the sake of our discussion on allergies and gut health, the top two signs that tell us something isn’t quite right are the presence of blood and/or mucus in their diapers.  

Digestive symptoms such as these often appear around the 2-month age mark when immunity shifts from maternal based to becoming more dependent on baby. At the onset of symptoms, the presence of blood can become slightly tricky. If accompanied by other symptoms of discomfort, it can be associated with an infection, much like a stomach bug for children or adults. However, once screened negative for infection, the continuous presence of blood, dark brown in appearance, begins to direct us toward mom’s diet as a potential causative factor. Mucus often times is paired with green stools and can signify irritation in the baby’s digestive system. If found independent from blood, this sign of irritation can be associated with food sensitivities. If mucus is found in combination with blood-tinged stools, it can be an additional indicator of an allergy present in baby. As with all abnormal symptoms, it is best to check in with your baby’s doctor to rule out other causative factors, especially those medical in nature. 

To eat or not to eat…That is the question. 

Corn, tomatoes, cow’s milk, OH MY! Often times the prescription for an elimination diet comes with lack of clarity in what to avoid, how to avoid it, and what to eat instead. Moms are so responsive to their baby’s needs that most are quick to do whatever they can to help their baby find a little relief. This, however, can come at the expense of their own sanity and nutritional status. Determining which foods to eliminate requires in depth knowledge in the mother’s specific dietary habits, baby’s specific symptoms, and an understanding in how the two intersect. Most often, moms come to my practice having already eliminated a handful of foods, randomly selected from a list of ‘top allergens’ or a friend’s personal experience with no regard to their intake. Unfortunately, often times this elimination is only partially complete as ‘hidden’ foods are consumed with no knowledge of the allergen’s presence. Listed below are the top 4 steps toward completing an appropriate elimination diet and getting you and your baby on your way to tip top shape! 

1. Recruit your support team. Find evidence based blogs, peer-to-peer support, a personal chef, cooking classes, and most importantly a registered dietitian experienced in lactation related food sensitivities to help you as you progress throughout this process. Having your toolbox full of resources will definitely be the best investment of time and energy in getting you back in control of your diet. Organizing your course and plan of attack, prior to removing potential allergenic foods, will help with efficiency and the level of control during this unpredictable process! 

2. Create a food log & symptoms log. Personalization and preservation are the two top goals for me as a professional working with moms on elimination diets. For 3-4 days, I recommend keeping a log of every food and beverage you consume, the time of consumption, and the time and type (breast or bottle) of feeding for your little one. Additionally, it is best to log the time and type of symptoms you see. Although this can be a huge undertaking, it is the gold standard in narrowing down potential causative factors in mom’s diet. 

3. Take it one food at the time. Finding purpose in each action we take can release our reactionary response of jumping in with both feet. When offering little thought into the aftermath of this technique, we find that as the allergy symptoms begin to fade, we are left with confusion and uncertainty of the true offender! This can make the road toward reintroduction very tricky and sometimes unsuccessful. To preserve your sanity and protect your preferred food selection, it is best to choose one food to eliminate at a time. It is frequently stated that 2-3 weeks are required to see a complete recovery from an eliminated food. While this statement is valid in some cases, for many, improvement appears within 24-48 hours after food elimination begins. Visualizing this change on a short-term basis allows for continued elimination until baby is well and the preservation of mom’s diet is honored… especially when meal preparation and planning are difficult enough! 

4. Reintroduce when the time is right. Unless otherwise directed by your pediatrician, do not fear the process of reintroduction! Permanently eliminating the food from your diet does not allow your baby the opportunity to build up adequate immunity toward this food prior to consuming it directly via solid foods. Before considering this step, allow time for your baby’s body to heal and demonstrate its ability to be symptom free for 2-3 weeks. This is most important prior to initiating this final step. Once successful, begin with the least offensive food and reintroduce in small amounts, eating a portion once per day, or once every other day. Give this step 3-5 days and if all is well, continue down the list until your diet is back to normal. It is important to keep great inventory of your intake and your baby’s symptoms via your food log to keep a good hold on what’s going on just in case symptoms resume. If your baby begins to show signs of intolerance, back off slightly until he/she is symptom free again, holding steady at the highest stage possible. Give your baby’s immune system a couple days to settle into this allergen load. Once ready, begin again, slowly introducing as tolerated. 

The key to success during an elimination diet is personalization, education, patience, and breastmilk! Despite having a potential allergen or sensitivity within mom’s milk, the immune boosting cells, digestive enzymes, and anti-inflammatory properties, to name a few, far surpass the effects of the sensitivity... especially when considering the potential harm from alternate sources of infant nutrition. For most, the benefit of breastmilk is crucial in the continued development of baby’s immune system and in prevention of further concern down the road. Although this process varies for each mom/baby dyad, the steps toward successful elimination hold true for each case. 

Want to find out more? Visit www.angelfoodlactationandnutrition.com to schedule a Skype consult with Lindsey and begin your journey toward better health and a happier baby today! Want to stay connected between posts? Find Angel Food Lactation & Nutrition on Facebook at www.facebook.com/angelfoodlactationandnutrition for current articles, events, fun discussions and more!

Podcast and Personal Stories about Tongue Ties and Lip Ties

Written by Robin Kaplan, M.Ed, IBCLC

Last week on The Boob Group, I had the esteemed pleasure of interviewing one of the most prominent experts on tongue ties and lip ties, Catherine Watson Genna.  Catherine has written multiple articles and books about the mechanics of the tongue while breastfeeding, as well as the breastfeeding challenges that can occur when a baby has a tongue or lip tie.  One of her earliest articles was written for the American Academy of Pediatrics, helping to bring awareness to this subject for the practitioners who babies see the most.

Click here to listen to The Boob Group's podcast episode: Tongue Ties and Lip Ties: Symptoms, Treatment, and Aftercare.

Here is a list of SDBFC's articles about tongue ties and lip ties, including serveral personal memoirs from breastfeeding mothers who experienced this with their children.

Does Your Baby Have a Tongue or Lip Tie? 

Advocating When Your Baby has a Tongue or Lip Tie

The Tongue Tie/Lip Tie Challenge

What a Difference a Tongue Tie Revision Can Make

Breastfeeding After a Tongue Tie Revision

If you have a story to share about breastfeeding a child with a tongue or lip tie, whether you have the revision procedure or not, please send it to Robin Kaplan (robinkaplan@sdbfc.com)

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

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

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

Tiffany: Your nipples start reminding you of Stretch Armstrong. 

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

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

Cat: They ask you to hold their cracker.

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

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

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

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

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

Paula: After nursing you find gum on your nipple!

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

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

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

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

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

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

Kristin: They are constantly upside down.

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

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

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

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

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

Toddler Nursing Part 2: Toddler vs. Breastfeeding

Toddler Nursing: Part 3: Super Breastfed Baby!

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

Breastfeeding Beyond Two Years

Breastfeeding Toddlers: Frequency, Biting, and Staying Motivated

Breastfeeding Toddlers: Night Nursing and Weaning

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

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

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

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

 

Are You Being A Good Host?

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

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

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

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

How does this relate to lactation? 

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

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

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

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

I am in! Now what do I eat? 

Improving your diet can begin with 3 simple steps. 

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

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

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

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

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

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

Does your baby react to the foods you are eating?  

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

A Resolution to the LA Fitness Nursing in Public Harassment Incident

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

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

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

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

Defining my Breastfeeding Experience: Inclusive Breastfeeding

Written by Aran Tavakoli

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

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

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

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

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

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

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

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

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

Witching Hour vs Colic

Colic is a word that is often used for a baby who cries for any length of time, but did you know that it’s normal for babies to have a fussy period every day, often called the witching hour?  While it’s distressing for any parent to hear her baby cry, sometimes understanding that the behavior is a normal part of infant development can be helpful.  However, there are times when the behavior may be caused by something else, and even though the cause isn’t always immediately understood, there are measures that can be taken to reduce the symptoms of colic.

 

What is the “Witching Hour”?

The witching hour is described as normal fussy periods that almost all babies go through.  It happens around the same time every day and most frequently occurs in the late afternoon and evening hours.  It will often begin between weeks 2 and 3, peak around week 6, and then fade around 3 months.  During this time, your baby will likely want to cluster feed, which again, is a normal behavior for babies. A baby who may go 2 hours or more between feedings will suddenly want to eat constantly.  He/she may be fussier than normal and more difficult to soothe.  Often it seems like the baby doesn’t know what he/she wants!  The baby will want to feed for a few minutes, then fall asleep, only to wake 10 minutes later wanting to feed again.  Some babies will fuss at the breast, giving hunger cues, but then pull off and cry.  All of this is normal behavior.

What Causes the Witching Hour?

While our babies can’t tell us why they’re so cranky during these seemingly endless hours, we have some theories on what causes it.  As it happens often towards the evening hours, it could be because mom’s milk supply is lower than it was earlier in the day.  What is so important for moms to realize is that her supply is not TOO low, but lower, which is a normal fluctuation that all women experience.  As the milk flow is slower, the baby may grow frustrated, and as the milk volume is lower, the baby may want to feed more often.  Again, this is not a sign that mom doesn’t have enough milk, but a common occurrence in breastfeeding.  Another cause could be overstimulation.  Your baby isn’t able to self soothe, or shut him/herself down at this age.  So by the end of the day he/she may feel cranky and overstimulated and have a hard time calming down.  It’s also often the busiest time of day in a lot of households, when partners are returning home from work, older siblings from school, and mom is trying to juggle activities like making dinner, or helping another child with homework.

What Can I Do to Help My Baby During the Witching Hour?

While you may not be able to 100% prevent the fussy period, there are lots of things you can do to help calm your baby and make your own life a little easier.  The best thing you can do is to offer your breast often.  Wearing your baby and learning to breastfeed in the carrier can be an absolute lifesaver!  Wearing your baby will also help to keep him/her soothed and your hands free, so you can attend to other children or activities that need to be done.  Another idea is to prep dinner earlier in the day so that you don’t feel the stress of having to do that during your baby’s fussy period.  Take a walk with your baby in the carrier, as the fresh air will benefit you both.  As much as you can, don’t plan events during this time.  And lastly, don’t be afraid to ask your partner for help!  A baby’s cry is incredibly stressful for mom and sometimes you may need a break.  Ask your partner to step in for a while to soothe baby while you take a bath, go for a drive or walk, or just sit in a quiet room.

What is Colic?

Colic is different than the normal witching hour and is defined as a baby who cries for 3 or more hours a day, 3 or more days a week, for 3 or more weeks at a time.  Colic can begin in the early weeks and often fades by month 3 or 4.  The behavior of a colickly baby is markedly different than that of a baby experiencing normal witching hour.  The crying is often more intense and the baby is unable to be soothed.  The crying may be accompanied by behavior that indicates the baby is physically uncomfortable - he/she will arch his/her back, or seem to want to change positions, or tense his/her legs up near the abdomen.  

What Causes Colic?

Like the witching hour, there is no hard and fast evidence about what causes colickly behavior in a baby.  There are however, some things that you can definitely rule out if you suspect your baby is colicky.  One common cause for colic is too much milk.  Mom with an oversupply of milk may find her baby exhibiting the symptoms described above.  If mom has a very forceful letdown and fast flowing milk, the baby can take in too much air while feeding which can cause lots of gas and periods of great discomfort.  Sometimes an oversupply can cause a baby to have a foremilk/hindmilk imbalance.  This also means discomfort for the baby as he/she is getting more of the diluted foremilk and not enough of the fattier hindmilk.  The foremilk doesn’t have enough fat in it to help balance the lactose, which can cause it to be difficult for the baby to digest.  

A tongue-tie or lip tie can also cause this type of behavior, even when mom doesn’t have an oversupply of milk.  A baby with a restricted tongue or upper lip may not be able to create a seal while feeding at the breast, which again, like the oversupply, causes baby to take in too much air while feeding.  

A sensitivity to something in mom’s diet can also be a culprit in causing this colicky behavior.  

What Can I Do to Help my Colicky Baby?

Change up your breastfeeding position.  If you feel like you may have a forceful letdown, try using the laid-back position.  This can help slow down your flow, making it more manageable for your baby.

If you suspect that something in your diet may be causing your baby discomfort, try keeping a food journal for 48 hours.  Record everything you eat, the time you ate it, along with the times your baby is exhibiting the colicky behavior.  If you start to notice a trend of discomfort following a certain type of food, you can eliminate that food from your diet for a few weeks to see if the behavior improves.  The foods most likely to cause sensitivities are dairy, soy, gluten, eggs, and nuts.  

Most importantly, seek the help of an IBCLC (International Board Certified Lactation Consultant) as she can help you identify oversupply, forceful letdown, tongue/lip tie, as well as a food intolerance/sensitivity.  Lastly, contact your pediatrician to rule out any serious conditions.  

And most of all, remind yourself that this will pass!

You Know You Are a Breastfeeding Mother When...

Cyndi: You have to plan your work meetings around your pumping schedule.

Sherry: You walk around the house for a few minutes before realizing you never put your boob away.

April: All your shirts open in the front.

Amy: You go to run a 10k and pack your pump as part of your post-race routine.

Kelly: Every shirt you own had a stain from leaking over one or both breasts.

Amy: You workout and apologize to your friends for smelling like a mixture of sweat and milk due to random let downs.

Dana: You are happy to have limo tint on the back windows of your car because you spend so much time pumping in the back seat.

KC: Your husband wakes up to a ‘peep show’ and you’re passed out.

Christine: Your knit shirts are all stretched out because of your toddler reaching down and grabbing for self service.

Bethany: You feel your boobs all day to see which one needs to be nursed from next.

Angelique: You fear the mailman has had a free peep show, but you don’t even care.

Melissa: You question how much milk spillage is acceptable on a shirt before you change it.... and the answer is A LOT!

Ruthii: When sitting next to you becomes a splash zone.

Jennifer: You catch your toddler breastfeeding her dolly.

Jennifer: You walk out the front door and reflexively grab your chest to make sure your boobs aren’t hanging out!

Julie: When you cry over spilling an ounce of milk on the counter.

Suzanne: You use your milk as a cure everything from sunburns to eye and ear infections. Breast milk is the equivalent to Windex from the film "My Big Fat Greek Wedding."

Ashley: You’re excited for a date night because it means you don’t have to choose your clothes based on which are the easiest to take off in public.

Jacqueline: Your boobs are often lopsided.

Alethra: When hunger, tiredness, getting hurt, or any other dilemma is solved and smoothed over with whipping out the boob.  Problem solved!

Brittany: You’re in public and when you hear a baby start to cry, your first thought is, “Oh, man!  I hope I put on my breast pads today!”

Angela: When you bring your breast pump on your Vegas trip and plan everything around your pumping schedule.  Times have changed!