Freeze Dried Breast Milk

Freeze Dried Breast Milk: What's the hype about?

Freeze drying milk is not a new concept. Powdered milk, sometimes called dried milk, milk powder, or dry milk, is a made by evaporating milk to dryness which can then later be reconstituted to the liquid form by adding water later. The first modern attempts at drying milk started as early as 1802 with specific processes for drying milk being created by 1837. Powdered milk is frequently used in the manufacturing of infant formula, confectionery such as chocolate and caramel candies, and in recipes for baked goods where adding liquid milk would make the final product too thin or runny. During the 1960s, commercial infant formulas became popular, and by the mid-1970s they had all but replaced evaporated milk formulas as the "standard" for infant nutrition.

Typically when we think of breast milk storage, freezing in either a standard freezer or a deeper freezer have been the go-to for years. Milk that has been frozen correctly and stored in a deep freezer is optimal for about 6-9 months before the flavor begins to change. Newer guidelines are saying that frozen milk may still be good about a year in the freezer. But freeze-dried milk which can last from 3 to 20 years on the shelf! So the while the idea and concept of freeze dried breast milk isn’t new, it’s taking the market by storm with many new companies popping up in recent months. So let’s do a deep dive into the world of freeze dried breast milk, the pros and cons, and the expense. 

HOW IT WORKS

Sublimation is the fancy term for the freeze-drying process which basically means all the water has been removed from the breast milk and turns it into powder. Low temperatures are used for a long time in the drying process to ensure the nutrients in the milk are protected. Freeze drying is different than dehydrating, which uses very high heat and is relatively faster. With freeze drying, 'low and slow' is the name of the game to protect precious nutrients.

Here is the basics of a freeze-drying process:

  • Deep freezing: Milk is deep frozen in a chamber at temps below -40 degrees Fahrenheit.
  • Pressure dropping: Air inside the chamber is removed via a pump, which drops the pressure to create a vacuum. The low pressure turns the solid to gas. The vacuum pumps out the water particles.
  • Drying: Ice crystals inside the frozen breastmilk is vaporized by drying the milk with alternating warm and cold air (without thawing the breast milk) leaving behind a breastmilk powder
  • Packaging: The powder is sealed in special airtight bags or packages that protect against air, light, oxygen, and moisture. 
  • Since everyone’s breast milk is unique, the company will send you specific directions for reconstituting your milk for baby to drink. This is NOT like standard formula where 1 scoop gets 2oz of water. Each bag of powdered breast milk will need specific amounts of water unique to your milk. 
  • You should expect that however much milk you send will equal however much you receive back. If you send in 200oz of your breast milk, your powdered milk will make 200oz of breast milk when you’re ready to use it. 

Breast milk powder should be stored and prepared properly in order to prevent contamination with Cronobacter and other bacteria that can cause serious illness if safe handling guidelines are not followed.

THE PROS TO TRY IT:

  • To preserve milk for longer than it would last in the freezer, especially if it is going to expire soon
  • For the convenience factor
    • It’s easy to travel with or to ship to someone else
  • Can help with high lipase
    • While freeze-drying doesn’t reduce the amount of lipase in the milk, by removing the water it reduces the enzyme activity that breaks down breast milk which can make the taste and smell much milder. For some whose baby rejected pumped milk in bottles because of high lipase may have a higher chance of taking it freeze dried
  • For those who are doing elimination diets, this may preserve the milk longer for when your baby outgrows the allergy or intolerance so you can offer your milk later in your feeding journey
  • In cases where breast cancer has been identified and a mastectomy would be life saving, freeze drying milk can ensure future children conceived after mastectomy could still receive mother’s own milk
  • Can add some nutritional value to your older child’s meals by sprinkling it in purees or on solid foods, or even baking with it for the whole family
  • Could be an option for surrogates or donor milk
  • Saves space 

THE CONS

The big concern medical professionals have is that freeze-dried milk has not been widely studied. Yet. Most current health care providers will stick with AAP guidelines, CDC guidelines, FDA guidelines, and they have not released a formal statement on the safety and the efficacy of freeze-dried breast milk. But I would anticipate as it gains popularity and traction that eventually studies will be down on it. Without sufficient studies, it’s unclear if freeze-dried milk has the right protein, fat, carb ratio that infants need. We don’t know exactly how freeze-drying impacts the nutritional composition of breast milk. Some research suggests that breast milk's natural carbohydrate and protein content remains intact for up to six months after freeze-drying. But other studies report that freeze-drying may lower the amount of key antioxidants, like vitamin C, that are naturally present in breast milk. There really is a lack of evidence in terms of the nutritional safety of freeze-dried human milk at this current moment in time. Another concern is that freeze-dried milk does not undergo a pasteurization process which kills harmful bacteria. Pasteurization is avoided on purpose, in order to preserve the vital probiotics that are present in breast milk, and which would be destroyed with pasteurization. Just as bacteria can grow in freshly expressed milk if it is left at the right temperature for extended lengths of time, the same can happen with rehydrated breast milk powder. And there is room for error when making up bottles of freeze-dried milk. Each bag may require different amounts of water for rehydration, which means parents need to pay close attention to how they are preparing each bottle. Too much or too little water too often can lead to adverse effects in baby, like low sodium levels or not enough calories per feeding. 

THE COST
Freeze drying breast milk is still a new science. Even though there are multiple new companies specializing in this, no matter what company you choose, it is going to be an investment. The cost to freeze dry your milk will vary based on the company you choose as well as the quantity of milk that you have.

Several companies will wait until they have your milk in hand before charging you. This way they know exactly how many ounces of milk there are! This is because we often aren’t accurate in our measurements of what we collect. The bag or the bottle lines can be inaccurate or we can tilt the bottle to see a different number than what’s actually there. Companies are very particular in measuring so that they can ensure proper ratios at the end too. They want to make sure they aren’t over or under charging you. Other companies may charge a flat rate or give you an estimate. Do your research but expect to pay several hundred dollars for your batch of milk!!

 

 

Freeze-drying human milk may still be an appealing option depending on your circumstances. If you are adamant about freeze-drying your milk, make sure to use a legitimate company with lots of reviews. And DON’T try it at home yourself as you're risking contamination.

How to safely prepare formula for your baby

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Being pro breastfeeding does not mean being anti formula. As an IBCLC lactation consultant, my job actually includes education on feeding infant formula. This includes helping families choose an infant formula that is right for them based on solid evidence based research, bottle selection and techniques for bottle feeding. It also includes how to safely prepare formula. If there was more education and less demonizing of formula, families would feel less guilt and stigma around just trying to feed their babies while feeling more confident in the process. Let’s talk about safely preparing formula.

Formula-to-water ratio:  Follow the directions on your particular can of formula. For most powdered formula, the recommendation is 1 level scoop of formula (not packed down) per 2 fl oz of water. Be careful not to add too much water as this dilutes essential nutrients and can affect baby’s nutrition. Too little water may cause baby’s kidneys and digestive system to work too hard and may cause baby to become dehydrated. You also do not want to use breast milk to make formula unless under the direct supervision of a pediatrician or pediatric dietician as this hyper concentrates certain nutrients and can lead to medical complications.

Reminder: Powdered infant formula is NOT sterile and should not be fed to premature babies or babies with compromised immunity unless directed and supervised by your doctor. Typically most pediatricians will recommend ready-to-feed formula (already a liquid) for babies under 2 months. When preparing baby’s powdered infant formula, it is important to know that recommendations can differ based on several factors including  baby’s age and the safety of the water. Your pediatrician should be guiding you on formula preparation based on your unique baby’s health. For infants under 2-4 months of age, those who were born prematurely and those who have a weakened immune system, hot water should be used to prepare formula to kill any microbes. To do this, boil the water and let it cool for about 5 minutes, and then wait for the mixed formula to cool down before giving it to baby. After 2-4 months, it’s safe to prepare powdered infant formula by mixing it with tap water (filtered or unfiltered) and following the manufacturer’s instructions on the container.

Preparing formula with boiled water:

Ask your baby’s doctor if you need to use cooled, boiled water for mixing and if you need to boil (sterilize) bottles, nipples, and rings before use. If you choose to boil, follow these steps:

1. Bring water to a rolling boil for 1 minute, then turn off the heat.

2. Let the water cool for about 5 minutes before adding the powdered formula. Making formula with boiling water can cause clumping and decrease the nutritional value. The hot water, though, is what kills harmful bacteria in the formula.

3. Once the formula is mixed, run it under cold water or leave it on the counter for a few minutes to cool down to the right temperature for baby. Before feeding, put a few drops on the inside of your wrist to make sure it is not too hot. Do not offer the bottle immediately after mixing.

4. Feed or refrigerate the prepared formula.

Note: If you are concerned about lead or other harmful substances in your water, talk to your healthcare professional before making formula with tap water. Bottled or filtered water can contain bacteria and should still be boiled.

Mixing Tips for Powdered Formula

Single bottle instructions

1. Wash your hands thoroughly with soap and warm water.

2. Measure and pour desired amount of water into the baby bottle. Make sure to measure the water FIRST.

3. Add unpacked, level scoop(s) of powder formula to the bottle as directed. Return dry scoop to can. (1 scoop of formula per 2 fl oz of water is a typical recipe.)

4. Put the cap on the bottle and gently swirl or shake. Stirring often causes less bubbles to be formed which if swallowed can make baby gassy.

Tip: Moving your wrist in a twisting motion helps powder formula mix more quickly and more thoroughly.

5. Feed or store immediately in refrigerator. You can mix 24 hours worth of formula in a pitcher and keep it in the fridge to pour out and feed to baby. Pour the correct amount from the pitcher into a clean bottle and either feed cold or reheat.

The can of powdered formula can be used for one month after it has been opened. Manufacturers don't recommend using the formula after the 30 days of opening because the nutrients start to degrade. Store powdered formula with the lid tightly shut in a cool, dry place – but NOT in the refrigerator.

How to pick a baby formula: Reading the label and picking the carb source

How to pick an infant formula: The sugar source, what do the ingredients mean?

Being pro breastfeeding does not mean being anti formula

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Being pro breastfeeding does not mean being anti formula. As an IBCLC lactation consultant, my job actually includes education on safely preparing, handling and feeding infant formula. This includes helping families choose an infant formula that is right for them based on solid evidence based research. If there was more education and less demonizing of formula, families would feel less guilt and stigma around just trying to feed their babies. 

So let’s break down how to choose an infant formula. Here’s the disclaimer: what works for one baby won’t work for all babies. So always speak with your pediatrician or personal health care provider if your baby is struggling to tolerate any infant formula you are using. 

There are three main ingredients that are essential and needed in all infant formulas. The carbohydrate, or sugar source, the protein and the fat. In this video we will just be concentrating on the carbohydrate. Carbohydrates are an important source of energy for growing babies, as they account for 35 to 42% of their daily energy or caloric intake. The number one sugar or carb in breastmilk is lactose. Lactose is not only a good source of energy, it also aids in the absorption of the minerals magnesium, calcium, zinc and iron. It’s also lowest on the glycemic index scale – meaning that it won’t increase blood sugar levels nearly as fast as glucose or sugar will. Lactose is healthier for babies to metabolize, and can help maintain stable blood sugar (and therefore insulin) levels. All human babies have an enzyme called lactase which breaks down the lactose and make sit easily digestible. After about 5 years of age, most people (about 75% of the world's population) stop producing the lactase enzyme. Without lactase, they can no longer digest milk, and they become lactose intolerant. This is actually the age of biological weaning, as in if children were left to self wean, they would do so some time between 2.5-7 years old, meaning the weaning age coincides with no longer being able to break down the sugar. Because of this it is EXTREMELY RARE for a human baby to be lactose intolerant. That disorder is called galactosemia and is an inherited genetic condition This hereditary condition is passed from parent to child as an autosomal recessive disease. This means that a child needs to inherit two copies of the defective gene (one from each parent) in order to have the disease and occurs in only 1 of every 30-40K babies born. 

To replicate the sugar in breast milk, most cow's milk-based formulas will also have lactose as the main source of carbohydrates. When possible, I typically recommend a lactose based formula for most babies because most of the time if an infant is having a reaction to a formula, they are reacting to the protein and not the sugar source. More on protein in a different blog/video. But more on carbs. 

So again, I typically recommend looking for a lactose based formula first. Human babies are designed to break down lactose and it is the most easily digested by the human gut. If you are using a lactose based formula and baby doesn’t seem to be tolerating it, consider a lactose based formula with an alternative protein source first before going to a lactose free formula. 

Because formulas without lactose will use other sources of carbohydrates. Both the FDA and the European Commission require that infant formulas provide 40% of their calories from carbohydrates. However, the source of those carbs is up to the manufacturer of the formula. In the US, carbs can come from five main sources: Lactose, Maltodextrin, Glucose, Sugar, or Corn syrup. Not all of these sugars are created equal! 

Glucose and corn syrup are the sugar source in over half of the formulas produced in the USA. WHY? Because they’re widely available and very cheap to produce. The problem with corn syrup (and all glucose/sugar in general) is that it’s a fast-acting carbohydrate. This means that it’s high on the glycemic index, and quickly increases blood sugar. The EU has some limits and guidance on how much corn syrup can be used, and bans the use of corn syrup solids in organic baby formula, but the US does not. Which means that infant formula in the US can contain 100% of its carb source from corn syrup! Now before you get all fired up, corn syrup is NOT the same as high fructose corn syrup, which is what we are told as adults we need to stay away from. High-fructose corn syrup is corn syrup that has been further treated with enzymes to break down some of the glucose into another common sugar, fructose to make foods taste sweeter. Infant formulas are nutritionally complete and need a source of carbohydrate to provide energy. 

Maltodextrin is a type of sugar that is made up of glucose. Maltodextrin will become syrup if it is broken down further, so it’s essentially the same thing as added sugar.

Glucose syrup is the same thing as corn syrup! It just means that the syrup was extracted from a different plant – but it’s still the same as sugar.Sucrose is table sugar, and has a lower glycemic index than glucose, but higher than lactose.

Corn syrup, sucrose, maltodextrin are most used in “sensitive” formulas. That’s due to the fact that these formulas are designed for babies who are lactose intolerant, and so formula manufacturers are trying to replace lactose with an alternative carbohydrate.

Sometimes some corn syrup or glucose syrup is necessary in hypoallergenic formulas, because those formulas use hydrolyzed milk proteins, which are essentially partially digested milk proteins – and they taste/smell bad! So the corn syrup is used to try to mask the taste of the hydrolyzed milk protein.

But there are hypoallergenic formulas that do not overuse glucose and use healthier forms of carbs. 

There are a few reasons why formula manufacturers choose corn syrup over lactose in baby formula:

  • It’s a carbohydrate that babies can digest
  • It’s cheap to produce
  • Some sugars like maltodextrin also provide the function of thickening and emulsifying the formula for a better “mouth feel”
  • Corn syrup is sweet! And babies like sweet things – which might make formula more palatable to babies.
  • In hypoallergenic formulas, corn syrup might be used to make the formula taste better and mask the hydrolyzed milk protein taste.

So to recap, when choosing a baby formula, lactose is the preferred sugar or carb source for human babies. Prior to switching to a lactose free version, which will have the sugar source coming from another carb product, we should be switching to a formula with lactose with a different protein source.

My baby is refusing the breast: breastfeeding aversion

Aversion to feeding means screaming or crying when offered the breast or bottle, refusing to eat, or needing to be fed while moving or while drowsy/asleep. This is not a temporary nursing strike where baby refuses the breast/bottle for a few days because of periods returning, mom going back to work, teething, or illness, etc. The behaviors seen in baby are much more extreme for a true aversion. Most common causes: 

👅Tongue tie: One of my biggest red flags for tongue tie is reflux and shutting down during breastfeeding (sleepy on the breast, popping on and off, refusing the breast and preferring the bottle but then shutting down on the bottle). Some babies with tongue or lip tie do fine for the first few months by compensating on a full milk supply. The aversion comes around 3-4 months when supply regulates. Address the ties and do oral motor exercises to strengthen the system and the refusal can go away. 

🥛Intolerances/Allergy: This looks similar to reflux, but often with bowel issues as well (constipation, diarrhea, or mucousy/foamy poops). Babies who’s digestive tracts are uncomfortable don’t want to eat. They learn quickly to associate feeding with pain, so they shut down on feeding.

🤮Reflux: Easiest culprit to blame and mask with medication. The medication may mask the pain but won’t actually take the reflux away. Reflux is usually caused by food allergy/intolerance, gut issues, or tongue tie. Address the issue, resolve the reflux. 

🥵Silent aspiration: Milk going into the lungs instead of to the stomach.

🤯Behavioral: The number one concern of parents is feeding the baby. When feeding isn’t going well, it causes extreme stress, which can causes parents to do extreme things to try to fix the problem. It’s easy to spiral out when you’ve tried everything and it’s not working out of stress and desperation. Occasionally the reason for the refusal is no longer there, but it was so stressful in the moment, the panic that it could happen again sets in and perpetuates the problem. Some times the root issue is still there, but you’ve compensated and it’s causing a behavioral manifestation in both you and the baby. 

I don’t like breastfeeding, it makes me feel sad or angry.

Ready to find out more?

You’re not alone if you’re experiencing some kind of breastfeeding aversion. Click here to learn more.

Breastfeeding is not all snuggles and cuddles. Some may actually experience an aversion to the act of breastfeeding. There are 3 types of aversions:

Sensory Aversion

Breastfeeding is a complex sensory experience full of touch, sound, smell, and movement. This is an aversion to the actual act of breastfeeding. While the baby is latched, mothers experience creepy crawling or tingling sensations in various parts of the body (especially legs), feeling overwhelmed, have an intense desire to unlatch, itching accompanied by intrusive thoughts. As soon as baby unlatches the sensations go away, but often leave a feeling of guilt or sadness for having felt that way. Some of those who identify as neurodiverse or who have ADHD may have higher sensitivities and become more easily overstimulated or overwhelmed by the process of breastfeeding than others. While other people may actually find that it calms and relaxes their sensory system.

Dysphoric Milk Ejection Reflex (DMER)

This only occurs during the actual let down and is a physiological response to the release of the hormone oxytocin. An intense, transient dysphoria results in feelings of dread, anxiety, sadness or irritability, felt for 30 seconds to 2 minutes while the hormone is released. the rest of the breastfeeding or pumping session is totally fine. 

Breastfeeding Aversion and Agitation (BAA)

In further contrast to D-MER, this aversion occurs unexpectedly for some who have previously breastfed for some time. It varies in onset, severity and duration. Those who experience this describe it as involuntary, overwhelming sensation of aversion in response to the act of breastfeeding or pumping lasting the majority of feeding, not just during let down. They experience negative emotions including anger, rage, agitation and irritability. There is a strong urge to run away due to feeling trapped by feeding. (Yate, 2017).

While most people who have BAA describe the feelings and thoughts in a similar way, BAA happens in varying degrees and durations and the onset and severity are unpredictable. This is different then D-MER where the feelings are only during let down. And the feelings during BAA are different than D-MER: anger and agitation are not the same as dread, despair or sadness.

We don’t know what causes it. Hormones, lack of sleep, unrealistic expectations and not enough self care may play a role? There is not enough research on BAA to know how many breastfeeding people it affects, why it happens, and what can be done to treat it. But if you experience this, you are not alone.  Distraction for the breast feeder, taking certain supplements, and peer-to-peer support may help. www.breastfeedingaversion.com

Up to 85 percent of us will experience the some severity of the baby blues.  It is normal to not be happy all the time, especially when transitioning to such a drastic life stage where a tiny human is completely dependent on you for all cares on top of a lack of sleep. You may feel happy one minute and overwhelmed and crying the next. If symptoms are severe or last for more than two weeks, a new mom should be concerned about a postpartum mood disorder, such as postpartum depression. Women who had anxiety or depression before giving birth are at higher risk. The signs and symptoms of postpartum depression include:

* Anxiety

* Sadness

* Anger and irritability

* Difficulty sleeping

* Intrusive thoughts (which may include thoughts of harming the baby)

Next steps:

💡 Know that what you’re experiencing is real and not just made up. You’re not alone in your aversion and there is support!

🍎 Nutrition and hydration are critically. Breastmilk is high in water, which is taken from your blood. Staying well hydrated is essential for not only making milk but also reducing feeling of depletion and aversion while feeding. Drink a glass of water 10-15 minutes before breastfeeding/pumping.

Be mindful of any nutritional deficits you may have, as this can make symptoms worse. Having lab work to determine if there are iron, vitamin d or b deficiencies can help. Many find taking A magnesium supplement may also reduce symptoms. Magnesium glycerinate is the preferred type of magnesium. Magnesium citrate is more common for constipation.

🛌 Sleep is the hardest to get,  but many find their aversion is worse without good sleep. Take any opportunity for a quick snooze

📺 Distract yourself. Watching Tv, using noise reducing or Loop headphones, listening to music or talking on the phone works because your brain can't process both the activity and attending to the emotions/thoughts

🧬Hormonal shifts caused by pregnancy, bf, and periods can throw even the most mindful person off. A blood test can check for abnormal hormone levels of LH, FSH, prolactin, estrogen, and progesterone. Diet changes, specific supplements, or medications can help under the guidance of a trained health care professional.

🛑 Time to wean. It’s absolutely OK to stop if you’re experiencing aversions. As long as you’ve reached your goals and are feeling well supported in your journey

Why does my newborn feel like they’re biting me?

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When a baby latches to the breast, the baby needs to cup the tongue around the niple, keep the tongue out over the gum line, and shape/form the nipple in the mouth while using the lips to seal the cavity to prevent milk from spilling out. This whole progress creates negative pressure, or a vacuum, in the mouth. The tongue then pumps to compress the breast to remove milk. In reality it’s quite the complicated process!

It’s the up and down pump action of the middle of the tongue that is essential for creating a vacuum (negative pressure) inside the mouth for baby to efficiently move milk from the breast. Babies need to be able to protrude the tongue out past the lower gum line AND MAINTAIN IT protruded for the duration of the feeding.

Many parents who have a tongue tied baby will describe breastfeeding with words like “pinch, chomp, bite, and gum”. OUCH. That is because a tongue without full range of motion can’t do these two actions: up and down and SUSTAINED out. If a health care provider told you your baby doesn’t have a tongue tie because baby could stick their tongue out, that single action is not enough. A full assessment makes sure the tongue can stay protruded to cup the nipple and not flick back after every few sucks. This flicking back is what causes the “chomp” or “gumming” sensation. If the middle of the tongue is restricted, that is where baby cannot generate and maintain the negative pressure in the mouth to be efficient at expressing milk. That is why many of those babies fatigue and are sleepy at the breast, feed for a really long time and then are still hungry. They often doing better on a bottle where they only have to compress the nipple to get milk (you don’t need the vacuum seal in the mouth on the bottle to still express milk and when you can’t maintain the seal that’s where the milk leaks out of the mouth).

Think your baby has a tie but you’re not sure what to do next? Consider taking my Tied & Untied class. Click here to enroll

Need some exercises NOW to help your baby’s tongue? Hop over to my YouTube channel for many videos on helping your baby learn to use their tongue. This VIDEO helps baby’s tongue move in all the right directions and can help get your baby ready for a tongue tie release.

Ready to find out more?

There are many informational videos on my YouTube channel to help on the next stage of your journey.

My postpartum breasts don’t feel as full, am I losing my breast milk supply?

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Breasts are made of a network of ducts, covered by a layer of fatty tissue. During pregnancy, estrogen and progesterone enlarge the milk ducts and multiply the glandular tissue that produces milk. After birth, estrogen and progesterone drop and prolactin and oxytocin rise. Prolactin makes milk production and oxytocin releases it into the ducts. Extra blood and fluid fill the breast just after birth to supoort your body adding hormone receptors in the breast to make milk. The blood and fluid surrounds the ducts and this extra pressure is what makes your breasts feel full between feeding. This blood and fluid reabsorb around 6-8 weeks once supply is established and you won’t feel that full/soft feeling except when you go a really long time between feeding or pumping. Breasts go back to prepregnancy size when supply regulates around 11-14 weeks but continue to make milk. When you wean from breastfeeding, it can take several months for prolactin levels to return to baseline (which is why you may still see milk for months after weaning). Once you stop breastfeeding, the milk making structures actually self-destruct – a process that involves massive cellular suicide, and the removal of the debris. Around 6 months after weaning, the milk-producing tissue is replaced with fatty tissue. If you return to your pre-pregnancy weight, your breasts most likely will return to the same size. They may not be as “perky” because the skin is a bit more stretched and the connective and fatty tissues in the breasts often shifts during pregnancy and breastfeeding. While they may look smaller after weaning most of us can expect that our breasts will return to a similar size as they were pre-pregnancy. They’re just a little more lived in and well loved.

 

There are two types of engorgement during breastfeeding.
🌞Primary engorgement occurs in the first week after birth. Hormones shift from pregnancy driven to breastfeeding driven.
🔆Breasts may feel lumpy/bumpy or hard as rocks.
🔆They may feel hot to the touch and you’ll often see visible veins on the surface of the skin.
🔆They can increase up to two cup sizes (or more!!).
🔆Breastfeeding or pumping makes the breasts soften.
🔆This marks the transition from colostrum to mature milk and typically lasts 12-48 hours if baby is frequently, efficiently breastfeeding
🔆Heat, massage, hot showers, hand expression and frequent, efficient feeding are the best to help with this transition
⏰Once your milk supply starts to regulate, around 6-8 weeks, you’ll no longer feel as full between feedings and the veining and huge breast size will go away. Around 10-12 weeks your breasts will transition back to prepregnancy size and you’ll no longer feel engorged between feedings at all.

🌚Secondary engorgement can happen at any time during your breastfeeding journey but usually when:
🌐Weaning
🌐Poor latch or inefficient feeding
🌐Change in feeding schedule
🌐Mom unable to pump frequently enough while away from baby
🌐Sleeping longer than normal
⏰Cool compresses before to help reduce swelling, hand expression, reverse pressure softening, gentle lymphatic drainage massage, emptying the breasts regularly and temporarily using cabbage leaf compresses can be helpful. If you can reduce the engorgement, schedule an appointment with an IBCLC to help.

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I have a gassy baby. How can I help?

 

Babies are gassy, fussy creatures. Did you know the majority of babies pass gas 13-21 times a day? Did you know most adults fart 5-15 times per day? Come on, admit it. You’ve passed a few SBDs in your day. Our digestive tracts are sensitive and impacted by what and how we eat. Before you reach for the baby gas drops and probiotics or trying major elimination diets, though, try these things first:

⭐️ TUMMY TIME. This puts baby on their belly which helps stimulate healthy movement through the digestive tract. 

⭐️ BABY WEARING. Having baby in an upright position with legs in a froggy position also helps with stimulation of good digestive movement 

⭐️ SMALL FEEDS. Smaller, more frequent meals can be easier for some babies to digest than larger, less frequent meals

⭐️ DEEP LATCH. Make sure to get a deep latch every time. Shallow latches where you can hear clicking or breaking of the suction during swallowing increases air in the gut. If you see a dimple in baby’s cheek that’s an indication of a shallow latch

⭐️ TONGUE TIE REVISION. When a baby can’t move their tongue correctly or fully they swallow more air. Tongue ties are one of the major culprits of gas, reflux and colic. Having the tongue released in many cases reduces babies reflux and gas 

⭐️ BURP BABY. Some times just being patient to burp the baby well can eliminate wind. After all, farts can just be butt burps

⭐️ MASSAGE. Giving baby a nice belly massage can also help soothe and relieve gas. 

How many times a day does your baby fart?

 

For my full YouTube video showing how to help your baby CLICK HERE



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ADHD and Breastfeeding

For me, being a parent with ADHD means being easily over stimulated by all the noise and energy. I get easily touched out where I want littles off my body. I’m easily distracted and will start one task only to find myself immersed in a less important task and never finished the first task. 

 

I have always been able to hyperfocus on tasks. It made me a work horse in my hospital job with the ability to tune out beeping monitors and nurses and patients talking around me. It is exceptionally helpful when writing social media posts and blogs. As a parent, this tendency gets in the way because there are more important things that need to be done but I get stuck in the loop. During hyperfixation I easily lose track of time and sometimes the ability to prioritize other tasks. Snapping out of hyperfixation is difficult and then everything that needed done gets rushed or put off until later. Always later. And some times when I’m hyper-focusing on a task, I won’t hear my kids until they escalate or crying or whining.  

 

Those with ADHD have an additional work load while breastfeeding. Often undiagnosed and misunderstood in women, those who are breastfeeding will experience additional challenges such as:

🤯Sensory overload: being easily touched out during feeding. Finding the noises and energy of the baby to be very draining and tiring. 

⛓Feeling restricted or trapped by feedings

⏱Time blindness: easily losing track of time during and between feedings

🙀Distracted by tasks, difficulty completing tasks, starting one task only to find yourself sucked into a less important task. You go to wash pump parts only to find yourself rearranging the glass cupboard. 

😵‍💫Overwhelming thought, swirling thoughts, easily anxious. This can have many impacts including inhibiting let down when feeding and reducing the ability to sleep when woken during the night for night feedings. 

 

🤱🏽 Breastfeeding was the easiest part of parenting. It was an excuse to sit in one place and have baby quiet for a long period of time. It meant an excuse for ignoring other tasks because I was feeding the baby. 

🥳Starting something and getting distracted, leaving half done tasks. Folding laundry and fixating on rearranging the sock drawer. Going to put the dishes in the dishwasher, setting them by the sink, cleaning the counter instead because there’s crumbs. 

🤫Listening is hard. I want to listen to my husband and kids, but I often find myself thinking about a million other things. Some times to the point of completely blocking out what they’re telling me.

🧐Hyperfocus. I have always been able to hyperfocus on tasks. It made me a work horse in my hospital job with the ability to tune out beeping monitors and nurses and patients talking around me. It is exceptionally helpful when building social media with posts and blogs. As a parent, this tendency gets in the way because there are more important things that need to be done but I get stuck in the loop. During hyperfixation I easily lose track of time and sometimes the ability to prioritize other tasks. Snapping out of hyperfixation is difficult and then everything that needed done gets rushed or put off until later. Always later. And some times when I’m hyper-focusing on a task, I won’t hear my kids until they escalate or crying or whining.  

🤯Overstimulated. Before kids, I didn’t think I was sensitive to noise and energy. I was the extrovert who loved being around people. But kids are a different kind of energy, especially while also working full time. There’s no downtime or escape from the energy and it’s very draining to the point of meltdown. Getting overstimulated and feeling sensory overload is a very common feeling for those with ADHD.

 

When considering ADHD medication use during lactation, while most medications are considered safe for mom and baby, there is no “zero risk” option. However, the benefits of using a medication to help decrease anxiety and increase focus usually outweigh the risks. If you have been on a certain med prior to breastfeeding and it worked well for you, it would be reasonable to resume that medication while breastfeeding.

 

When taking any medication, you want to monitor for side effects both in you and the baby. Most common side effects when taking ADHD meds are:

🥛 Changes in milk supply

🛌 Sedation/sleepiness or agitation/hyperactivity in baby

⚖️Poor feeding or weight gain in baby

 

Stimulants and non-stimulants for ADHD can work well to help you feel balanced again. Work closely with an IBCLC and your primary care physician when resuming or starting a medication to help continue and feel supported in your breastfeeding journey 



Best Bottle for the Breastfed Baby

Don’t fall for the marketing. There are so many bottle systems out there that are marketing themselves as “just like the breast” and even “shaped like the breast”. In truth the ones that look like a boob often function the least like it.  The good news is there are some really good bottles out there that even though they don’t work LIKE the breast, they can PROMOTE a latch similar to it to help baby go back and forth between the two.

There are many bottles marketed as “most like breast.” The bottle part may “look” like a breast, but the nipple typically has a wide neck and and short nipple, which is how some nipples look like at rest before a baby latches. I call these shoulder nipples. The baby tends to latch just to the short nipple in a straw-like latch because they can’t latch deeply to the wide base (breast tissue expands and fills baby’s mouth, but the rigid silicone of the bottle nipple doesn’t). If baby’s lips are super rounded and there’s dimpling in baby’s cheeks while they suck, they are in a shallow latch. They may still pull milk from the bottle, but this shallow latch back at the breast results in painful nipples and leas efficient feeding. 

 

Want to learn more? Take my Latched class to help find the right bottle for your breastfed baby.

CLICK HERE TO ENROLL

 

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Bottle nipples that have a more gradual slope from tip to base and a cylindrical shape are preferred for all babies, whether breastfeeding or not. Why cylindrical? We want your nipple to go in and out of baby’s mouth round. If your nipple is coming out pinched, creases, or flat, we’re talking about improving a shallow latch or releasing a tongue tie. Bottle nipples that are lipstick shaped, flat, creased, or pointed are going to promote incorrect sucking patterns which can transfer back to breast. Now hear me on this: while a round, tapered nipple are optimal, there are times when a different shape nipple is appropriate, especially if they’re the only shape baby will successfully take. We want all babies to have a wide latch to the bottle for more efficient feeding and better use of their facial muscles for skill development. I usually prefer the narrow neck to the wider versions for the majority of babies, as it helps promote better lip flanging, although some babies they will do just fine on the wider version. If your baby is struggling to take a round, tapered nipple, please seek the help of a qualified and specially trained IBCLC lactation consultant, occupational or speech therapist. CLICK HERE TO BOOK WITH ME NOW

 

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When a baby is at the breast, they create a vacuum in their mouth with negative pressure by making a seal with their tongue to the palate. They then use positive pressure by compressing the breast as their tongue moves in a wave like pattern from front to back called peristalsis. Positive and negative pressure are essential for a baby to efficiently feed from the breast. They need to maintain the tongue protruded over the bottom gun line and in that vacuum seal through the duration of the feeding, and the middle of the tongue needs to pump up and down to help compress out milk. This is why babies with tongue ties can struggle to feed both breast and/or bottle. Bottles work totally different than the breast and many only need the compression piece for baby to move milk. Some bottle nipples do a better job of approximating the breastfeeding latch and do require more suction in order to remove the milk. In general, bottles that require a combination of suction and compression to remove milk better promote breast feeding by using a more natural and functional sucking pattern. Those systems that use compression only promote a chomping sucking pattern or the baby squeezes the nipple harder to move milk, which can make it difficult (and painful) when transitioning back to breast.

What nipple “level” should my baby take? Nipple flow levels are not standardized across the bottle industry. Each company has their own set rate and it is completely different from company to company.  A level one will flow simple tell different across every brand of bottle. What is “slow” on one nipple can be very fast compared to “slow” on a different nipple. Britt Pados has done multiple research studies that measure flow rates. Turns out there are some brands “Slow” that are actually faster than other brands “Level 3” . Remember: don’t fall for the marketing. If your baby is coughing, choking, leaking milk or struggling to drinking from a nipple, try going to a slower flow nipple in the same brand and if that doesn’t work, switch brands. Do you ever need to go up a nipple level? No. They are marketing nipple levels by age like Carter’s does with onesies. If it fits, use it. No need to level up if your baby is content. Ever.

From a lactation perspective, we generally want breastfed babies to use a nipple that matches the flow of their mothers milk back at that breast. This is USUALLY the slowest flowing nipple (remember, this will vary from brand to brand). We want them to take a bottle slowly since breastfeeding is usually a slow process, and we want them to actively suck to get milk out. Although for those with a fast let down or over supply of milk, it’s totally fine to use a faster flow nipple that matches the speed at which your baby takes the breast.

 

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Babies are masters at compensating to feed. They learn very quickly what works and what doesn’t to get milk. But sometimes this comes at the cost of them compensating with their muscles which can lead to symptoms like lip blisters, two tone lips, lots of gassiness and reflux. Clicking while swallowing, leaking milk, coughing and eating too fast are all symptoms that something isn’t right: either with the nipple shape, flow level or their latch OR something else may be going on in their mouth like a tongue and lip tie. If baby is doing well with their bottle and you have no concerns, keep doing what you’re doing! No need to start fresh and buy new. Some babies do a really nice job of going back and forth from breast to bottle, despite requiring different mechanics. If you are seeing any red flags and something doesn’t feel right about your baby’s  bottle feeding skills, either breast or bottle, schedule a consultation. There is help and guidance for you to get things back on track.

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