Feeding babies has been my passion since I was ten years old. Almost twenty years ago, I pursued becoming a speech therapist to work with babies in the Neonatal Intensive Care Unit. In working in that setting, I realized I wanted a more intimate approach to working alongside families as they struggled to feed their babies. I became a board certified lactation consultant and have really fallen in love with what I do. There’s nothing better than empowering families to reach their feeding goals, wherever they are in their journey, whether it’s exclusive breastfeeding, combo feeding, pumping or bottle feeding. I offer prenatal breastfeeding classes, virtual, office and home consultations. I can assess for tongue or lip ties, educate on pumps to maximize pumping sessions, transition baby to bottle in preparation for parents going back to work, help increase or decrease milk supply, and assist with all breastfeeding challenges.
Babies are the best pump. They empty the breast better than either hand expression, manual or electric pumps. Even as the most efficient pump, babies never completely empty the breast. Breasts work on what could be called the “80:20 concept.” The 80 percent is the average amount of milk removed by your baby each day. The 20 percent is the residual amount of milk that remains in your breasts. If more than 80 percent of the milk is removed, supply increases to maintain the 80-20 ratio. If less than 80 percent is removed, supply decreases to maintain the 80-20 ratio. Even though this is an over-simplification of a very complex process, as new research emerges this core principle proves true.
Fact of the day: Babies actually control how much milk is in the breast through milk removal. The more that is removed, the more the breast makes. Research shows that the mother’s diet, her fluid intake, and other factors have little influence on milk production. If the “milk removal” piece of the puzzle is in place, mothers make plenty of good milk regardless of dietary practices. If the “milk removal” part isn’t there, nothing else can make up the difference.
These crocheted boobs were made by my coworker for my community breastfeeding classes!!!
Let’s talk honestly about nipples for a minute. Most basic breast-feeding classes talk about anatomy of the breast. They may touch briefly on anatomy of the nipple, but I don’t feel like it’s enough for us to fully understand the amazingness that is our nipples. In the anatomy of women, a nipple, mammary papilla or teat is a small projection of skin containing the outlets for 4-18 lactiferous ducts. The average woman has 9 of these ducts. They come in all shapes and sizes, but the average projection and size of human female nipples is slightly more than 3/8 of an inch (10mm) or the equivalent of about 5 stacked American quarters. Pregnancy and nursing tend to increase nipple size, sometimes permanently. Nipples are made of erection tissue.
They are actually made of the same erection tissue as the penis. It is why when these are stimulated by either a sexual partner or a baby, they perked up or erect. When nipples are stimulated, they send messages to the brain to release oxytocin, the cuddle hormone. This hormone is what makes you to feel all tingly, warm, secure, and in love with your spouse. But oxytocin released during breastfeeding is actually what causes your letdown reflex to happen. It’s basically what causes your milk to flow. As your newborn is stimulating your nipple, it sends a message to the brain “hey there’s a baby here! Send milk!” The brain then releases oxytocin which causes your letdown reflex to happen. It’s while your let down happens usually 1 to 2 minutes after your baby starts suckling at the breast. Erection tissue is never meant to bleed, crack, or scab.
Could you ever picture your husband letting you touch his penis if there was cracking, bleeding, or scabbing? And yet when new moms breast-feed, there is the stereotype that this is just a normal part of the breast-feeding process. Cracked, bleeding, and scabs nipples are caused by an incorrect latch of the baby or some other anatomical or physiological difference, such as a tongue or lip tie or an immature sucking pattern. Nipples were never designed to endure what so many women tolerate as “normal”. If you are experiencing any pain, cracking, or bleeding of your nipples during breast-feeding, please see me or another lactation consultant in your area as soon as possible. Let us help you correct the latch or look for a tongue tie that would be causing those problems. You deserve a pain-free, happy nipple breast-feeding story! Please also help stop the stereotype that it is OK for women to endure this. It is totally OK to experience initial discomfort when breast-feeding. Your nipples are not used to that kind of sensation at that frequency. But pinching or stabbing pain is never normal at any stage of breastfeeding.
I know I’ve mentioned it before, but I never really paid attention to it; the cream really does rise to the top. I know I had a higher fat content in my milk because I get frequent milk blebs. That’s basically where the nipple poor at the tip of the nipple clogs. It can look like a white pimple at the end of the nipple. It is really just congealed milk, like cottage cheese or a milk curd. They are easy to get rid of, but very painful in the moment. I never really realized how high fat my milk was until yesterday. I had several bottles in the fridge that I wanted to combine into one before I left for work. When I went to pour one into the other there was a good 3 or 4 inches of thick cream at the top! When I held the milk up to the light it was very dense and you could hardly see through it. Basically I pumped heavy whipping cream! 😂🍦 I pulled out my other bottles to see varying amounts of cream at the top. No wonder there are times when I don’t pump as much. The high cream milk is very fat and calorie dense. So the next time you get discouraged by only pumping 2 ounces, put your milk in the fridge for a few hours and see how much cream rises to the top. Be encouraged that this is a higher fat and higher calorie milk. And A friendly reminder, don’t vigorously shake the milk to combine it with the watery portion, make sure to swirl it. Shaking milk breaks down the fat protein and actually alters the milk at a molecular level. To make sure you get a more even fat content for your milk throughout the day, you can combine the milky pump in one day into one bottle. That makes a more homogenous mixture of fat and calories that you’re bottle feeding your baby throughout the day. Happy pumping!
The whole top 2 ounces is all heavy fat/creamYou can clearly see the fat/cream band at the top.
This is almost solid cream.This one is also thick cream.Both of these show clear separation of cream and water.
Every day is a new day. I’m really learning to take each day at a time. It’s so easy to compare my story to someone else’s. Especially when it comes to milk volume. I definitely have to work at my supply. Milk tea at night. Oats in the morning. Frequent pumping during the day. Occasionally pumping before bed. And yet my daughter has always had enough. She’s nine months old and eating EVERYTHING in sight. She loves fruits, vegetables, chicken, pork, rice, pasta, yogurt, and cheese. She will eat lemons and pickles and not bat an eye. She’s growing like a weed and constantly needing longer pants. I watch her for how my milk supply is doing and the milk I pump is based on her needs.
I do think it’s important to normalize pumping, though. It is important for women to feel empowered that their body is making good nutrition for their baby. It’s important to know your baby and know if he or she is getting enough milk. In the first two weeks of life, babies should eat 10+ times per day. Babies need to regain their birth weight by 2 weeks of age. This is a really good indication that the baby is getting the calories they need. The average baby gains 1 ounce per day until 3-4 months of life and an average of 1/2 an ounce a day after that. Wet and dirty diapers are also a good indication of milk intake. On day one of life they should make one wet diaper, on day two they should have two wet diapers. On day three they should make three wet diapers. This pattern continues until day 5 when they should start making 6-8 wet diapers a day.
*Addendum; I realized I should note, this is not all the milk my daughter gets in a day. She breastfeeds directly from me when she wakes in the morning, when I get home from work, around bed time, and usually still once or twice at night. This pumped milk is what she takes while I’m gone at work. Sometimes she will take more than what I’ve pumped the day before. My husband will take a packet of frozen milk out of the freezer for her. My daughter still prefers milk straight from the tap. AKA me. She nurses much more vigorously when I’m home. This is her personality and how she prefers to eat.
Your baby’s eating and sleeping patterns may be unique to him. You may pump more during the day if your baby eats more at each setting.
To all you moms out there reading my blog, I hope you have a blessed Mother’s Day. May you find joy in every moment you have with your babies, especially in those quiet moments when you have your sweet little one nestled to your breast. They grow too fast.
In honor of Mother’s Day, here is a tribute to all of the ways we have fondly nicknamed are breasts. No matter what you call them, please make sure to love them. They are the only ones your baby will ever know. Happy feeling! And happy Mother’s Day 💋
This picture kinda reminds me of “the girls”… if you know what I mean…
“I’d like a skinny vanilla latté, extra foam extra whip cream!!” One of the first questions I get from a lot of nursing moms is, “when can I drink coffee again?!?” Some doctors don’t have a problem if moms drink one a ounce cup of coffee throughout the entirety of the pregnancy. Other moms because of risk factors are told not to have any until after the babies born. Whether you have coffee or not during your pregnancy, there are a few things to know before introducing it after your baby is born. The first is that it affects infants differently than adults. The following chart was taken from Kelly mom.com. It shows the half-life of caffeine in the bloodstream. I was surprised that Caffeine will stay in the bloodstream of the brand newborn for an average of up to five days!
Their sensitivity to caffeine decreases as they age. Signs of sensitivity are hyperactivity, difficulty sleeping or sleeping for long periods of time, jitteriness, irritability, and fussiness. If you drink coffee during your pregnancy, you might not see as much of an impact on activity levels in your baby if you continue to drink after birth. However if you have stained from college and your pregnancy, you may notice changes in your baby. Per Medications and Mother’s Milk (Hale 2017, p. 139-140) caffeine is in Lactation Risk Category L2 (safer); milk levels are quite low (0.06-1.5% of maternal dose) and usually peak 1-2 hours after ingestion. The American Academy of Pediatrics has classified caffeine as a “Maternal Medication Usually Compatible with Breastfeeding.” If you’re iron deficient or iron deficiency rubs in your family, be extra careful. One study indicated that chronic coffee drinking might decrease iron content of breastmilk (Nehlig & Debry, 1994). We actually routinely give caffeine directly to premature babies in our neonatal unit for lung stimulation!
Remember caffeine isn’t just in coffee! Tea, soft drinks, sports/energy drinks (including the “sports water” products), some over-the-counter and prescription medications, and foods containing coffee or chocolate can also have caffeine!! I can’t have Haagen Daz coffee ice cream late at night because it keeps me up!!! Herbal products containing guarana/paullinea cupana, kola nut/cola nitida, yerba maté, or green tea also contain caffeine. Each food and liquid has varying amounts of caffeine. Different roasts of coffee and the way that the coffee is made also impacts caffeine level. Make sure to check the caffeine level you’re ingesting by serving size to see how much you’re getting!! According to Breastfeeding Answers Made Simple (Hale Publishing 2010, p. 521), excessive caffeine consumption by the mother (more than 750 mg per day) can result in a baby who shows signs of caffeine stimulation.
I typically recommend no more than one 8-ounce cup of coffee a day for nursing mothers (but as a note!! An 8-ounce Starbucks coffee has 250mg of caffeine while a non-gourmet brewed 8-ounce cup of coffee only has 120-160mg of caffeine!!!!!!) The important thing is to know your body and know your baby. Be informed of what you are putting into your body and what is going into your baby. Watch for how your baby reacts to that 1st cup of coffee and if you need to, cut out coffee for a little while longer or switch to decaf.
I personally have my one cup of Costa Rican drip coffee with almond milk every morning. If I’m really lucky, my husband will make me an Italian latte before I leave for work. I can only have one cup. The few times I’ve had a 2nd cup early afternoon, I am up all night. So far my daughter has never had a reaction to coffee. Although, I drink a cup of coffee through most of my pregnancy with the blessing of my midwife. As with anything you consume, if you have any concerns talk to your primary care physician or your pediatrician. You may still want to avoid the Unicorn Frap…
Everyday is a new day with its own stresses and joys. The more we can take time to enjoy each day, the less we are prone to worry and stress, the better it is for our overall health as well as our milk supply. The past few days I have been working in the neonatal intensive care unit at my hospital. It is my favorite place to work. I love coming alongside mommies and their new babies and helping them feed them in their most critical time. My job on the acute floors can sometimes be stressful. I am helping elderly patients and families make end-of-life decisions. I assess patients feeding skills and decide if the patients can still eat and the options they have for nutrition and hydration. This definitely impacts my milk supply. I always see more of my own milk when working in NICU. Of course when some of those hungry babies cry I can occasionally feel my mommy hormones stimulating my own letdown. Where is your happy place? Have you noticed certain aspects of your environment or work impacting your milk supply? Where do you find your peace when pumping? This really does make a big difference. Happy Pumping!!
I use whatever containers I have clean!! My pumping always decreases as the day goes on.
In a previous blog I talked about my work pumping room. It has two chair separated by two curtains. I would say about 50% of the time I pump alone. It is a great time to FaceTime with my husband and see the baby to help my milk supply or a nice quiet rest to be able to write a blog. The other 50% of the time when I walk in there is the distinctive whirring of another breast pump.
Every pump and every brand has a very distinctive sound. Nine times out of 10 I know exactly who is behind that curtain based on the sound of their pump. Yesterday was no exception. Usually through the course of time and conversation, I get to know the other moms behind the curtain. I’ve pumped with nurses from every floor and unit, chaplains, administrative assistants, and students. We talk about everything related to our babies: their ages, their developmental milestones, and how much they’re sleeping at night. The biggest topic of discussion, though, always is milk supply.
Typically there is only ever one other mom in the pump room. However yesterday at least 4 other mothers tried to come in and pump at the same time. It was like the 405 at 8am! The entering mom’s knew it was me pumping from the quiet drone of my spectra pump. In trying to be effective, twice I left the in coming mother behind the curtain with me so I could clean up while she could set up. Both times we talked milk supply.
There’s such a weird pressure to “perform” in our culture. Even with pumping milk. We are told by “them” how much to feed our babies and if you don’t reach certain milk goals during certain months of development your baby is going to starve and fall off the growth curve. That it the whole point of this blog.
I want to normalize breastfeeding. I want to normalize milk supply and help reduce even a fraction of stress pumping mothers feel. Your baby is unique. Your story is unique. The amount and fat content of your milk is unique and specifically tailored to the individual needs of your baby. Remember breastmilk can vary from 13-35 calories per ounce! One mom I talked to yesterday could pump TWENTY OUNCES in one sitting first thing in the morning. I don’t think I’ve ever pumped more than 18 in a day across four pump sessions!! And yet my daughter is growing and healthy and following her 75 percentile growth curve.
We need to stop letting “them” tell us how much and how often our baby needs milk and listen to our individual babies. Let’s support each other and encourage each other in our unique breastfeeding stories. I hope if you get nothing else out of these blog posts it’s encouragement to keep going, stop worrying, and own your personal breastfeeding story. Happy Pumping!!
My entire day of pumping. Three 20 minute sessions during an 8 hour shift. A little over 9 ounces.
*Addendum; I realized I should note, this is not all the milk my daughter gets in a day. She breastfeeds directly from me when she wakes in the morning, when I get home from work, around bed time, and usually still once or twice at night. This pumped milk is what she takes while I’m gone at work. Sometimes she will take more than what I’ve pumped the day before. My husband will take a packet of frozen milk out of the freezer for her. My daughter still prefers milk straight from the tap. AKA me. She nurses much more vigorously when I’m home. This is her personality and how she prefers to eat.
