Naturally Weaning Breast Milk

Natural weaning is the biological process of gradually decreasing milk supply as baby gets older. This process starts around 7-9 months as baby takes more solid foods and progresses toward sleeping longer stretches at night. It ends when baby finally weans (which may not be until 2-3 years old!!). Natural weaning doesn’t mean that you need to wean baby from the breast. Decreasing milk supply doesn’t mean you’re at risk of losing your supply, either. Your breast is designed to match the stage of development your baby is in.

Milk supply iss highest from month 1-6 when baby is going through multiple growth spurts. They need to double their birth weight by 6 months. Milk is also the only food in their diet. Therefore, your milk supply is supposed to be at its highest to meet their nutritional needs. From 6-12 months, weight gain slows but their need for milk volume needs remain stable. It is natural as baby transitions from a full milk diet to a milk+solids diet to then a solids+milk diet that breast milk supply will shift along with it. Your milk supply varies compared to baby’s solids intake and there is a wide range of normal based on your individual baby. Some babies love solids and eat them in large quantities many times a day. Other babies continue on a mostly milk diet until almost 1 year. At 12 months, milk finally takes a back seat to solids, but still fills in nutritional gaps and acts like medicine against illness. From 12 months on there continues to be a wide range of normal for milk supply depending on your child’s eating and feeding habits. Some babies continue to nurse occasionally over night while others seem to become boob barnacles again and would happily stay on the breast all day, every day.

So what does this mean? If you’re exclusively breastfeeding you may not notice anything. You can continue to bring baby to breast for as long and often as baby wants. You may notice baby spacing out feedings or not nursing as long. They may want the breast more when teething or going through growth spurts or developmental leaps. They have days with little interest in the breast.

Moms who pump (either exclusively or because of work) report overflowing milk in the early weeks, often able to pump 4-6 or even 8-10 ounces in a morning pump session. By 4 months supply regulates and mom gets about 3-5 ounces per pump in place of a feeding. By 9 or 10 months it can feel like your trying to wring out a wet rag to get even 2-4 ounces a pump session. As long as baby has unrestricted access to the breast when your not working and you still have a regular pump routine in place no intervention is usually needed. Every journey is supposed to look different because it is your unique journey.

Mastitis may be caused by your posture

Did you know mastitis may be related to your posture?!?

Fluid dynamics is the science of how fluids are supposed to move in our bodies. All of the fluids in our bodies are supposed to be free-flowing and unobstructed for optimal health. Milk is a fluid that flows through ever narrowing ducts and pores. Lymph is a fluid throughout your body (and breasts) that helps transport waste from cells and tissues in your body to help flush it from your system. It also helps reabsorb milk that doesn’t get emptied to a pump or baby. Anything that increases resistance of the movement of this fluid can increase the likelihood of getting a plugged duct or mastitis in the breast. Increased resistance can be caused by:
⭐️ Breast implants or history of breast surgery causing scar tissue in the breast
⭐️ Sleeping in the same posture especially on your side where you put pressure on the breast for extended periods of time at night
⭐️ Tight fitting clothing or bras that constrict movement of milk and lymph between feedings
⭐️ Shoulder injuries from sports where there is inflammation or scar tissue
⭐️ Neck injuries or issues with neck mobility
Tension in your body
⭐️ Not moving the body enough/sitting for prolonged periods of time in the same position
⭐️ Increased overall inflammation in the body such as from infection or excessive fluids from IVs used during labor and delivery
⭐️ Having very large, heavy breasts which act more like an appendage where milk and fluid can fill the lower quadrant of the breast and have difficulties moving out again

What can you do?
❤️ Shake your breasts!! Get that fluid moving by massaging and shaking the breasts.
❤️ Lean over and dangle your breasts to reduce pressure on them and help them free flow
❤️ Practicing yoga can actually work as well, especially as you do poses like downward dog where you’re changing the orientation of the fluid in your breast related to gravity.
❤️ Avoid restrictive clothing and bras
❤️ Get a massage!! Having hands on the body helps get the fluid inside moving in the right direction
❤️ See my video for lymphatic drainage massage

Sudden drop in milk supply/Baby fussy at the breast

Did you know that many of us will notice a supply drop right before our period is going to start and lasts through the period? This is caused by hormone shifts in your body. During this time, as supply dips, the milk flow slows and the milk can taste saltier than normal. Some babies become frustrated with this change. They may grab the nipple with their mouth and shake their head back and forth. Pop on and off the breast. Knead or beat the breast with their hands or become extra fussy at the breast. They may even cluster feed and act as if they’re still hungry. They’re trying all the strategies to get your milk to flow how they prefer. This is a temporary dip but can be surprising the first time it happens. Remember: this dip can happen once or twice before you actually have a period as your hormones are shifting back into baby making mode. If your baby is older than 6 months and eating lots of solids, you may not notice a difference. The strongest behaviors are seen under 6 months when babies need an exclusive milk diet. You may also notice the dip if you’re a pumper.
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What can you do about it? Knowing it can happen is the first step. Stay well hydrated and eat quality nutrition. Many find adding in a calcium/magnesium supplement (1000mg of calcium/500mg magnesium per day split into 3-4 “doses”) can help combat the drop. Others find adding in lactation specific herbs or supportive foods help. Iron rich foods like dark leafy greens and red meat and milk making foods like oatmeal, almonds and fennel can really help. Keep offering the breast or pumping frequently. It will get better and your supply will come back up as soon as your hormones shift again after your period. It usually only lasts a few days.
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When did your period come back? Did you notice a supply dip?

Sudden drop in milk supply/Baby fussy at the breast

Did you know that many of us will notice a supply drop right before our period is going to start and lasts through the period? This is caused by hormone shifts in your body. During this time, as supply dips, the milk flow slows and the milk can taste saltier than normal. Some babies become frustrated with this change. They may grab the nipple with their mouth and shake their head back and forth. Pop on and off the breast. Knead or beat the breast with their hands or become extra fussy at the breast. They may even cluster feed and act as if they’re still hungry. They’re trying all the strategies to get your milk to flow how they prefer. This is a temporary dip but can be surprising the first time it happens. Remember: this dip can happen once or twice before you actually have a period as your hormones are shifting back into baby making mode. If your baby is older than 6 months and eating lots of solids, you may not notice a difference. The strongest behaviors are seen under 6 months when babies need an exclusive milk diet. You may also notice the dip if you’re a pumper.
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What can you do about it? Knowing it can happen is the first step. Stay well hydrated and eat quality nutrition. Many find adding in a calcium/magnesium supplement (1000mg of calcium/500mg magnesium per day split into 3-4 “doses”) can help combat the drop. Others find adding in lactation specific herbs or supportive foods help. Iron rich foods like dark leafy greens and red meat and milk making foods like oatmeal, almonds and fennel can really help. Keep offering the breast or pumping frequently. It will get better and your supply will come back up as soon as your hormones shift again after your period. It usually only lasts a few days.
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When did your period come back? Did you notice a supply dip?

Nipple vasospasm: That tingling isn’t thrush

Has your nipple looked waxy or dull white after feeding or pumping? That’s because the blood vessels have gone into spasm and are not letting blood through. Vasospasm occurs when there is exposure to cold, an abrupt temperature drop, vibration, or repetitive motion in the affected area. The arteries go into spasm and stop letting blood through. There is a disorder called Reynauds that make peoples experience this in their fingers and toes on a more routine basis. When it happens in the nipple it really HURTS. Some say it feels like fire or ice. Others describe it as a pinchy, slicing feeling, or pins and needles. The nipple often turns pale and become painful right after the baby unlatches. It often gets misdiagnosed as thrush but will not respond to medications. So if you’ve been on multiple rounds of medications for thrush and it’s not working, you may actually be having vasospasm.

It can simply be caused by a bad latch, but can have several other culprits. For people prone to vasospasm, the repetitive action of feeding or pumping in combination with the abrupt drop in temperature when baby unlatches or the pump stops is enough to trigger the spasm.

The two main ways to help: massage and heat.

🤲🏼Gently massaging, rubbing, or pinching the nipple helps. Immediately cover your nipples with your shirt/bra/nursing pad, then gently rub or massage them through the fabric.

🌞Heat is important because of science: evaporation is a cooling process. When liquid turns to gas, it uses heat energy from its surroundings to transition. When milk and saliva evaporate off your nipple, the skin and surface tissue cool rapidly, causing the vasospasm.

🌞To slow evaporation, place heat on your nipple as soon as baby unlatches. Use dry heat like a lavender pillow, microwaveable rice/barley/flax pack, hand warmer/Hot Hands (like you use in snowy climates for skiing), or a heating pad can help. Leave heat on for a few minutes until the pain subsides.
🌚Avoid anything wet on the nipple as this promotes evaporation.
🌝Wear wool nursing pads between feedings

VASOSPASM TREATMENT.
Unfortunately, there isn’t a lot of good quality research about treating breastfeeding nipple vasospasm no. Much of what we know is taken from other vasospasm research, or applied from anecdotal evidence. You should always consult your primary health care provider before making any changes to your health, such as adding a supplement, taking medications, or making big lifestyle changes. At a basic level:
🌻Watch for a deep latch every time
🌻Have baby assessed for tongue tie
🌻Check your flange size. If you’re maxing our the suction on the pump, your flange is too big. When too much areola is drawn into the tunnel, the areola swells shut around the nipple and causes the spasm. Using too small a flange does the same: cuts off blood flow to the nipple tip.

Other tips to reducing vasospasm:
🌸Avoid nicotine and medications that cause vasoconstriction (such as pseudoephedrine, beta blockers).
🌸Limit or avoid caffeine
🌸Some research indicates hormonal birth control pills increase the risk of vasospasm.
🌸The main supplement that seems to help with vasospasm is vitamin B6. Dr Jack Newman suggests 100 mg of B6 twice day, as part of a B vitamin complex. If your B vitamin contains 50 mg of B6, you’d take two of them, twice a day. If it contains 25 mg of B6, you’d take four of them twice a day.
🌸Calcium plays an important role in blood vessel dilation. Magnesium helps in calcium regulation. Supplementing with cal/mag often helps with vasospasm.
🌸Being active helps prevent their vasospasm. An active lifestyle can keeps blood circulating through your body.
🌸The internet is full of conflicting opinions on if ibuprofen is a vasoconstrictor or vasodilator. Regardless, it sometimes turns up to treat/prevent vasospasm. If you have regular vasospasm, the risks of longterm ibuprofen use most likely outweigh the potential decrease in vasospasm. It may be OK for occasional vasospasm. Discuss regular ibuprofen use with a healthcare provider.
🌸For chronic, painful vasospasm that does not respond to breast-feeding help, some doctors may prescribe a short course of a blood medication called Nifedipine.

Cautions of the Haakaa and other similar silicone breast “pumps”

The Haakaa and similar manual pumps are extremely popular. I used one for the first few months after Peach was born. They typically suction on the opposite breast while feeding to collect “leaking” milk. It’s not an actual pump, but it does create a vacuum that removes milk from the breast. Like any product, it can be a wonderful tool or inadvertently cause problems.

⭐️Caution: milk collected in a tool like this tends to be “drip milk”, meaning high water content and low fat. It can be good to relieve engorgment or pull off milk if baby is sleeping longer, but you’ll want to mix it with other pumped milk to ensure a good fat content.
🌀Use hand compression while it collects or hand express after to help pull fat into that milk.

⭐️Caution: more so than breast shells or milk collectors that passively sit in the bra, the suction adds extra stimulation and can increase milk supply, to the point of an oversupply. The extra milk pulled off during feeding tells the body that baby is REALLY hungry and eating all the milk that is actually feeding the freezer. The body makes more and more milk. This can result in an overactive let down which causes baby to cough, choke, and pull off the breast while you spray milk in their face.

⭐️For some the focus shifts from what the baby is doing to what the other breast is/isn’t doing. Instead of enjoying baby, you’re obsessed with the silicone bobble dangling from your boob. And an active baby may kick it off and make a mess.

⭐️Those who don’t drip a lot it may wrongly believe there is something wrong with milk supply and have unnecessary concern. This is especially true if you were used to high yield in the first weeks after birth and once your supply regulates you only see drops collected. Many panic at this drop when that’s actually normal.
🌀Accounting for every drop may make you feel like you’re failing at feeding. Even if baby is getting plenty of milk and feeding fine.

⭐️For those with a true low supply, the Haakaa may be taking milk from the other breast that baby actually needs to grow. Sometimes baby needs that milk and not the freezer.

On the flip side, the Haakaa and other silicone pumps can be a wonderful tool. They can be a huge relief to reduce engorgment. Did you know you can suction two of them on while you’re in the shower to reduce engorgment and help keep milk moving? Or collect last minute milk before you leave for work? I’ve found they help pull out colostrum while baby is feeding better than an electric pump. they’re super handy for getting rid of a plugged duct or nipple blebs. For someone with a low milk supply, this tool could be the difference between supplementing your own milk vs formula. It can mean freedom from an electric pump while creating a stash for going back to work. Some see this as their way of giving back through milk donation. It is a fabulous tool to use for hand expression. It’s just the right shape and size for hand expressing milk when you don’t have an electric pump or don’t want to drag a pump with you. It’s easy for traveling, with no extra parts to lose or clean.

Understanding the tool is the most important thing. If you have an overactive let down and choking baby, consider reducing your Haakaa use. If you’re struggling with an oversupply, know that the Haakaa may be your problem. If you’re 4-6 months into your journey you may not collect as much as you used to when baby was 2 or 3 months old.

How do babies suck at the breast?

Breastfeeding babies tend to move through 3 sucking stages:

• Stimulation: A quick, light suck often done at the beginning of a feeding to stimulate a let down. The tongue cups the breast and baby’s lower jaw moves up and down while the tongue moves quickly. Breastfeeding hormones are released when nerves close to the nipple are triggered, and milk will usually begin to flow within 1-2 minutes. This may be mimicked by the “massage” or “stimulation” mode on your pump.

• Active feeding. Once the milk lets down (milk ejection reflex), baby should swallow every 1-3 sucks. This is active feeding. The lower jaw moves up and down rhythmically and drops just a little lower when the swallow actually happens. You might hear the swallow sound like a “puh” or “kuh”. Baby may take occasional breaks during active feeding to catch their breath. This is the “expression” or slower mode on the pump

• Flutter sucking. Towards the end of the feed, sucking slows down, jaw movements get less pronounced, there are fewer swallows, and baby may fall asleep or unlatch. Some call the fluttery sucking movements at the end of the feed “flutter sucking”. It’s a form of comfort nursing to help baby transition to sleep. Minimal milk is being transferred at this time and it’s ok to unlatch your baby is you are no longer hearing baby swallow.

Babies may alternate between these sucking phases several times during a single feeding. By changing the settings in your pump several times during a feeding session, you can get the pump to mimic how a baby would feel at the breast, triggering your body to let down and make more milk for the pump. If newborn baby is always using a stimualtion or flutter suck and you’re not hearing many swallows, work with an IBCLC to help figure out why and get baby feeding efficiently at the breast.

What bra should I buy for breastfeeding?

Pregnancy affects levels of estrogen and progesterone in your body. These hormones get the breasts ready for lactation and are responsible the breast changes you may experience. Estrogen stimulates growth of the breast duct cells and generates the secretion of prolactin, the milk making hormone. Prolactin stimulates breast enlargement and milk production. Progesterone supports the formation and growth of milk-producing cells within the glands of the breasts. In the 2nd trimester, estrogen levels continue to rise. Milk ducts continue to develop, making the breasts feel heavy or full. Some need to purchase a larger bra at this time as you can increase one cup size or several. A few days after birth when milk transitions from colostrum to mature milk, breasts can engorge and grow even more. For several weeks, breasts will feel full between feedings and soft after feeding. Eventually they will feel soft all the time and start to shrink back to pre-pregnancy size. Some breasts will stay large and some will shrink back significantly. Sometimes one can reduce in size and the other stay large.

I usually recommend not purchasing a bunch of bras while pregnant. You don’t know what size you’ll end up being and may waste money on expensive bras you won’t wear. Bralettes, nursing tanks with built in shelf bras, or soft wireless bras that have a lot of stretch can be helpful while your body is constantly changing. Once you’re several months into nursing, breasts may stabilize in size until you completely wean. Now it’s time to be re-measured for the support your girls deserve.

Breast milk storage

The composition and nutrients in your milk can be influenced by how you store and reheat your milk. Any containers that contact your milk should be clean and sterile. Avoid cross contamination with other foods when storing your milk in the fridge. It is acceptable to store breast milk for up to 4 days in the fridge (preferably the back, not the door, to prevent warming from the door opening). If you are going to freeze your milk try to freeze it within 24 hours of pumping it as the beneficial enzymes begin to change at approximately 25 hours. This doesn’t have to be a determining factor in the how quickly you freeze your refrigerated milk, but it’s worth it to store as soon as possible. If not used within 4 days, fresh breast milk should be transferred to the freezer in a clean, freezer-safe container and dated with the original pump time. It is acceptable to store breast milk in a freezer with an attached refrigerator for up to 6 months and in a deep freezer for up to 9-12 months, but the sooner it’s used the better. Nutrients in frozen breast milk are mostly preserved for 1 month, but after 3 months in the freezer, there is a noteworthy decline in concentrations of fats, calories and other macronutrients. Freezing kills some of the live antibodies found in your milk, so rather than freezing all of your pumped milk, feed as much fresh or refrigerated milk as possible.

• Breast milk stored in the refrigerator maintains most if it’s immune properties with break down starting after 25 hours.

• Heating breast milk at high temperatures (especially in the microwave—which is not recommended), can destroy the antibodies and other immune factors in your breast milk.

• Frozen breast milk loses some of its healthy immune factors, but not all.

The goal of breastfeeding

The goal is not to put gas in a tank to see how far it can go between top ups. It’s to teach a tiny human to listen to their body and it’s needs from an early age to help them grow and develop.

This is FEEDING. How you feed is different than how I feed. How your family feeds is unique and not how my family feeds. From what we eat, to how often we eat, to when we eat it’s such an individual process!! Some adults are grazers. They like to snack on small meals all day. They sip water throughout the day and always have a water bottle handy. Some babies are like this, too. Some adults are bingers. They eat really big meals less often. They only drink water in big glasses around meal times. Some babies are like this, too. And there’s everything in between. The goal is not to reach some magic number of ounces in a limited number of feedings because an internet blog said baby needed x number or ounces in 4 feedings a day. That can cause undo stress. The goal is to learn your unique baby’s feeding habits and help them foster those habits within your family context as they grow and develop into a bigger and bigger human.