Humans by design are predisposed to be lactose intolerant. The only reasons Westerners (mostly) lost this intolerance was due to centuries of eating cheese and having their bodies evolve to adapt to consuming it. Lactose is the number one sugar in breast milk. It’s broken down by an enzyme called lactase which is supposed to disappear in early childhood, right around the time we would naturally wean. Asian cultures are predominantly lactose intolerant because their cultures have had cuisine sans cheese and cow’s milk for millennia (think traditional Japanese, Chinese, and Korean dishes. No cheese. No cow’s milk.) Yet in Western cultures it’s occasionally encouraged to drink milk to make milk. There is no scientific evidence to back this up. You do not need to drink cow’s milk or eat dairy in large quantities to make breast milk. You do need to stay hydrated, eat quality foods, and routinely empty the breast.
Whats that smell?
SWEATY AND STICKY
Do you feel hot, sticky, sweaty, sopping wet and a little stinky? Welcome to motherhood. It does get better. There is an actual biological point to leaking from every pore and that weird stench that accompanies it.
Not all of our senses are developed at birth. It would overwhelm our littles too much to go from a dark, wet environment to such a bright, crazy world to actually have every sense developed like ours. Their vision isn’t great and they have no depth perception. But they have a fully developed sense of smell. They have been getting to know your odors since their womb days. Your amniotic fluid was constantly changing in its scent based on what you ate and drank and your unique hormone combination. All that leaking you’re doing postpartum has a similar scent which serves to orient your baby back to you. Your body odors are familiar to your baby and it makes them feel safe and secure that they are with their birth person and not someone else. Your leaking smells also stimulate their hunger, which is why baby may constantly root when on your body even if they aren’t hungry. Did you know that the breast secretes an oil from those little bumps on your areolas that smells just like amniotic fluid? This helps baby locate dinner when they are ready to eat. Showering is normal, but avoiding the use of scented products can actually be very helpful and calming for your baby. While you may find your body odor unbecoming, know that to your baby it makes you feel like home.
Caffeine and Breast Milk
Caffeine is safe to take while breastfeeding in moderation (up to 300mg per day). Only about 1.5% actually enters breast milk. Caffeine enters your bloodstream about 15 minutes. It peaks in your blood within 60 minutes and has a half-life of 3-5 hours. The half-life is the time it takes for your body to eliminate half of the drug. The remaining caffeine can stay in your body for a long time. The half-life of caffeine is about 97.5 hours in a newborn, 14 hours in a 3-5 month old baby and 3-5 hours in a baby older than 6 months. Because caffeine takes much longer to clear out of a young baby’s system it is possible that high caffeine intake can make a baby irritable. If baby is sensitive to the caffeine now, they may not be when they’re older. Cut caffeine now and try again in a few months.
So if you drink a cup of coffee with 100mg of caffeine at 7am, you’ll have 50mg of caffeine in your bloodstream at 10am. Your baby would get 1.5mg of caffeine.
Every baby is different in how they react to caffeine. If you drank coffee while pregnant, your baby had an IV of caffeine (called the umbilical cord) and is already used to having it in their blood stream. If you didn’t drink coffee or switched to decaf, your baby may have a more noticeable reaction when you drink coffee. When drinking coffee after birth, go low and slow. There’s nothing you can do to decrease caffeine in your system except time. Start with a very small cup first thing in the morning and see how your baby reacts. Drinking your morning cup of coffee while your breastfeeding gives you the most time for the caffeine to peak and start decreasing before your next feeding.
Nipple Damage: Now What?
It’s normal to experience nipple tenderness for the first few days after delivery. Tenderness peaks between the 3-6th days postpartum and then should resolves by the end of the second week. Any damage to the skin of the breast or nipple should be taken care of immediately to avoid further damage or infection.
Painful breastfeeding is not normal. The first step to decreasing pain while breastfeeding is to identify what’s causing it. Usually the simplest way to reduce nipple pain is to make sure baby is in the right position. Baby’s tummy should be touching mom’s body, with the belly button touching. Baby’s arms hug the breast and their face comes straight to the nipple. Baby’s Head should be straight, with their ear, shoulder and hip making a straight line. Their head should be slightly extended backward to allow the nose to pop up off the breast. Pulling baby in closer through the shoulders usually helps get a deeper latch. If nursing is still painful, even with careful attention to latch and positioning, there may be other things at play. Usually there is a tongue/lip tie, tension in baby’s body like from a long labor and delivery (greater than 24 hour labor and/or more than 4 hours of pushing), or tension on baby’s body from intrauterine position (sitting really low for a large portion of pregnancy or being breech). Having the tongue tie released and/or doing tummy time and bodywork on baby should resolve the pain. If you’re working on release and baby’s body, consider the temporary use of a nipple shield to protect nipples, until damage is resolved and the underlying cause of the damage is managed.
When your nipples are already damaged:
Step one: Wash and Rinse Damaged nipples are prone to bacterial infection. Washing and rinsing damaged nipples can help prevent this type of infection. When bacteria grows in a wound, they create a bio-film that lengthens healing time. Baby’s saliva also fosters this bio-film. Washing cracked or fissured nipples gently twice a day with a gentle, fragrance free soap (not an antibacterial soap) and rinsing them with water can help remove the bacterial bio-film and allow faster nipple healing. Stop washing with soap once the nipples are healed. After every feed, rinse nipples with either clean water or a saline rinse. You can make your own saline rinse by mixing ¼ rounded teaspoon of sea salt with 8 ounces of warm water. Soak your nipples in this solution for 30-60 seconds. Soaking for longer may actually over hydrate your skin and increase cracking.
Step Two: Moist Wound Healing after washing and rinsing and/or soaking your nipples, dry and apply your antimicrobial ointment of choice. This could be virgin coconut oil, Dr Jack Newman’s All Purpose Nipple Ointment, or medihoney. There are other nipple balms and butters on the market. Make sure the one you’re using is antimicrobial. While you may think airing the nipple out will help scab the nipple over, Keeping cracks covered with some type of ointment promotes moist wound healing which is better for the sensitive nipple tissue which is a different kind of tissue than the rest of your skin. A non-stick wound pad, reusable breast pad, or a cooling breastfeeding gel may be placed over the ointment to keep your nipples from sticking to your bra or clothing. Ointment should be applied like chapstick, in a thin layer. Gently wipe off any leftover ointment before baby feeds. Disposable nursing pads should be avoided as these do not allow for good air flow and the quick wicking material tends to stick to nipples. Wool breast pads are preferable for their antibacterial and air flow properties.
Monitor for Infection Contact your primary caregiver physician and an IBCLC lactation consultant if you have any signs of infection like increasing redness, fever, or pus. If you have a fever of 100 degrees or greater for 24 hours, or bacterial infection which will require oral antibiotics. Research suggests that taking probiotics containing lactobacillus fermentum and lactobacillus salivarius can also help treat bacterial infections of the breast.
My baby mouth breathes: when should I be worried?
Babies are obligatory nose breathers. They should be breathing through their nose all the time. This is how they can have their mouth full with a nipple during breast or bottle feeding and still breathe. Mouth breathing isn’t as efficient as nose breathing — especially when it comes to oxygen absorption in the lungs. And breathing through the nose helps to filter out bacteria and irritants from entering the body. Babies should be breathing through their nose all the time, especially during sleep. And snoring with mouth breathing is NEVER normal.
Mouth breathing as an infant can indicate several things:
🤢Nasal congestion from an illness or allergies
😛Tongue tie
👀Large tonsils/adenoids
👃🏽Deviated nasal septum
🧠Learned habit
Prolonged mouth breathing can cause:
• Atypical development of the mouth, nasal passages and face
• Poor quality sleep
• ADHD
• Increased risk of asthma
• Swollen tonsils
• Dry cough
• Inflamed tongue
• Teeth issues, like cavities and bad alignment
• Foul-smelling breath
If you notice baby mouth breathing regularly (other than when sick), please make an appointment with a health care provider to help figure out the root cause.
• Stay away from your baby’s known allergens
• Gently push the chin upward to close baby’s mouth when sleeping
• Consult with a doctor as soon as you notice baby breathing through their mouth consistently
• Put a humidifier in their room to prevent their mouth from drying out
• Have tongue tie revised and work on suck training exercises, tongue posture, and body work for proper body posture to correct habits baby made from compensating for the tie
Peppermint and Breast Milk
Good bye pumpkin, hello peppermint. Tis the season for peppermint bark, candy canes, peppermint lattes, and holiday cookies with crushed red and white striped mints. While you may binge on all things peppermint this December, be warned: it may drop your milk supply.
Peppermint is a soothing herb best known for treating stomach and digestive problems. Popular products like toothpaste, chewing gum and tea are often flavored with peppermint. The calming and numbing effect of peppermint treats headaches, menstrual cramps, diarrhea, anxiety, nausea, and skin irritation. Peppermint oil has even been used to treat cracked nipples!! It is also used as an active ingredient in vaporizers and chest rubs. Menthol and methyl salicylate, the active ingredient of peppermint, possess antibacterial, antifungal, and antiviral properties.
It’s been commonly reported that peppermint and spearmint decrease milk supply, especially when taken in large amounts such as during the holidays. Drinking an occasional peppermint latte shouldn’t be a problem. But if you start to notice your supply taking a dip this holiday season, check your peppermint intake.
Paced bottle feeding
Paced bottle feeding (meaning you’re setting the pace for how fast/slow baby drinks) helps prevent over feeding baby: it takes 20 minutes for the stomach to tell the brain that it’s full. If a baby takes a bottle too quickly, the mouth can still be “hungry” and wanting to suck when the stomach is actually full. Like going to an all you can eat buffet and eating a lot of food quickly and then realizing half hour later you ate way too much. A baby that happily sucks down too much milk from a bottle can make you think you don’t have enough breast milk even if you make a normal amount. It can also make baby frustrated by the flow of milk from the breast and inadvertently sabotage breastfeeding
These pictures are the same baby in two different positions for paced feeding: semi upright and side lying. Side lying is my favorite position to use as it puts baby in the same position as breastfeeding. Many parents feel baby is more supported in this position. Baby is supported by your leg or breastfeeding pillow.
Tips:
🍼Never feed baby on their back
🍼Keep the bottle parallel with the floor with about half the nipple filled with milk
🍼Use the slowest flow nipple baby will tolerate
🍼Rub the nipple gently on baby’s lips, allow baby to latch at their own pace, don’t force it into their mouth
🍼It should take 15-20 minutes to finish the bottle
🍼Watch the baby and not the bottle, stop when they show signs of being full
🍼Resist the urge to finish the bottle, even if there is only a little left, when baby is showing signs their tummy is full
🍼Take short breaks to burp and give the tummy time to fill naturally
🍼If baby is gulping or chugging, slow down
🍼If baby has taken a good volume of milk (2-4oz) in a short amount of time and is still acting hungry, offer a pacifier for a few minutes to help them digest and give the tummy to to tell the brain it’s full. If they’re still hungry, slowly offer more in 1/2oz increments
Dropping breast milk supply
Feel like your breast milk supply is dropping? It may be normal. The uterus doesn’t tell the breasts how many babies came out. Immediately after birth, hormones cause the breast to go into overdrive to try to figure out how many babies were born…to feed them ALL.
The breast makes milk by being emptied and learns your babies habits and how much milk it needs to make with time and experience. In the early weeks your breasts have extra blood and fluid support to help your breast tissue make milk. This is what makes you aware of the filling and emptying of milk. This extra fluid support goes away around 6-8 weeks and you’ll no longer feel that full/soft feeling. By 10-14 weeks your breasts become more EFFICIENT and only want to make what is routinely emptied. Your breasts will go back to prepregnancy size. You may stop leaking (if you leaked) and not be able to pump as much. That’s NORMAL.
Your body doesn’t want to make milk that isn’t needed. You biological body doesn’t know what a freezer is or that you’re trying to collect that leaking milk for later. Your body wants to be as efficient as possible and make only what is being routinely removed from the breast. It costs your body energy to make milk: about 20 calories per ounce of milk made. Your body doesn’t want to burn calories to make milk that’s not being regularly emptied so it can use those calories for things like your brain function. Because mom brain is real.
So before you reach for formula thinking you don’t have enough milk. Realize that when everything is going normal your milk supply is supposed to regulate and your breast aren’t supposed to stay engorged and full forever. Your body is efficient. As long as baby continues to make good wet and dirty diapers, has a pain free latch where you’re hearing baby swallow, feeding baby in demand and not to the clock, and baby gains weight over time, you body is just doing what it’s supposed to do. You can always increase supply by feeding or pumping more often and decrease supply by feeding or pumping less.
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#normalizebreastfeeding #normalizenormalbodies #postpartumbody #milksupply #milksupplyissues #makingmilk
Low breast milk supply
Whether it’s 3, 5, or 10% of the population, there are people that struggle to or never make a full breast milk supply. From 1 month to 1 year, exclusively breastfed babies average 25oz of breast milk per day. True low milk supply means making less than this when the breasts are stimulated every 1-3 hours day and night. Chronic low milk supply is linked to either a greater health concern or something out of your control which you cannot change or fix with cookies, teas or even sometimes medications and pumping.
🗝Low milk supply that can be increased with time and support:
💡Baby not feeding efficiently from lack of oral motor skill or tongue tie
💡Taking certain prescription medications with a side effect of dropping milk (Sudafed, Benadryl, antibiotics)
💡Not feeding or pumping enough, especially over night
💡Scheduled feedings or over use of a pacifier
💡Birth. Many medications designed to help you labor and deliver actually inhibit baby from latching and feeding effectively for hours to days after birth. Hemorrhage or birth trauma can also cause low supply in the beginning
💡Supplementing, especially in the two weeks after birth
🗝Reasons for chronic low milk supply that may increase even with maximal support:
💡Insufficient glandular tissue (IGT). Breasts never developed during puberty and look tubular or widely spaced. Signs of IGT include breasts did not grow in puberty, or increase in size during pregnancy. No engorgement in the week after birth
💡Uncontrolled or undiagnosed thyroid disorder
💡Uncontrolled diabetes
💡Hormone or endocrine disorders, including severe PCOS
💡Hormonal birth control placed/used too soon after delivery
💡Breast or nipple surgery, augmentation, reduction, trauma
💡Nipple piercing that scars shut instead of staying open
There is a mistaken belief that prescription galactagogues, teas, or herbs can cure ANY chronic low milk supply. Before self-prescribing or taking Domperidone, Reglan, fenugreek, or any other lactation supplement, consider having your serum prolactin levels tested and a full evaluation by a skilled lactation consultant. Continue to follow @lalactation for strategies of breastfeeding with chronic low milk supply.
#lowmilksupplyawarenessday #igtandlowmilksupplysupportgroup #igtandlowmilksupply #igt #lowmilksupply #lowsupply #normalizebf #normalizebreastfeeding #worldbreastfeedingweek #wbfw #chestfeeding #sns #atbreastsupplementation #breastfeeding #bf #ibclc #bottlefeeding #donormilk #mixedfed #pacedbottlefeeding #triplefeeding #breastfeedingproblems #breastfeeding #supplementalnursingsystem #postpartum #breastpump #milkbank #lactationcookie #lactation #galactagogues
How much milk should I leave my breastfed baby?
How many ounces should I leave if I’m exclusively breastfeeding but need to leave my baby a bottle?
The answer is: that depends. Some babies are grazers. They like smaller, more frequent feedings to keep their tummy from being too full or uncomfortable. Their feedings can range from 1-3 ounces and they may feed 10 or more times a day. Other babies are bingers. They like a big, full tummy and may take 3-5 or even occasionally 6 ounces but not as often. They may feed only 6-8 times a day and have longer sleep stretches. Their tummy doesn’t mind being stretched fuller and their bodies tell them it’s ok to go longer between feedings.
The question is: how many feedings do they get in 24 hours? From one month to one year, babies take between 19-32 ounces of breast milk a day. The average is 25 ounces in 24 hours. There’s a range because babies eat more or less depending on the activities of the day, growth spurts, teething, and even babies emotionally eat sometimes. In general, take 25 and divide it by the number of feedings they average in any given day. Also take into account that growth slows between 6-12 months and baby should be eating table foods, so you don’t need to increase the ounces in the bottle during that time. If your baby took 4 Oz bottles at 4 months, 4 Oz bottles are still appropriate at 9 months because they’re also begging for the food right off your plate in addition to what you’re putting on their tray.