How much water should I drink while breastfeeding?

Breastfeeding is an incredible bonding experience between a mother and her child, facilitated by various hormones, including oxytocin. Oxytocin, often dubbed the "love hormone," plays a crucial role in lactation and maternal-infant attachment. One intriguing side effect of oxytocin release during breastfeeding is the overwhelming thirst experienced by many nursing mothers.

So, why does oxytocin make breastfeeding mothers thirsty?

Oxytocin stimulates the let-down reflex, which is the process by which milk is released from the mammary glands. As oxytocin surges during breastfeeding, it causes the muscles around the milk ducts to contract, pushing milk towards the nipple for the baby to feed. This physiological response not only assists in milk ejection but also triggers a sensation of thirst in many mothers.

The mechanism behind oxytocin-induced thirst is multifaceted. One theory suggests that oxytocin may stimulate the hypothalamus, the region of the brain responsible for regulating thirst and fluid balance. Additionally, the act of breastfeeding itself can be physically demanding, leading to increased fluid loss through sweat and respiration, further contributing to feelings of thirst.

Now, how much water should breastfeeding mothers drink?

The general recommendation for breastfeeding mothers is to stay well-hydrated to support milk production and overall health. While individual water needs vary based on factors like climate, activity level, and body size, lactating women should aim to drink enough fluids to satisfy thirst and maintain hydration.

Aim to drink water whenever you feel thirsty, and consider these tips to ensure adequate hydration:

  1. Drink to thirst: Listen to your body's cues for water. Thirst is a natural indicator that your body needs fluids, so keep water within easy reach during breastfeeding sessions.
  2. Stay hydrated throughout the day: Make a habit of drinking water regularly, not just during breastfeeding sessions. Keep a water bottle handy and sip frequently.
  3. Monitor urine color: A pale yellow color indicates adequate hydration, while dark urine may signal dehydration. Aim for urine that is light in color as a simple indicator of hydration status.
  4. Consider fluid-rich foods: Incorporate hydrating foods like fruits and vegetables into your diet, which contribute to overall fluid intake.
  5. Avoid excessive caffeine and alcohol: Both caffeine and alcohol can have diuretic effects, potentially increasing fluid loss and impacting milk production. Moderation is key.

In conclusion, oxytocin-induced thirst is a natural response during breastfeeding, driven by hormonal changes and the physiological demands of lactation. By staying attuned to their bodies' signals and prioritizing hydration, breastfeeding mothers can support their own well-being while nurturing their little ones. Remember, a well-hydrated mother is better equipped to provide the nourishment and care that her baby needs.

The Importance of Night Breastfeeding: Impact on Milk Supply and Infant Weight Gain

Nighttime breastfeeding serves as a crucial component of infant nourishment and maternal lactation. While the idea of cutting out nighttime feedings may seem tempting for exhausted parents seeking uninterrupted sleep, it's essential to understand the potential consequences this decision may have on both milk supply and infant weight gain.

Here's why maintaining nighttime breastfeeding is crucial:

  1. Stimulation of Milk Production: Nighttime breastfeeding sessions play a significant role in stimulating milk production and maintaining a robust milk supply. Prolactin, the hormone responsible for milk production, is typically higher during nighttime hours. By nursing during the night, mothers help to sustain adequate milk production levels to meet their baby's growing needs.
  2. Infant Nutritional Requirements: Infants have high nutritional demands for growth and development, especially during the early months of life. Nighttime feedings provide essential nutrients and calories necessary for optimal infant growth, particularly during growth spurts. Cutting out nighttime feedings prematurely may deprive babies of the necessary nutrition they require for healthy weight gain and development.
  3. Satiety and Comfort: Breastfeeding offers more than just nutrition; it provides comfort, security, and emotional bonding for both mother and baby. Nighttime feedings help soothe infants, promote relaxation, and foster a sense of security, contributing to better sleep patterns and emotional well-being for both mother and child.
  4. Maintaining Milk Supply: Breastfeeding works on a supply-and-demand basis. The more frequently a baby nurses, especially during the night when prolactin levels are highest, the more signals the body receives to produce milk. Cutting out nighttime feedings prematurely can disrupt this delicate balance and potentially lead to a decrease in milk supply over time.
  5. Weight Gain and Growth: Research indicates that babies who receive nighttime feedings tend to gain weight more steadily and exhibit optimal growth patterns. Adequate nighttime feedings contribute to improved weight gain, ensuring that infants meet their developmental milestones and thrive.

While it's understandable that parents may seek uninterrupted sleep, it's essential to approach nighttime breastfeeding with patience and understanding. Here are some strategies to support nighttime breastfeeding while promoting parental rest:

  • Co-sleeping: Safe co-sleeping arrangements can facilitate nighttime breastfeeding while allowing parents and infants to rest close together.
  • Cluster Feeding: Encourage cluster feeding in the evening, where babies feed more frequently in a condensed period, potentially leading to longer stretches of sleep afterward.
  • Supportive Partners: Partners can assist by taking on other caregiving responsibilities, allowing breastfeeding mothers to rest during the day to offset nighttime awakenings.

In conclusion, the decision to cut out nighttime breastfeeding should be approached thoughtfully, considering both the short-term sleep needs of parents and the long-term health and well-being of both mother and baby. Nighttime breastfeeding plays a vital role in maintaining milk supply, supporting infant weight gain, and nurturing the emotional bond between parent and child. By understanding the importance of nighttime feedings and implementing strategies to support breastfeeding, parents can navigate this phase with confidence and care.

Common breastfeeding questions

Breast Milk didn't freeze in the freezer

You’re pumping and throw that bag of liquid gold in the freezer, but when you come back the next day the bag is still liquid. Puzzled, you hit up google only to find no actual answers for why this happened.

HELP! My breast milk won't freeze!!

There is only one research study done in Spanish that has attempted to research this phenomenon. Here’s what we know:

🍷It’s not because you’ve had too much alcohol. Yes, alcohol has a lower freezing temperature, but the amount of alcohol you’d have to consume to get that level in your milk would land you in the hospital

🧊Check to make sure your freezer is at the correct temperature.

🥶The quick fix is to take the bag out of the freezer, shake it vigorously and put it back in the freezer in a single layer without it touching other bags

🍦 There are a few theories about this. One PhD chemist says it has to do with the high osmolarity of that particular milk. Basically it has extra nutrients than other milk, extra vitamins and most likely a higher fat content  it’s why it doesn’t happen all the time

🔬Dr. João Aprigio Guerra de Almeida is Coordinator of the Network of Milk Banks of Brazil and states:

“The fact that human milk does not freeze is associated with a phenomenon called gelation, which is autocatalytic, begins even inside the mammillary ducts, continues after extraction, and is accentuated by temperature fluctuations (heating to thaw, pasteurization and cooling) and does not disqualify the milk for consumption.” Basically, pressure from the ducts changes the protein structure of the milk which prevents the milk from freezing. Even if the milk is kept at -18ºC in the freezer, it does not freeze, because the proteins form a network that ignites the water molecules, preventing them from coming together to form ice crystals.

Have you ever experienced this with your milk?

The discussion by Dr. João Aprigio Guerra de Almeida is translated from Spanish from an original blog post written on December 14, 2018  by Gema Cárcamo González-IBCLC.

SOS, mi leche materna no se congela.

How long is breast milk good for?

I often get asked about the safe handling storage of breast milk as well as formula. So let’s break it down:

Breast milk is a living substance with digestive enzymes that help break down milk in baby;’s digestive tract. It’s also full of live immune properties to help baby fight infections, bacteria and viruses. Formula is FOOD. I know that seems obvious, but it’s really important to remember. Since it is food, we have to follow food safety rules when preparing, using and storing formula. Breast milk is also a food, but like all foods, they have unique storage properties based off of what the food is and the risk of contamination and spoiling. So the rules for formula and breast milk are similar, but different. The rules for formula help prevent bacterial contamination which can make your baby sick. Keep in mind that these are guidelines. You know your home situation best, which includes your water source, what else is living in your refrigerator, the climate you live at, and your own cleanliness in the kitchen. 

Let’s talk about formula first. Prepared formula, meaning mixed powdered formula that you made with water following the manufacturer’s instructions but that has not come into contact with your baby’s mouth, can be stored in the fridge for 24 hours at an ideal temperature of 37 degrees Fahrenheit. CLICK HERE TO LEARN MORE Ready to feed formula that hasn[‘t been offered can actually be stored inthe feridge for up to 48 hours, ideally in an air-tight storage container. This is stored in the back of the fridge where it is coldest and least likely to be impacted by temperature fluctuation that happen near the door of the fridge. This does mean that if you are offering more than one bottle of formula per day you can mix your entire day’s worth of formula in the mourning, store it in a pitcher,and pour out of the pitcher into your bottle volumes to heat and feed. This can save you time when your baby is really hungry. You also want to make sure all of your containers for storage are air tight to prevent that formula from absorbing odors from other foods in the fridge. 

2 hours. That’s how long you have for formula to sit at room temperature once it’s been mixed, as long as it hasn’t touched your baby’s lips. That means you can mix up a bottle before you leave the house and leave it in your diaper bag to be fed within two hours of leaving the house. 

Once that bottle of formula has touched your baby’s lips, you have to use it within 1 hour or you need to toss it. This is because bacteria from your baby;’s mouth is introduced back into the bottle (thanks baby back wash) and the bacteria can multiply and grow to unsafe levels. Health care providers will always recommend safest practice to help keep your little one healthy. 

 

Worried about wasting formula? Here are a few tips: Mixing formula in a pitcher means you can pour out just enough for the feeding. If baby is still hungry, you can pour small amounts for top ups to prevent mixing too much and wasting formula. If your baby has a little formula remaining in the bottle and you know they will want a top off later, consider offering the bottle again at the 50-minute mark before the bottle expires. 

So what about freshly pumped breast milk? There are other rules that apply:

  • Use breast milk storage bags or clean, food-grade containers to store expressed breast milk. Make sure the containers are made of glass or plastic and have tight fitting lids.
    • Avoid bottles with the recycle symbol number 7, which indicates that the container may be made of a BPA-containing plastic.
  • Never store breast milk in disposable bottle liners or plastic/ziplock bags that are not intended for storing breast milk.
  • Freshly expressed or pumped milk can be stored:
    • At room temperature (77°F or colder) for up to 4 hours.
    • In the back of the refrigerator away from the door for up to 4 days.
    • In the freezer for about 6 months is best; up to 12 months is acceptable. Although freezing keeps food safe almost indefinitely, recommended storage times are important to follow for best quality. Freeze your milk flat to save space and make sure to store int he back of the freezer where it’s coldest, away from the door where temperature can fluctuate.
  • If you don’t think you will use freshly expressed breast milk within 4 days, freeze it right away. This will help to protect the quality of the breast milk. The longer breast milk sits out, the more the live digestive enzymes in it will break down the nutrients in your milk. 
  • When freezing breast milk:
    • Store small amounts to avoid wasting milk that might not be finished. Store in 2 to 4 ounces or the amount offered at one feeding.
    • Leave about one inch of space at the top of the container because breast milk expands as it freezes.
    • Breast milk can be stored in an insulated cooler with frozen ice packs for up to 24 hours when you are traveling. At your destination, use the milk right away, store it in the refrigerator, or freeze it.
  • Make sure to test for lipase before storing large batches of breast milk in the freezer. Lipase is the enzyme that breaks down the fat in breast milk. For some people with high lipase, their milk can taste soapy or metallic when stored. Some babies are fine to drink this milk and others may refuse it. See my other posts and videos on high lipase and what to do about it. 
  • Always thaw the oldest breast milk first. Remember first in, first out. Over time, the nutrients in breast milk start to break down. When at all possible, feed fresh milk. 
  • Breast milk can be defrosted in the fridge, normally in around 12 hours. Alternatively, hold the bottle or bag of frozen milk under warm running water (a maximum of 37 °C or 99 °F). Don’t leave frozen breast milk to defrost at room temperature. If you forget it on the counter for too long, past safe feeding guidelines, you may lose that batch of milk. And we cry over spilt and lost breast milk. 
  • Never thaw or heat breast milk in a microwave. Microwaving can destroy nutrients in breast milk and create hot spots, which can burn baby’s mouth.
  • If you thaw breast milk in the refrigerator, use it within 24 hours. Start counting the 24 hours when the breast milk is completely thawed, not from the time when you took it out of the freezer. If there are still ice crystals felt in the milk, it is still considered frozen.
  • Once breast milk is brought to room temperature or warmed, use it within 2 hours.
  • Never refreeze breast milk after it has thawed.
  • Breast milk does not need to be warmed. It can be served room temperature or cold.
  • If you decide to warm the breast milk, here are some tips:
    • Keep the container sealed.
    • Place the sealed container into a bowl of warm water or hold it under hot, running water for a few minutes.
    • Test the milk’s temperature before feeding it to your baby by putting a few drops on your wrist.
  • Swirl or shake the breast milk to mix the fat, which may have separated. Fat separation is normal for breast milk. There used to be an old wives’ take that shaking the milk could some how damage the milk. We’ve debunked that for years. If you’re concerned about the bubbles that form from shaking giving your baby gas, you can swirl or stir it as well.  
  • If your baby did not finish the bottle, use the leftover milk within 2 hours after the baby is finished feeding. After 2 hours, leftover breast milk should be discarded. Yes, you get a longer amount of time to offer breast milk in a bottle than formula.

Finally: If you’re mixing breast milk and formula together in the same bottle: Formula rules apply, meaning once that bottle has touched baby’s lips, you only have one hour to feed it to the baby. 

 

Headache while breastfeeding

I have a headache but am also breastfeeding. What can I safely take for me and my baby? Well, first, if you have a headache, start by drinking water. I see many new mothers who are breastfeeding who are not getting adequate nutrition and specifically hydration because of focusing on their little one. If you have a new onset headache, before reaching for the medicine cabinet, start by hydrating. Water, coconut water, soups or births, and High water fruits and vegetables like melon , pineapple, oranges or citrus fruits and cucumber, lettuce, and celery. If that doesn’t do the trick , there are safe medications to take. Dr Thomas Hale wrote the textbook on medication and breastmilk and categorizes them into 5 categories:

L1 safest

L2 safer

L3 probably safe

L4 possibly hazardous

And L5 hazardous.

If you have pain, such as a headache, body aches, pain post delivery or a fever, there are safe medications.CLICK HERE FOR VIDEO

Ibuprofen, Advil, and Motrin are all nonsterioial anti-inflammatory analgesics (NSAIDs), and considered L1 or preferred medications. Panadol, acetaminophen or Tylenol are pain relievers that are considered L1 and safe while breastfeeding. Aspirin, ASA, is considered an L2 medication. While L2 medications are typically considered safe while breastfeeding, Aspirin use  can lead to a condition in babies and children called Reye Syndrome which has been associated with brain and liver damage. Aleve (also known as Naproxen) is considered an L3 and while the AAP-approved it for nursing mothers, Dr Hale states it should be used with caution due to its long half-life and its potential effect on baby’s cardiovascular system, kidneys and GI tract. Use of  Aleve should be short-term, infrequent or occasional use which would still be considered compatible with breastfeeding. 

Ibuprofen or acetaminophen are better choices over aspirin and naproxen for pain relief in lactating women and you would want to discuss the risks and benefits of aspirin If your physician has prescribed this for you based on your unique medical history. 

Codeine is an L3 medication and not generally recommended while breastfeeding. If it is essential, and only where there is no alternative, it should be at the lowest effective dose for the shorted possible duration and you should stop taking it and seek medical attention if you notice side effects in your baby such as breathing problems, lethargy, poor feeding, drowsiness or slow heart beat. 

If you have another medication that you take for fever or pain, you can ask the IBCLC lactation consultant you’re working with to check out it’s safety in the Hale’s Medications and Mother’s Milk textbook, on you can search the LactMed database on the internet. You can also call Infant Risk which is a help center for questions about breastfeeding, infants and medications. If you are in the USA, The phone number for the call center is 1(806) 352-2519 and is open from 8 AM to 5PM Central Standard Time to answer your questions.

I have a sore throat or cough: In general, treat only the symptoms you have, so try to avoid combination medications when one that is for a single symptom could work. Short acting medications that are for less than 4 hours are preferred over longer lasting medications. How you take a medication does matter. Nasal sprays or topical rubs have less of a chance of passing to your breast milk than things you take orally.  

Throat lozenges and sprays are generally considered safe, but avid eating excessive cough drops contains menthol as some have found this can decrease their milk supply. 

Drinking lemon and honey or chamomile tea can be helpful to soother a sore throat and reduce coughing.  Fenugreek tea has also been reported to have a similar effect, although do not drink fenugreek tea if you have a thyroid condition or are on thyroid medications or tend to be hypoglycemic and be aware that it may cause increase gassiness and bloating for you and baby. 

Zinc gluconate or slippery elm bark herbal lozenges may be soothing, but avoid taking large amounts of zinc for more than a week, because it can interfere with other minerals in the body.

Salt water or apple cider vinegar mouth gargles, where you gargle and spit can also bring relief and would not be anticipated to impact milk supply or your baby.

Many forms of robitussin, delsum and benylin are considered compatible with breastfeeding, but always check the active ingredients as there are many versions available on the market. 

Always check with your prescribing physician before starting any herbal supplement or medication based on your unique medical history. 

The Stash

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The stash. It’s talked about and documented on social media like fashion in Cosmo. If you want a stash, or need a stash, I fully support your parenting and feeding goals. What I don’t support is the anxiety that a stash can facilitate. Your body was designed to feed your baby today, not next month. But even I understand the importance of the stash for many situations: NICU separation, going back to work with work trips, knowing you have a surgery or procedure and will be away from baby, the potential for illness or periods impacting supply. There are many factors that go in to creating a stash: the quality of your pump and the flange size you use, how often you’re removing milk, your unique anatomy and physiology for making milk. So before you go comparing your stash to someone else’s, just remember your journey is not someone else’s. And your worth isn’t measured in ounces.

#milkstash #milksupply #milksupplybooster #milksupplytips #galactogogues #breastmilkstorage #breastmilksupply #breastmilkstoragebags #breastmilkstoragebag

why is my baby so gassy?

BABY FARTS
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?
.
#babyfart #babyfarts #babyshart #gassybaby #breastfedproblems #breastfeedingproblems

Which baby bottle is best? Don’t fall for the marketing

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Don’t fall for the marketing. There are SOOOO many bottles out there that claim to be closer to the breast. Honestly, if it’s shaped like the breast, it typical works LEAST like a breastfeeding latch. Here’s my bottle schpiel: if you’ve found a bottle that works for your baby and you’re reaching your feeding goals, there is not necessarily a need to change your bottles. If your baby is clicking, leaking milk, coughing, choking, or taking really large bottles really quickly, pops on and off the latch, consider changing bottles

Pictures here:

Como Tomo: my LEAST favorite bottle system ever. I never recommend this bottle. It promotes a straw-like, narrow latch. The bottles tend to flow really fast as well.

Nanobebe: the same goes for this bottle. It has a short nipple and isn’t tapered from tip to base, promoting a shallow latch. You can see how the baby slides up and down the nipple shank. If baby did this on your breast it would hurt.

Dr Brown’s: This is a very standard bottle that does promote a deeper latch. While I LOVE the Dr Brown’s, it’s still not my favorite bottle for all babies. The long nipple can gag sensitive babies. It does promote a deeper latch.

Lactation Hub Gentle Flow: Designed by an IBCLC lactation consultant, this gradually tapered nipple is so much better for a breastfeeding latch. This system is my second favorite system to recommend for the breastfed baby as it does promote a wider latch than the Dr Brown’s. I have found the do flow faster than the Pigeon nipples of the same flow rate

Evenflo Balance: This is my favorite system. If the Lansinoh/Pigeon/Gentle Flow and the Dr Brown’s had a baby, it would be this bottle. It has the widest taper and a shorter nipple tip to help reduce gagging for sensitive palates while promoting The widest latch. This helps transfer the skills of a wider latch back to breast.

At the end of the day, we all have a favorite mug we like to drink from. The handle is angled just right and the rim the perfect width. If your baby can go back and forth from breast to bottle, go with what works for your baby. If it’s not working for either of you, work with an IBCLC to figure out why.

The Slacker Boob

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Slacker boob, AKA “shitty titty”, is the way some breastfeeding parents refer to one breast producing less milk than the other. It's important to note that breast milk production can naturally vary between breasts, and having one breast that seems to produce less milk doesn't necessarily indicate a problem. 70% of us naturally make more milk on the right side due to asymmetries in our anatomy! Breasts can have different storage capacities and respond differently to the baby's nursing patterns.

Factors such as latch quality, frequency of nursing, and hormonal fluctuations can influence milk supply. In some cases, a perceived difference in milk production might be due to variations in the baby's sucking efficiency or preference for one breast over the other.

Here are some strategies for dealing with your lower producing side:

Frequent Nursing: Ensure that baby nurses more frequently on the slacker side. Start with that side a little more often and use it as the pacification boob.

Switch Nursing: Alternate between breasts during a single feeding session, starting with the slacker side. This encourages more thorough draining of the breast and signals your body to produce more milk.

Pump After Feedings: After breastfeeding, consider pumping on the slacker side for an additional 10-15 minutes. This can help to fully empty the breast and signal your body to produce more milk.

Breast Massage and Compression: During breastfeeding or pumping, use breast massage and compression techniques. Gently massage the breast and compress it to help express more milk.

Hydration and Nutrition: Stay well-hydrated and maintain a balanced diet rich in nutrients. Proper nutrition is essential for optimal milk production.

Comfortable Latching: Ensure that your baby is latching well on the slacker side. A proper latch helps the baby effectively remove milk from the breast.

Breast Compression During Feeding: Use breast compression during breastfeeding. This involves gently compressing the breast while the baby is actively sucking, promoting a more effective transfer of milk.

Consult with a Lactation Consultant: If you're struggling with milk supply imbalances, seek guidance from a lactation consultant. They can assess your breastfeeding technique, provide personalized advice, and address any specific concerns.

Remember that breastfeeding is a dynamic process, and milk supply can fluctuate throughout the day. If you have persistent concerns about milk supply or notice significant differences between your breasts, consulting with a healthcare professional or a lactation consultant is recommended for personalized support.

Oxytocin Dosin’

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You are not just a meal.

As you breastfeed, baby’s heart rate slows, their bonding hormones spike, their breathing matches your breathing. Your body regulates their temperature like a thermostat. This whole process facilitates the baby brain to glide into a deep, restorative calm while feelings of relaxation and warmth wash over the parent. Harmonious synchronicity is achieved. Two become one.

Most of us are aware that oxytocin is released in the mother during the let down of her milk. But it is actually released in the baby’s brain as well, supporting safety, emotional stability, bonding and the feeling of satiety. Once breastfeeding is established, baby's brain will release oxytocin whenever he or she sees or smells you, or hears your voice, and so they will continue to feel its pleasant effects. Oxytocin lowers blood pressure and stress reactivity in mothers. In baby, oxytocin increases resilience to stress and drives the formation of more oxytocin receptors in the amygdala which helps lower the risk for childhood anxiety. ⁠The simultaneous oxytocin release, over and over and over again, literally wires the both brains to underpin long term attachment.

You are not just a meal.⁠

 

The Science of Oxytocin: 💕 Did you know that oxytocin, often called the ‘love hormone,’ is actively produced in your body during breastfeeding? Let’s break it down:

Brain’s Signal: The process starts in the hypothalamus, where certain neurons release a precursor to oxytocin.
Storage Mode: This precursor then travels to the posterior pituitary gland, where it patiently waits to be called into action.
Triggered by Stimuli: The magic happens when your baby’s touch or the act of breastfeeding stimulates the release of oxytocin into your bloodstream.
Muscle Coordination: Oxytocin then gets to work, coordinating smooth muscle contractions. In the uterus, it aids in labor and recovery, while in the mammary glands, it ensures the efficient flow of milk.
Emotional Harmony: Beyond the physical, oxytocin also contributes to the emotional bond with your baby and provides a sense of calm and stress relief.
🌈💖 #OxytocinScience #BreastfeedingJourney #MomLife”

Safe breast milk and formula storage

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I often get asked about the safe handling storage of breast milk as well as formula. So let’s break it down:

Breast milk is a living substance with digestive enzymes that help break down milk in baby;’s digestive tract. It’s also full of live immune properties to help baby fight infections, bacteria and viruses. Formula is FOOD. I know that seems obvious, but it’s really important to remember. Since it is food, we have to follow food safety rules when preparing, using and storing formula. Breast milk is also a food, but like all foods, they have unique storage properties based off of what the food is and the risk of contamination and spoiling. So the rules for formula and breast milk are similar, but different. The rules for formula help prevent bacterial contamination which can make your baby sick. Keep in mind that these are guidelines. You know your home situation best, which includes your water source, what else is living in your refrigerator, the climate you live at, and your own cleanliness in the kitchen.

Let’s talk about formula first. Prepared formula, meaning mixed powdered formula that you made with water following the manufacturer’s instructions but that has not come into contact with your baby’s mouth, can be stored in the fridge for 24 hours at an ideal temperature of 37 degrees Fahrenheit.  Ready to feed formula that hasn[‘t been offered can actually be stored inthe feridge for up to 48 hours, ideally in an air-tight storage container. This is stored in the back of the fridge where it is coldest and least likely to be impacted by temperature fluctuation that happen near the door of the fridge. This does mean that if you are offering more than one bottle of formula per day you can mix your entire day’s worth of formula in the mourning, store it in a pitcher,and pour out of the pitcher into your bottle volumes to heat and feed. This can save you time when your baby is really hungry. You also want to make sure all of your containers for storage are air tight to prevent that formula from absorbing odors from other foods in the fridge.

2 hours. That’s how long you have for formula to sit at room temperature once it’s been mixed, as long as it hasn’t touched your baby’s lips. That means you can mix up a bottle before you leave the house and leave it in your diaper bag to be fed within two hours of leaving the house.

Once that bottle of formula has touched your baby’s lips, you have to use it within 1 hour or you need to toss it. This is because bacteria from your baby;’s mouth is introduced back into the bottle (thanks baby back wash) and the bacteria can multiply and grow to unsafe levels. Health care providers will always recommend safest practice to help keep your little one healthy.

Worried about wasting formula? Here are a few tips: Mixing formula in a pitcher means you can pour out just enough for the feeding. If baby is still hungry, you can pour small amounts for top ups to prevent mixing too much and wasting formula. If your baby has a little formula remaining in the bottle and you know they will want a top off later, consider offering the bottle again at the 50-minute mark before the bottle expires.

So what about freshly pumped breast milk? There are other rules that apply:

  • Use breast milk storage bags or clean, food-grade containers to store expressed breast milk. Make sure the containers are made of glass or plastic and have tight fitting lids.
    • Avoid bottles with the recycle symbol number 7, which indicates that the container may be made of a BPA-containing plastic.
  • Never store breast milk in disposable bottle liners or plastic/ziplock bags that are not intended for storing breast milk.
  • Freshly expressed or pumped milk can be stored:
    • At room temperature (77°F or colder) for up to 4 hours.
    • In the back of the refrigerator away from the door for up to 4 days.
    • In the freezer for about 6 months is best; up to 12 months is acceptable. Although freezing keeps food safe almost indefinitely, recommended storage times are important to follow for best quality. Freeze your milk flat to save space and make sure to store int he back of the freezer where it’s coldest, away from the door where temperature can fluctuate.
  • If you don’t think you will use freshly expressed breast milk within 4 days, freeze it right away. This will help to protect the quality of the breast milk. The longer breast milk sits out, the more the live digestive enzymes in it will break down the nutrients in your milk.
  • When freezing breast milk:
    • Store small amounts to avoid wasting milk that might not be finished. Store in 2 to 4 ounces or the amount offered at one feeding.
    • Leave about one inch of space at the top of the container because breast milk expands as it freezes.
    • Breast milk can be stored in an insulated cooler with frozen ice packs for up to 24 hours when you are traveling. At your destination, use the milk right away, store it in the refrigerator, or freeze it.
  • Make sure to test for lipase before storing large batches of breast milk in the freezer. Lipase is the enzyme that breaks down the fat in breast milk. For some people with high lipase, their milk can taste soapy or metallic when stored. Some babies are fine to drink this milk and others may refuse it. See my other posts and videos on high lipase and what to do about it.
  • Always thaw the oldest breast milk first. Remember first in, first out. Over time, the nutrients in breast milk start to break down. When at all possible, feed fresh milk.
  • Breast milk can be defrosted in the fridge, normally in around 12 hours. Alternatively, hold the bottle or bag of frozen milk under warm running water (a maximum of 37 °C or 99 °F). Don’t leave frozen breast milk to defrost at room temperature. If you forget it on the counter for too long, past safe feeding guidelines, you may lose that batch of milk. And we cry over spilt and lost breast milk.
  • Never thaw or heat breast milk in a microwave. Microwaving can destroy nutrients in breast milk and create hot spots, which can burn baby’s mouth.
  • If you thaw breast milk in the refrigerator, use it within 24 hours. Start counting the 24 hours when the breast milk is completely thawed, not from the time when you took it out of the freezer. If there are still ice crystals felt in the milk, it is still considered frozen.
  • Once breast milk is brought to room temperature or warmed, use it within 2 hours.
  • Never refreeze breast milk after it has thawed.
  • Breast milk does not need to be warmed. It can be served room temperature or cold.
  • If you decide to warm the breast milk, here are some tips:
    • Keep the container sealed.
    • Place the sealed container into a bowl of warm water or hold it under hot, running water for a few minutes.
    • Test the milk’s temperature before feeding it to your baby by putting a few drops on your wrist.
  • Swirl or shake the breast milk to mix the fat, which may have separated. Fat separation is normal for breast milk. There used to be an old wives’ take that shaking the milk could some how damage the milk. We’ve debunked that for years. If you’re concerned about the bubbles that form from shaking giving your baby gas, you can swirl or stir it as well.
  • If your baby did not finish the bottle, use the leftover milk within 2 hours after the baby is finished feeding. After 2 hours, leftover breast milk should be discarded. Yes, you get a longer amount of time to offer breast milk in a bottle than formula.

Finally: If you’re mixing breast milk and formula together in the same bottle: Formula rules apply, meaning once that bottle has touched baby’s lips, you only have one hour to feed it to the baby.

Do I need to wean to take medications?

Women are often told they need to stop breastfeeding because of medical testing or a medication. Or told that they cannot receive treatment until the child is weaned. The good news is that most medications (even many antidepressants and meds for ADHD) are compatible with breastfeeding, and for those few medications that are a safety issue there are usually acceptable substitutions.  If you do need to take a medication, there are reliable resources to help you make the decision for if it is safe to continue breastfeeding

According to Thomas Hale, RPh, PhD (Medications and Mothers’ Milk 2014, p. 7-12): “It is generally accepted that all medications transfer into human milk to some degree, although it is almost always quite low. Only rarely does the amount transferred into milk produce clinically relevant doses in the infant… Most importantly, it is seldom required that a breastfeeding mother discontinue breastfeeding just to take a medication. It is simply not acceptable for the clinician to stop lactation merely because of heightened anxiety or ignorance on their part. The risks of formula feeding are significant and should not be trivialized. Few drugs have documented side effects in breastfed infants, and we know most of these.”

When you are taking medications and breastfeeding, the age of the baby, the dose of the medication, whether the medication is immediate or extended release, etc are all considerations for the timing of when to take the medication. Always double check your particular medication for drug interactions (for example: if you’re on a thyroid medication you need to avoid fenugreek because it can cause a drug interaction. Fenugreek is one of the most common herbal supplements used in “milk boosting” products). If you’re concerned about the medication you’re being prescribed or are being told you need to pump and dump or wean, please consult with an IBCLC to confirm.