Breastfeeding and lactose, dairy, food intolerances and allergies

Lactose is the number one sugar in breastmilk. It is the protein in cow’s milk that is difficult to digest for some babies. Human milk has human protein. It is easily digested by the stomach and absorbed in the intestines. The protein of cow’s milk is shaped different and not easily absorbed by the stomach and intestines as it’s designed to be absorbed by calves. It can sometimes make babies gassy or have poops that have bloody or mucous in them. Cow’s milk sensitivity or allergy can cause colic-like symptoms, eczema, wheezing, vomiting, diarrhea (including bloody diarrhea), constipation, hives, and/or a stuffy, itchy nose. Which can also be signs of other things. You could always try decreasing your dairy intake. Baby’s symptoms will usually begin to improve within 5-7 days of eliminating a problem food. Baby may not improve immediately, however, especially if the reaction is to a food that has been a regular part of your diet. Sometimes symptoms get worse before they begin to improve. It usually takes 2-3 weeks to see an improvement.

If baby is sensitive to dairy, it will not help to switch to lactose-free dairy products or put your baby in formula, which is cow protein based.

While culture may dictate what you can and cannot eat while breastfeeding, science does not. Most babies have no problems with anything that you eat. It’s generally recommended that you eat whatever you like, whenever you like, in the amounts that you like and continue to do this unless you notice an obvious reaction in your baby.

There is no list of “foods that every nursing person should avoid” because most of us can eat anything we want, and because the babies who are sensitive to certain foods are each unique – what bothers one may not bother another.

Babies’ guts are also constantly developing. So what bothers them as a newborn may not bother them the closer they get to a year.

Unless there are known food allergies in your family history or your baby is having severe reactions to what you think you may be eating, there’s no need to restrict what you eat. Remember: fussiness and gas is normal for a young baby, and is not usually related to foods you eat. If your baby is sensitive to something you are eating, you will most likely notice other symptoms in addition to fussiness, such as EXCESSIVE spitting up or vomiting, colic, rash or persistent congestion, crying inconsolably for long periods, or sleep little and wake suddenly with obvious discomfort. Other signs of a true food allergy may include: rash, hives, eczema, sore bottom, dry skin; wheezing or asthma; congestion or cold-like symptoms; red, itchy eyes; ear infections; irritability, fussiness, colic; intestinal upsets, vomiting, constipation and/or diarrhea, or green stools with mucus or blood. Fussiness that is not accompanied by these other symptoms and calms with more frequent nursing is probably not food-related.

Comparison will steal your peace

Too often we look around to see what everyone else is doing and it makes us feel incomplete, incompetent, like we’re doing something wrong or not doing enough. We see the success of others in parenting, sleep training, their milk supply, pumping, whatever, and it makes us feel like we’ve failed. Comparison is the number one way to have your joy and peace stolen. Stop looking at Becky over there with her oversupply and thinking your normal supply is inadequate for your content and growing baby. Stop looking at Gina over there whose baby has slept through the night since two months and thinking there’s something wrong with your happy child. Stop comparing your tiny but mighty that looks like the rest of your flock to my giant giraffe babies that look like the rest of my herd. You’re not getting a grade. Breastfeeding is not a pass/fail activity. Trust your baby. Trust your body. You’ve got this.

Ways to naturally boost milk supply without taking any herbs or supplements:

Ways to naturally boost milk supply without taking any herbs or supplements:

⌛️Empty the breast more often. The more you empty to either baby or pump the more you’ll make!

🕰Feed on demand and not by the clock.

🤱🏽Keep baby in skin to skin contact with you, even as an older baby. This contact has a hormone reaction to naturally increase supply at any age.

💦Drink more water (at least 10-12 glasses per day)

🥗Eat between 2100-2500 calories per day of high quality protein, low in sugar and processed foods

🍷Drink alcohol and caffeine in moderation, and make sure to drink extra water if you do a both dehydrate and can decrease milk supply

🍆Have sex! The same hormone released during orgasm causes milk to be released for let down. Having sex naturally raises the level of this hormone in your body for 24 hours, making it easier to let down milk the next day!

🏝Relax and have a calm routine during pumping. Stress and distraction can inhibit milk let down for some even when there’s plenty of milk in the breast.

🎧Listen to music and place heat on your breasts while pumping. Several research studies have found by doing these things moms can pump up to 30% more milk!

📏Make sure you’re pumping with the correct flange size.

🛌When possible, avoid sleep training. Letting baby wake at night helps keep your milk supply naturally high as milk making hormones are highest at night.

💊Be careful you’re not taking any medications that drop supply like hormonal birth control, antihistamines and antibiotics.

Oxytocin

Positioning tools and devices

Oxytocin is a hormone produced by the pituitary gland in the brain. It increases relaxation, lowers stress and anxiety, lowers blood pressure, and causes muscle contractions. Oxytocin, also called the mothering, cuddle or love hormone, is involved in social relationships, bonding, trust, and love. Breastfeeding stimulates the release of oxytocin from your brain.  When your baby latches on to breastfeed, the nerve cells in your breasts send a signal to your brain to release oxytocin. The oxytocin causes the muscles around the milk-making glands in your breast to contract, squeezing the breast milk into the milk ducts. The milk ducts then contract to push the breast milk through your breast, out of the nipple to your baby. This is called the let-down reflex. As baby continues to breastfeed, more oxytocin is released and milk continues to flow. You may experience 2-14 let-downs in one breastfeeding session! The release of oxytocin while you're breastfeeding may make you feel sleepy and relaxed. It can raise your body temperature and is one of the reasons you may feel so hot while nursing. It might also make you feel thirsty or even give you a headache!

Oxytocin can cause your milk to let-down when you're not breastfeeding. Hearing a baby cry, thinking about your baby or even smelling something that reminds you of your baby can trigger oxytocin flow and make you leak!! While oxytocin is responsible for the let-down reflex and the release of breast milk from your body, it has nothing to do with the amount of breast milk that you will make. Prolactin is the hormone that does that. 

Some people feel the oxytocin release (aka Let-Down) and others don’t. Both are totally normal!

Signs of let down include:

  • Tingling or a pins-and-needles sensation in your breasts. It could be a light sensation or even an electrical shock feeling.
  • Hearing baby swallow while at the breast.
  • Leaking milk from the other breast
  • Uterine cramps when breastfeeding, especially the first week.
  • Feeling happy and relaxed after you feed your baby.

Factors that inhibit oxytocin release and let down include: pain, breast surgery or trauma, stress, illness, fatigue, fear, embarrassment, drinking or smoking. 

Some mothers may breastfeed and let-down milk just fine to baby but struggle to release milk to an electric pump. A quality double electric breast pump will have two modes: a quick cycle/light suction or "stimulation" mode, and a slow cycle, hard suction of "expression" mode. By alternating several times between these modes in a pump session, you can trick your body into thinking baby is feeding to stimulate more let-downs of milk. When pumping, you can also help stimulate your body to let-down more often by:

  • Watching videos or looking at pictures of your baby
  • Smelling something that reminds you of your baby (a onesie, your baby shampoo or soap, lavender)
  • Listening to calming music
  • Using heat before and during pumping
  • Massaging your breasts before and during pumping
  • Eating a snack or drinking water while pumping

 

Pumping Log: When to throw in the towel

I’ve never been a super pumper. I’ve diligently pumped three times a day at work for the last 8 months. I’ve almost always made just enough for the next day of feedings. Sometimes I’ve even had a conservative stash in the freezer for low pump days or when my husband and I want to go out. There are definitely times when I have to work on my supply to keep it up enough to feed my daughter. Oatmeal for breakfast, teas at lunch, a Guinness with dinner, more tea before bed. Pump. Breast massage. Pump. Repeat. It’s exhausting. Especially since my uninvited monthly visitor has me with a low supply. As I come up on my daughters first birthday, I’m torn.  Continue the schedule I’m on with the highs and lows of constant pumping? Drop the pumping and only breastfed when I’m home and offer something else while I’m gone? Or gradually wean all together? The professional side of me (the crunchy, granola, die hard side) says, “Stick it out!!! It’s not that bad!! Breast is best!!! Your baby needs your milk!!! Show your boobs who’s boss.” While the personal side of me screams, “Screw it! You’re working so hard! Give yourself a break. You went a whole year. You did the best you could with the support you had. Some other milk won’t kill your kid. She’s eating like a champ and she won’t even notice.” I get it now. I understand why some moms give up breastfeeding, especially working moms. I also get why mom’s push through and keep going. We all just want the best for our babies. I’m still on the fence. We’re T minus 1 month to the big one year birthday. I’ll keep you posted on what I decide. But for now, Happy Pumping!!

Pumping Log : Boosting Supply

Every working mother I know it’s concerned about her milk supply. We are terrified that if we don’t make enough milk while at work our babies will starve to death. I’ve had my moments of discouragement where I, too, feel like a failure as a mother because I had a low pumping day. Of course this stress only causes a further decrease in supply which becomes a vicious cycle of stress and poor pumping. While I can’t turn my boobs on line a faucet to pump specific amounts of milk each pump session, there are several things I do to promote the best possible milk supply.

1. Hydration. The best hydration is to drink to thirst. Since times in the busyness of my day, though, I forget to stay well watered. I keep a water bottle in my pumping bag and try to drink while pumping. I also work feeding patients. So each time I go into the kitchen at work I try to grab a cup of water.

2. Nutrition. Eating the right kinds of foods also help with adequate milk supplies. Fresh fruits, vegetables and plenty of protein help keep my body working at its best. Oatmeal is also a staple in my diet. Oatmeal contains a protein that may increase prolactin, the hormone that facilitates milk production in mammals. Other whole grains such as quinoa and sesame also contain this same protein.

3. Supplements. Fenugreek, mothers milk tea, and fennel are all known galactogogues, a fancy word for milk makers. I try to drink a cup of tea every night. I’ll admit I’m not the best at taking the fenugreek, but I definitely notice a boost in my supply when I do. Another supplement known to help breast milk production is brewers yeast. Brewer’s yeast comes from a single-celled fungus and is a byproduct of beer making, though it can also be grown as a nutritional supplement. A good source of iron, chromium and selenium, brewer’s yeast also contains several B vitamins, though not B-12. Brewer’s yeast has a history of use as a galactagogue, which is a food, herb or medication that increases milk supply in nursing mothers. Some mothers find drinking a single beer can immediately increase milk supply (although drinking beer is best left to evenings or weekends). You can also buy a powdered brewers yeast from the store or Amazon. It can be added to smoothies, cookies, or other recipes. Here’s one of my favorites!!

 

Pumping Log: periods and breast milk

While we may affectionately call them jugs, breasts do not work like standardized cartons of milk. As I already discussed in specious post, the volume of breast milk pumped during the day varies by many factors. If stress and eating and hydration and life aren’t enough to alter your milk supply, Mother Nature throws in another curve ball. Once your period returns, hormones also impact your breast milk production. A few days before our periods start, our blood calcium levels drop. This drop in blood calcium can cause two things to happen

  • It can cause a drop in milk supply. Not every women experienced this, by side notice that starting a few days before their periods, their milk supply drops a bit. This lasts until a few days after the period has started.
  • It can slightly change the flavor of your milk. Again, this isn’t true for everyone. But Aunt Flo can slightly alter the flavor of your milk, making it less palatable for your baby. This alteration starts a few days before your period, and lasts until a few days after your period has begun.

The result? If your pumped milk is looking a little lean, you may just be about to ride the crimson tide. Make sure you’re eating a week balanced diet with foods rich in calcium when you start PMS’ing. Chocolate is high in calcium, right? Happy pumping.

PS this picture is from my morning pump. My baby started on the right side this morning and didn’t really want anything to do with the left side. See the difference?

Pumping Log #2

What’s in my pumping bag. A well stocked pumping bag is the most essential item you will need when you go back to work. Packing the bag efficiently and with necessities can help eliminate stress and worry while pumping at work. Here are a few of the things in my pumping bag. Obviously the pump is the most important piece. Make sure to check that you have all the pieces and parts in the morning before you leave for work. I had forgotten one or two pieces several times. I actually now keep a spare pump in my car that is always ready to go in the event that I forget something. I always keep instant oatmeal, mothers milk tea, and honey sticks ready for a quick snack on the go. When I know I am going to work the next day, I bring empty bottles to put my milk in. That way I can keep it in the fridge and handy for the next days feedings. If I know I am going to be home the next day, I use disposable milk storage bags. I’ve tried several brands and really like the Dr. DuDu. They’re sturdy and have a double zipper. Plus they come in a handy 8oz size for streamlining in the freezer. I can put my pumped milk in the freezer and it will be ready to go the next time I’m at work. I always keep extra nursing bra pads. I wear washable ones made of bamboo fiber. But you never know when you might need to change them. I keep it small stash of disposable ones in my bag at all times. Another necessity is my stash of essential oil’s. I use fennel to help keep my supply up. Serenity, lavender, balance, and citrus bliss help elevate my mood when I’m feeling down at work. What’s in your bag?

 

 

Myths and Old Wive’s Tales

We all have questions about what “normal” and “typical” feeding looks like for our babies. We also have lots of questions about when things go different than we anticipated or we run into problems with breastfeeding. So often we turn to other mom’s experiences that we find on social media or internet blogs. We think we’re doing something wrong or we inadvertently pick up the bad habits of others. Some of us learn fact from fiction by trial and error. Others turn to family and friends for help, but they each may have a very different answer and it can be extremely confusing. How do you make the right decision? By getting your information from the right, trusted source, you can save yourself from experimenting with things that may work in the moment but will set you up for feeding failure in the future. Here are common breastfeeding myths.

Myth #1: Breastfeeding is supposed to be the most natural thing in the world, so it should come naturally to me and my baby, right?

There are many reasons why you or your baby could experience difficulties breastfeeding, from anatomical differences to coordination issues. Babies are just as brand new to feeding as you are and it can take some time to learn the skills needed to effectively eat. Many moms see happily breastfeeding infants with their smiling mothers and just assume it will be easy. Due to poor education and lack of support, they can become easily frustrated or discouraged when challenges arise.

Take time before your baby comes to learn how to breastfeed and all that accompanies. Don’t wait to ask for help. As soon as you notice any problems with feeding, call for help. There is no stupid question. Even if you took a class before birth, you aren’t expected to know everything. We are here to help!
Myth #2: My body knows how much milk to make

Actually, you have to tell you body how much milk to make, which is why it is so important to stimulate milk production in the first 24 hours. The more you breastfeed, the more milk your body produces. The less you feed, the faster your milk decreases. Frequent breast stimulation tells your body that milk needs to be produced.

If baby is having difficulty latching and nursing early on, your baby has difficulties staying awake during feedings, or your baby sleeps for a long time, pumping or hand expressing will continue to facilitate milk production until your baby gets the hang of feeding and gets into a more regulated sleep/wake cycle.

As I always tell moms with babies in the NICU, if you’re away from your baby and your goal is to breastfeed, you still need to feed something or you will see a decrease in milk supply. If you can’t feed your baby because you are at work or your baby is in the NICU, feed your pump until you can feed your baby.

Myth # 3: Breastfeeding will be painful

Many new mamas try to muscle through nipple pain, cracks, blisters, and bleeding because they think it’s all part of the process. This is one of the biggest and worst myths out there!  While this is the experience of many women, it doesn’t have to be yours! Pain is not normal!

In my classes and consultations, I will teach you how to differentiate between the pressure and sensation of a proper latch and the pain associated with an improper one. What you should feel is something moms describe as a “tugging and pulling”. What you should not feel is pinching or sharp pain. Pain is always a good indication that something isn’t right! This is most likely a signal of a poor latch and you need to break the latch (you can slide your pinky finger in the corner of the baby’s lip between his lip and your areola to break the latch) and start over, repositioning the baby to improve the latch.

Myth #4 I can just get all the information I need at the hospital

Giving birth is one of the most emotionally and physically exhausting experiences you can have as a woman. If you give birth in a hospital, there is actually little time to rest. Nurses will come in every two to three hours to check on you and your baby. Then they will go over a whole laundry list of information, from umbilical cord care and monitoring poops, to symptoms you and your lady bits might experience and what to do about it. They will talk about car seat safety, birth certificate information, diaper care and follow up appointments with your physician. Do you really want to try to squeeze in even more information about the essential task of feeding your baby? Being prepared ahead of time will lighten the load your brain will have to process and let you focus more on just enjoying your new baby.

Myth #5: I don’t want to bother anyone with my problems, I’ll just figure it out

No mama is an island. We all need support, and this especially true for breastfeeding. Research shows that the opinions about breastfeeding of those close to you (including the baby’s father and your mother) affect the duration of breastfeeding overall. It is so important to have support when it comes to breastfeeding. Without it, many mothers wean within a week of giving birth!

Successful breast feeders typically have at least two people they know they can turn to for breastfeeding support, be it a friend, aunt, or cousin. Bring your spouse with you to a breastfeeding class. Talk to those around you about your breastfeeding goals. Join a Facebook breastfeeding support group. Hearing about other moms’ obstacles and how they overcame them can be so encouraging. Find another mom whose baby is a few months older than yours that you can talk to about each stage you’re in and what’s to come. Let me help connect you to other moms in your area.

Myth #6: I’ll just use formula since it’s just as nutritious and so much easier

This one’s a big myth that many people believe! While formula companies would like you to believe they are as nutritious and convenient as breast milk, the truth is actually quite the opposite! The American Academy of Pediatrics, the American Medical Association, the American Dietetic Association and the World Health Organization call recommend that breastfeeding is best for babies up through one year of age, as it helps defend against infections, prevent allergies, and protect against a number of chronic conditions. Breast milk contains antibodies that can lower the occurrence of ear infections, diarrhea, respiratory infections and meningitis. It contains the correct proportions of lactose, protein and fat, which are easily digested by a newborn baby. Babies that are formula fed are more likely to suffer from digestive problems, have a higher risk of childhood obesity and more likely to develop allergies and illnesses. They also do not receive antibodies from their mothers, which means they are less protected against infection and illness.

Not to mention formula is expensive. Feeding a baby exclusively formula can cost up to $3000 for the first year. There’s also the cost of time. Time to wash bottles, time to prepare bottles (especially at 2am this becomes a tedious task), time to buy formula ahead of time so you don’t run out (running out at 2am is the WORST!). And if you want to leave the house you have to consider carrying, storing, and preparing formula away from a full kitchen.

Myth #7: My baby has nipple confusion

The scenario is all too common. Mom has to go back to work or wants a night out so she offers the baby a bottle for the first time. The baby gets fussy, starts pulling off the bottle nipple and screams, spits our milk and gags or vomits. Mom tries fifteen different bottle systems and none of them seem to work. Both mom and baby are super frustrated. Let’s start with the truth. There is no such thing as nipple confusion. Your baby is not confused about what a nipple is. But she is confused about the rate that the liquid is flowing at from the nipple. The rate at which milk flows from the breast, in most moms, is significantly slower than a bottle nipple. Breastmilk flow is stimulated by the baby sucking, and goes through various rates depending on if the baby is just starting a feeding versus in the let down phase of feeding. Bottle nipples, however, are on demand and constant. As soon as that baby starts sucking there is milk available. And it’s always available as long as the baby is sucking. When babies are just born and/or exclusively breastfed, they can easily get overwhelmed by the high flow rate of the standard nipple that comes on most bottles. Signs of being overwhelmed by flow rate include pulling off the nipple, crying, arching the back, turning the head away, refusing to latch, hiccupping, coughing, gagging or choking, Starting with a slower flow bottle nipple, using positioning and pacing can all help the transition from breast to bottle. You can also learn other tips and tricks of the trade in my special breast to bottle feeding consultation.