Tag: breastfed

Pace bottle feeding

- Julie Matheney

**What is Paced Bottle Feeding?**

Pace(d) bottle feeding is a responsive feeding technique designed to mirror the slower, more controlled flow of breastfeeding. The idea is to allow babies to feed at their own pace, promoting better digestion, reduced gas, and helping to prevent overfeeding. There are a few things about how it’s being taught to families with older babies, though, that have always bothered me as NICU trained SLP.

Pace bottle feeding was originally used and taught in the NICU setting with preemie babies for before their suck, swallow, breathe coordination was fully developed. We needed to be in charge of the bottle, because babies born before their due date lack maturity for self pacing and are at a higher risk of fatigue and other medical issues like aspiration and bradycardia/tachycardia from feeding.

Pace bottle feeding is often shown as baby sitting upright with the bottle nipple only half full of milk. Caregivers are encouraged to tip the bottle down frequently every few swallows to slow baby down. The bottle is also removed at regular intervals for burping. This can work fine for the first week or two while baby is learning to feed, but there are a few flaws to this.

📌I’m not a fan of half full nipples. Air mixed with milk is what increases swallowing air which can cause reflux and digestive discomfort. I recommend keeping the nipple full

📌Externally pacing the baby is fine in the initial weeks after birth, but we really want baby pacing themselves. If they are constantly chugging from the bottle, that’s a bottle issue. Decrease the level or nipple or change bottles to find a flow that allows baby to take breaks when they want to

📌An upright position is fine for babies 3+ months, but I see so many newborns hunched or scrunched in this position, which leads to pressure on the belly. Having baby in an upright side lying position mimics being at the breast and allows a long, straight torso for easier digestion

📌Yes!!!! We want baby to pace their feedings. That means it would take a similar amount of time as the breast: 15-30 minutes for the first 6-8 weeks and then to match the time at the breast after that it can range from 5-30 depending on how fast mom’s let down is.

How Paced Bottle Feeding has been taught:

👶🏻Hold Baby Upright: Sit baby in a semi-upright position to reduce air intake and reflux

🍼Controlled Bottle Angle: Hold the bottle horizontally, allowing milk to fill the nipple (some are taught to only fill it half way) but not flow freely.

🧭Pause and Check-In: Offer short breaks during feeding to gauge baby's cues for hunger or fullness.

💡Encourage Sucking Reflex: Let baby control the pace of feeding by actively sucking to draw milk, rather than having milk continuously drip.

🔮Observe Cues: Watch for signs of satiety (e.g., slowing down, turning away) to know when baby is full.

Benefits of Paced Feeding:

- **Supports Digestion:** Reduces the risk of overfeeding and minimizes gas and spit-up.

- **Mimics Breastfeeding:** Helps babies develop a natural feeding rhythm similar to breastfeeding.

- **Promotes Self-Regulation:** Encourages babies to eat until they are satisfied, rather than finishing a bottle due to continuous milk flow.

**When to Use Paced Bottle Feeding:**

- **Breastfeeding Transition:** Ideal for young babies who are both breastfed and bottle-fed to maintain consistency in feeding patterns.

- **Preventing Overfeeding:** Helps prevent babies from overeating by allowing them to control the pace.

- **Bonding and Interaction:** Fosters a closer feeding experience between caregiver and baby.

**Final Thoughts:**

Paced bottle feeding is not just about feeding; it's about creating a nurturing and responsive feeding environment for your baby. By tuning into your baby's cues and allowing them to guide the feeding process, you can support healthy growth and development while fostering a positive feeding relationship.

Have you tried paced bottle feeding with your baby? Share your experiences and tips below! 💬🍼 #PacedFeeding #ParentingTips #BabyCare

Breast milk supply tips

- Julie Matheney

It's crucial to remember that every breastfeeding journey is unique, and breast milk pumping outputs can vary widely from person to person and even from day to day. Comparing your output to someone else's can create unnecessary stress and pressure.

Natural Variation: The amount of milk a person can pump varies based on factors like breast storage capacity, hormonal levels, baby's nursing habits, and more. Some people naturally produce more milk than others, and this doesn't reflect on their ability to nourish their baby

Frequency and Timing: Pumping output can fluctuate throughout the day and with different pumping sessions. It's normal for milk supply to be higher in the morning and lower in the evening. The timing and frequency of pumping sessions can also impact how much milk is expressed

Storage Capacity: Breast storage capacity differs among individuals. This affects how much milk can be stored in the breast at one time and consequently how much can be pumped in one sitting

Baby's Needs: Babies' needs vary, and not everyone needs the same amount of milk. Your baby's growth and development are better indicators of whether they're getting enough milk rather than the volume you pump

Typically, a newborn consumes around 1-3 ounces per feeding in the first few weeks. However, this can vary based on baby's age, appetite, and individual needs. Here are some general guidelines:

Early Days: In the first few days after birth, when your milk is transitioning from colostrum to mature milk, you might pump smaller amounts (e.g., 1/2 to 2 ounces per session)

Established Supply: As your milk supply regulates (around 4-6 weeks), you might pump around 2-4 ounces per session

Later Months: Pumping output can range from 2-5+ ounces or more per session as your milk supply adjusts to meet your baby's needs

Remember, the best indicator of successful breastfeeding is your baby's growth, diaper output, and general well-being. If you have concerns about milk supply or breastfeeding, it's always a good idea to reach out to an IBCLC for personalized support. And most importantly, be kind to yourself and focus on the special bond you're nurturing with your little one.

Iron for breastfed babies

- Julie Matheney

At birth, babies have a natural reserve of iron accumulated during the last trimester of pregnancy. However, these iron reserves begin to deplete around 4-6 months of age due to baby's rapid growth and increasing blood volume. While breast milk contains relatively low levels of iron, it is highly bioavailable, meaning it is absorbed more efficiently by the infant's body compared to the iron in formula. But breast milk alone does not provide sufficient iron to meet the growing baby’s needs. This depletion necessitates the introduction of additional iron sources once baby starts solid foods at 6 months.

Introducing iron-rich foods, such as pureed meats, iron-fortified cereals, beans, and leafy green vegetables, helps prevent iron deficiency anemia, which can lead to developmental delays and impaired cognitive function. Starting iron-rich foods at 6 months ensures that babies receive adequate iron to support their developmental needs, complementing the high bioavailability of iron from continued breastfeeding. This approach helps maintain optimal iron levels during a critical period of growth and development.


Iron is crucial for:

📏Growth and Development: Iron is vital for the production of hemoglobin, the protein in red blood cells that carries oxygen throughout the body. Adequate oxygenation is essential for the rapid growth and development of infants, particularly for brain development

🤢Immune Function: Iron plays a significant role in the development and function of the immune system. Adequate iron levels help protect babies from infections and support overall immune health

🧠Cognitive Development: Iron is crucial for neurological development. It is involved in myelination, the process of forming the protective sheath around nerves, which is essential for efficient nerve transmission and brain function

Iron deficiency anemia can lead to:

- Developmental Delays: Iron deficiency can impair cognitive and motor development, leading to long-term developmental issues

- Behavioral Problems: Low iron levels can affect a baby's temperament and behavior, causing irritability and reduced attention span

- Weakened Immune System: Iron deficiency can compromise the immune system, making infants more susceptible to infections

Thus, maintaining adequate iron levels through a combination of continued breastfeeding and the introduction of iron-rich complementary foods is essential for ensuring healthy growth and development in infants.

Pumping is not an indication of milk supply

- Julie Matheney

Hey you!!! Yes, you, the one pumping milk at 2am. Just a reminder pumping volumes are not a true indicator of your milk supply and don’t determine your work as a parent. There are many factors that go in to how much you can pump. Pump quality, the flanges you’re using, how you’re setting up the pump session, how long it was since your last session, time of day, medications, and where you’re at on your period all play a role in how much milk you will see in the bottles. 

Pumps were designed after babies and not the other way around. And they’re not usually as efficient as an efficiently feeding baby. A baby with no tongue or lip tie and a strong suck can remove more milk and trigger more milk to be made better than commercially purchased pumps. 

I expect you to be able to pump 1/4-1oz combined from both breasts when pumping after directly breastfeeding and 2-4oz every 2-3 hours when pumping in place of breastfeeding. Your worth is not measured in ounces. Nor is it measured by what that other lady on social media can pump. You’ve got this. Trust your baby and trust your body. 

If you’re struggling with pumping or how to understand the process better, consider taking my Pumped class. Or a personal flange fitting both in person and virtual.

What’s up with my baby biting, gumming, chomping, hitting, pulling and pinching the nipple/breast while breastfeeding?

- Julie Matheney

Babies are masters at breastfeeding. They will exhibit all kinds of behaviors at the breast that will make you question if you have any milk and wonder what’s wrong with the baby. Most babies discover they have power and control over the breast and that different behaviors get different things. Biting, tugging, gumming, pulling, patting, chomping, shaking the nipple and breast are normal infant behaviors. Repeatedly latching on and off can also be normal when it doesn’t happen all the time. They happen during growth spurts, cluster feeding and teething. And may increase when baby discovers they can get a reaction from you for them. These behaviors increase or decrease the flow rate of milk and help stimulate supply and let down during growth spurts and teething.

What can you do? Stay calm. Most likely it’s normal and will change with time. Lots of skin to skin time between feedings can help keep baby calm and will naturally increase your supply during growth spurts. Using breast compressions while feeding can help increase flow and help trigger let downs. If baby is teething, give plenty of opportunity to chew and bite on appropriate toys and food items outside of nursing times. If baby is biting to slow flow, try a laid back position and make sure you’re not promoting an oversupply from over use of the Haakaa or pumping at sporadic times. Continue to watch for wet and dirty diapers and know that usually these behaviors are normal and don’t last.

If baby is having these behaviors all the time and isn’t making the amount of wet and dirty diapers you would expect, schedule a lactation consultation immediately.

Breastfeeding weaning

- Julie Matheney

There is no right or wrong age, it is completely up to you. Breast milk does not lose nutritional value (ever), so you get to decide how long you want to breastfeed. You also get to decide when you stop and all reasons for wanting to stop are valid. It is OK to wean for your emotional or mental well being and you do not have to justify your choices of how you feed your baby to anyone.

The age of your baby and how quickly you want to wean can play a role in how you wean.

Be prepared that some may experience mood changes and feelings of depression when weaning as your oxytocin and other hormones are dropping to stop milk production. If you need a specific plan to help you quickly wean, schedule a consultation with me to develop a plan that works for you.

Tips for gentle weaning:

✏️Start when your baby has already naturally started to wean, ex. only a quick snack before nap or waking up at 2am to pacify to sleep

✏️If transitioning from breast milk to formula, you can add formula to your breast milk bottles in slowly increasing amounts to make the transition easier on baby’s tummy (ex mix 2oz of breast milk with 1oz of prepared formula for several days, then mix 1.5oz each if breast milk and formula for a few days, then 2oz of formula with 1oz of breast milk)

✏️Don’t offer, don’t refuse

✏️Wear clothing that makes accessing the breast/chest more difficult.

✏️Distract child with favorite activities or offer alternatives like a favorite snack

✏️Change your routine

✏️Postpone: “After we play”

✏️Shortening the length of feeding or space feedings out

✏️Talk to your toddler about weaning. Older children (2 years and up) can be part of the process by talking to them about what is happening.

✏️Alternate between offering bottles and the breast

✏️Be consistent – this is a hard one but it can be even more confusing to your baby if you allow them to nurse one time and not the next.

✏️Lots of cuddles. Your breast/chest is more than just food but also a great source of comfort. Showing them you are still a source of that comfort despite not nursing is incredibly important

Ways to quickly wean:

⚓️Empty the breast only to comfort, trying not to stimulate the breast to make more milk

⚓️Breast gymnastics/“milk shakes” often to keep milk from sitting in the breast and clogging the ducts

⚓️Epsom salt soaks of the entire breast for soothing

⚓️Drinking 2-4 cups of sage or peppermint tea per day

⚓️Green cabbage leaves in the bra until they are soggy and then replacing the leaves

⚓️Cabocream (an alternative to the cabbage leaves

⚓️Cold packs on the breasts after feeding or pumping to reduce swelling

⚓️Starting on a hormone based birth control, especially The Pill (estrogen based) will drop supply

⚓️A last resort would be to take an antihistamine like Benadryl or Claritin-D as these are also notorious for dropping milk supply. This should be done with caution and under the direction of your primary care physician

True SELF-weaning by the baby before a year old is very uncommon. In fact, it is unusual for a baby to wean before 18-24 months unless something else going on (work, inefficient feeding, tongue tie, etc). A self weaning child is typically well over a year old (more commonly over 2 years) and getting most nutrition from solids, drinking well from a cup, and has been cutting back on nursing gradually.

Reasons a baby under a year may be perceived to self wean:

🔑Solids were introduced too soon

🔑Scheduled feedings/sleep training/pacifier use (all decrease time a baby would naturally want to be at the breast/chest)

🔑Lactating parent loses a lot of weight fast which can decrease milk supply

🔑Medications or hormonal birth control which will decrease supply

🔑Lactating parent is pregnant

🔑Baby taking lots of solids before one (human milk should be the primary nutrition source through one year of age)

Empty breasts make milk faster than full breasts

- Julie Matheney

FULL/EMPTY BREASTS

While it seems counterintuitive, the emptier your breasts are, the faster they make milk. A full bread has no place to store or hold the milk, so milk production slows to prevent plugged ducts and breast discomfort. Cluster feeding on an emptier breast actually tells the body to make more milk at a faster rate!! Some incorrectly assume you have to wait for the breast to “fill up” before feeding your baby or for pumping while at work. This will eventually lead to less milk, as a fuller breast tells your body baby isn’t eating very often and to slow milk production. The more frequent you empty the breast, the higher the fat content in that milk and the faster milk is made. The longer often you wait and the fuller the breast, the higher the water content in that milk and the slower your body will make milk overall.

W atch the baby, not the clock. Breasts may feel really full between feedings in the first few weeks after birth, but they’re also not supposed to stay engorged. There will come a time when they stay soft and don’t feel full between feedings or pumping, so waiting for that as a cue to feed will also sabotage your supply. Don’t be alarmed when your breasts no longer feel full between feeding. You’re entering a new stage where you’ll still make plenty of milk for your baby as long as you’re routinely emptying that milk. Trust your body. Trust your baby.

The science vs the art of breastfeeding

- Julie Matheney

SCIENCE AND ART

Breastfeeding is the perfect blend of science and art. There are basic principles that apply, but within those principles is a lot of variation

🔬Science says you should switch which breast you start with at each feeding to keep milk supply balanced

🎨Art says this mom always starts left to try to increase supply on the slacker boob while that mom only feeds one breast per feeding. This mom needs to block feed and that mom offers whatever breast passes the boob shake fullness test

🔬Science says babies should poop at least once a day

🎨Art says some babies poop every time they sit in the car seat and others in the bathtub🤷🏽‍♀️ Some babies poop after every feeding and others have just one a day (or every other day)

🔬Science says eat whatever you want

🎨Art says one can eat dairy without a problem for baby and for another it causes a rash and digestive upset in baby

🔬Science says having baby in a good position will get you a deep latch.

🎨Art says you over here love koala hold a rolled up wash cloth supporting your breast to help reduce reflux. While you over there do better in cross cradle sitting up.

🔬Science says as baby ages they can sleep in longer stretches at night

🎨Art says many babies still wake up 1-3 times a night to nurse until 18 months and need help from an adult to transition back to sleep

🔬By understanding the science behind breastfeeding, we can understand typical patterns of behavior which helps guide us when things aren’t going well.

🎨By appreciating the art of breastfeeding, we can celebrate the unique differences of every feeding baby within its own family dynamic.

🔬If you’re struggling with the science of breastfeeding, find help.

🎨If breastfeeding is going well, appreciate the art of your own masterpiece that you’re creating with your little one.

Does breast shape impact making milk?

- Julie Matheney

We come in all different shapes and sizes, and so do our breasts/chests. They can be large, petite, round, tubular, wide, narrow, symmetrical, uneven, teardrop shaped, or droopy. All of these types of breasts/chest are normal.

The size of your breasts/chest is based upon the amount of fatty tissue in it. Those with smaller breasts have less fatty tissue, and those with larger breasts have more fatty tissue. The fatty tissue doesn’t make breast milk. Glandular tissue inside the fatty tissue produces the breast milk.

Unlike fat, the amount of milk-making tissue in your breasts is not necessarily related to the size of your breasts. People with all different breast sizes are fully capable of producing a healthy supply of breast milk for their babies.

Smaller breasts does not necessarily mean smaller milk supply. As long as the small size is not related to hypoplastic breasts (not enough glandular tissue), there shouldn’t be an issue. While you may have to breastfeed more often due to the amount of breast milk that your breasts can hold, you can still successfully produce enough milk.

Breastfeeding with large breasts has its own unique challenges, usually related to position and how to hold or support the breast. Side lying or rolling a towel to put underneath the breast to lift it can be very helpful. Some worry that their breasts will block baby’s nose. Pulling baby in the opposite direction of the breast and compressing the breast from the back can help pop baby’s nose up off the breast. If your baby’s nose gets blocked while nursing, they will open their mouth and let go of the breast so they can breathe.

If you were told your breasts were too big or too small to breastfeed, I am so sorry. Your body is perfect just the way it is.

If you’re concerned that you’re not producing enough milk, pay attention to your baby’s wet diapers and bowel movements. Generally, small infrequent bowel movements or less than six wet diapers a day, are cause for concern. Contact a lactation consultant (🙋🏽‍♀️)right away.

Maternal vaccines and breastfeeding

- Julie Matheney

Did you know babies routinely get antibodies to anything you’ve been vaccinate against? Babies get temporary disease protection from you in this way. When you are vaccinated, your body has an immune response that makes antibodies to what you were vaccinated against. Antibodies are then secreted in breast milk to your baby. The type and quantity of these antibodies, and whether they provide any protection for baby after they are swallowed, are dependent on the vaccine received and maternal factors that influence immune system function such as genes, age and health.

Antibodies in breast milk have not been shown to reduce baby’s response to their own immunizations. However, some studies suggest that breast milk may improve baby’s immune response to some of the vaccines they receive.

If you do decide to be vaccinated while breastfeeding, there is no need to pump and dump your milk. Or to stop breastfeeding for any amount of time. When considering the vaccine, or any medication, most want to know whether a dangerous amount of a substance will be filtered into our milk and cause harm to our baby. For most drugs, so little gets to the baby that there’s really very little theoretical risk. Even if a drug or vaccine does end up in breastmilk, anything that goes through breastmilk also then has to go through baby’s gut before reaching baby’s bloodstream. The mRNA molecules in the Pfizer or Moderna vaccines, if they made it into your milk, would have to survive baby’s stomach acid first.

While breastfeeding, it is highly unlikely that an intact lipid from the vaccine would enter your blood stream and be passed directly into your milk. If it does, it is even less likely that either the intact nanoparticle or mRNA could be transferred into your milk. In the unlikely event that mRNA is present in your milk, it would first go through baby’s digestive system and would be unlikely to have any biological effects. The vaccine is supposed to trigger an immune response in your body. It helps your body recognize the virus when you’re exposed and fights the virus early, reducing the severity and length of illness. Once your immune system recognizes the SARS-CoV-2, the virus that causes Covid-19, antibodies are made to protect you and those antibodies may pass into the breastmilk. Researchers have already found Covid antibodies in the breastmilk of previously infected women, though they don’t know yet how much protection these antibodies give babies.

Choosing to be vaccinated is a personal risk/benefit decision to be made between you and your health care providers. If you do chose to be vaccinated with the COVID vaccines, there is no need to pump and dump for concerns of your milk harming your baby.