Not only am I a lactation consultant, I am also a full time working mom with an 8-month-old at home. I’m gone around 40-50 hours a week for work and am pumping on the go. At the hospital where I work there is an employee lactation room. Half the time I’m in here by myself and the other half there is another mother behind a curtain pumping with me. It is amazing to see how universal our concerns are with breast-feeding.The number one complaint I hear about from the other side of the curtain is that the mom is “not pumping enough” or “can’t keep up with the baby”. I have never been a super pumper and have always had to really work on my supply. It is amazing to me how from day today, pumping to pumping, I can get varying amounts of milk. It’s depends on my stress level, what I’ve eaten, how much water I’ve been able to get in, and how often I can get away to pump during my shift. Pumping is also very psychological. It’s honestly hard to “feed a machine” instead of my baby, but the more I look at pictures and videos of her or FaceTime with her while pumping, the more I tend to make. Here are the top tips I give to the other moms pumping at work:
1. Shake the girls. Give your breasts a good shake before each pumping session. This wakes up the breast and helps release hind milk from the back of the breast.
2. Use the stimulation and let down modes on your pump more often. Use the stimulation mode for 2 minutes followed by the let down mode for 4 minutes. Go back to the stimulation mode for another 2 minutes followed by the let down mode for another 4. Do this up to 4 times in your pumping session to see an increase in your milk. Massaging your breast from top to bottom in a clock wise motion will also help empty the breast. End your pumping session with a few minutes of hand expression.
3. Keep well hydrated. Water water water!!!
4. If you feel like you did not pump enough during the day at work, add in an extra pumping at night before you go to bed. Keep this extra pumping going even if your home with your baby for the weekend. You can stock up this milk in your freezer for those occasional days where you don’t pump enough on your shift.
For more tips and tricks, feel free to give me a call, attend one of my working mother classes, or schedule a personalized consultation!
Tongue tie, technically known as ankyloglossia, is a condition present at birth that affects an estimated 2-5% of all babies born. It is characterized by a short, thickened, or abnormally tight lingual frenulum, which is the tissue that connects the tongue to the floor of the mouth. Depending on the severity of the tongue tie, range of motion of the tongue can be restricted. In very severe cases, the tip of the tongue can appear to be heart shaped. Because of this anatomical difference, sometimes tongue tied babies can’t maintain a latch for long enough to take in a full feeding. Others may appear to breastfeed for long periods of time without actually be effectively transferring milk. Some tongue tied babies will successfully breastfeed only during “let-down”, when the milk flows on its own from the breast into the babies’ mouths, but won’t be able to actively express milk out of the breast on their own. Many babies with tongue tie also have a lip tie, an abnormally tight membrane attaching their upper lip to their upper gums. This can be seen by rolling the upper lip upward. Babies with lip tie often have difficulty flanging their lips properly to feed which impacts their ability to latch well. This can cause them to take in excess air during breastfeeding which often makes these babies gassy and fussy.
While many pediatricians do not see tongue tie as an issue, current research and literature suggests that it can have a significant impact on breastfeeding. However, the American Academy of Pediatrics, among others, have documented the negative effects of tongue tie on breastfeeding. The most common complaint of mothers with tongue tied babies is sore nipples, which is due to poor latch and inefficient sucking. Other breastfeeding problems for the mother can include recurrent plugged ducts, mastitis or thrush, vasospasm, and supply difficulties. Babies with tongue ties typically have difficulty latching, make click sounds while nursing, may be gassy and fussy during feedings, and have slow weight gain despite having mothers who use correct positioning and nurse frequently.
Some babies with very short or thick lingual frenulums are able to compensate well and breastfeed without difficulty. Tongue tie needs to be diagnosed by function and not just appearance, so what the baby’s tongue looks like is not as important than what it can do. According to one study, simple inspection of a tongue-tie is not enough to determine which infants will need medical intervention. However skilled professionals will complete a clinical assessment which includes observation and measurement of the effectiveness of feeding to help determine appropriate action to improve breastfeeding skills. This is not a comprehensive list for tongue function, but it may give you an idea for why your baby is having breastfeeding difficulties:
Does the tongue elevate? When the baby cries the front edge of the tongue should come up at least as high as the corners of the baby’s mouth.
Does the tongue extend? The baby’s tongue should be able to protrude or stick out at least past the lower gum if not to the border of the lower lip
Does the tongue lateralize, or move side to side? Tracing the baby’s bottom gums triggers a reflex for the tongue to follow the finger..
The baby’s tongue should be able to lift towards the roof of the mouth and touch behind where the upper teeth will come in. Is there a membrane there that prevents the tongue from lifting? When very tight from tension, the membrane may appear white.
If it is determined that the tongue tie is indeed the culprit for breastfeeding difficulties, some pediatricians, ENTs and dentists can perform a frenotomy or frenectomy. This is a quick procedure to cut the frenulum which returns the full range of motion of the tongue and upper lip. Specialized scissors may be use to simply cut the tongue or lip tie. Some prefer to use lasers, which have the benefit of minimizing the amount of bleeding during and after the procedure and decrease the chance that the frenulum will grow back. Many practitioners use a local topical anesthetic to numb the area before the procedure and some use an injection of anesthetic as well. Babies can breastfeed as soon as the procedure is done. Post-procedure care should be done to minimize the frenulum from growing back. Current research shows this is a safe, easy procedure with minimal risk to the baby. The majority of mothers notice an immediate difference in breastfeeding effectiveness and a significant reduction in nipple pain.
When should the frenotomy be done? Current research shown between 2-6 days after birth to establish proper breastfeeding patterns. This same study showed that waiting more than four weeks for frenotomy drastically increased the likelihood that mothers would abandon breastfeeding all together.
If you suspect your baby has a tongue or lip tie, set up a consultation for a full assessment of your baby’s oral motor skills.
Lalakea, M. Lauren; Messner, Anna H. (2002). “Frenotomy and frenuloplasty: If, when, and how”. Operative Techniques in Otolaryngology-Head and Neck Surgery. 13: 93. doi:10.1053/otot.2002.32157.
Wallace, Helen; Clarke, Susan (2006). “Tongue tie division in infants with breast feeding difficulties”. International journal of pediatric otorhinolaryngology. 70 (7): 1257–61. doi:10.1016/j.ijporl.2006.01.004. PMID16527363.
Emond A1, Ingram J, Johnson D, Blair P, Whitelaw A, Copeland M, Sutcliffe A. “Randomized controlled trial of early frenotomy in breastfed infants with mild to moderate tongue-tie.” Arch Dis Child Fetal Neonatal Ed. 2014 May;99(3):F189-95.
Jack Donati-Bourne, Zainab Batool, Charles Hendrickse, Douglas Bowley “Tongue-Tie Assessment and Division: A Time-Critical Intervention to Optimise Breastfeeding/” Journal of Neonatal Surgery 2015; 4(1):3
Many moms need to breast pump for a variety of reasons, from going back to work, to increasing milk supply, to feeding a preemie in the NICU. I think it’s pretty safe to say these models have never seen a breast pump in their life. And if they have, I think they may need to see a plastic surgeon to help with their nipple placement! For help with fitting your breast pump, nipple shield, or nursing bra, feel free to set up an appointment with me!
The American Academy of Pediatrics recommends that babies be EXCLUSIVELY breastfed for about the first six months of life. This means that your baby needs no additional food (except Vitamin D) or fluids unless medically necessary. Babies should continue to breastfeed for one to two years or for as long as is mutually desired by the mother and baby.
When should I start solid foods with my baby?
How do you know when your baby is ready for solid food? After six months of age, they should be able to do these three things:
They sit unsupported for an extended length of time
They are starting to use a pincher grasp (thumb and forefinger together to grab little objects)
They start to have eye-hand coordination to bring their hands to their mouth
Welcome to LA Lactation. Congratulations on the newest arrival to your family!
LA Lactation’s blog is meant to provide you with quick and simple strategies to ensure successful (fun and hopefully enjoyable) breastfeeding.
People unwittingly tell new moms that breastfeeding should come naturally and easily, but honestly, breastfeeding can be tricky! Babies come into the world ready to learn, but feeding still takes practice!!!
The posts on this blog are packed with helpful information designed to walk you through the breastfeeding experience so that when baby comes, you will feel confidence in your own abilities and skills to feed your baby.
Of course, putting your baby to your breast immediately after birth is the first step toward breastfeeding. But what next? What if your baby won’t latch? What if his hands are constantly in the way? What if your milk is slow to come in? There are many questions new mothers have and you can find all your answers in the content of this blog.
The first feeding:
Baby’s first feeding should happen within the first 60 minutes of birth. Skin to skin contact is essential for starting the bond between mother and baby and is a catalyst to the first feeding. It stimulates hormones in the mother’s body to begin the production of colostrum, the first milk often called “liquid gold”. Colostrum is packed with immune boosting antibodies, all the essential vitamins and minerals your baby needs, and perfectly balanced nutrition for growth and development. When infants are placed on their mothers chests at birth, their feeding instincts kick in. They will begin to army crawl to the breast and root around for mama’s nipple. You can facilitate this by laying your baby on your belly when he is born and watching the magic happen. After the first latch, you can position baby for feeding. While there are several breastfeeding positions for your infant, which will be in another blog post, you’ll want to keep skin-to-skin contact while feeding.
It’s not immediately obvious, but a proper latch means baby has not only the nipple in her mouth, but a good bit of breast tissue from the areola as well. The areola is the colored area around the nipple. If the baby has a shallow latch just on the nipple, their tongue movement will cause chaffing which will lead to unnecessary cracking, bleeding, and pain. A deep, wide latch and will help prevent nipple soreness and discomfort, as well as allowing for a good flow of breastmilk.
If you need to break suction to reposition baby for a proper latch, be careful not to pull baby off your nipple, which will cause painful shearing over time. Instead, insert a finger between the gums to gently pop the suction, or use a finger to raise baby’s top lip toward her nose.
You should not feel pain in the nipple or breast when feeding. Women experience different sensations when nursing, like tugging or pulling. If there is any pain, your baby is most likely not latched correctly. Try breaking the seal and repositioning.
If you notice drying or cracking starting on the nipple, take immediate action. Nipple creams can help, but so can breast milk. Breast milk has been known to heal sore or cracked nipples faster than over the counter creams! Using a reusable/washable nursing pad made from natural bamboo fibers can help keep the nipple dry, which will also help with healing. If you use disposable nursing pads, make sure to change them frequently.