Parents who have breastfed their babies have great advice. Here are some of their suggestions.
Take a breastfeeding class during pregnancy
Breastfeeding is a natural thing to do, but parents need to learn how. Parents who take a breastfeeding class during pregnancy are less likely to have problems or pain.
Start breastfeeding right away
Spend an hour skin-to-skin with your baby. This is called the Golden Hour and it’s when they are most alert and ready to get started feeding
Babies cry more on their second day of life
This can be upsetting and you might not know how to calm your baby. Hold baby skin to skin and offer the breast frequently. This is called “Second Night Syndrome” though it can also happen during the daytime.
Feed throughout the night You do need to feed around the clock in the beginning. This brings in an excellent supply of milk and takes advantage of baby’s alert time which is during the night, at first. “Cat nap” during the day when your baby is sleeping.
Attend a breastfeeding support group Meeting and connecting with other moms can bring a lot of reassurance. The facilitator is a peer counselor who breastfed her own children and can answer questions and help you troubleshoot problems.
It shouldn’t hurt
How your baby attaches (latches) to your nipple and areola is the key to comfortable breastfeeding. Make sure the mouth is opened wide and baby gets a big mouthful.
Hold baby frequently
Skin-to-skin reduces crying, facilitates bonding, and improves breastfeeding. Use a safe baby carrier when baby is big enough for hands-free snuggling!
It gets easier Just like any new skill it gets easier with time and the more practice you have. Ask for help when you need it.
There are lots of sources of community help Check out the resources section for Lactation Consultants and Support Groups near you.
Anytime you are unsure if breastfeeding is going well, contact a Lactation Consultant.
Signs of poor feedings
✓Feeling pain during feedings ✓Sleepy baby ✓Difficulty latching-on and staying on ✓Clicking or popping sounds in your baby’s mouth ✓Prolonged nursing (more than 20-25 minutes on each side) ✓Infrequent nursing (baby does not wake to feed at least every 3 hours) ✓Baby is not satisfied at the end of the feeding ✓Inadequate wet diapers and stools ✓Rapid or excessive weight loss (more than 7- 10%) during the first few days ✓Has not regained birth weight by 2 weeks ✓Slow weight gain thereafter (less than 2/3-1 oz per day in the first few months)
Up to 80% of breastfeeding parents believe they have low milk supply. And while people do truly struggle with milk supply issues, it’s also true that only about 5% or less suffer from primary lactation insufficiency or a physiological inability to produce enough milk (usually because a health condition).
Milk supply issues can happen due to a secondary cause like a premature or complicated birth. These situations can make it harder to establish a full milk supply right away. This doesn’t mean your breasts can’t make enough milk ever. It just means that they aren’t making enough milk right now—often we can fix these issues!
After many years as a Lactation Consultant, the majority of low milk supply concerns I see are actually non-issues. That’s to say, parents feel like their milk supply is low but there’s no evidence that’s the case. Often this occurs because we haven’t fully learned what our babies are communicating to us. We think if our babies cry or fuss there might be something wrong with our milk! And it has a lot to do with how we feel about our bodies and how much we trust things to go well.
Perceived low milk supply is the number one reason breastfeeding parents give for why they stopped breastfeeding. Figuring out what’s really going on can be tricky because it’s not just you but also your baby in the picture. So milk supply has to match up with baby’s ability to eat well.
My baby cries and fusses often so my supply must be low…
Babies cry for lots of reasons! As parents we are quick to blame ourselves and worry that we don’t have enough milk or that something in our milk is bothering our baby. Most babies who aren’t getting enough are actually very sleepy. They are difficult to wake and have a hard time staying awake for a whole feeding. They are quiet, “good” babies.
Babies often have periods of fussiness related to gassiness, overstimulation, or just common evening crying. Snuggling your baby close, skin to skin can help soothe some of these discomforts. Alternately, hold your baby in a carrier or sling and go for a walk. The motion and change of scenery may help!
My baby wants to eat more often than every 2-3 hours…
Newborns who are fed responsively will feed on average 12-14 times in a 24hr period. Older babies and bottle fed babies do this sometimes, too! It’s normal to have increased feeding times at 4-6 weeks and 16-18 weeks. It’s also normal that your baby will cue to feed for soothing and snuggles. Touch and suckling are strong needs for baby and they are satisfied by breastfeeding.
My baby will take a bottle after breastfeeds so they must still be hungry
In the early weeks, suckling is a reflex. A bottle nipple stimulates the right spot on the top of baby’s mouth and they suck reflexively. The bottle nipple also drips which causes baby to swallow. When they swallow the nipple releases more milk…and then you are in a cycle! Babies also love to suck for comfort. So they are willing to take more if it’s offered. This can cause overfeeding which results in spit up and gas and that can cause more fussing!
I can’t pump as much as my friend so I think I’ve got low supply
On average, a pumping session without prior breastfeeding will yield 3-4oz (or about 1-1.5 oz if you’ve just breastfed). More than that can be normal but it’s not necessary. Baby’s stomach can only hold about 4oz. Also remember that milk flow comes from oxytocin (that lovey, warm hormone you get with skin to skin) and oxytocin isn’t as high with pumping as it is with your sweet, cute baby.
Your Lactation Consultant can help you find the right pump for you and make sure you have a good fit and a pumping plan that works for your needs.
My breasts don’t feel full anymore. I think I lost my supply.
In the early days our breasts can feel *very* full and heavy. Lots of that is from milk but even more of it is from fluid retention (which can also cause our hands and feet to swell). As that extra fluid is passed, our breasts get softer. They also start to respond to what your baby needs so they tend not to get overfull after a few weeks.
For many people, anywhere from 1.5-3 months is when they notice these changes. It can often coincide with returning to work and increased pumping sessions (see above).
The best indicator for a sufficient milk supply is to look at your baby.
Is your baby happy most of the time? Do they have some alert times during the day? Are they making daily bowel movements and lots of wet diapers? What about weight gain? If they are gaining 5-7oz per week in the first few months then they are doing great!
If you ever have concerns, drop in for a weight check at your local breastfeeding group or schedule a visit with a Lactation Consultant.
Here is a list of local providers and breastfeeding support groups:
On January 14th from 3-5pm at the Corvallis Birth and Women’s Health Center, the Linn Benton Lincoln County Breastfeeding Coalition honored Debbie Alba, CNM, IBCLC with the coalition’s fourth annual “Breastfeeding Advocate of the Year” award.
Debbie Alba, Breastfeeding Advocate of the Year
Debbie currently works as a Certified Nurse Midwife and lactation consultant for the Corvallis Birth Center and as a lactation consultant for Samaritan Health Services in Corvallis. Her passion is to support women and babies through the birth experience and beyond.
She started working as an advocate for women and children in 1995 in San Francisco, where she first learned of the power of a positive birth and breastfeeding experience. Debbie has worked in the local area as a public health RN for Benton County, and for Samaritan Health in the home health, inpatient, and outpatient environments as an RN and lactation consultant.
Debbie holds a Bachelor of Science degree from Santa Clara University and a Bachelor’s in Nursing with honors from Oregon Health Sciences University. She has been an International Board-Certified Lactation Consultant since 2002 and more recently graduated Summa Cum Laude from Frontier Nursing University with a Masters in Nursing in nurse midwifery.
She has served on the board of directors for the Oregon Washington Lactation Association, the Breastfeeding Coalition of Benton County, the Linn Benton Lincoln Breastfeeding Coalition, and the Breastfeeding Coalition of Oregon. She works to engage in and inspire innovative projects around the state of Oregon. This has included her role in Good Samaritan Regional Medical Center’s path to becoming a Baby Friendly Hospital.
This adds up to an impressive 25 years of helping breastfeeding families!
She is the mother of three children; and she and her husband live on a small farm outside of Philomath. She gardens and takes care of their herd of dairy goats, makes cheese, and runs on the hills around Corvallis with her two dogs.
To sum up Debbie’s passion for her work, here is a quote Debbie’s bio from the Birth Center website:
“I am committed to supporting women through evidence-based practice and informed choice throughout their personal journey towards health, and am particularly interested in providing a bridge from pregnancy care to overall health care, including mental health. I believe that empowerment of women in their life journey and optimum health and well-being of both women and children lays the foundation for a healthier, more sustainable society.”
Thank you, Debbie, for your valuable and impactful work and congratulations, on being this year’s Breastfeeding Advocate of the Year.
Over the years I have had many mothers ask me if low carb diets are safe while breastfeeding and recently several mothers have asked me if the keto diet is compatible. Many people find that a low carb or keto diet helps them to lose weight rapidly without being hungry all the time or experiencing cravings, and of course after having a baby, many women are looking for some kind of diet plan. A few weeks ago the IABLE came out with a parent handout about the keto diet in relation to breastfeeding, as well as making it the subject of their weekly #LACTFACT question.
They discuss a risk of low carb and keto diets called ketoacidosis. This can occur when the body is burning fat and produces an excess of blood ketones which causes the blood to become too acidic. This rare but life threatening illness is more likely to occur during breastfeeding because of the extra calories the body requires to make milk. This condition is fairly common among dairy cows during early lactation because the energy required to make large quantities of milk is often much more than the cow is physically able to eat. Cows suffering from this condition have to be given large quantities of intravenous glucose and steroids to save their lives.
In addition to the low but real risk of ketoacidosis (Google: lactating women ketoacidosis), a woman who starts on a low carb or keto diet is often restricting her daily calorie intake very rapidly and this can result in a decrease in milk production. Experts who study “blue zones” – areas of the world where populations live longer and are generally very healthy – have found that the typical diets in these areas consist of legumes, grains and vegetables and generally relatively low amounts of dairy, meat, and fat. Long term, these “blue zone” diets are probably more sustainable and balanced than low carb dieting.
The authors of the keto diet and breastfeeding handout recommend that women considering a low carb or keto diet while breastfeeding use caution. They suggest consultation with a dietician or physician before strictly eliminating carbohydrates or dramatically reducing calories. A diet with increased protein and fewer carbohydrates may be helpful for lessening hunger and cravings while losing weight, but completely eliminating carbohydrates while breastfeeding is probably not wise, particularly during exclusive breastfeeding.
Many breastfeeding mothers need to or choose to express breastmilk at some point during their breastfeeding journey. Many use breastpumps, though some prefer hand expression or milk collection devices to collect leaked milk. Many women pump while they are away from their babies for work or school, while others pump to increase their milk supply. Some choose to pump their milk and donate it to babies whose mothers can’t produce enough. Some mothers with babies who are born somewhat early, often called late preterm babies, use a technique called triple feeding to make sure their babies take in enough breastmilk while they wait for them to mature enough to be able to breastfeed exclusively. The three steps of triple feeding are: 1. Feed the baby at the breast. 2. Simultaneously pump both breasts with a double electric breastpump. 3. Feed some of this expressed breastmilk to baby via bottle. This cycle is generally repeated every 3 hours. Triple feeding is a lot of work and many women find it cumbersome or overwhelming.
Parallel pumping is a technique described in an article called Maternal Satisfaction With Parallel Pumping Technique by Kathleen McCue and Michelle Stulberger in a recent issue of Clinical Lactation. This technique aims to make triple feeding more manageable by combining two of the steps. The technique involves using a breastpump to pump one breast while simultaneously breastfeeding baby on the other. They recommend using a pumping bra to hold the pump in place, then latching baby to the other breast. Because the women in their study were pumping to maintain or increase milk supply for late preterm babies, they recommended using a hospital grade multi user breastpump. For mothers who want to use this technique for donating or for having some extra milk in the freezer, the regular double electric pump issued by insurance may be adequate.
Mothers who are triple feeding may want to use the parallel pumping technique every feeding. Others may only want to do this a few times a day, or only when they happen to need some extra milk. A blog post at The Leaky Boob.com explains the technique and has a few pictures.
According to the article Clinical Lactation, many mothers found this technique easier to manage and more efficient than triple feeding. In theory it may also increase milk production since women may experience a stronger let down reflex for the pump while they are also breastfeeding than they do when pumping alone. I hope that this technique will become more widely known and accepted as an alternative to triple feeding, and also for mothers who are pumping for other reasons.
At our most recent Linn Benton Lincoln Breastfeeding Coalition meeting one of our members brought information to share about Julia’s Way. Julia’s Way is a non-profit organization dedicated to inspiring parents, medical professionals, and the general public to reimagine what’s possible for those living with Down syndrome through education, advocacy, and awareness. Their website has many resources for parents of children with Down syndrome and a particular focus is on breastfeeding. They have a helpful educational brochure available in 9 languages which is available here.
They also have a whole page of breastfeeding resources for families here.
At our meeting we watched their video called Nursing Down Syndrome.
This video is very inspirational and a wonderful resource for families who have or are expecting a baby with Down syndrome, as well as for all of the professionals who work with these families.
Julia’s Way is in the process of writing a book called Breastfeeding and Down Syndrome: A Comprehensive Guide for Mothers and Medical Professionals. It will be available as a free download on their website when it is released later in 2019.
Please browse the Julia’s Way website to learn more about this inspirational organization!
On January 3rd from 3-5pm at Good Samaritan Regional Medical Center, the Linn Benton Lincoln County Breastfeeding Coalition honored Rocio Badger, Maternity Care Coordinator with Samaritan Health Services with the coalition’s third annual “Breastfeeding Advocate of the Year” award.
Rocio Badger is very deserving of the breastfeeding advocate of the year recognition award. She connects all of her Spanish speaking clients with WIC and other local resources prenatally so they can make contact with the programs they need and get support and education about breastfeeding. She calls WIC when babies are born to translate and report the births of the new babies and to get moms connected with support. She helps the families she works with fill out paperwork for OHP and Social Security. Rocio is extremely dedicated to the families she serves and she is a true asset to our Hispanic community in Linn County.
Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one you can keep depending on your insurance. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you’ll receive it (before or after birth).
Health insurance plans must provide breastfeeding support, counseling, and equipment for the duration of breastfeeding. These services may be provided before and after birth.
Contact your insurance plan with any questions about breastfeeding benefits for your individual plan.
Steps to take to get a breast pump from your insurance
Talk to your doctor while you are pregnant about wanting to get a pump after baby is born.
Insurance plans require a prescription from your doctor.
Your doctor will need to fax a prescription to a medical supply company.
The supply company will call when the pump is ready to be picked up.
Samaritan medical supply :
Corvallis – 777 NW 9th St., Suite 200 Corvallis, OR 973330 Phone: 541-768-7500 Fax 1-866-539-0313
Lebanon – 325 Industrial Way Lebanon, OR 97355 Phone: 541-451-6364 Fax 541-451-6366
Call WIC at 541-967-3888 if you do not have insurance or need to borrow a breast pump until your insurance provided pump is available.
“2017 House Bill 2503 created a program and license for lactation consultants. The program was placed under the authority of the Health Licensing Office. Administrative rules for lactation consultant licensing, license renewal and continuing education were developed with a rules advisory committee.
Licenses will be issued beginning Jan. 2, 2018. Rules take effect on Dec. 1, 2017; and applicants can submit their applications beginning on Dec. 1.”
Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one you can keep depending on your insurance. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you’ll receive it (before or after birth).
