I encountered my second panic attack last week regarding breastfeeding. After 3 days of frustration and worry, I decided to seek help from a lactation consultant. Although the session was $150 an hour, it worth every penny! So I think it’s a good time to write a post about breastfeeding in general and to share what helped me for the last 5 months (almost) of exclusive BF and pumping. Hopefully someone can find it useful. What I’m putting here is from my own research and experience.
Tips for breastfeeding
- Start early: as soon as they put the baby on you, start nursing! The early contact is great for both you. Your body temperature and closeness give the baby sense of security, it also helps him/her to learn nursing faster. Nursing is a innate skill but it is not fully developed. It requires practice for the baby to get good at it. For the mom it is good because it releases hormones to produce milk.
- Be patient: the actual milk might not come right away. My milk came in on the 4th or 5th day. Before that I had colostrum but it was not a lot. I didn’t see any of it dripping out, but Sofia was peeing and pooping, her mouth had a white cast, so I assume she was getting it. If the baby loses more than 10% of his/her weight, doctors might want to supplement with formula. In that case, I’d suggest to wait 12-24 more hrs until you do that because sometimes babies come out quite puffed due to all the IV the mother gets during labor, so they don’t actually lose their real weight, but more of it comes from the extra water they get. There are studies that show once the formula enters into the GI of babies, it takes 2 weeks to clean it out even you continue exclusively BF. Of course, if the worry is real, for example the baby also gets jaundice and it’s severe, you might want to start supplementing early.
- Nurse frequently: the first 4 weeks, feed in demand and nurse as long as the baby wants. That is the time that the milk supply gets established. Since it’s a demand/supply system, the more milk is removed from the breast, the more it is produced. Don’t worry about spoiling the baby by nursing constantly. First, you won’t be doing it for long (probably too short looking retrospectively!), second, it’s good for establishing well the milk supply for the long run.
- Drink, drink, drink: the first month I was easily drinking 3-4 liters of water every day, after 2 months until nowadays I still drink 2-3 liters. I’m a big drinker before pregnancy, and I drink even more now that I’m EBF. Just think about it, in average we produce 25-30 oz. of milk per day, so you should drink at least that amount more of liquid to replace it, if not more.
- Eat your protein: protein intake should be higher than when pregnant. I don’t know exactly how much more I am eating, but I’m consciously making an effort to incorporate protein in at least 2 meals of the day.
- Foremilk and hindmilk: babies need both of them because they contain different nutrients. Foremilk has more water content and calcium. Hindmilk has more fat therefore more filling. Make sure in every meal the baby gets both of them. For small babies, it means feeding each side at least 20 min. Don’t switch up so much because they could be getting too much foremilk and that can cause gas and green poop.
- Enjoy: lastly, enjoy the nursing sessions, even those 2 or 4 AM ones. It might seem tough at the beginning, but really it is not, it’s so enjoyable to be able to nourish your baby, and the bounding experience is the best part!
Because I never had a supply issue, I’ve never tried remedies to increase it. Things that I’ve read that might help includes eating oatmeal, taking fenugreek supplements, etc. If one day my supply drops, I’ll try them.
Tips for pumping. I started pumping when Sofia was 1 month old. And nowadays I’m pumping 5 times a day.
- Start early. At first you might not get much milk out of a 20 min pumping session because your breasts are not used to the pump. But after a week of consistent pumping, you can get anywhere from 1-3 oz. in between feedings.
- Take advantage of AM pumping. We started to give expressed milk to Sofia at night when she was 1 month old. That means there is 7-9 hours that I don’t remove milk from breasts. Therefore the first pumping session in the early morning I get between 10-12 oz. I was building a stash of milk so that early session really helped. Our milk production is the highest between midnight and morning, so if you want to build a stash, pump frequently during that period.
- Invest in a good pump and bra. If you plan to pump for long term, getting an electrical double pump is a necessity. It’s not cheap but it’s a great investment if you use it everyday. I have the medela freestyle and I love it. It’s small, easily portable, doesn’t need to be plugged into an outlet and it’s not too noisy. The handsfree bra is really convenient if you want continue working or do other things while pumping.
- Check your pump parts. This was the main reason I went to the LC. I wasn’t getting much from pumping. I freaked out because I thought my milk supply dropped. Normally I get 4-5 oz. in a 20 min pumping session at work, but last week I barely got 2 oz. in 30-40 min. Imagine how scared I got! 😯 But then I squeezed my breasts and milk came out. So the problem was the pump. During the session with the LC, we figured out that the tubing and the membranes were wore out, so I got them replaced and immediately was pumping more. For working moms who pump everyday, the membranes need to be replaced every 3-4 months.
- Find the right breast shield size. The medela freestyle pump comes with two sizes of breast shield, 24 and 27. I was using 24 mm and noticed that if I pump for longer than 15 min, sometimes my nipples get stucked in the tubes and were not moving much. If they’re not moving, the suction of the pump would not work, therefore no milk comes out. The LC made me try different sizes and determined that 27 mm work the best for me. Another tip that she taught me is to use some coconut oil or nipple cream in the breast shield to further help the suction to work its best.
- Aim for short and frequent sessions. I told the LC that I was pumping 30-40 min when I don’t see much milk coming out. She suggests to pump 15-20 min, take a 15-30 min break and pump another 10 min later. I don’t know the rational behind it, but it works!
- Massage while pumping to help with efficient milk removal. Manual expression can be helpful when pumping, specially those areas that you feel there’s more milk but it’s not coming out, just massage or give pressure on the spot, it helps to get things flowing.
- Continue to nurse. For working moms like me, pumping takes over nursing most of the time. But it is so important to continue to nurse as often as possible because the skin contact releases the hormone to produce milk. Even the baby doesn’t need more milk, another 5 min of nursing session helps to maintain the supply. In my particular case, she suggests that I nurse Sofia in the morning when she wakes up (7:20), and nurse another 5-10 min before I leave for work (8). The same thing at night, nurse her right after I arrive home, then do the night routine, and nurse her before bed. Of course, during weekends, nurse nurse and nurse!
- Learn manual expression. The pump is great and convenient, but we need to learn how to manually express the milk in case that the pump does not work. I didn’t think about it much until I saw the LC and realized how important it is. Just imagine one day if I travel for work and the pump doesn’t work, how freak out I’d be!!! It’s not difficult to learn, there is youtube videos that you can learn from. It’s just time consuming.
- Do not overfeed the baby. While I’m at work my mom aims to feed Sofia as much as she can take. Usually she’ll stop at 4-5 oz. but my mom will try 30 min later and makes her finish the bottle. That means she’ll eat 18 oz. while I’m away and I was only producing 12-13 oz. Although my morning pump session makes up for the difference, it’s still kind of stressful to know that she’s eating more than I am making. The LC told me Sofia was taking way too much. For her age (almost 5 months) and her weight (13-14 lb.), 4-5 oz. is what she needs.
- Fast and slow modes. The pump starts with 2 min of fast suction followed by a slower but deeper suction. It mimics the suction of babies. To make it more efficient, switch between modes. That means, when you start with the fast mode, observe when the milk starts to come out (let down), at that moment, switch to slow/deep mode. If at any time, milk stops coming out, switch back to the fast mode to induce another let down, and then switch to slow/deep mode.
- Relax. Stress might be the number one enemy in breastfeeding and pumping. The more obsessed I am with how much milk I’m making, the less milk I produce. Although it is not easy to relax when you see your supply dropping, but be aware that stressing out about it will make it even worse.
I think that’s all. I hope it is useful for some moms or to-be moms. I will write a post about how to pump and transport milk while traveling. Unfortunately I might have to travel for work soon, and I’ve done a lot of research of how to transport back the milk. I’ll let you know my experience later. 🙂
And the most important message I want to leave you is: breastfeeding is a wonderful experience! It’s much better than I’ve expected. If you are as lucky as I am to be able to do it, ENJOY the journey! 🙂