Ovulation and milk supply drops

Remember I was discussing my random milk supply drops a while ago? Well I finally figured out the culprit, and it's none other than ovulation. Many mothers notice their milk supply decreasing right before they get their periods each month, but then it picks up a day or two after its onset. However, some mothers notice this same drop on or about ovulation. Like me.

Before my period returned, I just assumed that my monthly drops were during my non-existent period. Maybe it was my period getting all geared up for the big day with practice runs each month? But now that I do have a period and can see when I ovulate, I came to realize that these sudden decreases in my supply were always timed on my day of ovulation. In fact, if I want to know when I'm ovulating, I can use those drops as indicators!

This month, Sam has been teething really badly so he is nursing for longer since it apparently comforts and or soothes him. I don't mind! So doing this upped my supply quite a bit (I pumped 4.75 ounces today when I normally pump about 3 oz these days) and my boobs feel full to the touch. Still, my letdown is on vacation. It takes a really long time for it to happen, even 5 minutes sometimes. But I know I have plenty of milk. It's just a matter of releasing it. In addition, the letdown doesn't yield so much at a time. However, if Sam nurses for more than a few minutes, he would stimulate another letdown eventually.

So I should really correct my original line of "drop in milk supply" to "slow and reduced letdown reflex."

Getting a breast pump from your insurance company

I recently got a message through my contact form at the right from Shaffizan, who wrote this post on her blog. She brought up a valid point about obtaining breast pumps from one's insurance company. I'll elaborate on that a bit now.

A good double electric breast pump is an expensive item, no question about it. It's this machine trying to replicate what the human body does, so I guess that's why it isn't cheap. When you have a baby, your expenses rise like a newborn's cry and the last thing you want is yet another important but pricey item to send you over the edge. Just to give you an idea, Amazon has the Medela Pump In Style Advanced Backpack model for $218 and the Ameda Purely Yours for $159. And these are priced at below retail price. If you're like me, you're just not interested in one for that price. Especially when you know they won't last for more than a few years at best.

Enter the new Affordable Care Act which you may or may not approve of. But one thing's for sure, they definitely had breastfeeding mothers in mind (yay!). Under the ACA*:

"Your health insurance plan must cover the cost of a breast pump – and may offer to cover either a rental or a new one for you to keep.

Your plan may have guidelines on whether the covered pump is manual or electric, how long the coverage of a rented pump lasts, and when they’ll provide the pump (before or after you have the baby).

But it’s up to you and your doctor to decide what's right for you."

So the best thing to do is to call your insurance company directly, preferably before you have your baby, and ask them about their breast pump policy. It's probably easier than to go through the ten-inch thick insurance contract book. They will tell you which suppliers they're affiliated with, and you will have to be in touch with them about placing your order. Some insurance companies require you to order the pump within 30 days of giving birth so it's best to find that out early on. It's really that simple.

Now what's if your insurance company won't provide you with the model you really want? Or what's if you want to own a second pump (so you can leave one at work and keep one at home for days off)? Here's a little tip. Since basically everyone's insurance company is providing them with pumps, what's if you don't actually need a pump? They'll still give you one. So these folks now have pumps that are not in use, just collecting dust. Then they sell them on eBay or someplace.

It's not too hard to find brand new still-in-the-box pumps being sold on eBay by people who got them from their insurance companies. How do you know? They come in the same insurance-given packaging (instead of the retail packaging you find in the store). Often, you can find a good deal on these pump since the sellers don't mind making a quick buck and aren't asking for the full retail price anyway. This is how I bought my second Ameda Purely Yours pump for $45 (brand new, never used).

I personally would not use somebody else's already used pump unless I just use the base and buy my own attachments. Even though most parts could be sterilized depending on the model, there are some areas that can't be sanitized well enough without damaging the equipment. Sometimes this works as another cheap alternative: borrow or buy off somebody's actual pump, but then buy the new pump parts.

You can read more about my pumping experience here.

*The ACA will also cover other breastfeeding-related needs such as lactation support. It also requires larger companies to allow pumping time and a place to pump for mothers who require it.

Sleeping training and schedules with a breastfed baby

The words "sleep training" are all a frazzled mother needs to hear to bring on a case of night terrors. We all want our babies to sleep peacefully through the night like little adults, but we don't want to teach them. Much like toilet training - we wish they would just finally use the bathroom like big kids, but who wants to mop up the accidents? Yet, we've all got to do it one way or another, unless you give birth to an angel who sleeps through the night since being a newborn.

First I must mention a few key points:

• Maybe the most obvious one, every baby is different. The sleep tactics that work for your friend's baby may not work as well for your baby. And formula-fed infants may sleep differently than your breastfed baby.
• A sleep problem is only a problem if it's a problem for you. Your baby is fine and is probably getting enough sleep the way he/she is. You only need to sleep train if it bothers you.
• Babies who sleep through the night from day one - sounds like a dream, doesn't it? Well, if you are a full-time working mom and need to pump more than once a day, you probably want your baby to nurse at night to maintain a good milk supply. Which brings me to my next point:
• Nighttime breastfeeding is SO good for your milk supply. This is because the level of milk-producing hormone prolactin is much higher at night and you want to take advantage of that.
• What I found - and this is by no means a scientific, proven theory - is that mothers whose babies sleep through the night very early on stop breastfreeding earlier than mothers whose babies nurse throughout the night. That's just what I noticed among friends and family.
• If you want to sleep train, you and your spouse have to be 100% committed to doing it right. You can't chicken out mid-way. If you don't feel ready, wait. 
• The term "sleeping through the night" (or STTN) has a wide definition. It can mean anywhere from 5-7 hours in a shot, to sleeping 12 hours straight. So take it with a grain of salt.
• Sleep training technically shouldn't be tried until a baby is four months old. However, that's precisely the time their sleep becomes all wacky anyway, so I wouldn't bother until about 6-7 months. Also that's when babies are distracted by daytime feedings, so they cash in on the calories they could get in the peace of night. Don't deprive them!
• Normal napping ensures good night sleep. If don't let your baby nap, thinking they'll be "good and tired at night" you'r just setting yourself up for an overtired baby.
• Follow established sleeping guidelines to know approximately how much sleep your baby needs at night. For example, a one year old shouldn't really be sleeping from 11pm to 8am and having random naps (though this schedule works great for a much younger baby!). 

There are basically two schools of thought regarding sleep training: (1) methods that involve letting a baby cry it out (CIO), or (2) gentle, no-crying sleep solutions. The first has been popularized by Richard Ferber, the second by Elizabeth Pantley. It's really up to you to decide which to use. The first is much, much quicker, but it can be pretty heartbreaking to let your baby cry when you know that a quick feeding will heal all. It's almost always effective and working after a 3-5 days. The second method is long drawn-out process that involves keeping sleeping logs and gently getting your child to sleep through the night, and it can take several weeks to months to achieve STTN.

I'll admit, I bought Elizabeth Pantley's book and found it really enjoyable, as a book. I learned a lot about baby's sleep habits and things like that, but I did not find the ideas implementable. For one, I work so I'm not with Sam all day and can't keep track of all his naps and stuff. Besides, the book kind of relied on the fact that the reader's baby is having normal, long naps each day. Sam took 3-4 smaller naps each day at that point.

Also, I have to say that I don't mind a little seemingly harsh training if the results are effective and if they would help both Sam and I sleep better. So I looked into Ferber's theory and found it pretty simple. I would have to let Sam cry for small increments of time before going in to calm him down and increase those amounts each time.

At the time of training, Sam was about 8 months old. Each night, I would nurse him before bed and then put him (awake) into his crib. He would cry a few minutes later. I'd go in and reassure him. Come out. Cry. Go back in. Usually I'd just rub his back till he fell asleep. Eventually he fell asleep. He'd wake up 2 hours later or less, and I knew he wasn't hungry since he just ate, but I still fed him. He wouldn't even nurse for that long (proof that he wasn't really that hungry). I know some of you might argue that he needed the comfort and all that, and maybe that's true. But he definitely got comfort from all the other breastfeeding times that he didn't absolutely require it every two-three hours at night.

After so many nights of broken up, choppy sleep, I decided we had to train him and we'd do it gently. No cold turkey for me. So I decided to go with reasonable chunks of time, which was 4 hours. If Sam woke up before 4 hours since his last feed I'd let him first cry for a minute or two to see if he actually needed me or would go back to sleep on his own. If his crying persisted, I'd go in after five minutes and then pat him and reassure him and help him find his pacifier. I walked out. If he went back to crying, I'd wait 7 minutes before going back in. Then 15 minutes. I never had to go back in more than 3 times. By the fourth night, he fell asleep for the night on his own without crying. And if it was four hours or more since his last feed, I'd just nurse him back to sleep like I've always done.

You know what? When he put himself to sleep he slept much, much better! He would sleep for longer chunks of time. We used this method to eliminate the 2-3 AM feeding which I really felt was unnecessary since he ate a lot at the 11-12 feeding (right before I went to bed).

So if you're feeling brave and or if you've had it with the incessant feedings and comforting in the middle of the night, try this. You have nothing to lose. Just give it your all. This won't work if your husband feels bad and will sneak into baby while you're chewing your nails in the other room during a crying bout. Both of you should follow the plan you create (e.g. creating a time limit, such as four hours, and using Ferber's method for when your baby wakes up earlier than that).

A baby who sleeps well at night wakes up HAPPY.

Let me know what works for you and what doesn't!

Sam's latest feeding schedule - 12-13 months

I always wondered how weaning works. Does the baby just decided to not nurse one day? Or is it gradual? How do you know how much to feed and to nurse? It's so confusing and there's no rule book! What ended up happening in our case was a gradual breastfeeding decline. Almost as soon as Sam turned one, he would refuse to nurse at certain times and that's when I realized he just doesn't want to eat then. So I followed his cue and nursed only when he was willing. That scheduling turned out like this:

8:00-8:30 AM: Even though Sam wakes up sometime between 7 and 8, I don't feed him until 8 or 8:30 because he did nurse recently in the early AM, which I'll discuss in a second.

9:00 AM: Breakfast time. Sam eats oatmeal cereal mixed with vegetables or fruits. Then he munches on some dry cereal or cut up fruit.

12:00 PM: He gets a yogurt and a drink. Lately he takes just a few sips of breastmilk or water and that's it. He doesn't go for drinking all that much so we have to sneak it in.

3:00 PM: A baby jar of either fruits and vegetables. Snack of corn pops, veggie straws, teensy fruits, Gerber's puffs, etc. Try to get him to drink some more breastmilk or water.

5:30 PM: We enjoy a good breastfeeding/reunion time.

6:30-7:00 PM: Suppertime. Sam usually eats what I make for supper (some of it). Otherwise I defrost some soup, or he has bread and cheese.

7:45-8:00 PM: Bedtime nursing.

12:00-12:30 AM: I breastfeed him before I go to bed. This is a dreamfeed. I don't wake him up for it.

5:30 AM: Breastfeeding.

Printable pumping output chart

Pumping output chart

If you're like me, the amount you pump each day is very important to you (and your baby, of course!). Some folks are pretty regular pumpers and they always produce their same amount of ounces each day. I am not like that. I often wanted to see a log of how much I pumped over a week, two weeks, or longer, but never had an organized way to do this. Until I made this chart. Just fill in the time and day of the pumping session (you can use two rows per day if you pump twice a day), and the amount you get from each side. Add it up and you've got your total pumping output per day.

Download and print the pumping output chart.

Printable feeding clock for new moms

When you're discharged from the hospital after delivering your baby, the staff will send you home with a badly photocopied feeding chart with all the hours written out, and you're supposed to circle the corresponding hour each time you feed. This way you can keep track of how many feedings your baby gets over a 24-hour period. That's great for the really early days, maybe a week or so. But afterwards, all you really want to know is when you last fed your baby. It can be hard to remember little details like numbers when you're so busy nursing, sleeping, changing diapers, etc. while your sleep tank is running on empty.

Printable feeding clock

So I created a handy printable clock that lets you keep track of prior feedings when you don't have a pen handy, or can't write (great for Sabbath). You can hang it on your fridge with a magnet and your baby's last feeding time will be prominently displayed in either pink or blue.

INSTRUCTIONS: Download and print the feeding clock or click the thumbnail to the left. Cut out the circle of the clock, along with both handles. You can use pink or blue for a girl or boy, respectively, or you can use both to show the last two feedings. Poke a hole in the center black dot of the clock, and the dots on the hands. Affix the hand/s to the center of the clock using a paper fastener. Alternately you can use a small magnet to hold it in place on the fridge, or affix the hands to the edge of the clock with a paper clip.

To use, simply move the hand to display the correct time when you finish feeding your baby.

Nursing position tricks for unwilling babies

Ever had the experience of your baby repeatedly refusing one side when nursing? Your baby can be doing that for many reasons, among them:

1. random quirk (most common) - babies do all sorts of weird things for no explainable reason
2. during a blocked milk duct - milk isn't coming out fast enough from the affected side so your baby is just not interested in waiting around for snail mail. 
3. after a blocked milk duct - the old, backed up milk from behind the plug is now being released and it doesn't taste that great (it can taste salty because of the high fat content).
4. ear/teething pain - if you suspect this, have your pediatrician examine your baby to rule this out

I came up with a pretty neat hack for this situation. Of course, if the reason is due to some kind of ailment (reason 4), deal with that properly. If you've determined that it's probably due to reasons 1-3, you can proceed to try this simply, yet very effective idea: switch nursing positions.

I normally breastfeed in one position only: cross cradle. Sam lays across a pillow on my lap, and for illustrative purposes, is nursing from the left side. My right arm supports back and my right palm holds his head and neck to face my nipple. My left hand supports my boob from below to give it some lift.

Let's say he refuses to nurse on the right side. I won't reverse the nursing position so he can eat from the right side. Instead I'll keep my hands and everything in the same original places, but I will slide his body over to the right just a bit so his face is now in front of my right breast. If needed I can use my left hand to now lift up my right boob, but usually I don't bother if I want this to be done as smoothly as possible. This can be done so deftly, he will be none the wiser (and he is wise!). Right now he is in more of a football hold, actually.

So a simple switch of positions is often all you need to get your baby to latch onto his/her less-preferred side.