We're down to one feeding a day. As of 2 weeks ago, I cut out the pre-bedtime bedtime since I was feeling very run down with a virus and pre-holiday preparations. I figured I'll replace that feeding with a cup of regular milk and see what happens. It worked surprisingly well.
I gave Sam his drinking bottle (popup sports water bottle filled with milk) and held him as he drank it. We walked around the house, talking and winding down while he consumed the milk. Then we came to his bedroom where I sang him a short lullaby and kissed him. I lengthened his bedtime ritual since I didn't want him to lose out on the physical and emotional bonding and comfort which nursing provided until now. After that I lay him down in his crib and he went to sleep.
It worked out so well, thankfully. And I got a chance to wind down myself. Nursing is quite relaxing - and I'll be the first to admit it - but I find the experience draining at the end of the day (and almost falling asleep myself, which wouldn't be safe given the position we're in). I feel more relaxed this way and Sam doesn't mind, so we'll stick with it.
I do nurse him in the early morning, before the real wake up time. Sam usually wakes up crying at around 6:30-7am but isn't really ready to wake up then. So that's when I feed him. It's a quality feeding since he's mostly asleep and undistracted. I put him back into bed afterwards and we both go to sleep. He'll usually sleep until around 7:45-8:15, which is way more convenient for me! I can't do early wake-ups.
What does a mom's milk supply look like when she is breastfeeding just once per day? It doesn't feel that different from the days I nursed Sam more often. I never felt "fuller" (which I believe is a myth in many cases - to me, everything feels the same!) the first few times we skipped that feeding. I don't feel emptier now.
One thing I do want to point out is that you can still nurse whenever you want, even though you're scheduled to only nurse once that day. There is still milk inside you! The other night we were traveling home from the city and Sam woke up from his sleep and kept on crying on and off for 20 minutes. Eventually I thought of nursing him (I think he was thirsty because he had a cold and was breathing through his mouth a lot) since I did not have his drinking bottle handy. I nursed him and he was blissfully sleeping in no time.
Showing posts with label supply. Show all posts
Showing posts with label supply. Show all posts
Tuesday, June 2, 2015
Tuesday, April 7, 2015
Nursing for fun!
It's just so much fun to nurse for fun. That is, to breastfeed when you don't really have to. This week is the holiday of Passover and that means lots of vacation days to spend with my family. Not working plus eating lots of good food is a great breastfeeding recipe, I've found. Sam is with me all day, and we spend a lot of the time with family.
A germophobe like me realizes all the nasty scenarios like kids drooling on each others' toys and stuff, a sick cousin, a sneezing nephew, etc. I figured, lemme load Sam up with protective ammo to fight off whatever he may be exposed to. So I gladly filled our days with a few nursing sessions. It's so relieving and stress-free to just nurse when you really don't have to, since Sam eats regular meals and has snacks and drinks and all that. So he technically doesn't need to nurse at all during the day. But why shouldn't he, when it's that easy for me and my boy? We both enjoyed the experience immensely.
At first I was kind of worried that these extra feedings would result in an uncomfortable increase in my supply, but it hasn't done that at all. I actually got my period a day before Passover (and our vacation) began and as you may recall from an earlier post, my milk supply jumps up during my period, after being kind of faulty from ovulation onward. So this was a perfect time to max out since my milk was flowing nicely. I had plenty, even during the day (not that I felt full or anything, just I did have availability as long as Sam sucked). Today I am back at work and don't feel uncomfortable at all - I feel like I normally do.
Speaking of sickness protection from breastfeeding, two weeks ago I came down with an awful case of strep throat. I don't know where I caught it, but it's been about 20 years since my last case of it and now it was back. I began to feel sick on a Friday but thought it was just another virus so I didn't go to the doctor. Over the weekend I felt worse and worse (with fevers, chills, aches, knife-scraping throat-ache, sore muscles... the works!) but didn't get a chance to see a doctor until Sunday. That's when I got medication and began to feel better. Now, all weekend before I took the meds I was most certainly contagious. But you know what? I was able to personally deliver the proper antibodies to Sam via our breastfeeding and that must be why he didn't contract my infection!
A germophobe like me realizes all the nasty scenarios like kids drooling on each others' toys and stuff, a sick cousin, a sneezing nephew, etc. I figured, lemme load Sam up with protective ammo to fight off whatever he may be exposed to. So I gladly filled our days with a few nursing sessions. It's so relieving and stress-free to just nurse when you really don't have to, since Sam eats regular meals and has snacks and drinks and all that. So he technically doesn't need to nurse at all during the day. But why shouldn't he, when it's that easy for me and my boy? We both enjoyed the experience immensely.
At first I was kind of worried that these extra feedings would result in an uncomfortable increase in my supply, but it hasn't done that at all. I actually got my period a day before Passover (and our vacation) began and as you may recall from an earlier post, my milk supply jumps up during my period, after being kind of faulty from ovulation onward. So this was a perfect time to max out since my milk was flowing nicely. I had plenty, even during the day (not that I felt full or anything, just I did have availability as long as Sam sucked). Today I am back at work and don't feel uncomfortable at all - I feel like I normally do.
Speaking of sickness protection from breastfeeding, two weeks ago I came down with an awful case of strep throat. I don't know where I caught it, but it's been about 20 years since my last case of it and now it was back. I began to feel sick on a Friday but thought it was just another virus so I didn't go to the doctor. Over the weekend I felt worse and worse (with fevers, chills, aches, knife-scraping throat-ache, sore muscles... the works!) but didn't get a chance to see a doctor until Sunday. That's when I got medication and began to feel better. Now, all weekend before I took the meds I was most certainly contagious. But you know what? I was able to personally deliver the proper antibodies to Sam via our breastfeeding and that must be why he didn't contract my infection!
Tuesday, March 10, 2015
Nursing at night and milk supply
On a parenting forum, someone wanted to know if she can skip feedings at night (and have her husband give the baby a bottle those times) and still keep her milk supply at a good level. It got me thinking about the ramifications of this breastfeeding "shortcut".
In the beginning, when your baby is a newborn, you start founding your milk supply "factories". Nurse often, on demand, and you are setting up lots of factories in full production mode. Nurse only sometimes, or most of the time (but not each time baby has to eat) and you're leaving out some valuable establishments. In the beginning your milk is just being produced based on your hormones that were set into motion when you experienced labor and delivery.
It's also so important to nurse AT NIGHT especially because your milk-making hormone called prolactin functions at its best during the night. So one nursing session at night can be much more effective in maintaining your supply than a session by day.
Now, at some point your milk supply will regulate. Your hormones that accompanied labor and delivery are phasing out and your milk won't be gushing out like there's no tomorrow. This point varies in women. Some find that their milk regulates at six weeks, while for others (especially those with oversupply issues) tend to find their supply regulating several months later. My supply regulated when Sam was three months old. This can happen overnight, suddenly, or gradually (for me it was rather suddenly).
At that point, your system of supply and demand takes over. Now is when your factory system comes into play. If you have 5 factories in working order versus 15 factories, it'll obviously be way harder to keep up to the demands of your baby. That's why it's so important in the early days to nurse, nurse, nurse. Your baby cannot overdose on nursing.
Some mothers who skip feedings at night will have no problem with nursing later on. But many do. A key difference would be whether the mother is separated from her baby during the day or stays at home with her child. If a mother has to pump because of a separation, it can be a lot more difficult than nursing on demand if she was at home. Say you can't produce enough with the pump, now what? But if you're at home with your baby it's a lot easier since you can nurse several times that day if your baby doesn't fill up with less feedings.
Additionally, lots of mothers have oversupply issues so skipping a feeding might make them uncomfortable later on, but wouldn't really harm their supply. Also, just because a lot of people can manage doing something, doesn't mean that this is the norm and the "right" way to approach something. A lot of people don't wear seat belts and don't die in car accidents, just as a dramatic example.
In the beginning, when your baby is a newborn, you start founding your milk supply "factories". Nurse often, on demand, and you are setting up lots of factories in full production mode. Nurse only sometimes, or most of the time (but not each time baby has to eat) and you're leaving out some valuable establishments. In the beginning your milk is just being produced based on your hormones that were set into motion when you experienced labor and delivery.
It's also so important to nurse AT NIGHT especially because your milk-making hormone called prolactin functions at its best during the night. So one nursing session at night can be much more effective in maintaining your supply than a session by day.
Now, at some point your milk supply will regulate. Your hormones that accompanied labor and delivery are phasing out and your milk won't be gushing out like there's no tomorrow. This point varies in women. Some find that their milk regulates at six weeks, while for others (especially those with oversupply issues) tend to find their supply regulating several months later. My supply regulated when Sam was three months old. This can happen overnight, suddenly, or gradually (for me it was rather suddenly).
At that point, your system of supply and demand takes over. Now is when your factory system comes into play. If you have 5 factories in working order versus 15 factories, it'll obviously be way harder to keep up to the demands of your baby. That's why it's so important in the early days to nurse, nurse, nurse. Your baby cannot overdose on nursing.
Some mothers who skip feedings at night will have no problem with nursing later on. But many do. A key difference would be whether the mother is separated from her baby during the day or stays at home with her child. If a mother has to pump because of a separation, it can be a lot more difficult than nursing on demand if she was at home. Say you can't produce enough with the pump, now what? But if you're at home with your baby it's a lot easier since you can nurse several times that day if your baby doesn't fill up with less feedings.
Additionally, lots of mothers have oversupply issues so skipping a feeding might make them uncomfortable later on, but wouldn't really harm their supply. Also, just because a lot of people can manage doing something, doesn't mean that this is the norm and the "right" way to approach something. A lot of people don't wear seat belts and don't die in car accidents, just as a dramatic example.
Thursday, February 26, 2015
Breastfeeding, pregnancy and a miscarriage
Here's the story of the beginning and the end.
On the night of December 6, 2014, I took a home pregnancy test because I felt I might be pregnant. My period wasn't really late yet, but I didn't feel any PMS and was curious. It didn't help that I also had plenty of unused tests lying around begging to be peed on. I got a faint positive line! After a few days I retested and got the same very, very faint line. Almost unnoticeable, but it did get darker out of the time frame specified on the package. So there definitely WAS some hCG (human chorionic gonadotropin, the hormone released during pregnancy) going on there.
I finally went and got a blood test December 10th just to confirm. HCG measured at 68, which is kind of low, but doesn't necessarily mean something is wrong. It was still early on. Progesterone was nice and high. The midwife who ordered the blood test and gave me the results was convincing me that I have to wean if I want a health pregnancy, but since I knew I had no problematic history and my progesterone was fine, there was really no reason to stop just yet. And it's a good thing I didn't. At that time I didn't know it, but breastfeeding would become my healing and coping mechanism.
I never experienced any pregnancy symptoms, just a missed period! No nausea, no cramping, no weird pains, no tiredness and fatigue, nothing! I kept thinking something was off because last time around I was feeling lots of symptoms at this point in the pregnancy. I got some pimples (which I never got last pregnancy). I wasn't curious for too long because on December 28th I started to bleed. First like a period, but then like Niagara Falls.
The next day I went to the ob/gyn office and the midwife who examined me said my cervix is closed so that's a good sign, but she ordered a vaginal ultrasound and blood test to see what's happening. Blood test on December 29th showed an hCG count of only 2300 which is way too low. The numbers have to double every 48-72 hours, and this was way, way behind. December 30th was the day for my ultrasound appointment and the results: no heartbeat, gestational sac inside the cervix, something else on one of the ovaries. So clear, I know. The doctor was also confused.
January 2nd I retake the blood test and the level is now at 568. That's a very good sign. Still bleeding. January 5th I pass what seems to be the embryo or whatever because it's just one big blob of something indiscernible. Finally. After that bleeding tapers off, my levels continue to drop, I breastfeed Sam.
It was so, so good that I was still able to nurse. Imagine I'd have weaned and then after this experience I'd lose that delicious, pleasurable, nurturing mothering bond. Devastating thought! Each time I nursed Sam throughout this ordeal, it gave me renewed strength. I delighted in nursing, more than I ever did.
I did not ignore the midwife's advice completely, though. I did drop two feedings in the span of those few weeks. I felt they weren't really necessary anyway, plus I needed more sleep (less waking up at night). It wasn't difficult at all because Sam ate much better and his sleeping development progressed to allow him to sleep much longer stretches at night.
Some points:
On the night of December 6, 2014, I took a home pregnancy test because I felt I might be pregnant. My period wasn't really late yet, but I didn't feel any PMS and was curious. It didn't help that I also had plenty of unused tests lying around begging to be peed on. I got a faint positive line! After a few days I retested and got the same very, very faint line. Almost unnoticeable, but it did get darker out of the time frame specified on the package. So there definitely WAS some hCG (human chorionic gonadotropin, the hormone released during pregnancy) going on there.
I finally went and got a blood test December 10th just to confirm. HCG measured at 68, which is kind of low, but doesn't necessarily mean something is wrong. It was still early on. Progesterone was nice and high. The midwife who ordered the blood test and gave me the results was convincing me that I have to wean if I want a health pregnancy, but since I knew I had no problematic history and my progesterone was fine, there was really no reason to stop just yet. And it's a good thing I didn't. At that time I didn't know it, but breastfeeding would become my healing and coping mechanism.
I never experienced any pregnancy symptoms, just a missed period! No nausea, no cramping, no weird pains, no tiredness and fatigue, nothing! I kept thinking something was off because last time around I was feeling lots of symptoms at this point in the pregnancy. I got some pimples (which I never got last pregnancy). I wasn't curious for too long because on December 28th I started to bleed. First like a period, but then like Niagara Falls.
The next day I went to the ob/gyn office and the midwife who examined me said my cervix is closed so that's a good sign, but she ordered a vaginal ultrasound and blood test to see what's happening. Blood test on December 29th showed an hCG count of only 2300 which is way too low. The numbers have to double every 48-72 hours, and this was way, way behind. December 30th was the day for my ultrasound appointment and the results: no heartbeat, gestational sac inside the cervix, something else on one of the ovaries. So clear, I know. The doctor was also confused.
January 2nd I retake the blood test and the level is now at 568. That's a very good sign. Still bleeding. January 5th I pass what seems to be the embryo or whatever because it's just one big blob of something indiscernible. Finally. After that bleeding tapers off, my levels continue to drop, I breastfeed Sam.
It was so, so good that I was still able to nurse. Imagine I'd have weaned and then after this experience I'd lose that delicious, pleasurable, nurturing mothering bond. Devastating thought! Each time I nursed Sam throughout this ordeal, it gave me renewed strength. I delighted in nursing, more than I ever did.
I did not ignore the midwife's advice completely, though. I did drop two feedings in the span of those few weeks. I felt they weren't really necessary anyway, plus I needed more sleep (less waking up at night). It wasn't difficult at all because Sam ate much better and his sleeping development progressed to allow him to sleep much longer stretches at night.
Some points:
- My supply was not affected by this at all. In fact I didn't have any hormonal drops in supply that I normally got with ovulation. So that's a good thing. People think the day they become pregnant is the day their milk supply vanishes into thin air and they've got to wean ASAP. It doesn't work like that. Most of the time the supply changes occur during the second trimester.
- The myth about breastfeeding during pregnancy causing miscarriages? Well, here's an explanation: For a pregnancy to be able to continue and the fetus to grow and be supported, you need adequate levels of progesterone. That's what thickens the uterine lining every month. Breastfeeding is associated with lower levels of progesterone. In most cases, if a woman doesn't have any history of low progesterone, breastfeeding will totally not cause a loss of pregnancy.
New menstrual changes during breastfeeding
I just got my second period after having a miscarriage. More on that soon. It's weird. Remember I wrote about how ovulation found me experiencing sudden letdown issues, resulting in less output but normal everything during periods? Well, now things have become the exact opposite! They do say that your menstrual cycle can change with each pregnancy you go through, so it makes sense. When I ovulated this cycle, I really wasn't sure if it was actually happening or not. I did not feel any nipple soreness during breastfeeding, no letdown delay, no supply drops, no stomach cramps... nothing! I just saw some extra discharge but that could have been anything. I still marked that day down in my calendar.
Two weeks later to the day I get my period. So I guess something did happen then. I just felt no breastfeeding-related symptoms. However, I got them now with my period! Guess I can't escape it. I feel the soreness, the stunted letdowns, less swallowing on Sam's part, and all that. However, the period itself didn't come with its own symptoms (yay!) like cramping, vaginal itching etc.
So if you're feeling despondent about how your body is running through its menstrual cycles in a way that's much more annoying than it ever used to be, don't despair. It can change yet again, and hopefully for the better.
Two weeks later to the day I get my period. So I guess something did happen then. I just felt no breastfeeding-related symptoms. However, I got them now with my period! Guess I can't escape it. I feel the soreness, the stunted letdowns, less swallowing on Sam's part, and all that. However, the period itself didn't come with its own symptoms (yay!) like cramping, vaginal itching etc.
So if you're feeling despondent about how your body is running through its menstrual cycles in a way that's much more annoying than it ever used to be, don't despair. It can change yet again, and hopefully for the better.
Tuesday, February 17, 2015
Hungry? Or not?
I met a cousin of mine over the weekend. She is a new mother to a 6-week-old baby. When I casually inquired how breastfeeding was going, she smirkingly answered, "Oh, my baby gave up on me after a few weeks!" Then she explained that her baby was always "hungry" after nursing and "she always wanted a bottle afterwards" so "I wasn't going to starve her."
After hearing that I really felt bad that this happened. Of course every mother knows what's best for her child but sometimes a bit of myth-y information can really lead her to make uneducated guesses and then decisions that probably aren't best for her baby. Let's see if we can figure out what went on with my cousin's baby.
My cousin was able to pump normal amounts of milk so she did not have a milk supply issue. Her baby was able to suck ok and transferred milk fine. Her latch wasn't a problem either. So then what happened? Babies love to suck. If a baby is given a pacifier, he'll probably enjoy it! A bottle is like a pacifier in that sense so many babies will gladly take a bottle at any time if offered (although Sam was NOT that kind of kid) even if they aren't hungry. Think of yourself after having eaten a delicious dinner of rib steak, fries and vegetables. You're probably feeling well-sated and going "ahhhh". But if I then served you a gorgeous dish of gooey chocolate brownie and mocha ice cream with fudge sauce, would you honestly turn me down? Babies love a good dessert too (and formula tastes great).
My cousin nursed her baby. Her baby was probably satisfied with the feeding, but probably not overly full (like bottle-fed babies tend to become after a feeding). Her baby cried for any of the following reasons: gas, general fussiness, the need to burp, dirty diaper, wanting to nurse for dessert, wanting to be held, or one of the other thousand inexplicable reasons why baby cry. She assumed her baby was hungry and offered her a bottle, which she slurped down (think of yourself attacking your dessert plate with gusto). Was her baby truly hungry before the bottle? No.
There's actually a condition called "Perceived Insufficient Milk" (which I believe I've experienced at some point!) where a mother honestly thinks she doesn't have enough milk for her baby. This happens when a mother misinterprets her baby's cues for hunger and she therefore thinks her baby is always hungry even though she isn't. This often causes premature weaning because the mother will just end up supplementing, assuming there are no solutions anyway.
After hearing that I really felt bad that this happened. Of course every mother knows what's best for her child but sometimes a bit of myth-y information can really lead her to make uneducated guesses and then decisions that probably aren't best for her baby. Let's see if we can figure out what went on with my cousin's baby.
My cousin was able to pump normal amounts of milk so she did not have a milk supply issue. Her baby was able to suck ok and transferred milk fine. Her latch wasn't a problem either. So then what happened? Babies love to suck. If a baby is given a pacifier, he'll probably enjoy it! A bottle is like a pacifier in that sense so many babies will gladly take a bottle at any time if offered (although Sam was NOT that kind of kid) even if they aren't hungry. Think of yourself after having eaten a delicious dinner of rib steak, fries and vegetables. You're probably feeling well-sated and going "ahhhh". But if I then served you a gorgeous dish of gooey chocolate brownie and mocha ice cream with fudge sauce, would you honestly turn me down? Babies love a good dessert too (and formula tastes great).
My cousin nursed her baby. Her baby was probably satisfied with the feeding, but probably not overly full (like bottle-fed babies tend to become after a feeding). Her baby cried for any of the following reasons: gas, general fussiness, the need to burp, dirty diaper, wanting to nurse for dessert, wanting to be held, or one of the other thousand inexplicable reasons why baby cry. She assumed her baby was hungry and offered her a bottle, which she slurped down (think of yourself attacking your dessert plate with gusto). Was her baby truly hungry before the bottle? No.
There's actually a condition called "Perceived Insufficient Milk" (which I believe I've experienced at some point!) where a mother honestly thinks she doesn't have enough milk for her baby. This happens when a mother misinterprets her baby's cues for hunger and she therefore thinks her baby is always hungry even though she isn't. This often causes premature weaning because the mother will just end up supplementing, assuming there are no solutions anyway.
Monday, January 5, 2015
Sleeping through the night and breastfeeding correlation
I randomly thought about this the other day and I wonder if this idea is of any significance. I noticed that mothers of babies who sleep through the night early on (sleeping longer than 6-8 hour stretches, in this case) are less likely to nurse their babies past the half-year mark. It's just that whoever I talk to whose babies were such good sleepers as newborns and young infants said they didn't nurse beyond a few months.
Here's why I think that happens. It's widely known that milk production gets a real boost during the nighttime when prolactin, the milk-making hormone, is at its best. Nursing (or even pumping) at night really gives your milk supply an edge even beyond the nighttime. Now, if a mothers isn't breastfeeding her baby at night because the child sleeps through the night (and why wake a sleeping baby?) her prolactin doesn't really get chance to shine.
If milk supply isn't given that extra oomph from nighttime nursing, it might not function so well during the day. This is even more hampered if a mother works full time and has to rely on pumping during the day to keep up her milk supply. If a mother can stay at home with her child and nurse on demand then this probably isn't such an issue because a nursing baby can effectively extract enough milk (whereas a pump doesn't do that great of a job).
Now this is far from a scientific fact; it's just a speculation on my part. What do you think? Do you have evidence to support or disprove this claim? If yes, share it! I will try to conduct a poll about this on a breastfeeding website and share the results here.
Here's why I think that happens. It's widely known that milk production gets a real boost during the nighttime when prolactin, the milk-making hormone, is at its best. Nursing (or even pumping) at night really gives your milk supply an edge even beyond the nighttime. Now, if a mothers isn't breastfeeding her baby at night because the child sleeps through the night (and why wake a sleeping baby?) her prolactin doesn't really get chance to shine.
If milk supply isn't given that extra oomph from nighttime nursing, it might not function so well during the day. This is even more hampered if a mother works full time and has to rely on pumping during the day to keep up her milk supply. If a mother can stay at home with her child and nurse on demand then this probably isn't such an issue because a nursing baby can effectively extract enough milk (whereas a pump doesn't do that great of a job).
Now this is far from a scientific fact; it's just a speculation on my part. What do you think? Do you have evidence to support or disprove this claim? If yes, share it! I will try to conduct a poll about this on a breastfeeding website and share the results here.
Tuesday, November 25, 2014
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."
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."
Monday, November 24, 2014
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!
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!
Wednesday, November 5, 2014
Printable pumping output chart
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| Pumping output chart |
Download and print the pumping output chart.
Tuesday, August 19, 2014
Mayday in May
One day in the middle of May Sam refused to eat. For twenty-four hours. He scared the milk out of me with this nursing strike.
For a few days he had a light fever with no other symptoms. His ears were clear and so were his lungs. I took him to the doctor to confirm that but his low fever remained for a few days. And then on Wednesday morning he nursed, but much less than normal. I didn't think much of it because he does do this sometimes. Nothing too weird for this distractible baby. I dropped him off at the babysitter. His first bottle (which was 11ish in those days) wasn't finished. He finished the rest at 2:30. And then it started. From when he came home he did not nurse one drop. Each time I brought him to my boob or even put him into a nursing position he arched his back and locked his little lips shut. He was not eating. Did I not notice?
I tried to offer my boob every our so but nada. Sam was just not going to eat and no amount of coercion was going to help. I tried nursing him outside on the swing (it was a refreshing, calm spring night), I tried other positions, I tried playing it cool (pretending I didn't care when I was worried as heck), I tried to nurse in the bathtub, but nada. I called the doctor at 10pm and he said that if he doesn't eat by the morning I should bring him in the morning so he can check him for dehydration. HELP!!!! Remember that he had a low fever and as far as I was taught, when you have fever you need to drink a lot - this was beyond nothing.
I finally just put him to bed. I tried to dream feed him before I went to bed but nope, he kept his lips shut and turned his head away. He actually pushed my boobs away with his little palms (any other day it would have been adorable). I pumped and got like 2 oz. And then he slept. He actually slept 10 hours straight that night, without waking up to eat. This never happened to him. The most he's ever gone was maybe 7 hours. The only good thing out of this was I got a full night's sleep.
In the morning he did not want to nurse. I pumped and got 4 ounces. Obviously the pump did not do a good job at all. I stayed home from work. I tried lots of skin-to-skin contact and we even bathed together. But still he turned his head away in disgust when I tried to get him to latch. I made an appointment to take him to the doctor at 2:30. I was really beyond the frantic, worried stage by now.
He was not yet eating drinking from a cup and wasn't eating solids other than occasional baby cereal. So at 2:00 I got him to take a few spoonfuls of baby cereal with expressed breastmilk. Thank goodness for that. The first time he's eating in 24 hours! Relief!
The doctor checked him out at 2 and said that he's not dehydrated because he was looking alive and following conversation, talking etc. His pupils were fine. He had tears. His mouth was moist enough. Then and there in the doctor's office, his fever broke and he felt like a sack of wet laundry. That was the finale to this whole saga.
By the time we got home, Sam was finally willing to nurse! I fed him every hour on the hour! 3:00, 4:00, 5:00... through the night! By the next morning all was back to normal.
Now the issue was my milk supply did take a little nosedive because of the lack of proper stimulation and milk removal. The few times I pumped were nowhere near adequate to maintain my supply. So when Sam finally was back on my breast, it took a long time for him to get a letdown. To help him, I'd manually stimulate for one and then latch him on to me. That helped.
The next day at work I was able to pump my usual amounts, so all's well that ends well.
But I can't do this again. Nursing strikes are not for the faint at heart.
For a few days he had a light fever with no other symptoms. His ears were clear and so were his lungs. I took him to the doctor to confirm that but his low fever remained for a few days. And then on Wednesday morning he nursed, but much less than normal. I didn't think much of it because he does do this sometimes. Nothing too weird for this distractible baby. I dropped him off at the babysitter. His first bottle (which was 11ish in those days) wasn't finished. He finished the rest at 2:30. And then it started. From when he came home he did not nurse one drop. Each time I brought him to my boob or even put him into a nursing position he arched his back and locked his little lips shut. He was not eating. Did I not notice?
I tried to offer my boob every our so but nada. Sam was just not going to eat and no amount of coercion was going to help. I tried nursing him outside on the swing (it was a refreshing, calm spring night), I tried other positions, I tried playing it cool (pretending I didn't care when I was worried as heck), I tried to nurse in the bathtub, but nada. I called the doctor at 10pm and he said that if he doesn't eat by the morning I should bring him in the morning so he can check him for dehydration. HELP!!!! Remember that he had a low fever and as far as I was taught, when you have fever you need to drink a lot - this was beyond nothing.
I finally just put him to bed. I tried to dream feed him before I went to bed but nope, he kept his lips shut and turned his head away. He actually pushed my boobs away with his little palms (any other day it would have been adorable). I pumped and got like 2 oz. And then he slept. He actually slept 10 hours straight that night, without waking up to eat. This never happened to him. The most he's ever gone was maybe 7 hours. The only good thing out of this was I got a full night's sleep.
In the morning he did not want to nurse. I pumped and got 4 ounces. Obviously the pump did not do a good job at all. I stayed home from work. I tried lots of skin-to-skin contact and we even bathed together. But still he turned his head away in disgust when I tried to get him to latch. I made an appointment to take him to the doctor at 2:30. I was really beyond the frantic, worried stage by now.
He was not yet eating drinking from a cup and wasn't eating solids other than occasional baby cereal. So at 2:00 I got him to take a few spoonfuls of baby cereal with expressed breastmilk. Thank goodness for that. The first time he's eating in 24 hours! Relief!
The doctor checked him out at 2 and said that he's not dehydrated because he was looking alive and following conversation, talking etc. His pupils were fine. He had tears. His mouth was moist enough. Then and there in the doctor's office, his fever broke and he felt like a sack of wet laundry. That was the finale to this whole saga.
By the time we got home, Sam was finally willing to nurse! I fed him every hour on the hour! 3:00, 4:00, 5:00... through the night! By the next morning all was back to normal.
Now the issue was my milk supply did take a little nosedive because of the lack of proper stimulation and milk removal. The few times I pumped were nowhere near adequate to maintain my supply. So when Sam finally was back on my breast, it took a long time for him to get a letdown. To help him, I'd manually stimulate for one and then latch him on to me. That helped.
The next day at work I was able to pump my usual amounts, so all's well that ends well.
But I can't do this again. Nursing strikes are not for the faint at heart.
Tuesday, August 12, 2014
Pump on the fritz
The time has come for my pump to big me a weak goodbye. For the past few days, I could not pump a decent quantity at work. I knew I did not have a supply issue because I had plenty in the mornings and evenings when I nursed Sam. And I had recently replaced the pump parts and they were in fine working order. So what could be the issue? The pump.
On Friday, the pump began to make protesting noises (instead of ch-CH ch-CH ch-CH, it was more like ch-ch-ch-CHAAA ch-ch-ch-CHAAA). I called Ameda parent line and the customer service agent asked me to put the phone to the machine while it's turned on so she can diagnose the sound issue. She immediately told me the pump sounded labored, and that she'd be sending out a replacement by Monday.
I knew the pump might not arrive by Monday when I need to pump so I brought in my backup pump that I keep at home. I already got more than I did on Friday. And today, Tuesday, I got a nice amount! Three cheers for new pumps that work!
If you've got an issue with your pump, call customer service today.
On Friday, the pump began to make protesting noises (instead of ch-CH ch-CH ch-CH, it was more like ch-ch-ch-CHAAA ch-ch-ch-CHAAA). I called Ameda parent line and the customer service agent asked me to put the phone to the machine while it's turned on so she can diagnose the sound issue. She immediately told me the pump sounded labored, and that she'd be sending out a replacement by Monday.
I knew the pump might not arrive by Monday when I need to pump so I brought in my backup pump that I keep at home. I already got more than I did on Friday. And today, Tuesday, I got a nice amount! Three cheers for new pumps that work!
If you've got an issue with your pump, call customer service today.
Wednesday, July 16, 2014
Milky supply and weaning
There's one question I've always had. And it's one question for which nobody would give me a straight answer. Basically, what happens to milk supply when you cut out one feed? Does your milk supply decrease in a general way or do you just have less milk for that particular feeding? I got different mixed up answers. A midwife at my ob/gyn practice told me that milk will decrease overall, rather than a no-supply situation during that dropped feeding time.
Why am I wondering about this? I am thinking about cutting out one pumping session at work so I only have to pump once. This would happen once Sam can eat a full meal at the babysitter. But then what happens on weekends when we are together and I'd like to nurse him whenever? I don't find my body in tune with the time of day it is when it comes to nursing. Like I don't feel full on weekends at the times I'd pump if I was at work.
The way it all works is a mystery to me!
I have cut out a feed at night and didn't notice a decrease in supply or anything because Sam just ate more at the next feed. See, I nurse him at bedtime at around 8:30 (all times are "-ish") and then at 11:30 before I go to bed. Then he'd wake up at 1:30-2 for some reason. Not hunger. But I'd feed him then. And then at 5. And then in the morning whenever he'd wake up, 7-8. I decided to cut out that 2am feed because I know he's not hungry 2 hours after a decent feed. Sam would cry at that time, my husband would give him the pacifier and shush him back to sleep, and that was that. He'd wake up at 5 for a feed and eat very nicely because it's been a while since his last meal. He'd never eat well at the 2am feed because he wasn't even hungry. By now our night schedule transformed to one nighttime wake-up sometime in the 4 range, instead of crying at 2 and eating at 5.
Why am I wondering about this? I am thinking about cutting out one pumping session at work so I only have to pump once. This would happen once Sam can eat a full meal at the babysitter. But then what happens on weekends when we are together and I'd like to nurse him whenever? I don't find my body in tune with the time of day it is when it comes to nursing. Like I don't feel full on weekends at the times I'd pump if I was at work.
The way it all works is a mystery to me!
I have cut out a feed at night and didn't notice a decrease in supply or anything because Sam just ate more at the next feed. See, I nurse him at bedtime at around 8:30 (all times are "-ish") and then at 11:30 before I go to bed. Then he'd wake up at 1:30-2 for some reason. Not hunger. But I'd feed him then. And then at 5. And then in the morning whenever he'd wake up, 7-8. I decided to cut out that 2am feed because I know he's not hungry 2 hours after a decent feed. Sam would cry at that time, my husband would give him the pacifier and shush him back to sleep, and that was that. He'd wake up at 5 for a feed and eat very nicely because it's been a while since his last meal. He'd never eat well at the 2am feed because he wasn't even hungry. By now our night schedule transformed to one nighttime wake-up sometime in the 4 range, instead of crying at 2 and eating at 5.
Thursday, July 10, 2014
Galactogogues
These are products to take that can help you increase your milk supply. I don't know if I'm a believer in these really because I've only tried fenugreek and it did not help.
Fenugreek is an herbal supplement responsible for lots of things, but nursing moms will often use it to increase milk supply. It's supposed to work well but really did nothing for me in terms of boosting milk. However, it did boost my appetite - hooboy! As I've later read, fenugreek increases appetite and makes you crave carbs, a sure recipe for piling on the extra poundage.
I took it for one whole week, 4 pills every 3 hours, which is about the upper limits of the dose. That week i felt extremely hungry. All the time. I would eat everything in sight. If I controlled myself, I just ended up feeling very weak and lightheaded, a symptom of low blood sugar. It was nuts.
I did try drinking some beer and I think it helped my supply. Too early to tell for sure. But I've been drinking 1 cup of beer for the past 3 nights after putting Sam to bed.
Fenugreek is an herbal supplement responsible for lots of things, but nursing moms will often use it to increase milk supply. It's supposed to work well but really did nothing for me in terms of boosting milk. However, it did boost my appetite - hooboy! As I've later read, fenugreek increases appetite and makes you crave carbs, a sure recipe for piling on the extra poundage.
I took it for one whole week, 4 pills every 3 hours, which is about the upper limits of the dose. That week i felt extremely hungry. All the time. I would eat everything in sight. If I controlled myself, I just ended up feeling very weak and lightheaded, a symptom of low blood sugar. It was nuts.
I did try drinking some beer and I think it helped my supply. Too early to tell for sure. But I've been drinking 1 cup of beer for the past 3 nights after putting Sam to bed.
Wednesday, June 25, 2014
Plugged Milk Ducts 101
A plugged milk duct is pretty much what it sounds like: a blockage forms somewhere in the duct which prevents milk from flowing out towards the nipple. The milk then pools in that area causing lots of discomfort, pain, redness, swelling, hardness and anything else annoying. The only way to relieve it is to free the clogged area. Let's analyze this a bit.
They say that in order to prevent plugged ducts, the breasts must frequently be emptied. That ensures the passageways are free and clear for milk to pass through. Sounds fine. But plugged ducts can also be caused by the very nature of the milk. If milk is fatty it will clog faster. Makes sense, doesn't it? So someone like me is prone to clogged ducts because my milk is pretty fatty sometimes. It's not that I don't empty my breasts enough by feeding often.
They sound scary. Especially because online everyone warns you that if you do not treat the plugged duct aggressively (and immediately) then you will most likely get mastitis. I can assure you that I have never gotten mastitis from a plugged duct and I've had at least 50 plugged ducts. They often resolve with some basic care and most are gone within 24 hours or less. I'll walk you through a typical scenario.
It's 3:30 PM, just after my second pumping session at work, and I feel a bit of soreness on the inner edge of my left breast (90% of the time the plug was in that spot since they tend to come and go in the same area). By the time I come home from work I can feel real pain each time I press the area. I also see faint redness. Not like poison ivy red, but more like my boob is blushing.
Now. If I do nothing, Sam will not really enjoy eating from that side since the flow is obstructed and slower. More and more milk will pool up in the affected area. My breast will really hurt by nighttime. Tomorrow it will also be hurty.
However, here's what I do. At 3:31 I head to the bathroom at work and start to really give it to my boob. Using the heel of my hand, I press down from the top of my chest, down the affected side of the boob, and squeeze hard. It's supposed to hurt. Sometimes I'll be lucky and I'll see a white pinprick show up on my nipple right away, but other times it can take even a day to rear itself. That's the plug showing herself. I massage and squeeze (as if I'm hand expressing) and I can literally see a white piece of hardened milk pop out. Sometimes there is more than one milky clump. Often there's a few stringy strands of milk that follow. I keep massaging until nothing comes out anymore. With practice I have learned exactly where on my boob I need to press in order for milk from that specific duct to shoot out.
Some disclaimers:
If you catch it early, treat it early, and you'll save yourself a lot of discomfort. And having a clogged duct is a pretty good sign - for me, at least - that there's plenty of milk for the baby. In a way, I welcome these since it means I've got lots of milk!
They say that in order to prevent plugged ducts, the breasts must frequently be emptied. That ensures the passageways are free and clear for milk to pass through. Sounds fine. But plugged ducts can also be caused by the very nature of the milk. If milk is fatty it will clog faster. Makes sense, doesn't it? So someone like me is prone to clogged ducts because my milk is pretty fatty sometimes. It's not that I don't empty my breasts enough by feeding often.
They sound scary. Especially because online everyone warns you that if you do not treat the plugged duct aggressively (and immediately) then you will most likely get mastitis. I can assure you that I have never gotten mastitis from a plugged duct and I've had at least 50 plugged ducts. They often resolve with some basic care and most are gone within 24 hours or less. I'll walk you through a typical scenario.
It's 3:30 PM, just after my second pumping session at work, and I feel a bit of soreness on the inner edge of my left breast (90% of the time the plug was in that spot since they tend to come and go in the same area). By the time I come home from work I can feel real pain each time I press the area. I also see faint redness. Not like poison ivy red, but more like my boob is blushing.
Now. If I do nothing, Sam will not really enjoy eating from that side since the flow is obstructed and slower. More and more milk will pool up in the affected area. My breast will really hurt by nighttime. Tomorrow it will also be hurty.
However, here's what I do. At 3:31 I head to the bathroom at work and start to really give it to my boob. Using the heel of my hand, I press down from the top of my chest, down the affected side of the boob, and squeeze hard. It's supposed to hurt. Sometimes I'll be lucky and I'll see a white pinprick show up on my nipple right away, but other times it can take even a day to rear itself. That's the plug showing herself. I massage and squeeze (as if I'm hand expressing) and I can literally see a white piece of hardened milk pop out. Sometimes there is more than one milky clump. Often there's a few stringy strands of milk that follow. I keep massaging until nothing comes out anymore. With practice I have learned exactly where on my boob I need to press in order for milk from that specific duct to shoot out.
Some disclaimers:
- Sometimes I have to repeat the process again, so I do that after each nursing session. The area WILL feel sore after the plug is released but that clears away within a day or so. Additionally, milk will flow slowishly from that side, so your baby might not love nursing there. Always start with that side, and then hand express when you're finished nursing.
- The milk from the plugged area might also taste ickyish and salty (it has happened to me plenty of times - the milk also turned a weird shade of yellow). That's why it's common for the baby to stop nursing after a few moments because he's stopping once the milk starts tasting weird - which is when the older milk is coming down the chute.
- It often hurst to breastfeed from the affected side. This is because the area is firm and the baby cannot get a perfect latch - the shallow latch causes sore nipples.
- Sometimes you cannot release the plug via massaging. In such a case I take a hot shower and use a sterilized needle to prod the plug from below, in an outward motion (poking it inward just pushes the plug in further). You shouldn't be bleeding from this. To sterilize a needle, stick it through a flame until the tip turns red, and then rinse under cool water.
- They say to use heat either by showering or a heating pad, but I found none to be as effective as brute force of my hand massaging. The last 30 or so clogs that I had were treated solely with this method, and no heating element.
If you catch it early, treat it early, and you'll save yourself a lot of discomfort. And having a clogged duct is a pretty good sign - for me, at least - that there's plenty of milk for the baby. In a way, I welcome these since it means I've got lots of milk!
Letdowns
Letdowns are so weird. Usually the word signifies something negative and disappointing. But not when it comes to BFing. The word letdown brings breastfeeding mothers (and their offspring) much joy. Letdown is an easy laywoman's term for "milk ejection reflex", which is a complex, highly wondrous process that brings your milk to your baby. When the baby sucks your nipple, the nipple and areola become stimulated, which releases oxytocin (the "mothering hormone"). This causes contractions in the milk-making glands, literally squeezing them like a tube of toothpaste. The milk then shoots through the ducts on high-speed and baby enjoys the meal.
Now I never felt letdowns when nursing in the early days. I would feel random letdowns when it was on or around the time Sam would normally eat (say, 2-3 hours since last feeding). It would feel like an 18-wheeler riding over my breasts, and then my nipples would feel somewhat sore for a minute or two. I never felt this while nursing, though.
Only once my milk regulated at 3 months did I begin to feel them! About 30-60 seconds after Sam would actively start to suck, I'd feel that heavy feeling again and his sucking/swallowing pattern became steady and consistent. I'd still feel it randomly between feedings. Those were much more painful than the ones I'd feel while breastfeeding. On fuller days, I'd feel lots of these random ones, and the nursing ones would come really fast, only after a few seconds of sucking.
These days I feel letdowns most of the time, and they're not that obvious either. I usually have to focus on it in order to even notice it! I rarely get the between-feeds letdowns. On lower supply days I can't get more than one letdown per hour or so, even if I try nursing Sam two times in one hour.
I find that when pumping, I need to achieve about 3 letdowns to get 4-5 oz of milk - these days. In the past I'd get that all with one letdown. But when I nurse/pump I can only get one letdown. I don't know, I see lots of sites writing about keeping baby on the breast for longer so you can get more letdowns. I don't have that. While pumping, the initial letdown might yield only 2-3 ounces. So what do I do?
Here's how to achieve a manual letdown muuuuuch faster than using the stimulation mode on the pump. This is also great if you for some reason can't get a letdown and baby really wants to nurse already. Or if you're trying to bring baby back from a nursing strike and you want it to be appealing (i.e. milk already waiting for him at the table):
Now I never felt letdowns when nursing in the early days. I would feel random letdowns when it was on or around the time Sam would normally eat (say, 2-3 hours since last feeding). It would feel like an 18-wheeler riding over my breasts, and then my nipples would feel somewhat sore for a minute or two. I never felt this while nursing, though.
Only once my milk regulated at 3 months did I begin to feel them! About 30-60 seconds after Sam would actively start to suck, I'd feel that heavy feeling again and his sucking/swallowing pattern became steady and consistent. I'd still feel it randomly between feedings. Those were much more painful than the ones I'd feel while breastfeeding. On fuller days, I'd feel lots of these random ones, and the nursing ones would come really fast, only after a few seconds of sucking.
These days I feel letdowns most of the time, and they're not that obvious either. I usually have to focus on it in order to even notice it! I rarely get the between-feeds letdowns. On lower supply days I can't get more than one letdown per hour or so, even if I try nursing Sam two times in one hour.
I find that when pumping, I need to achieve about 3 letdowns to get 4-5 oz of milk - these days. In the past I'd get that all with one letdown. But when I nurse/pump I can only get one letdown. I don't know, I see lots of sites writing about keeping baby on the breast for longer so you can get more letdowns. I don't have that. While pumping, the initial letdown might yield only 2-3 ounces. So what do I do?
Here's how to achieve a manual letdown muuuuuch faster than using the stimulation mode on the pump. This is also great if you for some reason can't get a letdown and baby really wants to nurse already. Or if you're trying to bring baby back from a nursing strike and you want it to be appealing (i.e. milk already waiting for him at the table):
- Try to relax. Right. Like pretend you're relaxed. Sit in a relaxing, comfortable position.
- Start massaging both nipples at the same time - one with each hand.
- Try different moves to see which feels better to you: pinching, pulling, twisting, stroking, flicking, etc.
- Focus on what the letdown should feel like. Usually within 5 minutes you can get a letdown.
- Enjoy the flow of milk.
For me, they are completely not psychological, but rather physical. I do not get letdowns by thinking of oceans of flowing milk nor when I look at pictures or videos of Sam (what lots of websites suggest). I can only cause myself to get them from direct stimulation, either from Sam's sucking, or from my hands.
Monday, June 23, 2014
Green poops
Green poops that are frothy and liquidy are supposed to signify that your baby receives an unbalanced amount of foremilk and hindmilk during feeds.
Foremilk is the thin, light, sugary milk that quickly hydrates the baby and entices him to eat further. Hindmilk is the rich fatty stuff towards the end that looks whiter and heavier. Really, with each suck, baby is getting both foremilk and hindmilk, but the problem happens when the baby doesn't get enough time to nurse to really reach the hindmilk finale. So he fills up on foremilk. Which is FINE, according to my pediatrician. It has all that baby needs. But the green diapers are ewwy, I must say. And explosive.
I always let Sam stay on each side for as long as he wanted, yet he still had green diapers until 3 months of age. Seriously, they were never yellow, the color of choice. Still, the doctor wasn't concerned so I wasn't either, but I was curious to know why they were happening. I finally figured it out. I was making so much more milk that necessary that Sam got full before he even was halfway through the breast. It's not that I didn't let him stay on that side long enough. He just didn't need any more (though I had plenty of milk to go around).
When my supply regulated at about 3 months, the green diapers disappeared too.
Foremilk is the thin, light, sugary milk that quickly hydrates the baby and entices him to eat further. Hindmilk is the rich fatty stuff towards the end that looks whiter and heavier. Really, with each suck, baby is getting both foremilk and hindmilk, but the problem happens when the baby doesn't get enough time to nurse to really reach the hindmilk finale. So he fills up on foremilk. Which is FINE, according to my pediatrician. It has all that baby needs. But the green diapers are ewwy, I must say. And explosive.
I always let Sam stay on each side for as long as he wanted, yet he still had green diapers until 3 months of age. Seriously, they were never yellow, the color of choice. Still, the doctor wasn't concerned so I wasn't either, but I was curious to know why they were happening. I finally figured it out. I was making so much more milk that necessary that Sam got full before he even was halfway through the breast. It's not that I didn't let him stay on that side long enough. He just didn't need any more (though I had plenty of milk to go around).
When my supply regulated at about 3 months, the green diapers disappeared too.
Monthly Dips
Even though it happens all the time I am still not immune to it. I freak out when it happens. Sunday I nurse Sam just fine. He has plenty to eat. Monday at work I pump only a total of about 5-6 ounces or less, instead of my usual 9 ounces. My breasts feel soooo soft and empty. Sam needs to keep nursing at night, and the letdowns don't last very long. I don't hear as much swallowing when he is nursing. This is a sudden, drastic dip in supply, and I only recently noticed that these happen every single month!
When there's such a sudden drop, they say it's either because of stress, pregnancy, or the onset of a period. Well, these were never preceded by any particular stress, I took dozens of pregnancy tests which all showed negative, and I never got my period! So where on earth are these drops coming from?
I finally realized one day that they happen every month, sort of like a menstrual cycle. I went back to old emails of mine and chat logs and saw how I vented to friends about this around every 4 weeks or so. Interesting! Lately I began to get these drops together with other PMS symptoms.
In my period days (haven't had one since January 2013 so my memory of them isn't stellar, but I definitely remember some stuff), my labia would itch severely for two or three days before a period, and then mysteriously stop once the period started. So I had that again. Also extreme thirst. And a lower backache. Oh, and menstrual cramps. The real deal.
Only no blood. Yay!
After a few days (about 5-7) I'd see a sudden whoosh of milk. Like waking up in the night engorged type of sudden. Always on weekends. People tell me it's because I eat and sleep better over the weekend. I say it's because I don't need to pump!
Edited to add: I finally learned the reason behind my monthly drops in supply.
When there's such a sudden drop, they say it's either because of stress, pregnancy, or the onset of a period. Well, these were never preceded by any particular stress, I took dozens of pregnancy tests which all showed negative, and I never got my period! So where on earth are these drops coming from?
I finally realized one day that they happen every month, sort of like a menstrual cycle. I went back to old emails of mine and chat logs and saw how I vented to friends about this around every 4 weeks or so. Interesting! Lately I began to get these drops together with other PMS symptoms.
In my period days (haven't had one since January 2013 so my memory of them isn't stellar, but I definitely remember some stuff), my labia would itch severely for two or three days before a period, and then mysteriously stop once the period started. So I had that again. Also extreme thirst. And a lower backache. Oh, and menstrual cramps. The real deal.
Only no blood. Yay!
After a few days (about 5-7) I'd see a sudden whoosh of milk. Like waking up in the night engorged type of sudden. Always on weekends. People tell me it's because I eat and sleep better over the weekend. I say it's because I don't need to pump!
Edited to add: I finally learned the reason behind my monthly drops in supply.
Wednesday, June 18, 2014
Fresh frozen and the excess lipase saga
Oxymoron? A scary thing happened to me, I freaked out, I worked to combat it, and it miraculously righted itself with an easy solution: fresh frozen.
So for now we are sticking with fresh frozen so I am spared the time-consuming task of scalding it each day. Freezing, I will dutifully point out, does cause some of the milk's important properties to be lost (scalding can also do that, btw), however it is MUCH better to serve this than formula. It's really of no health concern unless the baby only drinks frozen milk - we are talking just two bottles a day here, so no biggie.
Last week Monday Sam refused his normal amount of milk at the babysitter. He usually has a 5 oz bottle at around 11ish and then a 4 oz bottle at around 2-3. That day he had a total of 5 oz. Tuesday he did that again. Same with Wednesday. Each of those days he came home with the remainder of the milk in the bottle. It looked yellowish. I smelled it. I almost barfed. But milk smells, I've heard, so I daringly tasted a drop and BLECHEROO! It really tasted soapy and metallic. No wonder Sam turned it down. He has better taste than that.
Turns out my milk has excess lipase. There are SO many articles out there that discuss it so I won't go into too much detail. But basically, everyone's BM has lipase, which is an enzyme that breaks down the fat so the baby can digest it. Usually this breaking down of lipase does not happen right away (I think it takes place inside the baby's body), but in some people, they have so much of it that the milk fat becomes broken down much quicker. Some people 4 hours later, some a day later, and some only find their freezer stash of one month old milk is bad. So it's really a unique situation for everyone.
What does one do about that? Some babies are totally cool with the yucky taste and drink the milk anyway. It's perfectly safe. Remember, the milk is just broken down, not spoiled. If baby will not drink it, don't blame him because it truly is yucko. The solution? Heat the milk (aka "scald" it) to 180 degrees and then quickly cool it before storing - this deactivates the enzyme and keeps your milk tasting delicious. That's such a pain, though, if you have to scald at each pumping session because your milk won't last the day in the fridge.
I decided to see how long my milk can "last" before it gets that ewwy taste/smell. I pumped a bit and put it in the fridge. After 4 hours it was fine. After 8 hours it already had a faint metallic taste. 24 hours later it's a strong metallic/soapy taste, plus it smells bad when heated. It didn't smell in the fridge when cold.
Now this brought back to mind the early days when I went back to work. Sam did not take the bottle willingly at all. He would drink just an ounce or two and then another ounce or two a few hours later. He ate just to tide him over until he got hungry again. Poor boy. He did nurse well once at home and made up for it so I wasn't too worried. He was gaining weight as well. After about 3-4 weeks he would take a complete bottle. Now I think I know why. I'll bet that milk was also lipasey. In addition, Sam doesn't eat warmed up milk that slowly thawed in the fridge. Only milk that went straight from freezer to hot water.
Later on he either A) got used to the taste and realized this is the situation and you gotta adapt, or B) the lipase was only really bad in the early days, which is common because there is more fat then or something.
Well, now it seems to be bad again. Also lately I would freeze my milk only once I prepared the bottles for the next day - which was nighttime. Many hours after I'd pumped. So it was in the fridge during most of the day, slowly ickifying itself until the next afternoon when Sam would unwillingly drink just a bit. In the past I'd freeze the milk at work already, right after pumping - I don't know why. I just did that. Turns out that was the key to my solution.
I sent Sam some milk for this Monday that was scalded. He drank it beautifully. It also did not turn yellow, according to the babysitter. And the residue remaining in the bottle by the time he came home did NOT stink. On Tuesday I sent him with fresh frozen milk - milk that was frozen immediately after pumping - and he also drank it all really nicely!
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| Top: milk unaffected by lipase Bottom: milk affected by lipase |
Just a reminder: Milk that was affected by lipase activity looks yellower when thawed (but whiter when frozen), looks really fatty when warmed up, you can often see small globules of fat, it smells really bad, and has the taste of metal or soap. It IS safe to eat. The best thing to do if your baby is refusing bottles is to not blame it on the bottle - just taste the milk and you'll know for sure! Also, if you store milk for a freezer stash, defrost a bag every two weeks or so and make sure it tastes/smells fine.
Notice the picture on the left: The milk on top looks like milk should look when frozen. Pale yellow color, of even consistency. The bottom bag contains milk in which lipase already did its thing. You can see separate fatty sections and the milk is overall whiter and thicker looking.
Notice the picture on the left: The milk on top looks like milk should look when frozen. Pale yellow color, of even consistency. The bottom bag contains milk in which lipase already did its thing. You can see separate fatty sections and the milk is overall whiter and thicker looking.
Wednesday, June 11, 2014
No more pain at 3 months!
At three months breastfeeding stopped being painful, which is a ridiculously long amount of time to have to wait for it to start being enjoyable, if you asked me. What happened? One Sunday evening I came down with a stomach bug that totally cleared out my system from all fluids. I couldn't eat a thing or drink much either. At the time I didn't realize what not eating and drinking can do for your milk supply.
The next morning I woke up feeling fine but my boobs were like they were before I got pregnant! Very soft and small and empty. I nursed my baby and to my shock, it was a completely pain-free experience. I never had that. My supply definitely did drop, but I am thinking that maybe my milk supply suddenly regulated at that time.
Milk supply is initially regulated by hormones produced during childbirth and the body usually produces a lot of milk. Many moms feel engorged in the early days (I never did) and have oversupply issues. I think I had the latter. I always felt full. I often got plugged ducts. Sam's poop was lime green and frothy a lot of the time. That's a sign of a foremilk/hindmilk imbalance, by the way. More on that a different time. I guess I produced a lot (I was able to pump way more than my baby needed), I always felt full - which leads to two things:
A) Full breasts means that a baby with a tongue-tie can't latch on so well so that leads to painful nursing and all that soreness.
B) Full breasts means that there is lots of foremilk (watery, sweeter, lighter milk) that gets eaten in the beginning of the feed, and by the time he's full, he's hardly even touched the hindmilk (fattier, richer milk). That's probably why he had green diapers.
Another thing: I began to feel letdowns for the first time!
The next morning I woke up feeling fine but my boobs were like they were before I got pregnant! Very soft and small and empty. I nursed my baby and to my shock, it was a completely pain-free experience. I never had that. My supply definitely did drop, but I am thinking that maybe my milk supply suddenly regulated at that time.
Milk supply is initially regulated by hormones produced during childbirth and the body usually produces a lot of milk. Many moms feel engorged in the early days (I never did) and have oversupply issues. I think I had the latter. I always felt full. I often got plugged ducts. Sam's poop was lime green and frothy a lot of the time. That's a sign of a foremilk/hindmilk imbalance, by the way. More on that a different time. I guess I produced a lot (I was able to pump way more than my baby needed), I always felt full - which leads to two things:
A) Full breasts means that a baby with a tongue-tie can't latch on so well so that leads to painful nursing and all that soreness.
B) Full breasts means that there is lots of foremilk (watery, sweeter, lighter milk) that gets eaten in the beginning of the feed, and by the time he's full, he's hardly even touched the hindmilk (fattier, richer milk). That's probably why he had green diapers.
Another thing: I began to feel letdowns for the first time!
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