Pumping Basics Part 1- What The Experts Say To Do To Get Started Pumping Your Breastmilk

by Jessica Martin-Weber with Rene Fisher, IBCLC

This article made possible by the generous support of Ameda.

Ameda Finesse Double Electric Breast pump

When my baby was 4 weeks old, it was time for me to get started pumping not only for my baby to be able to receive my milk when I had to be away from her for work, but also for me to donate my milk to other babies.

To help me get started pumping, I spoke with Rene Fisher, IBCLC from Ameda, Inc. She helped me pick out a pump, the new Ameda Finesse Double Electric, and got me all set up. Via video chat and live stream, Rene got me all ready to go and before I knew it, I was filling milk storage containers with my milk. Thanks to Rene’s help, for the first time ever, after pumping through 6 babies, I’m finally using the right size flanges and pumping pain-free. See what I learned in the video and points below.

Setting Up Your Pump

Carefully read your instruction manual and ensure you have all the parts you need. Follow the directions for preparing your pump and setting up. Wash each part that comes in contact with your breast and milk including the flanges, milk storage containers (unless you intend to pump directly into bags such as the Store and Pour Ameda breastmilk storage bags), valves, and diaphragms. Do NOT wash the tubing. Plug in your power adaptor or install batteries. Wash your hands and assemble the kit (tubing, flanges, diaphragms, valves, milk storage containers, etc.).

Determine Your Flange Size 

Flanges are the horn shaped pieces that hold the pump and storage containers to your breasts. Correct fit of the flanges can prevent tissue damage and improve the effectiveness of your pump. All nipples are different and dynamic and the size of your flange may determine how you respond to pumping. Too small may cause pain and stress, reducing your output to the pump. Too large may cause too much areola and breast tissue to be engaged and not enough stimulation for let down or may result in reduced output. If your nipple presses against the flange or rubs, you may need a larger size. If there is a significant amount of space around your nipple and additional breast tissue is entering the flange which may rub, you may need a smaller size. Because nipples are dynamic, they may change during pregnancy, breastfeeding, and pumping. You may even need a different size flange mid-pumping session. See this video below and the information here to help you determine correct flange size.

Beginning: Set Up

If possible, set up in a quiet, relaxing space. Have a drink and a snack. Get as comfortable as possible, having read the manual prior to beginning.

Beginning: Positioing

Position the flange centered over your nipple, pressing in lightly to create a seal. Without a seal there will be no suction. If you are double pumping you can use your arms to help hold the flanges to your breasts but you may want to use a hands-free-pumping support.

Beginning: Before You Start

Relax. Close your eyes. Take a few deep breaths. Think of your baby. Focus on why you’re pumping rather than the output itself. You may want to watch a video of your baby, look at a photo, or smell their clothing.

Beginning: Turn Your Pump On

To get started with pumping, if your pump has individualized speed and suction settings, set your pump on the highest speed and, following the instruction manual for your pump, turn your pump on at the lowest suction level. Gradually increase suction strength to the highest comfortable level. Pumping should never hurt. It is not necessary to go to the highest level if it is painful for you and doing so could interfere with the milk ejection reflex and let down and result in reduced milk output to the pump, potentially causing tissue damage.

Beginning: Let Down and Expression

Stimulate let down with a high speed and the highest comfortable suction. Once let down begins (marked by spraying or flowing milk), reduce speed. You may feel ready to increase the suction level but only do so the the highest comfortable level. When the flow of milk slows to drips or a trickle, return to a higher speed and the highest comfortable suction level to stimulate another let down. It is possible to get up to 9 let downs in a 20 minute pumping session by adjusting speed and suction levels. It may be helpful to observe your baby’s pattern at the breast and mimic it as closely as possible with the pump during your pumping sessions.

When To Pump

When you pump for the first time will greatly depend on why you are pumping. If your baby is in the NICU and there is clinical separation from birth, you will need to begin as soon as possible and plan to pump 8-12 times within a 24 hour period for exclusively pumping. If you are pumping to return to work at 6 weeks postpartum, it is advisable to wait until 3-4 weeks postpartum and your milk supply and breastfeeding are established to protect your supply. If possible, introduce pumping gradually for partial separation giving at least an hour before breastfeeding again after pumping (though let your baby feed at the breast whenever they want to!). Many breastfeeding parents find they get more milk pumping first thing in the morning. Pumping one side while baby is latched and feeds from the other can also lead to more let downs while pumping.

How Long To Pump

Many breastfeeding parents find that 15-20 minutes is adequate time to pump. Some may find it takes longer but with the right pump and proper flange fit, 15-20 minutes will be plenty for most. Utilizing hands on pumping or breast massage while you pump can help encourage your breasts to empty fully, signaling your breasts to produce more milk for your baby. When you pump will depend on your reasons for pumping, how long you are away from your baby, and the amount of milk you need. Every breastfeeding parent and baby are different, figure out what works for you. For more on when and how long to pump, see here.

 

Mother of 4, Rene Fisher has been an IBCLC since 1998. Rene has worked in private practice before going on to be a hospital Lactation consultant for 10 years where she was responsible for nurses and patient education and hands on assistance with breastfeeding mothers. Rene got started in lactation support as a La Leche League Leader 1993 and became a member of La Leche League Area Professional Liaison Department from 2000 -2010. Today, Rene supports families in reaching their baby feeding goals working with Ameda breastfeeding products.

 

 

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, freelance writer, and co-founder of Milk: An Infant Feeding Conference. Jessica lives with her family in the Pacific Northwest and co-parents her 7 daughters with her husband of 21 years.
 
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Happy Sex Life – Happy Family, Good Clean Love

by Wendy Strgar

 

goodcleanlove.com

(Facebook livestream on The Leaky Boob with Jessica and Jeremy, parents of 7, featuring Loveologist, Wendy Strgar.)

It has been almost two decades since the birth of my fourth and last baby and yet, even 20 years later, I still remember the cold snap that overtook my marriage in the months that followed her birth. It wasn’t like the previous three kids hadn’t taken a cumulative toll on our sex life. But it was also easy to blame our degenerating intimate life on the overwhelming demands and exhaustion of raising four kids. Over time, it became clear that there were actually many other more important factors contributing to the sexless state of our marriage, and more importantly, that the lack of intimacy we shared was creating deep fissures in the foundation of our loving connection.

It was mind boggling for me, as I suspect it is for most every new parent, just how much of our attention is consumed by the fragility and wonder of a new life – often more than we think it is. In ways that I didn’t expect, a powerful internal conflict grew with each child I had, and worse still, lived at the epicenter of the ongoing and escalating conflicts I had with my partner. Who got to do their own thing, whether occupationally or personally, became our ground of competition. With each new baby the challenges of meeting my own needs and knowing my own desires left me feeling lonely and often angry at my husband. Our experience of growing a family was so different. His inability to understand my ambivalence about full-time mothering and my longing for myself isolated us from each other. And not surprisingly, it was our sex life that was held hostage by our ongoing estrangement in our relationship.

 

Wendy Strgar

 

This loss of a sex life is so common to new parents that it’s cliché. In fact, of all life transitions having a baby tops the list for the disruption of a woman’s libido and a couple’s sex life – sometimes for years. Of course there are many factors at play here – everything from hormones to how couples communicate and show up for each other after the birth of a new baby plays a big role. But even more important than many people realize is how a lack of sexual education and communication skills weighs on our ability to adapt and grow together intimately.

Initially, our sex life falls apart innocently with the many challenging circumstances of growing a family.   But often what becomes clear is just how our limited sexual education manifests and undermines our ability to both identify and express our sexual needs. Without realizing it, our deficit of sexual know-how degenerates into low sexual self-esteem and turns into a battleground of hurt feelings. I remember early in my marriage how little I understood about my own arousal mechanism and how uncomfortable we both were when it came to using words to describe our sexual preferences. Erroneously, I believed that my partner should just know what kinds of touch felt best or which positions worked for me – which was strange, because I didn’t know them myself.

The truth is that what we have no language for is often not available to us. And it is not surprising that so many relationships suffer from ongoing sexual dysfunction issues issues like pain with sex, the inability to orgasm, ongoing vaginal dryness or for men, premature ejaculation and the inability to maintain erections. In fact the sexual health issues are shared almost equally between male and female partners.

We struggled with this combination of sexual inexperience for more years than I would like to admit, which often created more frustration than our fledgling relationship could hold. We often degenerated into hurtful sexual blaming that made both of us feel impotent and afraid to engage. Living with persistent sexual frustration often evolves into an approach-avoidance game where everyone loses and one, or both, partners starts putting one foot out the door.

As our sex life starts to slip away, we don’t realize the impact it is having on the cohesion in the whole relationship. We forget how much emotional release that our physical intimacy brings. I often call it the glue that keeps all the rest of the mess intact, but we know that not engaging sexually undermines the health and longevity of the relationship in so many other ways.

Finding your way out of this downward sexual spiral is possible and deserves your attention. What helped us was both recognizing how much we didn’t want to lose the intimate space we had taken for granted, and developing the curiosity to learn more about our own sexual response. The more confident I became in my own ability to express my sexual needs, the more I could bring to our intimacy and stop blaming him when it didn’t work.

As he saw my willingness grow, and wasn’t worried about my wrath, he had time and space to figure out what helped for him to last longer. With practice, I also got better at finding ways to wake up my arousal which made it possible to throw out the entire idea of needing to “be in the mood.” The more I trusted my capacity to generate a sexual mood, the more we were able to synch up our sexual desires.

During all the baby years I usually had to think my way into desire. It never just came to me, but it became easier and easier to remember how much softer life was for everyone when we took care of our sexual needs first.

 

Wendy Strgar is an award-winning entrepreneur and the founder and CEO of Good Clean Love, a pioneer in the organic personal care product industry. She is a popular blogger and author of two books. Sex That Works: An Intimate Guide To Awakening Your Erotic Life, published by Sounds True Publishing in June 2017, is the companion to her first popular book, Love that Works: A Guide to Enduring Intimacy. Wendy has been featured in many publications including The New York Times Book Review. For more information about Wendy’s relationship help books, visit her author website.

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Pregnancy, Sleep, and New Baby Sleep Expectations

 

Many thanks to Bamboobies for sponsoring this important discussion on sleep expectations related to the arrival of a new baby. 


And heartfelt thanks also to Rebecca Michi, Children’s Sleep Consultant, for providing her expertise in this conversation. Connect with her through her Facebook page, her website, and her excellent book: “Sleep and Your Child’s Temperament.”

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Important points shared by Jessica and Rebecca during this Live Stream:

Today we are talking all about sleep in pregnancy and sleep expectations with a new baby. Some sleep myths, such as baby sleeping through the night, are just not true.

Sleep During Pregnancy (focus on 3rd trimester)

Peeing

Rebecca: I think in that last trimester sleep becomes more and more challenging when you’re pregnant. And it’s for a couple of reasons, one of them is that you’re probably gonna need to pee five times a night and that you’re being kicked in the bladder. 

Jessica: You have a little human being on your bladder, you’re gonna need to empty way more often. Plus, your blood volume more than doubles during pregnancy and at the end there that means you’re filtering all of that out, you’re gonna have to pee more often. This is just the deal. Plus the baby’s contributing to that so yeah, lots of peeing. You’re gonna have to get up and pee.

Discomfort

Rebecca: And then you’re just uncomfortable as well and you get more uncomfortable quicker  in a position than you would pre-pregnancy and feel like you’re having to move around lots. Pillows can really help but when you gotta move you’re gonna need to move pillows. Also, your whole center of gravity is different than it once was. You’re not just easily rolling over. So even if you were just gonna come into a light sleep, roll over and go back into a deep sleep, chances are you’re actually gonna be really fully waking up because the whole, “I’ve got to move pillows,” or “I just gotta move this bump from one side to the other,” is just uncomfortable and you’re just waking up way more. 

People say you need to be getting lots of sleep, and that stresses you out, which also impacts your sleep. Good news is you can’t stock up on sleep. It’s not something you can put in the bank and so when baby arrives we’re not as tired. You are going to be tired. 

Sleep is very different with a newborn than it is in the last trimester. 

Sleep training babies before birth

Rebecca: The idea that you can train a baby to follow a sleep schedule in utero is completely ludicrous. It’s absolutely bonkers. There is no actual way that this can happen. What you’ll notice is when you are up and about and moving the baby can be very quiet and very still. And then the second you lay down and try to go to sleep or to sit down and rest that’s when baby starts getting really active. 

Normal newborn sleep, first 24-48 hrs

Rebecca: Remember that all babies are good babies, regardless of how they sleep. They’re gonna sleep like a baby which is what we want. In the very early stages you may be lulled into a false sense of security because there’s a lot of sleep going on. Being born is absolutely exhausting. So you may find that your newborn sleeps really long stretches and you just think, “We’ve got an awesome sleeper! This is great.” But that quickly changes: they will soon be spending more time awake and much shorter stretches of sleep.

They’re always hungry, because your milk hasn’t come in yet, and that quickly gets in the way of sleep too.

Rebecca: The great news is we cannot create any bad habits, whatsoever. It’s just impossible to create bad habits. And that’s when you’re feeding, you’re rocking, you’re bouncing, you’re jiggling, you’re singing, you’re talking, everything is completely fine. The nurturing that was happening in utero continues when you’re with a newborn. You’re now in the fourth trimester  and it’s just survival mode for at least the first twelve weeks. 

Jessica: Just be responsive and watch your baby and interact with your baby. Let your baby sleep and feed them appropriately. 

Rebecca: You don’t need to worry if your 2 day old is not on a sleep schedule. Not in the slightest. I wouldn’t even think about getting on a sleep schedule until over twelve weeks old. 

Jessica: Our bodies do the most milk making processing at night. As wonderful as it is when babies start sleeping longer stretches at night it does, to some degree, threaten your breastmilk supply.

Can't create bad habits with newborns

Week one

Rebecca: Getting into that week one we’re still in that survival mode. They have no idea what is day or what is night and so they’re going to just be continuing to sleep, wake, sleep, wake, sleep, wake. Sleep is just sleep. They’re not thinking of it as nighttime sleep or as daytime sleep. So if you think that your child has days and nights mixed up, they can’t because they don’t really have days or nights.

Rebecca: When they’re born their stomach is so tiny it’s the size of a marble. And that’s tiny. As they grow older and they get bigger the stomach gets bigger and your supply begins to alter as well. That’s gonna really dictate why your child is waking up and when they get hungry. 

That can continue throughout that first twelve weeks. And you may notice that you’re able to get a little bit longer between the feeds and we’re not ever dropping feeds during the night, we’re stretching the time out between the feeds.

Rebecca: The majority of children, about seventy percent, at twelve weeks old are not even getting a five or six hour stretch of sleep. 

Jessica: One of the things we know is that that interrupted sleep for the baby reduces their risk of SIDs. 

I know for me, when I was really struggling, one of the things I would tell myself is, “I’m so glad you’re awake, just keep on being alive.” Because it was hard, and I would feel a little angry or resentful like “Please just sleep!” but it was so important for me to remind myself that her frequent waking was maybe even saving her life. So, just something to keep in mind, it’s important that our babies do what they need to do. 

Rebecca: Sleep deprivation is incredibly tough when you’ve had a newborn you can see why it’s used as a form of torture because it is so effective. 

Jessica: We need to recognize that it is a part of normal human development that, starting as infants, we wake often. Most of us do.

I’ve had one of those kids that slept long stretches right off the bat, that was super easy, immediately threatened my milk supply, immediately made some growth issues for us actually, and so my doctor was telling me to wake her because this became a problem (and to this day she is still a very good sleeper). But my very next kiddo still at 15 feels like she only believes in sleep when she wants to sleep on her terms. That has not changed. She was that way from coming out and stayed that way. We kind of have this range of normal for humans and what our sleep patterns look like as an adult it’s not fair to impose those on to babies. While at the same time there are different sleep personalities, or personalities in general, and my 15 year old’s sleep patterns are, in many ways, much better than they were when she was an infant – it’s true (in large part because she’s responsible for them and not me) but she doesn’t wake me up either way so she lets me sleep. There’s a pretty big spectrum here but I think one of the biggest mistakes we make going into parenting a baby is we expect our newborn human beings to function, in terms of sleep, as adult human beings. And that’s simply not how we’re wired, that’s not how we’re gonna work. 

Week one to week six

Rebecca: More of the same. Just waking and feeding and this is gonna be happening 24 hours a day. You may have wake ups where it’s not just straight back to sleep after the feed but these are gonna be quite short. And then as your child is getting older these awake periods just get longer and longer – but not hugely.

As we get to twelve weeks the longest awake period we should have is an hour and a half and that’s where we’ve got to get everything in. That’s the feed, the diaper change, the playtime, the bath, whatever it is, we’ve got 90 minutes to do that. So don’t feel you have to be home for every nap because you’re not going to be able to do feed, diaper change, getting dressed to go out to the car to get to the store to get back for that next nap. That’s going to be totally impossible to do. So whenever you can, napping on the go is completely fine. 

Jessica: I have definitely had those kids that have slept so much better when we are on the move and the reality is I have things to do. 

Rebecca: Temperament really does play a really big part at really young ages as to how your child is gonna sleep and that’s actually normal.

Jessica: So learn what’s normal from your baby. And be educated with your healthcare provider to make sure they’re growing appropriately and they’re developing on track and all of those things. You’re going to want to recognize that there is no one size fits all sleep standard. So normal is a range. And you have to learn your baby. 

Rebecca: Only help when you need to help. Your baby knows exactly how to get you to help, their cry is very effective, it’s not something we can easily ignore. Which is one of the reasons why the human race is still here, that cry getting us to do whatever we need to do to get it to stop because that’s how we survive. Don’t over help. If they’re happy to just hang out, perfect. It may be they’re happy to hang out for 10-20 minutes and then they may fall asleep or maybe then they need help. But you don’t need to over help especially in the middle of the night if you don’t actually need to be there helping. Generally when they’re crying they need something, even when they need sleep they’ll cry because they’re overtired. That doesn’t necessarily mean you should just leave them, if they’re fussing that’s fine, but you’ve got to figure out what works for your child. Because it may be that they actually need to be held and rocked whilst you’re patting their back. It may be that you need to rock side-to-side rather than back and forward. Every single child is completely unique with what it is that they need but when they’re crying and they need something they’re not manipulating you. 

Jessica: When they wake at night, close to twelve weeks, and they want to be awake for a little while do we engage them during that time or do we keep the lights low and things quiet?

Rebecca: I would keep the lights low with low interaction. And it may be that you need to do a diaper change or whatever it is you need to be doing and we don’t want to be creating this our awake time we actually want to be encouraging sleep at this time. Just keeping it dark, dim and using a very low voice and really low interaction because we want to be encouraging sleep. 

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Child Passenger Safety and Feeding On The Go- Answers From a CPST

by Jessica Martin-Weber with Allana Pinkerton, CPSI
This post made possible by the generous support of Diono.

September is child safety month and we’re taking a look at safety and what we talk about most around here at TLB: feeding our kiddos. Many of us find ourselves needing to feed on the go, from a snack in the car to an entire meal between one activity and the next. 

Allana Pinkerton, a child injury prevention specialist, CPST/CPSI, and mom of two answered our questions on The Leaky Boob Facebook page Live Stream on what we can do to minimize risk when it comes to feeding our children on the go. A huge thanks to Diono in making this conversation with Allana possible.

Whether your child is 3 months old or 3 years old or 13 years old, it is very likely there will come a time when meal or snack time happens on the road. It probably goes without saying that the safest option is to not eat in a moving vehicle. But we all live in the real world and can’t just stay in a bubble so sometimes that’s just not possible so we’re looking at what we can do to make the mobile mealtime as safe as possible. Below are the questions we asked Allana and the Leakies.

When it comes to feeding our children on the go, when we’re in a moving vehicle perhaps on a road trip or having to grab something quick between scheduling commitments, what is important to keep in mind?

*Please note: for safety and to reduce distractions, the driver should never eat and drive.

  • A seat that is more inclined is not a safe option to have a child eat food. Solids shouldn’t be fed in a laying down position.
  • Nothing too hot.
  • When possible, have someone keep an eye on a very young child when they are eating in a moving vehicle. Determine if a mirror is a safe or distracting option for you.
  • Pick foods that are easy to swallow.
  • Avoid choking hazards- for babies and toddlers, nothing hard or like grapes and popcorn.
  • Foods that dissolve easily will reduce choking hazards (i.e. puffs and yogurt melts, etc.)
  • Contained foods that aren’t as likely to spill and get car seat straps wet.
  • Keep in mind, if you’re always eating in the car it may be time to reevaluate how much we’re doing.

Is there anything in particular we should avoid when it comes to feeding our children on the go?

  • Hard candies, even lollipops (a sudden stop could result in injury and/or choking).
  • Foods you know will be messy.
  • Foods that may damaging to your child’s car seat (sticky drinks, dairy, etc.).

What do we need to keep in mind when it comes to installing children’s seats? How can parents find a local CPST to help them?

  • Read the manual. If you’re unclear about something, call the manufacturer. 
  • Have your seat checked by a CPST and be sure they watch you install it and check your install as well, not just have them install it for you. Find one here.
  • Do not use after market products with your seat that are not made by or approved by your seat’s manufacturer (i.e. strap pads) as they could compromise the safety of your seat.

Breastfeeding in the car seat moving vehicle child passenger safety

Are there any safety concerns related to these breastfeeding or bottle-feeding a child in their car seat in a moving vehicle?

  • Propping a bottle for a child not yet able to hold their own is dangerous in that the child may be overwhelmed with the contents of the bottle and has a higher risk of aspirating. Have someone give the baby their bottle and be able to pay attention to them as they feed.
  • Keep in mind a bottle would become a projectile in the case of an accident. Use as small a bottle as possible.
  • Breastfeeding a child in a seat, even if the breastfeeding parent isn’t leaning over the seat, is a significant hazard in the case of a car accident as it places something in front of the child’s face. Physics tell us that in a crash objects (including a breast) will weigh their weight times the force of gravity of the crash. For example, a 30mph crash is around 20-25 G’s (force of gravity). Let’s say the breastfeeding parent weighs 140 pounds. Multiplied by 23 G’s (right in the middle) means 3,220 pounds. That’s the total weight of their body with the momentum of the crash. Their chest alone will weigh at least 1,000 pounds, if not more. Being positioned in front of or possibly over the baby to breastfeed, that’s a minimum of 1,000 pounds being dropped or slammed into the baby. Potentially crushing the child and injuring the parent. This all would be true even with a seat belt on the breastfeeding parent as the parent would not be positioned properly with a chest belt to restrain them from hitting their child in the case of a collision or sudden stop. (See more on this here.)

Feeding on the go means seats will likely get soiled, what do we need to know about cleaning our seats?

  • Never hose a car seat down, that can compromise not just the cover and straps but also the frame and internal materials.
  • Follow your manual’s instructions. 
  • Replace straps if webbing becomes soaked.
  • See these cleaning tips.

 

Allana Pinkerton is the Global Safety Advocate for Diono. She began her career in Child Passenger Safety as a National Certified Child Passenger Safety Technician in 2001 and advanced into the position of a National Instructor in 2002. In 2004, she founded a non-profit organization, Sit Tight, which provided education and free car seats to underserve communities.
As the Global Safety Advocate, she facilitates educating the staff, consumers and the media about car seats. Allana works closely with the marketing team, educating at consumer and industry trade shows, as well as writing blogs on CPS issues. She is called upon to work with engineering and product development team on current and new products. As Diono expands across the globe, Allana continues to expand her role assisting the Diono European and China teams.
Allana has two children, Max (12) and Andrew (20) who is ironically a race car driver. She has been married to Paul for 22 years and he still cannot install a car seat.
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The Serious Injury No One is Talking About: Diastasis Recti

by Nicole Nexon, MSPT

This post made possible by the generous support of Chunkabuns

 

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Sometimes I feel like exercise has become a dirty word in the mommy sphere. I can understand that.

We get this message that we need to do everything – work, raise babies, maintain perfect households, create Pinterest worthy projects, not burn dinner… and erase any shred of evidence that our bodies have created life. Society settled on the idea that skinny = perfect and the backlash from that led to a movement of pride in our bodies. Which somehow turned in to “ real woman have curves “ and all kinds of craziness about skinny girls and curvy girls and…

It’s out of control.

And what has been missed in all of this is the truth of the matter – it’s not about skinny. It’s not about having curves or not having curves. It’s not about “mummy tummies” or thigh gap or muffin tops.

It’s about being healthy.

And not “healthy” in a way that has been co-opted by people meaning “stop eating junk food you fatty!” Healthy in way that allows people to live their lives in a manner they choose. Healthy in a way that allows you to lift babies and chase toddlers and carry laundry wherever you need to carry your laundry. Healthy in a way that makes you feel confident, that lets you sleep well and go about your life.

What happens when you’re injured…and you don’t even know it?

When I was pregnant with my second daughter, I began to feel a pretty distinct pain by my belly button. It was so specific that I was fairly certain I was developing an umbilical hernia. I brought it up with my midwife and was told it wasn’t a hernia. I was developing a diastasis recti – a split between the muscles and muscular tissue that runs down the center of the abdomen. The pressure inside from an expanding uterus/baby was just too much for the abdominal tissue to handle so the tissue and muscles were separating.

With my first pregnancy, I worked in an outpatient clinic that was less physically demanding. With this second pregnancy, my current position required a lot of physical lifting as a physical therapist in a subacute center for patients who were not sick enough for the hospital, not well enough to go home. I already had work restrictions due to the physical requirements of my job; working with those restrictions AND dealing with a developing case of Diastasis Recti made the restrictions even more difficult.

It was in this position that I recognized a growing group of people in need of support, awareness, and healing of Diastasis Recti: new moms.

Here were these women, trying to juggle new responsibilities, healing from the changes their bodies went through during pregnancy and subsequent post-partum recovery and there was little to no support or even awareness about the problems that Diastasis Recti presented.

Diastasis Recti can affect your body in some pretty drastic ways.

  • -Incontinence
  • -Irregular bowel movements,
  • -Lower back pain, spinal or hip injuries due to your abdominal muscle’s inability to support your body when you’re lifting or bending
  • -Pain during sexual intercourse
  • -Increased chance of sciatica or disc issues
  • -Increased chance of umbilical hernia
  • -Postural instability due to poor strength of the abdominal muscles

The effects are numerous.

Now it was MY body that was going to need to be supported.

My body that was going to need help carrying a car seat. A baby. My toddler. The laundry.

My body that was going to be more prone to injury- that would need me to completely rethink how I went about my day. I worked out through my pregnancy because I knew what was ahead of me. I knew my core was going to be compromised. I wanted to achieve a VBAC and I knew I would need endurance (among other things) to prevent a repeated OR experience. I went back to my books and read studies on exercise efficacy. I reviewed exercise programs for pregnant women, post partum women, and people who had just had abdominal or back surgery. I had a plan, and I HAD to be as physically strong as I could when I returned from maternity leave so I could perform my job effectively.

I ended up with a VBAC, a baby girl, and a three-finger diastasis.

*when I say “three-finger diastasis” I am describing how many fingers I can horizontally fit across the tissue separation. To find this, lay on the floor with knees bent and feet flat on the floor. Lift up your head slightly and contract your abdomen muscles gently. Find your belly button and make the “scout symbol” with your fingers…see how many you can fit in there. i.e. 1 finger, 3 fingers, etc. Check the same line down by your pelvis, and again up towards your ribs. Different points along your abdominal muscles may be different fingers of separation.

 


I feel blessed that my passion and my education allowed me to understand what my body needs to function well and heal from my condition. I am grateful for my colleagues and friends with whom I can discuss ideas or count on to help me with the hands-on techniques I can’t perform on myself. I know I am lucky to have access to the information that I have.

I want other women to have this valuable access to connections and resources that are out there for those recovering from Diastasis Recti.

I want women to know that sometimes “mummy tummy” can actually be caused by a medical condition.

I want women to know that the media are not medical professionals and there is a wide range of “normal” when it comes to our bodies.

I want other mothers to know that exercise and eating well are available to them.

I want women to know there are safe exercise routines that WON’T injure a body healing from Diastasis Recti. That recovering doesn’t need to be a series of scary, out-of-reach experiences. They don’t need to spend hours in the gym (Though you certainly can, if you enjoy it!).

Recovering means that you can take a walk, be it pushing a stroller or wearing a baby. You can do squats in your living room, jumping jacks, and eventually pushups and planks. (But until you’ve healed from your diastasis, it is best to do modified planks so that you don’t further separate your diastasis or have your abdominal muscles work against you or push on that separation while you’re healing!)

I feel sad when I hear people say “I can’t workout because…”

I feel sad because they are being taught that only the big efforts count.

That’s not true.

I work with people for whom sitting at the edge of their bed is enormous effort, and standing requires assistance of others. When you see the enormous joy on a person’s face brought by these small yet enormous victories, you begin to understand the true beauty of the movement our bodies are capable of. What may seem like a small victory may be an enormous triumph-a giant step towards hope and healing.

Misguided emphasis on skinny and perfect or the fear of never being _____ enough WILL STOP US in our tracks.

Enough.

You are enough.

It’s ok to start small.

It’s ok to fail.

It’s ok to not be perfect.

It’s ok to be YOU.

It’s not about meeting someone else’s standards.

It’s about taking care of yourself, teaching your family that our bodies are a great gift and we should treat them well. It’s about understanding that you are worthy of the time and energy it will take to begin, to HEAL, and to build healthy habits that facilitate that healing and well being.

Let’s get moving, because moving not only transforms your body, but it transforms your mind, no matter what size jeans you wear.

Some Exercises to Get You  Started:

Some Other Tips to Start Healing:

  • Sitting with the best possible posture: (Pull your belly button in towards your spine. Keep breathing while doing this. Pull your shoulder blades onto your back. Keep breathing!)
  • Kegels/pelvic floor exercises (contracting the pelvic floor muscles-the ones you use to stop your pee, if that makes sense!).
  • Standing on one foot while brushing your teeth while pulling your belly button in towards your spine.
  • Stretching before you get out of bed.
  • Taking a walk or parking further from the store.
  • You can climb your stairs.
  • Swim.
  • Dance.
  • Work out with a DVD program or take a class.
  • If pregnant, getting an abdominal/belly support band to help support your abdomen and relieve pain you may be experiencing.
  • If in post partum recovery, gently binding your belly to help pull the muscles together and support you in those first few weeks of initial birth recovery.

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Where am I now? I’m down to a one finger split at my belly button. I am confidently back to work full time with no restrictions. I’m still doing pelvic floor exercises and modifying my workouts to protect and strengthen my abdominal muscles so I don’t re-injure or reinforce the Diastasis Recti. I’m teaching my daughters that exercise and eating well are ways to treat your body with respect, to give it what it needs so when you need your body to work for you, it will. I’m teaching them that strong is beautiful, that healthy allows you to follow your dreams, that food is a tool and a pleasure and size is just another physical trait that varies from person to person.

Final thought… can we all agree to stop using the words “mummy tummy” ? Please? Your tummy is awesome, mommy. Growing a human is beautiful. A body that shows the results of growing a human is also beautiful!

For more information on Diastasis Recti click here.

*You are strong, and Chunkabuns knows it. Check out their “Mom Strong” Tee-shirts (and matching “Strong Like Mommy” shirts for baby! ♥♥♥) and other clothing options for mom and baby at www.chunkabuns.com

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Nicole Nexon is a mother of two, working full time as a physical therapist. Nicole has her master’s degree in Physical Therapy, and has been working for 9 years in both the inpatient and outpatient fields of physical therapy. She is a complete nerd when it comes to the human body and wants to encourage others to take the opportunity to treat their bodies well at whatever stage of life they are in. She is also a Beachbody coach and has found it to be a great platform to spread her mission of health and wellness. In her spare time, Nicole enjoys traveling and snowboarding. You can follow her at www.facebook.com/nicolerosenex )
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Bottle-feeding Tips- A Bottle-feeding Overview for The Breastfeeding Family

by Amy Peterson

This post made possible by the support of EvenFlo Feeding

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Moms who breastfeed often feel afraid, or even sadness, at the thought of introducing a bottle. The truth is bottles are a tool, a useful tool, and they don’t need to be scary, even if you need to use a bottle in the early days because breastfeeding isn’t going well. If you think your baby is lazy, you need someone to evaluate what’s going on because it’s not laziness, it’s something we’re not recognizing. It is a sign of something else. In the meantime, pump your milk and feed your baby. The bottle can be a tool you use to protect your breastfeeding journey, not to end breastfeeding.   

It can feel overwhelming when it comes to picking a bottle for your breastfed baby. Many bottles claim to be “more like mom,” but that is a marketing gimmick. Babies are unique, and a bottle that works for one baby may not work for another, siblings included. Below are some tips that may help parents looking for a bottle for their breastfed baby.

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Think of how a baby latches on the breast. There are many ways to evaluate if breastfeeding is going well. As it relates to picking a bottle, we specifically observe the baby’s mouth. It should open widely, resting the lips on the areola. The lips will roll out (flange) and be visible, with the corners of the lips sealing against the breast. Your nipple will reach far into your baby’s mouth. This is what you want to mimic with a bottle latch.

There are three predominant nipple shapes: narrow, gradually sloped wide, and classic wide.  Any shape is okay so long as your baby has a similar latch on the bottle nipple as on the breast. The right nipple for your baby should a) reach deeply into your baby’s mouth, b) allow the lips to open and rest on a portion of the base, and c) allow the lips to form a complete seal.  On a narrow nipple, let your baby latch and then wiggle it in deeper into your baby’s mouth so the lips are almost “kissing” the collar. On a gradually sloped wide, again, wiggle the nipple in deeper, then observe to see if your baby’s mouth remains opened widely rather than slipping to the tip.  On a classic wide, make sure your baby’s lips can rest on a portion of the base and form a complete seal rather than sucking on the nipple length like a straw.  

You will probably want to buy two or three nipples to try. Rather than reading packaging claims, look at the nipple. Ask yourself, “Will this nipple reach deeply in my baby’s mouth so the lips can rest on the base? (yes) Will this nipple shape help hold my baby’s lips open? (yes) Does it look like my baby will suck on this like a straw? (no)” Try different shapes until you find the shape that allows for a good latch for your baby.          

Start with a slow flow nipple. However, it is important to note that there is no industry standard for “slow,” and flow rates vary greatly between brands. It is also important to note that dripping is different than flow. Bottles that are advertised as “no drip” may flow very fast compared with other bottles that do drip.  With any bottle, you can control dripping by letting your baby latch on to the bottle before tipping it up so milk fills the nipple. You can’t control flow, but you can try different brands to see how your baby responds, and you can tip the bottle down and let your baby rest if he looks overwhelmed when swallowing Balancing Breast and Bottle lists bottle brands from slowest to fastest flow.  

The million dollar question—which bottle nipple is best for my breastfed baby—has no absolute answer. It all comes down to how your baby latches and swallows with a specific nipple.

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Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.
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Weaning Off Formula back to Exclusively Breastfeeding

by Shari Criso MSN, RC, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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“Supplementation with formula does not have to be the end of breastfeeding and it may be very possible to transition to exclusively breastfeeding if that is your goal.”

First of all Amy, great job at making it to the 8 week mark! It is a big deal and something to be very proud of. From your questions it is clear that you’re just about exclusively breastfeeding but now we need to help you over that last hump.

What I tell all my clients is that if all you’re supplementing is 1-2 feedings per day of formula and breastfeeding the rest of the time, then in most cases you probably don’t need to do any at all! It is obvious that your body is quite capable of producing adequate amounts of breastmilk, however the continued supplementation will not give your body the opportunity to catch up. What you need to do is feed a little more frequently so that your body can kick inn and start to make more.

If all you’re doing is one or two supplemented feedings a days and your baby is gaining weight adequately, I would immediately start cutting out formula supplementation and begin to encourage your body to make more milk. Those few ounces that you have been supplementing can usually be made of with more frequent feeding or were not really necessary anyway, as many supplemented babies are over fed and encouraged to gain weight faster than they need to.

Typically, it is when I see moms that have been supplementing for weeks and weeks with very little breastfeeding that I am more concerned about the status of their milk supply and the need to build that up slowly by cutting back formula supplement slowly over time with careful evaluation throughout.

However, for you Amy, what I would recommend is to stop the supplementation, increase the frequency of your feedings, allow your baby to stay on the breast longer, drain the breast completely by switching sides multiple times during a feeding (feed both sides and then return to the first side again), do lots of skin to skin and wear your baby as much as you can, and basically let the baby guide you right now.

As for how hungry he is, treat it as a growth spurt. In my online breastfeeding program “Simply Breastfeeding,” I have an entire chapter on growth spurts and what to do when your breastfed baby is going through one. These are times during the breastfeeding journey when you actually are not making enough and it is very NORMAL! These are times when you baby is growing and your body is attempting to catch up with your baby’s needs for more milk. The only way that it can do that is to respond to your baby’s signal of hunger, which is what happens when they start feeding very frequently. During these times, allowing your baby to nurse as long as they want and as often as they want for a few days is the answer. With frequent and “on demand” feedings, your body will kick in very quickly and start to get the message, “Oh…MAKE MORE MILK!”

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Regardless of the reason in the beginning or whether the initial supplementation may or may not have been necessary, it does not mean that you need to continue doing it indefinitely. For most mothers it is a lack of understanding about how much their baby’s need to be eating, how much and how fast they need to be gaining, and how the body responds and makes more milk that causes them to continue to supplement unnecessarily and eventually add more formula which further decreases their breast milk supply. What may start off as a true need under certain circumstances is then replaced with an issue that has been unknowingly created and unnecessarily continued.

Another important thing to understand is that babies should not be weighed weekly. This is huge! When moms and dads ask me, “How much should a baby be gaining every week?” The answer I give is somewhere between 4-8 ounces per week on average. The key point here being, ON AVERAGE. That means, under normal circumstances you are not bringing your baby in every single week to weighed. This is because one week you may only have a weight gain of 2 ounces and you are going to think something is wrong. Then the next week your baby is going to gain 10 ounces cause they had a growth spurt. This is why weighing your baby every week and monitoring so closely can cause you to think your baby is not growing appropriately and cause unnecessary supplementation.

The best way to monitor that your baby is doing well is to keep watching for those wet and poopy diapers, looking out for all the signs that I talk about in my DVD program on how to make sure your baby is getting enough milk, and weighing your baby monthly.

So after a month’s time you’ll go back to weigh the baby, you divide that gain by four weeks, and now you can say to yourself, “Okay, did they gain somewhere between 4-8 ounces a week on average?” If the answer is yes then you’re pretty much in the right spot. Babies grow at their own pace and we cannot be too rigid with this. Breastmilk is just too important to sacrifice that quickly. Just as a baby that truly needs to be supplemented must be addressed and few for their well being, your breastmilk supply and breastfeeding relationship is critical to their short and long term health and must also be protected and supported appropriately.

I recommend that you go back and watch my program and pay particular attention to the chapter on growth spurts. Work with your pediatrician and treat this time just like you would a normal growth spurt. With the right support, patience and understanding of what is normal, I believe you will be on your way to exclusively breastfeeding your little one in no time!

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Find more from Shari supporting your parenting journey including infant feeding on Facebook, or her classes at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

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Shari Criso 2016

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
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Clicking Sound While Nursing

by Shari Criso MSN, RC, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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Question:

From time to time while my baby is nursing, I hear a clicking sound. I try to take her off and re-latch her, but she gets really mad and doesn’t like to be interrupted… what could be causing this?

Answer:

I can’t blame your baby for being mad- who likes to be interrupted when they are eating?

As for the clicking issue… here is my definition of the perfect latch when breastfeeding: the one that doesn’t hurt and the baby gets milk. That’s the perfect latch. So, if your baby is clicking but the baby is not hurting you and seems satisfied, and your nipple come out looking normal and there’s no damage being done, I’d say to either try holding the baby a little closer while nursing, or don’t worry about it. Sometimes, that clicking sound comes from an oversupply, when you have a lot of milk. The baby keeps unlatching because it’s hard to latch when the nipple is so wet. So that’s probably what you’re listening to. But if you’re not in pain, and the baby’s latching, don’t disturb the baby – let her eat!

 

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Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

____________________

Shari Criso 2016

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
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Ask The IBCLC- Migraines, Blebs, and Teething

by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

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Dear Shari,

Help! I’m 8 weeks postpartum with my third child. It was also my third C-section and the third time I’m breastfeeding exclusively. I’ve been having dizzying migraines that sometimes blur my vision, make my ears ring, and make my head feel like it’s in a fog. My OB recommended an excedrin migraine or a little caffeine. That doesn’t often help and I don’t want to take an excedrin or two daily. I’ve gotten the depo shot two weeks ago, and the migraines are still unrelenting. Is it hormones like everyone says? Is there something I can do to help control them or relieve them?

Dizzy Mama

 

Hi Dizzy Mama,

I am sorry to hear that you are suffering so much at a time when your full focus should be on caring for and enjoying your new little one!  As someone who has migraines myself and cared for many women who have also experienced this debilitating condition, I truly feel your pain.  It is not an uncommon occurrence affecting up to 17% of women of childbearing age.  Migraines tend to get better during pregnancy, due to the high estrogen levels.  Although this is not always the case.  Non-pharmacological treatments should be the first choice when treating anything whether you are pregnant or breastfeeding and can be quite effective. Keeping a “headache diary” can help to identify triggers and make lifestyle changes that will work. Unfortunately, some of the things that do trigger migraines are the norm for any new mom such as not eating regular meals or getting good sleep, however knowing this you can make an effort to take care of yourself as well as your baby.  Something that we as moms can forget quickly!  Caffeine can make a big difference in the effectiveness of migraine treatments and is generally safe to use in moderation and as long as it is not affecting the baby.  Excedrin is actually NOT a drug that I would recommend since it contains Aspirin which is transferred into breastmilk.  The baby receives about 4-8% of the mother’s dose.  Breastfeeding women are advised not to use aspirin because of the risk of Reye’s Syndrome in their babies.  As for what prescription medication to take, Imitrex is generally considered safe for breastfeeding as the infant will only receive about 1% of the maternal dose and it is cleared quickly out of the milk.  No short-term problems or long-term developmental issues have been documented in breastfeeding infants exposed to these drugs.  Of course you will need to consult your doctor about this or any other medication, as well as to obtain the prescription.  If your OB is uncomfortable due to lack of experience or knowledge, maybe it is worth seeking a second opinion.  I hope this helps and that you have some relief quickly!

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Dear Shari,

My daughter is 16 months old now. Lately my nipples feel so sensitive and sore and I’m not sure why. I think she may be teething, cutting her molars now, could that be causing this pain? What can I do about it? My plan was to let her self-wean but right now I wish we were done. I don’t want to give up on my goal yet though, how can I get through this and how long will it last?

Feeding a teething baby

 

Dear Feeding,

Congratulations on your great success breastfeeding!  Yes, it is possible that her teething is causing her to clamp down while nursing and causing your nipples to feel sore. If that is what is happening, it is important to pay attention to when she is done “eating” and to remove her off your breast before she has a chance to bite down or rub against your nipple trying to soothe herself.  You can also offer her a cold or frozen washcloth or teething ring to chew on so that she is not using you!  The other thing that I was thinking as I read your question…is to take a pregnancy test   This is actually the very first sign for most pregnant moms!  Nipple pain and soreness all of a sudden after many months of pain free breastfeeding (in the absence of any infection or damage to the nipple) can be the first sign that you are expecting again and it is worth ruling that out first with a pregnancy test.  If the soreness is due to pregnancy, there is not that much that can be done about it since this is hormonal vs. mechanical or technique.  For many nursing moms who become pregnant this is the main reason that they decide to wean their older child, but for others it is not a problem and they can safely continue throughout their pregnancy and beyond to tandem nurse their children. Keep me posted!! xoxo

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Dear Shari,

I have a sort of white dot on the tip of my nipple and it is extremely painful when my baby is latched on that breast. It’s been there for a couple of weeks now, it looks sort of like a pimple. I tried squeezing it but that just hurt more and didn’t do anything. My baby is just 7 weeks old and the idea of this pain lasting until we’re done breastfeeding is so discouraging. Help!

Owie Nipple

 

Hello Owie Nipple,

I am glad you wrote in to ask this question because it is a fairly common issue that moms will encounter.  It is called a “milk bleb” or a blockage of milk inside one of the nipple pores where the milk comes out of the nipple.  That is why it is white.  A milk bleb is not serious condition, but can cause serious pain in the nipple especially when trying to nurse or pump.

The best way to approach this is to first not wait to do something about it. Left untreated it can cause your breast to become engorged which can lead to a decrease in your milk production as well as mastitis.  The first thing you can try is to soak your entire breast in a bowl of hot water.  Fill the bowl with water and then lean over it and just soak for 5-10 minutes or longer.  Immediately try to nurse your baby or pump after that.  The water will often soften and loosen the plug and it will be sucked out by the baby!  It is perfectly fine for them to swallow.  You may notice after nursing that it is starting to come out.  If you can you can pull it out, but I would not squeeze your nipple to try and “pop” it.  It is not a pimple and squeezing your nipple can cause more inflammation.  If the soaking and suction does not work you may need medical help from your doctor or midwife who can use a sterile needle to remove it.  This is not something that I would do at home (although I know women who have) due to the risk of injury or infection.  Good luck!

 

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Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

________________________

Shari Criso 2016

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
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Breastfeeding and Solid Foods

by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

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Once a baby is taking solids, how often should you offer your baby the breast, and how do you know when to initiate the weaning process?

Once the baby is taking solids, you should still offer the breast whenever they baby wants to eat. You can still breastfeed before each feeding of solids. But as the baby gets older, into the seventh or eighth month, if you wanted to cut out those feeding and substitute a meal, like breakfast, and have a meal of food and then breastfeed between those feeding, that’s totally fine. By the time my children were about 8 months old, I was feeding them three meals a day, breakfast, lunch, and dinner, and I was breastfeeding them maybe 4-5 times in a 24 hour period.

 

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How do I introduce solids and keep my supply up?

And your body will adjust to this. Your body will naturally keep its own supply. It does not need to make the same amount of milk it did in the beginning. Remember, you’re making more milk in the first 6 months of the year than you are in the second 6 months, because your baby will eat a certain amount of milk, somewhere around 3-4, sometimes 5 ounces of breastmilk per feeding, and never increase from there. What changes is that in the second half of the year, they start to eat solid foods, so the actual amount of milk you’re actually producing and feeding decreases in that second half of the year from 6 month to 12 months and beyond. So you don’t need to keep up with your supply; your supply will be adequate for what your baby is taking in. And by nursing more, you’ll just make more. 

Shari Criso MSN, RN, CMN, IBCLC

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Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

____________________

Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
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