How to Select a Breast Pump and Get It Through Your Insurance

by Jessica Martin-Weber with Leah De Shay, IBCLC, and Lauren Bennet, BSN

This article made possible by the generous support of Aeroflow Breastpumps.

Get Paired with your perfect pump through Aeroflow Breastpumps

Disclaimer: This information is not to replace the advice of your health care provider. If you are experiencing breastfeeding difficulties find IBCLC. Not everyone needs to pump, successful breastfeeding is not dependent on pumping if there is no need to pump. This article is simply for information, not promoting any specific pump but rather promoting finding the right pump for your needs.

Selecting a breast pump can be an overwhelming task. It can be confusing to sort through the various pumps on the market, what you need, the terminology, and what to look for in a pump. I talked with IBCLC and mom Leah De Shay, and BSN and pump specialist, Lauren Bennet about the basics of selecting a breast pump and, if you’re in the USA, getting your pump through insurance. You can see the entire conversation here:

I’m frequently asked what is the best pump and while I know people are hoping I’ll give them a specific brand and model of pump, the truth is my answer is way more open:

The best pump for you is the pump that helps you reach your breastfeeding goals within your budget, comfort, ability to operate, and that suits your pumping lifestyle and needs.

There is no one pump I can say is the “best” and while I may have my favorites (and it hasn’t always been the same with each baby), my favorites have been based on what has worked best for me at that time recognizing that my breasts and my lifestyle and pumping needs may not be the same as the next person.

Ameda Finesse breast pump

Ameda Finesse

So how do you figure out what pump you should get?

Fortunately, there are a good number of pumps on the market and it is very likely that there are a few that would be just right for you. Though you can’t know for sure what will work best for you until you try it and sometimes one pump may not be a good choice for you while another one could be ideal, there are steps you can take to get you closer to the perfect pump. Just because one pump works great for your best friend doesn’t mean that your breasts will respond the same to that exact pump or even that one particular pump doesn’t work well for you but another may. The best you can do is see what worked for other people and gather as much information as you can on the various pumps available to you before you make your decision. If you’re feeling confused, the pump specialist at Aeroflow may be able to help you further but for now, we’ll break down the terminology, ask questions to help you determine your pumping lifestyle needs, and share how to get your pump covered through your health insurance as part of the Affordable Care Act. For more in depth information, watch the above video.

Lansinoh Smartpump

What does it all mean?

There’s a lot of terminology used in association with breast pumps and if you don’t know what these concepts mean, it can sounds like a foreign language. This is just a quick look at some of the most frequently used terms:

Manual– a hand pump, doesn’t require electricity or batteries as it is powered manually.

Double Electric– a breast pump that can pump two breasts simultaneously with an electric powered motor.

Closed System– barrier designed to protect pump motor and tubing against moisture, mold, and pathogens.

Personal Grade– not a specific designation but usually used to mean a lower suction level, open or closed system, FDA approved as a single-user, limited pumping hours (usually 300-500), and available to consumers directly through retailers and DMEs (Durable Medical Equipment suppliers) usually with a maximum suction level of 25—300mmhgs.

Hospital Grade– not a specific designation but usually used to mean higher suction levels, closed system, FDA approved as multi-user, and longer life/higher pumping hours and limited availability such as renting through a hospital.

Multi-user– FDA approved for multiple users with their own individual kits.

mmHg– suction level.

Motif Duo Breast Pump

Your Pumping Lifestyle and Needs

While it may be tempting to get the pump with the most bells and whistles, the strongest suction level, and the highest dollar amount, reality is that may not be what you need or even the best pump to help you reach your goals. Keep these factors in mind when you assess your pumping lifestyle and needs:

  • How often do you plan to pump? Is it for working 40 hours a week away from your baby (approx. 3x/day) or to exclusively pump, or once a day as a breastmilk donor, or just for the occasional date night?
  • Will your pump need to be easily portable? Will you be lugging it back and forth frequently or will it be mostly stationary?
  • What will your pumping environment be? A relaxed, private setting, or an open cubicle or your car? Will you be multitasking or able to just focus on pumping? Does it need to be quiet? Will you have limited time available or however much time you need?
  • What type of power source will you need? Will you have access to an outlet?
  • Are there flange size options or will the standard available sizes work for your breasts?
  • How long do you intend to pump? Six weeks, six months, a year, or longer?
  • Will you be dependent on your pump and need to have access to replacement parts quickly?
  • Are you going to be more comfortable with independent speed and suction control or will preset options give you more confidence?
  • Will you need more than one pump?
  • Are there other factors unique to you and your situation you need to consider?

Medela Starter Set

Picking Your Pump

After you determine your pumping lifestyle and needs, you can begin to look at the various pumps available to you taking these factors into consideration. At the end of the day, picking the pump that is best for you is just as important as knowing how to use your pump correctly (i.e. don’t just crank it to the highest setting!). Remember, higher suction isn’t always better, longer cycling isn’t necessarily better at emptying the breast, and bells and whistles may not be what you need. In fact, higher suction can mean less milk output, particularly if the suction level causes pain. Your comfort is key in how you will respond to a pump. The pump that is best for you meets the criteria that fits your pumping lifestyle and needs.

Get your pump through your insurance

The Affordable Care Act means that many insurance plans now cover breast pumps. Each insurance company and even each policy can vary in what is covered, the options available, the criteria that must be met, and timing.

It can all be a bit overwhelming. Fortunately, Aeroflow Breastpumps has streamlined the process, simplifying everything. Typically it takes between 3-5 days to hear back from a Breastpump Specialist from Aeroflow and depending on your insurance provider and policy, you can typically get your pump anywhere from 30-60 days before your due date and any time up to a year after giving birth.

 

how to pick the best breast pump

Here’s what you do:

Submit your medical insurance information with a few other demographics and a dedicated Breastpump Specialist will verify your insurance coverage.

Your Breastpump Specialist will contact you to explain your benefits and your pump options, including possible upgrades and using your FSA or HSA funds to cover an upgrade.

They’ll ship your breast pump!

Find out online if you qualify for a free breast pump through your insurance.

Things Aeroflow Breastpump Specialist does for you:

  • Contact insurance agent and verify coverage.
  • Coordinate with your doctor to get your prescription to your insurance company.
  • Help you understand the different benefits of the variety of breast pumps.
  • Make sure your pump ships at the right time. Some insurance companies limit when a breast pump can ship (for example 30 days before your due date).
  • Handle all the billings with your insurance company.

Aeroflow provides a number of services and resources as well as products that may be helpful to you in reaching your breastfeeding goals. Picking a pump and navigating insurance coverage can be overwhelming but it doesn’t have to be!

 

Leah De Shay graduated from La Sierra University with a degree in Psychology and Speech Pathology and Audiology. She completed her post-baccalaureate work in lactation at University of California, San Diego and went on to get her CLEC (Certificated Lactation Educator Counselor) certificate, and completed her IBCLC (Internationally Board-Certified Lactation Consultant). Leah has since worked in various health care systems, including as Director of the Welcome Baby Program, Providence. She currently serves patients throughout southern CA as the coordinator for infant feeding at LOOM and the Lactation Specialist at Growing Healthy Together. In addition to her clinical practice and as a busy mom herself, Leah also assistant teaches for the UC system. 
Lauren Bennet is a graduate of the Medical University of South Carolina and a Registered Nurse (BSN), and practiced as an intensive care nurse for 3 years. Currently, Lauren leads an incredible group of passionate and fun people at Aeroflow Breastpumps as the team lead managing the breast pump specialists. In her free time, she enjoys hiking, camping and being outdoors in and around Asheville, NC. 

 

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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Breastfeeding While Sick and How To Recover Your Supply

by Jessica Martin-Weber with Rene Fisher, IBCLC

This article made possible by the generous support of Ameda.

Ameda Finesse Double Electric Breast pump

*Please note, this is not intended to be health care advice or to replace or be a substitute for being seen by a qualified health care provider. 

Is it ok to breastfeed when you’re sick? Could baby get sick from your milk? From being so close to you if you’re contagious?

We often hear how great breastfeeding is for our babies’ immune systems, a highly motivating reason to  breastfeed. There’s plenty of evidence that shows this to be true and even though it’s no guarantee that our babies will never be sick (lowering risk is not eliminating risk), it can certainly be a motivating factor to breastfeed. In fact, we know that in infants, breastfeeding significantly reduces respiratory infections, gastrointestinal infections, SIDS and infant mortality, allergic disease (asthma, atopic dermatitis, and eczema), celiac disease, inflammatory bowel disease, diabetes, and childhood leukemia and lymphoma. (For more, see here and here.) There’s no doubt that breastfeeding can help reduce how often a baby is seek, the severity of their illness, and the duration of their illness. (More on that here.) Most of the time, breastfeeding is exactly what your baby needs when they are sick.

But what about when the breastfeeding parent is the one sick? Particularly with an infectious disease that baby could easily get being in close proximity to the one sick? Is breastmilk that magical it can protect our babies even then?

Not exactly but, well… kind of.

“…the immunologic components found in breast milk appear increasingly likely to play a specific immunologic role in the protection of the nursing infant.” (Mucosal immunity: the immunology of breast milk)

While it is possible your infant nursling could catch a sickness from you even with breastfeeding and since reduced risk doesn’t mean no risk, it certainly does happen, breastfeeding can reduce the duration of infectious disease in the breastfed infant and even beyond the first year of life.

The American Acadamy of Pediatrics recommendation on breastfeeding while sick:

If a mother has a cold or the flu, it is not necessary to discontinue or interrupt breastfeeding. Through breastfeeding, the infant will receive the antibodies that the mother is producing to fight the illness. Most infectious diseases are also not a cause for weaning or interruption. Generally, by the time a disease has been diagnosed, the infant has been exposed and will probably benefit more from the protection he gets from his mother’s breast milk than from weaning. However, each case must be evaluated individually.

There are times when it would be dangerous to breastfeed during an illness such as when the treatment for the illness carries a higher risk to the baby in the mother’s milk than not breastfeeding would. While this is rarely the case for infectious diseases, it is possible. It is important to speak with your health care provider and disclose that you are breastfeeding when considering treatment options. As not all health care providers are fully informed on human lactation, you may find the following resources helpful in determining treatment options that are safe for breastfeeding and to check a medication’s potential impact on breastmilk supply.

  • LactMed app to look up the compatibility of pharmaceutical treatments with breastfeeding.
  • Infant Risk the leading research for medication safety during pregnancy and breastfeeding.

Sometimes, illness can have an impact on breastfeeding. Some changes to breastfeeding that can happen during an illness of the breastfeeding parent:

  • Low milk supply
  • Milk color changes
  • Increased feedings
  • Decreased feedings
  • Sensitivity
  • Fussy baby at breast
  • Sore nipples

Decreased feeding or pumping, fever, and dehydration can lead to a lower supply of milk. Severe dehydration (such as can happen with gastrointestinal illness) can cause a sudden and drastic drop whereas a slow decrease in milk volume is more typical of illnesses such as the flu. Low supply as a result of dehydration will typically come back quickly with hydration, electrolytes, and rest. Low supply as a result of not fully emptying breasts due to fatigue and other symptoms will take time to rebuild. Low supply as a result of medication side effects usually will begin to recover when the medication is stopped and frequent emptying of the breast increases.

American Academy of Pediatrics breastfeeding through sickness

Recovering Milk Supply Following Illness

If you experience low supply as a result of illness, the best way to increase your supply to meet your baby’s needs is simply to let them breastfeed as often as they are interested in doing so. Complete and frequent draining of the breasts will signal the body to produce more milk. Keeping your baby close and doing skin-to-skin will also help encourage milk production. For lactating parents who pump, adding a 10-20 minute pumping session after several feedings or in between feedings can have the same effect. Don’t be surprise if you pump for 10 minutes immediately following a feeding or even an hour later and get nothing or just a few drops. The stimulation will tell your body to make more milk. It may take several days to see results.

Always be sure to be seen by a qualified health care provider for high fevers, prolonged illness, or severe symptoms.

For further discussion and Q&A on breastfeeding through illness and recovering breastmilk supply following illness, see this video chat with Rene Fisher, IBCLC and Jessica Martin-Weber, The Leaky Boob.

This is general information and does not replace the advice of your healthcare provider. If you have a problem you cannot solve quickly, seek help right away. Every baby is different. If in doubt, contact your physician or healthcare provider.

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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Expert Bra Fitting For Pregnancy and Breastfeeding

by Jessica Martin-Weber with Judy Masucci of Levana Bratique.

This article made possible thanks to the generous support of bravado! Designs.

Pregnancy and breastfeeding can bring a great number of changes to your bust which can make getting a good fit with a bra challenging. Is it possible to get a good fit with all that fluctuating and changes?

I decided to find out and invited bra fitting expert Judy Masucci of Levana Bratique to help me figure out what size and type of bra I needed to be in during pregnancy and what to look for in bras for the changes to come. Judy has fit me 3 times before and every time got me into incredibly comfortable and well fitting bras. I knew I could rely on her again. You can see our video chat here and bullet points on getting a good fit for pregnancy and breastfeeding below.

Judy is a mom who owns and operates the bra boutique Levana Bratique. As a passionate supporter and advocate of breastfeeding, Judy knows first hand the importance of breast health and support in breastfeeding.

That passion led her to start virtual bra fittings because many don’t have a place to go get fitted locally and that could make it difficult for ordering online. She says: “I started this service to help women figure out what size they are, especially when you’re breastfeeding because your bra size changes, your body changes – even if you knew your size before your got pregnant, you don’t know your size anymore. It can be hard to figure out when you’re all alone and you don’t have someplace to go to get measured in person.” If you’re interested in a virtual fitting, go here and here

Good to know

Judy explained a few points about bra sizing and fitting that are just good to know and keep in mind when bra shopping.

  • Most women are wearing the wrong size bra. Limited options may lead to women being in the wrong size. Judy explained that this happens even when you go in person and get fitted because you go to a place that doesn’t carry your size and and instead of telling “hey we don’t have the size you should be but we don’t carry that, you should go someplace else” they try to fit you in a bra that they have. They actually do you a disservice because they end up putting you in a band that’s too big and a cup that’s too small and all you are is uncomfortable and unsupported.
  • Put your bra on correctly! There’s an art to putting your bra on. Try the “Swoop and Tuck” method for a better fit (find it here). Check your band too, if it is too high in the back your bra can feel too tight while not giving the support you need. Try pulling down the back of the band and see how that adjusts your fit.
  • With breastfeeding, improper fit can be more than uncomfortable, it can lead to clogs, mastitis, and neck and back pain. You need a well-fitting bra especially during breastfeeding for your breast health and even for reaching your breastfeeding goals.

Bra Fitting

So how do you get a good fit? Judy walked me through the process of measuring myself in the steps below.

  • Wear your most comfortable bra (for me that was the Bravado! Body Silk Seamless).
  • Use a flexible measuring tape.
  • Take 3 measurements: with arms down take a snug measurement parallel to the floor, just above your breasts; with arms down take a snug measurement parallel to the floor just under your breasts; with arms down take a loose measurement at the widest part of your bust. See this guide and calculate your rough measurement by subtracting the measurement of the fullest part of your bust from the above the chest measurement. (This is just to give you a starting point, your most comfortable bra may end up being a different size!)
  • Try on different bras in different styles.
  • Underwires shouldn’t be on your breast tissue at all.

The bra fitting, as you can see, is not a science, it’s more of an art. Judy asks questions such as What’s your best fitting bra? What size is it? And how does it fit you? There’s more to a good fit than your measurements and a specific number.

Bra Selection For Pregnancy and Breastfeeding

  • Measure and get fitted in person or virtually. But understand that there can be a lot of changes in your future still.
  • Look for a flexible fitting bra. Your breasts make more glandular tissue with each pregnancy so your breasts are changing every pregnancy. Once baby is born and milk production ramps up, they’ll likely change again and may continue to do so through out your breastfeeding journey. Flexible fitting bras (like the Bravado! Body Silk Seamless) without underwire can fit more cup sizes allowing for these changes.
  • Consider extenders for better fit in pregnancy. A lot of women will find that their bras feel too tight during pregnancy, because their rib cage is expanding and their belly is pushing out on their bra band. If your cup size hasn’t changed yet, but your band size has changed, then you can just use an extender on your bra to make it more comfortable.
  • Wait to see how your breasts change. With an extender you may be able to continue using the bras you already have and just wait to make your investment. When you go from pregnancy to breastfeeding there’s absolutely no way to predict how large your breasts might get. Some women don’t change at all. Some women go up one cup size. Some women go up 4 cup sizes. Even if you’ve had previous babies, it’s can be different with every baby. Give it 6 weeks to regulate or you may end up needing a completely different size later.
  • You don’t have to rule out underwire bras for breastfeeding. Just be sure that the underwire is not pressing on any breast tissue including on the side under your arm as that can compress milk ducts and potentially cause mastitis. The underwire bras for nursing, such as the Belle Underwire Nursing Bra from Bravado actually have flexible underwire and that underwire is less risk for your milk ducts. Even with a flexible underwire, you’re putting something into the bra that is restricting the movement of the cup. Judy recommends waiting until after the baby comes, about 6 weeks postpartum before getting something with an underwire because by the time 6 weeks comes you go up and then you come down a little bit, and then your milk regulates and so you’re about at the size that you’re going to be for the duration of your breastfeeding.
  • Even wireless bras that are too tight can cause issues. An ill-fitting bra that compresses breast tissue rather than support it can lead to reduced supply, clogged ducts, mastitis, and more.

Avoid these common bra mistakes when breastfeeding

  • Wrong size. Proper fit matters!
  • Only having one bra. The recommendation is that you have a minimum of 3 bras, and don’t wear the same bra more than one day at a time. Rotate them and they will last longer. This applies to non-breastfeeding moms too.
  • Sleeping in your daytime bra. Use a sleep bra. It should be only enough support to keep a breast pad in place and sleeping in a daytime bra can cause problems.

 

Judy Masucci is a Ph.D. Scientist turned bra fitting guru. She lives in Wexford, PA just north of Pittsburgh, where she operates the region’s only specialty bra boutique, Levana Bratique. Judy has been fitting women in great bras for over 10 years, both virtually and in person. She specializes in hard to find sizes, carrying over 150 different sizes of bras. Often referred to as the “bra whisperer,” Judy has made it her mission to change women’s lives- one bra at a time.

 

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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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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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.

starting pt image

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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 image
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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Picking Bottle Nipples for the Breastfed Baby

With Amy Peterson, IBCLC

This post made possible by the support of EvenFlo Feeding

Brand-Ad_29APR16________________________

Lots of breastfed babies will also use a bottle. Most of us have heard that introducing a bottle can potentially have a negative impact on the breastfeeding relationship. But thankfully, we can control these risks.

Lower risks

Latch:  The way your baby latches on the breast needs to be similar to the bottle. Look at your baby while s/he is feeding at your breast.  Notice how the bottom lip flares, and the top lip rests in a neutral position. Observe how the corners of the mouth seal on the breast, and how milk doesn’t leak from the lips while baby feeds. Pull down baby’s lip slightly and see the baby’s tongue cup or curves around your nipple. We look for these same characteristics when baby sucks on a bottle nipple.

gradual wide leaking bad

Not a good latch: Averted gaze (no eye contact), top lip rolled in, leaking at corners, latched more toward the tip.

wide abrupt good no leak

Decent Latch: Eye contact, flared lips, deep latch near collar of bottle, relaxed posture, no leaking at corners.

 

Flow preference: You want your baby to prefer the flow of your breast over the flow of a bottle. There is no standard flow rate for bottle nipples, so you might have to try more than one bottle to find a similar swallow pattern. Most babies will use a slow flow nipple, but slow flow isn’t best for every baby–match your own flow. For detailed information, Balancing Breast and Bottle lists bottle flow rates in Appendix C.

Milk supply:  Anytime the baby takes 2 ounces from the bottle, ideally you will be able to pump this amount so your body knows how much your baby is taking and can maintain your supply. But don’t worry if you don’t pump exactly what your baby eats every time, baby is likely more effective at removing milk from your breast than a pump will be. Adding a pumping session may be necessary to ensure you’re producing the amount needed for your child’s bottle feed.

 

breastfeeding and bottle feeding

Good latch: Eye contact, flared top and bottom lips, no leaking, medium depth latch, relaxed posture.

 

Reduce risks by picking a nipple shape

One way to reduce bottle risks is in choosing the nipple shape we use to bottle-feed our baby.

Nipples have three general shapes: narrow, wide-abrupt, and wide-gradual.  

bottle nipple - narrowbottle nipple - wide abruptFullSizeRender

Narrow neck nipples fit narrow neck bottles, and most have a gradual transition from nipple length to base where the baby’s lips can slide easily to latch deeply.

Wide neck nipples fit wide neck bottles.  Wide, abrupt shapes have an abrupt transition (like a 90 degree angle) between the nipple length and nipple base. Make sure your baby is able to rest their lips opened widely on the nipple base, not suck on the nipple length like a straw. Also, make sure your baby is able to fully seal the lips without gaps in the corners of the mouth.

Wide, gradual shapes gradually blend from the nipple length to the base. This shape may help the baby’s lips to rest on a portion of the base, and help the lips to form a complete seal. Make sure your baby is able to keep the nipple inserted deeply during feeding, rather than sliding down to the tip of the nipple.

 

Best does not exist

Different bottle nipple shapes work for different babies. One bottle will not be best for all babies, but you can find which bottle is best for your baby.  Therefore, beware of marketing and packaging claims. You’ve probably noticed many bottles claim to be best for breastfed babies, or to look just like the breast. But neither of these statements matters. How your baby latches onto the bottle nipple matters, not the packaging claims. You have found the right nipple when the nipple tip reaches deeply into the baby’s mouth; tongue cups the nipple; lips open widely and rest on a portion of the base; lips form a complete seal.

Additionally, now that you know that one bottle will not be best for every baby, don’t be swayed when you hear which bottle is “best” from other moms; what’s best for their baby might be terrible for your baby. You will need to look at your baby’s latch and then decide.

Picking bottle nipples - evenflo cobranded

Buying bottles

If you are having trouble finding a bottle your baby accepts, make sure you have tried all three types: narrow, wide-abrupt, and wide-gradual.  A lot of moms tend to buy various bottles marketed for breastfed babies, and then end up with a bunch of wide-abrupt shapes. Make sure you try the other shapes.

Chances are you will own more than one type of bottle, either bottles you have experimented with, or baby shower gifts that your baby can’t achieve a good latch with. Don’t despair.  As your baby grows, the mouth grows as well.  Nipples that do not work for young babies often work well when the baby’s mouth is bigger, say 4 months or so. Feel free to try the other nipples you have when your baby is older, and check the latch again.

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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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Nipple Pain in Breastfeeding

By Jessica Martin-Weber

This post is generously made possible by Bamboobies

bamboobies banner - 2016

All kinds of advice and myths abound when it comes to breastfeeding and preparing nipples for the experience or what to do when there is pain. Dire warnings and emphasis on getting a “good latch” can make it seem as though it is tricky, inevitably painful, and consuming. (Do you need to worry about your baby’s latch? See here for more on what to look for in a good latch and what to do if it is causing problems.)

But there’s good news! While some do experience nipple pain, many do not and for those that have pain, there is usually an answer and steps that can help resolve the underlying cause. Breastfeeding shouldn’t hurt but that doesn’t mean it won’t and it doesn’t mean that if it does it is your fault or that you did something wrong. Seeing a professional breastfeeding helper such as an IBCLC (International Board Certified Lactation Consultant) may help identify the cause of the pain and find a resolution that will help you reach your breastfeeding goals.

Here are a few points on nipple pain in breastfeeding and tips for how to handle such pain. It is our hope that nobody goes through pain in feeding their babies but if you do, most of the time it doesn’t have to stay that way.

bamboobies nipple pain

Is it serious? Figure out if this is the type of pain that indicates an issue or is within the range of normal sensitivity with initial latch. If it lasts for 30 seconds or so and doesn’t bother you when you’re not breastfeeding or pumping then it is possible it isn’t serious and just an adjustment period while your nipples are a little sensitive. If it is toe-curling, swear-worthy pain that makes you hold your breath and try not to scream obscenities or toss your baby far, far away from you, then it is serious and you need to be seen by an expert professional breastfeeding helper. Any tissue damage, cracking, bleeding, scabbing, inflammation, bloody expressed milk, etc., will require proactive treatment and you need to see a health care provider. Keep in mind that if your pain tolerance is high, you may push through pain that is a warning sign that something is wrong, don’t wait too long to get help from a breastfeeding helper such as an IBCLC.

What is the cause? It could be a number of causes from baby’s physiology such as a high palate or tongue-tie (frenulum restriction) to your anatomy such as flat or inverted nipples, bifurcated nipples, or Raynaud’s syndrome (vasospasms), or from a pathology such as a bacterial infection or yeast overgrowth, to a damaging latch. Unfortunately sometimes the case is baby just needs to grow more and it will take time but there may be ways to improve things until that time comes and a breastfeeding helper should be able to help you with that.

What’s the treatment? Working with an experienced breastfeeding helper, once the cause is determined, the first step is to address the underlying cause. This may mean changing positioning and learning latch techniques (such as this “Flipple” technique for latching), a prescription to treat thrush or a bacterial infection, using a device to pull flat or inverted nipples out, a procedure to correct frenulum restriction, therapeutic suck training, and a number of other possibilities. We should start with the easiest to implement first, such as positioning and latch but an early diagnosis can mean resolving the underlying cause for the nipple pain quickly and getting back to reaching those breastfeeding goals.

How to heal? Pain, particularly pain that was ongoing for a while, usually means some tissue damage that’s going to need to heal and until it does, the pain will continue. Treating the underlying cause of the pain is essential for complete healing but there are ways to encourage healing even as the cause is addressed.

bamboobies nipple pain 2

Air drying is important for healing, as much as possible, allow your nipples to air dry before closing up your bra. Air is healing and having the area dry prevents bacteria and yeast from growing in a dark, damp environment. Additionally, rinsing them several times a day (not after each feeding but frequently) can also reduce possible irritation from baby’s saliva.

A good nipple cream, one that is plant based, breathable, and safe enough to leave on during breastfeeding can not only help with healing but can prevent chapping in the early days of breastfeeding as a preventative measure. Wiping off an ointment from sensitive and damaged tissue is painful and can cause further injury so picking one that is safe for baby to ingest in tiny amounts is ideal. Apply after every feeding after allowing the area to dry and pick nursing pads that won’t stick to damaged tissue and your nipple cream.

Your own breastmilk may help your nipples heal. Breastmilk is full of good things that can expedite healing, including stem cells! Be careful though, the sugars in breastmilk will feed a yeast overgrowth, making thrush worse.

Air and sunlight may help nipples healing from thrush as yeast thrives best in dark, damp areas. Make the environment hostile for yeast by exposing your nipples to sunlight and taking a probiotic and cutting out refined sugar.

Heat or cold packs can provide comforting relief, it’s personal, some will love these and others will find them uncomfortable for addressing nipple pain. For those with Raynaud’s Syndrome there is no cure or way to permanently resolve the problem but a heat pack like this one may help minimize the symptoms, apply immediately after feeding.

Cold shredded carrots in the bra (will stain!) promotes healing and is soothing. After breastfeeding or pumping, put shredded carrots stored in the refrigerator in your bra (if you don’t mind your nursing pad turning orange, they can help hold the carrots in place).

Protect the nipples with a nipple shield may be necessary. Nipple shields should be used with caution and hopefully with the guidance of an experienced breastfeeding helper such as an IBCLC because there is a risk of lowering milk supply with using a breast shield (not everyone experiences this, just a factor to be aware is a possibility), but they can be a good option for some to help with tissue healing for a short time.

Take a break if you need to. Sometimes damaged tissue just can’t heal until it has the chance to rest. Regularly empty your breast to protect your supply and have breastmilk for your baby, be sure that you’re using the proper flange size so as not to potentially cause more damage.

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What are your tips for preventing and healing nipple pain and tissue damage?

Share with us in the comments, together we can support each other in reaching our baby feeding goals.

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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, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.
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How Lubrication Can Improve Breastmilk Pumping

by Kristine Phillips Keller

This post made possible by the support of Ameda

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I learned the answer to this question the hard way with my oldest son. I was not much of a reader but breastfed because both of my sisters did the breastfeeding thing. If they could do it, so could I. However, in hindsight, I pretty much did everything wrong that I could have done. I wanted a nursery (I needed sleep, right?), I wanted pacifiers (he can’t just suck on me or I won’t get any sleep) and I wanted bottles (dads need to help too, right?). I thought, surely I can make all of this work. Boy was I wrong!

Not only did I go into it uneducated, I also have flat nipples. I honestly thought they were broken as they never became fully erect prior to years of nursing/pumping. I also have really naturally dry skin. Early on, I had damage but didn’t realize how bad it was until it was visible, right at Stage III damage (which means skin is literally gone). I was in such pain that I would cry when my boys would cry because I knew what was coming. I would fear nursing them because of the toe curling pain that it took to get them latched on. For the most part, after a minute or two it became bearable. Other times, the entire feeding was excruciatingly painful for me.

At six weeks with my first, I gave into pumping full time. I asked for help from family repeatedly to try and figure out what I was doing wrong and what I could do to correct the latch. No one seemed to be able to offer me the advice that I needed to make direct breastfeeding work and I just didn’t have it in me to bear that kind of pain any more. However, I still wanted to give them my milk…so I continued on with pumping & still continued to have cracked, bloody nipples until a good 10-11 months of pumping.

Around that same time, I was talking with my sister about all of the bloody milk that I was dumping because, even though I was no longer nursing, I still had pretty bad damage on both of my nipples. I just thought that’s how it was going to be for me. She then asked me if I was lubricating before I pumped. My response to her was, “Isn’t that what you do when you have sex?” She laughed & then said yes but that the pump shields were dry. Babies have moisture in their mouth for lubrication but there is no moisture on the pump shield prior to pumping.

I mean, would you ever expect to drive a car with NO lubrication and have things go well? ABSOLUTELY NOT! There must be lubrication to prevent friction… and to prevent damage. After all, isn’t that what our healthcare is supposed to be about these days, preventative care? Well, let me tell you…the difference was night and day. I went from having constantly damaged, bloody nipples to pain free/damage free nipples overnight. It was such a relief to know that there was something I could do to prevent this pain and discomfort.

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I started working for WIC 2.5 years ago as a peer counselor and have since applied theory to moms that come to me with damaged or sore nipples. If you lubricate before you latch, you lessen the probability of damage happening from the initial suck (regardless of whether it’s baby or the pump). That lubrication gives both something to slide against instead of that reverse pressure working against dry skin.

I’ve asked numerous breastfeeding professionals and no one seemed to know of any literature that puts emphasis on “lubricating BEFORE nursing or BEFORE pumping”. The only reference that I’ve seen is to use breast milk on sore nipples AFTER nursing. If it works after, why not try it before?

Lubricant suggestions: (you may need to try a few different ones to decide which is most comfortable for you.)

  • Your breastmilk
  • Nipple cream/ointment (suggest vegan and edible, rather than animal based)
  • Coconut oil
  • Olive oil
  • Almond oil
  • Infant massage oil
  • Avoid synthetics such as traditional baby oil

Some moms have found that regularly lubricating their breasts and pump horns before pumping greatly reduces the amount of discomfort they experience which in turn helps them let down easier and respond better to the pump.  There’s no need for pumping to be a painful or uncomfortable experience, experiment with different lubricant options to find what works best for you.  I hope this simple tip helps you in your breastfeeding and pumping journey as it has helped me.  How about we pass along this little known tip and prevent the damage in the first place?

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What pumping tips do you have to share to help other moms?

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Kristine Thanks to her sister, Kristine breastfed/exclusively pumped for her two boys now 3.5 and 8 years old, she pretty much did everything wrong when it came to breastfeeding but managed to get the pumping thing right (after a while).  After experiencing discrimination she contacted WIC about becoming a breastfeeding peer counselor and begin training to become an IBCLC. She sits for the IBCLC exam this summer and looks forward to continuing to help mothers reach their breastfeeding goals.
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