Relational Resource

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

December 14, 2017 by theleakyb@@b Leave a Comment

by Jessica Martin-Weber with Rene Fisher, IBCLC

This article made possible by the generous support of Ameda.

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.

Filed Under: Article, Articles from the professional experts, Ask the expert, breastmilk donation, breastmilk pumping, breastpump, Featured, Pumping, Relational Resource Tagged With: Ameda breast pumps, Ameda double electric breast pump, breast pump, Breastfeeding, breastfeeding and working moms, getting started pumping breastmilk, pumping, pumping breastmilk, returning to work and breastfeeding, tips for pumping breastmilk, working mom

Happy Sex Life – Happy Family, Good Clean Love

December 5, 2017 by theleakyb@@b Leave a Comment

by Wendy Strgar

(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.

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.

Filed Under: Article, Articles from the professional experts, Ask the expert, body image, dads, family, father, Featured, motherhood, Parenting, postpartum, Relational Resource, sex Tagged With: intimacy, Parenting, partners, relationships, sex, sex after baby, sex education, sex for parents, sexual health

Pregnancy, Sleep, and New Baby Sleep Expectations

October 4, 2017 by theleakyb@@b Leave a Comment

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The Leaky Boob is committed to providing free information, support, and community. You can be a part of making that possible by joining our circle of support. Any and all support amount makes a difference.

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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.

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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Filed Under: #Nurturethenurturer, Article, Ask the expert, breastfeeding and sleep, Featured, Relational Resource, Sleep, sleep through the night Tagged With: baby and sleeping, Bamboobies, livestream, new baby sleep, pregnancy sleep, Rebecca Michi, sleeping with newborn

The Serious Injury No One is Talking About: Diastasis Recti

August 25, 2017 by theleakyb@@b 4 Comments

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.

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 )

Filed Under: and health concerns for mom, Article, Articles from the professional experts, Ask the expert, Featured, fitness, postpartum, Relational Resource Tagged With: Ask the expert, Chunkabuns, exercise, featured, fitness, postpartum, pregnancy

Picking Bottle Nipples for the Breastfed Baby

February 24, 2017 by theleakyb@@b 2 Comments

With Amy Peterson, IBCLC

This post made possible by the support of EvenFlo Feeding

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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.

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

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.

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.

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.

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.

Filed Under: Article, Articles from the professional experts, Bottle Feeding, Bottle feeding, Featured, Relational Resource Tagged With: Amy Peterson, bottle feeding, bottle feeding tips, bottle nipple tips, bottle nipples, breastfeeding and bottle feeding, IBCLC

Nipple Pain in Breastfeeding

January 13, 2017 by theleakyb@@b Leave a Comment

by Jessica Martin-Weber

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The Leaky Boob is committed to providing free information, support, and community. You can be a part of making that possible by joining our circle of support. Any and all support amount makes a difference.

_________________________

This post is generously made possible by Bamboobies

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.

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.

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.

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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If this resource was helpful for you, consider helping The Leaky Boob by giving back. Help us keep our information, support, and resources free by becoming a patron and get access to exclusive content just for our supporters. Join here today.

______________________________

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.

Filed Under: #Nurturethenurturer, Article, breastfeeding difficulties, Breastfeeding Pain, Featured, Jessica, Milk Supply, Nipples, Relational Resource Tagged With: baby latch, Bamboobies, bleeding nipples, bloody expressed milk, breastfeeding pain, breastmilk, cracked nipples, healing painful nipples, inflammation, lip tie, nipple cream, nipple pain, painful latch, scabbing nipples, sensitive nipples, tissue damage, tongue tie

How Lubrication Can Improve Breastmilk Pumping

January 12, 2017 by theleakyb@@b Leave a Comment

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.

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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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.

Filed Under: Article, Articles from the professional experts, Bottle Feeding, breastmilk donation, breastmilk pumping, breastpump, Featured, Pumping, Relational Resource, Supplementing Tagged With: Ameda, bloody breastmilk, bloody nipples, breast pump, Breastfeeding, breastfeeding challenges, breastmilk, breastmilk pumping, cracked nipples, pumping, raw nipples

Weaning Off Formula back to Exclusively Breastfeeding

December 13, 2016 by theleakyb@@b 1 Comment

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!”

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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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.

Filed Under: Article, Ask the expert, Ask the IBCLC, Breastfeeding, Featured, Relational Resource Tagged With: after feeding formula, ask the experts, breastfeeding exclusively from formula, ending supplementation, exclusively breastfeeding, formula feeding, formula supplementing, getting back to breastfeeding, relactating, transition to breastfeeding, transition to exclusively breastfeeding, weaning off formula

Seven Points To Know About Breastmilk Supply Issues

November 29, 2016 by theleakyb@@b Leave a Comment

by Jessica Martin-Weber

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The Leaky Boob is committed to providing free information, support, and community. You can be a part of making that possible by joining our circle of support. Any and all support amount makes a difference.

_________________________

This post is generously made possible by Bamboobies

For the most part, if you decide to breastfeed, the experience will be: have boobs, feed baby. A process that has worked long enough to get us to this point in civilization, as mammals, generally speaking we will produce enough milk for our young. If everything is working normally, our breasts are going to make the milk our babies need. Lactating after giving birth is, for our species, normal, like breathing.

Which is well and good. But for as normal as it all may be sometimes there are issues with breathing and sometimes there are issues with lactation. Sometimes those issues are related to milk supply.

Before you worry about it or before you tell someone else to worry about it or not to worry about it, there are a few things that may be helpful to know. This is all just the tip of the iceberg, we’ll have more on this topic in the future but for now this is just a quick overview of breastmilk supply issues and not intended to be health care or replace medical care. If you are experiencing any problems with your supply, please see your healthcare provider and an experienced, professional skilled breastfeeding helper.

1. Supply issues are real. Though biologically speaking it is normal to produce milk for our young, the fact is some will experience issues with supply. While they aren’t as common as it may seem, supply issues aren’t made up, they really do happen. Dismissing the concerns about supply can actually cause more supply problems as it may lead to feelings of isolation, failure, pain, grief, anger, and depression. If someone is concerned about their breastmilk supply, getting help is the right thing to do. They may discover that there is no evidence of supply issues and they can let go of their worry or they may find there is in fact a problem and take steps to address it to adequately care for their child(ren).

2. There is more than one type of supply issue. Often when talking about supply issues people assume it is low supply or not producing enough milk. Low supply is indeed a very concerning issue but it isn’t the only supply issue that may be experienced. Pumping supply, oversupply, and temporary supply issues (ovulation/period, illness, pregnancy, separation, etc.) are other supply issues that may present challenges for breastfeeding families. From poor weight gain to recurring mastitis to not reaching breastfeeding goals, the effects of supply issues cover a wide range and all of them matter.

3. Don’t borrow supply issue trouble. Yes, supply issues are real but before stressing about or trying to fix a supply issue, it is important to know if there is one (see related: Help, My Milk Supply Is Low, Or Is It?). This can be difficult to do if we don’t understand normal human lactation or normal baby behavior. For example, if you heard that I was pumping up to 24 ounce every pumping session at one point and you pumped 1-4 ounces in a session, you may think you have low supply (tip: this wouldn’t mean you have low supply- this means I had oversupply, one I manufactured to pump enough to skim the fat off to feed my very sick baby with two holes in her heart). Or if you found that your baby was extremely fussy and wanting to breastfeed every 30 minutes suddenly and you didn’t know what cluster feeding was and that it was common for babies to increase their feeding sessions during times of rapid growth, you may fear that your breasts suddenly weren’t making enough milk. Understanding the range of normal in human lactation is crucial!

4. There are multiple reasons for supply issues. Physiologically speaking, most breasts should have everything necessary to make plenty of milk (statistically less than 2% of breasts are equipped for adequate milk production) though there are some theories that this number is increasing. But a lack of milk making tissue isn’t the only cause of low supply. Other reasons for low supply include, but are not limited to, fluids in labor, tongue tie (frenulum restriction), high palate, hormone imbalance, diabetes, gut health, scheduled feedings, retained placenta, excessive pumping, ineffective sucking, health issues, some medication, early sleeping through the night, and the list goes on.

5. Supply issues can create other issues. Yes, even perceived supply issues can create other issues. Confirmed supply issues even more so. Postpartum depression, anxiety, mastitis, gas, poor weight gain, breast tissue damage, unwanted and unnecessary supplementing, early weaning from the breast, etc. Those encountering issues with supply need more support and care on both a social level and from health care professionals.

6. Supply issues aren’t all doom and gloom. For starters, it doesn’t have to be all or nothing when it comes to feeding our babies. There are ways to address supply issues including methods to boost supply, supplement at the breast, train baby to suck more effectively, and reducing oversupply. Identifying the type of supply issue, the cause, and then the most effective methods for improving the supply issue (i.e. skin-to-skin helps low supply, decreasing pumping duration and frequency helps oversupply, hands-on-breast compressions and proper flange sizes can help pumping low supply, and magnesium can help temporary low supply caused by fertility cycles) along with supplementing techniques to encourage breastfeeding (i.e. paced feeding and at the breast supplementing) may all work together to turn things around.

7. There is support for supply issues. I often hear from breastfeeders with supply issues that they feel broken and alone. Supply issues can directly impact a parent’s confidence, causing them to question their competency in parenting when the most elemental aspect of parenting, feeding the child, is so difficult and overwhelming for them. While it can feel lonely when you’re dealing with supply issues, we don’t have to be alone. From social media groups to in person breastfeeding support groups to specialized breastfeeding helpers in the healthcare field, there is support for those experiencing supply issues. Working with a breastfeeding helper such as an IBCLC may help resolve the issue more quickly.

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If this resource was helpful for you, consider helping The Leaky Boob by giving back. Help us keep our information, support, and resources free by becoming a patron and get access to exclusive content just for our supporters. Join here today.

______________________________

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.

Filed Under: #Nurturethenurturer, Article, Featured, Milk Supply Tagged With: breastmilk, breastmilk supply, breastmilk supply issues, low supply, milk supply, milk supply issues, oversupply, pumping supply, temporary supply issues

Everything You Need To Know About Postpartum Bleeding And Periods After Childbirth

November 16, 2016 by theleakyb@@b Leave a Comment

by Dr. Kymberlee Lake

Most women know that there may be some bleeding after giving birth but often women are surprised by how much and how long and they aren’t aware of the difference between postpartum bleeding and discharge and menstruation. The first bleeding after you give birth is called lochia.

What exactly is lochia?

Lochia is the discharge consists of blood from the area on the uterine wall to which the placenta was attached during pregnancy, the sloughed off endometrium (uterine lining which makes a bed for the fetus) which gets considerably thickened during pregnancy, blood and mucus from the healing cervix, and dead (necrotic) tissue. Your blood volume increases by approximately 50% in pregnancy, all that extra blood also has to go somewhere after birth. Most women will experience blood and lochia discharge for 3- 6 weeks though that time span can very from pregnancy to pregnancy and can be directly influenced by a healing mother’s activity level.

Why do we have lochia and where does it come from?

The blood in the lochia comes mainly from the large raw area left in the uterine wall after the placenta detaches from it. While bleeding from this area is controlled by contraction of the uterine muscles immediately after delivery, it takes on the average about two weeks for this area to heal. It is important to remember that this is a wound and it is possible to do too much before it has healed and reopen the wound, causing fresh bleeding. You will experience this bleeding for around four to six weeks postpartum.

For the first few days it will be a heavy flow (kind of like a heavy period) and will be colored dark red, with some clotting. About the end of the first week the flow should start to taper off, becoming lighter in saturation and color; as time passes, it will fade to a brown, yellowish or even almost-white discharge.

One thing to remember is that the placental area as well as the sites of sloughing endometrium are raw and open during this time and bacteria can easily spread from the vagina. So, the use of tampons should be avoided – sanitary pads are the best options to be used during this time.

What is normal and when should I be concerned?

You might notice a ‘gush’ of blood with clotting when you stand up – this is very normal. Also, if you’re breastfeeding, you might notice that you lose more blood after feeding baby; this is caused by your hormones doing their work to help shrink your uterus back to it’s pre pregnancy size. The lochia is sterile for the first 2-3 days but then becomes colonised by bacteria giving off a typical distinct lochial smell which is normal and should not be confused with the bad odor from lochia in postpartum infection.

If the discharge smells foul, you’re still noticing a lot of blood loss after the first four weeks, or the blood is bright red, these are signs of infection and you should speak to your health care provider as soon as you can. This is especially true if you also have a fever (no matter how slight) or are generally feel ill. Likewise, if your blood loss is so heavy that you’re going through more than a pad an hour, you should get medical help immediately – this can be a sign of a hemorrhage. If in question and something feels “off” it is worth a call to your health care provider for advice.

Types of Lochia

Depending on the color and consistency, lochia can be of three types:

Lochia Rubra: Lochia rubra occurs in the first 3-4 days after delivery. It is reddish in color – hence the term ‘rubra’. It is made up of mainly blood, bits of fetal membranes, decidua, meconium, and cervical discharge.
Lochia Serosa: The lochia rubra gradually changes color to brown and then yellow over a period of about a week. It is called lochia serosa at this stage. The lochia serosa contains less red blood cells but more white blood cells, wound discharge from the placental and other sites, and mucus from the cervix.
Lochia Alba: The lochia alba is a whitish, turbid fluid which drains from the vagina for about another 1 – 2 weeks. It mainly consists of decidual cells, mucus, white blood cells, and epithelial cells.

Do women who give birth by c-section still have lochia?

Many women believe that the flow of lochia is less after a cesarean section since the uterine cavity is cleaned out after the birth of the baby. This is not true. The flow of lochia is not dependent on the type of delivery – The amount and duration is the same in both cases.

Return of Menses

There’s no hard rule as to when your period will return post-baby – it can vary from woman to woman, and pregnancy to pregnancy. Here are some general guidelines:

Women who bottle-feed can see their menstrual cycle return within six weeks of birth – and most will have menses back by ten to twelve weeks.
Women who exclusively breastfeed may not get their period back for some time. When you breastfeed, you body releases the milk-producing hormone prolactin, which, in turn, keeps our levels of progesterone and estrogen low. Progesterone and estrogen are the hormones responsible for signaling ovulation and menstruation. Night nursing directly effects these levels, a decrease in breastfeeding at night may lead to a return of menses.

Once your period returns, it can take even longer for it to get into a regular cycle. If you are bottle feeding it can take around six months, while exclusively breastfeeding your baby can take 12-18 months. But keep in mind that this does vary from mom to mom and pregnancy to pregnancy. Even with exclusive breastfeeding on demand and no artificial nipples, there are women who see a return of their menses as early as 6 weeks while others may not breastfeed and still experience a considerable delay. Each woman is different. Some women experience lighter flows and/or less cramping with their menses after having a baby, others experience the same, and still others may experience an increase. The range of normal variations is considerable but very heavy bleeding, soaking a full size pad in 1-2 hours, may indicate a problem and should be addressed with your health care provider. There are a variety of factors that contribute to possible changes with the return of your period but keep in mind that diet, physical activity, and your menstrual products can all contribute to cramps and duration.

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Please be aware that your first egg (ovulation) will be released two weeks before your period starts, so if you have unprotected sex without realizing that you are ovulating, you could get pregnant before you have even began menses again. It’s a good idea to speak to your healthcare provider about contraception even before you start thinking about sex again, so you can be confident in your choice ahead of time.

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Kymberlee is a Physician/midwife, Therapeutic foster/adoptive parent with 6 kids ranging in age from 31 to 3 and three grandchildren. She is living life to the full with MS in the Pacific NorthWET. As an international travel enthusiast and fan of teleportation you can find her under the name “Dr_Kymberlee” live streaming and on social media, or on her often neglected blog, TheMamaMidwife.com

Filed Under: Article, Articles from the professional experts, Featured, motherhood, Relational Resource Tagged With: breastfeeding and menstruation, breastfeeding and periods, how much will I bleed when I have my baby, lochia, menstruation, period week, postpartum bleeding, return of period after having a baby

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What exactly is lochia?

Why do we have lochia and where does it come from?

What is normal and when should I be concerned?

Types of Lochia

Do women who give birth by c-section still have lochia?

Return of Menses

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