Nipple Pain in Breastfeeding

By Jessica Martin-Weber

This post is generously made possible by Bamboobies

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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.

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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.

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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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JMW headshot

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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Seven Points To Know About Breastmilk Supply Issues

By Jessica Martin-Weber

This post is generously made possible by Bamboobies

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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.

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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.

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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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Jessica Martin-Weber

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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Don’t Read This If You Don’t Have Time

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Dear Leakies,

Happy Mother’s Day Week. I hope it is everything that you want it to be and you know today and every day that you matter, you’re appreciated, and you are loved.

We’re keeping it short and simple this week because sometimes all we really need is to hear that we’re ok.

So, here you go.

You are ok. You’ve got this. You matter. You are appreciated.

Keep loving on,

Jessica Martin-Weber
Founder, TheLeakyBoob.com

*This is an excerpt from our TLB email, to continue reading, click here.

P.S. Preparing for summer travel, we did a chat about traveling with the breastfeeding baby, find Leaky tips here along with info on Mamava Lactation pods.

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Almond Joy Lactation Bars for Leakies

by Carrie Saum

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Truth: I once made these beauties to woo a potential future boss.  And it totally worked. I got the job and my (now former) boss still requests these delightful bites of almond and coconut bliss when we have him over for dinner or head out to his house for a hike. I made them to share with a class a few years ago.  The professor still reminds me that the almond joy bars put me on her radar in a good way, and hounded me for the recipe until I relented.

Mamas, food can be magic.

Of course these worked to woo friends and family over during the holidays, too.  Last year, I made these because I was on a Total Elimination Diet for my nursling during the holidays.  It was not the worst thing that has ever happened to me, but it was definitely not the best, either.  On one hand, I was glad to have a very good reason to say no to all the seasonal treats. On the other hand? NOPE.

I had to adapt and change my original recipe (which you can get here) to stick to my TED.  But I ended up liking these just as much, if not more than my original ones.  Everyone else did, too. Nobody knew that they were eating a healthy treat, and nobody cared.  They almond joy bars were gone in seconds.

This veer a bit from the traditional candy route.  I love sugar as much as the next gal, but I try to limit my intake as much as possible.  So, I opt for things that pack a punch and are legitimately satisfying without being cloyingly sweet or spiking my blood sugar. There are tons of benefits in coconut, which you can read up on here. Plus, it has a natural sweetness that shines on it’s own when handled properly. Combine this with a little flax to boost milk production during a stressful and busy season, and you’re pure gold.  Well, your milk is pure gold at the very least.

Ingredients for bars:

  • 2 eggs
  • 3 cups unsweetened shredded coconut
  • 1/2 can full-fat coconut milk
  • 1/2 cup coconut oil
  • 1/2 cup sugar, (or coconut sugar if you’re looking for a low-glycemic option)
  • 1/2 cup flour, sifted (I use Bob’s Redmill gluten-free blend)
  • 1 Tbsp flax meal (optional)
  • 1 Tbsp vanilla
  • 1  tsp cardamom
  • 1/2 tsp cinnamon
  • 1/2 tsp baking powder
  • 20 drops liquid stevia, or 2 Tbsp honey (optional)
  • a handful of raw almonds

Ingredients for chocolate drizzle:

  • 3 oz 90% cacao chocolate bar
  • 2 Tbsp coconut oil or butter
  • 1/4 tsp cardamom
  • 15 drops liquid stevia, or 2 Tbsp honey (optional)
  • 1 tsp vanilla

Directions for bars:

  1. In a large bowl, combine dry ingredients and mix well.
  2. In a smaller bowl, combine wet ingredients and stir.
  3. Mix wet ingredients into dry and pour mixture into 9×13 pyrex glass dish
  4. Evenly place almonds on top of batter
  5. Bake for 350 degrees for 30-40 minutes, or until the middle is firm.
  6. Cool completely then cut into bars

Directions for chocolate drizzle:

  1. In a double boiler or microwave, melt chocolate and butter.
  2. Once chocolate and butter are melted, stir in cardamom, vanilla, and sweetener.
  3. Transfer chocolate to small ziploc bag and close.
  4. Cut a tiny piece of the corner of the bag off and drizzle over cooled bars.

Joy to you!

Carrie

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*Note: It’s important to point out that most women aren’t going to need to eat food with the intention of upping their milk supply, if everything is working the way it is supposed to, your baby will know how to up your supply just fine themselves. Skin-to-skin and feeding on demand are the best ways to increase breastmilk supply to meet your baby’s needs. (Concerned you have low supply? Read this to help figure out if it is something you need to be concerned about.) For those women, galactalogues just happen and they don’t need to think about it. But some women, like me, do need a boost. As a mom who ended up exclusively pumping and indeed having low supply such that I ended up on medication solely to increase my milk production, I know what it’s like to look for anything, anything at all that would help my body make even just a little more milk to help feed my baby. With the support of my health care providers, we tried everything. It becomes “I will eat all the cookies, I will drink all the shakes, I will eat all the parfaits!” if it even just makes me feel like I’m doing something to address the low supply struggle, it is worth it.

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If you love this recipe, you might like this recipe for this Paleo version of the Almond Joy Barsor Peanut Butter Cookies on Our Stable Table.

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Carrie Saum, headshotCarrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices and health knowledge. Carrie has extensive first-hand experience in vast array of medical and service fields.
With background in paramedic medicine, Carrie spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. As an AWC, Carrie currently coaches her clients and their families about topics including nutrition, weight loss, and stress management. In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and the voice behind OurStableTable.com. She lives in Portland, Oregon with her husband and young son.
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Mean Green Lactation Sipping Soup

MeanGreenSippingSoup

Hello, Autumn, you beautiful season.

Your vibrant colors and warm days and crisp evenings with a promise of cooler temperatures to come hang heavy in the air.

And so does the promise of seasonal sickness.

As soon as the first fall snap whips us in the bums, the first sickness of the season starts seeping into our schools and homes. It’s suddenly everywhere.  There are a multitude of ways we can boost our immune systems, but one time-tested method to supporting our bodies before, during, and after illness is with FOOD.  Nothing fancy, nothing expensive, nothing you have to special order or sign up for.

Just food.

My favorite way to keep my body in good health during the colder months is with warm smoothies.  Yes, you can call it “soup”.  But I like the savory warmth of this first thing in the morning, and calling it a smoothie helps me accept it as a breakfast food, even though it is not a traditional way to start the day.

When I was responsible for producing milk and feeding my son exclusively, green vegetables and healthy fat gave me a great boost, especially on days when I was away from him.  I also noticed my body was more resistant to colds and sickness when I consistently gave it good fuel.  I’m not saying this is a cure, but when I cut out sugar and start my day with a blast of healthy, real, whole foods, sickness skips me.  Or at the very least, it doesn’t stick around for long.  Considering I can make it quickly and I don’t have to use any real precision with measuring ingredients, this is ideal for my morning routine.

Adding a few leaves of fresh basil not only adds flavor, but can contribute to increased supply if that’s something you need.

Ingredients:

One small handful of the following:

  • sliced, frozen carrots
  • frozen green beans
  • frozen peas
  • chopped zucchini (I use frozen for the sake of convenience, but fresh is also okay.)
  • spinach
  • 1 cup water or broth
  • 1-2 Tbsp Extra Virgin Olive Oil or other fat
  • 1 tsp apple cider vinegar
  • 3-4 leaves of basil
  • salt and pepper to taste

Directions:

  1.  In a small sauce pan, combine water or broth, and all the veggies except the spinach and basil. Cook on high until veggies are bright green and tender (about 7 minutes).
  2. Transfer cooked veggies and broth to blender.  Remove center circular piece on the blender lid.  (*This is VERY IMPORTANT.).  Cover the blender pitcher with the lid, and cover hole with a kitchen wash cloth to prevent splattering and burns from hot liquid.
  3. Blend on high, adding basil, olive oil, and apple cider vinegar as it blends.
  4. As soon as the soup is smooth and well blended, pour into your favorite mug and sip away!

This stays good for a day or two in the refrigerator.  You can also add other veggies like broccoli or swiss chard.  You can get creative.  But this is a great base with a ton of flavor, great vegetable based protein and fat, and gives your body the fuel you need to keep going.

Stay Healthy,
Carrie

*Blending hot liquid with a tight-fitting lid can cause heat and pressure to build up and blow the lid off the blender.  You have to leave a way for heat to escape safely, otherwise you risk burning yourself.  I fold up the kitchen cloth and hold it lightly but securely over the small opening in the lid when I start the blender.  I remove the cloth when the liquid stops splashing up the sides (usually within the first 5 seconds).  BE SAFE.

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*Note: It’s important to point out that most women aren’t going to need to eat food with the intention of upping their milk supply, if everything is working the way it is supposed to, your baby will know how to up your supply just fine themselves. Skin-to-skin and feeding on demand are the best ways to increase breastmilk supply to meet your baby’s needs. (Concerned you have low supply? Read this to help figure out if it is something you need to be concerned about.) For those women, galactalogues just happen and they don’t need to think about it. But some women, like me, do need a boost. As a mom who ended up exclusively pumping and indeed having low supply such that I ended up on medication solely to increase my milk production, I know what it’s like to look for anything, anything at all that would help my body make even just a little more milk to help feed my baby. With the support of my health care providers, we tried everything. It becomes “I will eat all the cookies, I will drink all the shakes, I will eat all the parfaits!” if it even just makes me feel like I’m doing something to address the low supply struggle, it is worth it.

____________________

If you love this smoothie recipe, you might like this recipe for Feel Better Broth or these Creamy Polenta Ragu on Our Stable Table

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CarrieHeadshot

Carrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices and health knowledge. Carrie has extensive first-hand experience in vast array of medical and service fields.
With background in paramedic medicine, Carrie spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. As an AWC, Carrie currently coaches her clients and their families about topics including nutrition, weight loss, and stress management. In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and the voice behind OurStableTable.com. She lives in Portland, Oregon with her husband and young son.
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My Nursing Days Might Be Done

by Karen, a Leaky

It appears as if after 10 years of breastfeeding my 4 children, my breastfeeding days are done. I had hoped that my “baby” (now 25 months old) would have chosen to continue our nursing relationship longer, but he appears ready to move on to be a “big” boy and catch up to his older siblings. 

With my older children, they nursed before bed or when they needed comfort after a boo boo, until well after their second birthdays. With all of them, as I was starting to feel ready to wean, I would gradually not offer, but I would not refuse nursing requests. My older two were about 2.5 years old when they each weaned and my third child was 3.5 years. I was sad when #3 weaned because we did not think we would have more children, but after 3.5 years, we were ready. I was so pleasantly surprised when I became pregnant with number 4 and was thrilled to be able to have that nursing relationship once more. And what a relationship it was. My little guy was milk and soy protein intolerant and so this lacto-ovo vegetarian mom cut dairy and soy out of my diet and I fought the doctor repeatedly when they pushed me feeding formula (both when he was severely jaundiced at birth and again with the MSPI). I was confident in my nursing ability – making milk was my super power and the way that I could calm and comfort my babies in a way that no one else could. 

I go over in my mind what I have done differently with this child than the others that he would wean sooner. Finding myself overwhelmed with four kids with 11 years between the oldest and the youngest, keeping up with activities, and therapies for my child with mild asperger’s syndrome, I was fortunate to bring in childcare help. At times when I had things to do, my toddler was distracted by getting snacks or cups of rice milk, or other activities. Being busy with other activities, there were times that I wasn’t able to be there at bed time to put my little guy to bed. We were blessed that he has always been a great sleeper, but that meant that there weren’t the middle of the night feedings (since he was around 2 months old – that was a first for me) and he was even so flexible that as a toddler he would go to bed for Daddy or a babysitter with a story and a cuddle. In general, I limited that to one time a week, but still, it could be why he was ready to move on so soon.

I can’t remember the last time my little guy really nursed. For the past month or so, he would latch on for a few seconds, then tell me all done. Recently, when it is my turn in the bedtime routine (after Daddy reads a book and then gives the little one goodnight hugs, it is my turn) he refuses to come to me in the nursing chair. He goes over to the crib and says “nigh nigh” wanting to go in. He is avoiding me at bedtime, and it breaks my heart. I ask him to come give me a hug and he eventually does so begrudgingly. Then I offer nursing. Sometimes he will do the few second thing, and even when I hand express down what is left of my milk, he says “all done.” Lately he says “no” and puts his head on my shoulder for me to sing our bedtime blessing. I think even though I am not ready to be done, he is.

I know I have done my job in providing nourishment and comfort to my children over all those years. I feel blessed that I made it through the tough stage four separate times and had as long a nursing relationship as I did with all my children. Our family is complete with four children. I am just sad that nursing seems to have ended before I was ready.

Last night as I was changing my little guy’s diaper at bedtime he asked to nurse. I got a little excited, but remained calm as I sat down in our nursing chair. Then when I lifted my shirt and took out my breast he very clearly told me “no” and “all done.” Perhaps he is a little conflicted by the fact that he asked, but something shifted for him and he seems done. Over time, I will come to accept this change and realize that child number 4 is really anxious to grow up like his siblings. I think from seeing babies nursing and from reading books about potty training he has come to see nursing as something that babies do and he does not see himself as a baby (even if I do).

Thank you for being there as support over the years. Thank you also for reading this far in my story. It seems like there should be some sort of ceremony for reaching the end of breastfeeding as well as the end of my childbearing years. 

Sincerely, 

Karen

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We agree, for those that want a weaning ceremony, that can be a very meaningful experience. This post has 12 suggestions for ways to commemorate the end of your breastfeeding journey with your child.

What would be a meaningful way for you to celebrate the end of your breastfeeding journey?

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Lactation Snack Station Biscuits

by Carrie Saum

Shortcake

When I pumped exclusively for eternity 21 months, I felt hungry pretty much all the time.  Rarely would a two hour window window pass without food needing to make it’s way into my mouth.   I often forgot to grab a snack before I sat down to pump because pumping and babies/toddlers just don’t mix.  Add the lactation fog that overtakes the mommy brain, and you have a recipe for a one hangry lactating lady.

I tried to get in the routine of filling my water and grabbing a snack. But I was forgetful and typically remembered exactly 30 seconds after hooking myself up to a pump for the next lifetime 20 minutes.  After only 8 months, I realized I could do something about this particular problem.  All I had to do was think ahead for a few days at a time and put some snacks at my pump spot and in my pump bag.

But that also meant I had to actually prepare a snack.  Because as much as I love trailmix and coffee, I needed a little more sustenance.  And to be honest, I needed something to look forward to because pumping exclusively is EFFING HARD.  That’s another post, though.

I tried a few different options to get a decent ratio of carbs:protein.  I also needed every single milk booster I could get because my body wanted to quit making milk right around month eight, but my son’s unique health required me to keep going.

I started tinkering with foods that would fit the bill, and could also be stored at my Lactation Station. (Yep, I named the place where I stored my extra water, snacks, nipple cream, coconut oil, homeopathic stress relief remedy, and positive thoughts.) The snack also had to be allergen-friendly because TED was my constant companion for over a year.  It wasn’t ideal. It was pretty awful actually.  But it helped my baby begin his long healing process to severe food allergies, and I discovered I’m gluten-intolerant in the process. (Damnit.)

One of my favorite foods to munch while pumping were these tasty biscuits.  One was totally satisfying and helped me lose the pumping hanger I fell prey to all too often. They were easy to transport, share, and eat on the go.  Plus, they tasted phenomenal with some strawberries and whipped cream.  I’M JUST SAYING.

Ingredients:

  • 2 cups sliced strawberries
  • 2 cups blanched almond flour (I use Bob’s Red Mill)
  • 2 eggs*
  • 3/4 cup butter, cold and cubed, or melted coconut or avocado oil
  • 1 scant cup tapioca or cassava flour (wheat flour can be substituted)
  • 2 Tbsp raw honey, or other sweetener
  • 2 tsp apple cider vinegar (omit if using egg replacer)
  • 1 tsp vanilla extract
  • 1/2 tsp sea salt
  • 1/2 tsp baking powder
  • 1/2 tsp nutmeg

*If you want to make this egg-free, go for it!  This can also boost your milk supply. To replace two eggs, I used 2 Tbsp ground flax seeds, 3 Tbsp water, 1 Tbsp apple cider vinegar.

Directions:

  1. Combine the almond flour, tapioca flour, baking soda, salt, and nutmeg in a medium mixing bowl.
  2. Add butter to the flour mixture and cut into flour until the butter is in tiny pieces. Or go easy on yourself and whisk in oil.
  3. In a small bowl, combine eggs (or egg replacement), vanilla extract, apple cider vinegar, and honey.  Whisk until fully incorporated.
  4. Add egg mixture to flour mixture and stir until barely combined.
  5. Spoon mixture onto a parchment paper-lined baking sheet and smush with your hand, or bake in lined muffin tins.
  6. Bake at 350 degrees for 18-20 minutes.
  7. Remove from oven and dust with a *tiny* bit of raw cane sugar. (optional)
  8. Allow to cool for 15 minutes before eating, and cool completely before storing in an airtight container.

ShortcakeBiscuits

Pile with strawberries and whipped topping of your choice for an extra special treat.  Dip them in chocolate or your hopes and dreams.  Or you can just eat them and keep the lactation hangries at bay. Your choice.  Either way, you lactating mamas are my heroes.  Keep on pumping!

Happy Milk Making,
Carrie

*Note: It’s important to point out that most women aren’t going to need to eat food with the intention of upping their milk supply, if everything is working the way it is supposed to, your baby will know how to up your supply just fine themselves. Skin-to-skin and feeding on demand are the best ways to increase breastmilk supply to meet your baby’s needs. (Concerned you have low supply? Read this to help figure out if it is something you need to be concerned about.) For those women, galactalogues just happen and they don’t need to think about it. But some women, like me, do need a boost. As a mom who ended up exclusively pumping and indeed having low supply such that I ended up on medication solely to increase my milk production, I know what it’s like to look for anything, anything at all that would help my body make even just a little more milk to help feed my baby. With the support of my health care providers, we tried everything. It becomes “I will eat all the cookies, I will drink all the shakes, I will eat all the parfaits!” if it even just makes me feel like I’m doing something to address the low supply struggle, it is worth it.

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If you love this smoothie recipe, you might like this recipe for Paleo Chocolate Chip Granola or these Gluten-Free Strawberry Shortcake on Our Stable Table. 

_________________________

CarrieHeadshot

Carrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices and health knowledge. Carrie has extensive first-hand experience in vast array of medical and service fields.
With background in paramedic medicine, Carrie spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. As an AWC, Carrie currently coaches her clients and their families about topics including nutrition, weight loss, and stress management. In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and the voice behind OurStableTable.com. She lives in Portland, Oregon with her husband and young son.
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TLB Comic: How to Handle Breastfeeding In Public

by Jessica Martin-Weber, illustrated by Jennie Bernstein

 

09.04.15, funny friday, TLB comic

BOOBS IN PUBLIC! WATCH OUT!

Ok, that never happens. Breasts are never out in public, they are always put away in a containing device that doesn’t bring any attention to them whatsoever.

Except for beer ads.

And car ads.

And lingerie ads.

And gun show ads.

And vacation ads.

And watch ads.

And jewelry ads.

And mall ads.

And liquor ads

And that’s just what I saw today on my train ride. The lingerie ad was on the side of a bus and each breast was bigger than my head.

But otherwise breasts are totally hidden from view.

Which is good because can you imagine what would happen if we saw breasts? Specially breasts feeding babies.

Breasts are particularly always hidden from children because seeing breasts will leave them thinking breasts are a normal body part for women scar them for life. Even more so if the manner in which they see breasts doesn’t involve lacy bras or pasties or provocative poses.

We can’t have that now, can we? I mean, how would we explain to kids what is going on if they see a mother breastfeeding? The horrors! The mountain of therapy bills! The child that will think maybe women have bodily autonomy! (Here, if this nightmare should happen to you or someone you know, here’s what to tell a child should they see a mother breastfeeding. We can hold your hand through this, don’t worry, it will be ok.)

Thankfully, most of the time breastfeeding moms aren’t going to encounter any issue when they feed their babies in public. Given how often it is in the news and social media you would think it happens every single time a woman feeds her baby but alas, no. (Does anyone else wonder how all these shop owners and managers have missed the gigantic social media memo DON’T BOTHER BREASTFEEDING MOTHERS OR YOU WILL BE TORCHED ON THE INTERNET IN A HUGE PR NIGHTMARE!) Though the stories of women being harassed are what make the news, millions of mothers around the world feed their babies every day without interference. Shocking, I know. The most negative response the majority of women will ever receive may be a dirty look.

But what if you’re one of those unfortunate women who ends up with an ignorant and pushy individual demanding you leave an area or cover your baby and yourself while you feed your little one? How do you handle it? How do you handle it and keep your sanity intact?  How do you handle it and keep your sanity intact and not end up going to jail?

We have a few suggestions. Take them or leave them. They’re not all going to apply to every situation and they may not be the best in the moment but hopefully they’ll provide some levity to the situation and keep you from losing your mind. What’s left of it from baby brain anyway. (You guys, that’s a thing. For real. Science says so. Maybe not quite what you think but it is a thing.)

How to handle negative reactions about feeding your baby in public.

  1. Smile. And think whatever you want in your head. You seem nice and approachable and it isn’t going to scare your kids but you could be thinking a string of profanity and they would never know. You could even start composing your Facebook status and tweets now to share the incident with your closest 2,000 friends.
  2. Practice. In the mirror or with a friend get an idea of what you would like to say should you ever experience someone offended by babies eating telling you to leave or cover. Knowing what you want to say could help. Whether you practice your “EFF YOU” to be sure it has the right amount of conviction or elect for a more diplomatic response (to tone it down you can try “go away” for starters followed by “you’re joking right?” and then if necessary “have you ever seen the news or been on social media? Don’t you know this isn’t going to end well?”), being prepared can help you resist the knee-jerk reaction of kicking them in the crotch.
  3. Be sympathetic. That they are a repressed and confused individual regarding women’s bodies and how babies are fed isn’t entirely all their fault. They are a product of their culture that prioritizes the over emphasis on the sexual nature of the female breast and regularly objectifies women. Being offended by seeing a baby being fed may be something they haven’t yet developed the skills to accept personal responsibility for and figure out how to handle themselves. From your deep well of sympathy for their condition, you could even offer them the name of a therapist that you would recommend to help them with their issues. That would be so nice of you.
  4. Find a blanket. True, they could and probably should do this for themselves but as mentioned above, their condition may impair their ability to take personal responsibility. So you could find a blanket, a jacket, sweater, towel, dish rag, even a paper napkin for them to put over their head so as to block the feeding baby from their view. Do warn them that it may get hot under there, they may miss other aspects of life going on around them, and it could be cumbersome in general which could actually be dangerous, but let them know you’ll yell loudly which direction to step if something is coming toward them. Might they be uncomfortable? Sure, but at least they won’t be offended.
  5. Have the law handy. Is it reasonable to expect people to know the law? Of course not! Specially if they are a business, they have so much to keep track of and can’t be expected to properly train their employees on costumer service or what the law actually says. Your local breastfeeding coalition may have nifty little cards you can print on their website with the actual legal code and everything. But there are a LOT of laws out there, too many to keep up with for even the most law abiding citizen. So help them out by knowing which laws pertain to you and having it ready. They may even thank you for helping them avoid a law suit! Wouldn’t that be nice.

We could go on, there are as many ways to handle such an experience as there are people willing to make those experiences happen. We’d love to hear your ideas, comment below with your suggestions.

 

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TLB Comic: Switch Sides

by Jessica Martin-Weber, illustrated by Jennie Bernstein

 

breastfeeding lopsided breasts

 

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