Breastfeeding and COVID-19 Research and Resources

Updated June 19, 2020
Compiled by The Leaky Boob, theleakyboob.com, Facebook.com/TheLeakyBoob

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This resource list is an evolving work in progress. If you are aware of some resources or materials that should be included, please comment with the link.

 

Health Organizations Recommended Practices and Protocols:

Considerations for Inpatient Obstetric Healthcare Settings

  • CDC (Centers for Disease Control and Prevention)

 

Evaluation and Management Considerations for Neonates At Risk for COVID-19 – Caring for Newborns

  • CDC (Centers for Disease Control and Prevention)

“…the risks and benefits of temporary separation of the mother from her baby should be discussed with the mother by the healthcare team, and decisions about temporary separation should be made in accordance with the mother’s wishes.”

 

Breastfeeding advice during the COVID-19 outbreak

  • WHO (World Health Organization)

 

ABM STATEMENT ON CORONAVIRUS 2019 (COVID-19)

  • ABM (Academy of Breastfeeding Medicine)

 

Pregnancy, childbirth and caring for newborns: Advice for mothers during COVID-19

  • Public Health Agency of Canada

 

Clinical Management of COVID-19

  • WHO (World Health Organization)

 

Infant and Young Child Feeding in Emergencies, including COVID-19

  • United States Breastfeeding Committee 

 

 

Pregnancy, Birth, and Breastfeeding and COVID-19 Specific Resources:

 

SARS‐CoV‐2 and human milk: What is the evidence?

  • Wiley Online Library
    • Kimberly A. Lackey, Ryan M. Pace, Janet E. Williams, Lars Bode, Sharon M. Donovan, Kirsi M Järvinen, Antti E. Seppo, Daniel J. Raiten, Courtney L. Meehan, Mark A. McGuire, Michelle K. McGuire

 

New Studies Investigate How COVID-19 May Impact Breast Milk and Pregnancy 

  • University of California San Diego School of Medicine – Michelle Brubaker

 

Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.

  • The Lancet
    • Huijun Chen, PhD – Juanjuan Guo, MS – Chen Wang, PhD – Fan Luo, PhD – Xuechen Yu, MD – Prof Wei Zhang, PhD – Prof Jiafu Li, MS – Prof Dongchi Zhao, PhD – Dan Xu, MS – Qing Gong, MS – Jing Liao, PhD – Prof Huixia Yang, MD – Prof Wei Hou, PhD – Prof Yuanzhen Zhang, BS 

 

Antibodies in Infants Born to Mothers With COVID-19 Pneumonia

  • Jama Network
    • Hui Zeng, MD – Chen Xu, BS – Junli Fan, MD – Yueting Tang, PhD – Qiaoling Deng, MD – Wei Zhang, MD, PhD – Xinghua Long, MD, PhD

 

Guidelines for Healthcare Facility Management of Perinatal Care of Persons with COVID-19 of Suspected COVID-19

  • Bryna Sampey

 

Skin-to-Skin Care and COVID-19: downloadable file

 

Breastfeeding and coronavirus disease-2019: Ad interim indications of the Italian Society of Neonatology endorsed by the union of European Neonatal & Perinatal Societies

  • Wiley Online Library
    • Riccardo Davanzo – Guide Moro – Fabrizio Sandri – Massimo Agosti – Corrado Moretti – Fabio Mosca

 

COVID-19, Pregnancy and Breastfeeding: What We Know Is Reassuring

  • Helpful blog post with compilation of materials explained

 

Mother-Infant Contact and Breastfeeding Should Remain Top Priorities during COVID-19

  • John Hopkins Nursing, Dr. Cecília Tomori

Breastfeeding, Separation, and COVID-19 Specific Resources:

When Separation is not the Answer: Breastfeeding Mothers and Infants affected by COVID‐19

  • Wiley Online Library
    • Cecilia Tomori – Karleen Gribble – Aunchalee E.L. Palmquist – Mija-Tesse Ververs – Marelle S. Gross

 

COVID-19: Separating Infected Mothers from Newborns: Weighing the Risks and Benefits

  • Harvard Medical School – Melissa Bartick, MD, MS, FABM

 

Mother-Baby Separation for COVID-19 Not Evidence-Based, Experts Say

  • MedScape – Troy Brown, RN 

 

Should New Mothers With COVID-19 Be Separated From Their Newborns

  • The Hastings Center
    • Stowe Locke Teti – Christy Cummings – Louise P. King – Cynthia C. Coleman – Kayla Tabari – Christine Mitchell 

 

 

Maternal Mental Health, Separation, and COVID-19 Specific Resources:

COVID-19 and maternal mental health: Are we getting the balance right? 

  • MedRxiv (The Preprint Server for Health Sciences) – CHS (Cold Spring Harbor Laboratory – BMJ – Yale
    • Anastasia Toplidou – Gill Thomson – Soo Downe

 

Effects of COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study

  • Taylor & Francis Online
    • Ferit Durankuş – Erson Aksu

 

 

Breastfeeding and Separation Resources, General:

Rights of Children in Relation to Breastfeeding in Child Protection Cases: downloadable file

 

 

Helpful Breastfeeding Resources, General:

Exclusive breastfeeding for the first 3 months of life may reduce the risk of respiratory allergies and some asthma in children at the age of 6 years.

  • Wiley Online Library – Gayla Bigman

 

 

Working with Health Care Providers Resources:

Breastfeeding Empowering Language in Medical Settings

  • Mom2Mom Global- Amy Smolinski

 

The SHARE Approach—Essential Steps of Shared Decisionmaking: Quick Reference Guide

  • AHRQ(Agency for Healthcare Research and Quality

The SHARE Approach is a 1-day training program developed by the Agency for Healthcare Research and Quality (AHRQ) to help health care professionals work with patients to make the best possible health care decisions. It supports shared decisionmaking through the use of patient-centered outcomes research (PCOR).

 

 

Current and Ongoing Studies:

ISRHML Activities and Guidance related to COVID-19

  • ISRHML (The International Society for Research in Human Milk and Lactation)

 

 

Additional Resources:

Safe Handling of Containers of Expressed Human Milk in All Settings During the SARS-CoV-2(COVID-19) Pandemic

  • National Library of Medicine – National Center of Biotechnology Information
    • Kathleen A Marinelli – Robert M Lawrence

 

Publishers Provide Scholarly Content Free on Project MUSE During COVID-19 Crisis

  • Project Muse

 

Is there a resource or research you’d like to see included here? Please let us know.

 

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Night Weaning Gently FAQ’s and Night Weaning Week 2020 with Giveaway

Night Weaning Week 2020 is made possible thanks to the generous support of Naturepedic and the Night Weaning Gently Workshop.

 

Learn more about all the brands sponsoring Night Weaning Week below, including Naturepedic organic mattressesArdo, Crane USA, Olababy, the “Night Weaning, gently” workshop, and the upcoming “Sex, Interrupted” e-book.

But first, we’re answering some common questions related to Night Weaning.___________________

Night Weaning Gently FAQs

by Jessica Martin-Weber

 

What is respectful, gentle night weaning?

Respectful, gentle night weaning is a mindful process of ending night feeds that considers the needs of the entire family with awareness of development and the importance of the parent/caregiver – child bond. This process cares for the whole family and can be done with any sleep arrangement in respect for the family’s values, priorities, and needs. While it may be with some tears, it won’t be traumatizing or isolating and there will be comfort for those tears, which teaches your child that they can be upset and still have care and support from you even when they can’t have what they want. It does not involve leaving your child to cry alone.

Ready to night wean but want more help in doing so? Take our Night Weaning Gently Workshop e-course.

 

When is a good time to start thinking about night weaning and does it have to mean moving baby into their own room? How do you know if they’re ready?

(Want to determine your family’s readiness for a respectful, gentle night weaning experience? Start with this free downloadable night weaning readiness checklist.)

I really think the answer to this is very unique to each family and each baby. Night weaning doesn’t have to mean moving the child into their own room if that is not what is desired by the family. It is important to remember that every child is different and their unique temperament may greatly influence their night weaning readiness. While some infants naturally give up their night feeds at a young age, more commonly night feeds remain an important part of an infant’s routine until 10-12 months of age or beyond for both nutrition and comforting reasons. Under 6 months night feeds for the breastfed baby are important in establishing and protecting milk supply and night weaning too early can lead to low milk supply. If your child is under 10 months, they may not be ready to night wean. Both child and parental readiness are important – if you are not ready to night wean your child, you do not have to. Your child’s level of readiness for night weaning is the most important consideration and we do not encourage attempting to night wean if your child’s readiness score is not optimal. 

(Points to keep in mind for your child’s sleep space.)

 

Will night weaning gently end all night wakeups?

Maybe, maybe not. It usually will help but we all wake for a wide variety of reasons, including babies, toddlers, and young children. Night weaning gently will end night wakings to feed while respectfully preserving the parent/caregiver-child bond.

 

How long does it take to night wean gently?

It is very unique and individual, every child and family is different but typically somewhere between 7-10 nights. However, sometimes it is a very smooth and easy-going transition, particularly if your child is very ready for the process and it may be complete in 3 nights. Other times it is a more drawn out process with additional steps, particularly if there are any set-backs such as illness or travel. 

Wondering if your child is really ready? See this checklist.

 

What are some cues that your baby may be ready for night time weaning?

Studies have shown that babies under 12 months still need to wake often to eat both for nutrition and for safety in their sleep cycle.  So I don’t look for any signs of readiness before 10-12 months. After the one year mark, though, any combination of these may be a sign of readiness to night wean:

  • Seems tired and grumpy during the day.
  • Eats well (solids and breast milk) during the day.
  • Has moved through some of the major milestones such as walking.
  • Does NOT have intense separation anxiety.
  • Is not actively teething or sick.
  • Seems frustrated and restless at night at the breast
  • Wakes to nurse but falls quickly back to sleep without really eating.
  • Shows basic understanding of phrases like “all done.”
  • Shows interest and awareness in bed time routines and daytime vs. nighttime.
  • May play putting toys to bed.
  • Responds to soothing other than breastfeeding (i.e. rocking, singing, back rubs, etc.)
  • For a more complete list of signs of night weaning readiness, download your free night weaning readiness checklist here.

I think night weaning is most successful if the child is truly ready for it, please don’t expect that just because your child is over a year old they will be ready to night wean.  If it is a giant struggle or at any time the parents feel this is all wrong and not what they want to be doing then they should stop. It is possible that a child won’t be ready one month but will be the next. Remaining flexible is perhaps the most important key to night weaning. Maybe for all of parenting actually.

 

What’s really involved in respectful, gentle night weaning?

It will depend on your child’s personality, your sleep arrangements, the support you have, and your primary goals in night weaning, but in general you set a kind of time frame that you won’t breastfeed during (your most valuable sleep hours) and soothe without the breast when they wake instead. Go over the night weaning readiness checklist and if it looks like you’re ready, you start with a block of time you don’t feed during the night, say 10pm – 4am and instead offer cuddles, back rubs, soft sounds, empathy for their upset with comforting words, and maybe a sippy cup of water. You may want to do more to prepare and it is likely you will want to more specifically customize the process to be mindful of your child’s personal sleep temperament.

Learn more about your child’s sleep temperament and night weaning gently in this do-at-you-own-pace e-workshop.

 

Can you respectfully and gently night wean a child without the help of a partner?

Absolutely. 

 

Are there options in how to night wean?

There are several and any method should be customizable to your family’s needs.

Night weaning gently method overviews:

The Feed To Sleep Method– For toddlers. If continuing to breastfeed to sleep for bedtime is something you want to continue, this method allows for gently ending middle of the night feeds while allowing for breastfeeding to continue to be the last step in the bedtime routine. With responsive comfort given for wake-ups during a set time frame of your most valuable sleep hours, the Feed to Sleep Method gradually reduces feed times during those hours over the course of several days but does not interfere with breastfeeding to sleep at bedtime.

The Gentle Weaning Method– For older babies and toddlers. This method involves including breastfeeding as part of the bedtime routine but gently weaning off breastfeeding to get to sleep at bedtime and through the night. A respectful, tuned-in approach that ends the connection between breastfeeding and nighttime sleep by observing how suckling changes and gradually reducing the time at the breast for each feed before laying baby back down.

The Time Block Method– For older toddlers and preschoolers. Involves the older child in the process with conversation that breastfeeding (or whatever your family calls it) will only happen when the sun shines or in a specific spot and not during sleep time any more. Selecting one feed to start with and using the light outside, the time on the clock, a color changing clock, or some other signal, the child knows that breastfeeding will not be available until that time but that comfort is still offered.

 

Do you have to night wean or will they eventually stop on their own?

Night weaning is completely optional. All children will stop feeding through the night on their own, often between the ages of 2-4 but sometimes later. However, no child has been breastfeeding through the night by the time they have gone off to college, they all stop at some point. If you don’t want to night wean, you don’t have to.

I can’t stress enough that being flexible and figuring out what works for your family, not following a set schedule of what someone has predetermined your child should be doing at what age is crucial for the night weaning experience to be free from trauma.

For more in-depth support in planning your respectful, gentle night weaning journey and for less than the cost of a night at a hotel, take the Night Weaning Gently Workshop with Jessica Martin-Weber and no-cry Children’s Sleep Consultant, Rebecca Michi. Register here.

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Night Weaning Week Giveaway

 

Many thanks to the brands that are participating in Night Weaning Week. They believe that parents should have easy access to the information they need to make the best decisions they can. Their products reflect that belief, and we’re excited to share a bit about the ones featured in this giveaway.

To enter the giveaway, please use the widget at the end of this post. 

 

Our Title Sponsor, Naturepedic, is all about sleep. Their mission is to provide everyone from babies to adults with a fuller, healthier night’s sleep on a quality organic mattress. Their handcrafted organic mattresses and accessories are a dream to sleep on. You can sleep soundly knowing that you are completely safe from unhealthy materials and chemicals.

Naturepedic Crib Mattress
Retail Value: $349 

The Organic Breathable 2-Stage Baby Crib Mattress combines breathability and waterproofing for a safe, healthy and hygienic crib mattress design. The mattress starts with a firm, flat waterproof surface made from non-GMO sugarcane that is so pure, it actually meets food contact standards and easily wipes clean.

 

 

 

 

A free registration for the “Night Weaning, gently” workshop
$295 Value

Learn how to gently end night feeds thanks to the Night Weaning Gentlyworkshop, with Jessica Martin-Weber, founder of The Leaky Boob and Rebecca Michi, children’s sleep consultant.

 

 

Ardo: Calypso-To-Go breast pump
Retail Value: $300

The Calypso-To-Go is a Swiss-made, closed system breast pump that features: 64 settings, 3 power options (battery, AC adapter, car adapter), less than a pound, piston pump (gentler than membrane pump), 250mmHg (same as most pumps), insurance covered. It goes where you go!

 

 

 

 

Crane: Elephant Humidifier
Retail Value: $55

Meet Elliot the Elephant! No matter the humidity level you would like to achieve we’ve got you covered. The Crane Adorable cool mist humidifiers offer variable output settings and an adjustable 360 degree mist lid making it easy to send the mist in any direction. Plus, our humidifiers are whisper quiet which makes it the perfect option for light sleepers, kids, and especially babies.


Olababy: a transitional feeding set, or a spoon + bowl feeding set
Retail Value: $25

Baby-led weaning training spoons and silicone bottles

 

 

 

 

12 free copies of the upcoming “Sex, Interrupted” e-book
Retail value: $17.99
Coming out April, 2020

What if intimacy and sex could actually be BETTER after baby?

Jessica and Jeremy Martin-Weber, together for over 20 years and still “doin’ it” in spite of having 7 kids, share their stories and thoughts on how they’ve kept their connection – and their groove – alive all this time. Straightforward and honest, they share the good, the bad – the ugly – the challenges and the beauty in maintaining a relationship when babies enter the picture – and stay there FOREVER. 

 

Enter the giveaway here:

 

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Looking to Increase Your Pumping Output? Try Parallel Pumping!

by Jessica Martin-Weber with Dr. Kathleen F. McCue, FNP-BC, IBCLC-RLC
This article made possible by the generous support of Littlebeam Nursing Pillows.

Not every lactating parent will find it necessary to pump to reach their breastfeeding goals. Many, however, do find it necessary. Whatever the reason for pumping breastmilk- whether it is to supplement your baby with your milk when you are away from them, to supplement at-the-breast feeds regularly, or in order to donate – efficiency and sufficient milk supply are certainly desired. While the primary way to increase breastmilk supply is to empty the breasts fully and frequently, and usually nothing is quite as good at that as your baby, sometimes other strategies are helpful particularly if you’re looking to increase your pumping output. It is important to note that output isn’t the same as supply and sometimes it is just about getting the milk that is in the breast, out of the breast! Typically, if everything is functioning normally, our sweet, soft, warm, cuddly babies are much better at emptying the breast than a cold, whirring machine pressed against your breast sucking mechanically. Letting down to a breast pump may take time and practice and there are several different aspects of milk let down with a pump that can help such as proper flange fit, lubricating flanges, and utilizing the suction and speed settings on the pump to customize cycles that encourage let down and expression. Without that cuddly, sweet, soft, and warm baby, trying to get letdown can be, well… a let down.

But what if you could have the cuddly warm baby help with both emptying the breast and having more of an output with the pump?

Rather than feeding baby directly from the breast, then pump, then bottle-feed (also called “triple feeding”), pumping one side while baby is latched on the other can cut down on a step if supplementing with mother’s milk is necessary. Pumping one side while baby is latched on the other is called “parallel pumping.” Parallel pumping may cut down on work, save time, and may lead to increased output. Parallel pumping is the breastfeeding version of working smarter, not harder. It is believed parallel pumping yields such results because having baby latched helps with initial letdown (ever leak from one breast when baby is latched and breastfeeding from the other breast?), trigger additional letdowns to the pump, and double stimulation increases the body’s response and increases milk production- much like having twins. My own personal experience with parallel pumping was such that even when my own babies no longer needed my milk, I was responding so well with parallel pumping that I continued in order to donate my milk to other babies. It made pumping seem like less of a time commitment in order to donate as I was able to do it when I was already sitting to feed my baby, and it took less time to pump while having an even higher output.

*Keep reading for tips on getting started with parallel pumping.

The technique of parallel pumping works so well and with such efficiency that many parents have tried it with excellent results. Dr. Kathleen F. McCue conducted a study that is being published in Clinical Lactation journal that looked at satisfaction with the technique of parallel pumping. 

Some comments from patients:

“I was able to sit there and nurse him and also pump so that my husband can do the next feeding, which was fabulous.”

“I felt a sense of accomplishment the first time I did it. [Like,] ‘Okay, look at this. It’s working really well.’ She got into the football hold. I was able to pump, and it did feel like it was maximizing time.”

“Once you get the mechanics down it felt good in a way to feel like you were being efficient, like an efficient use of time.”

“I feel like I’m getting the pumping done simultaneously. Because I’m only pumping one breast at a time I can have one clean flange waiting… for next round. It actually takes a little bit of pressure off of me and I feel like I’m getting more done.”

“It is just efficient, because if my daughter only wanted to nurse from one side then normally what I would do is that I would feed her and then get her down sleeping, and then pump the other side. So, if I could just pump while she was nursing, it’s more efficient that way. That was nice not to have to then, after I get her down, then sit down and have to pump for another 15 minutes.”

Now you have heard how well parallel pumping works, it’s time to get started!

  • Get comfortable feeding your baby with a variety of holds. Many find the football hold most comfortable for parallel pumping but try different holds and get comfortable with them to see what best works for you.
  • Pillows are your friend. Support your baby’s body with pillows. A versatile nursing pillow such as the Littlebeam Nursing Pillow will allow you to find the best position that works for you and your baby. Use as many pillows as necessary to support your baby at your breast.
  • Choose your pump. A double electric pump may be most efficient even though you’re only using one side to parallel pump. However, some find a single electric or manual pump to be sufficient. A passive silicone suction pump may be a comfortable, effective option as well.
  • Set up and be familiar with your pump before trying to parallel pump. A few pumping sessions with just the pump can go a long way in making the experience of parallel pumping a smooth one. Remember, it isn’t always best to crank the speed and suction all the way up, particularly if it makes you uncomfortable or causes you pain. Instead, use the highest comfortable vacuum setting with the highest speed to encourage letdown, slowing the speed when letdown is achieved. Adjust multiple times through the feed/pumping session for best results.
  • A hands-free-pumping bra is the way to go. Free up your hands to support your baby, use the pump controls, utilize hands on pumping/breast massage, or even just to be able to take a drink while you feed the baby and the pump.
  • Get comfortable. Find a spot that is comfortable with plenty of room for you, the baby, and your pump. 
  • Don’t wait for late hunger cues. Set up before baby is too hungry by catching those early hunger cues and get situated before baby is upset and “hangry.” Have flanges and milk storage container (bottle or bag) washed and ready to go between feedings/pumping sessions.
  • Position pump first. Have the pump placed on your breast before bringing your baby to your breast. It is much more challenging to get the pump in place with a squirmy baby on the other breast.
  • Distraction. Some babies find the pump to be a distraction and may hit or kick the pump, yank tubing, or simply stop feeding to look at it. Have something for baby to focus on such as a nursing necklace or safe toy.
  • Have baby prime the pump! Latch baby before starting to pump then turn on the pump (remember, not too strong- pain interferes with letdown!) and pay attention to your baby. Before you know it, your milk will be flowing!

Want more on parallel pumping? Watch the following video with Dr. Kathleen McCue.

Your Marvelous Changing Bust And What You Need To Know- Breast Changes In Pregnancy

by Jessica Martin-Weber with Tracey Montford
This post made possible by the generous support of Cake Lingerie.

Breasts change throughout our lives are influenced by hormones, genetics, age, and other factors. For many, after puberty, the most noticeable change comes with pregnancy and breastfeeding. It can be helpful to know what to expect and what may help with comfort through these times of transition for our breasts and what to look for bras that provide gentle transitional support. You may not recognize your breasts with all the changes you may experience in pregnancy and breastfeeding but you still can have support, comfort, and know what you need to know to enjoy your marvelous changing bust.

Breast changes in pregnancy

For some, breasts are like their own personal magic 8 ball. Give them a little shake, ask them a question, and see what the answer is. Should I wear that underwire or go with the yoga bra? Is it a good day for potato chips or should it be salad? Should I carry pads with me or is it going to be 9 months before I need those? Or boobs are like horses. Gently pat them and ask “is it looking like rain, snow, or ice today girls?” “What do you think, facing the red flood or are we pushing a new human being out in less than a year?” “Are we craving chocolate or need a puke bucket?”

Second to puberty, during pregnancy breasts tend to experience significant growth and change. Thanks to pregnancy, it’s like you get to relive the wonders and magic of puberty all over again only this time, strangers may want to rub your belly and ask you what you’re having. (A human, we can safely guess you’re having a human!)

Pregnancy triggers the breasts to prepare for lactation to feed the developing baby after birth. The grape-like clusters of milk making tissue in the breast begin to increase in volume and number causing the tissue to expand. Yes, your boobs typically are going to grow in pregnancy- likely the biggest and most noticeable change to you’re breasts you’re going to experience since you were 11 years old. So many breast changes in pregnancy, milk making tissue expands, you grow more milk making tissue, blood flow increases, the tissue becomes more dense, the nipples and areola darken and often grow, and more. This involuntary biological response is often the first noticeable symptom of pregnancy for many women and can be quite sudden. Others may not notice any change until later in their pregnancy. Those that experience discomfort during their regular cycle are more likely to experience additional discomfort during pregnancy. Be kind to your breasts, understand that every individual and every pregnancy is unique, and find what helps you feel comfortable in this time of transition.

*Note: No change at all may be an indicator, along with other markers, of a lack of glandular tissue and should be discussed with a health care provider. This alone is not a determinant factor or sign of future breastmilk supply.

Breast changes common in pregnancy- first trimester

  • Rapid growth sometimes even before positive pregnancy test.
  • Tissue may feel more dense.
  • Achy pain is common and may last for weeks.
  • Skin my itch and be sensitive.
  • Nipples may become more tender and sensitive.
  • Areola may begin to get larger.
  • Rapid growth may lead to stretch marks on the breast.
  • Veins may become more visible as the skin gets thinner.

Support for breast changes in first trimester

As your breast size and shape may begin to change rapidly with growth being common, a transitional bra that offers flexible support with a size range in cup sizes my minimize discomfort and sensitivity. Look for a bra that is very soft with minimal structuring while providing support with a wide band and fabric that gives, providing gentle support. Some breasts change 5-6 cup sizes, it may be necessary to shop for new bras that accommodate the new breast growth. Limiting refined sugars and caffeine may also reduce discomfort.

Breast changes common in pregnancy- second trimester

  • Growth may slow down or even stop.
  • Sensitivity usually lessens.
  • The nipples and areolas may begin to darken.
  • The areola may continue to get larger.
  • To accommodate the growing baby, the rib cage may begin to expand.
  • More blueish veins may be visible under the surface as blood volume increases.

Support for breast changes in the second trimester

The second trimester tends to be more stable with changes slowing down and discomfort decreasing. If breast growth has slowed or ceased altogether, wearing a more structured bra may be more comfortable. As the rib cage begins to expand adding an expander may provide more comfort or getting sized for a better fitting bra may be necessary. During pregnancy, blood volume typically doubles and due to the thinner nature of the skin of chest area, veins may become more visible under the surface.

Breast changes common in pregnancy- third trimester

  • Some discharge or dried flakes of colostrum may be noticed on the nipple.
  • Breasts may become more sensitive again.
  • Growth may increase again.
  • Rib cage expands further as the hormone relaxin loosens tissue and baby gets bigger.
  • Breasts may begin to feel more heavy.
  • Nipples may become more sensitive to touch.
  • Areola may darken.
  • Areola may grow larger.
  • Bumps on areola may be more noticeable (Montgomery Glands).

Support for breast changes in the third trimester

As the body prepares to feed the growing baby, the breasts again enter a time of transition, particularly closer to the due date. Structured bras may be uncomfortable and compress the tissue and as more milk producing tissue develops, breast size may be in flux. A soft, supportive transitional bra may be more comfortable during this time and into the immediate postpartum. Some may notice their breasts beginning to leak or to find dried bits of colostrum on their nipple or on their bra. Though it is unusual for leaking to be noticeable through clothing in the third trimester, soft nursing pads can be used to absorb any leaks and prevent soaking through and may be more comfortable. Montgomery Glands around the nipple and on the areola my increase in size. These glands secrete an oil (lipoid fluid) that helps keep the areola and the nipple lubricated and protected and the smell of this oil may serve as a signal to the newborn of where to latch and suckle.

Pregnancy and breastfeeding breast myths

  • Myth: Use a toothbrush or rough cloth to toughen up nipples for breastfeeding.There is no need to prepare nipples for breastfeeding by using anything on your nipples. Nipples naturally prepare themselves. The one exception could be with inverted nipples needing to be drawn out. To prepare for breastfeeding, take a class, read materials, and if you are concerned, meet with an IBCLC or other breastfeeding support person to have your breasts evaluated.
  • Myth: Breast size indicates how much milk you will makeWhile your breast size may indicate how much milk your breasts may store, breast size is not an indicator of breastmilk supply. Shape of breasts and the space between the breasts may indicate how much glandular tissue is present which may impact milk supply but this can impact breasts of all sizes. If you are concerned, see an IBCLC or other breastfeeding support person to have your breasts evaluated.
  • Myth: Breastfeeding causes breasts to sag. It isn’t breastfeeding that causes sag, it is thought to be a combination of factors such as genetics and pregnancy. While breast tissue changes in density sometimes through pregnancy and breastfeeding, breastfeeding doesn’t mean sag. Read more in this study here.
  • Myth: No leaking means you don’t have milk. Some breasts never leak through pregnancy or breastfeeding but this is not a sign breastmilk supply or ability to breastfeed.
  • Myth: Inverted or flat nipples mean you can’t breastfeed. Inverted or flat nipples do not automatically mean baby won’t latch. Often inverted or flat nipples are drawn out with breastfeeding and there are options to help otherwise, even before baby is born. If you are concerned, see an IBCLC or other breastfeeding support person to have your breasts evaluated.

The hormonal response of breast changes through pregnancy all lead up to breastfeeding. There are more changes through breastfeeding and then again through weaning but the majority of the breast changes take place in pregnancy. 

How the right bra can make a difference

A good bra that fits well and accommodates these important changes in pregnancy and through breastfeeding can make a difference in comfort levels in this time of flux. Some bra fitting tips for the stages of pregnancy and breastfeeding:

  • Band should be snug but not tight. The majority of the support comes from the band, not the shoulder straps. Be sure it sits straight around the body for best fit. If it feels tight but is the right size, try loosening the shoulder straps some and pull the band down in the back. A band riding up in the back compromises fit and support.
  • Center front sits plat on chest, breasts fit comfortably within the cups.
  • Straps fit comfortably, not digging into shoulders or slipping off. 
  • Flexible sizing with minimal structure. Look for a transitional bra such as Cake Lingerie’s maternity and nursing bras, Rock Candy, Cotton Candy, and Sugar Candy, that accommodate 4-5 cup sizes with supportive fabric that has give. This doesn’t mean you have to accept uniboob, a good transitional bra will provide gentle lift, separation, and support.

Get your best fit with this step-by-step fit guide and calculator.

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Use the discount code TLB15 for 15% off at cakematernity.com.

Tracey Montford created Cake Lingerie in 2008 when she wanted bras that worked for the modern mother. With a background in creative arts and teaching, she never imagined having her own business, let alone creating one out of her own personal need. She now owns and runs Cake Lingerie from Sydney, Australia with her husband, Keith and their children.
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 22 years.

 

 

 

 

 

Tips For Hiking With Baby- The Family Hike

by Jessica Martin-Weber
This article made possible by the generous support of We Made Me Baby Carriers.

 

Whether it is out in nature in a park or an urban hike, venturing out for walks together with your family can become a regular part of your family routine. Though it can seem overwhelming to get out of the house and tackle even the most mundane activities with a baby and young children, with a little bit of planning and having realistic expectations, hiking with babies and young children can easily become a favorite activity for the whole family. 

I initially started family hikes because I needed to get moving and never could find the time without kids to get in any kind of effective workout. My only goal was to get my own body moving while still taking care of my children. Walking around our neighborhood was fine but got boring and I wanted some diversity, so I started looking for hiking trails in our area. It didn’t take long for me to realize there were a number of other benefits to hiking for my whole family. 

Family hikes are an opportunity for shared family fun experiences, expose your children to the world around them, normalize physical activity for your children, give you the chance to be physically active while being with your family, and connect your family more deeply with nature and/or your community. Hiking with my children has helped me find energy by getting moving and helped my kids burn energy by getting out of the house. Sleep has improved with regular hikes, our knowledge of our community has grown, and as our screen time has been reduced, our communication with each other has grown. I love the conversations that flow during hikes with my older children and I treasure the exploration that feeds my younger children’s curiosity, and there’s nothing like my baby’s calm happiness being close to me as she observes the world around her on our walks. There is something in particular about being out in nature, walking and soaking in fresh air away from the expectations of house keeping and other responsibilities that is like a deep cleansing breath that helps me tune in more and be the parent I want to be. Whether it is a new hike we’re trying for the first time or an old favorite, venturing out with the family has brought us closer together and been a centering part of our week.

In the years I’ve been hiking with my family, there are a few things I’ve learned to help make it easier and more enjoyable for all of us. If it is overly complicated or isn’t fun, it isn’t going to happen. Here are my tips for getting hiking with baby and small children.

  • Know where you’re going. Paved path? Woodsy trail? Shade? Full sun? Waterfalls? Water? Buggy area? Steep incline? Bathrooms available? How long is the trail (double or triple the time if you have toddlers or small children walking too)? Look up as much information as you can on any designated hike and hiking area. If it is a public park most have information on their website and Yelp reviews can be helpful in knowing what to expect including difficulty level, terrain, and amenities. Dress appropriately (if you’re breastfeeding, be sure your clothes make that cool and easy with babywearing!) and select the right type of footwear. Higher elevation may be cooler, be prepared with sunblock (if you need it, put it on before leaving the house), hats, insect repellent, change of clothes, etc.
  • Babywear/Toddlerwear. Maybe even preschoolerwear. Select a carrier you are comfortable using, can adjust, is breathable, lightweight, and supportive. If you’re not sure what kind of carrier that is for you, see if you can visit a local babywearing group and if they have a library, try several options. Join social media groups to learn more about options. Keep in mind that one person’s favorite carrier may not work for you, and your favorite may be considered “undesirable” by someone else. Baby carrier preference can be very individual.
  • Comfortable shoes. Typically sneakers with thick breathable socks for everyone are a safe bet but some hikes will be better with hiking boots or hiking sandals depending on the terrain. When it is hot, hiking sandals on a paved path are a great option for breathable comfort and support.
  • Share the load. Pick a carrier that works for you and your hiking partner if applicable so you take turns babywearing. My partner, my teens, and I can all use the We Made Me Venture carrier so instead of us bringing different carriers along or having just one person wear her, we take turns with her in the Venture. Be sure the one being worn is comfy too, knee to knee support in the seat of the carrier will help their legs be more comfortable, avoid irritating their sensitive skin, and make it a smoother ride for your baby or toddler.
  • Hydrate! This is important for everyone, any time but particularly for young children and if you are breastfeeding and when it is very hot. Water bottles that fit in back-pack pockets or hip holsters, camel-back systems, and fresh fruit can help your crew stay hydrated.
  • Fuel. Have easy snacks you know are favorites. A hangry toddler out in the woods will be misery for everyone so be prepared. Remember there may not be good places to stop on nature hikes, and leave the place in the same condition you found it in.
  • Community. For inspiration/ideas, join a local hiking group such as Hike It Baby.
  • Be in the moment. Family hikes are less about exercise and more about taking in the setting and spending time together. Enjoy it for what it is. Babywearing can certainly make it more of a workout, though be sure you are aware of your posture and engage your core to help you avoid straining or injuring yourself. With toddlers and young children, play games such as I Spy or a nature scavenger hunt can help hold their interest.
  • Know your limits. Even a short hike is worthwhile. Get started with something that isn’t going to physically push or stretch anyone in your party, including you. Pick a time of day that is already an energetic time and won’t interrupt a nap. Be realistic and flexible. Take breaks as needed and keep the rest of the schedule that day open. If it doesn’t go well once, don’t give up, try a different type of hike at a different time another day and see if that helps. Respecting your limits is key to having fun!
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.

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

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

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

Get Paired with your perfect pump through Aeroflow Breastpumps

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

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

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

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

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

Ameda Finesse breast pump

Ameda Finesse

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

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

Lansinoh Smartpump

What does it all mean?

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

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

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

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

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

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

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

mmHg– suction level.

Motif Duo Breast Pump

Your Pumping Lifestyle and Needs

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

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

Medela Starter Set

Picking Your Pump

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

Get your pump through your insurance

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

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

 

how to pick the best breast pump

Here’s what you do:

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

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

They’ll ship your breast pump!

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

Things Aeroflow Breastpump Specialist does for you:

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

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

 

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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.

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Leah De Shay graduated from La Sierra University with a degree in Psychology and Speech Pathology and Audiology. She completed her post-baccalaureate work in lactation at University of California, San Diego and went on to get her CLEC (Certificated Lactation Educator Counselor) certificate, and completed her IBCLC (Internationally Board-Certified Lactation Consultant). Leah has since worked in various health care systems, including as Director of the Welcome Baby Program, Providence. She currently serves patients throughout southern CA as the coordinator for infant feeding at LOOM and the Lactation Specialist at Growing Healthy Together. In addition to her clinical practice and as a busy mom herself, Leah also assistant teaches for the UC system. 

 

Lauren Bennet is a graduate of the Medical University of South Carolina and a Registered Nurse (BSN), and practiced as an intensive care nurse for 3 years. Currently, Lauren leads an incredible group of passionate and fun people at Aeroflow Breastpumps as the team lead managing the breast pump specialists. In her free time, she enjoys hiking, camping and being outdoors in and around Asheville, NC. 

 

 

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of wereallhumanhere.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 23 years.
 

Breastfeeding While Sick and How To Recover Your Supply

by Jessica Martin-Weber with Rene Fisher, IBCLC

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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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This article made possible by the generous support of Ameda.

Ameda Finesse Double Electric Breast pump

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

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

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

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

Not exactly but, well… kind of.

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

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

The American Acadamy of Pediatrics recommendation on breastfeeding while sick:

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

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

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

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

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

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

American Academy of Pediatrics breastfeeding through sickness

Recovering Milk Supply Following Illness

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

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

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

 

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

 

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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.

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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 wereallhumanhere.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 23 years.
 

 

Expert Bra Fitting For Pregnancy and Breastfeeding

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

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

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

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

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

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

Good to know

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

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

Bra Fitting

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

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

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

Bra Selection For Pregnancy and Breastfeeding

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

Avoid these common bra mistakes when breastfeeding

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

 

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

 

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

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

by Jessica Martin-Weber with Rene Fisher, IBCLC

This article made possible by the generous support of Ameda.

Ameda Finesse Double Electric Breast pump

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

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

Setting Up Your Pump

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

Determine Your Flange Size 

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

Beginning: Set Up

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

Beginning: Positioing

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

Beginning: Before You Start

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

Beginning: Turn Your Pump On

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

Beginning: Let Down and Expression

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

When To Pump

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

How Long To Pump

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

 

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

 

 

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

Happy Sex Life – Happy Family, Good Clean Love

by Wendy Strgar

 

goodcleanlove.com

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

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

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

 

Wendy Strgar

 

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

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

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

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

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

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

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

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

 

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