Pumping Breastmilk and What You Need To Know

By Amy Peterson, IBCLC

This article made possible by the generous support of Earth Mama Angel Baby.

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Not every mom needs to pump. When baby is with mom for feedings and transferring milk effectively, there is no need to pump. But there are times when pumping breastmilk is important:

  •      Baby needs more milk (a supplement for one or more feeds)
  •      Mom wants to increase her supply
  •      Mom and baby are apart for feedings, such as when mom is at work or school
  •      Mom wants to have someone else participate in feedings
  •      Anytime mom will miss a feeding

In these circumstances, using a breast pump helps maintain or increase the milk supply for future feedings, and the pumped milk offers the perfect food for baby. This article touches on choosing between the different types of breast pumps, general pumping guidelines, and tips for increasing milk supply if necessary.

When possible, choose a pump that meets your unique situation. If you’ll only miss a feed or two each week, a manual pump or single electric is plenty. If you need to pump for several feedings a day, a high quality, double electric pump is a better choice.  If your baby is hospitalized or you need to dedicate time to increasing your supply, a hospital grade/rental pump is the best choice.

You can get a breast pump from many different places: box stores (Babies ‘R Us, Target, WalMart, etc.), online, a friend, thrift store, or possibly through your insurance company. Buying a used breast pump or borrowing a pump is usually not recommended. Most brands are considered single user items. These pumps do not control for the transfer of bacteria or germs between the pump motor and the milk, putting the baby’s health at risk. If you know the pump brand has a closed system, you could consider purchasing a new collection kit with tubing. Even so, you may not know if the pump is working less effectively than when purchased new, potentially putting your supply at risk.

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It is also important to note that not all women respond well to pumps and not all pumps work equally well for every lactating individual. This is why we have options. There are various contributing aspects that may impact how well a pump performs such as flange size, suction strength, type of suction, etc. If a pump is not working well for you it is possible that another would. Some breasts prefer one pump over another and some breasts prefer manual expression.

Most breast pumps have two settings. One button controls the vacuum, and the other button controls how fast the pump cycles (sucks). These settings let you fine tune the pump to mimic your baby’s suction and rhythm. For maximum milk production, use the highest comfortable suction. Use a fast cycling rate until your milk flows, then adjust to your comfort level; this mimics how your baby sucks before and after a let-down. A few brands of breast pumps have a built in feature that begins with fast cycling and adjusts slower. Some moms find they have better milk flow when they reset the button and continue with fast cycling.

Here are some general pumping guidelines to get you started:

  •      Pump for any feeding you will miss. Your milk supply is based on supply and demand, and pumping for each missed feeding tells your body to keep producing milk during that time.
  •      Pump the amount of milk your baby needs.  For example, if your baby takes 3 ounces of milk, pump 3 ounces total (1 ½ ounces from each breast).  If you pump what you need in 4 minutes—you can stop pumping.
  •      Pump between feedings to build a bottle. You can combine the milk from several pumping sessions to make a larger bottle of milk.
  •      Pump at night or in the early morning hours when your supply is highest.
  •      A gentle breast massage routine, called hands-on pumping, has been proven effective in increasing the amount of milk a mom can pump. Check it out here.

For moms who are not able to pump enough milk and who want to increase their supply, there are additional pumping tips:

  •      Pump until your milk stops flowing, and then pump two more minutes. This limited extra pumping is enough to tell your breasts to make more.
  •      Pump more often. Leave your pump set up (where your toddler can’t reach it!). Pump for 5-10 minutes once or twice an hour.
  •      Use the hands-on pumping technique listed here and above.
  •      Know that pumping alone may not increase your milk supply. Work with a breastfeeding helper who is knowledgeable about other targeted methods to boost supply.
  •      While you work on increasing your milk supply, feed your baby. You can combine your breastmilk with donor milk or formula to be sure your baby is getting enough. Some moms choose to feed breastmilk separate from formula to avoid wasting any breastmilk if baby doesn’t finish the bottle. As long as your guestimate is cautious, it is safe to mix; the milks will mix in baby’s belly anyway.

While pumping is an important aspect for many families in reaching their breastfeeding goals, how much is pumped is not a reliable sign of milk production. As with most areas of parenting, take your cues from your baby. When baby is growing well and reaching milestones within range then how much you pump doesn’t need to be a concern. If you see signs of dehydration or poor weight gain, speak with your child’s healthcare provider.

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Happy pumping mamas! You’ve totally got this and we’ve teamed up with Earth Mama Angel Baby to support you in your pumping journey with a giveaway of Earth Mama Angel Baby’s Milk-to-Go kit for Leakies in the USA. A $40 retail value, this kit includes:

One pair of Booby Tubes® (one pair) for cold or warm therapeutic use, 1 box of Organic Milkmaid Tea (16 tea bags) a fragrant comforting blend that supports healthy breast milk production, safe Natural Nipple Butter (1 fl. oz.), Happy Mama Body Wash (1.67 fl. oz.), one Eco-friendly Reusable Insulated Bag, and a tasty recipe for Organic Milkmaid French Vanilla Chai.

Use the widget below to be entered!

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a Rafflecopter giveaway

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

 

 

Clicking Sound While Nursing

by Shari Criso MSN, RC, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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Question:

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

Answer:

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

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

 

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

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

____________________

Shari Criso 2016

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

Ask The IBCLC- Migraines, Blebs, and Teething

by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

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Dear Shari,

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

Dizzy Mama

 

Hi Dizzy Mama,

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

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Dear Shari,

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

Feeding a teething baby

 

Dear Feeding,

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

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Dear Shari,

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

Owie Nipple

 

Hello Owie Nipple,

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

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

 

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

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

________________________

Shari Criso 2016

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

A Heartfelt Latch – What You Need To Know

by Jessica Martin-Weber

This post is generously made possible by Bamboobies

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That moment when they’re finally in your arms and you can count fingers and toes and sniff their head and stroke the softest cheek you’ve ever felt in your life, that moment is, whether you can feel it right then or not, when you heart is captured forever. Suddenly everything this little person needs from you, you are ready to do with all your heart. Comfort them, change them, bathe them, sing to them, and feed them, simple yet profound tasks of care are heartfelt acts of love.

No matter how your feeding journey unfolds, there is no doubt that every moment is fueled by love. Even if it is stressful at times. But it does help to know some of what you can expect, how things may unfold, and what you should know going into it. Love may be all you need but love with information and support is just so much more… well, lovely.

There’s a lot of information so we’re just latching onto one little tidbit for now here: the latch.

If you’re breastfeeding or planning to, you’ve probably heard a lot about the importance of a “good latch.” For some, that can create some anxiety about getting that good latch and a sense that doing so can be elusive so we wanted to help break it down a bit with 3 need-to-know tips about a breastfeeding baby’s latch.

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  1. If it ain’t broke, don’t fix it.

Many of us want manuals for everything, how-to guides so we avoid making mistakes and pursue the elusive perfection. You’ll find all kinds of diagrams, pictures, and descriptions of what constitutes a “good” latch. Step 1, step 2, step 3 and if you follow them exactly, voila! The thing is, that’s very rarely how it works with human beings, not even textbook babies.

It is really very simple: if it’s comfortable and it’s working, it’s a good latch.

If it isn’t comfortable and it isn’t working well, then it may not be a good latch.

Baby has plenty of wet diapers? Gaining weight? Good signs!

Baby has low wet diaper count? Difficulty gaining weight? Hmmm, not so good signs.

Mommy can feel her breasts soften a little with baby at the breast? Nipples doing well? Good signs!

Mommy has pain beyond initial latch through the feed? Nipple damage? Not so good signs.

There is a real possibility that your baby’s latch won’t look like the textbook “good latch”, there may even be clicking (though I’d get that checked out just in case anyway), but if it is working for you both then it’s not a good latch, it’s a great one!

A good latch is one that works for mom and baby!

  1. It’s a team effort.

Mom and baby make a dyad, a new team, and they have to work together. Which can be tricky since you barely know each other. But you also know each other better than anyone else. Working together can seem really complicated but don’t borrow trouble and remember that you’re both equipped to do this.

Given that one of the team hasn’t been around too long, that can get tricky sometimes, especially if there are other obstacles in the way such as jaundice.

What team work looks like in achieving that latch of your dreams:

Mom is in a comfortable position and has brought the baby to her level to her instead of leaning down to the baby.

Baby has wide open mouth.

Baby’s body is facing yours.

Chin will touch the breast, nose will be unobstructed, lips will be flared like a flange around the nipple taking in as much of the areola as possible.

Hold baby securely, a snug, close hold will help.

Pull baby in quickly when mouth is open wide.

If you can relax, try leaning back on some pillow, work together, and remember that first rule, it may all just surprise you.

If your baby is not able to do their part of the teamwork, it is time to seek out the support of a health care professional. Speaking with an IBCLC and your child’s pediatrician to identify the cause and options early can go a long way in getting on track to reach your breastfeeding goals.

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  1. If you’re hurting or even just worried, ask for help.

Once upon a time women feeding their babies was visible in our communities and while we’re shifting that way now thanks to the global village of the internet, we still don’t really see it regularly and not all that up close and personal. This has led to us entering our baby care days without much of an idea of what’s normal and even when to ask for help. In fact, it can be easy to start thinking we shouldn’t ever ask for help.

Can you imagine telling your child some day that their nipples may be in agony but they shouldn’t ask for help? Of course not! That would be cruel.

Thankfully, between the internet, hopefully some in-real-life friends, and health care providers, more and more we have resources to help us find our way. Ask in forums, watch videos (this “flipple technique” is helpful for correcting some common latch problems), and read resources (like this one and this other one).

If you’re experiencing anything more than an initial twinge of pain with breastfeeding your baby it may be a sign that something is wrong. Not that you’re doing something wrong or have somehow failed, but rather pain can be a common sign of a problem that with support may be able to be corrected. (There are some conditions that will lead to regular pain in breastfeeding such as Raynaud’s phenomenon.)  It is possible that a painful latch, a baby with too few wet or soiled diapers, low weight gain for baby, stabbing or burning feeling in the breast, or a fussy baby at the breast in combination with any of these issues could be an indicator that there is some problem to address. From tongue and/or lip tie to high palate to jaundice to any number of reasons that a mom and baby dyad would be experiencing difficulty, seeing an IBCLC (International Board Certified Lactation Consultant) can help bring things together and set you and your team mate well on your way to reaching your breastfeeding goals.

And then you can get back to doing what you do best, holding them close to your heart and loving them completely.

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What helped you get a good latch?

Leave a comment below! We’d love to hear how you figured out what was best for you and your baby.

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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.

Breastfeeding in Public- You’ve Got This

by Jessica Martin-Weber
This post is generously made possible by Bamboobies

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Not sure about baring your breast, at least partially, and feeding your baby in public?

Mama, you’ve got this.

If you’re uncomfortable with breastfeeding your baby while out and about you’re not alone. Many women experience some nervousness over feeding their baby away from home. It’s no wonder either, spend any time on social media and it would seem that women are regularly experiencing harassment for breastfeeding in public.

Thankfully, that isn’t really the case. Out of hundreds of thousands of breastfeeding moms every single day, only a a couple of dozen or so will end up on the news talking about harassment she experienced for feeding her baby. A few more may experience negative comments or looks from strangers or more likely, friends and family. But more often than not, breastfeeding in public is either appreciated and encouraged or not even noticed. Far more women have positive breastfeeding in public stories than harassment stories.

With that in mind, there are some steps a breastfeeding mom can take to help her feel more comfortable with breastfeeding in public. Drawing from 17 years of off and on, mostly on, breastfeeding experience and from helping others in their journey, there are a few ways I have found can make it all a little easier.

*A note about covering to breastfeed in public. Covering is a matter of personal preference. Do what works for you and what will help you reach your personal breastfeeding goals. Whatever you choose to do, I encourage you to make the decision for yourself, not for others. If you choose to cover, do so because you feel more comfortable covered, not because you want other people to feel more comfortable.

 

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Get comfortable. Breastfeeding may be natural but it is a skill to develop for both you and your baby. Getting comfortable with it may take a little time for both of you and being able to develop that skill in the comfort of your own home in those early days will go a long way for when you need to breastfeed on the go. Get comfortable with breastfeeding with your baby, when you feel like you know what you’re doing it will be a lot less intimidating. This doesn’t mean you can’t leave the house until then, just that the more time you spend breastfeeding where you feel safe the more you’ll feel confident in other settings. You’ve got this.

Practice. Does practice make perfect or is it practice makes permanent? Either way, practicing can be a game changer. Practice breastfeeding in public as soon as you can with baby steps. Breastfeed in front of people you feel safe with- your partner, your best friends, family, etc. Work your way up gradually to breastfeed around people you’re not sure are supportive. Two of the most effective ways to practice breastfeeding in public are 1) breastfeed in front of a mirror and 2) practice what you would say if someone was to harass you for feeding your baby. By breastfeeding in front of a mirror or by video recording yourself feeding, you may find you don’t expose as much as you feared. By have a prepared response to possible negative reactions to you feeding your baby, you may find you feel equipped. Plus, the more prepared you are to stand up for your baby’s right to be fed, the less likely you’ll ever need to. You’ve got this.

Get the tools you need. Have boob, feed baby! But you may feel more comfortable with some additional items. A nursing bra or tank, nursing pads (or breast pads) so if you leak your shirt stays dry, breastfeeding top or dress, easy access clothing, a portable breastfeeding pillow, a nursing cover, a water bottle, etc. Figure out what is going to help you feel more comfortable and secure to confidently feed in public. Having clothing that works for you to get a breast out is crucial (avoid back zip up high neck dresses!) whether you’re lifting from the bottom, doing the two layer method so your tummy and back are covered, pulling down from the top, using clothing designed specifically for breastfeeding, or choosing a breastfeeding cover. Having the tools that work for you can be a big confidence boost. You’ve got this.

See it. One of the reasons we may be uncomfortable feeding in public is because we’re not used to seeing it. It seems weird to us and we’re the ones having to do it! Seeing it can help a lot. Look at breastfeeding photos on social media (check out the hashtags #beautifulbfing, #brelfie, #normalizebreastfeeding, and yes, #breastfeeding), attend a parenting group that supports breastfeeding, spend time with friends who are breastfeeding. And if you’re really anxious about breastfeeding in public, go out with other women who breastfeed your first few times. There’s strength in numbers. You’ve got this.

Be informed. Most areas have laws protecting breastfeeding in public. While there aren’t really any teeth to those laws, breastfeeding in public isn’t illegal and is protected in most places. We shouldn’t have to but knowing the law, even having it printed out and with you, puts you in a position of being informed of your rights. Feel confident that the law is on your side. You’ve got this.

Focus. Now that you’ve done the prep work, when it’s time to feed your baby, just focus on feeding your baby. Don’t look for the negative, look at the positive right there in front of you. Shut out the world for just a moment and draw strength and courage in this shared time together. Focus on your baby and let any negative reactions pass you right by. You’ve got this.

Let it go. You are not responsible for the thoughts and feelings of others, particularly when it comes to you caring for your children. Sure, some may disapprove, some may be offended, some may take issue with breastfeeding in public, but it isn’t your job to protect them from what offends them and it certainly isn’t your job to sacrifice your child’s needs for someone else’s comfort. Let it go, you can’t make everyone happy but you can ensure that your little one is. You’ve got this.

You matter. Your baby matters. You deserve to live life fully, feeding your little one with confidence. It isn’t asking too much to feed your baby in peace out in the world as you live your life. You’ve got this.

Breastfeeding in public, you’ve totally got this.

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Check out the Bamboobies nursing shawl, it’s practical for breastfeeding and long after as a fashion accessory!

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View More: http://yourstreetphotography.pass.us/martinwebberfamily1

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.

Breastfeeding and Solid Foods

by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

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

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

 

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How do I introduce solids and keep my supply up?

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

Shari Criso MSN, RN, CMN, IBCLC

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

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

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Shari Criso 2016

 

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

Ask the IBCLC Breastfeeding Help: Low Supply and Breastfeeding in Pregnancy

The Leakies with Shari Criso, MSN, RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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We’ve asked Shari Criso to share her answers to Leakies questions about feeding their babies. If you have any questions you’d like to ask Shari, leave a comment!

 

My little 4 month old is refusing to take bottles. I’ve started taking him to daycare, and he is refusing bottles, not even taking a full ounce while he’s there for 6-7 hours. When we’re together he’s still drinking well from the breast and nursing frequently at night. His weight is good and we’ve had no issues other than this. I’m worried about him becoming dehydrated during the day. What can I do and what can I tell the daycare to do?

Mama to a hungry but stubborn baby.

 

Hi Mama,

I totally feel your pain and the anxiety that comes when your breastfed baby refuses the bottle and does not eat when you are not around. I had one myself! Reading your question, my first thought is that this transition may take a little time for not only you to get used to leaving but for your little guy to get into a new routine, new people, and a NEW way of eating! This is one of the reasons that I really recommend introducing your breastfed baby to a bottle earlier than most will (like within the first 2 weeks!) which makes this transition much easier. I actually have an entire chapter dedicated to this very thing in my online breastfeeding class “Simply Breastfeeding” because I know there are so many moms that need to return to work and this issue can be so distressing. I know that is not helping you now…so my best advice is this: First, try different types of nipples to see if there is one that he will take over another. Try offering the milk cold instead of warm. Sometimes this can also make a difference (not exactly sure why, but it worked with my own and other mamas I have worked with). Try feeding him in different positions instead of cradling him. Holding him outward and distracting him by moving around, staring at a picture on the wall, etc. Try an infant feeding cup. YES…babies can be fed through a cup and don’t need to take an artificial nipple! Lastly, if all of these things fail don’t stress. This may just take a little time and a few more feedings during the time you’re home and at night. Let him co-sleep with you and try to get as many feedings in that you can while you are together. Watch wet diapers, signs of dehydration and weight loss. If all seems normal, just let it be and allow your baby to adjust at his own pace. In the meantime, you should still continue to pump on schedule as to not decrease your supply and also not get too engorged while you are away.

I hope this helps and that things start to smooth out very soon for you!

Xoxo,
Shari

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Dear Shari,

I am 7 weeks with my 3rd and my son is 8 months old today, so I am still nursing very much so for nutritional purposes. He doesn’t like solids, of course, so I’m lucky if he eats 1 additional solid meal per day. I have noticed a drop in my supply already, just now I was up to nurse him and it took a good 10 minutes before he got a let down and they definitely aren’t as strong. Please tell me it won’t drop any further than it is now, I want to tandem, I nursed my daughter until 22 months so him and I would both be devastated if it just went away!!

You’ve been so encouraging before, thank you!

Not ready to stop!

 

Dear Not Ready To Stop,

First, congratulations on your new pregnancy! Having you children close in age has many benefits and can also present certain challenges as you are experiencing, however this does NOT need to be the end of your breastfeeding relationship with your older child. Many, many mothers are able to continue breastfeeding safely during pregnancy and way beyond, going on to tandem after birth. Most moms will have a decrease in their milk supply during pregnancy. This is especially common in the second trimester but can start as early as the first. It is thought that increased levels of Progesterone during pregnancy is what causes the milk supply to drop. This typically begins to resolve towards the 3rd trimester and especially at birth when the placenta is delivered and prolactin levels rise. AS always, it is important to continue to offer the breast to your nursling frequently and not decreasing “demand.” This will only add to your decreased production. Co-sleeping and night feedings can help here. Be careful on any herbal supplements that you are considering as they may help your supply, but they are not all safe during pregnancy. Always consult your doctor, midwife, and lactation consultant. The decreased supply may actually encourage your little one to start taking mores solids, as he will naturally be hungrier. This is fine as long as your are getting in at least 3-4 feedings per 24 hours. Take this opportunity to experiment with new and yummy foods, and keep trying even if he rejects it at first. It can take 5-7 “rejections” of a certain food before a child will accept and even learn to love it. As always, monitor wet diapers, signs of dehydration, weight loss, etc. Most of all, try not to stress. This is temporary and your milk WILL come back so that you can go on to provide for both of your babies! 

All the best to you and your family.

Good luck,
Shari

AskTheIBCLC_26JUL16

Dear Shari,

My little is almost 6 months old. My supply has taken a huge turn for the worse. I am barely producing anything. I Had a huge over-supply in the beginning. This has all started about a month ago. I know that you are supposed to adjust and pump more of what baby needs close to 3mo plus. Well I started doing that. Was pumping like 20-25 ounces a day.. Then it decreased to 10-15 and now I’m at 1-6… The past two days have been around 2 ounces the whole day. I have done pretty much everything I have read to do. I have also switched pumps. I have tried switching flanges. Replaced membranes, replaced hoses. I know stress is a horrible killer for your supply. I honestly am not stressing. I do not feel stressed, do not feel worried. I have a freezer full of milk so I know my little girl will have momma milk for a while longer even if I am done producing. I just would like to know if I am done ya know. I have tried nursing her more too. Day before yesterday I nursed her more and she didn’t seem satisfied at all. Today I nursed her more and she seemed fine. What is going on?

I appreciate any light you can shed on this!

Dwindling supply and hungry baby.

 

Hello Dwindling,

It sounds like you are trying to pump in addition to fully nursing your baby at the breast. It is completely normal for milk supply to fluctuate and for there to be times when your supply may seem lower. This will naturally happen as your child ages and also during times of growth spurts when they are eating ALL THAT YOU HAVE! That will of course leave less to be pumped. Normal growth spurts occur around 2-3 weeks, 6 weeks, 3 months, and 6 months. There is also a very common decrease that happens around 6 months postpartum for many moms. This can be due to hormonal changes, the return of you period, nursing less frequently, returning to work, introduction to solid foods, etc. I talk about this a lot in my online class “Breast Pump & Briefcases,” as it is something that so many breastfeeding and pumping mothers face. It is important to understand that while there may be times where you are able to produce way more than your baby is eating (which leads to being able to pump a lot of extra feedings for storage or donation…like your freezer full of milk), there will be other times where you may just be making exactly what your baby needs in the moment and not any more. This is not abnormal, and also not a problem as long as you feel that your baby is getting what she needs at the breast (which it sounds like she it). Your pumping and storing may have to take a back seat until the growth spurt is over. This will usually pass within a few days of concentration and baby led feedings. Small but frequent feedings whenever the baby wants to go back to the breast without supplementing, will usually have your supply back within a few days. Delaying feedings or supplementing with your freezer supply or formula during theses times will have the opposite effect, delaying the decrease or decreasing it further. This is SO important to understand. There are also foods like oatmeal and herbal supplements like Fenugreek that can help during these times, but I would always consult a Lactation Consultant before using anything. 

I hope this helps you and congrats on doing such a great job feeding your little girl!

Much love,
Shari

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Shari Criso 2016

 

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

#TLBmoves: Let’s Get Moving and Win!

So much of our lives revolve around feeding our families and sometimes that is fun, sometimes it’s draining.

Seriously, how can they be hungry again!

But nourishment isn’t the same thing as just feeding. Related, but not the same.

Nourishment is so much more than just nutrition for our bodies; our spirits find nourishment in connection, our relationships find nourishment in each other, our children find nourishment in our arms, our minds are nourished through learning and conversation, and our hearts are nourished by being with the people we love.

Which is why we’re hoping to nourish you with a giveaway to compliment your nourishment journey wherever it takes you. #TLBnourish giveaway is all about supporting you as your nourish those you love.

#TLBmoves Giveaway Bundle includes items from Thinkbaby Thinksport, Belabumbum, and Tula Baby Carriers.

 

The Giveaway!

 

Thinkbaby Thinksport

Thinkbaby_favoredby

Thinkbaby Thinksport, Title Sponsor for this #TLBmoves campaign, is featuring 2 great products.  Learn more about the Thinkbaby Sunscreen and Thinksport Insulated Sport Bottles below. Check out their website for different these great items and more.
 

Thinkbaby Sunscreen

  • First Sunscreen to pass Whole Foods Premium Care Requirements
  • Top Rated by EWG with a “1” rating since 2010
  • Free of biologically harmful chemicals. No Avobenzone, Oxybenzone, or UV Chemical absorbers.
  • Highest SPF 50+ (per FDA 2012 Rules – any sunscreens boasting higher are falsely marketing)
  • Highest level of Broad-spectrum UVA and UVB protection (per FDA 2012 Rules)
  • Highest level of water resistance (80 minutes) (per FDA 2012 Rules)
  • Non-nano formulation – Average particle size >100micron
  • Non-aerosol formulation (High concern of both ineffectiveness and particulates being inhaled)
  • Paraben, phthalates, PABA and 1,4 dioxane free
  • Applies and absorbs easily.  Non-oily feel.
  • Sunscreen produced in the USA
  • Does not have an obtrusive smell that many organic sunscreens have.
  • A member of the Safe Cosmetics Campaign Compact
  • Foundering member Sun Safety Coalition
  • Gluten free  (third-party verified)
  • No animal testing (Leaping Bunny member)
  • More awards than any other sun care line
  • Featured in: Tennis, Bicycling, Natural Child, Daily Candy (top pick), Men’s Health (top pick), Competitor, Backpacker (Top Pick), Standard, People Magazine (Must haves), Pharmacy Times, Men’s Journal (top pick), Chicago Tribune, The Bump (Top pick), Favored.by (Top Pick), Times Square, The Daily Green, YNN News, Denver News (Must haves), Triathlete, Cribsie and Red Hat Product Finalist. Eco – Excellence Finalist. Silver Award NAPPA, Baby Maternity Magazine (Top pick), Babble (Top 10 Best), Its a Belly (Seal of Excellence), Metro Moms (Hottest Product), Green Scene Mom (Winner) and a whole lot of blog reviews…

Why sunscreen?

The majority of sunscreens currently on the market are full of questionable ingredients and known carcinogens. Simply look at the ingredients and you’ll quickly realize you don’t recognize any of them. Many existing sunscreens have been brought to market with little concern for their safety. Not only do ingredients in sunscreen interact with skin, but data shows after application of lotions, some of the same chemicals can be detected in the bloodstream. Most people wear sunscreen to reduce the chance of developing cancer, so why apply something that could potentially increase this risk? This question has unfortunately left many people moving away from using sunscreen at all.

How is the Thinkbaby and Thinksport different?

At Thinkbaby and Thinksport, we are continually expanding our mission to provide safe products by identifying consumer product categories with known human health issues. Specifically, we target products that contain high levels of hormone disruptors and carcinogens. We then work with leading scientists worldwide to create safe alternatives.

  • Thinkbaby and Thinksport sunscreen is highly effective, falls into the highest category for water resistance and has a sensible SPF 50+ rating. A quick look on your local drugstore shelf will show an increasing number of chemical sunscreens boasting ultra-high SPFs of 70 and greater. An SPF higher than SPF 30 offers only minimal improvement in sun protection and does not provide insight into its ability to protect from both UVA and UVB. Instead, these ultra-high SPFs are inflated through the use of chemical UV absorbers.   The FDA has recently ruled that SPF numbers above 50 are not allowed. They have also ruled the terms “Sweatproof” and “Waterproof” as false claims.
  • You should know that the effective difference between SPF 30 and SPF 100 is approximately 2.5% difference. Don’t be misled by ultra-high SPF numbers. Additionally, Thinkbaby and Thinksport sunscreens utilize average zinc oxide particles greater than 110nm. Kevin Brodwick, founder of Thinkbaby and Thinksport explains why: “We always use the precautionary principle and as we expect the debate on the safety of nano particles to continue, we asked a simple question: Does the product have to contain nano particles to be an effective sunscreen? The answer is, quite simply, “NO”!
  • We also do not and will not use aerosol dispensers, nor should you.  Scientists have shown that parents apply 25% of the correct amount when using aerosol.  As the SPF is actually a logarithmic function,  if you are applying a SPF 100, you’re actually only putting on SPF equivalent of 3.  More importantly, there is significant concern that children and parents are inhaling the particulates.  If you look at the ingredients in aerosol sunscreens, you’ll quickly determine why you don’t want to breathe it.

Retail Value:  $12.99 for 3oz and $23.99 for 6oz  (shipping in US & Canada only)

For more information visit Thinkbaby

 

Thinksport Insulated Sports bottles –

  • Double-walled and vacuum-sealed stainless steel – keeps contents hot or cold for hours
  • Perfect for hot or cold beverages – does not sweat (for cold contents) or burn your hand (for hot contents)
  • Contoured design – makes the bottle easy to hold and visually distinctive from the many, many straight-walled bottles
  • Removable mesh filter – keeps ice from blocking the drinking spout and allows users to conveniently brew tea on the go
  • Unsurpassed testing for material safety – our products undergo rigorous chemical and biologic testing to insure they do not contain toxic chemicals
  • Available sizes: 750ml (25oz), 500ml (17oz) and 350ml (12oz)
  • Available colors: Natural silver, matte black, blue, purple, green and orange.  Light Blue, White and Light Pink available in some sizes

How long does your bottle keep drinks cold?

The short answer is results will vary….but a long time!  Because of all of the different situations out there, we do not guarantee a time period.  The 25oz bottles hold ice cold for approximately 18 hours. Some tell us about how they left their Thinksport bottle in the car in 100 degree weather only to return to clinking ice five hours later.  Others tell us how we kept their drinks cold for longer than 24 hours.  One customer even put our bottle in a thermal testing chamber and reported that it was the best bottle he had ever seen.  On average the sports bottles hold contents hot for 4 hours.  Because of the double-walled construction you also won’t feel the temperature of the products. So its important to be careful if you’ve placed hot liquids into the bottle.

Do your bottles fit in cup holders or water bottle cages?  

Our 350ml/12oz and 500ml/17oz bottles are designed to fit in car cup holders while our 750ml/25oz bottles fit some (but not all).  12oz and 500ml bottles will fit into water bottles cages.  The 750ml fits most bottle cages on spin bikes.

The perfect all around bottle!  Great for….

  •        Having cold / hot beverages at the office.
  •        Going for hikes or camping.
  •        Throwing into the backpack for school.
  •        Your yoga, cross-fit or spin class holder of lifesaving water.
  •        A companion while you work in the garden.
  •        Long road trips to your in-laws.  
  •        Bedside for late night dry mouth situations.

Retail Value: $19.99 / 17oz sports bottle – $17.99 / 12oz sports bottle $15.99    (shipping in US & Canada only)

For more information visit Thinksport.

 

Belabumbum

BelabumbumActiveLogo

Belabumbum’s Ultra Smooth Nursing Sports Bra offers medium-impact support with wireless microfiber cups lined with cotton and removable spacer pads to provide coverage and wick away moisture. The bra’s side cup is made with breathable stretch mesh and elasticized for fit. Ventilated side panels transfer moisture and heat away from mom. 

Retail Value: $69.00 (shipping to US only)

For more information visit Belabumbum

 

Tula Baby

TulaLogo

Prance is a Tula Coast carrier with a whimsical, spirited print. Fields of flowers and happy, prancing unicorns fill the design that is paired with a fun purple canvas and mesh center panel. Prance is the ultimate wish come true!

Tula Coast is designed to bring a cool breeze to your day! This line of Tula Baby Carriers offers a reinterpretation of our original framed panel design using breathable mesh material which creates a ventilated carrier perfectly suited for active lifestyles and warm weather locales.

Retail Value: Prance is $149 (standard) and $169 (toddler)  (International shipping available)

For more information visit Tula.

 

 ____________________

 

TLBmoves giveaway image

Prize Bundle Total Value : $246.98

 

Thinkbaby Thinksport – Sunscreen $12.99 value for 3oz, Sports bottle $15.99 value for 12oz

Belabumbum – Nursing pumping bra, $69.00 value

Tula – Prance Carrier$149.00 value

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Good luck to everyone!  Please use the widget below to enter. The giveaway is open from now through July 30, 2016. A big thanks to Thinkbaby Thinksport, Belabumbum, and Tula Baby Carriers for their support of TLB and all breastfeeding women. 

This giveaway is open to participants in the USA.

a Rafflecopter giveaway

Ask the Sleep Expert- Rebecca Michi- Sleeping Transitions for your Baby – Sleep In Arm’s Reach

The Leakies with Rebecca Michi

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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 post made possible by the generous support of Arm’s Reach Co-Sleeper

Arms Reach Banner Logo

We asked sleep consultant Rebecca Michi to come help us all get some more sleep and we asked the Leakies to share their current sleep struggles. Here are a few of the responses, followed by Rebecca’s support.

 

My son is 13 months old and has co-sleept with us since birth. At first he was in a co-sleeper next to our bed and when he outgrew that he was in our bed with us. I’m feeling ready for him to be in his own sleep space because my back gets sore. How can we transition him to his own little bed in our room for now without traumatizing him and making him feel rejected?

Thank you so much for your support!

Ready to sleep alone.

 

If you’re beginning to think about making the transition to more independent sleep, now is the time to start preparing. Getting ready to make the move will take you much longer than actually making the move.

Make sure that your son is comfortable with the space you want him to sleep in, so set up the toddler bed and make sure he has plenty of awake/playtime there. Start small and increase the time as he gets more and more comfortable with it. You can play with him initially, but do work on moving away from the bed, you can do other things in the room as well as leaving for short periods of time. When he is comfortable with around 20 minutes you can work on making the change.

Make sure the mattress is on par with yours, if yours is super squishy and his isn’t he may have a tough time sleeping there as it is so different. You may want to buy a mattress topper or put a quilt or blanket on top of the mattress but under the sheet.

You could start with naps in his bed or just the beginning of the night. It is never an all or nothing when it comes to making changes to sleep, you can gradually make the changes. You just want to make sure you are being consistent with the changes. If naps are going to be in his bed, then naps need to be in his bed, especially when you begin to make these changes, changing venue one day to the next can be very confusing and unsettling and he could have a much harder time making the transition.

Good luck.

 

Co-branded Arms Reach- July 2016

 

My mother-in-law insists I’m spoiling my son by rocking him to sleep and then transitioning him to his own sleep space. Is this the case? He’s 6 weeks old and I just love this time with him snuggled up to me, I’m not ready to let it go. Am I ruining his sleep by doing this?

I appreciate all you’ve shared with us before, thank you!

Still Rocking

 

You are certainly not spoiling him, food spoils babies don’t! He’s only 6 weeks old, he’s just so new. I suggest you give him all the help he needs to get to sleep and enjoy those wonderful cuddles. When he goes through a really big sleep transition at around 12 weeks old (52 weeks from conception), he will sleep quite differently and at that point you may want to try for the elusive drowsy but awake, though I do feel that drowsy but awake may be an urban myth! Make changes when you are ready and enjoy those amazing snuggles.

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I love bed sharing, as a matter of fact I sleep better with him next to me and my partner and I love waking up with his smiling face between us but I have Problem …. Naps! I love laying with him but I cannot get anything done during the day because I’m stuck in bed with him. He will sleep without me for about 30 minutes but he needs more than that and I need to be productive! He’s 8 months and I can no longer spend a couple of hours in bed during the day. I want to do crib naps but he will NOT tolerate it as he will scream for 30 minutes with me next to him patting him etc. I don’t feel comfortable getting him to sleep and then sneaking away, in part because he won’t sleep long but also because of the safety of him alone in my bed is an issue, he wakes up silently and will crawl right off of I’m not there.

Thank you for your help!

Searching for a miracle Answer.

 

One day stay near him and watch him sleep as he naps, you need to know when he comes into a light sleep, this will be when he make a noise or moves and should be around 10 or so minutes before he actually wakes. Take a note of the time he begins to make those movements, that is when he is coming into a lighter sleep. At this point you want to be really hands on and help him back into a deeper sleep. This can take 10 minutes or more so don’t rush off. When he has got back down into a deeper sleep you can leave the room. The following day/nap you want to go back into the room a few minutes before you expect him to come into a lighter sleep, be hands on again, pat, shush until he is in a deeper sleep and then leave. As he gets really used to not waking up you can try leaving him and see if he can get through the sleep cycle without any help. It’s not a quick fix, but it is super gentle.

 

Be sure to check out Rebecca’s book Sleep And Your Child’s Temperament and don’t miss out on the opportunity to participate in her Sleep Academy here.

If you have a question you would like Rebecca to answer next time, leave a comment.

 

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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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small Rebecca Michi121

 

Rebecca is a Children’s Sleep Consultant who has been working with families for over 20 years. She is a gentle sleep consultant who doesn’t believe in leaving your child to cry-it-out when teaching them to fall asleep more independently. She is passionate about helping children and their parents build healthy habits so they can finally get some sleep. By transforming drama into dreamland, her mission is to help your children—and you—get a good night’s sleep.

Pregnancy Sonograms: What You Will Learn- Part 2

by Elizabeth MacDonald
This post made possible by the generous support of My Baby’s Heartbeat Bear
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This article originally published on mybabysheartbeatbear.com on November 10, 2015.

 

In the article “Pregnancy Sonograms and What You Will Learn, Part 1” we talked about the different kinds of ultrasounds and their purpose, ending with more detail about the general anatomy scan common around 20 weeks of pregnancy. In this article, we’re taking a deeper look at the types of scans done prenatally and the reasons why your healthcare provider may recommend them as a diagnostic tool. These scans can provide valuable information on the health of your baby when necessary.

MBHBB- Preg. sonograms, June 2016

Your doctor or midwife may recommend one or more of the following sonograms throughout your pregnancy, for various reasons. You may not know when you conceived or may have suffered previous miscarriages. You may be over the age of 35 and your doctor requires extra screening. There may be genetic reasons for extra scans, or a low lying placenta that could threaten a vaginal delivery. Your little fetus may stubbornly decide to lay transverse and a late sonogram is needed to see position. There are numerous reasons to receive sonograms other than the 20 week anatomy scan.

  • Dating Scan: A dating scan is an ultrasound examination which is performed in order to establish the gestational age of the pregnancy. If you or your doctor/midwife is unsure of the date of your last menstrual cycle, if you have had an bleeding, are unsure of when you conceived or your estimated due date, you will receive a dating sonogram. This ultrasound will show you exactly how far along you are, and can see the start of a pregnancy as early as 4 weeks and 3 days along (but some pregnancy cannot be seen until 5 weeks). You will see the beginnings of a gestational sac, but no heartbeat or further fetal development yet at this stage. An embryo and fetal heartbeat can be detected as early as 6 weeks and 3 days, but may not be picked up until further along. You will also know the location of your pregnancy. If there is a chance that it is ectopic, you will find out now. At this stage of pregnancy, the dating scan will be done transvaginally, meaning the ultrasound wand will be inserted into the vagina to see the pregnancy. A dating scan can determine the number of gestational sacs present (which may decrease by the end of the 1st trimester, if there is more than one). Your cervix, uterus position, and ovaries will also be seen, and you will learn if there is any visible clotting or fibroids. A sonogram done before 9 weeks will be the most accurate to use for dating the pregnancy.
  • Breakdown of what can be seen:
    • At 5 ½ weeks gestation tiny sac can be seen in the uterus, but the baby and its heart beat may not be detected yet. 5 ½ weeks gestation means 5 ½ weeks from the first day of the last menstrual period, which is usually about 3 ½ weeks from the date of conception (confusing, isn’t it!).
    • By 6 to 7 weeks gestation the fetus is clearly seen on trans-vaginal ultrasound and the heart beat can be seen at this early stage (90 to 110 beats per minute under 6 to 7 weeks, then 110 to 200 beats per minute as the baby matures).
    • By 8 weeks gestationthe baby and its heart beat can be detected relatively easily with trans-abdominal and trans-vaginal examination.
    • This is presuming that the pregnancy is actually at this stage of development.
    • Sometimes a trans-vaginal examination shows that your pregnancy is less advanced than expected.
  • 1st Trimester Scan (Also known as a NT Scan): Having a transabdominal sonogram between 12-13 weeks is performed to confirm your baby’s heartbeat and conclude first trimester screening for chromosomal abnormalities. The screening is optional for one or all of the following: Down’s syndrome, Edward’s syndrome, and Patau’s syndrome. Down’s syndrome is also called Trisomy 21 or T21. Edwards’ syndrome is also called Trisomy 18 or T18, and Patau’s syndrome is also called Trisomy 13 or T13. The screening test offered at 11-14 weeks is called the combined test. It involves a blood test and an ultrasound scan. If a screening test shows that you have a higher risk of having a baby with Down’s, Edwards’ or Patau’s syndromes, you will be offered diagnostic tests to find out for certain if your baby has the condition. In addition to screening for these abnormalities, a portion of the test (known as the nuchal translucency) can assist in identifying other significant fetal abnormalities, such as cardiac disorders. The screening test does not detect neural tube defects. The combined accuracy rate for the screen to detect the chromosomal abnormalities mentioned above is approximately 85% with a false positive rate of 5%. A positive test means you have a 1/100 to 1/300 chance of experiencing one of the abnormalities.
  • Level II ScanWhile technically the anatomy scan is a Level II scan, there are other reasons to come in for a Level II sonogram. During your anatomy sonogram, you will learn if another Level II scan is needed. Level II scans are reserved for higher-risk mothers, but may be used to rule you out of the high-risk category. Common indications for a Level 2 ultrasound include family history of birth defects, maternal medical problems associated with birth defects (poorly controlled diabetes, for example), exposure to medications associated with birth defects, a maternal age of 35 or older, abnormal serum screening results, and birth defects suspected on a Level 1 ultrasound. While there is no ultrasound that can detect 100 percent of serious birth defects, most birth defects that are undetected with a Level 2 ultrasound usually are clinically less significant (such as a small hole in the heart which commonly closes on its own after birth or an isolated cleft palate with intact upper lip which can be fixed surgically after birth without any long-term complications). A survey of your baby’s internal organs will be conducted, as well as:
    • The umbilical cord
    • Amniotic fluid
    • Location of the placenta
    • Fetal heart rate

The total score will help decide the overall health and well-being of your baby and help your doctor or midwife determine if your baby should be delivered sooner than planned.

  • Bpp Scan (Biophysical Profile)This sonogram combines an ultrasound evaluation with a non-stress test (NST) and is intended to determine fetal health during the third trimester. This test is performed if there is a question about fetal health and well-being resulting from either an earlier examination, maternal/fetal symptoms, or if the pregnancy is considered high risk. There are two parts to the BPP, a Non-stress Test (NST) and an ultrasound evaluation. The NST involves attaching one belt to the mother’s abdomen to measure fetal heart rate, and another belt to measure contractions. Movement, heart rate and “reactivity” of heart rate to movement are measured for 20-30 minutes. The ultrasound portion may take up to an hour, and the technician will watch for a variety of signs that are important in measuring the health of your baby. Usually, five specific fetal attributes are studied and “scored” during the BPP:

Biophysical Attribute- MBHBB 06.16

  • NST Scan: The Fetal Non-Stress Test is a simple, non-invasive test performed in pregnancies over 28 weeks gestation. As mentioned above, The NST involves attaching a belt to the mother’s abdomen to measure fetal heart rate, and another belt to measure contractions. Movement, heart rate and “reactivity” of heart rate to movement are measured for 20-30 minutes. A NST may be performed if:
    • You sense the baby is not moving as frequently as usual
    • You are overdue
    • There is any reason to suspect the placenta is not functioning adequately
    • You are high risk for any other reason

The test can indicate if the baby is not receiving enough oxygen because of placental or umbilical cord problems; it can also indicate other types of fetal distressThe primary goal of the test is to measure the heart rate of the fetus in response to its own movements. Healthy babies will respond with an increased heart rate during times of movement, and the heart rate will decrease at rest. The concept behind a non-stress test is that adequate oxygen is required for fetal activity and heart rate to be within normal ranges. When oxygen levels are low, the fetus may not respond normally. Low oxygen levels can often be caused by problems with the placenta or umbilical cord.

Many pregnancies progress just fine without ever having an ultrasound and health care providers use a wide array of skills and tests to ensure the safety and health of both the mother and the baby through pregnancy and birth. Having any of these scans done isn’t immediately an indication of a problem, it is just an opportunity to check. It is a gift to hear your baby’s heartbeat and see them developing, one to treasure. While it can be exciting to hear your baby’s heartbeat and to see them on the screen, the purpose of ultrasounds is to be an important tool in your prenatal care, not an entertainment experience. They may provide some answers to questions and concerns, reveal a potential problem or that everything is developing normally, and provide reassurance. Be sure you are using a reputable ultrasound technician to perform your scans, your healthcare provider should refer you to one they trust and use regularly if it is out of office. If you feel that a scan is unnecessary and are unsure you want to go through with it, be sure to speak with your healthcare provider about your concerns to better understand the purpose of the scan. If at any point there is something you don’t understand, speak up and let your healthcare provider know you have questions.

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me
Elizabeth is mom to four breathtakingly-beautiful children, and wife to one lucky man. She is a research writer, blogger, and a ghost writer of books.  As a natural-minded woman, Elizabeth takes pride in spreading factual information that may benefit other mothers and future generations.  She has spent the last seven years (and counting) growing babies in the womb and/or with breastmilk.  When she is not writing, she enjoys drinking wine, running, cooking, reading, homeschooling, and loving her family and friends.