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Category Archives: Lactation Support

Breastfeeding Health Literacy Survey and Questionnaire

Things are going great in our neck of the woods! How about you?

We are all working hard to get the public supported and educated on birth breastfeeding and more. One of our ladies is part of a food bank that just got started. She will hopefully soon start work on a diaper bank that will include classes on how to use and make cloth diapers!

I’ve been observing birthing classes in preparation to begin some pregnancy and birth classes in the future. That’s something I really want to get started but worry about my adequacy in teaching. I had some pretty quick births and I will have to learn a lot of things that need to be used or may be wanted during longer births.

I do need some help from you all out there, though. I’m trying to do a a quick “Breastfeeding Basics in Less Than 30 minutes” series. We will be starting the class as part of our breastfeeding support group for the Greater Valley area. We will do it once a month for 4-6 weeks. The key to making this work is focusing on the information that is needed most during those quick 30min, or less, lessons. You can help me out by filling out out this survey and then sharing it. Thank you so much for helping!

http://goo.gl/forms/bV1lCg5HoR

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Packing Your Pump Bag – Things to think about.

Things to Think About: Wall Plug: When packing your walk plug be careful not to wrap it tightly this can causing damage to the wires. (speaking personal experience here) Battery pack: If your pump comes with a battery pack cord go ahead and put new batteries in it and toss into your breast pump bag. I put […]

Pumping In Preparation of Returning to Work or School

Full 20 min pumping… and I still made it!

Getting Started

During the first 2 weeks, pump to relieve engorgement. Practice hand expression often, you never know when you might need to use the skill. Save the milk by storing these small amounts in closed containers in the refrigerator throughout the day. After you have pumped and refrigerated that last bit for about an hour you can then combine all the milk for that 24 hour period and freeze. Try to store the milk in 1-3 ounce portions for easier defrosting. Be careful not to overfill containers and bags, leave at least a one inch space at the top to allow the milk to expand during freezing, seal tightly, and lay bags flat in the freezer.

After about 2 weeks you can add pumping to your daily routine to begin building a stash. Think about the times your baby doesn’t need to nurse. During naps, sleeping a 3-5 hour stretch, or after an early morning feeding are good choices. Try to choose a time to pump that will be good for you every day. Once a day is fine to build a stash, if you are looking to increase your supply you may want to add 2 times.

Supply and Demand

Remember your body has been making what your baby has been demanding over the last couple of weeks. When you first add pumping to your daily routine you may get just a little, .25 ounces – 1 ounce, that’s normal. Again, just combine that milk with the above recommendations. After 3-5 days you will begin to see an increase from the extra demand of milk. You are tricking your body into increasing supply just a small amount.

Practice

By starting a couple of weeks postpartum or at least two weeks before you return to work you will give yourself time to learn how your pump works and how your body reacts to the pump. The pump is not your baby and you may be uncomfortable and/or feel clumsy handling it, its ok that’s normal. If you feel pain that is not normal and indicates that you may need a different size breast shield or that you are using a setting that is too high on the pump. Start gently slowly increasing to the highest setting that is comfortable. Practice putting everything together. Getting comfortable can decrease the stress during that first day back.

Duration and Frequency

Don’t time yourself while pumping read a book or watch TV. For best results keep an eye out on your milk and after that last drop of milk pump for a couple more minutes. When you have gotten into your pumping routine then time how long it takes to fully express your baby’s milk, requesting breaks that are about 5 minutes more that it took to express may be a good idea. Try not to pump less than 15 minutes or longer than 30, pumping a short time may not remove much milk or too long may cause breast soreness.

After you have returned to work you will need to keep up with your milk demand. Think about how often your baby is nursing. If your baby nurses every 2 hours ask to for frequent breaks, For example 15-30 minute breaks every 2 hours (one of these breaks could be your lunch time).

*If you are not covered by the ACA pumping break laws, or you are a student you may want to think about getting creative. Try keeping those extra pumping times that you started during your maternity leave, especially ones in the early mornings when prolactin hormones are highest. Pump as often as you can even if it is for just 5 minutes just to relieve any engorgement. You will probably want to look into co-sleeping and reverse cycling so that you are meeting more of your babies needs when you are at home rather than when you are away.

Lisa Horstkamp ©2014

How Breastfeeding Taught Me to be Me

How Breastfeeding Taught Me to be Me

mayjunejuly 039This is my story and our family’s journey to and though breastfeeding. The good, the bad, the ugly.

In 2008 I was pregnant with our first child, a son. At 18 weeks we found out that there was a problem. The baby had intrauterine growth restriction (IUGR). At 23 weeks 3 days when they found our son had not grown at all in the last month. I was admitted into the hospital, and placed on bed rest.

During our stay a NICU doctor came to speak with us. He asked if I was planning on breastfeeding. I said yes I wanted to try, my mother breastfed my sisters and I for a few months each, and that I knew it was best. He then said that breastfeeding was going to be the biggest deciding factor in my baby’s life that I had control over, because he was going to be very tiny and his entire system was immature and needing every chance for survival. He explained the condition NEC, something I had never heard of, and how breast milk could prevent it. By breastfeeding I could save my baby’s life. Sadly, only a few days later we found that my Son was no longer with us. Part of me died with him. I was induced and 14 hours later on Aug 15th 2008 at 25 weeks gestation my son Joel Robert-Lee was born at 11.5 ounces and 10.5 inches. His cord had become tied.

That NICU’s  Doctors comments on breastfeeding has stayed with me, and will forever.

A very short time later (to short). We found that I was again pregnant. I lived in fear every single day, but thankfully, my pregnancy was mostly normal. When I was 38 weeks pregnant I asked to be induced as soon as possible, because of the fear she would die inside me. At 38 weeks 6 days I was induced. First off, the hospital couldn’t find my test results showing I didn’t have strep B so I had to have antibiotics, then they started my pitocin, broke my water, I had a epidural at 7cm, and gave birth in 4 hours at 11:05 am. She was tiny, the doctor had made a guesstimate that her weight was around 7 pounds, he was wrong. I remember him saying “she’s small”. She was only 5 pounds 9 ounces and 18 1/4 inches.

I was an emotional mess, talk about post traumatic stress. I couldn’t stop crying. I was so sad, so happy, and filled with so much fear. I could hardly hold her, all I saw was my Joel, but I didn’t want to let her go. My husband held her for most of the time before she was taken to the nursery. I didn’t nurse her when she was born, and I wouldn’t be able to for 5 hours, because the nursery nurses took so long to bring her to us. She latched fine, but ended up with jaundice (a “pit.” birth and delayed breastfeeding I’m sure had a lot to do with it).

I had no information, no Lactation consultant, and no one who knew anything about breastfeeding exclusivity. At 2 1/2 weeks we added formula per the pediatrician, because I felt like she wasn’t getting enough food. The pediatrician did nothing to sooth my fears. I returned to work early, because of many things, but I pumped 3 times during work for 15 minutes each. I would breastfeed her and give her bottles. For the first 2 1/2 months I slept in her room in a bed with her and breastfed through the night. Eventually by 2 1/2 months she slept through the night and I could no longer have that time with her. The pediatrician had advised us to use Enfimil AR and that I was to only pump and add rice cereal to each bottle. At that point I stopped the actual act of breastfeeding, and at 4 months we added food per that pediatrician. At 5 1/2 months I threw in the towel. I felt like my body had failed me again.

Then in January of 2011 I found out that I was pregnant again. This time I had to use another Doctor and hospital. I educated myself about breastfeeding. I read and read on low supply and what to do. Then 13 days before our son was due I went into labor suddenly at 3:33 am. I didn’t think it was real labor because it didn’t hurt enough. I had two previous induced births and the natural contractions in my mind weren’t hard enough to be real labor. I went to sleep and awoke again after 6am. We went to the hospital, we arrived at 7:00 (on the dot according to the clock in the car. At 7:19am naturally, unmediated, and very quickly I gave birth to my 2nd son. He was 6 pounds 8 ounces and 20.5 inches long. The nurses cleaned him and took his vitals. Suddenly, they realized and asked “Are you breastfeeding” I answered an ecstatic “yes!”. She apologized and brought my son to me. I held and fed him for the first time, and we connected. He and I laid there I’m not sure how long. I healed during that time. He and I looked at each other and I thought of my other two children. I talked to God. I knew what had happened with my daughter at that point and I remembered how long it took for us to “connect”. I regretted her birth. I had taken it away from her. I didn’t trust Her, my body, or God. Her birth was the first mistake I made in our breastfeeding journey and as her mother. I felt so sorry I could not give her what was best nor had I been able to give her all of me. I made a promise that I was new. I had lost part of me but I found a new part and a much stronger person.

My son was Exclusively breastfed from 3 weeks until 6 months. I and my husband gave some formula around 3 weeks for fear he was hungry. At that point I sought out help, and started to attend weekly support group meetings. I was educated about “The Virgin Gut” of a newborn, and I threw out all the samples that we I had been “gifted”. I met many moms and learned so much. I, also, got a few friends. They were and are blessings.

For my whole pregnancy I had prepared a long maturity leave. I enjoyed both my children during that time. At 11 weeks postpartum I returned to work on the Thursday before thanksgiving. I took pumping breaks every 2 hours for 20 minutes each. the next week of course was only a 3 day week (perfect planning). Things went well and mostly as planned for a couple months.

Then my son and I got sick when he was a few months old with RSV. My daughter had cought it and so lovingly brought it home to share. He quickly wasn’t able to nurse properly and that effected my supply. I started supplementing with my own stored milk with a syringe at my breast. First, I tried fenugreek, then goats roe with the fenugreek, finally I got a prescription for Domperidone. I had enough milk to supplement 3 days while I was at work. By the next Thursday if  it didn’t work quickly I would have to find donor milk, or use formula. I started friday morning, Saturday woke up and nursed and pumped like a crazy woman the whole weekend. By Monday I woke up with the “full feeling” and i knew it had worked like a charm. I used Domperidone from about 5 months till my son was 10 months when his food intake was enough for me to risk slowly stepping down off of Domperidone. Finally, at 10 months I was starting to collect 4-6 ounces of extra milk a week so I began extending the time between my pumping breaks to every 2.5 hours, as well as weaning off domperidone.

I was eventually given the opportunity to donate that extra milk to a beautiful adopted baby girl of a woman in our support group. The mom was inducing lactation and wanted her baby exclusively breastfed, if possible. Later I donated to one other child. I ended up pump at work for 22 months to help provide milk for those other children. I’m still amazed I went from perceived Low supply to real low supply all the way to milk donor. I never thought I would get there.

Our pediatrician, Bless her heart. I think I will call her Dr. “breastfeeding is never complete nutrition”, the same one who recommended formula at 2 weeks for My daughter continued to be our pediatrician. Dr. “BF NcN” tried pushing me to add baby cereal at 4 months. I flat refused stating that the AAP, CDC, and WHO said to wait till 6 months. At around 6 months I would not add baby cereal, but I would add “real” foods. He didn’t need the cereal according to the research I had read. Dr. “BF NcN”s response? “hummph”, yeah cocked her head to the side and poked her lips out and everything. She then stated that if the mothers Iron is low then so is the babies. That the cereal was needed to add that iron that the mother was lacking, and told me I was going to give him rickets that will cause bone defects and anemia that would cause him to be learning disabled. In my head i was thinking “So you are telling me  Human milk isn’t enough for a human? nor is it full nutrition? That I’m a bad mother? or both? I informed her that I had given blood only a week before and that amazingly enough my iron level was great! That when we went to WIC for his 3 month check-in his iron was great, too. She had nothing else to say. Needless to say we didn’t go to the next visit and we scheduled the 12 month appoint with a new doctor. I did make it to magical 12 months. I then set a new goal of 24 months. After pasting that goal the last goal was till he was done. My son nursed 33 months, 3 weeks, and 1 day.

My son is beautiful, strong, has straight legs, and has no learning disabilities. Contrary to what poor Dr. “BF NcN” warned I would cause by exclusively breastfeeding past 4 months.

More than nourishing my children breastfeeding made me a better parent in the end. It set me out on a journey that has given me strength that I never knew existed in me. It changed me forever. I know now that I did not fail at breastfeeding my daughter, I did breastfeed her. What happened is I didn’t meet my goal. I’ve learned to set reachable goals for myself and my children. I’ve been taught that not reaching a goal isn’t failure, but not reaching a goal is a learning opportunity in itself. Life doesn’t always go our way. You have to learn from your mistakes, and those of others, to find a new way.

Ten Steps to Successful Breastfeeding

Have you ever heard of the Ten Steps to Successful breastfeeding ? Seen them? Read them? Know them? love them?

Here they are if you have never seen them, or just need a refresher:

The Ten Steps to Successful Breastfeeding are as follows:
1. Have a written breastfeeding policy that is routinely communicated to all health care staff.

2. Train all health care staff in skills necessary to implement this policy.

3. Inform all pregnant women about the benefits and management of breastfeeding.

4. Help mothers initiate breastfeeding within a half-hour of birth.

5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants.

6. Give newborn infants no food or drink other than breast-milk, unless medically indicated.

7. Practice rooming-in—allow mothers and infants to remain together—24 hours a day.

8. Encourage breastfeeding on demand.

9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

When I gave birth to my children these were not being followed in the hospitals I birthed in, though one hospital did better at helping me meet my personal breastfeeding goals than the other.

With my first I got #3, #8, #6 waa waa waaa
With my second I got #3, #4, #6, #8, #10

Number 10, oh number 10, I can’t say enough about number 10. The support group at the hospital I gave birth to my son at was a life saver. It helped me establish relationships with other breastfeeding moms, and know that I was not alone. I Learned what mistakes I had made, whether in my control or outside of my control, and what to do.I feel that I made life long friends. I completely and wholeheartedly know that without them I wouldn’t have met my goals. The friends I made have different breastfeeding stories and we all had different issues and breastfed different lengths of time, but we supported each other! We messaged on social media, we posted to each others accounts, and we watched our children grow. Now we are all are breastfeeding counselors looking to make a difference in others moms lives, and support their goals.

I’m most likely done having children, but it doesn’t take away the passion I developed over 33 months of breastfeeding and nurturing my son at the breast. They are not finished with their families and I will be there for them when they expand and have there 2nd children.

In America many of our Grandmothers and mothers were told that they couldn’t breastfed or shouldn’t breastfeed for the last 60+ years. In so many cultures the family is the support group. The family says “hey, is that latch comfortable? that baby is only on the tip that’s going to hurt!” or “yeah, newborns nurse a lot that’s totally normal, you’re doing great!!” For many our families don’t know how to breastfeed, or tried and were given terrible information. Support groups are important to grow our generation back into breastfeeding being the norm.

P.S. Thanks Girls

NICHQ Launches Unprecedented National Effort to Increase Breastfeeding Rates in US Hospitals

Newborn child, seconds after birth. The umbili...

Newborn child, seconds after birth. The umbilical cord has not yet been cut. (Photo credit: Wikipedia)

http://www.nichq.org/who_we_are/in_the_news.html?id=80

http://www.nichq.org/our_projects/cdcbreastfeeding_participating_teams.html

I’m so happy about our local hospital getting a grant to help them work on becoming baby friendly. The first link here is the press release and the second is the list of 90 hospitals across the nation getting the grants.

I have spoken once before about the Baby Friendly Hospital Initiative. A hospital taking the BFHI steps will help so many more Momma’s and babies get to have the wonderful bond and relationship of breastfeeding.

No breastfeeding is not always easy or beautiful and some times it does down right hurt (thanks to new teeth). I have never heard a woman say “I wish I had formula fed” but I have heard many say “I wish I would have”… “tried”…”not stopped”….”had milk” (don’t get me started on that one)….”know more and had more help”. When a hospital takes these steps to becoming a BFHI many of these statements and pit falls could be avoided by many.

My hope and wish is for every mother to at least try to breastfeed. I would love to see that the U.S. not only meet the goal of have 75% of babies born in the U.S. to start out breast feeding But to exceed that and have 90% of babies start out breastfeeding and 75% still exclusivity breastfed at 3 months. Now that is a goal to have!

Do you know how much newborns need?…

Do you know how much newborns need?…

5-7ml. Most of the time they are spending at the breast is for them to learn how to latch and to stimulate your body to produce more milk.

They are also nursing often in the beginning for comfort. Just imagine how tired they are after birth and if it was long or hard then they need time. Un-swaddle them, lay them on your chest, ask for a warm blanket, and if they don’t do it on their own don’t worry give them time. The hour after delivering my son was wonderful. That first hour after birth is so amazing. They are learning what you smell like, feel like, and how your milk tastes. They realize this taste just like home! because your colostrum tastes like your amniotic fluid they are used to. Take the time to fall in love with your new baby. They are wonderfully made, aren’t they?

P.S. Even if you don’t want to breastfeed your baby have them lay on your chest skin to skin. Let your new baby learn your smell and how you feel. You both need time to meet each other.

Lisa Horstkamp, CLC