Introducing a Bottle to Your Breastfed Baby
Many mothers will need to utilize an alternative feeding method at some point during their breastfeeding journey.
It is not uncommon as a breastfeeding mom to worry about your nursling biting even before they develop any teeth. Be reassured you can continue to breastfeed throughout teething and beyond. A baby may bite during feeds for various reasons. These can include teething, discomfort, distraction or fast milk flow. Read on for some helpful tips regarding what to do if your baby bites while nursing.
If your baby bites you at the start of a nursing session, they may have discomfort from erupting teeth. Offer your baby a cold teether prior to nursing to help numb their gums. A frozen washcloth can also be used. A baby may also bite at the start of a feeding session if mom has a fast or forceful let down of milk. To help remedy this feed your baby in a more upright position such as koala hold or football hold. You can also apply gentle compression with your hand above your areola to slow milk flow.
If the biting occurs at the end of a nursing session, your baby may be distracted or simply done feeding. To help with distraction try nursing in a dark, quiet room or while the baby is drowsy. Avoid having the tv on or looking at something else besides your baby. You can also wear a baby safe teething necklace during feeds to help keep your baby’s focus on the breast.
If you sense that your infant is about to finish the nursing session, take them off the breast before biting occurs. A baby that has an effective latch and is actively feeding will not be able to bite. The best way to prevent your baby from biting is by watching intently during the nursing session. If your baby appears disinterested or his sucking and swallowing slows, this may be a sign that your baby is done. Unlatch your baby at this point. Be sure to use your finger inside of your baby’s cheek to break the latch. Avoid pulling your baby off the breast.
If your baby does bite, there are a couple of things to do to discourage it from happening again. First, calmly remove your baby from your breast and say nothing. This should send the message that biting leads to ending the nursing session. Offer your baby a teething toy to bite on when you remove her from the breast. You can also calmly say something like “Okay. All done nursing.” Try to avoid yelling or wincing out loud. Depending on your child’s age this may either scare them into a nursing strike or if they are older, they may think this is funny and turn it into a game. Give your baby a few minutes to rest and try to offer the breast again.
If your child bites you and will not let go you can try to sneak your finger into their mouth and unlatch them by putting pressure on their gums with your finger. You can also try to pull your baby in close which makes it slightly more difficult to breathe which will in turn have them open their mouth and pull off the breast. Watch for any signs of nipple damage and treat your nipples as needed to avoid infection.
If you are having issues with biting during feeding sessions contact The Care Connection either by phone 716-725-6370 or by email at firstname.lastname@example.org to speak with one of our IBCLCs.
There are many reasons as to why or how long a baby needs to be in the Neonatal Intensive Care Unit or “NICU”. Some babies only need to be monitored for a short period whereas other babies need extended stays. Either way, you can still provide your baby with the best nourishment possible, breastmilk. This is a contribution to the infant that only the mother can provide. If mom’s own milk isn’t available, donor milk is the next best option. There are many resources available to obtain donor breast milk. Ask your NICU staff or call The Care Connection so we may better direct you.
Each baby’s scenario is unique to them but if your baby was born preterm, or before 37 weeks gestation, they may have additional obstacles related to breastfeeding. Babies need to be able to coordinate sucking, swallowing, and breathing to breastfeed. This typically happens around 32 to 35 weeks gestation. A preterm infant will not have as forceful of a suck. Therefore, mom may need additional stimulation to help increase milk volume. Frequent skin to skin care as permitted by the neonatologist is very important. Some infants as early as 28 weeks gestation may be able to lick expressed milk from mom’s nipple. Be sure to discuss when your baby can have oral feeds with your neonatologist.
Preterm breast milk is designed specifically to protect your premature infant for life outside of your womb. It has a higher concentration of calories, lipids, high nitrogen protein, sodium, chloride, potassium, iron, and magnesium compared to full-term breastmilk.
So, what can you do to encourage a full milk supply? Depending on your own health, it is ideal to start stimulating the breasts as frequently as your infant would, which is about 8-12 times every 24 hours. Using a hospital grade pump is highly recommended as this is one of the best ways to insure adequate stimulation in the early stages. Your NICU should be able to provide this pump for you but you may need to bring your own tubing/plastics with you at each visit. You will want to pump both breasts simultaneously for 15 minutes. Once milk has stopped flowing, try hand expressing to further empty the breast. This technique is very effective in helping to increase milk production. Warm, moist heat or a warm rice sock applied to the breasts prior to pumping can also help increase output.
Another key factor is to make sure your flanges fit well. An improper fit can negatively affect your milk supply and cause nipple trauma. Request to have your flange fit checked by a lactation consultant. Pain, pinching, or discomfort while pumping is not normal. Your nipple should move freely within the tunnel of the flange. If you have questions you can also get measured for the proper flange fit at The Care Connection.
Along with any other breastfeeding mother it is important to avoid things that are known to decrease your milk production. These things can include smoking, caffeine, birth control pills and injections, decongestants or antihistamines, and extreme weight loss diets. Excessive amounts of oregano, parsley, peppermint, and sage can also impact supply. Discuss any supplements or medications with your neonatologist prior to taking.
It is important for any infant, especially an infant in the NICU to avoid any possible bacterial contamination to breastmilk. This can happen with collection and storage. Prior to pumping wash your hands thoroughly including under your fingernails. Wipe your nipple area with water only (no soap). Plastic bags are not recommended for milk storage for preterm infants. Ask your NICU staff about the use of Snappies for milk storage. These are hard, plastic, leak proof storage bottles that are free of BPA. When milk collection is finished, wash all pump parts thoroughly with hot soapy water and rinse. Sterilize pump parts/collection bottles at least once a day. Be sure to label all expressed milk with labels printed from your NICU. If they do not provide you with labels make your own that includes your child’s name, date of birth, medical record number, and date and time of pumping. Check with your NICU staff about their current recommended storage guidelines.
Once your baby can start feeds at the breast, ask for a lactation consultant in the NICU to assist you in latching your baby to your breast.
Finally, having a baby in the NICU can be a challenging time for anyone involved so make sure to take care of yourself. Join support groups or speak to other NICU families. A follow up appointment with a lactation consultant after hospital discharge can also be very beneficial. If you have any questions or concerns or would like to speak to a lactation consultant contact The Care Connection by phone 716-725-6370 or by email at email@example.com.
If you are exclusively breastfeeding and your baby is not meeting the minimum weight gain requirements or is having difficulty transferring milk at the breast it may have been recommended by your pediatrician to supplement your baby. Ignore that mommy guilt, you are still doing a great job! There are probably as many opinions about how to supplement your baby as there are lactation consultants themselves. Each method has pros and cons.
First off, if you have any breast milk in your refrigerator or freezer, use this milk first before formula. Your baby needs it more than the freezer does. There may be other opportunities to replenish your stock pile later. If you have a very young baby and do not have any milk stored formula may be initially advised. Another option is to mix breastmilk with formula for supplementation if you have a small amount stored. Rest assured this is usually a temporary measure until your milk production increases. Be sure to discuss a plan for supplementation with your pediatrician and IBCLC including how much you should give and how often. Regular weight checks during this time will help to gauge when supplementation can be decreased. Gradually weaning down on the amount/frequency of supplementation while continuing to monitor baby’s weight and diaper output is usually the best course of action.
Whenever your baby gets any form of supplement away from your breast, you need to be stimulating your breasts by pumping or hand expressing. This goes back to the supply and demand of breastfeeding. Extra stimulation is demanding your body to make more milk.
A supplement does not always need to be given in the form of a bottle. If your baby has not taken a bottle yet and a supplement is needed, ask an IBCLC about options available to you. Often times if a bottle is introduced early on, especially if baby is having difficulty nursing at the breast it can pose complications. A baby can become used to the fast flow of a bottle and refuse the breast. Some babies may also start to prefer the firm shape of a bottle nipple over mom’s soft breast. Let’s review several of the options you can use to offer a supplement to your baby. One option is a Supplemental Nursing System, also known as an SNS. This device allows the baby to be fed extra milk through a small tube while latched onto your breast. If the SNS is not an option for you, your baby can be supplemented by giving breastmilk in a cup, spoon, oral syringe, or by finger feeding. Finger feeding is a method where your baby gets extra milk through a small tube attached to your finger while they suck. You may find that you need to try out several of these options to find the best one that works for you and your baby.
If a bottle is the only option for you and your baby, the best way to offer it is through paced bottle feeding. Please refer to one of our previous blog posts for further details on paced feeding.
Remember, supplementation may be a temporary situation. It is important to choose a supplementation method that is the most comfortable for you to prevent yourself from getting “burned out”. Call the Care Connection at 716.725.6370 to talk with an IBCLC to explore which option may be best for you and your baby. We can work through this together!
Presently one-third of babies born in the United States today are delivered by Cesarean or C-Section. This is a major surgery and can pose an extra set of challenges for moms to get breastfeeding off to a good start. We hope that the following tips will help you in your breastfeeding journey.
Many hospitals are improving skin to skin contact for moms and babies. If possible request that your baby be placed skin to skin in the operating room while your surgery is completed. Studies show that skin to skin contact can help stabilize baby’s temperature, respirations, glucose, and babies often feed better at the breast. Have a partner do skin to skin if mom is not able.
Breastfeed your baby as soon as possible after delivery, preferable in the recovery area if able. Breastfeeding early and often will help bring in a full milk production. Request help from the hospital lactation staff and/or your partner to assist with positioning. Position yourself first with pillows then have your support person help you get your baby in a comfortable position. Don’t hesitate to use plenty of pillows to support your baby and protect your incision. Football hold can be the most comfortable for moms after a C-Section birth as it keeps your baby away from your incision.
If you are separated from your baby or have difficulty getting your baby to latch in the hospital, request that a hospital grade breast pump be provided for you. Have the hospital staff educate you on its use. Early stimulation to your breasts will help bring about a healthy milk production. Should your baby need to be supplemented request that this be done via a cup or syringe and not a bottle. Discuss supplementation with your baby’s medical provider. Try to avoid the use of artificial nipples or pacifiers until breastfeeding is well established. Most moms feel their milk come in around day 2-6 postpartum. However, stress from surgery, pain, medications, and excess fluid can delay this process. Therefore, it is very important to seek support from a lactation consultant soon after delivery.
Your recovery postpartum will also be much different than a vaginal birth. A C-Section is major abdominal surgery. If possible plan on having your partner take an ample amount of time off work to help. An extra set of hands to assist you with positioning and lifting your baby will be very beneficial. In addition, your support person can prepare meals, do housework, and assist with various other needs you or your baby may have. It is also very important that you take pain medications as directed by your provider. Stress and pain can influence your milk let down and production.
If you’re having a scheduled cesarean birth you will have the option to discuss some of the above-mentioned issues with your physician prior to surgery. It is important that you discuss anesthesia, pain medications, skin to skin contact with baby, and having baby feed soon after delivery. Knowing that you and your physician have a plan in place will help ease your mind prior to surgery having a positive impact on your breastfeeding experience.
Should you have any concerns about having a C-Section and breastfeeding please contact The Care Connection at 716-725-6370 to speak with on of our lactation consultants.
Traveling for vacation or work? This post will help address some concerns you may have for travel with and without your baby.
If you’re traveling with your baby bring along a nursing cover to help give you privacy in a crowded, busy place. This can also help with nursing an older baby as they may be easily distracted by things around them. Many nursing covers can also double as a car seat cover, high chair or shopping cart cover.
When traveling by plane, breastfeeding during take off and landing can help ease pressure changes that may upset your baby. Sucking at the breast can help relieve pain in baby’s ears associated with flying. Look for “nursing pods” in airports if you would feel more comfortable nursing or pumping in a more private setting.
Do the best you can to stick to your baby’s feeding routine, watching for hunger cues. This will help to maintain milk production and prevent problems such as blocked ducts and mastitis.
If you’re going to be traveling without your baby be sure to maintain a pumping schedule. Practice hands on pumping. Look at videos or pictures of your baby, or sounds of your baby crying to help your milk let down. Bringing along an article of clothing your baby has worn (and smells like them) to keep with you during pumping can also help your milk to let down.
Your breastmilk can be stored in an insulated cooler with 3 frozen ice packs for 24 hours as long as it remains below 60 degrees Fahrenheit. Breast milk can be left at room temperature for 4-6 hours at temperatures below 77 degrees Fahrenheit. If you have refrigeration available to you while traveling, your milk can be stored here for up to 5 days below 39 degrees Fahrenheit. Always make sure the refrigerator is plugged in and running before leaving any breastmilk in it. However, it is best to freeze your milk within 48 hours if you do not plan on using it right away. You can consider packing it in dry ice for transport to keep it frozen.
Another option for moms traveling without their baby is to ship collected breast milk to their home. FedEx is one company that offers this service. You can find out more by visiting: http://images.fedex.com/us/healthcare/pdf/Cold-Shipping-for-nursing-working-moms.pdf.
For moms concerned about traveling by plane with breast milk the TSA states you are allowed to bring any amount on board. Breast milk is not subject to the 3 oz liquid limit, regardless of whether your baby is with you or not. You will need to declare your breast milk upon security screening. Visit tsa.gov for more details.
Please contact The Care Connection at 716-725-6370 should you have any additional concerns regarding traveling and breastfeeding.
Having concerns about your milk production and whether or not baby is getting enough are common especially in the early days. Here are some things that you can do to ensure a good milk supply and help you in your breastfeeding journey.
Here at the Care Connection we see mothers for a lactation consultation for many reasons. Concerns with milk supply, latching, supplementing, nipple pain, and positioning just to name a few. During your 1 hour one-on-one visit we can address feeding concerns and any questions you may have in a comfortable, private setting. At the end of your visit with us we provide you with a take home plan to best suit your needs. Below are a few recommendations to help you best prepare for your appointment with one of our lactation consultants.
1. Feeding: We recommend scheduling an appointment around a time when baby normally feeds. Or at the very least try to avoid giving baby a full feed within an hour of your consult. However, we realize that sometimes this can be difficult, and baby may not be on any predictable schedule. If baby is ready and eager to feed when you arrive we will address that first. If not, we will talk first and work on developing a plan, then work on getting baby to the breast.
2. Clothing: Please wear something that you are comfortable in (even if this means pajamas!). Nursing tanks, nursing bras, or a shirt that opens down in the front provides easy access for feeding or skin-on-skin with baby.
3. Equipment: If you have been using any tools to assist with feeding baby like a nipple shield or a bottle please bring them with you in case we need them during your visit. Also, if you have been exclusively pumping or pumping after feedings please bring you pump with you. This way you can empty your breasts after the consult if necessary. It is helpful to see what you have been using to assist with feedings and discuss what may work best for you.
4. Supplements: If you are currently giving baby any supplementation or have been advised by you pediatrician to do so please bring this with you should we need it during our consult.
5. Questions: Please write down any questions you may have and bring to your appointment. This allows us to be sure that we address all of your concerns in a timely manner. Our lactation consultants are also available by phone for any questions or concerns that may arise.
6. Significant other or support person: As long as you are comfortable, bringing a support person to your consult is fine! Sometimes this person can take down notes for you and may remember things that you forgot when you get home. The more support you have to continue your breastfeeding journey the better!
7. Siblings: If you have other children it is best to find someone to care for them during the 1-hour consult. If this is difficult for you, please bring along something quiet for them to do in the room while we are working with you and baby. Bringing along a snack for them works well too!
8. Follow up: Depending on the outcome of your visit we may ask that you come back in for a follow up appointment. This will be scheduled at the end of your visit to best suit your needs.
If you need a consultation, please call The Care Connection (716.725.6370) to set up an appointment. Your health insurance may even cover the cost! Call today to get scheduled.
Warm, sunny days have finally arrived and summer is upon us! Along with this brings up some questions or concerns that may be on the minds of breastfeeding moms. Let’s discuss a few common questions.
1. Can I use sunscreen when breastfeeding? Yes. Applied topically, a minimal amount is absorbed through the skin that passes into your blood stream and then into breast milk. Avoid application around the areola and nipple so that baby does not directly ingest. Always clothe (hat, long sleeves)the baby and yourself to protect both of you from the sun
2. Insect repellent: Per the Centers for Disease Control no adverse reactions have been reported in breastfeeding moms using insect repellent containing DEET.
3. Self tanning lotions and spray tans: Both of these are similar to applying sunscreen and minimally pass into breast milk. Be sure to wash off your breasts if applied to this area to avoid direct ingestion by baby.
4. Pools: Swimming in a chlorinated pool is fine. If baby is swimming in the water with you he will ingest more chlorine from the water than breastfeeding. Public water systems that provide us with drinking water are also chlorinated. If you are still concerned you can shower or wash your breast with fresh water prior to feeding baby.
5. Hot tubs: Be sure that the hot tub you are using is clean and well maintained. Practice usual precautions as hot tubs can breed organisms causing a variety of issues such as skin rashes/infections, digestive infections, and urinary tract infections.
6. Hair removal: Laser hair removal and electrolysis are both compatible with breastfeeding. Topical hair removing creams are also safe, but be sure to avoid applying to nipple and areola.
7. Hair dyes/relaxers: No evidence has been found that any of these causes harm for breastfeeding infants.
8. Hydration: It is very important for your milk production to remain hydrated. Try to drink mostly water, drinking to thirst. Carry a water bottle with you in your diaper bag.
Have a safe and enjoyable summer. As always be sure to contact The Care Connection at 716.725.6370 to speak with a lactation consultant should you have any breastfeeding questions or concerns.
Being a mom of a newborn or just being a mom in general has its challenges. It is very easy for moms to put all of their time, energy, and focus on their children and forget about their own needs. It is very important to take care of yourself not only for you but for your children too. In celebration of Mother’s Day checkout these tips below on how you can improve caring for yourself.
1) Sleep. This may be one of the most challenging concepts for moms. In fact, you probably just laughed when you read that sleep was number 1 on the list. But it’s true. When you lack needed sleep it not only affects your physical health, but your mental health as well. This is why you hear the common phrase “sleep when your baby sleeps”. Sleep deprivation also raises your stress hormone, which can negatively affect breast milk production and let down.
2) Diet. Many moms forget about the importance of their own nutrition. Sometimes they tend not to eat as healthy while caring for a newborn or may skip meals altogether. Take advantage of the offered help from friends and family and ask them for healthy meals or snacks. It may help to keep healthy snacks around your breastfeeding “spot” so you can quickly grab some while nursing. Some good ideas for healthy snacks can include nuts, fruit, and cheese. It is also okay to occasionally splurge on one of your favorite less healthy snacks too. You deserve it! Some places offer grocery delivery if you and Dad are finding it difficult to get to the store.
3) Fluids. Along with diet, it is sometimes tough to keep track of your water intake. Treat yourself to a new water bottle if it means you will drink more water throughout the day. Keep your water bottle with you wherever you go. There are also many apps that you can use to help track your water intake throughout the day. For those moms that find it hard to drink plain water try adding some fresh fruit to change up the flavor.
4) Fresh air. Especially if you live in the Buffalo area you know the importance of getting fresh air. Take advantage of warmer weather and bring your baby for walks. For younger babies you may want to consider a strap on baby carrier or sling to keep baby close to you. In inclement weather try locating a mommy and me yoga class or perhaps a workout center that provides onsite child care. Not only will this help you get some good Vitamin D and exercise, getting some fresh air can help with your mental health too. Even if you are not up for taking a walk yet, just sitting outside is helpful.
5) Me time. In between feedings, have someone else look after your baby so you can get some time to yourself. In the beginning this could be just sitting outside alone, reading a book, taking a relaxing bath, or even taking a trip by yourself to grab those diapers you need. As you feel more comfortable take some time to do the things you enjoy. Go out to lunch with friends, go shopping, or get your hair and nails done. You may end up talking about your baby the whole trip and that is okay! Know that you are doing such a great job. You have dedicated your whole self to your children for the entirety of their lives. Don’t feel guilty spending time on yourself. We encourage it!
Stop by The Care Connection and checkout all of the treats we offer for moms from nursing bras, tank tops, lactation tea and snacks! We hope that you all have a very happy Mother’s Day!
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