Lactation support thread

I'm not a lactation consultant. I am not affiliated with the La Leche League (yet).

I'm just a mom with a baby who happens to really enjoy speaking openly about lactation.
This thread exists for me to toss all sorts of useful tips that I want to share with my friends here who are also considering breastfeeding and/or pumping, and to field any questions that my friends (you, tilted forum friends) might have on the topic.

For starters, here's something that I recently wrote up in a PM.



First things first. When lactating you will need:
- nerves of steel
- ibuprofen
- prenatal/postnatal vitamins
- a solid pro-breastfeeding/pumping support network
- determination

Things I couldn't do without during those first 2 weeks:
- stretchy nursing bras in ludicrous sizes I never thought I'd wear (buy a bunch, keep tags on until you know what you need. Oddly enough, my favorite bras came from Wal-Mart)
- a bunch of button-down shirts and cardigans, a bathrobe, button-down nightgowns, or otherwise easy-access super-comfy clothes.
- super thick disposable nursing pads (change them whenever they're a little moist or you'll risk getting thrush. Once milk supply established around month 2, washable nursing pads work great and are cost-saving)
- comfy socks and/or slippers
- nursing cover to use around the in-laws
- someone to help with cooking and laundry (my MIL lived with us the first month, but would have been a-ok to have a friend stop by once or twice a day to help out)
- an exceptionally supportive husband who was utterly in love with my baby and excited about this parenthood thing
- a safe co-sleeping set-up in my bed
- a neck pillow
- a pillow for nursing, such as the cuddle U pillow
- cocoa butter and lanolin for aching, bleeding, hamburger-looking, or otherwise abused nipples

Things you can do to build a healthy supply:
- eat oatmeal every day, mix in milled flaxseed and brewer's yeast
- stay hydrated (1 liter of water each nursing/ pumping session)
- be prepared to nurse every 2 hours around the clock. If you choose to pump and have someone else feed for some of those feedings, it works really well - but be careful not to do this too often if you notice that you're starting to develop a burdensome oversupply - unless of course you want to pump your heart out for the first few months, stop lactating early, and make it to your goal using the stored breast milk. Most lactation consultants don't recommend pumping until your supply is well-established through breastfeeding alone. But I think it's a bunch of hooey and just want my kid fed, dangit!
- nursing support/lactation support herbal tea. I really love Yogi Woman's Nursing Support. Other moms swear by Mother's Milk. I prefer the Yogi brand because I like the flavor better. I steep a mug of it before every pumping session and gulp it down along with my water. The fennel in the tea makes letdown easier.
- massage your breasts while pumping/feeding. Here's a great tutorial on how to do it while pumping, there are a bunch of other great resources for nursing moms on that site, too.

Things I always keep in my pump bag for work:
- extra bottles and lids, or milk bags for freezing.
- my double electric pump
- tubing
- 2 valves with membranes, 2 connectors, and 2 shields (assembled and ready to go)
- extra membranes
- a microwave sterilization bag
- hands-free pumping bra (Simple Wishes or Medela)
- nursing cover
- coconut oil (to lube the shields)

There are so many other things I want to share!

 

Today I think I'll add a few tips for hand-expression...

For me, hand expression takes just as much time as a pumping session. To empty both breasts, it takes a little under a half-hour, but with more practice it might take less time. It is often hard on the hands so it's not something to replace pumping, but it gives my nipples such a wonderful break, I'm going to start doing it more often.

• Moisturize your breasts before you get started so you're less likely to rub your skin raw. Having a lot of lotion on the breasts while hand-expression tends to hinder the application of sufficient pressure, but moisturizing one breast thoroughly then allowing the lotion to soak in while working on the other seems to work best.
• Have an easy-to-hold container with a wide lid. Making the container even wider with a funnel works even better. If you use a narrow container with a funnel, you may find the milk bounces out and makes a bit of a mess. A little description of my setup: A friend had given me a milk storage kit with a bunch of avent pump adaptors The narrow end of these adaptors fit snugly into the top of a tommee tippee bottle, allowing for the wide side to have an even wider lid. It was just right for collecting the milk, and I could just remove the funnel, screw on a nipple, and feed it to my daughter immediately.
• While expressing, hold the container with one hand and work your breast with the other. Push the milk out. Make sure you move smoothly from back of breast to the areola. At the areola, do a double-press motion and adjust the angle to maximize flow. At first, nothing may come out, but after a few strokes you'll find that the milk starts flowing quickly. The harder you press, the faster the milk will work its way forward.
• Make sure you get your breast from every angle. As you become more comfortable with self-expression, you'll be able to feel the pockets of milk that still need to be released.

 

Today is all about breastfeeding positions.
The possibilities are endless. I'm just going to post a bunch of sketches from various sources.



This one is obscure, but it was my daughter's favorite while she had colic:

(Hopefully this image works. The last one didn't. It's the laid-back position, with baby on tummy. Good luck finding a bottle that can do that!)

Here are some that are especially recommended for moms who have had C-sections, so they don't irritate the scar, mostly variants on the side-laying position.


(the last two of this series for c-section)


I kept falling asleep while breastfeeding and getting a sore neck. Best advice I got? Use a neck pillow.

 

Here's a hilarious read for those moms out there who are considering doing what I've been doing for the past 11 months to feed my daughter...

39 steps to help prepare you for exclusively pumping | Exclusive Pumpers

 

Going back to work, finding yourself pumping a lot, and having trouble meeting your baby's needs?

Check out this video on maximizing production while pumping. Maximizing Production - Newborn Nursery at LPCH - Stanford University School of Medicine

Here are my usual tips:
Pumping suggestions:
- Lube your pump flanges. Coconut oil, lanolin + cocoa butter, or olive oil.
- Massage as you pump - push the milk out.
- Warm compresses or warm shower before you pump - and stay comfortable & warm as you pump.
- Watch YouTube videos of babies laughing as you pump to stimulate let-down.
- When done pumping, hand express the last few drops from your nipples and rub it in like a nipple cream.
- Pump/Nurse every 2 hours until your supply increases.

A few dietary suggestions:
- Brewer's yeast tablets or Wine yeast from packets sprinkled on food
- Whey protein shakes
- Oats
-Pearled barley
- High fiber snacks
- 1 liter water with every pumping session
- Women's Nursing Support tea by Yogi (or other lactation-promoting herbal tea)

Lifestyle changes:
- Wear your baby on your chest in a carrier without a shirt on - skin to skin- for 2 hours total every day
- sleep with baby in your room, within sniffing-distance. Crib directly next to your bed or co-sleep.
- nap together, with your baby on your chest.
- even if your baby sleeps through the night, pump at least once in the middle of the night.
--- merged: Apr 1, 2014 at 10:38 AM ---
And here is an interesting read on just how common it is for women to experience difficulty with lactation.
How often does breastfeeding come undone? | Breastfeeding Medicine

 

Let's talk about working with inverted nipples.

I have grade 3 inverted nipples. When I started my milky journey 13 months ago, a lactation consultant warned me that I might never be able to lactate because of my extreme inversion along with a deformation of my left nipple. The milk ducts were tightly pinched. Nothing everted my nipples at first. And every time I turned on the pump, I felt a huge ripping sensation, even on the lowest suction. It was brutal.
Once my nipples loosened to the point where I could manually evert them prior to hooking up the pump, things got much less painful. I rub coconut oil on my nipple and with a rolling motion roll out the nipple, then put on the pump before it has a chance to invert again. The oil is critical because it's really very painful to evert a nipple without oil. I start on the lowest suction and gradually work my way up in suction as I pump. During let-down, I have the suction higher. Between let-down events I give my nipples a break by lowering the suction and massaging more to induce another let-down. I chew fennel seeds (though I love fennel!) and take huge gulps of warm water as I pump to encourage another let-down to come more quickly. When it does, I crank back up the pump and push the milk out with my hands, loosening any knots and tights spots in my breasts.
After I have finished pumping, I hand express the last of my milk. When I hand express, I place a wide-mouth bottle (like Tommee Tippee) between my thighs and bend over so I have gravity working with me as I express the milk. I work my hands from the widest point in my breast forward. I always find a few pockets of milk that I just couldn't get with the pump.
If your nipples are killing you and your supply is low, I highly recommend hand expressing after each pumping session, and replacing a pumping session or two each day with a hand expression session. Take care to stretch your hands adequately so you don't end up with a repetitive stress injury.

 

You also might want to try rubbing a vibrator on a clogged duct. It helps.
And if you take a daily dose of lecithin, you'll get fewer clogs.
Lecithin treatment for recurrent plugged ducts : KellyMom

The fact that you got mastitis in your under-producing breast shows that you're not fully emptying that breast. My lefty will underproduce vs my right if I don't treat it properly. Each breast has its own expression needs. Over time you'll notice that the disparity between breasts will increase if you don't work harder to empty the under-producing breast. Any time milk is left in a breast, that's telling your body that it doesn't need to make that milk. I need to hand-express a little bit from the under-producing breast to wake it up before hooking up the pump. It also has helped to use a slightly smaller diameter flange on my under-producing breast. And letting that side single-pump longer at the end of the pumping session to get the last of the milk also helps.

Have you looked into Pumpin' Pals Super Shields flanges? Breast Pumping Breastfeeding Accessories from Pumpin' Pal
They are much more comfortable than traditional flanges.

 

Your daughter might be favoring your left breast. That's pretty common too. Even if you offer equal time on the breasts, she may choose to suckle for comfort on one and eat from the other.

 

Forget the signs. Booby trap the doors.
















Booby trap. You know that was funny.