Krista Gray, IBCLC

Krista Gray, IBCLC – Lactation Services

Positioning and attachmentWhether you’re preparing to breastfeed or need support with your current situation, Krista Gray, IBCLC – Lactation Services is here to help.  I am a certified lactation consultant and offer face-to-face and online breastfeeding support (as well as prenatal breastfeeding classes) to assist you in meeting your breastfeeding goals.   I see clients throughout the Upstate of South Carolina and North East Georgia as well as via Skype and FaceTime worldwide.

Lactation Consultations

Initial Consultation – $135 for a 1 – 1 1/2 hour private consultation.  Sometimes you just need that bit of extra support to get breastfeeding off to a good start or to overcome challenges. I can help you reach your personal breastfeeding goals. This visit can take place in your home or my home office.  (Follow-up phone/text/emails for home or office consultations are always free!) Discount for clients who have a prenatal appointment with me.*

Follow Up Consultation – $75 For new concerns and follow up appointments*

Pump Consultation – $60 Heading back to work and want to make sure your pump is working properly? I can help get your pump set up, ensure the flanges are the right size, and share tips and information about maintaining your supply as you return to work.*

Virtual Consultation – $50 I offer virtual breastfeeding consultations worldwide via Skype or FaceTime. (Up to one hour consultation; Payment made via PayPal) 

Telephone/E-mail Consultation – $30 Do you have a specific breastfeeding question? I can discuss this with you on the telephone (up to 30 minute call) or through e-mail.

Monthly Retainer Option – $150 For those who would like me to be available for unlimited calls/texts/emails throughout the month.  There is no limit to how often you can contact me and, if I am not available at the time of a call/email/text I will always respond the same day.

*In home rate applies to homes within 15 miles of 29655 zip code.  Beyond that area, there will be a fuel surcharge and hourly travel fee, which will be quoted at time appointment is made.

*Payment can be made with cash, check, and PayPal.

*Payment is expected at the time services are rendered.  Nursing Nurture does not file insurance on your behalf, but will provide you with an itemized Super Bill for your health insurance provider.

What happens during a consultation? Find out more here.

Download the forms for your breastfeeding consultation.

Learn more about Krista Gray, IBCLC or contact Krista to schedule a lactation consultation. Continue reading »


Krista Gray, IBCLC

Prenatal Breastfeeding Classes

Whether you’re preparing to breastfeed or need support with your current situation, Krista Gray, IBCLC – Nursing Nurture Lactation – is here to help.  I am a certified lactation consultant and offer in-home lactation consultations as well as prenatal breastfeeding classes to assist you in meeting your breastfeeding goals.   I see clients throughout the Upstate of South Carolina and North East Georgia as well as via Skype and FaceTime worldwide.

Prenatal Breastfeeding Classes

Private Prenatal Breastfeeding Class – $85 for a 1 1/2 hour private class.  We will discuss the basics of breastfeeding from what you can do to be prepared, the early days, common problems and solutions, how to express and store milk, maximizing your milk supply, and what to expect as your baby grows.*

Prenatal Consultation – Addressing specific concerns – $50.  Do you have a specific concern about breastfeeding? I’d be happy to meet with you over coffee and discuss your concern so that you can be better prepared for your new baby’s arrival.

Prenatal Group Class – $35 per couple.  Minimum of 3 couples, maximum of 6.  Do you know other couples that would like to take a prenatal breastfeeding course with you?  This class includes information and encouragement for a successful breastfeeding experience, including how birth affects breastfeeding, getting breastfeeding off to a good start, positioning your baby at the breast, common problems and solutions, how to express and store milk, maximizing your milk supply, and other helpful support.

*in home rate applies to homes within 15 miles of 29655 zip code.  Beyond that area, there will be a fuel surcharge and hourly travel fee, which will be quoted at time appointment is made.

*Payment can be made with cash, check, and PayPal.

*Payment is expected at the time services are rendered.  Nursing Nurture does not file insurance on your behalf, but will provide you with an itemized Super Bill for your health insurance provider.

Learn more about Krista Gray, IBCLC or contact Krista to schedule a breastfeeding class.


Ethnic Hispanic Mother breastfeeding her son

Breastfeeding Positions

How should I breastfeed my baby?

There is no right or wrong way to nurse your little one.  Any position that is comfortable for you and your baby is just fine.  And while it is important to ensure your baby is positioned and latched well in the beginning, after a few months your growing baby and then active toddler just might choose some positions you never would have considered!  The following breastfeeding positions will give you ideas of ways many moms have comfortably and effectively nursed their babies.

Positioning Techniques

Many moms find it helpful to have plenty of pillows to prop up around them so they don’t have to support the weight of their baby while nursing.  Other moms find having pillows and feeling like they can only nurse in their “nursing station” to be cumbersome.  These moms prefer to not use pillows or other support.  Either way is perfectly fine!

What is most important is to make sure your baby is supported throughout his head/neck/shoulder region, his head and neck are in alignment, and he has equal muscle movement on both sides of his body.  This means you will want his body gently pressed against yours – his tummy on your body – and your hand securely holding his head between his shoulder blades.  Make sure your hand does not hold his head though as this is very uncomfortable and keeps a baby from latching well.  (Imagine if you had to keep your chin down on your chest while you chewed and swallowed your food!)  His head should be free so that he can bring it back if his nose becomes blocked.  Your baby should have firm contact against his mother (skin-to-skin is ideal!).

Latching Techniques

In addition to ensuring good positioning in the early days, it is equally important to ensure a proper latch.  A mother can support her breast with her hand if necessary.  Make sure to keep your fingers behind the areola and position fingers in a C-hold so that you can easily help your baby latch on and take enough breast into his mouth.  A baby’s nose should be level with the mother’s nipple.  Your baby should have his head tilted back and lead his mouth to the breast with his lower jaw.  His mouth should be opened wide, tongue down and extended over the bottom gum, with nipple pointing up toward roof of baby’s mouth.  His chin should be pressed against breast with bottom of jaw/lip taking in more areola than the top.  Your baby forms a teat with the nipple and breast tissue, which should be tucked well into baby’s mouth.  His mouth should be open very wide with both top and bottom lips relaxed on the breast and flanged outward.  There should not be any pain!  Make sure to allow your baby to nurse as long as he wants – don’t set a time limit.

Cradle Hold

Cradle Hold

Cradle Hold

This is one of the most popular nursing positions.  A baby lies on the forearm of the side she is going to nurse, and her body extends across the front of her mother.  Her head may be cradled in the bend of the elbow or down lower on the mother’s forearm depending on the size of the baby.  The baby’s chest is against her mother’s chest without space in between; baby’s chest should not be facing up toward the ceiling.  Her legs/feet may be tucked in around the mother’s waist to feel more secure.  It is important that baby is held at breast-level rather than the breast being lowered down to reach baby (which can alter the latch, put pressure on the breast, and keep milk from draining adequately in some areas leading to plugged ducts and mastitis).

Cross-Cradle Hold

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Cross-Cradle Hold

Similar to the cradle hold, but the baby is supported in the arm opposite of the side she is nursing on.  If nursing on the left side, baby would be held by the right arm.  In this example, a mother could support her breast with her left hand and help ensure an optimal latch.  This position is often used with preterm infants.

Football/Clutch Hold

Football Hold

Football Hold

In this position, a baby lies at breast level on the arm of the side she is going to nurse.  Her head is by her mother’s hand and her body wraps around the side and back of her mother.  This hold is especially helpful for a mother who needs to be able to better see her baby’s latch – with large breasts or with a painful latch – as well as after a c-section so baby doesn’t put weight on the incision.  Many mothers of twins also nurse their babies in this position.

Laid-Back Nursing/Biological Nurturing/Reclining

Laid-Back Nursing

Laid-Back Breastfeeding

It has a variety of names but in this position, rather than sitting straight up, the mother is comfortably reclining.  She could simply slide down in a straight back chair, sit in a reclining chair, or lie on a bed propped up with a couple pillows.  A baby can then be positioned across the mother’s body allowing gravity to securely position baby’s body against hers as well as allowing gravity to help with the latch.  This position allows a baby’s natural breastfeeding instincts to kick in.  It is particularly helpful for a tired mom to get rest while nursing or when your baby struggles to open wide to latch such as in cases of tongue tie.

Nursing Lying Down (Side-lying)

Side-Lying Breastfeeding

Side-Lying Breastfeeding

Nursing lying down is an essential tool for breastfeeding and sleep.  Since babies need to nurse at night but mothers also need sleep it is a wonderful way to meet both needs.  In this position, mother and baby lie next to one another on a safe surface.  Baby is securely pressed against mother’s body, and a mother protects her baby with her legs curled around the bottom of her baby and arm over the top.  It can be challenging to first learn this position, but with practice most mothers find it very relaxing to know they can nurse while also getting rest.

Upright Nursing (Baby Sitting)

Upright Breastfeeding

Upright Breastfeeding

Some babies prefer to be in a seated, upright position when nursing.  This type of position is especially useful when a mother has a forceful milk ejection, baby has breathing or swallowing issues, cleft palate, etc.  This position helps reduce choking from a fast flow of milk.  It is still important to adequately support a baby in this position allowing her body to feel a secure touch across her body as well as ensuring her head is well supported by holding one hand in between the shoulder blades at the base of the neck.


Milk Supply Issues

Whether real or perceived, low milk supply is one of the main reasons given for mothers to supplement or wean their baby.  There are a number of things that can cause milk supply issues; these are known as antigalactogogues.  The Top 10 most common antigalactogogues in our western culture are listed below:

  • alcohol, tobacco, other recreational drugs
  • caffeine
  • decongestants & antihistamines
  • contraceptives with estrogen
  • chasteberry (fruit/leaf)
  • greek oregano
  • parsley
  • peppermint
  • rosemary
  • sage

While not every mom reacts to these, if you are at all concerned about your milk supply it would be wise to steer clear.  But it is important to remember that these antigalactogogues are dose-dependent – the more you have the greater the negative impact on milk supply issues. For example, an occasional glass of wine or daily cup of coffee is usually fine for most breastfeeding mothers.  But daily alcohol intake or multiple sources of caffeine throughout the day can definitely cause milk supply issues.  And while most drugs are completely compatible with breastfeeding, decongestants and antihistamines should be taken with extreme caution.  Not only do they dry up the sinuses but they can dry up a mother’s milk supply quite fast.

Perhaps the most often overlooked antigalactagogue is STRESS.  If you are facing milk supply issues, seek out qualified help and support and try not to spend time worrying about making milk.  Also, try to eliminate other sources of stress you may be dealing with.

Two herbal galactagogues that can increase your milk supply are Fenugreek (3 capsules, 3 x per day) and Blessed Thistle (3 capsules, 3x). It usually takes at least 24 hours to begin to see any effect.

In Egypt, home to the fenugreek research for increasing women’s milk supply, the common wisdom is to cook fenugreek (it looks similar to wheat) like you would oatmeal and then serve with milk and honey. All new moms drink this regularly after giving birth.

For any mothers with supply issues, please let me know if you’ve found any of these to be true and what has worked for you!

Additional information about reasons for low milk supply and increasing your milk supply can be found here.


What To Do When Baby Won’t Latch

Cindy and Jana

Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.  You can download their app NuuNest – Newborn Nurse Answers and Baby Tracking for expert guidance through the first crucial weeks after childbirth or visit their website, Cindy & Jana.  You can also connect with Cindy and Jana on TwitterFacebook and Pinterest.

Noella was just 35 weeks into her pregnancy when her water broke. 12 hours later, her baby boy, Nathan, was born. Nathan was admitted to the neonatal intensive care unit  for antibiotics and monitoring. His first feed was a bottle of formula. Noella pumped faithfully throughout Nathan’s two week hospital stay but had little opportunity to try breastfeeding. When he was discharged from hospital, she began to offer the breast every feed but Nathan was used to bottles. Breastfeeding attempts became increasingly frustrating for both mom and baby. After two more weeks, Noella made the decision to discontinue all feeding attempts at the breast and instead focus her energy on pumping, bottling her expressed milk, and enjoying her newborn.  A month later, we received a phone message from Noella: “You aren’t going to believe it.  Nathan is now breastfeeding! I just decided to try it one day and it worked!”

Why babies may not latch at birth

Noella is not alone in her struggles to establish breastfeeding. Many babies are born prematurely and are not yet strong enough to maintain a latch. There can also be other reasons why babies don’t initiate breastfeeding right from the start:

  • Baby may be recovering from a difficult birth.
  • Baby may have a tongue tie.
  • Baby’s first feeds may have been given by bottle and baby is therefore unsure how to suck at the breast.
  • The shape of mom’s nipples may make it difficult to grasp the breast.
  • Baby may have an anatomical challenge such as a cleft lip or palate or the shape of the mouth or jaw may make latching challenging.

If baby will not latch in the first 24 hours after birth:

  • Keep your baby skin to skin as much as possible.
  • “Practice” breastfeeding: express a drop of milk on your nipple and let baby lick and nuzzle. Try to keep these practice sessions pleasant and free from frustration for both mom and baby.
  • Support baby well during feeding attempts to help baby feel secure. If you are feeding in a cradle or football hold, use pillows to support baby. If you are feeding in a laidback position, baby’s body will be well supported against your body.
  • Begin to use hand expression to stimulate your breasts to begin producing milk. (Learn how to hand express with this video.)
  • Feed any drops of milk obtained back to baby with a spoon. Baby will “sip” the milk from the spoon.

If baby continues to not latch after 24 hours:

  • Continue with “practice sessions”. If either you or the baby becomes frustrated, take a break. Calm your baby by snuggling. Remember, dad can snuggle baby if you need a break!
  • Do some massage and hand expression before attempting at the breast so that the milk is “right there” for baby.
  • In addition to hand expression, begin to use a hospital grade electric pump. We suggest you pump about every 3 hours for 10 minutes per breast (or every time the baby feeds). Please do not be discouraged if you don’t get a single drop! The pumping “tells” your body that baby is here and will need milk. Developing a good supply of milk will be key in coaxing baby to the breast.
  • Consult an International Board Certified Lactation Consultant to have a thorough assessment. The consultant will have suggestions based on the cause of the difficulties.
  • You will, of course, need to feed your baby. Your health care provider may suggest you feed baby by spoon, cup or finger feeding. The first choice is to use your own expressed milk. If, for medical reasons, your health care provider recommends additional supplement, banked human milk is the next choice. If donor milk is not available, infant formula may be used. Feeding your baby will help ensure he has the energy to continue to learn to breastfeed.
  • Some women find using a 20-20-20 principle helpful. “Practice” at the breast for 20 minutes; feed the baby in an alternate way if needed (approximately 20 minutes) and pump/hand express for 20 minutes. (Please note: the times are suggestions only. Please modify according to your baby’s cues. Sometimes babies are quickly frustrated and 20 minutes of trying may be too long.)
  • Sometimes, giving baby a little milk prior to a breastfeeding attempt may be helpful, especially if the baby is quite hungry. Taking the edge off the baby’s hunger may help baby to be more relaxed with the latching attempts.
  • Once baby is taking larger volumes, your health care provider may suggest beginning to use a bottle to feed your baby. This does NOT mean we have given up on breastfeeding! Again, it is important to feed your baby so that he will have energy to learn to feed. When baby is taking larger volumes, some babies will tire before they have been able to complete the feed. If you choose to bottle, use a rounded nipple rather than one with a flattened cross-section. Choose a slow flow nipple. Entice the baby to gape widely when taking the bottle to simulate latching at the breast.
  • A nipple shield may be useful in some instances once milk supply is established. Using a nipple shield before the milk supply is established is not recommended. Please discuss this with your Lactation Consultant.
  • Search out a mother-to-mother support group such a La Leche League.

In our experience, with time and patience, most babies who do not latch initially will eventually go to the breast. While working towards getting baby to the breast, stimulating the milk supply and having lots of skin to skin time are the most important things you can do.


ULMas Breast Pads

ULMas Breast Pads – Review and GIVEAWAY!

 

ULMas LogoAre you an Undercover Leaky Momma? “What’s that?!” you ask.  Do you wear breast pads while breastfeeding?  If you do, then you are seriously going to love ULMas Breast Pads.  Washable and reusable, these breast pads are the best I’ve found on the market.  Here’s why I love this product, and why I think you will too:

  • They absorb. A lot.
    Most washable breast pads can’t hold anywhere near the amount of disposables.  Not ULMas; I’d put them up against any disposable for as much as they can absorb.
  • Wicks away moisture so you feel dry.
    ULMas are made of performance fabric so that your skin stays dry even while your breast pad is absorbing milk that leaks.  There’s another added bonus to this fabric – they dry very quickly after washing.
  • You don’t look like a deer in headlights flashing a sign a saying, “Yes, I’m wearing breast pads!”
    These are thin, like a disposable, so you don’t have the “ring” around your breasts that everyone sees and knows, “Oh, she’s wearing breast pads.”
  • Fun designs
    I love the bright, fun prints.  I know this has nothing to do with absorbency but isn’t it nice to feel happy about what you put on?  And, let’s face it, a lot of us new mamas aren’t putting on fancy clothes each day so having cute breast pads is all the more exciting.
  • Helps the environment
    Okay this is true for any washable breast pad.  But it’s an important point.  If you’ve been wavering between disposables and washables, ULMas can help you take the jump into washables.
  • Variety of absorbency levels
    Every woman is different.  Most women need breast pads for the first month or so.  Many need them for the first few months.  And some, like me, need them pretty much the whole time we’re nursing. With ULMas, I can have heavier absorbency pads in the beginning and lighter absorbency later on.  Or, I can use the regular absorbency during the day and heavier absorbency at night (though both are thin and can be worn at any point while nursing – day or night).

yellow winter flowers pink w logoWhen I had my first child nearly 8 years ago, I found I needed breast pads continually.  I liked the ease of disposables but not the price or what I was doing to the environment.  I researched washables and bought the best I could find on the market.  Compared to disposables, they were thick, anything but discreet, and would leak.  When my daughter was just 4 months old we moved overseas.  There I met a friend who felt the same about breast pads as me. So we handmade some breast pads for our personal use – out of performance fabric.  I always wished someone would put a product like this on the market but no one ever did.  When I discovered ULMas, I contacted the owner and requested a sample so I could see if they were what I thought and hoped they would be.  I was not disappointed!  I am so excited about these breast pads!

Where can you find ULMas breast pads?  Well, you can order them online and you can also enter to win a free set of 2 pairs of regular and 1 pair of overnight – for a total of 3 washable breast pad sets.  There will be 2 winners.  The contest will run from noon April 10, 2014 – midnight April 20, 2014 EST.  Winners will be notified by email on April 22nd.  (This is a great gift to give to an expecting mama too!)

a Rafflecopter giveaway

Disclaimer:  ULMas provided me with a free demo pack at my request.  I was under no obligation to write a product review or sponsor a giveaway in return for the free sample.  I do not have any vested interest in this product nor do I stand to benefit in anyway if you choose to buy ULMas breast pads.


FI-14

10 Ways to Wake a Sleeping Baby

For the first few weeks following birth, newborns can be sleepy and hard to rouse to feed.  It’s tempting to let them sleep for extended periods of time, but sleeping too long can have a detrimental impact on a baby’s weight gain and a mother’s milk supply.

In general, newborns should nurse at least 8-12 times every 24 hours.  If weight gain and breastfeeding are going well, it is fine for a newborn to have one longer sleep stretch each day, but this shouldn’t be more than five hours.  Always watch for your baby’s early feeding cues and make sure to count wet and dirty diapers as they are a good indication of how much your baby is taking at the breast.

After the first few weeks when breastfeeding is off to a good start, baby’s weight gain is on track, and she is meeting developmental milestones, it is more appropriate to allow your baby to sleep and feed on her cues without waking her up.

Here are 10 tips to wake a sleeping baby:

  1. Change her diaper
  2. Take off her clothes and hold her skin-to-skin
  3. Wipe her face with a damp cloth
  4. Gently stroke her ears, back, legs, arms, or tummy
  5. Take off her socks and tickle her toes
  6. Talk to her, sing to her, tenderly call her name
  7. Rock her or take her outside for some fresh air
  8. Turn on soft lighting – you don’t want the room to be dark but you don’t want your baby to have to squint from the brightness either
  9. Gently roll her from one side to the other
  10. Express some milk and touch it to her mouth – wait to see if she eats it and wants more.  She may nurse if you have a drop of expressed milk on your nipple – if so, that is great!  Research shows that babies can nurse effectively while in a light sleep.[1.Colson, S., et al. (2003) Biological Nurturing increases duration of breastfeeding for a vulnerable cohort. MIDIRS Midwifery Digest, 13(1), 92-97.]

 


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Perseverance at the Pump

Mary Straits HeadshotMary Straits resides in North Carolina with her husband of ten years and two energetic boys, ages six and three.  She earned a B.A. in English and music from Columbia College and a Masters of Education from Liberty University.  In her spare time, Mary teaches 8th-grade English and somehow finds time to blog at www.marystraits.blogspot.com.

When our ob gave us the list of classes the hospital was offering for soon-to-be parents, we actually said, “Nah.  We don’t need the breastfeeding class.  I mean, how hard could it be?  It’s natural, right?”

Out loud.  To each other.

It took about two hours of mommy-hood for me to realize that breastfeeding, albeit natural, is an art form.  It takes coaching and practice and patience and sometimes a trip to the ER at 2 am.

When my first son was freshly born, we started nursing about two hours later. I came to the hospital ready.  I didn’t just have a Boppy—I had a “My Breast Friend.”  I had my own pump and all the parts.  I thought breast-feeding was going rather well until the nurse came in and started saying things like, “Nope.  He’s not latched.  Let’s try it again.”  And, “It’s not supposed to hurt.  You’re wincing.”

Then, when they called in the lactation specialists, things got real.  I learned about all sorts of positions that involved stacks of pillows.  They gave me something called a nipple shield.  Then came a syringe with a tube to connect to the shield.  In the tube, we put formula.  The idea was to make baby associate my breast with his food source.  But we couldn’t use the shield too long or he would become dependent on it.  And then we’d REALLY have problems.  I was to feed baby with the system and then pump to get my milk to come in faster.

Two days later, we went home with a shield and a syringe feeding system, which I promptly abandoned once my milk came in the next day.  In fear, I used the shield off and on, and pumped after each feeding.

When our pediatrician’s lactation specialist called me at home to see how nursing was going, I stupidly said it was going fine.  And no, I didn’t need to see her.  She didn’t let me off the hook, though.  When she found out we were bringing baby in for his weight check, she said, “Great!  I’ll check in with you then!”

The next day, however, I came down with a high fever and chills that would not go away.  Being that our baby was five days old at this point, we ended up in the emergency room at midnight and I endured all sorts of trauma I hope I never relive.   I was discharged hours later with a heavy dose of Tylenol and a label of “Fever of Unknown Origin.”

When we showed up at the pediatrician the next day, I looked like a mess.  But not your average mess.  A HOT mess.

The lactation nurse took one look at me and said, “Oh, you poor thing.”  Then, when we showed off our breast-feeding ritual, she knew we were really in bad shape.  My nipples were raw and cracked in several places.  She said I had a touch of thrush as well and gave me a concoction of creams to put on my nipples after every feeding:  Neosporin, Monistat, and Lanolin.  We were to use only the shield until my nipples healed and continue pumping in between.  And see her again in two days.

A few days later we checked back in, and my skin was on the mend finally.  Baby, however, was not latching properly.  Come to find out, his frenulum was tight, which prevented him from latching properly.  We had to drive across town to the pediatrician who could clip his frenulum and then continue on with the work of breast feeding.  With the shield, pumping after a feed.

At this point, my milk supply was very profound, as I was pumping off 4-5 ounces after baby was done with a feed.

A few days later, the fever came back with a vengeance.  It hit me almost instantly, and I struggled to even pick up the baby to feed.  I somehow loaded up the baby, lifted the car seat, and headed to the ob-gyn, who said I had a bladder and sinus infection.  They gave me a z-pack and sent me on my way, and I felt remarkably better in about 6 hours.

At this point, I tried abandoning the nipple shield, but it didn’t take long for me  to get a little crack and then have shooting pains during a feeding.  I promptly used the compound the lactation nurse told me about.  A few days later, we found out both baby and I had thrush.  At this point, I didn’t try to feed him straight from my breast, but just pumped and bottle fed until we both were cured.

The next week or so, the fever came back AGAIN on a Saturday.  This time I had a red patch on one my breasts, which really freaked me out, but I took ibuprofen and waited for my primary care doctor to open on Monday.   All the while, I continued to pump for feedings, as I was too weak to try and latch baby.

On Monday, all mysteries were answered.  My primary care doctor finally figured out what was causing the fever:  Mastitis.  There is a specific antibiotic that treats it, and he advised me not to feed the baby the milk I was expressing but to be sure that I completely emptied my breasts often.

At this point, my milk supply reached epic proportions, as I was pumping for a long time every two hours or so.

After I finished the antibiotic, my husband and I decided that we had enough drama with this breastfeeding journey.  But, it was so important to me that my baby had breast milk.  For one, I knew it was the best for him.  For two, formula feeding would have cost us $30 a week (at least).  For three, we had a great pump and my supply was ample, to say the least.

I ended up pumping on a schedule of 5:45 am, 8:30 am, 11:15 am, 3:15 pm, 6:30 pm, 10:30 pm, and maybe during the night if baby woke up.  It took me about 10 minutes to totally empty both breasts, which was a lot easier/ faster for me than before.  After a while, I was able to drop a pumping session and still maintain my milk supply very well.  In the end, in fact, I ended up giving my sister bags and bags of frozen milk and using the other bags of frozen milk in baby food purees.

I found pumping much less stressful than our previous experience, which I learned later was pretty extreme.  When I ran into the lactation nurse on a routine pediatrician visit when Noah turned one, she congratulated me on making it a full year and assured me that pumping “counted.”  For some reason, I had it in my head that I wasn’t really breastfeeding by pumping full-time, but I couldn’t bring myself to give up and quit.  And I knew it was best for my baby.

When our second son was born, as soon as we started having latch problems and I started getting cracked nipples, I broke out the pump and began pumping full time.  With a very energetic almost three-year-old, I did not have the stamina and the time for any semblance of our first go round.  I brought out my trusty pump (Medela, if you’re wondering!), and once again, had a solid supply in about 5 days time.

The second time around, though, I worked on pumping a bottle right before baby would eat so that he could have fresh milk more often than not.  I ended up having an epic milk supply the second time around, all from the pump.  At one point, I had so many bags of milk in the freezer, that our freezer actually broke.  Ha!

The point of my story is this:  If you’re passionate about breast feeding and struggling to find peace from any challenges you may be facing, consider pumping full time.  Don’t listen to the masses, who tend to view a breast pump as a ball and chain.  It was an awesome avenue for us to be able to give our boys the most optimal start. And saved us hundreds of dollars!

{Note from Nursing Nurture: Mary’s determination allowed her to give her babies breast milk even when the medical system really failed her.  Though every issue she had could have been remedied with good, qualified lactation support this mother – like so many – did everything she knew to do.  If you are experiencing breastfeeding issues and your lactation support is not helping solve the problems at hand, find someone else!  Look for an IBCLC – which is the only certification showing a lactation consultant is a specialist.  And, if your IBCLC is not helpful, find another (just like you would any medical doctor you weren’t pleased with).}


Induced Lactation

What is induced lactation?

Induced lactation is when a mother who has never had her own biological children stimulates lactation in her breasts.  The term is also used when a mother, who is not currently breastfeeding, adopts a child and goes on to nurse the infant (adoptive breastfeeding).  It is different than relactation, which occurs when a mother’s milk supply is stimulated to nurse a baby she gave birth to but has been weaned.

How do you induce lactation?

There are many techniques that women use to help induce lactation, however the most important is frequent and effective breast stimulation (and milk removal once milk begins to flow).  Many women around the world have effectively induced lactation solely by regularly nursing a baby and/or through pumping/hand expression.1 Conversely, no amount of additional tools (galactagogues, hormonal stimulation, skin-to-skin, etc.) will effectively induce a milk supply without this first step.

Strategies for inducing milk supply

  1. Breast stimulation on both sides for at least 100+ minutes every 24 hours.  A woman may start with shorter sessions, say 5 minutes or so, and build up to expressing 15-20 on each side 8-12 times a day, including at least once at night.  The more frequently the breasts are stimulated, the quicker the milk supply will build. A newborn eats approximately every 2 hours, 10-12 times per day so expressing this often would be ideal.
  2. It is not essential to express on both sides at once, though this is a great way to save time.
  3. The milk ejection reflex can be trained so thinking of your baby, nursing or pumping in the same place, listening to relaxing music, hearing a baby cry, etc. can help to stimulate it.  Conversely, stress can inhibit hormones involved with milk ejection.
  4. If you already have your baby, and if he is willing to nurse at the breast, try nursing with an at-breast tube feeding device. This allows your milk supply to be stimulated by your child rather than pumping or hand expressing to stimulate your supply.  It reduces a step because while you are “pumping” you are also feeding your baby.  As you begin to develop a milk supply you can reduce the amount supplemented in the tube feeding device.  It is important to make sure your baby has a good latch in order to effectively stimulate your milk supply.
  5. When nursing at the breast (and at other times throughout the day and night as well) make sure to spend time skin-to-skin with your baby.  There are many tremendous benefits for both mother and baby, but this time together will help you bond and help maximize a mother’s breastfeeding hormones.
  6. Taking pharmacological and/or herbal galactagogues while expressing/breastfeeding can increase breast milk supply.  Domperidone is generally considered the safest pharmacological option and fenugreek and blessed thistle are common herbal options.  Eating oatmeal several times a week or even daily may also increase milk supply.
  7. Acupuncture may also increase a mother’s milk supply through enhancing the secretion of the hormone prolactin, which is necessary for milk production.2
  8. Having a support system around you cannot be overestimated!  Having family and friends that can support and encourage you as well as getting involved in a local mother-to-mother breastfeeding support group are essential.  There will be challenges you face with adoptive breastfeeding.  Having others to encourage you and share their experiences will help you tremendously.

If you have several months before getting your baby

If you are in the process of adopting but will have to wait weeks to months, there are medications you can take that mimic pregnancy hormones in your body.  By taking an oral birth control pill with estrogen and progesterone, and skipping the week of “sugar pills” each month, your body’s hormones will mimic those in pregnancy.

In addition to the oral birth control pill, a mother would take Domperidone which is used in lactation to increase breast milk supply.  After at least 30 days on this protocol, but longer (6 months) if possible, a mother would stop the birth control pill and begin pumping or breastfeeding.  She could also take Fenugreek and Blessed Thistle – 2 herbal galactagogues known to help increase milk supply.  Please read here for further details on how to implement the Newman Goldfarb Protocols for Induced Lactation.  Though the treatment protocols for inducing lactation have not been tested in clinical trials, women from around the world have successful adoptive breastfeeding stories by using these strategies.

There are many challenges that adoptive breastfeeding mothers may face.  Arming yourself with knowledge is half of the battle!

You may also be interested in reading adoptive breastfeeding and how to encourage your adopted baby to latch.


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5 Challenges of Adoptive Breastfeeding

Mothers who are inducing lactation, trying to relactate, or planning to breastfeed an adopted child will face many challenges.  These difficulties are not insurmountable by any means. Most mothers who have been through this are thankful for the opportunity and believe the challenges are well worth it.

In fact, breastfeeding will not only provide your baby with the best start in terms of nutrition and health but also to help forage a strong bond between mother and baby.  Breastfeeding is a normal part of development and will allow your adopted child to participate in this important stage of life.

Being aware of the challenges mothers face will help prepare and equip you for the potential difficulties as well as strengthen your chances for success.

These are five common challenges adoptive mothers face when breastfeeding:

  1. Not having enough preparation time before receiving baby
    Rarely do parents know exactly when they will receive their adopted child.  Many parents start the adoption process and it takes years to complete.  Other parents receive their babies with just a day’s notice.  Stimulating your milk supply years in advance is no more tenable than expecting to have a milk supply overnight.  Even when a mother begins to stimulate her supply thinking it will just be a few months away there could be a roadblock in the process that causes an unanticipated delay or a milestone that eliminates the waiting entirely.  So, not knowing when a mother needs to have milk can lead to a situation where, for one reason or another, she finds she is receiving her baby and she hasn’t stimulated her milk supply.If you find yourself in this situation, there are a couple routes you can take.  You can put your baby to the breast immediately using an at-breast tube feeding device so that you can begin to bond through breastfeeding while allowing your baby to stimulate your supply.In addition, you can talk with your health care provider about taking Domperidone – a medication that has been shown to increase breast milk supply.  You can also take herbal galactagogues such as fenugreek and blessed thistle, along with eating oatmeal, to further help your supply. Another option is to try the accelerated Newman Goldfarb induction protocol which requires waiting 30 days before beginning to stimulate supply.In most situations, if your baby is willing to latch on your breast, there are many advantages to stimulating your supply breastfeeding with an at-breast tube feeding device rather than waiting to have your baby suckle.
  2. Finding the time to stimulate your milk supply
    If you already have older children, work outside the home, or have other competing demands on your daily routine it can be challenging to find the time to add in regular pumping sessions throughout the day and night.  Women can begin to feel exhausted or overwhelmed and question whether their bodies will respond with a milk supply and if it is really worth it, especially when many adoptive mothers don’t even know if their baby will latch and take to breastfeeding.  Hang in there – with dedication, determination, and regular stimulation your breasts will begin to make milk!
  3. Stress and worry about milk supply
    It is common for mothers to worry if their bodies are producing enough milk, if their baby is getting enough milk, and how to maintain breast milk expression when a mother must travel (especially with international adoption) to pick up her baby.  When stimulating a milk supply for adoptive breastfeeding, it is important to have the counsel of a qualified lactation consultant to help you in your specific situation.  She can help you figure out how much milk your body needs to make, if your baby is getting enough, and give tips for how to express when traveling – including hand expression when electrical currents are different.
  4. Helping baby transition to the breast
    Building a milk supply takes dedication and work, and most adoptive mothers don’t know if their infant will ever take to nursing at their breast.  In general, the younger the baby (particularly within first three months), or if the baby has been breastfed before adoption, the higher the chances for the infant to latch and breastfeed from the adoptive mother.1  Mothers worry that all their hard work to build a supply might still not afford them the opportunity to nurse at the breast.  However, while there are no guarantees, many adoptive babies can transition to the breast with time and patience.  Expressing milk on the nipple before latching the baby on is one technique to encourage an adopted infant to breastfeed.  Lots of skin-to-skin contact and availability of the breast – but without pressure – are other great strategies.  It is important to give an older baby time to trust his adoptive mother and feel safe at the breast; always make the breasts a happy place!  (You may also enjoy reading Strategies to Encourage Your Adopted Baby to Breastfeed.)Ultimately, even if your child doesn’t take to nursing at the breast, you can give her your expressed milk and do so in a way that still promotes bonding – paced bottle feeding at the breast, skin-to-skin contact while feeding, etc. Your milk is a special gift of love no matter how your baby takes your milk!
  5. Pumping and equipment difficulties
    Adding a new little person to a family is a major transition.  Sometimes “small things” can present large amounts of stress in these times.  Learning to pump, ensuring the flanges fit properly, and setting up a routine can present worry and stress.  Other mothers use an at-breast tube feeding device which can present additional steps – filling the supplement in the bottle, running the tubing, working on proper latch, cleaning and sterilizing the equipment afterwards, knowing how much milk to supplement and when to decrease the amounts…you get the idea.  It cannot be overestimated how important it is to surround a mother with support – from family, friends, other breastfeeding mothers, as well as qualified lactation assistance.