Maximizing Your Maternity Leave

Whether you will have 6 weeks, 6 months, or something in between for you maternity leave, you’ll want to use the time getting to know your baby, finding your rhythm of being “mommy” to a new little blessing, and be preparing for the time when you return to work.  Many new moms spend this time worrying about who will take care of their child, how they will express milk, wondering whether they will have enough milk to express, and so forth.  And some things you read and hear encourage new moms to express from the very beginning and practice giving your baby bottles each day.  Even more stress!

While there are some things you will want to do to prepare for your return to work, the most important thing you can do during this time is bond with your baby, get to know your baby, and fall totally in love with your baby.  You need to get breastfeeding off to a good start and not have to worry with pumping and giving bottles in the beginning.  So, until 3 weeks before you return to work, it is a good idea to not spend time worrying about pumping and bottles or teaching your baby to drink from one!

Several weeks before you return to work, though, you will want to familiarize yourself with your pump, learning how to operate it, clean it, and store your milk.  Never throw milk you pump away but you also don’t need to give all the milk you pump to your baby right now.  You are still home with her so enjoy these moments of cuddling and nursing before you return to work.  This milk can be frozen for the future when you do go back to work.

You will also need to give thought as to how you want your baby’s caregiver to feed your baby your expressed milk.  Do you want to give a bottle?  Cup?  Sippy cup?  Make sure to talk about your desires with your baby’s caregiver beforehand.  Many moms and caregivers choose to use bottles for their convenience but the other options should be explored.  Make sure to educate your baby’s caregiver on how to give a bottle if this is what you choose to do.

Finally, don’t worry about your baby “taking a bottle” from you.  Many babies refuse to take a bottle when their mothers are around.  They know what they want and prefer and therefore won’t drink from a bottle when you’re around.  When you are away, though, these same babies will take a bottle from someone else.  Your baby may also “reverse cycle” and drink less milk while away from you throughout the day and take in more while with you in the evening, night, and morning before work.

Ultimately, you want to feel comfortable with how your pump works and how to store your milk before you return to work.  You will want to feel comfortable with your caregiver and share with her your desires for feeding your baby while you’re away.  But, as you plan and prepare for your return to work, make sure to enjoy these precious moments while you are with your baby.  Enjoy nursing at the breast while planning for the time you are away.  Try not to stress and worry about it.  You are mommy to your precious little one and if you are exclusively nursing your baby at one month old then you have the milk to feed your baby at six months and beyond as well!

Reverse Cycle Breastfeeding

Reverse Cycle Breastfeeding

Reverse cycle breastfeeding is when a baby changes his/her nursing schedule to be able to breastfeed more when he’s with his mother and eat less/sleep more when he’s away.  It occurs quite commonly when a mother returns to work.  Whereas her baby had nursed frequently throughout the day while they had been together, he now sleeps more during the day and nurses more frequently throughout the evening and early morning hours  to make up for the time away from mom during the day.  It can be a coping mechanism for babies to be able to tolerate being away from their mothers for long periods of time.

Reasons Babies Reverse Cycle

  • Return to work
  • Newborns who have not yet established a circadian rhythm with their sleep patterns
  • Toddlers who are easily distracted throughout the day and involved with all that is going on around them
  • Mothers who are overly busy during the day (frequently happens around holidays) and there is not much time for nursing throughout the day.

Tips for Handling Reverse Cycle Breastfeeding

Reverse cycling can be challenging when a mother returns to work as she is now working outside the home and usually not as free to nap and be with her baby as before.  However, breastfeeding is relaxing in and of itself and mothers should look at the extra time nursing when together as a good excuse to relax and rest.  Bed sharing or co-sleeping throughout the nighttime will also help a mother maximize her sleep while still frequently nursing her baby.

Babies are incredibly resilient and reverse cycle breastfeeding is just one testament to this fact.  If your baby is reverse cycling, it can be helpful to look at it as a positive characteristic.  Your baby is able to go with the flow of the day’s schedule and then snuggle with his favorite person in the world when you are together in the evenings/night/early morning. He is able to adapt to taking in just the basic requirements while away from you, waiting patiently for the most nutritious and best-tasting food ever made while in his mama’s arms at night.

What is the Best Bottle for a Breastfed Baby?

I am often asked, “What is the best bottle for my breastfed baby?” Every bottle manufacturer seems to claim theirs is the best and they always tout how theirs is most similar to feeding at the breast.  And while some are

Bottle feeding my preterm baby

Bottle feeding my preterm baby

better than others, there’s no perfect bottle.  There are some things to look for in a bottle, though.  Here are 5 tips for finding the best bottle for your breastfed baby:

  1. Narrow teat doesn’t necessarily mean wider latch
    While breastfeeding, it’s important for baby to have a wide latch – hence why we call it “breast” feeding and not “nipple” feeding. In an effort to portray bottle feeding like breastfeeding, manufacturers created the “wide mouth” bottle supposedly so babies could have a nice, wide latch even while bottle feeding. However, wide-mouth bottles are so wide that many babies end up with a very shallow latch.  The best way to find a teat that your baby can have a wide latch on is to test out several and see what works best for your little one.
  2. Select a slow-flow nipple.
    Breastfeeding has bursts and pauses in its milk flow.  There are times during a feed when a baby is getting lots of milk (during the milk ejection reflex when you “let down”) and then periods where there is a pause.  Bottle feeding, on the other hand, tends to have a constant flow.  Finding a bottle with the slowest flow your baby will allow is especially helpful if your baby switches between bottle and breastfeeding. The best way to find a slow-flow nipple is to try out several by turning the bottle upside down and watching the rate at which milk flows out.
  3. Bigger is not necessarily better.
    A breastfed baby from 6 weeks of age until solids are started takes in roughly the same amount of milk in a 24 hour period. (Typically between 25-32 oz a day.) If your baby eats around 8 times a day, that would be roughly 3-4 oz of milk each time.  (Of course sometimes a baby eats more and other times less – just like we might have a larger meal or a snack.)  Find a bottle that suits your needs – there is no need to get a larger bottle thinking your baby will consume more and more breast milk as the weeks go by. (You may be interested to read this article if your caregiver says your baby needs more milk.)
    Is there a best bottle for breastfed baby?
  4. Find a bottle you can pump directly into.
    If you’re a working mama you already know the word b-u-s-y all too well.  Anything you can do to simplify your life is essential.  There are many bottles that will attach directly to your pump and save you extra steps.  If this makes your life easier, definitely consider this as you make bottle purchases.
  1. Don’t break the piggy bank.
    These days bottles range from a few dollars to $40 or more! There’s a lot to think about, but if your baby is breastfed, then the majority of his/her feeds will come at your breast rather than the bottle anyway. There are many good bottles out there, that won’t break the bank.  It may take buying several and trying them out – or better yet checking out a friend’s stash so you can confidently purchase just a couple – but an affordable bottle can be found. For a breastfeeding mom who’s returning to work, it is not necessary to consider buying a bottle with a steep price tag.

    You may also be interested in reading My Baby Won’t Take a Bottle, How to Pump Effectively, Breastmilk Storage and Transport, and How to Give a Bottle.

Baby Won't Take Bottle

My Baby Won’t Take a Bottle

Returning to work after having a baby can be a stressful time for a mother.  Many moms today find that they’ve just hit a stride breastfeeding and mothering, only to have everything turned upside down as they now must find a caregiver, pump milk, and return to work either part-time or full-time.  In their preparations, one big hurdle for many moms is having the reassurance their baby will take a bottle. And if their little one doesn’t, and mom finds herself crying, “Help! My baby won’t take a bottle!” it causes much anxiety and stress thinking about what will happen when maternity leave is over.

Try not to push a bottle or worry about your baby taking one.
This is hard, I know.  As moms, we want to have everything sorted out and know our babies will be fine if we have to be away.  But, many babies will take a bottle from someone other than their mother when their mother is not around.  Babies are smart and know what they like.  Many will refuse a bottle when their mom is near because they prefer to breastfeed.  However, when mom is gone, survival sets in and they will take a bottle when they get hungry and mom is not there.

There is no need to introduce a bottle early-on in maternity leave.
Research confirms that most babies will accept a bottle regardless of when it is started. 1  Thus, starting a bottle at one month does not make it easier for a baby to accept than starting at 3 months, 6 months, or whenever it is necessary.  In fact, starting a bottle before breastfeeding is well-established can interfere with a mother’s milk supply and a baby nursing effectively at the breast.  From a bonding and breastfeeding perspective, there are many benefits to waiting to introduce a bottle until later rather than earlier.

Maternity leave is too short to spend it worrying.
There are always going to be things to worry about in motherhood.  But maternity leave (in the US especially) is so short, the best way a mom can spend this time is enjoying her baby, nursing her baby at the breast, and soaking up lots of cuddles and skin-to-skin time together.  Worrying won’t change the “bottle status” and introducing bottles earlier won’t help baby accept them any quicker than right before maternity leave ends – or even waiting for your baby’s caregiver to give the first bottle.

Realize many babies reverse cycle while away from mom.
This means they essentially change when they are feeding – consuming the majority of their calories during the evening, throughout the night, and morning while they are with their mother.  Then, during the day while with a caregiver they don’t need nearly as much (if any) milk. You can find more information about reverse cycle breastfeeding here.

But what is a mom to do if her baby absolutely refuses to take a bottle? Below are 10 tips to assist you in feeding your baby while you are away.

  1. There is more than one method to give a baby expressed milk. If you have tried everything and your baby’s caregiver has tried everything while you are away, perhaps a bottle is not the best method to give your baby milk.  Expressed milk could also be given via spoon, sippy cup, regular cup, etc.
  2. Delaying your return to work, even by a week, can make a difference.  Babies grow and develop by leaps and bounds every single week.  What a baby can’t (or won’t) do one week, she may do easily a week later.  Every bit of time helps so delaying your return to work, even by a week, could be hugely beneficial to helping your baby take a bottle.
  3. Find a caregiver near work.  This allows your last breastfeed before going to work to be later, your first breastfeed after work to be sooner (do them both at the caregiver’s location) and might mean you could stop by during lunch or a break to breastfeed.  Depending on how long your baby is with a caregiver and/or the age of your baby, she may not need much (if any) more milk throughout the day.
  4. Not all bottles are created equal.  Experiment with different ones, trying different shapes, sizes, and materials to find one your baby is comfortable with.
  5. Try walking, dancing, or swaying while giving your baby a bottle.  Some babies like this rhythmic motion which can calm him and help him more willingly try a bottle.
  6. Try giving a bottle when your baby is calm, or even sleepy.  Waiting until your baby is fussy and hungry, then trying to introduce something new can be a bad combination.  If your baby is with her caregiver and refuses a bottle, the caregiver could give some of the milk with a spoon or cup to take the edge off the hunger, then try again when baby is calmer.
  7. If your baby is 6+ months old, offering solids is a good way to feed baby while you are away, without her having to take a bottle. Many moms find that their babies eat solids with their caregiver and nurse frequently while mom and baby are together – waiting until around a year old to really eat more solids while at home.
  8. Though it can be tiring if your baby reverse cycles, remember this too shall pass.  By the time your baby is a year old she should be able to manage without any expressed milk or bottles while away from you.  She will certainly be eating more food alongside nursing too, so it won’t seem like you are spending all your time together breastfeeding.  Parenting, in general, during the first year is tiring, especially while working.  Though each day may seem like it will last forever, looking at the big picture you know the first year will go by all too soon.
  9. Consider safe bedsharing.  Especially if your baby is reverse cycle breastfeeding, bedsharing will allow your baby to nurse as often as she likes without you having to be up and down all night – which can really wear a mom out who then must get up early and go to work the next morning.  (Safe bedsharing includes a flat mattress – not couch or waterbed; no smoking or drugs of any kind; no other children or pets in bed; partner who is supportive; covers that are not too heavy for baby; and baby not swaddled).
  10. Remember nursing won’t last forever. In fact, it will be over before you know it!  And you will probably look back and miss this precious time in your life.  Your baby is not the problem and breastfeeding is not the problem – it’s just the demands of life and you are doing the best you can to make everything work.  Use the time you have together nursing your baby to relax, escape from your hectic day, and enjoy these moments while she is still young.

How to Pump Effectively

How to pump effectively and efficiently is extremely important so you spend the least amount of time behind a pump as possible.  If you are returning to work or have other children, your time is limited!  Learn what steps to take to maximize output in minimal time.

How frequently you express depends on how much milk you require.  If your supply is established and you are returning to work, you will need to pump to make up for the times your baby eats while you are away.  Learning how pump effectively is an essential time saver.  If you are jut starting pumping and trying to build your supply, make sure to read about building your supply pumping.

Not only is it important to empty your breasts when you pump, but how you do this is also critical.  Effective pumping is key.  One study found that a good quality double electric breast pump was able to remove 99% of milk in the breasts within the first five minutes of pumping for most mothers. 1  Not only is a double electric pump going to increase output, but choosing one that has intermittent suction of 50-80 cycles per minute and an adjustable vacuum ranging from 50-250 mm Hg is important.  Also, make sure the vacuum is comfortable.  A strong vacuum that causes pain is not helpful to milk expression!  However, research also shows that using breast compressions while pumping will increase milk output.2  This is important to note since some moms notice a drop in their supply when they pump (versus nursing at the breast).

Breast compressions can easily be done while pumping.  Either use a hands-free pump (you could even cut small holes in a nursing bra to allow your pump flange to be held in place by your bra) or sit high enough that your pumping bottles can rest on the counter while you use your hands for breast compressions.  As you are pumping, gently massage spots on your breast working from your chest forward to your areola.  Hold down until you feel the area soften with milk expression and then work on another area.  Continue breast compressions while you pump until your breasts feel very soft and no more milk is being collected by your pump.

If you are still concerned about the volume of milk you are expressing, following pumping with hand expression can further increase milk output.  In fact, Morton et al found a 48% increase in milk production when breast compressions while pumping followed by hand expression were incorporated! 3

If you just have a few minutes here and there while away from your baby, it may be easier to hand express.

Breastfeeding Twins, Twice

Tara Dew HeadshotTara is a former 2nd grade teacher who now spends her days at home with the “Dew Crew,” the loving term she has given to her two sets of boy/girl twins. She is married to her high school sweetheart and they reside in NC, where she stays busy homeschooling the children and supporting her husband in ministry.

I’m excited and thankful for this opportunity to be a guest blogger today. My name is Tara and I am the proud Mommy of two sets of twins. Our first set, Natalie and Nathan, are now 6 ½ years old and our second set, Samuel and Samantha, are 3 ½ years old. I’m very grateful to be a breastfeeding Mom that was able to nurse all 4 of my children for the first year of their lives.

3But, let’s rewind back to the beginning…When my husband and I found out that we were expecting twins, we were shocked! Never in a million years did we dream that we would have twins. (Turns out that I have fraternal twins three generations up on my father’s side, and the genes were passed down to me :))

As we began preparing for their arrival, one of my biggest fears was if I’d be able to produce enough milk for them. I so desired to nurse my children, not only for the bonding and nutritional factors, but also for the economic reason: We couldn’t afford 2 in diapers AND 2 on formula! My mom had breastfed my siblings and me, so I knew that breastfeeding was what I’d love to be able to do. But, would my small-breasted self really be able to produce enough milk for not one, but two babies?

Natalie and Nathan were born at 34 weeks gestation, and were immediately taken to the NICU. I was not able to nurse them for the first few days of their life (since they hadn’t acquired the suck/swallow/breathe reflex yet). So, my first experience with “nursing” was actually with the hospital breast pump. I can remember pumping that first time and NOT GETTING ANYTHING! I was so discouraged. But the sweet nurse reassured me that this was normal: My milk hadn’t come in yet, and we were just stimulating and “prepping” my breasts for what they were created to do.

Two days later, my milk came in… And then I acquired the nickname of “Dairy Queen.” I often cried tears of joy at how my biggest fears had subsided. My body produced all that my babies needed to eat! And even when I wasn’t in the NICU, the nurses would feed my pumped breastmilk in through a small tube in Nathan and Natalie’s noses and then down to their tummies.

2When they were several days old, I was able to nurse them for the first time and though it was an unusual feeling, it was not painful for me. I praise the Lord that I never dealt with cracked or bleeding nipples, and that my body was able to produce enough milk for both babies! The only “hurt” that I had with nursing came when the kids were 2 weeks old. I developed mastitis in both breasts and felt like I had the flu with a fever! It was terrible, but cleared up quickly with medicine.

During the first few weeks of their lives, I nursed them separately in the cross-body position. They were learning how to latch correctly and stay awake for a full feeding. But after the first month, they became excellent nursers and I began feeding them at the same time. I used a double-boppy pillow, which I fondly call “my boppy on steriods” because it is so much bigger than a normal boppy. I fed the children in a “football-hold” position. One child would nurse on one side, but then at the next feeding, they would get the other side.

I fed the twins’ simultaneously until they were about 9-10 months old. By this time, they were getting more and more interested in the world around them and would “lose interest” in nursing. I found it easier to nurse one at a time at this point. They were such efficient nurses though, so feeding one and then the other didn’t cause any issues. When they were 13 ½ months old, they weaned themselves and gave up the last early morning feeding/snuggle session.

1Samuel and Samantha have a very similar nursing story, except they were born at 37 weeks and didn’t spend a day in the NICU! They were “full-term babies,” who latched correctly the very afternoon they were born and were excellent nurses the entire time! I was so blessed to be able to nurse them until almost 14 months old as well. Though nursing required a lot of dedication for that first year, I am so thankful that I was able to produce enough for them and that I was able to share that special bonding time with my children.

Adoptive Breastfeeding

Breastfeeding My Adopted Baby

Mary Straits HeadshotKaren Lytle is the mom of four kids so far, three biological and one handsome adoptive son.  She has had the amazing privilege of breastfeeding all four of them, including her adopted son. Karen’s story is as unique as each mother’s breastfeeding journey, but she shares it hoping that some of it helps to inspire other adoptive moms as to the wonders of intimacy that can be a part of nursing adoptive children.

When our oldest was 15 months old, we brought home two beautiful, identical twin girls. Life was busy, but good. I was learning the joys and challenges of nursing multiples. When the girls were 6 weeks old the Lord told us it was time to start a process of adoption. We had always known we would adopt, but he told us the time was now.

We explored foster care, international, but in the end for this time, God was leading us to adopt a newborn – one who fit the qualifications of “more difficult to place.” We were matched when the girls were 14 months old, and Isaac’s birth mother was 37 weeks pregnant. I was still nursing the girls twice a day at this point, and I started weaning them the day after we met Isaac’s birth mother. As I weaned them, I began to pump every 1 1/2-2 hours including a nightly pump to get ready for the demands of breastfeeding my adopted baby.

Adoptive Breastfeeding

I had always struggled with low milk supply issues, so I think like every adoptive mother who tries this, I went through all of those concerns of whether or not I would be able to produce enough milk. But I was determined to teach him to breastfeed. So, I began to research, and I put myself on a nursing mother’s diet. I drank barley water and ate a variety of foods and spices (such as anise) that helped to nourish my milk. I also took fenugreek and blessed thistle supplements.

We brought him home when he was two days old. And I still remember that night. I told my husband that I wanted to have that first night where it was just Isaac and me so that I could be totally relaxed and work just with him on his feeding while he was sleepy and just get him used to my heartbeat. I stripped him down to his diaper, and laid him on me skin to skin. Every time he stirred, I would offer him my breast, and within a few offers, he had latched on just suckling instead of nursing. But, by the end of that first night, he had nursed twice. We slept together skin to skin, or I should say dozed together, like this for about a week. And he rarely wore any clothes during those first days together. I wrapped him up next to my skin and held him almost the entire time.

Adoptive babies need to acquaint themselves with their adoptive mother’s heartbeat, scent, and touch. With a biological newborn there are changes outside of the body, but there is an instant connection with sounds and sensations when their biological mother holds them.

With an adoptive infant, those connections need to begin to form with that new adoptive mother’s heart rhythms and touch. While there is no physical memory at this point, a child still has something called cellular memory. So, imagine this as a time where you are helping them through a grieving process that they don’t even know they have.

Also while helpful for every infant, light infant massage can be especially helpful for an adoptive infant’s transition into your family. It has also been proven to heal and correct any sensory pathways that might have received slight damage due to stress in utero or stress during delivery.  For an adoptive infant there is the added stress of separation from their biological mother.

Big brother with adopted baby.

Big brother with adopted baby.

Now, truthfully, nursing wasn’t a perfect process. While he was nursing like a champ, I have always struggled with low milk supply, so we did supplement some. And the most difficult time nursing him actually came when he was about 3 months old. I had emergency surgery and was in the hospital for four days, and while I pumped, I couldn’t nurse him. Fortunately, my sister had just had a baby, and so while I couldn’t nurse him she was able to.  But, by the time I got out, my milk supply had dropped even lower.

I met with a lactation consultant two days after I came home, and for the next 2 weeks, I used an at-breast-tube-feeding device when I nursed him. I think the amount of pain I was in and my stress that I might not be able to keep nursing him was affecting my supply. But, we made it through that, and I was able to nurse him until he was a year old.

I hope this inspires other adoptive mothers. This is a precious time with your child; relax and do everything you can to make it happen. You will not regret it. Nursing builds intimacy and trust between a mother and child.

Adoptive BreastfeedingWhile it is their best nourishment for their body, it is also building their emotional well being, and promoting their brain development beyond just nutrition as well. And when you are nursing your precious infant, especially your adoptive infant, remember to use it as a time to look deep into their eyes.

There is a reason the eyes are called the windows of the soul, and science has proven that those moments of eye contact between a mother and child in those early years provides a foundation of trust and connection that supports them for years to come. And for an adoptive infant, these times are being built at placement rather than before, so by doing this you can recoup some of that
lost time.

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

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).}

How is Milk Supply Established?

How is my milk supply established?

After 16 weeks of pregnancy, lactation occurs though it is kept in check by progesterone produced by the placenta. (This is why a mother who has a late miscarriage may still produce milk.)  Once the placenta is removed following birth, prolactin and oxytocin are greatly increased and your body begins to make copious amounts of milk (this is evidenced by your milk “coming in” 3-4 days postpartum).  Though the initial “coming in” of milk happens whether a mother has been breastfeeding or not, this autocrine control of lactation changes to endocrine control and, if milk is not removed, the body will not continue to make milk.

During the first six weeks or so following birth, your body is flooded with hormones that make and regulate your milk supply.  As you breastfeed, prolactin receptors are being laid down within the breast that can impact how much milk your body will make for the duration of breastfeeding.  Therefore, it is extremely important to nurse your baby on demand ensuring that you breastfeed often both night and day in the early weeks.  If your baby is in the NICU, or is unable to nurse effectively for whatever reason, pumping or hand expression as often as your baby would nurse is critical.  Prolactin levels are higher at night so it is especially important to nurse your baby during the night, especially in the early weeks, to help establish your supply.

Milk supply is governed by the law of supply and demand: an empty breast makes more milk.  Therefore, nursing frequently, and having a baby effectively drain your breasts, is the best way to establish a strong milk supply.

While it seems that hormonal imbalances or a lack of glandular tissue (whether from hypoplasia and/or breast surgery) get a lot of attention, the majority of women who experience low milk supply do so because of infrequent or ineffective milk removal.  Every woman’s body and breast milk supply are different.  While one mother’s body may be more forgiving if a bottle is given on occasion, this could very detrimental to another mother’s supply.  One mother and baby dyad may be able to survive scheduled feeds, while another baby and mother may have significant problems that lead to a dissatisfied baby and low milk supply. This is why there is no “one size fits all” approach to feeding a baby, despite what some parenting books may want us to believe.

Regardless of what has happened to cause a low milk supply, there are strategies you can employ to help increase your milk, even while continuing to nurse your baby at the breast.

Adoptive Breastfeeding

Adoptive Breastfeeding

There is an increasing trend today of mothers who are interested in breastfeeding their adopted children.  Breastfeeding, in general, is on the rise in western cultures and many adoptive parents don’t want their infants to miss out on either the nutrition or bonding that nursing provides.  Whether the child is a newborn or toddler, many adoptive parents are researching what it takes to be able to breastfeed when it’s not a mother’s biological child.

Important questions to consider

There many factors that must be considered:

  • Has the mother ever breastfed a child?
  • If so, how long has it been since she nursed a child?
  • How long did she nurse the child and why did she wean?
  • How much time does the mother have until she will receive her baby?  ie does she need to begin lactating immediately or does she have time to prepare her body hormonally?
  • How old is the baby to be adopted?
  • Has the baby ever nursed before? What is the likelihood of baby latching to breast?
  • What are the mother’s goals – full breastfeeding, partial breastfeeding, comfort at the breast, nursing at the breast with at-breast tube feeding device, etc.?
  • Does the mother have a supportive network around her?

Frequent breast stimulation and milk removal are critical

Even when an adoptive mother has never had her own biological children, it is possible to induce lactation and breastfeed a child. There are many things that are important for success with adoptive breastfeeding, but, if a mother wants to nurture her child at her breast with milk (rather than just comfort nursing and snuggles) then frequent breast stimulation and milk removal are critical.

It doesn’t matter what else a mother does – hormones to mimic pregnancy, being surrounded by a supportive network of friends and family, skin-to-skin contact with baby, galactagogues to increase milk production, etc. – if the breasts are not stimulated at regular intervals throughout the day and night and milk effectively removed once production begins, then a mother’s body will not build a milk supply.  Frequent and effective milk stimulation and removal are essential!

How can a mother who hasn’t given birth make milk?

Hormones in pregnancy prepare a mother’s body for breastfeeding.  Breast milk is kept in check by progesterone.  When a mother delivers the placenta her progesterone levels dramatically decrease and the body begins to rapidly make milk – which a mother notices as her milk “coming in” between days 2-5.

However, the mammary glands can also be stimulated by suckling – with a baby, breast pump, or hand expression – which facilitates the growth of mammary tissue and release of hormones essential for lactation. Frequent suckling is what allows this process to continue.

Keys to successful lactation

  • Maternal motivation
  • Support system surrounding mother including supportive partner and mother-to-mother breastfeeding support group
  • Excellent breastfeeding counsel from a qualified lactation consultant
  • Baby who can effectively suckle at breast or pump/hand expression system
  • Frequent and effective milk stimulation/removal…remember, an empty breast makes more milk.

Things to be aware of:

  • Oxytocin, one of the hormones essential to lactation, can be inhibited by stress.  Make sure to have a tribe of support surrounding and encouraging you!
  • If you have breastfed before, the longer the gap since this experience, the longer the time it will take for milk stimulation1 But, even if you have never breastfed, inducing lactation is completely possible!
  • Babies younger than 2 months are more likely to suckle on the breast naturally2
  • Babies and toddlers of any age can learn to breastfeed.  In fact, many infants who have never breastfed may initially refuse the breast.  This doesn’t mean they always will though.
  • Children who were breastfed before adoption may naturally seek the adoptive mother’s breast as well.
  • Some mothers will achieve a full milk supply while others will not.  Even if a mother doesn’t make enough milk for exclusive breastfeeding, she can exclusively feed her adopted baby at the breast through an at-breast tube feeding device.
  • It can take weeks to begin to see the first drops of milk once frequent, effective breast stimulation occurs.
  • Milk typically creeps in – as opposed to a mother’s milk “coming in” following birth where she may experience engorgement
  • 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 critical to your success.  There will be moments when you wonder why you are doing all of this and having others to encourage you and share their experiences will help you tremendously.

You may also be interested in reading 5 Challenges Adoptive Mothers Face with Breastfeeding as well as How to Encourage your Adopted Child to Breastfeed.