Pumping and Feeding

Sometimes situations come up where nursing from the breast is difficult. These may include, but are not limited to the following: latch issues (baby won't latch well on the breast), cracked and sore nipples (resulting from poor latch), mother discomfort with nursing (physical pain or emotional discomfort with using her breasts for feeding). Any or all of these can contribute to moms resorting to pumping milk from the breast and feeding it through a bottle.

　

Pumping and feeding is certainly an adequate way to nurse a baby, when nursing from the breast is not possible. However, moms should be informed that exclusively pumping, without baby nursing at all from the breast, can result in a diminished milk supply. Milk supply is created through supply and demand. As more milk is drained from the breast, the body in turn makes more milk to ‘keep up’. The body will generally not let down as well or as completely from an artificial pump as it will from a baby on the breast. For that reason, supply will eventually diminish if baby is not put back to breast, or if pumping is not increased adequately to reflect baby’s needs. Pumps can help maintain supply for finite time periods, when skin to skin nursing is not possible; however, it rarely makes a complete substitute. Babies are much better at draining a breast than any pump will be, hospital grade or otherwise. Therefore, if pumping and feeding is your only means of breastfeeding, be aware that supply can diminish if not carefully monitored. Pump more often to increase supply. Pump for longer periods. And If at all possible, re-introduce the breast to baby, as it is the BEST way to stimulate milk production and adequately drain the breast. The more often baby is put to breast, the more likely milk supply will fall into the right place.

　

Below are some good articles and resources on pumping and feeding from KellyMom.com (the author is an International BoardCertified Lactation Consultant):

• For more information on pumping and feeding, what to expect in terms of output when pumping, and ways to increase milk supply while pumping, read the following article:http://www.kellymom.com/bf/pumping/pumping_decrease.html
  
• For more information on establishing and maintaining a good milk supply when baby is not nursing directly from the breast, read the following article:
  http://www.kellymom.com/bf/supply/maintainsupply-pump.html
  
• For a complete list of articles on pumping and milk supply, look to the following:
  http://www.kellymom.com/bf/pumping/

Breastfeeding and the Law

Wisconsin has state laws on the books to protect the rights of breastfeeding mothers. Basically, a woman can breastfeed anywhere where she and her baby are permitted to be together. We have federal law that requires empolers to allow breastfeeding mothers the opportunity to express milk for their child for the first year after birth. They must also provide a place to pump, other than a bathroom.

http://www.ncsl.org/default.aspx?tabid=14389

Wellness Center of Door County

Some links for reference:

Facebook info page:
http://www.facebook.com/wellnesscenterdoorcounty?ref=ts&sk=wall#!/wellnesscenterdoorcounty?sk=info

Website:
http://www.wellnesscenterofdoorcounty.com/

Women Food Pregnancy Program (for women of childbearing age):
http://www.wellnesscenterofdoorcounty.com/programs/woman-food/index.php

When to Nurse Your Baby - How to Calm Your Baby

Q: When should I nurse my baby?
A: You should offer the breast first when baby shows signs of hunger or fussiness. It’s the first and best line of response. Early signs of hunger will be displayed by lip smacking, rooting (biting on fists), turning head from side to side, and showing increased restlessness. You will learn to recognize these cues easily as you get to know your baby better. Offer the breast early for easiest feeding. Crying is a late sign of hunger. Often, if feeding is put off, baby will be fussy and will be more likely to feed poorly. If you offer the breast right away when early hunger cues are being shown, baby will be happier, calmer, and more likely to feed well. Nursing when baby is hungry is called, "nursing on demand." Breastfeeding experts agree that nursing on demand is the preferred way to breastfeed. Rigid nursing schedules and following the clock can threaten milk supply.

 

Q: What if my baby is still fussy.
A: If baby won't take the breast when offered, try to calm the baby with other methods. Below are a few tried and true other ways to sooth a fussy baby, especially in those early weeks. Some of these are taken from Dr. Harvey Karp's book, The Happiest Baby On the Block. I would highly recommend this as a reference:
http://www.amazon.com/Happiest-Baby-Block-Harvey-Karp/dp/0553381466/ref=sr_1_1?ie=UTF8&qid=1350418202&sr=8-1&keywords=the+happiest+baby+on+the+block

1. Is it anything obvious: check or change diaper. Is there something scratching, poking baby? Check clothes for anything that might be uncomfortable. Is baby too hot or too cold? The general rule is to dress baby in one layer warmer than what you would be comfortable wearing. Sometimes, just checking the basics associated with general comfort can be a good place to start.
2. Reduce stimulation: Babies are constantly learning and taking in new information. When in a room with new people, they are looking at and trying to identify with each new face. It is exhausting work. Sometimes they get overstimulated--especially in the later part of the day. Turn down the lights, turn off TV, put baby up on your shoulder, letting them nuzzle (or cry) on your shoulder. Protect them from the world a bit. Find a quieter place if you can. Be patient. It takes time for them to calm sometimes. Sleep is often  the 'reboot' button that allows their brain to settle. More tips on getting them sleepy follow.


3. Swaddle: Wrapping a newborn tightly in a blanket, called swaddling, can help soothe baby. A snug wrap around the body will simulate the feelings the baby had in the womb. It has a natural calming effect. Slings and wraps that hold baby snugly to your body can also be soothing in this way. For techniques on swaddling, look here:http://www.youtube.com/watch?v=CSYPqGtFBYQ
   http://pediatrics.about.com/od/weeklyquestion/a/0607_swaddling.htm
   
4. Swing or provide movement: Gentle, rhythmic movement also helps calm babies by simulating what happened in the womb. When you wrap baby tightly AND move them rhythmically, it simulates that movement they felt in the womb, when mom was walking and moving around during the day, while baby was held snugly inside. Ways to provide gentle movement include dancing or walking with baby held securely in your arms (or a sling). Swaying back and forth with baby held securely in your arms (or a sling). A baby swing or rocking bassinet will also do a good job providing this movement. Rocking together in a rocking chair is also soothing. A ride in the car (in a safe car seat, of course) is another good choice.
5. Shhhhh: Sometimes it comes naturally, we say shhhh, shhhh, shhhh to baby in their ear. Well, good science has found there’s a reason we do this. Rhythmic loud noise also simulates womb environment by providing the noise that was present all the time in their pre-birth existence. The rushing of mom’s blood through the blood vessels in and around the placenta is loud for babies, in the womb. That same kind of loud rhythmic, white noise is soothing in the early weeks/months, too. You can provide this by saying, "Shhh, shhhh, shhh," loudly in baby’s ear. Sometimes running a vacuum or standing near a running laundry machine is helpful, too. My husband, desperate to help, stood next to one of his loud ‘tools’ in the shop. It did the trick & put our baby to sleep. You will find that when baby is in a loud environment, s/he will often ‘shut down’ and sleep. This is good to use to your advantage with shhh-ing or creating some loud background noise.
6. Suck—again, offer the breast. The sucking helps soothe babies to sleep. Dads can sometimes offer a finger to suck on, or a pacifier, if baby is not too young. Breastfeeding experts usually advise against using any artificial nipples in the first 4-6 weeks. Talk to your health care provider about this.
7. Skin to skin contact—Strip baby down to diaper. Take off your shirt. Let baby be close to you, touching your skin. This skin to skin contact helps release hormones in you and in baby that calm and relax you both. Rock in a chair, under a blanket, and let the two of you be in close, skin to skin. Several of the soothing mechanisms will be triggered.
8. Pressure on the stomach—First and foremost, it is important to reiterate ALWAYS PUT BABY TO SLEEP ON HIS/HER BACK. THIS IS AN IMPORTANT SAFETY MEASURE TO REDUCE THE RISK OF SIDS. That being said, sometimes pressure on the tummy when fussing is helpful in soothing baby to sleep. What we did is put a pillow on our lap, sitting in a good chair or couch, put baby on the pillow on her tummy, gently rocking her back and forth with our knees, and then offering a pacifier, if she wasn’t sucking her fingers. We, of course, had hands on baby to make sure she was securely held. My husband was good at holding baby on his forearm on her tummy and swishing her back and forth, using the other arm as support. This movement  coupled with pressure on the tummy helps soothe baby to sleep.
9. Stay calm – baby can tell if you’re stressed out. Take some deep breaths yourself to reduce your stress level. Put in ear plugs, if it helps. I know being around a crying baby for an extended period of time is stressful. If you have a co-parent/partner/friend around to help, take turns and give the other person a chance to step away & take a walk around the block—get out of the environment. A few minutes of quiet can do wonders to help calm the nerves. If nothing else, if you have no one there to help, put baby where she is safe, in her crib, for a few minutes and step away. It is important that you find a way to calm yourself. Baby can pick up on your stress and react to it, making the situation even worse. NEVER SHAKE A BABY.  For more info, go here: http://www.uihealthcare.com/depts/uichildrenshospital/childprotection/pdf/sbsflyerfinal.pdf
   
10. Remember, this won’t last forever. Sometimes as parents and human beings, we think whatever challenge we’re facing will last indefinitely. When a baby is upset, it can feel like it will last forever. IT WON’T. Try to keep this in perspective. Babies get fussy. Babies cry. This is the only way they have to communicate when they are upset. If you can’t figure it out, for the short term, just be empathetic for your baby. Be that soft place to land. Look at her in her eyes and say, "I know you’re hurting. I’m so sorry. I’m here to help you." Just passing that emotion of wanting to help to your baby can go along way. Keep this in perspective. If your baby is inconsolable, call your doctor and see when you can bring him/her into the office next. Always consult a health professional if you’re feeling that something is truly wrong. Trust your gut. Trust those instincts.

Low Milk Supply

Technically, low milk supply is supposed to be rare. However, I have recently heard of several cases of moms having concerns and real issues with milk supply. Here is a link to a book put out by La Leche League, a trusted breastfeeding source. It has all kinds of information about milk supply, how to tell if you are producing enough, and ways to encourrage greater supply. I have not read it, but knowing La Leche League, I would trust it's a good source:
http://store.llli.org/public/profile/362

Nipple Pain

Here is a good article from La Leche League about causes of nipple pain and remedies.

http://www.llli.org/llleaderweb/lv/lvfebmar00p10.html

Common Breastfeeding Myths

This is a very comprehensive and accurate list of breatstfeeding myths and the truthful story behind each. I'd encourrage you to read and pass it on:

http://blog.nurturedchild.ca/index.php/2011/01/30/the-truth-behind-common-breastfeeding-myths/