Recommendations From A Lactation Consultant

I’m excited to get to share with you all my secret weapon, my resource for all things baby, my mama! She has been a mom/baby nurse for over 20 years, and has been a licensed lactation consultant for almost a decade. She is a plethora of knowledge in the baby nursing world and has been able to help myself and many of my friends.

This post is just a general list of resources and recommendations. We will get to the Q&A answers later this week.

Hi everyone, I have to put a disclaimer, first:
I do the newborn period in the hospital, so that is what I am most familiar with. I cannot prescribe. Anything I recommend, follow up with your physician first, as he/she knows you and your baby specifically.

Good Web Resources:

  1. bfar.org Diana West, IBCLC and Lisa Marasco, IBCLC are big names in lactation and are good resources.
  2. kellymom.com
  3. med.stanford.edu Breast feeding/Newborn Nursery/Stanford Medicine. Getting started with breastfeeding”. Stanford has a great hand expression video. “Making More Milk.”
  4. www.asklenore.info “relactate”ask Lenore.” Lenore Goldfarb, PhD, CCC, IBCLC, ALC.

 

Recommendations for in the hospital, right after birth:

  1. I recommend that when you come to the hospital to bring your breast pump, just incase you need it. Some women have a harder time getting their milk in and having your breast pump can be helpful.
  2. Things to help get your milk in faster: kangaroo care in between feedings, breastfeed every 2 to 3 hours (8 to 12 times in 24 hours) using breast compression as you feed, and hand express for five minutes total between the two breasts.
    *The key to hand expression is to go back a forth between the two breasts. You should expect nothing to droplets. Anything beyond that is great. Drip the colostrum into a spoon and spoon feed it to your baby. Or, you can breast pump after breast feeding for 15 minutes to help establish your milk supply.
  3. If you have any questions, you can ask to see the lactation consultant at your hospital. We are happy to help.
    Once your milk supply is in, then make adjustments to your breast pumping.

Recommendations for Pumping:

If you are staying home:
I would pump once a day after a breast feeding, do it at the same time a day, and store it.
This will yield you 30 bottles in one month, perfect to quickly grab for those date-nights, or
Store in 2 to 4 ounces as it is easier to thaw.

Life Span of pumped milk:
5 days in the refrigerator
3 to 6 months in the normal freezer we use all the time
6 to 12 months in the deep freezer.
Never thaw in the microwave, it kills all the nutritive properties of breast milk.

If you are returning to work:
Figure out your comfort level and how much milk you want to have stored. My NICU nurses like to have 100 to 120 bottles stored before they go back to work. They buy a deep freezer. They say they would rather deal with an oversupply than not have enough milk.
Pumping twice a day is easy, once in the morning and once in the evening, for example. I would not pump more than three times a day as you end up battling an oversupply. Some symptoms of over supply are projectile vomiting, gassy, loose green stools. In this case, the baby, is getting mostly foremilk.

During engorgement, especially if you have large breasts, warmth before for 5 minutes. You can use ice before, but I find warmth works better. Afterward, ice packs the breasts for 20 minutes. Some people only have to ice once or twice, and others have to ice the full 24 hours. Engorgement lasts 1 to 3 days on average.

 

How much do I feed my baby?

Here is good general ballpark rule of thumb to know if your baby is getting enough.
10 cc per pound.
A 3 pound baby = 1 ounce (30ml) per feeding times 8 feedings in 24 hours.
A 6 pound baby = 2 ounces (60 ml) per feeding times 8 feedings in 24 hours.
A 9 pound baby = 3 ounces (90 ml) per feeding times 8 feedings in 24 hours.
This is once your milk supply is in. Obviously, some babies eat more.

Foods to increase milk supply.

There again, if you are allergic or have dietary restrictions do not eat them.Always, ask your doctor, first:

  • increase the protein in your diet, the dark green vegetables (folic acid), foods high in iron.
  • Do not eat alfalfa if you have autoimmune disorders or lupus in the family.
  • Do not take fenugreek if you are allergic to peanuts, have hayfever, asthma, or allergic to chick peas (hummus).
  • Steel cut oatmeal in the morning with some form of protein increases milk supply.
  • Nuts that increase milk supply: Almonds, cashews, macadamia nuts, peanuts.
  • Barley releases prolactin: grapenuts, malt shakes, malto-meal. Coconut, homemade chicken soup with a whole chicken, dandelion greens, malunggay, apricots, avocados, asparagus, basil, beets, black pepper, nutritional yeast, brown rice, carrots, hummus, chicory, barley based coffee substitutes, coconut, dates, dill, fenugreek, flax, garlic, ginger, natural ginger ale, goats rue, granola bars with oats and almonds, green beans, green leafy vegetables, green papaya cooked, hops, kelp (high in iodine: so don’t eat if issues with iodine), lentils, malt, marjoram, milk,  milk thistle, millet, mung bean, natural root beers, nettle leaf, onions, peas, black sesame seeds, spinach, turmeric, water cress, yams, salmon, white horse radish, red clover (not fermented red clover).

Power Pumping to increase milk supply.
It’s like mimicking cluster feeding. Watch a movie and pump off and on during the move: pump for 10 to 15 minutes, then rest for 15 to 30minutes, then pump, then rest, like a baby does at growths spurts to increase milk supply. Do this several days in a row. Prolactin is higher at night. So, evenings are better, if possible.

Things to Avoid:

  • Sage has been known to dry your milk supply up.
  • If you chew spearmint gum every day for a week it will decrease your milk supply by an ounce.
  • If you take sudafed around the clock or Benadryl around the clock it can dry your milk supply up.
  • Kombucha tea has been categorized in many lactation books as an L5.

Other things can be cause of decreased milk supply: undiagnosed thyroid problems, anemia, retained placenta, decreased prolactin levels, etc… let your doctor know as he/she can help figure out the cause of the low milk supply for you.

 

Thanks for having me.
I look forward to answering your nursing questions later this week.
-L

Too see the post where we asked for you to submit lactation/nursing questions click here.

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