Just when we thought we were coming out of the crazy world of 2020 and 2021, 2022 hits us with a formula shortage. I’m here to answer the most common questions that I am hearing about the formula shortage.
Why? “Current shortages have been largely caused by supply chain issues and the recent recall of several baby formula products over concerns about contamination.” Basically, there are only a few companies that make baby formula for the big brand names as well as store brand formulas. Unfortunately, if one of these companies has problems, it can lead to massive disruption in production for lots of different brands. In this case, it’s Abbott, and they’re sorry .
What are families supposed to do?
Well that depends. If you’re already breastfeeding or pumping, continue to do so to the extent that you’re able. If you are having difficulty breastfeeding or pumping, please contact a certified lactation consultant asap to make a plan to get things on the right track. Issues such as painful breastfeeding, painful pumping, low supply, and others, can be solved by working with an expert who knows how to solve them!
If you’ve been buying retail formula, I know it’s tempting to stock up on formula when you see it in stock, but I recommend that you buy only what you need for 10 to 14 days. Stocking up on formula only adds to the shortage on the shelves for other families.
If you have been using WIC to obtain formula, North Carolina is now allowing WIC families to use their waivers for different brands of formula according to what they are able to find on the shelves.
You can try to find your formula at smaller local retailers or online.
Importantly, you can use a different brand of formula than what you have been using. Most babies tolerate a change in formula without difficulty, if the formula is the same type that they have been taking. I also recommend that you make only the amount that the baby needs at that time, to minimize waste.
It is very important that parents avoid trying to make the can of formula last longer by diluting the formula with extra water when they mix it. Mixing the formula in any way other than what the directions on the can say can be very dangerous to the baby. If the baby is on a specialized formula, or you just can’t find any formula at all, please contact the baby’s medical provider asap.
What about donor milk?
There is one certified milk bank in North Carolina, and obtaining milk through the bank is difficult and expensive. The milk is primarily used for babies in the NICU or medically fragile babies, and a prescription is required.
Another option is casual milk sharing.
But is it safe to feed my baby someone else’s breast milk?
Mothers have been sharing breast milk since the beginning of babies. The better you know the donor, the more likely the donated milk will meet your standards. Start with close friends and family to see if there is anyone who has extra milk that they can share with you. To be sure the donated milk is free from bacteria and viruses, you can pasteurize the milk at home. Please click here for detailed instructions for how to safely prepare donated breast milk.
How Can I Get This Baby Weight Off Safely?
Safe weight loss is healthy and realistic for breastfeeding women. Breastfeeding uses calories stored up during pregnancy, and a breastfeeding mother will lose 1-2 pounds a month with a normal, healthy diet (eating to hunger) and normal activity. If you want to lose weight faster, you can safely lose 1 pound a week through changes in diet and moderate exercise.
A weight loss of 1 pound a week with a healthy diet (at least 1500 to 1800 high quality calories) and moderate exercise has no effect on the fat content of the breast milk or on the baby’s growth. When you make healthy nutritional choices like eating lean meat, and cutting sugary or salty, high-fat junk food, refined flour, and high calorie drinks, you will experience healthy weight loss. Small changes can make a big difference. For example, cutting out a can of soda per day eliminates 140 calories, or 14 pounds a year!
You may begin a moderate exercise program after getting clearance from your OB or midwife 6 to 8 weeks after delivery. You can safely cut 500 calories from your diet and add a moderate 45 minute exercise routine 4 days a week and lose weight without affecting the quality of your breast milk or the growth of your baby.
I recommend slow, healthy, natural weigh loss through healthy nutrition and moderate exercise. If you have questions, or would like a personalized plan, I can help you! Call or email me if you would like to discuss healthy postpartum weight loss.
This article from the New York Times has more information.
Breastfeeding mom, are you ready for a break? Are you dreaming of a night out without your baby, or a night of sleep? Are you returning to work soon?
First of all, congratulations on exclusively breastfeeding your baby! That is a huge accomplishment and you deserve a medal! But now, you may have some questions about introducing a bottle to your breastfed baby.
These tips are not meant to be rules, or make you feel guilty if you do bottle feeding a different way. They are just meant for you to pick what works for you to make bottle feeding easy and pleasant for you and your baby.
Keeping it Safe
For Babies who are Like, Nah, I Only Eat from the Breast!
If your baby is not taking a bottle, try these tips:
Keep it Fun!
I am very excited to now provide expert breastfeeding help at the office of Carolina Pediatrics of the Triad!
If you are looking for a pediatrician for your new baby, Carolina Pediatrics is now the only pediatric office in Greensboro offering Lactation Consultation services.
Carolina Pediatrics understands the importance of on-site breastfeeding help, and they have opened up office space for Greensboro Lactation Consultants to see families at the first weight check, or whenever concerns arise. Appointments are available on Monday, Tuesday, and Thursday mornings, and drop-ins are welcome.
Call, text, or email if you'd like breastfeeding help at Carolina Pediatrics.
Got (Enough) Milk?
As a Lactation Consultant, I have been asked everything under the sun that has anything to do with breastfeeding, from “can I drink some coffee?” to “can I nurse with a pierced nipple?” to “how does a pump work?” But by far, the most common question I get is, “am I making enough milk for my baby?” Weighing the baby over time is the best way to know if the baby is getting enough milk, but it’s impossible to weigh the baby every feeding or every day. There are some other great ways, besides weighing the baby, to know that breastfeeding is going well.
Here are 5 tips to help you know if your baby is getting enough breast milk:
1. You are feeding your baby very frequently, every time your baby acts hungry. If you are feeding your baby every time your baby acts hungry, 8 to 12 times (or more) every day, even if your baby just finished a meal, you are getting off to a great start. By offering very frequent, on-demand, unlimited feedings at an early age, you are making sure that your baby gets all the milk he or she needs, as well as triggering your body to make lots of milk in the coming weeks and months. Every time your baby latches, your baby is telling your breasts to make more milk. More feeds in the early days results in more milk in the coming months.
But how will you know that your baby has a good latch and is actually getting milk?...
2. You can hear your baby swallowing. All that chugging? That is the sound of your baby getting lots of milk. If you can hear your baby swallow frequently from day 5 on, you can be sure that your baby is drinking. Babies who are getting plenty of milk from breastfeeding will suck once or twice, then swallow, and they will repeat this suck, swallow pattern until…
3. Your baby is content and relaxed after a feeding. Babies are usually tense when they are showing hunger cues. Before the feeding, many babies have their fists clenched up and their arms pulled in tight to their bodies. As the feeding progresses, and you hear frequent swallowing, watch your baby’s arm and hand. The arm and hand will began to loosen and relax, and the fingers will splay open. A hungry baby will pull their arm in if you (gently) pull the hand away from the body. A full, satisfied baby will have a relaxed arm and hand, and when you lift the hand away from the baby’s body, the arm will drop like a wet noodle. The baby’s arm is a good gauge as to how satisfied the baby is after eating.
Your baby needs to have a wide mouth and a deep latch to make sure that he or she is getting enough milk. If your baby has a shallow latch, you could experience sore, painful nipples and engorgement. Another good sign that your baby is getting enough milk is that…
4. Your breasts and nipples are not in pain. Some women feel their breasts fill up every feeding, and some women don’t feel the filling as much. If you generally feel your breasts fill up with milk, and your breasts get softer during a feeding, this is a good sign that your baby is getting lots of milk.
In the early days and weeks of breastfeeding, a little discomfort and tugging on the nipples is common, but toe-curling pain is not normal. If your nipples hurt so much that it takes your breath away, get someone to help you adjust your baby’s latch. Healthy, comfortable nipples are a sign that your baby is latched well.
Besides frequent feeds, lots of swallowing, a content baby, and comfortable nipples, there is one other thing to look for…
5. Pees and poops What comes out of your baby says a lot about what went in your baby. If your baby is having lots of wet diapers and at least a few yellow poops every day, AND you are experiencing ALL of the above, you can be confident that your baby is getting plenty of milk and that your body is making enough.
Bonus Tips! Things that do NOT mean that your baby is starving:
1. Frequent feeding. If it seems like your baby wants to eat all the time, see tip #1 above. This is not a sign that your baby is starving, it is normal for your baby to want to feed very frequently, which ensures that your baby gets fed enough and your body makes enough. More sucking = more milk!
2. Your friend’s baby takes more formula than you pump for your baby. You be you. Moms are valuable teachers for each other, but comparing your baby to another baby isn’t always a good idea. Babies who drink formula require more than babies who take breast milk. Use the tips above to be sure, and when in doubt, it’s always ok to call for a weight check.
If you aren’t seeing all 5 signs that your baby is getting enough milk, or if you have any concerns about it, call your baby’s pediatrician or an IBCLC and get some help.
Nurse on, mama!
Breastfeeding is not supposed to hurt. A little discomfort may be normal in the early days, but toe-curling pain is not normal. Positioning errors cause about 95% of severe pain in the early weeks of breastfeeding, and often, small adjustments can make a big difference! I would love to help you breastfeed without pain. I will do a full breastfeeding assessment in your home, including a weighed feeding with my hospital-grade baby scale. If there is something else going on besides positioning, I will work with you to come up with a plan that will help you reach your breastfeeding goals while reducing your pain and keeping your baby thriving.
Call or email if breastfeeding is painful. You don't have to continue to suffer - I am available for in-home breastfeeding help usually within 24 hours of your request.
Help! Breastfeeding is Painful! Is Something Wrong?
The early days and weeks of breastfeeding can be difficult as mom’s hormones are shifting dramatically and she is getting less sleep than she is used to. Sore nipples can make the adjustment even more stressful. Some well-meaning friends or family members might tell moms that they need to “toughen up” their nipples, or advise them to give up and just bottle-feed. If your nipples are hurting, it is important to find the cause of the pain and to make the necessary adjustments so you can continue breastfeeding.
Discomfort in the early days of breastfeeding is not uncommon and might be normal, as long as it is mild, it lasts only a few seconds at the beginning of a feeding, and the nipples look normal after feeding. Toe-curling pain that lasts throughout the feeding and/ or between feeds, and nipples that are misshapen, white, scabbed, or cracked are not normal. Moms who are experiencing these things are encouraged to seek help from an IBCLC right away.
Most of the time, sore nipples can be resolved by making some adjustments in how the baby is positioned at the breast. The vast majority of nipple pain is caused by positioning and latch errors. Sometimes, small adjustments can make a big difference in mom’s comfort!
Could My Baby Have Tongue-Tie?
If you are experiencing pain while breastfeeding, it is important to seek help from an IBCLC who can help you with positioning, evaluate your baby’s latch, and evaluate your baby for anatomical variances such as tongue or lip-tie. If your baby does have a tongue or lip-tie, and you are having breastfeeding difficulties, there are some very affective treatment options that your IBCLC can discuss with you. Sometimes a tongue-tie is hard to see. Sometimes, a baby might have an obvious-looking tongue-tie, but a full evaluation is necessary to make sure there are not other problems going on.
If it’s Not Tongue-Tie, What Could it Be?
Some other things that can cause severe nipple pain include Raynaud’s Syndrome, skin conditions, or infection. The baby may have difficulty with sucking and require suck training. Some babies have misalignment that causes sucking difficulties, and can be helped by a specialist in Cranio-sacral therapy.
If you are hurting, get help right away! There is no need to continue suffering, when an IBCLC can help you find out what the problem is and what to do about it.
Help! My Baby is Feeding All the Time! Is This Normal?
In the early days of your baby’s life, between the hormones, the visitors, the other children and pets, and the exhaustion, it’s easy for moms to feel overwhelmed! Add to this a baby who seems to want to breastfeed all the time, and moms can despair and lack confidence.
On your baby’s first day of life, he will take an average of 1 to 2 teaspoons of colostrum per feeding. Those tiny meals allow your baby to lose some of the extra fluids that are in his body at birth, empty his bowels, and practice lots of feedings without taking in too much.
Your baby might not have many meals in the first 24 hours, but by the second day of life, he will be eating 8 to 12 times or more per day! Most babies cluster feed in the evening and nighttime hours during the first few days of life. Cluster feeding simply means your baby wants to have several meals back to back. It’s important to understand that when your baby cluster feeds, this is perfectly normal and expected, and it does not mean that something is wrong or that your baby is starving.
If everything is fine, why is my baby sucking so much?
Each time your baby latches, even though he isn’t getting a large meal, he is doing a very important job: telling your body to make lots of milk for him. As he sucks at the breast, your breast is changed and milk production is triggered. The more he latches in the first few days, the more milk you will be making in the first weeks and months.
More sucking now = more milk later!
Your colostrum is all your baby needs, and it’s really important to not despair and give your baby formula during those few nights of cluster feeding! Continuing to offer him your breast when he is acting hungry, even if he just had a meal, will:
1. Give baby everything he needs and wants
2. Trigger your breasts to make lots of milk
3. Help prevent engorgement
4. Help calm you and increase your confidence.
Anytime you are not sure if things are going well, make sure to consult your pediatrician or an IBCLC. I can visit you in the comfort of your home to assess a feeding and make a customized feeding plan for you. I will weigh your baby with my hospital-grade baby scale before and after he eats, so we will see how much he's getting. I am available to come to your house to help you usually within 24 hours of your request! Contact me here.
Having a baby in the NICU can be extremely stressful and traumatic for families. Moms who want to breastfeed experience additional stress because they are separated from their babies most of the day.
Pumping milk for your NICU baby is worth the effort!
If you have any questions about pumping milk for your NICU baby, I can help you. I have experience in the NICU both as an RN and as an IBCLC.
In-home consultations are usually available within 24 hours of your request. If you have any concerns, don’t hesitate to call and get help!
What are Plugged Ducts?
Plugged ducts occur when cells and breast milk get stuck in the milk duct and the milk does not drain properly. Plugged ducts can cause a painful, red lump on the breast behind the duct as the milk gets backed up.
What Causes Plugged Ducts?
Plugged ducts can be caused by poor milk drainage. It is important to have a lactation consultant check the baby’s latch and assess the baby for tongue tie. A poor latch or tongue tie can lead to inadequate milk drainage, which can cause a plugged duct.
A lactation consultant can also assess mom’s breast for milk blebs. Milk blebs can block the nipple pore from allowing milk to come out. If mom is using a nipple shield, experiencing oversupply or engorgement, sore or damaged nipples, thrush, she is at a higher risk for plugged ducts.
Plugged ducts can also be caused by chronic inflammation from unresolved or inadequate treatment of previous mastitis.
Moms who are interrupting or abbreviating feeds, tired, over stressed, busy, not getting enough rest or proper nutrition, experiencing illness, dehydration, or anemia, or eating too many saturated fats have a greater risk for plugged ducts.
How to Prevent and Treat Plugged Ducts
Make sure mom is getting some rest, and look for ways to reduce stress. Good hydration and nutrition – a well rounded diet with limited saturated fats – will help.
Supplements of Vitamin C and Lecithin have been shown to improve clogged ducts.
Eliminate pressure points on the breast (squeezing the breast during feeds, tight or restrictive clothing, etc.)
Use a moist, hot compress and gentle massage before feeding, and gentle pressure behind the lump during the feeding.
If you are struggling with plugged ducts or milk blebs, I can help! Click here to request an appointment. I will come to your home and help determine the cause of your breast pain and make you a customized feeding plan to help you get back to feeding in comfort.
Beth Sanders, BSN, RN, IBCLC