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.
Even though breastfeeding is natural, it is not always easy, especially in the early days and weeks. Speech and walking are also natural, but it takes some practice and some pretty good coaching before speech or walking become easy for us.
It is also natural to have difficulties with breastfeeding at first. If you are having any difficulties with breastfeeding, I make lactation consultations in your home, and I can help you on the path to a breastfeeding experience which feels natural and comfortable to you. Call or email me, I can help you usually within 24 hours of your request!
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!
If your baby was born before 37 weeks, he was premature. Some babies who are born between 34 and 37 weeks are healthy and large and strong, but they need to be watched closely to make sure they feeding well and gaining enough weight.
Babies’ brains grow and develop a lot during the last few weeks of pregnancy. If your baby was born early, his brain is still growing and developing just as it would if he were still in the womb. As his brain grows, he becomes more and more ready to take all of his meals from breastfeeding; but in the early weeks, he might not be ready, and supplementation may be necessary.
It is very possible for you to breastfeed your premature baby, but you might face some challenges. You might have to pump frequently to make sure you establish a good milk supply if your baby does not have the stamina to take a full meal from the breast. Before your baby’s brain is mature enough, he might not be able to stay awake long enough to take full meals from the breast. There are distinctive suck patterns that you can look for to know when your baby is strong enough and awake enough to take a full meal at the breast. A weighed feeding will also help you know how much milk your baby is taking, and if he needs more.
It is important to remember that your early baby is probably behaving and feeding normally for his age and that feeding challenges are not your fault! A Lactation Consultant can help you make a plan that allows for your baby to thrive while guiding you toward your breastfeeding goals. When working with an IBCLC, you will be able to figure out how much supplement your baby needs, and explore different feeding options that work best for you.
I would love to help you make a feeding plan that works for you and your family. I am available to visit you in your home, with my hospital-grade baby scale, so we can evaluate how your baby feeds and how much milk he gets during breastfeeding. I am usually available within 24 hours of your request. Please call or email me if you have any concerns about breastfeeding your premature baby! I can help you!
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.
Pumping at work is a big source of stress and worry with new moms. Most employees are protected by law to pump breastmilk while at work and must be provided with time for pumping and a clean, private place to pump that is not a bathroom.
Breastfeeding women are tremendous assets to their employers; they are organized, hard workers, creative, and motivated. Most importantly, their babies tend to be sick less often than formula feeding babies, which keeps mom at work instead of taking sick days.
Skipping pumping sessions can be painful, can lead to mastitis, and can put mom's milk supply at risk. NPR recently posted this article about missing pumping at work. Perhaps it will help your boss and co-workers understand how important it is for you to get a break to pump.
I am available to help you make a plan for returning to work. Contact me for an appointment and I will help you feel confident and ready to return to work.
All moms are working moms, but this mom redefines "working mom". All respect!
The answer depends on whom you ask, so let’s ask the experts.
The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend breast milk only for baby’s first 6 months of life, and continued breastfeeding with the addition of solid foods from 6 months to at least one year.
Many studies worldwide have shown that the health benefits of breastfeeding to mom and baby are dose-dependant, meaning, more is better. For example, the longer a woman breastfeeds, the lower her lifetime risk of breast cancer, ovarian cancer, type 2 diabetes, and other illnesses. This longevity affect is cumulative, so breastfeeding multiple babies increases the protective power of breast milk on mom’s health.
Furthermore, the health benefits to the baby are increased the longer the baby breastfeeds. The longer the baby breastfeeds, the less likely he will experience health risks such as childhood cancer, diabetes, obesity, and certain infections. Older babies and toddlers still need immunity protection from breast milk because their immune systems are not mature yet. There is great nutritional value for a toddler in his mom’s breast milk.
Studies have also demonstrated that children who were held often and for long duration as babies, and who received comfort from breastfeeding as toddlers, grow to develop confidence and independence. When toddlers learn that they are safe and nurtured, they grow into confident children.
The American culture has decided that breastfeeding older babies or toddlers is weird, and that cultural norm hurts our babies and families. Worldwide, and throughout history, babies have been breastfed well into childhood, and this practice has been perfectly normal and healthy for children and communities.
It is important for you to decide how long to breastfeed your baby based on the scientific facts of the health and emotional benefits to you and your baby from extended breastfeeding as well as the impact that breastfeeding has on your family. If you decide to continue breastfeeding beyond your baby’s first birthday, you are perfectly normal! You and your baby will benefit, and there is nothing harmful about this practice. Feed on, mama!
Click here for the AAP policy statement on breastfeeding.
Beth Sanders, BSN, RN, IBCLC