Pumping is breastfeeding. Say it loud for the people in the back. Pumping is breastfeeding. Though breast milk is given to your child through a bottle, your baby is being breastfed. 

Not every mother and child has the same breastfeeding experience. There are many reasons why breastfeeding directly is not an option, sometimes babies have trouble latching on, or the parent or the child has a medical issue preventing them from feeding directly from the breast. Whatever the case, pumping your milk to feed your baby is a form of breastfeeding. 

When it comes to breastfeeding, and after a couple of kids and much reflection, I finally realized that I should not hold myself to standards out of my control and that the most crucial thing was feeding and nourishing my children.

Passing Moments

Oh, the many things that happened during my first birth. The baby was overdue, I had complications during delivery, and she had health issues resulting in a painful NICU stay. I couldn’t hold her after birth or physically breastfeed her until a week after that. However, the nurses quickly focused on pumping milk so she could benefit from the colostrum and I could be prepped for direct breastfeeding.

I personally was not looking forward to breastfeeding, but I was open to it. I knew breastfeeding would be good for the baby and me, and I was prepared to do it in the months leading up to her birth. But having missed the moment to feed and hold her directly after birth, I began to sink into an intense guilt and feeling of failure that further deepened my sadness and pain due to my daughter’s health.

Negotiations

When I could finally breastfeed my daughter, I found myself surrounded by the lactation specialist and the nurses, all doing their best to get my little one and me to come to an agreement. After a week of strictly bottle-feeding breast milk, she told me she was not having it. Let’s just say I learned a toothless bite still hurts a lot. The look on her face was of frustration and hunger. 

I’m pretty sure if she could have spoken at that moment, she would utter what her eyes said: “I don’t want to work so hard for my food.” Despite the support around me, I was starting to settle into the idea of being incapable. My mom, who formula-fed us, toggled between supportive and encouraging words while declaring that formula feeding was okay (which it is!)

A pumped-up approach

Though my daughter would not latch on, I kept pumping away at home and in the hospital daily to help her get better. It also helped me cope with having my baby stay in the hospital while I got to go home. With my daughter in the NICU, I looked at breastfeeding as one way I could try to break her out of that joint. So I took on pumping like a champ and crushed it. My husband even joined in, sometimes pumping manually for me while I tried to eat, was too exhausted or depressed.

I pumped in the hospital. I double-pumped. I would have triple-pumped if I could find a way to grow another breast. She thankfully got better, I took her home, and she’s now a whole adult. 

Embracing the reality

When my son was born a few years later, he also had some complications and did not latch on. I was once again wondering what was wrong with me. I realized that nothing was wrong with me. I breastfed my little buggers with purpose. I breastfed like a champ. The milk was coming from me. It was just delivered differently. I also stopped thinking about what was “right” and started understanding what was best for my child.

I learned that I did not have to define my motherhood by other people’s standards but by my unique experience as a mother. 

Does your newborn want to feed several times close together, often during the evening? Do they crash after this timeframe and often have the longest sleep of their day? This may be frustrating, but it’s completely normal — it’s a feeding pattern known as cluster feeding. Here’s what you need to know, including tips for this often-tiring pattern. 

What is cluster feeding?

Cluster feeding is when your baby wants to feed several times during a shorter period. A cluster feed usually lasts for a few hours at a time, and looks differently from baby’s typical feeding habits. Baby might alternate between eating, crying and possibly resting several times in a 2-3 hour period. They might want to feed as often as every 20-30 minutes within this timeframe. 

Cluster feeding is perfectly normal, so don’t be alarmed at the changes in your baby’s feeding routine. If however, your baby seems to cluster feed around the clock, this may be something else, and it’s a good idea to get some support for feeding.

Why do babies cluster feed?

Cluster feeding is a way for newborn babies to make sure they get enough breastmilk (or formula). Often people notice it when they’re going through a growth spurt, increasing milk intake to satisfy their increased developmental needs. 

During this growth spurt, Baby instinctively knows that feeding in clusters is the best way to encourage their mother to produce more breastmilk. Breastmilk production is all about “supply and demand” — the more baby drinks, the greater supply their mother will have to meet their needs. 

If you’re breastfeeding, this doesn’t mean that you weren’t producing enough milk before, baby’s just entering a time where they need more milk.

While cluster feeding is most common in breastfed babies, don’t be surprised if your bottle-fed baby starts cluster feeding.

Cluster feeding can also happen when a baby is tired or sick and needs shorter, more frequent feeds. When babies get overwhelmed or tired at the end of the day – you often see some cluster feeding as they soothe their needs in the best way they know how. 

How to know if Baby is cluster feeding ?

Generally, your 0-3 month old baby will feed 8-12 times every 24 hours. If they’re looking for more than this, they’re likely cluster feeding. Here are some other signs:

• Baby wants to feed repeatedly and constantly 
• Even if they’ve already been fed, baby doesn’t seem satisfied with the feeding (especially in the evenings or later afternoons)
• Baby eats more frequently, in shorter sessions than normal
• Your baby won’t stop crying until they’re fed- other soothing methods don’t help
• Besides the urges to feed frequently and the added fussiness when hungry, nothing seems “wrong” with baby
• Baby is content during feedings
• Baby still has the same amount of wet and dirty diapers

When they’re in the cluster feeding phase, your baby will usually exhibit signs of hunger frequently during the evenings, even after they’ve already been fed. These may include:

• Rooting (searching for the breast or bottle, or turning their head towards whatever touches their cheek)
• Nuzzling against the breast
• Opening the mouth wide 
• Mouthing
• Moving the fists to the mouth
• Lip-smacking
• Fussiness 
• Becoming more alert

How long does cluster feeding last? 

Cluster feeding can be a normal part of a baby’s daily pattern or it can be brief, lasting for a few days at a time. Babies usually “grow out of” cluster feeding around 3 or 4 months of age (of course, every baby is different.) 

Again, if your baby’s “cluster feeding” goes around the clock, it’s a good idea to check their weight and get feeding support, as this might be a sign that your baby isn’t efficiently getting enough milk.

How to deal with cluster feeding?

While it can be exhausting, try to lean into this pattern and feed Baby as often as they need and want to. This time will pass.

Here are some tips

• Don’t be afraid to ask for assistance when you need it.
• If you’re breastfeeding and you’ve pumped breastmilk, or if you’re bottle-feeding, you could have another family member offer a bottle (or bottles). Use that time for self-care (such as a walk, a shower, or a few uninterrupted minutes to yourself), 
• Keep water and nutritious snacks by your feeding area to stay nourished. 
• Try to nap just prior to when you expect the cluster feed.
• Plan ahead in other ways if you can. Use the bathroom, and try to get comfortable in your feeding area, right before you think Baby will want to cluster feed.
• Plan to cluster feed in front of the TV so you can watch a movie or show that you enjoy. 
• Or, plan to listen to an audiobook, podcast, or music during a feed. 
• Practice feeding Baby in a sling or carrier. That way, you’ll be able to walk around hands-free
• Call a friend or family member during feedings
• Lie down to feed Baby, so that you can rest your body as much as possible.
• If you have older children, designate special toys (or shows) for them that they can only take out during baby’s feeding times.
• Ask your partner (or friends/relatives) for help with cooking and housework during baby’s cluster feeding periods.

A lactation consultant can be extremely helpful as you navigate breastfeeding, cluster feeding, and caring for your mental health. 

How to soothe Baby during cluster feeding times?

Cluster feeding usually coincides with baby’s fussiest times. They may cry a lot in between feedings, even though they’ll be satisfied during the feedings themselves. 

Try these tips

• Move Baby around while feeding (walk while using a sling or carrier, or gently rock Baby). 
• Try skin to skin snuggles
• Sing or talk to Baby with a gentle voice. 
• Play soothing sounds (white noise or calming music). Turning on a fan may also create white noise.
• Hold Baby close to help them feel secure. Lightly swaddling them may help as well.
• Feed Baby in a quiet, dark room to remove unsettling stimuli.
• Try holding Baby in different positions.

What is the difference between cluster feeding and colic?

When your baby is cluster feeding, they may cry a lot, especially during the evenings, but they’ll be satisfied during feeding. However, if Baby keeps crying for several hours per day, for no reason you can find, and feeding and other efforts don’t soothe them, they may have colic.

Colic crying can sound like screaming, while cluster feed crying will sound like Baby’s normal “hungry” cry. Also, colic crying tends to peak at six weeks, continue without a break, and stop around three months of age.

You’ve got this

Even though it may be frustrating, cluster feeding is a normal feeding pattern. Lean into ways to cope. You’ve got this!

Reviewed by the Ovia Health Clinical Team

Allergic reaction vs. eczema flare-up

• Eczema may flare up when your child’s skin is exposed to any number of triggers, including food.
• Food allergic reactions should be reliable and reproducible. If your child is allergic to a food, they’ll reliably develop an allergic reaction shortly after eating that food, every time they eat it.
• The red itchy rash associated with eczema is different from the hives that food allergies can cause
• Food allergic reactions should only appear when your child is exposed to an allergenic food. Eczema is most often chronic or lifelong, with symptoms persisting regardless of your child’s exposure to allergenic foods
• Eczema and food allergies belong to the atopic march. In other words, eczema is a precursor to food allergies, and eczema symptoms usually appear before food allergies. 

Food allergies and eczema are closely related. Both conditions involve the immune system. Babies with eczema are at the greatest risk of developing food allergies. And foods can cause both allergic reactions and eczema flare-ups.

But how can you tell the difference between an allergic reaction such as hives and an eczema flare-up, so you can get the right care for your child? We break down what parents need to know.

Food allergic reactions: What triggers them?

Our immune systems protect our bodies from foreign invaders, like viruses and bacteria. But when someone eats a food they are allergic to, their immune system mistakes the proteins of that food for a foreign invader. The immune system signals their body to over-defend itself against those food proteins, and this triggers an allergic reaction. 

Food allergic reactions: What do they usually look like?

In babies and young children, the most common signs of an allergic reaction are hives and vomiting.

Hives caused by a food allergic reaction

Mild or moderate allergic reactions can also cause swelling of the face, lips, and eyes. Usually, these symptoms appear within seconds or minutes and they’ll almost always occur within 2 hours of eating the food. 

People with food allergies don’t always develop the same symptoms every time they have an allergic reaction. So, you can’t predict what an allergic reaction will look like in your child. 

Most importantly, remember that a mild to moderate reaction can sometimes quickly turn severe. This is true even if your child never had an allergic reaction before. 

Severe food allergic reactions: What do they look like?

Symptoms of a severe food allergic reaction can include:

• Swelling of the tongue
• Swelling or tightness of the throat 
• Struggling to swallow
• Struggling to breathe
• Noisy breathing
• Persistent coughing
• Wheezing
• Struggling to vocalize
• Change in voice or cry
• Diarrhea 
• Dizziness 
• Collapsing or fainting 
• Pale appearance 
• Feeling floppy (only in infants and young children)

When a food allergic reaction causes severe symptoms in more than one organ system, it is classified as anaphylaxis. Anaphylaxis can be life-threatening.

Eczema flare-ups: What triggers them?

Your child’s eczema may flare up when their skin is exposed to any number of triggers. If your child has food or environmental allergies, their allergens could trigger a flare-up. In addition to allergens, dry skin, dry air, heat, existing skin infections, and irritants may also trigger eczema flare-ups. Some irritants that may trigger flare-ups include fabrics (like polyester, nylon, or wool), fragrances (found in soaps, laundry detergents, lotions, and shampoo), chemicals, and metals.

Eczema Flare-Ups: What do they look like?

Eczema makes the skin dry, red, and itchy. It can cause patches of red or dry skin, rough and itchy skin, or crusty scales and bumps that may leak fluid. These flare-ups often appear on the forehead, cheeks, scalp, knees, elbows, arm joints or leg joints. 

Eczema flare-ups v. Allergic reactions

Foods can trigger both eczema flare-ups and allergic reactions. So, how can you tell the difference? If your child has food allergies and eczema, a food allergic reaction may make their eczema worse.

But, the red itchy rash associated with eczema is different from the hives that food allergies can cause. And there are many other symptoms of an allergic reaction that aren’t associated with eczema (like swelling and vomiting). A good rule of thumb is the National Eczema Association’s explanation that food allergic reactions are “reliable, reproducible, consistent and timely.”

If your child is allergic to a food, they’ll reliably develop an allergic reaction shortly after eating that food, every time they eat it. Once you remove the food(s) they are allergic to from their diet, they will no longer show symptoms of a reaction. 

Whenever your child appears to have a flare-up, keep track of all their surroundings, including what they ate within the past 2 hours. What fabric is their clothing made of? Did you use soap, lotion or shampoo with a fragrance? It can be difficult, but finding and removing other consistent eczema triggers can help you figure out whether food is an eczema trigger — or an allergen. 

If you’re having trouble pinpointing the issue, allergy testing is the most reliable way to determine whether your child has a food food or other allergy. 

The atopic march and chronic eczema

The atopic march describes how children with one allergic condition are at increased risk for others, and how allergic conditions tend to appear in a certain order (one usually “marches” after the other).

Eczema and food allergies are both considered allergic conditions, and both are part of the atopic march. Babies usually develop eczema before food allergies, and infants with eczema are at increased risk for developing a food allergy. 

Most food allergic reactions like hives should go away within a few days or weeks, and by avoiding the allergenic or “problem” food, should go away altogether. On the other hand, eczema can often be a chronic condition and usually starts in infancy. Chronic eczema is the most common type of eczema and can be lifelong. 

Introducing Allergens

The USDA Dietary Guidelines state: “if an infant has severe eczema, egg allergy, or both (conditions that increase the risk of peanut allergy), age-appropriate, peanut-containing foods should be introduced into the diet as early as age 4 to 6 months.”

Feeding your baby these foods consistently, starting between 4-11 months of age, is especially important for babies with eczema, because of their increased food allergy risk. 

Reviewed by the Ovia Health Clinical Team

Content provided by Ready, Set, Food!. Ready, Set, Food! is a complete guided system that gently introduces your baby to the top 9 most common childhood food allergens, including peanut, egg, and milk. 

The basics

For the first few months, babies need about 24-32 ounces of formula in 24 hours. If you’re combo feeding, they will likely drink less than these amounts. There is a lot of room for flexibility, which can make things confusing. You can directly breastfeed and then top up with formula, you can breastfeed with an at-breast supplementer, you can mix bottles if you’re pumping, or you can breastfeed all day and do formula all night. There isn’t a right and wrong way to do it — just what works best for you and your baby. And don’t be afraid to experiment! As long as your baby is making enough diapers and growing steadily, you can try on some different methods of combo feeding.

Supplementing because of low milk production

Sometimes adding formula isn’t a family’s first choice, and there are a lot of emotions that come with this adjustment. Everything you’re feeling is okay. If you’re struggling with low milk production, breastfeeding has likely been time consuming and painful, which may have taken the joy of feeding away from you. Sometimes adding formula allows you to start fresh. Know that formula is an amazing medicine and food supply in so many ways. 

If you decide to continue to breastfeed in addition to formula feeding, any breastmilk you provide can still be beneficial for comfort and antibodies. If you’d like more information, check out The Low Milk Supply Foundation.

Supplementing to share responsibility

Some families introduce formula supplements after a period of full breastfeeding because they want to be able to share the responsibility for feeding with a partner, or if they’re going back to work and don’t plan to pump. For these families, it’s a good idea to ease into supplementing one feed at a time, so the breastfeeding parent’s body can start to lower milk production while, hopefully, avoiding painful engorgement, clogged ducts or mastitis. In these cases, it can also be helpful to introduce a bottle part-way through a feed the first few times. This will allow Baby to get some breastmilk before getting formula, so that by the time they get a bottle, they won’t be quite so hungry and may be happier and more willing to try new things than they would if they were hungry and fussy.

Tips

• If your little one doesn’t take to the taste of formula right away, you are not alone. Formula just tastes a little different than breast milk, and some breastfed babies are suspicious of the change in taste when they first try it. It is possible and perfectly healthy to mix pumped breast milk with formula to give your little one a flavor that’s a bit more like what they’re familiar with.
• Babies are smart – if they can smell that the breast they’re used to being fed from is nearby, they may not be as willing to explore the bottle, so it can be helpful for the first few bottles offered to come from someone other than the breastfeeding parent.
• Adding regular pumping to the routine can help maintain your milk supply when supplementing if you wish.
• If you plan to maintain a breastfeeding relationship and are worried about how combo feeding will impact that, there are a few things you can try! Paced Bottle Feeding, comfort nursing, and some contact naps or breast sleep can help to keep baby happy at the breast.

Infant feeding is complicated and rarely is it all or nothing. Combination feeding can be a great way to maintain the benefits of breastfeeding, to help your baby grow, and/or to make infant feeding work for your family.

Reviewed by the Ovia Health Clinical Team

Sources

• “How to combine breast and bottle feeding.” NHS choices. UK.GOV, February 10 2016. Retrieved October 26 2017. https://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/combining-breast-and-bottle.aspx.
• “Mixed Feeding.” Australian Breastfeeding Association. Australian Breastfeeding Association, August 2017. Retrieved October 26 2017. https://www.breastfeeding.asn.au/bfinfo/mixed-feeding.
• “Mixed feeding: Combining breastfeeding and bottle feeding.” NTC. NTC, January 2016. Retrieved October 26 2017. https://www.nct.org.uk/parenting/mixed-feeding-combining-breast-and-bottle-feeding. 

When do babies start eating prepared baby food from a jar?

Here’s more information about the different types of prepared baby food you can feed your little one.

Stage 1:

The simplest form of baby food is designed for babies transitioning away from breastfeeding. Inside the average jar, you’ll find a single ingredient food, smoothly pureed. A few Stage 1 staples include bananas, sweet potatoes, and green beans. Stage 1 is the easiest for babies to handle.

Stage 2:

After mastering the softer foods that correspond with of Stage 1 foods, Baby should be ready to start mixing and matching food groups. Stage 2 baby food offers combinations such as veggie medleys and two to three ingredient fruit salads. The other distinction here is that Stage 2 baby food isn’t pureed, it’s strained. This gentle escalation in food texture will allow Baby to become familiar with variations in texture, and begin to experiment with chewing.

Stage 3:

Once Baby has passed the average teething age, it’s time to adjust their diet accordingly. Stage 3 baby food takes infant edibles to the next level by combining strained foods and small chunks of solids. Jars of Stage 3 tend to be slightly larger than earlier stages to compliment the average baby’s increased appetite, and you’ll also notice several options in the baby food aisle that contain meat ingredients.

Exercise impact on milk while breastfeeding

If you’re breastfeeding, even intense exercise should not impact how much milk you produce or how willing Baby is to feed. As long as you’re staying comfortable,hydrated, and fueled with enough food, exercise is beneficial for most new parents. Even a simple walk with Baby can increase cardiovascular fitness levels, improve insulin response, and decrease anxiety, 

Debunking the myths

For a long time, the impact of exercise on breast milk was covered in mystery. Then a widely publicized study from over 20 years ago found that breast milk is higher in lactic acid right after exercise, and that babies find it less appealing for that reason. The study concluded that mothers should pump or nurse prior to exercising and avoid nursing until an hour after exercise. Later research called this finding into question due to the use of a medicine dropper to feed these babies (not the breast or bottle). Because  the babies were unaccustomed to feeding from a medicine dropper, this likely impacted the study’s accuracy.

Other studies showed increased milk supply for women who exercised regularly, and decreased IgA levels – antibodies that fight infections – in women who had exercised strenuously. IgA levels returned to normal after 30 minutes, however, which makes the finding less significant in the bigger picture of breastfeeding. Overall the findings of these studies do not merit any change in exercise patterns.

Preparing for exercise

Make sure to support your breasts as much as possible – wearing a supportive sports bra is a must, and if you need to add extra support (doubling up on bras, for example), don’t hesitate to try. Some folks find it best to pump or nurse prior to exercise to minimize pain during high impact exercise such as running. Hydration is particularly important during breastfeeding, as is pairingexercise with enough food and water to offset what you lose during any exercise sessions. It is possible for milk supply to decrease if you exercise and don’t fuel your body appropriately. 

Don’t get discouraged if exercise is difficult at first, even if you exercised during pregnancy – between recovery from childbirth and all of the energy that goes towards taking care of Baby, it only makes sense that exercise might be harder than you were expecting. During your workout, take care with any exercises that might cause injuries, especially soon after giving birth. The hormone relaxin may still be in your system, which could make your joints more flexible, which can make it easier to push your body too far. If lack of sleep is making it hard to get motivated, try starting slow with a simple, short walk most days.

Post-workout, as long as Baby is happy to nurse, there’s no reason not to nurse right away. Some babies don’t like the taste of sweat, so if you’re concerned, you can shower off or wipe down before nursing to prevent this.

The bottom line

Exercise isn’t just safe when breastfeeding – it’s downright healthy! Whether yoga, lightweight exercise, or something more strenuous, exercise will help keep you healthy for the months and years to come. Remember to take it slow after you get clearance to start more activity at around 6-8 weeks postpartum. Listen to your body’s cues and be sure to fuel yourself!

Sources

• Renee Kam. “Exercise and breastfeeding.” Australian Breastfeeding Association. Australian Breastfeeding Association, April 2022. Web.
• Dewey KG, Lovelady CA, Nommsen-Rivers LA, McCrory MA, Lönnerdal B. A randomized study of the effects of aerobic exercise by lactating women on breast-milk volume and composition. N Engl J Med. 1994 Feb 17;330(7):449-53.
• Mayo Clinic Staff. “Exercise after pregnancy: How to get started.” Mayo Clinic. Mayo Clinic, July 27 2016. Web.
• “Exercise.” La Leche League International. La Leche League International, Jan. 2018 Web.

How to effectively burp your newborn

Burping is often helpful for both breastfed and bottle-fed babies, though many breastfed newborns need less burping than bottle-fed infants. There are four common positions that many parents use to burp, but every baby is different. Some may burp easily, while others almost never seem to give up a burp! See if a different approach improves burping or your baby’s overall comfort.

1) On the chest

This tried and true position begins by holding Baby against your chest so that their chin rests on your right shoulder while their body stays centered. As you support their head with one hand, rub or pat their back with the other hand. This position takes into consideration the unique shape of the stomach to help any air come up and out.

2) Sitting on your lap

Begin this position by sitting Baby on your lap facing to the side or away from you. Use one hand to gently support their chin while being careful not to strain their neck, and use the other hand to rub their back. Encourage Baby to lean forward while you pat their back until they burp. This may lead to some spit up, so be prepared!

3) Face down across your lap

One of the easiest burping positions involves laying Baby face down across your legs so that they is lying across your knees. Make sure to support their head and gently rub or pat their back to release the air bubble. You can also gently place your baby on their side on a firm surface after feeds to help them burp.

4) The wiggle

For newborns and smaller babies, a gentle rotation of their tush can sometimes release gas! Hold your baby by the shoulders and the hips, and gently rotate their hips in a circular position. 

Remember that every baby is unique. Burping can sometimes lead to more upset, especially when it’s done as Baby has already started to drift off. A full stomach of milk may feel uncomfortable if their position is changed suddenly and there is a lot of jostling and patting. It’s always okay to experiment with what works best for your baby. Although burping can commonly make babies feel more comfortable, it’s not a must-do for everyone!

Sources

• “Burping, Hiccups, and Spitting Up.” HealthyChildren. American Academy of Pediatrics. November 21 2015. Web.
• “You don’t need to burp babies.” McGill Office for Science and Society. March 29, 2019. Web. https://www.mcgill.ca/oss/article/did-you-know/did-you-know-you-dont-need-burp-babies

How often should I feed my newborn?

A general rule of thumb is that newborns should feed at least 8 times in 24 hours. The appetites of newborns can vary, as some newborns might yearn for a meal just 90 minutes or so after their last, while others may wait up to three hours before requesting another feeding. Breastmilk and formula are helpful for hunger, but they are also there for thirst; there are actually so many reasons why a baby may show you cues! While it’s difficult to put a newborn on a true feeding schedule, a newborn should generally never go more than 3 to 4 hours without eating, including overnight, although your pediatrician or lactation consultant may have recommendations that are more specific to Baby.

Making sure to wake the Baby for feeds should continue for about the first two weeks or until your baby is back to its birthweight. At that time, your pediatric provider might okay slightly longer times between feeds if the Baby is sleeping at night, but spoiler alert—these are pretty rare. Babies have tiny tummies and need frequent feedings to stay hydrated, fed and comfortable.

Signs of hunger

Because on-cue feeding is generally regarded as the best way to feed a newborn, it’s important to be able to recognize the signs of a hungry one. These may include:

• Early signs: Opening their mouth, licking their lips, puckering their mouth, or turning their head ‘rooting’ for breast or bottle.
• Mid signs: Putting their fingers, fist or clothes in their mouth, sucking, restless movements, stretching, trying to lie in a ‘nursing’ position.
• Late signs: Frantic movements, crying.

Even if a newborn isn’t showing signs of hunger, it’s still important not to go more than three to four hours without offering them a feeding until you’ve gotten the all clear to do so. If you’re having trouble waking them, try a gentle diaper change and some skin-to-skin time. If they are so sleepy that they don’t reach at least 8 feeds in 24 hours, it’s important to let their provider know. 

While it’s tempting to start a schedule for feeds early on, this can negatively impact breastmilk supply for many people. Going too long between feeds can make Baby uncomfortable and frantically hungry, too. If the routine of feeding is feeling overwhelming, it can be great to get support from a lactation consultant or the reassurance and validation of a local parents’ group.

Sources

• Mayo Clinic Staff. “Feeding your newborn: Tips for new parents.” Mayo Clinic Staff. Mayo Clinic Staff, April 20 2022. 
• Jain, S and Bunik, M. “How Much and How Often Should Your Baby Eat.” HealthyChildren. American Academy of Pediatrics, April 2 2024.
• “Breastfeeding Info: Feeding Frequency.” La Leche League International. La Leche League International, https://llli.org/breastfeeding-info/frequency-feeding-frequently-asked-questions-faqs/

How can you store your breast milk?

There are a number of storage options — from glass bottles, to BPA-free plastic bottles, to specially designed plastic or silicone milk storage bags. Whichever option you choose, the containers should be clean and properly sealed before they are stored (keep in mind that milk will expand when frozen). 

Ideally, milk is stored in a variety of sizes ranging from 2-5 ounces (the size range of an average breastfeed). A variety of serving sizes can be helpful in case your little one needs a full meal, snack, or even just needs to eat quickly. 

You’ll always want to clearly label the bottles or bags with the date that the milk was expressed and the amount inside. If you’ll be sending the milk off to childcare with Baby, you’ll also want to make sure their name is on the label.

How long does expressed milk stay good for? 

How long milk can be stored depends on just where it gets stored.

• Out at room temperature: If you’ve just pumped and are fairly confident that your baby will drink the fresh milk soon, it can sit out unrefrigerated or unfrozen for six to eight hours (at up to 77°F or 25°C), but using or storing the milk in a colder space within four hours is ideal. The milk should be covered and kept as cool as possible, so if it’s a particularly hot day, you may want to move the milk to a fridge or freezer right away. 
• In a cooler or insulated cold storage bag: If you pump and are then traveling with expressed milk, you may very well decide to store it in a cooler or insulated bag as you travel. It’s best to keep ice packs against the milk containers and to not to open the cooler or bag unless necessary. All recommendations suggest avoiding storing milk like this for longer than 24 hours.
• In a refrigerator: It’s optimal to store milk in the refrigerator for three to five days, although it’s acceptable to store there for up to eight. It’s also recommended that you store the milk in the back of the fridge (as opposed to close to the front or on a door) where it’s a bit chillier. 
• In a standard freezer (meaning a freezer that is part of a refrigerator but has a separate door): Milk can be stored for between three and six months.
• In a deep freezer: Milk can be stored here for up to 12 months (though 6 months is ideal).
• Partially used bottle: A feeding that was not finished can be used again within 2 hours

Milk that gets stored longer than these recommended times in a fridge runs the risk of spoiling. Milk that gets stored longer than these recommended times in a freezer is usually still safe, but some of the fats may break down and some of the nutrients may be lost. 

Thawing frozen milk

You can thaw frozen breast milk by placing it in the fridge several hours before you plan to use it, or thaw it more quickly under warm running water or in a bowl of warm water. Some research shows that milk warmed quickly via a warm water bath retains better fat and nutrient profiles. And some babies might even prefer that refrigerated milk be warmed up (what refined taste!). Heating it on the stove or in the microwave is not recommended, because the milk might heat unevenly or get a bit too toasty for Baby. Once frozen milk has been thawed, if it goes unused, it can be refrigerated for later use for up to 24 hours, but it should not be refrozen. However, if frozen milk has been partially thawed (as sometimes happens in the event of a power outage), as long as it still contains ice crystals, it’s considered safe to refreeze.

As you begin to pump and store your milk, you might notice that it’s a particular color or that the color changes over time or even depending on what time of day you pump. When chilled, you might also notice that it will separate into milk and cream layers. And once thawed, you may notice the milk looks like it’s of a somewhat different consistency or smells slightly different than when it was freshly pumped. As long as the milk has been stored properly, this is normal. But use your judgment; a little sniff should tell you if things have gone bad. (Milk that smells soapy is still safe and nutritious for your baby, it just happens to have excess lipase activity. Lipase is a normal enzyme found in all milk, but your little one might not love the taste. Scalding the milk quickly, for just a few seconds before freezing, can fix this issue. You can read more about milk with excess lipase activity and how to scald it here.) If you ever have questions or are really concerned that the quality of the milk is questionable, it’s better to err on the side of caution and toss it.

When it comes to storing milk for long periods of time, keep in mind that the quality and makeup of your breast milk changes over time as Baby gets older and has different needs. This means if you expressed a lot of milk when Baby was first born, it’s best to use that when they are still fairly young, and not save it until they’re nine months old.

Reviewed by the Ovia Health Clinical Team

Read more

• Breast pump cleaning guidelines
• Continuing to breastfeed when going back to work

Sources

• Mayo Clinic Staff. “Breast milk storage: Do’s and don’ts.” April 7 2015. Retrieved August 11 2017. Mayo Clinic. Mayo Foundation for Medical Education and Research. http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breast-milk-storage/art-20046350?pg=1.
• “Proper handling and storage of human milk.” Centers for Disease Control and Prevention. U.S. Department of Health & Human Services, July 24 2017. Retrieved August 11 2017. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm.
• “Storing breast milk.” Cleveland Clinic. Cleveland Clinic, March 25 2015. Retrieved August 11 2017. https://my.clevelandclinic.org/health/articles/storing-breast-milk.
• “What are the LLLI guidelines for storing my pumped milk?” La Leche League International. La Leche League International, July 8 2014. Retrieved August 11 2017. http://www.lalecheleague.org/faq/milkstorage.html.