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. 

One of the advances in Covid care is the medication Paxlovid. Wondering if this might be a good fit for you? You’ve come to the right place!

What is Paxlovid

Paxlovid is a combination of two medications, nirmatrelvir and ritonavir. For it to be effective, you need to start it within five days of your first symptoms and take it for five days. The goal of treatment with Paxlovid is to reduce the chances of hospitalization and death for people at increased risk.

Providers have used ritonavir for a long time to treat pregnant people, and it has a good safety profile. We have less information about nirmatrelvir, but expert opinion is that its benefits in helping people avoid serious illness from Covid likely outweigh any unknown risks. 

Paxlovid during pregnancy

If you’re pregnant, at the very least your provider should offer you Paxlovid and feel comfortable discussing its risks and benefits given your unique health situation. They will consider your vaccination status and additional risk factors like diabetes, kidney disease, and any challenges to your cardiovascular health. 

Paxlovid while breastfeeding

If you’re breastfeeding, then you’re aware that it’s important to check the safety of all of your medications, as many pass into your breast milk. If you have risk factors for severe illness or are not vaccinated, you may want to talk to your provider about Paxlovid. 

Again, there isn’t a lot of safety data on nirmatrelvir, so it’s important to have a risk and benefit discussion with your provider. There is conflicting information on breastfeeding safety, and that can be very difficult to navigate. Parents are choosing a range of solutions, including continuing to breastfeed and pumping and dumping. The experts at the Infant Risk Center are updating information as it becomes available and are available for free consultation by phone. 

If you have questions or are interested in taking Paxlovid or understanding more about it so you can be prepared if you get Covid, reach out to your provider for more details. They have all the most up-to-date information and should be able to talk through your options. 

Read more

COVID-19, postpartum, and breastfeeding: your questions answered

Everything you need to know about the COVID-19 vaccines

What are inflamed ducts?

Inside your breast there are dozens of milk ducts. Imagine tiny strands of spaghetti that are crisscrossing and creating the pathways from milk making cells deep in your breast all the way out to the tip of your nipple. When your breast tissue gets overly full, irritated or injured, those tiny ducts can swell. It makes it harder for milk to comfortably let down and pass through your breast. Sometimes it feels like a hard pea, and sometimes the area gets so inflamed that it feels like multiple golf balls or a big lemon. If you notice lumps or bumps before a feeding — that could be okay. But if you have painful lumps and bumps after you’ve fed or pumped, it might be a sign of swollen ducts. Some people also notice that less milk is coming out of the impacted breast. 

What do I do first?

Identify the area and try some easy strategies. Most inflammation will improve  over 12-24 hours. Here are some tips:

• Breastfeed directly or pump on a normal schedule. Don’t increase stimulation to that side by feeding or pumping more. Feed or pump for what your baby needs during this time, don’t follow advice to “empty” breasts.
•  Keep things cool. Ice is your friend when it comes to inflammation. Apply cold or ice packs to the  swollen area for about 5 minutes every hour.  If it feels better to use cold during a feed or after, be flexible – the timing is up to you. 
• Take an anti-inflammatory medication like Ibuprofen if it’s safe for you. Regular use can decrease inflammation overall and lessen your pain. A win-win.

• Rest. Breast inflammation can progress to mastitis, and your body is working overtime right now. Extra rest, hydration and support can make a huge difference. 
• Some older advice can actually be harmful. Deep massage, excessive suction (from person or machine), and lots of heat can actually make inflammation worse and prolong the problem.

Other Ideas:

• Try changing your breastfeeding position. This may not decrease inflammation, but it may increase your comfort. Dangle feeding can be dangerous for very young infants.
• Try therapeutic breast massage. This type of gentle massage can help elongate milk ducts temporarily and give relief. 
• Ask your provider about therapeutic ultrasound. While it isn’t a common practice in the US, there is some research suggesting it can be helpful.
• Consider a Lecithin supplement (discuss potential gut health impacts with your provider) or a probiotic. Both have benefits for certain people, you can check out specific info here as not all supplements are created equally!

What if I’m not getting better?

Sometimes inflammation takes time to improve. As long as you aren’t seeing symptoms of mastitis, continuing to monitor your breasts closely and sticking with the tips above is advisable. In many cases, inflammation is persistent because your body has an oversupply of milk. Working on managing the oversupply can also help relieve inflammation (especially if it happens frequently). A professional lactation consultant can help you do this safely while meeting your personal feeding goals. 

How do I keep this from happening again?

Many people experience swollen ducts no matter what preventative steps they take — it’s not your fault. In addition to checking for oversupply, looking for ways your breasts may be getting injured is helpful. Injury and trauma aren’t always visible! Checking your baby’s latch is a great place to start for prevention. Teething, growth spurts or illness can all change a baby’s latch temporarily and cause trauma. If you’re pumping, it can help to check your flange size, fit, and settings. Poor flange fit and too much suction can cause injury in the same way a poor latch can.

You might also want to consider any recent schedule changes. Did your baby recently start sleeping for much longer stretches of time or did you return to work? Are you wearing a new bra or baby carrier that is pinching or putting pressure on your breasts? Did you start sleeping on your stomach or go for a long car trip? It takes time for your breast to fully heal after a significant episode of inflammation. It’s not unusual to feel that lumps and bumps are gone, but pain or a “bruised” feeling remain. Contacting breastfeeding support for frequent swollen ducts is another great idea.

We know that it takes a long time for newer information to make its way into normal discussion when it comes to parenting. You may have been told by well-meaning friends, family or healthcare workers that you have a clog, and been given outdated advice. It’s also possible you’ve read the newest information and feel like it’s not for you – this can be especially true for exclusive pumpers or people with blebs. Your Ovia experts are here to help you navigate this time and all of your choices, and most importantly – to feel better!

Reviewed by the Ovia Health Clinical Team

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

Breastmilk is the optimal form of infant nutrition. That said, the history of breastfeeding practices and the current landscape of breastfeeding support has severely impacted who is breastfeeding in the U.S., resulting in racial disparities in breastfeeding. In fact, for as long as breastfeeding data has been collected, the rates of breastfeeding among Black women has significantly lagged behind white women. 

The 16% breastfeeding gap

In 2015, 69.4% of Black infants initiated breastfeeding, compared with 85.9% of white infants, a difference of 16.5 percentage points. Beyond initiation, the disparity continues and deepens. The rates for exclusive breastfeeding at age 3 months were 36.0% among Black infants and 53.0% among white infants. At age 6 months, the rates were 17.2% among Black infants and 29.5% among white infants. 

The history of breastfeeding

The story behind these numbers is extremely complex. Part of the issue is that the history of breastfeeding is riddled with racism and systemic oppression. During slavery, Black women were stopped from breastfeeding their own children and were forced to breastfeed the children of their masters, often to the neglect of their own. In slave narratives, you can read heart-wrenching stories of slaves whose own babies suffered or died because they were forced to breastfeed their oppressor’s child. Later, when there were limited work opportunities for Black and brown women, wet nursing became a form of “labor” that they provided to affluent, white women. This created a generational legacy of breastfeeding as an act that Black women were stopped from doing for their own children, forced to do for others or paid to do others. Either way, Black infants became the least likely recipients of their mother’s milk and a generational legacy of little or no breastfeeding continued. 

Access to breastfeeding support

Over time, the models of breastfeeding support that were created excluded the needs and lived experience of Black women. For example, La Leche League, the most well-known mother-led lactation support organization which has done great work fighting for the legal rights of mothers for years, historically only set up support groups in white suburban neighborhoods and for many years only catered to stay-at-home mothers.

Yet, for decades, the ‘evidence’ for developing breastfeeding support interventions nationwide was modeled after La Leche League. That data set provided zero insight on the cultural barriers in Black and Latino communities, the impact of employment, or the role of grandmothers, who have been proven to be critical to continued breastfeeding among women of color. Black women were denied the culturally relevant resources.

The lack of culturally relevant support led to fewer Black women breastfeeding which led to a narrative that Black women didn’t breastfeed — a short-sighted approach that became a self-fulfilling prophecy. Physicians assumed Black women didn’t breastfeed so they were less likely to offer breastfeeding information and support. 

The role of formula

Meanwhile, 60% of infant in the U.S. are born WIC-eligible. The important supplemental nutrition for mothers and infants also remains one of the largest purchasers of infant formula in the U.S. That created the perception in many communities, that infant formula was “government approved.”  Commercial influences continue to aggressively market infant formula in Black communities — another thread in the decline of breastfeeding rates. 

Today, the policy gaps that continue to impact all mothers in the U.S. cause disproportionate harm to Black women and other birthing people of color. For example, the U.S. is the only industrialized nation that still does not offer a federal paid leave. Thankfully, some employers have filled in the gap, offering family leave as a critical employee benefit. Unfortunately far too many Black women and other women of color are in fields, including retail and factory work, that by and large don’t offer paid leave, making continued breastfeeding a privilege for those who have corporate jobs or can afford to take unpaid leave.

Black Breastfeeding Week

These systemic barriers on top of the cultural barriers created by a history of racism, have sparked a revolution to address racial disparities in breastfeeding and reclaim breastfeeding in Black communities. That work has been buoyed by awareness movements such as Black Breastfeeding Week (August 25-31), and organizations such as R.O.S.E. (Reaching our Sisters Everywhere) and the National Birth Equity Collaborative, along with a renewed call for more culturally relevant lactation consultants at the IBCLC (International Board Certified Lactation Consultant) level. 

Looking forward

The racial disparities in breastfeeding that were created over time will take intentional and concerted work to undo. The work will include leveraging technology and digital platforms to level the playing field when it comes to access to lactation support. It is equally important that we create a new narrative that Black women do breastfeed and that we hold providers accountable to provide equitable access to information and support for all. When it comes to breastfeeding, no mother that wants to feed her baby with her body, should be left behind. 

Read more by Kimberly Allers: When breastfeeding isn’t going how you planned.

Kimberly Seals is an award-winning journalist, five-time author and internationally recognized strategist for maternal and infant health. She is the founder of Irth, the first of its kind, Yelp-like app for Black and brown women and birthing people to find and leave reviews of maternity doctors and birthing hospitals. She is also host of Birthright, a podcast about joy and healing in Black birth. Kimberly’s fifth book, The Big LetDown—How Medicine, Big Business and Feminism Undermine Breastfeeding was released by St. Martin’s Press in 2017. Learn more at www.KimberlySealsAllers.com and www.IrthApp.com 

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. 

How will your breast milk change?

The nutrition of your milk will change as your baby grows. Why exactly? Incredibly, it changes to keep up with Baby’s needs as they grow. It also responds to offer immune benefits based on what’s around you and your family.

What should you expect immediately after birth?

The first few days after they are born, your milk will look unique. This first breastmilk is called colostrum, and it’s rich in protein and antibodies to help nourish and protect your baby. It’s often called “liquid gold” because of its golden color and just how good it is for infants. Colostrum will help your baby’s new digestive system function properly, pass along immunity, and help them gain weight. You’ll only produce a little since your new baby’s tummy is so small at this point — quality, not quantity, is important here.  

When can you expect to be producing milk?

Gradually after giving birth, this colostrum will transition to what we often picture as breastmilk. And since you’ll be producing a lot more milk than you were producing colostrum, it’s normal for your breasts to feel very full, swollen and over all – different! 

After colostrum, you’ll produce transitional milk — because your body is transitioning over to producing what’s called mature milk. The transitional milk will seem very creamy in texture and color. It will be high in fat, calories, and lactose, and it will also still have plenty of protective agents like antibodies. The amounts will be higher than the first few days of colostrum, but it takes about 4 weeks for your baby’s stomach to hold its maximum amount, and supply gradually increases over that time. 

By the time your little one is about 1-2 weeks old, you will be producing mature milk. Mature milk is still full of the good stuff your baby needs — including vitamins and minerals, protein, sugar, hormones, enzymes, and even protective antibodies if you or your baby get sick — and this will continue to be the case as your little one gets older. 

After a few weeks, you’ll feel less engorged as your body adjusts to your little one’s needs. And as you continue to breastfeed your baby over the coming months or more, the composition of this milk will continue to change, providing the nutrients that Baby needs at that particular time. The amount of breastmilk your baby drinks in 24 hours doesn’t typically increase after about 4-6 weeks of age. Breastmilk itself changes to meet their growing needs. Mind-blowing, we know! This can cause some confusion if you’re used to formula feeding or combination feeding. Formula amounts needed in 24 hours definitely increase as babies grow older because they need more of the nutrients it provides. Because formula itself can’t change, bottle sizes and 24 hour feeding amounts have to get bigger over time. 

What if you want to learn more about how all of this works?

If you’re preparing to breastfeed, it’s always helpful to take a breastfeeding class to learn all the ins and outs, how to work through challenges, how to best take care of yourself and your baby, and how to get more comfortable with what to expect. If you’re having trouble of any sort, wondering what’s normal, or just have questions about how to best take care of yourself and your baby, you can reach out to your child’s healthcare provider or a lactation consultant. Just like your milk changes as your baby grows, it’s not uncommon for your breastfeeding experience to change over time too, and you deserve all the support you need on your breastfeeding journey. 

Reviewed by the Ovia Health Clinical Team

Read more

• Signs that your baby is hungry (and full!)
• How often should a baby breastfeed?

Sources

• Kelly Bonyata. “Frequently Asked Questions about Milk Production.” KellyMom. KellyMom.com, January 1 2018. Retrieved July 22. https://kellymom.com/bf/got-milk/basics/milkproduction-faq/.
• “Transitional Milk and Mature Milk.” healthychildren.org. American Academy of Pediatrics, November 2 2009. Retrieved July 22. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Transitional-Milk-and-Mature-Milk.aspx.
• “How will my milk change when I am breastfeeding through pregnancy?” KellyMom. KellyMom.com, January 2 2018. Retrieved July 22. https://kellymom.com/tandem-faq/16milkchanges/.

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 to get your newborn to latch on

If you’re breastfeeding for the first time, even if the process goes relatively smoothly for you and Baby, you might still face some challenges along the way. Even though newborns have the instinct to breastfeed, in many ways, breastfeeding is still a learned skill, both for you and for your little one.

One common challenge is difficulty with the baby’s latch onto the breast. Educating yourself early, even while you’re still pregnant, can help you prepare for a smooth transition. If you gave birth at a hospital or birthing center, you may have had access to lactation consultants to help you get comfortable nursing your baby and begin to address any latch issues early on. But there are always surprises when adjusting to something new, no matter how well you prepare.

Even if you don’t get it right the first time, there’s a good chance you and Baby will just need to make some slight adjustments to find the right latch. If you continue to have trouble — especially if you don’t have support early on — it can be helpful to reach out to a lactation consultant, ask your healthcare provider to refer you to someone who might be able to help, or bring it up with your baby’s pediatric provider. In the meantime, here are some tips and tricks that might help you both get more comfortable.

Early bird special

Introducing Baby to your breast as soon as possible after birth can help with latching success. As long as you and your little one were healthy and able to, chances are good that your OB provider placed them onto your chest for skin-to-skin contact. This allows parents to immediately try nursing, which helps tap into baby’s earliest latching and nursing instincts. Some newborns may even try to independently wriggle their way right up to the breast to start latching on their own.

Even once you bring your baby home, continuing skin-to-skin contact will reinforce their natural nursing instincts and reflexes and may help facilitate a comfortable latch. Although some babies need a lot of direction, try letting Baby lead the way just like they did the first time around.

Get into a comfy position (or two… or three)

Even though most of the time, when you breastfeed, you’ll be sitting or lying down, it’s definitely hard work. Try to get comfortable as you begin settling in to nurse Baby by using any pillows, footstools, or other support you might need.

You can try several different breastfeeding positions, and some might work better than others in terms of comfort and latching, so it’s a good idea to experiment as needed. If there’s one position that helps Baby get a better latch, then you might want to rely on this early on, as you occasionally try new ones when you have the energy.

Rest assured, as you get into the swing of things and your baby grows, you can continue to try different positions that allow you to nurse comfortably.

Whatever position you’re in, in the early days of nursing when Baby is still so little, make sure that their back and hips are supported and that they’re snuggled close to you so you are both tummy to tummy. Pro tip! Holding the back of your newborn’s head or neck may make them reflexively push away from the breast.

Pucker up

If Baby isn’t opening their mouth, you can brush your nipple across the top of their bottom lip and down to their chin, almost as if you are tickling their lip. This may help them wake up some feeding reflexes to open wide! You can also hand-express a bit of colostrum, then take your nipple to your baby’s nose so they can smell it, and then bring your nipple toward your baby’s mouth. Hopefully, this will make your baby open their mouth wide and drop their chin, bringing you closer to a good latch!

Aim high

Once Baby is opening their mouth, your instinct might be to try to place your nipple right into the center of their open mouth — especially if you’re feeling desperate to get them to latch already — but if you instead aim your nipple toward the roof of their mouth, it may help facilitate a deeper latch.

A deep latch is a good latch. This will allow your little one to draw more milk from the breast and cause less nipple discomfort for you. Every baby is unique, so feel free to experiment with which angle or aim is the most comfortable for you. If you are holding your breast to support or aim it while Baby’s latches — don’t let go until the feeding is well underway. Every baby is unique, so feel free to experiment with which angle or aim is the most comfortable for you. If you are holding your breast to support or aim it while Baby’s latches — don’t let go until the feeding is well underway. 

All hands on deck

If you are trying to guide your nipple into Baby’s mouth, you may have to hold the breast they’re trying to feed from. Your thumb and fingers should form a “C” shape around the breast to guide things along, keeping your fingers as far from their mouth and chin as possible. It’s easy for your hand to accidentally get in the way and force a shallow latch.

Depending on the size of your breasts, you may even want to gently squeeze the breast a bit, so that you can compress or “sandwich” your breast tissue, allowing Baby to get a better latch. If you do this, make sure that the compression is parallel to their lips, like you would eat a sandwich yourself. And if your breasts are on the larger side, placing a rolled-up towel beneath them and a very firm pillow beneath Baby might make it easier for you to do all of this (often challenging) baby and breast juggling.

If your baby also wants to bring their hands up toward your breast and their mouth while nursing, don’t feel the need to move them aside or use mittens. If they really get in the way, that’s probably a sign that you should hold your baby just a little bit closer to your body. But having their hands there will provide them with greater comfort and expertise as they eat.

And when your baby gets bigger, they may even try to help guide your breast into their mouth. So helpful!

Easy does it

If Baby is having a hard time latching, you may be tempted to push their head onto your breast, but this could cause them to arch away.

It’s more effective to bring their body towards the breast and then hold your breast steady for them to latch onto, either letting them explore and self-attach or guiding the nipple into their mouth as described above. Try not to jiggle them or move your breast continuously. Again, it’s important to focus on supporting your baby’s and hips rather than the back of their head. Babies like to feel secure, so making sure their hips are supported with a little hug to their tush can help as well!

Avoid the ouchies

You will know that your little one is latching correctly if you feel only a pulling or tugging sensation and there is no discomfort for you.

Your nipples might be a little tender in the early weeks of breastfeeding as pregnancy inflammation and hormones decrease. But there should never be visible skin changes to your nipples, bruising, cracking or blistering. Once you’re in the swing of things, breastfeeding isn’t supposed to hurt when done correctly. If it does, it’s often a sign that there may be something not quite right about the latch and that you may need to try to make some adjustments.

If things are really hurting — if you feel pinching or pain after a few sucks — and you need to take Baby off your nipple, don’t try to pull them directly off, or you’ll be facing even more ouchies. To break the seal of the latch with minimal discomfort, gently slip your finger between your breast and the corner of Baby‘s mouth, break the suction from your breast, and then try again. Many lactation consultants can also show you how to adjust the latch without starting from zero, which can lessen the wear and tear on your nipples, and the frustration for Baby.

Listen up

Another way that you can be alerted of a not-so-perfect latch is if you hear clicking or smacking noises because when Baby latches well, things shouldn’t be so noisy. These sorts of noises could mean that your little one needs work on their latch, which can cause nipple pain. If you feel pain-free and notice a lot of noise, it can be helpful to get an experienced opinion, as some babies are just naturally noisy and gulpy eaters!

Lip locked

Once your baby is latched, their chin should be pressed into your breast, with their body in alignment facing you. If Baby’s hands are tucked in front of their chest, their tummy is facing the ceiling or their neck is bent forward – these can all make it tricky for Baby to swallow milk. You can make gentle adjustments to Baby’s position as the feeding gets going to achieve ideal positioning.

A deep latch happens when Baby puts not just your nipple but, in fact, as much of your areola into their mouth as possible. This allows your nipple to get past the hard palate of their mouth, and into the softer territory in the back of the mouth.

A deep latch also allows your baby’s gums to compress the milk ducts behind your nipple, stimulating the mammary glands behind the areola. This is great for milk production and flow.

If at first you don’t succeed, try, try again

Unfortunately, it takes time to figure out an A+ latch consistently. There might even be times when it seems like Baby is fighting you or pushing you away as you try to maneuver them into a better latching position, which can be frustrating. But Baby isn’t trying to make your life harder. Your little one is just as new to the whole process as you are, and it may take a little time for the two of you to figure out how to work together. 

Remember, you can and should seek out help if you need it. Baby’s pediatric provider will certainly let you know if they’re gaining weight as they should be — one indicator of how well they’re eating — and may also answer your latching questions. Lactation consultants can be a huge help during this time, so reach out if you need support or have pain or concerns about latching. These experts will be able to let you know if you’re facing normal latching challenges or if Baby is having trouble eating due to other issues. 

But most early latch issues are totally normal, and it may just take a little bit of trial and error to get things right. Again, it’s highly likely that you’ll work through these early challenges quickly and will soon be breastfeeding with ease!

Reviewed by the Ovia Health Clinical Team

Read more

• Breast pain while breastfeeding: What’s normal and when to get help
• Lactation consultants: what they do and how they can help

Sources

• “Positioning” La Leche League International, Retrieved Aug. 23, 2024. https://llli.org/breastfeeding-info/positioning/
• “Baby led attachment” Australian Breastfeeding Association, 2022. https://www.breastfeeding.asn.au/resources/baby-led-attachment