FAQ: How can I increase my supply so I can stop supplementing?

Of all the questions we hear from new mothers, this is one of the most common. There are a number of reasons that a mommy may end up supplementing her breastfed baby's intake with formula, but many mothers and pediatricians prefer babies to be exclusively breastfed, if possible. Here are some key pieces of information and basic steps you can take to help achieve exclusive breastfeeding for your child.

1) Call a lactation consultant. Every situation, every family, every mother, and every baby is unique. There is no one-size-fits-all fix, so if you're having any difficulty with breastfeeding or your milk supply, the first thing you should do is set up an appointment with a lactation consultant as early as you can. Lactation Consultants are trained to recognize latch and positioning problems, tongue and lip ties, and many other problems that can hinder your breastfeeding relationship. Don't balk at the cost: it often takes only one visit to point you in the right direction, and in the long run, it's much cheaper than buying formula!

2) Breastfeeding is a supply-and-demand system. Particularly at the beginning, as you establish your supply, the only thing that will regulate how much you make is the frequency with which you completely drain the breast. A baby (even a newborn with a wonky latch) will always drain the breast more effectively and efficiently than a pump, which means that a nursing baby will stimulate your supply more than the pump will. If you've been relying mostly on pumping so far, that could be one reason why your supply hasn't caught up yet. Limiting feed times or adhering to a strict schedule instead of feeding on demand can also cause supply to lag.

3) An additional problem that might be going on if you're supplementing is a bottle preference. It's less work for a baby's mouth to get milk/formula from a bottle than it is to get it from the breast (literally, the tongue has to make a completely different motion), so many babies who are bottle-fed develop a bottle preference and become frustrated at the slower flow of the breast. A problem that comes with that is that they can drink more fluid in less time from the bottle, meaning their stomachs (which are TINY and usually can only hold an ounce or two as newborns) expand faster than they would were they drinking from the breast. And finally, breastmilk is metabolized much faster than formula, meaning a breastfed baby is hungry more often than a formula-fed baby.

As long as your baby can get his food from somewhere other than your breast, he won't be stimulating your production enough to increase your supply.

4) As long as your baby can get his food from somewhere other than your breast, he won't be stimulating your production enough to increase your supply. The most effective solution is also the most upsetting: Stop giving baby formula and offer the breast as often as possible. If he still wants to nurse after 40min, let him! If he wants to nurse again only a few minutes later, let him! If he wants to nurse 3 times in 2 hours, let him! Even if you think you have no milk left, you usually do, and better, if he really does manage to suck you dry, that means he's getting the fat-rich hindmilk, which is great for his weight gain! AND having him nurse you completely empty will send your supply into overdrive..... odds are you'll be engorged within 24 hours!

5) Some mothers who have been in this situation often recommend going into a quiet, dark room and just nursing for hours, some recommend trying skin-to-skin, some recommend co-sleeping, and so on: you'll find what works for you. And keep in mind that fussiness is not always hunger..... if she cries after eating, it could be gas, a wet diaper, tiredness, the desire to be held or swaddled, or just frustration. Keep in mind that your baby is likely to be upset and crying the first few days that you withhold the bottle, but as long as she's having regular wet and dirty diapers, she is healthy and there's no need for concern.

Make sure you are in communication and agreement with a pediatrician you trust at all times while transitioning your baby's diet, both for your child's safety and for your own peace of mind.

Keep calm and nurse on, mamas!

You get your milk from where? 3 Myths about milk-sharing

On May 10th I felt lucky to participate in the Best for Babes 1st Nation Wide Milk Walk, to bring awareness to the importance of human milk and milk banks.

Why is this such an important cause? Because there are still a lot of myths and misunderstandings about milk donation.

Myth #1 - It's Weird
Donating or recieving breast milk is no more weird than pouring milk on your morning cereal. Cow milk is for baby cows, human milk is for human babies. It's just that simple.

Myth #2 - It's not safe
There are 2 ways women share milk: either through milk banks or mother to mother. When going through a milk bank there is a screening process to even become a donor, just like there is a screening process for blood banks. I have personally donated mother to mother. I expected the mom I was donating to to ask me questions about my diet. lifestyle, etc. What she told me was "I have seen you give your daughter this milk, that's enough for me." Whatever your comfort level is, there is a safe way to get milk. The argument could also be made that formula can not be safe in certain situations either. There have been numerous recalls, and if not made properly, it can be harmful.

Myth #3 - It's not Important

The WHO recommends that when it comes to feeding an infant it should be

1. breast milk from the breast
2. pumped breast milk
3. donated breast milk
4. formula

Formula is LAST. Breast milk can not be replicated. There are over 100 ingredients in human milk that are not in formula.

Human Milk Saves Lives. 500 U.S. & Canadian preemie infants die annually, and 5000 more are sickened, from Necrotizing Enterocolitis (NEC). Feeding these fragile babies human milk has been shown to reduce the risk of NEC by 79%. NEC causes indescribable anguish to babies and parents. - See more at: http://www.bestforbabes.org/miracle-milk-stroll/#sthash.DITW1i6O.dpuf



At the end of the day, I have felt a special bond with these moms that I have been able to donate my milk to. After the walk, a friend and I decided to get lunch at a local farmers market. We were both still clad with our " I make milk" and "I donate milk" stickers when a woman stopped us and said "Thank you! Because of women like you, my son is alive." Pumping is hard work and I applaud any mother who does so. Pumping for the love of a baby not your own is a gift unlike any other. I can't wait for next year's walk.

My Friend and I half way through the walk

The Vanishing Finish Line

Before my son was born, I obsessed over the birth process. I read every book, every website, haunted message boards, practiced yoga and meditation, spent weeks drafting a birth plan, and so on. Then, the day came, and through an unexpected set of circumstances, I got my perfect birth. I was sitting there in the hospital, snuggling my squishy little 6lbs 15oz burrito and basking in the glow of having finally crossed the finish line, when I overheard a nurse saying "....his latching score is pretty low...."

Wait, what?

And it suddenly hit me that with all my preoccupation of how to bring this baby into the world, I hadn't given a single thought as to how I was supposed to keep the little squirt alive! Oh sure, I'd put a breast pump on my registry and somehow managed to pick up a couple of nursing bras, but had I read a thing about breastfeeding? NOPE.

Remember what the nurse said about his latching score? Yeah. Suddenly my boob was a "sandwich" and nurses were jamming my baby's face onto it, handing me a little tube of Lanolin and telling me that I might feel "sore" for a few days. I don't know about you, but when I hear the word "sore," I think of how my muscles ache after a long run, or how my toe feels when I stub it, or how my head feels when I bump it getting out of the car.

None of those is comparable to the feeling of having a tiny and adorable yet voracious little monster chew on your heretofore mostly-untouched nipple as if his life depends on it (because, in fact, it does). I told the nurses, "It hurts" and they said "It shouldn't hurt if he latches right." After a brief visit from a lactation consultant who assured me everything looked good, we were headed home. Where was the finish line now?

As I write this now, I'm looking over the New Mother's Nursing Journal that the hospital gave us and which we used for the first month of K's life to track feedings and wet/dirty diapers. Next to "Feeding Time" is a column for "Comments." Here is a sampling of what appears in that column in the first two weeks of my breastfeeding career:

This image and header by Susan Holstein Photography.

Hurts me!
Very difficult stop-start, painful
Stopped short due to nipple pain
Hellish feeding, so much pain
Bloody nipple :(
painful
super-hungry, painful! :(
OW
Ow again
Owwww....

.... and my personal favorite:

HOLY HELL

I told my husband that I would rather give birth ten more times than let our son near my nipple again (thankfully, I didn't follow through on that threat). I dreaded every feeding, and screamed and cried each time he latched. I remember being absolutely furious at the idea that this was supposed to be some kind of bonding experience for me and my baby, because I honestly felt like breastfeeding was inhibiting bonding. Worst of all, his weight gain was way behind where it should have been.

Craving some reassurance that this was just a phase that couldn't possibly last, I turned to my online mommy group for support. Upon hearing my woes, the more experienced mothers said: "Don't worry, the pain goes away after the first 4-6 weeks." I was horrified: I wasn't sure I was going to survive the next HOUR, so a month sounded like an eternity! The finish line seemed farther away than ever.

And then, when my little boy was only eight days old, this happened:

My memory of this period is so fuzzy (read: repressed) that I actually only remember one formula feeding, but the journal says he had several within a 24-hour period. With the benefit of hindsight and experience, I know now that I was on a slippery slope, seriously risking my supply and any continuance of our breastfeeding relationship. At the time, however, I only knew that I absolutely could not continue without sleep and a break for my poor nipples. I fed my sweet baby that first bottle of formula myself, crying the whole time, then handed him to my husband and went to bed. It could have been the end for us.

Fortunately, my very next entry in the book says "Back to the breast!" I wasn't dropping out of the race just yet. We visited a lactation consultant who noticed K's tongue tie and recommended we get it clipped immediately so that he could better transfer the milk (and it would be less painful for me). It took only a couple of days to get the appointment, but even that brief wait was agonizing.

After resolving the tongue tie, I was looking forward to the blissful and painless feedings that would surely begin.... and while it was a tiny bit more bearable, I still winced and yelped more often than not. My little boy was now two weeks old and still not back up to his birth weight. I knew that my supply was not our problem: our newborn was a heavy sleeper, whom we often had to wake to eat. I needed to get him on the breast more frequently, but I was terrified of the pain.

At the suggestion of a friend, I set up camp on the couch with a giant bag of trail mix and started watching through all of Doctor Who. I had decided to stop looking for the finish line, to stop looking beyond anything other than the current feeding. I told myself that my only job was to sit in one place and let my baby eat, with minimal flinching, if possible. And that's what I did, all week.

When K was three weeks old, my family came to visit. In a valiant attempt to do what normal people without newborns do, I accompanied them out to lunch and on the way, I stopped by the breastfeeding center to weigh my son. I remember unwrapping his skinny little limbs and removing his heavily wet diaper, praying he wouldn't pee on me. The numbers on the scale spun and settled: 6lbs 15oz. I had gotten my baby back to his birth weight.

It was a victory and a wonderful relief, but I decided then that it wasn't the finish line. "Heck, I might even go all the way to three months!" I thought. Recently, we passed nine months of exclusive breastfeeding. K has never had another drop of formula since that one day, his growth on-track and his health "perfect," according to his pediatrician. I don't know where the finish line is now - a year, two years? - but I no longer care. I'm too busy enjoying the journey.