Why should you keep track of the amount of milk you are pumping?

Well, sometimes in your foggy middle of the night pumping session, you realize you have lost track of how much you have pumped over the last 24 hours. Well, here is a pumping log that you can use to help you keep track. Why should you keep track? You may need to keep track of how much milk you are making if you have a preemie, or you may need to keep track of how much milk your baby is taking in over 24 hours and at each feed. This pumping log will help you keep track of how much milk you are making, to ensure you are pumping enough to keep your new precious baby fed! You can also refer to the document on helping to maintain or reach a full milk production for you baby.

http://www.motherschoiceproducts.com/pdf_documents/public/Reachingfullmilkproduction2010.pdf

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Pumping Log
	Name:				Date:
	GOAL:
	Stage 1 (Birth to milk increase, ~Day 3-4):
		8-10 pumpings/day, 10-15 min per breast, hand expression after
		Expect:  Drops, but pumping now “puts in your order” for more milk later
	Stage 2 (Day 3-4 to full milk production, 750-1050 mL per baby per day):
		8-10 pumpings/day, 20-30 min. per breast and/or hand expression after
		Expect:  More milk expressed every day
	Stage 3 (At full milk production: 750-1050 mL per baby per day)
	6-7 pumpings/day, 10-15 min. per breast to maintain milk production
		To maintain milk production, once a week total daily milk yield
		Expect:  To maintain milk production
	Time Started Pumping	Time Ended Pumping	Total Pumping Time	Minutes Hand-Expressed After Pumping	Total Milk Expression Time	Oz/mL Milk Pumped Left Breast	Oz/mL Milk Pumped Right Breast	Total Milk Expressed
					0			0
					0			0
					0			0
					0			0
					0			0
					0			0
					0			0
					0			0
					0			0
					0			0
					0			0
					0			0
					Total Milk Expressed per 24 hrs			0
	Minutes Spent Today in Skin-to-Skin Contact with Baby:
	Mother
	Father
	Other
	Total
	Flange size used on in mm:
	Left Breast-	21.0	22.5	25.0	28.5	30.5	32.5	36.0
	Right Breast-	21.0	22.5	25.0	28.5	30.5	32.5	36.0

Diet and Breastfeeding - Myth or Mystery!

How many foods really effect your breastmilk? That is a good question and one that doesn't have a simple answer.  If you are concerned of course you should talk to your doctor or breastfeeding professional. There is no one size fits all with breastfeeding, every breastfeeding "team" is different. Mom and baby work together to find what is best for them.

http://www.motherschoiceproducts.com/pdf_documents/public/DietandBreastfeeding2010.pdf

Are there foods I should eat or avoid while I’m breastfeeding?
ANSWER:
No. There are no foods (such as cow’s milk) that every breastfeeding mother must have. (Cows don’t "drink milk to make milk".) And there are no foods that all mothers must avoid. In most cases, there is no need to steer clear of chocolate, spicy foods, onions, garlic, broccoli, or cabbage. The key is: everything in moderation. In one study mothers had lots of garlic—more than anyone could eat with a meal. And their babies breastfed more. They liked the taste! In many countries, such as Thailand and Mexico, mothers eat spicy foods while breastfeeding with no ill effects on their babies. Enjoy!

If my diet is not perfect, will my milk still be good for my baby?
ANSWER:
Yes. Although eating well is good for you (it boosts your energy and resistance to illness), an ideal diet is not necessary to produce good quality milk. As breastfeeding expert Ruth Lawrence, MD, writes: "All over the world women produce adequate and even abundant milk on very inadequate diets." Studies have found that it takes famine conditions for several weeks before a mother’s milk is affected.

How will I know if my baby is reacting to something I’ve eaten?
ANSWER:
First, keep in mind that almost all babies have fussy periods and such reactions are unusual. Your baby’s fussiness is probably unrelated to your diet. Besides fussiness, other signs in a baby are dry skin, congestion, bloody stool, rash, and wheezing. If you suspect a food is affecting your baby, try avoiding it. (Cow’s milk takes two weeks or so to clear.) Then try eating it again. If your baby reacts, you’ll know to avoid that food for a few months. (Most babies will not react after about six to nine months of age.) The most likely culprits are protein foods such as dairy, soy, egg white, peanuts, and fish. Only changing your diet will tell you for sure.



Do I need to eat more than usual to make enough milk?
ANSWER:
No. Just "eat to hunger." Extra calories do not seem to be as important as once thought. Your fat stores at your baby’s birth provide much of the fuel needed to make milk. Research has found that your metabolism may be more efficient while breastfeeding than at other times. This may reduce your need for extra calories. More active mothers will need more calories, but they will likely also feel hungrier, too.  Listen to your body, it will tell you if you need more calories?

As a vegetarian, is there anything special I need to know?
ANSWER:
Yes. You need to either eat foods that have vitamin B12 (such as eggs or dairy), eat foods with vitamin B12 added, or take supplements. If you are on a vegan or macrobiotic diet or any other diet that does not include animal products, be sure to get enough B12.

Are there foods that will increase my milk production?
ANSWER:
Not that we know of. Again, milk production is based on how many times each day your milk is drained well from your breasts. The more times you breastfeed or express your milk and the more drained your breasts are, the more milk you will make. For information on herbal and prescribed medicines that increase milk production, talk to your lactation consultant.

Is it okay to diet while I’m breastfeeding?
ANSWER:
Yes. In fact, this may be the best time, as breastfeeding helps burn fat stores. But it’s best to go slowly and lose weight gradually. Any diet should include at least 1800 calories per day. Talk to your doctor about what a healthy weight should be for frame. Any diet should be rich in fruits and vegetables and lean protein.
As with other food products, artificial sweeteners are all right in moderation, one to two servings per day.

What about caffeine?
ANSWER:
As with all parts of your diet, think moderation. One or two cups of coffee (or other caffeinated drinks such as teas or colas) are not likely to cause a reaction. Unless a baby is unusually sensitive, there is no need to abstain.

How much should I drink while I’m breastfeeding?
ANSWER:
"Drink to thirst" is the simple guideline. Research has not yet found a link between the fluids a mother drinks and her milk production. (Milk production is based on the number of times per day your milk is drained well from your breasts.) If your urine is dark yellow, this is a sign that you need more fluids. To make it easy to get a drink when thirsty, keep a container of water or juice at your usual nursing spot.

Can I have an occasional glass of beer or wine while I’m breastfeeding?
ANSWER:
Yes. Moderate to heavy drinking is risky for your baby, but a little alcohol in the milk now and then has not been found to be harmful.

Mothers who want to avoid any alcohol in their milk can have their drink right after nursing. Research shows that alcohol passes quickly into a mother’s milk, peaking within 30 to 60 minutes (60 to 90 minutes when taken with food). But it also passes out of milk quickly. For a 120-pound woman, it takes 2 to 3 hours for the alcohol in one glass of beer or wine to leave her milk. And there is no need to pump to make your milk alcohol-free. As blood alcohol levels drop, alcohol leaves the milk. If a breastfeeding mother has a stronger drink or more than one glass of beer or wine, it will take much longer for the alcohol to leave her milk.






Adapted from
　

Nancy Mohrbacher, IBCLC, FILCA, Lactation Consultant Co - Author of Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers

This is general information and does not replace the advice of your healthcare provider. If you have a problem you cannot solve quickly, seek help right away.

Every baby is different, if in doubt, contact your physician or other healthcare provider.

How important is the fit of the flange when you are pumping?

Every mother needs a good flange fit for greater comfort and better milk flow. What determines a flange’s size—and your fit—is the width of its opening. To get an idea of your flange size, compare your nipple to a  nickel. If your nipple is wider than a nickel, you will likely need a larger-than-standard size breast flange. But because the breast changes as you pump, measuring tools alone are not the most reliable gauge.

The best way to check your fit is to watch your nipple during pumping. With a good fit, you should see space around your nipple as it moves freely in the flange’s tunnel (see below Photo A). With a tight fit, your nipple may rub along the tunnel’s sides or move very little (see below Photo B). A tight fit squeezes the nipple and slows milk flow. The rubbing can also cause discomfort, skin irritation, and skin breakdown.

PHOTO A: GOOD FIT

PHOTO B: TIGHT FIT

A pump flange can also be too large. In this case, more than about ¼ to 1/8 of an inch (3-6 mm) of the area around your nipple will be pulled in as you pump or your nipple may appear to bounce in and out of the nipple tunnel.
If your flange is too large or too small, you may feel discomfort even on low suction settings. You may also pump less milk than expected.
But once you find a good flange fit, this isn’t the end of the story. Flange fit can change with birth, breastfeeding, and pumping. The flange that fits you well when you start pumping may need to change as you pump longer. For this reason, it makes sense from time to time to recheck your flange fit.
Ameda offers seven flange sizes. Some Ameda pumps and kits include multiple flange sizes like the Ameda Purely Yours Ultra.    Check with your Lactation consultant or Public Health nurse any time you have discomfort or pain with pumping.  Pumping should not hurt!

Some of this information is adapted from:

Nancy Mohrbacher, IBCLC, FILCA, Lactation Consultant,
Coauthor of Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers

Congratulations you're pregnant. Now you need a breastpump?

Well, not really! Buying a breastpump is something many pregnant women think about. When should you buy a pump? There are a few factors to consider when you are ready to buy. The first is are you planning to breastfeed, or are you planning to feed your baby breast milk? If you are going to exclusively breastfeed with the occasional bottle given by dad, or grandma or whomever then a manual pump will likely do the trick.



If you are planning to go back to work early then sure, a double electric pump is a no brainer! But what about if you are in between those stages? A double electric pump can be a good purchase especially if this is your first child and you are planning (hoping!) for more. You will get quite a bit of use out of it. If you can afford it then it will be a useful tool in your parenting arsenal!


Personal Breast Pump selection

Should you buy a pump while pregnant? Our advice is no, you should wait. What if you have breastfeeding challenges and need a hospital grade pump for an extended time? What if your baby refuses the bottle no matter what you try?  There are many factors in an individual breastfeeding experience and you won't actually have the anwsers until you hold that precious bundle in your arms. Breastpumps don't really go on sale, so waiting until you have your baby won't change that. Plus they are readily available at most pharmacies, check behind the counter with your pharmacist!  Breastfeeding is a unique and rewarding experience for most families, and some will struggle and some will have an easy time. Just remember a pump cannot replace skin to skin contact and the benefits to mom and baby that come with that! Enjoy your pregnancy, and start thinking about breastfeeding.   Do your research, think about which pump you would purchase, but wait until the time is right!
Good luck and happy feeding.

Storing Your precious liquid!

Storing and Handling Mother’s Milk

QUESTION: What do I need to know about storing my milk?

ANSWER: In addition to the milk storage times (see chart below), it also helps to know these points:

•  Glass or hard plastic containers can be used.

•  Milk freezer bags are also an option.  Ameda Store and Pour are perfect for this. You can pump directly into the bag and the write the date and put in your fridge or freezer directly. No muss no fuss!

•  Avoid thin bottle liners. These are meant to be used as feeding bags, but not for freezing milk. They can split when frozen. 

•  Store your milk in the smallest amount your baby might take. When your baby takes a bottle, her saliva mixes with the milk. You can always add milk to it, but don’t save leftover milk after it’s been fed.

•  Write the date and time on your milk container with a sticky label or non-toxic marker. Add your baby’s name if she is in daycare or in the hospital.

•  You can combine milk pumped at different times. When combining milk from different days, write the date of the oldest milk on the container.

•  If you plan to use your milk within 8 days, you can keep it in the fridge. Otherwise, plan to freeze it in the coldest part of the freezer. Avoid storing in the door, the deeper into the freezer the better.

• You can add fresh milk to cooled milk. And you can add fresh milk to frozen milk if it’s  cooled first and there is less fresh than the amount frozen.

• Before freezing large amounts of milk. Freeze a batch or two, then thaw and smell it. Some mothers make milk high in lipase, an enzyme that digests fat. When thawed, the frozen milk of these moms has a strong, soapy smell. If this happens and the baby refuses this milk, deactivate the lipase before freezing it by scalding the milk first. (To scald your milk, heat it in a pot on the range until bubbles form at the edges, then cool and freeze.)

• If you follow the times on the chart below, you can keep your milk at room temperature, then refrigerate it, and then freeze it.

QUESTION: Why do some milk storage guidelines differ?

ANSWER: Why can’t the experts agree? First, research confirms that your milk will not spoil before the times in the table below. But the longer your milk is stored, the more vitamins and antioxidants are lost. That’s why some breastfeeding books list shorter storage times. Those experts prefer you to use your milk sooner rather than later. But this doesn’t mean that your milk will spoil if you wait longer.

It’s never a bad idea to give your milk as soon as you can after pumping. But what should you do if you find some stored milk in the back of the fridge that has been there for up to eight days? When in doubt about the freshness of your milk, smell or taste it. Spoiled milk will usually smell spoiled.

QUESTION: Why do I need to warm my milk before feeding it to my baby?

ANSWER: An older, larger baby can handle drinking chilled milk. But milk needs to be warm for a tiny baby. If a newborn is fed cold milk, it can bring down his body temperature. For a younger baby, warm your milk to between room and body temperature.

QUESTION: What should I know about warming and thawing my milk?

HERE ARE SOME POINTERS:

•  Whether warming chilled milk or thawing frozen milk, keep the heat low. High heat kills the live cells in your milk that help keep your baby healthy.

• Warm your milk to between room and body temperature under cool then warm running water. Keep warm water away from the bottle lid so that it doesn’t mix with the milk. 

•  One way to do this is to put a bottle in a bowl with the sides lower than the bottle’s lid. Run warm water in the bowl. The warm water against the sides of the bottle warms the milk.

•  You can thaw frozen milk in the refrigerator.

•  Your milk is not “homogenized” like the milk in the store. So it may separate into layers. If this happens, just gently swirl it to mix.

HERE ARE SOME “DON’TS” TO KEEP IN MIND:

•  Don’t warm milk in the microwave. It changes the milk and causes hot spots that can burn your baby’s mouth and throat.

•  Don’t heat the milk in a pot on the stove. High heat can make the milk too hot for your baby, and it destroys the antibodies your baby needs.

You know how much your milk matters to your baby. That’s why you make the time to pump and store your milk.

Ameda Personal Breast Pumps

Help! My breast are engorged!

Many woman who are breastfeeding experience this and it is normal for your breasts to become larger, heavier, and a little tender when they begin making more milk. Sometimes this fullness may turn into engorgement, when your breasts feel very hard and painful. You also may have breast swelling, tenderness, warmth, redness, throbbing, and flattening of the nipple. Engorgement sometimes also causes a low-grade fever and can be confused with a breast infection. Engorgement is the result of the milk building up. It usually happens during the third to fifth day after birth, but it can happen at any time.
Engorgement can lead to plugged ducts or a breast infection, so it is important to try to prevent it before this happens. If treated properly engorgement should resolve,  usually in a couple of days.

Now what?

Breastfeed often after birth, allowing the baby to feed as long as he or she likes, as long as he or she is latched on well and sucking effectively. In the early weeks after birth, you should wake your baby to feed if four hours have passed since the beginning of the last feeding.  (This opinion varies, you know your baby best and if they need to sleep longer, use your "mom instincts".  They are ususally right!) 

Make sure you have a good latch. If you are having trouble or you feel things are not going well,you can contact your nearest Lactation Consultant or La Leche League. 

Breastfeed often on the affected side to remove the milk, keep it moving freely, and prevent the breast from becoming overly full.

Avoid overusing pacifiers and using bottles to supplement feedings.

Hand express or pump a little milk to first soften the breast, aereola and nipple before breastfeeding, or use an electric breast pump if you have one, but not for too long. Remember more milk out means more milk you will make! Your body is trying to adjust and make the right amount for your little one.

Massage the breast. This works really well in a nice warm shower. Don't be surprised if you notice milk leaking out if you do this. This is normal and probably will provide some relief.

Use cold compresses in between feedings to help ease pain.

If you are returning to work, try to pump your milk on the same schedule that the baby breastfed at home. Or, you can pump at least every four hours.

Get enough rest, proper nutrition, and fluids.

Wear a well-fitting, supportive bra that is not too tight. Use some breast pads if you feel that you might leak!

These things should help and engorgement usually doesn't last more than a couple of days. Once your body adjusts to the demands of your baby, you might have some leakage and a bit of soreness but it should go away. If you are still having pain or engorgement, it is important that you contact your local breastfeeding support person.

When Do You Need a Hospital Grade Pump?

There is a lot of information about pumping out there these days. Many moms are even putting breast pumps on their baby registry. How do you know what your breastfeeding experience will be before your baby even arrives?  What if your baby is premature?

 It also depends on your goal. Is your goal to breastfeed your baby or feed your baby breast milk? Purchasing a breast pump is something that you should think about and be prepared for , but you can wait until after the baby is born.

If your goal is to breastfeed, you may only need a manual pump for occasional expression. If you are planning to feed your baby breastmilk and not actually breastfeed then you will most likely want (and need!) a double electric pump. If your baby is premature or you have problems with low milk supply then you will most likely need a hospital grade pump, and a lactation consultant.

Hospital grade breast pumps provide top of the line pumping technology. This type of pump is the ideal choice for mothers of multiples or pre-term infants. Hospital grade pumps are also the best pump option for mothers who need to initiate lactation or increase milk production.

Hospital grade pumps are available as rentals from hospitals, health units and some pharmacies.  Each mother will need her own milk collection kit to use with the hospital pump.

This is a great way to get started with pumping. You may not need to pump long term, or you may need the functions that a hospital grade pump can offer such as more cycle speeds and more options for increasing the milk. Once you have your milk supply established you can move on to the next phase.

If you are going to continue pumping you can go to a personal use pump. Some pumps will use the same kits as the hospital grade pumps. For example if you use an Ameda Elite or Platinum pump, your collection kit will work with an Ameda Purely Yours personal use breast pump.

Trying to decide which type of pump you need can be tough, but you do want to take into consideration things like milk contamination, ease of use and comfort while pumping. Talking to a breastfeeding specialist and other moms may give you some help, but you will be the one who knows what kind of pump you will need.  It is a big investment to purchase a double electric pump so you want to make sure you make the right decision.

If you are not sure, then renting a hospital grade pump is your best option. This will help you make the decision if pumping is for you!  Remember breast is best, but sometimes you need an option to help give your baby the breastmilk if you are unable.

Good luck and happy feeding!