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!

Should Pumping Hurt?

Some moms assume pumping should be painful. Not so! “No pain, no gain” does not apply here. Painful pumping means something needs to be adjusted. What causes pain? The two most common causes are: 1) pump suction set too high and 2) flange fit issues.

Pump Suction Set Too High. First, the strongest pump suction does not always pump the most milk. In fact, too-high suction can actually slow your milk flow. Set your pump at the highest suction that feels good…and no higher. (If you’re gritting your teeth, it’s too high!)

Pumping milk is not like sucking a drink through a straw. With a straw, the stronger you suck, the more you get. When pumping, most milk comes only when a let-down, or milk release, happens. Without a milk release, most milk stays in the breast. What is a milk release?

• Hormones cause muscles in the breast to squeeze and milk ducts to widen, pushing the milk out.
• Some mothers feel tingling. Others feel nothing.
  

A milk release can happen with a touch at the breast, hearing a baby cry, or even by thinking about your baby. Feelings of stress, anger, or upset can block milk release.

While breastfeeding, most mothers have three or four milk releases, often without knowing it. To get more milk with your pump, you need more milk releases, not stronger suction. See our Q&A Series sheet Making the Most of Your Breast Pump on the MCP website under the "about breastfeeding tab" for tips on triggering more milk releases during pumping.

Flange Fit Issues. Many mothers pump comfortably with the standard size flange (25 mm diameter nipple opening). But if pumping hurts even on low suction, you most likely need another size. If the standard flange is too small or too large, a better-fitting flange will feel more comfortable and may even pump more milk.

To check your flange fit, watch your nipple during pumping. If you see a little space around your nipple as it’s drawn into the flange’s nipple tunnel, you have a good fit. If your nipple rubs against its sides, the flange is too small (click here to see fit photos). If too much of the dark area around the nipple is pulled in or the nipple bounces in and out of the tunnel, it is too large.

Thankfully, Ameda has seven different flange sizes available, so you can go larger or smaller, as needed. (Click here to see the range of fit options.) Nipple size changes with birth, breastfeeding, and pumping, so the pump flange that fit you well when you started pumping may need to change as you pump more. For that reason, you’ll want to recheck your flange fit from time to time.

Breast or Nipple Issues. There are other possible causes of pain during pumping related to breast and nipple health. If your pain is not due to too much suction or the too-small or too-large flanges, it is time to ask more questions. Do you have nipple trauma (broken skin on the nipple)? Could you have a bacterial infection of the nipple (can occur with a history of nipple trauma)? Do you have an overgrowth of yeast (also known as thrush or candida)? Is mastitis a possibility? Does your nipple turn white, red, or blue after pumping? If so, see your lactation or other health-care provider to rule out Raynaud’s Phenomenon and other possible causes.

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

Nipple Pain and Trauma - oh what to do!

In the early weeks of breastfeeding you may experience sore or tender nipples. Tender nipples at the start of a breastfeeding are normal during the first week or two. But pain, cracks, blisters, and bleeding are not. Your comfort depends on where your nipple lands in baby’s mouth. And this depends on how your baby takes the breast, or latches on. Learning the correct latch takes practice, and the help of a Lactation consultant is often needed.

To understand this better use your tongue to feel the roof of your mouth. Behind your teeth are ridges. Behind the ridges the roof feels hard. When your nipple is pressed against this hard area in your baby’s mouth, it can hurt.

But farther back in your mouth the roof turns from hard to soft. Near this is the area some call "the comfort zone." Once your nipple reaches your baby’s comfort zone, breastfeeding feels good. There is no undue friction or pressure on your nipple.

To make this happen, let gravity help. Lean back with good neck, shoulder, and back support and your hips forward. Lay your baby tummy down between your exposed breasts. When your calm, hungry baby feels your body against her chin, torso, legs, and feet, this triggers her inborn feeding reflexes. When her chin touches your body, her mouth opens and she begins to search for the breast. In these "laid-back positions," gravity helps the nipple reach the comfort zone.

Image of proper latch. The nipple should be deep and past the hard palate.

In other positions, you need to work harder to help your baby take the breast deeply.

• With your baby’s body pressed firmly against you and her nose in line with your nipple, let her head tilt back a bit (avoid pushing on the back of her head)
• Allow her chin to touch the breast then move away.
• Repeat until her mouth opens really wide, like a yawn.
• As she moves onto the breast chin first, gently press your baby’s shoulders from behind for a deeper latch.

That last gentle shove helps the nipple reach the comfort zone. Breastfeeding tends to feel better when your baby latches on off-center, so her lower jaw lands far from the nipple.

In the process of mastering the latch, you may experience pain, and sore cracked nipples. If you feel nipple tendeness or discomfort,  Ameda ComfortGel pads can prevent clothing friction and sootheand help heal your nipples.  Ameda ComfortGel pads are comfortable to apply and easyto use. Just wear in your bra like a nursing pad. Plus, they do not stain clothing. Each water-based ComfortGel pad may last up to six days, making it an economical and convenient choice. Also, because Ameda ComfortGel hydrogel pads will not absorb any milk you can use them with Ameda No Show premium breast pads against your bra. This is the best moist would healing treatment available today. Ask for them at your pharmacy counter.

　

CNN article regarding Used Breast Pumps

This is written from an unbiased person in the US, who happens to be a medical doctor! Very aware of contamination issues and safety!  Used pumps are popular, just be informed when you are shopping for one.

http://thechart.blogs.cnn.com/2011/06/13/is-a-used-breast-pump-safe/

Ameda Product support videos

Well, have you ever had a question about your Ameda pump and our customer service center is closed? Well now you can have access to multiple videos at the click of your mouse!  Want to find out how to put the pump collection kit together? How about checking if your flange is the right size? Now there are some videos online to help you with your questions.


http://www.ameda.com/ameda-products/product-videos

Happy video watching!

What's in the Bottle - From Nancy Morbacher ICBLC

What's In the Bottle?

Nancy Mohrbacher Tuesday, May 17, 2011 at 8:54AM

Scientists have found that babies not breastfed have a 30% to 40% increased risk of childhood obesity.¹ Milk intake and weight gain vary greatly among formula-fed and breastfed babies.  (For more, see my earlier post.) Formula-fed babies consume 49% more milk at 1 month, 57% more at 3 months, and 71% more at 5 months.² This significant difference in milk intake is due in part to how milk flows from breast and bottle.  Recent studies have examined these feeding differences in more detail to help answer the question “How is obesity risk affected when the feeding bottle contains mother’s milk?”  

The study mentioned above provides a partial answer.  Caregivers’ behaviors during bottle-feeding—which are independent of the milk—influence babies’ intake.  For example, when bottles contain more than 6 oz. (177 mL), babies consume more milk.  Also, babies whose caregivers encourage them to finish the bottle are heavier than other babies.
An important part of obesity prevention is the ability to self-regulate what we eat to match our energy needs.  Breastfeeding naturally teaches babies this self-regulation by giving them more control over feedings.  While breastfeeding, baby must actively draw milk from the breast.  He learns to take milk when hungry and stop when full.  This helps baby become attuned to his body’s hunger and satisfaction cues.  During bottle-feeding, baby’s role is more passive.  Fast, consistent flow and regular coaxing to take more milk, even when full, can lead to a habit of overfeeding and poor self-regulation.
In one recent study of 1250 U.S. babies, researchers used bottle-emptying as a measure of poor infant self-regulation.³ (An earlier study verified this link.⁴) It didn’t matter whether expressed milk or formula was in the bottle.  The more often the babies were fed by bottle during their first 6 months, the more likely they were to empty the bottle during their second 6 months.  Only 27% of the babies who were exclusively breastfed during their first 6 months emptied the bottle during their second 6 months.  Of those fed at first by both breast and bottle, 54% later emptied the bottle.  Of those fed at first only by bottle, 68% later emptied it.
In a U.S. pilot study,⁵ weight gain was monitored for the first 4 months in 37 human-milk-fed babies.  Nineteen were bottle-fed no more than once per day and 18 were bottle-fed significant amounts of expressed milk because their mothers were employed full time.  Although the difference in weight gain between these groups was not statistically significant due to the small sample size, the differences were obvious.  From 4 to 6 months of age 10% of the babies in the breastfeeding group were at or above the 85^th percentile for weight, whereas 33% of those in the bottle-feeding group were at or above the 85^th percentile.
Mother’s milk plays a vital role in a healthy beginning.  But as these studies demonstrate, there is more to breastfeeding than the milk.  Even when mother’s milk is in the bottle, regular bottle-feeding can increase a baby’s risk of childhood obesity.
References
¹Dewey, K.G., Infant feeding and growth.  In G. Goldberg, A. Prentice, P.A. Filtreau, S., & Simondon, K. (Eds.)  Breastfeeding : Early influences on later health (pp. 57-66).  New York, NY: Springer.
²Kramer, M. S., Guo, T., Platt, R. W., Vanilovich, I., Sevkovskaya, Z., Dzikovich, I., et al. Feeding effects on growth during infancy. Journal of Pediatrics 2004; 145(5): 600-605.
³ Li, R., Fein, S.B., & Grummer-Strawn, L.  Do infant fed from bottles lack self-regulation of milk intake compared with directly breastfed infants?  Pediatrics 2010; 125(6): e1386-e1393.
⁴Li, R., Fein, S.B., & Grummer-Strawn, L.M.  Association of breastfeeding intensity and bottle-emptying behaviors at early infancy with infants’ risk for excess weight at late infancy.  Pediatrics 2008; 122 Suppl 2: S77-S84.