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This site  is dedicated to helping mothers find answers to their breastfeeding concerns and to provide a platform for posts regarding current breastfeeding topics. It has recently been optimized to be smartphone friendly. Breastfeeding information is easily accessible by clicking on the Menu link or Search box located at the top of the site.

None of the information on this site is intended to replace medical advice. Please consult your health care provider for medical advice. If you are not able to solve your breastfeeding difficulties, please contact a lactation consultant or breastfeeding peer helper for more assistance.

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Find a La Leche League Leader 1-877-4-LA-LECHE (877-452-5324)

Other Breastfeeding Support

The contents of this site are the property of Laura Spitzfaden. Please do not reproduce anything without permission. You are welcome to link to my site if you wish to share any of the material you find here.

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USDA Child Nutrition Program, Breastfed Toddlers and Day-Care

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Under the USDA Child Nutrition Program guidelines, infants and children 1 year of age and older, who are in licensed day-care programs, must be offered fluid cow’s milk (or approved alternative milk) in order for their day-care providers to be reimbursed for their meals. This is in conflict with what is best for employed moms of breastfed toddlers and their day-care providers, who have limited breastfeeding friendly options under these guidelines. Continue reading

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One Possible Reason for Low Milk-Supply in Some Moms

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“Why Some Women Don’t Have Enough Breastmilk for Baby: Important Role of Insulin in Making Breast Milk Identified”

http://www.sciencedaily.com/releases/2013/07/130705212228.htm

This is very exciting news and may be one of the reasons why some moms have milk-supply difficulties.  Moms with gestational diabetes and diabetic moms tend to have a slower increase of full milk-supply and now there is evidence that shows why this may be true.

For those who are interested in reading the original research:

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0067531

These are early findings but if you have low milk-supply and insulin resistance, you might consider using dietary modifications to lower your blood sugar in order to increase your milk-supply.

One dietary modification that may be helpful in lowering blood sugar is magnesium supplementation. Low magnesium is associated with insulin resistance and sugar cravings.

http://wholehealthsource.blogspot.com/2010/02/magnesium-and-insulin-sensitivity.html

Many breastfeeding moms notice a milk-supply drop coinciding with sugar cravings during certain times of their menstrual cycles and have found that magnesium (and calcium) supplementation can help them to avoid this supply drop.

Since many of us are low in magnesium, supplementation of this mineral may be one dietary intervention that could positively affect blood sugar and milk-supply.

Laura Spitzfaden, LLLL, IBCLC

 

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Maintaining a Robust Milk Supply When Mom and Baby Must Be Separated

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I was inspired to write this post due to some recent helping situations.  I decided to compile all this information in one place.  I may add to it later.

In order to have an excellent milk supply, it is important to remove milk from the breasts at least 8-10 times a day. (http://feedthebabyllc.com/care-plan-for-milk-supply/)  When mom and baby are together, it is beneficial to keep baby skin-to-skin and allow free access to the breast.  A baby is better at maintaining a milk supply than a pump and the extra nursing stimulates mom’s breasts to make more milk.

When mom is separated from baby, it is important to express milk as frequently as possible, at least every 3 hours from the beginning of one expression to the beginning of the next.  A double electric pump with properly fitting flanges works the best.  Be sure to check the membranes frequently and change them at least every 3 months.  A pump that is older than 1 year may not be as efficient.  See (http://newborns.stanford.edu/Breastfeeding/MaxProduction.html) for learning a technique that increases the amount of milk that can be expressed by 48%!

Continue reading

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Why I Became an International Board Certified Lactation Consultant

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In Honor of IBCLC day, March 6th 2013, I decided to explore the reasons why I chose to become an IBCLC, though there are easier and less costly pathways to providing professional breastfeeding support.

I had already been an active La Leche League volunteer leader for nearly 12 years when I decided that I wanted to extend my services to include professional breastfeeding support.  I knew that I had acquired a lot of the experience and knowledge needed through my volunteer work.  I had dedicated thousands of hours to learning about and supporting breastfeeding.  I had helped several hundred moms overcome breastfeeding difficulties and realize their breastfeeding goals.  I did not believe, however, that this was adequate training to provide professional breastfeeding services. Continue reading

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How Tongue-Tie and Lip-Tie Affect Breastfeeding

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Tongue and lip-tie are common causes of nipple pain, uneven breast drainage, slow weight gain and low milk supply. Many physicians do not properly assess for tongue or lip-tie or recognize their impact on the breastfeeding relationship, leaving moms and babies vulnerable to early weaning.

Image credit: Qole Pejorian on Flickr

This photograph  shows a very obvious tongue-tie and visible frenulum (the bit of tissue holding down the tongue) but not all restrictions are this obvious. Some restrictive frenulums attach further back on the tongue. Some are even buried under the floor of the mouth, causing the tongue to appear, “short.” The only visible indication may be that the floor of the mouth rises when baby lifts his tongue or the tongue stays flat or doesn’t rise to the palate when baby cries. Sometimes the sides of the tongue will rise but the center of the tongue will stay on the floor of the mouth. Even if a baby can reach his or her tongue past the gums or lips, there may still be a tight frenulum restricting baby’s ability to breastfeed effectively. Continue reading

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Nipple Latch Trick

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I think this is a very helpful technique for moms who are having difficulty achieving a comfortable latch due to mom’s or baby’s anatomy.

The following is posted with permission from http://www.drmomma.org/

Breastfeeding Latch Trick

By Danelle Frisbie © 2010

Continue reading

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Milk Sharing

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I was inspired to write about milk-sharing when I read this article by Amber McCann, IBCLC.

http://www.ambermccann.com/blog/milksharing/

Like Amber, I am an International Board Certified Lactation Consultant.  I am also a La Leche League Leader.  La Leche League’s position on milk-sharing discourages leaders from providing moms with information about informal milk-sharing unless the mother specifically requests such information.  If mothers ask a LLL Leader how to obtain human milk supplements for their babies, they must be directed to milk banks, even though the cost of purchasing human milk from a milk bank is prohibitive.  In most cases, there is not enough milk available for the ill or preterm babies who need it, let alone any excess available for purchase for healthy babies.  This is simply not a viable option for most families. Continue reading

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New Breastfeeding Classes

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Mother and Earth http://www.motherandearth.com/ is sponsoring a breastfeeding class and triage/clinic presented by Laura Spitzfaden, IBCLC.

There will be only one class in July 2013.  There are no classes scheduled for August.  The July class, “Getting Started with Breastfeeding” meets **Wednesday** July 10th at 6:00pm.

This class is an ongoing event that occurs on the first Saturday and third Tuesday of each month.   The triage/clinic is available on Saturday, only. Please register at least 3 days in advance to ensure that the class will not be cancelled.  Late registrations may be accepted if space is available. Continue reading

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Breastfeeding Videos

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I would like to promote these amazing videos created by the Norwegian, mother-to-mother breastfeeding support organization, Ammehjelpen.  Each video is available in Norwegian and in English.  After clicking on a video, scroll down for the English version.

Breastfeeding Videos

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First Days of Breastfeeding

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Before Birth

Learn to hand-express colostrum. This milk is already in your breast and will be your baby’s first food.  If your baby has any difficulty latching in the first few days, you can hand express this colostrum and feed the baby by spoon.  Moms with gestational diabetes may even consider expressing and freezing some colostrum while pregnant, in case supplementation is indicated after birth.  This article written by By Deanna M. Soper, PhD and posted at the Breastfeeding USA website outlines the benefits and concerns regarding milk expression before birth.

Do not use this frozen colostrum as a replacement for feeding at the breast!  It is important to future milk supply that colostrum is removed in the first few days after birth, by breastfeeding or by hand expression. Continue reading

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Milk Expression

If you are expressing milk after you have established a full milk supply, a personal pump such as a Hygeia Enjoi, an Ameda Purely Yours or a Medela Pump in Style will likely be adequate for your needs.  If you are establishing a milk supply for a baby who is not directly breastfeeding, a multi-user pump will likely be necessary.  This type of pump is also referred to as a, “hospital grade pump.”

Be sure that you check and change membranes and tubing as needed and have properly fitting flanges.  Your nipples should fit well into the flanges with just a little space between your nipple and the flange.  Your nipples should not rub in the flanges.  Your nipples should also not bobble about in the flange.   This would indicate that the flanges are too large.  You may want to experiment with flange sizes to find which remove the most milk.  Some moms have better success with alternative type flanges such as Pump in Pals.

Before begining to pump try these techniques

-Massage your breasts in concentric circles as when doing a breast self exam.

-Draw the backs of your fingers or a comb across your breasts from the chest wall to the nipple all around your breast.

-Lean forward and shake your breasts.

Use reverse pressure softening (developed by K. Jean Cotterman RNC-E, IBCLC) until you see drops of milk, then apply the pump.

Use hands-on double pumping. Whenever milk flow slows, take the pump off and repeat everthing including the reverse pressure softening and re-apply the pump. Try to do this cycle three times.

Hands on pumping:

http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

Reverse pressure softening (developed by K. Jean Cotterman RNC-E, IBCLC):

http://www.youtube.com/user/IBCToronto?feature=mhee

If you only have single pumping capacity, just switch back and forth a few times using all the techniques in this article.  If you do not have a pump, use these techniques and then hand express.

http://www.bfmedneo.com/BreastMassageVideo.aspx (from Breastfeeding Medicine of Northeast Ohio)

http://newborns.stanford.edu/Breastfeeding/HandExpression.html

http://ammehjelpen.no/handmelking?id=907  (video created by the Norwegian mother to mother breastfeeding support organization, Ammehjelpen–scroll down for English video)

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