What is an IBCLC and do I need one?
Going back to work and breastfeeding
Breast pumps vary in sound. In general, they are not very loud and have low, rhythmic hums. Covering with a blanket can often mask the sound. When ordering one, many women mention noise level in their reviews so if you're concerned about bothering neighbors, be sure to read the reviews.
Price of pumps vary. Manual pumps, not surprisingly, are the least expensive coming in at around $30-$40. Single user electric pumps are more expensive and cost anywhere from $60-$400. Hospital grade pumps are the most expensive and can cost upwards of $1000.
For more information, visit the FDA's Breast Pump Section.
Pumps vary. When choosing, look at cost, portability, power source, noise level, ease of use and efficiency as well as how often you will need it. If you are only planning on pumping occasionally, the cheaper manual pump might be perfect. La Leche League notes that the "bicycle horn" style manual pump is NOT recommended.
Electric pumps are more expensive and become fancier the more you spend. If you need a lot of milk fast, full-size, automatic, electric pumps are available, often to rent. These have a suck-release cycle that more closely mimics the baby's pattern than the smaller electric pumps, which have continuous suction. These are less portable than the cheaper electric and manual pumps. In addition, if you rent one, you will also have to purchase an attachment kit that attaches the pump to you.
It's important to note that if you pumped in the hospital, the pumps for personal use will be less effective. If you are pumping to increase milk supply or to feed a preemie you may want to look into a hospital grade pump, though this will be the most expensive, least portable option. To find which pump is best for you, ask friends, look at product reviews online both on mother blogs and manufacturer or supplier websites.
For more information, visit the FDA's Breast pump section
It is best to not share breast pumps. If they are marketed and created to be single user, and cannot be autoclaved (some manual pumps can) there is risk of contamination. This is the reason you must purchase an attachment kit if you rent, your attachment kit will be sterile and this will be with what your milk comes in contact.
In addition, single user pumps are built to last about a year and will start to break down. This process is slow and will begin to affect the efficiency at which milk is extracted.
See the FDA's statement on sharing breastpumps.
Breastmilk should be stored at cooler temperatures. The hotter the surrounding environment is, the faster it spoils. See the FDA's explanation of how long breastmilk should be stored at which temperature for more specific information.
Make sure to store breastmilk in a clean, labeled container. To reduce waste, store in 1-4 oz amounts. It is okay to mix pumping sessions/days in one container, just be sure to label with the oldest pumping date.
Many find it helpful to arrange the milk in the fridge from front to back with the oldest milk toward the front so it's easy to find and less will spoil.
Frozen milk should be thawed in the fridge or with running water. Try not to leave it out to thaw. Thawed milk should never be re-frozen.
To reheat, use running hot water or water heated (but not boiling) on a stove.DO NOT use a microwave as that does not evenly heat the milk and could cause burning.
*Note: Breastmilk will expand in the freezer, to avoid broken bottles leave room for expansion.
Is this breastmilk bad?
Breastmilk varies in color based on what you eat, so don't be alarmed if it doesn't look like the gallon of cow's milk in your fridge. Also, it is normal for breastmilk to separate and the fat to rise to the top. Simply swirl (don't shake or be too vigorous) to remix.
For more information, please see La Leche League's article, What's making my milk that strange color?.
In the US, you should not breastfeed if you:
- take illegal drugs,
- have high alcohol intake,
- have HIV or take antiretrovirals (ARVs),
- have untreated, active tuberculosis (TB),
- are infected with T-cell Lymphotopic virus (type I or II),
- take prescribed cancer chemotherapy agents (like antimetabolites),
- are undergoing radiation therapy (can resume once complete).
In addition, you should not breastfeed if your infant has:
- maple syrup urine disease,
For more information, see the WHO's Acceptable medical reasons for the use of breast-milk substitutes.
Yes! Alcohol levels in breastmilk mirror the levels of your blood alcohol level in that they are at their peak about 1 hour after consuming and will then go down. The level of alcohol is your milk is only a fraction of what you consumed, and if you drink moderately, should not be a problem for your infant or your milk supply.
Remember the old wives tale that beer increases milk supply? It's false, beer can actually decrease milk supply for the time alcohol is in your system.
If you pump close to drinking, the alcohol in that milk is permanent, just discard, wait a few hours and try again.
For more information see the InfantRisk Center's page on Breastfeeding and Alcohol
Yes, though you are encouraged to quit smoking while pregnant and breastfeeding, the AAP does not indicate a smoking mother should not breastfeed. It is suggested that breastfeeding and smoking it less harmful to your baby's health than bottle feeding and smoking. However, consider stopping as 2nd hand smoke can have adverse affects on your baby's health as well.
Yes! Since you now know you have a cold, you've probably started passing it to her anyway. However, you've also started passing her antibodies to help fight the cold. If you stop, you could deprive her immune system of what she needs. Also, if she catches a cold, your antibodies start working in the breast and are passed back to her. There are very few illnesses that require breastfeeding cessation.
For more information on specific illnesses, visit the InfantRisk Center.
Yes! In general, the amount of the drug that the baby will get through your milk is very small. The older your baby, the better he will be able to deal with it. "Pumping and dumping" is an option, though rarely necessary. However, if you are worried about it, Dr Thomas Hale's Medications and Mothers' Milk is the most complete source of information on this topic.
For more information on how drugs enter and affect breast milk, visit the Infant Risk Center's page on Drug Entry in Human Milk.
Usually, caffeine in moderation (less than 5 cups of coffee per day) will not bother the baby. The AAP approves of caffeine while breastfeeding and Dr Hale of Medications and Mothers Milk lists caffeine as a low risk substance.
If you successfully abstained from caffeine during your pregnancy, your baby may be more sensitive during breastfeeding. Lay off for a while (2-3 weeks) and try again when your baby is older and his digestive system is more developed.
A lactation consultant is a specially trained and registered health care professional who has spent extra hours in the classroom learning specifically about how to help mothers and babies. In addition, they have hundreds of practical hours. If you are having problems you are encouraged to contact one near you. There is one national accrediting body and if they have passed that certification exam they may put IBCLC (International Board Certified Lactation Consultant) beside their name. There are also regional accrediting bodies which may give CLC (Certified Lactation Consultant) or CLE (Certified Lactation Educator) accreditations.
Use zipmilk.org or call Tulane-Lakeside Hospital Lactation Department- 504-780-4365 to find a lactation consultant near you.
The new law has two requirements for employers: Reasonable break time for an employee to express breastmilk for her nursing child for one year after the child's birth each time such employee has need to express milk, and A place, other than a bathroom, for the employee to express breast milk. The Department of Labor is in charge of this law and the specifics are still being ironed out. If you would like help developing a lactation policy or site in your workplace in New Orleans, contact Caitrin with the NOLA Breastfeeding Support Program and see our page on Workplace Lactation Support.
You ideally should pump as often as you would breastfeed. This is where the new law is less specific and thus less helpful, as that varies from mother to baby. To maximize time you are able to pump, a double pump, one that uses both breasts, is great.
The amount of time it takes also varies. A single pump might take 20-30 min while a double pump could cut the time in half.
It is okay to cluster pump. This is a technique used to increase milk supply, but it is aimed at getting more milk in a shorter amount of time by pumping more often. If it's easier for you to get an hour a few times a day than 20 minutes multiple times a day, this might be an option for you.
Pumping will be more efficient if you take care to breastfeed your baby while you are with her, as she is the most effective at getting milk out of your breasts.
Herbal remedies have been successful and can include herbs, foods and prescriptions**.
Garlic (in moderation)
Ginger (in moderation)
Fenugreek and Blessed Thistle
**Please Note: Speak to your doctor or health care practitioner before starting any medications. No drug is 100% safe and there are side effects, besides lactation, of the above prescriptions. Medications should not be the first approach in an attempt to correct breastfeeding problems.
Please see Dr. Ruth Laurence's article on Herbs and Breastfeeding for more information regarding safety of herbs.
Teas can also be effective, though you may need to drink a lot to get enough herbs and this is not always recommended. Many women anecdotally report that lactation teas, mother's milk teas, and nursing teas are helpful and don't taste too awful.
Beware of things that can decrease milk supply:
Hormonal birth control
* Before drastically changing your diet or cessation of medications, check with your health care practitioner. If you're worried your baby isn't gaining enough weight, check with an IBCLC to ensure adequate latching and frequent enough feedings.
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