In the United States, concern about low milk supply is the most common reason given by women for supplementation and early weaning. Why do so many women in our culture lack confidence in their ability to adequately nourish their babies? Sociologists believe, that during the last century, the decline in breastfeeding contributed to the loss of knowledge about how breastfeeding really works, and how breastfed babies behave.

What Mothers Need to Know:

• It is normal for women to feel that they don't have milk in their breasts the first days after birth. Frequent breastfeeding during this time will meet the new baby's need and cause the milk supply to increase rapidly.
• A good milk supply is encouraged by frequent sucking and effective removal of milk. If milk is not being removed from the breast, the supply will not increase, but instead drop. If a baby needs more milk he will usually nurse more frequently which causes the hormone Prolactin to rise and the milk supply to increase.
• New research shows that although almost all women can produce plenty of milk, some women need to nurse more often than others in order to meet their baby's caloric need.
• A baby needs to be latched deeply onto the areola, not just the nipple, to effectively remove milk.
• Human milk passes through the baby's stomach in 48-90 minutes. The breastfed newborn needs to nurse 8-12 times/24 hours, while the formula fed baby feeds only 6-8 times/24 hours. If a breastfeeding mother tries to feed her baby on a bottle schedule, her baby may not get enough food.
• A baby will often need to be held, rocked, jiggled and bounced (just as in the womb) even after a good feed. Babies cry for reasons other than hunger. Don't worry about "spoiling" a newborn by holding him too much. If a baby's needs are met, trust is built and good self-esteem and independence will follow.
• Young babies have a 3-hour wakeful stretch every day, during which they want to be at their mothers' breast the majority of the time (the marathon feed). This usually occurs in late afternoon/evening and is normal.

Possible Causes of Low Milk Supply:

• Difficult or poor latch-on that leads to poor milk removal. If a baby cannot sustain attachment to the breast for more than a few sucks or if he is only on the nipple, he cannot remove milk and is not nursing well.
• Early introduction of a bottle. If given formula, the baby won't need to breastfeed often and decreased breast stimulation will generally result in a decreased milk supply. If your doctor advises supplementing your baby, check with a lactation consultant for extra guidance in protecting and maximizing your milk supply.
• Babies set their own schedule and some need to eat more often than others. Research indicates that a mother needs to be responsive to her particular baby's lead and not adhere to a rigid plan.
• A sleepy, non-demanding baby. Make sure the baby is coming to the breast 8-12 times in 24 hours. Once weight gain is established, relax and follow the baby's lead.
• Anything that keeps a baby from nursing vigorously (jaundice, prematurity, illness).
• Augmentation and reduction breast surgery are both possible risks for a low milk supply. A lactation consultant can help devise a plan to maximize milk supply.
• A woman who has absolutely no breast changes during pregnancy or during the first week after birth may be at risk for a low supply. Seek extra advice from a consultant.
• Reduced breast stimulation as a result of: (next li Long Sleep... should be nested)
  • Long sleep stretches by the baby
  • A mother's busy lifestyle
  • Insufficient rest due to a mother's return to the workplace
  • Introduction of alternate baby foods
• Hormonal contraception. Even the "mini" pill causes some women's milk supply to drop dramatically.
• Pregnancy
• Excessive exercise and/or dieting

Ways to Increase Milk Supply:

• Improve the baby's latch.
• Increase breast stimulation:
  • Add more feedings and/or nurse longer. Wake the baby for feeds if necessary. Unwrap and undress to help waken.
  • Use a good quality breast pump (hospital grade) and follow most breastfeeds with a 15-minute pumping session. Be patient, it may take a few days or longer to see results.
  • While nursing on the second side, pump the breast the baby just finished (third breast pumping). This effective technique saves a lot of time.
  • Switch sides. When the baby gets sleepy, remove from the breast, burp and switch to the other side. Repeat until the baby won't nurse anymore.
• Try herbal supplements: Mothers Milk tea, Fenugreek capsules (3 capsules 3 times daily), and Fennel seeds (crushed and made into tea, or just chewed). The effectiveness of these remedies is anecdotal, not research-based, but many mothers find it very helpful.
• Eat a well balanced diet with lots of whole grains and increase your fluid intake.
• Ask your OB/GYN to help you choose a non-hormonal contraceptive method.
• See a lactation consultant for an in-depth evaluation and strategies for improving your milk supply.
• Ask your doctor to prescribe Reglan or Domperidone (Motillium). These medications are usually used for gastric problems but have a side effect of raising the level of the hormone that increases milk supply. Domperidone must be made by a compounding pharmacy.

Essential Breastfeeding Support and Baby Care Items
The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products

Products to help increase milk

Mother's Milk Tea Organic	Motherlove More Milk Plus	Motherlove Goat's Rue
Motherlove Shatavari	Milkmakers Lactation Cookies	Rent Hospital Grade Pump

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Copyright©2017 by The Pump Station & Nurtury®. All rights reserved. No part of this handout may be reproduced in any form without permission from The Pump Station. This article has not been prepared by a physician, is not intended as medical advice, and is not a substitute for regular medical care. Consult with a physician if medical symptoms or problems occur. Revised 01/06

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Breastfeeding women with Raynaud’s phenomenon experience debilitating nipple pain that usually follows the feeding (although it can occur during the feeding) and may last for hours. When the warm mouth of the baby comes off the breast, the face of the nipple, or part of the nipple, will blanch white and burning pain begins. The nipple can go through several color changes (white, blue, red) and the entire breast may throb. Poor positioning and poor latch may cause nipple damage, nipple blanching and pain, and are thought by some to trigger the problem. However, the symptoms of Raynaud’s phenomenon can occur even without improper breastfeeding techniques and nipple damage. Not all nipple vasospasm is Raynaud's Phenomenon and may fully resolve if the latch can be improved and the damage healed. Exposure to cold is also a known trigger in Raynaud’s phenomenon.

• If your nipples are sore and damaged, make an appointment to see a lactation professional who can evaluate your latch technique and help you to improve it.
  Lactation Consultations are offered at The Pump Station & Nurtury®
• Prevent or decrease any cold exposure to your breasts. Heat will usually stop the vasospasm, which will increase blood flow to the nipples and help alleviate the pain.
  • Cover breasts and keep them warm. Even your warm hands can help.
  • While nursing, keep the opposite breast covered and warm.
  • Wear hand warmers inside your bra when going out into cold air.
  • Use dry heat when experiencing pain. Try a hair dryer or heating pad to warm breasts. Wet, warm compresses will help during use, but when removed, evaporation will occur causing cooling, and the pain can start again.
  • Massage olive oil, warmed between your fingers, into the nipple when it is burning. Press forward from the base of the nipple which helps blood flow forward into the nipple.
• Don't smoke. Nicotine is a vasoconstrictor and can increase episodes.
• Avoid caffeine and other stimulants. Check labels to make sure soft drinks don't contain caffeine.
• Avoid vibration. Use a good quality breast pump that has a smooth, comfortable action.
• Reduce stess. Try a post partum yoga class, a few minutes of meditation or a little nap when the baby is sleeping. Let others help with cooking and chores if at all possible.

• Nifedipine. (one 30 mg., long-acting tablet/daily). This prescriptive medication is a calcium channel blocker and vasodilator used in the treatment of high blood pressure. It has been shown to be very effective in quickly relieving the pain of Raynaud's phenomenon and might be the best course of treatment. Very little of this medication enters the milk so it is considered by the American Academy of Pediatrics to be a safe option for breastfeeding women. Call your primary care physician or your obstetrician to discuss. Try Nifedipine for two weeks; if the pain returns you can go back on the medication.
• Vitamin B6. Take 100-200 mg daily for 4 days, then 25 mg/day from then on. If pain free for 2 weeks, try weaning off altogether.
• Fish Oil has been helpful to some women. A recent study suggests that a higher than usual dose (perhaps 12 g daily) is required to get results. Check with your physician.

Essential Breastfeeding Support and Baby Care Items
The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products

Items Our Team Recommends
Lansinoh 3-1 Breast Therapy	Earth Mama Booby Tubes	Medela Breast Pumps
Luna Lullaby Nursing Pillow	The Pump Station Back Pillow	My Brest Friend Adjustable Stool

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Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers.

Fluid retention during pregnancy can cause symptoms of carpal tunnel syndrome, which often go away after delivery. However, some women report exacerbated symptoms after delivery due to continued early post partum swelling and the constant bending of the wrist in baby care. There may be a combination of causes of CTS including arthritis, fractures and irritation due to repetitive, prolonged, and/or forceful motion (for example: a roofer pounding nails, a computer user keeping wrists constantly bent).

Carpal tunnel syndrome symptoms usually include pain, numbness, tingling, or a combination of the three. The numbness or tingling most often takes place in the thumb, index, middle, and ring fingers. The symptoms usually are felt during the night but also may be noticed during daily activities such as driving or reading a newspaper. Mothers may sometimes notice a weaker grip, occasional clumsiness, and a tendency to drop things.

The first step is to call your doctor for assessment and proper diagnosis of your symptoms. Patient education and proper body mechanics are key for minimizing carpal tunnel symptoms.

1. Maintain the wrist in a neutral position with daily activity. After you latch your baby, avoid using your hand and wrist to support your baby's head during the feeding. Instead, use a rolled up blanket or small pillow to avoid positioning the wrist in a prolonged bent position.
2. Since we often sleep with our wrists bent in a 90 degree angle (fetal position), wearing wrist splints at night can be very helpful to decrease pressure on the nerve and reduce swelling and symptoms.
3. Avoid positioning the wrist in a bent position while sleeping or sleeping on your wrists, once the wrist immobilization splint is discontinued.
4. Avoid a sustained pinch/grip and awkward motions, particularly with the wrist in a bent position.
5. Identify and treat medical conditions such as thyroid conditions, rheumatoid arthritis, and diabetes which can be associated with carpal tunnel syndrome.
6. Take rests and stretch breaks from activities to prevent overuse of repetitive motions.
7. Anti-inflammatory medications, such as ibuprofen and other nonprescription pain relievers, may ease symptoms that have been present for a short time. Please consult with your physician regarding any medications especially if you are pregnant or breastfeeding.
8. Some mothers find pain relief with the use of paraffin wax baths. Dip both hands and wrists into the paraffin wax 4-5 times and relax for 10 minutes. Home use paraffin bath units can be purchased at places like Bed Bath and Beyond.
9. You may also feel pain relief with Contrast Baths which can be done 2-3 times per day. The purpose of contrast baths are to assist with reducing inflammation along the wrist, which may serve as the contributing factor for the carpal tunnel symptoms. In addition, the contrast baths facilitate blood flow and thus helps “pump” the swelling out of the hand and wrist.

1. Prepare one basin of hot water (to your tolerance)
2. Prepare one basin of cool water with ice
3. Immerse your hand/wrist into the hot water for 2-3 minutes
4. After 2-3 minutes, immerse your hand and wrist in cool water for 1 minute
5. Repeat steps 2 & 3 two more times always ending with your hand/wrist in cool water.
6. If pain, numbness or weakness recurs and persists, return to your physician.

Some people find that a rehabilitation program designed by Occupational Therapy Hand Specialists which include education of ergonomic principles particular to their daily activities, nerve glides, stretching, splint fabrication and treatments such as paraffin wax treatments, ultrasound, and electric stimulation can minimize carpal tunnel symptoms. Additionally, alternative therapies including acupuncture and chiropractic care have benefited many people.

The Pump Station & Nurtury® has decades of experience providing new families with outstanding educational, breastfeeding and baby care support, including products and classes which can make all the difference to you and your baby. To see a list of some of the essential products that our Lactation Professionals have recommended, click Essential Breastfeeding and Baby Care Products

Baby's Nursing Position
Baby Care 101 DVD	Luna Lullaby Lil Something Pillow	Luna Lullaby Nursing Pillow
Mom's Nursing Position
The Pump Station Back Pillow	My Brest Friend Adjustable Stool	Bravado Body Silk Nursing Bra

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Definitions of Breastfeeding Acronyms & Abbreviations

What do all these abbreviations mean?  Here's a quick, alphabetized cheat sheet on the shorthand you'll find in the world of babies & breastfeeding!

• BA/BS/BSN - Bachelors of Arts/Science/Nursing
• CCE - Certified Childbirth Educator
• CEIM - Certified Educator in Infant Massage
• CIMI - Certified Infant Massage Instructor
• CLE - Certified Lactation Educator
• DC - Doctor of Chiropractic
• IBCLC - International Board Certified Lactation Consultant
• ICCE - International Certified Childbirth Educator
• LAc - Licensed Acupuncturist
• LCCE - Lamaze Certified Childbirth Educator
• LCSW - Licensed Clinical Social Worker
• LMFT - Licensed Marriage and Family Therapist
• LMT - Licensed Massage Therapist
• MA/MS/MN - Master of Arts /Science /Nursing
• MD - Medical Doctor
• MFT - Marriage and Family Therapist
• MFTI - Marriage and Family Therapist Intern
• MPA - Master of Public Administration
• MPH - Master of Public Health
• MSED - Master of Science in Education
• MSW - Master of Social Work
• PsyD - Doctor of Psychology
• RD - Registered Dietitian
• RN - Registered Nurse

Certified Lactation Educators (CLE):
We have certified lactation educators available by phone or email 7 days a week. We also have certified Lactation Consultants available for appointments. Our Pump Station library of educational handouts covers a variety of topics ranging from sore-nipples and engorgement, to dealing with thrush and mastitis. Our educators can assist you in finding the educational materials you need in our stores and on our website.

Store Locations & Hours

Phone: (310) 998-1981

Email: info@pumpstation.com

See other blog posts:
Breastfeeding Tips For The Working Mom
Plugged or Clogged Milk Ducts and Mastitis Prevention: The Latest Treatment Tips
6 Reasons Why You Should Join a Parent & Me Group

Products we love:

Baby Care 101 DVD	Luna Lullaby  Nursing Pillow	Pump Station Exclusive:  Nursing Back Pillow
My Brest Friend  Nursing Stool	Kindred Bravely Hands Free Pumping & Nursing Bra	Medela Symphony PLUS Hospital Grade Breast Pump

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How to Collect Breastmilk for Newborns

• Wash hands well with soap and water.
• Wash all the collecting bottles and breastpump parts that touch your breasts or the milk. Use hot, soapy water or a dishwasher. Rinse carefully. Air dry on a clean towel. When soap and water are not available use Medela Quick Clean products. If your baby is premature or ill, the hospital may ask you to sterilize your pump parts.

• Read the instruction book that comes with your pump and follow the suggestions. Sterilize your pump parts once a day as described.
• Practice pumping when you are rested, relaxed and your breasts feel full. Once a day try to nurse your baby only on one side and pump the other breast. Or pump for a few minutes if your baby skips a feeding or nurses for only a short while. Read the Storage Guidelines chart to learn how to store breast milk. Be sure to use the right size breastshield so that your nipple fits comfortably. Medela makes different sizes of PersonalFitT breastshields to fit all nipple sizes, from small to extra large.

Working Moms

• Working moms can help their baby learn to take a bottle once breastfeeding is going well. It is best to wait for 3 to 4 weeks to introduce bottles. If you are having problems breastfeeding, ask for help.
• Begin to pump to store milk 1 to 2 weeks before returning to work. Many employed moms use the fresh milk they pump at work for feedings the next day. They refrigerate Friday's milk for use on Monday. Save your frozen milk for emergencies.
• Pump 3x during an 8 hour work shift, or every 3 hours you are away from your baby. 10 minutes of pumping during breaks and 15 minutes of pumping during lunch with a good pump will help protect your milk supply. If you can't pump 3x, pump as much as you can during each day. Breastfeeding in the evening and over the weekend helps your milk supply and protects your special bond with your baby.

Storing Breastmilk

• It is normal for pumped milk to vary in color, consistency and scent depending on your diet. Stored milk separates into layers. Cream will rise to the top. Gently swirl the warmed bottle to mix the milk layers.
• You can continue to add small amounts of cooled breastmilk to the same refrigerated container throughout the day. Avoid adding warm milk to already cooled milk.
• Store your milk in glass or hard plastic containers, or in milk storage bags made especially for breast milk. The Medela Collection-Storage-Freezer (CSF) Bag is designed with two-layer construction to protect your stored milk. The bags come with twist ties for easy sealing. Place smaller bags inside a larger food storage bag to prevent accidental punctures.
• Freeze milk in 2 to 5 oz portions. Small amounts will thaw more quickly. You will waste less milk this way and will avoid over-feeding. Liquids expand when frozen. Be sure to leave some extra room at the top of the container so the bottle or bag won't burst.
• Seal containers tightly. Write the date on a piece of masking tape on the bag or bottle. Use the oldest milk first.
• If you do not plan to use the milk within a few days, freeze it right away in the coldest section of your freezer. Do not place the bottle or bag up against the wall of the freezer.

Breastmilk Storage Guidelines (For Healthy Term Babies)

Defrosting

• Thaw milk overnight in the refrigerator, or hold the bottle under warm running water to quickly thaw. You can also place the sealed container in a bowl of warm water for 20 minutes to bring it to body temperature.
• Thawed milk is safe in the refrigerator for 24 hours. Do not refreeze.

Feeding Tips

• Choose a slow-flow bottle nipple and limit feeding size to 3 to 5 oz of milk for babies younger than 6 months.
• Remove the bottle nipple out of the baby's mouth periodically to let the baby catch his or her breath.
• Pause to burp the baby when needed.
• If baby seems fussy in between feedings it may be because of thirst. Offer 1 to 2 oz of milk. Babies 4 months or older can have a sip of water from a cup.
• Avoid over-feeding. Offer a pacifier or teething toy to give your baby more sucking enjoyment after finishing a bottle.
• Sometimes, babies do not fully finish bottles of breastmilk. Mothers wonder if they can re-refrigerate and re-use this milk. We have no information about whether or not this is safe to do. Please check with your doctor.

Your Milk Supply and Your Baby's Needs

• We used to think that mothers needed to make more and more milk as their babies grew. Scientists now know that a healthy milk supply remains fairly constant over the 6 months of exclusive breastfeeding.
• During the early weeks, babies eat very frequently and grow very quickly. By Day 10, babies should recover any lost birth weight. For the next few months, little girls should gain about an ounce a day, and little boys slightly more than an ounce.
• Around 3 to 4 months, a breastfed baby's rate of growth begins to slow down. Continuing to gain weight rapidly after this time may contribute to obesity later on. This means that the milk supply established in the early days will continue to satisfy the baby until it is time to introduce solids at 6 months.
• By the end of the first week of life, women who are breastfeeding one baby normally make between 19 to 30 oz of milk each day. Infants between 1 and 6 months of age normally drink an average of 19 to 30 oz a day. (Daley, Owens, Hartmann, 1993.) An average size "meal" for a baby is between 3 to 5 oz of breastmilk. Formula is harder to digest and less well absorbed. Formula fed babies may need larger feeds. Consult your doctor for advice.

 

 

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