We are officially at the peak of cold and flu season here on the East Coast, according to a report from sickweather.com. Many mothers wonder if they can continue to breastfeed while experiencing symptoms associated with the common cold or flu. In most cases, the answer is YES! In fact, breastfeeding may be the very best thing you can do to help your baby to keep from falling ill.
Wait…. If I’m feeling sick, wont I pass those germs on to my baby, too?
Yes, but here’s the thing… before you even begin to experience symptoms, your baby has already been exposed to whatever it is that you have been exposed to. The good news is that your body has also producing antibodies to any viruses or pathogens you have come into recent contact with. Numerous studies have shown that the synergistic components in breastmilk offer children protection from all sorts of nasties such as Haemophilus Influenzae Type B (a common cause of ear infections in infants), Streptococcus pneumonae, (the bacteria that cause spinal meningitis), respiratory syncytial virus, and many microbial organisms that cause diarrhea.
Sugars in breastmilk called Human Milk Ogliosaccharides retard the growth of pathogens by producing organic acids that break down the cell walls of viruses and germs. They pass through the infant gut undigested, as they are also a pre-biotic. A pre-biotic? Is that different than a probiotic? Yes, sort of. Prebiotia are FOOD for probiota. That’s right…HMOs do not provide nutrition for your baby! Their main role is to provide nutrition for the beneficial bacteria found in the infant gut, which surprise…human milk also contains several identified species of beneficial bacteria, too! Namely Lactobacilli and Bifido bacteria. These helper bacteria have been proven effective against destroying E. coli, the bacteria that cause Cholera, Campylobacter shigella, and Giardia as well as in the defense of Rotavirus, and cytomegalovirus. So in short, human milk contains not only beneficial bacteria to help your baby fight disease and infection, it contains the food those bacteria need to survive and thrive.
And guess what? It doesn’t end there. Introducing the star of the immune factory show: Breastmilk contains a heavy hitter called Secretory immunoglobulin A (in addition to all of the above mentioned). That’s a mouthful so we just call it SIgA for short. SIgA is your baby’s first line of defense against infection and is responsible for the prevention of bacteria and viruses from binding to the intestinal tract, neutralizing microbial toxins, and increasing virus excretion. Buh-bye bad guys. SIgA is found in its highest concentrations in colostrum and weaning milk.
Human milk also contains a unique form of iron called lactoferrin. The most biologically available form of iron, lactoferrin promotes healthy maturation of the infant gut and protects the newborn against numerous bacteria and fungi by destroying harmful microorganisms.
If you are not feeling well, rest is obviously in order. Avoid cold and flu medications that contain decongestants, as these can sometimes cause a drop in milk supply. Be sure you are getting enough fluids so as not to become dehydrated. Washing hands frequently is always a good idea. Try not to sneeze directly on your baby and certainly don’t use your sling pocket as a tissue receptacle! Curl up with your squish, whatever Netflix guilty pleasure you have not had time to catch up on, and take a nursing vacation. Now is time to call on family or friends for backup, and takeout. Many times, when a cold runs its course through a family, the nursling is the only one who does not end up getting sick. Most colds really only need a few days to run their course and before you know it, you’ll be feeling good as new.
Stuebe, Alison, MD, MSc.. The Risks of Not Breastfeeding for Mothers and Infants. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/
Ballard, O., JD, PhD (candidate), Morrow, L., PhD, MSc
Human Milk Composition: Nutrients and Bioactive Factors
Michelle was a former intern at the BRC and has come back to work for us since passing her IBCLC exam. Before becoming a mother and Lactation Consultant, she enjoyed a career as a biological anthropologist studying the behavioral ecology of non-human primates and indigenous cultures in the rainforests of South America. She currently lives with her husband, two youngest children, two chickens, and a feisty cat in New Jersey.
It’s that time of year again. We all are ready to start the New Year off right. The biggest resolutions usually include ways to improve your health. I’m going to lose weight. I’m going to exercise more. I’m going to stop smoking. I think losing weight is typically the number one choice for new mothers. But some worry about going on a diet when they’re breastfeeding. Here are a few tips for you!
- Throw the fads out the window! Most fad diets are intended to have you lose weight quickly and people who use these methods tend to become victims of the yo-yo effect! They gain the weight back quicker then they lost it. Gradual weight loss is what we’re looking for.
- First you must learn balance, Daniel Son. That’s a Karate Kid reference in case you were wondering. There are many diets where people are refusing to eat carbs or gluten. This is fine if you’re a diabetic, have Celiac disease, or some other health concern caused by eating these foods. The problem with eliminating these foods just to lose weight, is that you can be robbing your body of some important nutrients if you don’t know how to replace them. Try to eat a balanced diet of carbs, proteins, fruits and vegetables.
- Get moving! If you don’t exercise at all, you may want to add a walk to your daily schedule. Pop that baby in a carrier or stroller and burn some calories. You don’t have to join a gym and start taking boot camp classes (unless you want to), you just need to do a little more than you were doing before. Doing some resistance or weight training can increase your muscle mass and a person with more muscle mass burns more calories. Grab some small weights or a resistance band for when you have a little downtime (I know, I know… what downtime?!)
- Trash the trash! Do we really need a nutrition course? No! You know what you’re eating that isn’t good for you. Drop the sweets, sodas, and other junk food. Substitute them for some healthy alternatives. Have you ever heard anyone say, “Wow. I really gained a lot of weight. I was eating way too much broccoli!” If you’re having trouble with this one you can keep a log of your diet. Then, it’s easier to see where your difficulty lies.
- Eat several smaller meals a day instead of sticking to the old breakfast, lunch and dinner routine. You’ll feel fuller and less likely to fall off the diet wagon.
Good luck if this is your New Year’s resolution and don’t beat yourself up too much if you falter. Continue nursing on demand. Drink to thirst and eat to hunger, just watch what you put in your body to satisfy it!
Many new parents have looked forward to their first Holiday Season with their new baby. But others have anxiety; more people around their babies mean more germs!
The good thing about breastfed babies is that their moms “share” their immune system with them. That doesn’t mean that Uncle Joe who has the flu can hold your baby! What it does mean is that being around others who may be sick, and not even know it, is a little safer for your baby. (That being said, next time you are in the grocery store, grab some hand sanitizer and bring to your family gatherings. Asking family and friends to use hand sanitizer is not an absurd request.)
Another option? Baby wearing. If Mom or Dad is ‘wearing” the baby, others are less likely to touch the baby. Many babies can nurse while in the carriers, making it unnecessary for mom to find somewhere to nurse. Using wraps or carriers while doing your holiday shopping is another way to make the experience a little less anxiety filled http://babywearinginternational.org is a great site to help you find the right carrier for you and your baby.
This also leads us to the question…where should I nurse my baby when family is in? In my opinion, use your judgment. If you are in your own home, letting everyone know that you are going to feed the baby, gives everyone the option of leaving if they are uncomfortable with public nursing (you are in your own home, not public nursing by the way). The holidays are about being with family, not hiding in another room feeding your baby. Unless, YOU feel uncomfortable with nursing in front of others, I suggest giving them the option to leave. http://www.llli.org/faq/discreet.html ßclick here for more tips on breastfeeding in public.
If you are in someone else’s home, you should speak to your host about their feelings with you nursing your baby in the “open”. Some older family members may be uncomfortable. If that is the case, find a quiet room to nurse your baby and enjoy the quiet away from the hustle and bustle of the day.
Try and enjoy this magical time with your baby without being overwhelmed. Being with family and friends should be a joyous time, not anxiety filled.
Now that you’re at a party, I bet you’re wondering about how alcohol affects your baby. Luckily, our own Janice wrote an article about that for St. Patty’s Day. Same info, just a different day. Cheers!
The question is often asked, “What should I eat (or not eat) while breastfeeding? The simplest answer is….a nutritious diet. Yes, this what you’ve been told growing up, even though vegetables may not have been your top pick going through the school lunch line. Yes, it’s what you were taught in health class. And yes, just like when you were pregnant, eating for two didn’t mean eating whatever and however much you wanted. It meant eating a quality diet for you and your baby. However, just as you probably marveled at how your body developed this new baby of yours inside of you (in spite of maybe a less than perfect diet) know that while you were pregnant, your body was preparing for lactation by storing extra nutrients and fat for milk production.
So, hopefully, during your pregnancy, your overall eating habits improved. To continue those better eating practices has ongoing benefits throughout your life, including while breastfeeding. But, don’t worry if your diet during pregnancy wasn’t the best (and still isn’t), lactating women don’t have to eat a perfect diet to produce good breastmilk for their baby. Women around the world, even with limited variety of foods, make ample amounts of quality milk for their babies. A nutritious diet is recommended, though, not just because you’re breastfeeding, it’s what’s in the best interest for your health.
What needs to be different with your diet while breastfeeding? There actually is some need for increased calories and fluids. Your body is producing a liquid food with calories for your baby. Listen to your body. If you’re hungry or thirsty, eat or drink more. It’s helpful to keep some simple nutritious snacks and water by the area where you most often sit to breastfeed your baby. If family or friends ask how they can help, request they prepare a home cooked meal for you. And, if you’re a planner (especially while pregnant) – cook larger batches and freeze some healthy meals ahead of time. This will help you continue to eat healthy when you’re exhausted from those sleepless nights caring for a newborn. Looking for some new ideas to eat healthy but save time and money, check out this Extension website called, “Spend Smart, Eat Smart.” http://www.extension.iastate.edu/foodsavings/
So what is a “nutritious” diet? There’s an old standard saying to a healthy diet; eat a variety of foods in moderation. Eat lots of fruit and vegetables, enjoying a variety of colors. Choose whole grains and low fat dairy foods. Protein foods can include lean meat, poultry, fish, beans, eggs, nuts and seeds. Continue to follow the fish guidelines you had during pregnancy limiting to no more than 12 oz. per week while avoiding high mercury fish. http://www.choosemyplate.gov/moms-food-safety-fish Use healthful oils, in small amounts. Limit the “empty calorie” foods that are found in foods high in added sugars and fats such as desserts, fried foods and sodas.
Not sure how many calories to eat? This varies on your weight, height, age, activity level, if exclusively breastfeeding or supplementing. So, for more specifics use the “My Plan” food tracker offered at: http://www.choosemyplate.gov/moms-daily-food-plan
Another advantage to you eating healthy while breastfeeding is you set the stage for your baby to prefer nutritious foods. What foods you eat flavor your breastmilk. So, your baby will have the preference to the foods you eat as he or she begin eating solid foods. http://www.eatright.org/resource/health/pregnancy/breast-feeding/expanding-your-babys-flavor-horizons
So, don’t fret about needing to eat a perfect diet while breastfeeding. Your body is designed to make an amazing food for your baby to thrive on, irregardless of eating a perfect diet on your part. Do the best you can to make overall healthy choices. Respond to your body’s hunger and thirst mechanism. Then know that by breastfeeding, you’re giving you and your baby a gift of health that lasts a lifetime!
Heading back to school while still breastfeeding your baby? You can do it! Careful planning, knowing your schedule, and finding out when breaks are available are the keys to success.
If you have not received your breastpump yet, go get one! Most insurance companies provide you with a pump. Call member services to find out how you can access this benefit. A breastpump is an essential tool to make returning to school possible. Knowing how to hand express in a pinch is also important. There are many videos online that you can view to help you learn, one example is http://newborns.stanford.edu/Breastfeeding/HandExpression.html.
Contact your teacher or professor prior to your return and let them know your plans to express breastmilk. Yes, you might feel uncomfortable talking to your teacher about pumping, but it is your right to be able to continue breastfeeding your baby. The more “upfront” you are, the easier it can be.
- A safe, clean and private place to pump (other than a bathroom) that has a chair and an electrical outlet
- A little bit of flexibility to allow you to pump when needed.
The amount of time you are going to be away from your baby dictates how often you need to pump. You should aim to pump about every three hours. If you’re away from your baby for 6 hours, you will need to pump 1-2 times. It’s important to nurse the baby right before you leave, and as soon as you get home.
Items you might need:
- Breastpump, electric or manual
- Storage bottles or bags
- Cooler bag to transport milk
- Hand sanitizer
- Extra set of pump parts: This will cut down on time, because you won’t need to clean right away. Just rinse off and clean them thoroughly once you get home.
- Breast pads
If there is absolutely no way for you to take a break to pump, but you still want to breastfeed, it can be done. Before you return to school, try pumping once a day after the morning feeding and try to collect as much milk as you can. If you won’t be pumping during school hours, you’ll need to train your body to reduce the supply at that time. Drop a feeding and offer a bottle of expressed milk or formula. Wait several days until your breasts feel soft at that time. Continue this process for each feeding you need to drop. In situations like this, you can always keep a manual pump handy if your breasts get too full and you need to pump for your comfort. Don’t forget to nurse your baby right before you leave and right when you get home!
Once you get into the swing of things when you return, you will figure out your schedule and what works best! You and your baby are a great team!
-Jennifer McClure, IBCLC
Breastfeeding and Work – Let’s Make it Work!
by Carole Hahn, RD, LD, IBCLC
Many breastfeeding moms face difficult work situations that make continuing to breastfeed when they return to work a challenge. Such situations might include:
- the military mom who is deployed oversees
- the night shift fast food worker who only has a manager’s office with windows and a camera available to pump in besides the public bathroom and she works in a dangerous location in town which doesn’t allow their employees to go to their cars alone
- the ER doctor working a 12 hour weekend shift, not knowing when the next moment would be available to pump where there isn’t a medical crisis needing immediate treatment
- the meat packing plant assembly line employee who has to where full outer protective wear she has to remove and then shower before leaving the locker room to pump
- the dental hygienist who works for a dentist that adamantly has told her he never wanted to see her breastmilk; he was formula fed and turned out just fine
- the police officer who patrols in a squad car with a male partner and wears a bullet proof vest
- a waitress who needs to find a co-worker to cover her tables so she can pump in her car, which depending on the season, can be below zero or over 100 degrees heat index
- the receptionist of a busy office who gets treated poorly by the co-worker who has to cover for her pump breaks (yet the co-worker regularly takes smoking breaks herself)
- a clerk at a busy convenient store working by herself
- a business employee who regularly has international travel
- an employee who has to walk 10 minutes of her 15 minute break just to arrive at the designated ”pump room”
- a nursing student who was awarded a full ride scholarship at a university an hour from home in which she contacted her professors for permission to bring her newborn to class initially. Most instructors approved, however, one contacted the dean of the college to complain and the dean notified the mom she couldn’t bring the baby to class.
The above examples are some of the many reasons the theme for this year’s World Breastfeeding Week was chosen.
World Breastfeeding Week (WBW) http://worldbreastfeedingweek.org/, coordinated by World Alliance for Breastfeeding Action (WABA) http://www.waba.org.my/, is an annual celebration in over 120 countries. The 2015 World Breastfeeding Week theme is “Breastfeeding and Work: Let’s make it work!” WABA calls for international action in supporting women to combine breastfeeding and work. Whether a woman is working in the formal, non-formal or home setting, it is necessary that she claims her and her baby’s right to breastfeed.
So what “rights” do women have returning to work in the United States? Since the passing of the Affordable Care Act in 2010, employers are required to provide reasonable break time to nursing moms until their child’s first birthday. The employer must also provide a private space, other than a bathroom, for a mom to express her milk. For more information regarding the law, please check out the Department of Labor’s “frequently asked questions” page at: http://www.dol.gov/whd/nursingmothers/faqBTNM.htm If you know an employer wanting to know how to better support breastfeeding families, a good resource is: http://mchb.hrsa.gov/pregnancyandbeyond/breastfeeding/ or http://www.womenshealth.gov/breastfeeding/business-case-for-breastfeeding.html
Are you a mom returning to work soon? How can you successfully continue to breastfeed your baby when you’re with him or her plus continue to provide your milk while being separated? A couple basic points usually help foster success. One, plan ahead. Two, when you’re with your baby—breastfeed! Leave the bottles for someone else to use to feed your baby.
Planning ahead is key. This involves talking to your employer; Human Resources and/or your supervisor. Find out if your company has a breastfeeding policy for staff. Will your employer let you go back part time at first? If you work Monday through Friday, maybe start your first week back on a Wednesday or Thursday to ease your way back. Some moms are negotiating to do some of their work from home. Other moms may find a daycare close by their work so they can breastfeed during their lunch break rather than pump. Give your boss a general idea of your need to pump 2-3 times in an 8 hour day to express your milk plus, you’ll need a private space, that’s not a bathroom.
Most moms are receiving a breast pump from their health insurance provider. Pumping with a quality double electric breast pump is best. Efficiency is important! Every mother is different, but most pumping sessions take 10-20 minutes. Run the pump at the highest vacuum, comfortable setting. Hands on pumping is also helpful. See Dr. Jane Morton’s of Stanford University’s video on the topic at: http://newborns.stanford.edu/Breastfeeding/MaxProduction.html. Many moms find having a “Hands Free” breast pump bra invaluable.
You’ll most likely be very familiar with your pump by the time you go back to work as you start getting extra milk stored for the return. Time will be a factor on your side with this. If one month before your return you put just 2 oz. away in the freezer every day…you’ll have 60 oz. (or approximately 4 days worth) of breastmilk stashed. Many moms accomplish this by pumping after the first morning feeding and before bedtime when the baby has the longest sleep period.
Concerned if your baby will take a bottle? Start giving the baby a bottle by 3-6 weeks. Use a wide-base, slow flow nipple. Don’t buy a lot of a certain brand until you know your baby will accept it. Have the care giver use a paced bottle feeding technique. This is demonstrated in a youtube video found on the BRC website resource link. http://breastfeedingresourcecenter.org/resources/
A few days before the big day, do some practice runs with the care giver. This helps you and the care giver make any necessary adjustments. Have a discussion with the care provider about not over feeding (most babies drink 3-5 oz. per feeding from 1-6 months of age.) Also, discuss not feeding your baby shortly before you arrive home or pick up your baby. If it’s necessary to feed the baby shortly before your arrival, aim for a partial feeding. The goal… when mom walks in, the grand reunion begins for both mom and baby! Both are happy to be breastfeeding. Again- one of the best ways to preserve the breastfeeding relationship and your milk supply will be to breastfeed when you are with your baby-no bottles! On your day off, maybe even attempt some extra nursing sessions.
So- you can make breastfeeding when you return to work be a success! Plan ahead and breastfeed as much as possible when you’re with your baby. It’s worth it!
There. I said it. Hindmilk is more of a concept, than an actual thing. There are not two different kinds of milk. There is no switch, at 15 minutes or 20 minutes into the feeding, where your milk changes over from foremilk to hindmilk.
What does happen? The fat content in your milk gradually increases as the feeding progresses. The milk that comes out first tends to be lower in fat. Towards the end of the feeding, your milk tends to be higher in fat. Your baby needs both!
If you have a:
Normal Milk Supply
I frequently hear moms tell me, “He has to feed for 20 minutes to get to the good stuff.” If you have a normal milk supply, and your baby is breastfeeding well, you don’t have to worry about the fat content in your milk. (It’s all good stuff!) Offer the first breast. Watch for signs that your baby is finished the first side. How do you know if she is finished?
• She may come off the breast on her own.
• She may start to slow down or fall asleep at the breast.
• The pauses between sucks may become longer than the suckling bursts.
Take her off, offer a burp, and then offer the other breast. Most of the time she’ll probably want both breasts, sometimes she’ll be satisfied with only one. Listen to your baby.
Low Milk Supply
Some mothers tell me that they are only offering one side because their baby is gaining poorly. They say, “I keep him on one breast per feeding so there will be more fat in the milk.” I can’t stress enough the importance of offering both breasts if you have a low milk supply, or if your baby is gaining poorly. It’s all about quantity of milk (not quality of milk). If your baby is gaining weight poorly, he probably needs more food. It’s as simple as this: if you have 1 oz. in each breast, it is better to give your baby 2 oz. of milk than 1 oz. of milk.
Oversupply of Milk
Ok, I’ll admit that when a mother has an oversupply, “hindmilk” imbalance may actually come into play. Suppose you have 6 oz. of milk in each breast. If your baby can only transfer 3 oz., she’ll never fully drain your breast. She will tend to drink the lower fat milk that comes out first. Lower fat milk is higher in lactose. An overabundance of lactose tends to make bellies feel bloated and uncomfortable. They tend to nurse frequently. The message from your baby’s stomach to her brain is: My belly hurts… I must be hungry again… and she cues to nurse again. Babies whose mothers have oversupply, typically gain at least 2 oz. per day.
In this instance, offering only one breast will allow your baby to get the more fatty milk that comes towards the end of a feeding. Offering only one breast is a plan for DECREASING milk supply. You are allowing one breast to remain unused for several hours, which causes that breast to make less milk for the next feeding. Again, my goal is to decrease milk supply.
I want to be very certain that the supply is overabundant before I start trying to decrease it. If you start an oversupply plan, and the milk supply is already low, we are in trouble. Unfortunately, the symptoms of oversupply can look similar to the symptoms of low supply. Before starting a plan to decrease milk supply, seek out the help of an IBCLC.
If you don’t have an oversupply… forget about “hindmilk.” There’s no such thing.
I recently worked with a mother; let’s call her “Tina.” She is a second time mom, who breastfed her first baby for over one year. When I met them, Tina’s new baby girl was 7-days-old, and had not latched to her breast since they left the hospital. The baby attempts to latch, but cries and pulls away.
Tina has been pumping and offering breastmilk in a bottle. She was so worried that pumping was the wrong thing to do – she was almost afraid to tell me! She was instructed in the hospital to refrain from pumping until breastfeeding was well established. She searched online and found the same advice: “don’t pump in the first few weeks.”
The fact is, Tina did EXACTLY the right thing! She deserves a huge pat on the back!
Breastfeeding 101: RULE #1 – FEED THE BABY! Lactation consultants and breastfeeding counselors live by this rule. So why are we telling mothers not to pump?
Here’s the dilemma: The pump is designed to stimulate the breast and extract the milk (in place of the baby). If we have an effectively feeding baby, and then add a pump, the body essentially thinks there are 2 babies to feed. This can create an oversupply of milk.
But what if the baby isn’t doing their job? We need to pump to stand in and protect the milk supply. We also need to collect milk to feed the baby. Pumping is the right thing to do in this situation.
What we have to do is change the verbiage. If the baby is breastfeeding well, there is no need to pump. If there is a problem, such as breast refusal or poor weight gain, the pump is an essential backup plan! If all is well, stick to the breast; if there is a problem, pump!
Are you working with breastfeeding mothers and want to know more about pumping and tricks to maximize output, register for a Lunch and Learn session at the BRC on 6/18/2015. Call 215-886-2433 for information.