Breastfeeding Crash Course

Updated: Nov 22, 2019

For months, I have been doing my own research as to why so many moms give up breastfeeding so soon. Some don't even last a week. And from what I've seen, 9 out of 10 women give up for the following reasons:

  • Assuming (with no proof, it's just all in their heads) they don't make enough

  • Lack of support from friends and family

  • Lack of proper education

  • No resources or not knowing of any resources

  • Having a rough start

  • Going back to work or school

  • Doctors giving out outdated or incorrect information

Assuming they don't make enough. I think this is the one reasons moms give up. Baby is gaining weight, making enough wet diapers and moms STILL question if their milk is enough.

Lack of support from friends and family. Even though nobody else's opinion about what you do with your breasts should matter, it helps when the people you love and care about support you through your breastfeeding journey. More women are successful at breastfeeding when they have support from their loved ones.

Lack of proper education. My advice, take a breastfeeding class, they are usually FREE! In fact, don't take just one, take two and pick up a book while you're at it. The more knowledge you have, the more you'll understand and it will make your breastfeeding journey easier...trust me.

No resources or not knowing of any resources. There are so many organizations out there that can provide you with the information you need. La Leche League International, WHO (World Health Organization) and American Academy of Pediatrics being the main three that are most recommended and most up to date on the lasted in health and breastfeeding. There are also breast milk banks popping up everywhere, and companies like Human Milk 4 Human Babies and Only The Breast where moms can get donor milk. Human Milk 4 Human Babies has a Facebook page for just about every city. Just type in Human Milk 4 Human Babies - (insert your city).

Having a rough start. If you don't get proper information on ensuring baby gets a good latch, everything can go downhill from there.

Going back to work or school. Lots of moms give up because they think they won't have time to pump while away from their baby, or simply don't think or know pumping is an option.

Doctors giving out outdated or incorrect information. If you wouldn't get pregnancy advice from your dentist, why would you get breastfeeding advice from a doctor? How does that even make sense. I see too many women taking advice about their breastfed babies from doctors. And guess what? The majority of the time, they are using formula fed babies stats and charts. Breastfed babies have a completely different chart.

Breastfeeding Crash Course

Now that we got that out of the way, I'm going to cram a lot of information into this blog post. If there is a concern that you do not find the answer for, search for a lactation consultant in your area.

Here are key topics that are a MUST KNOW:

  • Letdown

  • Cluster Feeding/Growth Spurt

  • Oversupply

  • Clogged Ducts

  • Mastitis

  • Engorgement

  • Thrush

  • Hand Expressing

Now, let's start from the beginning...colostrum. Colostrum is produced during pregnancy around 16 weeks. Sometimes sooner. Some women leak colostrum while pregnant, some don't. Leaking or not leaking doesn't determine if you can breastfeed or not.


Colostrum is like your babies first vaccine. Banies are born with small openings in the intestines. Colostrum helps seal those openings. Colostrum is the first milk that your baby will get before your mature milk comes in, which is typically between 2-4 days after giving birth (and in some cases, it can take longer), so no need to supplement with formula.


"The main function of sIgA, along with other immunoglobulins, is to "paint" the lining of the infant’s stomach and intestines. These surfaces are then able to defend the baby against viruses and bacteria by not allowing pathogens to adhere to them (Alm and Engstrand 2002). Some of these incredible immunoglobulins actually attack pathogens and kill them. These components are important in fighting and preventing necrotizing enterocolitis (NEC) in premature infants, which can be fatal (Hanson & Korotkonva 2002). These defensive actions provide the newborn with optimal protection.

Colostrum is a living fluid, resembling blood in its composition. It contains over 60 components, 30 of which are exclusive to human milk. It is species-specific, designed for human babies (Neville and Neifert 1985)."


Just like cows milk is specific to cows, but I'll get to that later. Read more about colostrum here.

Tips on getting a good latch


Use a ursing pillow

Trying different positions

Make sure baby is tummy to tummy with you

Holding your breast creating a "C" or "U" shape with your hand




Hand expressing


How to know if your baby is getting enough. When your baby is born, his/her stomach is no bigger than the size of a cherry.



Lots of moms automatically think they don't make enough, not realizing a baby's stomach isn't big at all, and they only need a few ml worth of colostrum/mature milk. In order to ensure you have a great supply, it is important to nurse your baby every 2 hours, 3 hours TOPS! A few days after your baby is born, mature milk will come in. You will notice your breasts get really full. Nursing the baby is very important. It will help relieve the fullness and regulate your supply. Your supply should regulate between 4 & 6 weeks.

Things that do NOT determine low supply

Baby crying

Baby not wanting the boob

How much you get from pumping

Baby being hungry all the time

Not feeling full

Just because your baby may cry while nursing, doesn't mean he/she isn't getting enough milk. There may be other issues going on that you aren't thinking about, like thrush, high levels of lipase, etc. If your baby doesn't want the boob, just keep trying. It takes time and practice. Remember, this is new to them just like it's new to you. What you pump dose NOT determine how much you produce, it's only what the pump can get out. Your baby gets more directly from your breast. Baby wanting to nurse all the time, also doesn't mean you have a low supply. Babies clusterfeed often during growth spurts. This helps regulate your supply as well.

They can want to nurse anywhere from every 15 minutes to every 30 minutes. It can last for a few hours or a few days at a time. Trust me, baby Jai had me glued to the couch with the remote, my laptop, snacks and drinks, hoping he'll give me a long enough break to go to the bathroom.


Not feeling full doesn't mean you have a low supply. For many women, that full feeling eventually goes away. It's normal. So just relax, grab some snacks and chill!

Diaper count and weight gain is important. Breastfed babies can lose up to 10% of their birth weight, so don't be concerned if you don't see any weight gain in the first week or t, or if baby loses weight during the first few weeks. As long as baby is making enough wet diapers a day...

Day 1 - 1 Wet Diaper | 2 Soiled Diapers

Day 2 - 2 Wet Diapers | 2 Soiled Diapers

Day 3 - 3 Wet Diapers | 3 Soiled Diapers

Day 4 - 4 Wet Diapers | 3 Soiled Diapers

Day 5 to 3 weeks - 6 Wet Diapers | 3 Soiled Diapers


What is a let down?

The let down reflex happens after your baby begins to suckle, or when your breasts become full. A let down can itch, tingle, have a burning sensation or even be painful. You can apply a warm compress, take a warm shower, and relax to help. My let down is harsh, itches and burns a little due to me having an oversupply. I have a old school rubber bottle warmer. You know, the red one that you fill with hot water lol. I lay it across my chest and it helps a lot!

Pumping

Unless absolutely necessary (baby is in the NICU, lip tie, inverted nipples, etc.), pumping before 4-6 weeks is not ideal, and can cause issues like oversupply, engorgement, clogged ducts and mastitis.


Some people may be thinking "what's so bad about an over supply?" As someone who has an oversupply, let me explain. Yes, it's a great thing to make more than enough to feed my son, but it's also not so great. I am always full and it's often times painful and uncomfortable. If I don't hand express before nursing him, he will choke due to too much milk coming out. It can also cause babies to spit up a lot and cause them to be gassy. This in turn, making baby upset and not want to nurse. This may cause them to have a shallow latch to prevent too much milk from getting in their mouths, which means that they aren't efficiently "emptying" the breasts. Because of that, it can cause engorgement and engorgement can lead to clogged ducts. If it is not taken care of, eventually, it can lead to mastitis. Often times, moms pump to relieve the pain, but pumping doesn't remove milk as efficiently as the baby, and it can make engorgement worse.


Dealing with engorgement and clogged ducts is not fun. Here are some tips to help:

Warm compress or shower while massaging. Massaging the breasts often, including while you're nursing (be sure to ONLY massage when baby pauses, otherwise, you'll squirt too much milk in baby's mouth). Dangle feed (nurse the baby while you're on all fours).

Going Back To Work Or School

The thought of going back to work or school as a breastfeeding mom can be stressful. But it's not an impossible task. First, it's important to know the breastfeeding laws in your state. Be sure to tell your employer that you will need a clean, private area (NOT the bathroom) and time to pump. You must pump every 2-3 hours that you are away from your baby. And there is no need to have a large stash before going back to work. You can start pumping two weeks before. The milk you pump while you're away will be used for the following day.

Rule to remember, 1.2-2oz of milk for each hour that you are away. Store milk in bags with no more than 3oz in each, that way, milk doesn't go to waste. Make sure the person watching your baby knows how to pacefeed to mimic breastfeeding.

Storing Milk


LLLI (La Leche League International

"Your milk is a living substance so precious some call it "white blood". It is essential to store your expressed (pumped) milk properly to maximize its nutritional and anti-infective qualities. Human milk actually has anti-bacterial properties that help it to stay fresh. Giving your baby the freshest milk you have pumped ensures its high quality.

This information is based on current research and applies to mothers who:

  • have healthy, full-term babies;

  • are storing their milk for home use (as opposed to hospital use);

  • wash their hands before expressing;

  • use containers that have been washed in hot, soapy water and rinsed.

Storage Guidelines:

All milk should be dated before storing. Storing milk in 2-4 ounce (60 to 120 ml) amounts may reduce waste. Refrigerated milk has more anti-infective properties than frozen milk. Cool fresh milk in the refrigerator before adding it to previously frozen milk. Preferably, milk should be refrigerated or chilled right after it is expressed. Acceptable guidelines for storing human milk are as follows.

At room temperature (fresh milk) 66° to 78° F (19° to 26° C) for 4 hours is (ideal) up to 6 hours (acceptable). ontents should be covered and kept as cool as possible; covering the container with a damp towel may keep milk cooler.

Insulated cooler bag, 5° -39° F (-15° -4° C) for 24 hours. Keep ice packs in constant contact with milk containers; limit opening cooler bag.

In a refrigerator <39° F (<4° C), up to 72 hours (ideal), up to 8 days (acceptable). Collect in a very clean way to minimize spoilage. Store milk in the back of the main body of the refrigerator.

Freezer (compartment of refrigerator), 5° F (-15° C) for 2 weeks. Store milk away from sides and toward the back of the freezer where temperature is most constant. Milk stored longer than these ranges is usually safe, but some of the fats break down over time.

Freezer (compartment of refrigerator with separate doors), 0° F (-18° C) for 3 – 6 months.


Deep Freezer, -4° F (-20° C) for 6 – 12 months

The preference is to refrigerate or chill milk right after it is expressed. What Type of Container to Use

Bottles

  • glass or hard-sided plastic containers with well-fitting tops

  • containers not made with the controversial chemical bisphenol A (BPA), identified with a number 3 or 7 in the recycling symbol. A safe alternative is polypropylene, which is soft, semi-cloudy, and has the number 5 recycling symbol and/or the letters PP. You can avoid the dangers completely by using glass bottle.

  • containers which have been washed in hot, soapy, water, rinsed well, and allowed to air-dry before use

  • containers may also be washed and dried in a dishwasher

  • containers should not be filled to the top - leave an inch of space to allow the milk to expand as it freezes

Important: Plastic bottles and component parts become brittle when frozen and may break when dropped. Also, bottles and component parts may become damaged if mishandled, e.g. dropped, over-tightened, or knocked over. Take appropriate care in handling bottles and components. Do not use the breastmilk if bottles or components become damaged.

Bags

  • freezer milk bags that are designed for storing human milk

  • put only 60 to 120 ml (two to four ounces) of milk in the container (the amount your baby is likely to eat in a single feeding) to avoid waste

  • Squeeze out the air at the top before sealing, and allow about an inch for the milk to expand when frozen.

  • Stand the bags in another container at the back of the refrigerator shelf or in the back of freezer where the temperature will remain the most consistently cold.

Disposable bottle liners or plastic bags are not recommended. With these, the risk of contamination is greater. Bags are less durable and tend to leak, and some types of plastic may destroy nutrients in milk. Mark the date on the storage container. Include your baby's name on the label if your baby is in a day care setting.

How to Warm the Milk

Frozen milk: thaw in the refrigerator overnight or under cool running water. Gradually increase the temperature of the water to heat the milk to feeding temperature.

Refrigerated milk: Warm the milk under warm running water for several minutes. Or immerse the container in a pan of water that has been heated on the stove. Do not heat the milk directly on the stove. Some babies accept milk right from the refrigerator.

Do not bring temperature of milk to boiling point.

Human milk may separate into a milk layer and a cream layer when it is stored. This is normal. Swirl it gently to redistribute the cream before giving it to baby.

Do not use a microwave oven to heat human milk. It may cause the loss of some of the beneficial properties of the milk. Microwaves do not heat liquids evenly and may leave hot spots in the container of milk. This could be dangerous for infants.

Sometimes thawed milk may smell or taste soapy. This is due to the breakdown of milk fats. The milk is safe and most babies will still drink it. If there is a rancid smell from high lipase (enzyme that breaks down milk fats) activity when the milk has been chilled or frozen, the milk can be heated to scalding (bubbles around the edges, not boiling) after expression, then quickly cooled and frozen. This deactivates the lipase enzyme. Scalded milk is still a healthier choice than commercial infant formula.


If you or your baby has a thrush or yeast/fungus infection, continue to breastfeed during the outbreak and treatment. While being treated, you can continue to express your milk and give it to your baby. Be aware that refrigerating or freezing milk does not kill yeast. After treatment is finished, any leftover milk that was expressed during the infection should be discarded.

Thawed Milk

Previously frozen milk that has been thawed can be kept in the refrigerator for up to 24 hours. While there is limited evidence to date that milk thawed for a few hours may be refrozen, this results in further breakdown of milk components and loss of antimicrobial activity. At this time, the accepted practice is not to refreeze thawed milk. While some mothers and caregivers reheat expressed milk that was leftover and refrigerated after a previous feeding, there is no research on the safety of this practice. There is also no research about whether freshly expressed milk left unfinished at room temperature should be discarded, or can be saved for a short time (perhaps up to one hour as reported by some mothers and caregivers) to finish the feeding if the baby wakens from having fallen asleep or still appears hungry.


Expressed milk can be kept in a common refrigerator at the workplace or in a day care center. The US Centers for Disease Control and the US Occupational Safety and Health Administration agree that human milk is not among the body fluids that require special handling or storage in a separate container."

Bottle Feeding

Bottle feeding does not mean formula feeding. Breast milk can obviously be put in bottles. Bottle feeding is just that...feeding with a bottle. Whether it be breast milk or formula, ALL BABIES FED WITH A BOTTLE NEED TO BE PACE FED!!!!

Have you ever heard a mom say "he's a big baby so he needs to eat a lot"? It doesn't work like that. No matter the size of the baby, their stomachs are still small (go back to the chart at the beginning of this post). Babies can not control how much they get from a bottle, so it is very easy to overfeed them and THINK they they're drinking what's in the bottle because they are "hungry." By allowing them to guzzle down ounces upon ounces of milk, you are stretching their little stomachs and moms have a hard time keeping up with the demand and often times think they have a low supply because they "aren't pumping enough ounces."

Quick Notes

Yes, you can drink while nursing


"The following is from a blog by a mother who tested her milk for alcohol. Not one of those useless kits that you can buy at various stores, but tested at a toxicology laboratory. I will copy from her blog the method she used and the results. I think this puts the lie to the notion that women should not drink while breastfeeding or need to "pump and dump" (an appalling term) after having even one drink. The following is an exact quote from her blog:

Method: First I took a sample of my milk (about 1 mL) prior to drinking any alcoholic beverage. I expressed the milk mid-nursing session to ensure I had a goodly portion of fore & hind milk. After completing the nursing session, I mixed myself an alcoholic beverage consisting of 2 oz of 80 proof (40%) vodka in 10 oz of soda (Sprite). I proceeded to drink the entire 12 oz in about 30 minutes. About 30 minutes after finishing (1 hour after beginning to drink), I expressed some milk (about 1 mL) and labeled it 'immediate'. I then waited 1 hour and expressed more milk (about 1 mL) and labeled it '2 hours'. In the 2 hours (from the beginning), I did not drink any more alcoholic beverages, drink other beverages, or eat any other foods. Another day, 1/2 of a beer (4.3% alcohol) and 2-6 oz glasses of wine were consumed within 1.5 hours. About an hour from the beginning of the last drink, a milk sample (about 1 mL) was taken. This sample was labeled '1 hour - 3 drinks'. Another sample was taken about an hour after that (2 hours after the beginning of the last drink). This sample was labeled '2 hours - 3 drinks'.

The samples were stored in the refrigerator until processing. An Agilent headspace instrument was used to run the tests. Propanol and ethanol standards were also tested to ensure the instrument was within limits. The instrument is maintained by the KSP Lab Toxicology Section and used in forensic determinations of blood and urine alcohol content.

Results: The sample labeled as 'immediate' registered as 0.1370 mg/mL which correlates to 0.01370% alcohol in the sample. The sample labeled '2 hours' registered as 0.0000 mg/ml which correlates to 0.0000%. The sample labeled '1 hour - 3 drinks' registered as 0.3749 mg/mL which correlates to 0.03749% alcohol in the sample. The sample labeled '2 hours - 3 drinks' registered as 0.0629 mg/mL which correlates to 0.00629% alcohol in the sample.

Conclusion: The alcohol content in breast milk immediately after drinking is equivalent to a 0.0274 proof beverage. That's like mixing 1 oz of 80 proof vodka (one shot) with 2919 oz of mixer . By the way, 2919 oz is over 70 liters. Two hours after drinking one (strong) drink the alcohol has disappeared from the sample. Completely harmless to the nursing infant. Drinking about 3 drinks in 1.5 hours resulted in higher numbers, but still negligible amounts of alcohol would be transferred to the child. One hour after imbibing in 3 drinks, the milk was the equivalent of 0.07498 proof beverage. That would be like adding 1 oz of 80 proof vodka (one shot) to 1066 oz of mixer (1066 oz is over 26 liters). Two hours after imbibing in 3 drinks, the milk was 0.01258 proof. That would be like adding 1 oz of 80 proof vodka to 3179 oz of mixer (over almost 80 liters). So, even though an infant has much less body weight, any of these percentage of alcohol in breast milk is unlikely to adversely affect the baby. Bottoms up!

Yes, you can nurse if you're sick (breast milk has and creates more antibodies to help prevent baby from getting sick)

Yes, you can workout while nursing (probably not a good idea to do at the same time if you're using equipment. I had to throw that in there in case some idiot tries to breastfeed while lifting weights). Just be sure you continue eating healthy

No, what you eat or drink does not increase milk supply. Milk is made from blood, not what's in your stomach. No amount of oatmeal, water, gatorade, teas (ESPECIALLY fenugreek which can have damaging side effects) will increase your supply. Just nurse your baby!


If you want to have a successful breastfeeding journey, pretend like formula doesn't exist. For years...it didn't exist!


Solids should NOT be introduced until 6 months of age, and even then..."food before one is just for fun." Just because your baby can hold his/her head up, sit up alone or reaches for what's on your plate, doesn't mean they're ready. They do not produce the proper enzymes to break down solids until 6 months of age. If your doctor tells you otherwise, just know that you are receiving outdated information. Give your baby a spoon with nothing on it and just wait!


And stay away from rice cereal!!!!!


You do NOT need to transition to cows milk, or any other milk for that matter

Resource - Kelly Mom

"Many nursing moms are told that they must introduce cow’s milk at a year. Your nursing toddler is already getting the best milk he can get – mother’s milk! Breastmilk has a higher fat content than whole cow’s milk (needed for baby’s brain growth), and all the nutrients of human milk are significantly more bioavailable than those of cow’s milk because it is species specific (not to mention all the components of mother’s milk that are not present in cow’s milk).

There is no need to add cow’s milk to your toddler’s diet (or the equivalent nutrients from other milks or foods) as long as your baby is nursing at least 3-4 times per day. Cow’s milk is really just a convenient source of calcium, protein, fats, vitamin D, etc. – it’s not required. There are many people in many parts of the world who do not drink milk and still manage to get all the calcium, protein, fats, vitamin D, etc. that they need."

If you truly can not breastfeed, donor milk IS an option. Hospitals provide donor milk, there are breast milk banks, and other resources to get you donor milk. Yes, it is safe. Women are screened and tested before their milk is accepted to be donated.


Please know that is is not all there is to breastfeeding. But I can guarantee you, everything you just read is more than what you will learn in your typical breastfeeding class.


Be sure to contact your local La Leche League breastfeeding support group for more support.