Reminiscing About My Son's Birth

As I rested with my son, Ryan, tonight, I told him the story of the day he was born, exactly 6 years ago.  How he entered this world so peacefully and beautifully and how grateful I am that he is my son.  My eyes filled up with tears as I hugged his sweet little body, my heart feeling like it would explode right out of my chest.  There are no words to fully describe the way I love this little guy and his birth was just the beginning.

6 years and 9 months ago, I found out that I was pregnant with my soon-to-be Ryan.  Ben was 7 months old and I had just returned to work full time.  Let’s just say that SHOCKED cannot even begin to describe how I felt when that little stick had two lines.  We knew we wanted to have at least 2 children, but never thought it would happen this soon!  Feelings of guilt filled my heart as I thought about how I had robbed Ben of months where he would be an only child.  Panic set in when I counted how many months apart my kids would be (15!!!)  How would I tell my boss?  How would I tell my parents?  Most importantly, how would it be possible for me to love another human being as much as I loved my 7-month-old Ben?  I just wasn’t ready!

As the months flew by, I slowly became connected to my growing baby.  I felt his movements much more quickly than I had with Ben and I loved how my stomach would contort and expand during the staff meetings at work.  I wasn’t quite as sick while pregnant this second time around, which was a blessing since I had Ben to contend with as well.  I still wondered how it would be humanly possible for me to connect with this new baby as I had with Ben.

About 3 days before Ryan was born, I woke up around 6am with this very weird feeling, like something was wrong.  I pushed on my belly to stir the little one, but didn’t feel any movement.  For 30 minutes I rolled from side to side in my bed, walked around from room to room (praying I didn’t wake up 15-month-old Ben), and drank a glass of water.  I still didn’t feel any movement.  I decided to wake up my husband, Jason, and instantaneously broke out in hysterical tears. I hadn’t felt Ryan move in over 45 minutes and I wanted to go to the hospital immediately!  I cried the whole way there, trying to talk myself out of thinking the worse, but I just couldn’t.  We ran into the hospital and begged them to hook me up to see if anything was wrong.  Within minutes, we were in triage, strapped to a monitor and saw to our relief that our baby boy was just sleeping soundly.  I drank some orange juice and he started to stir.  It was one of the scariest moments in my life and as we drove home, I hugged my belly and told him I would be waiting patiently for him, whenever he was ready to arrive.

Three days later, after a gorgeous evening walk, pizza dinner, and a little vino, I was awoken from my semi-deep sleep to some mild abdominal cramping.  I checked my clock and started to feel some excitement as the cramping continued to surge every 10 minutes.  After an hour, I woke up my husband to tell him that I was having contractions and that they were starting to get pretty regular.  Now, this was the first time I had felt contractions like this, as I was induced with Ben and never felt the growing, consistent surging I was feeling now.  As I rolled out of bed, the contractions started to become even stronger and jumped to about every 6 minutes.  We immediately called my step-mom, as she was going to watch Ben, and left for the hospital as soon as she arrived.

The drive to the hospital was pretty horrible, as I was bent over with my head between my legs, trying to breathe… I am not one who can handle pain very well!  The check-in at the hospital was a blur, as all I wanted to do was get into my room and the walk down that hospital corridor seemed like a 10K, as I paused every few steps to grab my pulsating belly.  By now it was 3am.  My mom and mother-in-law joined us in the labor/delivery room.  My mom began to massage my legs as I breathed through the contractions.  Had I known what I know now, I would have gotten out of that bed and walked around as much as I could to just keep things going.  Instead, I sat in bed, breathing through every contraction, gripping my mom and husband’s hands until each one dissipated.  Then, the shaking set in….I was so frustrated because mentally I felt like I could power through this a bit more, yet I felt like my body was showing me that it couldn’t handle this anymore.  I waited until about 4:30 before calling for the anesthesiologist.

After the epidural was administered, we all relaxed a little, just watching the contractions ebb and flow on the computer screen.  By 7am, I was fully dilated and the doctor was paged.  I had no idea what to expect from here.  With Ben, I was in labor for over 18 hours and pushed for 2.5 hours.  I wondered if I was in for a marathon again.  The doctor arrived and asked if I wanted a mirror to watch the birth.  While I was petrified to do this during Ben’s birth, I felt much more confident this time around and agreed to roll in the mirror.  Well, 2 pushes in, Ryan’s little head slipped out and the third push delivered his beautiful body.  And I was able to watch the whole thing!

My doctor brought Ryan to me and laid him on my chest as his umbilical cord finished pulsating.  My stomach immediately grew warm as he peed all over me and we laughed that at least his ‘parts’ were in working order!  Within 20 minutes, my sweet one had latched on beautifully and we laid there for over an hour just gazing into one another’s eyes, memorizing each other’s face and scent. 

And as I held my brand new son, this overwhelming sense of love enveloped me.  It was as if I knew how much joy this incredible being was going to bring to our lives.  That fear that I had felt for the past 9 months… the one where I would be incapable of loving another child as much as I loved Ben… it just disappeared within minutes.  That guilt that I initially felt about depriving Ben of more time with just me and Jason flew out the window as I began to envision the two of them as brothers, sharing things only brothers get to share.

Six years later, I remember Ryan’s birth like it was yesterday.  I still love to hold him and memorize his face and scent, as I know his face will continue to change and get older.  My heart still melts when I watch Ryan and Ben act like loving brothers, for I know that a sibling is the greatest gift a parent can ever bestow on a child.  And, while I may not have consciously chosen to have my kids 15 months apart, I know deep down in my soul that we were meant to have our Ryan.

Happy birthday, beautiful boy!  We all love you so very much!

What about My Freezer Stash of Breastmilk During a Power Outage?

As many breastfeeding moms prepare for Hurricane Sandy and her aftermath, we wanted to share a fantastic article written by our friend, Katy Linda of Stylin’ Momma.  Here’s all you need to know about what to do with your frozen breastmilk during a Hurricane, or any power outage for that matter. 

Our thoughts are with all of you on the East Coast who are bracing for this monstrous storm and hope Sandy is much weaker than expected.

Weathering a Storm with a Freezer Stash of Breastmilk

Reposted with permission by Katy Linda, IBCLC of Stylin’ Momma

As Hurricane Sandy approaches the east coast of the US, many moms are wondering, ‘What about my freezer stash?‘.  And with good reason.  There is concern about what this storm will do and how long people may be without power.  Many moms have worked hard to have frozen milk on hand for their babies, and the thought of losing that liquid gold is just too much to bear.

So how long can you go without power and still save that precious breastmilk?  Let’s see…

We know that the safest place to store breastmilk is in a chest freezer or deep freezer at a temperature of 0 degrees Farenheight. ABM Protocol #8

We also know that a freezer generally stays frozen for 24-48 hours without power, especially if it is full. via USDA

So, we know off the bat that breastmilk frozen in a full chest freezer is absolutely safe for 48 hours!  Great news.  The best way to protect your milk is to store it in the center of the freezer, where temperatures are more stable. This will ensure it stays frozen as long as possible.

And what if the power is out longer?  Let’s see –

Breastmilk is still considered frozen if there are ice crystals in it or it is a slushy consistency. via HMBANA’s best practice, 2005.

Wow.  So even beyond 48 hours we can look for ice crystals to tell us the milk is still frozen. Wonderful news. But what do we do when the milk is thawed and there are no ice crystals left?

Take a look at this:

“The data generated by the authors support the contention that milk is relatively robust. Milk that has been left unrefrigerated for less than 8 hours, or placed in the refrigerator for a day, is safe to use and retains a good portion of its nutritional value. Moreover, it appears that unpasteurized milk that has been accidentally thawed remains safe to use provided it has not been left too long in an unthawed condition. Based on these data, it appears that unpasteurized milk that has thawed in the refrigerator for up to 8 hours may be safely refrozen. Moreover, this data would seem to support the use of frozen milk to which fresh milk has been added and then refrozen. This should allow for more convenient storage and for the salvage of milk that mothers might otherwise have been told to discard.

 Rechtman DJ, Lee ML and Berg H. Effect of environmental conditions on unpasteurized donor human milk. Breastfeeding Medicine. Spring, 2006;  1(1): 24-26.

So it looks like thawed milk CAN be refrozen if necessary.

Let’s keep in mind that breastmilk is a living fluid, and is full of live cells and active immune factors and enzymes which can be, and are, damaged in the freezing process.  The BEST way to have breastmilk is fresh.  That is when the nutritional content is at its highest.  The more we change the temperature the more we denature the proteins, and we lose some of those important qualities.  You might consider leaving out the milk that would be used in the next 24 hours, then re-freezing the rest.

*** Keep in mind that this is to be used for emergency situations, not on a regular basis.  Since you don’t pump in a laboratory you may want to make sure the milk passes the sniff test before feeding it to the baby.  Breastmilk that is bad will smell BAD and you will know.  If it smells fine, it likely is.

Some tips to maximize the length of time your milk will stay frozen & safe -

1. Store milk in the center of a full chest/deep freezer. To help fill the freezer you can fill plastic bags or containers with water and freeze them into ice.

2. Group bags of milk into plastic container or larger bags to avoid leaking in case of defrost.

3. Avoid opening the freezer, this will allow warm/room temperature air in and speed up the thaw process.

4. Dry Ice can be added to the freezer to keep milk frozen for extended periods of time – More info can be found here.

5. Feed your baby directly from the breast as often as possible during the power outage, and avoid using the frozen milk when proper heating isn’t possible.

Stay safe and warm, and enjoy some downtime with your little ones.

*** This article was first posted on Stylin' Momma

Toddler Nursing and How it Helped Me Manage My Circus – Pt I.

Written by guest blogger, Andrea J. Blanco, IBCLC

When my first son was a baby, he absolutely hated car rides. On a trip to the bookstore, I came across Dr. Seuss’ “All Aboard the Circus McGurkus!.” I read that book to him every day and soon came to find the only thing to keep him calm during those car rides was my reciting lines from the book.

“The Circus McGurkus, the World’s Greatest Show. On the face of the Earth or wherever you go…” 

My son is seven now and I still remember most of the lines. So, when I asked a group of moms to give me one word to describe toddler nursing in preparation for this post, imagine my delight in realizing their answers could fit right into our beloved book:

“Amazing. Demanding. A Haven. Stupendous.”

“Loving. Convenient. Tantrum Fixer. Endless.”

Ok, so maybe no one said “stupendous”. But, you get the idea.

If you are the mom of a newborn, the mere thought of nursing a toddler probably seems really daunting, and my advice to you is the same advice I give to my clients: Take it one day at a time. Nursing isn’t a race and the person who goes the longest doesn’t win or lose. This is about your personal journey with YOUR baby and doing anything other than taking it day by day is rushing an already hurried adventure.

My son was ten months old when I first realized maybe I would nurse him past a year. I remember thinking there probably wasn’t going to be some alarm that went off to tell him (or me) that he was supposed to be finished with nursing because it was his 1st birthday. I remember feeling like maybe, in my heart of hearts, we would continue. And we did, but not without some questions.

Is it “ok” to nurse into toddlerhood? 

There are myths out there that after a certain age (I’ve heard as young as 4 months), your breastmilk loses all value and *poof* you’re making water. This couldn’t be further from the truth. Yes, by the toddler years, your baby will be able to eat a wide variety of foods, but your breastmilk is still perfectly suited for his growing needs. In this second year of life, your breastmilk’s most important role takes center stage: continuing to support an immature immune system. It is the ultimate immune booster and is packed with tailor-made antibodies to help your toddler fight off all those germs she’s picking up at the playground (“Sweetie! What is that in your mouth?!”) and on all those playdates (“No, honey, that is NOT your water bottle.”).

Will I still be nursing every 2-3 hours?!

For one whole year, you have been at your baby’s beck and call. You, sweet mommy, are AMAZING. Don’t let those words, which fit perfectly in a Dr. Seuss story, scare you! While some mothers find it’s easier at times to nurse when the toddler wants it (remember, “Tantrum Fixer” is also up there), you are now living with a busy little bee who is newly mobile and has time for a lot of things, but sitting still and nursing isn’t top priority. Consider yourself her pit stop. Discovering the new world is about the most fun thing ever, but being so independent is also frightening. No, you won’t be nursing for hours on end like you did when your baby was younger. Instead you will be her home base. You will be what grounds her and tells her that it’s ok to go explore. And you will be that sense of reassurance in the same way you have been for the last year – by nursing.

Why would anyone want to nurse a toddler?

Aside from the very real health benefits, nursing a toddler is like being Mary Poppins. Let’s face it – we aren’t dealing with the most reasonable age group. They want what they want when they want it and still aren’t verbal enough or patient enough to understand why that can’t always be. They have teeth coming in, separation anxiety, bumps and bruises all over, difficulty understanding why you don’t understand what they’re saying and their veryadamant point of view, timeouts to protest, physics experiments to practice [by flinging things across the room]. Nothing softens those blows like curling up on Mommy’s lap and taking in the scents, sounds and feelings of the familiar: Love. Whether you are at home with your children or working outside the home, the reconnection that happens when you take a break with your little one is incredible. Sometimes, we don’t have 30 minutes to try and solve the problem (and often times, reasoning with a toddler no matter how much time we have just doesn’t work). But, just like Mary Poppins, we too have a magic potion we’re able to use to our advantage. Breastfeeding in the time of the Toddler Meltdown is often all it takes to defuse the situation.

The Technical Stuff. Did you know that, along with many other health agencies, the American Academy of Pediatrics recommends nursing for a minimum of 1 year and “continuation of breastfeeding for as long as mutually desired by mother and baby”? The World Health Organization recommends breastfeeding for “up to 2 years or beyond.” And, while it may not be common in the United States, considering the natural age of weaning worldwide is somewhere between 2.5 to 7 years, nursing into toddlerhood is really just a part of normal nursing.

In his book, Dr. Seuss introduces us to the Juggling Jot, “who can juggle some stuff you might think he could not”. Now when I read the original, longer version to my sons (If I Ran the Circus), I’ll be inclined to think that maybe, just maybe, he was really talking about the mom of a toddler as that Juggling Jot (he does, after all, juggle 22 question marks, 44 commas and also 1 dot). I, for one, am so thankful I was able to continue nursing past one year. Juggling my life, plus the life of my toddler and my family, would have been much more challenging had I stopped.

Come visit me again for Part II of Toddler Nursing, where we’ll talk about what to do when you have little support, how your milk supply will change while nursing a toddler, and how to handle tricky situations, like nursing a toddler in public.

Andrea Blanco is an International Board Certified Lactation Consultant at The Milk Collective Lactation Care, working with families in the Miami/Ft. Lauderdale area. She is the proud mom of 2 loving, spirited boys, who teach her humility, patience, humor, and the rules to more sports than she thought she’d need to know every day. When she’s not helping families achieve their breastfeeding goals, you can find her on the sidelines, at karate tournaments, or with her toes in the sand. She can also be found at themilkcollective.co, on Instagram @themilkcollective_ , facebook.com/themilkcollectivelactation or by email at: andrea@themilkcollective.co.

Have you enjoyed nursing your toddler?  

What advice do YOU have for other moms who are thinking about breastfeeding into toddlerhood?

When a Toddler Bites While Nursing

Written by guest blogger, Leigh Anne O'Connor, IBCLC

Nursing a toddler is a confounding joy! He demands you sit. He does gymnastics and yoga while slurping your sweet nectar. Nursing is a great tool to calm a wild child or heal a skinned knee or a broken heart. These little people are growing rapidly. One day they are crawling, the next they are waddling toward the stairs or the dog food dish.  One day they mumble “mama” and “gaga” and then they learn the power of “NO!!” 

Another big change going on in the little body is the mouth – teeth are multiplying like bunnies in there. If a baby is latched correctly, his teeth are covered by his tongue.  Ah, but the older nursling has teeth on top and bottom! Yikes! As he is feeling those incisors pushing through his flesh nothing will sooth that sensation like biting down on something nice – like a breast!  Ouch! 

So, what is a mother to do?

Just as when a baby of any age bites the hand, (or breast that feeds him), the thing to do is not scream,  “ You little demon, you nearly amputated my breast!” Nor is it to cry out and run weeping into the streets or punt him across the room – though these ideas may make sense at the time. You take the little chomper off your breast and calmly, but firmly, tell him “No, you may not nurse if you bite.” Put him down off your lap and remain as emotionally neutral as you have it in you to be. This should neither be a game nor a horrifying experience. Biting is simply an unacceptable behavior.  After a brief period of being ignored he will either go on about his business or he may plead to have more sweet milk.  If you do offer the breast again tell him in no uncertain terms, “If you bite me again, you may not “nonnie” (or whatever word you use to nurse) again.” I do not mean forever – just at this time of the day.   A time or two like this should tame your little piranha.

Another reason toddlers bite is if they have a cold and cannot breathe so well while nursing. Some saline spray or nursing in a steamy bathroom or bedroom with a humidifier can help open up those little nasal passages.  

Some moms say that her baby bites if she is pregnant or if her milk supply is low (which can be caused by being pregnant). I cannot count how many women have called me to discuss their newly biting toddler. We run through the list of possibilities.

“Are you pregnant?” I ask.

I can almost see through the phone the look of surprised possibility on her face.

“Well, I don’t know. I don’t think so. Well, maybe. I gotta go now!”  

A couple days later my phone rings. “You were right! I am pregnant!” She had run to the drug store to buy a pregnancy test.

If your baby really chomps down hard you can hold him tight to you so that he is forced to open his mouth. Another approach is to put your finger in his mouth   between the teeth and break the latch.

Many moms think this is a time to wean. It can be scary. And, if you talk about it you can be led to believe that this is a sure sign to wean. It is just a stage that some – not all, I promise – toddlers go through.

As you negotiate your way, nursing an older baby in a world where most babies are weaned by their first birthday, you step lightly in your discussions with other mothers. Sometimes you find you are part of a secret society. You find these other mothers who nurse their toddlers and you laugh together at the antics and the sweetness of nursing a talking, opinionated human. You share your battle scars, which can sometimes be teeth marks on your areola.

Here are a few other great articles about how to deal with a toddler who bites while nursing:

Teething and Biting by Anne Smith, IBCLC

Nursing a Teething Toddler by LLLI

Here is some advice from our Facebook readers:

Marie: A firm no and gentle tap on his cheek usually disctracted him.  If he continued to bite, then we stopped nursing for a minute.  If he was done, he’d go and play.  If he still wanted to nurse, I would try again.  A third bite meant we were done.  Also, I would use phrases he understood like, ”Biting gives Mommy owies.  We do not bite.”

Chloe: We have one serious bite at 8 months.  It was at the zoo.  I had to unlatch him and leave him with a friend to go to the restroom and deal with the blood.  That was traumatic enough that he didn’t do it again.  Sometimes he gets a little wild while nursing if something strikes him as funny, but he calms right down if I unlatch him for a minute.

What tips do you have for a mother whose toddler is biting while nursing?

Leigh Anne O'Connor is Lactation Consultant in Private Practice in New York City, as well as a La Leche League Leader. Her blog is Mama Milk and Me.  She lives with her husband, Rob, and their three children, Phoebe, Chloe & Finn.

Breastfeeding during Your Period: When Aunt Flow comes to visit

How many of you thought (or hoped) that breastfeeding was going to keep your period away forever (or at least for the time you were breastfeeding???)  I know I definitely thought that would be the case.  Boy was I surprised when my dear old friend (cue sarcasm) came to visit 5 months after my son was born.  And I was even more surprised when she didn’t show back up after her second visit….yep, apparently you can get pregnant while breastfeeding as well!

So, what’s the deal with breastfeeding during your period and how can you keep the crimson wave away for as long as possible?

When will my period return while breastfeeding?

Unfortunately, there is not a definitive answer to that question.  Breastfeeding will definitely suppress your period for a while.  Some moms may not menstruate for months or years while breastfeeding and other women may start their periods after a few weeks or months. 

Here are a few factors that determine when your period will return:

• How often your baby nurses

• How often your baby receives a supplement (other than your milk) in a bottle

• If your baby use a pacifier

• How long your baby is sleeping at night

• If your baby eats solids

• Your own body chemistry

Essentially, it comes down to this… the more time your baby is at breast, both during the day and during the night, the longer your period might be delayed.  My son was sleeping for about 8 hours a night at 5 months and was using a pacifier, which I think contributed to the early return of my period.  My sister, on the other hand, never used a bottle or pacifier, nursed her son until he was almost 3, and breastfed a few times a night up until he weaned.  Her period didn’t return for over 2 years.  This was nature’s way of holding off conception for my sister for a while.  In my case, nature thought my little guy was old enough to have another sibling, so bring on the period.

Will breastfeeding be different when I have my period?

Some women don’t notice much of a difference in their breastfeeding while they have their period.  Other women may notice some changes, such as:

• Nipple tenderness during ovulation and menstruation

• Temporary drop in milk supply the few days prior to getting your period and for a few days during.

• Baby wanting to feed more frequently, due to the temporary dip in milk supply

• Baby wanting to feed less, as your baby may detect a slight change in taste of your milk during this time.

These types of changes are all temporary and are related to a fluctuation in hormone levels.  A few days into your period, you should feel like your ‘normal’ breastfeeding relationship and supply have returned.

What can I do to compensate for this temporary dip in milk supply?

• Let your baby nurse as often as he/she wants to (it may seem like a temporary growth spurt)

• Start taking a daily magnesium glycinate supplement (120-240mg/night) to help your body detox excess estrogen during fluctuations during your cycle.

• Increase your iron during your period with iron-rich foods (like meat, green leafy vegetables, and beans) or with a supplement, like Floradix or Green Super Foods

• Add a few milk-increasing herbs (galactagogues) to your routine

(*** disclaimer: always speak with a healthcare provider before taking supplements or herbs)

We asked our Facebook friends how they deal with the temporary dip in their supplies and here is what they had to say:

Monica: Since my first cycle, I add an extra pumping session while at work daily.  On weekends I nurse on demand and notice that my daughter wants to nurse more often just before and during my period. 

Ariel: I up my intake of iron-rich foods, lactation cookies, and letting baby cluster feed.

Amanda: oatmeal, water, legumes, and yoga!

Do you notice a dip in your supply when you have your period? 

How do you deal with it?

The Myth of the “Good Baby,” And Other Questions People Just Shouldn’t Ask

Please enjoy this fantastic blog article, written by talented my sister-in-law, Kim Bourne!

When I’m out and about with the little ones, I’m often the recipient of well-meaning yet extremely annoying comments and questions - “Are they all yours?” “Um, no. This one’s mine. The other two are random street urchins who just started following me around”. “Three girls? Your husband must want to try for a boy!” “We’re actually OK with the ones we have - who can hear and understand you by the way...” “Wow, you really have your hands full!” At which point, since I usually have the baby in a wrap, I do my jazz hands and say, “My hands are free, actually!” Sometimes I have a witty response, other times it’s more like “The jerk store called...” , but in general, I’ve learned that these questions and comments come from people who want to say something and so they revert to the tried and true, even if the tried and true is actually quite obnoxious. 

But there are two questions that really make me angry, and I’m hoping that drawing attention to them might stop someone somewhere from subjecting an unsuspecting new mom to them - or worse asking me and having me unleash my mama fury on them. And these questions are “Is she a good baby?” and her evil stepsister “Is she sleeping through the night?” 

Is she a good baby?! Seriously?! Well, she hasn’t knocked over a liquor store in the three months she’s been alive, so I guess she’s a good baby... But seriously, what happens when some sweet looking old lady at the Target squeezes baby’s foot, smiles at her, and asks New Mom, “Is she a good baby?” At first, New Mom is confused. How does she determine if her baby is a good baby? Perhaps New Mom senses what her role is supposed to be, so she replies, “Oh yes, she’s a good baby! She barely ever cries! Just when she’s hungry or needs a new diaper. She’s a little angel.” Yes, yes, New Mom. That’s exactly what the Old Lady at the Target wants to hear! Old lady at the Target gives New Mom an approving smile. Hooray for New Mom! She passed the test! 

What gets me so angry is that all this does is train a poor new mom to equate “easy for me” as “good.” Some babies are very easy-going, adaptable, and generally happy. Some babies are not. Is it easier to take care of a baby who hardly ever cries and spends her day quietly eating, sleeping, and cooing? Obviously! But that doesn’t make a baby “good.” When I think of the qualities that make a person “good,” I think of a kind heart, a giving spirit. Babies can’t fit into that equation yet. What if the baby does cry for considerable amounts of time and doesn’t like being put down? Is the baby a bad baby? Even though the lady at the Target was just making conversation, what she has really done is create a definition in New Mom’s head that isn’t fair to her or the baby. We have babies for many different reasons, but making our lives easier certainly isn’t one of them. They are here to be loved, respected, and accepted as they learn how to adapt to a world that is challenging and new. There are no good babies or bad babies - just babies who have different needs and different ways of dealing with those needs. [Also, it turns out that many “bad babies” make pretty kick-ass adults. Check out Raising Your Spirited Child by Mary Sheedy Kurcinka to learn more.]

The other question, sometimes asked in conjunction with “Is she a good baby” is “Is she sleeping through the night?” Now, this is a fair question I suppose. Those of us who haven’t had four consecutive hours of sleep since we saw two pink lines on the pregnancy test and who nod off on the toilet are relatively easy to spot. Perhaps this question is a kinder way of saying, “Wow, you look like hell.” What really bothers me is the frequency with which this question is posed. I would venture to estimate that 70% of people ask me if my baby sleeps through the night when I first meet them. As a new mom, one can’t help but get the message: this is very important and you are being judged by your response here! Much like having a “good baby,” having a child who sleeps through the night has become an important metric in determining whether or not you are succeeding or failing as a parent. Have you ever talked to a mom who beams with pride as she tells you her child started sleeping through the night at 6 weeks? Now, some of that beaming is probably just the good skin that comes with a full night’s rest, but a lot of it comes from feeling like she passed the test. And if your child doesn’t sleep through the night? Well, better get on that quick or you’ll be stuck in MommyFail land forever. 

This pressure to be able to provide the right answer to the question leads parents to approach sleep in a totally unnatural way. Some may feel the need to start “sleep training” before they or their child are ready. Or they may turn to methods that don’t feel right, but they do them anyway because they are told they’ll get the quickest results. The issue here is that sleep training is often a response to a manufactured problem. If there is truly a problem with the amount of sleep everyone is getting, then by all means parents should try to address the sleep situation and use whatever method they think will work best for them. However, “everyone says she should be doing it by now” or “it must be a big deal because everyone keeps asking me about it” is not the same as a legitimate problem. I’m not sure what mythical land most people are living in, where all tiny-bellied infants are supposed to make it through the night without eating at just a month or two old, thus defying biology. But beckoning new parents into this dream world is not useful or helpful. My kid wakes up once or twice a night. I wish she didn’t, but she does. Now stop asking me about it because I’ve got 99 problems and this ain’t one (right now). 

I’m pretty sure that when most people ask these questions, they aren’t meaning to give a new mom some crazy complex, but still, if we could change the tried and true to something more empowering and positive, NewMommyLand would be a much more beautiful place. My inspiration for comments when I see a new mom come from a short encounter I had with a man out on the street one day. As I’m getting my oldest daughter out of the car, an older man looks over at us and smiles. When he sees my second daughter also get out, he says, “Oh, two of them!” Now, at this point, I’m anticipating all the annoying “you must have your hands full”-type comments. But instead he says, “You are so lucky! You are doubly blessed!” I remember it to this day, how happy I felt to hear him say that. So that’s what I go with. Instead of judging or pressuring, I go with loving, supporting, and admiring.

I Never Knew I Had Insufficient Glandular Tissue

Today, on the San Diego Breastfeeding Center blog, I'm honored to share Jennifer Thomson's memoir about her battle with Insufficient Glandular Tissue.  If you would like to submit your story as well, please email me at robinkaplan@sdbfc.com.  Thank you so much, Jennifer, for sharing your story with us!  I know that your words and wisdom will provide endless support to other breastfeeding moms!

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When I went for my first prenatal check up, the midwife asked me if I intended to breastfeed. I immediately replied, “I’m really looking forward to it!” Those words have haunted me for years.

My first child and I had a rocky start to breastfeeding. After her traumatic birth at almost 35 weeks, I didn’t even see her for over 15 hours and she was too weak to breastfeed in earnest for the first couple of weeks. I was so in shock after my bout of preeclampsia and sudden C-section, I nearly forgot about breastfeeding entirely until a nurse wheeled in a pump and said I’d better get started. I never got engorged, and could only pump 3-10 mls of colostrum and then milk, not that I could tell when it had “come in” other than a change in color. I dutifully pumped what I could for my little 4 pound preemie, and the nurses in the NICU were very supportive and would hold my tiny syringes of milk until I got there each morning so that I could witness a gavage feed of only breastmilk once a day. It was something, and it did make me feel a bit better.

Living in an area that has no shortage of lactation specialists and breastfeeding support, I did everything they said and nothing seemed to make a difference. Several weeks in, my mom asked one of them when I was going to get engorged. The lactation specialist responded that she didn’t expect that I ever would. No one ever mentioned why. I was so confused – everything I ever read or could find said anyone who wants to breastfeed can and should. Most people had problems with latch, or engorgement, or blisters, not an absence of milk. I blamed the C-section, the early arrival of my daughter, the traumatic birth experience, the fact that she was in the NICU for three weeks, the medicine they pumped into me for the 5 days following her birth. But the truth is I knew that there was something wrong with me and my breasts. If I went too long between pumping sessions, I would leak and could feel engorgement in some areas of my breasts. Why could I feel individual ducts, and why weren’t they everywhere?

After a few weeks I ended up on Reglan, which helped a bit, but made me depressed and I didn’t need any help in that department. Several lactation consultants vaguely mentioned Domperidone, so I started my own research and ordered some from New Zealand. It worked, at least somewhat. I was able to pump an ounce from each breast every 4 hours and I nursed my daughter as much as she was willing. By the time she was 3 months old, I grew tired of wrestling with her at the breast. She didn’t want to nurse unless it was the middle of the night. I found myself getting so angry with her denial of me that I needed to stop trying to force her to breastfeed in order to save my own sanity. She preferred the bottle, and that was that. So, I pumped and gave her 2 ounces of breastmilk followed by 4 ounces of formula until she was 8 ½ months old and I just couldn’t do it anymore.

I kept a two week supply of Domperidone on hand in case I needed it one day for another baby, wishing and hoping all the while that maybe I was normal but it was the circumstances that caused my low milk supply. Two years later I was pregnant again, but this time I was under the care of a perinatologist from the beginning, did not develop preeclampsia, and was able to carry my second daughter to 38 weeks. I did have another C-section, but this time I was prepared, awake during the surgery, and was in my room breastfeeding 45 minutes after my full-term baby was born. What a difference! She had great latch from the first try and was happy as a clam nursing for hours on end. I wasn’t engorged, but my baby seemed content and I could tell when my milk came in. But she started to lose weight, and fast. She nursed around the clock, but didn’t seem content once she was a few days old. I went to see the lactation consultants at the hospital where I delivered, and they told me I had to give her a supplement at that point. This is a big deal since this is a breastfeeding-friendly hospital, so they have to buy formula for cases such as mine. She filled a syringe with formula, attached a tube to it and taught me how to have her latch around my nipple and the tube and to gently push it in as she sucked. I didn’t even need to – she sucked so hard she got the formula herself. She looked relieved as she drank and promptly fell asleep, satiated at last. I was crushed.

So, by day 5, I was back on Domperidone. It worked again in combination of around the clock nursing and pumping, and by the time she was 8 weeks old she started to refuse the bottle. I was forcing it on her like I had tried to force my first child to breastfeed. I was so worried that she wasn’t getting enough food that it didn’t occur to me that she might actually be getting enough breastmilk until a friend pointed out that it was possible. I stopped bottlefeeding, and she stayed happy and growing. I couldn’t believe it. By the next growth spurt, though, I couldn’t quite keep up so I started giving her 3-4 ounces of formula at bedtime. That did the trick, and I still felt pretty good about the whole thing.

I took Domperidone for a full 12 months. I was shocked to find that at her first birthday my supply was as high as it had ever been and my daughter was still happily breastfeeding around the clock. I don’t think I ever had much more than an ounce or two in my breasts at a time, but it was enough. The biggest difference was that because we started out strong, even with an SNS supplement, she always preferred breastfeeding. My supply dwindled over the next year, without the Domperidone and as nursing became less and less frequent. By her second birthday, I noticed she wasn’t swallowing at the breast anymore and there were only drops coming out. She didn’t care. These two things on my chest that I had deemed useless countless times were hers and she loved them. She still breastfed just as often even though nothing came out. She still breastfed to go to snuggle, to calm down and reset her day. She still demanded to nurse before bed and upon waking in the morning. Somehow, through all the trauma of my breastfeeding experience, she was just like any other breastfed child. It’s been three months since I dried up, and she still asks to nurse a couple of times a day. We did it, together.

Today is the first day I have ever heard the term “insufficient glandular tissue”… there is a name for this? I asked around to see if it was common to be missing what I called “breast tissue” and I never really found an answer anywhere. I am relieved to hear that I am not alone. That being said, I am so thankful for the support I did receive from my perinatologist, my obstetrician, countless lactation consultants, my primary care physician, my cardiologist, the hospital where I delivered, my husband, my friends, Dr. Jack Newman, the New Zealand pharmacy, the local compounding pharmacy, and the area where I live that has lactation rooms all over the place. I want to share my story so that other women in this predicament know that they aren’t alone, that they can have a breastfeeding relationship with their child even if they aren’t making enough milk. One lactation consultant told me once that I was breastfeeding, no matter how much I needed to supplement. It seemed at first like a silly thing to say. But it stuck with me. You are breastfeeding and your child is breastfed if they are receiving a drop of breastmilk. Just ask my two year old, who still thinks my empty breasts belong to her.

Jennifer Thomson

My Battle with Insufficient Glandular Tissue

Today, on the San Diego Breastfeeding Center blog, I'm honored to share Nikki Williams' memoir about her battle with Insufficient Glandular Tissue.  If you would like to submit your story as well, please email me at robinkaplan@sdbfc.com.  Thank you so much, Nikki, for sharing your story with us!  You are an incredibly dedicated mom and a true breastfeeding warrior!

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When I developed in puberty my breasts were never perky and upright; even at 16 they were pendulous and looked like they had already nursed a dozen kids, even though I am relatively slim, and the shape wasn't inherited because my mother had no breasts to speak of (I was not breastfed in part because my mother believed she would make no milk because she was barely an AA cup.)  They have always been a source of embarrassment for me, but I resisted getting a breast lift and areola reduction because I wanted very much to breastfeed and I knew that could cause problems.  To add insult to injury, my breasts are also fibrocystic, meaning they are lumpy all the time and burn and throb in the week before my period starts. 

In June 2008, my breasts were burning and swelling as they usually do before my period, but my period never came- I was pregnant, but it took me seven weeks to figure it out.  Throughout my pregnancy, I was able to fit into the same bras- the only breast changes I noticed were dark, peeling nipples.  I checked my bra every day for signs of colostrum, but it never came.  My water broke and labor didn't start for a few days, so my midwives had me try to use a pump to induce contractions.  Nothing even came out in the several hours I pumped. 

Labor did eventually begin and I had a perfect, natural water birth ending with a beautiful, long, skinny daughter.  I really strived for a natural birth to maximize breastfeeding success, because I just had this deep feeling that something was wrong with my boobs.   Because my nipples are tiny and flat and my breasts lack fullness, the first latch didn't happen for several frustrating hours, but finally it happened and I just waited for my milk to come in.  My nipples were cracked and bleeding by 24 hours- my home nurse said my latch was great, my daughter was peeing and pooping meconium, everything was fine.  I got a prescription for Canadian Nipple Cream and a nipple shield to help shape my shapeless nipples.  

Day two and Day three:  No engorgement.  No yellow poops.  Baby was definitely a "nipper napper," so chilled out- never crying, always sleeping.  Nipples still agonizing.  Back to another LC, who checked for tongue ties and said everything was great, and that I could prod my daughter's rectum to remind her of that body part and that it has to do something.  I did, and nothing happened.  
 

Day five:  No feelings of letdown, no engorgement, no leaking...but some milk visible around my daughter's mouth.  I heard swallowing when she was awake to feed.  Still no bowel movements.  Red crystals in the diapers, which I started needing to change less frequently.  My nursing diary says I have spent 18 out of the last 24 hours nursing.  I cried with pain with each feeding.  

Day eight: We took her to get her professional photos taken, and she urinated all over the white fluffy beanbag she was posed on.  I'll never forget how dark and smelly that urine was.  But we were congratulated on no poop accidents in the studio!  

Day 11:  Something was wrong- my daughter had not pooped since the day of her birth.  She was so sleepy. I took her to the pediatrician, who weighed her.  She had lost a full pound from her birth weight.  She saw she was dehydrated and rushed out of the room to return with a case of formula.  I broke down.  I had been cruising kellymom.com while nursing (still 18 out of each 24 hours), trying block feeding, fenugreek, anything.  I was doing everything right.  The pediatrician said she didn't know what was with all of these new mothers who made such a big deal about breast milk.  I asked for a syringe or something because I was not going to feed her with that pre-mixed nipple-confuser bottle.  The doctor gave me a prescription for daily weight checks, an order to exclusively pump for 24 hours to see what I was producing, and a periodontal syringe that I could use to finger feed my daughter.  It was, and still is, the worst day of my life.  I exclusively pumped 20 minutes every 2 hours for 24 hours- I managed to collect 4 ounces.  

My daughter came alive on formula.  Her eyes opened for the first time in several days.  With her mouth moistened, my nipples were able to finally heal.  I was horrified that I had been starving my daughter while bragging to everyone how content she was.  That's something I'll never get over, as long as I live.  

In a daze, I went to visit my husband's cousin, who exclusively pumped for her son.  When she pumped, she had to use 8-oz bottles, which she would fill in 20 minutes.  I told her what was happening to me, and she mentioned she had a huge stash of breast milk in her freezer that she was about to throw away because her son was rejecting it in favor of formula.  I said I would take it.  It was several gallons' worth.  I cried and cried with relief.  During that visit, my daughter had her first bowel movement since her birth.  It was about 10 percent breast milk (2 weeks worth), then 90 percent hard nuggets of dark green formula, and she filled two diapers as I watched and rejoiced.  

That donated breast milk lasted me for two months.  In those two months, I had an appointment with an OB/GYN for an issue I had with my bladder during pregnancy.  During the exam, he asked me how motherhood was going, and I broke down right there with my legs in the stirrups. I told him about my nursing difficulties.  He stopped and asked if I would like him to have a look with the ultrasound machine.  I was confused, but a few minutes later he was giving me a breast ultrasound.  He said that he hadn't done this before, but he knew what a lactating breast should look like, and mine did not look like a lactating breast.  He pointed out that my glands were clustered all around my nipple, and where there should be glands and ducts radiating out and up into my armpits, I had only fat.  That would explain it.

I dug out my copy of The Breastfeeding Mother's Guide to Making More Milk and flipped to the section about insufficient glandular tissue, a section I had skipped over gleefully in my pregnancy.  There I was, there was my chest in a sketch.  I was redeemed!  It was really not my fault!  Now I was angry that I had been led to believe that I was not doing something right by the various LCs that I had visited with.  Why didn't any of them make me show them my whole chest?  Why didn't any of them touch my breasts?   Why didn't any of them ask me if my breasts had changed during pregnancy?  

Furious google searches and research dominated my life.  I had started to use a bottle by now because the 1-oz serving through the periodontal syringe was not working anymore.  My husband was able to feed her while I banged the keyboard.  Packages of domperidone began arriving from Fiji. I found the Medela SNS and obtained it from one of the LCs I had visited, annoyed that this hadn't been offered to me right away.  I was almost immediately more annoyed with the SNS, however, and more late night research led me to the Lact-Aid SNS, which was so expensive to me at the time that I rinsed and re-used the baggies. I dominated the refrigerator with frozen milk, thawing milk, tubes, bottles, bags.  The SNS affair lasted a few weeks at most.  I couldn't endure it.

It was all very annoying and demeaning at the time.  Twiddling with a SNS and searching for more donated breast milk via Milkshare consumed my life.  I don't remember my daughter's infancy until she was three months old, when I found a long-term donor and relaxed about finding donated breast milk.  She had a son exactly my daughter's age who was born through a traumatic cesarean, but she was struggling with oversupply.  Here we were, complete situational opposites, bonding over the same horrible postpartum feelings.  She ended up donating over 20 gallons of milk to me- enough for six ounces a day for a year.  

I found several other donors here and there through Milkshare and word of mouth, bringing my total to about 30 gallons of donated milk over a year.  That's actually not very much as far as a baby's consumption goes.  To bridge the gap between that and the four ounces of milk I was making per day, I began making the Weston A. Price homemade kefir formula. My daughter struggled on the store-bought formulas- another slap in the face for me.  Chronic constipation.  Poop that smelled like a steel mill.  Anal fissures.  Suffering. I couldn't find enough donated breast milk.  Many would-be donors saw my seemingly healthy, older baby and declined to donate to me, preferring a newborn or sick child instead.  Making the homemade formula was my meditation- I was still able to honestly say that I was making my daughter's food.  She flourished on the combination of me, my donating friends, and my homemade formula.  Finally I was able to relax and be her mom.    

Alas, now I had to go back to work.  Within a few weeks of returning to work, my period returned and my milk supply dropped.  I had a 50-mile commute one way, and I would pump with one hand on the wheel and the other on a flange, and after 20 minutes of zoning out on the Capital Beltway, I would look down and see only a few drops not even in the bottle, but still in the flange.   I was also bloated and 10 pounds heavier from domperidone, and almost $1000 lighter from that and the industrial-size bottles of goat's rue tincture, a better pump, and all the SNS doodads.  It wasn't worth it.  I stopped the galactogogues.  I quit pumping at work.  I didn't offer the breast to my daughter one day when she turned six months, and she never indicated she wanted to nurse again.  That was that.  No cabbage leaves required. Easiest weaning in history.

When my daughter was one year old, I became a doula.  I was inspired by the gal who gave me all that milk- her birth story was so hard to hear and I vowed that someday I'd help her heal the way she helped me- and I was indeed able to attend her homebirth after cesarean as her doula and friend.   Now I love helping other women overcome breastfeeding problems.  It is so ironic that I only breastfed exclusively for 11 days and for 6 months total, but I am one of the biggest supporters and champions of breastfeeding that I know.  I KNOW I know more about IGT and primary lactation failure than many lactation consultants, and that hurts me.  I would have never gotten a diagnosis of my condition if I hadn't happened to be in a room with an ultrasound machine one day. 

I am so pumped (no pun intended) to see the publicity and coverage that IGT is getting these days.  As of now, I won't be having another child in part because I do not want to go through lactation failure again, but if it does happen, I will be so prepared and I will be the poster child.  My only regret is stopping nursing altogether and not giving the SNS a better try, but I have to be gentle with myself considering it was the best I could do at the time.  And I think I did pretty darn good!  My daughter is healthy, athletic, graceful and still skinny and long, the way she was born and meant to be! 

Nikki Williams

How Long Does My Breast Milk Stay Fresh?

Breast milk storage guidelines can be incredibly complicated to decipher.  With each pump company and breastfeeding website having its own storage and handling recommendations, how's a mother to know which one to follow?  Plus, throw in whether the baby is full-term, pre-term, healthy, or in the NICU, and we have quite a confusing situation.

After delving into our lactation consultant guidelines for human milk storage, I think I have the definitive list for you….at least for this year!

How long does my breast milk stay fresh?

Here are the recommendations, for a healthy infant, according to the Core Curriculum for Lactation Consultant Practice, 2012:

Room Temperature 72 º:   6 -10 hrs.

Refrigerator:  5-7 days

Insulated cooler with ice pack: < 24 hrs.

Completely thawed in the refrigerator: < 24 hrs.

Freezer compartment in 1-door refrigerator: 2 weeks

Freezer door in 2-door refrigerator (not in door): 3-6 months

Deep freezer: 6-12 months

Here are the recommendations for a hospitalized infant, according to the Core Curriculum for Lactation Consultant Practice, 2012:

Room Temperature 72 º: < 4 hrs.

Refrigerator:  up to 7 days

Insulated cooler with ice pack: < 24 hrs.

Completely thawed in the refrigerator: < 24 hrs.

Previously frozen, brought to room temperature: <4 hrs.

Freezer compartment in 1-door refrigerator: not recommended

Freezer door in 2-door refrigerator (not in door): < 3 months

Deep freezer: < 6 months

How should I store my breast milk?

• Glass or plastic baby bottles

• Clean food storage containers with tight-fitting lids

• Disposable feeding bottle liners and mother’s milk bags

How do I warm my stored breast milk?

• Never use the microwave to warm up breast milk.  Not only does the milk heat unevenly in the microwave (which could cause unintentional burning), but it decreases the anti-infective quality of the milk and reduces its overall health properties (ABM Protocol #8)

• Defrost frozen breast milk in either the refrigerator overnight, by running under warm water, or setting it in a container of warm water. (ABM Protocol #8)

• There have been no studies done to provide recommendations for how long milk can be kept at room temperature after a baby has partially fed from the cup or bottle.  The Academy of Breastfeeding Medicine recommends using the milk within 1-2 hrs after baby finished feeding.  (ABM Protocol #8)  Many lactation consultants and pediatricians recommend using the rest of the milk at the next feeding sessions and then throwing any leftovers away.

Do I need to sterilize my bottles and nipples?

• Bottles, nipples, and pump pieces need to be sterilized before you first use them.

• Once a bottle, nipple, or pump piece has been used, sterilizing is unnecessary.  Instead wash everything in hot, soapy water and then rinse, or throw them in the dishwasher.

Less complicated, right?  

I hope that I was able to clarify a few of those difficult-to-figure-out questions you had. 

Now go.... breastfeed, pump, and give that delicious goodness to your child!  And, definitely check back in a few years to see if anything has changed!

Battling and Resolving Excess Lipase in Breastmilk

While it is unknown how common it is for a mother to have excess lipase in her breast milk, causing it to smell or taste soapy, I come across it often enough that I thought it would be helpful to share how to deal with it, from a mom's perspective.    Christina Williams was gracious enough to write this article, walking us through her journey battling and resolving her issue with excess lipase and her baby who refused to take a bottle, even when she went back to work.  Thank you so much, Christina, for sharing your knowledge and determination!

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In preparation to be a first-time mom, I’d been tearing through books and following countless blogs for months prior to my daughter’s arrival. I was sure I had everything in order and was ready for anything motherhood had to throw at me. I could distinguish common rashes from those that are more worrisome, had memorized the slide deck of normal infant poop, and had figured out the optimal wash routine for my growing collection of cloth diapers. Was I prepared to do the seemingly simple task of giving my new baby a bottle after we established our breastfeeding relationship? The thought hadn’t even crossed my mind.

We struggled for months to get my breastfed daughter to take a bottle. We tried every trick in the book – countless fancy bottles, different people, positions and places, and my husband even devised a few feeding contraptions. Nothing worked. She could see that bottle coming at her and would seal those cute little lips right up until it was out of sight. Everyone tried to be encouraging, “She won’t starve herself,” they would say. Maybe not, but she sure liked to scare me into thinking she would try. When I went back to work she reverse cycled, completely refusing milk during the day but eating almost constantly through the night. Staying up most of the night and working all day is not a recipe for success for a working mom. I was lucky to squeeze in two hours of broken sleep a night.

Then, when my daughter was nearly 5 months old, I tasted some breast milk that had been in the fridge for a few days. It tasted rancid, soapy, and a little metallic. No wonder she had been refusing it! I thawed some milk from my freezer stash – that was terrible, too. That confirmed it; there is excess lipase in my breast milk.

What is lipase, and what is it doing in my breast milk? Lipase is an enzyme that breaks down the fats in your milk to help baby digest it. When lipase occurs in excess, this process happens much more rapidly and can make the milk taste off or sour after a period of time. Milk with excess lipase is safe to drink, but some babies dislike the taste and refuse it. Sometimes this change happens in a matter of hours, but many women find that they have 24 hours or more before the milk fats break down enough to alter the taste. 

I think I have excess lipase. What can I do about it? Fortunately, lipase can be inactivated at high temperatures, and milk can be safely stored in the fridge or freezer. Milk must be scalded before freezing, as lipase is still active even at low temperatures. Unfortunately, many women find out that they have excess lipase after establishing a freezer stash and finding that their baby won’t take any of it. If you find yourself in this situation, consider donating. Many babies will accept this milk, and it is often used in tube fed babies who can’t taste it, anyway. My regional milk bank was thrilled to accept my milk, excess lipase and all.

The first step is to determine at what point your milk starts to taste funny. I tasted my room temperature pumped milk hourly until I noticed a difference. I found that I need to scald at work after each pump session, as I don’t have enough time before it turns to make it home at the end of the day and do it all at once. Once you’ve determined your personal timeline it will help you make a plan for scalding your milk.

What do you recommend as the easiest, most effective method to scalding pumped milk? There are two popular ways to scald – in a pan on the stovetop and using a bottle warmer. Both methods require that the milk reach a specific temperature and then cooled.  Some methods suggest heating to 180° and cooling immediately. Others*** recommend heating to 144.5° and keeping it at this temperature for 1 minute, or heating to 163° for 15 seconds and then cooling. Personally, I prefer the bottle warmer method and heating to 180°. I find it difficult to reliably heat to either of the lower temperatures and maintain those temps for the recommended length of time, so I tend to stick to the 180° method. Plus, having a new baby makes even basic tasks seem complicated, so I opt for the simplest option.

***Per Lawrence & Lawrence, bile salt-stimulated lipase can also be destroyed by heating the milk at 144.5 F (62.5 C) for one minute (p. 205), or at 163 F (72 C) for up to 15 seconds (p. 771).

How do you scald milk in a bottle warmer? What supplies are needed? How long does it take? I scald at work 2 or 3 times per day. It takes me exactly 7 minutes to scald and clean up.

Here are the supplies I use:

-Bottle Warmer – Select a bottle warmer that doesn’t have an automatic safety shut off. You need to heat the milk to a high temperature, so having the auto shut off kick in mid-scald isn’t going to get the job done. I prefer warmers that contain the entire bottle versus those that allow half of the bottle to stick out the top.

-Stainless Steel Bottle - I don't like to heat in plastic, especially to such a high temperature, and I found that heating in glass is sketchy. My glass bottles broke in the bottle warmer on too many occasions, plus the hot glass can’t be transferred directly into cold ice water or it will shatter. It must be poured it into another container first before cooling. Too many steps if you ask me! Stainless steel allows you do all the steps without transferring containers.

-Digital Thermometer - You'll need one of these regardless of what scalding method you use.

-Container for Ice – Select a container that is deep enough to submerge your bottle and around 3-4 cups of ice. I use a large, glass measuring cup.

-Ice - I like to bring a huge bag of ice in once a week. I can never remember to pack a bag of ice from my own freezer every day, and this seems to make the whole process a little easier.

Steps:

 1. Fill up bottle warmer reservoir, fill the stainless steel bottle with milk, and set the timer for at least 5 minutes. I can usually heat 7-8 ounces in 3-4 minutes. It will take longer to heat if you are using a glass container.

2. Prep your ice bowl with a few cups of ice and cold water. I find it helpful to have this ready before I start heating the milk, as the last few degrees change very quickly and you don't want to over heat. Those last 20 degrees seem to happen in just a few seconds.

3. Start the bottle warmer and stick in your thermometer. As your milk is heating, stir it around a bit with the thermometer so it heats evenly.

4. As soon as you reach 180°, quickly remove from heat and submerge in the ice bath. I let it sit with the lid off for a few minutes while I pack everything else up.

5. After a lot of the steam has escaped and the milk is relatively cool, I put the cap on the bottle and put the container with the bottle inside in the fridge. Usually, I put a paper towel over it if I’m putting in the office fridge. It isn’t necessary to put the ice bath in the fridge, but if I leave it on the counter I will inevitably forget about it until it's too late. The fridge is a nice insurance policy for those Mommy Brain moments.

6. Once completely cooled, transfer the milk into a storage container.

Anything else I need to know? I find that my scalded milk doesn’t always last a full 7 days in the fridge. Your experience may be different, but it’s best to make sure it passes the sniff test after a few days before using. Scalding milk may reduce some of the anti-infective properties and nutritional value of the milk, but not enough for it to be of concern unless baby is getting only scalded milk all the time. Lastly, this all may seem overwhelming, but it is completely do-able, even at work. It took a bit to get in the swing of things, but now it’s just a part of my daily routine.

It took a while to get my daughter to start accepting a bottle, even after I started scalding. After all, we had been conditioning her to think bottles are full of gross milk. It took a few months of patience and persistence, but she now does most of her eating during the day and sleeps at night (well, maybe the sleep part hasn’t been worked out just yet). In true baby fashion, she hates the beautiful, enormous collection of glass bottles I picked out when I was too hormonal to know better. She loves the cheapest, least eco-friendly bottles out there. Typical.

Disclaimer: If you suspect you have an issue with excess lipase, please consult your physician or lactation consultant for advice on how to best manage your situation. I am not a medical professional, just a mom sharing my own experience.

Have you experienced excess lipase in your breast milk?  

Did it cause difficulties with your baby taking a bottle?