Common Concerns While Breastfeeding - Yikes! Why Are My Nipples Burning?

Welcome to our blog series…. Common Concerns While Breastfeeding.  These aren’t the complicated, ‘come-to-my-house-immediately’ phone calls I receive.  Rather, these are the questions that come from clients and friends in the middle of the night, by text or by email, that don’t necessarily warrant a lactation consultation.  They can often be easily resolved with a few simple tricks.  So, I would like to share those tricks with you!

Why Are My Nipples Burning????

Oh, those itching and burning nipples and breasts.  It takes all of your will power to not walk up to the closest tree and rub your front side on it, like a bear would rub on a tree to get rid of fleas.  The itching can feel insatiable.  This is often your first sign that you have thrush, which is a yeast infection of a mucus membrane, your breasts being one of them.

How did I get thrush?

Well, just like a vaginal yeast infection, thrush is caused by an overgrowth of yeast in your gut.  Breastfeeding moms may often find that they get thrush after a dose of antibiotics.  This is because antibiotics kill NOT ONLY the bad bacteria in your gut, but also the good bacteria.  Yeast loves when there is an absence of good bacteria in your gut, so it decides to multiply and aim for any mucus membrane. 

Moms and babies who also have inflammation, such as a food intolerance which limits the absorption of important nutrients, or are just temporarily dealing with a compromised immune system, are also more susceptible to thrush. 

What does thrush look like?

• Burning, itchy nipples and breasts

• Red or pink nipples and areola

• Painful feedings after a time period of painless feedings
  

• And thrush doesn’t just affect the mom.... babies can get thrush as well.  When your baby has thrush, he may have white, cauliflower-textured spots in his mouth along the gum line or on his cheeks.  He may also have a raging diaper rash.  Babies with thrush may cry while breastfeeding because the milk stings the sores in their mouths.  And to complicate matters more, your baby may show no signs of thrush at all!

How does one get rid of thrush? 

• First and foremost, make sure that the pain you are feeling is not due to a less-than-perfect latch. Also, if the burning happens to only occur after the feeding, not during the feeding, it might be worth it to see if you have Raynaud's, which is a vasospasm of the nipple.

• Remove sugars (including most fruit and fruit juices) from your diet for about a week. Yeast grows on sugar, so removing it from your diet restricts yeast growth. It might help to eliminate dairy as well.

• Consider starting a course of a high-quality probiotics to help recolonize your gut, and your baby’s gut, with good bacteria. I would recommend choosing a probiotic from the refrigerator in the herb section of a natural food store. Probiotics are alive and begin to die off when at room temperature, so don’t purchase anything sitting on a shelf, unrefrigerated.

• You will want to wash all of your bras and underwear in a distilled white vinegar rinse cycle. Also, soak anything that goes in the baby’s mouth, like a bottle nipple, in apple cider vinegar before rinsing it in soapy water. The vinegar should help kill off the yeast hanging out on these items.

• All Purpose Nipple Ointment (APNO) - if that pesky thrush will not go away after trying the above recommendations, Jack Newman has a protocol for getting rid of thrush. You can ask your primary care physician for a prescription for this to bring to a compounding pharmacy. Midwives often have recipes for this as well, that you can make with over-the-counter medications.

• If all else fails, you can ask your physician for Diflucan, which is the same medication used to clear vaginal yeast infections.

• Lastly, definitely discuss this issue with your pediatrician or a lactation consultant. He or she may have some other recommendations to help remedy the out of control yeast.

Why Women Should Attend a Breastfeeding Support Group WHILE Pregnant

There are few things that I really focus on when a pregnant mama asks what she should know about breastfeeding before her baby is born.  One, it is incredibly beneficial to take a prenatal breastfeeding class to learn about positioning, latching, following baby’s feeding cues, and how to tell if your baby is getting enough.  Most importantly, though, when it is all whittled down to the core, in my mind what helps a mom reach her breastfeeding goal has all to do with support!  When mamas share with me why they stopped breastfeeding, the most prominent theme is lack of support and assistance when breastfeeding challenges became complicated. 

So here’s the deal - breastfeeding is something you learn on the job.  In really supportive jobs, we usually have professional development at the start, as well as throughout our employment to keep us up to date and provide needed support.  Parenting is definitely a full time job, yet we often have to seek out our own unpaid professional development, to have our questions answered and continue the learning process.  This ‘professional development’ can often be challenging to find, as well as not all support is equally beneficial.

This leads into why I think it is a fabulous idea for women to attend a breastfeeding support group while they are still pregnant.  Still pregnant, you may ask… why not wait until after the baby is born?  Great question, my friend, and here are the reasons why.

Why women should attend a breastfeeding support group WHILE pregnant:

1. Make it a familiar place.  There is nothing scarier than going to an unfamiliar place with a brand new baby.  I didn’t get on the freeway for 4 weeks after Ben was born and I definitely didn’t want to go someplace I had never been before.  What if the people were weird?  What if Ben started screaming and I couldn’t calm him down?  What if I couldn’t find parking?  That’s the perk of finding a breastfeeding support group while pregnant…..no baby in tow.  Now, you can find where to park your car or stroller, at your own pace.  You can check out the setting and the flow of the group without feeling like you have to stay the entire time.  You can try out the seating situation and make note of where everyone puts their enormous diaper bags.  You just turned an unfamiliar place into one where you will hopefully feel comfortable returning to once your little one is born.  Doesn’t that sound less stressful?

2. Meet the facilitator.  At work, every professional development facilitator has her/his own style and tone.  It is the same way with support group leaders.  You get to be choosy while pregnant.  Maybe the first group seemed too crowded or the facilitator didn’t jive with you.  Go check out another one!  No need to settle.  Find one that appeals to you and makes you want to return as soon as you have your baby.

3. Witness a live baby latch onto a real breast.  This many sound funny, but how many of you have really ever seen a live baby wiggle and shift and slide down a mother’s torso to latch onto her breast?  Maybe in a breastfeeding class video, but that’s not LIVE.  Be a lurker…you’re pregnant…no one will mind J  When I interviewed Ina May Gaskin for The Boob Group in 2012, this was one of her main recommendations.  Surround yourself with breastfeeding mothers.  Watch them and learn from them.  It’s amazing how much you will learn from just observing a few different mothers at a group.  Quickly you will realize that there are MANY ways to position and latch a baby….there really doesn’t need to be so many rules about it.

4. Chat with some new mothers who are going through exactly what you will be going through in a few weeks.  New moms love to talk about their experiences.  It’s like starting a new job that you are totally obsessed with and want to share as much as you can IMMEDIATELY!  Participate in their conversations.  Learn from their experiences.  Ask a bunch of questions.  They have gained so much knowledge in their few weeks/months as mothers…. Soak it up!

5. Learn where to find support and assistance if you need it or where all the cool breastfeeding moms hang out.  You never know if you will need some extra breastfeeding assistance, so preparation is the key.  Not all situations can be resolved at a support group (which is why I also highly recommend finding a lactation consultant before you have your baby, as well…just in case), but it is often a great place to start!  One thing I’d also like to point out - not all of the mothers who attend a breastfeeding support group are having breastfeeding challenges, which is awesome!  Many just come for the conversation and to have a place where they know their kiddos can be fed easily.  Sit next to one of them and feel the breastfeeding love!  They might even ask you to join them for lunch after the meeting! 

Help a Mama Out: Surviving the First Few Weeks of Breastfeeding

What tips do you have for surviving the first few weeks of breastfeeding?

Maren: Lots of skin to skin to get those endorphins going so you can take advantage of all that delicious oxytocin (which will make you want to keep breastfeeding, even with things might be tough!)  Take advantage of all of the support you can – it will help normalize the experience so that you feel totally confident in your decision to breastfeed.  And know ahead of time that there is definitely a learning curve, but it only gets better and better, so hang in there!

Amanda: Make sure to talk to your partner about how you need him/her to support breastfeeding and encourage you, even when you get discouraged and feel like giving up!

Jamie: Get the latch correct right away!  Take advantage of the lactation consultants at the hospital and ask for a referral even if you don’t think you will need one.

Andrea: Trust your body!  Skin to skin, lots of water, and lots of rest.

Heather: Surround yourself with at least one supportive person.  I would never have made it through those weeks without the support of my husband.

Alicia: Hire a postpartum doula.

Juli: Surround yourself with women (and men!) who support breastfeeding.  It gets easier – it is definitely worth pushing through the tough parts in the beginning!

Billie: Make really good friends with the lactation consultant and local breastfeeding support group before delivery.  They will be able to offer so much support in those first few weeks.  Trust your supply.  Make sure you are comfortable!

Monica: I went to classes and read books, which helped, but nothing prepares you for the real thing.  Get help early, if you need it.  Hiring a lactation consultant was the best thing I did.  Keep telling yourself you will try it for one more day and one day it will become second nature.  Coconut oil worked wonders on sore nipples.

Christine: OMG… best advice I got was to rub breastmilk around your nipples after every nursing session!  My cracked tatas healed within 2 days of doing that!

Chelle: If it hurts and you are dreading the next nursing session, don’t just tough it out!  Get help ASAP before it gets worse or turns into an issue that makes you quit! Take a prenatal class.  Breastfeeding is natural, but that doesn’t mean you will naturally know what to do.

Sarah: Don’t expect anything else from yourself.  Set up what you can ahead of time and find someone else to do everything else that needs to be done.  Establishing your breastfeeding relationship is your job.

Jen: Get a Netflix subscription and ignore the dirty dishes!

Danielle: Don’t do anything but rest, breastfeed, nap, and eat.  Nothing else matters right now.

Abbey: Celebrate every success, no matter how small it seems!

Desiree: Find support!  And be patient…it’s not always easy, but it’s most certainly worth it! 

Sofia: Learn the basics!  Before birth is possible!  Proper latch, how milk supply works, most common myths about breastfeeding, how to know if your baby is getting enough, why it is REALLY important to feed on cue rather than a schedule, why baby doesn’t need ANYTHING else but your breastmilk, etc.

Amanda: Don’t give up! Get help and support!  Spend as much time as you can with your baby (in bed if you can.)

Priscilla: Relax.  Don’t listen to anyone that’s not helpful. Determine your own needs for comfort.

Joanna: Expect to care for your baby and get others to help with meals and housework.

Thanks to everyone who responded to our questions on our San Diego Breastfeeding Center and The Boob Group Facebook pages.  Check back every Tuesday for a new Help a Mama Out tip!

To find an international board certified lactation consultant, visit www.ilca.org

Here are a few more articles on our website, specifically dealing with breastfeeding a newborn:

Advice for a Newly Breastfeeding Mama’s Partner

Breastfeeding Expectations for the First Month

Newborn Hands: Why are they always in the way while breastfeeding?

Advice for the New Breastfeeding Mom

Advice for a Newly Breastfeeding Mama’s Partner

Let’s face it… becoming a new parent can be extremely overwhelming!  I still remember that first drive home from the hospital.  My husband and I were cracking up as we stared at our son in the car seat behind us.  “Can you believe that they trusted us enough to take this little guy home?  Do they know that we have never changed a diaper or bathed a baby before?  What were they thinking????”

As I spent the first few weeks mastering breastfeeding, it became apparent that two sets of hands were often better than one.  It amazed me that an entire day would pass before I realized that I forgot to eat or take a shower.  It was my hubby, aka breastfeeding cheerleader/parenting partner, that made sure that I was being taken care of as I was all consumed in feeding and caring for our newborn.

I often get asked by the soon-to-be parents in my breastfeeding classes about the roles of the partner.  What role does he/she play while mom is breastfeeding? Many partners often feel like they don’t have a defined role when their partner is breastfeeding because unless his/her breasts start lactating, it is truly a one person feeding show for those first few weeks.   Plus, diaper duty doesn’t sound too glamorous!

So, instead of writing an article for the newly breastfeeding mama this week, this blog post is actually for her partner… the one who makes sure that the ship doesn’t sink!  Let me tell you…. your job is WAY more important than you may think. 

Before we get to the advice, I’d like to let you in on an important secret…. You are the glue that binds your new family together.  You are an integral component in the happiness and sanity of your household!  The bond you form with your partner, who has just stepped into this new parenting role just like you, is just as powerful as the bond you create with your new baby.  Your compassion and support will not only increase your partner’s self-esteem, but will also make or break her breastfeeding experience.

So, now here is some advice for the newly breastfeeding mama’s partner, from a few of my favorite breastfeeding mamas!  Here’s how their partners supported them during those first few weeks:

Marie: Encouragement and the willingness to wake up around the clock with me.  I nursed, he did diapers… it helped me not feel alone and crazy at 2am.

Grace: My partner constantly replenished my snacks and water glass!  And reassured me that what I was doing was the right thing.  I’m so glad he didn’t let me give up and let us see a new lactation consultant, ENT doctor, and chiropractor… otherwise we wouldn’t still be nursing at 13 months!

Jessica: He prepared all of my meals and then did the dishes!  With such frequent breastfeeding in those first few weeks/months, it’s hard to get in good nutrition for mom.  I was so grateful that I didn’t have to think about feeding myself or my husband!

Danielle: My wife did everything…brought me food and water, did the dishes and laundry, fixed our cloth diapers, and made sure I got to bathe.  And when it was super painful, she looked up stuff on google, got ice packs and coconut oil, and helped him latch each time.  It was truly a team effort!

Cassandra:  Helping with household chores – running to the store, encouraging me to drink water… all those things you don’t have time to do in the beginning because you’re busy sustaining your newborn.

Arelis: My baby is now 20 weeks and exclusively breastfed.  My husband calls breastfeeding a ‘special treat.’  Whenever he holds our daughter, he asks her if she is ready for her ‘special treat.” The baby just giggles and knows what’s coming next.

Maren: Dividing duties because breastfeeding in those early weeks is so all-consuming – so, changing diapers, clothes, rocking and comforting – just trying to even out the responsibilities so that I didn’t get overwhelmed.  And not judging me when marathon feeds meant sitting in front of Netflix for 3 hours.  Those were actually wonderful days made more lovely by my awesome husband!

Liana: For me, it was just knowing that he never doubted my ability to nourish our child and never questioned when I said that the baby wanted/needed to nurse again (even if he just finished 15 minutes prior.)  What’s more, with an oversupply, he supported my pumping so that I could donate to others, despite my milk taking over the freezer!

Shannon: I couldn’t have gotten through those 1st 8 weeks without my partner.  He got up with me to help with every night feeding while we still had to finger feed one of the twins.  He helped swaddle them, get them into their crib, and do whatever while I pumped.  He brought me water and snacks, took care of me and the babies each time I got mastitis, and took care of our 4 year old, too.  I think I would have given up if it weren’t for him, but I’m still going strong and the boys are almost 5 months old!

Melissa: Stayed by my side during night time feedings.  He kept me awake when things were going smoothly and kept me calm when feedings were frustrating.

Alicia: Since our daughter was so early, my husband did skin to skin with her for the first few weeks!

Exercising After Baby Just Got a lot Easier

Last week, we featured Autumn Bonner, of Tailored Fitness, as a guest blogger about Breastfeeding and Exercise.  We thought her business was so amazing that we wanted to share it with you!  The best thing about Tailored Fitness.... it is all online so you can access it anytime, anywhere!  Here’s my recent interview with Autumn.

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When did you first become interested in fitness for moms? 

I have always known that I wanted to be a mom and when we began planning for a family, I started looking into how I could continue to teach exercise classes with my baby.  I came across Stroller Strides, which is a fitness program for moms, that was started right here in San Diego. It combines my passion for kids, exercise, and being outside.  I immediately fell in love with the moms and really enjoy being a part of helping them take better care of themselves. While teaching Stroller Strides, I saw how quickly the kids picked up on exercises we were doing. We would often see the kids practicing their push-ups and sit-ups while playing.  I realized that the moms in my class were setting a powerful example of health for their kids, just like my parents did for me!

What inspired you to start Tailored Fitness? 

As my passion for helping moms grew, I wanted to be able to reach a bigger audience than just the moms in my Stroller Strides class each week.  I wanted to create a convenient way to workout at home, because let’s face it, some days it’s just too much work to get out of the house with kids. Through talking with friends with little ones, I realized that there wasn’t really a good option for those moms who wanted to work out at home. So I decided to create one! That’s how Tailored Fitness was born.

How can moms best use your videos? 

 The awesome thing about the Tailored Fitness program is that you can truly create a tailored fit, hence the name!  The video clips are divided into sections (warm up, cardio, upper body strength, lower body strength, core, and cool down). 

To get the best workout, you should choose a mix of cardio and strength videos to make up your workout.  A combination of cardio and strength work is the best recipe for weight loss.  Because the exercises in the videos are designed to get you the best workout in the shortest amount of time, you can make big strides in your fitness in just 30-45 minutes 3-4 days a week! 

We also have pre-made workouts you can choose from. The best part is that you can have all of this in the comfort of your home, whenever it is most convenient for you to workout. We are offering a free 30-day trial so you can try out the program! http://members.mytailoredfitness.com/accounts/register/

What can moms gain from exercising after having a baby, other than the obvious (losing their pregnancy weight)?

I love that you asked this question!  I always remind my Tailored Fitness clients that there is so much more to exercise than just fitting back into your clothes. We often just focus on the physical changes we want to see and when they don’t come as quickly as we hope, we tend to give up.  It’s the more meaningful reasons to work out that will keep you motivated on the hard days! 

1. Most moms don’t realize the psychological benefits of working out. For example, you will have more energy when you work out. I know it seems counterintuitive that working out when you are already exhausted can actually give you more energy, but it’s true!
2. You will also feel better about yourself.  The changes a woman’s body goes through during pregnancy and in those first few months postpartum are staggering.  It can be hard to look in the mirror and accept what you see.  When you exercise, you are doing something good for yourself that will eventually help you get back to feeling and looking like yourself again. 
3. Spending time caring for yourself will make you a better mom!  Don’t let mom guilt get in the way in of your workouts. You can even get a great workout with your kids. Check out a local Stroller Strides class or try out our Workout with your baby video series on Tailored Fitness.  You are worth taking care of!        
4. As we discussed, you are setting an amazing example for your kids by exercising.  They are learning that exercise is important and that it can be fun, just by watching you.  You are giving your children an amazing gift!

What are your top five tips for easing into an exercise routine after having a baby?

1. Start slow!  Your body has just been through a lot and needs time to recover.  There are two things you can start right away: 1) Kegels – Doing kegels several times a day will help rehab your pelvic floor and avoid urinary incontinence, which is common for new moms. 2) Walking – Getting outside in the fresh air will be good for you and the baby. Start by just walking around the block or around your apartment complex.  Add a few minutes each week as you feel stronger. Once you have your doctor’s clearance (usually around 6 weeks) you can resume more exercise.  I have been chronicling my post partum experience on my Tailored Fitness blog. You can follow along and read about my exercise routine and see pictures month by month. 1st month , 2nd month , 3rd month , 4th month coming soon
2. Focus on strength work! You will be burning lots of calories breastfeeding and getting cardio with your baby is pretty easy by simply walking with them in a carrier or stroller.  Strength work is extremely important, but it is often neglected by new moms.  Every new mom soon comes to realize that the life of a mom is physically demanding.  From lifting the baby in and out of their bed to carrying the car seat, you will be using muscles you didn’t know you had.  Plus, you probably lost some strength during your pregnancy.  It is important to incorporate strength work into your exercise program as soon as you have your doctor’s clearance. It will not only help you with your everyday tasks as a mom, it will help you fit back into your pre-pregnancy clothes sooner!
3. Ease back into ab work! Your abs are definitely weaker after pregnancy, even if you worked your core while you were pregnant. Ease slowly back into ab exercises and be patient as you rebuild strength in your core.  It’s best to start with bracing core moves like the plank and save twisting moves like bicycles for later. Some women experience separation along the midline of their abs, so rebuilding overall core strength first is best. 
4. Be consistent, even when you are tired! There will be lots of days as a new mom when working out is not going to sound like much fun. Especially those days when you are tired because you’ve been up the night before caring for your kids. Remember that the benefits of exercise stretch far beyond achieving a certain number on the scale. It will benefit you mentally in tremendous ways.  Even if it’s short, a little is better than nothing at all. Tailored Fitness has a ton of great video clips that you can combine to create an excellent workout in just 20-30 minutes. Remember you have to take care of yourself to care for your baby! Exercise will also help boost your immune system, helping you avoid sickness, which is common during those first few months postpartum when you are low on sleep.
5. Find a routine that works for your new life as a mom!  The way you worked out before may not be possible or practical once you have a baby.  Find a new routine that works well with your schedule as a mom.  You may find that working out at home is a lot simpler and makes it easier to be consistent than getting to a gym. I encourage you to give Tailored Fitness a try. We even have videos you can do with your baby to exercise.  Our goal is to simplify exercise so you can make it fit into your day and experience the benefits. 30 days free - http://members.mytailoredfitness.com/accounts/register/           

Lastly, what tips do you have for eating to keep up your energy after having a baby?

1. Request healthy meals. If you are lucky enough to have friends and family bringing you meals, it’s usually comfort food, loaded with fat and carbs, with a cookie or two to finish things off.  Although it may taste good, this is not the type of food that is going to give you the energy you need to recover and care for your little one. When people ask what meal that can bring you, ask for something healthy and request that they hold the desert (at least sometimes!)
2. Focus on WHAT you are eating, rather than stressing about HOW MUCH and counting calories. While you are breastfeeding it is not the time to worry about dieting.  In fact if your daily calorie intake drops below 1500 calories your milk supply can be negatively affected. Instead, focus on what foods you are eating.  Focus on consuming lots of lean proteins and vegetables.  Enjoy fruits and dairy as well in moderation.  Try to avoid processed foods and refined carbs (like bread and crackers).  These are the types of food that your body can convert easily into energy.
3. Keep your cooking simple. Caring for a newborn is overwhelming enough.  Trying to prepare gourmet meals can sometimes add more stress.  When you start cooking meals again, keep them simple!  A typical dinner should contain a protein (such as fish, turkey, chicken, tofu, or pork loin), a high quality carb (such as quinoa, brown rice, brown rice pasta) and at least half a plate of vegetables (either steamed or in a salad).  The crockpot will be your best friend too!  Check out our Tailored Fitness Pinterest board where we have a ton of easy, healthy recipes. https://pinterest.com/tailoredfitness/healthy-recipes/
4. Drink lots of water.  I know you have probably heard this before, but when you are nursing, it is EXTRA important to drink water.  Did you know that we can confuse feeling hungry with feeling thirsty? Often times we think we are hungry and reach for food, when really, our body just wants water.  By drinking enough water throughout the day, you’ll be able to tell the difference and avoid overeating.  Don’t love the taste of plain water?  Try a one of these recipes to mix it up.https://pinterest.com/pin/425308758529863503/ , https://pinterest.com/pin/425308758529863475/, https://pinterest.com/pin/425308758529863450/ 
5. Stock up on healthy, high protein snacks.  Especially if you are breastfeeding, you need to make sure you are consuming enough calories to keep your milk supply steady and support your body’s needs.  Having easy to grab snacks is essential.  You may even want to keep a few snacks near where you nurse. Here are a few of my favorites:

• • Cheese stick and an apple
  • Greek yogurt with berries
  • A handful of almonds
  • Peanut butter on a banana
  • A couple slices of turkey bacon
  • Check out this blog post for more ideas: Snack Ideas

Tailored Fitness Links:

www.MyTailoredFitness.com

www.facebook.com/mytailoredfitness

www.Pinterest.com/mytailroredfitness

To hear Autumn’s personal story about her background and finding her passion for fitness, take a look at her video: http://youtu.be/lAm-nts0aVY

Breastfeeding and Exercise – What you need to know

Today I am sharing a post from a fellow momprenuer. Autumn Bonner is the co-owner and co-founder of My Tailored Fitness, an online video-based fitness program for moms.  Through her program, moms can build their own custom workouts based on how much time they have and the intensity they want.  It’s like having your own custom workout video!  The exercises are created specifically for moms and use limited equipment so you can squeeze in a workout at home during nap time. Autumn is passionate about helping moms be healthy so that they can be examples for their kids. She talks with each member monthly to give suggestions and provide support to reach their goals. You can try her program free for 30 days. Just visit www.MyTailoredFitness.com or like her Facebook page www.facebook.com/mytailoredfitness for helpful fitness tips and great healthy recipes.

Recently, I’ve received a bunch of questions from moms about exercising while breastfeeding, so I thought it would be a good topic for a blog post so we can cover everything you need to know!

After I had Sienna, I was really anxious to get back into my regular exercise routine so I could regain some sort of normalcy in my life.  I did wonder, however, what exercise would be like while nursing.  Would it be painful to run?  Would exercising affect how much milk I made? Do they make breastfeeding-friendly exercise tops? 

I decided to do a little research to find out.  Let’s cover the science stuff first and then we will take a look at the practical side. 

My resource for all things exercise and pregnancy related has been Dr. James Clapp’s Exercising Through Your Pregnancy. He has a chapter on breastfeeding and exercise that has a lot of great information.  Here are the highlights.

• Regular exercise, even at high intensity, does NOT alter wither the quality or quantity of breast milk produced, unless the mom isn’t consuming enough calories.

• Women who exercise and breastfeed should be sure to eat at least 1500 calories per day so that their breast milk production is not reduced.

When you exercise, you burn calories, and breastfeeding also burns calories (about 500 per day), so breastfeeding moms need to make sure they are consuming enough calories to cover the extra they are burning off during exercise and breastfeeding.  If the number of calories consumed drops below 1500, milk production can be affected. You will also need to increase your water intake, especially if you workout outdoors in warm weather.  The Boob Group has a great episode on this topic: Lose Weight While Maintaining Your Milk Supply.  The San Diego Breastfeeding Center blog also has an accompanying article: How to Lose Weight while Breastfeeding without Losing your Milk Supply

Ok, now on to some practical tips that will help make exercising while breastfeeding more comfortable

Buy a supportive sports bra

Prior to being pregnant, I never really had to worry about supportive sports bras because, well, I wasn’t too well endowed on top.  But that changed when I became pregnant and even more since Sienna arrived.  Luckily, the girls in my Stroller Strides class told me about Juno by Moving Comfort.  It’s a great, supportive bra that even has adjustable straps.  They also have a non-racerback version called Fiona.  Lululemon also sells a bra called the Tata Tamer.  Love the name!  It doesn’t have the adjustable straps, but works well too.  I wrote a blog post about supportive sports bras that you can read on my website: Support for your Girls - The best sports bra

 

Feed your baby right before you exercise

This will help a lot with comfort during your workout, especially for high impact activities like running or kickboxing.  Side note, did you know that there are laws that protect the right for women to breastfeed in public?  My lactation consultant, Robin, was actually just involved in resolving an incident here in San Diego where a woman was told she could not breastfeed her baby while she was waiting in traffic court.  Check out Robin’s article /blog/2013/2/7/a-resolution-to-the-chula-vista-courthouse-nursing-in-public.html here to read about it.  You can find your own state’s breastfeeding in public laws at www.breastfeedinglaw.com.  It’s always good to know your rights, just in case your little one decides she/he wants to breastfeed during your workout.

 

Try low impact exercise if you still have breast pain

If you still have any breast pain, try switching to lower impact exercise until your milk supply regulates and you are able to move around more comfortably.  You can still get a great workout without any jumping.  In all the Tailored Fitness videos, I give low impact options.  I also just filmed a series of Exercise with your Baby videos, which are all low impact and designed specifically for the newly postpartum mom.

Hope these tips help you to be able to breastfeed and exercise comfortably! 

Help a Mama Out: What to Do When Your Baby Refuses a Bottle

What tricks have worked for you when your breastfed baby refused a bottle?

Michelle La Plante: Bottle boot camp with daddy!  I left the apartment for the day, leaving baby and daddy there with plenty of expressed breastmilk and a bottle.  By the end of the day, they had figured it out.  (Kudos to hubby for this – it was tough on him to see her cry and fuss…. But, then again, his breasts didn’t leak at the sound of the baby crying!)

Amanda Garfinkel Young: Early and often worked well with my second.  With my first, the nanny had a good trick.  She held him facing out, looking out the window and fed him with the bottle in the other hand.  A little awkward, but it seemed to distract him from the fact that he wasn’t looking up at mama while eating.

Danielle Smith: Try lots of different bottles.

Stephanie Lorenzen: After trying a number of different bottles, we used a spoon and a shot glass.  We then moved on to a straw cup after 4 months of age.

Julie Chapin: As a nanny, I went through this.  Had to have mama away at first.  Plus, baby had to be laying or sitting out of arms… could not resemble nursing at all.  First successes were warm bottle given in a drowsy state as baby was waking in her bassinet.  Windows and toys distracting baby at other times or in a bouncy chair.  Had to use droppers and spoon feeding with a few babies leading up to the bottle.

Natalie Quebodeaux Cavender: Sippy cup!  Turns out he hated the warmed milk and not the bottle.  He likes mama’s milk cold when not from the tap!!!  LOL!

Jennie Bever: My first one took a straw cup fine.  Second one reverse cycled.  Now that he’s older, he’ll also take breastmilk warm in a straw cup.  He would also drink out of a regular cup, although it’s a bit messier!

Liz Anderson Weaver: At daycare, we have had to resort to using medicine droppers with two babies.  Then we tried ERERy NIPPLE EVER until we found their perfect bottle combo.  Both suck ‘em down like champs now!

Stacey Singh: I read that if you have the person who is feeding your baby wear the robe or another article of clothing you wear frequently, it can really help.  I had my husband try it and my baby actually did take a little from a bottle.  We’re still working on it though.

Sylvia Padilla Sullivan: We tried different bottles.  Because he is older (4.5mos), one with a pretty fast, easy flow worked better than the ones we had been trying (like when he was tiny and still learning to suck.)

Thanks to everyone who responded to our questions on our San Diego Breastfeeding Center and The Boob Group Facebook pages.  Check back every Tuesday for a new Help a Mama Out tip!

Help a Mama Out: Tips for Breastfeeding the Distracted Baby

Over the past few months I have been posting readers' questions on our Facebook page and have been blown away by the fantastic advice and support you have shared.  The downfall with Facebook, though, is that eventually the terrific advice will work its way down the wall and succumb into Facebook oblivion, never to be found again.  

Well, that's just a travesty!

So, here is what we're going to do....

Each week I will post a topic and question (or maybe a few!) on the San Diego Breastfeeding Center and The Boob Group Facebook pages.  At the end of the week, I will collect all of YOUR fabulous breastfeeding mama advice and tips and place them into a blog post, which I will share the following Tuesday!  Now your breastfeeding expertise and support will be documented and saved for moms to cherish and learn from, even years from now!

So, let's get started.....

'Help a Mama Out' Topic of the Week:

 Tips for Breastfeeding the Distracted Baby

What's Your Best Advice for Nursing a Distracted 8-10 month old Baby?

Gina: Strap toys to bra, like the kind with a loop for a play gym or use a nursing necklace.

Kat: Different things worked for my daughter at that age. Sometimes I would nurse with a cover so she wouldn't get distracted by the environment. A nursing necklace sometimes helped. Sometimes I would sing a song so she would only look at my face.

Yolanda: I sing, hmmm never thought to clip toys to me lol. 

Melissa: Nursing/teething necklace. TONS of patience :-)

Christine: My daughter (who's now 10 months, not a lot has changed since then) loved to hit, pinch, and slap me so I would simply take her hand and hold it and talk to her. Talking to her seems to help her focus because she has one thing to focus on, my voice. I also will position her upright straddling my knee to nurse so she can somewhat look around while she's nursing and then she feels like she's not missing out on all of the way cooler things than eating lunch. Or simply latching her and standing up to walk around with her so she can nurse and still look around at all of the would-be distractions. I find it's better for her to nurse in busy areas where she has lots of things to look at in those ways than nursing in a quiet, dimly lit room because then she'll just do the "fake sucks" and try really hard to listen to noises outside.

Michelle: Dark room and soothing music

Kara: A quiet, out of the way - darker room! From about 7-10 months my first nursling required no distractions whatsoever!

Jennie: Go in a dark room:)

Ria: Read them a book and hold it up so they can see the pictures. Or keep a pile of toys just for that time, toys with different textures and and colors. Works for us.

Katie: In a room away from others/TV...use a nursing necklace. 

Kathy: I always started playing with my son's hands. I would rub them, fold them into a fist, etc. Now he plays with my hair the whole time! :-)

Jessica: I tap on my daughter's leg or arm gently and that helps keep her focused.

Tammy: Tapping the bottom of her feet. All of mine went through periods (just days) where they were not as interested.

Jeni: I found hanging a toy off a necklace helped focus him back towards me and then he played while he ate.

Jona: Patience; reducing distraction by nursing in a quiet, dark room; breastfeeding when baby is sleepy.

Amy:  Babywearing! I'm relearning it 1st hand with my super distractible 9 month old. 
I put him up in a front carry and it helps immensely. Otherwise even in a calm environment he's too busy checking it all out. Wearing him is my saving grace every day and some days the only reason he gets a good milky feed in the daylight hours. I'll stand by it now and forevermore as the 2nd best parenting tool!

Creating a Sense of Community When Using Donor Milk

In an effort to demystify milk sharing, for the next few weeks we will be sharing stories from breastfeeding moms who either donated their excess breastmilk or supplemented their baby with someone else’s milk.  For more information about milk sharing, both informal and through milk banks, please visit our article: Supplement Options: Donor Milk, Milk Banks, and Formula, as well as our Boob Group podcast episode, Low Milk Supply: Donor Milk, Milk Banks, and Formula.

Today on the San Diego Breastfeeding Center blog, I am honored to share Cara's story, which demonstrates how a sense of community can blossom through supplementing with and donating breast milk.  If  you would like to submit your story to be shared with our readers, please email me at robinkaplan@sdbfc.com.  Thank you so much, Cara, for sharing your inspiring story with us!  Your daughter is so lucky to have you as her mother!

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I feed my daughter a mix of my breast milk, formula and donated breast milk from 5 different women. Not only has donated breast milk benefitted my daughter's digestion and overall health, it has introduced me to other moms that I'm now proud to consider part of my community.

We were only two days postpartum, after a beautiful unmedicated birth, when the first hospital-based lactation consultant looked at my breasts and her face fell a little bit. She informed me with a matter of fact tone that I might have breast hypoplasia/Insufficient Glandular Tissue (IGT).  She said not to try too hard or be too hard on myself, as physiologically I might never make enough milk for my daughter.  It turns out, she was right. When my milk finally came in, my daughter only transferred 10ml per feeding - less than half an ounce.  However, through herbal supplements, medication, and pumping after each feeding I've managed nearly 4 months later to increase that amount to 20-30ml per feeding, but that's another story for another time.  Bottom line: I've only ever made 8-10 ounces of breastmilk a day, max. Not nearly enough for my daughter.  So at 4 days postpartum, after my daughter's weight dropped too far and my milk supply was not increasing: my husband helped me begin supplementing with formula using a syringe and feeding tube at the breast.  I was just relieved to have a plan, and as my daughter thrived I was grateful for formula and the nourishment it was offering my baby.

At 6 days postpartum we met with a local IBCLC.  She guided us on how to continue trying to increase my milk supply, and in the meantime how much to supplement.  And she also mentioned donor milk.  

I originally brushed off the idea of donor milk.  While it made sense since human breast milk is the best food for babies, it seemed like it would be awkwardly intimate to use another mother's milk, and I was also afraid of disease. My husband and I were not in a place to pay the high price for formal milk bank donor milk, and informal channels made me nervous.  I was also clinging to the hope that all the work I was putting into making my own breast milk would pay off and I might someday be able to exclusively breastfeed.  A few weeks later, however, I had to come to the painful realization that would never happen.  I cried as I realized I would be supplementing my daughter’s diet with either formula or donor milk for the long-term.  

So I began looking into donor breast milk.  I checked out the Human Milk for Human Babies Facebook pages, but was too uncomfortable with the idea of taking milk from strangers, so I sent an exploratory email to the moms I know in the area, asking if they or anyone they knew had extra milk they could donate.  Somehow breast milk from friends or friends of friends made me a lot more comfortable.  I only sent that email to 6 other mamas, but one friend responded that her friend had some extra milk due to an oversupply.  Another friend/co-worker responded that she herself was weaning her toddler, and had just stopped pumping at work.  She offered to resume pumping once a day and donate that milk to us.  I was blown away with gratitude - what a gift… but, also nervous.  Do we trust other milk enough to feed it to our daughter?  My husband and I made a decision together: to trust.  We decided these moms were feeding this milk to their own babies, so we would choose to feed it to our baby as well.  

I first accepted donated breast milk from my friend and co-worker.  I supplied her with breast milk storage bags which she filled and labeled.  For her it was very little milk, just 4 ounces or so a day, but for us and my young baby that was a significant amount.  I was so grateful, and felt humbled.  This was a gift I could never repay.  I would normally be uncomfortable with this imbalance - accepting a gift I couldn't repay - but was willing to do anything for my baby.  And my friend's attitude helped tremendously - she was so kind and sweet and seemed honored to give this gift to my baby.  A few days later, this friend texted me asking if my daughter liked her milk.  I laughed as she explained that it felt like she'd made a casserole for someone -- and wanted to know if she liked it!  My daughter certainly liked her milk, and I texted her a picture of my daughter in a post-meal milk-drunk stupor with a happily full tummy.  After all - that happily full tummy was the reason we were doing all of this.

The friend-of-the-friend was also incredibly kind, and we set up a time to pick up the milk from her.  She made me comfortable by asking if we were OK with the two cups of coffee she has in the morning.  Just her awareness of this issue made me feel she was a conscientious Mama aware of how her breast milk could affect her baby, and my baby.  She did request that we not tell her husband - as he would be weirded out by it all.  This honestly made me a little uncomfortable as I was so recently myself overcoming the 'weirdness' factor.  But she also seemed honored to help out and with an oversupply was happy her milk was going to good use.

I then met a woman with oversupply at a breastfeeding support group.  She was exclusively pumping and had repeated bouts with mastitis so was pumping far more than her daughter needed in a day.  I picked up some donated breast milk from her - feeling comfortable because we'd met a couple times at group, and I knew she'd struggled to do her best for her baby.  We laughed a bit sadly as we realized we were in similar conundrums.  Both pumping all the time - me in an effort to build supply and her in an effort to stave off mastitis.  She seemed happy to help my daughter, and I promised to provide her with replacement breast milk storage bags.  Somehow - buying donor moms breast milk storage bags feels like I'm repaying them just a bit - or at least making it a bit easier for them. 

By 8 weeks of age my daughter was thriving with about a quarter to a third of her diet coming from my breast milk, and the rest a mix of formula and donor milk.  I was first afraid to tell my daughter's pediatrician that we were using donated milk.  At my daughter's two month appointment I tentatively brought up donor milk - then quickly mentioned I was aware of the risks of contracting diseases and the like.  Our pediatrician didn't seem fazed at all that I was using donated breast milk - and she even encouraged it.  She brought up the fact that women with new babies have been tested for infectious disease during their prenatal care - so the risks are very low.  She was very comfortable with us feeding my daughter donated breast milk, which made me even more comfortable myself!  

I was also so grateful for the donated breast milk as it also seemed to help my daughter’s tummy, as she began struggling with constipation from the iron in formula.  We switched formulas to a brand we thought was better and cheaper - double bonus.  However, my daughter started straining to pass hard little pellets, and stopped eating as much. We were very concerned.  We began to consider giving her apricot nectar to help her bowels and with the hope she would start eating enough again.  However, before the fruit juice, I wanted to try one more thing - my friend/co-worker had just given us about 12 ounces of breast milk so instead of spreading that amount out over a couple of days, I decided to try feeding it to her all in one day to see if it helped her tummy.  It did!  It made me sad to realize formula was affecting her so negatively, but so happy to have a tool on hand - donated breast milk - to help my daughter gently.  We switched back to a brand of formula we knew worked better for my daughter, but she still had sluggish bowels.    

Having seen the benefit of breast milk on my baby's tummy I decided to give Human Milk for Human Babies a try - milk from strangers.  This decision was also encouraged by an internet community I had found of other mamas with low milk supply - some of whom were exclusively feeding their babies with donated breast milk from many different mamas. I posted a request on the Human Milk for Human Babies Southern California page on Facebook.  Immediately after posting I panicked realizing the post might go up on other people’s news feeds.  While my husband and I had become comfortable with donated breast milk, and I was open about my low milk supply struggles with friends and family, I was NOT open about using donated breast milk.  I just didn't want to have to defend our decision, when we had been a bit conflicted about it ourselves.  I'm still not sure if it went up publicly or not, but I decided to only deal with it if someone brought it up. They didn't.  

First a woman in Anaheim asked if I would make the 3-4 hour round trip drive up there to get breast milk from her. I decided I wouldn't.  I wanted donated breast milk for my baby, but formula was working OK and I decided the time in the car in Southern California highway traffic was not worth it for me and my daughter.  Then another woman private messaged me saying she was in the area, had never donated before, didn't have any diseases, only had small amounts of alcohol after her infant daughter goes to bed for the longest stretch between feedings, and had some frozen breast milk that was about to expire and needed to be used.  Her message made me feel comfortable, and I messaged her back thanking her for her openness and explaining I had never accepted milk from a connection with a stranger on a website before.  We decided to meet for the first time at a mall near me, as she was going to the Hollister nurse-in.  

It felt kind of like a Craigslist sale, meeting this stranger to exchange goods, except without the financial component.  I texted her telling her to look for a woman wearing a sleeping baby in a baby carrier (me)- then she walked up wearing her daughter in a baby carrier as well - and with a large cooler full of frozen breast milk.  Her husband and older son were with her, but as we started talking breastfeeding and postpartum struggles they wandered away.  She sort of smiled and said her husband had wanted to come with her to meet this stranger from the internet.  We laughed and then I wondered: why the heck was I so willing to just go meet a stranger from the internet without anyone with me?!  Minutes after meeting her I'd felt comfortable.  She was a mama with plenty of breast milk who stored some up when her daughter was much younger - and as the frozen milk neared its expiration date, she didn't want it going to waste.  We are both moms who knew breast milk was best for our babies, and both moms doing our best to provide what we can.  We've stayed in touch, as she might have some more milk for us in the future as she easily pumps above and beyond her daughter's needs. Even if she doesn't, we are grateful for the gift she has given us.

Since then, I met another mom in a breastfeeding support group, also exclusively pumping and with more milk than her daughter needs.  After meeting her a few times and running into her in my neighborhood, she insisted she could begin providing us with fresh breast milk every couple of days.  I accepted. Once again, I felt comfortable as I knew she was doing the best she could for her baby and attending support groups for support.  Since then I've enjoyed meeting up with her for walks as we compared the struggles of new mama-hood.

I still sometimes have fears of my daughter contracting a communicable disease - or imagine the horror of a donor realizing she has something she didn't know she had - but have decided that the benefits outweigh the risks.  I'm not yet open with family about the fact that we're using donor milk.  Perhaps that's an indicator that I'm still not 100% OK with it, but mostly I think it's because I just don't want to have to defend our decision.  The heartbreak of low milk supply is something I've learned to speak rather matter of factly about -- but how we choose to feed our daughter is nobody’s business, but our own.  Who we choose to involve in that decision (for example: our pediatrician, our lactation consultant) is just that - our choice. Perhaps over time I'll be more open about the donor milk that is helping to nourish my daughter -- writing up our experience like this is a start!

Thanks to my breast milk, donated breast milk, and formula my daughter is thriving.  Thanks to donated breast milk I've gotten to know other moms in a new way and we've built a community I never even dreamed we'd have.  I am just so grateful for this gift other moms have given my daughter!

Mustering Courage to Accept Breastmilk From a Friend

In an effort to demystify milk sharing, for the next few weeks we will be sharing stories from breastfeeding moms who either donated their excess breastmilk or supplemented their baby with someone else’s milk.  For more information about milk sharing, both informal and through milk banks, please visit our article: Supplement Options: Donor Milk, Milk Banks, and Formula, as well as our Boob Group podcast episode, Low Milk Supply: Donor Milk, Milk Banks, and Formula.

Today on the San Diego Breastfeeding Center blog, I am honored to share Christine McCarty's story about how she mustered up the courage to ask a friend for extra breastmilk for her baby.  If  you would like to submit your story to be shared with our readers, please email me at robinkaplan@sdbfc.com.  Thank you so much, Christine, for sharing your inspiring story with us!

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My story starts several months ago, when my daughter was about 5 months. I have a friend who has Raynaud's disease and pumps constantly to continue to give her son the best nutrition she can. We were having a conversation about breastfeeding (as most of our conversations are about, lol) and she mentioned she produced 80-120oz PER DAY! A few weeks later I was off to see my favorite IBCLC frantic and in tears because for 2 days I had only pumped 1.5oz (from both breasts total, not individually) per pumping session at work. I remember hugging my lactation consultant, crying in her shoulder, telling her "I'm losing it, I'm losing my daughter's lifeline, I'm such a poor mom, I just can't keep up." After much reassurance, we got back on the right track, but I still had the issue that my production hadn't gotten back up to speed for the next day I had to go to work.

I was in the grocery store about to buy some formula when I thought of my friend and how she was complaining she was running out of freezer space.  I immediately put the formula back on the shelf. I knew I had to do something, but nothing about giving my daughter formula felt comfortable, and I wanted to exhaust the only other option I thought I had… my friend! I had to think about how to approach her to ask her about using her milk because I wasn't sure how comfortable she would be with it, since there's such a huge stigma attached. I mustered up the courage and called her to ask her to discuss milk sharing with her husband and see if they were mutually comfortable with it.  

My friend started crying and I was in shock! Had I offended her? Was she sorry for me and my low production rate? Was this the end of our friendship? No way! She said she was so honored that I would come to her to ask for help and this meant so much to her to be able to help our family and help my daughter! She talked it over with her husband that night and it was settled.  They brought 180oz to my house the next day along with her medical testing she had gotten done throughout her pregnancy and all she had afterwards, along with her son's paperwork.

The funny thing is, after I had gotten her milk, I became a total milk maid! My production boosted SO much! I'm sure it was because I knew I had her milk to rely on and that took off all the pressure I had put on myself.  I didn't even need to use her milk until I had to go out of town for a week for work when my daughter was 8 months old. This time she donated 300oz. My daughter drank and lived happily off of her milk while I was across the country and when I came back she latched right back onto me and we've been nursing beautifully ever since.  Now at 9 1/2 months she's still sucking strong and we'll continue to support breastfeeding and milk sharing :)

Also, my friend now feeds two other families who's children are exclusively drinking her milk (no solids yet), as well as her own six month old son, WHAT A ROCKSTAR!!!