All Things Breastfeeding Podcast

Great question! Basically it means getting breastmilk out of a lactation breast without a baby or a breast pump. At The Breastfeeding Center of Ann Arbor, hand expression is a typical tool we review with most of our families because you never know when you might get caught with no baby, no pump, and a full breast! Literally a life saver. Practice does make perfect with hand expression.

We have a brand new podcast about this! Enjoy here!

Here are just a few reasons you might want to hand express. Listen to our podcast to here many more!  The first is the day or two after the baby is born. If the baby is having trouble with latching, the hospital staff are concerned about the baby for a medical reason and want to supplement, or not the baby is not draining your breasts well, doing hand expression in the first hour after birth, right into a clean teaspoon, is a great way to help keep your baby fed and protect your breastmilk supply.

Another reason is to help entice the baby to latch. A little hand expressing before latching gets the breastmilk right there, at the end of your nipple for your baby to taste. Some hand expressing after pumping to help finish draining the breast when increasing or protecting your milk supply is also a great use. Having a preterm or a baby in the NICU is a great time to get going immediately with hand expression while the hospital staff gets you set up with a breast pump.

There are so many different ways to hand express. One of our very favorites was created by Maya Bolman, IBCLC from her experiences in Russia where hand expression is very common. Here is a link to her video. It is also great for engorgement or any time you have a really full breast. Don’t worry if this method is not for you. There are others listed below to try. Whatever method you use hand expression should not hurt! Be gentle with your body!

1. Have a clean container ready to catch the milk and wash your hands. If you are in a bind and don’t have a container, a sink will do in a pinch. A shame to waste the milk but better to protect your body!

2. Preparing the breast. Consider doing some gentle massaging before hand expressing. Research shows this and/or warmth before trying to hand express or pump for that matter increases the effectiveness of hand expression. Maya demonstrates a “tapping” on the breast which seems to be important. Spend a few minutes getting your breasts ready to be expressed. If your skin feels tight or fragile, consider using a bit of olive or coconut oil on your hands for comfort.

3. Maya has families place their hands close to the nipple. Think about where a baby latches on. Not way back in the breast. We like to think of lining up the finger tips with the nipple. Finger tip, nipple, finger tip. See the photo.

4. Push the fingertips together gently. Release. Bring together. Release. It may take 10-30 of these gentle squeezes before milk appears. Don’t get discouraged! If milk is not coming yet. Just go back to step one. Breathe deeply and try to relax. This will help as well. If the milk is still not coming try going a little closer to the nipple or a bit further away from the nipple. Put your fingers in a different spot.

5. Alternative hand expressing with tapping and massaging until your breasts feel comfortable.

Another popular hand expression technique is from Jane Morton. Here is a link to her video.

1. Again, Jane encourages some gentle massaging before beginning to hand express.

2. Having a bigger handful of breast might be helpful, still having the nipple centered.

3. Having families, gently push back in their breast, bring their fingers together, and release, Jane’s method can be effective. We encourage you to give 10-30 of these gentle squeezes before getting frustrated.

4. If the milk is not flowing yet, do some more massaging, shift your hands a bit, and try again.

Here are some other examples of hand expression. Everyone does it a bit differently!

Great one! Global Health Media

A modified version of Jane Morton’s technique

Another version of Jane Morton’s technique

Another example

The post All Things Breastfeeding 68: The Beauty of Hand Expression appeared first on The Breastfeeding Center of Ann Arbor.

Our nipple shield survey is discussed in this podcast. We had a whopping 4500 families and 500 lactation professionals fill out the survey! We got so much interesting information from this survey. Of course there are some limitations from the information we gathered. First of all, this survey was only distributed from Facebook. I put an announcement on my Facebook page, two professional pages, and three colleague’s Facebook pages. This means our reach went as far and our reach! Secondly, people who are viewing these pages are people who are pretty serious about breastfeeding to be looking at this pages.

Some of the things we found surprised us! One of the most surprising pieces of information was that many families use nipple shields far longer than the professionals who completed our survey imagined. Quite a few families used a nipple shield for over a year. The longest professionals thought nipple shields would be used was a few months at the most. More than 10% of our families used nipple shields for over a year. No professionals thought families used them for this long.

One of the things that was discovered, and this was no surprise, is that nipple shields are given out to frequently and many families have a negative experience with them. We found that families were being given a nipple shield in the first day or two of the baby’s life! We know this is not optimal. There are no clear standards as to when and how to use this tool for lactation professionals. This lack of standards is hurting families and causing professionals to be confused.

We also found there was a lack of confirming the nipple shield was an appropriate tool (doing pre and post weights, making sure the size of the nipple shield was optimal for families, assessing for improved comfort) and then follow up care to help families wean off of the nipple shield. This lack of follow up seemed to have causes many of the issues families had with nipple shield use.

This survey reiterated the need for standards for the use of nipple shields. Professionals need clear guidelines as to when using a nipple shield might be an appropriate intervention, how to teach families how to use it, and how to wean off of the nipple shield. Follow up care is crucial for any intervention but it appears it is critical for use.

It was clear that nipple shields “save breastfeeding relationships”. This was a predominant theme throughout our survey results. Viewing these as a transitional tools (as I say, like training wheels on a bike!) that families should out grow. In the future, hopefully standards will be created for professionals so this tool can be used more effectively for shorter periods of time. However, if you are using a nipple shield, having an IBCLC help you will greatly increase your odds of breastfeeding success.

The post All Things Breastfeeding 52: Nipple Shield Survey Results! appeared first on The Breastfeeding Center of Ann Arbor.

Really, this is true! Yes, in this podcast Barbara and Jessica talk about how breastmilk changes over time. It is really quite amazing! Many health care providers tell families there is no nutritional value for babies from breastmilk after one year. Like it turns into water! Breastmilk is a living, dynamic fluid that works in real time to protect babies with the optimal nutrition.

Your breastmilk is perfect! Full of ready to utilize goodness. Designed perfectly to help the baby’s body shift from intrauterine feedings to oral feedings. Colostrum comes in small amount loaded with immune protection for your baby. These small amounts also help the baby’s metabolic system establish itself. There are also things in breastmilk that help the newborns gut to keep out pathogens.

As the baby gets older the breastmilk supply increases to about 25-30ish oz per 24 hours. This amount doesn’t need to keep increasing over time because the baby’s growth slows so they don’t need more calories as they get bigger for the first six months or so. Of course, at around six months we do add solids to make up for those needed calories. You can influence the quality of your breastmilk as well. Having plenty of good fats and Vitamin D in your diet transfers to your breastmilk! Your good nutrition helps make more nutritious milk for your baby! You can take care of both of you by eating well.

Breastmilk immune protect revs up again as the baby start to really move and is putting everything is their mouths! Thank goodness for this protection! We like to think of breastmilk as the perfect protein shake or vitamin a baby could have after a year. Remember, at all times when a baby is expose to illnesses their saliva tells mothers what antibodies to make to protect them! Customized! To find out more about older babies and nursing listen to our podcast! We talk about all of the benefits of nursing older babies, social emotional benefits as well as nutritional benefits.

6 Magical ways that breastmilk changes to meet your baby’s needs

Breastmilk composition is Dynamic: Infant feeds, mother responds

Human milk composition: Nutrients and Bioactive factors

And of course one of our favorites:

Frequently Asked Questions about Milk Production

The post All Things Breastfeeding 51: Breastmilk Changes Over Time appeared first on The Breastfeeding Center of Ann Arbor.

Most women in the USA want to breastfeed yet many of these women don’t reach their breastfeeding goals which is often defined as “breast feeding failure”. In some states, as many as 90% or more of families initiate breastfeeding. These states tend to be on the east and west coasts of our country. The lowest number of mothers who start out breastfeeding is Mississippi which has an initiation rate of 63.2%. But still, these numbers are high! Why aren’t we seeing breastfeeding everywhere? This podcast is about all the reasons we are struggling with this “natural” process.

First of all, I hate the term “breast feeding failure” which is commonly used by the medical profession. However, failure implies that if you just try hard enough, you can do it! For breastfeeding, trying harder is not the answer. The odds are stacked against you. It is like if a normal person tried to ride one of those mechanical bulls and expected to stay on. Sure, some people have experience and can do it and some people have some internal natural untapped skills that make them a natural, but most of us would need practice and coaching to even have a chance.

People talk about breastfeeding as being the easiest thing they have ever done and then you have a large group of people who say breastfeeding was the hardest thing they have ever done and then another group who didn’t beat the odds. How can this be? The easiest and the hardest? I think we all believe we are going to fall into the earth mother super easy group of breastfeeders. That it will come naturally.

Maybe. But maybe not.

The bottom line is that getting help and support is not something we are used to but with breastfeeding, and honestly everything (Who hasn’t needed some tennis lessons?), but I think we feel we should somehow be a natural at this and if not there is something wrong with us, not the system, not that we were set up for struggles.

This podcast is about all the ways that we are being set up for “breast feeding failure”. I got off on a rant and didn’t talk about solutions. The solution is to get help. And if the first person doesn’t give you the answers you need, get more help. The point is you don’t have to do this alone and again, most people need help!

Finally, for all those families who didn’t get the help you needed, my heart breaks for you. It was not your fault you didn’t reach your breastfeeding goals. You were set up from the start.

The post All Things Breastfeeding 50: You’re being set up for breast feeding failure appeared first on The Breastfeeding Center of Ann Arbor.

Didn’t we all decide that nursing in public was fine? Apparently not! There are still so many people who get their panties in a bunch when they see a family breastfeeding in public!

Jessica and Barbara discuss the latest study on nursing in public. This article concerns the images of women nursing in public and how they are almost always of a woman by herself, not in a social situation. This implies that woman SHOULD nurse alone, whether they are at home or out and about. Where are the images of women just living their lives and nursing out in public? Just part of the social norm?

In the past Barbara wrote a blog about working and breastfeeding and asked the question, is nursing in public dangerous?

The two of them also review an article, “Ten tips for breastfeeding in public” Here are their suggestions:

1. Know your legal rights

Barbara and Jessica also get real about their own experiences with nursing in public. Do people feel safe? What are the risks? Does the public have a mother’s best interests at heart.

Barbara could not find the photo of the woman nursing her baby in the town square (she’ll keep looking for it!) but here are some other images to check out.

The post All Things Breastfeeding Episode 49: Nursing in Public appeared first on The Breastfeeding Center of Ann Arbor.

Non-profit milk banking in the United States is rapidly growing! We have the Human Milk Banking Association of North America (HMBANA) here is the US, Mexico, and Canada. At this point we have 27 milk banks and 5 under development in North America. Milk banking was developed in 1985. These milk banks have donor screening, testing for bacteria, and pasteurize the donated breastmilk. Milk banking had a rough time in the 1980s when the HIV virus was emerging and it was not understood that the pasteurization destroyed the virus. Now, mother’s are screened for HIV and due the the Holder Pasteurization process, this virus is not found in banked human milk.

Non-profit milk banking is being used more and more in NICUs and hospitals for both preterm, fragile, or even term babies when their own mother’s milk is not available. Banked human milk is critical for helping to prevent NEC (Necrotizing Enterocolitis). This condition causes a babies gut to become infected and rot. It is incredibly expensive both monetarily and emotionally for families and hospitals. Providing banked human for little babies helps reduced NEC by 90% in many hospitals. We have a great podcast on this.

Globally, there are 560 milk banks actively milk banking as of 2018. The largest milk bank system in in Brazil. In 1980s, the Ministry of Health supported the development of milk banks as a strategy to improve child health by avoiding the use of formula. In 2016 there were 210 milk banks and 100 milk depots. This has improved the outcome of babies all throughout this country. Europe has 224 milk banks. In 2017 India has replaced milk bank with lactation management center to help focus on parents breastfeeding their own babies and that pasteurized donor milk is available if needed. Norway and Germany use mostly using raw human milk vs. pasteurized milk for their preterm babies.

The process of becoming a part of this milk banking movement involves:

1. Oral phone screening- Explain minimum donation, how old the milk can be, and shipping and handling

We have written about milk sharing. Check out our podcast and blog about this. Here are some resources on milk sharing:

Human Milk for Human Babies http://hm4hb.net/

Milk Share http://milkshare.forumotion.com/

Eats on Feets  http://www.eatsonfeets.org/

The post All Things Breastfeeding: All You Wanted to Know About Milk Banking with Kim Updegrove appeared first on The Breastfeeding Center of Ann Arbor.

What is D-MER? This is a condition that every family should be aware of, not because it is going to happen to you. It is actually quite rare. But because when it does happen to a breastfeeding family the mother can feel like she is going crazy. So please listen to this podcast so you can help other families!

D-MER stands for Dysphoric Milk Ejection Reflex. Let us explain. When a mother starts to breastfeed (or pump or hand express) she may feel a wave of emotion that is not pleasant. These feelings can come either right before, or during, her oxytocin surge, the let down. Most mothers feel a sense of peace, calm, or relaxation when they have an oxytocin surge. However, with D-MER she may feel despondency, anxiety, and/or aggression. For despondency, these feelings can range from a surge of mild sadness to extreme depression. For anxiety, a feeling of restlessness might come up or maybe panic or dread. Anger is the least likely of the three emotions and it again, it can present in a range from irritation to rage.

Sadly, there is not much to do about this rare condition but letting families know that what they are feeling is real and this can provide relief and validation! Knowing that this is a temporary condition is also helpful. These feeling usually last for a few seconds to a minute or two. This condition also tends to go away after a few months as the hormones settle down. Only very rarely does this continue beyond 3-4 months. Again, once mothers know what is gong on they often can ride out the waves and continue to successfully breastfeed.

If you or a family you know are experiencing such sadness, anxiety, or aggression that it seems at all out of control, please contact your health care provider right away. They may need to be educated about D-MER so be prepared to share this resource, a wonderful site created for women who suffer from this condition.

The post All Things Breastfeeding 48: D-MER appeared first on The Breastfeeding Center of Ann Arbor.

Breastfeeding and medications can cause a lot of confusion! Many mothers are told they cannot breastfeed while taking certain medications but this is often not true.

We will discuss how medications can possibly get into breastmilk, a process called diffusion, FYI, and what families can do if they have questions or concerns about medication usage.

Most medication are safe for breastfeeding. Some things to consider are whether a baby could take it. Many medications are given to babies safely so this is something to look for. Also, how is the medication taken? If it is through an intramuscular injection,  then it most likely doesn’t have much effect if orally consumed. Finally, can the medication even get into the breastmilk? If not, then the risk is greatly reduced. Please contact an IBCLC or your health care provider if you have any medication questions.

The great news is there is great information about breastfeeding and medications from some reliable resources.

First of all, Kellymom.com! Kelly is always a great source of information for families and professionals about breastfeeding and medication.

For another professional resource there is Lactmed.

In our office, we use Thomas Hale’s book, Medications and Mother’s Milk. This is an invaluable resource for us to be able to help our clients get the facts about the safety of breastfeeding and medications.

There is also the Infant Risk Center. This site has a lot of great information and you can call to ask specific questions.

Of course, don’t forget to contact your local IBCLC! Most have access to Medications and Mother’s Milk so they can look up a medication for you and read you what the recommendations are.

The post All Things Breastfeeding 47: Breastfeeding and Medications appeared first on The Breastfeeding Center of Ann Arbor.

Barbara and Jessica are busting breast feeding myths! What have you been told about breastfeeding? So many things! People have all kinds of thoughts and opinions.

Breast feeding myths come from many places. Family and friends have many old wives tales or assume that what happened to they must be going to happen to you, no matter how weird. Sadly, our health care providers can also harbor miss-information from past personal experience or out dated information.

The biggest source of breast feeding myths is, of course, the internet! So many lies out there so please be careful when surfing! Formula companies literally pay people to be voices on the internet that have just enough miss-information so something sounds reasonable but is actually the source of bits of information designed to sabotage your breastfeeding relationship.

In this episode we talk about foods, sore nipple self-diagnoses, what to do when you are getting started with breastfeeding, and more!

When looking for solid, reliable, information about breastfeeding go to kellymom.com or visit our pages on common problems. We have ones on pain, bottle feeding, low milk supply, when babies aren’t latching, and working and breastfeeding. Check them out.

Of course, when battling breast feeding myths, nothing can replace getting information in person from a well trained IBCLC. If you have breastfeeding questions or concerns this is going to be the best place for you to go to make sure you are getting the accurate medical information you need to move forward. Don’t hesitate to contact us!

Going to a local support group is also a great way to bust breast feeding myths. We offer a free weekly support group to help with this.

Let us know your “favorite” myth! We can record another episode and bust some more!

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What are the top 5 breast feeding concerns? Well, we have been busy bees figuring this out and helping to provide information to families! I have spent a lot of time and resources on marketing this past year trying to address the needs of my clients. This means a new website! I have created new sections on the website that address specific topics that many families have concerns about.

The top 5 breast feeding concerns we found are:

Milk supply worries:

Babies who won’t latch:

Bottle feeding help:

Breastfeeding at work:

Remember thought, nothing can replace the help of a well qualified IBCLC. Contact us if you are having breastfeeding problems.

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