Five Signs Your Baby Has A Good Latch

Updated September 21st 2021

How are you supposed to know if your baby has a good latch when the most common thing you hear about breastfeeding is that it can hurt? While it’s common to hear this because yes, some people do have painful experiences, breastfeeding should not hurt. There should never be a time where you’re tightening up your body, bringing your shoulders to your ears or holding your breath in anticipation of the latch.

More importantly than what a latch looks like is how it feels. I ask every parent I work with how the latch feels. The latch could look pretty good from the outside and meet some of the below criteria but if you’re in pain, or uncomfortable or it’s causing damage to your nipples, then it’s not a good latch and something needs to be adjusted.

A good latch should feel comfortable. You should feel a gentle tugging/pulling/stretching sensation. If you’re feeling anything other than that, the latch should be assessed by a professional. This includes compressing (nipple comes out squished) pinching or pain.

So, what can you look for to know whether or not your baby has a good latch?

1. You are not in any pain

Breastfeeding should not hurt. While it’s quite common to experience pain or hear horror stories of painful nursing, it means the latch could have been improved. Some slight discomfort and tenderness (similar to when you were pregnant) can be normal and temporary in the first week or two but pain should always be addressed. You should never feel like you need to tough it out or suck it up.

Breastfeeding can and should be a comfortable and enjoyable experience. Sometimes, it might hurt just on one side. In that case, it’s likely just how your body or your baby is positioned. Some simple adjustments such as reclining your body and turning your baby’s body completely towards yours can help.

2. You baby’s chin is touching your breast

Your baby’s chin should be touching your breast to help get a deep latch. While their chin is against the breast, their nose is free to breathe. This is important to ensure the coordination of “suck-swallow-breathe” and ensures the nipple reaches all the way to the back of the mouth.

Having your baby’s chin touching your breast should also create a pain free latch. When the latch is too shallow, the nipple is compressed against the hard palate making feeding quite uncomfortable. Another giveaway that the nipple is not far enough back into the baby’s mouth is if your nipples are coming out in a different shape than when they went in. Sometimes they look like a tube of lipstick where part of the tip is flattened. Misshapen nipples are one sign you should get breastfeeding support.

3. Their bottom lip flanges outwards

Their bottom lip should flange (or fold outwards) and the top lip is neutral or only slightly flanged. If the top lip or bottom is curling under (folding in on itself) this is a sign to have the latch evaluated by a lactation consultant.

A flanged bottom lip allows your baby to get a deeper latch by fully drawing the nipple all the way back to the soft palate. If the bottom lip does not flange outward, you can gently try and flip it outward while your baby is latched with the pinky finger of your free hand. If this won’t work and the latch is painful or your nipple is being compressed, unlatch your baby and try again. You can unlatch your baby by inserting the tip of your finger into the corner of their mouth to break the seal they have on the breast.

4. You can see or hear swallowing

When a baby has a good latch, they are able to transfer milk from the breast. This means, after sucking, they swallow. If they are latched shallow, your nipple will compress against their hard palate. Not only will this hurt, but it can also reduce the amount of milk they remove. If they are not removing much milk, they wouldn’t swallow as frequently and over time, it can reduce your milk production.

When a baby is drinking milk, their swallows sound like soft “kah” sounds. You can also see the swallows happening. Their jaw moves down and briefly pauses when the milk is being swallowed. Swallowing is also a clear sign they are getting milk.

5. Milk is not spilling from their mouth

If your baby has a good latch, their tongue and lips create a seal around the breast. This seal does not allow any milk to leak or spill from the corners of their mouth. If milk is spilling, it could mean their position needs to be adjusted slightly. Sometimes this could means your baby is having a hard time creating or maintaining a seal meaning the function of their tongue might need to be assessed. Sometimes due to weaker facial muscles milk spilling can also happen. This is why it’s an important sign to ask for help from a lactation consultant. If there’s no milk spilling or leaking, you are comfortable and the criteria above are met, there’s a good chance your baby has a good latch.

As mentioned above, when a baby has a good latch, they are drinking milk. When they drink enough milk each feeding, they feel content afterwards. Noticing your baby is more relaxed after a feeding is another good sign they are content. Falling asleep after a feeding (and after a period of actively swallowing milk) is another sign your baby is content after a feeding.

All that said, if your baby is content after a feeding BUT that feeding was causing you pain or discomfort, then the latch should still be evaluated by a lactation consultant.

A final word

You will always know your baby best. You should never doubt your instincts. If something doesn’t feel like it’s right, reach out for help. You can find a lactation consultant within your community or work with one from anywhere in the world, online. I do offer virtual consults.

If this was helpful but you need more, join my community and receive helpful tips, recipes, support and exclusive access to my online programs.

This is THE PLACE to be for all things breastfeeding

Get ready to dive into all thing lactation and breastfeeding and how you can achieve a confident experience!

We respect your email privacy

Taking Care of Your Nipples While Breastfeeding

Why does breastfeeding hurt sometimes and how to care for your nipples

Updated December 4th 2022

Let me start this by saying you do not need to toughen up your nipples or do anything to prepare them for breastfeeding. If your experience is anything like mine, you received unsolicited advice from well meaning friends and family as soon as you shared the news of your pregnancy. The advice might not have anything to do with your goals around how you want to feed your baby.

I didn’t grow up seeing other people breastfeed in my family. My mom breastfed my siblings and I for short periods of time. Her struggles included painful latches and mastitis. Ultimately, she didn’t have access to the support she needed. Others told me about their cracked nipples and to expect it to hurt.

While it’s common to experience some nipple pain or discomfort during the first few weeks breastfeeding, this does not mean it’s normal. It’s actually a myth that breastfeeding has to hurt. Breastfeeding should be pain free and comfortable. A comfortable latch feels like gentle tugging and/or pulling. Nipple pain is an indicator that there’s an issue that needs to be addressed. 

Breastfeeding, while a natural way to feed a baby, doesn’t always feel natural at first. It comes with a learning curve. It takes time for both you and your baby to get the hang of it. Think about it like driving a car or riding a bike. There was a time you didn’t know how to do this. Someone helped teach you and as you practiced and learned, you got the hang of it. Now, it’s second nature but it didn’t start out that way.

So why do some people experience pain?

As you’re working to practice the best latch, you might experience some nipple pain or tenderness along the way. Sometimes it’s a mild soreness or tenderness due to hormonal shifts. This usually fades with time provided there are no underlying issues. If you have any pain or discomfort whether mild or not, you should work with a lactation consultant.

The most common cause of pain I see, is from a shallow latch. When a baby latches to the breast they need to take in not only the nipple but some surrounding tissue as well. They use their tongue to draw it all the way to the back of their mouth, where their soft palate is. When the latch is shallow, the nipple is pressed against the hard palate which creates pain and can change the shape of your nipple immediately after a feeding. It may appear squished or compressed and be pointed or look similar to lipstick.

The shallow latch might be due to suboptimal positioning in which case it’s a quick fix. Sometimes the shallow latch is because your baby cannot get a deep latch. This is usually anatomical meaning their tongue mobility is impaired (although there are other causes). This requires an oral evaluation and feeding assessment. If you’re struggling to get a deep latch despite your best efforts, always work with a lactation consultant.

Another very common cause for early nipple pain is due to your breast pump. Specifically, the wrong size flange. This is why it’s important to have your flanges sized by a lactation consultant.

If your nipples do become cracked (which is common if you’re nursing a baby with a poor latch) you can take steps to support healing while you’re waiting to see a lactation consultant.

Should you buy a nipple cream?

If having a nipple cream makes you feel more confident about breastfeeding then please, use one. It’s important to use one that is food safe and therefore safe for your baby to ingest. Vaseline and petroleum jellies as well as mineral oil are petroleum bi-products and can irritate the skin and clog pores. Because of this, I strongly advise against these products.

Some nipple butters and creams also contain herbs and essential oils so it’s important to be mindful if you have very sensitive skin as this may cause a reaction. When too many creams or ointments are used on the nipples it can cause contact dermatitis for some. Contact dermatitis is itchy, red, inflamed skin on the breast, nipple and areola.

Your skin actually breathes and perspires through pores and this holds true for the sensitive skin of your areola and nipple. In addition, when something is placed on your skin, it’s rapidly absorbed into your skin. Another reason I don’t suggest petroleum bi-products.

What about lanolin?

Lanolin is another popular topical treatment. It is a thick ointment that comes from sheep raised for wool. Most parents I work with have already purchased this. Some parents have great success and for others, it does nothing to help with healing or pain.

There’s evidence that suggests lanolin is allergenic (can cause contact dermatitis) so it’s not my first choice for nipple care. The evidence also suggests it’s not that effective in healing damaged nipples.

Most nipple pain can be corrected by changing your baby’s latch and positioning. This does not mean all nipple pain can be corrected this way but this an important part of the puzzle. There are also those situations where the latch has been corrected but because of previous damage, your nipples are still very sore.

If at any point, the pain is too much or the damage is worsening, call a lactation consultant. You can pump or hand express to protect your supply and feed your baby with an alternative method such as cup feeding until you have your appointment.

What actually heals your nipples?

If you’re waiting to see a lactation consultant over nipple pain and need some relief in the meantime these are some of my favourites to use with clients.

Expressed breast milk. Human milk has properties that support wound healing. It protects against infection, it’s antiinflammatory and there’s evidence that demonstrates it works quickly. You can hand express a few drops directly onto your nipple and let it air dry as long as you don’t have deep open wounds. It won’t cause harm but healing a significant wound requires a different method (it shouldn’t be exposed) and a 1:1 assessment.

I also suggest the use of organic olive oil as it is antioxidant and antiinflammatory and it has some research to show it supports healing. It is also food safe so it’s ok to be left on your nipples. There’s no need to wipe it off before your baby feeds. Coconut oil has similar properties. There isn’t any clinical evidence that supports it use however, culturally, it’s used all over the world with similar results.

Another wonderful support for nipple healing is silver caps. Silverette caps are little caps to wear in between feedings over the nipple, in your bra. They are made of silver. Silver is naturally antimicrobial and there is research that demonstrates they can help heal damaged nipples. They are not meant to be used in conjunction with creams but rather, just worn on their own or with a little breastmilk.

TL;DR
  • Breastfeeding may not feel natural at first
  • Breastfeeding has a learning curve that everyone gets at their own pace
  • Your baby should draw the nipple all the way to the back of their mouth to create a comfortable latch
  • One of the most common reasons for nipple pain is a shallow latch
  • ANY pain is worth investigation with a lactation consultant
  • You don’t have to have different nipple creams and butters to successfully breastfeed but you can if it makes you feel confident
  • Anything that you do put on the sensitive skin of your nipple and areola should be food safe and allow your skin to breathe

If this was helpful but you’re wanting more…

I also have a private support community. It’s THE PLACE to be for all things breastfeeding support and postpartum.

It’s free to join. We’d love to have you!

JOIN THE FACEBOOK GROUP HERE

References:

Campbell, S.H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core Curriculum for interdisciplinary lactation care. Jones & Bartlett Learning.

Newman, J. & Pitman, T. (2014). Dr. Jack Newman’s Guide to Breastfeeding. HarperCollins Publishers Ltd.

Breastmilk Freezer Stash: Why you don’t have to have one

Or why you don’t have to have one as large as you think!

Updated April 2nd 2022

When I gave birth to my son and started breastfeeding, I felt like I was supposed to be storing milk. No one explicitly told me to do this. I just thought it was something you did. I saw other moms on social media storing loads of breastmilk in the freezer. So I thought I needed to be doing that to.

The problem though, was that my son was tongue tied and it was creating a low supply. I was pumping on top of feeding at the breast and my son was drinking it all! PLUS we needed to supplement with formula until my supply increased. Because of this, there was no way I was going to be able to save any milk. If you want to know how I turned my supply around, keeping reading.

My reality was though, I was going to be home for the next 50 weeks as I live in Canada so there really wasn’t a urgent back-to-work need for me to store milk. I did however feel societal pressures (largely from social media) and let’s be honest, a lack of proper prenatal education.

Having a freezer stash seems to be something on every new parents mind. I work with many parents who ask about freezer stashes in our first consult which is usually in the first 3 weeks after delivery even when these parents live in Canada with long maternity leaves.

Even if you’re returning to work quickly (to anyone in the US or anywhere with a short maternity leave) you still don’t need a huge stash⁣. You may be thinking there’s no way this applies to you and that you do in fact need a large supply in the freezer but I’m going to share with you why you may need less than you think.

Creating the stash

In order to create a freezer stash in the first place, and keep your baby exclusively breastmilk fed, you have to have an oversupply. Between 1-6 months old, a breastfed baby consumes an average of 3-5 oz each feeding. That’s it assuming they are eating 8-12 times in 24 hours. The volume does not need to go up because your body is constantly changing the nutritional composition! This averages to around 25-30 oz per 24 hours. To store milk on top of this, you need to be producing more than this number.

This would require pumping on top of feeding at the breast to tell your body to make more milk. This means washing, sterilizing and drying pump parts as well as bottles. In addition you may also need to be warming milk before feedings. You might be realizing at this point how much extra work it is to store milk on top of exclusively breastfeeding your baby.

That doesn’t mean you can’t do it, I just want to you think about your situation to help determine if you really need a freezer stash.

But what about the haakaa?

If you don’t know what the heck I’m talking about, that’s ok! The Haakaa is a brand name of a silicone pump. It can be used while your baby is feeding often for the purpose of collecting the milk let-down on the opposite side. While in theory, it sounds like a great way to collect milk for storage, I need to caution around this type of use. If there are concerns over your supply or your baby’s weight gain, the Haakaa (or other silicone pump) should not be used while your baby is feeding.

Because it is still a pump, there is a continuous suction that can remove beyond just the initial let-down. When the time comes for baby to feed on that side, you have now removed milk they need to eat to grow. If this milk is going into storage and not going back to baby, it can impact their weight gain. There’s some more info about this kind of pump here. It’s use, just like anything else related to your feeding journey should be individualized.

Creating a stash for back to work

Now, if you are returning to work after a short period of time (such as a few months) I highly recommend working with a lactation consultant. Ideally you’d want to work with them 2-4 weeks before returning to work to create a plan for collecting milk. Once you have 1-2 days worth stored, the pumping you’ll do away from your baby provides milk for the next day. I want to point out the 1-2 days worth is not 50-60oz because you’re still going to breastfeed your baby when you’re with them. The stored milk is to be used by the care provider while you’re away from your baby during the day. This could be 8-12 oz per day (keep reading to find out why).

And just like that, you don’t need to have 50oz in the freezer before returning to work! I hope you’re already feeling less anxious about creating a large supply.

⁣Tips & things to consider when creating a freezer stash: ⁣

If you’re returning to work or spending a long day away from your baby, you should plan for 1-1.5oz for every hour baby is away from you. So, for an 8 hour work day that’s anywhere from 8-12 oz which could be 2-4 feedings depending on your baby. This means you may only need to collect an extra 3-4 ounces (or one feeding) per day as you build your storage supply.

It’s helpful to freeze in 2-4 ounce portions as well as 1oz portions. Just like adults, a baby’s appetite is not the same day to day. Some feedings they’ll drink more than others. Rather than always freezing 4 oz and possibly having to (gasp!) throw some away, storing in smaller portions will reduce any waste.

The logistics:

In order to maximize and make the most of the milk you collect, consider thinking about the following questions:

Can you breastfeed your baby when you drop them off with the caregiver?

Can you breastfeed upon pick up?

Are you close enough to go breastfeed on your lunch?

Being able to do any one of these things would reduce the amount of milk you have to leave. Reducing the amount of milk you have to leave, reduces how much extra to have to pump and store.

The care provider should use paced bottle feeding to avoid over feeding. I hear many stories of parents who receive phone calls that their baby ate everything that was sent and to please send more. For a demo of what paced feeding looks like, check out my instagram reel below.

⁣If you live in a country where you have a longer maternity and parental leave, the longer you’re with your baby, the less need for a large freezer supply⁣.

But what if something “happens” ?

I hear this from parents all the time. They want milk “incase something happens”. In case something happens means different things to different people. If you’re having surgery for example, most medications are compatible with breastfeeding and once you’re alert after general anesthesia, you can safely breastfeed.

If you get sick, have a cold or are feeling under the weather you can safely continue to breastfeed your baby. Your body actually would have begun producing antibodies for your baby long before you even felt symptoms. You’ll feel rundown so I always encourage as much rest as possibly and drink plenty of fluids but there’s no need to have to have a supply in the freezer for a situation like this one.

If you’re still thinking about how this post started out and wondering what I did to increase my supply, you can get all the tools and techniques I used HERE.

I hope you’re feeling much less anxious now about having to pump and store large volumes of milk. Focus on feeding your baby first, not the freezer and work with a professional when it does come time to head back to work or be separated from your baby.

Need more tips like this?

Then join my free VIP community

This is THE PLACE to be for all things breastfeeding and postpartum. Join our community and receive helpful tips, recipes, support and exclusive access to our online programs. Get ready to dive into all things postpartum and breastfeeding and how you can achieve a confident feeding experience!

We respect your email privacy

References:

Campbell, S.H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core Curriculum for interdisciplinary lactation care. Jones & Bartlett Learning.

Newman, J. & Pitman, T. (2014). Dr. Jack Newman’s Guide to Breastfeeding. HarperCollins Publishers Ltd.

14 Tips for Breastfeeding in the First 14 days

Updated December 4th 2022

Breastfeeding can be completely unexpected. I encourage you to prepare in advance but you may still end up surprised by changes in your body or your baby’s behaviour. You may also come across unexpected challenges.

This is why I put together my top 14 tips for breastfeeding in the first 14 days. These are based on what I teach my clients and what I did personally (or wish I did!).

Don’t worry about schedules or routines in the early weeks. Newborn life is often unpredictable, just when you think you’ve figured them out, they reach a new milestone and change things up. Try to surrender and go with the flow, especially during the first few weeks. If you need a routine to thrive, try keeping some of the same activities daily.

These tips will help set you up for breastfeeding success.

Set up a breastfeeding station

A breastfeeding station can makes things so much easier and help facilitate a lot of these other tips. My recommendation is to have a “breastfeeding station” or a wheelaway cart that you can fill with a water bottle, healthy snacks and anything else you need while feeding your little one(s). It could be filled with wipes, burp cloths, a few diapers, cream and a onesie or two. You could also include breast pads, your pumps/extra flanges and a phone charger. Maybe you have some hair ties or headbands included to keep your hair out of the way. If you’re using a nipple cream add it to this cart.

No visitors

Setting boundaries for visitors or denying visitors is completely OK and can be very supportive for breastfeeding. This ensures you are always with your baby. This will help facilitate lots of skin to skin contact and help you learn their early hunger cues.

It can also reduce your stress levels. You don’t have to worry about anyone being around the baby or feeling like you need to be doing anything for these people especially if they are in your home.

Skin to skin

Spending time skin to skin means having your baby in a diaper on your bare chest. You can wear a bathrobe and just open it or be completely shirtless. Whatever you choose, you should be undressed from the waist up. Your baby should be in just a diaper. If it’s a little cool you can keep a light blanket over you both, making sure not to cover your baby’s head. 

Enjoying time skin-to-skin with your baby releases oxytocin which is the hormone that helps your milk let-down. In addition, this provides comfort and a safe space for your little one. Skin to skin helps regulate your baby’s body temperature and reduces stress in both your baby and you. A lower level of stress helps support milk production. Your baby is biologically wired to want to be close to you.  

You can also do skin to skin in a warm bath. This is another great environment to breastfeed your baby. Allow any attempt or opportunity your baby takes to breastfeed during skin to skin.

Rest

It’s important to rest after birth. Your body just went through an athletic event and you may have also had major abdominal surgery (a caesarean birth is major surgery). You shouldn’t be trying to do anything besides resting and caring for your baby.

Plan ahead to have friends or family arrange a meal train for you. A general guideline that I love for postpartum is the 5-5-5 rule. Spend 5 days in the bed, 5 days on the bed and 5 days near the bed. This means you’re not cleaning, cooking, washing dishes etc. You are literally in bed, feeding your baby and spending time skin to skin with them. You can make trips to the bathroom (of course!) but there shouldn’t be anything on your to do list.

The second set of 5 days is about resting and napping when you can. You can move into a different room or spend some time on the couch but you shouldn’t be trying to go out with your baby. The last 5 days near the bed is still about resting and not doing much. You are still focusing on skin to skin, breastfeeding and rest but maybe now you’re moving around the house a little more. The chores should be left to someone else.

Laid Back Breastfeeding

Make sure you are relaxed and in a comfortable position. I work with parents all the time who are breastfeeding in very uncomfortable positions putting unnecessary tension on their neck, shoulders and back. If you ever feel awkward holding your baby to nurse, switch it up and try a new position. Use as many or as little pillows as you need. Sometimes larger breasts need pillows or rolled towels for support. Do whatever works to make yourself comfortable. I often recommend the laid back position for a comfortable latch.

This position uses gravity to keep your baby on your body and stimulates their natural instincts to breastfeed. It pairs beautifully with skin to skin.

I also cover this position as well as many others inside my self study prenatal breastfeeding course called The Breastfeeding Before Baby Program.

Hydrate

Breastfeeding makes you thirsty! This is due to the hormone oxytocin which is released when your baby begins suckling. Drink to thirst. Keeping a water bottle on your breastfeeding station or a couple around the house will help. Enlist your partners help (or the help of a close friend or family member) to help keep them full for you. Each time you nurse, take a drink. Keeping hydrated is important.

Eat

Your hunger increases while breastfeeding. The average amount of calories required for milk production ranges from an extra 450-600 per day! It’s important to eat. It’s not the time to cut calories. Despite what you may have heard, there’s almost no foods that are off limits while breastfeeding. Instead of worrying about what kind of food you’re eating, focus more on replacing any junk with whole foods. Foods that are full of protein, fibre, and fat will help fill you up and keep your blood sugar steady. Whole foods (like veggies, fruits, whole grains, legumes, meats) are also great sources of vitamins and minerals your body needs for breastfeeding and repair after childbirth.

I love creating balanced smoothies because they are easy and can be consumed one-handed while breastfeeding. Here’s a recipe for a filling smoothie and here’s a breakfast cookie recipe I created.

Feed on demand

Your baby is experiencing hunger for the very first time. They had 24/7 access to nutrition via the umbilical cord in utero. It’s normal for them to want to feed every 1-3 hours. Often, it’s on the lower end of that.

Newborns eat frequently and the best thing you can do for your milk supply and breastfeeding is to feed them on demand. This is known as responsive feeding and essentially, is feeding your infant whenever they cue they are hungry.

These early hungry cues include your baby starting to open their mouth and smacking their lips. Your baby will begin rooting and turning their head. They will begin to increase their movement (arms and hands moving) and start to become more vocal to eventual crying if they are very hungry. Crying is a late sign of hunger. It’s actually a distress signal and it can make for a very frustrating and difficult time trying to latch them. You baby will need to be calmed first before trying to latch them.

No swaddle or scratch mitts while breastfeeding

Newborns need their hands to breastfeed. Their hands help them get organized and find the nipple. They also help by kneading the breast to assist with a let-down. When a newborn’s hands are covered at the breast, it can make latching and feeding more difficult.

The same goes for when a newborn is swaddled at the breast. To get a deep, comfortable latch, your baby needs to be very close to your body. In fact, they should be touching your body. A swaddle prevents them from being able to be optimally positioned for a good latch and effective milk removal. You can’t do skin to skin if your baby is swaddled.

The swaddle and scratch mittens should be removed at every feeding.

Learn how to hand express

Hand expression is a valuable skill for all lactating parents to have. It is not cost prohibitive because all you need is your hands! It’s been shown that hand expression increases breastfeeding rates when compared to pumping at 2 months postpartum.

Hand expression is useful in the first 24 hours after birth as it can help assist with the transition from colostrum to copious milk production and assist with colostrum collection. Hand expression is a valuable collection method even for someone with a pump because colostrum can get stuck in the tubing of a pump due to the small volume that is produced and it’s thick consistency.

To learn more about hand expression and how to perform this technique, click here. I wrote an entire blog post dedicated to the subject.

Have your pump flanges properly sized

Incorrectly fitting flanges can cause damage, make pumping hurt and negatively affect milk supply.

The flanges, also called breast shields, are the piece of the pump that actually goes on to your body. Your nipple should sit centered in the flange prior to starting the pump. It’s also important the pump flange is appropriately sized. Flanges are available in a variety of sizes. The difference between them being the diameter. Every body is different. The flanges that came with your pump may not be the ones that fit you. It’s best to measure the diameter of your nipple, add 1-2mm and purchase the flange size according to that new number or an insert to size down your flange. Your nipple should not rub on the sides of the flange. If your areola is pulled into the flange or you see an air gap between the flange and your breast, the flange is too large.

For more information about your breast pump and the parts click here.

Use expressed milk to heal your nipples

Your own milk can be used to treat sore or damaged nipples. It’s a natural remedy to promote healing. I’ve seen it happen very quickly.

You can hand express a few drops right onto your nipple and allow it to air dry.

If you have deep cracks or open wounds, this method is not sufficient enough to heal them. It would also indicate something about the latch isn’t quite right. Connect with a lactation professional in this situation. Click on ‘book now’ under my services tab.

Prepare for safe sleep

Even if you’re not planning to co-sleep, prepare for safe sleep. It’s easy to fall asleep on the couch or in a chair with your baby and these are dangerous sleep environments.

It’s biologically normal for your baby to want to be held. It’s normal if they cry when you set them down. You are their safe space. They want to be close to you. Setting up a safe sleep space will help facilitate this as well as allow you both to safely get some sleep.

This means no pillows or blankets on the bed. No gaps around the bed that your baby could fall into. Your baby also cannot be swaddled.

Read more about preparing for safe sleep here.

Call a lactation consultant

It’s a good idea not to wait until you’re facing a challenge to call a lactation consultant. Many challenges and obstacles can be prevented when you’re informed about what to expect and you are supported in your decisions.

To recap…
  1. Set up a breastfeeding station
  2. No visitors right away
  3. Skin to skin
  4. Rest
  5. Laid back breastfeeding
  6. Hydrate
  7. Eat
  8. Feed on demand
  9. No swaddle or scratch mitts
  10. Learn to hand express
  11. Have your pump flanges sized correctly
  12. Use expressed milk to heal your nipples (unless they have open wounds)
  13. Prepare for safe sleep
  14. Call a lactation consultant

Join My Community!

Connect with other moms inside my free Facebook Support Group called Breastfeeding Mavens. It’s a great community of parents supporting each other. You’ll also receive support from me as well as early access to workshops on all things breastfeeding!

Click to Join

To learn more about The Breastfeeding Before Baby Program, click the button below

An IBCLC’s Guide to Packing Your Hospital Bag

Updated January 7th 2023

When I was pregnant and it came time to pack my hospital bag, I really wasn’t sure what to bring. I was delivering my baby at our midwife clinic. They had a beautiful birthing suite there that included a fridge for drinks and snacks.

I knew I needed a diaper and clothes to bring my baby home in. I knew I needed something comfy to wear on the ride home as we were only staying about 3 hours after delivery (very standard for a clinic delivery with midwives).

I knew I needed my phone and a charger so we could keep our families updated. We also had a playlist for labouring with relaxing spa-type music. I figured I should pack some underwear and postpartum pads (which I didn’t use because I went home in a diaper) but that’s really all I had on my list.

I didn’t have a hard copy of a birth plan because I thoroughly discussed my options with my midwives and made informed decisions prior to labour starting. They knew what my birth preferences were and so did my husband. If something were to “stray” from the “plan” they knew what my preferences would be. If you do have a formal birth plan, do bring a few copies with you.

I thought about it some more and after chatting with the midwives…

I packed a few more things. Because I had access to a fridge and was freely going to be able to walk around, move and eat during labour if needed, I packed coconut water and lots of organic juice boxes. The coconut water and juice boxes were to hydrate me and provide my body the quick energy I needed to get through labour. I also packed snacks to eat after birth. I packed allergen friendly granola bars (and ate the whole box of 6!)

I bought a nightgown specifically for this event. I did not previously own one but my midwives suggested one. They suggested one because they do not provide hospital gowns and not everyone labours naked. I thought for sure I would wear this nightgown. Long story short, I laboured in it for a little while but when I had the option of hydrotherapy (water to manage labour pains) I had to take it off. From that point on it stayed off and I laboured and delivered naked. The exact opposite of what I thought I would do.

I packed organic olive oil for perineal massage. This was encouraged by my midwives and we never ended up using it! I didn’t end up with any tearing so I didn’t need it after all but it was nice to have.

I packed organic cotton breast pads. I didn’t need these because I was heading home 3 hours after birth but if you will be staying longer, these will be especially helpful when your milk volume starts to increase around day 3-5. Again, because I wasn’t staying long toiletries weren’t really needed but I definitely suggest packing some if your stay will be longer than 3 hours. Think toothbrush, toothpaste, soap, deodorant (although I do prefer not wearing any immediately postpartum to allow baby to get used to and comfortable with your natural scent), makeup if that sparks joy for you. Hair elastics if you have long hair or a headband and a brush or comb.

For a longer stay I would suggest socks and slippers as well as a nursing bra/tank top and any additional clothing and underwear you or your partner may need.

What do you need to pack for breastfeeding?

I love answering this question and this is one of the questions that prompted this entire post. Essentially, YOU! That’s it. Honestly. Your body has been making milk since the second trimester. It’s called colostrum and is very thick and sticky. It might be clear in colour or it might be a deep, golden-yellow. It’s only produced in small drops because that’s all your baby needs at first.

Colostrum is THE PERFECT food for your baby and your body has it ready to go as soon as baby is in your arms.

Practicing the skin to skin immediately after birth and allowing your baby to find the breast themselves (this is called the breast crawl) will help get breastfeeding off to a strong start. Hand expression is another skill you can learn to help maximize your success. You can get a head start on reaching your breastfeeding goals inside The Breastfeeding Before Baby Program.

In addition to the above, you may want to consider the following popular items as some can be left at home.

Breast pads

As mentioned above if you’re staying a few days (and sometimes you won’t know this ahead of time) breast pads will be helpful. When colostrum transitions and your milk volume rapidly increases, your breasts might leak. This is when breast pads can be great to have.

Nipple cream

I am asked all the time about nipple cream. I always go back to the research. Evidence shows us that if a baby is latched well (deeply) breastfeeding should not hurt. Mild tenderness or soreness is to be expected in the first few weeks but you should never be in pain. If you’re in a lot of pain, or your nipples are cracked or damaged, you need the support of a lactation professional.

While nipple creams are marketed to support nipple damage, the evidence for healing is weak. Hand expressing your own milk into your nipple is actually more effective at healing damaged and sore nipples. Your body also has a built in feature to help your baby find the nipple. The montgomery glands (bumps on the dark part around your nipple) secrete an oily substance that protects the nipple and smells like amniotic fluid. If you choose to bring a nipple cream, it should be unscented.

I believe you should feel confident. If having a nipple cream packed makes you feel confident, please bring one.

Breastfeeding Pillow

My first suggestion is always laid-back breastfeeding. If you deliver via c-section, you may want to sit up to feed in which case a breastfeeding pillow may be helpful to have. You also don’t need a pillow specifically for breastfeeding, you can use any kind of pillow to provide your body and your baby a little extra support.

Pacifier

This is not something you need to bring to the hospital most of the time. I say most of the time because premature infants as well those born before 39 weeks don’t quite have the suck-swallow-breathe pattern of breastfeeding figured out. These babies benefit from a pacifier. For a typical healthy full term infant, pacifier introduction should be delayed until breastfeeding is well established (which can take several weeks).

Formula

The Academy of Breastfeeding Medicine indicates formula supplementation should only happen after birth if medically indicated. As you read, your body started making milk for your baby in the second trimester. Colostrum is there. It might be clear (for some) but it’s there and it’s all your baby needs. Hand expressing will help colostrum transition to mature milk faster and is a great skill to have. You can perform hand expression in between feedings and collect the milk onto a clean spoon to feed back to your baby. You do not need to pack ready made formula in your hospital bag.

  • Diaper (for you and baby)
  • Baby wipes
  • Diaper cream
  • Couple of onesies
  • Outer layer depending on the season
  • Comfy clothes to wear home (track pants NOT jeans)
  • Slippers
  • Underwear
  • Postpartum pads
  • Peri bottle
  • Chapstick
  • Phone
  • Phone charger (a long cord!)
  • Nightgown/robe
  • Snacks and water
  • Olive oil
  • Breast pads
  • Nipple cream
  • Toiletries
    • Toothbrush
    • Toothpaste
    • Deodorant
    • Makeup
    • Soap/shampoo/conditioner/cleanser etc (depends on your stay)
  • Hair elastics/headband
  • Brush or comb
  • Nursing bra or nursing tank top
  • Health cards/insurance
  • Any medications
  • Birth plan

And make sure your partner is included too with a change of clothes and some toiletries.

Get this packing list sent straight to your inbox with my Postpartum Prep Guide

With my second pregnancy, I opted for one of Healing Mama™ Co Labour and Postpartum Recovery Bags. Healing Mama™ Co was founded by a new mom after she had a difficult time finding what she truly needed after birth to help her recover. The founder is on a mission to change the birth and postpartum experience for the better.

Their labour and postpartum bags are a must-have for childbirth and postpartum care. The founder walked me through everything that comes in a bag and literally, everything you need (and then some!) is in there. They also offer a c-section birth bag.

Healing Mama™Co has generously offered my community a 10% discount on all of their products using the affiliate code: motherhoodbloomshealing at checkout. There’s no expiry on this coupon code.

Need a supportive community of other parents who are breastfeeding? You’ll be able to connect with like-minded parents, receive support from me and get access to exclusive trainings on all things breastfeeding!
Join My Free Community!

Click here to join the Facebook group

What You Need to Know About Your Breast Pump

So you bought the pump, opened up the box, took a look at the manual and all those pieces and put it away. I get it. It can be overwhelming wondering how to put a pump together and sort out how it works. Or maybe you’re using a pump but wondering if you need to replace any of the pumps parts.

You might have purchased your pump before the birth of your baby or it might have been after you started working with a lactation consultant. Regardless of timing, you should understand how all the pieces fit together for optimal function, how to clean it and when to replace the pump parts. I will break it down piece by piece (pun-intended) so you have a clear understanding of the role each piece has because there are a lot!

Anatomy of a breast pump

When you buy a pump, it does not come assembled. All the pieces are separate with instructions how to put them together. The parts you’ll find in that box include:

  • Flanges (sometimes called breast shields)
  • Connectors (may or may not be required depending on brand)
  • Valves (duckbill or offset; depends on pump)
  • Membranes (may or may not be a part of the valve)
  • Back flow protectors (may or may not be required depending on brand)
  • Tubing (electric pumps have tubing)
  • Collection bottles
  • Collection bottle lids

All of these parts including their function and how often they need to be replaced are covered in much more detail below.

Before we dive into the details, what is a breast pump?

A breast pump is either a manual, electric or battery operated pump designed to remove milk from the breast. It works by stimulating the nipples and generating suction to remove milk and collect it in a collection container.

Hand Pump a.k.a Manual Pump

This is a pump that needs to be operated with your hand. You continuously squeeze a lever which generates the suction. These pumps are inexpensive when compared to electric or wireless pumps. Hand pumps are also a great option if you do not need to pump frequently. Another bonus is they do not require electricity you so can use them anywhere. The downside is that it’s a little more work for you as your hands are not free.

Single Electric

This pump would be an example of the graphic above. It’s an electric pump with just one flange. The upside is that because it’s electric, you can play with the settings to find what’s most comfortable and supports milk production. You also have the option of buying a pumping bra to be able to use this pump without having to hold it against your body the entire time. In the case of single mastectomies, a single electric pump can be a good choice.

The downside is that it will just take more time to pump if you need to pump both breasts.

Double Electric

This pump would also be an example of the graphic above. Electric pumps (even singles) are more costly than a hand pump. Double electric pumps can run several hundred dollars. This brings up the question of whether or not your breast pump will be covered by insurance. In the US, breast pumps are usually covered by insurance. Here in Canada, it depends. I have worked with parents that have been able to have their breast pump covered by extended health benefits. You won’t know until you ask. Check with your current benefits provider and see if reimbursement is covered under your plan. If it is, save your receipt. They will not cover a used pump, it will have to be purchase brand new.

Wearable/wireless/cordless/pump

These are some of the next generation pumps that you can wear right inside a nursing bra. They are often very quiet and great for on-the-go pumping. They even come with an app that allows you to track estimated milk volumes. For some these can be a great back to work option as you can freely pump while driving if ever needed.

Just like double electric, these pumps are also quite expensive. Because of the way they are designed, they are not meant for frequent pumping. They are also not a good option if you’re pumping to increase milk production. A double electric is more ideally suited in that situation.

Wearable pumps also do not allow you to see your nipple inside the flange. This can sometimes lead to nipple damage if you don’t first correctly line up your nipple with the arrow on the pump.

Silicone Pump

A silicone pump is a passive pump that suctions directly to your breast. The most well-known is the Haakaa but there are many brands on the market. While this pump can be a handy tool for many, it can also create a lot of problems for others. It honestly deserves it’s own post. For now, here is a great post by a lactation consultant on cautions around silicone pumps.

The Parts

Variations of these parts exist in all types of pumps. For the purposes of this post, they are based on the above graphic which comes from a double electric pump.

Flanges

The flanges, also called breast shields, are the piece of the pump that actually goes on to your body. Your nipple should sit centered in the flange prior to starting the pump. It’s also important the pump flange is appropriately sized. Flanges are available in a variety of sizes. The difference between them being the diameter. Every body is different. The flanges that came with your pump may not be the ones that fit you. It’s best to measure the diameter of your nipple, add 3-4mm and purchase the flange size according to that new number. Your nipple should not rub on the sides of the flange. If it does, the flange is too small. If your areola is pulled into the flange or you see an air gap between the flange and your breast, the flange is too large.

Connectors

Your pump may have separate connectors or the connectors may be attached to the flange. It really depends on the brand of pump. When they are attached, you need to be a little more diligent about cleaning than when they are separate. In the graphic above, the connector is attached to the flange. The flange and the connector are one piece instead of two.

Valves & Membranes

The type of valve your pump has will differ based on the brand of pump. In the pump above, the valve is an offset valve. This type of valve has a membrane attached to it. The membrane is a thin plastic piece that covers the valve. The milk flows through the valve, past the membrane and into the collection container. Duckbill valves are given that name because of their look. They are a hard plastic piece that resembles a duck bill. Duckbill valves do not require a membrane.

Back flow protectors

These are also a piece that may or may not be a part of your pump. These are typically made up of hard plastic pieces and a silicone or softer plastic piece. The silicone piece fits in between the two plastic pieces. This then attaches directly to the flange and the tubing. Black flow protectors prevent any milk from backing up into the pump tubing or into the pump motor. These are often a part of closed pump systems. A closed system means no moisture can get to the motor of the pump. This is also the type of system used in hospital grade breast pumps.

Tubing

Tubing is a part of every electric pump. Manual pumps generally do not include tubing because they are structured differently since your hand is the motor. Wearable or wireless pumps also do not include any tubing.

Collection bottles & lids

Usually the collection bottle that comes with your pump are the ones you will need to use. There are some where you can use another brand of bottle. It just depends whether or not it securely screws into the connector. You will also need lids that fit the collection bottle. If you plan to store the milk in the bottle collected (even for just a while) before using or freezing, it should be sealed with a lid. Wearable and wireless pumps have special bags the milk is directly collected into.

Replacing pump parts

When you start using a breast pump, you do need to be mindful of the care required. The pieces should be replaced overtime. The timeline varies because it depends how frequently you are pumping. If you are an exclusive pumper or are pumping at least 3 times per day, you’ll want to replace the pieces sooner than if you’re an infrequent pumper.

Here are the general guidelines for replacing parts on a single or double electric pump

  • Membranes: every 2 – 4 weeks
  • Valves: every 1 – 3 months
  • Backflow protectors: every 3 – 6 months
  • Tubing: every 6 months or if it cracks, becomes dirty or discoloured
  • Flanges: if they crack or become discoloured
  • Connectors: same as flanges
  • Collection containers: if they crack

Other Considerations

Cleaning your pump parts

You should always follow the manufacturer’s guidelines for use and cleaning. The following general guidelines can be used for cleaning manual and electric pumps.

  • First take it apart
  • Rinse the pieces in lukewarm water to remove any milk
  • Wash them in hot soapy water in a clean dish pan (sinks can harbour bacteria)
  • Rinse them well in hot water
  • Dry with a clean paper towel or shake them off to remove excess water. They should air dry on a towel or a bottle drying rack
  • Store them in a clean container once they are dry
  • Wash and then dry the pan used for washing the pump parts

If you have a premature or ill infant, all pump parts should be disinfected once per day. You can do this by boiling them for 5 minutes after cleaning. For a full term healthy infant, sterilizing daily is not required. This link will take you directly to the CDC guidelines for cleaning, sanitizing and storing infant feeding items.

Can I buy a second hand pump?

While many people do choose to buy a second hand pump, it may not always be the best option. It can be difficult to determine just how frequently the pump was used. While you can replace just about all of the physical parts, the motor may or may not be in great shape. It’s also important to consider whether it is a closed system or not as moisture could have made its way into the motor if it’s not.

If it turns out you need to pump often and you’re using a second hand pump that was used frequently, the motor may not be up to the task. This could affect how efficient it is at removing milk which could begin to affect milk supply.

Still have questions after reading this? I offer virtual 1:1 consults for anyone with infant feeding questions

Alex Wachelka is a Lactation Educator and breastfeeding problem solver passionate about educating families.

Milk Boosting Berry Smoothie

Updated May 9th 2021

If you’re here, it’s likely because you feel your milk supply needs a boost. The most effective way to increase milk production is to effectively remove more milk. Milk production works on supply and demand. This means the more often milk is removed, the more milk is made.

Removing milk could be by your baby at a feeding or by a pump or by hand expression. What’s most important to consider is that the milk removal is effective. If milk is removed ineffectively, milk will be left behind in the breast. When milk is left behind, the body adapts and slows down milk production. When your baby is effectively removing milk because they have a good latch and you’re still concerned about your supply, you may start considering galactagogues.

There are foods and supplements (and medications) that can increase milk supply. These are called galactagogues. While there’s many products out there claiming to boost milk supply, it’s important to know galactagogues are not a “quick-fix”. Galactagogues will not stimulate a let down nor will they help empty the breasts. They need to be combined with an effective latch and frequent milk removal.

Ultimately any use of a “milk boosting” supplement should be discussed with and used under the direction of a lactation consultant or a herbalist. This is because some can interact with medications and be contraindicated depending on your medical history. For this reason, I chose to make this smoothie with milk boosting foods instead of herbal supplements.

This smoothie is made with milk boosting foods including moringa and flax seed. It’s also balanced nutritionally. This smoothie won’t send your blood sugar spiking because it contains protein, fat and fibre. This will satiate your breastfeeding appetite and prevent you from getting hangry.

One milk boosting ingredient I’ve included in this smoothie is moringa. Moringa is a tree native to India and often called the “tree of life” because it’s a superfood. It has a high iron content, rich in many different minerals and vitamins and has cultural use to increase milk production. Because it’s the leaves from a tree, when we talk about it’s safety, it’s similar to eating a green veggie.

Flax seed is another ingredient I have added into this smoothie. It’s a source of protein and healthy plant based omega 3 fat and has some evidence that it supports milk production. I prefer to purchase whole flax seeds and grind them with a coffee or spice grinder as I need them. This ensures they remain fresh. Because they are a source of plant based omega 3 fats, they could go rancid if not properly stored. Keeping them whole and in the freezer optimizes their freshness. I grind about 1/2 cup at a time, keeping them in a glass mason jar in the fridge.

Oat milk is the base of this smoothie. Oats are also considered a galactagogue but more so when they are consumed in their whole form and not necessarily as a milk. I just enjoy the flavour of oat milk and it a great dairy free option.

Almond butter is included in this smoothie as a source of healthy fat and protein. Almonds are also a source of B vitamins, vitamin E as well as minerals.

When talking about eating for breastfeeding, it’s largely about nourishing your body. You are still growing a human being. They are just on the outside of your body now. No matter what you eat, your body will make the most nutritious milk for your baby. Some vitamins and minerals are prioritized in your milk supply when you are breastfeeding when means over time, your body can become deficient. Ensuring you are eating a variety of nourishing foods means your body is supported in addition to your milk supply.

Full disclosure is important to me. The below links are affiliate links; if you choose to purchase through these links I receive a small commission.  I only share products and companies that I believe in fully, and those I use in my own home.  I would welcome your support.

Let’s make this smoothie.

What you’ll need:
  • 1 ¼ cup vanilla oat milk (sweetened or unsweetened)
  • 2 scoops Aura™ collagen powder (I prefer the Collagen Generator)
  • 1 scoop Aura™ vanilla vegan protein
  • ½ tsp moringa powder
  • 1 tbsp ground flax seed
  • 1 tbsp almond butter
  • ½ cup frozen berries
  • ½ cup frozen cauliflower (trust me, you won’t taste this)
Add everything to a blender and blend until smooth!

Depending on the consistency of smoothie you prefer, you may need to add more liquid or some additional cauliflower or ice. This smoothie makes an easy and fast breakfast especially when you’re a busy new mom. It’s also a great afternoon meal when you’re feeling hungry.

As I mentioned, milk boosting foods may help your supply but it’s most important to have frequent and effective milk removal. To learn more about milk production and learn ways you can maximize your production, enroll in Milk Supply Masterclass.

Learn more about your milk production in the milk supply masterclass

Breastfeeding With A Nipple Piercing

Can I breastfeed with a nipple piercing? What if I used to have one? Will a nipple piercing affect my milk supply or my baby?

You might not have previously considered breastfeeding at the time you got your nipple pierced. Maybe now you’re thinking about breastfeeding or you’re about to have a baby and wondering if you need to take out the piercing.

When a nipple piercing is placed, it’s important to consider the possible implications it could have for breastfeeding.

The short answer is yes, most people who have had nipple piercings can successfully breastfeed but their breastfeeding experience may look different than they planned. This is because a nipple piercing will affect different nipples in different ways.

Most people who have had nipple piercings can successfully breastfeed but their breastfeeding experience may look different than they planned

The possibility of nerve damage

There is a possibility of nerve damage that could interfere with milk let-down and may cause pain. Your body will still make milk because the breast tissue is healthy but when your nipple is stimulated (by a suckling baby or a pump) the nerves do not tell your brain to let-down milk. This can also interfere with the feedback required to sustain milk production. This means in the first few weeks you might have a strong supply but a times goes on, you may find your supply decreasing. Every body is different. You won’t know how it will affect your body until you start breastfeeding. Overtime and over multiple breastfeeding experiences, sometime the nerves regenerate. They are reports however of some people experiencing nipple pain at the site of the piercing possibly due to nerve damage.

Generally, the longer the amount of time between your piercing and breastfeeding, the better the outcomes.

The possibility of scar tissue

With a nipple piercing, there is a risk of scar tissue that could block some of the ducts. This could affect milk production over time. If your nipple piercing scars shut, it won’t affect your initial ability to make milk but rather how much milk comes out of the nipple. If the milk cannot exit the nipple, there is a higher risk for plugged ducts and mastitis. What happens in these conditions is the milk sits in the ducts and coagulates. It creates a lump or a firm spot. It can quickly become inflamed and lead to an infective condition known as mastitis. With recurrent plugged ducts and an inability to exit the nipple, the milk making cells in that part of the breast may stop producing milk overtime. Your body will adapt to producing all the milk that can be removed. Ultimately, this may affect supply on that side only. Your baby may be fussier on the side with less milk and may prefer the opposite side (if you had just one side pierced). Every body is different. You won’t know how it will affect your body until you start breastfeeding.

Do you have to remove a nipple piercing to breastfeed?

If you do currently have a piercing, it is recommended you remove the jewellery before breastfeeding. The jewellery could rub on the baby’s hard palate (roof of the mouth) and make breastfeeding uncomfortable for them. Not to mention it could damage the soft tissue. In addition, if the jewellery were to come loose, it’s a choking hazard. Removing the jewellery will leave holes that are no longer plugged. It is very common to leak milk from these holes.

The possibility of leaking through the extra holes

When you remove any piercing, a hole is left behind. With a nipple piercing, two holes are left behind in an area where milk exits the breast. It is not uncommon to leak milk through these additional holes. The nipple itself has an average of 9 pores milk exits through. This number varies per person and ranges from 4-18 per nipple. When you remove the nipple piercing, there is now one large hole on each side of the nipple. Depending on the gauge of your piercing the holes may be relatively small or possibly much larger. This means, when your body has a let-down there is a possibility milk will also come out the sides of the nipple. If this happens when you are not breastfeeding (because you heard your baby cry) just wear some breast pads inside your bra. When your baby is breastfeeding, ensure they have a deep latch and are actively swallowing milk. For some babies, the extra milk can be challenging to manage if they don’t have a deep, effective latch. Despite the extra milk leaking through your nipple(s), you shouldn’t see any milk pouring from your baby’s mouth.

Will a nipple piercing affect my milk supply?

It’s unknown if your nipple piercing is going to affect your supply or your breastfeeding experience until you actually begin lactating. It’s important to understand the implications it might have and to have realistic expectations of what it means for breastfeeding. Our bodies are intelligent and amazing and many people can feed a baby on one breast alone. Other times, there is no impact to supply. It’s truly individual. If you’re concerned about what it means for breastfeeding, meet with a lactation consultant during pregnancy to discuss your goals and options. They will also create a plan for you and makes adjustments after you begin breastfeeding.

Last updated March 30th 2021

References:

Garbin, C., Deacon, J., Rowan, M., Hartmann, P., & Geddes, D. (2009). Association of nipple piercing with abnormal milk production and breastfeeding. JAMA, 301(24), 2550-2551.

La Leche League International (LLLI). (n.d). Nipple Piercings. LLLI.org. Retrieved from: https://www.llli.org/breastfeeding-info/nipple-piercings/

Wilson-Clay, B., & Hoover, K. (2017). The breastfeeding atlas (6th ed.). Manchaca, Tex.: LactNews Press.

4 tips for plugged ducts

It can be common to hear about someone who experienced a plugged duct (sometimes called a clogged duct) while breastfeeding but what does that actually mean? And what do you do if you find yourself with a plugged duct?

Before jumping right to what to do, it’s important to understand a little more about breast anatomy. This helps you understand why what is happening in your body is happening and when I share the tips to helping relieve and prevent them, they will make more sense.

The (absolute) basics

To be able to understand what is happening when you have a plugged duct you should first understand basic breast anatomy. During the second trimester of pregnancy, your body is already preparing for breastfeeding by growing a network of milk ducts. In simplest terms, the milk ducts are tubes and they carry milk from the milk sacs (where milk is made) to the nipple. Milk then exits from multiple pores in the nipple. When milk cannot be removed (due to an obstruction) or sits in the duct for a long period of time it can coagulate. The milk ducts can start to narrow due to inflammation.

So what is a plugged duct/clogged duct?

In short, a plugged duct is a palpable lump in the breast due to inflammation. “Plugged” ducts is technically a misleading term. They should however be promptly looked after. If they’re not, there’s an increased risk of mastitis which is an inflammatory condition that can quickly become infective. If you notice a red, shiny streak on your breast paired with a fever, chills or body aches, these are signs mastitis which as mentioned, is a more serious concern because it can become infective.

Why did I get a plugged duct/clogged duct?

Plugged ducts can occur when milk flow is obstructed or milk is not being removed. They can happen for a number of reasons. Plugged ducts can happen:

  • If you miss a feeding or a pumping session
  • If you space out the time between feedings (whether intentionally or unintentionally)
  • If your baby isn’t effectively removing milk at the breast. This could be due to their latch or poor positioning at the breast
  • If you are using the wrong flange size when pumping
  • If you have an abundant milk supply
  • If there’s lots of pressure against your breast such as with a tight fitting bra
How do I know if I have a plugged duct/clogged duct?

Get familiar with your breasts. Regularly feeling your breasts after a feeding or in the shower will help you become familiar with their normal landscape and quickly allow you to recognize changes. You will be able to feel a firm lump or knot in your breast. The lump should be palpable which means you should be able to located the edges of it. A lack of symptoms is also helpful when thinking about plugged ducts. If you do not have a fever, redness on the breast, chills or body aches, that’s a good sign it’s more likely to be a plugged duct. When locating a plugged duct use the pads of your fingers to feel for the border of the plug so you know where it begins and ends. This will be important when you begin some of the massage techniques.

How can I remove a plugged duct/clogged duct?

There are several ways you can care for a plugged duct. With any of the methods, it’s always about reducing inflammation. My four personal favourites that I use with families are the following. These are not meant to all be used. Start with one method first. Using all of these at once can created unwanted inflammation in the breast and quickly escalate to something worse. If you have a plug that you would describe as stubborn, always reach out to a lactation consultant to they can get to the bottom of the issue with you.

BREASTFEED/REMOVE MILK

Breastfeed and remove milk as usual. The newest guidelines from The Academy of Breastfeeding Medicine suggest there’s no need to try and “empty” the breast. Excess pumping can increase inflammation further.

GENTLE MASSAGE AND COLD

Gentle breast massage to move the excess fluid towards the arm pits to the lymphatic system can help. Use cold after milk removals. If you’re pumping, ensure the flanges fit correctly. You can also use a little bit of coconut oil to lubricate the flanges.

A great video about breast massage

https://www.mayabolman.com/videos/v/breastgymnastics

REDUCE INFLAMMATION

Reducing inflammation can include anti inflammatory foods as well as over the counter medications like Advil and Tylenol

How do I prevent a plugged duct/clogged duct?⠀

Frequent and effective milk removal are the keys to preventing plugged ducts from reoccurring. If you are frequently experiencing plugged ducts, go back to the list at the beginning. Can make any changes to your baby’s latch and/or positioning, the frequency of feedings, your bra type or pump flanges? If you have and you are still always experiencing plugged ducts, get in touch with a lactation consultant. You can connect with me HERE.

4 Signs Your Baby is Getting Enough Milk

How do I know if my baby is getting enough milk?

This is probably one of the top questions I get from new parents. It makes sense. You can’t see the milk going into their body so how do you really know? The good news is, there are definitely a few signs to watch for that will tell you if your baby is getting enough milk.

1. Looking or listening for swallowing

When a baby is taking in milk, they have to swallow it. 4-5 swallows per feeding of colostrum is what we’re looking for. When milk transitions, and the volume goes up, we’re looking for a 1:1 ratio of suck:swallow after let-down has been initiated. But what are you actually looking for? When a baby swallows milk, you will see their jaw drop slightly lower and pause momentarily. You can also have a look at your baby’s ears or the side of their face as you may notice the bottom of the ears move when the jaw drops down. This is a swallow. You can also listen for a swallow. A baby’s swallow sounds like a soft “kah” sound.

2. Generally content after feeding

Your baby should be alert prior to feeding and generally more sleepy and content after a feeding. Every baby is different and not all babies experience a milk coma right after feeding which is why we pay attention to their behaviour. If they are no longer showing those early hunger cues and seem relaxed, you can take it as a sign that they are content after the feeding. Many babies will also have their hands in fists prior to feeding and then relax to a more open hand afterwards. Sometimes their arms get really floppy after feedings too. This is just another sign they are full and relaxed after a feeding.

3. Diaper output is age appropriate

Newborns produce a lot of wet and dirty diapers. During the first week, we look for 1 wet and 1 dirty diaper for each day of life. On day 1, or within the first 24 hours we are looking for 1 wet diaper and 1 dirty diaper. Baby’s first poop is called meconium and is very dark, sticky and tarry. After this, on day 2, we are looking for 2 wet diapers and 2 dirty diapers. The poop will still be dark but may resemble a darker green than brown. As the days progress, by day 5 your baby’s poop should have transitioned to a mustard yellow in colour and you should be seeing 5+ wet diapers and 3-4 yellow dirty diapers. If there’s so many that you’ve lost track, chances are your baby’s diaper output is appropriate. It’s always important to track during that first week because it’s a question all lactation consultants will have for you. The first couple of poops your baby has should be about the size of a toonie or larger.

4. Your baby is gaining weight

This is a clear sign that milk intake is enough. What is most important though is that your baby is sticking to their own growth curve. The growth percentiles are not report cards. A baby in the 50th percentile is not doing poorly nor is a baby in the 95th doing better than others. This is just simply comparing their size and weight to other babies of that age. Humans are different sizes. It’s normal! We’re not all supposed to be the same size so the same goes for babies. Your doctor/pediatrician should be using the World Health Organization growth velocity charts. These charts take into account infant growth and development from all over the world and use the growth of a breastfed baby as the norm.

The new growth curves are expected to provide a single international standard that represents the best description of physiological growth for all children from birth to five years of age and to establish the breastfed infant as the normative model for growth and development

The World Health Organization

If you can see or hear your baby swallowing for a few minutes each feed, they seem content afterwards and are producing lots of wet and dirty diapers while gaining weight, your baby is getting enough milk.

If all the above are happening BUT you’re in pain or breastfeeding is not enjoyable or doesn’t feel sustainable, always reach out for support. Lactation consultants are detectives; always working to get to the bottom of every feeding issue. They are trained specifically in the area of human lactation and are the specialists when it comes to infant feeding.

Want more information like this?

Join my community!

This is THE PLACE to be for all things breastfeeding and postpartum. Join our community and receive helpful tips, recipes, support and exclusive access to our online programs. Get ready to dive into all things postpartum and breastfeeding and how you can achieve a confident feeding experience!

We respect your email privacy

Last updated March 5th 2021

References:

Campbell, S.H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core Curriculum for interdisciplinary lactation care. Jones & Bartlett Learning.

Newman, J. & Pitman, T. (2014). Dr. Jack Newman’s Guide to Breastfeeding. HarperCollins Publishers Ltd.