Motherhood Blooms Lactation™

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 April 14th 2023

If you’re feeling like your milk supply needs a boost, the most effective way to increase milk production is to effectively remove more milk. This is because milk production works on supply and demand; 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.

What does ineffective milk removal mean?

This would be anytime milk isn’t removed well from the breast. It could be because your baby is having troubles with nursing or your pump flange is the wrong size. Either of these would affect how much milk is being removed which would then affect how much your body is making.

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 with the support of an IBCLC.

What’s a galactagogue?

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 (or flange fit) 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.

Let’s make this smoothie.

What you’ll need:

1 ¼ cup vanilla oat milk (sweetened or unsweetened)
2 scoops collagen powder (I prefer the Collagen Generator)
1 scoop 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, you can watch my free class below

Breastfeeding With A Nipple Piercing

Last updated July 10th 2023

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

Consider 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.

Consider 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.

If you have a baby on the way and are planning to breastfeed, working with me prenatally can help ease your mind when it comes to things like this. We can chat about all of your concerns, I can answer your questions and help you make a plan based on how you want to feed your baby.

Click Here to Book An Appointment

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!

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.

3 tips to get a better latch, NOW!

Updated February 20th 2023

I’ll start by saying there is tons of information online that references “a good latch”.

The hospital staff might have said to you “he has a good latch”. The new parent blog you read said “Be sure to get a good latch”. You see posts on Instagram that say “A good latch shouldn’t hurt”.

Before I tell you how to get a good latch, let’s talk a little about how to know if it’s not a good latch or rather, not an optimal latch.

What if it doesn’t really hurt but you’re still not sure if it’s a good latch? How do you know?

So first, if there’s pain the latch needs to be checked. If you’re tensing up, curling your toes or holding your breath as you latch your baby because of pain, it’s not a good latch. You should get help for that, asap.

If breastfeeding is comfortable and you’re pretty sure your baby is drinking milk but your nipples are coming out flat or misshapen (meaning they are not round anymore) there’s room for improvement.

When your nipples come out of your baby’s mouth as a different shape, this means the nipple is not reaching to where it should. The nipple is being compressed against the hard palate.

If your baby’s chin is not touching your breast or if their nose is ending up buried in breast tissue and the only way for them to breathe is for you to hold down your breast tissue with your finger for the whole time…it’s not a good latch. That one is usually a quick position adjustment.

Lastly, if milk is leaking out of the sides of your baby’s mouth while they are drinking or if they are making slurping or smacking sounds, it’s a poor latch. There’s an issue with the seal they are creating on the breast and this also means you should get support.

Ok, so how do I get a good latch?

A good latch can mean the difference between a comfortable breastfeeding experience or a painful one. While pain can be common during breastfeeding, it indicates your baby’s latch can be improved as I mentioned above.

There are a few adjustments you can make to help relieve the pain and reposition your baby for a more effective latch. Especially if you’re waiting to see a lactation consultant, hours feel like days when the latch is wrong. I know because I was there too.

So here are 3 things you can do right now to get a better latch.

1. Relax and Get Comfy

Make sure you are relaxed and in a comfortable position. I often work with parents who breastfeed in very uncomfortable positions putting unnecessary tension on their neck, shoulders and back. If you’re doing this you’re not alone!

If you ever feel awkward holding your baby to breastfeed, 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.

Whatever position you’re in, there’s no real right or wrong if you’re comfortable and your baby is able to drink well. Our bodies are different shapes and sizes so are our chests, adjustments are what tailor a position to you and your baby.

2. Watch Your Baby

It’s easy (especially in the very early days) to want to scroll through your phone, place a few online orders or watch a movie when you are breastfeeding. Breastfeeding has a learning curve for both you and your baby. While you’re working to perfect your latch, tune into the feed and watch your baby.

Your baby’s tummy should be facing yours and their ears, shoulders and hips should be in alignment. An easy way to remember this is “nose and toes” should be pointing in the same direction. They should also be very close to your body, touching actually. Any gaps can make getting a comfortable latch more difficult.

You also want to watch them so you can latch your baby when they open wide like a yawn. This will ensure the entire nipple gets into their mouth and all the way back to the soft palate. You can always tickle their lip with your nipple to encourage the wide gape.

When your baby gets ready to take in the nipple, they should lead with their chin. More of their bottom lip should be covering the areola than the top. This is known as an asymmetrical latch. It encourages the nipple to point to the roof of the mouth which assists with getting a deep, pain free latch.

3. Bring Your Baby to The Breast

Bring your baby to the breast, NOT the other way around! Please, do not stretch and pull your breasts towards your baby. Bring your baby to your breast. If you’ve followed tips 1 and 2, you should already be in a position where your baby is at your breast. If you are still finding yourself stretching or pulling yourself towards your baby, adjust your body again, and then attempt latching.

I hope this provides you with some more clarity.

If you’re still struggling with latching, join my community of other breastfeeding parents, going through the same things you are.

This is a safe space to ask questions and support each other. We talk about all things postpartum, breastfeeding and babies!

Click HERE to join now!

View this post on Instagram

A post shared by Alex | Breastfeeding Support (@motherhoodbloomslactation)

References:

La Leche League International. (n.d). Positioning. La Leche League International. https://www.llli.org/breastfeeding-info/positioning/

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

How to Hand Express

How to perform this Press, Compress and Release method to collect milk

Updated August 14th 2023

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 (aka milk “coming in”) 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.

Hand expression can also be used prior to the birth of your baby. Provided your midwife or OB/GYN has cleared you, hand expression can be used as early as 37 weeks gestation to collect colostrum in advance of baby’s arrival. The reason you need to be cleared to do this is because the nipple stimulation can lead to early labour for some (thanks to oxytocin) and so, it’s not recommended for everyone. If you’re not on pelvic rest, it’s generally considered safe to hand express but always consult with your care provider.

You can access my Hand Expression Masterclass below that cover this in more detail.

Why would you want to collect colostrum prior to your baby’s birth?

Collecting colostrum while pregnant can be very helpful if you’ve previously struggled with breastfeeding or milk production. This ensures you have some additional nutritional support if your baby is having troubles effectively latching.

This is also a supportive technique if you have gestational diabetes as your baby can become hypoglycemic at delivery and having the extra colostrum on hand will support their blood sugar.

If you’re expecting multiples it can be helpful as well. If you’ve had prior breast surgeries and are unsure how it might impact milk production, collecting beforehand can be invaluable.

Colostrum collecting before birth requires collecting and saving the colostrum in feeding syringes that are 1mL – 5mL. You can freeze the syringes. They should then be placed in a container or bag labelled with the date and your name. It might also be helpful to add your health card number to them. You can then bring the frozen colostrum to your birth.

Whether you are collecting colostrum prior to delivery or expressing milk after your baby’s birth, the method is the same.

The Method of Hand Expression

With clean hands find a comfortable position, ideally resting with your back and body supported and massage the breasts in circles, working towards the areola. This will help stimulate the flow of milk.
Either doing this yourself, or with a partner, the milk collection container should be placed underneath the nipple. A small cup, spoon or syringe will work to collect the colostrum.
Your thumb and index finger should be placed on the breast about one inch above and one inch below the nipple. Your hand will create a “C” shape or a “U” shape. It’s important to measure from the nipple because areolar size varies significantly.
Press your fingers back towards the chest wall (your rib cage), gently compress the breast tissue (squeezing, bringing your fingers together) and then release the compression. Repeat this over until you begin to see colostrum* or mature milk depending on which stage of milk production you are at. Go back and forth between sides. *if you’re expressing colostrum, hold the compression for about 3 seconds before releasing
It’s important you always remain relaxed as it can take a few compressions before you see milk. In addition, you should always feel comfortable. If there is any pain or discomfort, you should adjust what you are doing until you are comfortable. It may also be helpful to have your baby nearby as this will increase the release of oxytocin which stimulates milk let-down (milk flow). The entire process may take 20-30 minutes.

If you are collecting colostrum PRIOR to your baby’s birth, you would perform hand expression twice a day for about 10-15 minutes and you would save the colostrum in feeding syringes which you can freeze and take to your birth.

And remember…

This technique should not damage your skin and delicate breast tissue. Always be gentle. Your breasts are not like the muscle tissue of your body. You do not want to be using a lot of force on them. If you are doing the technique correctly, it should not result in damage to your breast tissue.

Feeling like you need to know more?

My Hand Expression Masterclass will walk you through not only hand expression but also HOW to set yourself up for breastfeeding success!

This one hour masterclass includes a mini prenatal breastfeeding class built right in! Learn about the powers of breastfeeding and how to overcome potential challenges created during labour and birth inside the Hand Expression Masterclass

CLICK TO LEARN MORE

If you’re looking for more specific support to help you breastfeed your baby whether you’re nursing or pumping, you can work with me here.

Alex Wachelka is an International Board Certified Lactation Consultant passionate about helping you to confidently feed your baby. She owns her private practice Motherhood Blooms Lactation and sees clients virtually and in person.

References:

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

La Leche League International. (2020). Hand expressing. La Leche League International. https://www.llli.org/breastfeeding-info/hand-expressing/

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

4 Ways to Help Your Distracted Baby Feed Better

mother using phone while breastfeeding her child

updated March 7th 2023

Your baby has been nursing well for the past 12-15 weeks when suddenly, you notice your baby becoming more distracted when they are nursing. Every sound seems to catch their attention, the dog walks by or someone new comes into the room. All of these events will cause your baby to stop nursing and have a look around. If you previously nursed in public, you may notice your baby is having a very difficult time now.

Latch on, pull off, latch on, pull off…

It can be very frustrating nursing a distracted baby. Around 3-4 months babies become much more aware of the world around them. Suddenly they are paying more attention to the room they are in, the sounds they are hearing in and outside the home. They may latch on and pull off only to latch on again, maybe feed for a minute and then pull and become frustrated because they are no longer drinking milk. This makes feedings difficult and may be misinterpreted as weaning when it’s not. Babies younger than 18 months typically do not self wean.

When distracted feedings happen, your baby will nurse for a shorter period and may nurse more frequently at night to make up for the calories. This is completely normal and the night nursing is beneficial for your milk supply. It’s also a quiet, calm, distraction free environment.

So what can you do about those distracted daytime feedings?

1. Offer the breast frequently

This may mean prior to your baby cueing especially if they are alert as they are staying awake for longer periods at this age. You want to provide many opportunities for them to latch and drink milk especially when the feedings are interrupted by their own curiosity. ⠀

2. Minimize distractions

A common piece of advice is to head into a room, preferably one where you can darken the environment by pulling a shade or drawing the blinds. This will shut out the distractions and help create an environment where your baby will effectively nurse.

While this might be effective, if you have an older child, this is not something you can do without another adult present. Chances are, it’s just you and your kids so this is why I like to suggest you take advantage of the nighttime feedings.

Nighttime nursing is still very much needed (and normal!) by this age group and often, they will do some of their best feeding because they are sleepy. Side lying position is wonderful for night time nursing, especially if you safely co sleep. A semi reclined breastfeeding position is also great for night time. Practise to see what feels most comfortable and works best for you.

3. Try motion

Using motion such as rocking or swaying your baby while nursing them might help to reduce the distractions. You can use a baby carrier/wrap or a sling and walk around and nurse them while they are in it. It takes a little while to get the hang of but it.

4. Skin to Skin

Skin to skin acts like an amazing re-set button. It is so helpful when feeding a distracted baby. This will not only help calm your baby but help encourage your baby to latch. Skin to skin also releases oxytocin which helps your milk let down. Not all older babies will respond well to this so experiment and do what works best for your baby.

Bonus tip

Here’s another option your baby may respond well to. Clipping a toy or a pacifier clip to your bra strap to keep them distracted but at the breast so they continue to feed.

View this post on Instagram

A post shared by Alex | Breastfeeding Support (@motherhoodbloomslactation)

Join My Free Community

Are you struggling with breastfeeding? Have questions about whether or not something is normal? You are not alone. I have an entire community of soon to be and current moms talking all things postpartum, breastfeeding and babies. We’d love to have you join us!

CLICK HERE TO JOIN THE FACEBOOK GROUP

References:

Bonyata, K. (2018, Jan 1). The distractable baby. Kellymom.com. https://kellymom.com/ages/older-infant/distractible-baby/

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

La Leche League Canada. (2015, Dec 17). Thursday’s tip: Breastfeeding the distracted baby (6-12 months). La Leche League Canada. https://www.lllc.ca/thursdays-tip-breastfeeding-distracted-baby-6-12-months

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

Lactogenic Breakfast Cookies

Updated March 29th 2023

Who doesn’t love cookies for breakfast? Or snack, or anytime really? The reason these cookies are great for anytime is that they are full of nutrient dense ingredients and free of refined sugars. They are made with oats and flax to help nourish your body and support milk supply but can be enjoyed as an after day-care snack as they are great for kids too.

When I was making these cookies I wanted to keep them egg-free so that the recipe could be made vegan. The cookies overall are very allergen friendly as they are:

Egg free
Gluten free
Nut free
Dairy free* (if strictly coconut oil is used)
Sesame free
Peanut free
Soy free

They remain soft and chewy after baking and will keep this texture once they are refrigerated. They can also be frozen and thawed out the day prior to eating.

They’re not your typical cookie. They’re sort of like a granola bar combined with a cookie because of the texture and the type of ingredients.

You don’t usually think of chia seeds or pumpkin seeds when you think of cookies. These cookies are made with ingredients that will help give you a calorie and nutrient boost which is essential when you’re recovering from birth and making milk for your baby.

Not the prettiest picture but this is what the dough will look like once everything is mixed

Some of the nutrient dense ingredients used in these cookies include:

Chia seeds: very good source of omega 3s, iron and fibre. Essential nutrients when you are recovering postpartum and lactating.

Pumpkin seeds: source of magnesium, protein and other trace minerals.

Oats: oats are a source of fibre called beta-glucans that can help support healthy cholesterol levels. They are also thought to boost milk production; acting as a galactagogue (increasing milk supply)

Banana: rich in potassium, fibre and a source of vitamins and minerals. The banana also helps naturally sweeten the cookies while boosting the nutrition

How to make them:

Ingredients:

1/4 cup water
2 tbsp ground flax seeds (also known as flaxmeal)
1/2 cup ghee (ghee is lactose free but not vegan as it is derived from butter. You can use coconut oil in place of this to keep it dairy free)
1/2 cup coconut sugar
1 tsp vanilla extract
2 cups gluten free oats
1 banana
1/3 cup pumpkin seeds, unsalted
2 tsp cinnamon
1/4 tsp salt
2 tbsp chia seeds
1/2 cup dairy free chocolate chips

Directions:

Preheat oven to 350°F. Line two baking sheets with parchment paper.
Combine water and ground flax. Set aside for 5 minutes. This will create a flax egg.
In a larger bowl mash the banana (using a fork is fine). Add the ghee (or coconut oil) coconut sugar and vanilla. Whisk together. Add in the flax egg. Whisk until combined.
Combine oats, cinnamon, salt, pumpkin seeds and chia seeds. Stir. Add to wet ingredients. Fold everything together. Add in chocolate chips. Fold again just until combined.
Use a 1/8 cup measuring cup to scoop cookies. Alternatively you can use a small ice cream scoop or place 2 tbsp of dough at a time into your hands and manually form the cookies. Place on lined baking sheets and flatten slightly.
Cookies will not expand or spread out so don’t worry too much if they are close together.
Bake 12 mins. Allow to cool on pans and refrigerate after they are cool.
Yields 16-17 cookies.

The cookies will look very similar to this after baking as their shape will not change

I have a free weekly email sharing tips and tricks for navigating breastfeeding challenges ⤵

Navigating the Holidays with a Newborn

How to manage a newborn and breastfeeding during the holidays

Updated November 12th 2021

I’m going to start with a little story. I had a 4 week old at Christmas back in 2019. I was a first time mom, newly postpartum and I was having a very difficult time breastfeeding. I was exhausted and stressed.

I reluctantly agreed to have some family over for Christmas. Because we live far away from family, they were also ALL staying in my home. Making the decision to have multiple people staying in my home for Christmas added to the stress I was experiencing. It didn’t help that I asked half of them to book a hotel and they flat out refused. You can bet I’ll be taking about boundaries later on.

There is SO MUCH going on when you have a brand new baby and the holidays can bring added stress and challenges. I’m going to provide you some tips for making your life easier and still focusing on yourself and your baby during this time.

How do you manage newborn life during the holidays

Watch Your Baby

What I mean by this is actually look at your baby to see what’s happening and how they are feeling. It’s important to know babies can become overstimulated. Newborns do not have the ability to shut out external stimuli and can easily become overwhelmed. They will express this overwhelm by crying, fussing and becoming irritable. Bringing them to a quiet, dark space will help. This helps to shut out the distractions and will be very helpful when nursing them. You may also find they want to nurse more. This is because the act of suckling helps regulate their nervous system.

Watch them for feeding cues as well. Catching those early hunger cues which include stirring, their mouth opening, turning their head side-to-side and rooting around can be missed if your baby is with another family member. When a baby escalates those hunger cues to stretching, bringing their hands to mouth and moving around more, a family member may try to shush them in the hopes of soothing them or pop a pacifier into their mouth. This will then start to spread out feedings which can put you at an increased risk of plugged ducts.

When these early cues and escalations are missed, babies start to cry, turn red and get very agitated. This may be the point that Aunt Doris says “let’s get you to mommy” for a feeding but at this point, your baby is going to need to be calmed by you before they will feed.

When a baby is crying because they are hungry, this is more of a distress signal than a true hunger cue so rocking, bouncing, singing, cuddling – any number of these things may need to happen before your baby is in a calm enough space to latch on and feed.

>> For more tips around breastfeeding a newborn in the first two weeks, check out my post ’14 tips for breastfeeding in the first 14 days’

person covering infant with swaddling blanket — Photo by Isaac Taylor on Pexels.com

Take a Time Out

The holidays bring their own special kind of stress. Stress hormones can interfere with oxytocin and your let-down. They can also impact your overall production (noticing a dip in your supply).This can make breastfeeding feel more stressful. Supporting milk production by reducing stress is about reducing your stress hormones and increasing oxytocin.

Taking time away in a quiet dark room with your baby can help. Watching videos or looking at pictures of your baby while you’re pumping can help support your let-down. Smelling something of your baby’s can also help.

It’s about finding ways to calm and relax yourself. When your stress hormones are low, your body can optimize oxytocin and prolactin. Maybe this means listening to music you enjoy while feeding your baby. Or maybe it’s using an essential oil you love while in the shower. Maybe you can find 5 minutes to sit still and deep breathe. All of these activities can naturally reduce stress hormones in your body and help to increase your milk production.

If it’s feeling like it’s too much, tell your company you need to feed the baby and take a time out. Go into the bedroom or nursery and spend 30-45 minutes alone with your baby skin to skin. Skin to skin releases oxytocin which is a feel-good hormone that relaxes both of you. Your baby should be in just a diaper and you undressed from the waist up. Your baby can breastfeed during this time if they want to but they can also just rest or sleep. This will help calm the both of you and give you much needed time alone.

>> if you’re wondering what else might be affecting your supply, grab my free video here

Set Boundaries

You are in charge of who is allowed to come over and for how long. It can be very difficult as a new parent to tell family you don’t want them over for an extended period of time but if the people visiting are close enough to be spending time with your new baby, you should be able to set some rules with them.

Set boundaries and stick to them and say NO whenever you need to. They don’t have to hold your baby. You do not have to justify your decisions, whatever they may be. You are the expert of your own baby.

When you’re navigating questions from family like “why don’t you use a bottle?” or “why are you giving him a pacifier?” or unsolicited advice like “just let her cry” you can simply respond with “because this is what works for us”.

Put Your Guests to Work

Having someone else hold your baby is not what you need. Ask them to:

Rake leaves
Shovel the driveway
Take out the garbage
Pick up groceries
Do some of the cooking or bring some food
Do a load of laundry
Fold laundry
Vacuum
Set the table

You get the idea…you are not there to wait on them. You just brought another person into this world and your body needs time to rest and recover. Tell your guests ahead of time if they intend to come, you’ll expect them to help support you.

Your body will tell you if you’re doing too much. Your bleeding (called lochia) can increase the more you’re physically doing. So be sure to take time to rest.

Make Sure You Eat

When you are lactating your energy needs are higher than when you were pregnant. Make sure you’re eating enough. Don’t worry so much about what you’re eating but that you’re eating. It’s so busy being a new mom and if you have company over, even moreso.

The holidays are filled with foods that will support your postpartum recovery and milk supply. Protein is very important when it comes to your body healing and your energy levels. It also has a role in milk production because it helps balance your blood sugar. Turkey and ham are great holiday sources of protein. So is roast beef which is also a great source of iron, a mineral needed for milk production. Nuts are also a great snack filled with protein, fat and fibre to support you postpartum.

Other holiday themed foods that can support milk production include oats, dates, molasses, apricots, fennel, sweet potato, almonds and dark leafy greens to name a few.

Your breastmilk will always be the most nutritious milk for your baby no matter what you’re consuming. Your body will always prioritize the milk and your baby. No one’s diet is perfect.

>> You can learn more about foods that support milk supply and other ways to help your body maximize your milk production inside the Milk Supply Masterclass.

sliced orange fruit in clear drinking glass — Photo by Olenka Sergienko on Pexels.com

What About Alcohol?

Of course I had to include this one as it’s a question on the mind of many. I’ll start by saying, no you do not need to pump and dump. You can consume alcohol while breastfeeding.

When you drink alcohol, the alcohol level of your breastmilk matches the alcohol level in your blood. Because of this, the general rule is if you’re sober enough to drive (or parent) you’re sober enough to breastfeed.

How much can I enjoy?

For most women, 1-2 drinks at a time can safely be enjoyed. This means you do not have to worry about the glass of wine you enjoyed with dinner, provided it was around 4oz. The general rule for alcohol consumption is a 4oz glass of wine, 1 oz of hard liquor or 8 oz of beer.

Remember to also drink water as alcohol is dehydrating and preferably enjoy the alcohol with a nutrient dense meal.

What if I’ve had too much?

There’s a few things to keep in mind.

If you are not sober, you should have someone else care for your baby.
It’s dangerous to care for an infant while intoxicated.
You may also want to wait until you are sober to breastfeed.
This could be several hours, if you find your breasts starting to feel very full, I would pump and discard that milk (since you were intoxicated)

Helpful info:

If you’ve only had 1-2 drinks and you are feeding your baby, you may find your breasts feel very full. This could actually be due to reduced transfer of milk.
The feeling of full breasts after drinking alcohol is because the baby is inefficiently transferring milk because it’s been found that alcohol blocks the release of oxytocin which is the hormone responsible for milk let down.
Hand express after your baby feeds to ensure the breast is empty and offer your baby the breast frequently.
>> here’s a link to how to hand express

To summarize this for you, you are allowed to set boundaries and say no. Continue to feed your baby when they cue they are hungry and take a time out if you need it. Don’t forget to enjoy all the delicious foods and cocktails that come with the season. Being a parent is hard. We’re all just taking it one day at a time.

Have questions? Join my private Facebook Community and connect with other new moms.

Save yourself hours spent on google and connect directly with me and my community. I’d love to have you join us.

CLICK HERE TO JOIN

Your support helps to continue to fund free content like this

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.

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