Will any of my pre-pregnancy work clothes ever fit the same?

                            Will making a decision about daycare/nanny/part time/full time/gradual start/home daycare be easy?

                            Do I have to stop breastfeeding if I’m going back to work?

answer to all of the above? NO. One of the most common questions I get is how to prepare for going back to work if you’re breastfeeding. If you’re lucky and live in Canada (and can live off Maternity leave for a year) then you may have a very different experience than most parents living south of us in the United States who have to return within weeks of their birth.

Although we can feel lucky that we have a whole year to be with our babies, and get a chance to establish breastfeeding in the early weeks and months, we also go through very different phases and many babies have never had a need to drink their breastmilk in any other way then straight from the tap.

Many people think that it’s expected that they will just stop at a year because they’re going back to work (and we’ll talk about how to approach that if it’s your choice) but MANY parents decide to continue breastfeeding once or twice per day or more, even if they are going back to work full time.

Breastfeeding an older baby is very different than breastfeeding a newborn. Often, many day-to-day things are intertwined with breastfeeding, including nap time, meal time, the need for magical nursing sessions to cure any problem/injury/injustice and even just chilling out and snuggling. Many moms don’t know that they can absolutely continue to breastfeed, even if they also want to make sure that baby can drink from a bottle/cup/straw so they can go to daycare, still have naps and have a way to get liquids when their usual source is at work.

1. FIGURE OUT YOUR PERFECT PLAN

What would your perfect scenario be for nursing/pumping/bottle/cup/weaning be?

There are many ways to continue breastfeeding even if you are going back to work full time. Many people breastfeed just first thing in the morning, right when they pick up baby or get home, or at bedtime. Some babies will nurse once overnight or early morning instead, and some will do any combination of these. Whatever works, what do YOU want to do?

2. DON’T PANIC!

Many breastfeeders think that they have to plan for MONTHS ahead of time for their return to work at a year, but many people need almost no drastic changes ahead of time. I usually say about 4-6 weeks is enough time for most plans, even if you want to drastically reduce the number of nursing sessions that you do per day.

Many people just continue to nurse as usual right up until the first day of daycare/return to work, and they may just have had their baby practice with a cup/bottle ahead of time so they know that their baby can take liquids in another way. Recommendations say that a child at a year doesn’t necessarily need replacement ‘MILK’ (pumped/cow/ formula etc) as long as they are breastfeeding two or more times per day. Water and food can be enough during the day, and baby can nurse and make up for it when you’re together again….. get ready to be tackled!!

3. BE READY TO PUMP OR EXPRESS IF NEEDED.

Sometimes moms are told that if they pump they will increase their milk supply (which can be helpful if needed see blog HERE. )…. If you are stopping, reducing or skipping a feed, then your body is still expecting that you will need that feed as usual and the milk will be ready. If you skip the feed then you may become very full and uncomfortable. Pumping or hand expressing just a little bit (not to empty the breast as much as usual) can be helpful and necessary to prevent painful engorgement and even mastitis. You’d still be removing less milk than usual, so you would still technically be weaning.

If you want to maintain your milk supply, or collect and provide expressed breastmilk for baby while you’re away, then you may want to pump once or twice for 10-15 minutes, and collect as much as you can. More pumping advice HERE.

4. TEACH BABY ANOTHER WAY TO FALL ASLEEP

If you nurse your baby to sleep, it can be very helpful to give them a chance to ALSO learn another way of falling asleep. I never stopped nursing to sleep whenever I was home, at bedtime or on weekends, but I made sure that during the few weeks before my return to work, my babes were able to practice being rocked, walked in a baby carrier, back rubbed etc to sleep.

If possible, ask your daycare provider what they are able to do for nap time, and what the usual routine is. Will they be willing to provide individual care? Rocking babies etc? Then have another member of your family give it a try a few times. At around 1 year, most babies are able to figure out that when mom is here they get to breastfeed, but when dad/partner/nana/friend/caregiver is here, I get the other way.

5. KNOW THAT IT WILL GET BETTER WITH TIME….

Everyone needs time to learn a new thing, practice a new way, and get used to a big change. Just like we can feel sad or nervous, babies will still have big feelings and nursing when we are with them can be a wonderful way to re-connect. Research shows that nursing even a couple of times per day can be very helpful for reducing illness during the transition to a new daycare situation, so it can really be worth it to keep it going if possible. Your body and your baby will adjust to the new routine.

If you need more help setting up a plan or want to discuss all the options for you and your situation, feel free to reach out for a chat, or schedule a ‘Return to Work’ consult with us.  We’d love to help!

http://www.nutmegconsulting.ca

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Maybe you got scared that your baby wasn’t eating enough and you sent your partner out for some formula?

Maybe your doctor told you your baby was losing too much weight so you needed to start giving bottles? Did you know that you can still breastfeed?No matter what’s going on with you and your baby, there are always options if you want them. Even if it’s not going according to plan, if you want to keep breastfeeding, there is almost always a way to make things better. Even if you’ve started using, want to keep using, or need to keep using bottles, formula, pumping (or some combination) forever, YOU DON’T HAVE TO STOP BREASTFEEDING … even if you’ve entered the ‘Breastfeeding Grey Zone’.

What is the Grey Zone?

If we can agree that the usual definition of breastfeeding is the pretty traditional version where mom just sticks her baby on her breast and exclusively breastfeeds right from the source; then a mom enters the ‘Breastfeeding Grey Zone’ once she starts using any other method to feed her baby. Whether it’s using formula or donor milk, or if she has to start pumping or using tubes or bottles or cups, finger feeding or nipple shields, there are lots of things that can complicate breastfeeding. Even when these things are absolutely necessary, entering ‘The Breastfeeding Grey Zone’ can make things really hard.

Often, I meet new parents when they are in the thick of it. They are trying to latch their baby and nurse, they are pumping after feeds, AND they are giving supplements too. Their nipples hurt, they’re worried that their baby might be starving, and they haven’t slept in days. There’s a lot of crying, their crotch hurts and their boobs feel like they might explode, and they don’t know what to do next.

Don’t give up. Get help

Unfortunately, there is a belief right now that breastfeeding is supposed to be some ‘perfect’ experience, but THAT JUST DOESN’T ALWAYS HAPPEN!!! Telling mothers that it’s ‘so natural’ and that ‘babies will just crawl up and latch themselves on’ and know exactly what to do, is unfair and often, unhelpful. Sure it’s good to teach that breastfeeding is a normal thing that our bodies can do, but I disagree that it’s natural for most women right now. Did we all grow up in some magical village where all the topless nursing mothers sat around breastfeeding all day? Did we get to spend our lives watching babies feed, so we could learn about normal newborn behaviour, how to deal with common breastfeeding issues, and the best way to get a good latch? Um…. Nope.

Well, most of us in Canada and the U.S. didn’t anyway, and that’s a BIG part of the problem. It’s not ‘just natural’ right now. It takes work. It is a learned skill, and just like with any new skill, it takes practice, and we might not be ‘perfect’ at it right away. Be gentle with yourself during this process.

It seems like there are two extremes right now, when it comes to feeding a baby. Some providers don’t know how to help, so they just tell parents to start formula feeding and don’t offer support for breastfeeding at all! Even on Facebook mommy groups, the desire to eliminate guilt about ever using formula is making the phrase #fedisbest the first response when moms really just want some breastfeeding support. This is not enough…. (#supportisbest #informedisbest)

On the other hand, even well-meaning Doctors, Nurses and Lactation Consultants sometimes confuse ‘support’ with a tendency to issue blanket statements of what HAS to happen to make sure that breastfeeding works. I don’t think this is always helpful either! I don’t think being strict and judgmental about things is the best way to support new mothers and breastfeeding parents. If parents feel like they’ll be judged for ‘doing it wrong’ then they may be reluctant to ask for help, for fear that they will be criticized. Sometimes breastfeeding is messy…. And that’s ok. Things aren’t always just black or white, and that’s where the ‘Breastfeeding Grey Zone’ comes in. Support should meet you where you are in the journey, and offer help… not ultimatums.

It’s true that supporting mothers in the Breastfeeding Grey Zone can be hard. The knowledge that any of the things I mentioned can complicate the breastfeeding process, can make us worry enough to even tell mothers that these things shouldn’t be used at all! To me, it all depends on the goals of the individual family that I’m working with. If THEIR goal is exclusive breastfeeding, then yes, it’s important to teach about the risks and benefits of each method, and go from there. If they WANT to use these extras, then we still need a plan.

It’s important to me, that we make a distinction for those moms who JUST want to breastfeed their babies, because they usually need more support and are sometimes just not getting it.

The trend of telling a mother who is struggling with breastfeeding, that ‘fed is best’ is similar to saying that it doesn’t matter how we feed our babies! To many women who REALLY want to breastfeed, it IS important. What they really need is better support, and help to actually breastfeed.

Now hold on there for a second…. You know that I support moms who WANT to breastfeed in the Grey Zone too, right?? This is absolutely NOT a discussion of how a mother is any less of a breastfeeder or less of a good mother if she WANTS to use any of those things, like formula, pumping or bottles. LOTS of moms simply chose to do ‘a bit of both’, or maybe they don’t want to breastfeed at all. As long as that’s because they WANT to, (and not because they are doing it due to lack of proper breastfeeding support) then that’s just fine.

The important thing to know, if you’re in the middle of Breastfeeding in the Grey Zone is that some mothers sometimes NEED to use these things on a temporary basis and it’s still ok… you don’t have to stop breastfeeding! You can end up needing these things if baby is sleepy, can’t latch, has a tongue tie, you had a traumatic birth, you are in pain, you have postpartum depression, you adopted your baby, had a surrogate, you had breast surgery, you weren’t taught about normal newborn feeding behaviour, you didn’t pump/express when it might have helped, you were told to give a bottle and just needed your baby to eat, and you didn’t know what to do next!! Not everyone can do it, but if YOU still want to breastfeed, there is almost always a way to keep going. It may not be ‘perfect’, but YES, you can still breastfeed.

I am a Private Practice Lactation Consultant, NICU Nurse and Doula who has worked with parents and babies for almost 20 years, and I have breastfed my three children (#3 is still going!) so I have seen a lot of breastfeeding in my day. Breastfeeding doesn’t have to be perfect to still ‘count’. I see so many mothers who are struggling in the first few weeks and they think they might have missed their chance. It’s not too late. Get help as soon as possible. Find someone who supports you and helps you reach YOUR goals.

If it is important to you, then is important to me. If you want to keep breastfeeding, don’t give up.

The post Are You “Breastfeeding In The Grey Zone”? appeared first on Nutmeg Consulting.

PUMPING IN THE FIRST WEEK:

If you are pumping in the first few days after your baby is born, expect NOTHING!! For about 2-5 days, you have colostrum milk (which is produced in your breasts starting at 16 weeks of pregnancy, so trust me, it’s in there!)
Colsotrum is thick, and harder to actually collect with a pump, so try to hand express also. You might not get anything when you pump, but it’s good to stimulate your hormone if that’s what you need.

If you are pumping to increase your supply, then pump after feeds.
If you are pumping to soften your engorged/painful breasts, then pump just a bit, to soften your breasts.

PUMPING TIPS TO GET THE MOST MILK:

Try using warm cloths on your breasts, massage, and hand expression before pumping to get the milk going before you start pumping.
Pump for 10-15 minutes… to increase supply, pumping more often is more helpful than pumping for a longer session.

DON’T hurt yourself. Cranking the pump up really high will NOT necessarily give you more milk, because if you’re in pain, your stress hormone will work against you. Make sure it’s comfortable. Use your hands to massage or gently squeeze more milk out if you need to.

Cut some holes in an old sports bra to make a ‘hands free’ bra for pumping (or you can always spend a bit and buy some great hands-free pumping bras.)

PUMPING AFTER YOU’VE BEEN BREASTFEEDING FOR A WHILE:

Pumping is not an accurate measure of how much milk you have, so don’t freak about your milk supply if you start pumping and don’t get much! A baby that is breastfeeding well can get WAY more milk that a pump… everybody responds to pumps differently. I’ve breastfed 3 kids and my body ‘sucks’ at pumping….

If you are pumping to build a ‘freezer stash’ after you’ve been breastfeeding for at least a couple of weeks, it can be helpful to pump around the same time each day to teach your body to build in a bit of extra milk supply for the ‘pump baby’.

Don’t expect extra milk to just be waiting if you just randomly pump, your body has adapted to whatever baby has been needing and doesn’t have extra ounces just lying around!

If breastfeeding is going well (baby is gaining weight, pees & poos are good, breastfeeding isn’t painful) then it usually takes 2-3 weeks for you to reach your full milk supply.

The average feed for a breastfed baby is only 2-4 ounces once they are around 2 weeks old, to 6 MONTHS!! They don’t need more milk as they get older. Instead, their intestines mature, so they are able to absorb more of the milk… they also poo way less around the 2-3 month mark because of this!

You don’t need to pump in the night if baby starts sleeping longer, your body will adapt (and if your baby is sleeping all night, then that’s ok!)

MILK STORAGE AND PUMP CLEANING:

Ideally, you should wash your pump parts with hot, soapy water every time you pump, but you don’t have to sterilize every time! Boiling parts for 5 minutes (or using a steamer) every few days if you’re using it often is fine. YOU DON’T NEED TO WASH THE TUBES that come with your pump.
If you’re pumping for a healthy, term baby MANY times per day (it’s soooo hard!!) you can pour the milk into a storage container in the fridge, then just rinse your pump parts and keep them in the fridge until the next session. Wash thoroughly every 12-24 hours.

Don’t add warm milk to cold milk. If you pump a little bit everyday, you can put it in the fridge each day, and then you can mix the milk from those pumping sessions together, (make sure it’s all the same temp before you mix it) then you can freeze it.

Freeze milk flat in Breastmilk storage bags, so they are easy to stack.
Check out the Toronto Public Health Breastmilk Storage guidelines for fridge/freezer rules.

Watch the Stanford University Hand Expression video to learn how to Hand Express milk/colostrum. If you’re in Toronto or the GTA and would like more information about Lactation Consultant Home Visits or Breastfeeding Prep Consultations, then feel free to give me a call (416) 300-7064 http://www.nutmegconsulting.ca

The post PUMPING BREASTMILK…here’s everything I can think of that you WANT and NEED to know if you ever WANT or NEED to pump!! appeared first on Nutmeg Consulting.

Whatever your breastfeeding story, it is very common to have at least a few struggles with breastfeeding especially in the first week. Whether it’s a painful latch, a sleepy baby, constant crying or someone telling you that baby isn’t getting enough, there are lots of challenges you might encounter. Most of us didn’t grow up in a village where all the mothers were topless and sat around a fire breastfeeding all day. If we had, more of us would find breastfeeding natural, instinctive and easy….but for many, it’s not. It’s something you need practice, help, and time to get good at. Also, there are some great tricks that can make a big difference if you know about them, so that’s where I come in!

Now Presenting: The top 4 things that will help you keep breastfeeding, even when things aren’t quite perfect at the start…..

1. Learn about Hand Expression

If there is ANY reason a baby is having trouble breastfeeding in the first few days after birth, hand express your colostrum every 2-3 hours. You might only get a few drops but it signals your body that you’re still ‘IN’ for becoming a breastfeeder and that you would like to request a great milk supply. We can figure a lot of things out later about a deep latch, nipple comfort and excess weight loss if your body is reminded to continue making milk. Check out a great Hand Expression video here

2. Spoons are made for babies too!

If your baby isn’t able to get colostrum out of your breast the ‘usual’ way because he’s tongue-tied, sleepy, it hurts you or he just can’t latch, then use a spoon! First, read #1 and watch that video. Now hand express right into a spoon & give it to the baby! Spoons are easy to use, hold small amounts (which is usually all newborns need anyway….seriously!) and you can express your thick colostrum right into it so you don’t lose your 3 precious drops in the pump valve thingy!

3. Take off your shirt and hold your naked baby.

This one seems simple and obvious once you learn about how much ‘skin-to-skin holding’ can improve breastfeeding outcomes. Most parents however, think they’re supposed to immediately put their new baby in all the cute outfits and hats they’ve had washed and waiting for this moment…. I don’t blame you, that outfit IS super cute, BUT if your baby is having trouble waking up, calming down, latching or is cold, I promise that the science here is right. Mama’s chest is the place to be. Put your feet up, get comfy and hold your baby.

4. Keep trying, and get help.

Ask for help, ask for more help, then if you still need help, find different help…and CALL ME! Breastfeeding takes practice. Learning about a few ‘normal’ things can make a big difference in your confidence too.

• Shaping your breast the SAME direction as the baby’s mouth will help him get a deeper latch
• The tiny amount of colostrum that babies actually need
• That weight loss in the first week is NORMAL (get help if it’s more than 10-12%) because of ‘water weight’
• That breastfed babies need to SUCK! (That’s what brings your milk in so don’t expect to sleep longer than an hour or two in a row for a while!)

The sooner you find help the better, but even if things aren’t perfect right from the start, try these things and your breastfeeding career really can continue almost always, if you are a bit stubborn, a bit knowledgeable and just a little bit lucky.

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