- Vitamin D Council: http://www.vitamindcouncil.org/about-vitamin-d/how-do-i-get-the-vitamin-d-my-body-needs/#
- Kellymom http://kellymom.com/nutrition/vitamins/vitamins/#VitaminD
- National Institutes of Health, Office of Dietary Supplements: QuickFacts:http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/ … Factsheet for Health Professionals, has info on sources, recommended daily values, etc: http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
- American Journal of Clinical Nutrition: http://ajcn.nutrition.org/content/87/4/1080S.full
- Dr. Mercola’s opinion on where to get Vitamin D: http://articles.mercola.com/sites/articles/archive/2008/11/25/why-sunlight-is-your-best-source-of-vitamin-d.aspx
Breastfed infants typically have more than three bowel movements per day and are rarely constipated. Watery stool may be normal; however, parents should contact their physician if the infant’s stools run out of the diaper.Urination PatternsSix or more wet diapers per day is normal for a breastfed infant after the mother’s milk has come in, as well as for bottle-fed infantsBowel movementsMore than three bowel movements per day is normal in breastfed infants.Bottle-fed infants may have fewer bowel movements
AbstractTo identify the normal defecation patterns and the factors affecting these patterns in the first two years of life, a questionnaire was given to the parents of 1,021 children who were followed in a well-child clinic. The time of first meconium passage, presence of colic symptoms, frequency, color, and consistency of stools were recorded. Mann Whitney U, Wilcoxon, chi-square, and correlation tests were used in the statistical analyses. The median number of defecations per day was six in the first month of life. This decreased to once in the second month and almost all cases remained so until the end of the 24th month. At the second month of age, 39.3% of infants passed stools less than once a day. This pattern of rare defecation was seen until the end of 6 months, when supplemental foods were started. Stool frequency was higher in exclusively breast-fed infants (p = 0.0001). Infants who had colic symptoms in the first 2 months had less frequent defecation during the first 2 years of life (p = 0.0001). In addition to confirming the previously observed defecation patterns of 0–2-year-old infants, this study provides the relationship between colic symptoms and stool frequency, and showed that the second month of life was unique in the sense that the frequency of stooling decreased to half of the previous month and 39.3% of these infants defecated less than once a day.
Paced Bottle Feeding
What Bottle is the Best?
How Long Should it Take to Feed a Bottle?
How Much Milk?
When to Feed?
How to Determine Feeding Schedule:
Do I Need to Practice?
Help! My baby won’t take a bottle!
Storage Guidelines of Expressed Breast Milk:
Mixing Expressed Milk:
Oops! I didn’t use/need what I HEATED!
Does the milk have a metallic taste or smell funny?
The STUDIES the Storage Guidelines are based on:
Here are a few examples of those problems:
- Preterm babies, some studies have shown that a nipple shield can be effective when working with babies that aren’t term.
- Babies with tongue tie, if you are waiting on a referral to get a tongue tie revision a nipple shield can be helpful and it extends far enough into the baby’s mouth to maintain latch.
- Babies with poor muscle tone can sometimes benefit from the rigidity of the shield.
Here are some reasons NOT to use a nipple shield:
- Baby will not latch, if you are using a shield, baby is still not latched.
- Breastfeeding is painful, if breastfeeding is painful it is because baby isn’t latching well. If you are using a shield, you still have a baby that is not latching well only now it is to the shield.
- Baby keeps coming off the breast, if baby stays on with the shield, please have infant evaluated for tongue tie/lip tie.
- If you are using a shield for any reason, please note that there is s good chance that your milk supply will diminish over time. This is because your baby’s saliva doesn’t come in contact with your nipple and stimulation is decreased by the layer of silicone.
Most methods of birth control are not harmful to nursing infants but any hormonal birth control can cause issues with milk supply. Progestin-only birth control is generally considered breastfeeding compatible, but combination birth control (containing estrogen and progestin) is typically not recommended.
Breastfeeding can cause the delayed return of fertility for some mothers, but only if certain conditions are met. Like any method of contraception, there is a certain rate of failure and many factors can affect the success rate. Check out the graphic below for more information on this method.
For more information on hormonal birth control:
- LLL Breastfeeding Answer Book, March 2012: Contraception
- Academy of Breastfeeding Medicine Clinical Protocol #13, Contraception During Breastfeeding
- Safe Use of Birth Control While Breastfeeding, Hale’s Infant Risk
- Birth Control and Breastfeeding, Kellymom
Long-acting Reversible Contraception (LARC) Methods
LARC methods include the intrauterine device (IUD) and the birth control implant. Both methods are highly effective in preventing pregnancy, last for several years, and are easy to use. Both are reversible—if you want to become pregnant or if you want to stop using them, you can have them removed at any time.
The IUD is a small, T-shaped, plastic device that is inserted into and left inside of the uterus. There are two types of IUDs:
- The hormonal IUD releases progestin. One hormonal IUD is approved for use for up to 5 years. Another is approved for use for up to 3 years. The progesterone-releasing IUD delivers its hormone directly to the lining of the uterus, which only leads to a slight increase in progesterone levels in the blood stream (much lower than that found with the progesterone-only pill). As a result, there is much less chance of side effects from the progesterone than from the injection or mini-pill.
- The copper IUD does not contain hormones. It is approved for use for up to 10 years.
The birth control implant is a single flexible rod about the size of a matchstick that is inserted under the skin in the upper arm. It releases progestin into the body. It protects against pregnancy for up to 3 years.
For more information on LARC:
- The American College of Obstetricians and Gynecologists http://www.acog.org/Patients/FAQs/Long-Acting-Reversible-Contraception-LARC-IUD-and-Implant
Other birth control options include barrier methods and fertility awareness methods. They are not harmful to nursing infants and don’t affect milk supply.
For more information on other birth control:
- Barrier Methods https://www.acog.org/Patients/FAQs/Barrier-Methods-of-Birth-Control-Spermicide-Condom-Sponge-Diaphragm-and-Cervical-Cap
- Fertility Awareness Method http://www.tcoyf.com/fertility-info/birth-control-faq
- Natural Family Planning http://nfpandmore.org/
Whatever method of family planning you choose, we love to recommend that any person with a uterus read the book Taking Charge of Your Fertility, to better understand your reproductive system, and truly take charge of your body.
Often, one of the first challenges a mother faces is jaundice. Doctors and nurses may indicate that all jaundiced babies must be fed formula, but evidence suggests that this is not case. Infants can absolutely overcome jaundice and grow into healthy babies while consuming only breast milk. Although management of breastfeeding and jaundice varies among the nations, the principles and recommendations outlined in the link below apply universally.
Support is key to the success of any breastfeeding relationship. It truly takes a village! Use the links and resources below to find a lactation professional or breastfeeding support group near you.
Why an IBCLC?
An Internationally Board Certified Lactation Consultant (IBCLC) is a highly trained lactation professional. IBCLCs spend hundreds of hours studying the biology and best practice of lactation, and are certified by the IBLCE, which establishes the highest standards in lactation and breastfeeding care worldwide. There are many wonderful CLE and CLCs out there, but IBCLCs undergo a uniquely rigorous and thorough course of training to receive their certification. Overall, their knowledge tends to be more complete and up to date.
Savannah, GA Resources
We have 3 IBCLCs (all in the Savannah/Statesboro area of GA) in the Milky Mommas group. These ladies are amazing and can literally turn your breastfeeding relationship from a nightmare into a dream come true:
Helen Pastures https://www.facebook.com/LatchSAV/
Find an IBCLC in Your Area
La Leche League
There are local La Leche League meetings in every state. Many groups have local Facebook pages.
See link below to find your local group:
- Call the Leader Locator at 847-519-7730. This number provides access to an automated system for finding LLL Leaders in the US by entering a local zip code. In Canada, call 800-665-4324, or 514-LA-LECHE for a French-speaking Leader.
- If you are unable to find a Group or Leader near you, 24-hour breastfeeding help is available toll-free in the US from the LLL Breastfeeding Helpline-US at 877-4-LALECHE (877-452-5324).
If you are local to Savannah GA, here is the LLL of Sav page: https://www.facebook.com/lllsavannah.
The mission of Breastfeeding USA is to provide evidence-based breastfeeding information and support, and to promote breastfeeding as the biological and cultural norm.
Find a Breastfeeding USA group in your area:
How to Become an IBCLC
If you are interested in becoming an IBCLC, you can find more information here:
If you have worked with an incredible IBCLC or LLL in your area, feel free to share their link with us. The more resources we have, the more support our fellow Milky Mommas will have on their amazing breastfeeding journey.
One of the most common concerns of the breastfeeding mother is that they aren’t making enough milk for their baby. Let me assure you, true low supply, or the inability to produce adequate milk, is rarely the problem. What signals your body to make more milk? Removing milk!
“But he wants to eat all the time!”
Ok…Let’s look at the whole picture:
- Is baby very young? Newborns have a stomach that, at 10 days old, is still only the size of an egg, and he’s eating a perfect food that is completely digested quickly.
- How old is he? Just like a teenage boy that eats all the time, babies are growing…and fast! There are several physical and developmental spurts that occur, usually around the same time for each child. Take a look at the Wonder Weeks chart (http://www.whosthatmom.com/wonder-weeks-week-by-week/) and see if your baby is either having a growth spurt or about to have one.
- Is he latched correctly? Can you hear him swallowing? A proper latch is comfortable for you, not painful, and allows baby to efficiently remove milk from the breast. If you have access to an IBCLC, have them check baby’s latch. There are several valuable resources here, as well: http://kellymom.com/ages/newborn/bf-basics/latch-resources/
“He fusses at the breast. I don’t think any milk is coming out.”
- Let’s talk about supply and demand. Babies demand milk…and you supply it. Fussing at the breast, beating on you, on-and-off nursing, etc, all signal your body to make more milk. Your breasts don’t ever truly become “empty”, they continuously make milk.
- Does he need to burp? Is he distracted or overstimulated? Are you distracted or stressed?
- Is he getting too much milk? Check our document on oversupply to see if it sounds like you.
“I’m pumping barely anything.”
- Pumping is never a good way to judge what you’re actually producing. Babies are much more efficient at getting milk out than a pump.
- Also see our document on Pumping Tips for help when pumping at work.
“My breasts feel empty. I think my supply dropped.”
- Probably not. Most of us only experience super-full feeling breasts for a limited time. What is most likely happening is that your supply is regulating. Your body and your baby’s demands have come to an understanding and your are meeting his needs without becoming overfull.
- Your breasts always make milk. When milk is removed, they make more. “Your breasts are a factory, not a storage facility.” They are never truly empty.
- Babies can typically always get out more milk. Even if it’s minimal; they are very efficient at their job.
“How do I make more milk?”
- Firstly…nurse your baby more. Most concerns about supply can be fixed by simply nursing more.
- Nurse baby on demand. Let him decide when he wants to eat.
- Pay attention to baby’s hunger cues. Rooting, smacking lips, sucking hands, etc, are all signs of hunger. Crying is a late hunger cue.
- Soothe at the breast. Comfort nursing can be frustrating sometimes, but it is the best means of comforting your baby and ensuring an abundant supply of milk.
- Nurse until baby lets go. Let him decide when he’s done.
- Don’t be a clock-watcher. Allow baby to run on his own time.
Signs that your baby is getting plenty of milk:
- baby starts gaining weight after your milk comes in. Remember, weight gain varies with every individual. Don’t compare your baby to your friend’s or yourself.
- baby is having at least 3 quarter-sized poops per day. These can be spread out over a 24 hour period. More than three is fine.
- baby is swallowing when he’s nursed.
- baby is nursing at least every three hours until he reaches about 10 pounds. Again, more is fine.
- baby passes birth weight by around 2 weeks. Remember to calculate that by baby’s lowest weight.
- baby continues to gain weight.
- still has 3 quarter-sized poops per day. Until around 6 weeks, this is what we want to see. Others may tell you that it is normal for exclusively breastfed babies to go several days or even a week or more without pooping. That is not true until around 6 weeks, and even then, not the norm.
- baby has gotten the hang of latching on and staying attached.
- baby is sucking with long, steady sucks soon after latching.
6 weeks on:
- baby continues to gain weight.
- baby is meeting developmental milestones.
- baby has plenty of wet diapers and regular poops (they become less frequent around 6 weeks).
- baby is getting longer and gaining in head circumference.
What if your supply is truly low?
Sometimes baby really isn’t getting enough milk. It’s important to understand why.
It’s important to figure out if he’s not taking enough because you’re not making enough, or if you’re not making enough because he’s not taking enough, or if he’s taking plenty but not using it well.
Source: The Womanly Art of Breastfeeding, 8th ed., p.396
What might be the issue with baby?
Possible causes of baby taking too little milk are:
- he’s improperly positioned
- his nursing time is being cut short
- he’s being fed too infrequently
- he has a tongue-tie or other latching issue
What might be the issue with me?
Possible causes of mother making too little milk are:
- thyroid problems
- PCOS (Polycyctic Ovary Syndrome)
- breast surgeries
If your supply is truly low and your baby is not thriving, it is our advice at Milky Mommas to seek out and meet with an IBCLC to identify and correct the problem.
Most of these scenarios are completely reversible, so don’t give up hope. Remember, if you must supplement due to medical indication – and at the recommendation of a professional – there’s a strong chance that supplementation need be only temporary and you can return to being your child’s sole source of nutrition.
- A tooth visible below the gum
- Swollen, bulging gums
- Trying to bite, chew, and suck on everything she can get her hands on
- Rubbing her face
- Difficulty sleeping
- Turning away food
- Grabbing at the ears
- A clean cold wash cloth
- A clean cold wash cloth that has been in the freezer for a bit
- Frozen fruit like an apple slice or berries in a mesh holder (for those over 6 months and already on solids)
- Milk-sicles (breastmilk frozen in a popsicle mold or ice cubes in a mesh holder)