Wondering about Weaning

I cannot give the exact date when my son finally weaned from breastfeeding. I guess it was about on the start of this year, he had just turned 3 years old. Now, he just promptly refuses whenever I offer to nurse him, just for the fun of  it. We would just turn away from my breasts, as if nursing was the ickiest portion of his young life.;)

Now after weaning, i can finally drink beer or wine without having to worry about nursing later. Now i can drink gallons of coffee without needing to count the milligrams of caffeine i've taken in. Now my wardrobe won't be confined to nursing clothes! But a wee bit part of me often misses that side of me, the nursing mama.

Looking back, here are some key points about our own weaning journey:

#YolandaPH : Yet Another Reason to Go Back to the Breast

Being able to breastfeed is equal to empowering all moms to feed a hungry baby at any time, no matter how worse the situation may be! I can only imagine how bad the situation in Yolanda-hit areas - still no electricity after more than a week since the brunt of the storm and almost all the establishments leveled - but I am sure that among the supplies quickly depleted is clean and potable water.  Such water plus clean feeding bottles are the among the things you need should you decide to formula feed.  Such may be difficult or in most cases, impossible to come by during emergency situations. This is the main reason why breastfeeding is the safest option, emergency or not.

The World Health Organization puts is in much simpler terms, " Infant formula usually needs to be mixed with water. When there isn’t sufficient safe water available, babies who drink it can get very sick".  

Breastfeeding Stats in the Philippines

'Been swamped at work and family time, but as i was doing some research i found this! I just want to share some findings from National Statistics Office' 2011 Family Health Survey. The survey has some interesting breastfeeding statistics!

The good news: 92% of children were breastfed for some time! Hooray for moms who attempt and keep on breastfeeding! Some breastfeeding is better than none at all right?

Some more good news -  higher percentage of poor children than non-poor children were exclusively breastfed. 34% of babies from poor household are exclusively breastfed. For higher-earning households, that only24%. This means that babies from poor families usually get breast milk. That's good news because this means poor households won't spend on formula.

My life without breastfeeding

My son P is nearing his 20^th month and we’re 4 months shy of my 2-year nursing goal.  Now I’m reading up on weaning stories from other moms. I realized, weaning is not easy! You need to be firm in not offering the breast despite the child's pleading.  Gosh how can i do that when breastfeeding is in our routine? This makes me wonder how to initiate the weaning process. Anyway, I have about four more months to reflect on my weaning strategy. Or maybe I’ll see if he weans naturally? Read more on weaning from Kellymom and La Leche League International.

Talking about weaning makes me think of my mommy life without breastfeeding! Hmmm.. A life without breast pump and breast milk storage?  I’d certainly like that! For me, it’s only  the system of pumping and storing breast milk that complicates my nursing life.

Here are what i look forward to when my son finally weans:

No more office pumping

This i look forward to! I'll definitely do more office stuff. Hehehe.. No more checking the time and rushing when it's time to express milk.

I'd appreciate life without a bulky breast pump and all its parts. My commuting life will be easier once i stop carrying the pump and the cooler bag daily from home to work and work to home. Plus, this means no more cleaning pump parts and bottles! Cleanup is among the stuff i definitely won't miss.

No more breast milk storage

I won't be stressing myself about keeping breast milk safe in storage. I won't be bothered every time brownout strikes. This is a relief!

Hooray for more space in the refrigerator, too. I'll free up the ref space once i pull out those BM containers. I won't be freezing the ice packs, too. That means more space in the freezer and lower electricity consumption. Yehey for that!

No more biting

Now this is a relief, right? My child sometimes bites my nipple when he's sleepy or when he's teething.  It really hurts when he does this.  I definitely won't miss all the pain from biting.

More wardrobe choices

I made it a point to wear breastfeeding friendly clothes. This is a must for easy nursing.  I also look for clothes that allow easy access. I usually wear button-down shirts and  v necks. Wearing such is a must when pumping at work,  definitely gives you privacy and ease as you about your pumping business

Nursing is a  major consideration when i buy clothes, Now i can wear round neck shirts and high-neck blouses. Hooray for more clothing options!

[caption id="attachment_2908" align="aligncenter" width="239"] From the start, my son has been an avid nurser.[/caption]

Missing nursing

Nursing has been a great bonding experience between me and my son.  Till now, we still rely on nursing as a main form of bonding, My favorite part is when we nurse during the night, when everyone else is asleep. It's our own "mom and me" time.

Nursing is my own convenient way to soothe a distressed baby. My toddler is fast approaching the "terrible twos", but sometimes,  nursing still works to calm him. Nursing is my secret weapon! My kid learned to sleep on his own, especially during daytime when i'm out. But often, during the night, he comes to me to nurse to sleep. For me, nothing beats the convenience of side-lying position while nursing. I can lie down while my son drinks his milk.

His first word in the morning is "Dede", even if he's not that hungry and will suck on for only a few minutes. At night his last word is "Dede", too as he cozies himself to sleep.

Breastfeeding became a big part of my life! I truly think it’s among my proudest moments. I  exclusively breastfed for 6 months and we're still nursing till now. I think that's a big achievement. This makes me wonder how i'll get started weaning him.

Uh oh...  Sounds like i'm going to truly miss nursing. I think i need more time to prepare for weaning! It's a two-way street. It's not only my son who needs to be prepared for weaning.  I'll need some conditioning as well.  Weaning is among those stages a child must get through. My kid can't breastfeed forever right?

For more tips about breastfeeding, please read my All About Breastfeeding page.

***

A tale of three breast pumps

I'm kinda reminiscing on those times when i yield ounces and ounces of breast milk after a pump! Now, after 18 months of breastfeeding, i'm lucky to get 3 oz per pump. So give this mama some time to contemplate on her old breastfeeding buddy - the breast pump! Without the pump, i think i would not have lasted to nurse this long!

I had two breast pumps before i found that one true pump for me.

First was the First Years single manual pump.  

Hubby and i got this out of necessity, really! We bought it for around P1300 (i'm not sure about the exact price anymore). It was a good single manual breast pump for beginners. Yup beginners, because hubby bought it for me got it right after i gave birth.  I could imagine him looking for a breast pump in the baby section, asking the sales lady for a demo. Hehehe. He got this pump the next day after i gave birth.

My baby can't latch after birth and he was stuck in the NICU for one week. So we really really needed a pump, just to facilitate breast milk production.

[caption id="attachment_2537" align="aligncenter" width="242"] This pump was my breastfriend in my first weeks of breastfeeding.[/caption]

I was actually very masipag  to pump back then, i religiously pumped every 3 hours.  If i remember correctly, i got around 6 ounces per session using this manual pump. I was really pleased with my pumping output back then.

But my hand hurt after all those squeeze and release motion, i felt my fingers were about to fall off. Also, i wrecked the valve within 2 weeks! It was my own fault actually, because i brushed the insides of the valve. This was a no-no pala, since the pump should be kept "vacuum". When i brushed the insides of valve, the sides cracked, hence the "vacuum" was disturbed!

So we had to get extra spare parts right way.  Luckily, the department store also sells spare parts for this kind of pump!

So to the rescue naman si husband. We had an emergency trip to the mall to get a cheap electric pump.

Next was the Precious Moments single electric pump.

We got it for around P1700. Cheap diba? But so was the quality!  It was a single electric pump but you still have to squeeze and release to control the sucking motion. You have to learn the ropes to work with this pump. Kahit electric sya, you still have to press the release button when you need the pump to let go of your nipple. Ayyy.. it really sounds painful.After using this for two weeks , my  nipple bled. Thankfully, after several days, it healed.

[caption id="attachment_2538" align="aligncenter" width="292"] This was the cheapest single electric breast pump in the mall.[/caption]

I think i did not have the knack to learn how the squeeze-release system for this pump works.  Actually, there's really a technique to breast pumping. Minsan, kahit naman hindi high-end na pump, it still works, moms just have to learn to get a hang of it.

Last was Medela Pump in Style Advanced double electric breast pump. 

When my nipple bled, that's when i really decided i need a good breast pump. This is precisely the reason why i recommend splurging on a pump!

We spent about P 13,000 for the Medela Pump in Style pump! Hubby bought it right after we got my maternity allowance check from SSS. He got this from an online seller  on EBAy. It was really expensive but i tell you, it was worth every centavo! So pikit mata na lang nung binili namin.

[caption id="attachment_2539" align="aligncenter" width="235"] We got the one with backpack. In hindsight, i should have gotten a shoulder bag type, para bagay naman sa kahit anong outfit![/caption]

What i love about this Medela pump is the 2-Phase Expression technology - wherein there's fast sucking motion  in the first two minutes. Then next na ung long sucking motions - ito na daw ung let down stage. According to Medela, this 2-phase expression mimics how direct nursing works. On first minutes, baby sucks to stimulate the breast flow. Then later, baby sucks longer and deeper to get more milk.

This technology is not present in other double electric pumps.  What you can do with other pumps is adjust the intensity or speed of suction, depending on your own let down. Well, who knew that longer and deeper suctions let out more milk than faster suctions!

Sana magamit ko pa ito for the next baby para todo sulit na!

Just some important notes:

Hand expressing is vital.

•  I can not underestimate this skill, especially during those days when you accidentally left behind some itty-bitty parts like the valves or membrane. On page 9 of this booklet from Unicef, there are tips on how to express breast milk by hand.

Direct nursing  is better than breast pumping.

• I still find breast pumping mechanical and such a job! Direct nursing is still the best way to feed baby. You can cuddle and hug the little bunch while you're at it. Plus, the baby's sucking empties the breasts more than any other pump.

Also worth reading:

• Get more milk from every pump


• Breastfeeding essentials and tipid alternatives

Breast Talk

Hmmmm.

I'm going to talk about my boobies now, a bit TMI for most.

But still, i'm still talking about them.

Breasts and my body image

I have always been self conscious about my breasts. When i hit puberty, my peers often teased me about how my breasts were getting bigger.  Let's just say that i was among those kids who needed to grow up earlier than most, because of my developing body. I've avoided playing skip ropes, chinese garters and those games that require jumping and running when i was 10 years old.  I guess much of it involves how uncomfortable i was about carrying a heavy front load.

I was teased all the more during my high school days! I even resented wearing body-hugging shirts and blouses because i did not feel comfortable about my body image.

When i was in college, that's when i started appreciating my built. It was then i've accepted my God-given big boobies!  It was not like i flaunted them, but i've accepted them as part of being me. My barkada would often call me "Busty" but i didn't care much about that. I just laughed off my nickname. I guess every girl have a body issue - some being flat chested. And then there are girls like me, who's issue was their full bust.

Of  course, let's not underestimate the power of the breast. Admittedly, "the girls"  helped me snag a husband....  to a limited degree... somehow... wahahaha... 

When i got pregnant the big boobies got even bigger. This was to prepare my body for its ultimate function. I was a milk machine in the works!  And boy, am i ever so proud raising an exclusively breastfed baby! He was slightly underweight as a newborn  and with my milk,  he grew up healthy and strong!

[caption id="attachment_3259" align="aligncenter" width="253"] Body changes takes a backseat, my boy's health comes first.[/caption]

Breast changes after giving birth nursing

Now after 18 months of breastfeeding, i really feel and see changes with my breasts! First - the size, they got smaller.  I'm now a cup size smaller than before i got pregnant!  Second - the shape. They're not as round and perky anymore.  I also feel "empty" breasts especially now since i'm not oozing with BM anymore. Last, they sagged.  I noticed that they drooped a bit - like down to my tummy. But I can't blame gravity for this right?  Sagging or drooping is more noticeable for women with big boobs, to begin with.

But I'm not really sure if i should attribute these boob changes to breastfeeding.  Kellymom , citing a study published by the  National Center for Biotechnology Information, says breastfeeding is not the cause of breast sagging or breast ptosis, which is its technical term.  The study  listed these risk factors to be possible and more apparent causes of breast sagging -

• age (as we age, our skin becomes less tight, hence possible wrinkles) 


• 
  

  history of significant (>50 lbs) weight loss - preggy women  have rapid weight loss on d-day... yehey!!!!

  
  


• higher body mass index - being overweight puts women at risk to breast ptosis?


• 
  

  larger bra cup size - hmmm i fall under this category

  
  


• number of pregnancies - what???   but i'm still on baby number 1! 


• 
  

  smoking history - hmmmm... attention smokers... this is another good reason to quit... right now!

  
  

Ayun naman pala!  So the sagging  is not directly caused by breastfeeding. According to this WebMD article,  the stretched out look may be due to the shrinking of milk-making structures in the breasts. These milk-making structures go on overdrive as your near delivery to trigger breast milk production. They then shrink after pregnancy.  The good news is, saggy breasts, is more often not a medical concern.

When i became a mom, I understood the higher purpose of my breasts! No, they're not not just for aesthetics, or for the pleasure of my husband!  These are for nourishing my offspring.  As mammals,  we are equipped with the machinery to care for our babies. Breastfeeding  is the most natural  way to nourish our young.

Possible sagging or drooping should take the back seat when moms are weighing in on breastfeeding! Undeniably, breastfeeding and being a mom, has taken a toll in my looks.  The saggy breasts, along with the stretch marks, i shall wear them proudly as battle scars of motherhood. Why should i waste time over this when the reward is much much more precious - it's the special bond my boy and i  had developed through nursing!  I'll just get me some more push up bras!

I'm not really THAT bothered by the sagging issue, thankfully, so is my husband.  Sabi nya, superficial lang kung ang dahilan nang hindi pagpapasuso ay dahil sa pag-sag ng boobs. Para naman  sa akin, kahit umabot pa lampas ng tuhod ang dede ko, magpapasuso pa rin ako!

Also worth reading: 

• Top 10 reasons why Breast is best 


• Alarming facts about breastfeeding in the Philippines 

 

Who has time to wash the pump parts?

First off, let me tell yah that washing these pump parts is the most hated job of this lazy mommy! I don't know but i just find it too tedious! It's taking time away from my boy while at home. In the office, i don't have the luxury of time to wash them every..... single.... time!

But what's a mama gonna do? Someone's gotta do it so that someone might as well be me,  since i am too OC to let anyone else do this task!

This is why i'm trying to find ways to make washing pump parts in the office much easier.

First know that I don't wash the parts after every use.  My rationale for this is that breast milk stays good at room temp until  6 to 8 hours   according the Centers for Disease Prevention and Control. My own  bm shelf life is 4 hours, because of varied ambient temperature in my workplace.  Personally, if it's within the 4-hour interval, i reuse the parts.

(Disclaimer: If you have access to a fridge, play safe and keep the parts there until your next use.)

Having a refrigerator nearby would have been perfect, but our lactation station is not accessible to me. It's on our ground floor in the clinic, while my office is at the second floor.  I try to limit per pumping session up to 15 minutes. Going up and down the stairs every time is just a no-no for me. So i do my pumping business right on my own work station.

If you're still queasy about leaving the parts at room temp, bring a big cooler to store all parts - bottles, flanges, valves and connector. This can act as your mini ref so bring in a lot of ice packs, too.  Warning: This can be bulky and heavy to lug around!  I used to do bring in a big Lock and Lock cooler to store my pump parts, too! But i got lazy doing this, so when my baby turned one year old, i stopped doing this. Hence, my 4-hour rule.

When my 4 - hour rule is up, then i face the music and wash up.

Here' s my setup:

[caption id="attachment_2235" align="aligncenter" width="256"] Here are the items for my washing up ritual.[/caption]

• Clean water- i raid our office's drinking station for this!


• Lots of clean white cloth -  for drying and wiping


• Food grade container - should be big and deep enough to submerge the parts


• Chicco sanitizing liquid - This is available in most baby section of malls at P300 per 1 Liter. If this sterilizing liquid is not available, a very mild cleanser can do the job. I use Messy Bessy natural dish cleaner.


• Alcohol - to sanitize through out the washing procedure


• Tissue - to wipe any mess or spills

My cleaning procedure

• Mix 1 doze of the sterilizing liquid ( see label for instruction and dosage) with 1 liter of clean drinking water. Or add a few drops of dish washing liquid to the water.


• Dismantle the valves and flanges into separate parts to ensure all the breast milk trapped inside these parts are washed away.


• Submerge the pump parts to be washed for at least 1 hour.


• Rinse thoroughly with drinking water until any trace of soap or grease is gone.


• Never lay the parts on your keyboard or the sink, use the clean cloth as liner. Make sure your hands are clean before touching the parts.


• Air dry for a few minutes and wipe with a clean cloth.  Air drying would have been ideal but since time is of the essence here, use clean cloths to wipe the flanges, valves and bottles to try.

Bring extra parts to save cleaning time!

I bring at least 4 4oz bottles so i have fresh ones every pump.

It's actually a good idea to have spare flanges, valve and bottles so you won't need to wash these in the office. But pump parts are expensive.  Buying extra parts before the need to replace them will eat a large portion of our budget.

There! Just some tips from a lazy mommy like me.  Every second you save on pumping and cleaning  will  give you extra time to do more work in the office, right?

How about you, how do you wash your pump parts? It would be nice to hear some more time-saving tips!

Also worth reading:

• More tips for working and breastfeeding mommies 


• Office Pumping after on year


• How to serve breastmilk while you're not with baby. 

***

A Year of Office Pumping

I just realized, it's been more than a year since I got back from work! That means i'm a working mama for one year already and I've been a pumping mama for a year now! At first i thought pumping at work was an ordeal but as i progressed, it got easier and pumping became like second nature for me!

I really feel lucky that my job allows me to pump regularly. I know some moms who find it hard to pump while at work so they just forego breastfeeding when they get back to work.  A working mama's line of work can really greatly influence her choice on whether to breastfeed or not. I'm just very thankful that i'm among those who can breastfeed while e lucky ones who can

I think the main difference now that my son's 15-month old is that  i only pump in the office. When my child was less than one, i made it a point to pump or nurse every 3 - 4 hours. For me, that meant bringing the electric pump everywhere so that when baby can't nurse, i'll have to pump.  But now that he's a toddler, i make it a point to directly breastfeed whenever possible.

Here are pumping tips so you can last this long!!!!

Pump as often as you can! 

• If pumping three times is just not possible, then aim for two sessions!  I try to squeeze in a pump every 4 hours when i'm really busy.  When i go beyond 4 hours without nursing or pumping, my breasts feel heavy and full. 


• Frequent but short pumping is better than few but longer sessions. I used to pump for around 15 minutes but now one pumping session lasts 1o minutes. By Philippine law nursing employees should be given a total of a least 40 minutes in an 8-hour work period as lactation break.
  
  
  
  • To save time, i reuse pump parts for the next session, provided it it within the 4-hour window. If it's beyond that, i'll need to wash them. Store in container with ice packs to delay contamination.
  
  
  
  

[caption id="attachment_2106" align="aligncenter" width="300"] I invested in a good double electric breast pump. Using one makes expressing milk shorter and much more comfortable.[/caption]

• Pump where it's more convenient and accessible. By Philippine law still, they should be given lactation stations where they can pump in private and store milk.


• In our office, that lactation station is in the clinic, which is one storey away.    So instead of going there to pump, i just pump in the comfort of my own work station. I just cover up the best i can. I no longer mind than  my breast pump is a bit noisy.   I'm lucky my office mates don't seem to mind, (or at least, they don't show that they mind). While pumping,  i get to answer the phone and work on my computer. Over the few months, i mastered some multitasking skills - expressing and working is one of them!

Except drop in your pumping output

• Don't despair if you get much less than the amount you used to get months before. I used to get around15 to 20 oz of EBM when baby was below 6 months but now i'm getting just around 5 to 10 oz daily.  At one point, i yielded 1 oz after 15 minutes of double pumping.


•  Your production  adjusts to your child's demand, he needs less milk now your production also follows. 

Pump, pump, pump to extend nursing.

•  If you want to sustain your breast milk supply for extended breastfeeding then pumping might be a good idea. Unlike when he was less than one year old, your growing toddler's main source of nutrition is solids. He's also much more mobile and curious and chances are, the only decent nursing you have is during the night! Decreased nursing sessions might signal lower demand for milk. Pumping can help sustain your production for nursing longer.  

In my one-year pumping career, here are the mistakes I STILL MAKE:

Forgetting to refrigerate EBM after getting back from work

• Solution: If you can't put EBM in the fridge right away, assign someone to do so.

Forgetting to freeze ice packs for next day's pumping

• Solution: Have backup ice packs so you always have ice packs ready

Leaving behind small pump parts like valves or screw caps

• Solutions: Count all the parts before leaving the house. Learn hand expression. This can be handy in situations when can't use the electric breast pump.

So there - just some tips to sustain your pumping career! Happy pumping!

Also worth reading:

• Who has time to wash the pump parts?


• More tips for nursing and working mommies


• A working mom's guide on thawing and serving breast milk


• Breast milk storage tips from a working mama 

***

My Biggest Concern Right Now!

Feeding has been an issue between me and my kid. As he got older, he's getting more picky about his food and this is really getting into my nerves! I sometimes feel like he's just testing my reaction when he spits or plays with his food. He would often spit out his food, especially if it has a new taste or different consistency!  But he never spits his  favorites - banana, lugaw and french fries!

So i'm really thinking about the nutrition of my little guy. Most kids by one year can consume family foods of a solid consistency.

Below is the text from Unicef and WHO's Facts for Life

By 12 months:Most children are able to consume 'family foods' of a solid consistency. They can still be offered semi-solid foods, which are easier for young children to eat. Additional nutritious snacks (such as fruit, bread or bread with nut paste) can be offered once or twice per day, as desired, starting at six months. If the quality or amount of food per meal is low, or the child is no longer breastfeeding, give 1–2 cups of milk plus one or two extra meals each day.

They can still be offered semi-solid foods, which are easier for young children to eat.

I've been looking everywhere for sample menu to get a good idea of the best foods to five my toddler. Feeding him has been such a concern, especially since i work during the day, i can't monitor what he gets.  So i'm making it a point to prepare his meals for the day so the caretaker can serve him what i prepared.

Meal plan for toddlers

I contacted our FNRI (Food and Nutition Research Institute), looking for sample menu with our locally grown ingredients for toddlers.  They gave me this very informative and useful guide! Toddlers can eat basically what the rest of the family eats, just in smaller proportions.  The guide below shows how much for kids ranging from 1 to 9  years old.

[caption id="attachment_2016" align="aligncenter" width="300"] Sample Menu for Kids Source: Food Nutrition and Research Institute-DOST[/caption]

When planning your child's diet, make sure you give a variety of food. Here's DOST- FNRI's guide to a balanced diet for kids! Below is a rough of about the food pyramid. Click on the type of food for corresponding amounts per serving.

Here's a rough estimate of the type and amount for food per day:

• 4 to 7 glasses of water and other beverage


• 2 to 4 1/2 serving of rice, grains, bread, noodles, pasta, etc


• 1 to 2 medium servings of fruits


• 1/2 egg


• 1 to 1 1/3 serving of fish, beans, nuts, etc


• 4 to 5 table spoons of sugars and sweets


• 6 tables spoons fats and oils

[caption id="attachment_2013" align="aligncenter" width="265"] Use this guide when planning your kid's daily diet. Source of Photo: Food and Nutrition Research Institute[/caption]

About your little one's milk

I'm still breastfeeding so how much milk he takes in is really a matter of importance to me!  According to the guide above, toddlers should  get  1  glass  (a standard glass is 8 ounces)  of whole milk daily.  I'm quite confident he's getting enough because he takes in 4 to 8 oz of EBM + 4 oz of fresh milk (this also includes chocolate-flavored milk).  Plus he also nurses during the night.

After the first year, SOLIDS should be his primary source of nutrition, so it's ok to feed him first before nursing.  If he gets his milk  before he eats, chances are he'll be too full to ingest his solids!

(Just a note to myself) Do not despair is he spits up the food you lovingly prepared!  This, too, is a phase and shall pass. Patience is a virtue! Today is the best day to develop good eating habits.

Good luck (to me) feeding the precious child!

Also worth reading:

• My teething toddler

***

Coming to Terms with Low Milk Supply

Not giving enough breast milk for one’s baby is among the worst nightmares of a new mom!  For a mom who has early on decided to nurse, not producing enough milk is major cause of stress!   My previous guest post is about a mom’s struggle with her milk supply and how she was able to move on.

If you’re among those moms who struggle with very low milk supply, read on for some points to keep in mind.

For moms who just gave birth, these are some ways to start producing breast milk:

Directly breastfeed your newborn as frequently as possible.

During his first weeks, he may need to nurse every three to four hours. If for some reason,  baby can't directly nurse, pump pump pump! This is what happened to us. Baby got held up in the NICU for almost a week so i pumped like there's no tomorrow during the time he spent there.

Consume lots of malunggay products.

They come in the form of capsules, powder, tea, cookies or chips. Malunggay or moringa is a well known milk supply booster.

Eat a lot! I really noticed that when I eat more, I get more milk when pumping at the office. Dieting right away after giving birth may not be advisable for moms who want to breastfeed.

Think twice about supplementing.

Supplement may come in the form of  breast milk donations or formula.  I dare say that supplementing should be a last resort, especially for those with newborns. Direct breast feeding triggers milk production. So if you feed baby through the bottle (with breast milk or formula), you decrease baby’s time at your breast.  During the first weeks, direct nursing prompts your brain to produce more milk.  Also avoid giving pacifiers. All his sucking should be on the breast.

When you feel your supply is not enough

Seek medical advice to check if your milk supply is genuinely not enough. We can’t measure the amount milk your baby drinks when he’s directly breastfed.  So you must look for other telling  signs that he’s getting enough. Among the tell tale signs that your baby is getting enough is he's not gaining enough weight and if he's not regularly passing stools and urine. Consult a breastfeeding-friendly pediatrician for the correct diagnosis. Read here for signs to watch out for when choosing a nursing-friendly doctor.

Be informed!

Do your homework even before D-day. In the Philippines, where formula feeding is the norm, getting sound advice from other moms, or peers or even doctors can be a challenge. In the US, they even have La Leche Leauge hotlines for moms  having trouble with breastfeeding.  Try to get in touch with breastfeeding advocates like Latch and Breastfeeding Philippines.  I've tried emailing Latch once about my nursing issue and they responded so kudos to them! The internet offers a wide variety of breastfeeding sites that are a gold mine of good information about nursing, among the best is Chronicles of a Nursing Mom.

[caption id="attachment_1934" align="aligncenter" width="220"] Even nursing mother dogs need some prodding from caretakers during the first days post partum!                   Source of Photo: austintexas.gov[/caption]

Below are some good suggestions for moms having problems with low milk supply:

Have a nursing goal.

Set your nursing goal early on and assess this goal regularly. Decide until when you want to nurse, until baby’s 6^th month? Or do you have plan to nurse until his toddler years? For moms will ultra low milk supply, being able to nurse until the 6^th month can be quite a feat.  While those with rich supply might not think of weaning until baby’s first year! Really ask yourself if long-term breastfeeding is  for you.  By setting that target, you can manage your expectations.  Most moms will be happy knowing that they've achieve the nursing goal she set.

Avoid comparison.

Never compare your own situation with other nursing moms. Keep in mind that every body is wired differently. Some moms have abundant milk supply, even able to donate milk by the liters. And for some lucky ones, nursing comes naturally. Don't ever dare to pity yourself for not doing so.

Learn to accept

Come to terms your own nursing situation! When you’ve tried virtually everything and that supply still won’t come up, acceptance is the next best step. Be at peace, knowing that you tried your best to breastfeed your child!

Breastfeeding isn't the end-all and be all of being a mom. Nursing is just one of the million or more skills we must master to raise the little one! But it would not hurt if you try to nurse for as long as you possibly can!

Also worth reading:

• How you could be wasting breast milk

***

Guest Post: Tales from a "Nursing Failure"

Our latest guest post is from mom Kristen Hurst. In her post Kristen shares her struggles with low milk supply and how she initially wanted to breastfeed exclusively for six months but was able to do so only until her baby's four month. Although she considers her nursing career a "failure", I consider it a success because i felt she tried everything to make nursing relationship last. Low breast milk  supply is still better no breast milk at all! 

[caption id="attachment_1901" align="aligncenter" width="265"] Not all moms are wired the same way. Some struggle with breastfeeding, while for others, nursing comes naturally.                                 Source of Photo: nih.gov[/caption]

I remember before my son was born, I just assumed all babies naturally latched onto their mothers, just like a nursling fawn to its mother doe, mother nature at her finest hour; no fuss, fretting or worrying about such things like sore nipples, mastitis and a feeble milk production.   Yes, indeed, I got a crash course in nursing, taught to me exclusively by my newborn!

Not only did my son not latch, he screamed and reared his head back, refusing to nurse, at all. No matter how hard I cajoled, rocked and bathed him and enticed him to try, over and over again, it was to no avail and now we were both in tears. In my exhausted and hormonal state, I began to break down my nursing allegiance and eye that forbidden baby bottle.  I did call the La Leche hotline one night, out of options and basically a giant emotional mess, where they calmly told me to put the bottle down, and walked me through the whole nursing process.    For my son and I, it ended up being months of pumping, but I did get the breast milk down him, just not the way I had ideally envisioned.  I never did manage to produce much milk, even with all my incessant pumping, which made me feel like a failure.  After all, shouldn’t my body have continued caring for my child even after birth?

I had this image of my child and I bonding and connecting, that final little piece of the parenting puzzle, where it wouldn’t matter if there was a devastating natural disaster, I could rise above any dangerous floodwaters or devastating ashes.  Just my newborn and my lactating lifeline who would thrive with all my maternal glory.  Yep, didn’t quite happen that way, but that doesn’t mean I didn’t try.

If this sounds at all like your breastfeeding experience, then I’ve got a few tried and true tips to heed and hopefully help you through the stressful first days of nursing.

• Breast milk versus formula: Let’s break down the differences so that as your child’s mother, you can make that best choice for them.  Breast milk is of course, designed as the perfect food for your child, it is balanced with gentle enzymes for ease of digestion, it has immunity boosting factors that can never be reproduced in a store-bought formula.  If you were like me, then you probably already know all about the unique qualities that breast milk has over commercially manufactured products, as a result I decided to supplement my meager breast milk with a couple bottles of formula.  As a fretful parent there is nothing more alarming than those weight charts, especially when your little’s ones weight has dipped into the ‘below’ average range.  My perfect medium became, pump, feed and then supplement.  And we went through this routine until I eventually dried up and he became strictly formula fed.


• Have a nursing plan: Like many pregnant mothers, I daydreamed of the day, when I held that tiny bundle, when he and I would find a cozy little spot to cuddle up together, just a blissful moment of feeding and nurturing.  So was the plan, and I had every intention of following up on it until of course, reality set in and thwarted all of my nursing dreams.  Fortunately, I was able to persevere and move forward and most importantly, care for my son with everything I had available.


• Support System: I can’t really complain here as I had great support, I remember my husband giving our son a tiny ‘cup’ of precious colostrum at three-o-clock in the morning, a miniscule portion I had painstakingly pumped out for him, as I knew that colostrum is an essential component for growing and developing newborns. My own mother came to visit and worked endlessly with the whole latching process, but at the end of the day, it just didn’t click!  Even appointments and consultations at the hospital and La Leche League failed to get the nursing going.  I had decided (sagely) that parenting was never going to be a perfect science for me.  It was time to go to a new plan, which meant ‘whatever works’.

Yes, parenting is an adventure and it starts right from the get go.  Don’t forget that what works for you and your family may not work as well for someone else.  I felt guilty at times when my son and I would meet for my ‘mommy/baby’ classes and I was the only one with a bottle.  I felt at times, they looked down upon me as somehowI lacked the same parenting philosophies or status that they all shared.   Of course, what they didn’t know was nursing had always been upfront and most important in my nurturing mind and my difficult decision to stop breastfeeding certainly wasn’t for lack of trying.

Many years later, my mother shared with me that her own mother had a lot of issues with breastfeeding and she fretted constantly about her own lack of milk and nursing prowess.  It all made sense to me, perhaps due to genetics and conditions out of my control, I truly couldn’t produce the same amounts of milk like some of my more successful nursing peers.

The good news? He turned out fine, but like I said about parenting, it’s never a ‘one-size fits all’ process, it’s a learn as you grow, one.

How about you moms, how do you measure breastfeeding success? 

Kristen is a stay at home mother of three who enjoys blogging.  She received her bachelor's degree in fashion marketing, and writes often maternity wear.  When she's not trying to juggle the lives of Casey, Austin and Ben, she enjoys painting and catching up with a great Jane Austen novel.

Also worth reading:

• Coming to terms with low milk supply


• How you could be wasting breast milk 

***

Nursing my Toddler

Nursing remains our very own bonding session. It gives me much comfort knowing that my "dede" nourishes and soothes my growing toddler. La Leche League discusses the benefits of nursing beyond one year.

But apart from the health benefits extended breastfeeding bring, my very own selfish reason to nurse at this stage is because it's the topnotch way for us to cuddle and connect!  A growing boy like P is always distracted  about learning to talk and walk and in dealing with his emerging social life.  It gives me much satisfaction knowing that he's all eyes on me when he wants to nurse.

However, extended breastfeeding  is not at all a picture of  "mother and child" worthy of a painting.  There's an ugly and frustrating side to breastfeeding a toddler. You'll have to deal with an overactive and distracted child. But just so we're clear, any breastfeeding issue you might have can still be dealt with utmost patience and with the right information.

Here's what i deal with as a milk machine to a one-year old. I also wrote some ways how i deal with such issues.

 

Acrobatic breastfeeding positions

Remember how hard it was to find that perfect latch during baby's first weeks? Well, this won't be as hard when nursing a toddler. He'll know how to place his mouth already. In fact, he has mastered this so much that he'll try sucking in different positions! At one year old, some babies are very mobile they'll try nursing while sitting up, standing or upside down. Name it, P and i might have tried it!  Most of these new positions are just too awkward that it's just not possible to do outside the comfort of our private space.

[caption id="attachment_1775" align="aligncenter" width="300"] Here's our more "decent" nursing picture.[/caption]

As an eager explorer, P has learned to play with my other nipple while nursing. This irks me because he keeps fiddling and pinching my nipple. I guess this relaxes him and helps him go drowsy and sleepy. Again, this twiddling and pinching falls under the awkward category. I've learned to tolerate him.

Pain from biting

At thirteen months, my baby only has three teeth and he's teething right now. He enjoys biting because his gums are itchy. Our nursing session goes like this; he nurse for 5 to 10 minutes then stop. Then he'll bite my nipple. I cringe in pain, sometimes i laugh. I noticed that he would keep on biting if i react, whether i cringe in pain or if i  laugh. I guess he thinks that i like him biting me. He thinks i'm teasing him so he teases me back and biting my nipple!  When he starts biting i take this as a sign that he's done nursing. I stop nursing so he won't be encouraged to bite. He can ask to nurse later.

Asking for "dede"

My baby would touch my breast to indicate that he wants to dede. He does this every time he wants to nurse. When i come home from work, instead of a welcome home kiss, a get some breast frisking from him. Sometimes we would hear an occasional "dede" from him! Yes, my 13-month old can say a few words and "dede" is one of them.

He would also do this breast frisking while we're outside. Sometimes he'll go further by lifting my shirt!  It will help if you will give in right away to avoid a major tantrum. He could be really thirsty for milk, that's why he's asking! I made it a point to cover up to avoid shocked glances from onlookers.

Less breast milk intake and pumping output

A toddler needs more solids for steady weight gain and growth. At this point, he'll need more than milk. That means, we can expect a decrease in the intake of breast milk. I just make sure that i nurse on demand.

Since baby's demand for milk has decreased, expect a decrease in your pumping output as well.  Mine has halved since my pumping heydays during around baby's sixth month.

Shorter (or longer) breastfeeding session

How long a nursing session varies greatly. Sometimes it lasts just 3 to 5 minutes and that leaves me wondering whether he is satisfied at all.  Since he has turned his back on the bottle completely, he makes up for lost nursing time by nursing more at night.

For more information on extended nurse, here's Kellymom's notes.

***

How you could be wasting breast milk

During the height of my breast pumping and milk storing days, i had too much milk in the ref. This left my housemates complaining  that they don't have enough space to  store food! Now that my pumping output has dwindled to a meager half of what i used to bring home from work, i needed to adapt system that lessens milk wastage. To a pumping mama, every ounce of breast milk counts, so it calls for a wiser way to manage milk supply. Here are ways you could be wasting this liquid gold:

Storing too much in one container

• Keep breast milk in small amounts, just enough per baby feeding session.  This way, you'll thaw or heat just enough breast milk, since it's divided in "single serves".  The rest of your milk stash will be kept safe frozen or refrigerated. 

Transferring in too many containers 

• Minimize transferring milk from one container to the next. Use storage bottles that can double as feeding bottles, so you can just snap off the sealing disc and replace with synthetic nipple before serving. I've seen brands like Avent and Evenflo have such caps that can hold sealing discs and nipples. This way, you won't need to transfer in different containers.

[caption id="attachment_1649" align="aligncenter" width="300"] When you transfer to and from containers, you'll leave behind specks and drops of breast milk.[/caption]

Freezing right after pumping

• Suggestions on how long you can keep milk in the fridge varies. The US Center for Disease Prevention and Control says three days.  Mayoclinic says five to eight days. In the the Breastfeeding Answer Book of La Leche League International, eight days in the ref is still acceptable. Keep breast milk at the back, away from the door. I maximize milk shelf life by keeping mine for five days in the fridge, then freezing if it's not used up. Remember that thawed breast milk will be safe to consume up to 24 hours when stored in the fridge.  

Thawing too much too soon

•  If you won't be able to use milk in 24 hours, then avoid thawing breast milk. Thawed breast milk have shorter shelf life than cold refrigerated milk.  Put numbers your milk bottles so your baby sitter will know which one of the milk should be consumed first.

Not putting expressed breast milk in the ref right away

• I don't know about you, but as a working mom, i forget everything else when i get home from the office. This includes tucking that precious milk you pumped in the  fridge, so sometimes i wake up the next day to discover that the ebm is still in the cooler and the ice packs have melted already!!! Darn... such a waste of milk! But don't throw it out just yet!  If it's still cold to touch, then it's still good. Consider how long you left it like that, most ice packs keep milk cold up to 12 hours. If you're still in doubt, room temperature breast milk lasts until four hours.  So if it's within that period, then the milk is still good.  To avoid this predicament, make refrigerating your ebm and freezing the ice packs the second thing you do when you come home. The first thing, of course, is to hug that child who has been waiting for you all day long!   

Throwing away leftover breast milk

• Some moms just throw out milk that baby failed to consume in one feeding. I, however, reuse breast milk, but only until baby's next feeding. After that and there's still leftover, that's when i discard. It's better to refrigerate leftover milk than leaving it at room temperature to slow down the growth of bacteria.


• If you're concerned about reusing breast milk, read this post from Kellymom on reusing breast milk.   Whether you decide to reuse breast milk may or not may depend on your baby's sensitivity to bacteria.  I guess reusing breast milk may not be advisable for a newborn, since her immune system is still developing.  You may also hold off on reusing when baby is sick, since his immune system may be down at this point.

A nursing working mommy will always doubt if she'll be able to make enough milk for her little  one.  One way to cast the doubt is by making sure every drop of milk is well spent! Also worth reading:

• A working mom's guide on thawing and serving breast milk


• Breastmilk storage tips from a working mommy


• Coming to terms with low milk supply

***

Is Your Pediatrician Breastfeeding-Friendly?

Your child’s pediatrician and your OB play a crucial role in your breastfeeding success.  They can influence your decision to breastfeed.  If they are not knowledgeable about breastfeeding and they seem like ambassadors for a certain milk brand, then they can sabotage your plan to breastfeed.

[caption id="attachment_1596" align="aligncenter" width="197"] Your doctor can make or break your nursing plans.
Source of Photo: ky.gov[/caption]

Formula feeding seems to be a norm in the Philippines. I really think this is partly caused by the attitude of health practitioners towards breastfeeding.  Here are some tell-tale signs that you ought to look out for.

The pedia suggests giving solids at four months.

WHO says complementary feeding should start by six month. Before this time, breast milk alone is the only and sufficient source of nourishment. Introducing solids earlier can decrease breast milk production, since baby might be too full to nurse! The golden rule if you want to keep your milk supply up is to nurse, nurse, nurse!!!

The pedia’s office shows promotional items from milk companies.

If you can see  pamphlets, pads,books or growth charts sponsored by a milk company. These may be direct violations of the Milk Code. Well,  they may argue that they are not advertisements per se, just some form of information campaign. But moms do connect the dots.  If the name of a milk company is written there, then that is a form of advertisement

What’s sad is that these materials misguide the moms about breastfeeding, somehow saying that there’s an easy way out of her “breastfeeding misery” and that they can’t and won’t provide enough breast milk for their child.

If the pediatrician often asks you if you have enough milk supply and seems surprised when you answer yes!

Admit it moms, being asked if you have enough milk is one of those “touchy” subjects.To me, it feels like she's doubting my capability to produce enough. I guess they mean well, just checking if the baby is getting enough. But being surprised when i say I do have enough baffles me.  If you are breastfeeding-savvy then you know that almost all moms can and will produce just enough for her baby.

Pedia does not prescribe iron supplement at six months.

An infant’s iron reserve is depleted by the six months so she needs other sources of iron. For formula fed ones, there are several milks that are iron-fortified. Iron supplementation is needed for breastfed babies at six month. This may come in the form of iron drops or iron fortified cereals.

Introduces formula milk by one year.

Follow-on milk or formula milk for toddlers is non-existent or not popular in other countries. Most babies just “graduate” to whole fresh milk after reaching one-year old. The Philippines is among those countries where formula milk  is popular – we have formula milk for 1 to 3 years, for pregnant women and even for breast feeding mothers!A good breastfeeding-friendly pedia will encourage mommies to continue nursing, even beyond one year.

So, do you have pediatrician  like this? Well… I do! Sadly, she’s not breastfeeding –friendly and breastfeeding-savvy at all.  Come to think of it, which doctor would say she’s not breastfeeding-friendly? Of course, they would say they support breastfeeding. But being a true breastfeeding advocate needs more than just lip service.

Yes, we have a pedia like this. But what can we do? I’ve looked for the doctors as recommended by Latch, but their schedule just don’t fit ours.  Besides, she’s also accredited by our company’s HMO. So we opted to keep her.

What to do when you’re pedia is not breastfeeding-friendly? BE INFORMED! The best way is to look for peers who breastfeed. They will provide utmost guidance and support.  The internet provides a universe of helpful information to breastfeeding moms. Kelly Mom and Jenny Ong’s blog are by far the best sources of information. They provide well researched materials for nursing moms.

If you find yourself conflicted and doubting your doctor, just be consoled by the fact that final decision on rearing your child lies SOLELY ON YOU.  It’s YOU who know’s what’s best for your child.

***

Why Breastfeed Even during Disasters

Breastfeeding is best ESPECIALLY during disasters and emergencies! I’m lucky I have not yet experienced any severe any disaster like flood or typhoon like Pablo and Sendong as a nursing mom. But I imagined it will be more practical to be breastfeeding during a catastrophe like Pablo,  rather than to be on infant formula.

[caption id="attachment_1531" align="aligncenter" width="600"] Disaster strikes when you least expect it! It pays to be prepared. Breastfeeding gives the mom a sense of comfort, knowing that she can readily feed her infant on any event, disaster or not.
Source of photo:pcoo.gov.ph[/caption]

Breast milk is the only complete ready-to-eat meal for baby.

• Imagine having prepared a complete meal for your baby anytime and anywhere you go! Breast milk alone is best for babies until 6 months! You don't have to give any formula supplement or extra water.

Breastfeeding is the safest method of infant feeding! 

• The thing is, during disasters, access to clean water is probably impossible. On disasters, infrastructures might fail so potable water can be compromised. Formula feeding requires clean water to sanitize those synthetic nipples and bottles. Formula-feed if you have a constant and sure supply of clean water to dilute formula. Instead of being a lifesaver, formula can even do more harm if the water you used to dilute the powdered milk is safe.


• We usually see a rise in the number water-borne diseases like cholera, diarrhea and gastroenteritis  in the aftermath of floods or typhoons because the supply of fresh clean water was depleted. Would you risk using unclean water to feed baby?

Nursing comforts babies.

• On disaster events, a mom's warmth can help calm and soothe a baby in distress.  You can amplify the comfort by nursing baby in times of disasters. Skin to skin contact between mom and baby is maximized when breastfeeding. Babies older than 6 months can enjoy the warmth and comfort during nursing. 


• Breast milk has antibodies that strengthen the baby's immune system, which could be at risk during severe weather.

Nursing calms mom’s stress.

• To say that nursing moms in devastated areas are stressed in a understatement! Disasters of Ondoy, Sendong or Pablo proportions may leave the nursing mom in misery, hence the possible reduced capacity to produce milk. This situation will be overcome with the help of  a well trained health worker. It’s a must for evacuations centers to have a designated breastfeeding station. This way, moms and baby can concentrate on nursing.

According to WHO, malnourished mothers or mothers who lack food can still adequately breastfeed, if they are given extra fluids and food to protect their health.

Among the countless reasons, this, by far is the best reason to breastfeed!

Also worth reading:

• Top 10 reasons why breast is best


• Keeping your breastmilk safe during brownouts

***

On Being Paranoid about Baby's Weight

Yes, lately i've been bothered by Baby's weight gain (and weight loss).  Suffice to say that he's not nearly as chubby as most babies his age.  Hindi talaga siya puede pang diaper commercial kasi medyo payat ang hitsura nya! Add to that that he lost some weight during his bout with pneumonia. He's been bouncing up and down from 8.7 kilos from his 8th to 10th month!

The husband drove me even more paranoid as he said he would like to ask the pediatrician to recommend formula milk because he noticed that P is drinking less breast milk lately. He went on saying that baby looked thinner now if you look at his pictures as a newborn. Even his clothe size proves that he's not on the chubby side.

[caption id="attachment_1444" align="aligncenter" width="225"] He really looked thinner after he got sick![/caption]

On growth charts

But i was soon appeased after our checkup. The doctor plotted baby's weight for his height and weight for his age on the growth chart.  She assured as that although baby seemed to be in the low percentile based on the weight for age and weight for height charts, it's still within the normal limits and we need not panic.

She emphasized that growth charts tend to be biased  for babies born full term. My son was born 2-3 weeks short of his expected birthday. Hence, growth charts in the the usual baby books supplied in clinics may not be a good tool to use.

It's also good to check if the growth charts in your baby book are based on the WHO standard. WHO recently revised their growth charts to make breastfeeding a norm or the main basis of measuring the baby's growth.  There's a big possibility that the growth charts in the baby book are based on privately funded studies of formula milk companies, who also supply these baby books that most pediatricians use. Thankfully, we're using WHO-based growth charts naman pala. Click here for boys and here for girls  if you want to check your baby book!

Birth weight vs current weight

I was just not sure how the pedia computed but she said at the rate baby's growing, he's surpassed his expected growth rate!  Given his birth weight, at 10 months if he weighed just 7.6 kilos it was still  ok. P, being a preemie, was born underweight, just 2.1 kilos.  In the Philippines,  babies with birth weights less than 2.5 kilos have low birth weight.

[caption id="attachment_1414" align="aligncenter" width="300"] How primitive is this scale to weigh a baby?!
Source of Photo:www.loc.gov[/caption]

Average weight gain for breastfed babies

According to Kellymom, for 6-12 month olds weekly weight gain ranging from 57 to 113 grams is acceptable. Click here for more of Kellymom's discussion on weight.

There's also a study by the US CDC showing that directly breastfed babies gain less weight than bottle fed counterparts. This is largely because directly breastfed babies eat on their own demand and liking, rather than on cue (usually by the feeder) , as in the case of bottle fed babies.

Feeding issues

Unlike other babies who seem to be hungry all the time, P seemed to be less interested in eating and more fond of playing and exploring things around him.  That's why it's very important that he'll be (force)fed on time and with the enough amount.

I'm lucky my MIL is an eager feeder so i can be at peace while at work knowing that my baby does not go hungry. Read this for more tips on feeding older babies.

It's in the genes!

Note that genes will play a key factor in baby's  growth.  So there's a very big chance that if his parents are on the skinny side, the baby will grow to be thin as well.

To summarize, the pedia reassured as that baby's weight is ok. As long as baby seems happy and active and is fed regularly with nutritious foods and milk, then we need not fret.

Hopefully he'll be heavier on our next checkup!

***

The Nursing Mom’s Diet

One of the best things I learned being a mom is to take good care of myself. A large part of that was to watch what I eat. I think the best perk of breastfeeding for moms is the fact that breastfeeding burns 500 calories daily! That means we really need that extra grub to keep up.  But this does not give us the license to munch on just about anything we can lay our hands on.

Minute amounts of what we eat can be ingested by the baby thru the breast milk. So we need to be extra careful about what we eat and drink.

I've been lactating for 10 months now (yahoooo....). Here are some guidelines that i follow to keep in nursing.

Eat a healthy and balanced diet.

Nursing moms should not try to lose weight right after giving birth. Doing so could jeopardize your breastfeeding plans. Don’t worry too much because breastfeeding burns calories so soon, you’ll be shedding off those pounds.  Yup, if you breastfeed, you’ll get back your pre pregnancy figure faster. So, did I convince you to breastfeed already?

Below is USDA's suggested menu for breastfeeding moms.

[caption id="attachment_1321" align="aligncenter" width="600"] Source: http://www.nal.usda.gov/wicworks/Topics/BreastfeedingFactSheet.pdf[/caption]

The Philippines' Food and Nutrition Research Institute has a similar nutritional guide.  Click here for equivalents of one serving of common foods.

[caption id="attachment_1966" align="aligncenter" width="263"] This is a bit outdated, though, because in the US they already use the food plate as basis for healthy nutrition![/caption]

All you really need is a healthy balanced diet to produce breast milk enough for your baby. But there are foods known to aid lactation. According to FNRI calcium rich foods will increase milk flow. Such foods include whole milk, clams and malunggay. Oatmeal is also known to increase milk supply.

Nursing is another reason for moms to eat more.  I really noticed that when i pump more milk when i'm full.  And i really get hungry after pumping.   Have those healthy snacks on hand and munch on when you feel the urge to eat. Trying to lose weight right away may effect your breast milk production so try to do so gradually!

Water and other fluids

Nursing moms need to stay hydrated. Otherwise, manunuyot tayo! We need to take adequate amounts of fluids like water, juices milk and soups.

Coffee

I cut down on coffee after being a mom. Before  I would gulp down about 5 to 6 cups of coffee. As in, pakiramdam ko noon kape na ang nananalaytay sa katawan ko. But when I got pregnant, I cut down on coffee. Hindi naman daw bawal, sabi ng  OB ko. But just to be safe, umiwas na din ako. But I had 1 to 2 sips from my hubby’s cup while I was pregnant. Now that I’m nursing I do take just one cup daily, when I feel that I need a jumpstart. Take note caffeine is also present in colas, chocolate and green tea.

[caption id="attachment_1110" align="aligncenter" width="300"] 1 to 2 coffee cups per day is ok
Source of Photo:cancer.gov[/caption]

Observe if baby is sensitive to your caffeine intake. Too much caffeine can lead to hyperactivity and difficulty in sleeping. I observed my baby was agitated when i had 2 to 3 coke cans.  Imagine, alas dos na ng umaga, gusto pang makipaglaro! Since that time, i limit my caffeine intake na.

Also remember that coffee is a diuretic, which means it will make you urinate more.

Alcohol

Limit alcohol intake because it passes through our bloodstream, then to breast milk. If you consumed alcohol, wait for at least four hours before breastfeeding to get the alcohol out of your system.

[caption id="attachment_1106" align="aligncenter" width="292"] Alcohol and breastfeeding don't mix.
Source of Photo:openi.nlm.nih.gov[/caption]

Vitamins and supplements

My baby's pedia suggested that i take in prenatal vitamins and Natalac malunggay capsules to keep my production up. But really, the general guideline is to consume a balanced diet. We must not take vitamins and supplements as a short cut to healthy eating. If you’re not eating enough, chances are your milk production will slow down. Wag lang iasa sa malunggay!

My daily supplements include ascorbic acid, calcium lactate and malunggay capsules.

About street foods

Unless you're pretty sure about the cleanliness of your street food favorites like isaw, fishballs or barbeque, avoid them.  Unsanitary food handling can spread food-borne diseases.

So moms, munch on with care!

***

Breastfeeding Tips for Husbands and Daddies

SUPPORT is key in successful breastfeeding. Let's face it,moms. Without the support from the mister, breastfeeding will be very much harder. Just like any other aspect of marriage, breastfeeding should be a partnership between mommy and daddy.

I am very lucky, my husband has been supporting breastfeeding from the start.  This is primarily because he was a breastfed baby. He tasted the goodness of breast milk. It was not hard for me because we both knew that formula was not an option for the both of us. Breastfeeding is not all about the mom and the baby. Family support play a key role, too!

[caption id="attachment_1810" align="aligncenter" width="225"] Don't feel left out because of mother-baby nursing. Maximize daddy-baby bonding buy cuddling as much as you can![/caption]

For daddies and daddies-to-be, here are some tips to make your nursing wife's life easier.

Loooonng string of patience

Postpartum moms are highly emotional. Add to that the pressure of producing milk for an infant who can't seem to be satisfied and you'll have a weepy and wrecked wife. No, you won't get pogi points by just being silent and doing nothing. Get involved. Ask the wife what she needs and try to give him that.

I remember during my first week, i was an emotional mommy, too. Baby was stuck in the NICU and i had to pump to initiate breastfeeding.  So i pumped like crazy, to the point that i broke the manual pump. Tears rushed down as i showed my husband what it did. Instead of blaming me, he just listened and offered to accompany me to the mall to buy new part.

Spoil the wife.

Working nursing moms will need breastfeeding supplies like breast pump, milk containers, nursing bra, nursing cover, malunggay supplements, etc. Mommies enjoy shopping for these stuff, too!

[caption id="attachment_1286" align="aligncenter" width="300"] Spoil the wife by giving her the free hand and the budget, of course to get these supplies.[/caption]

Do your breastfeeding research. 

Sometimes dads feel left out in the mom-baby bonding. But breastfeeding know-how need not be the mom's sole responsibility. My husband was in to breastfeeding as i am. Months before i gave birth, he bought magazines about breastfeeding and taking care of baby.

Dads need to learn about nursing as well.  It's a sign that you care. Besides, knowing about breastfeeding will be great. Whenever she bugs you about buying a "better"  set of breast pump or extra milk storage bottles or a separate freezer for the stash, you'll be able to give an educated disapproval.

Be a knight-in-shining armor. 

When mom and baby are on a breastfeeding marathon, be the gentleman that you are and offer to help. Prop a pillow on her arm or neck, prolonged latching does strain your muscles.  Offer her something to eat or drink.  Take a a more cavalier step and spoon feed your starving wife.  This way she won't need to unlatch while eating.  Do you know how hard it is to get that perfect latch?

Take that extra effort. Whether they admit it or not, such kind gestures bring "kilig" to the nursing wife.

Do the housework. 

Mommies recovering from a delivery, whether normal or cesarian need to rest.  Rest and relaxation will encourage milk production.  You can help her by doing simple things like keeping your room tidy, cooking  or by  cleaning the breast pump.  All these little gestures much appreciated by a new mom. That's moral support put into actions.

Have an open mind. 

If mama wants to nurse in public, try not to be queasy about it.  Feeding baby is a normal act. If you're concerned that she'll just flash her boobs, that's what the nursing covers are for. Some moms, like me,  think that nursing in public is the best way to promote breastfeeding.

Offer words of encouragement.

Choose your words wisely, words are like swords. They do hurt a lot especially to a mommy who's just about to build that EBM stash. So instead of commenting on how little milk she make, try to be a positive influence by smiling and saying, "Ok lang yan,  dear. Pump lang ng pump. Dadami din yan."

Hearing such encouraging words is like music to mama's ear. Make her feel that you're beside her all through out your breastfeeding journey.

Breastfeeding is a decision both moms and dads should take. So, BOTH  must takes steps towards successful nursing.

Thanks, Daddy for being my number one breastfeeding fan!!!

***

For Breastmilk Givers and Takers

"Welcome to the Milk Mama Diaries Carnival (September). For this month, we will tackle milk sharing and how it can nurture the community, and how this spirit of giving can be sustained. Participants will share their thoughts, experiences, hopes and suggestions on the topic. Please scroll down to the end of the post to see the list of carnival entries."



Being able to donate milk is a great    sense of pride. What better way to spread the culture of breastfeeding than sharing the precious liquid to babies in need? I'm overjoyed to be successfully breastfeeding my son and helping other babies in the process.

Yup, beyond the need to free our freezer of ounce and ounces of EBM is the genuine desire to help other babies in need of breast milk. Nagpaparinig na din kasi si MIL na wala nang space sa freezer. haha....

I’ve kept tabs of the amount of breast milk I’ve shared – about 800 ounces so far!  An online ad selling breast milk at Php 150 per 5 oz! Imagine, add that rate, I would have earned Php 24,000! Kaaashhiing... Kashinggg. When i'm preparing milk for donation, my husband would jokingly ask, "Kikita ba tayo dyan?”

But seriously, I don’t believe breast milk should be sold or bought. I’d be uncomfortable about earning over something that some one else is in dire need of. I’d rather give than sell. I’d rather receive than pay for it.

[caption id="attachment_1079" align="aligncenter" width="300"] Building an EBM stash is a pumping mama's goal. Blessed are those who have enough ... and more to share to other babies.[/caption]

Having shared BM for some time, let me share my notes for breast milk givers and takers.

Choose your method of sharing. 

You can contact hospitals with milk banks to donate. Puede rin namang peer to peer lang, kagaya ng sharing among office mates. Kahit sa web, through sites like  Human Milk for Human Babies, puede naman makahanap ng willing magdonate.

My first milk sharing experience was at the Philippine Children’s Medical Center in QC. Initially I wanted to share milk strictly to formal systems – like hospitals, since there are strict rules for donors. They can also pasteurize the milk. This way, makakahinga ako ng maluwag, knowing that what i'm sharing only goodness to the babies, hindi bacteria or virus.  Sayang nga kasi tatlo lang yata ang milk bank sa atin - UP Philippine General Hospital, Dr. Jose Fabella Memorial Hospital and the Philippine Children's Medical Center.

Donating to PCMC is really fulfilling, knowing that it’s for needy baby patients.  PCMC admits only high-risk pregnancies, so there are limited breastfeeding moms in the hospital. Kaya sila umaasa sa mga outside donor. Since hindi naman kami mayaman to donate financially, I donate breast milk, which i had in abundance at that time.

My next donation was through informal platforms. Actually,  it was to my nephew. My sister had difficulty producing milk after giving birth due to flat nipples.  Nakatulong din naman ang milk ko kasi natuto sya magpadede.   Actually, pinilit ko talaga sya magpadede. Kaya ako nagbigay ng gatas sa kanya para di na sya bibili ng formula. I think supplementing with formula is the first step to sabotage breastfeeding.  Now, I’m happy  she’s exclusively breastfeeding her two-month old.

Nakapag-share na din ako sa katrabaho. It was for newborn who's hypoglycemic. The mom had APAS while preggy and she  gave birth thru c section. I commend her  for actually working hard to produce. I know she’ll manage to produce enough. Napapraning lang siguro kasi konti pa lang ang napapump nya.

Breast milk sharing has risks.

Importante din na aware ang mga tumatanggap ng milk na may health risks. Even the  US Food and Drug Agency discourages informal breast milk sharing, like through the internet.

According to the FDA, risks to baby include exposure to:
infectious diseases, including HIV
chemical contaminants and illegal drugs 
prescription drugs that might be in the human milk

Possible rin na hindi maayos ang handling and tranport ng milk. Hindi naman makakasiguro unless kilala mo mismo ung nagdo-donate diba?

Maihahambing din daw natin sa mga organ at blood donor ang mga breast milk donors. Diba ganun ka-delicate. Kaya dapat talaga mula sa mapagkakatiwalaan ang tatanggaping gatas! Bukod dito, malay mo ba kung tumira ng ilang galong kape ang milk donor. Eh di good luck sa baby mo,baka 24/7 syang mulat!!! hahaha....

In the Philippines, donated breast milk seems a much more limited resource than in the US.  We only have a few milk banks, which could make breast milk sharing much safer and easier. To donate to milk banks, moms need to undergo screening by filling out an application form and undergoing a blood test. Puede rin makabili ng breast milk dito, kaso may kamahalan. Saka dadaan talaga sa butas ng karayom ang mga bibili. Recipients will be screened under a strict criteria. Saka madalas daw na ubos ang breast milk sa milk bank.

At dahil nga kakarampot lang mga milk bank natin, malamang hindi rin pasteurized ang makukuha sa mga donors, like your friends or ung nakotantak mo sa FB. You may also be taking milk from a mom who's not screened as a donor.

Hindi naman ako tutol sa peer to peer breast milk sharing kaya lang dapat aware lang ang mga recipients. There are ways to mitigate the risks.

Naniniwala din naman akong walang masamang intensyong ang mga milk donor. Syempre, isang gatas lang naman ang ido-donate nila at yung ibinibigay nila sa mga anak nila diba.

Just to be safe, recipients should inquire about the donor’s health background before accepting milk. Alisin na ang kyeme ng mga donee moms sa pagtatanong, para ito sa kapakanan ng baby.

Another safety measure donee moms can take is to have the milk pasteurized in hospitals with milk banks. You can inquire if they offer such service. You can have the milk pasteurized there for a fee. Kung taga Quezon City, you can contact PCMC Milk Bank at 9246601 local 288.

You may also opt to do some pasteurizing at home.  Here's USAID's instructions on how to heat treat breast milk while keeping nutrients for babies. Kung para sa  premature babies, you might want to pasteurize milk since premies have weaker immune systems.

Breast milk expression is not free.

There are some expenses involved in this whole pumping at work system, like breast milk bags!  Sa totoo lang, medyo magastos din pala ang storage bags, lalo na kung madaming gatas ang nae-express. Donee moms can at least replace the bags.  I recently asked my breast milk recipient to replace the bags I used.

At first I was hesitant to ask for replacement bags. But I’m surprised because the recipient was happy to replace them. I guess it was her way of giving back and saying thanks.

Watch out for INVALID breast milk recipients.

Breast milk seems to be scarce resource when in virtually every mom can make enough milk for their babies, that's according to WHO.  So I really think donor moms should choose the recipients wisely. Expressing breast milk takes time and effort, you know. I’ve allotted time to pump while at work. I’ve let go of long merienda breaks just to express milk for my baby. Other moms should do the same for their babies.

I figured, I’m not actually helping such moms, because I tolerate their “katamaran”. Breastfeeding succes takes time, effort and the right information. Your breast milk is better off donated to babies and moms in GENUINE need of breast milk.

Nabasa ko dati "It takes a village to raise a child"?  Well, in so many ways,  breast milk sharing is a top way how moms can help in raising healthy children in the community. I am happy to share the best nutrition my baby enjoys to other babies.

Bukod sa pasalamat na natatanggap ko, sharing breast milk is a privilege. I hope to do this as long as possible.

***

In commemoration of World Milk Sharing Week 2012, share your own experiences as a milk donor or a recipient. Don't forget to visit the other participants of our blog carnival:

Mafeth wrote about being a milk donee
Cris donated her liquid gold
Pat had a happy problem donating solved
Jenny wrote about wet nursing from a relative's experience
Rachel discussed how she felt about receiving donated milk and nursing an adoptee's baby
Mec insists it takes two to Milk Share Tango
Cai received milk from her sister
Nats has a Milk Sharing Story too

Also worth reading:

• Alarming facts about breastfeeding in the Philipines


• Rights of the Filipina working mom