It seems we are hearing more and more moms concerned about not having enough milk to feed their baby these days.  There are many effective strategies for helping women increase their milk supply but first we need to determine if there truly is a concern about your milk supply.  Once that is established, we recommend: (1) breastfeed more frequently  (2)  use a breastpump to help stimulate your supply  (3)  consider the use of supplements to help increase milk production such as Fenugreek  (4) take a "nursing vacation" and  (5)  seek the help of a lactation consultant if the first steps don't show an improvement in your supply.

 It seems we are hearing more and more moms concerned about not having enough milk to feed their baby these days.   There are many effective strategies for helping women increase their milk supply but first we need to determine if there truly is a concern about your milk supply. Is your baby gaining about an ounce a day in the first 3 months and half of an ounce a day for months 4 to 12?  Do your breasts soften after the feed?  Is your baby peeing and pooping appropriately (at least several poops a day for the first 6 weeks and at least 8 wet diapers a day)?  If so, you have enough milk and don’t need to work on increasing your supply.

If you find your baby isn’t gaining enough weight or isn’t peeing or pooping enough, here are some suggestions for increasing your supply.

1. Breastfeed more frequently.  Most newborns feed anywhere from 8 to 12 times a day.  If you have been feeding less than 8 times a day, offer your breast anytime the baby shows signs of hunger.  Frequent emptying of the breasts signals the breasts to make more milk.
2. Use a breastpump to help stimulate your supply.  Consider renting a hospital grade pump such as Medela’s Symphony for a week and try pumping after as many feeds as possible.  10-15 minutes of pumping is appropriate- it is the frequency of the pumping that will help the most, not the duration.  Remember, nurse first, then pump.  You may not collect much milk but you are pumping to stimulate supply, not collect milk.
3. Consider taking a supplement designed to increase your milk supply.  Many women have found herbal supplements such as Fenugreek, and the herbs in supplements like Mother Love’s More Milk Plus or Go-Lacta tremendously helpful in boosting their supply.  They don’t replace frequent feedings but are a good addition.
4. Take a “nursing vacation”.  Since the reality is that you won’t be getting much of anything else done if you are feeding 8-12 times a day, plan on 48 hours where you can stay in bed with the baby and feed all day.  Ask your partner to wait on you with food and lots of water and just stay in bed for a few days.  Skin to skin contact has been shown to increase prolactin, the hormone that helps with milk production, so curl up with your naked baby on your chest in bed.  It is remarkable how effective this tool is in jumpstarting your supply.
5. If you have tried the first four tips and aren’t seeing an improvement in your supply, consider making an appointment with a board certified lactation consultant (IBCLC).  Many times there are things we can spot when we observe a feeding or assess the mom and baby that could be contributing to the low milk supply.  Lactation consultants are there to support you in your efforts, so utilize them!

At the end of the day, it is important to keep in mind that a baby needs to be fed and if you don’t have enough breastmilk, formula or donor breastmilk are options to make up the difference and support your baby’s growth and development.

Play encourages the development of language and physical skills. Play releases the imagination, develops concentration and builds social skills. Mothers, fathers and babies all feel good after playing because fun and laughter release endorphins that help to relieve stress.

Play encourages the development of language and physical skills. Play releases the imagination, develops concentration and builds social skills. Mothers, fathers and babies all feel good after playing because fun and laughter release endorphins that help to relieve stress.

It is important to understand that mothers and fathers often play differently with their infants and to understand what these differences are.

A mother’s play often contains a teaching emphasis. For example, mothers may name objects and describe the color, the texture or the taste. A mother’s play tends to be more mediated, verbal and visual.

A father's play is often more unconventional, more unusual, and less predictable. Dad’s play is usually more active. This kind of active play can shift and expand the infant's style and range of behavior. Fathers are also often louder, more jovial, and more physical with their baby. Dad's play encourages the extroversion and self-confidence of the baby.

Is there a certain way that you usually play or interact with your baby?

-Sara Duskin, IBCLC, Teacher and Parent Educator

“Morning sickness” is the uncomfortable nausea and vomiting experienced by many pregnant women, especially in the first trimester. And unfortunately, as many women know, morning sickness can occur at any and all hours of the day. The good news is that typically women start to feel better in their 2nd trimester (starting around 12-14 weeks)

“Morning sickness” is the uncomfortable nausea and vomiting experienced by many pregnant women, especially in the first trimester. And unfortunately, as many women know, morning sickness can occur at any and all hours of the day. The good news is that typically women start to feel better in their 2nd trimester (starting around 12-14 weeks). (Note: If you continue to experience nausea and vomiting well into your 2^nd and 3^rd trimesters, contact your OB provider.)

Below, I’ve compiled a list of some of my tips for surviving the first of what I call, “The Joyful Discomforts” of pregnancy:

    •    Try to keep a small amount of food in your stomach at all times. Nausea is worse on an empty stomach. This may even mean keeping crackers at your bedside table to nibble on before you get out of bed in the morning. For many women, this will also mean eating small, frequent snacks rather than larger meals.
    •    Eat bland foods and stick with foods/drinks that sound good to you.
    •    Consume foods and liquids separately.
    •    Sip liquids slowly after an episode of vomiting. Drinking too fast can cause you to vomit again.
    •    Rehydrate with fluids like lemonade or ginger ale. Some women also find relief from smelling a lemon.
    •    Let your OB provider know if you are unable to stomach your prenatal vitamin. They may have an alternate brand to offer or recommend folic acid alone, as it is important to get the right amount of folic acid in your first trimester.
    •    Try wearing “Sea Bands” (the acupressure wrist bands sold at drugstores for motion sickness)
    •    Remember that it is not uncommon to not gain weight or even lose weight in the 1st trimester and early 2nd trimester. It generally does not mean that your baby is not getting sufficient nutrients, except in extreme circumstances. Discuss your weight with your OB provider if you have concerns.

Discuss your symptoms with your OB provider- they may want to prescribe you an anti-emetic (anti-vomiting drug) such as Zofran or Reglan to control your symptoms at home so you don’t become dehydrated if you are experiencing severe nausea and vomiting. If you’re severely dehydrated, call your OB provider, as they may want you to go to the hospital for IV rehydration. Stay well.

-Courtney McSpadden, RN, MSN, FNP

When you understand your baby’s temperament, it can help you better appreciate the way he plays and the how you can best interact with him. Here are some typical infant temperaments.  See which describes your baby best:

When you understand your baby’s temperament, it can help you better appreciate the way he plays and the how you can best interact with him. Here are some typical infant temperaments.  See which describes your baby best:

Slow to Warm Up Temperament:

This baby will take a little more time than others to warm up to people and other babies.  They need time to embrace new experiences and can be easily over stimulated. A baby with this temperament will respond slowly to hunger or discomfort.

Easygoing Temperament:

This baby will adjust easily to new environments and situations. They will eat regularly, react mildly to discomfort and find ways to self-comfort when fussy.

Restless Temperament:

Babies with this temperament are restless and often will need constant motion to be content. They can be easily distracted and difficult to soothe when upset. They tend to be light sleepers and loud criers.

Although not every baby will fit into one of these categories, you can generally recognize your baby’s tendencies and learn to work with their style.

-Sara Duskin, IBCLC, Teacher and Parent Educator

Have you been wondering what foods are great to have on-hand when the baby is born for recovery and breastfeeding?

Today, we’ll focus on nutrients that are important for you to include in your diet after your baby is born.  I always recommend that my expecting parents prepare and freeze meals ahead of time that incorporate some of the foods that contain these important nutrients.  In my next post, I’ll share some of my favorite recipes for postpartum recovery and milk supply.

Have you been wondering what foods are great to have on-hand when the baby is born for recovery and breastfeeding?

Today, we’ll focus on nutrients that are important for you to include in your diet after your baby is born.  I always recommend that my expecting parents prepare and freeze meals ahead of time that incorporate some of the foods that contain these important nutrients.  In my next post, I’ll share some of my favorite recipes for postpartum recovery and milk supply.

So what’s important to add or maintain in your diet after the baby is born?

Calcium:  Vital to strengthen bone density. Calcium helps with nerve function  and blood clotting, which are very important as you heal from birth. If you are a breastfeeding mom you will need additional calcium, as much of it is drained out of your system through your breast milk for your baby’s developing skeletal system.

How can you add calcium to your diet? Have plenty of milk-based products on-hand, like cheese, yogurt and cottage cheese. Another option is leafy greens and juices fortified with calcium. I would also recommend calcium magnesium supplements (the magnesium helps the calcium to be better absorbed).   DayOne offers a very high quality, well absorbed Calcium Magnesium supplement.

Iron: An essential part of your red blood cells and their ability to carry and use oxygen in the cells. Without enough iron, you may find yourself fatigued, weak and at a higher risk for infection.

If you are taking iron supplements, adding foods rich in Vitamin C like tomatoes, oranges, baked potatoes, and steamed broccoli can help your body better absorb the iron. If you want to increase iron through diet, you’ll want to consider eating more lean red meat, spinach, beans, and egg yolks.

Zinc: Helps support a healthy immune system. It also increases cell production, wound healing, and tissue growth and repair, which are vital as you recover from birth.  Good zinc-rich foods are red meat, oysters, poultry, legumes, eggs, fish, seafood, wheat germ, whole grain products, black-eyed peas, and miso (fermented soybean paste).

Protein will help you rebuild muscle in your body postpartum.   Chicken, fish, lean beef, nuts and eggs are all high in protein.

Fennel is a good herb to incorporate into soups and everyday meals to help with milk letdown.

Finally, choose liquids like water and milk instead of coffee or soda. Drink at least six to eight glasses of water a day. This will help with milk production and also prevent dehydration, constipation, and clogged milk ducts. Drinking a glass of water each time you nurse will ensure that you are getting plenty of fluid throughout the day.

-Lindsey O'Connell, CLA, Certified Postpartum Doula, Services Coordinator at DayOne

Did you know taking care of your teeth and gums during pregnancy may help lower your risk of preterm birth?

Taking care of your teeth and gums during pregnancy may help lower your risk of preterm birth.

Have you had issues with your teeth and gums during pregnancy?  Did your OB or midwife encourage you to see a dentist to help prevent preterm birth?

Studies have shown that pregnant women with periodontal disease are up to seven times more likely to have a baby born prematurely or be born with a low birthweight. The March of Dimes has stated that preterm birth is the number one obstetrical problem in the United States.

This seems to be caused by the higher levels of the labor-inducing chemical prostraglandin, which is found in bacteria of the mouths of people with pronounced periodontal disease.

Most dental procedures are safe during pregnancy, but be sure to advise the dentist of your pregnancy.  The most common treatment for periodontal disease is a very deep, thorough cleaning of your teeth and gums called scaling and root planing. 

This procedure helps remove the bacterial toxins that may cause preterm labor.

So, visit your dentist and take care of your teeth.  Your baby’s health depends on it!

-Nancy Held, RN, MS, IBCLC, VP of Clinical and Educational Services

Did you know that babies learn from their interaction with other babies? That’s why it’s so important for a baby to have regular play with other children throughout the week. Next time you’re at a playgroup, watch the babies. You’ll be able to see them learning together the entire time.

Did you know that babies learn from their interaction with other babies? That’s why it’s so important for a baby to have regular play with other children throughout the week. Next time you’re at a playgroup, watch the babies. You’ll be able to see them learning together the entire time.

What do babies learn in a group?

• In a group, your baby can learn social interaction tools, like clapping their hands or new facial expressions. They’ll learn and experiment with new movements like scooting, rolling, sitting, crawling, standing, walking and using their arms and legs in new ways.
  

• Your baby will learn to encounter and adjust to new temperaments and personalities. Learning to react to other babies in a close environment is a key skill for your little one to experience.

• They’ll also learn to interact with new toys and sounds when they’re exposed to a group of babies in a play environment. This can help them pick up on new skills or fine-tune pre-existing skills.

Have you seen your baby learn from other babies in a group? What skills or social interaction tools did you notice they learned?

-Sara Duskin, IBCLC, Lactation Consultant, Teacher and Parent Educator

Have you ever considered donating breastmilk? Did you even know that you could?

You can donate milk with the help of a milk bank. Just like blood banks, milk banks provide a valuable resource. They focus on safety for the recipient, who in this case, are premature and sick babies.

Have you ever considered donating breast milk? Did you even know that you could?

You can donate milk with the help of a milk bank. Just like blood banks, milk banks provide a valuable resource. They focus on safety for the recipient, who in this case, are premature and sick babies.

To ensure safety, milk banks pasteurize the milk that you donate. This makes it a very different process than just giving a friend breast milk to use for her baby. Bacteria and viruses including HIV/AIDs and Hepatitis B can be transmitted to a baby through unprocessed donated milk, possibly causing harm.

Milk Banks have been helping premature and sick newborns thrive for over 100 years. And currently, there is an urgent need for donated breast milk across the nation.

The San Jose Milk Bank – a non-profit organization – is one of the few Human Milk Banks in the entire country. It’s an amazing resource that has tripled the amount of breast milk shipped to infants in need in the last 7 years. Last year, they shipped over 250,000 ounces of donor milk to babies throughout California and the West.

So, do you want to donate milk to the San Jose Milk Bank?

Read through their pre-screening requirements and see if you qualify to donate milk (even milk that’s been in the freezer for up to 5 months!)

Just like donating blood, donating your special breast milk is something you can feel really good about.

-Nancy Held, RN, MS, IBCLC, VP of Clinical and Educational Services

Let’s talk about something you probably won’t get advice about from many people before you have the baby: caring for your vaginal and perineum areas in the days and weeks after childbirth.

During that time, your body can go through a number of changes that you’ve likely never before experienced. Your vaginal area may be swollen and your perineum will be very sore. You may see varicose veins appear that weren’t there before childbirth. You will also experience bleeding similar to a heavy period for one to three days after their baby is born.  This bleeding continues for several weeks, though it’s not typically as heavy after the first few days.

Now, I don’t tell you all of this to make you nervous. Because the good news is that you can prepare for these changes ahead of time with homemade, natural remedies and simple items you can pick up from the drug store. And the best news is that these changes mean you have a new baby to share life with!

Wondering what you should have on-hand? Here are some of my top suggestions as a postpartum doula:

-Sanitary pads (not tampons until about 6 weeks postpartum)

-Motrin or Ibuprofen for pain relief

-Single use disposable panties

-Sitz bath spray

*You can also add a small amount of witch hazel to your peri bottle with warm water while using the bathroom to help decrease burning during urination.

-Lindsey O'Connell, CLA, Certified Postpartum Doula, Services Coordinator at DayOne

I’ve seen so many new mothers put extremely high expectations on themselves following the birth of their baby. They think they have to do everything “perfectly” when it comes to motherhood and don’t often give themselves any grace as a new mom. Those expectations, coupled with isolation and hormonal changes, can lead to emotions many women have never before experienced.

Baby Blues

Often, people refer to postpartum emotional changes as the “baby blues,” which can affect 80-85% of new mothers. For most, baby blues are typically most identifiable within the first few weeks following birth. You might feel yourself become sad and tearful in situations that normally wouldn’t faze you. You may feel inadequate, exhausted and overwhelmed. These are all normal feelings for a new mom to experience.

In my experience, the best thing any new mom can do for their own well-being and her baby’s is to spend some time away from the house and with other new parents. There is so much comfort in getting to know other moms who are experiencing some of the same feelings or concerns that you are. You’ll build friendships and feel like others out there understand the same emotions you’re going through. This alone can create positive change in your role and emotions as a new mother.

Postpartum Depression

For some women, their experience is much more intense. Postpartum depression can affect up to 20% of new moms. Moms who experience postpartum depression can be filled with anxiety and panic, feel overwhelmed and unable to cope, and fear hurting their baby or themselves. Postpartum depression lasts longer than baby blues, but it can be treated. You don’t have to go through it alone.

I’ve provided a list of some books about postpartum depression that may be helpful. However, if you think you or a loved one might be experiencing postpartum depression, I always recommend you seek help immediately from a healthcare provider who can direct you to further help from a psychologist or support group.

Books

The Mother-to-Mother Postpartum Depression Support Book  Poulin, S. Penguin, 2006

Beyond the Blues Bennett S, Indman P. Moodswings Press, 2006

Postpartum Depression for Dummies Bennett S, Codey M. Wiley, 2007

This Isn’t What I Expected: Overcoming Postpartum Depression  Kleiman K, Raskin VD. Hyperion, 1994

The Postpartum Husband: Practical Solutions for living with Postpartum Depression Kleiman K. Xlibris, 2001

Down Came the Rain: My Journey Through Postpartum Depression Shields B. Hyperion, 2005

-Lindsey O'Connell, CLA, Certified Postpartum Doula, Services Coordinator at DayOne