Karima Isberg, RN, lactation consultant, Carle Community Breastfeeding Clinic, answers real questions from real moms about resources, support groups, supplies, milk supply and returning to work. Find out what you need to know about breastfeeding as the conversation continues offline. View the original chat on Chambanamoms’ Facebook.

Choosing Supplies

Why do you recommend the Spectra pump?

Carle Foundation Hospital provides a prescription for the Spectra S2 pump when you deliver, but some online retailers and pharmacies still carry the S1 version. Carle selected Spectra because many women report it’s most comfortable. The Spectra has multiple features that make it – technologically speaking – superior to other models. A digital timer remembers your pump settings, a night light, and back-flow protectors prevent milk from passing back through the tubing to the pump motor. This allows women to re-sell their pump after use. Finally, mothers can customize the Spectra breast pump to their particular needs by adjusting both the suction and the speed. However, while most women find them more comfortable, some have more trouble getting milk out. 

Support and resources

When should you take the pumping class – before or after baby arrives?

The pumps, pumping and storing breastmilk class can be taken when it’s convenient for you. When you take the class after baby is born, you have the added benefit of bringing baby along (and several parents have done this already).

Can you comment on nursing with twins?

Most importantly, breastfeeding twins is possible, however, twin moms face special challenges including early gestational age (normal for twins) and sleep deprivation. When babies arrive early, it’s likely the babies will need some extra support to receive proper nutrition, which can include pumped colostrum. I recommend pumping regardless of who feeds the babies. Sleep deprivation occurs when Mom manages both feedings, pumping and supplementing. Working out a routine with Mom and her partner is critical to avoid burn out.

Are there any local online support groups?

Online resources are constantly evolving. CU Birth and Chambanamoms provide a forum for women to ask about all things pregnancy, breastfeeding and parenting, however they are not breastfeeding-specific. Public health offers an online group. OSF Moms of Beautiful Babies - Urbana offers breastfeeding support as well.

Returning to work

Do you have any tips on bringing up needing a space to pump in a male-dominated workplace?

Start by approaching your manager under the assumption your employer already knows the Illinois and Federal laws about breast pumping support. Ask directly what the accommodations will be for pumping breast milk once you return from maternity leave. If needed, take the opportunity to provide education to your manager. You may be paving the way for future female employees. A great resource for employers is the Business Case for Breastfeeding.

How do you tactfully inform your daycare provider about pace feeding?

Pace feeding allows your baby to be in control of the feeding pace, allowing them to eat more slowly and take breaks. First, focus on your own concerns about your milk supply and frame it as a way for them to help you rather than a criticism of them. Start by using a slow-flowing nipple like a preemie nipple. This makes it difficult to feed too fast even without pacing. Then, mention baby eats more at daycare than at home and you’ve heard it’s possible to over bottle feed a baby which may be the reason you are unable to keep up with baby’s demand at daycare. Ask if it’s possible for them to slow the bottle feeding down to see if baby might eat less if the feeding occurs over a longer period of time.

Are there tips or training for employers who wish to better support breastfeeding moms?

Champaign-Urbana Public Health District offers training to businesses and day care providers. It includes information on laws/regulation, recommendations for supporting breastfeeding, a review of current accommodations, policies and procedures, and suggestions for improvement. To schedule, email Rachel Jones at rjones@c-uphd.org.

Weaning and low milk supply

I am an overnight nurse at Carle, and I am really struggling with my supply since returning to work. I’m using natural supplements and pumping three times during a 12-hour shift. What else can I do?

First, check the suction on an older pump. Or, consider a hospital-grade pump while at work. Request one through your manager. Do power pumping once a day to boost overall supply. To power pump, you pump for an hour – 10 minutes on followed by 10-minute break. Repeat. For specific concerns about supplements, call the breastfeeding clinic at (217) 326-2610 for customized advice.

What’s the best way to wean? Is mastitis still a worry even though supply is low and baby mostly comfort nurses at this point)?

Take it slow. You might be surprised how much milk your baby is getting when only “comfort” nursing. Don’t offer, but don’t refuse the breast at first. Then, choose one breastfeeding session to stop. Distract baby with other things and offer solids first. Continue pulling back on a session every couple of days but avoid two sessions in a row to keep milk supply fresh. Your body naturally receives the message and slows down production.

Can returning to work or returning menstrual cycle decrease the milk supply?

Milk supply can decrease around three months after delivery for many reasons. Normal milk production slowdown occurs between two and six months when your endocrine system no longer provides a cushion. To increase output and overall supply, do breast compressions when pumping and breastfeeding or increase your pumping time. You may see a temporary decrease around the time of your period but don’t give up.

My baby will be 4 months. He is starting to get really frustrated and fidgety. He pulls away from my breast frequently after nursing for less than three minutes. Could slower flow from the breast rather than a bottle be causing his frustration, or is he not getting enough food?

Most babies become more distracted around 3 to 4 months of age. Babies become more mobile and aware of their surroundings. They are very interested in checking everything out and often are waking more at night to eat or snacking, resulting in being a little “off.” They are less willing to sit at the breast for a lengthy feeding. Begin to nurse baby in a darkened room to limit distractions.

In addition, Mom’s milk supply “down regulates,” meaning it no longer has a surplus of milk but just enough to meet baby’s needs. This reduces the pressure and flow rate, sometimes frustrating babies. This usually worsens as the day goes as the volume of milk decreases naturally even though the calorie count of the milk increases.

To solve these issues, compress the breast throughout the feeding to increase the pressure in the breast and the flow. Get the milk to “let down” with gentle massaging of the breast before offering to baby. Monitor any change in baby’s diaper output or energy levels. Make an appointment with a lactation consultant to conduct a weighted feeding to measure food intake and ensure the baby is gaining weight appropriately. Follow up with your pediatrician with concerns about baby’s weight gain, weight loss or development.

Categories: Staying Healthy, Community

Tags: Carle, support, pediatrics, breastfeeding, baby friendly, lactation, chambanamoms, Women's Health