Maternity

What to do if you think you are not producing enough milk

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World Breastfeeding week is celebrated August 1st to 7th every year. This year we at Underpinnings are even more aware as our founder recently became a new mom for the second time and is once again experiencing the joys, and lets be real, the frustrations that can come along with attempting to breastfeed successfully. ​

In our last blog we talked about how you can enhance your nursing experience. We shared some tips on what you can do to make your experience a more positive one. In this post we speak about a topic that some mothers experience in their breastfeeding journey: worries about supply.  At the start, many new moms may be worried that we don’t have a good enough supply to satisfy our child, but often we may just need to settle into a routine, consult our doctors, or break out of certain habits which may be sabotaging our attempt at breastfeeding.

First, let us talk about what are the signs we must look for that indicate that our supply is indeed low. One of the major indicators of low supply is a lack of weight gain. Typically, most infants lose weight after birth; in fact, full term babies may lose over 7% of their birth weight! However, within two weeks babies should at least return to their birth weight and begin to gain an average of 4 to 7 ounces each week. Once you are keeping up with your wellness checks for your baby, your doctor would make a note of if this is in fact occurring. This is also a great opportunity to obtain tips on ensuring that your latch is correct and your nutrition is on point. Many doctors may even suggest that you work with a lactation specialist. If you are in Trinidad and Tobago a great resource for assistance with latching problems or nursing issues for new moms is the Breastfeeding Association of Trinidad and Tobago.

What may cause low supply you may ask? Here are the top reasons:
Supplementing: Initially you may think that the colostrum is not enough, and your baby is constantly wanting to be fed. You may see this as an indicator of low supply (which it is not) and be encouraged to supplement. However, supplementing will cause your baby to breastfeed less frequently if formula has been introduced. Babies’ stomachs are quite small during the first few months of life and therefore they need to be constantly fed; be patient with your young one.
Infrequent feeding: When the time between feedings is too long (upwards of 4 hours for example), the breasts are not stimulated as they should be. This is a signal that the demand for milk is low and the end result is that you would not produce enough milk to adequately nourish your baby.
Short feedings: Feeding for less than 5 mins on each breast would cause the baby to not get the nutritious hind milk and prevents your breasts from being sufficiently drained. When they aren’t drained, they won’t be stimulated to produce more milk.
Pacifiers: The act of sucking on a pacifier may cause some babies to have less inclination to suckle at the breast. Less suckling means less stimulation and therefore low milk supply.

So, what can you do to boost your supply? Here are some easy to follow tips:
Feed on demand:  Let your baby set the pace! Feed as often as they wish to feed within the first few months of their lives. This act will sufficiently establish your supply and get you on your way to being able to feed your baby well!
Avoid supplementing: Unless there is a medical reason indicated by your doctor to supplement, if you want to expressly breastfeed, avoid supplementing with formula. Many people suggest supplementing to get babies to sleep, or to fatten them up, however breastfed babies sleep and gain weight just as well as formula-fed babies. Be patient with your babe and follow their lead.
Limit pacifier use: As stated above, pacifiers mimic the act of suckling. This act is a soothing act for babies and if the breast is replaced with a pacifier then they are not stimulated enough to increase the milk supply.
Pump between feedings: Even stay at home mommies can pump! Pumping is an amazing advancement and addition to breastfeeding. It allows you to increase milk production, gives other family members an opportunity to bond with baby, as well as allows you to have a back up supply.
Get rest, eat well and stay hydrated: As we stated in our previous post this is very important. When you are well-fed, well-rested and well-hydrated the milk production increases.

However, if all else fails please talk to your doctor or a lactation specialist. A specialist will give you the support you need to ensure your latch and overall breastfeeding routine is right. Low supply is indeed a concern, but don’t think that you are alone. If it is indeed bothersome, talk to your doctor. In the meantime mama, remember that you are doing fine and are a great mom!


Tips for Nursing mothers

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As an expectant or new mother, you may have made the decision to breastfeed your precious child, but you may also be wondering if you would have the ability and tools to do it well. In this blog, I give six tips on how to make breastfeeding a beautiful bonding experience that is as stress-free as possible.

1. Find the Right bra
While not usually thought about, the correct nursing bras will make your breastfeeding journey that much easier. You will appreciate bras that unclasp one-handed, and that accommodate the fluctuation in size that you may experience during the course of the day. In my last blog post I discussed the difference between nursing bras and maternity bras and when is the perfect time to purchase each. Do not skimp on the purchase of good nursing bras because it would be an item of clothing you would be wearing almost 24/7. We suggest buying in two phases: before the baby is born, and after your milk has come in and you and baby have settled into a breastfeeding rhythm. Your bra should fit comfortably on the slackest hook and the cups should fit with no wrinkling or bulging.

2. Eat healthy
When we breastfeed, our baby eats what we eat. So, pay attention to what you are putting into your body. Don’t smoke or drink alcohol and try to stay away from fast food as much as possible. Plenty of water, and a diet that incorporates whole, unprocessed foods and many vegetables and fruits is best. You can still take your prenatal vitamins at this time as well as any additional supplements your doctor recommends.

3. Get comfortable while feeding
When baby is here, and you are ready to get into the groove of breastfeeding, finding a comfortable spot is paramount to a positive experience for everyone. So, when it is time for a feeding, gather your snacks, the remote, tablet or phone and relax in your favourite chair or in bed. You are going to be in that position for quite some time, so make sure it is a position where you have access to as many things as possible to make you comfortable.

4. Get your baby in a comfortable position
Once you are in a comfortable position, then make sure baby’s head is supported and they are in the appropriate nursing position. You don’t want them squirming and being too uncomfortable or the nursing experience would not be a pleasant one.

5. Breastfeed at your convenience
When the baby is hungry is the best time to feed them—don’t be ashamed to feed your baby wherever you are! Once you are comfortable, your baby can eat. Breastfeeding is a natural bonding experience that should happen once mommy can produce milk and baby is able to latch. Don’t give up, but also don’t feel too pressured if circumstances arise that prevent a smooth transition to breastfeeding.

6. Relax: your baby can feel it
Yes, a lot of times we find that comfortable nursing position, baby is comfortable, but we are thinking about all the things that need to be done. Breastfeeding is a wonderful opportunity to bond with your baby, as well as to take a break of sorts. Put up your feet, look at your beautiful baby and marvel at them and stop thinking about the dishes and laundry to be done. When you are stressed it can hamper let-down and then baby is unsatisfied. So, if you are having a hard time, maybe put on some relaxing music or utilise aromatherapy (check with your doctor on what scents and oils are safe to use around baby)…and Relax!


What to expect when you are expecting (Bra edition)

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When we are pregnant we often are so focused on the impending baby, we sometimes forget that we are also part of the equation. While our precious child is growing and developing, our body is also changing in ways we may not expect. Oftentimes, we tend to neglect the process of finding the correct maternity bra or nursing bra. In this blog post we’ll break down the importance of when to get a fitting and how to choose the right one.

Nursing Bras vs. Maternity Bra
Nursing bras and maternity bras share many of the same features, especially regarding enhanced support.  In many circles the terms nursing bra and maternity bra are therefore used interchangeably, however one of the main distinguishing features of a nursing bra is that the cups are designed to provide easy access to the breast for feeding the baby.  This is usually accomplished by having the cups drop down from a clip.

I. Maternity Bras
When should I buy a maternity bra?

Wearing a bra that fits correctly is always beneficial, but it is especially important during pregnancy. During this time your breasts will become not only fuller, but also heavier due to increased blood supply, fatty tissue and the development of milk glands. As soon as your old bras no longer fit you should consider purchasing maternity bras; for most women this occurs near the end of the third month of pregnancy. Note: limit your initial purchase to two bras to manage expenses since your breasts will continue to grow throughout your pregnancy.

When trying on maternity bras look for the following:

Ensure that your whole breast is encased in the cup.  It is very important that the band, seams and underwire (if applicable) do not press into breast tissue.  Note that many experts advise against wearing an underwired bra during pregnancy and nursing.  An ill-fitting underwired bra is much less forgiving than an ill-fitting soft cup bra as underwire that presses into breast tissue could lead to a painful infection.

The band should be wide and supportive, and the shoulder straps should not be overly narrow. It should also fit snugly but comfortably on the TIGHTEST hook.  This is the opposite guidance to buying a bra any other time in a woman’s life and is to allow room to loosen the band as your ribcage expands during pregnancy.

The inside of the cup should be smooth, with no exposed seams.  With all those hormones coursing through your body your breasts are likely to be very sensitive and seams that may not irritate at any other time may feel like sandpaper against your tender nipples. This is one of the best measure for preventing nipple pain.

II. Nursing Bra
When should I buy a nursing bra?
Many women find that their cup size fluctuates widely in the first few weeks and months of breastfeeding before the baby and their bodies settle into a breastfeeding rhythm.  We therefore suggest buying nursing bras in at least two phases:

Early Phase
We suggest having at least 2 nursing bras on hand before the baby is born.  Yes, it is true that you won’t know exactly what size you will be when your milk comes in but shopping for nursing bras in the first weeks of motherhood will most likely not be high on your list of priorities.  The bra should fit on the middle row of hooks.  This allows both room for expansion in the last few weeks of pregnancy, as well as for tightening as your ribcage shrinks after the baby is born.  Many quality nursing bras have four rows of hooks and eyes instead of the usual three rows to give even more room for adjustment of the band.   Buy one cup size larger than the size you are in the 8th month, as this will allow for the increase you will experience when your milk comes in.  As a practical matter, look for nursing bras with clips that are easy to open and close one-handed. It is best that these early nursing bras are wireless since wireless bras are more forgiving than underwired bras to the fluctuations in breast size that occur in newly nursing moms.  Any underwired bra that does not fit properly poses a risk of clogged ducts and mastitis.

Later Phase

Once you and baby have settled into a comfortable breastfeeding rhythm it may be time to get fitted for additional nursing bras.  At this point the fitting becomes more like a traditional bra fitting. The nursing bra should fit comfortably on the slackest hook and the cups should fit your current size, with no wrinkling or bulging.  If you are used to underwired bras you may return to them at this point but bear in mind that as your baby goes through changes in feeding cycles breast size fluctuations may continue.  To avoid any potential issues, pay attention to fit and ensure that the underwire lays flat against your ribcage all the way around and does not press against any breast tissue.


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Will nursing my baby cause my breasts to SAG?

Many women hold the belief that nursing their babies is directly linked to changes in the firmness of their breasts.  However research indicates that whether a woman chooses to breastfeed or not has little to no effect on the degree of “sagging” she experiences after pregnancy.  Research shows that it is largely the changes that a woman’s breasts go through during pregnancy itself that leads to sagging, not whether the woman breastfeeds.

First, a little biology

Breasts have no muscle tissue.  Rather, they are composed of fat, connective tissue and the milk producing system.  The breasts are supported and connected to the chest by Cooper’s ligaments which naturally lengthen and stretch over time.  Stretching of these ligaments is exacerbated by weight gain, and excessive movement of the breasts, such as during vigorous exercise if not properly supported.

During pregnancy your body prepares for the baby by starting the lactation (milk producing) process.  Your breasts will become bigger and heavier as the milk glands develop.  It is this increase in size along with other factors such as skin elasticity, smoking (which weakens skin elasticity), number of pregnancies and larger pre-pregnancy breast size, that scientists have found to contribute to sagging.

If a woman chooses not to breastfeed, or as the baby is weaned, milk production slows and eventually stops.  Since milk producing glands comprise a greater proportion of the breast during lactation than fat, when lactation ends a woman will usually experience some decrease in volume.  In some women this decrease in volume is temporary as fatty tissue will increase.  In other women  it is a permanent change.

So what does all this mean?

Basically, the research shows that once a woman decides to have a baby, the volume and firmness of her breasts after pregnancy is dependent on genetics and lifestyle factors rather than whether or not she chooses to breastfeed.   However there are a few things you can do to minimize breast changes.

1.       Moisturize.  This improves skin elasticity, so while you’re rubbing cocoa butter on that tummy don’t forget the ”girls”.

2.       Avoid wide weight fluctuations outside of pregnancy.  When a woman is not pregnant or lactating the size of her breasts are largely determined by the amount of fatty tissue.  Wide weight fluctuations will cause the breasts to increase and decrease in size which could put strain on the Cooper’s ligaments.

3.       Wear a supportive bra that fits you now.  Not one that fit 3 months ago or one that you will grow into.  Bras that are too small or too big cannot do the job they are meant to do.

If you are not sure how to tell if your bras fit correctly don’t hesitate to reach out to us for a fit consultation.  We’d also love to hear from mamas on what your experience has been so drop us a line.

References:

  1. http://women.webmd.com/guide/a-lifetime-of-healthy-breasts
  2. http://www.plasticsurgery.org/News-and-Resources/Press-Release-Archives/2011-Press-Release-Archives/Myth-Prevents-Successful-Breastfeeding-in-Augmentation-Patients.html
  3. http://www.medicalnewstoday.com/releases/86982.php

 

Guide to choosing nursing bras

In the first post of our maternity series we covered selecting bras during pregnancy.  This week we will cover the basics for moms who choose to breastfeed.

Nursing Bras vs. Maternity Bra

Nursing bras and maternity bras share many of the same features, especially with regard to enhanced support.  In many circles the terms nursing bra and maternity bra are therefore used interchangeably, however one of the main distinguishing features of a nursing bra is that the cups are designed to provide easy access to the breast for feeding the baby.  This is usually accomplished by having the cups drop down from a clip.

When should I buy a nursing  bra?

Many women find that their cup size fluctuates widely in the first few weeks and months of breastfeeding before the baby and their bodies settle into a breastfeeding rhythm.    For this reason we suggest buying nursing bras in at least two phases:

1.  Early Phase

We suggest having at least 2 nursing bras on hand before the baby is born.  Yes, it is true that you won’t know exactly what size you will be when your milk comes in but shopping for nursing bras in the first week of motherhood will most likely not be high on your list of priorities.   Husbands and friends may be well meaning but the chances of them returning with a decent fitting bra if sent on a shopping expedition are fairly slim.  A good time to get fitted for nursing bras is in the 8th month of pregnancy.

The bra should fit on the middle row of hooks.  This allows both room for expansion in the last few weeks of pregnancy as well as for tightening as your ribcage shrinks after the baby is born.  Many quality nursing bras have four rows of hooks and eyes instead of the usual three rows to give even more room for adjustment of the band.   Buy one cup size larger than the size you are in the 8th month, as this will allow for the increase you will experience when your milk comes in.  As a practical matter, look for nursing bras with clips that are easy to open and close one-handed.

It is best that these early nursing bras are wireless since wireless bras are more forgiving that underwired bras to the fluctuations in breast size that occur in newly nursing moms.  Any underwired bra that does not fit properly poses a risk of clogged ducts and mastitis.

2.  Later Phase

Once you and baby have settled into a comfortable breastfeeding rhythm it may be time to get fitted for additional nursing bras.  At this point the fitting becomes more like a traditional bra fitting.  The nursing bra should fit comfortably on the slackest hook and the cups should fit your current size, with no wrinkling or bulging.  If you are used to underwired bras you may return to them at this point but bear in mind that as your baby goes through changes in feeding cycles breast size fluctuations may continue.  To avoid any potential issues pay attention to fit and ensure that the underwire lays flat against your ribcage all the way around and does not press against any breast tissue.

Comments, questions, feedback? Drop us a line below.

How to choose bras during pregnancy

Whether you are an expecting or breastfeeding mom this is a very special time in your life.  Your body is nurturing another human being as only a mother can do, and you deserve to feel and look your best.

Stay tuned as over the next four weeks Underpinnings answers some of the most frequently asked questions about bras during pregnancy and nursing.  This week we focus on maternity bras.

 

When should I buy a maternity braWearing a bra that fits correctly is always beneficial but is especially important during pregnancy and nursing.  Your breasts will become not only fuller but also heavier due to increased blood supply, fatty tissue and the development of milk glands.  A quality maternity bra will offer additional support to accommodate your enhanced breast size and weight.

As soon as your old bras no longer fit you should consider purchasing maternity bras.  Many women find that this first occurs near the end of the third month of pregnancy.  Because you will likely need to purchase bras again as your breasts continue to grow throughout your pregnancy you may want to manage expenses by limiting your initial purchase to two bras – one to wear and one to wash.Choosing a maternity bra

When trying on maternity bras look for the following:

1.       Ensure that your whole breast is encased in the cup.  It is very important that the band, seams and underwire (if applicable) do not press into breast tissue.  Note that many experts advise against wearing an underwired bra during pregnancy and nursing.  An ill-fitting underwired bra is much less forgiving than an ill-fitting soft cup bra as underwire that presses into breast tissue could lead to a painful infection.  If you are used to wearing underwired bras and choose to continue to do so during pregnancy it is crucial that you pay attention to ensuring a proper fit.

2.       The band should be wide and supportive and the shoulder straps should not be overly narrow.

3.       The band should fit snugly but comfortably on the TIGHTEST hook.  This is the opposite guidance to buying a bra any other time in a woman’s life and is to allow room to loosen the band as your ribcage expands during pregnancy.

4.       The inside of the cup should be smooth, with no exposed seams.  With all those hormones coursing through your body your breasts are likely to be very sensitive and seams that may not irritate at any other time may feel like sandpaper against your tender nipples.

Next week we’ll discuss nursing bras.  Until then feel free to drop us a comment or ask a question.