Back in October, I was nervous as we prepared to take our preschooler and kindergartner on an 8 hour flight to Germany. I was reminded of the fear of traveling with small children.  I longed for the days when I could just quietly put them to breast and all would be well in the world.  So in honor of my jealousy, I am devoting this blog post to how to continue your breastfeeding journey while traveling with or without your baby. 

Travel is NOT a reason to stop breastfeeding. In fact, breastfeeding an infant while traveling is probably easier than bottle feeding.  You don't have to look for places to get safe, clean water and you don't have to carry around ample amounts of formula to prepare.  Not to mention you won't need to worry about cleaning bottles and nipples in order to prepare the formula safely.  I'll hop off my soap box now. 

Travel is not only stressful on parents, but the baby or child as well.  If you are traveling with an infant who is less than 6 months of age, preparation is key! Remember:
- You are your child's source of comfort
- Lots of skin to skin, when possible
- Bring an infant carrier or sling to keep baby close and give the use of two hands
- Allow for baby to nurse whenever they need to, even if for comfort only
- IBCLC's and CLC's are located worldwide, and you may want to find one in your destination location
- You can bring your electric pump if you believe that you will need it, but for most mothers, who are exclusively breastfeeding, a hand pump as back up, will do the trick for short trips (to relieve engorgement, a dinner away from baby, etc.) with baby in tow
- You have rights as a nursing mother- never forget that and don't be afraid to state them

If baby is staying home on this trip, you can prepare in other ways to make sure that your milk supply is protected and your baby is adequately fed while you're away.  Again, preparation is the key to success and less stress while away from your baby!  Remember:
- Determine how long you will be away from baby and estimate how many ounces/day baby will need
- Reach out to an IBCLC or CLC to aid in determining an estimate if you are unsure
- Begin pumping at least four weeks prior to travel and pump appropriately to "stash" milk for while you are away
- Pack a double electric breast pump for your trip, and all necessary accessories:
      - tubing, flanges, valves, membranes, storage bottles or bags, ice packs, freezer
        bags, permanent marker to date/time bags or bottles, cleaning wipes
- KEY: while you are away from baby, you will have to pump on the same schedule as you would typically nurse/pump, in order to protect and maintain supply!
- Again, know that you have rights as a breastfeeding mother! 
- If air travel is required, breast pumps are considered "personal items" and can go as a "carry on" item, just as a purse or small suitcase
      - You CAN travel with breast milk that has already been expressed, check with your airline for their specific policies related to this

Keep in mind your pumping to-do list:
- Clean all pump parts and accessories with warm, soapy water and let them air dry 
- Storage: freshly expressed milk: 4 hours on counter-top, 4 days in the refrigerator, 6-12 months in the freezer. 
- If you won't be using milk within 4 hours, put it immediately in the fridge
- If milk is frozen, it must be used within 1-2 hours out on the counter-top and 1 day if it is in the refrigerator.  You can never re-freeze breast milk that has been thawed!
- Use cooler bag for travel with ice packs

Even though this all seems like a lot of work and stress, if you prepare in advance, your travel will be smooth sailing.  After all, seeing the world is what we should be doing and if we can bring our babies along, even better! Never hesitate to reach out for help when you don't know something or you're just needing some reassurance.  You got this. 

Many new moms will question their milk supply after about the first 12-24 hours of life. If you have been there, you know that once cluster feeding starts, you wonder why your once sweet newborn is now screaming uncontrollably and nursing for hours on end.  Cluster feeding is totally and completely normal and is how your baby tells your body that he or she is on the outside now and needs food out here!

Oftentimes, if there is a marked weight loss or the baby is jaundice, formula may be recommended.  When this occurs, the mother starts to use supplementation of formula for feedings.  Those bottles of formula, although beneficial (but no more beneficial than breast milk) for weight gain and bilirubin, are detrimental to a mother’s milk supply.  We must remember, it is supply and demand at the core.  If it is not on demand, your body will say “hey, she must not need it” and stop production or decrease it dramatically.

We have ways to combat this while in the hospital, and your best bet is to always reach out to a lactation consultant who can guide you through supplementation.  We have special tools and feeding devices that can make formula feeding an option while still breastfeeding.

In other situations, there are some women who physiologically will not produce enough milk.  Whether it be insufficient glandular tissue or a hormonal imbalance, these women will never make enough for their baby.  That is the extreme, but many mothers can increase their milk supply with simple changes to routine in their feeding schedules. 

Below are some changes in routine that may help to increase supply:

For Mom:
Relax between feedings
Spend one on one time with baby for 48 hours only feeding and cuddling
Lots of skin to skin
Deep latch
Galactogogues
Record feeding times and supplementation used
Use a hospital-grade pump for 5-10 minutes after each nursing
Improve diet: more protein, fruits, vegetables
Decrease caffeine
Increase water intake

For Feeding Routines:
Relax during feedings
Put baby skin to skin while nursing
Make sure baby is alert before nursing
Check latch to make sure it is deep
Switch breasts within each feeding
Feed more frequently and try to go longer
Nurse for comfort if the baby is fussy, avoid the pacifier
Continue night time feedings
If giving supplements: use paced bottle feeding

A galactogogue is a food, drink, medication, or herbal supplement that is believed to increase milk production.  Before turning to a galactogogue of any kind, you should first figure out the underlying cause of your low milk supply.  If it is just a supply and demand issue, the techniques above will help to improve milk supply if it is possible.  Some common herbal galactogogues include: fenugreek, blessed thistle, and goat’s rue.  Research is mixed on their effectiveness.

There are prescription medications, but their use is controversial when it comes to breastfeeding and many are not available for such use in the United States.  Medication should not be the first course of treatment for insufficient milk supply and the things mentioned above should be attempted first. 

Any normal mother worries that she is going to do something that harms her baby, especially when it comes to feeding them.  Unfortunately, our breasts are not transparent, and we cannot say “oh good, little Jonny took in 2 ounces at this feeding.”  We can, of course, do pre- and post-feeding weights to see how much milk is transferred, but that won’t help with the day in and day out of feeding. 

Women must trust in themselves, their bodies, and their ability to adequately feed their babies.  When in doubt, reach out! Call a lactation consultant, call the pediatrician, call your obstetrician, or call the hospital where you delivered.  Use the resources available to you.  There is no one right or wrong way to breastfeed, but we can help it become more manageable, as well as give you the courage to continue your breastfeeding journey.
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You got this mama!

I was lucky enough to be a part of the generation who was consistently told from day one that “smoking is bad for you.” I consider myself lucky because I always had the confidence to say “no” and I never felt the desire to even try a cigarette. Despite this, it would be foolish to believe that no one of my generation, or those in child-bearing ages, do not smoke currently. We know the health risks, we know we shouldn’t, but many still do and it has great impacts on not only their health but the health of their children.

You might ask how this relates to breastfeeding? Well, many women believe that because they smoke, they cannot also breastfeed. While it is strongly encouraged that women quit once they become pregnant, we must live within some people’s realities. If a woman smoked during her entire pregnancy and then gives birth, we cannot expect her to magically not be addicted on the day of delivery. So, what are the impacts of smoking on breastfeeding and lactation?

Research has found that smoking mothers are less likely to continue breastfeeding. This may be because of a lower motivation to continue, as well as the perception of harmful effects on the quality and quantity of their breast milk.

Nicotine, from smoking, does transfer into a mother’s milk. Smoking 20 cigarettes daily increases the nicotine in a mother’s milk to harmful doses and may cause nausea and vomiting in the infant. Other possible side-effects in infants include fussiness, shock, rapid heart rate and restlessness.

The American Academy of Pediatrics (AAP) states that maternal smoking is not absolutely contraindicated but is strongly discouraged (AAP, 2013). Concerns cited within this policy also cause some anxiety in pregnant and breastfeeding mothers, which cause them to choose not to breastfeed. Those listed are concerns with: respiratory infections, sudden infant death syndrome, low milk production, and low weight gain.

So, what do you do if you smoke? Understand your options.

• You should attempt to quit smoking before you give birth
• Find a smoking cessation program before and during pregnancy, and continue while breastfeeding
• Talk with you obstetrician and your baby’s pediatrician about it

What is important is the management of smoking, if you continue, during pregnancy and after baby is born. Second-hand smoke is linked to many issues with children, and therefore smoking around your child is strongly discouraged. Nicotine intake from second hand smoke is much greater than nicotine intake from breastfeeding.
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Children who are exposed to smoke within the home may have:

• Higher risk of respiratory infections and illness
• Higher risk of asthma
• Higher risk of neurobehavioral problems
• Decreased performance in school
• Higher risk of ear infections
• Higher risk of sudden infant death syndrome

If you continue to smoke after birth, do not do it inside of the home, in the car, or anywhere that may confine your child to be exposed to the smoke. Go outside, wear a “smoking jacket” or change your clothing after you smoke, and wash your hands thoroughly before interacting with your baby again. Also, try to time out your smoking with feedings. Feed your baby before you have a cigarette and then perform all the previously stated to even further decrease your child’s exposure.

Mothers who continue to smoke during pregnancy and breastfeeding often feel guilty. The best thing is to understand that you are not alone and to make the best decisions that fit the needs of both yourself and your baby. It is better for a baby of a smoking mother, or a baby who is exposed to second hand smoke, to be breastfed as they receive protection from breastfeeding that they would otherwise not get. We are all trying to do our best as parents, and we must work within our own realities. You got this mama.

Source Credit: Lauwers, J., & Swisher, A. (2016). Counseling the nursing mother: a lactation consultants guide. Burlington, MA: Jones & Bartlett Learning.

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Humans evolved and survived by breastfeeding.  If it weren’t for breastfeeding, you would not be reading this blog right now.  You might say “well that’s not true, my grandmother, mother, and I were all formula-fed, and I’m sitting here.” While recent generations may have been formula-fed and survived, historically the only way for babies to survive prior to that was by being breastfed.

Humans are among 5,000 other types of mammals which use their own milk to feed their babies.  Human babies have been traditionally fed mothers milk or the milk of another human woman.  It is only recently in our history that human babies have begun to consume milk of other mammals. In early colonial America, it was known that women would feed their infants “through their second summer.”  Therefore, the child would be two years old or just about two years old (which is on par with current AAP and WHO recommendations!).

By the 1800’s is when we saw the shift from human babies consuming human milk to human babies consuming cows milk, and it wasn’t long before physicians of that era began to “decry the trouble and dangers of artificial feeding.” Once this shift occurred, most mothers began to wean their children before three months of age, much like current trends in the United States.  Most often during this time period, wealthy or royal family members would choose artificial feeding methods, formula or wet nurses, to “stay beautiful or to get pregnant again.”  High formula usage has maintained as a norm in the United States, but around the world breastfeeding is still the primary source of nutrition for infants.

What is a wet nurse? Wet nursing is defined as “the act of a woman nursing a baby other than her own.”  This practice dates back to 2000 BC and was commonly used when a woman could not produce enough milk and her infant was likely to die without intervention. Also, in the same class, is a common practice of cross-nursing.  Cross-nursing is when mothers in a community nurse each other’s babies. 

It was not until the 18th and 19th centuries that technology changed the terms of artificial feeding and created the products we now call “infant formula.”  During this time, it was noted a greater number of infant deaths occurred. Then, instead of focusing efforts on increasing breastfeeding rates, the focus shifted to improving artificial substitutes. 

An obstetrician, Pierre Budin, who founded the study of neonatology, recognized the association of increased infant death and illness resulting from contaminated cows milk during the 19th century.  He then started the well-baby visits (so we can thank him for those frequent doctor trips!) and focused his attention on education of mothers on the benefits of breastfeeding for infant health. 

Formula use continued to increase through the 20th century and was promoted as “modern,” “civilized,” and “a sign of wealth.” Breastfeeding therefore became associated with lower social classes and looked down upon.  By 1971, breastfeeding rates in the United States were at an all-time low, with 24% of mothers ever having breastfed before leaving the hospital. 

Early in the 20th century, medical schools began to shift their focus on advocating for medical students to spend more time studying breastfeeding and infant nutrition versus artificial feeding methods.  During this same time, it can be noted that studies began emerging showing the correlation between breastfeeding and increased IQ.  It was shown that babies who were studied and had an IQ of 130 were all breastfed. 

The feminist movement during the 1960’s spurred many social reforms and breastfeeding was an intrinsic part of it.  We continue to see a movement back to breastfeeding, which closely mimics the movement away from it during our early history.  Breastfeeding is now known as the best way to feed a baby, although it is not always followed. The focus of current trends shows a respect for the rights of both mother and baby while promoting the best possible health comes for both.

Source Credit: Lauwers, J., & Swisher, A. (2016). Counseling the nursing mother: a lactation consultants guide. Burlington, MA: Jones & Bartlett Learning.

While we have not met our Healthy People 2020 goals, the breastfeeding rates in the United States have improved over the years.  One of the reasons that women have found it difficult to choose breastfeeding or to maintain breastfeeding, is the fact that they must return to work very soon after having their babies. 

There is an ever-increasing number of women entering the workforce with a child less than one year of age.  Some studies have suggested that employment has a negative impact on a woman’s decision to breastfeed, especially if she must return before or at twelve weeks postpartum.  For many women within the workforce, it is seen as incompatible with long term breastfeeding. 

Type of occupation also influences a women’s decision and longevity of breastfeeding.  Those within professional, administrative, or managerial positions tend to have longer duration of breastfeeding than women in lower-skilled occupations. 

Barriers to successful breastfeeding and employment:

• Insufficient milk supply
• Lack of knowledge in how to manage breastfeeding at work
• Lack of time
• Workplaces that are not conducive to breastfeeding/pumping

Facilitators to successful breastfeeding and employment:

• On-site childcare
• Longer maternity leave
• Flexible work schedule
• Availability of a lactation room
• Types of breast pumps
• Supportive work environment

Steps to help prepare to return to work:

• Learn as much as you can BEFORE baby arrives
• Plan, plan, plan- talk with your employer BEFORE you go on maternity leave
  • Establish or find out a place where you can breastfeed or pump at work when you come back
  • Establish or find out where you can safely store your milk in the facility or if you will need to bring your own cooler bag
• Talk with other women who have returned to work and successfully breastfed
• Seek a lactation counselor about six weeks before you return to work to develop a plan
• If possible, start back by working from home for a few weeks and then transition back to full-time, on-site employment

Benefits for employers:

• Increased productivity
• Reduced absenteeism
• Lower healthcare costs

Returning to work after having your baby is a very hard decision to make.  The times are hard, but the moments are fleeting.  Many women struggle with this decision.  Ultimately, if being able to stay home from work is an option, financially, a family may decide to do that to increase breastfeeding duration and time spent with baby.  If this is not an option, going back to work and breastfeeding duration is closely correlated with preparation and knowledge.  The more confident you feel going back to work and the more supportive the environment, the better the outcome. 

​You got this mama!
 
Source: Wambach, K. and Riordan, J. (2016). Breastfeeding and human lactation.  Burlington, MA: Jones & Bartlett Learning.

I know some other lactation consultants will shudder at the thought of recommending a nipple shield, but I really believe in them. My personal belief is that if we can get a mom to continue to breastfeed for a few days, weeks, months, or years than she would have without the shield, then give that lady a nipple shield! Personally, I used a nipple shield for the DURATION of breastfeeding both of my children, 15 months and 24 months.

What is a nipple shield?
A nipple shield is an artificial nipple that is placed over the mom’s actual nipple and the baby latches to it. Older nipple shields were made from glass, plastic, rubber, or latex. Newer shields are made using a very thin silicone. They allow for more direct contact with the breast, with cutouts by the baby’s nose and chin. The silicone shields also do not appear to interfere with milk production or appropriate infant weight gain (although there is a “mixed bag” of research out there).

First and foremost, a nipple shield is NOT for everyone and should NOT be used as a pain management technique. The use of a nipple shield should only be implemented under the care of a lactation consultant and after all other techniques to aid in breastfeeding have failed. Common reasons that a nipple shield is used:

• Preterm babies
• Babies with a short tongue, tight frenulum, or high palate
• Moms who have flat or inverted nipples that do not respond to techniques to evert
• Transitioning a baby who has been solely bottle fed to breastfeeding
• Moms who are having difficulty with the breastfeeding process and want to wean early (nipple shield may help them get through the difficult time and preserve breast milk supply)

A nipple shield is, at appearance, a simple looking device to use, but it’s application is important for correct usage.

1. Moisten the edges (breastmilk)
2. Partially inverting the nipple portion
3. Place over the center of the nipples
4. Push back the outer edges of the shield and smooth over the breast

Weaning from the shield may not happen quickly, especially if a baby has been using it for a long period of time. The mother should watch for signals that the baby may nurse without the shield. She can then try and go cold turkey, and if that works, ‘hats off to ‘ya!’ or she can start feeds with the nipple shield in place and then remove it and allow the baby to nurse once they have already gotten a little full. Skin to skin is very important for this process, so please keep that in mind. Also, never trim down a nipple shield to try and wean the baby from the breast, it’s not safe.

At the end of the day, remember what the goal is: healthy baby and happy mom. Do not let one person’s opinion influence your success at breastfeeding. Do what feels right for you and your baby, and if that means using a nipple shield temporarily or forever, so be it. Just arm yourself with knowledge and support, always.

You got this mama!

Recently, I was asked on my social media platform about weaning and whether I offered a course (shout out to Melanie!).  Well simply, I do not, but maybe in the future! With that being said, I decided a blog post related to weaning was needed!
The preferable method for weaning is what we call “baby led weaning.” What the what? As the name states, it is essentially when your baby decides, on their own terms, that they are done with breastfeeding.  If you can continue to breastfeed and are comfortable with extended breastfeeding, baby led is the way to go.

First and foremost, I want you to ask yourself “why am I weaning?”  Are you weaning because you just want to stop, are you wanting another child, are you overwhelmed, are you returning to work? All of these are valid reasons, but when armed with a bit more information, you might change your mind.

Let’s first start with facts: globally, the normal range for weaning is anywhere between 2.5 - 7 years (when first molars erupt). Before you run away screaming from this post, let me say that I know that sounds like an obscene amount of time since I am from a Western culture, where the most common ages for weaning are between 12 months and 3 years, and in the United States, between 3 and 6 months (that’s obscener to me than the first set of numbers!).  Remember that statistic is based on EVERY country worldwide.  They may not have clean water, easy access to food, etc.  Therefore, they breastfeed their children for so long for pure survival and necessity.  My point is: if your baby is nursing at 2 years old and you’re panicking because your husband, sister, or mother in law keeps saying “is that baby still on the boob??” Calm down, you’re not an oddball, you’re not a freak, your baby will one day stop nursing, he or she will not go to college still requesting a nighttime feeding, I promise (but if they do, technically they are the freak and you’re in the clear…just kidding). 

Baby led weaning is the natural and biological way of a child determining when they are ready to move on to the next best thing! So how do you know when this is happening?

• Mom does not deny or initiate breastfeeding, but baby begins skipping sessions
• Baby is more self-assured and can go for long periods without nursing
• Baby may accept a snack or drink in place of a normal nursing session
• Baby may spend less time at the breast or become easily distracted
• Baby may refuse the breast and show more interest in solids
• Baby may prefer rocking, cuddling, reading or quiet activity to calm themselves down

What if you don’t have the time or patience to wait for this to occur?  Then we call that “mother led weaning.” What the what? Again, exactly as the name states, its when mom decides breastfeeding is done without the baby initiating these steps.  Again, I want you to ask yourself why are you weaning? Make sure it feels right to YOU and keep in mind your baby’s needs and understand that they might have some difficulty during this time.

If you want to initiate weaning, start gradually, do not go cold turkey.  You will suffer, and your baby will be super confused. 

• Eliminate the least favorite feeding first and do this for 2 days before making any other changes
• Substitute a drink or snack for this feeding
• After 2 days, eliminate another feeding and so on and so on until there are no feedings left
• This may take weeks to a few months to complete

Be wary of weaning too quickly:

• Baby may rebel and become even more needy and want to nurse more frequently
• Baby may become constipated
• Mom’s breasts may become full and uncomfortable
  • Watch for plugged ducts, engorgement, and mastitis
• Mom can express milk, but just to relief, not to completely empty (you’d only compound the problem)

Another option is to practice what is called “minimal breastfeeding,” which is a nice compromise between the two.  You work your way down to 1-3 feedings per day and maintain that level until the baby is ready to completely wean on their own terms.  This is an option when mom and baby need to be separated for periods of time during the day but still want to maintain the connection and benefits of breastfeeding to some extent.  If you wanted to do this, you would use the mother-led weaning until you reached 1-3 of your favorite feedings, when you know you’ll always be with your baby.  Then offer baby other snacks, drinks, and activities while you’re apart or not having nursing sessions, and only breastfeed those 1-3 times per day until your baby decides they want to decrease it further.

Remember to watch your baby’s cues very carefully before, during, and after weaning.  Some reasons your might mistake that your baby is ready to wean:

• You have been told “you should”
• Your baby is crying a lot- so naturally you’re questioning everything
• Your baby is biting
• Your baby is teething
• Your baby is sick, and you’re told he/she needs more calories
• Your baby is feeding frequently at night
• Your baby is stressed by family circumstances and exhibits different behaviors
• You experience a nursing strike

At the end of the day, it’s your baby, it’s your body, and it’s your choice.  How you wean should be left up to you.  My final piece of advice is to make the decision that best meets the needs of your baby and yourself.  Next time someone says, “is that baby still on the boob??” Smile, nod and reply “are we still obsessed with my boobs??”
 
You got this mama.

According to the 2016 Breastfeeding Report Card, four out of five infants born started to breastfeed and “high breastfeeding initiation rates show that most mothers in the U.S. want to breastfeed and are trying to do so. However, low breastfeeding rates among infants six to twelve months of age indicate that many mothers do not continue breastfeeding as recommended. These rates suggest that mothers, in part, may not be getting the support they need, such as from healthcare providers, family members, and employers.”

Hey mamas!

You might ask yourself “why in the world would I take an online breastfeeding course?” Many parents do not seek any prenatal education, nonetheless breastfeeding education, because they cannot get out to a hospital or clinic for a class with a set time. So, what other options do they have?

Yes, you could YouTube it, but what if it’s not scientific, what if it’s just anecdotal information, what if it scares you, or what if it confuses you further? Yes, you could read books, but if you have the time to actually read a whole book, kudos to you and you may want to think about going to an in-person class! Yes, you could skip it altogether and take your chances, but you’ll probably be grossly underprepared and overwhelmed when your little one arrives.

The beauty of online prenatal breastfeeding education is you can do it anywhere and anytime. All you need is an internet connection. You and your partner can literally snuggle on the couch in your pajamas and watch, or if you’re even more strapped for time, start watching on your phone at your lunch break, while you’re sitting at the bus stop, or even if you’re on the toilet (shout out to my dads!).

The courses can can either be purchased alone or as a group of three. A single course is $30 and the package is $75. So you don’t have to break the bank to get what you need! Insurance does typically cover some form of breastfeeding education, but this is not guaranteed- even with the hospital or clinic courses. At the finale of each course, you will get an e-mailed certificate that you can submit for reimbursement, if possible.

The first online course called “breastfeeding basics 1” covers topics including basic breast anatomy, milk production and hormones, types of milk, nipple flow, alternative feeding methods, getting the best start, partners and breastfeeding and finally gives a nutrition overview. “Breastfeeding basics 2” then covers infant oral anatomy, position, latch, feeding routines, hunger cues, how to know if your baby got enough, challenges, and finally returning to work and talking to employers. The final course of the series is called “pumping, storage, and paced bottle feeding,” which is a comprehensive review of types of breast pumps, how to assemble them, how to clean all of the parts, assessing phalange fit, returning to work while pumping, and finally paced bottle feeding.

As as you can see that’s a lot of information to take in, and may be too much for one night. You can start and stop your courses at any time and return when you’re ready.

If you’re not sure, you can always ask questions or try my FREE “nutrition and lifestyle during pregnancy” course to see what it’s like. While it’s not exactly the same, it will give an idea of my personal teaching style. The 3 series courses have videos built in to explain some of the items that I discuss.

I hope you will will take some time to look them over and let me be the start of your prenatal journey!

You got got this mama! (and partners, too!)

Visit:
​www.breastlearningonline.com/online-courses.html

​On the first few days postpartum, I often hear mothers say, “it’s supposed to hurt” or “my sister said it hurts so bad” or “my friend’s nipples were cracked and bleeding when she breastfed!”  While some women do report a level of nipple soreness when they begin breastfeeding, many do not.   So, what’s normal?  When do you worry and how do you treat it? Let’s look!
There is such a thing called “transient nipple soreness,” which is essentially when a women’s nipples feel tender in the first days postpartum.  This level of soreness is categorized by:

• Pain with the initial latch and the first few sucks
• Pain does not persist throughout the entire feeding
• Peaks around week 1 postpartum

If a mother’s pain lasts for the duration of a feeding and does not dissipate over time, this may require more investigation.  Some common causes of nipple pain are:

• Ineffective or Improper latch
• Sucking pressure
• Anomalies in the infant’s oral structure
• Nipple shape
• Engorgement or mastitis
• Improper use of breast pumps or nipple shields
• Thrush
• Impetigo or Eczema
• Paget’s Disease, Psoriasis, Poison Ivy, Herpes
• Bacterial infection
• Raynaud’s Syndrome

So, what should a mother do if her nipple pain lasts beyond the first week of life? Contact your OB/GYN and call a Lactation Consultant to assist in assessment of the problem.  Although no one wants a new mom to be in pain, there is no better way to heal anything except for to give it time and care.  Some at-home remedies include:

• Ibuprofen (check with your healthcare provider FIRST)
• Ice
• Gel pads
• Ointment (Lanolin)
• Olive oil
• Coconut oil

Finally, did you know that a mother’s breast milk has healing capabilities?  Therefore, if you experience a cracked nipple, soreness, or blisters, express some of your own breast milk and rub it on the area.  Allow that to air dry and repeat after each nursing session.  Remember you are making a life-saving substance within your own body! It has many talents and so do you! You are doing what is best for you and your baby…you got this mama.

If you live in the Northeast or even the Eastern United States, you just experienced, what was described as a “bomb cyclone.” Also known as a far-reaching snow storm.  I don’t want to get political or discuss global warming, but I cannot help to highlight that over the recent years, we have seen an increase in these massive storms and weather patterns that are unusual.  So, whether you believe in global warming or not, you might ask yourself “what does this have to do with breastfeeding?”  Let’s look.
Being from a developed nation, we don’t often think of emergencies or natural disasters occurring in our area, and we wholeheartedly believe that in the event of one, our government would provide for us.  While this may be true in some cases, the aid will not come on the day of the disaster and you will most likely be facing a rough road for, at minimum, a few weeks even with government aid.  Look at what happened in New Orleans, New York, and most recently Puerto Rico.  Many people in these areas did not have power for an extended period, and in the case of Puerto Rico, still don’t.  What about clean water? How about food? How about toilet paper, shampoo, soap, and the list goes on… All of these items and many, many, many more would be troublesome to attain in the event of a natural disaster.
So, what is the one thing that women can make, that’s nutritionally complete, clean, and safe during a natural disaster or emergency?  Breast milk.  I will often hear mom’s say, “my diet is terrible, and I don’t drink enough water, so I can’t possibly breastfeed.”  My response is always the same, “while YOU might feel like garbage because your diet stinks and you don’t drink enough water, your body will continue to make the PERFECT food for your baby.”  The woman’s body is truly magical, and it will supersede its own needs to meet the needs of its growing child, no matter the age or size.  Therefore, during a natural disaster or emergency this is a life-saving substance.  It is nutritionally perfect for your child or children, it’s always the right temperature (which helps the child to regulate their own temperature), it contains antibodies which help to protect from diarrhea or other common illnesses that occur, and the act of breastfeeding reduces both maternal and child stress levels. It’s a no-brainer for me!
On the contrast, formula fed children may face many difficulties in the event of an emergency.  First, you may be unable to find any.  The stores will be closed, and if they do have it, it’s probably sold out.  Secondly, powdered formula can easily become contaminated if it not prepared correctly, unclean water is used and/or refrigeration is not available.  Finally, even though there are many more disadvantages to formula use during an emergency, your child does not receive the protection from disease when they drink formula like they do when they drink breast milk.  So, although I do believe formula has a time and place for use, for medical reasons, it should not be the first choice of feeding method during a natural disaster or emergency. 
Finally, while I sincerely hope you and your family never have to experience such an emergency, know that life is unpredictable.  We cannot possibly plan for a hurricane, a snow storm, a tornado, a car accident, a home fire, etc.  We can put the best steps in place to make those times easier. Breastfeeding is one. 
Breastfeeding Facts from the American Academy of Pediatrics on Feeding During an Emergency

1. Mothers can continue to lactate in times of physical and emotional stress but will need support.
2. Malnourished women and women with medical illness can breastfeed.
3. Optimal human milk supply is maintained by infant demand.
4. For some mothers and babies, once breastfeeding is stopped, it may be resumed successfully.
   1. Frequent skin to skin
   2. Supply increases over days to weeks, gradually
   3. Careful assessment of the infant nutrition and hydration status
   4. Full milk supply is better established with a younger infant
   5. Mothers will need encouragement during this entire process

You got this mama!
http://www.usbreastfeeding.org/emergencies
https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Pages/default.aspx
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The average cost of savings from non-use of formula is most likely grossly underestimated.  For the purposes of this post, we will look at the actual cost of formula and how much it will likely cost to formula feed a baby.  So, lets use a 7 pound, normal delivery, healthy baby as our “standard” baby just to make a nice solid number.  Commercial formula ranges in anywhere from a generic at about .11 cents/ounce to a brand name at about .17 cents/ounce.  Of course, there will be outliers.  Sometimes a baby will need a specialized formula, in which case you would pay much more. 
I looked up “similac advanced with iron” and found that at Target, you can buy a 38.8 oz of powder (282 oz liquid) formula for $32.99, which equates to .17 cents/ounce.  Remember, powder formula is not recommended until at least 4 weeks, so that same formula, ready to feed, 1 qt (32 oz liquid), is $6.99, which equates to .22 cents/ounce. 
Now comes the math:
A 7 lb baby on day 1 needs 17.5 oz / day. 
Day 1: 17.5 oz x .22 = $3.85
We must keep in mind that babies gain about .75-1.00 ounces/day for the first 3-4 months.  So ideally, by day 30 this baby would weigh 8.88 pounds.
Day 30: 22.2 oz x .22 = $4.88
So lets say the average cost/day is $4.36.  That means for the first thirty days it costs you approximately $131.00 to feed your baby.
Now, if this baby is still on this formula, but you wanted to switch to the powdered version, you’re looking at .17 cents/ounce, but your baby is bigger, so he or she needs more!  Let’s say for the next 11 months, your baby may need between 40-60 ounces of formula/day (this is not a recommendation, but rather for estimation purposes). 
1 month = 30 days = 30 x 40 oz/day = 1200 oz/month x .17 = $204.00/month
Or 1 month = 30 days = 30 x 60 oz/day = 1920 oz/month x .17 = $326.40/month
Therefore, for the next 11 months you would pay $204.0-$326.40 per month for formula.
$204.00 x 11 = $2,244.00  - $326.40 x 11 = $3,590.00
Now add in the first month and you’re looking at an average of $2,375.00 - $3,721.00 per year for this formula. 

You want to know how much breastfeeding costs your family? Nothing.  It’s free. 
Add in the cost benefits of less illness and less missed work days to care for a sick baby and your savings are even higher!
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Just my two cents.
You got this mama!

As I see many people saying “bye, Felicia” to 2017, I can’t help but have some mixed feelings. I can’t really say I’m happy to see 2017 go, but I’m looking forward to the journeys ahead in 2018. For starters, in 2017, my brother and Jacque tied the knot in April, which could not have been more perfect of a day and now I have a new sister in my life, that we all adore. In addition to that, Aubrey completed her first year of preschool, she finished out t-ball and soccer strong, and she turned FIVE years old! Nolan started speaking in an understandable language, melts the world with his smile, and he turned TWO years old! My kids are my world, and I love that I get to teach them. With that being said, we got to vote again in our primary elections, as well as the general elections. The kids and I also got to travel to the Outerbanks with Nanny and Jeppie for a quick vacation. As for me, I got my CLC (Certified Lactation Counselor), started my clinical rounds at Moses Taylor, and started my own private company providing nutrition and lactation support. As a family of four, we went to Kalahari (with Michele, Laynee, Nylee, Nan, and Jep) and Knoebels…rode so many rides, ate too much food, and laughed a lot. Then the icing on the cake was a fifteen-day trip to Italy with the entire family. It would be impossible to sum up the trip into a few sentences, but highlights were: surviving two extended plane rides with a toddler and preschooler (8 hours and 10 hours), seeing Rome, the Colosseum, the Vatican, the Pantheon, seeing Florence, Michelangelo’s David, the Ospedale degli Innocenti (my personal highlight), getting to see Paul, Jessica, Bela, and Sophie (and experience all of these places with them), the gelato, the villas, the vineyards, the tiramisu, the views to die for, the pasta, the sauce, the wine, seeing Arezzo, Nerano, Ravello, Positano, Sorrento, finding sea glass at all the beaches, finding treasures wherever we went, hiking Mt Vesuvius, getting Miss Marie and Grandpa to the crater of Mt Vesuvius (we spread their ashes there), swimming in Nerano, spending time with our awesome drivers, seeing Pompeii, and finally, and most importantly, experiencing these places with people who mean so much to us. My parents, my brother and Jacque, Aunt Linda, Aunt Patty, Paul, Jessica, Bela, and Sophie. I know that I have missed so many things, but this is a good sampling as to why I am thankful. So as much as I am looking forward to what 2018 has to bring, 2017 has been VERY good to us. Ciao dolce 2017, 2018 you have BIG shoes to fill. ​

Whether you just had your baby last week, six months ago, or ten years ago, buying anything that you can online will save you the time, energy, and endless fights over what your child wants right then and there (because lord knows they cannot wait that extra four weeks for Santa).  You also can score some really great deals that might not be available in the store.  If you did just have your baby last week, holiday shopping has probably had you stressed! You just had a baby so your hormones are wild, your bank account is low, you're tired and cranky, and now you have your little hoover on you for what feels like 24/7.  Shop online and don't feel guilty about not seeing the inside of Walmart and all of its insanity. 

Along the same lines as the last tip, stop putting so much pressure on yourself to find that "perfect gift" for Aunt Ethel.   If the only store you make it to is the grocery store or pharmacy, Aunt Ethel will have to settle for a Target gift card or get nothing at all.  Let your family buy what they want, when they want.  I don't believe in buying something just to buy something, it's a waste of money on your end and then that person has to either stare at the gift in the corner of their house for the next year (because they keep forgetting to return it) or they have to return it and lose time out of their life.  No shame in gift card game.

This is more for those with younger children: kids like routines.  The holidays throw off these routines.  New people, new places, new toys... they can become uncertain in many ways.  If you have a child who can fit in the baby carrier, wear that puppy around everywhere! Not only will your baby find comfort in being with you and touching you, but it will also deter Great Uncle Greg from kissing you or your baby too much.  If you have an older child, they also might be feeling stressed because of the change in routines.  Spend some extra time snuggling and reading with them at night to let them know that they are your main priority, always.

It's the time of illness. No matter the age of the child, the thought of having a sick kid on Christmas is sad.  So while I'd love to say "don't let them leave the house" that's not really practical.  For your older kids, really reinforce the importance of hand washing and not sharing drinks or food with friends.  For your newborns, politely tell family and friends that the doctor has discouraged you from having too many people touch or hold the baby for fear of illness.  If they don't like it, too bad. Your child's health is more important than their need to kiss your brand new baby.

Raise your hand if you're guilty of lashing out on your partner over the direction that they placed a knife on one place setting at the table! Is it just me? Can't be.  Tension runs high at the holidays. You and your partner have the same goal at the end of the day: making sure your family and children have a wonderful holiday season.  Realize that you're fighting on the same team for the same goal. Take a step back if you feel overwhelmed.  Retreat. Give yourself a moment to say "whoa, calm yourself Sally," and move on.  Don't hold grudges and remember why you're doing what you're doing in the first place. 

It's okay if you can't meet your friends to see Santa with their kids for the 90th time this year.  Your kids are no worse for the wear.  In fact, I think my five year old has caught on that Santa doesn't always look the same when we see him and that there is no way he can be everywhere that we tell her he is.  My advice: just say no.  You don't have to go to every holiday party or Christmas gathering.  Say no.  You don't have to travel to every distant relatives house to see them on Christmas day.  Say no.  You are the ruler of your own life and you have the power to just simply say no.  No explanation needed (unless that argument is with your partner, then talk it out).

On the other hand, learn to say yes.  You're not superwoman.  No matter how old your kid is, sometimes you just need a minute.  You're neighbor wants to cook you a casserole because it makes her happy? Yes.  Your mom wants to take the kids to see a movie? Sure.  Your sister wants to come over and hold the baby so that you can nap.  Yes.  We all need help sometimes and just remind yourself that you either have helped those same people or will help them in the future.  That's what family (or framily {friends who are family}) does.  

Whenever traveling with a newborn, toddler, preschooler, or school age child, preparation will be your best friend.  If you know you will be traveling for the holidays, don't wait until the night before you're supposed to leave to pack.  If you're supposed to be at your sisters house at 12:00, don't start to shower at 11:45. Planning will help to alleviate some of the stress and maybe reduce some arguments between yourself and your partner.  Time it out: we have to be fed/nursed by this time, we have to be dressed by this time, we have to be in the car by this time, and barring any traffic we will arrive by this time.  It just helps.

If you're on your home turf, this could be your bedroom. Find somewhere to escape, to retreat when you have had enough.  If you are still nursing, use it as an excuse to give yourself a minute to clear your head (not to mention that oxytocin will make you super calm!). When you're not in your own home, look for a quiet room where you can go with your baby or children if they are also feeling overwhelmed just to regroup.  

I still don't have this one down pat, but kids have made it better.  Realize that no matter how much you plan and prepare, there will be snafus.  The dog will all the sudden decide it can't walk, the kids will start puking, the gifts your ordered didn't arrive in time.  Things happen.  We can try our hardest, but life gets in the way.  So realize that you need to ride the wave.  Roll with it.  If you allow yourself to get so overwhelmed by what went wrong, you'll miss what you have going right.  

You got this mama.