Fenugreek: Myth or Miracle??

I have to admit, up until very recently I was staunchly against use of herbal supplements to increase milk production. Then a trifecta of change hit: I wasn't able to pump as often, I got sick and my son decided he didn't want to eat solids as much. The net result? A hit on my milk supply and lowered production. It was bad, and I became extremely concerned I was drying up and the end was near. 


SO ... I decided to reconsider Fenugreek. After much belabored research, I took a chance on the maple-syrupy herbal supplement, and held my breath.


The result? A noticeable increase in my milk production. Yes - noticeable! Dramatic, no, but it brought me back up to normal (where I had been down by nearly 50%). Of course, I have to mention this was MY experience and yours may differ, but I can say with confidence it is worth the effort if you are desperate.


Side effects include maple syrup smelling BO. Seriously, not to get too personal (though I think we crossed that line long ago), but my armpits smelled like maple syrup. It's crazy. That's it though ... no aftertaste or burping, no weirdness. There are blood-sugar level effects, but nothing that I noticed. Then again, I'm not diabetic, so be sure to do the proper research before taking the plunge.


Some links as you start your research:


Fenugreek - An Herb to Increase Milk Supply 
What is the most important information I should know about fenugreek?
All About Fenugreek
Fenugreek: One Remedy for Low Milk Production
Fenugreek: Uses, Side Effects, Interactions and Warnings


Good luck, moms.

What's the Big Deal with Breastfeeding?

Curious why the big hype about breastfeeding? After all, formula-feeding has been the norm for many years and we're all just fine, aren't we?


There are countless benefits to breastfeeding - both to you and your baby. My personal favorites include:

• formula feeding is fine (gasp!) and you're baby will grow to be a beautiful and healthy child. But breastmilk offers an incredible immunity-boost that no man-made formula can deliver. Nothing compares to mommy's antibodies.
• breastfeeding is cheaper, even if you are an Expressive Mom! See the real numbers in this post
• it's the easiest way to get back to pre-baby weight (breastfeeding burns 500 calories per day!). I've actually dropped a dress size from my pre-baby size - I eat like pig and haven't bothered with dieting or exercising, so it's definitely the breastfeeding.
• you may benefit from a reduced risk of breast cancer among at-risk women.  To be sure, there are MANY correlations for causes / prevention of breast cancer. Click to CNN Article
• you may also benefit from a reduced risk for uterine and ovarian cancers 

Plenty of articles out there on the benefits of breastfeeding ... some for the sampling:

7 Ways Breastfeeding Benefits Mothers - Ask Dr. Sears
Why Breastfeeding is Important - WomensHealth.gov
Benefits of Breastfeeding - Natural Resources Defense Council 
Your Guide to Breastfeeding - WebMD

Why breast milk could hold the key to beating Alzheimer's

Why breast milk could hold the key to beating Alzheimer's

Embryonic stem cells could revolutionise treatment of cancer, blindness, diabetes, Parkinson’s and paralysis

Breast milk cells can turn into cells of the bone, cartilage, fat, brain, liver and pancreas

By FIONA MACRAE

The milk, intended by Mother Nature to give babies the best start in life, is rich in stem cells, which have the chameleon-like properties found in those taken from embryos.Breast milk contains stem cells that could potentially beat diseases from Alzheimer’s to cancer, according to scientists.

The milk could provide a ready and ethical source of stem cells, which are widely seen as a ‘repair kit’ due to their potential to turn into any cell type in the body. Cancer, blindness, diabetes, Alzheimer’s and Parkinson’s diseases and paralysis could all potentially be healed by the power of ‘master cells’.

The use of embryonic stem cells is mired in controversy because harvesting them from an embryo leads to its death. But the New Scientist reported that breast milk stem cells can turn into bone cells, cartilage, fat, brain, liver and pancreas, a breastfeeding conference will hear next year.

Researcher Foteini Hassiotou, of the University of Western Australia, said: ‘Breast milk offers a new exciting opportunity for stem cell therapies.’

Chris Mason, professor of regenerative medicine at University College London, said more proof is needed that the cells are as versatile as billed, but added: ‘If they are truly embryonic, this will be another way of getting stem cells that would not raise ethical concerns.’

Even if they do not turn out to be as versatile as hoped, said Newcastle University stem cell scientist Lyle Armstrong, a woman could still bank stem cells from her milk and use them to help in the treatment of a disease such as diabetes later in life.

Embryonic stem cell research suffered a major set-back earlier this week when the first company to test them in people withdrew from the field.For instance, a woman could bank the stem cells from her milk and then use them  to help in the treatment of a disease such as diabetes later in life.

Californian biotech company Geron hoped the revolutionary therapy would help  the paralysed walk again.

The trial on men and women with spinal cord injuries caused by car crashes and  sporting accidents was hailed as 'the beginning of a new chapter in medical  therapeutics'.

But after treating just four patients, Geron shelved the work, blaming the high costs and red tape of stem cell research as well as 'uncertain economic conditions'.

However, others questioned whether it would have given up on the treatment if  it really was going to produce the miracles promised.

Geron, which now intends to focus on cancer drugs, has not released any  information about how well the treatment worked.

Europe's first embryonic stem cell trial is due to start later this year when a jab to cure blindness is tested at London's Moorfields Eye Hospital.

http://www.dailymail.co.uk/health/article-2062922/Scientists-use-breast-milk-embryonic-stem-cells-row.html#ixzz1e8GlSXDL 

The Perfect Latch

Just as with breastfeeding, the perfect latch is critical to success.


When you pump, you need to be sure you have a proper latch in order to maximize your production, minimize your time investment and avoid roughing up your delicate nips.


Some pointers:

• be sure you have the right flange size - yes! they can vary in size! Your nipple should fit comfortably in the neck of the flange; it should not be squeezed and it should not have space around it (see below, courtesy Medela):

• when you start pumping, make sure your nipple is parallel to the neck of the flange, as depicted above. If it is sideways or crooked, you will have decreased efficiency
• start on a lower speed and increase once your milk has let down to a comfortable level. you do not need to pump at maximum speed / strength - this can make for some very tender nipples!!
• you should feel "tugging" on your nipples, but under no circumstances should you feel pain. consider a lower setting if you experience discomfort during or after pumping

If you have the perfect latch, but your nipples are only being slightly stimulated, check that your pump is attached properly:

• is the flange airtight to your breast?
• is your nipple properly centered in the flange?
• are the pump membranes in place?
• are you missing any pieces
• are the hoses airtight?
• is every piece snapped in place properly?

Do the Math: A Cost Analysis of Expressing v. Formula-Feeding

I don't think anyone would disagree that breastfeeding from the breast is cheaper than formula-feeding.

But what about us Expressive Moms who bottle-feed breastmilk? Is there still a cost-advantage?

I did a cost analysis (what? I am a business-woman and an MBA candidate) focusing strictly on financial figures and found the following:

Cost to be an Expressive Mom:

• 100% expressing: $423
• Expressing + 1x Bottle per day Supplement: $608

Cost to formula feed for one year:

• Generic brand formula: $749
• Brand name formula: $1,258

If you continue to feed your baby breastmilk until age two (as recommended by most health organizations other than the US government), you can save an additional $178 by not buying whole milk.

Notes and assumptions:

• Calculations were made on average feedings, based on this chart (which have been quite accurate, according to my experience).
• I assumed ZERO waste ... as in every drop of every bottle is consumed. Remember, formula goes bad after an hour, so this is likely a VERY conservative estimate.
• Growth spurts were not accounted for - and it's been my experience that consumption can increase by as much as 20% during growth spurts!
• I used the largest containers of powder formula for this analysis - they are the cheapest - so the figures inflate for different sizes, pre-made, portable variations.
• Included in 100% expressive figure are Medela brand hands-free breast pump, storage containers, cleaning wipes, and freezer bags. These are definitely some of the more expensive items, so costs can be cut further by using cheaper brands (ie. Lansinoh, Simplisse, etc)
• Supplementing 1x bottle per day uses generic powder formula costs
• Assume feeding 16 oz of whole milk from age one to two per day, with a cost of $3.89 per gallon
• Cost for bottles, nipples, bottle cleaners, and anything else related to bottle-use are the same for expressing and formula-feeding, so they are not reflected in these figures.

Generic formula used for analysis was CVS Milk-Based Powder Infant Formula 0-12 Months (cost: $15.49 // 23.4 oz). Brand name formula used for analysis was Similac Advance EarlyShield Powder with Iron (cost: $25.79 // 23.2 oz). 

... and, remember if you have more than one baby the costs decrease with each child, since pumps and containers are reusable!

Free Nursing Cover-Up & Washable Breast Pads!

If you enter the code "breastfeeding" or "WTE" you can get a free nursing cover-up and free washable breast pads (4x packs - 10 pair!). You have to pay shipping and handling, but it's a fraction of what these would cost at retail.


https://www.uddercovers.com


I got the cover-up that I use from here ... I balked at having to spend nearly $40 USD on the thing, so I simply couldn't resist this offer. It works just fine, covers what it needs to and isn't too heavy or bulky. This is the one I have:

The breast pads are on back order, but I'll be doing a full review of disposable v. washable in a later post.

Break Time for Nursing Mothers under the FLSA

Did you know you have rights protected by the federal government as a nursing mother?? Check our Fact Sheet #73 from the U.S. Department of Labor Wage and Hour Division: 


Fact Sheet #73:  Break Time for Nursing Mothers under the FLSA  
This fact sheet provides general information on the break time requirement for nursing mothers in the Patient Protection and Affordable Care Act (“PPACA”), which took effect when the PPACA was signed into law on March 23, 2010 (P.L. 111-148).  This law amended Section 7 of the Fair Labor Standards Act (FLSA). 

General Requirements  
Employers are required to provide “reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth each time such employee has need to express the milk.” Employers are also required to provide “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk.” The FLSA requirement of break time for nursing mothers to express breast milk does not preempt State laws that provide greater protections to employees (for example, providing compensated break time, providing break time for exempt employees, or providing break time beyond 1 year after the child’s birth).

Time and Location of Breaks 
Employers are required to provide a reasonable amount break time to express milk as frequently as needed by the nursing mother.  The frequency of breaks needed to express milk as well as the duration of each break will likely vary. A bathroom, even if private, is not a permissible location under the Act.  The location provided must be functional as a space for expressing breast milk.  If the space is not dedicated to the nursing mother’s use, it must be available when needed in order to meet the statutory requirement.  A space temporarily created or converted into a space for expressing milk or made available when needed by the nursing mother is sufficient provided that the space is shielded from view, and free from any intrusion from co-workers and the public.   

Coverage and Compensation 
Only employees who are not exempt from section 7, which includes the FLSA’s overtime pay requirements, are entitled to breaks to express milk.  While employers are not required under the FLSA to provide breaks to nursing mothers who are exempt from the requirements of Section 7, they may be obligated to provide such breaks under State laws. 
Employers with fewer than 50 employees are not subject to the FLSA break time requirement if compliance with the provision would impose an undue hardship.  Whether compliance would be an undue hardship is determined by looking at the difficulty or expense of compliance for a specific employer in comparison to the size, financial resources, nature, and structure of the employer’s business.  All employees who work for the covered employer, regardless of work site, are counted when determining whether this exemption may apply. 
     
Employers are not required under the FLSA to compensate nursing mothers for breaks taken for the purpose of expressing milk.  However, where employers already provide compensated breaks, an employee who uses that break time to express milk must be compensated in the same way that other employees are compensated for break time.  In addition, the FLSA’s general requirement that the employee must be completely relieved from duty or else the time must be compensated as work time applies.


http://www.dol.gov/whd/regs/compliance/whdfs73.pdf

Oh! The places I’ve pumped …

Most often, I am able to pump in the comforts of my home or in the office’s Mother’s Room.
For those inopportune times where I simply couldn't miss a pumping, I've gotten creative in where I've taken care of business:

• In a car, driving on the expressway
• In a car, driving through town
• In a car, parked in a surface parking lot
• In a car, parked in a parking garage
• In a car, parked on the street
• In a car, in the back seat while on the expressway
• On an airplane, in my seat
• On an airplane, in the airplane’s bathroom
• In a school bathroom
• In my work’s bathroom
• In a restaurant bathroom
• In a bathroom on the set for a commercial shoot
• In the bathroom of a studio
• In a first aid building at Disneyland
• In the hospital
• In a closet at work
• In the doctor's office

Please share the most unusual place(s) you've pumped!

Cleanliness is next to godliness

Keeping your breasts - and especially your nipples! - clean is imperative to warding off bacterial infections, which can cause mastitis (which in turn can lead to an abscess).

I found this little brush perfect for clearing out clotted milk in the shower. I bought it to use it for it's designated purpose - a facial brush - but found it even more useful as a nipple brush. The bristles are soft but effective. The construction is durable enough to leave it in the shower and use every time. The size and shape are aptly made to fit in the palm of your hand with maximum control.

And it's only $3.

http://www.thebodyshop-usa.com/skin-care/skin-care-accessories/rounded-handle-facial-brush.aspx

How Do I Increase and Sustain My Milk Supply?

What can you do to sustain your milk and even increase your supply?

• keep WELL hydrated! this is oftentimes the cause for a decrease in production for me
• pump often - figure out your schedule to keep the appropriate amount of milk on hand and stick to it
• pump longer in the morning, when your production is at its peak
• use compression methods while you pump (see previous post for "hands-on pumping" video)
• relax! stress is the other factor that leads to decreased production for me

I can't recommend Mother's Milk tea or other herbal remedies because I haven't used them. I would advise exhausting all other options before introducing any supplements.

The Dirty Details

Finding precise information about how much milk you can expect to produce is nearly impossible. Rightfully so, since it is a very personal matter ... there are many factors that can cause you to produce more / less milk and just as many that can affect how much you're able to store. So. With all of that in mind, I'll share MY details for some perspective ... but be mindful this is me, and YOUR experience will likely be very different.


Breast size: 38C - 36D (depending on bra maker / style)
Total production per day: 30 ounces (887 ml) average
# of daily pumping sessions: 4 minimum, 5 average, 6 max (rare)
Duration of sessions: 15 minutes average, 20 minutes for first session of the day
Production per session: 6 ounces (177 ml) average


The most my breasts have ever held is 7 ounces (207 ml) in each, for a total of 14 ounces (414 ml) produced in one session. This was a morning session after about 11 hours. I do not nurse my son on my breasts ever ... so 100% of my milk production is accounted for in these figures.


Please feel free to share your details!

Maximize Your Milk Production with Hands-On Pumping

This video demonstrates how Expressive Moms can maximize milk production by using compression. No herbal supplements or medications required!

http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

I Can't Tell You How Much I've Used This Chart ...

When Do I Start Pumping? And How Long Do I Pump?

One of the first things I asked the lactation consultant at the hospital was "when should I begin pumping?" Unfortunately, the consultant on staff was terrible and really couldn't give me an answer. 

So I figured it out on my own.

Let me share my experience with you for some guidance ...

When we went home (after two days in the hospital), I tried pumping colostrum. It just didn't work out. I sat for 20 minutes pumping at the highest level, not really knowing what I was doing, and got a little dribble. I bawled my eyes out ... how was I ever going to feed my baby?? I digress.

So it wasn't until my milk came in (late in the evening of day three) that I tried again. I pumped for 20 minutes on both sides and got about an ounce per breast. It was very yellow-y. None of it was like I expected.

I continued to pump every two hours, for 20 minutes at a time. My supply grew, and soon I was getting two ounces per breast. That's when I decided to cut back on the length of time I pumped, thinking if I got two ounces after 15 minutes, why should I bother with the extra five?

I waffled with how long I pumped - sometimes it was only seven minutes, sometimes 10. I assumed my supply wasn't going to grow any more than it had, so I stopped pumping whenever I got two ounces.

Then logic kicked in ... if I pumped longer, over time my supply would react and I would get more milk. Sure enough, I extended my sessions back to 15 minutes and before long I was getting three ounces per breast, every three hours.

For me, this was the perfect ratio of duration, frequency and output. I pump four to five times a day (six if I’m super disciplined) and am able to keep a very stable and constant supply. There is the one exception of my morning session, which is longer and more productive … but more on that later.

To find your right balance, consider how much milk you produce, how big your breasts are (not discriminating! but bigger breasts hold more milk longer), and how frequently you can commit to pumping.

Welcome to Expressive Moms, an Introduction

Hello fellow moms -


Welcome to Expressive Moms ... a resource for moms who choose to express breastmilk and bottle feed their babies!


There is no shortage of sources for moms who breast- or formula-feed exclusively, but finding information for mother's who opt to pump their milk and bottle feed exclusively is challenging.


And, let's face it, there is a weird stigma around it. Or perhaps it's the mommy guilt we're all so used to feeding. I should be breastfeeding from the breast. I am not being the best mommy if I don't.


Time to let it go. We should stand proud of our decision to bottle feed breastmilk! Our babies are fed beautiful breastmilk - the best food for a baby - and we have the luxury of knowing precisely how much our baby is eating, having someone else feed the baby, stocking up extra milk for emergencies and extending the amount of time we breastfeed. And don't forget we are doing TWICE the work: expressing and feeding the baby. It's no easy feat!


So how is it exclusively expressing isn't more popular? For one thing, it is a commitment. Not a "when-I-feel-like-it" commitment, but rather a real, everyday commitment. And, I suspect, there just aren't enough resources out there to let moms know it is an option that can be sustained.


For me, I knew even before I was pregnant I wanted to breastfeed. I eagerly put my son to my breast after he was born, and he latched on perfectly and fed. I couldn't have been happier. But my bliss was short-lived as he became a lethargic eater and fussed incessantly when I brought him to latch. Instinctively, I knew he wasn't eating enough, but I hated the thought of feeding him formula. I broke, supplemented until my milk came in, and considered my options. I could torture him by trying to teach him how to breastfeed; I could continue with formula, or I could pump my milk and bottle feed it. I chose to express exclusively. I knew it was the best option for me: I work full-time and am completing my Master's degree part-time. I would only have two weeks before returning to school, and maternity leave would end by five months.


As I started on my journey to expressing exclusively, many questions arose ...


How much breastmilk should my baby be drinking?


Can I mix Vitamin D drops in my baby's bottle?


How often should I pump? And for how long?


Am I pumping enough milk? Am I pumping too much milk?


Should I refrigerate a bottle after it's touched my baby's mouth or can it stay at room temperature?


What is the best bottle?


Which is the best pump? What should I be looking for?


What are the rules for traveling with breastmilk if my baby isn't with me?


I wished there was a one-stop-shop of answers - or at least a collective of resources. And with that in mind, I decided to create Expressive Moms. If I am going to go through the trouble of finding out the information, let me share it with other moms who have the same queries.


I intend to share my personal experience, relevant articles and factoids I come across, and anything else I think may be of interest. I encourage you to comment, reply, and message with yours!


Happy pumping, moms.