Dealing With a Clogged Duct

If you’re a breastfeeding mom, you’re bound to get a clogged milk duct. You’ll recognize it instantly – a hard lump in your breast, extreme tenderness and soreness, and a short supply of milk being produced.

I’ve had my fair share … no less than three by my estimation, all brought on by a missed pumping and engorgement.

How do you deal with them? Conventional wisdom suggests keep nursing and pumping to push it through, but that doesn’t always work. And the discomfort in between is grueling.

Here is my recipe for relief, start with #1 and move down with severity of the clog:

1. Don’t miss a pumping! If you pump every 3-4 hours, try shifting to every 2-3 hours until the lump is gone.
2. Massage the affected area gently as you express. Be careful though, the clog can migrate!
3. Apply a warm compress before and during pumping. The best way to do this is to take a diaper and fill it with warm water (not too hot though!). It will stay warmer longer than a rag.
4. Get on all four. That’s right – it will make you feel very vulnerable and uncomfortable, but the power of gravity really does the trick. Make sure you put down lots of towels and know that you will likely lose everything you pump (those containers were not made to be used sideways).
5. Repeat as necessary.

Good luck and happy pumping!

Milk to Spare? Consider Donating!

I have to admit I was initially very turned off by the thought of donating my milk. I'm not sure why, but I was. Then I learned more about what donated milk is used for: helping premature little babies! Who wouldn't want to get behind a cause like that?!

At one point I was very flush - with a huge stockpile in frozen storage and several days available in fresh supply. It never dawned on me to consider donation.

My stockpile was consumed very quickly upon returning to work, but if you are so lucky as to have milk to spare, do consider donating!

Basic qualifications include:

• you're drug / smoke / alcohol free
• you don't have any life-threatening diseases (ie. heart disease, HIV, cancer, VD, etc)
• you haven't had vaccinations or tattoos in the past 12 months
• you don't take medicine (other than prenatal vitamins)

Full details here: http://www.nationalmilkbank.org/

The Five Senses of Expressing

Expressing milk isn't a task just for your ta-tas ... in fact, all five senses are involved, some directly and others indirectly!

Check it out:

SIGHT

• Freshly expressed milk will blend into a seemingly homogeoneous mixture
• Chilled milk will separate, with cream rising to the top (it will blend again once warmed or if shaken gently)
• Milk comes in many shades of white, yellow, and even red
• If you consume a lot of artificial colors, it will pigment your milk!
• Sometimes my milk looks blue-ish when I first pump - then it becomes a creamy white after being chilled (see below - left is chilled, right is fresh)

TASTE

• No, I haven't tasted my breastmilk. But I've heard what you eat will "flavor" it, thereby shaping your baby's tastebuds!

SMELL

• Breastmilk smells like milk - but it's a very mild smell
• Just like milk, it will sour when left out too long
• After a while, your milk will start to smell like your baby (for obvious reasons)

TOUCH

• When you express, you should feel a tug on your nipples and the suction of the pump
• However, it should not be painful!! Pain is your body's way of telling you you're doing it wrong
• Check out this post for more information on how to get the "perfect latch" when expressing

SOUND

• I don't know there is a "sound" to expressing - though my pump definitely makes a lot of hums, squeaks and shreaks
• Interestingly, when your baby cries it can cause your milk to let down! Mother Nature is pretty amazing at guiding new moms

Which Bottle is Best?

Finding the best bottle is a feat that can add up rather quickly. First you have to decide between glass and plastic. Then if you want a liner system or a standard bottle. Then the whole nipple question - standard or wide base, breast-like, flow. THEN brand. Wow. Fortunately, your baby will help you decide rather quickly. Unfortunately, you need to have the bottle before you baby can tell you his preferences ;)


I made the mistake of investing in rather expensive bottles (buying six of them for nearly $6 a pop!) without considering the fact my son may not take to them. 


Turns out the bottles I bought had a super fast flow - too fast for my little guy, and he HATED them. So I tried standard nipples on the milk collection containers that come standard with a breast pump. Those were fine, except they caused quite a bit of gas for my newborn.


I moved on to another brand. And another. And ANOTHER. Finally, I found an anti-gas bottle that seemed to appease baby. For three months. Then it was time to switch, again. Ironically, we ended up back with the expensive bottles I had initially thought were the solution and they've gotten us to the finish line (it's time to transition to sippy cups 100%!)


For us, here are the brands that worked and didn't:


Best: Playtex VentAire, Tommee Tippee (after four months)
Ok: Dr. Brown's (fine but a nuisance to get clean), MAM (were fine but didn't solve gas fussiness)
Not for Us: Tommee Tippee (before four months, even with "slow" nipple), Medela Breastmilk Bottles (made for a gassy baby)


And here are a few articles to help as you consider bottles:


The 5 Best Bottles for Breastfed Babies Lil' Sugar Article
Medela Introduces Award-Winning Calma in the United States WSJ MarketPlace Article

The "F" Word.

FORMULA.


There's an immediate reaction for mother's who opt to breastfeed ...


When I was pregnant, I was certain I was going to breastfeed. So certain that I actually donated the formula samples I received in the mail to a local food bank. I didn't need them, so why keep them?


Let's be honest with ourselves ... if you're a modern mom, you will almost certainly need formula for your baby at some point.


And there are LOTS of options out there. Some guidance as you navigate the formula aisle, courtesy What to Expect:

• Regular iron-fortified formula. Cow's milk is a definite no-no for babies younger than 12 months because it's hard to digest and doesn't provide the complete nutrition developing infants need. But most formulas for bottle-feeding are made with cow's milk that's been modified for human babies. Proteins are altered to be easily digestible, milk sugar (or lactose) is added to more closely resemble breast milk, and vegetable oil is substituted for butterfat. (Because iron is so essential for infant growth and development, both the American Academy of Pediatrics and the majority of pediatricians recommend iron-fortified formula for most babies until at least their first birthday.)

• Hydrolyzed formula. The protein content is broken down into smaller proteins, making it easier for baby to digest (which is why it’s also known as predigested formula). There’s a lot to consider about switching to hydrolyzed formula or even partially hydrolyzed formula (for one, it’s often more pricey) so be sure to talk to your pediatrician about bottle-feeding an allergy-prone baby before you make this choice.

• Soy-based formula. Originally popularized by dairy-averse vegans, soy-based formulas are made from soybeans supplemented with vitamins, minerals, and nutrients. However, because soy formulas differ more from human milk than cow's milk, they aren't usually recommended as a drink-of-choice except under certain circumstances (e.g., a cow's milk allergy, though keep in mind it's common for infants with a milk allergy to also be sensitive to soy protein). The American Academy of Pediatrics maintains that soy-based formula should only be used in a handful of situations, for example in the rare instance that a baby is intolerant to galactose.

• Special formula. Some babies that are bottle-feeding, such as premature infants or babies allergic to both cow's milk and soy formulas and babies with metabolic disorders such as PKU, require special formulations. These infant formula products, which aren't necessary or recommended unless your pediatrician says so, are often hypoallergenic, lactose-free, or especially easy to digest (and come with a particularly steep price tag).

• Organic formula. These come from milk products that are produced without the use of pesticides, herbicides, antibiotics, or growth hormones, and for that reason are considered healthier. However, certain organic infant formulas are sweetened with cane sugar (sucrose), which is significantly sweeter than the sugars commonly used in formula, and which, some experts worry, could contribute to problems like tooth decay and excess weight gain. Not all organic formulas use sucrose, however, so check the labels and, if you still have questions, ask your pediatrician.

• Probiotic and prebiotic formula. Some formulas for babies are now fortified with probiotics, a bacteria which is supposed to prevent diarrhea in otherwise healthy children. However probiotics should not be given to chronic or seriously ill babies, and according to AAP, the jury is still out on whether or not they are effective in treating diarrhea or preventing any other diseases. Prebiotics are also added to some formulas in order to reduce infections in healthy children, but it is still uncertain whether or not they are effective, either.

• Follow-up formula. These formulas are geared toward bottle-feeding babies older than four months who are also eating solid foods. They are not a good choice for a younger baby and you should always ask your doctor before introducing them to the menu.

And my own 2¢ ...


Infant formula is government regulated (click to see the FDA Infant Formula Overview), so there isn't any nutritional benefit to bigger brands (which command a significant premium). This is heresy to say as a marketer, but it's the truth. I recommend using samples to see how your baby's tummy handles the stuff. And try a generic / off-brand.


For me, Similac was my preferred brand (I got a TON of samples), but it caused my baby to spit-up really bad. I also tried Enfamil in the "to-go" packets with similar results. Walmart's Parents Choice brand was fine, but it was very smelly going in and coming out. We've settled with the CVS brand, which doesn't smell as terrible as other formulas and has been the mildest on baby's digestive system.

I buy the small 12 ounce cans, which last me about four weeks if I use them for mid-night feedings exclusively. William wakes up around 3a or 4a every night and wants a snack before going back to sleep. Rather than make him wait for an expressed bottle to warm, I make 4 ounces of formula, which is just enough to soothe him and hold him over for another three hours.

***Update: Rosie is an Enfamil kinda girl. I got a ton of samples for Enfamil, and my new pediatrician recommended it as well, so we've gone brand name. I have plenty of coupons that cut the cost to near generic, so that helps. We tried a can of Gerber Good Start and it put poor sweet Rosie in absolute misery. Turns out, according to our pediatrician, many babies can't tolerate Gerber Good Start! Just be careful not to over supplement when trying a new brand, or you can open the door for a bought of colic!