Expressing Breastmilk

As a general rule if babies are given adequate access to the breast and are not separated from their mothers, expressing is not necessary.  However, if you have an unwell/premmie baby, are returning to work, having a few hours apart from your baby or working on increasing supply, knowing how to express your breastmilk for your baby can be a great skill to have. It’s important to remember that the amount you express is not an accurate reflection of how much milk you have – babies are often far more efficient. There are two ways to express milk – using a pump or hand expressing.  There are pros and cons for both, but both methods are a learned skill and often get easier with practice.  Having expressed my milk for several months, I have a personal interest in this topic.  With any type of expressing, the key to draining the breast is to stimulate a let-down – this makes the milk flow more freely and is how your baby gets most of their milk.  Information on let-down is HERE. Hand expressing is free, can be done almost anywhere and requires no power.  It is also much more gentle than some alternatives and is shown to be more effective in the first few days after your baby is born.  The down side is that it is very-much a learned skill and can be quite time-consuming.  This method is great for when your baby is very young or you need some milk to leave with your baby if you’re going out for the evening. For all pumps, it is important to find one that works for you and is COMFORTABLE.  Most pumps have a flange (the portion that sits on your breast) that comes in a variety of sizes.  Having the correctly fitting flange can make expressing much more effective and comfortable.  Pumps come in three basic varieties.  There are manual pumps, basic electric, double pumps and hospital-grade pumps. A manual pump uses suction to draw milk from the breast.  This is done using one or both hands.  These pumps are often inexpensive and are best for occasional expressing.  The downside is that it may be difficult to stimulate a let-down with these pumps as it’s a bit of  ‘hard work’. Basic electric pumps use either an electrical or battery power supply to do the suction for you.  Some of these pumps...
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Breast Refusal

When a baby refuses to go to the breast or goes to the breast very briefly before coming off crying it can be a very distressing time for everyone.  They may refuse one or both breasts. There can be many underlying reasons why a baby does not want to go to the breast.  Some of them are – Milk flow – too fast or too slow Milk supply – over supply or low supply Physical issues with baby or mum Difficulties attaching Baby is unwell Introduction of a bottle Baby is becoming distracted (often around 4 months) Hormonal changes with the mother Lots of other reasons No matter what the cause of breast refusal, it can be a challenging time.  If you find yourself in this situation, it’s important to try to find a cause for the breast refusal and correct it if possible.  For most babies, this is a temporary stage that they can move through with help.  In the meantime, supporting  your supply and making sure your baby is getting adequate nutrition will be a very high priority.  Accessing professional support and information to help you through a time like this can be invaluable.  There are many strategies to help overcome this situation, so if you want to discuss your issues with breast refusal or arrange a consultation, please contact me.   Image by Louisa...
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My Facebook Page

As an LC, I try to keep in sync with expectant and new parents, and what they need from my services.  During a consultation I often need to convey large amounts of information.  It can be very daunting for new parents to take all this in.  For this reason, I set up an easily accessible platform for this information – a facebook page to provide my clients (and anyone interested) with some information on breastfeeding and gentle parenting.  The aim of the page is to give people evidence-base information on infant sleep breastfeeding information expressing tips breastmilk science supportive organisations and services resources which may be helpful to a breastfeeding mother, her baby and family This page is much broader than my website, so please feel free to have a look around the page, comment and ‘like’ the page if it appeals to you.  Look for me under ‘Stacey Revie – Lactation Consultant’...
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What Happens During A Consultation?

If you have not seen a lactation consultant in private practice, you might be wondering what actually happens while I’m with you.  There is a general flow that I usually follow, but ultimately, I work around what the baby and the mother need.  All of my consultations are in your home. There are three basic types of consultations I provide – Breastfeeding Preparation Sessions (for before birth), Breastfeeding Not Going To Plan Consultations (after the baby’s born) and Return To Work Plans.  This post will discuss the Breastfeeding Not Going To Plan Consultation – which are the majority of my work. Before a consultation, there has usually been a brief phone/email conversation to establish what is needed and have arranged timing so that the baby will be looking for a feed at some point during the consultation.  We usually start with a short health history of mum , briefly discuss the birth and the potential impacts this may be having on breastfeeding and then we discuss how feeding has been going.  If your baby is not ready for a feed at this time, we discuss the likely things that may be going on and suggest some strategies that are likely to improve the situation – so you know what to expect and feel prepared when your baby is ready to feed. If the baby is showing feeding cues while we are discussing the birth or feeding history, I usually suggest we go back to the history after your baby has fed. After or during the feed (depending on the length and comfort level of the feed), we make a breastfeeding plan that the mother feels is manageable – trying to meet breastfeeding goals for both you and your baby.  We agree on a timeframe for you to contact me to discuss your progress (usually 24-48hrs depending on the situation)  After I leave, I email a summary of our discussion to you so that you can refer back to it when necessary. The consultation fee is payable on the day and includes follow-up with phone/text/email and a discount should another consultation be needed.  I do my accounts once/week usually and will email the paid invoice to you.  Some private health funds will give a rebate for my services. Things to do if I’m coming to you – Have your child health record handy (the red/maroon book) Write down any questions you...
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Weaning?

Weaning can be a joyous celebration of an amazing breastfeeding achievement for some and for others it can be a time of great distress and emotional turmoil.  There are lots of factors which influence how you feel about weaning.  One of them is what breastfeeding goals you set yourself.  If you’ve reached those goals – whether it’s to feed for 3 weeks or just to enjoy breastfeeding – will have a big influence on how you feel about weaning. Technically, weaning is the introduction of anything other than breastmilk into a baby’s diet.  This may be when you start solids or start to introduce a breastmilk substitute.  Most people understand weaning as the process of stopping breastfeeding. The decision to wean may be initiated by the baby, the mother or a mixture of the two.  If the baby is less than 12 months old and seems to be weaning, it may be that s/he is going through a period of breast refusal.  This can be a very distressing time for both the breastfeeding mother and her baby.  There are many techniques which can be used to encourage a baby to go back to breastfeeding, and support your supply in the meantime. If the baby is older than 12 months and starts the weaning process themselves, it may come as a shock to the mother and she may be distressed that her baby has initiated weaning before she is ready.  During these times, it can be helpful to discuss breastfeeding goals and strategies, to either support the weaning process or ways to encourage the baby back to the breast. If the mother is initiating weaning her baby, for whatever reason or age, it can be helpful to discuss the likely progress of this process and ways to reduce the risks both to your baby and to the mother.  A slow and gentle process can help the baby to adjust to the lack of breastmilk and let the mother’s supply dwindle naturally.  Very rarely, there is an immediate need to wean the baby off the breast, and in these cases much management may be needed to help the transition. In all cases of weaning – if you’re not ready to wean, but feel unable to continue – getting the right information and support can often help you to overcome the hurdle and continue to breastfeed until you feel the time to wean is right for both of you.  Please...
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Asthma and Breastfeeding

There has been much discussion in the last few years about the link between exclusive breastfeeding and asthma prevention.  Here’s an article from ScienceDaily.com discussing research supporting the view that exclusive breastfeeding duration reduces asthma-related symptoms in children. Breastfeeding May Prevent Asthma, Research Suggests ScienceDaily (July 22, 2011) — Feeding a baby on only breast milk and for up to 6 months after birth can reduce their risk of developing asthma-related symptoms in early childhood, according to new research.   The study, which is published online July 21, 2011 in the European Respiratory Journal, looked at the impact of the duration of breastfeeding and the introduction of alternative liquids or solids in addition to breast milk. The researchers, from the Generation R Study, Erasmus Medical Center in The Netherlands, used questionnaires to gather data from over 5,000 children. They ascertained in the first 12 months after birth whether the children had ever been breastfed, when breastfeeding was stopped, and whether any other milk or solids were introduced. Further questionnaires were completed when the children were aged 1, 2, 3 and 4 years to check whether they had any asthma-related symptoms. The results showed that children who had never been breastfed had an increased risk of wheezing, shortness of breath, dry cough and persistent phlegm during their first 4 years, compared to children who were breastfed for more than 6 months. The strongest links were seen with wheezing and persistent phlegm, as children were 1.4 and 1.5 times more likely to develop these symptoms if they had never been breastfed. Children who were fed other milk or solids during their first 4 months in addition to breast milk had an increased risk of wheezing, shortness of breath, dry cough and persistent phlegm during the first 4 years, compared to children who were exclusively breastfed for their first 4 months. While previous studies have shown a similar effect between breastfeeding and asthma risk, this research is the first that showed a link between the length of breastfeeding and the number of wheezing episodes. Also, this study found evidence that the first asthma-related symptoms occur earlier in life if children were breastfed for shorter lengths of time or not exclusively. Dr Agnes Sonnenschein-van der Voort, researcher at Generation R and lead author from the Erasmus Medical Center in The Netherlands, said: “The link of duration and exclusiveness of breastfeeding with asthma-related symptoms during the first...
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