Should I Keep Breastfeeding During the Coronavirus Outbreak?

In a word, YES!

Parents and caregivers are rightly concerned about keeping their babies safe as coronavirus becomes a global health issue- read on to learn how your amazing breastmilk protects your baby from illnesses!

The CDC states that breastmilk as the best source of nutrition for infants, and protects against many illnesses.  

The Academy of Breastfeeding Medicine says that “there are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended.”  

According to UNICEF, mothers can continue breastfeeding.

These guidelines are being updated often, as more is learned about how COVID-19 is spread. Continue to check back for current guidance for breastfeeding families.  

Your breastmilk is an amazing substance: It contains antibodies to illnesses you may be exposed to, and helps your baby fight them off. 

Human milk provides your baby with the best possible protection against disease.  It’s packed with living cells that prevent infection, and the free fatty acids in human milk are antiviral. 

Proteins in human milk are antimicrobial and stimulate baby’s immune system. Even the carbohydrates in breastmilk have a role in fighting pathogens like bacteria, viruses and fungi.

We can help you protect your breastfeeding relationship, milk production, and your baby’s health. Call us today for support!  Now offering virtual visits.

Breastfeeding and Coronavirus- Keeping You Safe

Breastfeeding and Coronavirus- Keeping You Safe

Even as the Coronavirus crisis spreads globally and is changing how we go about our lives, families continue to need support in feeding their babies. As International Board Certified Lactation Consultants (IBCLCs), we work with vulnerable populations. You and your baby’s health & well being is our top priority. This is what we are doing to ensure the safety of your family during home or office visits:

 

  1. We thoroughly clean and disinfect all supplies and equipment (breast pumps, scales) and surfaces using an EPA- approved sanitizer. We also disinfect our electronic devices used for documentation before each visit.
  2. We are spacing our office visits further apart, to allow time for increased cleaning, and to reduce interaction between clients.
  3. Upon entering our office, everyone must use hand sanitizer before touching any surfaces.  We will soon be implementing thermoscan temperature screening for all who enter our office.
  4. We will move families directly into an exam room as soon as possible, rather than have them wait in a shared waiting area.
  5. We ask that when making an appointment for an office or home visit, if any of your family members have had recent travels outside of the country in areas where the virus is endemic, please keep us informed.  If any family members have symptoms such as coughing, fever and/or runny nose, please inform us so we may all make prudent decisions.
  6. Prior to the start of all home and office visits, and between clients, as always, we wash our hands with soap and water.
  7. Our staff will stay home if experiencing any symptoms of illness.
  8. We are offering virtual visits, so families can continue to get the support they need while staying safe at home.  Many insurance companies are providing coverage for virtual visits during this situation- please contact your insurance provider for details on what your plan covers.  We are also happy to contact your insurance company to clarify telehealth benefits.
  9. We will teach you proper sterilization methods to use on pumping and feeding supplies.

 

Information about COVID-19 (Coronavirus) transmission is emerging daily. The Academy of Breastfeeding Medicine has best practice recommendations for breastfeeding and breastmilk handling both at home and in the hospital. Please consult resources such as the CDC and the WHO for the most recent guidance.

With the proper precautions, we can continue to help parents breastfeed, use expressed breast milk, and maintain milk production, while staying safe and healthy.

With thanks to Karolina Ochoa, IBCLC

 

What Can a Lactation Consultant Do for Me?

What Can a Lactation Consultant Do for Me?

“What can a lactation consultant do for me?”  In order to answer that question, I’d ask you “how many different opinions and pieces of advice have you received so far regarding the right way to feed your new baby?”  If you answered “more than one”, then scheduling a consultation is for you!

Of course, there’s truly not one right way to breastfeed, but several different ways determined by a variety of factors specific to mom and baby. Lactation consultants (and by the way, we’re all either board-certified-IBCLC’s, or board-eligible) can help you answer all your questions by spending an entire hour with you, baby, and your partner (or even the grandmother, nanny, or postpartum doula!). Everybody helping mom is welcome to come take part in this important visit.

All you need bring is your baby, a swaddling blanket, a bottle of water for yourself, and a list of your questions (or your partner’s questions). The consultant will watch a latch or teach you to latch. She can help you determine how often to feed baby or pump based on baby’s weight and your milk supply. She will also discuss helping you get into a routine to ensure baby gains about an ounce a day from day three onward. With a hospital grade scale, they can even do pre- and post-feed weights (meaning the baby is weighed, you feed and they baby is weighed again). They will address any nipple soreness, teach you comfortable positioning, decipher cluster feeding (meaning feeding ALL the time), and teach you new burping techniques. Maybe you need help with having too much milk or not enough milk; maybe it’s time to wean or baby is simply chomping like a little shark…..this is all part of what they can do for you.

You can rent a hospital grade pump or scale, buy the perfect feeding bottle for your baby, get the best nipple cream or purchase a littlebeam breastfeeding pillow. If you’d rather bring your own supplies, that works too. The responsibility of the consultant is to help you achieve your breastfeeding goals. If you’ve decided to feed both breastmilk and formula, you won’t find any judgement or arm twisting….it’s all about you.

Even if you think breastfeeding is going fairly well, there’s always a trick or two the lactation consultants will be able to teach you. Alternatively, they can offer reassurance that both you and baby are amazingly in sync! Partners are also usually happy to pick up tips on how they can help mom.

So, feel free to getting touch with us- you’ll be on your way to feeling confident on your breastfeeding journey!  Most all private insurances accepted for home and office visits, and we have several convenient locations throughout the DC area, including Northern Virginia at TPG Pediatrics, Columbia, MD and Bethesda, MD. Please call Metropolitan Breastfeeding at 301-943-9293 to schedule today!

Milk Supply?  Work Smarter, Not Harder.

Milk Supply? Work Smarter, Not Harder.

Today our expert owner Dr. Kathleen F. McCue is sharing her thoughts on low milk supply and some of the underlying reasons.

Dr. McCue:

It’s fair to say that I make a living regulating milk supply. The number one complaint we hear from clients is, “I don’t have enough milk!” Sometimes I’m in agreement and other times, expectations are totally unrealistic. There are so many things that come into play; storage capacity of the breasts (meaning amount of glandular tissue and milk-making alveoli within the breast itself); adequate nipple stimulation to help produce prolactin (a hormone that promotes milk production); suckling ability of the baby (big strong baby or jaundiced baby with a low birth weight); frequency of stimulation by either baby or breastpump.

Here are some of the issues I look for, and as always, a consultation with an International Board Certified Lactation Consultant (IBCLC) will help determine what’s happening and how to assist:

  • Do you have adequate breast tissue, in other words, do you have very small or conical shaped (meaning tubular-shaped) breasts? Did your breasts increase with size during pregnancy? You should have gone up approximately one cup size.
  • Are you bleeding for a prolonged period or passing clots in addition to not making enough breast milk? These are signs of retained placenta, which can prevent the milk from fully coming in.
  • Are you using a personal use pump to express milk more than 3-5 times a week? The pumps from insurance companies are rarely adequate to pump when separated from babies for extended periods. This means if you’re exclusively pumping, or back at work, leaving the house at 8 and returning at 6, you’re going to most likely need a hospital grade pump. Insurance pumps that you own are sometimes called “hospital grade” but in the world of lactation consultants, we mean the kind that you rent from your lactation consultant or hospital. My favorite is the Medela Symphony because it’s only seven pounds and has a soft stimulation phase that helps moms produce prolactin.
  • Are your flanges the correct size? The flanges are the funnels that cover your breasts and nipples. I can’t tell you how many times we’ve seen JUMBO flanges that are totally unnecessary. You want some stimulation for the nipples. You can size your flanges properly by looking at the nipple when you pump. There should be clearance enough around the entire perimeter of the nipple (mid base to tip) and you should not have a large part of the areola or breast itself being sucked in. You also don’t want them too small or you could cause damage (read: soreness) from pumping, and prevent milk from draining well from the breast. This can be tricky, so again, find a local lactation consultant to help you.
  • I always recommend double pumping (both breasts at once) for 20-30 minutes when back at work or when pumping to substitute for direct breastfeeding. Fifteen minutes rarely cuts it unless you have an oversupply but again, if that’s your problem you’re not my reader! Yes, I know the milk stops coming but if you can hang in there a few minutes longer, you’ll get another letdown, meaning the milk will start to squirt out again. It’s great to have at least two or three letdowns.  Some moms can initiate another letdown but putting the pump back on the stimulation (or letdown) phase, or by taking a short pause to massage the breasts before resuming pumping.
  • Have you had a low supply since baby’s birth? Maybe you’re dealing with a tongue tie or lip tie or both. Is baby a good feeder, meaning is he/she gaining at least an ounce a day?  If you suspect your baby is having difficulty latching onto your breast and emptying them well enough to bring your supply in, an in-person evaluation with an IBCLC will help you figure out how best to help.
  • Is your baby sleeping through the night? If they are in bed by 7 or 8pm, you should pump before going to bed at 10 or 11pm. If you go to bed when baby does, you should optimally not go longer than 6 hours without stimulation to the breasts.
  • Do you have PCOS, thyroid problems, low iron or insulin resistance? These can all cause low milk supply.
  • Are you on ANY type of hormonal contraception? OBs and midwives sometimes aren’t aware that even progesterone only (mini-pill) or IUDs like the Mirena can really impact milk supply negatively.
  • Are you drinking more than what you’re thirsty for? More water than you need actually works against you and you’ll end up peeing more and making less milk.

If you’ve ticked through this entire list and are still unable to increase your milk supply, visit your local IBCLC or contact us!

 

 

 

 

Help!  My pump won’t work!

Help! My pump won’t work!

If you’re experiencing an issue with your Medela Symphony rental pump, our troubleshooting guide may help you resolve the issue. If you’re still having difficulty with your pump after following these troubleshooting steps, please contact us at 301-943-9293, or support@metropolitanbreastfeeding.com for assistance!  If necessary, we will make arrangements to exchange your pump.

 

Issue #1: My pump won’t turn on!

Please make sure the back of the Medela Symphony pump is plugged in properly – the short black cord needs to be plugged back into the pump itself, while the long cord is plugged into a power source.  See the photos below for an example:

1 2

 

Issue #2: My pump has low suction!

There are several possible causes for low breastpump suction. First, please check your pieces. The valves and membranes should be free from defects.  Make sure the white membranes lay flat against the yellow valve and don’t have any tears.  Over time, these membranes will need to be replaced.  If you pump often (4 times a day or more), the membranes may need to be changed every 2 weeks or so.  If you pump less frequently, every few months should be sufficient.

3

Your tubing should be purchased from a Medela-authorized retailer. It is common for generic tubing to not work well. If your tubing appears to have any crimps, punctures, or mold growth, please purchase another set of tubing.

The flanges (the pieces that come in contact with your breasts) should fit properly. Not every woman will need the 24mm flanges that are included with the kit. Aside from some discomfort, your pump may appear to have suction issues if you are using the wrong flange size. You can view Medela’s sizing guide here to determine if you need a different size. If you are still unable to determine your best size, please contact us to set up a time to visit us in our office for a professional fitting.

The caps under the lid will sometimes come loose during regular use. Make sure that the caps are properly secured. When you put them in the breastpump, you should hear and feel a small “pop”, and that means they are secured correctly. See the photos below:

5 4

If you think only one side of your breastpump is having suction issues, you can do a quick test to determine the cause. Open the lid and switch out the parts from one side to the other, caps and all. If the side with the suction issues is suddenly better and the other side is worse, you should inspect your parts for defects; there is likely nothing wrong with your breastpump. If you’re still experiencing low suction on the side you initially thought was the problem, contact us to arrange an exchange.

 

Issue #3: My pump displays an error message, chirps, then shuts down!

Sometimes unavoidable problems occur with the pumps as they age. If your pump is displaying an error message, you can reset the pump to get you through the next couple of pumping sessions, but you should make arrangements to exchange the pump as soon as possible.

To reset your pump, follow the steps outlined below:

  1. Press the let-down button and hold.
  2. While holding the let-down button, press the on/off button.
  3. Release both buttons when pump reads “please wait.”

You can also do a hard reset of the breastpump by removing and reinserting the program card. To do that, disconnect the plug from the wall outlet, remove the screw from the cord protector, and slide everything up until it comes off. Remove the card, gently dust it off with a clean, dry cloth, then reinsert it. Put the cord protector back on the breastpump and screw it in place. Refer to the pictures below:

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This is what the back of the cord protector should look like before you put it back on the breastpump:

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Keep in mind, it is normal for your Symphony breastpump to shut off automatically after 30 minutes.

 

Issue #4: My battery-operated Symphony breastpump keeps saying “battery flat” or “battery low” even though it just finished charging!

Just like a laptop, sometimes the internal batteries in the Symphony Plus model need to be replaced. If your pump has charged for the recommended amount of time (12 hours) and will not remain on for at least two full 30-minute pumping sessions throughout the day, please make arrangments to exchange it as soon as possible. The pump will continue to work while plugged in, but you shouldn’t depend on a spent battery for continued cordless operation.

Here are some tips to extend the life of your Symphony Plus pump:

  1. Charge the pump for a full 12 hours upon receipt.
  2. Do not fully drain the battery on a regular basis.
  3. Allow the pump to charge when not in use.
  4. Charge the pump for 12 hours each night at a minimum. Pumps will still work while they are plugged in.

 

Issue #5: My Medela breastpump is making strange noises, movements, or noticeably fluctuates in suction while pumping.

Some noises and lid movements are normal, especially if you’re using higher suction settings. Unless you notice a decrease in performance, it is not always necessary to contact us about these issues. However, if the suction on your breastpump fluctuates without any user input or if you become concerned with noises/lid movements, please do not hesitate to contact us for troubleshooting, or an exchange. We want you to be completely satisfied with the services you receive from us!

If you are having any other problems with your pump that haven’t been discussed in this article and would like to discuss a solution, please don’t hesitate to contact us.