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Are you currently trying to make the decision on how to feed your baby and don’t know where to start?? Need more info to get you going? Here are the basics of feeding, lets start by explaining breastfeeding vs pumping.

Breast or Pump?

As most of us know, breastmilk compared to infant formula is better for your baby due to its heightened nutrient level, immunity benefits, and perfect composition for exclusive breastfeeding for the first 6 months of your baby's life.

But did you know?

There may be a difference between pumped breast milk and actual breastfeeding?

A study looked at the bacterial profile of breast milk after pumping and then compared it to breastmilk expressed and received at the breast. The makeup of the breast milk from both sources did indeed differ. This is thought to be due to the exchange of 'good' bacteria (that aids in a positive gut microbiome) between the mom and baby while the baby breastfeeds.

Potential risks of using a Breast Pump:

Breast pumps have the possibility of bringing external sources of 'bad' bacteria due to poor sterilization and pathogen exposure. That being said, breast pumping is still better than infant formula due to its nutrient content, however, proceed with caution in regards to proper cleaning and sterilization of the actual breast pump.

What about 'Hand Expression'?

An alternate method to breast pumping is hand expression. If a mother is unable to breastfeed and would like to avoid the use of a breast pump, hand expression can be a cleaner and actually easier option to collect breastmilk. Hand expression reduces the amount of surface area the breastmilk is exposed to (reducing contamination) and no fancy/expensive equipment is required!

How do you 'Hand Express'?

Mamas Maternal Health Dietitians and Lactation Counselors can teach you how to hand express in an easy and effective manner--- if you would like to learn more, please find us at www.mamasmaternalhealth.com and set up an appointment. We would LOVE to hear from you.

If you are able to breastfeed at the breast--- please do! If you are transitioning back to a 'working' schedule and need a different way to express breastmilk--- think about hand expressing. It may be a better choice than breast pumping due to its lack of equipment and sterile nature.

Pumping Guidelines

PUMPING... This crazy concept where a machine pulls breastmilk out of you--- If pumping is the journey for you, never fear!

How does this machine even work? How does it collect my milk? How do I keep it clean? There are so many types-- which one do I choose? Do I even NEED one?

Does this sound like YOU?

If it does--you aren't alone! In fact, this is probably the same reaction that every new mom has when thinking about breastfeeding and pumping for the first

time --

There are quite a few models and it can become very confusing and frankly-- SCARY --- so let's break it down for you. Here are some guidelines on how to properly use a breast pump to keep your baby happy and healthy!

Hospital Grade Pumps:

These are typically meant for multiple users HOWEVER each user has their own accessory kit to be cleaned. It prevents contamination from other users and you are only responsible to clean your own set of equipment.

This may be helpful in a setting where multiple women may be using the same pump (such as a hospital). They are larger and inconvenient to move around. BUT--they are also the strongest and most durable which is why some women prefer them---especially if they feel their milk supply is running low or they are solely pumping and not breastfeeding-- as in the case of a NICU baby.

Personal or Single Use Pumps:

These are typically meant for one person because all parts are used. They are typically better for bringing around with you but require all parts to be cleaned. They are not as strong as the hospital grade pumps but work well for already breastfeeding babies and supplementing such as when mom is at work.

Hand Pumps or Manual Pumps:

These are the smallest--- mainly because they do not require all the machinery, you are the manual work. You use the lever yourself to pump the breastmilk into a container and that is about it. Some moms really like this method ---others do not want to deal with having to make sure the suction and pressure are just right.

Mechanical pumps will typically have a suction that is around that of an infant. With a manual pump, there may be some user error that may harm a mom if she isn't careful.

Hand Expression:

This way requires the LEAST amount of equipment. All you need is a bowl or other container--- and YOU! This method requires the most amount of work in the actual pumping process but is actually the most sanitary method as long as your hands and bowl are clean.

It does not require extra cleaning and confusing parts. Once you get the rhythm down, many women actually prefer it!

If you want to learn more about this method, Cassie or Mikayla would be happy to coach you through a 'How to Hand Express' --- and you will be a PRO in no time at all!

So how do you use a pump?

This will depend on what you have selected from above. You should always follow the directions from the manufacturer for both assembly and cleaning, but here are a few guidelines to make sure that you are keeping your equipment sanitary and safe.

Before use:

Make sure to wash your hands thoroughly with soap and warm water for about how long it takes you to sing "Happy Birthday". Before you assemble, make sure the kit or tubing is clean and does not have any dirt or mold on it. If it does, discard that piece. You should always have spare tubing in case of this happening. If you are using a shared pump--its always a good idea to disinfect that as well.

After use:

Make sure you are storing your milk safely! Give it a date and time collected and either store it in the refrigerator or the freezer to defrost later. DO NOT KEEP AT ROOM TEMPERATURE! Your milk is like food, it will be exposed to food-borne diseases if left out.

Make sure you always clean both the pump and your pumping area thoroughly.

Take apart your pump to its full extent for optimum cleaning. Rinse all parts and as soon as possible clean either by hand in a washbasin (not the sink) with soap and hot water. Scrub, rinse, and air dry well before putting away. Do not use a dish towel to rub or pat items dry because doing so may transfer germs to the items. You can also use a dishwasher on high heat settings to sanitize and again let them air dry.

Wash your hands again before reassembling and storing equipment.

To make sure that your pump is extra clean, it is recommended to sanitize once daily, especially if your baby is less than 3 months old. Young infants are more susceptible to disease because their immune system is not yet fully formed.

Side note: 'If your tubing is damaged, dirty or it has mold -- always discard. If your tubing has water droplets in it at the end of a pumping session, disconnect the tubing from the flange/pump kit, but leave it attached to the pump. Run the pump for a few more minutes until the tubing is dry. If your tubing has milk or mold in it, throw it away immediately because it is difficult to clean properly. Replace it with a new set of tubing, and check to see if the problem happened because the valves or membranes need to be replaced. If the outside of your tubing is soiled, wipe it with a damp cloth or disinfectant wipe.'

Communicating with your baby

Now, you may be thinking, how do I know when my baby is hungry? When should I feed him/her??

Your baby will have a unique way of communicating their needs to you. This section is meant to help you better read your baby’s signals which will help to facilitate your relationship together!

Your baby will communicate in several ways:

1) Crying is the number one way infants communicate that they DO NOT like something. Whether it is a sound, the texture of something, a wet diaper, hunger, etc. Some parents are able to tell different types of crying for different emotions. As both you and your baby learn to fine-tune your communication patterns you will find crying to be used less and less as a way to express discomfort. Grimacing and arching of the back may indicate that your baby is overstimulated and may need some time to rest.

2) Watching feeding cues is one way to prevent crying and fussiness in a newborn infant. They are characterized in a few different motions. Early signs are licking the lips and 'mouthing'. Another way is called 'rooting' where an infant moves their head back and forth looking for the breast. Hand movements towards to mouth or trying to suck on objects are another sign of hunger. Stretching and body flexion, different from arching of the back, and may indicate your baby is ready for a feed. Crying is a late sign of hunger and it may be difficult to feed until she is calmer. If you feed your baby when they give you these signals you can greatly decrease the amount of crying.

3) Eye contact/facial expressions can be a great way to read emotions as well as the baby reading your emotions. They can sense stress or fear, happiness, and excitement. They will reflect their emotions to what you portray which can help to facilitate their cognitive development. This is especially important during breastfeeding to increase bonding and the feeling of security for your baby.

4) Cooing is your baby's reaction to positive stimuli. As you speak or sing to your baby they will respond to your voice through laughing and 'cooing'. This is their way to verbally respond to you and maintain a conversation type of communication.

In general, babies respond the best to higher-pitched soft voices that verge on a melodic tone that crescendos and decrescendos to allow your baby time to interpret what you are trying to say.

The more social interaction a baby gets when it is younger, the more apt they will be. It is important to not have too many stressors through loud and deep voices, this causes a rise in cortisol which can inhibit cognitive function and cause anxiety.

Is it normal for a baby to wake up in the middle of the night to breastfeed?

Every mother gets asked: "Does your baby sleep through the night?"

Not only does this question seem loaded (in that if the answer is yes --- everyone states how amazing your baby is, but if the answer is no--- everyone gives you pity responses regarding your lack of sleep) but it also puts unnecessary pressure and spotlight on the baby's parents.

The truth is that it is NOT NORMAL for a newborn to sleep throughout the night. This is primarily due to the fact that their stomachs are not big enough to last a full 6-8 hours. It is also because babies do not know the difference between night and day at such a young age.

What is the 'norm'?

A newborn feeds on average every 1 1/2 to 2 hours due to the size of their small stomachs. During the night, a newborn may be able to sleep for 3 hours at a time, but most certainly will wake up intermittently throughout the night for feedings. Most infants wake up ~3 times a night.

Fun Facts:

Did you know that breastmilk composition differs throughout the day?

At the beginning of the day, there is a high amount of carbohydrates within the breastmilk that provides 'quick energy' for the newborn. Breastmilk at the end of the day/closer to bedtime is higher in fats. Because fat is the most satiating of the micronutrients, it takes the longest to digest (allowing more sleepy time). This reiterates that the newborn may be able to sleep for a longer period of time without feeding, however, it is still not enough to keep the baby sleeping throughout the night. Many moms perceive not sleeping through the night as insufficient milk supply, but fear not, it is normal!

How can we compare breastmilk to formula?

Infant formula will not have the same composition as breastmilk. As stated above, breastmilk composition changes throughout the day, however infant formula does not. Because of this reason, formula-fed infants may sleep less than a breastfed infant (due to the lack of additional fats that work to keep the baby full and nutritionally satisfied throughout the night). Parents of breastfed infants may also sleep 40-45 more minutes each night. This may not seem like a lot, but for new parents--- it makes all the difference!

Mamas and Dads... do NOT get discouraged when your baby wakes up to feed. Your baby is hitting their feeding milestones and Mamas breastmilk is still perfect. Rest assured --- this is normal behavior and a sign that your baby is healthy and thriving!

Once formula is given, it does not mean game over for breastfeeding.

If you have looked at any of our blog posts or social media pages, or have even made it this far in the blog post, you may have guessed we are pro-breastfeeding. No, we don't go around chanting "Breast is Best", but we do promote its benefits for both mom and baby. It protects against a variety of short and long-term illnesses for the baby as well as decreasing risks for certain types of cancer in mothers. It also promotes bonding between mom and baby.

Breastmilk contents are so unique, they cannot be copied and made into infant formula. It provides immunities and micro/macronutrients specific to the mother/baby dyad. It's really a win-win for both mother and baby.

We also understand that for many women, breastfeeding is not easy. They face possible roadblocks such as preterm infants staying in the NICU, minimal to no maternity leave that creates difficulty with milk supply, lack of supporting family, lack of support from health care providers, poor latches that leave them in pain with no one to turn to, etc. These are only a FEW instances of many that would lead to the possible use of formula.

After formula supplementation, women often feel discouraged, like they failed. But Mama, that is not the case at all. If you had to give formula for the first couple days, but then were able to breastfeed, you succeeded. If you were never able to breastfeed but pumped and gave them breastmilk anyway, you succeeded. If you were able to give your baby any breastmilk you succeeded. If you did what you could, you succeeded, and that is enough to make you the best mom in the world.

We want to say that if there is or was a time during your breastfeeding journey where you had to or will have to supplement with formula, that is okay. That does not mean you are done breastfeeding if you still want to. You were courageous enough to make a decision that you may have not wanted to make to give your baby nourishment even if it wasn't your milk. Again, this supplementation isn't game over. On the contrary, its just a little break that you need to get to the next steps. Many women have given infant formula for a couple of days, like we said, to get over a rough patch or hump in their journey, but if willing, most are able to keep on breastfeeding either by themselves or with a little help from a lactation specialist. There is no shame in this, in fact, it shows how strong you are that you chose to keep going even when times got tough.

At Mamas Maternal Health, we know it can be difficult. If no women ever had issues breastfeeding there would be no such thing as a lactation specialist. BUT it's normal!

What frustrates us the most is that many women are unsupported during this time and that is why they end up giving up breastfeeding. That is why we became a company-- to support mamas and show them just how powerful and capable they are. Just because the healthcare system can be flawed doesn't mean your care and support has to be.

But let's talk about the other option for formula supplementation...

Donor Breastmilk

Within the last few years, donor breastmilk banks have become increasingly more accessible. But what exactly do they do?

In general, the idea behind donor milk is to provide milk to infants whose mothers cannot provide milk themselves. It is considered similar to blood banks because they test and treat the milk through the pasteurization process to make sure it is sterile for the infant.

Although this may alter the milk in some ways, the protective elements as well as other important components--- that formula does not have-- are kept intact. For premature infants (with or without other medical conditions), breast milk is viewed as medicine do its healthful properties.

It also gives women who may otherwise be unable to provide their own breastmilk (due to specific medications or diagnoses) breastmilk to their infant---with a fee of course.

Some insurance companies may or not pay for the costs of obtaining donor breast milk. This may be a turn-off for some women because costs are significantly higher than that of formula. Why? This is due to increasing demand as well as a shortage of donors for the milk. However, as we look at breastmilk vs formula, we know that breastmilk straight from the mother's breast is the best option, then donor breastmilk, and then formula.

Many women feel that the cost of donor breastmilk is worth the extra dollar due to the protective properties of breastmilk that come with its unique composition. Others may not feel this way or may not be able to afford it. Feeding your baby PERIOD is ultimately the most important --- no woman should feel guilty about the way she chooses to feed.

How can you become a breastmilk donor?

Most places have a few requirements for becoming a milk donor. This includes but is not limited to being able to donate a minimum amount, making sure you are able to provide in excess so that your own baby is not deprived, some have infant age limits (milk composition will change over time), not taking certain medications/herbs, and/or being overall a healthy individual.

There are different places to donate through, some will pay you, others won't --depending on whether they are keeping costs down for other mothers. Here are a few:

https://rmchildren.org/mothers-milk-bank/donate-milk/

https://www.milkbank.org/get-involved/donate-your-milk

Many local children's hospitals and/or other clinics may also take your breastmilk.

Each state may have different regulations, therefore you may have to do your own personal research for your area.

What to expect?

You will typically receive little containers to place breastmilk in and once you have enough, you will either turn it in (to the milk bank) or mail it. Many places will cover the cost of shipping, so no need to worry there.

Or...

If you are breastfeeding and do not have a problem with milk supply, donating milk could be a great way to give back to your community and impact not only the life of another baby but their whole family.

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With Love,

Coaches Mikayla and Cassie <3