Congratulations! You made it through pregnancy, birth and the first few weeks of leaking boobs, engorgement, clogged milk ducts, blistering, tears (so. many. tears.) and all the things that may or may not have come with breastfeeding. Hopefully, you’ve begun to feel like you’re getting the hang of it. Now here you are, a brand new person on the other side of birth, preparing to share the feeding responsibilities with others. Maybe you’ll be returning to work soon, planning a date night or Moms’ night out, or maybe you’re just ready for a few solid hours of uninterrupted sleep while your partner handles a few feedings. Whatever the circumstances, this stage can present a whole new series of challenges.

Scroll down for resources, tips, and a few of my favorite products!

Choosing the Right Pump

Not all pumps are created equal. No two breasts are exactly alike. Not all bodies respond to pumping. Find a pump with various flange sizes (that’s the piece that looks like a funnel) so that you can find the best fit for you. Many pump manufacturers provide sizing guides on their websites. Generally, you’ll need about 2mm of space around your nipple on the inside of the flange (the “tunnel” that leads to the bottle). Follow the sizing guide for your pump to make sure that your flange isn’t too tight or too loose. You shouldn’t feel any rubbing or pinching, and the suction shouldn’t be painful when the pump is running. Try adjusting the suction one click at a time until you find the best setting for you.

This mother is using a hand pump, combined with massage, to stimulate milk flow. Check out this video from Stanford Medicine on maximizing milk production using a hands-on pumping technique.

Consider the amount of milk you’ll need to collect and store. If you’ll be returning to work full-time, a double electric hospital grade pump is probably your best bet. For others, a small hand pump and some gentle hand expression might do the trick.

Which Bottle is Best for Breastfeeding?

There are so many bottles out there. How do you know which one is right for you? What if you’ve tried a few and your little one wanted nothing to do with any of them?

  • Look for a bottle with a nipple that encourages a wide latch, similar to breastfeeding.
  • Choose a nipple with a slow flow. Your breast milk takes a few seconds to start flowing. We’re trying to achieve the same effect with the bottle.
  • If all else fails, just know that there are other ways to feed a baby. If yours refuses to take a bottle, try using a small cup. You might be surprised at how well they manage using a cup like a big kid!

Is Nipple Confusion Really a Thing?

Ahh, the dreaded “nipple confusion”. The bad news? It is a real thing. The good news? It can be avoided. When a baby takes a bottle while laid back, with the bottle pouring straight down into their mouth, they are forced to swallow in order to avoid choking. That means they may take in much more than they need or want, causing gas, spit-up, colic, and yep… You guessed it! Nipple confusion. Practicing paced bottle feeding can help. Paced feeding mimics the way that babies feed at the breast. They control how much milk they take in and how quickly. They take breaks, stopping when they need to rest or burp. Baby feeds at his own pace, just like he does at the breast.

Talk to your partner and caregivers about paced bottle feeding. Not only will this help prevent nipple confusion, but it will also ease your worries as you work to keep up with the demand of pumping enough milk while you’re away from Baby.

How Much Milk Do I Really Need to Pump?

We’ve all seen the Pinterest-worthy photos of the deep freezer full of frozen breast milk. It can be discouraging to see when your stash consists of just a few bags of liquid gold.

But have no fear! Those moms may have enough milk to feed a whole daycare, but they’ve got their own set of problems *cough* oversupply? *cough, cough*. You, on the other hand, have the perfect amount of milk for YOUR baby.

You don’t need a huge supply to keep your baby fed.

1) Pump when you feel most full (usually first thing in the morning).

2) Store your milk in small quantities, so you don’t end up thawing more than you need for one feeding.

3) Schedule pumping sessions when your baby usually takes a bottle.

Keeping Your Supply Up

If you’re going back to work and worried about losing your milk supply, you are not alone. But not to worry. The basic rules of milk production still apply. It truly is all about supply and demand.

  • Upon returning home, plan on relaxing for a bit. Nurse your child as soon as they are ready, and on demand throughout the night. Talk to your daycare or care provider about taking a few minutes to nurse before you head for home.
  • The laws are on your side. You have the right to a private pumping space while you’re at work. But even if you’re finding it hard to pump at work, your body will continue to keep up with the demand of nighttime feedings.
  • When pumping, try keeping pictures, videos, or a piece of baby’s clothing (with their scent) on hand to help you relax and think about nursing your baby. This will help your letdown come easier, even when Baby isn’t with you.

A Few of My Favorite Products

(Because shopping, obvi.)

  1. The Kindest Cup: This thing is genius. It collects milk, AND serves as a cup to feed milk to Baby. It suctions to your breast and collects leaking milk during letdown, fits neatly in your bag for hand expression on-the-go, and is made from 100% silicone for easy cleaning.
  2. The Milkies Milk Saver: Collect leaking breast milk while out and about by slipping this handy tool inside your bra. You can save and store that milk for later use.
  3. Lansinoh Glass Baby Bottles: These bottles come with a nipple that is great for breastfed babies, as it encourages a wide-open latch. The glass bottles are safe and easy to clean.
  4. The Tiny Cup: This little cup is perfect for feeding Baby without a bottle. Available at my favorite local baby store, Colorado Baby!
  5. Milkies Milk Trays: Trays like these make it easy to freeze small quantities of milk, so you can thaw only what you need for a feeding. Nothing goes to waste!

And remember… You’ve got this! Try to relax but don’t be afraid to ask for support. Find a lactation specialist to help you find the right fit. Know your rights when it comes to pumping at work. Talk with your care providers. Ask for help when you need it.

You are doing a wonderful job.

– Ali

If you’ve been a parent for any length of time at all, you’ve probably gone searching for advice once or twice. Or, you’ve been handed advice whether you asked for it or not. Spend a few minutes perusing a parenting group on Facebook and you’ll likely witness someone asking a question about lactation. “How can I increase my supply?” “My baby has gas. What should I do?” “How should I treat my sore nipples?” “Is my baby nursing too much?” “When will my baby sleep through the night?”

Sigh…

I can’t help but keep reading, to take in the inevitable barrage of advice from people who have undoubtedly experienced the same concern. “Lactation tea!” “Give up dairy!” “Nipple butter!” “Sleep training!” As a new, exhausted parent who only wants their baby to be happy and healthy, it’s easy to hop on social media and ask any question under the sun, and it’s even easier to scroll through the endless suggestions until you find something that resonates with you and your situation. As a mother who has been through these struggles and unfortunately given plenty of this advice myself, I now cringe at most of what I read in regards to breastfeeding tips and tricks. Our society has traveled so far from the days of passing down knowledge from one generation to the next and exchanging evidence based, time tested wisdom on the topic of feeding our babies. We have all but abandoned the practice of learning from those who came before us, feeding their infants without pain or concern for low milk supply. I believe they must have known a thing or two about overcoming the challenges of breastfeeding. Otherwise, we humans surely wouldn’t have made it this far.

Last week, I made an Instagram post that surprised a lot of people. I mentioned that everyone should stop telling nursing mothers to drink more water to increase their milk supply. My post was met by people who have nursed multiple babies, with years of experience, surprised to hear this revelation that water intake has nothing to do with milk production. Honestly, I was shocked that people were so surprised by this. Then I remembered that I, too, have not only convinced myself that water was the answer to my own milk supply woes, but I have also been guilty of telling friends to drink more water to make more milk. Then I thought, “What other advice is out there that has been passed around for so long that it has become a new accepted truth??” I set out on a mission to scope out the most commonly spread misinformation about breastfeeding and finally set the record straight. If I can help plant just a few seeds of factual information, I’ll be happy. Here, we have my own compilation of the top 10 most common myths about infant feeding, and the truth behind them.

“We are the only mammals on Earth that doubt our own ability to feed our babies.”

valley lactation

Myth #1: Breastfeeding hurts.

Let me ask you a question. If you were to go to the doctor and tell them that you were in excruciating pain, what would you expect them to tell you? “That’s completely normal. You’ll get used to it after a while.” Um, NO!

They’d likely do an exam, maybe run some tests, ask some questions and figure out what’s causing the pain, then come up with a solution! I can think of very few situations where pain is a good sign. Generally, pain is a sign that something is wrong. Breastfeeding is no exception.

If you experience nipple pain, bruising, cracked or bleeding nipples, your body is trying to tell you something. Nipple pain is usually a sign of an ineffective latch, making it harder for Baby to get enough milk and causing your milk supply to suffer. Breastfeeding should not hurt. If it does, get help now.

Many parents turn to bottle feeding when breastfeeding is too painful. Many of us are conditioned to believe this is normal.

Myth #2: You should give up dairy.

Show of hands – how many of you have been told to quit eating dairy if your baby appears gassy, spits up a lot, or won’t stop crying? Now listen, I’ll be the first to preach the fact that cow’s milk was never intended for human consumption. It’s breastmilk for baby cows. They are mammals, after all. HOWEVER… the symptoms I mentioned may have zero to do with your diet and everything to do with a breastfeeding issue. Could be Baby’s latch, could be positioning, could be your letdown. The only way to know for sure is to have a lactation specialist assess a feeding and figure out what’s really going on.

Remember, your milk is made from your blood. The food you eat is digested and the nutrients are absorbed into your bloodstream before being made into milk. Jumping so quickly to a dairy intolerance could lead to more problems than it may solve. On the other hand, a forceful letdown can cause spit-up, gas, irritability and discomfort. If you have eliminated dairy or any other food from your diet and haven’t noticed a change, it probably wasn’t the dairy in the first place.

Myth #3: You pumped and didn’t get much. You must not have enough milk.

Say it with me: “Pumped milk is NOT an indicator of milk supply”. There is no pump in the world that will remove milk quite as well as a well attached baby. Many will come close. Lots of people pump and exclusively bottle feed for many months or even years. Those people are incredible, because they’re doing twice the work and more.

But I’m not talking to those people. I’m talking to the ones who pump (for any reason) and nothing comes out. Maybe they wanted a date night. Maybe they’re going back to work. Maybe they want to pump some extra milk to increase their supply or supplement between nursing sessions. Maybe Baby wouldn’t latch, so they decided to pump and give Baby a bottle instead. So much to unpack here.

Bottom line: just because you only got a few drops from a pump does not mean you have no milk. It could mean nothing at all. It could mean you’re using the wrong flange size, or the suction isn’t strong enough. It could mean you’re stressed from watching those empty bottles (which may prevent your milk from letting down, by the way). It could mean all sorts of things but it does NOT mean you’re all out of milk. Take a deep breath. Relax your shoulders. Stay calm. Remember that your baby can feel your stress and could be feeding (pardon the pun) off of your anxiety. A lactation specialist can help you look for signs that you have plenty of milk, and even help you get more out of each pumping session. This video from Stanford on maximizing milk production is another excellent resource.

Massaging your breast while pumping can help you to express more milk.

Myth #4: Drink more water to make more milk.

Ah, yes. This one, I must admit, I have shared myself. I have experienced the extreme thirst that can come from nursing but I have also convinced myself that I can make more milk if I drink more water. I’ve also told friends to drink tons and tons of water when they think their supply is dwindling. It was a sad day when I learned that hydration has very little to do with milk production.

Truth is, milk is produced on demand. When milk cells are emptied, they make more milk. When they are full, they stop making milk. The only way to make them produce more milk is to drain them. With demand, supply will follow. Keep in mind, this process works best with an effective latch or a properly fitted pump. Check with a lactation specialist to ensure your baby is well attached and transferring the milk effectively.

“What if we told you that your baby isn’t using you as a pacifier but that he’s using a pacifier as you?”

La leche league

Myth #5: Your baby is eating ALL. THE. TIME. You must not have enough milk.

If you think your baby is feeding too frequently or never seems to settle, there are many other factors to take into account. A lactation specialist will ask many questions, like how many times your baby is feeding, peeing and pooping each day. We will assess your baby’s mouth and latch to look for signs that Baby is transferring plenty of milk, or if they can’t because of a restriction like a tongue or lip tie. We may do a weighted feed to give you reassurance and know exactly how much milk she’s taken in.

Watch your baby, not the clock. Infants don’t care what time it is or how long it’s been since their last meal. They only have a few ways to communicate with you and they don’t know how to lie. When your baby tells you she’s hungry, it’s important to recognize those signs. Responding to Baby’s feeding cues quickly will keep them fed and content, and keep your milk supply up. If you’re already doing these things and still feel that your child is feeding too often or not getting enough milk, it’s time to get help from a qualified lactation professional.

Bottom line: Just because your baby is eating all the time does not mean that you don’t have any milk. Maybe they’re cluster feeding to increase your supply. Maybe you have plenty of milk but their latch is too shallow to remove the milk effectively. Maybe you’re stressed, making it more difficult for your body to release (let down) the milk. Let’s not jump to conclusions until we have all of the facts. Chances are, your milk supply is not the problem.

Paced feeding will ensure that your child isn’t taking in more milk than they want or need.

Myth #6: Spit-up is normal.

Yes, babies do spit up from time to time. If your baby is spitting up after every feeding, or even during feedings, we need to figure out why. Many babies are diagnosed with acid reflux when they spit up frequently or seem uncomfortable and fussy after feedings. However, these are common breastfeeding concerns that are often misdiagnosed or ignored. If an infant has a shallow latch, no matter the cause, they may be unable to control milk flow. If they take in too much milk too fast, they may not be able to digest it properly. Your baby needs to feed with a deep, effective latch, using their tongue to draw the milk and slow the flow when it is coming too fast. Certain nursing positions can also be helpful in giving Baby more control over the feeding.

A skilled lactation specialist will assess Baby’s sucking and swallowing patterns to see how well they are taking in the milk. Sometimes, a few simple changes can eliminate spit-up and discomfort by allowing Baby to eat at a pace they can handle. They will also check Baby’s mouth for tongue and lip ties, and help with positioning to get a deeper latch. Before turning to medicine or switching to formula, schedule a consult to rule out any of these simple breastfeeding issues. If you are bottle feeding, make sure to practice paced bottle feeding in order to give Baby the same control they have when breastfeeding. In many cases, the problem is not the milk or brand of formula, or even the bottle, but rather the technique. A lactation consultant can help with this, too. 😉

“Just because your baby isn’t getting enough, doesn’t mean you don’t have enough.”

valley lactation

Myth #7: You need to supplement until your milk comes in.

I hear it all the time. Your milk hasn’t come in yet, so how can you know if your baby is getting full? The answer? Look at your child. What do they look like while they are nursing? And after each feeding? There is a very good reason why it takes some time for your milk to “come in”, or transition from newborn milk to mature milk.

First of all, let’s redefine this idea of your milk “coming in”. You have milk. Many people have milk for a few months before Baby is even born. Right after birth, you have what’s called colostrum. It’s thick and slow, and it has SO many benefits. Think of it as the training wheels of breastfeeding. Colostrum teaches your baby how to suck and swallow food for the very first time. Think about it… they’ve never had to eat with their mouth before! As Baby digests the colostrum, it fills their tiny stomach and digests slowly so that they can rest after their long journey. Colostrum acts as a laxative to push meconium (the black, sticky newborn poop) out of Baby’s intestines.

Once Baby gets the hang of eating and peeing and pooping, your milk will begin to transition. Your body will add water to the colostrum and your milk will increase in volume. Your milk is in, but you had milk the whole time! Any sort of supplementation will only slow this process. Keep that in mind if supplementation is recommended (which should only be done out of medical necessity, recommended by your provider, not your cousin’s best friend’s brother). If you do need to supplement for medical reasons, it is important to keep your milk flowing, with a pump or hand expression, until Baby is able to latch and nurse at the breast.

Babies cry to tell us something. Learning to understand their feeding cues can make for a happier baby and a happier YOU!

Myth #8: You should toughen up your nipples while you’re pregnant.

Someone actually told me this 14 years ago and if I could track that woman down and set her straight, I would.

Repeat after me.

BREASTFEEDING SHOULD NOT HURT.

As I teach in my class, if breastfeeding hurts, your body is trying to tell you something. Usually, it’s a very easy fix. Even in more complex cases, there is usually a solution. The fact that so many women are told that breastfeeding will hurt and that they should prepare their nipples by literally sanding them (?!?) and then grinning and bearing this take-your-breath-away pain because it’s what’s best for their precious bundle of joy… well, that’s what got me into this profession in the first place.

If you are in pain while nursing, get help quickly. This is NOT supposed to hurt.

Myth #9: You need to nurse every 3 hours.

Watch your baby, not the clock. Your baby is telling you everything you need to know. How many times has she nursed in the past 24 hours? How many wet/dirty diapers has she had in 24 hours? If your infant is getting at least 8-10 feeds in 24 hours and producing lots of wet and poopy diapers, there is likely no need to wake her if she wants to sleep for a few hours. Look at the big picture before waking her up or forcing her to feed before she’s ready. Watch for feeding cues to know when she’s ready to eat. She will tell you she’s hungry by moving her lips, clenching her fists, kicking or rooting for your nipple. Responding to these cues early will keep her happy and maintain your milk supply.

Myth #10: Your baby is using you as a pacifier.

Anyone who tells you this has never thought about why pacifiers were invented in the first place. They were invented to mimic the breast!

When your baby sucks on something, whether it’s a breast or a pacifier or a finger, their Cholecystokinin level rises. That’s the hormone responsible for telling our brain that our stomach is full. The problem with sucking on a pacifier is, there isn’t any milk in it. Baby’s brain gets tricked into thinking it’s full when it’s not. Baby falls asleep without getting the milk they were asking for, and your body isn’t being told to produce that milk because Baby isn’t sucking on the breast. Supply and demand, remember?

Your baby is not using you as a pacifier. They’re using a pacifier as you. If they are showing hunger cues and a pacifier is the only way to calm them, talk to a lactation specialist. There may be a way to make sure they’re getting the milk they need and keep them satisfied without any mind games.

Nursing is about so much more than food. It is a conversation between you and your baby.

Share facts, not fiction.

It’s up to all of us to change our own expectations. Next time you see this type of misinformation being shared, speak up. Once we reframe the conversation and make sure that new parents’ expectations are accurate, they will be better prepared for what’s to come. Spreading accurate information keeps parents informed and makes for positive breastfeeding outcomes.

Take a breastfeeding class. Schedule a lactation consult. Attend a support group. If you’re not sure about the facts, send your friend to a trusted lactation specialist before spreading information that could be harmful to her feeding struggles.

We can all do our part to bring back the village that once passed down the wisdom of birth and breastfeeding. One evidence-based, helpful tip at a time.