A breast pump becomes an accessory for every breastfeeding Mum. Many new Mums are often left confused/unsure as to what to look for and that is after you navigate the mindfield of terminology and gadgets. So lets break down some information relating to breast pumps to give you the best start of where to look.

Pumping can have a way of making us human mamas feel a little like milk machines. 

Even if you plan to exclusively breastfeed (often referred to as "EBF"), it is helpful to have a breast pump on hand. Why? It can help to increase your milk supply, especially in those early days. Breast milk is produced on a supply and demand basis, so pumping for a few minutes after nursing or adding in a pumping session an hour or so after baby finished can up your supply. Some woman have attachment issues or their newborn has difficulty feeding, or they are placed in a neonatal unit so it becomes necessary for the Mum to pump to generate a supply.

Having some expressed breastmilk on hand can also mean that someone else can do the feed giving Mum a break through the night or alternative an escape during the day- a breast pump gives you the freedom to do so.

Of course, if you’re planning on breastfeeding after returning to work, you’ll want a breast pump so you can keep your supply up, have a stash in your home freezer and relieve engorgement when you’re at the office.

There are basically four types of breast pumps:

1. Double-electric breast pumps: These powerful electric models let you pump both breasts at once, important if speed is a concern.
2. Single-electric breast pumps: You’ll only be able to pump one breast at a time, which can take longer. On the plus side, these cost less than a double-electric pump.
3. Battery-operated breast pumps: These can be slower and run through batteries pretty quickly. The advantage of a battery-operated pump is that they're portable and helpful if you don’t have access to an electrical outlet (such as when you’re commuting to work or traveling).
4. Manual breast pumps: These are lightweight, portable and inexpensive. The downside? You'll be doing a lot of the work yourself and you may not get as much milk as a result.

So the decision then comes down to answering these questions in relation to the pump and financial outlay:

• Manual vs electric
• How many hours a week do you think you'll be pumping? 
• Weight
• Sound
• Will you be pumping occasionally or regularly, short-term or long-term?
• Quality versus price
• Suction and speed control
• Product support and Warranties
• Nipple Size
• Ease of cleaning

Here are a few options to consider:

Best Breast Pump Overall: Medela Pump in Style Advanced

Most Efficient Breast Pump: Spectra S1 Plus Hospital Strength Breast Pump

Best Budget-Friendly Breast Pump: BellaBaby Double Electric Breast Pump

Best Breast Pump for Travel: Medela Freestyle Flex

Most Comfortable Breast Pump: Philips Avent Comfort

Best Single-Electric Breast Pump: Nuk Expressive

Best Manual Breast Pump: Lansinoh Manual

Best Hands-Free Breast Pump: Willow Wearable Breast Pump

Best Breast Pump for EBF Moms: Haakaa Silicone Breast Pump

Quietest Breast Pump: Spectra S2

For a sleep deprived mother coffee becomes life...

The caffeine helps to get through the sleep deprived days. So the question often gets asked how much coffee is too much for the breastfeeding mum. 

Statistics show that nearly half (46%) of Australian’s drink coffee and that having children increased the weekly coffee consumption by 2.4 cups (7.2 v 9.6 cups per week).

Most breastfeeding mothers can consume a moderate amount of caffeine (eg a few cups of coffee or tea each day) without it affecting their babies. Caffeine does transfer to breast milk but in very low concentrations (0.06%-1.5% of 300mg of caffeine) Newborn babies however can be particularly sensitive to caffeine. This is because it can take a newborn baby a long time (ie half-life of 50–100 hours) to process caffeine. By 3–4 months, however, it takes a baby only about 3–7 hours. (According to ASN)

 Caffeine content in common drinks and food^1,2

Tips to combine breastfeeding and coffee:

• Pre term or ill infants may experience larger issues with metabolizing caffeine, you may want to limit caffeine intake during these times.
• Studies have shown that ingesting less than 300mg/day of caffeine should not cause issues for infants. Be wary of what products contain caffeine, so you can track how much you have consumed. 
• If caffeine affects your sleep, try not drinking any coffee after 2pm. Sleep is essential for health and wellbeing.
• If you find caffeine intake effects your little one, but still need one, try having a coffee as soon as you breastfeed. This gives you the largest amount of time to process the caffeine before feeding again as peak levels occur about 60-120 mins after consumption.
• If caffeine does have an effect on your child, try giving it a few weeks/months and trying again. The half life (time it takes for the body to get rid of half the dose) reduces significantly with age ( eg 97.5 hours for infants- 2.6 hours at 6 + months).

So the take away is you can still enjoy a cuppa but just be mindful of how much you are ingesting.

SUMMER for many is their favourite season of the year...until they get PREGNANT and then it becomes uncomfortable!!! There are a few things to take note of as you brave the heat this summer.

PREGNANCY

It's not just that it's hotter outside, but pregnant women are hotter too: In the first trimester, the progesterone hormone increases body temperature. Pregnant woman's body temperature is already higher than normal so add in scorching summer temperatures and if you are not careful dehydration or other medical problems could arise.

Dehydration is common in the summer months. Did you also know pregnant woman is more prone to sunburn than non-pregnant woman? Other not so nice side effects of the summer heat is swelling, chaffing, 

Surviving the summer heat is necessary if you are pregnant and here are some tips:

1. Avoid direct sunlight.

Do outside activity early in the morning or after the sun sets. 

2. Stay hydrated.

Water intake should about eight to 10 glasses per day and should be more if you are exercising. Drink low-sugar electrolyte fluids, especially if you’re going to spend time outside. 

3. Dress for the heat.

Wear loose, breathable clothing and a hat to reduce sun exposure. 

4. Spritz water often.

Carry a spray bottle with you and spritz yourself with water to cool down your body temperature. 

5. Be smart about exercise.

Swimming is a terrific way to exercise and keep your body cool. Or stay inside and work out at the gym or walk laps at the mall. 

6. Wear sunscreen.

Be sure to reapply after sweating or swimming. Choose a brand with at least SPF 30 and make sure your face is protected. 

BREASTFEEDING

Newborn babies need extra care and attention when it becomes hot. Quite often they will want to breastfeed more reguarly, though become agitated due to the sweaty nature of skin to skin so might feed more less time.  

The Australian Breastfeeding Association reports the following:

"Most parents worry at some stage that their fully-breastfed baby may not be getting enough to drink in hot weather and they ask if they should give boiled water or fruit juice 'just in case'. The answer in most cases is that extra fluids are not required if your baby is breastfed whenever he needs and this may be more often than usual - just as you are drinking more often.

Breastmilk contains a perfectly balanced ratio of food and water to meet all your baby's needs. It is a living fluid, ever-changing to suit your baby and even in response to the weather! The first milk your baby gets from a full breast has a low fat content and naturally quenches baby's thirst. Once the let-down has occurred, the fat content of the milk gradually increases as the breast softens. This later milk has a creamier appearance and satisfies baby's hunger. 

In hot weather a thirsty baby may want to breastfeed more frequently but for shorter periods. In this way he is getting more low-fat milk and so is satisfying his thirst. If you need to be away from your baby, it is preferable that he has your expressed breastmilk (EBM).

An older baby or toddler who is no longer exclusively breastfed may be encouraged to drink water between breastfeeds. You can also offer extra 'snack' breastfeeds to keep him well hydrated. Another refreshing idea for toddlers is to freeze fruit pieces, such as orange quarters, peeled banana or slices of pineapple - cooling and fun, just be prepared for the very sticky mess!

• Some babies become sleepy travelling in hot weather. You may need to stop and wake your baby for feeds.
• The effect of car airconditioners can cause some dehydration - so extra breastfeeds may be necessary on long trips, even if you are cool.
• Prams that are enclosed are airless and can get very hot. An open-weave bassinette, cradle, layback stroller, baby hammock, cot or portable cot is probably cooler for your baby to sleep in."

As a result of Mum needing to feed more often and the heat making her dehydrated she needs to increase her water quantity. Signs of dehydration include irritability, headache, dry mouth, a feeling of thirst, and darker-than-usual urine. Prevent dehydration by carrying a refillable water bottle with you. It is suggested  drinking a glass of water every time baby drinks. If water’s not really your thing, eat more high-water-content fruit, like watermelon, as well as frozen fruit and other fresh fruits and vegetables.

Outfits should also be loose, comfortable and made from a performance/breathable fabric. You may also want to carry a bamboo/cotton sheet to place between yourself and the baby during a feed. Our new cotton breastfeeding tshirt is a great idea as the zip allows for easy discrete access and there is material that remains between you and bub.

Stay vigilant and HYDRATED this Summer!

A new study finds even moderate exercise during pregnancy increases a compound in breast milk that reduces a baby's lifelong risks of serious health issues such as diabetes, obesity and heart disease.

A new study led by researchers at The Ohio State University Wexner Medical Center and College of Medicine finds even moderate exercise during pregnancy increases a compound in breast milk that reduces a baby's lifelong risks of serious health issues such as diabetes, obesity and heart disease.

They already know that exercising during pregnancy is beneficial to the unborn baby but they wanted to also understand the WHY. When they did their original study they found that the health benefits from fit mums transferred to the pups, proving that they were, in fact, passed through breast milk and not simply inherited genetic traits.

Researchers followed about 150 pregnant and postpartum women using activity trackers and found that those who had more steps per day had an increased amount of a compound known as 3SL in their breast milk, which they believe is responsible for these health benefits.

They are now trying to see if they can extract this 3SL so that maybe they can add it to baby formula to help Mums who were maybe on bed rest or can’t breastfeed.

Dorothy M. Davis states: “Exercise is also great for your overall health during and after pregnancy, so anything you can do to get moving is going to benefit both you and your baby."

So there you have it even more reason to get out and get moving with your bump on board!

Information from the study was published in ScienceDaily.com

The World Health Organisations are continuing to learn about the deadly CON-VID19 virus. Like many we are trying to stay abreast of the changing developments to help us to make informed decisions about our health and the families health. Due to this being so new we have a lot to learn and the effect on some/implications is unknown.

One of those areas of the flow on effect is with breastfeeding mothers. What we do know from previous studies is that breastmilk is like liquid gold and helps with the babies immunity- like almost putting a protective bubble around them.

The Centre for Disease Control and Protection outlined the following:

Transmission of COVID-19 through breast milk

Much is unknown about how CONVID-19 is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread. In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk; however we do not know whether mothers with COVID-19 can transmit the virus via breast milk.

CDC breastfeeding guidance for other infectious illnesses

Breast milk provides protection against many illnesses. There are rare exceptions when breastfeeding or  feeding expressed breast milk is not recommended. CDC has no specific guidance for breastfeeding during infection with similar viruses like SARS-CoV or Middle Eastern Respiratory Syndrome (MERS-CoV).

Outside of the immediate postpartum setting, CDC recommends that a mother with flu continue breastfeeding or feeding expressed breast milk to her infant while taking precautions to avoid spreading the virus to her infant.

Guidance on breastfeeding for mothers with confirmed COVID-19 or under investigation for COVID-19

Breast milk is the best source of nutrition for most infants. However, much is unknown about COVID-19. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers.  A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast.  If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendation for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.

So in a time like this it is probably more advantageous then ever to keep breastfeeding babies to give them some immunity to this pandemic.

Many woman struggle in the first few weeks/months of breastfeeding until they establish their supply and/or get the hang of it. A number of lactating woman also feel that they are not producing enough in order to meet the demands of a newborn baby. This can often be the thought due to having a screaming baby, one that keeps searching for a suck, poor weight gain etc, not thriving etc etc. 

Here are a few tips to maybe get things flowing:

1. Allow lots of sucking:Breastmilk is produced on demand, and the sucking stimulates your body thinking there is more demand for milk.
2. Pump between feeds: This will also trigger the supply-and-demand cycle in your body to produce more milk.
3. Lots of skin to skin contact: This will release a hormone called prolactin. Prolactin stimulates oxytocin (the feel good hormone). Both prolactin and oxytocin can help stimulate breast milk production.
4. Drink more water: to avoid dehydration. Institute of Medicine recommends arounds 3.1 L compared to 2.2 L in non breastfeeding mothers.(This changes according to activity levels/environmental needs etc)
5. Manage stress when possible: Outsource tasks if they are becoming too overwhelming. Listen to relaxing music during nursing sessions. 
6. Empty breasts during feeding: The more milk that is removed the more you will make.
7. Consider fenugreek tea: Fenugreek is one of a few herbs that has data to support its use as a galactagogue (substance to help increase milk supply).
8. Make sure you are getting the additional 500 calories (a day) to help aid the increase in nutritional demands.

For further assistance see your local Lactation consultant or call the Australian Breastfeeding Association.

Having trouble breastfeeding?

The answer to your difficulties could lie inside your babies mouth…

Tongue-tie (ankyloglossia) is a condition in which the thin piece of skin under the baby's tongue (the lingual frenulum) is abnormally short and may restrict the movement of the tongue. Tongue-tie occurs in about 4-11 per cent of babies and is a condition that can run in families. It is more commonly found in boys.

Some babies with tongue-tie are able to attach to the breast and suck well. However, many have breastfeeding problems, such as nipple damage, poor milk transfer and low weight gains in the baby, and possibly blocked ducts or mastitis due to ineffective milk removal.

The Australian Breastfeeding Association states that a baby needs to be able to have good tongue function to be able to remove milk from the breast well. If the tongue is anchored to the floor of the mouth due to a tongue -tie, the baby cannot do this as well. The baby may not be able to take in a full mouthful of breast tissue. This can result in ‘nipple-feeding’ because the nipple is not drawn far enough back in the baby’s mouth and constantly rubs against the baby’s hard palate as he feeds. As a result, the mother is likely to suffer nipple trauma.

If you see any of the following signs it could be a signal to go and have a consultation with a lactation consultant, GP or paediatrician:

• nipple pain and damage
• the nipple looks flattened after breastfeeding
• you can see a compression/stripe mark on the nipple at the end of a breastfeed
• the baby fails to gain weight

Seeking advice or getting another opinion will help to alleviate issues. Our director had tongue tie with her second and it was four months into the feeding journey when it was picked up. This was after the babies weight plummeted to the 5th percentile and constant pain, screaming etc accompanied every feed.

Breastfeeding is hard work and in those first few days, weeks and months you want to do all that you can to meet your baby’s needs.

Some woman struggle to get enough supply whilst others are like a leaking cow- it just keeps on coming! For some they are left on a solo journey to try and navigate their way through the jungle of breastfeeding.

The BREASTFEEDING ASSOCIATION offered the below advice which we found beneficial. Remember there are also lactation consultants that are only just a phone call away.

How to make more breastmilk: Demand = Supply

To build your breastmilk supply, the following ideas may help.

• Provided that your baby is correctly attached, you will find that the quickest and most successful way to boost your supply is to breastfeed more often. Offer a breastfeed every 2–3 hours during the day, for a few days, or increase the number of feeds by offering the breast in between your baby's usual breastfeeds.
• Here is an easy way to do this. If your baby does not settle after a feed, try offering another quick little ‘top up’ breastfeed. Those few minutes of extra feeding and cuddling may be all that is needed to soothe and satisfy him.
• Let your baby finish the first breast before switching to the second breast. 
• Or, you may find it helps to change sides several times during a feed, whenever your baby's sucking seems to become less strong. Some people find that this encourages the baby to suck more strongly and stimulates a good let-down reflex.
• You can also try massaging your breast. Stroke it towards the nipple on all sides as your baby feeds. Take care not to disturb the nipple in your baby's mouth.
• If your baby is awake you can offer little ‘snack’ feeds without waiting for baby to cry for them.
• You can try offering the breast to soothe your baby for a few days, instead of other comforting strategies (eg a dummy).
• You may find that your baby has fussy periods when he wants to breastfeed more frequently. There is more about this in the Fussy periods and wonder weeks article on this website.
• Although they vary greatly, many new babies need 8–12 or more feeds in 24 hours. Babies generally feed less often as they get older. Babies also generally feed more efficiently as they get older. 
• To increase your supply, you will need to fit in more feeds than is usual for YOUR BABY. Feeds do not need to be very long, just more often. In each 24 hours some feeds may be only 5–10 minutes long, others may be 30 minutes or longer, particularly when baby feeds to sleep slowly and contentedly.
• Help your milk to let-down quickly. Relax and enjoy feed times. Try to remove distractions (turn your phone off, put a ‘do not disturb’ sign on your door), then settle with baby into a comfortable chair. Breathe deeply, relaxing each part of your body separately as you may have learned to do at antenatal classes. Have a drink on hand, a book or a magazine, listen to the radio or watch TV. For more ideas, see the let-down reflex article on this website.
• Babies vary greatly in the amount of sucking they seem to need. There is no need to worry if your baby is contented with a fairly short feed. Some babies however love to continue sucking long after the flow of milk has dwindled to a trickle. This is fine too. Your baby will let you know how long his feeds need to be.
• A baby who is well attached and positioned is more able to drain the breast well. For more information, see the Attachment to the breast article on this website.

MORE FREQUENT FEEDING MEANS MORE MILK!

• Feed your baby more often than usual.
• Check that baby is well positioned at the breast.
• Allow the baby to decide the length of a feed.

Struggling with a low milk supply can be very upsetting and frustrating. Remember that any amount of breastmilk you provide your baby is valuable. If you have tried these ideas and are still finding low supply to be a problem, speaking with an Australian Breastfeeding Association counsellor on the Breastfeeding Helpline , a lactation consultant or your medical adviser may help.