Lactation 101
Making the decision to breastfeed your baby can be one of the most empowering, but intimidating decisions.
There are many benefits to breastfeeding or even bottle feeding your pumped breastmilk or a donor’s milk. Breastmilk is packed full of antibodies that help form your baby’s immune system. When you are exposed to a sickness your breastmilk changes to protect your baby from whatever it was you were exposed to.
Breastmilk contains a varied array of nutrients that are unique to each family. It also contains beneficial bacteria and prebiotics for the beneficial bacteria. Breastmilk nurtures the microbiome and helps play a role in lowering the risk for chronic diseases like asthma, obesity, allergies, dermatitis, inflammatory bowel disease, and neurodevelopmental disorders. They also regulate anxiety, mood, cognition in the brain/gut axis, and pain in the brain/gut axis.
Breastfeeding your baby is a great opportunity to do skin-to-skin. It can be a great opportunity to bond with your baby. When you breastfeed, oxytocin flows through you. This improves your mood, promotes bonding, and helps the uterus contract postpartum for optimal healing. Breastmilk truly is the perfect food for babies and has many benefits for the mother as well!
Despite all of the wonderful benefits and reasons why you might want to breastfeed, it can still feel extremely intimidating. Education and support are key to being successful in your breastfeeding journey.
Support could come from a lactation professional or even your partner. There are many lactation providers you could encounter. You might see a CLC, IBCLC, CBE, or even just your postpartum doula.
Types of Lactation Providers
Certified Lactation Counselor (CLC):
The Certified Lactation Counselor credential identifies a specialist in lactation counseling who has completed a minimum of 45 hours of training and successfully passed a criterion-referenced examination. CLCs demonstrate the competencies and skills required to provide safe, evidence-based breastfeeding management for pregnant, lactating, and breastfeeding people.
International Board Certified Lactation Consultant (IBCLC):
IBCLCs can complete one of three pathways to becoming certified. These pathways include between 300-1000 clinical hours, 95 hours of lactation education, and at least 14 college health courses. The IBCLC was the first certificate for professional lactation support and the only breastfeeding certification recognized by the US Surgeon General, and the only one used as a quality metric by the Centers for Disease Control and Prevention.
Certified Lactation Specialist (CLS):
The Certified Lactation Specialist Course is designed for aspiring lactation consultants and those who wish to improve their knowledge base and skills in working with breastfeeding people. A CLS has taken a 5-day course and obtained a certification to be used as a stepping stone to the IBCLC credential.
Certified Breastfeeding Educator or Certified Lactation Educator (CBE or CLE):
These programs are provided by various private companies and organizations. They have variable standards. CBE or CLEs are qualified to teach families about preparing for their infant, how lactation works physiologically, common challenges to expect, and other general lactation support. Certified Lactation Educators have completed a 20-hour breastfeeding training course and passed a final online examination.
Peer Specialist:
Peer Counselors are people who have at least 6 months of personal experience with breastfeeding and have received 20 hours of on-site training to provide people with breastfeeding information and support from pregnancy through weaning.
Support from your Doula:
A postpartum doula might provide educational support postpartum on breastfeeding. A birth doula might help initiate the first latch. Doula programs include basic lactation education.
You can also find support in postpartum groups, La Leche League, WIC, and other breastfeeding networks.
Another huge part of your support network will be your partner. If your family members are confused and uninformed about breastfeeding, your partner can be there to empower you and make sure you have the space and resources you need to breastfeed. In the early weeks, it is important to track diaper changes. This may seem like a boring task, but it is important for your baby’s health. Having your partner do diaper changes and track them to make sure your baby is having enough wet diapers and bowel movements can give you a break after feedings or allow you to sleep a little later while your partner preps your baby for the next feed. It might also help your partner feel more involved in the transition to parenthood.
If you choose to pump they may take on some of the nighttime feeds so that you can split tasks better and optimize sleep. After you pump, your partner can clean your breast pump parts, put away the milk, and set things up for your next pump. Maybe you are breastfeeding during the night, but have to pump at work? Bring your pump parts home and have your partner assist with the cleaning and sterilizing each evening. It may feel hard to ask for help, but it can make your partner feel needed and involved in the intimate postpartum period where your body is doing so much.
You may have a lot of questions about the actual logistics of breastfeeding. That’s okay! Every other parent has had the exact same questions.
The Breastfeeding Basics
Milk production timeline:
Milk doesn't come in immediately after delivery. It can take three to five days postpartum for this to happen. During those first few days, you produce colostrum, which provides protective antibodies and helps the baby's digestive system develop.
Milk production:
92% of people produce enough breastmilk for their baby, but 92% of people also report having issues with breastfeeding, so how do you know if you actually are producing enough milk? By knowing what is normal and trusting your providers. It may feel like you are not producing enough, but that may be because media shows people producing an abnormal amount and donating it. That is actually one of the dangers of overpumping. Each time you empty your breast you are telling your body to produce more milk. Introducing a pump session can increase milk supply, but introducing too many can have you producing the milk quantity for two babies. When this happens it can be hard to get back to the necessary amount for just your baby and you may be left feeling engorged. When this happens many people save a large supply or choose to donate, which we see a lot on social media or in the news. To actually know if your baby is getting enough milk you should monitor diapers and go to the pediatrician for weight checks. They will notify you if there is reason to be concerned and you can seek help from an IBCLC before making a big switch to something like formula.
Supplementation:
If you do need to supplement the best option is your pumped breastmilk. If that is not an option the next best is safe donor milk from a milk bank. Next is a soy-free formula. Soy-based formula should be the very last resort.
Changes in Milk:
You may notice changes in the fattiness or color of your milk throughout a 24-hour period or over the course of a few weeks. Milk changes colors when it transitions from colostrum to milk and even when the antibodies in milk change due to exposure to different germs. Your milk might turn pink, yellow, orange, green, white, or light blue! Many people notice greater volume and faster flow in their breast milk in the early hours of the day, which may be due to higher levels of prolactin, a hormone that helps produce milk, at that time. At nighttime, your milk contains melatonin to help your baby sleep. The hormones in your milk are changing all throughout the day! You may notice your milk seems thicker and creamier towards the end of a feed. As the feed progresses, the fat composition gradually increases due to the mechanics of milk moving through the breast. This is usually referred to as hindmilk. Foremilk is the more ‘watery’ milk that comes at the start of the feed. Both are extremely important and beneficial to your baby.
The decision to breastfeed your baby is a huge investment in the health of you and your baby but requires support. You can read more about breastfeeding 101 here! Louisville Newborn Care is here to offer support and be a part of your postpartum team. Our staff is trained in infant feeding and we are happy to care for your baby in between nighttime feeds, handle the diaper changes and charting so your partner can sleep, or educate you on what normal bowel movements and feeds look like!
