MILC Moment: The Truth About Pumping & Dumping

By Rebecca Costello, IBCLC

Pumping and dumping: not being able to nurse, and pouring your milk down the drain, is NOT a fun experience! Mothers are often told to stop breastfeeding and/or "pump and dump" because they are on medications, or needed to have a scan or test (like an MRI). This seems to be widespread - we hear about this advice being given by everyone from dentists to urgent care doctors to pediatricians. And yet so often, when we look up the medication or test, it is perfectly safe for breastfeeding to continue. You poured your milk down the drain for nothing! Moms may pump and dump for hours or days before finding out they could have breastfed all along. Why does this happen?

Which book or website your health care provider uses to look up medication or test safety can make a big difference. One study used a list of 14 drugs that were commonly prescribed to breastfeeding mothers, and looked how many were considered safe in frequently consulted resources. Several resources said NONE of the medications were safe. Others said about 50% were. It turns out, 85% were fine! Many health care providers don’t get any education about which resources are most accurate.

So where should you turn for advice about medication safety and breastfeeding? One option, of course, is WBWC! We often take calls with questions like “I had a CT scan today – they told me I couldn’t breastfeed for 24 hours, is that true?” or “I’m having a dental procedure next week – which pain meds are safe?” Our most frequently used accurate resource is the book Medications & Mother’s Milk, one of the “bibles” of breastfeeding and medication safety. It’s on the shelf in almost every office!

An even more accessible reference we sometimes use – and that you can use from anywhere with an internet connection – is Lactmed, a free website from the National Library of Medicine. They provide information on thousands of medications, herbal supplements, contrast used for scans (try typing “CT contrast” into the search box), and even specific procedures (try “MRI” or “X-ray”). Often the information makes it very clear that it’s safe to keep breastfeeding. If you have questions or concerns about what you read, please give us a call; we are happy to help you sort through it. We want you to continue nursing or pumping with confidence, knowing that you’re continuing to provide the best you can for your baby!

MILC Moment: How to make breastfeeding successful – before you even give birth!

By Rebecca Costello, IBCLC

Our lactation consultants work with a lot of families – over a third of the moms who give birth with WBWC end up seeing one (or more!) of our LCs. We also see many moms and babies who birthed elsewhere – often they say we were recommended to them by a friend or family member who came to WBWC for their birth/and or breastfeeding help. (Thank you, and we are honored!)

     Working with so many new families, we get a chance to see up close what types of resources help new parents. Many people take childbirth classes, but we really notice a difference when first-time parents were also able to do some preparation for what happens after birth! They tend to be calmer, more confident, and adjust more easily to life with a newborn. All of this affects breastfeeding – big time! (Especially when challenges arise.)

     How can you prepare for your baby to arrive? Spend some time asking your friends who are parents about what life with a newborn is like, and their best tips for a smooth transition! Get some books on baby care and breastfeeding – read them, and get your partner to read them too! No friends with kids? Not into reading? WBWC offers classes on Breastfeeding Basics and Newborn Care to help you get ready. Our classes are fun, interactive, and taught by experienced lactation consultants and nurses! Not able to make it to the WBWC classes? Many local childbirth educators, doulas, and other professionals offer baby care and breastfeeding classes. We encourage all first-time parents to sign up and study up! We think you’ll be more likely to have a successful experience breastfeeding, and be happier, more confident parents all around.

MILC Moment

A lot of things go pink in October for Breast Cancer Awareness Month. We talk about early detection of breast cancer, supporting breast cancer patients and survivors, and finding better treatments for breast cancer. But let’s also talk about breast cancer prevention – and part of that is breastfeeding!

So much of the discussion of breastfeeding focuses on benefits for the baby. But we know that there are big benefits for mom as well. When we get pregnant and give birth, there’s a complicated interplay of hormonal and physiological changes that prepare the body for breastfeeding. Our bodies expect it to be part of our reproductive life cycle. When our society doesn’t support mothers to breastfeed, we are disrupting this cycle and placing them at increased risk for a number of issues later in life: osteoporosis, heart disease, hypertension, diabetes, and ovarian and breast cancer.

The longer you breastfeed, the stronger the “dose” of prevention against getting breast cancer later in life. For each 12-month period a woman breastfeeds, one study calculated a 4.3% reduction in relative risk of getting breast cancer later in life, compared with women who didn’t breastfeed. So a mother who breastfeeds 3 children for 2 years each would reduce her relative risk by over 25%! There is also growing evidence that breastfeeding specifically reduces the risk of particular aggressive types of breast cancer, which are more common in African-American women.

Does this mean someone who breastfeeds is totally protected against breast cancer, and someone who doesn’t breastfeed will definitely get it? Nope! This is just about changes in risk – sadly, there is no way to know exactly who will get breast cancer. But we know that by supporting all moms to breastfeed, some cases of breast cancer will be avoided. And the next time someone tells you your baby is “too old to breastfeed”, smile and say “Oh, we need at least another 12 months! We’re reducing my risk of breast cancer!”

Your MILC LCs,

Rebecca, Ellen, Deborah, Elley, and Nancy

WBWC Officially Part of First Breastfeeding Family Friendly Community

by Rebecca Costello, IBCLC

One year ago, the mayors of Chapel Hill and Carrboro partnered with members of Rotary, Chamber of Commerce, health departments, faith communities, and UNC-Chapel Hill on an initiative to become the first Breastfeeding Family Friendly Cities in the country. One important step is for businesses throughout the community to welcome and support breastfeeding families. They just have to follow 4 simple practices:

1.      Breastfeeding mothers are always welcome and respected. They will never be treated poorly, asked to stop breastfeeding, or asked to cover up or move.
2.      All lactating employees are allowed breaks to express milk or nurse their children, and access to a private space for expressing milk or nursing that is not a bathroom. The space is lockable and shielded from view, includes an electrical outlet, and has hand hygiene available
3.      Business does not advertise infant formula or related products.
4.      Business will post the "Breastfeeding Welcome Here" window cling.
WBWC definitely qualified on all counts, and we were excited to join the other local businesses that have signed up - everything from physical therapy to boutiques to optical shops to restaurants! Above is a photo of Kathleen Anderson, from the Carolina Global Breastfeeding Institute at UNC, with our executive director Maureen Darcey and with our new window cling. Do you know other businesses in Carrboro/Chapel Hill that might be interested in signing up? Or do you own a business and want to complete a quick and easy application? You can e-mail klanderson@unc.edu for an application.
Get more information at:
 https://www.facebook.com/BreastfeedingFriendlyCommunities/ - like the page to get updates on businesses that have joined

MILC Moment: Breast Massage for Plugged Ducts and Mastitis

 When you get a plugged duct, it may start as a little lump in the breast. It may feel a little tender, and the skin over it might look more pink or red. If it doesn’t get better, it may get bigger and the congestion may start to spread to other areas of your breast. More of the skin might look red. You might feel body aches or chills, or get a low grade fever. If the congestion still doesn’t go away, you might start feeling worse – like you have the flu, with a high fever. At that point, you should definitely be calling WBWC (or your OB care provider) – “Help! I think I have mastitis!”

A round of antibiotics will usually clear up mastitis pretty quickly. But we like to avoid antibiotics if we can, and of course we like to avoid you getting sick! Could we prevent a bad case of mastitis? Plugged ducts, engorgement, and mastitis can sometimes be treated with just our hands - just by clearing out those congested areas before your breasts get really inflamed. A lot of the suggestions you read online suggest getting behind the plug and forcing it forward. We used to do this too, until we learned new techniques from an IBCLC named Maya Bolman, who teaches LCs about traditional Russian breast massage and hand expression, which can work much better than pumping for a plugged duct.

If you’re getting a plugged duct, or if you feel like your plugged duct is getting worse, check out this video for techniques from Maya on how to massage and hand express to help clear your breasts: https://vimeo.com/65196007

All the WBWC LCs, and many of the midwives and nurses, have been trained on how to do breast massage to help clear plugged ducts and breast congestion. If you feel like a plugged duct is getting worse, and you’re not able to clear it yourself, you can call for an appointment to get some hands-on help. If you believe you are getting mastitis, or have mastitis, you should always call WBWC (or your OB care provider) for care. Do not delay in getting care for mastitis, as it can become more serious if it is not treated. Some cases of mastitis require the use of antibiotics for treatment.

We hope that you never have to deal with plugged ducts, engorgement, or mastitis, but if you do it’s good to know that you have some very good tools to deal with them – your own two hands!

Best,

Your MILC LCs: Rebecca, Ellen, Elley, Nancy, and Deborah