Tips for Breastfeeding Success (from a mom who learned the hard way)

*I have had a couple of friends say they've sent my post to several women, and saying I should get paid for this post 😆 Honestly, I just want other moms to have a better experience than I had. Sifting through all the info in the newborn fog was SO hard. So I'm genuinely happy to compile all this and update it periodically if it will help anyone have a better experience than I had. BUT if you found this helpful at all and would like to buy me a coffee, my Venmo is @janaeandmatthew (thank you!). Don't feel obligated. This post exists for free on my personal page for a reason. Thanks for reading and thanks for sharing!*

So, you're either here because you know my breastfeeding struggle the last 15 weeks, because you're expecting and I want you to be more prepared than I was, or because you are trying to see if you've missed anything worth trying in your own struggle.

Let me just say right off the bat that we all have different capacities. We all have different levels of support. We all have different energy levels. We all have different demands on our time. And we all get to decide when we're at the end of our rope and done trying. And after the hell I've been through, I judge NO mom for stopping breastfeeding, or for doing formula only. It's hard knowing that breastmilk truly is liquid gold, and the best possible thing our infants can consume, but not having it come as easily and naturally as we hoped it would, whether it's a latching struggle or a supply struggle or something else altogether.

My experience has been heartbreaking. I've been through the ringer, and know that so many women have had it even harder than me! I sat looking at my baby, telling him through tears that I am so very sorry I can't provide enough for him (cue everyone telling you that he doesn't care, but I do!). I have a list in my phone of amazing women who have fed my child with breastmilk. I experimented with six different formulas before I landed on one that he didn't react terribly to. And right as I was building up his tolerance to formula, a long-term donor stepped in.

I've scoured the Internet trying to figure out how to make this work. What else could I try? What worked for other women? Am I fighting a losing battle? Will this ever get better? What's normal supply? Where did I go wrong at the beginning?

And that's where this post comes in. I want to save other moms the trouble before they have any. After a two hour lactation class from an IBCLC, and after repeatedly studying her slides, I was not prepared at ALL for the struggles I would face. (If you'd like more details about those struggles, please go here for part one and go here for part two.)

I'm posting this imperfectly and probably will be back many times to edit it. If you know an expecting mom or if you know someone struggling with breastfeeding, maybe something in here can help. Please feel free to share this far and wide. I've organized it in the way that makes the most sense to my brain.

If you need some solidarity and support, please feel free to reach out to me on Facebook, or Instagram @fitwithjanae. I'd be happy to be your sounding board and your shoulder to cry on. Wherever you're at in your journey, my heart is with you. It breaks with you. I cry with you. You're not alone.

On Being Prepared

Take an extensive and thorough breastfeeding class. NOT a 2 hour hospital offered class. One 2-3 hour sitting is not enough.

I've purchased and briefly glossed over The Thompson Method and hope to be able to implement it with my next baby. It flies in the face of a lot of common IBCLC teachings, emphasizing facial symmetry, fine tuning, and trusting the baby's instincts to prevent nipple trauma. Explore their Instagram page, and join their free Facebook group.
There's The Boob School by @thebalancedboob
I cannot vouch for any of these in thoroughness or quality, but there's a list of online classes here: https://www.verywellfamily.com/best-online-breastfeeding-classes-5074435

Have an IBCLC picked out before delivery.

Make sure they size you for flanges (or use Legendairy's sizing service)
Make sure they watch you pump and teach you the ins and outs of your pump
See if your insurance covers lactation support (Utah folks: SelectHealth doesn't, but you may be able to go through your OB/GYN, pediatrician, or see if Intermountain has outpatient support near you)

Collect and freeze colostrum before baby comes. (This will require you to learn hand expression)

See pinned posts from @bemybreastfriend about this

Express into a medicine cup and suck up with sterile syringes
Start collecting after 38 weeks of pregnancy usually
Helpful reel from @heysleepybaby: https://www.instagram.com/reel/Cj-0l2apmWn/

Learn hand expression and do it ONE HOUR after birth, then for 5 minutes 5 times a day in the first three days (or more) postpartum. This is key!

Hand expression is more effective than a pump in those first few days, and safeguards your supply if baby isn't effective or latching well
Here's a good how-to post from Lactation Link
@thebalancedboob and @go_milkyourself are good accounts emphasizing hand expression
@mommy.labornurse posted a reel on August 3, 2022 that's helpful as well: find it here
It takes practice. Hang in there.

Thyroid and hormonal balance are vital; milk supply is driven by hormones primarily (prolactin). Make a game plan with your doctor to ensure healthy hormone levels for successful breastfeeding.
Order your breast pump ahead of time covered by insurance

You can do this at www.edgeparkbreastpumps.com and www.aeroflowbreastpumps.com

On Baby's Needs

The goal is for baby to be back up to birth weight by two weeks old. 10% weight loss is normal.

If baby loses more, I would suggest that you DON'T panic or let doctors make you panic. This is why you stored colostrum. If you don't want to give formula, advocate for yourself, and consider having some frozen breastmilk from donors on hand just in case.

They should gain 1/2 to 1 ounce daily.

Note: The growth chart commonly used by pediatricians is based on data from FORMULA FED BABIES! Breastfed babies tend to gain weight much more slowly than formula fed babies. Advocate for yourself. If possible, and if you want to avoid formula, supplement with YOUR OWN milk if you're worried about weight gain.

Post here: https://www.instagram.com/p/ClGtPhNMo9A/

Note: The Thompson Method doesn't like these numbers and averages, insisting that every baby's growth curve is unique. Try not to stress too much if your baby has all the right signs of being satisfied and fed.

Learn hunger cues. Feed before you even see the cues. By the time they're crying, they've been hungry for a long time.

Note: The Thompson Method suggests that too frequent feeding can contribute to gastrointestinal upset, and that they may be nursing for comfort because of the GI upset, making the problem worse. So a offering the breast may not ALWAYS be the answer.

Learn satisfaction signs from baby

Good post here: https://www.instagram.com/p/BeUDobmF6g_/

Baby's intake needs change very quickly. By 4 weeks old, they drink about 24-30oz per day on average. The amount they drink doesn't increase after this point. It decreases once they start eating solids (6 months, by the way. Don't let your pediatrician convince you it's 4 months.)
Baby's needs max out around 24-30oz, but your milk composition changes as your baby's needs change, becoming more calorie dense as your baby grows.

On Supplements and Galactagogues

Common food galactagogues are: Oats, brewer's yeast, flaxseed
Common supplements are: Moringa, goat's rue, and blessed thistle.
Legendairy supplements help a lot of women. They're not cheap, but they have a rewards program. They're available at Target. (Pump Princess and Liquid gold helped me a little)

Note: The Thompson Method discourages the use of most supplements, claiming they can affect your baby's GI and change the taste of your milk

Sunflower lecithin can help flow and reduce clogged ducts.
Fenugreek can have the opposite effect in lots of women.

On Nursing

I wish someone had told me that latching would take lots of practice, especially with tongue and lip ties. Be patient with baby and with yourself. Look at it as practice. Try not to get stressed. Remove milk with a pump if your baby isn't removing it effectively.
If you're doing everything right, baby may need body work from craniosacral therapy or a chiropractor. Mobility is important for good latching and comfortable breastfeeding.
Tummy time can be started immediately and is vital for neck strength (important for breastfeeding comfort).
Nipple shields can help baby latch, but they're hard to quit. Do a lot of research about the pros and cons of shields.

See this @legendairymilk post for some considerations

Night time breastmilk has melatonin and other awesome benefits.
Soreness is normal. Pain is not. See an IBCLC.
Provide belly to belly contact for baby. Reclined position is often the best place to start. It also can help to have baby's feet in contact with something so they feel stable and supported.
Learn various nursing positions.

The Thompson Method focuses primarily on symmetry of the cheeks and nose on the breast, and they typically discourage the cross cradle position. Again, this flies in the face of what is commonly taught.

Bottles matter!

IBCLCs recommend paced bottle feeding (if you introduce a bottle).
Note: The Thompson Method recommends simulated feeding instead of paced feeding
Some babies can go back and forth from breast and bottle; others are pickier.
They do make slow feed bottles; stick with those
IBCLC and Thompson Method practitioners recommend Dr. Browns' or other long, narrow teats if you're using a bottle; see this post or this post

Finger feeding, syringe feeding, spoon feeding, or SNS are a good way to supplement if needed, before introducing a bottle.

SNS is often recommended to provide stimulation to the breast to help your supply and help you have that bond, while ensuring baby is fed enough. There is a learning curve. Many people prefer homemade SNS devices to the Medela ones (just search YouTube).

This is what IBCLCs suggest, Thompson Method has other priorities

On Milk Supply

Low supply is a possibility and is more common than people think. Look for signs of IGT before baby comes.

Follow @lowsupplymom on Instagram. She explains the difference between primary and secondary low supply. You may do EVERYTHING RIGHT, and still have low supply.

Producing 1oz of milk per hour is normal. 3-4oz every 3 hours is normal supply.

We are led to believe that higher amounts are normal. Don't feel inadequate when your supply is normal.
Offering 3-4oz breastmilk per feeding in a slow flow bottle is how you can support continued nursing. Offering larger portions will alter their expectations, so when your breast cannot offer 5+oz in a session, baby will prefer the bottle.

Frequent milk removal is more important than duration (most IBCLCS suggest that 10-12 times per 24 hours in the first few weeks; 8-10 later on).

@bemybreastfriend shared a study, and The Thompson Method also indicates, that 7 feedings in 24 hours is usually ideal

Latch every two hours (or more often), before baby is hungry. This will help you practice latching, and help your supply.

Note: Again, The Thompson Method indicates that 7x in 24 hours is usually sufficient

Try to get a 5-6 hour stretch of sleep, but going longer than that can hurt supply in the early days.

Even when baby is sleeping through the night and caught up on weight, you may need to get up after 5-6 hours to pump!
@legendairymilk often does middle of the night removal challenges that may help.

Skin to skin in the first 12 weeks is vital for milk supply. Having baby nearby is vital.
Your milk supply typically regulates after 10-12 weeks. Don't panic when your breasts don't feel as full anymore. Watch your baby's diapers and satisfaction signs.

Mindset, mindset, mindset. The first 12 weeks, look at each feeding as an opportunity to increase supply, even if baby wants to feed every hour. It's exhausting but purposeful.
Milk production (prolactin) is highest in the morning and lower in the evening, which is why babies often want to cluster feed in the evening.

Cluster feeding is more common in the evening when supply is lower.

Milk removal from 2-4am is critical; skipping this can rapidly reduce milk supply. For some women, continuing to pump overnight when baby is sleeping through the night is super important for supply. For others, supply will be fine/maintain even if you sleep through the night.

One of the reasons babies wake at night is for survival; feeding overnight protects your supply!

Before taking any medication, check on the effects of breastfeeding. Decongestants can hurt supply.
Getting sick can hurt your supply; it should come back up with regular emptying.
Menstruation AND ovulation can temporarily affect your supply.
Peppermint and parsley in large amounts can hurt supply.
Hydration can help supply. Many women see a difference with electrolyte drinks like Liquid IV or Body Armor.

To build a freezer stash, the best time to pump is about an hour after your first nursing session in the morning. Supply is highest at that time.
Don't cry over spilled milk (yeah, right). But, you can absorb your spilled milk with a towel and freeze it in a plastic bag to use for milk baths later on.
Power pumping can help women increase supply; one hour a day for a few days (or up to two weeks) will usually show improvement.

On foremilk and hindmilk:

See these helpful posts:

https://www.instagram.com/p/Ch8c6ROr3qH/
https://www.instagram.com/p/CRaLiaILTcq/

On Baby's Oral Function

Oral function is important, with or without tie revision.
Tongue and lip ties are super common, and have contraindications outside of breastfeeding.
A pediatrician is not qualified to assess lip and tongue ties.
Have a pediatric dentist picked out in advance. Ask your insurance if they cover tongue and lip tie revision in your infant. If not, set the money aside in advance.
Exercises may be recommended after a revision.

Chiropractic or other body work may be recommended after a revision.

On Pumping

Get a pump through your insurance if you can.

Spectra S2 is the most commonly recommended by IBCLCs.
Spectra S1 is portable which can be super nice when you have a baby to chase.
"Hospital grade pump" actually isn't really a thing. Some pumps are better than others, but there's no real features or functions that qualify a pump as "hospital grade."
Links are above for AeroFlow and Edgepark breast pumps through insurance

Use the fridge hack (put pump parts in a bag in the fridge until your next pump; wash once daily instead of after each pump)
Learn hand expression and do it for a few minutes between feedings or after pumping. (Legendairy has a great highlight; it will take practice!)
Figure out your pump before baby arrives. Learning to pump effectively is important.

Alternate between expression mode and regular mode
Increase suction throughout your session
Massage and do compressions while you pump; gentle is better so you don't damage breast tissue
Warm compresses can help (Frida Mom makes a heated massager)

Get a pumping bra (or 3-4)! $20 MomCozy gets the job done.
Use pump spray like this one, or food grade coconut oil to lubricate your flanges. Your nips will thank you.
You can hack your nursing bra to make it work for pumping (less comfy, but it's fine).
Figure out your flange size before baby arrives. Flange size can make a huge difference for some women (in either direction). IBCLCs can do fittings, or Legendairy can do them.

Some women really like silicone flanges like LacTeck, Pumpin Pals, or Pumpables (though a friend said hers had problems; and the company never replied).
Use the jar method. Bring fresh milk to fridge temp before combining with already cold milk.
Milk gets stuck in the duckbills. Don't lose those drops when you're emptying your pumped milk.
Replace duckbill valves or membranes depending on how frequently you pump. Pro tip: Get the kind with pull tabs. Post here.

Know that portable/in-bra pumps (Elvie, Willow, etc.) can be less effective at emptying; you may need to pump for a longer time to get the same amount. These pumps can really hurt supply in a first time mom.
Many exclusive pumpers recommend the Baby Buddha for a portable pump.

Follow @bemybreastfriend for her reviews of all the pumps

If pumping after nursing, 10-15 minutes is enough for most moms.
If pumping to replace a session, extend to 20 or more minutes. Some women require up to 30 minutes to fully empty.
It is recommended to pump for at least two letdowns (stay in the massage/expression mode until you feel a letdown, then switch to the regular mode. When flow slows down, switch back to expression mode to get another letdown.)

A letdown is when your milk starts to spray instead of drip. Many women find this to be a tingly or staticky feeling in their nipples. It tends to be incredibly uncomfortable in the first 10-12 weeks while your supply is regulating. It's much more subtle after you've regulated.
Many moms don't feel a letdown while nursing. I never could. But I can see and feel them when I pump!

Get the Haakaa with a lid! Keep Haakaa in a mug so it doesn't fall over.

Haakaa loses suction. Check it frequently.
You can also wrap a lanyard around your neck and the Haakaa so if it falls off it won't spill everywhere
Haakaa ladybug is nice for collecting leaking without emptying your breast before your baby gets to it

For many women, pumping too soon will create oversupply. For others, it will create the necessary demand. I would have pumped sooner, more aggressively, and more often if I had known what my struggle was going to be.

On Life and Commitment

Breastmilk is incredibly beneficial to baby, but so is your mental health and happiness.
Breastfeeding can be both convenient and inconvenient:

You have a food source available at all times (cool!)
The connection you feel with baby is awesome
Easy to put baby back to sleep at night or do dream feeds (no bottle prep or cleaning)
You need to maintain supply, either feeding regularly or pumping regularly (so you need to have pump supplies with you if you're not with baby)
You have to wear easily accessible clothing, be aware of what you're eating, watch what medications you take, how much you're eating, what you're drinking and when. It can be a whole lifestyle change for some. (lots of work)
Baby can be picky and prefer you over anyone else, or not take a bottle if you're in the room (less freedom for mom)

Breastfeeding can be mentally and emotionally taxing. Prepare for it and know it gets easier. Take it a day at a time. There will be hard days. It's OK.

Reminder: Latching takes practice for you and baby
Give yourself permission to take a break from latching (but still remove the milk via pump, and choose the best way to feed that will facilitate nursing, like a spoon, syringe, or cup, or see paced feeding above)
If the stress of breastfeeding is interfering with you enjoying your baby, make a plan with an IBCLC
If you're triple feeding (nursing, pumping, bottle feeding), have an exit plan. This is just a temporary strategy!

Every drop counts, but no drop matters as much as you.

Facebook groups to join:

Low Milk Supply - A Mother's Love
Human Milk for Human Babies Utah
Eats on Feets Utah
Wet Nurses of Utah
Breastfriends & More - Mom & Breastfeeding Support Group

Organizations to follow:

La Leche League

Instagram accounts to follow:

@nourishedyoung
@breezy__babies
@legendairymilk
@kellyibclc
@bemybreastfriend
@thebalancedboob
@lowsupplymom
@lactationlink
@thelactationexpert
@karrie_locher

Checklist of things to help supply:
- Frequent milk removal (8-12x a day) via pump or baby
- Skin to skin
- Galactagogues (oats, flaxseed, brewer's yeast)
- Supplements (Legendairy, Moringa, Blessed Thistle, Goat's Rue)
- Hydration (especially electrolytes or coconut water/Body Armor)
- Make sure you're empty after each feeding
- Power pumping (some see results in a few days, some in two weeks)
- Check pump flange size
- Check for oral ties/restrictions
- Eating enough

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