Breastfeeding Month: Hand Expression (commonly forgotten option)

Before Breastfeeding Month is over, I had to write about this since it's commonly ignored, yet important information. Hand Expression is becoming a forgotten art that needs to be reiterated. It's free, the second most gentle form of getting milk out of a lactating mother (first is direct latching), and what more can you ask for!

I have to really love the web/Internet. If only information about breastfeeding was more forthcoming and readily available when I first gave birth to my son. I was alone and pretty much on my own with regards to being able to ensure I had ample milk and finding the right strategy in moving to breastfeed my son, whether it be mixed (for some time) to exclusively breastmilk back in 2010. Information and support were rarer and were quite limited in information.

Searching about Breastmilk Hand Expression is now so many!!?!!! Just see the below reliable sources that I would like to share with readers and friends who ask me about this. Got to love love love the support and education these writers share with all of us!

It's a more efficient (also under-utilized) mode of breastmilk extraction without the requirement of a pump. I've been using this nowadays when I am lazy to bring my pump. I just make sure I have a bottle and I'm good to go!

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Base on Ask Dr. Sears

Hand Expressing Your Milk

The Low-Tech Approach: Hand Expression

Expressing milk by hand works very well for some women. It's a handy skill to have when:

• You are caught somewhere with full breasts and you don't have your baby or a breastpump, you'll be able to relieve breast fullness and avoid problems with engorgement.
• You do not need to express milk regularly.
• Your breasts are more responsive to the skin-to-skin feeling of hand expression than to plastic pump parts.

HERE ARE 6 EASY STEPS TO EXPRESS MILK FROM YOUR BREASTS BY HAND:

1. Position your hand on your breast, with the thumb above and fingers underneath, about an inch to an inch-and-a-half behind the nipple. If your breast were a clock, your thumb would be at 12 o'clock and your fingers at 6 o'clock. Don't cup your breast in your hand. Instead, your thumb and fingers should be directly across the nipple from each other.
   
   
2. Press your thumb and fingers directly back into the breast tissue, towards the wall of your chest. Don't move them further apart. Just press straight back into the breast.
   
   
3. Roll your fingers and thumb forward to squeeze milk out of the milk sinuses, which are located under the areola behind the nipple. Don't slide the thumb or fingers along the skin--this will quickly make you sore.
   
   
4. Repeat this sequence--position, press, roll--until the milk flow ceases. Then move your hand so that the thumb and fingers are positioned at 11 and 5 o'clock and do it again. Use both hands to work your way around one breast, then switch to the other side until you have emptied all of the milk sinuses. As soon as you see milk squirting from your nipple, you know you are compressing the underlying milk sinuses. (This position is also where the baby's gums should be during efficient latch-on.)
   
   
5. The trick to hand expression is discovering where to position your fingers. Experiment until you find the right spot. Having someone show you how is very helpful, too.
   
   
6. Combining hand expression with breast massage can be a very effective way to stimulate the milk ejection reflex. Massage first, then express. Massage again, and repeat the hand-expressing routine.

"When I relaxed, I could pump more milk. A friend who's a dairy farmer told me that cows yield less milk when they're in a bad mood or if milked by a stranger."

HOW TO COLLECT THE MILK

When you hand-express, milk sprays out in all directions.

• If you're expressing just to make your breasts more comfortable, you can lean over a sink or express into a towel.
• If you want to save the milk, you'll need something in which to collect it. Some mothers manage to aim the nipple directly into a baby bottle. Or, try a container with a wider mouth, like a coffee cup or a small jar. As the cup fills up, transfer the milk to a storage container.
  
  
• TIP: I use the funnel cones (from breast pumps) for hand expression that collects the milk and channels it down into a standard baby bottle --> I no longer use this since I basically do the above which makes it easier.
  
  

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Based on KellyMom.com

Links: Milk expression tips & pump information
July 28, 2011. Posted in: Pumping issues

• More Sharing Services
• Manual/hand expression of milk
• Pumping tips
• Choosing a breastpump
• Used Breastpumps
• Breastpump comparisons and reviews
• Breastpump troubleshooting and repair
• Breastpump Manufacturers
• Insurance reimbursement for lactation services, pumps & other supplies

Manual/hand expression of milk

• Hand Expression of Breastmilk – a great video from the Stanford School of Medicine Newborn Nursery at LPCH
• Expressing Breastmilk from Breastfeeding.com.
• Manual Expression of Breastmilk: Marmet Technique
• The Knack of Hand Expression by Linda Smith, BSE, FACCE, IBCLC
• Making It Work: Hand-Expression from the LLL website

Breast Massage: Therapheutic Breast Massage referred by Maya Bolman IBCLC


HAPPY BREASTFEEDING MONTH!!!

PIA News Feature: 10 steps to successful breastfeeding

By: Joelyn G. Baluyut - See more here.

SAN FERNANDO CITY, Pampanga, Aug 16 (PIA) -- Breastfeeding is still the best for babies and here’s 10 baby-friendly steps to successfully feed baby.
Department of Health Medical Specialist Dr. Lailani Mangulabnan said that breast milk is the best food since it contains essential nutrients completely suitable for the infant's needs. Because of its importance to the baby, government had created Republic Act No. 10028 or the Expanded Breastfeeding Promotion Act to enable mother to feed her baby. And to attain successful breastfeeding, Dr. Mangulabnan has cited these steps that can help local government units (LGUs) in particular, to fully implement breastfeeding.

First, it must have a written breastfeeding policy communicated to all health care staff; second, it must train all health care staff in skills necessary to implement this policy;third, inform all pregnant women about the benefits and management of breastfeeding; fourth, help mothers initiate breastfeeding within an hour of birth.

Fifth, LGUs must show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants; sixth, give newborn infants no food or drink other than breast milk, unless medically indicated; seventh, practice "rooming in"— allow mothers and infants to remain together 24 hours a day; eighth, encourage breastfeeding on demand; ninth, give no pacifiers or artificial nipples to breastfeeding infants; and tenth, foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

Mangulabnan said breastfeeding is, “The best bonding moment of a mother and a baby.” Consequently, it helps in building a stronger relationship between mother and child, and it has physiological, psychological, and financial benefits to mothers.

Breastfeeding promotes uterine involution, decreases risk of postpartum hemorrhage and increases period of postpartum anovulation, and decreases the risk of breast cancer, ovarian cancer and hip and bone fractures. (CLJD/JGB-PIA3)

Smart Parenting Feature: 19 of the Best Breastfeeding / Nursing Stations in Metro Manila

By Jazer Basan | 16 August 2013
Article is featured here. [Note: I was able to contribute for #5!]

Out with your baby and you need to nurse? Head on to these breastfeeding-friendly locations.

In March 2010, the Expanded Breastfeeding Promotion Act of 2009 was signed into a law. Also known as Republic Act 10028, it required all establishments or institutions to have lactation stations, or nursing stations, which would provide privacy to mothers who need to feed their babies while they’re out. Since then, nursing stations have been set up in malls, airports, and workplaces in compliance to this requirement. At present, however, supermarkets, restaurants, bus stations and other public facilities are yet to catch up with this ordinance.

Republic Act 10028 requires lactation stations to be equipped with a sink for hand washing, a cooling facility such as a refrigerator to store expressed milk, electrical outlets for breast pumps, a small table, and comfortable seats. Many breastfeeding stations in malls even went beyond these requirements to make breastfeeding comfortable and relaxing for moms. Let's take a look at some of the breastfeeding stations around Metro Manila, and what moms have to say about them.

1. SM Megamall
Location: Lower ground floor of Building A (near the food court and exit to Bank Drive). Its entrance is through the mall's clinic.
Facilities: a sofa, side tables, and a changing table.
Note: SM Megamall is the first mall in the country to put up a breastfeeding station in 2006.

"Their lounge has been useful to me because we frequent this mall. Their seats are comfortable and amenities are okay. Having it beside the clinic is an advantage in case I need medical assistance for myself or my baby."
- Ludy Adrao, Senior Accounting Analyst, mom to Lyka, 9 years old and John Louie, 3 years old

2. SM Mall Of Asia

Location: Inside the mall clinic, at the far end of the 2nd floor on the Southside, Entertainment Mall, fronting Cosmic Kids.
Facilities: a sink, changing table, electrical outlets, and cushioned seats.

"Their nursing station is clean and well-equipped."
- Mercy Yu-Lim

3. SM Cubao
Location: Inside the Department Store, near Cashier 21 and Baby Co.
Facilities: cushioned seats with armrests, sink, electrical outlets

4. SM North EDSA

Location: Lower ground floor of City Center, near the food court.
Facilities: cushioned seats with armrests, sink, electrical outlet.

5. SM Centerpoint Sta. Mesa
Location: Ground floor inside the clinic, near SM Appliance Center
Facilities: electrical outlet, changing table, 1-seater sofas, easy access to the restroom
Note: Only mother and baby are allowed inside for the duration of the feeding.

6. Greenbelt 5 Family Lounge
Greenbelt 5’s Family Lounge was styled by renowned Filipino designer Ito Kish

Location: 4th floor, Greenbelt 5.
Facilities: Private area for breastfeeding, nursing chair with footstool
Lounge Amenities: kids’ play area, tree design bookshelf, a business lounge, computer area with wifi, and restroom with changing table.
Note: Use of the family lounge requires an Amore or VIPinoy card but the use of the nursing area is free.

"I find the couch and lighting sufficient. The curtain provides privacy to nursing mothers but lounge users could mistake the nursing area as another washroom. There's also an electrical outlet for pumps."
- Cheryl Chan-Wong, 35, stay-at-home mom, Mandaluyong City

7. Glorietta Family Lounge

Location: Glorietta 4, 3rd floor near the Food Court
Facilities: 2 private nursing cubicles, each with an electrical outlet, cushioned single arm chair, cushioned stool. The restroom is adjacent to the Nursing Room. There is a changing table in the restroom. The lounge has a play area for kids and a mobile phone charging area.
Note: Nursing are free to use the nursing station. The lounge can be used for free by VIPinoy & Amore cardholders.

8. Trinoma

Trinoma boasts of a spacious breastfeeding room with space for strollers. With dim, relaxing light and cool ventilation, it calms both Mommy and baby for that bonding moment.
Location: Level 3 beside Sony Square
Facilities: sink, changing table, electric outlet, private cubicles
Lounge Amenities: kids’ play area, wifi, lounge, TV, charging station, restrooms
Note: Use of the family lounge requires an Amore or VIPinoy card but the use of the nursing area is free.

"The only thing I was expecting to see in a breastfeeding station is a couch, sink or refrigerator. When we got to the lounge, I was really surprised because it was way, way, way, way beyond my expectations."
- Eva Gozon, nurse and work-at-home mommy to Carlos

9. Market Market

Location: 2nd floor, inside the family lounge.
Facilities: cozy interiors, cushioned seats with armrests, side table with lampshade, changing table, sink
Note: Free use for nursing mothers. The lounge is for the exclusive use of Amore and VIPinoy cardholders.

10. Robinson's Galleria
Location: 3rd floor, East Wing, near Mothercare
Facilities: sofa, changing table, sink

"I actually don't need to use breastfeeding rooms because I use a nursing cover but I did check out the one at Robinson's Galleria. The hallway leading up to it was cheery and bright. The basics are there -- couch, sink, and changing table. It was okay but a bit cramped. "
- Bessie Colet Campillo, Enterpreneur/Owner of Nursingmom shop , mom to Amara and Adriana

11. Robinson's Place Manila
Location: 3rd floor of Pedro Gil Wing, near the Security Office and David's Salon.
Facilities: 2-seater couch with an elevated center partition that can be used as a changing table.

12. Rustan's Shangri-la Mall EDSA
Location: 2nd floor, infants' section
Facilities: Pretty interiors, 4 armchairs, changing table, high chair, side table

"The best breastfeeding station for me would be at Rustans Shangri-la. The walls are designed with cute fairy decors, it has a  clean and sturdy changing table, comfy seats with pllows, cushioned flooring and bean bags for kids. Use of this nursing station is free."
- Raquel Chua, 33, full time mommy to Saffron 2 y/o.

13. Rustan's Makati

Location: 3rd floor infants' section.
Facilities: cozy interiors, couches, crib that can be used as changing table, side tables and a few toys.

"It looks very new. There are cute stickers on the wall. I loved that they really took time to design it. There was a changing table, the couches were really comfortable with lots of pillows."
- Ginger Palma Arboleda, 32 from Taguig, mompreneur and blogger

14. Rustan's Alabang Town Center

Location: 1st floor, infants’ section
Facilities: couch, changing tables, toys, electric outlet, easy access to restroom.

"The Rustans breastfeeding station in ATC is spacious and comfortable. They don't have a sink inside the room but bathroom is just a few meters away."
- Ysabelle Lorenzo

15. Shangri-la Plaza, EDSA
Location: Level 2, near Crossings Ramp and Planet Sports
Facilities: cushioned chairs with arm rests and pillows, refrigerator, water heater, microvawe oven, hand dryer, changing tables, electrical outlets

"Among the nursing stations that I have been to, Shangri-la Plaza Mall is the best. It is complete with amenities for moms who pump and feed directly. Now that I have switched to cloth diapers full-time, having a wash basin nearby is very helpful which Shangri-la has also kindly provided. In the many times that I have been there, there is always someone who is ready to assist, even just to open the door for you. And the place is always kept clean. It is also beside a ladies' toilet if you need to use one. "
- Smiley Bernardo, 31, QC, full-time mommy to Caitlin, 2, and Olivia, 1.

16. Eastwood
Location: 3rd floor, between Babyland and Toys R Us.
Facilities: sink, changing table, cushioned seats with curtain partitions. There are also visuals on proper breastfeeding, and magazines

"Eastwood is one of my favorite malls because of its nursing station. They have 2 curtain-covered stalls and cozy chairs with pillows, unlike others that are open. In my experience, when my baby sees other babies in the room, she gets distracted and wants to play with them instead. "
- Jennifer Baradas-Bringas, mom to Dagny

17. Lucky China Town
Location: 3rd floor, near the pay bathroom, between My Phone and Cherry Mobile.
Facilities: plenty of seats, sink, side table, changing table and TV.

18. Mothercare Bonifacio High Street

Location: In-store, Bonifacio High Street Taguig
Facilities: sofa, sink, changing table, reading materials

"I love the double stations, the safety bars and the big mirror! My little one likes looking at his reflection while I change his diaper. The friendly staff are also always ready to assist."
- Jelyn Parian-Panol, mom to Ethan

19. NAIA Terminal 1

Location: Departure gate after final X-ray, near gate 16
Facilities: electrical outlet, changing table, private cubicles with doors, hot and cold water, long sofa, tissue dispenser and hand sanitizer
Note: Open 24 hours for departing and arriving passengers.

"What’s great about the NAIA feeding station? It’s airconditioned, with 4 cubicles, cots and comfortable chairs. It comes with amenities like hand sanitizers, a water dispenser, bottle warmer and first-aid supplies, and is located right across Duty Free."
- Jenny Ong, mom and breastfeeding advocate behind Chronicles of a Nursing Mom


Sources:
Breastfeeding Pinays
http://www.gov.ph/2010/03/16/republic-act-no-10028/
http://www.unicef.org/philippines/mediacentre_9539.html
http://125.60.203.88/miaa/
http://www.chroniclesofanursingmom.com/
http://www.everydaymommydiary.com/
http://gojackiego.com/
http://kish.ph/
https://www.facebook.com/nursingmom
http://lhenglang.blogspot.com/2009/08/breastfeeding-station.html

Photo credits (used with permission):
Jenny Ong for album access
Jackie Go - Glorietta
Ito Kish - Greenbelt 5
Bessie Colet Campillo of Nursing Mom - Robinson's Galleria
Eva Gozon and Precious Quintos - Trinoma
Germaine Angeles - Robinsons Ermita
Jennifer Baradas-Bringas - SM Cubao photos
Michelle Esteban - NAIA photos
Jelyn Parian-Panol - Mothercare
Megaworld Malls Marketing Communications Team - Eastwood and Lucky Chinatown
Rustans Commercial Corporation - Marketing Communications Department
Shangri-la Plaza Marketing Communications Department
Thumbnail image from babies411.com

Breastfeeding Questions: Is my baby eating enough? Can I give water to my newborn?

I bumped into this information that I really believe this to be very important. I'm crediting the author and posting this a whole below. It's a reminder to all mothers that we are all what our babies need with regards to their sustenance, most especially from newborn up who "feed on demand".

The post below is from Katie Wickham RN BScN IBCLC of Babiesfirstlactation.com.  They have a facebook page here that you can follow. I encourage you read it to further help you build your confidence and take out any doubt that your baby is not getting enough milk.

Is my baby eating/getting enough milk?"I see many new families in the hospital, as a staff Lactation Consultant, and in their homes, with my private practice, and I hear many similar questions.  One of the recurring themes comes across in statements like “my baby can’t be getting very much” or “my baby is feeding so frequently, I must not have milk. This cannot be normal!”  There are many charts on the Internet that show an illustration of the size of a newborn’s stomach, I felt putting these illustrations into real world sizes we can see would be helpful.

Below is an illustration I have created showing the approximate size and volume of a newborn’s stomach on day one, day three, at one week, and at one month.  Newborns’ tummies are tiny, and cannot/should not take in large volumes, so they need to feed frequently.  In the first day or two, their little tummy fills with 5-15 ml during a breastfeed, and then, snuggled in close to your warm chest and familiar heartbeat, they fall asleep.  Just as you may be drifting off to sleep or decide that you too should eat something, they start to wake up and show signs of hunger; their sweet little fists fly frantically to their mouth and their lips start smacking together.  Their little tummies have started to digest that perfect amount of colostrum, and they are starting to get hungry again.  A newborn baby feeds 8-12 times in 24 hours, which means they will be feeding about every 1-3 hours.  They often cluster feeds together; this means your precious little one may breastfeed for 45 minutes then fall asleep, then wake 30 minutes later and feed for another 30 minutes, and fall asleep.  The next feed may happen 2 hours later, then 3 hours after that, then an hour later… I’m sure you get the idea; there is no set schedule.

Many families feel the need to supplement their baby; maybe they are concerned with the frequent feedings, or feeling pressured from their doctor or family.  I often hear my clients comment that they hear their well-meaning family members say “The baby is crying again, she must be hungry” or “The baby is fussing, are you sure you have milk?” or “the baby just ate an hour ago, you must not have enough if he is hungry already.”  This can create, or further feed the insecurity a new mother may already be feeling, and often leads to unnecessary supplementation.  Some families feel they need to supplement due to pressure from the Doctor, and other families are supplementing for legitimate medical reasons.  When you are supplementing it is crucial that you keep in mind how small those little tummies are.  If you supplement too much this will cause baby to sleep longer and feed less frequently and any time they are supplemented away from the breast you losing the stimulation  and removal of milk needed to signal your body to make more milk; this will directly impact your milk supply.  If you are supplementing always seek guidance from an expert in feeding- a board certified lactation consultant (IBCLC) will help guide you through how to supplement and how to wean the supplements when the time is right.

Understanding the size of your Baby’s stomach, the average volume taken in during a breastfeed and typical newborn feeding frequency can help alleviate some anxiety a mother feels when she is trusting her body to nourish her child.  Newborns are only this tiny for a short time, those stomachs grow quickly and they get more efficient at breastfeeding which means breastfeeding sessions become less frequent and shorter.  For now enjoy those snuggles, and feel encouraged that your baby is feeding frequently and doing a fantastic job of “demanding” a healthy supply of breast milk.  The great effort you and your baby put in during the first few days establishes a solid start for a happy and healthy breastfeeding relationship."

 ~ Katie Wickham RN BScN IBCLC

Can I give water to my newborn child?

No, newborns are not advised to give your newborn water. Even when a mother's milk supply is just coming in during the first few days after delivery, the baby is getting colostrum, which is enough to keep her well hydrated. Water can interfere with a young baby's ability to absorb the nutrients in breast milk and may prevent her from feeding as much as she should. Most importantly, it can also cause water intoxication, a serious condition that happens when too much water dilutes the concentration of sodium in the body, upsetting the electrolyte balance and causing tissues to swell. It's uncommon but serious, potentially causing seizures and even a coma.
~ reference KellyMom

It's N@W or Never: Breastfeed Your Child - A Photo Exhibit

In line with another breastfeeding month events around town that I was able and honored to join is a photo exhibit titled "It's N@W or Never! Breastfeed Your Child".  For more information about the exhibit, kindly read the below.

The Office of Senator Pia Cayetano , together with Newlyweds@Work, proudly present this breastfeeding exhibit entitled “It’s N@W or Never: Breastfeed your Child”. The entire month of August has been designated as Breastfeeding Awareness Month under Republic Act No. 10028, or the Expanded Breastfeeding Promotion Act of 2009. This year’s theme is "Breastfeeding Support: Close to Mothers."

Newlyweds@Work (or N@W) is an online community/support group for Filipino couples on marriage, pregnancy, parenting, family life home improvement. N@W has also become a lifeline for new moms, especially regarding breastfeeding. The exhibit showcases N@Wies who breastfeed their children and provide breastfeeding support to their fellow N@Wies. These photographs were originally intended as personal keepsakes of each mom on their breastfeeding journey. The N@W community is honored to share these to a wider audience.

Blogger Jenny Ong of Chronicles of a Nursing Mom shares how N@W patched her up with breastfeeding supporters that eventually led to a successful breastfeeding relationship with her firstborn. N@W co-founder Benz Co-Rana likewise achieved breastfeeding success with the help of several N@W breastfeeding counselors. Jenny and Benz are just two of the growing number of N@Wie moms who opt to breastfeed their children despite the 21st century challenges that come with it.

This project is a collaboration between Stanley Ong Photography and LIFE at Imagine Nation Photography. Since 2008, Stanley has taken yearly breastfeeding photographs in support of the breastfeeding advocacy and his breastfeeding photographs have been exhibited in several locations. Despite being a male photographer, he has photographed almost 100 breastfeeding mothers.

Imagine Nation Photography is a team of young and creative photographers in pursuit of excellence and perfection in their field
because of their huge love for Jesus. It has been a known brand in wedding photography for 10 years. For family celebrations, victories, and bite-sized milestones, the team brings LIFE– its fresh new name for family, portrait, and lifestyle photography.

More updates and photos soon! For now, please check out the poster and a sneak peek of the exhibit.

 

Poster Credit:  Oj of The Pretty Palette by OJ for our Poster Design;

Mec Arevalo for the title

Sneak Peek Credit:  Chronicles of a Nursing Mom

Hakab Na 2013 ("Latch On 2013): A Breastfeeding Mob

Hi!

I am slowly moving to Wordpress to better suit the growing needs of this blog so kindly click on the link below for the details of this entry.  Enjoy!

https://multitaskingdoula.wordpress.com/2013/08/10/hakab-na-2013-latch-on-2013/

DIY Superhero Baby Shower

I'm doing some catch-up postings and I really wanted to post this DIY project I did for a friend's Superheros baby shower theme. When the date and theme was settled, I jumped into google and searched through as many inspiration and DIY projects as they come to pull off a good Superheros-themed baby shower.


I made a simple superhero (modern chibi take) invite to give a flavor to the party theme and the sky was the limit on creativity for this. The tags were also fun to make!

I thought of initially decorating their nursery to help the newbie parents before their bundle of joy arrived but due to time and location constraints (the room was still not ready to be decorated by the time the party rolled in) so I chose decoration where they can be displayed at the party and can be easily put up at their home or used by their little one when he comes out in May.
The very first thing that came into my mind that would look great in their nursery is the initials of their baby boy - "J" and "N", a DIY comic book covered letters and took inspiration and instruction from Bird's Party Blog and Cherish Bliss. I wasn't able to get wooden letters or know where similar items were sold so I did it via styrofoam and cut out the letters then wrapped used/old comic books around it. It was tough to fully cover a styrofoam letter since the surface was not flat compared to a wooden or cardboard letter but it will have to do. I was able to do thicker lettering than the normal wooden one, which came out quite nice. :)
I then bought some picture frames that would have cute baby chibi superheroes in them. The stuffed toys plaster on the windows are from a local stuff toy vendor.

For the banner, I got the idea for the comics and bib & onesies banners at Thriftress and PampersPlaydatesParties. I was able to find/source old action figurines & kiddie toys at a thrift store and loot bags had the same superhero theme in it.

It was a definite labor of love to see the expressions on the new parent's faces when they saw the whole place. Happy partying!!!