What's Inside

• Everything You Should Know About Breast Pumps

  • Before you have the baby

  • 1-4 days after baby is born

  • 4 days - 2 weeks after baby is born

  • 2+ weeks - to the rest of maternity leave

  • When you’re back at work

• Fact Or Fiction: Breast Size = Milk Production

• What I’m Seeing at Work: Concussion Season

• Money-Saving Tip: Cradle Cap Savings

• WWWD: Swimmer’s Ear

• Recalls & Alerts: Bikes

• Funny Things: Weird Cake Flavor

Everything You Should Know About Breast Pumps

It’s Breastfeeding Awareness Week. Tons of great information out there about the benefits of breastfeeding, why it’s so good for your baby, etc. But some of the questions I get asked most often are about pumping.

Lots of us are working moms or have other activities that take us away from our baby for hours at a time. A breast pump can be a lactating woman’s best friend. Like your cell phone, you simply don’t leave home without it.

I remember, one morning with my last baby, I was in a rush to get kids dropped off to school and make it on time to work.

Going home would put me way behind (and running behind drives me crazy), but the prospect of not pumping all day is like being told you can’t go to the bathroom all day. You know at some point soon your boobs are going to start killing.

Pumping for your baby while working is a lot of work (and sometimes filled with mishaps), but the benefits for your baby are huge. So, for all the moms out there who may be away from their baby for more than a couple of hours at some point—probably all of you, this post is for you.

Before you have the baby

1. Get the pump. If you’re serious about pumping when you go back to work, you must have a good double-electric pump. If you’re going to try and have your insurance cover it, work on the details BEFORE the baby comes (the delay can take weeks).

2. Figure out how it works BEFORE the baby comes. When your boobs are sore and you’re exhausted is not the time to be trying to make sense of the instructions. (The pic of my pump is typical of most pumps; the milk goes through the funnel like cup directly into the bottles, never going through the long tubing).

1-4 days after baby is born

1. If the baby nurses well do NOT pump those first few days. Just allow the baby to stimulate/drive your milk production. Besides, in the beginning, your baby should be feeding every 1-3 hours. You won’t really have extra time or milk to pump.

2. If the baby does NOT nurse well, then pump every 1-3 hours. Always pump AFTER breastfeeding your baby and make sure you get lactation help/support. Don’t allow those first few days to pass without giving your breasts appropriate amounts of stimulation. Milk production is completely a supply and demand thing. If there isn’t enough stimulation, your body simply won’t make milk later. Make sure you consult with your pediatrician about appropriate amounts of feeding for your newborn if breastfeeding isn’t going well.

3. Pump right away if your baby isn’t able to feed. There are lots of situations where your baby may be unable to breastfeed initially (e.g., your baby is premature, sick, or has a problem). Again, you’ll need to artificially create the demand for the supply to be there. You will need to pump as often as your baby would feed, if he/she were able.

4 days - 2 weeks after baby is born

1. Pump to increase supply and for relief. Hopefully, your milk is well established at this point and your baby feeds frequently. When you plan on going back to work, getting a really robust milk supply is important (because pumping at work and maintaining milk can be difficult). Having more milk than your baby initially needs is ideal for a working mom. Pump occasionally between feeds (right after breastfeeding is ideal) to relieve pressure and help build milk supply.

2. Introduce a bottle. Once your baby is a good breastfeeder (can latch within 5 seconds and stay feeding), introduce a bottle. Don’t be afraid of “nipple confusion.” If you’re going to be going back to work, you need your baby to be able to take a bottle. Introducing it early, can save a lot of grief later. Have dad (or anyone besides the breastfeeding mom), feed the bottle. Do this once a day to once every few days (just to ensure your infant has the skills to go back and forth between breast and bottle).

2+ weeks - to the rest of maternity leave

1. Pump 1-4 times a day. This is the time to help build a store of frozen milk. Choose a time that is convenient for your life. For me, I find it easiest just before I go to bed and in the morning after I get the other kids off to school (these are the quietest moments at the Wonnacott household). Always feed your baby first; you are essentially pumping off the extra.

2. Get your baby weighed. Typically, after having a baby, you will go to the pediatrician a couple of days post hospital discharge and again when your baby is 2 weeks old. These are great opportunities to ensure your baby is growing well, gaining weight, and getting plenty of milk. All of my suggestions of pumping are dependent on you having enough/extra milk and not taking milk at the expense of your baby’s current needs.

3. Continue giving a bottle. During your entire maternity leave, you will need to continue to give occasional bottles. While directly breastfeeding is often easier, it is important your child learns to be able to go back and forth between breast and bottle.

When you’re back at work

1. Pump at least as often as your baby feeds at home. If your baby feeds every 2 hours, you can’t pump once during lunch in an 8 hour day and hope to maintain your milk supply. In the first few days, you’ll make tons of milk and pump big volumes, but after a short time, your body will stop creating so much milk and start weaning. You have to prevent your body from thinking it’s weaning the baby. Depending on your work environment, this is often easier said than done.

2. Pump for 3 minutes beyond when milk stops flowing. Pumping dry boobs helps stimulate extra milk production and you often get a little extra burst that will come with the extra few minutes of pumping (this is the “hind milk,” which is nutritionally awesome).

3. Coordinate (as much as possible) breastfeeding at the beginning and end of the work day. Typically, I will get fully ready and then breastfeed the baby just before I leave for work. I will also call my sitter just as I’m getting ready to leave work for the day to let her know I’m on my way home to feed the baby. That way, she can calm the baby without giving a bottle and then I can breastfeed the baby right when I get home. This approach saves me a couple of times of pumping, helps maintain breastfeeding, and encourages bonding. In complete disclosure, this is easier said than done (especially if you have more children and the other children have increasing needs).

Pumping for your baby when you go back to work is time consuming. Rotating milk, storing milk, finding places to pump, and learning all the ins and outs to safe storage and usage, etc., is difficult at best. But so much of what we do for our children is not what is easiest, but best for our children. Hang in there. Every ounce you can give your baby (even if it isn’t exclusively breast milk) is good for your baby.

Fact Or Fiction: Breast Size = Milk Production

A friend told you that smaller boobs produce less milk, so your baby may not be getting enough milk. Is that true?

FALSE

A woman’s breast size has nothing to do with how much milk they produce. Big breasts don’t equal tons of milk. Small breasts don’t equal too little milk.

It’s that simple.

Fear not and put this rumor to rest.

What I’m Seeing at Work: Concussion Season

Summer in pediatrics means an increase in accidents. This week, I’ve had an unusually high number of patients who have fallen off things (bikes, trampolines, counters, etc.) and hit their heads resulting in concussions. So, here’s a quick reminder on concussions.

Simply put, a concussion is a brain injury that temporarily disrupts brain function. A concussion results from a forceful blow to the head or body that results in rapid movement of the head (essentially shaking the brain in the skull). Any activity that results in a smack to the head (e.g., falls, sports, car accidents) can cause a concussion. It will cause a change in behavior, thinking, or physical functioning.

Typical signs and symptoms of a concussion:

1. Headache

2. Nausea or Vomiting

3. Balance problems or dizziness

4. Slow to answer questions or follow instructions

5. Confusion or trouble concentrating (may even have trouble recalling the events before or after the injury)

6. Sleep disturbances

As a parent, one of the most difficult calls is when to worry and seek medical help. If your child exhibits any of the following signs, you should seek immediate medical care (it may be something more serious).

When to worry:

1. Worsening of any of the above symptoms (e.g., with time the head is hurting more or repeated bouts of vomiting).

2. Weakness or numbness

3. Slurred speech

4. Unequal pupils (the black parts in the eyes are not the same size)

5. Seizures or convulsions

6. Any loss of consciousness

7. Drowsy or difficult to arouse

8. Inconsolable or won’t eat (infants)

9. Any usual behavior

While treatment is tailored to the individual situation and severity, concussions are generally treated by cutting back on physical and mental activities. Just like you’d give any other injured body part a chance to rest, recover, and heal, the brain needs the same recovery.

Money-Saving Tip: Cradle Cap Savings

Cradle cap can be treated with the over-the-counter shampoo Selsun Blue. Cheaper still, buy the store brand equivalent next to it (the active ingredient is selenium sulfide). Use it by scrubbing the shampoo on the head, leave the suds on for 5 mins, and then rinse off. After you get the infant out of the tub, use a hypoallergic thick lotion or cream on the scalp. Use the shampoo every day or every other day until resolved (which typically takes 1-2 weeks).

COST SAVINGS: $132 (average office visit cost)

WWWD: Swimmer’s Ear

I often joke that if it weren’t for my profession, we’d be at the doctor’s office weekly with one of our four kids. I use my skills at home all the time. Here, I’ll share a recent example from home and how I handled it, including the products I used. This isn’t an advertisement—I don’t have any financial interest in these products. I simply have parents ask me all the time about what to do in certain situations and the products I use.

This is one where being a doctor saved me a trip to the office. I had my otoscope at home, took a peek, and confirmed the suspected diagnosis of otitis externa. The ear canal was red and swollen. I put 5 antibiotic drops in her ear, sent her to bed, and problem solved. (She’ll continue the drops twice daily for 7 days). Specifically, I used prescription Ciprofloxacin Ophthalmic drops since that is what I had on hand—more on that in the Pro Tip below.

If you suspect an ear infection, you’re going to have to go into the doctor’s office. The money savings comes in addressing it early (don’t wait a week where you may experience more costly complications) and going to the office instead of the ER.

Because it was an infection of the outer ear canal (otitis externa), I could treat it with an antibiotic drop alone. Note: Swimming is the most common cause of otitis externa. If it was an infection of the middle ear (otitis media), I would have used an oral antibiotic. This is because the ear drum prevents a drop from getting to the infection (the exception is kids who have ear tubes or a ruptured ear drum). Also Note: Runny noses/colds are the most common cause of otitis media.

Recalls & Alerts: Bikes

Funny Things: Weird Cake Flavor

I had a cute little 4 year-old in my clinic who had just celebrated a birthday. I asked all about her party and cake, and then asked:

Me: What’s your favorite flavor of cake?

Patient: Chicken-Ella!

Not sure what that cake flavor is, but I think I’ll pass. 🤣 

Legal Disclaimer: The information provided in this article is for educational and informational purposes only. It is not intended as a substitute for professional advice or medical treatment. Always seek the advice of your physician or qualified healthcare provider with any questions you may have regarding a medical condition or the health and welfare of your child. We do not endorse any specific products or brands mentioned in this article. Readers are encouraged to perform their own research and consult with appropriate professionals before making any decisions based on the information provided herein.