As you probably know, these days, "breast is best." The American Academy of Pediatrics and leading professional organizations recommend breastfeeding for a baby's first six months, unless there's a medical reason not to do so, without supplementing with water, formula, or juice.
If you want to continue breast-feeding exclusively after that, those groups say all the better. That's because breast milk--custom-made nourishment specially formulated by Mother Nature--offers so many benefits. It boosts your baby's immune system by providing antibodies against illness, promotes brain and vision development and a healthy digestive tract, and may reduce your child's risk of sudden infant death syndrome (SIDS). It may also reduce the risk of some diseases later in life--diabetes, some types of cancer, obesity, high cholesterol, and asthma. Breast milk also changes over time and even during the course of a day to meet the needs of a growing baby. Breast-feeding helps moms to return to their pre-baby weight faster, and may decrease the risk of breast and ovarian cancer, and even osteoporosis.
Breast-feeding is convenient--there are no bottles to prepare and warm--and it's free! There's no formula to buy, which can run you about $170 per month, depending on the type of formula you buy. But unless you plan to take your baby with you wherever you go and the process always goes smoothly, you'll probably need a breast pump. In fact, a pump can be indispensable for nursing mothers in a number of scenarios: You are returning to work and want to continue breast-feeding, you need to formula-feed your baby temporarily for medical reasons but want to resume breast-feeding when you get the go-ahead from your doctor, your baby can't physically breast-feed for whatever reason, or you need to miss a feeding occasionally because you're traveling or otherwise away from your baby.
A breast pump may come in handy during those first few days after you've delivered, when the breasts can become so full that a baby may have trouble latching on. Things can be sailing along in the hospital, but when you get home, supply can outpace demand. The solution is to express some milk with a breast pump--and to have one on hand before your baby is born, so you're ready to go as soon as you return home after delivery. A breast pump also allows you to store milk (in bottles or storage bags) for later, then bottle-feed it to your baby or mix it with a little cereal when she reaches the "solid" food stage at about 6 months.
Refrigerating breast milk
You can refrigerate breast milk safely for 24 hours, or freeze it for three to six months. But when you put breast milk on a shelf and let it sit, the fats may begin to break down and a few of the many other components may begin to change, according to Miriam H. Labbok, M.D., M.P.H., director of the Carolina Breastfeeding Institute at the University of North Carolina at Chapel Hill. So use expressed milk as soon as possible, with the oldest milk first.
A housekeeping note: Always refrigerate expressed milk as soon as possible. When you're away from home, use an insulated container packed with ice or frozen ice packs to keep your breast milk cool. When freezing breast milk, date it when you freeze it and store it in the back of the freezer, not on the door--that's a warm spot that can prompt thawing every time the door is opened. When the time comes to use it, thaw breast milk in warm water. Don't boil or microwave it; both of those heating methods can destroy valuable immunological components that make breast milk the liquid gold it is. Microwaving can also create uneven "hot spots" that can scald a baby's mouth and throat. Finally, don't add fresh breast milk to already frozen or refrigerated milk for storage, and don't refreeze breast milk once it has been defrosted. If you can't use it up, throw it out.
What's on the market
There are several types of breast pumps available--large, hospital-grade pumps, midweight personal-use automatic pumps, small, lightweight, easily portable electric, battery-operated, or manual models that work one breast at a time, and hands-free pumps that strap around your waist, so that you can multitask instead of simply sitting through another pumping session. You'll want a pump that's appropriate to your particular situation. Pumping can be time-consuming and just one more thing to do, but it shouldn't be painful or frustrating. Choosing the right pump can make the difference in breast-feeding success. A baby's natural sucking rhythm is 40 to 60 cycles per minute (one pull per second or a little less). Hospital-grade and personal-use automatic pumps typically operate at 30 to 50 cycles per minute. Other pumps are usually less efficient. As a general rule, the more suction and releases per minute a pump provides, the better it will be at stimulating your milk supply. Consider this: Breast milk naturally changes during each feeding in conjunction with a baby's swallowing technique and suction. In the beginning of a breast-feeding session, breast milk is thin and watery. In the middle, it gets fattier, becoming whole milk. Toward the end, it's even creamier, Labbok said. The fat is healthful; it contributes to satiety, among other benefits. Ideally, you'll want a pump that mimics a baby's natural sucking action. Efficiency is important if you plan to save a large quantity of milk. If you're returning to work, for example, you'll need to have much more breast milk on hand than if you stay home with your baby or are supplementing breast milk with formula.
Once you find the right pump, you'll need to learn how to position it correctly and adjust the suctioning to get the best results. Don't worry--with the right pump, you'll soon get the hang of it. Pumps require some assembling and disassembling for cleaning. Use the dishwasher or hot soapy water to clean any parts of the pump that touch your breasts or the milk containers. Drain them dry before each use.
Consider renting a hospital-grade breast pump if you're not sure how long you'll need to use a pump or if you know you'll need to pump for only a short time and you plan to be home with your baby. If you expect to use a breast pump regularly, especially if you plan to return to work, buy a top-quality midweight, personal-use, automatic model at the best price you can find. This caliber of pump will help you to get a significant volume of milk in a given time and will be your best bet for maintaining your milk supply. If you plan to use a breast pump only occasionally, a manual pump or a small electric or battery-operated one will probably be all you need.
Because using a breast pump can be tricky, most manufacturers now supply informational brochures with their units. You also can call manufacturers' customer-service lines if you encounter problems with a specific pump. Your pump may have a warranty that allows repair or replacement. Check the terms before you buy because they vary. Keep your receipt or the printout from your baby registry as proof of purchase.
There's a host of information on the Internet about breast-feeding in general and specific guidance on such issues as how to get into a pumping routine after you return to work. The La Leche League, at www.llli.org, is a good place to start. This website offers a mother-to-mother forum, an online community of other mothers to whom you can turn for ideas on how to overcome breast-feeding obstacles, answers to your most-pressing questions, podcasts on breast-feeding and being a parent, and information on monthly meetings with experienced mothers in your community who are accredited by La Leche League International. To find a La Leche League group near you, visit www.lllusa.org/groups.php.
Chemical caution: BPA and bottles
The breast-pump bottles that come with most breast pumps are now made without bisphenol A (BPA), a chemical used to make polycarbonate rigid and shatterproof that has been associated with adverse health effects in children. To play it safe, look for "No BPA" labeling on product packaging.
Plastic bottles made without BPA (non-polycarbonate) are solid and sturdy, and a safer way to store breast milk than plastic milk storage bags, which can become contaminated with bacteria if they get bumped by anything sharp, such as the edge of an ice cube.
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