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Breastfeeding or Breast Milk Feeding?

Breastfeeding or Breast Milk Feeding?. Rebecca B. Saenz, MD, IBCLC, FABM Mississippi Breastfeeding Medicine Clinic, PLLC Madison, MS. Everyone, please get a drink for this talk!. Exclusive Pumping – Why?. NICU graduate Early challenges (soreness, jaundice etc.)

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Breastfeeding or Breast Milk Feeding?

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  1. Breastfeeding or Breast Milk Feeding? Rebecca B. Saenz, MD, IBCLC, FABM Mississippi Breastfeeding Medicine Clinic, PLLC Madison, MS

  2. Everyone, please get a drink for this talk!

  3. Exclusive Pumping – Why? • NICU graduate • Early challenges (soreness, jaundice etc.) • Desire to “know how much he’s getting” • Better “scheduling” • History of sexual abuse • Underlying assumption: It’s all about the milk.

  4. Breastfeeding vs Breast Milk Feeding • Milk composition (fresh on tap) • Changes over • Course of feeding • Course of day • Age-dependent changes happen in sync with baby • Milk composition (freshly pumped) • Similar 24-hour totals for most nutrients • Same from beginning to end of any particular feeding • May or may not change over course of the day • Oversupply may cause fractionated collections • Age-dependent changes may be delayed

  5. Breastfeeding vs Breast Milk Feeding • Milk composition (fresh on tap) • Changes over • Course of feeding • Course of day • Age-dependent changes happen in sync with baby • Milk composition (frozen > thawed) • Nutrients may be very different depending on lengths of time stored and at what temp. • Age-dependent changes may be very delayed

  6. Breastfeeding vs Breast Milk Feeding • Immunities are current • Immunities may be to last week’s germs or to mom’s office germs

  7. Breastfeeding vs Breast Milk Feeding • Milk production regulated by baby • Good latch • Good milk transfer • Growth spurts > increased hunger > sooner feeds, better emptying, etc. > increased production • Milk production regulated by pump • Flange size • Speed, suction, etc. • Pumps don’t grow • Growth spurts can be simulated by changing pumping routine

  8. Breastfeeding vs Breast Milk Feeding • Delivery System = Breast • Dental arch formation in a “U” • Flat hard palate • Oral musculature suckles • Coordinated breathing • Delivery System = Bottle and Artificial Nipple • Dental arch formation in a “V” • High-arched hard palate • Oral musculature suck some • Breath-holding

  9. Breastfeeding vs Breast Milk Feeding • Breast • Gravity less a factor • Stops flowing when baby stops suckling • Posture matters less • Side-lying ok • Bottle • Gravity a factor • Keeps flowing even when baby stops, unless • Baby sitting upright to feed • Bottle horizontal

  10. Breastfeeding vs Breast Milk Feeding • Feeding style – baby regulated • Hunger cues • Timing varies feeding to feeding – more physiologic • Amounts vary also • Less reflux • Feeding style – parent regulated • Hungry crying baby has to wait? • Timed? • Pressure to finish specific amount • Prone to reflux

  11. Breastfeeding vs Breast Milk Feeding • Close Relationship • Holding often • Mom does most of the feeding herself • Eye contact • Communication • Skin-to-skin contact • Oxytocin and Prolactin rise • Different Relationship • Mom doing double-duty > tired! • May be feeding on cue • Pumping on schedule • Others often doing the actual feeding • Can do STS contact • Pumping causes hormones to rise, but not as much

  12. Supporting Moms Who (Chose to ?) Exclusively Pump • ? Offer latch assistance • May depend on reasons for pumping • Discuss physiology of lactation “Milk out = Milk made” • Flange size • Pumping routine • Hands-On pumping technique (Morton) • Simulating Growth spurts

  13. Supporting Moms Who Chose to Exclusively Pump • Discuss milk storage times • Fresh > room temp > refrigerated > frozen • retain nutrients better • Discuss handling of human milk • Cleaning pump • Thawing (oldest milk first) • Warming

  14. Supporting Moms Who Chose to Exclusively Pump Discuss ways to normalize bottle feedings-- • Skin-to-skin contact • Switching sides • Eye contact • Verbal communication • Paced feeding

  15. Supporting Moms Who Chose to Exclusively Pump Keep in mind: This mom is doing the best she can in her particular situation.

  16. Supporting Moms Who Chose to Exclusively Pump Keep in mind: Bottled breast milk Is better than No breast milk!

  17. Mississippi Breastfeeding Medicine Clinic, PLLC Rebecca B. Saenz, MD, IBCLC, FABM 111-A Depot Drive Madison, MS 39110 601-898-7979 Fax 601-898-7989 Find us on Facebook! Follow us on Twitter: @litldoc

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