StorkNet interview with
Elaine Moran
Author of
Bon Appetit, Baby! The Breastfeeding Kit
A Survival Guide for Expectant Mothers and Their Families

Click here to order this book

Introducing the First and Only Breastfeeding Organizer for the New Mother!

With more and more studies consistently confirming the superior health benefits of breast milk, there has been an increase in the number of American women who choose to breastfeed their babies. However, while current statistics show that approximately 65% of new mothers are breastfeeding their babies upon leaving the hospital, less than half of these women continue to breastfeed after six months-and most discontinue during the first six weeks postpartum! Today, 48-hour hospital stays are sometimes not allowing for the necessary observation and parent education that is needed to get breastfeeding off to a good start.

Many new mothers fear that their breast milk is insufficient, since they have no way of measuring how much their babies are consuming. During the early weeks postpartum it is sometimes difficult to tell--especially for first time mothers. In order to ensure that a breastfeeding newborn is thriving, the American Academy of Pediatrics and most breastfeeding experts recommend keeping a daily record of the baby's feeding and elimination patterns, and if necessary, a diary of the mother's own nutritional intake. Yet, there is no formal tracking system available on the market today to offer new parents the tools they need to help them through this critical learning period-UNTIL NOW!

Created by a veteran breastfeeding mother, this unique hands-on breastfeeding organizer takes the mystery out of the nursing experience. It provides new parents with accurate, up-to-date information, reassurance and the actual tools they need to get breastfeeding off to a good start. It is the first and only breastfeeding book to offer a formatted nursing diary for easy monitoring of early nursing progress. It features the Nursing Mother's Daily Nutrition Diary, which allows the mother to easily follow a healthy eating plan by using check-off boxes to monitor her own nutritional intake; and the Nursing Baby's Daily Diary, which consists of the Nursing Wheel and Diaper Wheel for recording the baby's feeding, sleeping and elimination patterns--simply by filling in time bars. This beautifully designed hard cover, journal type book is written in a supportive mother-to-mother style with inspirational quotations and illustrations throughout. The information and tools in this user-friendly book will help new mothers establish a successful breastfeeding relationship with their babies and reduce the rapid drop-off rate during the early weeks of nursing.

Bon Appétit, Baby! The Breastfeeding Kit:

  • Helps parents recognize the early signs of "insufficient milk intake."
  • Allows fathers to participate in the breastfeeding experience by helping to make diary entries.
  • Is a dependable reference for the baby's doctor and lactation specialist during the first weeks of life.
  • Includes a "Breastfeeding Baby in Training--Please, No Bottles or Pacifiers" sign for the hospital.
  • Has a Complete Resource Guide and an attached dual-colored pencil for making diary entries.

Elaine Moran is a veteran breastfeeding mother who developed the idea for Bon Appétit, Baby! The Breastfeeding Kit while nursing her first child. This is the book she wishes existed when she was a new mother learning how to nurse. After her baby was born, she realized she had spent so much time focused on the pregnancy and childbirth that she had not prepared herself for the physical and emotional aftereffects of this dramatic life-changing event, nor did she know what to do instinctively. Moreover, she was so used to being in control of her own time that responding to the constant demands of a newborn required a big adjustment. During the early weeks postpartum, in a need to make order out of chaos, she began to record her baby's every move-- from nursing and sleeping times to wet and soiled diapers. This put some order back into her life and her mind at ease knowing that her baby was healthy and thriving. She eventually began to see patterns in her baby's behavior and could anticipate when she was going to have a little block of time to get a few thing done. In addition, she began to keep a daily food diary to ensure she was eating a healthy diet, and she started taking walks outdoors with her baby for exercise. This allowed her to maintain an optimal milk supply and keep her energy high, while safely returning to her prepregnancy weight.

Since necessity is the mother of invention, as the days went on, her tracking system became more efficient and sophisticated and finally evolved into an informal version of the Nurse-N-Track System.™ After sharing her idea and receiving positive feedback from other new mothers, and reading newspaper articles about breastfed babies who became dehydrated, she realized that there was a great need in the market for a book like this. Three years later, Bon Appétit, Baby! The Breastfeeding Kit was born.

Click below to visit Elaine's site!

Click here to visit Elaine's Website!

StorkNet: Welcome to StorkNet, Elaine. We'd like to thank you for participating in our World Breastfeeding Week Celebrations. We're thrilled that you are here to take member questions and we look forward to an enlightening and supportive discussion!

Elaine: I would like to thank all the wonderful people at StorkNet for their dedication to offering breastfeeding information and support to women all over the world. I am also grateful that they embraced my book and graciously gave me the forum to share my story and answer your questions. I feel so much compassion for breastfeeding moms because I know first hand how difficult nursing can be during the first few weeks, as I was tempted to throw in my nursing bra several times during this period--but my own determination, keeping a journal, and support from my family and La Leche League meetings enabled me to persevere. I created this book because I feel that breastfeeding is such a momentous time in a woman's life that it is deserving of its very own special memory book and journal to capture these precious and ever so fleeting moments. In writing this book I also felt it was necessary to include all the essential breastfeeding and nutrition information a new mom needs to get breastfeeding off to a good start, thus "Bon Appétit, Baby!" was born. My hope is that this book will inspire, encourage, and support mothers through the rough waters of the first few weeks of nursing and enable them to smooth sail ahead to a happy and healthy breastfeeding relationship!

Kenyatta: Hello Ms Moran! I really like the concept of your book, and think it is excellent - especially for first-time nursing Moms. I would have loved something like this, a more compact version, to fit into my briefcase when I was pumping for my son (which I did for 18 months!). Any plans or ideas for a pocket size, for working Moms?

Elaine: Hi Kenyatta, congratulations on your determination to continue to breastfeed your son, even while working, and thanks so much for your valuable input! We are planning a softcover version of "Bon Appétit, Baby!" in the fall of next year. I would also love to create a "Breastfeeding Kit for the Working Mom," which would include breastfeeding basics, tips for working moms, pumping and storage guidelines and a tracking system for the pumping mom. It would definitely be pocket size to carry in a purse or briefcase. Being that you are an experienced working and pumping mom, I would certainly welcome your ideas and feedback as to what you would like to see in a book of this type. Please feel free to Email me with your suggestions. Thanks for you interest, Kenyatta. Best wishes to your and your son!

Kimberly: I am getting ready to return to work after being off for the summer. My 7-month old daughter will be taking a bottle for at least 2 feedings during the day and I would like to use formula for these 2 feedings. I had planned to introduce more solids during my time off, but Chesney isn't going for it (still won't even eat a whole jar of baby food). Do you have any ideas on making this transition easier for us? I am still able to nurse on my lunch hour.

Elaine: Hi Kimberly, as a working mom, how lucky you are to be able to spend the summer off with your daughter and then have the ability to nurse her on your lunch hour once you return to work! I think that nursing on your lunch hour will definitely make the transition much easier for both of you. In that case, she would only need one or two supplemental feedings during the day. Have you considered pumping once or twice a day rather than offering her formula? Besides being able to offer Chesney pumped breast milk, pumping will ensure that your breasts are being stimulated to maintain your milk supply, and it will also help with engorgement. I also have a feeling that once you are back at work, your daughter will gradually take an interest in eating more solid foods. Good luck to you, Kimberly!

HeatherE: My little one was extremely sensitive to any dairy in my diet, is this normal?

Elaine: Hi Heather, unfortunately some foods in a mother's diet do adversely affect her baby's developing digestive system and dairy products happen to be the most common culprit. The protein in cow's milk passes into a mother's milk and if a baby is sensitive to this, it can cause fussiness. An allergic reaction is most likely to occur in a sensitive baby who has a family history of allergies. Other symptoms may include skin rashes, hives, vomiting, and diarrhea. If you do have a baby with a dairy sensitivity, it is recommended that you eliminate all dairy products that contain cows milk proteins. You may want to seek the advice of a registered dietitian to help you plan an appropriate diet to ensure you are meeting your daily nutrition requirements. Oftentimes the sensitivity to dairy products subsides after six months, when your baby's intestinal lining becomes mature enough to screen out potential allergens. Thanks for the question, Heather!

Megan: Do you have any suggestions on how to prevent engorgement? I had a big problem with this with my first baby. This baby is due in a couple weeks and I'm thinking about what a time I had with this, so would like to be prepared. Thank you ahead of time.

Elaine: Hi Megan, the best answer to your question (and the answer to many breastfeeding difficulties) is to nurse as frequently as possible for as long as possible, around the clock, from the very beginning! The more minutes a newborn spends nursing during the first 48 hours after birth, the less likely the mother is to become painfully engorged. Breast fullness is a normal condition, however, if your baby is not emptying your breasts often enough, this normal breast fullness may progress into engorgement. This is when the mother's breasts feel painfully hard, tender, and warm to the touch. Other tips for preventing engorgement include, beginning each feeding session with the breast offered last, avoiding pacifiers or supplemental bottles of water or formula, wearing a supportive bra that fits well, and avoiding bras with underwires or that are too tight. It also helps to express your breast milk if you miss or delay a feeding to relieve breast fullness. Just remember that frequent unrestricted breastfeeding is the best preventive measure for engorgement. Good luck with little angel #2!

Jennifer T: How can a good nursing relationship be established when a baby can't nurse for an extended period of time due to medical reasons and must receive tube feedings of EBM instead?

Elaine: Hi Jennifer. Luckily, medical professionals are recognizing and becoming more supportive of a mother's need to form an attachment to her baby in the ICU. Physical closeness can help reduce emotional stress for both of you. Spend as much time as you can with your baby. Sit beside your baby's incubator and look into his eyes, to develop contact, and touch and stroke him a much as possible. Gently talk to your baby and say his name often. Befriend the nursing staff and don't hesitate to ask questions. Change and feed you baby whenever possible and take pictures of him and keep a record of his progress. Some babies are very sensitive to stimulation, so watch your baby's cues to discover what kinds of sounds and touches work best for him to be sure he doesn't get more stimulation than he can handle. Once you are able to begin breastfeeding, it will be calming and comforting to both of you.

If your baby is premature, ask the nursing staff if you can try "kangaroo care," a practice that is physically and psychologically beneficial to both you and your baby. This highly effective technique involves holding the baby skin-to-skin, upright on the mother's (or father's) chest between her breasts under a loose-fitting blouse or blanket. The baby is kept warm by the mother's body and is soothed by the soft touch of her skin and the rhythm of her heartbeat. It's not surprising that babies' heart rates and breathing become more regular during kangaroo care. The baby may look at the mother, respond to her voice, breastfeed at will (if he has begun breastfeeding), or just fall asleep peacefully. Studies have shown that babies who receive kangaroo care gain weight faster, are found to spend less time crying and more time in quiet alertness and deep sleep, and have shorter hospital stays. Mothers who give kangaroo care have more confidence in caring for their babies and have been found to breastfeed longer and more frequently. Best wishes and enjoy your precious baby!

Tristin: Does it matter which side (right or left) I will start nursing on each time? Can you explain how that works?

Elaine: Hi Tristin, what a great question! When I first began to nurse I didn't think it was much of an issue until all of a sudden my right breast (my preferred nursing side) weighed about a half a pound more than my left breast! Since it was very noticeable, even while wearing clothing, I decided to encourage more nursing sessions on the left side, until I was balanced out!

Since creating a milk supply works on the basic principal of supply and demand, it is important to stimulate and empty (as completely as possible) both breasts by nursing on both sides as equally as you can. Ideally, it is best to nurse on both breasts during each feeding session, but if your baby is not interested in the second breast, don't worry, it is more important that he breastfeed well on one breast than insist that he take the other if he is not interested. Just make sure to begin the next feeding session with the breast offered last. The Nurse-N-Track System in my book is an ideal place to keep track of which breast to offer at the next feeding session during the first few days. You will soon be able to tell on your own, since the breast taken last or not at all will feel fuller and heavier than the other breast. If your baby has a favorite breast, you may try a simple maneuver that many mothers have successfully used to entice their babies to take the less-preferred breast. Start nursing on the favored side (a cross cradle hold works well) and then slide the baby over to the second breast without changing his position. Many babies can be fooled into thinking you have two right (or left) breasts! For those babies who don't fall for it, there's no need to worry, as long as your baby is gaining weight and thriving (and it doesn't bother you to feel a little lopsided), it's perfectly fine. Your breasts will eventually return to a more even size after your baby is weaned.

Carolyn: My baby is due in October and I plan on breastfeeding. I'm really tired of my mother-in-law telling me that I should bottle feed. I need a good reply for her that will make this well-meaning but unwelcome advice stop. Any suggestions?

Elaine: Hi Carolyn, it's probably safe to assume that your husband wasn't a breastfed baby. Let your mother-in-law know that the American Academy of Pediatrics recommends breastfeeding for at least the first year of life and that the World Health Organization encourages moms to breastfeed even longer. Mention that numerous studies have found that breastfed babies are less colicky, are better nourished, are more resistant to infections and illnesses, are more intelligent, and thrive better than formula-fed infants. Inform her that human breastmilk cannot be duplicated by any formula because it contains a unique combination of proteins, fats, carbohydrates and other vital nutrients custom-made for her grandchild to provide superior nutrition and promote optimal body growth and brain development. The antibodies contained in colostrum, the first milk, have important immune boosting qualities, which may be considered her grandchild's first immunization. Breast milk is sometimes called "white blood" because it contains living white blood cells that protect newborns by destroying the harmful bacteria that their immature immune systems are not yet able to fight off. Finally, ask her this question, "How would you rather you grandchild be nourished, with living white blood cells or lifeless white powder?" Good luck, Carolyn!

Ally R: I am 29 weeks and my nipples are itching badly. Is this normal?

Elaine: Hi Ally, as your breasts begin to grow and expand during pregnancy, and especially in the last trimester, avoid washing your areola and nipples with soaps or shower gels which tend to dry out the skin. Plain warm water rinses are all that is necessary. If you have dry skin or your nipples feel dry and itchy, use a small application of 100% modified lanolin (such as Lansinoh), to moisturize the nipples and help to keep them soft and supple. The small bumps on your areola that enlarge during pregnancy are called Montgomery glands and produce a special oil that naturally cleans, lubricates and protects the nipple. Continue to avoid using soaps, shower gels, creams, ointments, or moisturizers while breastfeeding, as they may remove the beneficial oil secreted by the Montgomery glands. However the use of 100% modified lanolin can be continued as needed while breastfeeding.

Heather: My sister is supplementing her 5 week old baby with formula (at her doctors request), and she wants to get back to strictly breastmilk. Do you have any suggestions on what kinds of things she can do to get her milk supply back to a level where her baby will be getting enough? I should also mention that her baby was 3 weeks old and has a "lazy" latch ... she won't stay on properly for more than 10 minutes now. Thank you so much! Heather

Elaine: Hi Heather, it's hard to tell from your question how many bottles of supplemental formula your niece is receiving and how often she is breastfeeding. Anyway, the first thing I would recommend is to have your sister get a hospital grade breast pump so that she can begin pumping to build her milk supply. She should also nurse her baby as frequently as possible, around the clock. Make sure she offers both breasts at each feeding and have her pump what remains. She should also pump each time her baby takes a bottle of formula. As the baby increases her time at the breast, your sister can decrease the number of bottles of formula offered. The best way to ensure that her baby is "getting enough" is to check the baby's weight gain and wet and soiled diapers. At five weeks, she should be gaining approximately 4-7 ounces per week and have 6-8 wet diapers and 2-5 bowel movements in a 24-hour period. Also make sure your sister takes care of herself by drinking plenty of fluids, eating a nutritious diet, and getting plenty of rest (suggest that she sleep when the baby sleeps, or at least lie down while nursing). Although from your question it sounds like the baby may have a problem taking the breast, since she had a lazy latch at three weeks, and most likely, by now, she has also become accustomed to the artificial nipple. If this is the case, and your sister is having problems getting her baby to take the breast or to latch on, I would highly recommend seeing a lactation consultant for further assistance. Your sister sure is lucky that you are so supportive--I wish her much luck!

Karen: Does your book have any hints or tips for working moms? I'll be going back to work just part time when my baby is three months old. I would like to continue breastfeeding. Thanks much. Karen.

Elaine: Hi Karen, I do have a chapter in my book entitled "Expressing and Storing Breast Milk" which includes: When to Introduce a Bottle, When to Express, Manual Expression, Choosing and Using a Breast Pump, and Storage Guidelines. Since my book is primarily meant to be used during the first six weeks of breastfeeding, it doesn't include tips specifically for working moms, however most of the information in the book is useful to all breastfeeding moms. But, it sounds like my next topic should be a book for working moms! The best advice I can give to moms who will be going back to work is to not let the preoccupation of returning to work rob you of the joy of the early weeks with your newborn. Relax and enjoy this special time, as it is your opportunity to form a strong attachment to your baby and learn all you can about him. And your baby will learn that you are the one special person he can always depend on. Your attachment to your baby will help you keep your priorities in order and enable you successfully combine working, parenting, and breastfeeding. Good luck to you, Karen!

Cammie: Dear Elaine, On the message boards I hear reference to tracking wet diapers. What's this about?

Elaine: Hi Cammie, in order to ensure that a breastfed newborn is thriving, the American Academy of Pediatrics and most breastfeeding experts recommend keeping a daily record of the baby's feeding and elimination patterns during the early days of breastfeeding, and if necessary a diary of the mother's own nutritional intake (in the case of food allergies). The most important indicators of whether a baby is getting enough nourishment from breast milk are his weight gain and the amount of wet and soiled diapers. I have a special section in my book, called the Nurse-N-Track System, specifically designed for recording this information in an easy-to-use format. This diary will become a dependable reference for the baby's doctor and lactation specialist, and it will become a treasured keepsake in the years to come. Maybe when your child is a teenager you can have him/her do the dishes for every diaper you've changed! Best wishes, Cammie!

Monica: When I had my first baby I had contractions during the first few days I breastfed. They were awful . . . will I have those again? Why? What can I do about them? Thank you. Monica

Elaine: Hi Monica, after childbirth, as your uterus gradually shrinks and makes its descent back into the pelvis, you may experience mild contractions called "after-pains." These after-pains feel similar to menstrual cramps and may be mild to fairly strong. During the first few days postpartum, they may be more intense when you are nursing your baby, since the same hormone (oxytocin) that delivers early milk to your baby also causes your uterus to contract. These after-pains become more pronounced with each subsequent pregnancy. Another great advantage about breastfeeding is that it helps the uterus shrink back to its normal size more quickly and reduces the flow of lochia by stimulating these uterine contractions and constricting uterine blood vessels. These after-pains should subside within a few days postpartum.

Laurel: I drink diet sodas (caffeine free) and occasionally use equal. Will the nutra sweet be passed to the baby, and if so, is there any evidence that it is harmful to him?

Elaine: Aspartame, originally marketed as NutraSweet and Equal, is an intense sweetener found in many foods and beverages. Although the FDA has approved aspartame, the jury is still out on the effects of aspartame to a breastfeeding infant; therefore I would recommend using it in moderation. Additionally, since aspartame contains an amino acid called phenylalanine, people with phenylketonuria (PKU) need to be cautious about consuming anything with aspartame. PKU is a rare genetic disorder that doesn't allow the body to metabolize phenylalanine properly. Fortunately, all infants in the US are screened for PKU at birth and it only afflicts one in every 15,000 people in the US.

Mary Beth: Hi Elaine! I am the mother of three with number four due 9/8/00. I nursed my first until 8 months and my second until 12 months without any problem. Number three however was a different story . . . she was a "lazy nurser" and was not gaining weight properly. To make a long story short, after much fretting, pumping and anything else I could try, my pediatrician finally terrorized me into supplementing with formula, and sadly, nursing went downhill from there. I'm terrified this will happen again; I so much want to nurse this baby. What can I do to try to make sure things are successful this time? Thanks, Mary Beth

Elaine: Hi Mary Beth, I'm sorry to hear that you were pressured into doing something that didn't feel right to you. However the great thing is that you successfully nursed your first two children! Focus on these two experiences and remember that each breastfeeding relationship is as unique as your child. I would try to relax and take one day at a time. Since you are so determined to nurse your fourth child, I have a feeling that you will be successful. However if you do experience difficulties, I would recommend consulting a lactation specialist at the first sign of a problem. Best wishes to you and your fourth little angel!

Grace: How old should your baby be before you wean him/her?

Elaine: Hi Grace, there is no optimal age that a baby should be weaned, as we can see from the great range of weaning ages around the world. Weaning is a personal decision that will be made by you and your baby. The best approach to take is to not set an advance deadline as to how long you will breastfeed. Just take it one day at a time and when the time seems right for both of you, you can decide then on the best way to wean. Enjoy your baby!

Jessie: I would like to know if it is in bad taste to breastfeed in public (as my mother says) or if it's good for educating others? I feel mixed . . . so many times I go to the car so I won't offend people--who, in my opinion, shouldn't be offended.

Elaine: Hi Jessie, I believe it is important that we see mothers nursing in public more often so that the next generation accepts this as the natural way to feed infants. If women can feel more comfortable in public when they're doing the best they can for their babies, then maybe more women will consider breastfeeding. The truth is that when you are nursing in public, few people are even aware of what you are doing, as they are usually preoccupied with their own business. Nonetheless, there are many ways to be discreet while breastfeeding in public. Using a baby sling or a shawl usually works well. Practice your technique at home in front of a mirror until you feel comfortable. As you breastfeed in public, be proud that you are a dedicated mom who chooses to give her baby the best nutrition possible. It's also important to support other breastfeeding moms. So, when you see a mom nursing in public, make sure to smile at the baby and say, "Bon appétit!"

Alexandra: When I am breastfeeding, can I go back to eating some of the foods that were considered taboo during pregnancy like soft cheeses, lunch meat, and fresh tuna?

Elaine: Hi Alexandra, yes, the good news is that while breastfeeding you don't have to be as restrictive with your diet as you were while you were pregnant. Moderation and eating a varied diet is key. Although there are certain foods commonly cited by nursing moms as being troublesome for some breastfed babies, don't let the fear of having to restrict your diet deter you from breastfeeding. Babies are happily breastfed all over the world while their moms eat a wide variety of foods. There are no universal rules for the types of foods a nursing mother should or shouldn't eat. Most moms are able to eat a wide variety of foods with no restrictions. It is not necessary to eliminate any food from your diet unless your baby is showing an adverse reaction to something you've consumed, and this is most likely to occur in sensitive babies who have a family history of allergies. Bon appétit, Mom!

Erica: My first baby was a real sleeper and didn't want to wake to eat. We had trouble getting him to breastfeed, so a nurse at the hospital insisted he had to have formula from a syringe (about day 2). Well after having 3 ounces of formula it was even more difficult to get him interested in the breast. With the help of a lactation consultant we eventually got the whole thing working and I breastfed for 7 months. My question is this: How long can a newborn go without eating (much if at all) before intervention is needed? I really feel that nurse was hindering our breastfeeding efforts and want this cleared up before I deliver our next child in October.


Elaine: Hi Erica, Congratulations on your determination to breastfeed your baby! I'm glad that even after a rough start you were successfully able to nurse for 7 months. Since it is the responsibility of the nursing staff to ensure that newborns are thriving, it is understandable that they insisted on offering formula to your sleepy baby who wasn't taking the breast. Many babies become excessively sleepy a few hours after birth or they may still be under the influence of medications used during labor and delivery. It is important to continue to stimulate the sleepy newborn and offer him feedings every hour. Most babies' nursing techniques usually improve after a day or two when they become more alert and your milk becomes more abundant. However the point at which intervention is needed is different for every baby. Because babies are born with excess fluids in their tissues at birth, dehydration is rarely an issue in the first 48 hours. However if the mother has concerns about it, she may appreciate knowing the symptoms of dehydration so that she can be certain that her baby is not at risk, they include: listlessness, lethargy, loose skin, a dry mouth and eyes, a weak cry, minimal urine output, and fever. As long as the baby is not dehydrated and is testing normal for hypoglycemia (low blood sugar) there is no need for supplementation. If for whatever reason it does become critical and it is necessary to feed the baby, I first try finger feeding along with the syringe. This involves having the baby suck on your finger while pumped breast milk (or formula) is being dripped into his mouth. This technique will allow the baby to begin to learn how to suck and encourage him to more easily take the breast. Good luck to you, Erica!

Stacey: I have three questions. First question is I would like to give a bottle of expressed breast milk for outings and/or for babysitters. Is there a best time in the day to pump milk that won't hurt my milk supply? I'm especially concerned with the early weeks.

Second question: Everyone talks about the discreteness of those baby slings. I used a baby snugly with my first daughter but it is not a sling and I never thought of breastfeeding her in one of those things. Blanket shawls were awful and the blanket kept falling off my shoulder. Can you breastfeed with those "upright" type of snugglies successfully? And if so how? How can you be discreet with those, say in the grocery store without taking your hand to help baby latch on without people noticing? If they are very discreet, then I would rather use my snugly. If it is better to get a sling, then I will get one of those, but I would love some tips in this area.

Third question: My daughter had colic that lasted for two months. It was a nightmare. She is 4 years old now, but I am expecting baby number two and would like to know if there is a way to prevent colic this time around. When I had her I was overjoyed with the fact that because she was breastfed. I wouldn't have a colicky baby because they can digest breast milk better than formula. Boy was I wrong! Nothing I did seem to help and unfortunately in a panic, I gave her supplement bottles of a special formula, thinking that would help. I think it did a little, but then again, her colic ended coincidentally at the usual time colic ends around 3 month. So maybe it was never the formula after all, but just timing. Thanks so much. *S*

Elaine: #1. Hi Stacey, the question of when to express your breastmilk will depend on the situation. If you are separated from you baby for an extended period of time, you should pump at the approximate times you would normally nurse your baby. If you want to prepare a bottle for later use, it is best to pump in the morning about an hour after a feeding session, since your milk supply is usually most plentiful between early morning and early afternoon.

#2. I believe that that baby sling is greatest thing for discreet nursing. Once you get the technique down, you can stroll through the mall or grocery store while discreetly keeping your baby latched on and hidden behind the fabric of the sling.

#3. There are many theories about why babies have colic, but the true cause is still somewhat of a mystery. Unfortunately, there is really no way to prevent it. Whatever the cause of colic, calm and gentle handling is essential. Oftentimes with a colicky baby, nothing that you do seems to help. But as distressing as colic is for parents, it is important to accept it as a passing phase and try to cope as calmly and rationally as possible. Help ease your baby through this difficult time by responding to his distress. He doesn't know why he is feeling this way any more than you do. Respond to him and let him know you are there for him. The good news is that babies usually outgrow these colic symptoms between six weeks and three months of age--without any ill effects. Best wishes to you and your little ones!

Pam: My baby seems so hungry all the time when I am strictly breastfeeding. He seems so much more satisfied and sleeps longer when I supplement with formula. How can I be sure he's getting enough to eat and not starving on just the breastmilk?

Elaine: Hi Pam, since breast milk is more quickly and easily digested than formula, breastfed babies need to eat more often than formula fed babies. Nursing moms often worry whether their babies are "getting enough," especially since they have no way of measuring exactly how much breast milk their babies are consuming. In the first few weeks it is sometimes difficult to tell, especially for first-time moms. Here are the signs to look for in the first few weeks to ensure that your baby is thriving: your baby has 2-5 bowel movements and 6-8 wet diapers in a 24-hour period; you can hear your baby sucking and swallowing while nursing; your breasts feel full before each feeding and softer after the feeding; your baby seems satisfied or sleepy after each feeding, not fussy; your baby is gaining at least 4-7 ounces per week; your baby appears healthy and has good color and skin tone; your baby is filling out and growing in length and head circumference; and your baby is alert and active. After the first month or so you will intuitively know that your baby is getting enough by the way his body is filling out and growing. Good luck to you and your little guy!

Wilma: What can be done about milk overproduction? (Breasts are filling up very quickly after nursing and are always very full, even though the baby is already 11 weeks).

Elaine: Hi Wilma, too much of a good thing is a problem that other moms wish they had! Some women seem to produce more milk than their babies are able to handle and they may feel uncomfortably engorged much of the time. You may also leak and spray milk and your baby may gasp and choke as the milk lets down. Women with an overabundant milk supply usually have exceptional production capacity, a strong milk ejection reflex, and a very efficient nursing baby. You can relieve an overabundant milk supply by nursing your baby on just one side at each feeding, alternating the breast you use. If the other breast becomes uncomfortable while nursing, express a small amount. If you happen to get caught in the cycle of expressing milk while nursing full-time, gradually decrease the amount of milk you pump until you are no longer expressing any. Best wishes to you and your baby!

Dayan: I am four weeks pregnant. Please tell me how I should start preparing for breastfeeding.

Elaine: Hi Dayan, preparing for the breastfeeding experience while you are pregnant will enhance your breastfeeding success. There is an abundance of valuable books, reference materials, classes, and knowledgeable people that can assist you in nursing your baby. The following are some ideas to help you prepare: discuss breastfeeding with your healthcare provider; have a prenatal breast exam; check your insurance coverage regarding lactation support; educate yourself about breastfeeding; enroll in a breastfeeding class; attend a La Leche League meeting; ask for support from family and friends; select a doctor for you baby; and prepare a list of breastfeeding resources. Also while you have the chance, pamper yourself with a haircut, manicure, facial, or whatever makes you feel good. Purchase some nursing pads, a nursing bra, and some comfortable oversize or button front pajamas, as you will be spending much time in them during the early days! Good luck to you, Dayan!

Robin: Hi. I want to breastfeed, but I would like to use the pump. I will be returning to work and I would like for my husband to share in the feeding. How do I take the baby off the breast and onto the bottle without confusing her or making her upset? Strange question . . . foes breastfeeding hurt? What about pumping?

Elaine: Hi Robin, it is recommended that you wait until breastfeeding is fully established, usually about three to four weeks, before offering supplemental bottles of breastmilk. This will minimize the chance of the artificial nipple interfering with your baby's breastfeeding technique. (If it is necessary to supplement before your baby is three to four weeks old, it's best to use a syringe, small cup, medicine dropper, or nursing supplementer). Look into renting a hospital grade breast pump and gradually introduce the bottle at least a week before you have to go back to work. This will allow you and your baby time to adjust to a new feeding routine and enable you to build a milk supply before going back to work. Once you begin working and are separated from your baby, you can continue to pump at the approximate times your baby would normally nurse, about every three to four hours, to maintain your milk supply. Breastfeeding or pumping should not hurt! In the case of breastfeeding, if it hurts or is painful, it means the baby is not latched on properly. In the case of pumping, is means that your are not using the pump correctly. Granted pumping may feel a little unusual in the beginning and you may get only a small amount of milk, but the key is to feel comfortable and relaxed. Take a few minutes before each pumping session to unwind. Thinking about your baby or looking at his photo may also help stimulate let-down and get the milk flowing. If you are using the breast pump properly, you will soon see an increase in the amount of milk expressed and pumping will become almost as natural as breastfeeding. Good luck, Robin!

Elaine: My children are as different as night and day. My older child has no food allergies and my younger child has very bad allergies to milk, eggs, and peanuts. I breastfed them both for extended period (3 years and almost 2.5 consecutively). They both had trouble with weight gain in the early weeks. I am expecting my third child. How likely am I to experience the problems with weight-gain again and can I expect another severely allergic child? Thank you! Elaine

Elaine: Hi Elaine, I have a pair just like yours--like night and day, but as we know, that is what makes them each so special and unique. As far as your question of how likely your third child is to be a slow weight gainer during the early weeks is dependent entirely upon your baby and your breastfeeding relationship. Try to initiate breastfeeding early and often and if your baby 's weight gain does becomes an issue, make sure to get help immediately at the first sign of a problem. As far as expecting another severely allergic child, the chances are greater, since most likely you have a family history of allergies. However, prolonged exclusive breastfeeding is important for infants at high risk for allergic disease. The protective benefits of breastfeeding are further enhanced when the mother excludes common allergenic foods such as milk and dairy products, eggs, fish, peanut, and soy from her diet during pregnancy and lactation. The allergic risk to her baby is also reduced if the mother varies her diet and avoids eating any single food on a daily basis. If you are finding it necessary to eliminate whole food groups, such as dairy products or citrus foods, you may need to consult a registered dietitian to help you plan an appropriate diet to ensure you are getting all the nutrients you need. Bon appétit, Elaine!

Jen: What is your opinion on the use of nipple shields to help with flat nipples? Do you have any other suggestions on preparing the nipples prior to the baby's birth? I had an extremely difficult time nursing my daughter, even with the help of several lactation consultants, and gave up early. I'm determined to be successful with #2 and to nurse for at least a year.

Elaine: Normally I wouldn't recommend any treatment until the baby is born, because sometimes the problem is resolved with the baby's suck, however since you mention that you had an extremely difficult time nursing your daughter due to flat nipples, you may consider wearing breast shells inside your bra beginning in your second trimester (unless you've had a miscarriage or have a high-risk pregnancy, since any type of nipple stimulation can provoke contractions of the uterus). Breasts shells are two-part plastic devices designed to gently compress the areola and encourage the nipple to protrude and stretch out. Since skin and tissue are elastic and can be reshaped, the logic behind breast shells is that the more often you can get the nipple to protrude, the more likely it is to remain protruded. You can also continue to wear breast shells between feedings once your baby is born. It is important not to confuse breast shells with nipple shields. A nipple shield in contrast, is a silicone nipple that fits over your own. The baby actually latches onto the nipple shield instead of your bare nipple to nurse. Nipple shields are a tool used temporarily to help resolve breastfeeding problems. The problem with nipple shields is that they can cause nipple confusion, and babies can become so dependent on them that they refuse to nurse without one. In addition, weaning a baby from a nipple shield is sometimes a long process. If you are continuing to have problems, it is best to seek the advice of a lactation consultant. Best wishes to you and your baby!

StorkNet: Thanks again to Elaine Moran and to our StorkNet members for creating this informative and exciting interview. Bon Appétit, Baby!

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