405 – Breast and Bottle Feeding

Episode Intro and Overview 0:00

So to recap, things you'll need for breast or bottle feeding are some shirts that allow you to easily get your breasts out for best feeding, perhaps some covers, some pump pieces and accessories with that. Some bottles, Some nipples and some regular formula. Hi, you're listening to season four of the Baby Manual Podcast, the podcast that helps new parents all over the world navigate the everyday challenges that arise when you have a young baby. This season will help you decide which pregnancy, baby, and toddler items you actually need and which ones are a waste of time and money.

I'm pulling on the knowledge of hundreds of thousands of new parents around the world, other pediatricians, doctor moms, the Academy of Pediatrics, breaking pediatric news sites, all to give you the best information and recommendations that I can, because I know how overwhelming it can be. I am your host, a pediatrician, mom, and author, Dr. Carol Keim. Hello my friends, welcome to this week's episode. We're going to talk all about the supplies that you need for breastfeeding and bottle feeding.

So whether you've decided already if you want to do one or the other, I still recommend that listen to the whole episode because sometimes for whatever

Breastfeeding Clothing and Comfort Supplies 1:12

reason you end up switching from one to another. Sometimes it's a baby preference, sometimes it is a parental preference. Here we go. For breast feeding supplies, we'll start with those first. I definitely recommend that you get some nursing bras and some tank tops and shirts. And I recommend all three of those because you definitely need something that is easy to get your breasts out to breastfeed. Nursing bras have clips on the front of them that allow you to pull down the cup of it so that can get out your breast very easily for your baby.

With tank tops as well, you could wear that instead of a bra. And so those are really nice to have if it's really hot and you just want to wear. Or in the winter if you want an extra layer. So I do suggest getting both the bras and the tank top with the clips in front because those really easy to work with. Regular ones you're just going to end up pulling on the strap to pull it down low enough to get your breast out and that will hurt your shoulder over time. Nursing shirts are great because they usually allow you to stay covered up while you are breastfeeding.

So they typically have an opening in the front where there's kind of two layers of fabric and you can move one up and one down. Now, if you prefer, you could also just use a regular shirt with a nursing tank top and then lift that shirt up, and have the tanktop go down, And that can also allow to get your breast out but with minimal skin exposure. In terms of pajamas, you don't necessarily need nursing pajamas. But if you have ones that button in the front, those are pretty easy to get them opened so that you can breastfeed.

Also, if have a two-piece pajama, like a top and a bottom, You can always lift that top up. A lot of times when you're in your pajamas you are at home in privacy of your own house. So you may or may not need ones specifically made to only get a breast out. It's okay to probably show a little more skin during that time. And then you can also use pajamas that have a very low neckline. So if you have say like a one-piece pajama that has like thin straps and a lower neck line, sometimes that works as well to get a breast out.

I recommend getting some gel breast pads. Those are really nice because you can make them either warm or cold and put them in your bra. If your breasts are feeling a little bit sore, like when your milk first comes in, the first two weeks or so of breastfeeding tends to be the hardest. And then after that, your body gets very used to it. Sometimes it doesn't even take that long. But at least for the couple of weeks, I would say it's good to have some breastpads on hand. that you can cool down, say, in the fridge and then put that into your bra so that it'll help with any soreness that might have.

And then as time goes on, sometimes you develop mastitis. Mastitis happens when one of your milk ducts gets clogged and the milk kind of backs up and it grows some bacteria in there and forms an abscess inside of the breast. So if you feel like your breasts aren't fully emptying or you have a spot that just won't seem to work out, sometimes it's nice to have little bit of a warm pack on that to help it to loosen up and to get that extra milk out. While you're breastfeeding, I do recommend that you use your hands starting at the top of your breasts way up in your armpit or on the top of the chest and press downwards toward the nipple and then work in a clockwise direction all the way around your breast.

It doesn't have to be clockwise, either direction is fine. Work in circle around the breast and move all of that milk towards your nipples and that can also really help your chest to empty out and can help prevent get mastitis as well. For breastfeeding moms, also it's good to have some absorbent breast pads because sometimes you leak a little bit of milk in between breast feeding sessions, or sometimes one side will leak little while the other one is being nursed on. So it is nice to some good absorbant pads.

My favorite brand is Bamboobies. They are actually another local company in Colorado, but they are made out of bamboo and very, very soft. I've tried actually a few different types of absorbent breast pads, and all the bamboo ones are great, but the other ones that I tried that were a bamboo fabric tended to stick to my breasts, so that was a little bit painful sometimes to take off, whereas the Bamboobies, I never had that problem. You probably want to get two pairs or more just so you can have the option to wash a pair and then still have some on hand.

Nipple covers can sometimes be helpful. I've heard a lot of really good things about silverettes, which are these just silver nipple cover. They're a little disc that's kind of shaped like a half sphere and that just goes over your nipples and protects them from rubbing on your bra and stops them sticking as well. So those can be another nice option if you don't want to do the bamboo pads or if don t need the absorption. Just after babies are done breastfeeding, breast milk is a little sticky and so anything that's kind of left on there might potentially make your nipples stick to your bra.

So some nipple covers can great for that. Nipple cream, one of the best pieces of advice I ever got as a new mom was to aggressively hydrate those nipples. Your nipple skin is sort of like the skin of your lips, and you know how if you lick your lip a lot they can get chapped and then it starts to sting a little and they kind of burn? And that happens with the nipples as well.

Nipple Care, Shields, and Milk Collection 6:54

So your nipple are not used to being sucked on 15 to 20 times a day like they're going to be. Some niple cream can be really helpful to put on after each time your baby breast feeds. There's a lot of different ones. Two of my favorites, there's Laniso, which is just sort of the lanolin-based one. It's a thick ointment and lanalin is actually made from sheep's wool or from a sheep. So if you have an allergy to sheep wool, you may not want a lanilin- based one, another really good one is Mother Love and that one's beeswax based and can be really soothing and nice.

But really, any nipple cream should be good and should safe for your baby to consume. So I say after your babies done breastfeeding every single time for the first couple of weeks, you want to put on some nipple cream just to keep those nipples really nice and hydrated. And then the next time you breastfeed your Baby, You don't have to wipe it off. Most of it absorbs anyway, but if there is any left on there, A lot of times it just ends up being sort of like chapstick for your baby. And you know, babies sometimes get little chapped lips too.

So I really am a big fan of nipple creams. Things that you don't necessarily need. So there's nipple shields, and those are for breastfeeding. They are silicone and it's sort of like a bottle nip that goes over your nipples. If you have breasts that have inverted nibbles where the nible goes in instead of out, or if they're completely flat, a nipple shield might be helpful to get your baby to latch on. but it may or may not be necessary. You can check with your OBGYN before the baby's born or speak with a lactation consultant and they can help with that.

The good thing about nipple shields is that it's very easy for babies to latch onto. But the bad thing is they're not directly against your breast and so they have to suck for a little bit longer before milk starts to come out and they can get frustrated. And also your breasts aren't getting as much stimulation as they would when the baby's directly on there. So sometimes that can affect supply over time. But if you have the shape of breasts that needs a nipple shield, then absolutely, I'd say go ahead and use it.

If you're not really sure, again, just ask someone and they should be able to help you out. And if need it even just for a couple of days while breastfeeding is getting established, sometimes you can then switch back to direct breast feeding. Some babies do have to be kind of weaned off of the nipples shield because it is so big and long and easy for them to latch on to. They sell these sort of suction, vacuumy things. It's like a little plastic device with a rubber suction cup at the top of it and a, rubber bulb, sorry, that you squeeze.

And then you put it over your nipple and it sucks your Nipple out. That can be helpful. You can also just use your fingers to do that, where you can just, you know, squeeze on the sides of your nipple, and that should make your nibble come out. So, again, those vacuum things you may or may not need to get. Generally not, I would say. A haka is something that suctions onto one breast while you're feeding on another side. If you tend to leak more than would be useful for one of those absorbent breast pads, a haaka can really be really helpful, This is something you're probably not gonna know until your baby's at least three to five days old and your milk is fully in.

But if you are leaking a lot of milk at the end of pregnancy, then you may want to get a Hakka and have that on hand. And that's just sort of a suction device with a, it doesn't really suck, sorry, you like squeeze, It has a larger bulb at bottom to collect the milk and you squeeze that and then stick it on your breast and it provides very mild suction, like just to hold in place. And then as the milk comes out, it just catches the extra. Breastfeeding covers, kind of here and there. I don't know that they're necessary anymore because there's such great options for nursing shirts.

You don' necessarily need another breastfeeding cover to put over you and the baby, but that is something that you might consider getting. You can decide depending on how often you plan on going out in public and how shy you are about breastfeeding and cultural things also. I mean, like in some places, it's not appropriate to breastfeed in a public. So if that is the case, then you may want a breast feeding cover. And I find that with those covers, you want to start using it right away if you're going to, because when babies are used to best feeding without it, they can then get really distracted when they're covered up and they don't necessarily stay on very well on the breast.

All right, for pumping supplies. For every mom that is breastfeeding, I always recommend also pumping because at some point, well, if you at any point want your baby to take a bottle, you want to start them fairly early on, not immediately necessarily, but before four months of age. What I found in my practice is that moms who wait until their baby's at least four-months-old tell me that their babies never takes a and that they refuse it and they scream and cry and hate it. So if you are planning to go back to work at some point or you want to be able to leave your baby with another family member or babysitter during the time that their breastfeeding, it's a great idea to have a pump and some bottles on hand.

So I recommend an electric breast pump, and they make multiple different kinds of those. There are manual breast pumps as well. With the manual ones, it just has sort of a hand squeezy part that you squeeze it and it pulls the milk out, but it only has one level of suction. So you can't adjust it up and down, so it may not be enough suction for you, or it might be too much suction, So that can be a little tricky. The only good thing about a manual breast pump is that it's a lot more portable than any others.

But I usually don't recommend a Manual Breast Pump, at least at the beginning. Electric ones are nice. the ones that plug into the wall tend to have the best options for variety of suction, where you can turn it up or down. When you're using a breast You want to get the suction just to the point that milk is coming out and not any higher. If you turn it up higher, you're not necessarily gonna get any more out. It actually can make less come out because then it can be painful and pull on your nipples.

When you're choosing the flanges for your breast pump, you want to make sure that the size is right for you nipple. There's a lot of great guides online to decide what size of flange to get based on the width of your nipples. If it's too big, it ends up sucking too much of the areola in and you can end up with calluses and bruises around the nipple. And if it's too small, it just causes trauma to the nibble itself. So it needs to be the right size of flange when you get that. A lot of these sets come with multiple sizes of fringes and also inserts to make them smaller if needed.

Pumping Gear and Storage 13:48

So for the electric breast pumps, Modela is one of the really good companies that makes breastpumps that plug in that are also able to be brought along with you. Say if you're going to pumping at work or traveling or whatever, those can be really nice. Wearable breast pumps are also really great if you're planning to be pumping at work and you need to walking around while you pumping. With the breast pump that plug into the wall, you gonna be spending about 20 minutes sitting there while your pumping, so if have a job that you can sit and work, then that's great, or if your taking time off of work.

Electric ones are great for that. The wearable ones good if gonna need be able to get up and walk around. I looked into a lot of the different wearable ones, and there's, I'd say, three most popular ones. The mom cozy ones are probably going to be the cheapest of wearables. And they do work, but they also have a part of pump that sticks up out of your bra, so it is a little bit visible. So going back to those breastfeeding covers, this is maybe one exception where if you are doing a pump like that, or even a regular electric breast pump that pumps into the wall, and you're in a place where, say you were in an office that people might walk into, the room that you in, then you may want to have a breast feeding cover just for pumping.

The other two wearables are the Willow and the Elvie. And when I was deciding between those two, because I needed some for work, the elvie is quieter. But the only sort of complaints I had seen about that one are that the suction isn't as high as with the willow. Also, if you bend forward while you're wearing them, they will leak. and that can sometimes be problematic. So if you go to bend over and pick something up off the ground, you may end up with milk on your shirt. And so the willows are less likely to leak in that case.

A hands-free pumping bra is excellent when you are pumping with one of those electric pumps that pumps into the wall. You want one that holds tight against your chest. It should be as tight as a sports bra, and that's because you need that pressure for the flanges to be in place, because the plastic flange don't suction directly onto the breast. They just kind of sit there. And it's very difficult to hold them while you're pumping. Your arms will get tired. It's a long time to be sitting in that position and holding on.

So a hands-free pumping bra can be very helpful. There's couple of different types and actually now they make bras that are for both breastfeeding and for pumping, which means that they have a clip at the top so you can pull down the entire cup to breastfeed and there's some coverage over your breast as well. And then they also have slit that opens over the nipples. so that you can wear those flanges in there. And so those are really handy because it's a sort of all purpose bra and you don't have to get changed in between.

If you wanted to just do, if you're having just a regular bra or regular nursing bra, then they make these hands free pumping bras that go around your body. It's just rectangle shape of material and then you close it around, clip it in the front and there's holes over the nipples for you to breastfeed. A pumping bra is not meant to be worn outside of pumping just because of the holes over the nipples. It's not going to give you coverage during the rest of day. And so the ones that are only for pumping and have straps on them are ones you're going have to change your bra out and your shirt.

So those can take a lot more time and be a little less convenient. I usually don't recommend those types. Breast milk storage bags are something you're definitely going to want if you are pumping. And those can be put into the fridge or into freezer, and you write on them how many ounces are in there and the date that you pumped it. Breasts milk is good for six days in the refrigerator and six months in freezer. So depending on how your supply is, And if you're able to pump after your baby eats, if your trying to build up your supply, that's one way to do it.

And you can put the extra into those breast milk bags. It is okay to mix milk from multiple sessions throughout a day in the same bag, depending on how much you are getting out. The storage bags are great for that. You can also, with some of the breast pumps, like the Medela pumps. you use a baby bottle on the end of the pump, like it attaches to the flange. So you can pump directly into the bottle and then just put a nipple on that and feed that to that baby. That can be really handy, too. I definitely recommend some accessories like that, bottles that can attach to your breast pump if you do have a wall pump.

And then also bottles and nipples, which we'll talk about in a second with the bottles feeding. Other breast-pump accessories So some of them are helpful and some are not. I would say if you have a breast pump that's portable but a plug-in, you probably want the bag that goes with it. There's handbags and backpack style bags that are made to go with your pump and it fits all the pieces really nicely and there's typically room for some bottles in there as well. for when you store your milk. And then also, if you're pumping outside of the home and bringing it back home, you'll want a cooler bag and some ice packs to keep that milk cold, and also keep the milk in the fridge at work until it's time to go.

So if have a cool bag that can go into the refrigerator, that's the handiest thing, because then you can just put the bottles right in there, or your bags of breast milk there if your using just the storage bags at the work too, then bring that home easily. You don't necessarily need a sterilizer for pump parts. You want to wash out your pump after you use it. And you can rinse and then just use a little bit of soap lightly to get the fat that is in breast milk that naturally will stick on the sides there.

If you don' wash your pumps after each use, it will get smelly like rotten milk. You do need to be washing it, but you don't have to sterilize it necessarily. And the tubes that are with the manual, or sorry, with electric pumps that plug in, there's this long tubing that goes from your breast to the machine. Those generally don' t need be cleaned because there are valves and things so that the milk doesn't actually end up going in there. So the only parts that have be washed are the parts touch your breasts and that hold the for bottle feeding.

So whether you're feeding breast milk or formula, it's a good idea to have bottles on hand. And there are many different types of bottles. There are just some sort of standard size plastic ones that go with the breast pumps really easily. Some moms prefer to glass bottles rather than plastic bottles, just because of concerns of plastic and microplastics.

Bottles, Nipples, and Formula Basics 21:00

I don't have a personal preference. I'd say both are good, but I'll link my favorite glass bottle below because it has these silicone covers for it so that it won't break if the baby drops it on the floor. And then my favourite plastic ones that are the ones go with the pumps. You need nipples for the bottle to attach onto it. And if you're planning to breastfeed and give bottles at the same time, I recommend starting with preemie flow nipple. The preemie nipples are the slowest flow ones. They're slower than slow flow and they make your baby have to work.

That can help to keep breastfeeding going because your babies does have work to get breast milk out from your breast. So the pre-me nipples are fairly easy to find, and they come in standardized sizes to go with the bottles. And then maybe get a couple of slow flow as well. If you tend to have a really strong letdown, then the slow-flow can help with that as, well, it's not going to be any harder for the baby. Then the babies will take both. So if you find that your breast milk comes out pretty quickly, sprays your baby in the face if they pop off, you might want actually a slow flow nipple for that baby because it will most closely mimic what's coming out of your breasts.

When you're starting to give a bottle for a baby who's breastfeeding, you should start with the bottle horizontal so that they're not getting milk immediately, and then after two or three seconds, tilt it a little bit so the milk starts to come out. And that can also mimic what's going on with your breasts because it takes a few seconds for your body to start realizing that your baby is there and start letting the baby come up. Burp cloths are really nice to have just to wipe baby's face, to wiping any milk that spills, and then also when you burp your baby after feeding, a lot of babies will have a wet burped or a tiny spit up afterwards.

So burb cloth are great, you can put it over your shoulder while you're burping your babies there, so you don't get your shirt dirty every single time. And then if you're planning on doing formula feeding or even if your breastfeeding, I suggest starting with regular infant formula. There are a lot of different options for formula and a lotta different brands, and for the most part, the brand names and the generics tend to be fairly equal. My best advice is to look at the ingredients. So take that can of formula powder and flip it around.

And if the first or second ingredient is cow's milk, then that is generally a good one to start with. Some of the other formulas, like Gentile's, start from corn syrup solids, and I don't love that because it's not even close to breast milk. It's a sugar and they just don't really need it. So regular formula that's cow's milk based and has other good ingredients and some vitamins added in is great. All infant formula should have iron added into it and vitamin D. So those are pretty standard now, at least in the US.

You don't necessarily need to get formula that is a different animal base like goat's milk or camel milk. I've heard these aren't necessary for babies. They're all, I'd say, fairly equal in terms of being gentle on the stomach and all that. So a regular cow's-milk-based formula is the very good first choice for most babies, Things that you don't necessarily need, a bottle warmer is something that I usually don' recommend. Most babies are okay drinking milk that is cool or room temperature. It doesn't have to be body temperature And if you do use a bottle warmer, some babies will start to only drink milk that is warmed up.

And then that can be difficult when your baby's being watched by other people or say at daycare or babysitter at home, or if your traveling, then you'd have to bring the warmer with you. It's really okay for babies to have cold milk, if you think about it. We drink cold out of the fridge all the time, right, as adults. So it's okay, it is not dangerous for them. It just burns a couple more calories while they are digesting it, so if your baby is having trouble with weight gain or they're a preemie, you might want to just, If you have milk that's coming out the refrigerator into a bottle, You can just use a bowl of warm water and swirl it around in that or run it under the hot water in the sink for a few seconds and swirled around.

and that's enough to just get it so it's not cold cold from the fridge. But there's nothing dangerous about giving cold milk to babies. It is safe to do and it is okay to deal. You don't need a bottle sterilizer. it totally fine to wash the bottles with soap and water to get that milk out. So you don' t need to sterilize for it. They do make formula makers, like the Baby Brezza is one. I don't necessarily recommend those anymore because I see that a lot of them, the different brands as well, have trouble mixing exactly.

Sometimes the ratio is a little bit off and that can be dangerous over time. If your baby's formula is too diluted or too strong, either way it can cause problems. with things like salt and water in their body and the balance of those. And over time can be very, very dangerous and possibly deadly. So it's very important when you are making baby formula that you follow the mixing instructions exactly when they are entirely formula fed. because they need to have that right ratio. When I say entirely formula fed, I mean also if they're breast and formula feeding, that needs to be the case.

Once they start having solid foods around six months of age, baby's kidneys are more mature and they are able to pee out extra water or extra salt if needed. But up until that point, a buildup of salt or a built up of water could be dangerous. They also sell these cute little drying racks for bottles, and you don't necessarily need one of those. Any drying rack will work for when you wash the bottles out, or if you're washing them in the dishwasher, you won't need a drying rock at all. So that's something that you do not necessarily.

All right, I hope this was helpful. Thank you for joining me today. Next time, we're going to talk all about diapering and also pottying, because I'm a big fan of potter training from a very young age, even as early as a couple of months. Alright, take care, have a wonderful day. Thanks for listening. Remember all of the links from this episode are in the show notes and you can always go to my linktree which is l-i-n-k-t-r dot e-e slash d- r- k- e i- m. If you know anybody who is pregnant or has a little baby, tell them about this show.

Maybe they would like to listen to this podcast, they might find something helpful in here. And if you know any friends who are pregnant and want to get them something for their baby shower, I would definitely recommend my book, The Baby Manual. It's meant to be all inclusive. Really, all the questions that arise in the first year of your baby's life are in that book. So Baby manual is also linked in The Show Notes and on my link tree. Have a wonderful day.