7. Feeding
The third and most important leg in the holy trinity [ahem]:feeding. Your decision to breastfeed or formula feed is entirely up to you. It's an important and personal decision. You can read my 2 cents here. Take it or leave it.
Politics aside, this is what you’ll need to feed....
Bottles
Whether you are breastfeeding or formula feeding, you need some bottles. Yes, even nursing moms who EBF (exclusively breasfeed) need bottles... unless you want to be tethered to your baby for months on end. Don't wait too long to offer a bottle, lest you lose your window of opportunity. It's a disaster situation when a baby definitively refuses to take a bottle (I don't care what LCs say, talk to enough moms and pediatricians and you will learn otherwise).
Generally speaking...
A "regular" neck bottle is best for nursing moms who will be pumping (a little or a lot), because you can attach the bottle directly to breastshield (horn thingy) and pump straight into the bottle. No adapter required. A wide-neck bottle, on the other hand, is best suited for formula feeding, as it's much easier to pour the powder into a wider area without risking major spillage.
The Best Bottles
Here are the 3 best bottles on the market, according to the mommies in my group and hundreds of testers across the internet:
1. Born Free
The best, basic baby bottle is the Born Free (BPA free). This bottle has a simple venting system to prevent colic (read: gas). The wide nipple base on this bottle mimics the shape of a real nipple and makes switching back and forth between the bottle and the breast easier by forcing a wide latch. ** A downside: as with any other "wideneck" bottle, you must buy their adapter so you can pump directly into the bottle.
Born Free bottles
Price: $40 for starter set
2. Dr. Brown's Natural Flow
The best bottle for "colicky" babies by far is the Dr. Brown's Natural Flow. We used Dr. Browns because Lucie had major issues with regurgitation and spitting up (omg, this child made the Exorcist look like a novice).
This bottle has a straw-like insert that equalizes the pressure and prevents babies from swallowing air as they drink. This helps to reduce spit-up, burping, and gas. The 2 extra parts (the straw and the stopper) make it a little more tedious to clean, but for us it was well worth the added trouble.
If your baby doesn't have issues with gas/burping/spits, you may prefer a simpler bottle that's easier to clean. ** These bottles WILL leak like crazy if the straw/stopper insert is not firmly in place.Price: At $20 for the starter set, this one's a best buy.
3. Playtex Drop-in Nursers
These are favorites among formula feeders and nursing moms alike. This bottle combines a disposable inner liner with an outer bottle shell thingy. Since FFs go through several bottles a day (and thus, must CLEAN several bottles a day), they enjoy the fact that the drop-in (ahem: bottle condom) can be thrown away each time. Not the most eco-friendly choice buuuuut, whatevs. Another pro to this bottle is that you can squeeze the air completely out of the liner to prevent a burp-fest.
Nursing moms love that you can pump, store and feed all from the same liner - without having to transfer the milk - by using the pump adapter that comes with the breastmilk storage kit. This is the bottle for you if you're not sure if you want to FF or BF and especially if you are FFing and don't have a dishwasher.
** Don't ignore the fact that you will have to buy lots and lots of bottle liners for these bottles, which is a pain. If you run out in the middle of the night.... eek.
Price: $28 for the starter set.
Honorable Mention
My personal favorite bottle is the Comotomo. This bottle is very expensive and therefore not for heavy bottle feeders (plus, you can't pump into it), but I do love him. This guy is beautifully designed with few parts (therefore, easier to wash than, say, Dr. Brown's), it won't leak, and it has a great hand-feel (yes, I just made that up). If you are an occasional pumper or FF'er, get yourself one or two of these bottles; they're slick.
Comotomo Bottle
Notes
** I am no longer recommending the Breast Flow bottle by First Years, there were just far too many complaints about nipple collapse...
** These are all BPA-free, but you can get the Born Free and the Dr. Brown's in glass if you want to go old-school style. Just don't drop it, butterfingers.
** Bottles usually come in two different sizes: 4 (or 5) oz and 8 (or 10) oz. The smaller ones are for newborns (0-2 months). Get several of both size.
** Bottles are a bit like pacifiers: you may have to try a couple of different ones until you find one that works well for you and your baby.
Nipples (for your bottles, that is...)
Each brand of bottle has several nipples to choose from. The nipple controls how fast the milk flows from the bottle. For a newborn, start with a Stage 1 or a slow nipple (months 0-3). The higher the number, the faster the flow. The fastest flow comes from a Y-cut nipple, which even allows your baby to drink juice or other fluids thicker than milk.
ParaphernaliaAlong with bottles, you'll need a bottle brush. I dig the one that stands on its own next to the sink. You can use regular dishsoap to wash your bottles and nipples or you can put them in the dishwasher.
If you are formula feeding or plan on bottle feeding frequently, you may want to purchase a bottle drying rack.
Another item you've probably heard a lot about is a bottle warmer. Yes, it's true that babies prefer warm milk to cold. In fact, my little Princess and the Pea won't drink it if it's not warm, but be aware that many bottle warmers are notorious for not warming the bottle enough. If you plan on buying one, I suggest the Dr. Browns Bottle Warmer. Again, if you plan on bottle feeding frequently, this may be a worthwhile investment. If not, you can always just warm the bottle the old-fashioned way in hot water from the stove or micro.
Next: bottle sterlizing machines. Just say no, don't waste your money. You don't need to sterilize your junk, unless you have a preemie or a special needs baby.
Burp Cloths/Bibs
Some babies are major spitters, meaning they spit up ALL THE TIME and EVERYWHERE (ahem, Lucie and Alice). Some babies don't spit up at all.
In any case, you'll want at least some burp cloths and if you have a serious spitter, some spit-up bibs to prevent them from soaking their clothes after every feeding.
Formula
I recommend that you have formula on hand regardless of whether you are breastfeeding or not (just don't open it unless you're ready to use it because it starts the expiration clock ticking). What if you get hit by a bus? Or have to take Rx meds? It's a good idea to keep formula on hand somewhere in your house, even if you never use it. The "lactivists" hate it when I say this, but whatever.
Like diapers, baby formula has come a long way since we were babies (when they actually thought formula was a superior food source to breastmilk - ha!).
What is formula, anyway? Most formulas contain purified cow's milk whey and casein as a protein source, a blend of vegetable oils as a fat source, lactose as a carbohydrate source, a vitamin-mineral mix, and other ingredients, depending on the manufacturer. *The cow's milk proteins are broken down, so it's not the same as feeding your baby cow's milk*.
I don't have a strong preference for brand of formula. On the rare occasion we used formula, we used Enfamil, which worked out fine. Similac is fine too. For a newborn (0-3 months), you'll want to buy a Newborn version of formula. After 3 months, switch to the Infant version. Yes, you guessed it, there's a toddler version too. *If your baby has special needs, please consult your pediatrician for the appropriate kind of formula to use.
Breastfeeding
If your baby takes to the breast like a duck to water, you are SO money. However, many new moms are not so fortunate.
I talk a lot about how difficult breastfeeding is in the beginning, so I made a small collection of items that I recommend you have on hand to prepare for the travails of nursing. You can usually purchase all of these things directly from your LC (lactation consultant), but you will probably pay double (not that you give a flying F at that point about what things cost).
The Entire Breast Care Kit (shortcut)
Soothies: Soothies are cool, silicone pads that pamper sore (cracked, bleeding, oozing) nipples. The $10/pair price tag becomes a complete non-issue when you have tears streaming down your cheeks from pain. I recommend having 1 pair on hand to start, you can buy more if you need them. Each pair lasts for several days.
Your nipples take so much abuse from those early days of learning how to latch properly. Think of the abuse your clutch took when you were learning how to drive a stick shift for the first time. Same thing for your nipples. There are 2 things I recommend to apply directly to your nipples:
1. Earth Mama Angel Baby nipple cream This is an olive oil based cream that is much less viscous than a lanolin-based cream. Applying thick, honey-like lanolin to sore nipples can in and of itself be painful. Use this instead.
2. Neosporin. If there are open sores on your nipples, you can apply Neosporin to help them heal quickly. My lactation consultant said you can use a little bit without having to wash it off before nursing (who cares: because washing your nipples hurts.) If that freaks you out, consult your pediatrician. It works well, trust me!
For pumping, a lanolin-based nipple cream is perfect for smearing around the inside of the breastshield (see below). Like pistons in your car’s engine, your nipples also need to be lubricated while pumping or else they can become badly chafed. Think of this as Valvoline for your nipples. I don't recommend using it directly on your nipples if they are torn up -- this stuff is super viscous and may hurt just to apply it.
Applying lanolin to a breastshield
I love the ice/heating packs that are circular shaped for your breast. You will almost certainly experience engourgement and/or blocked ducts at some point in your nursing career. Trying to balance a bag of frozen peas on your sore breast will only get you so far.
If your nipples become damaged, use breast shells to prevent them from touching... anything, including you own bra. Ah, oooh, ouch ouch ouch. So painful.
Breast Pads
Drip, drip, drip. Your breasts will leak milk when you aren't nursing, especially in the beginning - and ESPECIALLY during your let down. If you don't wear breast pads, you will get embarrassing milk circles on your bra/shirt, which is super sexy, but no. Some people leak for almost a year (me - ha!) and others stop leaking after a few months. You will be buying breast pads as often (perhaps) as you buy diapers, so get used to it.
My favorite solution in the beginning is an old-fashioned disposable breast pad. You can get them from Medela or Lansinoh. A couple of annoying downsides for both of these disposables are 1) they come individually wrapped in plastic, so you have to unwrap, peel the sticky tabs off, blah blah. This requires 2 hands. It's kind of a pain. 2) they aren't totally smooth, so you may have that I-stuffed-my-bra-with-kleenex look. Oh well, you're nursing. Looking smooth may not be at the top of the priority list.
I've tried a couple of other solutions, none of which I liked. Lilypadz ($25) are silicone cups that fit tight against your skin. It makes your nipples look like a bug on a windshield. These are washable and re-usable and are *supposed to* last for weeks. However, I found them to be itchy and suffocating and they did NOT last very long for me - maybe 10 days or so. Meh. They are good, however, for special occasions when you need to wear a tight-fitting or tailored shirt or dress. Fine.
Washable cotton pads are awful. They stick to your nipples when you take them off - yeowwww! Hated it.
If you have a low supply and need to preserve as much milk as possible, try the Milkies milk-saver pads. You can contain the milk that you leak and re-use it. Brilliant! I know a lot of moms who use these religiously.
Nursing Pillows
In the first 3-4 months, you will benefit greatly from a nursing pillow. A newborn can conceivably spend 4 hours a day on the boob (pardon?), so it behooves you to get comfy.
The 2 pillows that mommies love are:
The Brestfreind is essentially a soft shelf-like pillow that baby lies on to nurse. It wraps around your whole body and buckles on the side. Because of this, the setup is a little more tedious because you need both hands.
Some people find that it’s hard to hold the baby and wrap this thing around you at the same time. I agree, but I still think it's a great pillow. It also makes a very fashionable skirt or tutu to wear to the door when the UPS man is delivering your diapers...
They now make one especially for twins. My lord, you could land an F-16 on this thing!!
2. The Boppy
The Boppy is a thicker, horseshoe-shaped pillow that you place around your waist. No buckling necessary. It's easier to get on (and off) than the Brestfriend, but it may not feel as sturdy.
The Boppy is a multi-use pillow; your baby can hang out in it, especially on a couch or in an airplane seat when you need something to corral your baby in place. Baby can also use it for tummy time practice. Heck, I even use it as a sleeping pillow. My Boppy and I? Yeah, we are close.
Having more than one nursing pillow is very convenient, especially if you have a 2-story house. You don’t want to run upstairs to get your damn pillow every time you want to nurse (and believe me, you won't want to nurse without it).
The Brestfriend is wonderful during the early days when your baby has no head control. The Boppy is better around 2-4 months because it's less of a hassle to get on. After about 4 months or so, your baby is big enough to nurse without a pillow.
Both of them (usually) come with washable covers. *Be careful to not shrink it in the dryer after washing*.
Nursing Covers
If you are nursing and ever have hopes of leaving your house, you need a nursing cover. Keep it in your diaper bag and it will always be there when you need it. [You may not use it when you have your 2nd child because you stop giving a crap what people think, ha!]
One thing that moms and babies alike always complain about is that it can can VERY hot under there - like a mini-inferno. If you live in a warm climate or are expecting a baby in the spring or summer, opt for a thinner, more breathable nursing cover.
The vast majority of moms in my group use the Bebe au Lait Nursing Cover. It comes in many different colors/patterns. If heat is a concern, go with the Peanut Shell nursing cover, as it tends to be thinner and more breathable.
If you will be an at-work pumper, a nursing cover might also come in handy. I can't tell you how many moms I know who have been pumping at work when someone inadvertently bursts through the door to ask about the status of the TPS report (most office doors don't lock apparently!). You wanna see a man back-pedal like Scooby Doo? Yeah. Have him walk in while you're pumping.
This is a must-have for nursing moms. Don't leave home without it!
Pumping
As a nursing mom, you need to be in control of your milk supply (rawr!) and to do so, you need a pump.
There are electric pumps, which plug into the wall or your car's 12V battery supply, and there are hand pumps. The ideal situation is to have an electric pump, but if all this silly baby business has you considering a second mortgage on your house, your broke ass can probably get by with a hand pump. Remember, if you are going to be pumping frequently, you most definitely need an electric pump. Otherwise it'll be like painting a huge house with a tiny brush.
I want to start by dispelling a rumor. A vicious rumor. They say that you can't/shouldn't use somebody else's breast pump. This is the biggest load of BS I've ever heard. Perhaps the Breastpump Manufacturer's Association of America (BMAA) got together and created this publicity in order to sell more pumps (haha, just kidding - I made that up). Honestly though, this is a bit ridiculous.
Do I recommend using a 4th-hand breast pump from a total stranger? No. Do I recommend borrowing a pump from a sister or close friend? Absolutely. In fact, while it could happen in theory (with some pumps), there have been no documented cases of mothers or babies becoming infected from anything using a second-hand pump. You are buying new parts anyway, so what's the deal? It's absurd. Anywho, I digress.
If you are using a second-hand pump, you should note that pumps DO lose their power and suction over time, so do ask how many miles have been logged on it before you take it over. *A pump with insufficient suction could affect the supply of a heavy-duty pumper. *
Electric Pumps
1. The Medela Freestyle: Expensive but Awesome
Do you have some money to spend on a super badass breastpump? If yes, you should definitely get the Cadillac of breast pumps: the Medela Freestyle (~$370, usually much less on Amazon). I won't lie, I have breast pump envy. This pump is small, totally handsfree and lightweight. It has a 2-phase expression system that is supposed to more closely mimic the way a baby naturally nurses. This speeds things up a bit. Look how small it is, omagah:
Medela Freestyle
2. The Medela Pump In Style (PIS): A Workhorse for back-to-workers
Next to the Freestyle, the Medela Pump In Style Advanced (~ $275) is by far and away the best double electric breast pump on the market (below). If you are going to be pumping at work, this is the pump you need. It has a discreet, handsome carrying case which holds the pump, a storage cooler for the milk, and a battery pack. I use this pump and love it. And guess what, it was a hand-me-down from my sister. It's about 37 years old and it still runs great (just kidding, it's 5 years old, but you get my point).
Medela Pump In Style
*I should note that this is THE go-to pump (non-commercial) for every lactation consutlant I've ever spoken to. That should mean something.
3. The Ameda Purely Yours: a reliable pump for at-home pumpers
If you don't need all of the appurtenances and the pump-that-looks-like-a-briefcase-ness of the Pump In Style, go with the Ameda Purely Yours (~ $150) double electric pump (below). This pump performs very well but without all of the extras. For at-home pumpers, this is your dog.
Ameda Purely Yours
Hand Pumps
I recommend that all nursing women have a hand pump, including those that also have an electric pump. It is great for traveling or going to any other event where you don't want to schlep around your huge electric breastpump. I can't tell you how many times I've used my hand pump on road trips, running into the bathroom to get some relief during an unexpectedly long meeting at work, and even during a power outage. Yes, it takes a longer time to express a bottle, but it's really not that bad. I use it every time I fly back East, as there is NO WAY I am checking my Pump In Style or having it serve as my one precious carry-on. Forget it!
A hand pump is perfect for once-in-a-while pumpers. They are cheap, portable, discreet and don't require a power supply. The one that I recommend is the Medela Harmony (~ $30).
Medela Harmony
Remember, if you rent an industrial-grade hospital pump, like the Medela Lactina or Medela Symphony, you have to buy your own parts kit anyway. This kit is yours to keep after you return the pump and IS - itself - also a hand pump. Ask the LC to show you how to use it as a hand pump when you return your rented pump. It's a lifesaver.
* There has been a lot of talk about health insurance companies covering the cost of a pump. Currently, they only cover it if you have a preemie or another special needs baby where the doctor has determined that breastfeeding is "medically necessary". HOWEVER... this is all changing soon (in theory) with the advent of the Affordable Care Act (also known as Obama's healthcare reform), which will require insurance companies to cover "breastfeeding support, supplies, and counseling", which means renting pumps, etc. Stay tuned for more details.
Pump Parts & Pieces
Admittedly, there are a lot of bits and pieces that go along with a pump. If you're buying a new pump, all of these accesories should come with it. You may need to buy more horns (see below) to get you through the day. If you are borrowing or inheriting a second-hand pump, you may want to buy new tubing and breastshields, or just sterilize the ones you inherited.
For an electric pump, there are 2 plastic tubes (or 1 tube if you are using a single) that go from the housing and connect to the back of the horn. The air in these tubes creates the suction that expresses the milk. They don't ever get wet or anything, they only carry air. You only need 1 pair.
The breastshield (below) connects the tube to the bottle. It looks like a megaphone or a horn. It's more fun to call it a horn, no?
Your nipple goes into the horn and the flange creates a tight seal on your breast. You'll want to have MANY of these on hand so you don't have to run to the kitchen and wash them each time you need to pump again. OH -- and, they come in 5 different sizes. It's okay for them to be too BIG, but if they are too small you will squeeze the bejesus out of your poor nipple.
The default size is Medium (24 mm). This works fine for normal size nipples (and dainty English nipples). If you have big Italian pepperoni nipples, you need to get the larger horns (they come in 30 and 36mm). [If you're not sure if your nipples are big or small, they are big.]
The bottle then screws onto the bottom of the horn. In between the bottle and the horn is a little white piece of plastic that acts like a valve. It keeps the milk flowing in one direction. You can buy extra valves too because they get lost easily.
And finally, the milk flows into and collects in the bottle.
Nursing Bras
I actually know moms who nurse and never bought nursing bras. I honestly can't think of anything worse. You NEED a nursing bra. Several, actually.
The highest-rated all-around bra for nursing moms is the Bravado Silk Seamless. Yeah, it rocks. For large-breasted women, also look at the Medela Softcup Bra. If you are VERY large-breasted, check out Anita nursing bras.
Pumping bra
For double-pumpers who need an efficient way of pumping milk, get the Simple Wishes pumping bra. I know it looks like something out of Austin Powers, but everyone uses it. You know she's trying not to laugh (below)...
You can pump both breasts at once handsfree without having to sit there and hold the horns on your breasts. Yes, many a working mum (pretending to be English) is sitting up in her office (or lactation room) wearing this bra as we speak. Ah, the things you learn!
All non-widemouth bottles should screw into whichever horns you buy, so you don't need to buy special bottles for pumping unless specified. Ideally, you should pump directly into the bottle you are going to use to save on dishwashing.
Milk Storage
If you're not planning on using your pumped milk within 6 hours, you should put it in the refrigerator (in the bottle is fine). If you're not planning on using it within 6 days, you should freeze it. In the freezer, it will stay good for a maximum of 6 months. *You may not want to pump too far ahead because the composition of your milk - and your baby's needs - will change over time.
This is the 6/6/6 rule. Cool huh? Six hours, six days, six months.
To freeze your pumped milk, use breastmilk storage bags. Each bag holds up to 6 oz. of milk.
And you thought strollers were overwhelming ;-)
Next ------> 8. Clothing...
