Tuesday, June 19, 2012

How Do I Handle Expressed Breast Milk

I think I received quite a number of requests on how to handle breast milk. Perhaps it's good if I could share with more mothers by blogging about it. But please keep in mind that this is not a guideline, rather an information sharing on how do I do it, with 2-babies-amount of experience. Some of the practises might not suit you or even might not be agreed by you but I practised these for my 2 babies and alhamdulillah, nothing bad occured and both now membesar bagai johan. There are a lot of storage guidelines, resulted from "EBM storage guideline" google. I did a lot of reading during breastfeeding my first baby and matched the best with my working-mom-with-no-maid-lifestyle i.e. the most convenient for me.

Storage :

Everytime I express, I'll store the EBM in cooler bag with 3 ice packs. At home, it would be inside chiller section of a refrigerator. This is because later that day or day after (still within the storage rules hours), I would want to combine those bottles in storage bags.

For example : I might be able to express 5 oz during the 1st session and 9 oz during the 2nd session and 6 oz during the 3rd session. All bottles will be stored at the same storage place until all reach the same temperature. Later I'll combine all 20 oz of EBM and store them in 7 oz storage bags.

There are a lot of storage guides when it comes to EBM. I would suggest that the best reference is using temperature guides. By saying that, you have to know roughly what is your EBM storage place's temperature. If this is hard to achieve, to be safe, go with the lowest number of hours/days advised for each storage place. The idea is the longer EBM is stored, the more nutritiens lost and the higher exposure of contamination.

For the next day use :

First of all I'll identify how much does my daughter consume. It would be 2-3 dry run of bottle feeding session, starting with 2-3 oz. Now Eivie consumes 3 oz per feeding, around 5 times while I'm at work. That means I need to provide the daycare with at least 5 x 3 oz of EBM.

Remember I keep freeze my EBM at 7 oz each? That way I could provide the daycare with around 2 x 7 oz thawed frozen EBM? No, I don't do that. This is because if Eivie does not finish all 14 oz, the milk could be used for the next day (note : After being thawed (defrost), EBM have to be used within 24 hours, else to be discarded).

So, I only defrost 7 oz of milk and top up with the previous day fresh EBM. I put the defrosted EBM in 2 bottles, measured by 3.5 oz (easier for carer to handle), labeled with "19 June -  Bottle 1" and the second bottle as "19 June - Bottle 2". Fresh EBM will be labeled as "19 June - Bottle 3", "19 June - Bottle 4" and "19 June - Bottle 5". Carer will be informed to always use bottle number 1 first. That way, if Eivie doesn't able to finish all 15 oz, at least EBM in bottle 3, 4 or 5 (whichever left) could still be used for the day after. Besides, this is also to avoid the early frozen EBM reached it's expiry. (Please take note that for fresh EBM, I keep the 2-day rule of storage, before being frozen and I'm using 2-door fridge).

How did I defrost? By transferring the frozen EBM from freezer to chiller the night before.

And for the day after, carer will be informed to use bottles dated 19 June first, before could use bottles dated 20 June (and yes, the first two bottles dated 20 June contain defrost EBM, while the rest 3 bottles contain 19th June's expressed EBM). Repeat until the last day of breastfeeding. :)

Till then, happy breastfeeding mommas! Do drop any queries or suggestions in comment section, so we could share more information.

Note : http://www.kellymom.com among those websites offer good reference for breastfeeding.

Monday, June 18, 2012

Talking About Expressed Breast Milk

I managed to breastfeed Eirsa for 24 months; 21 months solely with breastmilk (plus solid food when she reached 7 months old) and we had to top up with formula since the supply was no longer sufficient. And the good side was, these 3 months of combination of breastmilk and formula somehow did ease the weaning off process.

Eirsa was a heavy consumer of breastmilk, being a baby girl. As early as 5 months old, I have to send 4 to 5 bottles of 5 oz expressed breast milk (EBM) to her daycare and usually she would finish them all. Even when she started her solid food, the amount didn't reduce. When she was about 8 months old, I had to send 5-6 bottles of 5 oz EBM.

When I started working back then (still talking about Eirsa's era), I only had around 40 oz of EBM stock, with the knowledge that it would be sufficient. Yes, it was, in fact I manage to top up another 20 oz of stock, but only until she reached 5 months old. For the record, I started making stock after confinement days, while still undergoing maternity leaves.

It was a sudden drop in my milk supply, with no warning, no significant cause as far as I could recall. Instead of being able to express 5 oz in the morning at home and 16 oz while at work, I only managed to express 18 oz in total. It wasn't alarming until noticed at one point I only had 10 oz of frozen EBM. Then I started to google for some quick milk supply boosters.

I tried many things as far as my appetite and tummy could take. Booster tea, fenugreek, dried longan, red date, soy, milk, ASI, Shaklee and some other that I already forgot. 3 years ago the options were still not as many as now, or may be I didn't know about them. Among those that I've tried, some did show temporary miracle, some did consistent yet gradual improvement. But still, to catch up with 20 - 30 oz per day of supply, sometimes I could just send whatever I had in stock and pray that they would enough for Eirsa for the day. 

Alhamdulillah, during those hard and stressful days, Eirsa still managed to enjoy my breastmilk with no significant incidents of starving and no formula milk involved. There were days when she slept a lot and I managed to keep 2-3 oz per day, to be used for the next day. Meanwhile I didn't give up trying to boost the supply, even though I cried once a while thinking that 'that was it' moment was about to come.

While some of the remedies worked, I could keep small amount of stocks. At the same time I added more pump sessions, usually at home. I would pump right after I arrived home and before going to bed. Every day. It was tiring and a little bit mentally torturing but my husband kept all the positive vibes around the house. He helped with taking care of Eirsa, washing and sterilizing bottles, giving me motivations while rubbing my back when I pumped. During the weekend, I did do tender pumping even though it was a struggle since Eirsa didn't like "competition" but finally she got used to it. During these hard times in breastfeeding, I would keep even 0.5 oz EBM. Too precious. I would prefer to tender pump or to pump right after each feeding, as compared to pump in between feeding session, so my body could produce sufficient amount of milk for my baby for her next feeding session.

After about 1-2 weeks of the routines, I could see significant amount of supply increase. In fact, in the next few months, I managed to make 60 oz of frozen stocks while maintain the day in day out supply for Eirsa. I still topped up the stocks during weekends and at one time I had around 100 oz of frozen stock. All praises to God!

So for Eivie, I started keeping stock as early the third week of confinement period. 4-5 oz each morning and sometimes another 3-4 oz when my breasts engorged (when Eivie slept at unusual longer hours), I managed to make some 200 oz of frozen EBM, before I got back to work. Alhamdulillah.. Alhamdulillah.. Alhamdulillah. And so far, Eivie consumed around 13-15 oz per day and I still managed to top up the EBM stock and I now have around 300 oz of frozen EBM. I hope this suffices during my low supply days, especially during the fasting month.

In short, for those struggling (with the target to fully breastfeed their baby but low milk supply) moms :

1) you could try one milk supply booster at time, give it 1-2 weeks to see the improvement before changing to other milk supply booster. I could not suggest any specific milk supply booster as it might work for me but not for you, but you could find them from many forums and mommy-baby online shop. Read the instructions carefully, especially the impact to moms and babies.

2) do increase your pumping session. No, you could not see the results in 1-2 day. It might take 1-2 weeks to really work, but it helps a lot. The more consistent it is (in terms of timing), the better, especially tender pumping or to pump right after each feeding session.

3) keep any amount of milk that you managed to express each time. 0.5 oz times 100 is a good 50 oz.

4) do drink a lot and eat adequately.

5) do keep positive thoughts about your supply. Not only during expressing but, all the time (if possible). Stress might affect the supply. And trust that God will take care of the rest as long as we try our best. There was a time when I only has 18 oz of EBM as compared to 25 oz of Eirsa's daily consumption, but it was still enough for her for that day as she had longer than usual afternoon and she ate more than usual thus didn't demand for milk a lot.

Good luck (and do share your experience, if it is not too much to ask. :) )

While breastfeeding Eivie at a restaurant

Till then. Muah.

Breast milk info (from Wikipedia) : Whole cow's milk does not contain sufficient vitamin E or essential fatty acids. Whole cow's milk also contains excessive amounts of proteinsodium, and potassium, which may put a strain on an infant's immature kidneys. In addition, the proteins and fats in whole cow's milk are more difficult for an infant to digest and absorb than the ones in breast milk. Evaporated milk may be easier to digest due to the processing of the protein but is still nutritionally inadequate.

Friday, June 15, 2012

"You Are Selected! Hooray!"

I have this habit of reluctance to answer calls from unknown numbers.

This started when I received several calls from some insurance agent during office hours, to promote their product with pick up lines "You are among those lucky ones!" And these agents would usually still annoyingly force me to listen to their attractive packages even though I had nearly a thousand times said that I was not interested. They would want to know why wasn't I interested or whether they could give me another call later. Or even worse, they would hang up on me with bitter thank you tone.

Just now I received another unknown "cantik" number. And I chose to ignore.

Oh. It's also a habit to google that number, to ensure that I've ignored the right caller. I also did the same to this and so it resulted to these :

So yes, it was a right decision. But how true was the google result? I don't dare to verify it. If you did, please let me know. Sharing is caring. ;)

Till then. Muah.

Some interesting info about prank call : Even very prominent people have fallen victim to prank callers, as for example Elizabeth II, who was fooled by Canadian DJ Pierre Brassard posing as Canadian Prime Minister Jean Chrétien, asking her to record a speech in support of Canadian unity ahead of the 1995 Quebec referendum.

Of Things So Far

Twitter really does a good job by keeping me away and away from this blog. Everything could be shared instantly, in simple form, as compared to sit down and write everything cumulatively.

Our life is relatively stagnant nowadays. With Eivie's around and barely reached 4 months old, hectic weekdays (refer to previous entry) we prefer to stay at home during weekends. Once a while, with the company of my in-laws, we'll dine out. We've tried once dining out, just the four of us and as expected, it's not going to be dining, but more to putting everything in the plate into your mouth whenever you can and as fast as possible while attending the two girls. Manageable, but not really enjoyable. As such, we still believe that dining out (just the for of us) will be more meaningful if Eivie could sit on her own, strap her on a high chair and everybody could enjoy their meals more.

As for mommy, losing weight is snailing. Or more of not losing any. I still could not get into my old S size office pants and shirts so I have (seriously, I almost had nothing to wear during the first week to office) to buy some new loose tops/blouses, so that my yummy could breathe. And with limited time that I had for myself, most of the shopping happened online.

These are among online websites that I regularly visit :

1) http://www.thepoplook.com
2) http://www.prettychase.com
3) http://www.fashionvalet.net

Yeah, you can have fun too! Go browsing and if financially permit, shopping!

Till then.
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