Every Wednesday for the last couple of years the IBCLCs of The MILC Group have opened their doors from 10am to Noon for drop in Weight Checks and Lactation Chats. We decided we should write a short blog post letting people know what to expect during Weight Check Wednesday (WCW).

• Weight Check Wednesday is a "drop in" event meaning we do not require appointments.
• Since WCW is a "drop-in" event you will not have privacy while chatting with us.
• Some days we will see one breastfeeding family and others we may see five. We do our very best to give individual attention and to move people in and out in an organized manner.
• We ask that families fill in a very short form for us to be able to keep a track of who attends and also to track the baby's weight gains each week.
• Babies will be weighed before feeding and after feeding in order to get an idea of intake during that feeding. 
• The Lactation Consultants of The MILC Group will sit and observe the baby nursing in order to assess external latch and to listen for any indicators that there may be a latch issue. 
• The IBCLCs will answer any basic breastfeeding questions that families have during the Weight Check.
• Recommendations will be given if a full lactation consult seems to be needed.
• The baby's weight will be recorded for future reference and will be written down for you to take with you. 

Weight Check Wednesday is an excellent way to get accurate information from an International Board Certified Lactation Consultant for a minimal fee and in a short amount of time! It does not substitute for a consult.

The fee for Weight Check Wednesdays with The MILC Group is just $20. Come in and see us this Wednesday!

The MILC Group offices are located inside of Go Baby Go, 6104 Broadway, #C-4, San Antonio, TX 78209. Contact us online at www.TheMILCGroup.com or by phone at 210-960-MILC/210-960-6452.

When The MILC Group first started out we ran a series that we called "JJs Nip Tips." They were named for an adorable chunky baby who we spent a lot of time with. JJ is now a rambunctious preschooler and we wanted to take a moment to pull together a list of our favorite Nip Tips and post an adorable updated pic of our chunky mascot. 

1. Breastfeeding isn't just about food. It is about love and closeness and more!
2. If you have breastfeeding questions, don't wait to ask for help. Have a list of local resources on hand before you deliver your baby.
3. A good latch is a good thing. Wide open relaxed mouth...lips flanged out...chin deeper into the breast than the nose. These are a few quick nip tips.
4. Don't forget that the best way to build your milk supply is to breastfeed your baby frequently. 
5. Breastmilk has a mild laxative effect that helps to prevent constipation. 
6. A supportive bra is one of the most important breastfeeding tools you can buy. Invest in a good one!
7. Breasts come in all shapes and sizes. Yours are perfect for your baby.
8. Remember, when baby is being fussy they are not trying to manipulate they are trying to communicate.
9. Finding a group of breastfeeding friends can be great for you and baby.
10. Make sure to take some time for yourself. A few quiet moments with a lovely cup of something warm can help to relax and rejuvenate you.
11. Nursing in a carrier can make things easier for babies on the go.​

If you need breastfeeding support you can contact The MILC Group here:
www.TheMILCGroup.com
210-960-MILC/210-960-6452

​

Getting through the week can sometimes be so challenging. For new parents the week can seem to drag on forever. Having something to look forward to can really keep you going. I can't remember how we decided to host our Breastfeeding Support Group on Friday afternoons but it was a great idea!

What do we talk about during our Friday Support Group? I wanted to share a sample of last week's topics...

One of our Mamas asked how everyone enjoyed Mother's Day. No one seemed to do anything overly special but it was a nice way to start our chat.

Another Mama asked about feeding older breastmilk to her baby. This Mama will be enjoying a special event with some friends in the fall and was wondering if milk she pumps now will still be good to leave. Breastmilk  is always good even though the composition changes as baby's grow. We suggested leaving a mixture of fresh and frozen milk for baby.

We discussed spit up and babies who are happy excessive spit-uppers. We talked about the lovely odor after you have been spit up on and how spit up down your bra gives off a nice cheesy smell by days end.

One of the babies had a tongue and lip tie revision that week so we asked how he is doing and discussed the procedure and changes in latch. 

Birth control came up which led to discussing the lack of sex after babies and to a description of lactational amenorrhea.

Many of our parents will weigh their babies on our scale when they are at the Support Group. It helps them to keep a track of their baby's growth and development. We love providing this service at no charge.

Other random topics....super random :)

Natural cleaning products
The meaning of "Seventh Generation"
Menstrual cups
Cloth menstrual pads
Family cloth (look that one up yourself)
Healthy foods and your babies

This particular Friday we had a nice group of parents with babies in tow and a Grandmother was in attendance too! Our Group is casual and lively. The parents look forward to having a safe space to share and discuss their questions and concerns. Ginger and I look forward to seeing these parents and their babies too. Seeing the babies grow and change is so lovely. 

If you have been on the fence about whether or not to attend a MILC Breastfeeding Support Group maybe this will make you feel more comfortable. We hope to see you soon!

Find our Schedule of Events here. 

Families in the San Antonio area have a good number of choices for their breastfeeding support needs. We wanted to compile a list of reasons that you should choose The MILC Group. 
​

1. Ginger and Tina have a combined 25 plus years of experience working with breastfeeding families! That's a lot of experience.
2. Ginger and Tina both started their careers as La Leche League Leaders. Why does this matter? La Leche League is the largest non-profit breastfeeding organization in the world. As La Leche League Leaders both Ginger and Tina have had the privilege of working with families from birth into the toddler years which creates a wide range of knowledge. They also show an obvious passion for this work since they continue to volunteer their time to La Leche League instead of only doing paid lactation work. 
3. Giving to their community is of the utmost important to The MILC Group. Both Ginger and Tina still are active with La Leche League leading monthly meetings and attend many outreach events in our area to give as much to our community as possible. 
4. Education is the foundation of what Ginger and Tina do. They both attend in person and online conferences regularly to keep their skills up-to-date. 
5. Both of the MILC ladies have sought out additional hands-on training in the evaluation of tongue and lip ties as well as other structural issues. Other IBCLCs may have taken online trainings or sat through talks, but hands-on training is so valuable to this profession. 
6. Integrity is of the utmost importance to both Ginger and Tina. We are who we say we are. 
7. Relationships with other care providers is also so important and so we work to develop these relationships to benefit our clients. 
8. Developing relationships with our clients matters to us. We strive to continue to support the families that see us for as long as they need. The MILC Group offers weekly Support Groups and Weight Check opportunities to help families keep on track with their breastfeeding goals without breaking the bank. 
9. Last but not least....we are awesome! We work daily to be the best International Board Certified Lactation Consultants that we can be :) 
10. I feel like I should make one more to create an even number.....how about the fact that we are amazing parents and our kids love us. That's pretty darned important!

Your baby has arrived and you are having problems breastfeeding. What should you do? Some of your knowledgeable friends suggest that you should see an IBCLC (International Board Certified Lactation Consultant). That sounds okay, but you want to know what to expect during a meeting with one. Here is what to expect if you choose to meet with an IBCLC from The MILC Group.

• The Lactation Consult  lasts about 1.5 - 2 hours whether in our office or in your home. 
• ​We make every effort to arrive on time and call or text you if we are running behind.
• We bring a high quality baby scale which we use to weigh your little one. 
• If we make a housecall,  we set up our scale on a flat surface (kitchen counter tops work great), otherwise we always have a scale in our office.
• We wash our hands thoroughly before we touch you or your baby and we also use non-latex gloves during our exam.
• We  ask you to fill in a brief intake sheet which can be found ahead of time on our website, but we always have them available to fill out in person.
• If baby is hungry, we skip ahead and weigh the baby so you can start to feed them. If baby is sleeping, we complete the paperwork before waking the baby to feed.
• We take a health history, talk about your birth and your breastfeeding experience so far and we ask some possibly odd seeming questions (we will always explain their purpose). We get a lot of insight into issues during this part of the meeting.
• We weigh your baby in a diaper only. We always ask you to put a clean diaper on your baby before the weight which stays the entire time for the most exact pre and post feed weight possible.
• The MILC Group IBCLC performs an examination of the baby including an oral assessment. We explain what we are doing as we do it so that you feel completely comfortable as well as to point out what we observe along the way.
• Getting you comfortable before nursing is important so we in your home we set up in whichever space you feel most at ease and in our office, you choose your spot and which pillows you want to use (or not use).
• We assist your baby in latching as needed and watch and listen as your baby feeds at the breast. We correct positioning as needed during the nursing session and make any other adjustments. 
• After the nursing session, we again weigh the baby to get an idea of how much baby has transferred at the breast. 
• All of this information will go into our assessment of what issues you may be having and we will write up a care plan for you to refer back to and to share with your care providers. 
• The MILC Group provides you with a Superbill for your insurance company to be reimbursed for our services.
• We take payment at the time that services are rendered. We accept cash, checks or credit cards. 
• It is extremely important to The MILC Group IBCLCs that all of your questions and concerns are addressed so we do not rush you through the appointment and we make sure along the way that you have time to ask questions. Feel free to have a list ready for our appointment :) 

We hope that this answered your questions about what to expect if you schedule a Lactation Consultation with The MILC Group. We look forward to meeting with you and your family!

​We can be reached by phone at 210-960-MILC/210-960-6452.

The topic of increasing iron intake for toddlers comes up often in our Support Groups. This recipe for a yummy quick bread was mentioned so I typed up the recipe for everyone to have. One tbsp. of blackstrap molasses provides 3.5 mg of iron. This provides half of the recommended daily intake for toddlers, and 13 percent of the recommended daily intake for pregnant women.

Low milk supply seems to be a main concern for today's breastfeeding mother.  I do remember mothers asking, "how will I know that my baby is getting enough?" and, "how much milk does my baby need?" back when my first child was born (19 long years ago).  The difference I suppose was that we were satisfied with the answers we were given and we never pumped to see how much our body was presumably making.  We relied on observing our baby. Today's mother seems to want more answers and to know exactly how much milk she is making.  Here is a brief overview of Low Milk Supply. 

When should we be concerned that our milk supply might be low?  

• Insufficient Weight Gain
  
• Babies are expected to gain approximately one (1) ounce per day for the first two months and then half an (.5) ounce per day until around six months of age.  Remember however that all growth charts are just guidelines to follow.  They were developed to help monitor the growth and development of a large amount of babies especially in poor areas to watch for anything going wrong.  Now we utilize them for every baby but often we put too much stock into those numbers instead of looking at the whole child.
  
• Lack of  bowel movements
  
• The first several days of life a baby's bowel movements are what we call meconium.  Usually by day four, the baby is transitioning to bowel movements that are lighter in color and moving towards yellow or brown and mustardy.  If baby is still having meconium bowel movements at day five, you should contact your health care provider.  During the first few weeks of life, a baby should have frequent bowel movements.  If a newborn baby goes more than 24 hours without a bowel movement, you should contact your health care provider.  After three weeks of age, the bowel movements may space out more.  As long as baby is happy and healthy there is no cause for concern. 
  
• Lethargic Baby
  
• Some babies are very relaxed.  Relaxed and lethargic are quite different.  We want to see a baby being "active and alert" at the breast when feeding.  Your baby should be moving actively, looking around, making noises, etc.  If your baby seems inactive or overly sleepy you may wish to contact your health care provider.
  

What can cause a low milk supply?
Maternal Concerns
*Note that the majority of maternal issues would be present from the onset of the breastfeeding relationship.

• Breast Surgery
  
• Breast reductions and augmentations would be the top of this list however biopsies, injuries and surgeries of other types fall into this category.  If you have had any of the above at any time you should consult with your OB/GYN and an International Board Certified Lactation Consultant (IBCLC) to discuss how these may effect breastfeeding for you and what you can do to improve your chances of being able to provide a full or partial milk supply to your baby.
  
• Insufficient Glandular Tissue (IGT)
  
• These breasts have less milk making tissue and so mothers who have IGT may need to supplement.
  
• Thyroid Problems
  
• Can cause issues with milk release.
  
• Diabetes
  
• Milk production can be affected if insulin requirements are not well managed.  Mothers who are diabetic can reduce their child's risk of developing both type 1 and type 2 diabetes in adulthood by breastfeeding.
  
• Polycystic Ovary Syndrome & Other Fertility Issues
  
• If a mother had issues preventing her from becoming pregnant without assistance these issues may also affect lactation.  
  
• Retained Placental Fragments
  
• Can occur even after cesarean birth. 
  
• Breastfeeding Mismanagement
• Most often IBCLCs find that milk supply has been reduced due to what we call breastfeeding mismanagement.  This can mean that either baby was not being put to the breast often enough (early scheduling or sleep training) or baby was at the breast but with poor positioning and thus unable to nurse effectively.

Infant Concerns

• Prematurity
  
• Premature babies may be smaller or have weaker jaws and may need assistance transferring milk in the beginning.  Usually these babies will become more efficient as they grow.
  
• Oral Concerns
  
• Tongue Tie and/or Lip Tie are the most common however there are other oral irregularities that can affect breastfeeding. Congenital malformations such as Cleft Palate and/or Cleft Lip can also make breastfeeding challenging and cause mom's supply to drop if baby is unable to nurse effectively.
  
• Muscle and Neurological Issues
  
• As with prematurity these babies may need help until they are able to develop their oral muscles more or may need continued assistance but can transfer a portion of their food at the breast.  Remember that breastfeeding is more than food.  The closeness and comfort for many babies will help them to grow and develop and provide comfort to both mom and baby.
  
• Chromosomal Disorders
  
• Down's Syndrome is among the most common.  Many Down's Syndrome children are able to breastfeed with little assistance but perseverance from their amazing mothers. 
  
• Heart Conditions or other illness
  
• These babies may be too weak to transfer milk effectively.  
  

What can we do?
With any of these concerns the first step would be to work with an experienced Health Care Provider (HCP).  This can be your OB/GYN, Pediatrician and/or an International Board Certified Lactation Consultant (IBCLC).  Who you work with depends on which issue you are dealing with.  While seeking out a professional who can assist you and working on a care plan you will want to:

1. Make sure baby is being fed.
   
2. Make sure you are protecting your milk supply by pumping and/or hand expressing in addition to breastfeeding.

Ways to Increase Milk Supply

• Increasing Milk Removal
  
• Breastfeeding more frequently, pumping more frequently and in general increasing the removal of milk from the breast.  Breast compressions may also assist with this.
  
• Assist Baby in Gaining Oral Strength/Developing Orally
  
• Working with an IBCLC you can develop a care plan to work with Pediatric Dentists, Pediatric Ear, Nose and Throat Doctors, Speech Therapists, Occupational or Physical Therapists, Chiropractors and/or Cranio Sacral Therapists to aid baby in gaining oral strength and function.  By doing this you will find baby is able to stimulate your breasts to make more milk.
  
• Bring Mother's Health into Balance
  
• Your OB/GYN or other HCP can work with you to check maternal hormone levels, thyroid function, etc. to bring mother's health into balance to assist her body in being able to produce more breastmilk.  This includes checking for retained placental fragments which must be removed.
  
• Utilizing Galactagogues
  
• Galactagogues are any substance that increases milk production.  These include herbs, foods and prescription medications.  A list of common galactagogues is below.   
  

Common Galactagogues

• Goat's Rue - Often used for IGT and Breast Surgery situations
  
• Shatavari - Often used for hormonal support
  
• Fennel - Often used for milk release problems
  
• Alfalfa
  
• Fenugreek
  
• Barley
  
• Brown Rice
  
• Oatmeal
  
• Domperidone (Motilium) - Often used to increase Prolactin
  
• Metoclopramide (Reglan, Maxeran) - Often used to increase Prolactin
  
• Metformin (Glucophage) - Often used to stabilize blood sugar
  

There are many great Low Milk Supply Resources.  Following is a list of just a few:
http://www.mobimotherhood.org/
http://www.lowmilksupply.org/
http://kellymom.com/hot-topics/low-supply/
http://www.llli.org/nb/nbmilksupplyissues.html

If you have questions or concerns about your milk supply we will be happy to meet and discuss those concerns with you either prenatally or after baby arrives.  www.TheMILCGroup.com  210-960-MILC/210-960-6452