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It is very, very rare for a mom to need to stop breastfeeding for any illness. There are only a few very serious illnesses that might require a mom stop breastfeeding for a period of time or permanently. Per Dr. Ruth Lawrence, “HIV and HTLV-1 are the only infectious diseases that are considered absolute contraindications to breastfeeding in developed countries” (Lawrence & Lawrence 2001).



During any “ordinary” illness such as a cold, sore throat, flu, tummy bug, fever, mastitis, etc. you should continue to breastfeed. Just remind your doctor you are nursing so that if medications are needed he can prescribe something that is compatible with breastfeeding. Most medications are safe to take while breastfeeding, and for those that are not recommended there is almost always an alternative medication that is safe.

If mom has food poisoning, breastfeeding should continue. As long as the symptoms are confined to the gastrointestinal tract (vomiting, diarrhea, stomach cramps), breastfeeding should continue without interruption as there is no risk to the baby. This is the case with most occurrences of food poisoning. If the food poisoning progresses to septicemia, meaning the bacteria has passed into mom’s bloodstream (mom would most likely be hospitalized), see this guidance from Dr. Ruth Lawrence:

“Maternal infections of the genitourinary or gastrointestinal tract do not pose a risk to infants except in the rare circumstances when septicemia occurs and bacteria might reach the milk. Even in this event, continued breastfeeding while the mother receives appropriate antibiotic therapy that is compatible with breastfeeding is the safest course for the infant. If the infecting organism is especially virulent or contagious (e.g., an invasive group A streptococcal infection causing severe disease in the mother), breastfeeding should continue after a temporary suspension during the first 24 hours of maternal therapy. Prophylactic or empiric therapy for the infant, against the same organism, may be indicated.” [source: Lawrence RM & Lawrence RA. Given the Benefits of Breastfeeding, what Contraindications Exist? Pediatric Clinics of North America 2001 (February);48(1): 235-51.]

The best thing you can do for your baby when you’re sick is to continue to breastfeed. When you have a contagious illness such as a cold, flu, or other mild virus, your baby was exposed to the illness before you even knew you were sick. Your milk will not transmit your illness to baby, but it does have antibodies in it that are specific to your illness (plus anything else you or baby have been exposed to) – they’ll help prevent baby from getting sick, or if he does get sick, he’ll probably not be as sick as you.

 

Withholding your breastmilk during an illness increases
the possibility that baby will get sick, and deprives baby
of the comfort and superior nutrition of nursing.

You can also take measures to prevent baby from getting sick by doing the usual things to prevent the spread of illness: washing hands often, avoid sneezing/coughing on baby, limiting face-to-face contact, etc .

When you’re sick, it can help to just tuck baby into bed beside you and nurse lying down whenever baby gets hungry. If baby starts getting sick and not wanting to nurse, then see Baby refuses to nurse when sick.

Many times moms don’t nurse frequently enough and don’t get enough fluids to keep the milk supply going. Sometimes medications can cause your milk supply to diminish, as well. To avoid a decreased milk supply, drink plenty of fluids to avoid dehydration, continue to nurse often and avoid/limit any medications that tend to decrease milk.



Read More Sources: kellymom.com 

When You Should Pump

We recommend breastfeeding as much as possible. It is the best way to feed your baby. However we understand that not every mom can feed on demand and be with their baby 24 hours a day. If you want to continue to provide your baby with breastmilk , a breast pump is an effective way to establish and maintain a good milk supply. There are many reasons to pump breast milk.

• You may want to store milk for when you’re away from your baby. Maybe you’re going back to work, leaving your baby with family, friends, or a babysitter, or running errands.
• Your baby is unable to latch or feed directly from the breast.
• You want to give your baby breastmilk but don’t want to feed directly from the breast.
• You’re interested in donating milk to a milk bank or milk exchange program.
• You’re trying to increase your milk supply, are weaning and need to alleviate pressure, or are suffering from mastitis or need to drain your breast to help healing
• Many other reasons!

Things You Need to Know before Breast Pumping

Once you’re ready to start breast pumping, there are a few things you need to know. If you have a full-term, healthy, breastfeeding baby, you can wait a few weeks to start pumping and storing breast milk. If your baby is preterm or ill and cannot breastfeed yet, or if you have chosen to exclusively pump, pump as soon as you can after birth, preferably within one to six hours of delivery. 
If you’re primarily breastfeeding:

• Pump in the morning. Many moms get the most milk first thing in the morning.
• Pump between breastfeeding, either 30-60 minutes after nursing or at least one hour before breastfeeding. This should leave plenty of milk for your baby at your next feeding.
• If your baby wants to breastfeed right after breast pumping, let them! Some babies are patient and will just feed longer to get the milk they need.

If you’re exclusively breast pumping:

• Plan to pump 8-10 times in a 24 hour period. Full milk production is typically 25-35 oz. (750-1,035 mL) per 24 hours.
• Once you have reached full milk production, maintain a schedule that continues producing about 25-35oz of breastmilk in a 24 hour period.
• Each mom and baby are different, plan your pumping sessions around what works best for the two of you.  

Remember, a quality, electric breast pump is essential to breast pumping success.

Learning to Pump

Learning to pump can be a daunting process. These steps will set you and your baby up for success.

1. Do a little homework. Read up on the basics of breast pumping, and be sure to review your breast pump instructions.
2. Find a quiet, comfortable place to sit.
3. Bring a drink and a snack.
4. Plug in your pump or make sure it has working batteries.
5. Wash your hands with soap and water. 
6. Assemble the pump kit.
7. Center the flanges over your breast(s) and center the nipple in the flange opening, making an air seal. Flange fit is important!
8. If you’re double pumping, cup each flange to the breast with fingers below the flange and thumb on the top.  When adjusting  your dials, switch to using one arm across both breasts, keeping an airtight seal.
9. Turn your pump on.
10. Similar to a baby nursing at the breast, start out with high speed and low suction until you see milk flow (let-down), then adjust speed to medium and increase suction based on comfort level.
11. Once milk flow decreases, increase speed to high until the next let-down, then decrease to medium speed.  

Keep going! You’ll find pumping gets quicker and easier with practice.

How Much to Pump

How much milk you should expect to pump will vary depending on factors such as your baby’s age, time since last feeding or pumping, time of day, pump type, how much practice you’ve had with your pump, and whether you’re relaxed or stressed.
If you’re primarily breastfeeding, on average, you can expect:

• More milk production in the morning hours .
• Volumes gradually decreasing during the day into the evening.
• Breast milk volumes are dependent on many variables and each breast may produce different volumes.

If you’re exclusively pumping, on average, you should try maintain full milk production of about 25-35 oz. (750-1,035 mL) per 24 hours.  It may take some time to achieve this target, do not worry about hitting this on day one!
Babies may take more milk from the bottle than when breastfeeding. The faster, steadier flow of the bottle causes some babies to take more than they need. A slow-flow bottle may help prevent overfeeding.  

How to Reach and Maintain Full Milk Production

If you’re pumping because your baby is preterm or too sick to breastfeed, or because you have chosen to exclusively pump, follow these tips to reach and maintain full milk production. Pumping often to drain the breast completely sends a signal to the body to produce more milk. The more often you drain your breasts the more milk they will make.
From Birth to Day 4

• If you can, start pumping within six hours after birth.
• Use a multi-user pump to initiate and maintain milk supply.
• Expect to pump just a little colostrum (the first milk) at first.
• As soon as possible, pump 8-10 times every 24 hours. This is how many times each day your baby would typically feed from the breast.  In most cases, the more times each day you pump, the more milk you make. The reverse is true, too. Pumping  fewer times will produce less milk.
• Double pump (pump both breasts at once); this saves time and may boost production more quickly.
• Pump at least 10-20 minutes, until your milk comes in on Day 3 or 4. Then, hand express any remaining milk. Remove and place the breast flange under your breast to collect the milk you hand express. (The hand expression helps to better drain your breast, and drained breasts make milk faster.)
• To help establish milk supply, pump at least twice between 1 to 6am. In early morning hours milk- making hormone levels increase and taking advantage of this will increase your milk production.

From Day 4 to Full Production
When your milk increases from drops to ounces on about day 4, make these changes:

• Pump longer, two minutes after the last drop of milk or until your breasts are softened/no longer feel full.
• Focus on the total number of pumpings each day (8-10 times per 24 hours) rather than the time between pumpings (every 2-3 hours).
• Don’t allow more than one five-hour period to pass without pumping during your baby’s first two weeks of life.

Many moms find it easier to focus on their daily total rather than pumping at a set time each day. This daily total also seems to be most important to your milk production.
Maintaining Full Milk Production
When you reach 25-35 oz. (750-1,050 mL) per baby per 24 hour period, you’ve met your goal. Most moms can then pump fewer times each day and maintain production. At this stage:

• Maintain a schedule that continues producing approximately 25-35oz of breastmilk in a 24 hour period.
• While maintaining your optimal production of milk, you can try and sleep more. Once full production is developed, many moms pump right before bed and first thing in the morning. See if you can do this without too much breast fullness or a decrease in milk production.
• Pump for a shorter period of time. For many moms, 10-15 minutes of pumping is long enough.
• Once a week, add up the milk you pump in a 24-hour period. Write it down and compare your totals each week. You’ll know right away if your production drops.

Increasing Milk Production
If you need to boost milk production, the sooner you work on it, the faster you’ll see results. Some ideas to try are:

• Pump more. 8-12 pumpings per a 24 hour period boosts milk production for most moms.
• Pump longer, two minutes after the last drop of milk or until your breasts are softened/no longer feel full
• Check your breast flange fit; it can change with time.
• Use breast massage before or during pumping.
• Hand express after pumping.
• Ask your lactation consultant or healthcare provider for additional information on increasing milk supply.

Weaning From the Pump
When you decide to wean from the pump, remember the safest and most comfortable weaning is almost always a gradual one. There are a couple of ways to wean from the pump:

• Drop one daily pumping. Give your body two to three days to adjust. Then drop another daily pumping. Leave your first and last daily pumpings until the end. Repeat until you’re fully weaned from the pump.
• Keep the number of pumpings the same but pump for a shorter period of time. For example, if you were getting 4 oz. (120 mL) at each pumping, stop after 3 oz. (90 mL). Give your body two to three days to adjust and then do it again. Repeat until you no longer feel the need to pump.

While weaning, if your breasts ever feel full, pump just long enough to make yourself comfortable. Letting your breasts stay too full puts you at risk for pain and infection.



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