The whole process was so quick and discreet no undressing required and Erin’s knowledge of the Intimo product range was amazing. My bras arrived just two days later!

About Erin

I had worn Intimo bras since my early 20s and never wore another brand again. There was something special about the quality and fit, even back then. Now, in my mid-30s, I appreciate this even more deeply. The craftsmanship, the comfort, and the confidence that comes with a great-fitting bra it all stayed with me.

For years, I thought fitting women for bras would be such an enjoyable and empowering thing to do. But I was working full-time as a Social Worker in Child Protection, and my focus was elsewhere. It wasn’t until I had my first child in 2016 that something shifted. I opened up to the idea of doing something different still being of service, still helping women but in a new way.

And so began my journey into bra fitting. Nearly eight years on, I’ve had the honour of fitting women across Australia. The brand has grown, our style range has expanded significantly, and our capsule wardrobe offering is now an exciting part of what we do. But what hasn’t changed is the heart of this work: supporting women to feel truly good in their bodies.

So, When Is It a Good Idea to Have a Bra Fitting? There are so many moments when a bra fitting can make all the difference not just for comfort and appearance, but for confidence and self-care too.

1. If you haven’t been professionally fitted before

Even if you think you know your size, a professional fitting can be eye-opening. You’ll not only learn your correct size but also how different styles suit your shape and lifestyle. It’s about so much more than the number on the tag.

2. If your body has changed

From adolescence to pregnancy, weight fluctuations, hormonal shifts, and aging our bodies are constantly evolving. Each change can impact the fit and function of your bra. A re-fit ensures you’re supported through every stage.

3. If you’re trying a new bra style

Just like shoes, not all bras fit the same. A balconette will fit differently to a plunge or soft cup. Being fitted when trying a new style helps maintain comfort and support across all your bras.

4. If you’re pregnant or breastfeeding

This is one of the most important times to be professionally fitted. Breasts change in size, shape, and density often multiple times! Having the right bra during this stage supports both your comfort and feeding needs.

5. If it’s been over a year since your last fitting

Micro-changes in your body can lead to bras becoming less effective over time. An annual fitting helps you stay in tune with your body and ensures you’re getting the right support.

6. If your current bra doesn’t fit correctly

Notice any of the following?

• Straps falling down
  
• Underwire digging in
  
• Skin indentations
  
• Gaping or spillage from the cup
  
• General discomfort
  

If so, it’s time to book a fitting.

What Does a Well-Fitting Bra Really Provide?

Aside from the obvious physical benefits like comfort, support, posture and breast health a great bra does something deeper.

It makes a woman feel good.

It’s incredibly powerful to witness a woman take time for herself. To book a fitting, step into my studio, and say, “This is for me.” That alone is an act of self-care. And from there, I get to curate a lingerie capsule that supports her body, her wardrobe, and her lifestyle.

This level of personalised, expert care is hard to come by and I never take it for granted.

Ready for a fitting?

Erin offers a complimentary in-studio or virtual fittings and stock a full size range from 8A to 24G available to try on in person.

Book your fitting below, and let’s make sure you’re wearing something that makes you feel supported, confident, and beautifully you.

 Book your fitting with Erin here

I’ve helped so many mums with nipple pain when it comes to pumping, and you know what’s often the culprit? An ill-fitting breast pump flange. Unfortunately, the majority of mums who are using a pump do not have the right size, as most hospitals take an outdated “one size fits all” approach, with staff tending to size up when there is any discomfort.

If you’re using that standard 24mm shield that came with your pump, or someone’s told you to go bigger with a 28mm or 30mm, there’s a very good chance you’re using the wrong size. And that could be causing you unnecessary pain and affecting your milk supply.

Discussing the details of fitting a pump, and even what type of pump to use for each scenario is something I take my clients through during the pregnancy Breastfeeding Planning sessions and when I see them at home with their newborn.

Here’s what we actually know from research and experience

Recent research highlights that;

• Comfort and effective milk removal are highest when flange diameter closely matches nipple diameter plus room for movement (generally 1–2 mm). ¹
• Mismatched flange sizes can lead to reduced milk output and nipple trauma.²
• Ultrasound studies revealed that overly large or small flanges can cause edema, pain, and inefficient milk removal.³

When your nipple and areola are repeatedly suctioned too far into a plastic or silicone flange, it causes swelling, discomfort, redness, inflammation, and possibly trauma. We want to avoid this by measuring your nipple diameter properly and finding a flange that allows only your nipple to move during pumping – not your areola.

But it’s not just about comfort (though that’s important!). Flange fit directly impacts your milk yield, which matters hugely if you’re trying to increase or maintain your supply. When there’s trauma happening at your nipple, the pain and inflammation can block oxytocin – that crucial hormone that helps release your milk. Plus, swelling can physically narrow or block the milk flow, reducing your pumped volume.

Quick note: If your output is great and you’re comfortable, there is no need to read any further – Just keep this in mind if things change down the track.

How to tell if your flange is the RIGHT size

No pain or discomfort whilst pumping
Your breast feels ’emptied’ after pumping
Your milk volume is optimal or higher than with previous flanges

Signs your flange is TOO BIG

Your nipple swells up whilst expressing
Your breast loses contact with the flange during pumping
Milk leaks out the bottom of the flange
You are using a high vacuum to get any milk out
Your letdown (start of flow) takes several minutes
Your breasts still feel full after expressing / not fully drained
Feels ‘tight’ but there’s still room between nipple and flange sides

Signs your flange is TOO SMALL (less likely)

Your nipple doesn’t move freely at the start of pumping
Your nipple doesn’t fit into the flange or insert at all

Measuring your nipple for a flange

At the end of the day, the right flange size for you is the one that feels best, gives you the best output, and doesn’t pull any areola or breast tissue in – only your nipple.

How to measure properly

Choose a breast shield size that’s as close to your nipple diameter as possible. For example, if your nipple is 16mm wide, you’d likely need a 17mm breast shield.

Best practice: Try a few sizes around your measurement. Using that 16mm example, I’d suggest trying 15mm, 17mm, and 18mm shields to see which feels most comfortable.

Important: Always measure both nipples – it’s incredibly common to need different sizes for each breast.

If you have access to a printer, a nipple ruler is brilliant for finding your perfect fit or you can use something more tailored like the silicone measuring ruler above (more brands are starting to make these now which is positive to see!).

Things to remember

Your nipple size can change throughout your feeding and pumping journey, so it’s worth checking in with sizing if things start feeling off.

Other causes of pump pain: Sometimes discomfort isn’t about flange size – it could be that your nipple isn’t centred properly (stop and reposition), your vacuum is too strong (turn it down), or there’s a deeper cause like vasospasm, breast inflammation, or nipple infection / poor healing.

The bottom line? You shouldn’t have to suffer through painful pumping sessions. Getting the right flange size is often a simple fix that makes a world of difference to your comfort and milk supply.

If you’re still struggling with pump pain or low output after trying different sizes, it might be time to get some personalised support. Every pumping journey is different, and sometimes you need an expert eye to troubleshoot what’s really going on.

Need support with supply or troubleshooting your pump? If you have a Youha pump (use code JWPCARE for 10% off) I highly recommend their amazing customer support team. If you are wanting to work 1:1 with an experienced Lactation Consultant, please explore my services here or contact me here, I would love to support your feeding journey.

References

1. Kent, J. C., Ramsay, D. T., Doherty, D. A., Larsson, M., and Hartmann, P. E. 2008. “Response of Breasts to Different Stimulation Patterns of an Electric Breast Pump.” Journal of Human Lactation 24 (2): 168–78. https://doi.org/10.1177/0890334408316071. 
2. Prime, D. K., Geddes, D. T., Spatz, D. L., Robert, M., Trengove, N. J., and Hartmann, P. E. 2012. “Using Milk Flow Rate to Investigate Milk Ejection in the Left and Right Breasts during Simultaneous Breast Expression in Women.” International Breastfeeding Journal 7 (1): 1. https://doi.org/10.1186/1746-4358-7-1.
3. Geddes, D. T., Kent, J. C., Mitoulas, L. R., and Hartmann, P. E. 2008. “Tongue Movement and Intra-Oral Vacuum in Breastfeeding Infants.” Early Human Development 84 (7): 471–77.https://doi.org/10.1016/j.earlhumdev.2007.12.002.

As well as my own experience and knowledge around this aspect of supporting mums to breastfeed and feed their baby breastmilk, this article also draws inspiration from Cherished Parenting (Perth) and Nurturing the Flow (Melbourne)- two excellent sizing and pumping support businesses. 

1. Taking a breastfeeding-specific probiotic first thing each morning. 

There is plenty of research to show us that Salivarius and Lactobacillus. Fermentum strains of beneficial probiotics directly impact the breast microbiome.  This means that the more beneficial bacteria in the breast, the more healthy and effective the immune response will be if inflammation arises in the breast tissue.

I take my probiotic first thing on waking for a couple of reasons, mostly it’s about doing it habitually, and the morning is the most potent when it comes to habits sticking. I have been taking a probiotic since my early weeks of pregnancy, so it’s fair to say this habit is pretty well formed. And secondly, I had my probiotic ( along with other supplements) muscle tested, and the results came back to have it on an empty stomach and away from food for best efficacy. Muscle testing is unique for each person and can also change depending on what the body needs. 

2. Monitoring my breast health, keeping an eye out for any lumps or redness. 

It is important to be familiar with the texture and feel of your breasts. This can start during pregnancy with a beautiful belly and breast massage routine. Lifting under the breast where the bulk of the breast tissue generally is to inspect for any lumps and redness is necessary. The more you become familiar with your lactating breasts in a healthy state, the quicker you will pick up any variations that may require more attention. 

3. Caring for my immune and lymphatic systems. 

The health of the breasts are dependent on the lymphatic system. I make sure I drink plenty of water, practice some form of movement daily and perform a dry brush or suction cup ritual a few times a week to boost lymphatic drainage. 

One of the helpful remedies for mastitis is lymphatic massage to assist with flow and drainage of the lymph fluid, helping to remove immune debris and harmful bacteria away from the breast tissue. Importantly, lymphatic massage should only be around 5-10% pressure, as the lymphatic system is just under the skin and requires very little pressure to be activated. When time allows, performing a quick yet gentle lymphatic massage around the breast area either during or after the shower can be a nice way to support your breast health.

4. Making sure my baby drains the first breast before moving to the next. 

While it’s true each breast will never be “emptied”, aiming to drain as best as possible is important to reduce milk stagnation and inflammation in the breast tissue. Signs your baby may be ready to switch to the next side are; reduced swallows, fussiness, sleepiness, increasing distraction/play, a very soft breast and length of feed. If you are someone with a very abundant supply, perhaps block feeding, or feeding from one breast per feed is more appropriate to achieve breast drainage. 

5. Prioritising nutrition, supplements and hydration. 

In order to keep my body strong and my immune system healthy, nutrition plays a foundational role in this. I make sure I am consuming enough protein with each meal, protein being an important building block of the immune system.  I take a regime of supplements that are tailored to my needs.  This includes keeping my iron levels optimal, as iron deficiency is linked to an inadequate immune response. I also have an immune complex supplement (a mixture of nutrients and herbs) on hand in case I am feeling under the weather or notice any early signs of breast inflammation.  Hydration is important to keep the water content in breast milk optimal, supporting lymphatic system health and my overall energy levels. 

6. Being mindful to not overdoing it, as mastitis is often a sign of not enough rest. 

Throughout my years caring for breastfeeding families, I’ve commonly seen mastitis strike when a mother is not getting as much rest as her body needs. In this case, mastitis is often a siren from the body to slow down, and with such horrendous symptoms of fatigue, fever, aches, chills and pain rest becomes a non-negotiable.  It’s important to honour your body’s messages when it’s tired and where possible to prioritise necessary tasks and do the bare minimum when you can. 

7. Know where to go for support. 

Having a team of health professionals lined up during pregnancy is a really important part of breastfeeding planning.  As mastitis often requires quite urgent attention it will feel more seamless to make contact with a care provider you already have a relationship with and who is familiar with your circumstances and needs. I personally have a relationship with my go-to GP & IBCLC, and know where I would book in for therapeutic ultrasound if needed. 

The fear around mastitis is real, and taking steps to prevent it is always more ideal than treatment. Having mastitis takes a huge toll on your body and may temporarily reduce your milk supply during and after the inflammation has settled. Use these holistic steps to take care of your breast health and milk supply to feel more confident in reducing your likelihood of experiencing breast inflammation and/or mastitis. 

This is a common question I get asked, and often very early into the breastfeeding journey. Ideally waiting six weeks for breastfeeding to get established is a good idea. generally introducing a bottle before 12 weeks may be best as this is when sucking becomes more learned than instinctual.

Choosing the right bottle and teat; 

I suggest looking for a wide-neck teat with a seamless latch (no gaps between the baby’s mouth and the teat). Avoid short and asymmetrical teat shapes 

The technique is crucial. Paced bottle feeding is a non-negotiable here, especially for younger babies. With paced bottle feeding you will reduce; digestive discomfort, overfeeding, drinking too fast and the likelihood of bottle/flow preference. 

Here is what I recommend: 

1. Ideally, the switch may work best in the evening. 
2. Pump 1-2 hours post-feed (1-1.5 hours to allow the breasts to refill). 
3. Go to bed or commence your “downtime”. 
4. Your partner/family member stays up and feeds the baby the bottle of breastmilk when the baby wakes and then supports the baby to sleep. 
5. Mother wakes for the next breastfeed.

The other common question I get is how much milk do I offer my baby?

Each baby will be different depending on their age, size, weight and how many feeds they typically have every 24 hours; 

The volume of feed could be approximately 90-150 ml for under 6 months and after 6 months, a baby may drink 150–230 ml at one feed.

Take your time with introducing a bottle and finding your rhythm with expressing the milk. Allow your baby and body some time to adjust. If you know your baby will need to have some bottle feeds while you are away or at an appointment etc then I would suggest trying this from at least two weeks prior to when the bottle will be required.

Planning ahead

If you feel mixing formula and breastmilk may be on the cards for you, I encourage you to plan ahead, and book a 1:1 session with an IBCLC lactation consultant or other feeding expert who will support your preferences and provide you with the information you need to succeed in your plans. Ask around for recommendations of support options that others found helpful who had similar goals. There is strong support for exclusive breastfeeding in the lactation community, however, all parents are entitled to non-biased feeding support that is going to work for them. Choosing to mix feed has many elements to consider, and the more informed you are the more positive your journey can be.

Establishing breastfeeding 

Even if you are planning to introduce bottles and formula at some point, you will want to initiate breastfeeding if that feels right for you. Learning about how to latch (the breastfeeding technique) to keep your nipples comfortable is a great place to start. Opting to try the breast crawl, the very first feed your baby has, allows them to make their own way to your breast and latch on using the power of their inbuilt instincts – this takes patience and staff will need to allow your baby to take the lead. 

To support your milk supply, you will want to enjoy skin-to-skin as much as possible and offer your baby the breast frequently. Be mindful that when your milk comes in your breasts may feel full, and you can choose to breastfeed or express to help with any discomfort, as well as use cold therapy (ice packs) and pain relief if necessary. Pay attention to how full your breasts feel and keep breastfeeding or expressing regularly to allow your body to establish your milk supply, through the process of supply and demand. If you repeatedly leave your breasts full for too long, this can downregulate the milk-making process and your supply may not be established, meaning you may need to feed with formula more than you were hoping to. 

Introducing Formula  

Deciding what formula you will choose for your baby is important. I recommend that parents do some research and make this choice before the baby arrives where possible. It doesn’t mean you need to purchase anything, but just knowing what you would choose if you needed to use formula for whatever reason really helps you feel prepared and reduces the stress in the moment. 

There are so many options out there, and often parents look to health professionals for the right answer. Unfortunately, no IBCLC lactation consultant can make a recommendation about which formula is best. Choosing a formula is a very individual choice. I would suggest considering the following;

• Company values
• Quality of ingredients including organic ingredients
• Availability 
• Affordability

Be open to switching brands if your little one doesn’t seem to take well to what you have initially chosen. 

Items you will need

Do some research around feeding equipment, cleaning and sterilizing practices that will work best for you. Anything that formula is fed with needs to be sterilized after every use. I recommend UV sterilizers as an option as they are the most efficient and least messy. Boiling on the stove is okay as a very short-term measure, but this method really adds to the mental load. 

The choice of a bottle is important too, we want a wide-neck bottle, avoid narrow-neck teats, and make sure you watch a video about Paced Bottle Feeding to get the technique right for a newborn to reduce flow/nipple confusion/preference. 

Balancing Breastfeeding and Formula

Switching from breasts to formula can be confusing as there are two very different processes. When you are feeding with a bottle it is very obvious how much your baby is and isn’t consuming. This can be very different from the more observational tools required for feeding directly from the breast.

You may notice there are guidelines for feeding volumes on the formula tin, however, it’s important to keep in mind that it is in the interest of the formula company for you and your baby to consume as much product as possible, and there is little research to support that these volumes are best practice. As a guide 150 mils per kilo per day divided by the number of times your baby is feeding is generally what is medically acceptable to offer your baby per feed (i.e. 150 x 3.4 / 8 = 510 /8 = 64 ml per feed).  This is a good starting point and just remember that your baby may want to drink less or more at different times during the day and at different feeds.  The biggest feedback that your baby is getting the right amount of milk is their level of digestive discomfort after a feed, the level of contentedness throughout the night and day, their amount of wet and dirty nappies, and also their weight gain each 1-2 weeks. 

Maintaining Milk Supply

If you are mixed-feeding and want to maintain your milk supply long-term then breastfeeding directly from the breast as much as possible will really support this.  Other supportive measures include using a quality electric breast pump taking care to rest, staying hydrated with a tasty hydration powder and consuming a diet that is nutritious for a breastfeeding parent, including extra snacks to make up for the additional calories your body needs to produce breastmilk. 

Understanding the concept of supply and demand when it comes to breast milk production is very important.  The more your baby drinks from your breast and the more you express aka remove the milk the more your body will work to replenish your breastmilk supply.  If your baby is consuming more formula than breast milk we tend to see a steeper decline and breast milk volume, particularly in the early weeks.  As a guide it takes around six to eight weeks to establish breast milk production however this can be a very individual process. 

Seeking Support

Regardless of the reason you are choosing to mix feed, everyone is entitled to quality support and feeding their baby. It’s important that health professionals offer non-judgmental and emotional support, as well as practical tips and tricks to make the process as streamlined as possible. As your baby’s needs grow and change so will the type of information and support that you need change and evolve too.  Sometimes turning to other parents who have been down the path of mixed feeding can be helpful. Just keep an open mind that every baby is unique so what works for one baby may not work for yours.

Returning to work can be a huge shift in your parenting journey, with the potential to affect your hormones, mental health, breast milk supply and much more. Taking the time to consider each of the following points and coming up with a plan ahead of time will help you feel as prepared as you can be and reduce the stress unexpected challenges may bring. 

Notify your employer

In Australia, it is deemed as discrimination to prevent a breastfeeding parent from continuing breastfeeding in the workplace. It is suggested you inform your employer of your intentions to continue breastfeeding/expressing before your return to work. If you have colleagues who have returned to work whilst breastfeeding it can be helpful to reach out for their experience and any learnings they may have to pass on. 

Your milk supply 

If you are returning to work and your baby is breastfeeding exclusively or mixed feeding, and your goal is to continue with this, you will need to think about how you will maintain your supply. The best way to do this is using a double electric breast pump, and starting this 4-6 weeks before your return date. It’s not that you need a huge stash of milk, a buffer can certainly help, it’s more about getting familiar with pumping and what it looks like for you and your family life. 

Sometimes building an extra supply is best done very gradually for parents who have an abundant supply of milk and don’t want to overstimulate milk prosecution with the additional pumping. And sometimes if milk supply is just enough for what the baby needs, you are feeling very depleted or have had challenges with milk supply then extra time helps to create a stash. 

I would say as a minimum you would want 2-3 days of feeds stored in advance just to give you some flexibility when returning for work, in case your pumping schedule is missed or you are unable to pump enough for whatever reason. Having ‘spare’ milk also helps reduce stress if there is bottle refusal or mishandling of milk that has been defrosted. 

Milk storage

Generally, I recommend 4 hours at room temperature, 4 days in the fridge and up to 4 months in the freezer. If you are expressing and not using that milk in the next 24 hours, it’s best to transfer it straight to the freezer. I suggest storing milk in volumes of 30-60 mls so that you are not defrosting too much and wasting that precious milk and time spent pumping where possible. 

Store your milk in bags, lying flat until frozen, then stack them vertically for a more space-efficient approach. Each bag needs to be labeled with the volume, time and date of expressing. 

Choosing a pump

When it comes to choosing a breast pump I would suggest a double eclectic wearable. I am a huge fan of The Embody by Youha as it is incredibly discrete and comfortable, ideal for pumping at the workplace. I find wearable pumps work exceptionally well due to their flexibility and mobility, as a baby grows old the more on the move we become! If you are unsure of how long you want to pump for, and are hesitant to invest, or have previously purchased a pump that you know won’t be that convenient at the workplace (attached to powerpoint, not battery operated, takes a long time to express what you need) then opting for a single wearing such as the INS by Youha is a great choice. You can always purchase a second if you find pumping is working well and you want to do this longer term. Use code JWPCARE for 10% off all Youha products. 

Under 6 months

If your baby is under 6 months then replacing all feeds is essential, as milk is their main source of nutrition at this stage. You can continue breastfeeding when you are not working, and on your days off. Often parents like to breastfeed before they go to work and as soon as they return, whilst doing 2-3 pumps during the workday – this depends on how frequently your baby likes to drink, and how much milk you can produce. As a guide, 150mls is generally the maximum volume your baby would generally consume before the 6 month mark, and depending on their age/size, they consume around 30 mls of milk per hour. Please note these are just guids and you will need to take time to work out what your baby needs, particularly if they are new to a bottle. 

After 6 months 

If you are returning to work After the 6-month mark, your baby will also be consuming water and some solids. With the benefit of your baby having water and solids this does give you some more flexibility in terms of the amount of milk required to get them through the day when you’re at work. you may find that your baby is consuming water through a straw or sippy cup and if bottle refusal is something you’re dealing with then using either of these vessels to offer milk can be helpful. Milk feeds can tend to reduce at this stage (not always), so you can experiment with the right amount of pumping when you are at work. 

Nutritional considerations

Returning to work can bring up many emotions and it is a time of big change for not only your little person but also for yourself and your daily routine. You not only have to adjust to your roles and responsibilities at work, you also have an increased mental load and getting used to having periods of time away from your baby can be very emotionally challenging. 

It is really important to keep up your self-care and nourishment during this time. I always suggest continuing your prenatal supplement and any other supplements you find particularly beneficial to your health and hormones while you’ve been breastfeeding.  Also staying hydrated is incredibly important. This will help maintain your milk supply.  I love the Franjos kitchen hydration powders and really notice a difference and the amount of water I can assume when I am adding the powders into my daily routine.  Also having a protein rich nutrient-dense diet is incredibly important and having snacks on hand like the lactation cookies by Franjos Kitchen is also very beneficial to your milk supply and how you can stay nourished. 

Get support from a Lactation Consultant 

Get in touch with a local IBCLC to support your return to work plan if you’re feeling overwhelmed or just need some guidance around this.  A lactation consultant can help with bottle refusal, maintain your milk supply pumping hacks and routines and also guide you with weaning your breast milk supply if that is your goal for the season. I offer return-to-work planning virtually or in my clinics – head to my services page to find out more.

Firstly, start by placing your baby tummy down on your chest while you recline your torso, creating a very slight incline. This option is perfect for when you are resting in bed or on the couch. This gentle approach helps your baby ease into using the required muscles to lift their head while they look around and make eye contact with you. When you notice changes in your baby’s behaviour, such as them becoming upset, grizzly, or excessively wriggling, it’s a sign to switch positions. This method works well for babies who may have struggled during tummy time on a mat or the floor and need time to adjust.

Secondly, introduce tummy time in small doses right after a nappy change on the changing mat. This approach allows for short bursts of tummy time multiple times a day. It’s generally not recommended at night. After feeding and dressing your baby, place them on their tummy on the changing mat, ensuring something is engaging, like a black-and-white book or a favourite toy, to keep them entertained. Repeat this throughout the day, and gradually, your baby will become more comfortable with this position. This doesn’t have to be long, and again just follow your baby’s body language in terms of how long they can maintain this position. Being consistent in short bursts will help to build up their comfort, strength and familiarity in this new position. 

Lastly, a favourite long-term option is having a designated play mat on the floor. The Toppy’s Goods Wriggle Mat, for example, is made of incredibly plush, soft natural wool fibres that are beautiful and easy to keep clean. The sheepskin mat offers warmth in winter, and cooling in summer and provides a rich sensory experience as your baby touches and brushes against the fibres. Again, make sure your baby has something engaging to interact with when they are on the mat. Look for cues that indicate your baby is ready for something new, such as a dwindling attention span or tired muscles.

Tummy time offers numerous benefits and can be easily incorporated throughout the day to support your baby’s growing body. Experiment with what your baby enjoys and be open to change when they show signs of discomfort or disinterest.

The Wriggle Mat and other gorgeous sheepskin products can be found at Toppy’s Goods

What is Antenatal Hand Expressing?

Antenatal hand expressing is the process of manually stimulating and collecting any colostrum that may be present in the breast during the last few weeks of pregnancy and can be commenced by most pregnant mothers from 36 weeks onwards. Mothers are generally encouraged to express up to two-three times per day for approximately five minutes on each breast. 

Eight basic steps for hand expressing: 

1. Wash your hands thoroughly with soap and warm water.
2. Find a private, comfortable, quiet place to sit where you can relax.
3. Gently massage your breasts for a minute or two before expressing to help stimulate oxytocin.
4. Place your thumb and index finger about an inch behind your nipple, keeping your thumb and finger in the same place, and pull them deeper into your breast.
5. Gently squeeze and compress the breast tissue, returning your thumb and finger to the starting position.  Once you get the hang of the technique, repeat it rhythmically.
6. If you see a drop of colostrum on the tip of your nipple, you can scoop this with a clean medicine cup or suction it off with a single-use medical-grade syringe. 
7. Rotate your fingers around the breast and repeat the squeezing motion in different areas to help stimulate milk flow.
8. Switch to the other breast after a few minutes and repeat the process.
9. If you experience uterine pain, contractions or vaginal bleeding at any point, you should stop immediately and contact your care provider if you feel concerned. 

What are the benefits?

Research on antenatal hand expression is limited, but some studies have investigated its potential benefits. Here are six key findings:

1. A 2017 study published in the Journal of Human Lactation found that women who practised antenatal hand expressing had higher milk volumes in the first few days after birth than those who did not¹.
2. Another study published in the same journal in 2012 found that antenatal hand expressing was associated with better breastfeeding outcomes, including higher rates of exclusive breastfeeding and longer breastfeeding duration².
3. A 2018 study published in the International Breastfeeding Journal found that antenatal hand expressing was associated with increased colostrum production³.
4. A 2016 study published in the Journal of Perinatal Education found that women who practised antenatal hand expressing reported feeling more confident about breastfeeding⁴.
5. For women with Gestational Diabetes, a large trial in the UK found that the women in the antenatal expressing group had higher breastfeeding initiation rates than the control group⁵.
6. The trial also found that antenatal expression of colostrum was associated with a lower incidence of hypoglycemia (low blood sugar) in newborns and a lower incidence of neonatal admission to the intensive care unit⁶.
7. Even if you don’t collect any colostrum, practising the technique is hugely valuable as it is one less thing to learn when your baby arrives. 

How do I know if antenatal hand expressing is right for me?

Antenatal hand expression is generally considered safe. However, there are specific scenarios where your health provider may provide against this. Any nipple and breast stimulation can have a stimulating effect on the uterus. Situations where hand expressing is advised against can be:

• If you are at risk of preterm labour, your healthcare provider may advise against hand expressing or any kind of breast stimulation, as this can stimulate contractions and increase the risk of premature delivery.
• Vaginal bleeding: If you are experiencing vaginal bleeding during pregnancy, your healthcare provider may advise against hand expressing or other forms of breast stimulation
• There are complications around your placenta, such as placenta previa, accreta and percreta.
• Your pregnancy is complicated, and a planned cesarean is advised

If you are experiencing a more high-risk pregnancy, you can still learn the technique of antenatal hand expressing; you just won’t be able to start trying it until your baby is born.

How do I talk to my health care provider about antenatal hand expressing?

In your third trimester, you can ask to discuss antenatal hand expression with your care provider. It is important that your care provider is happy for you to proceed in case you have any complications that could mean hand expressing is inappropriate for your current pregnancy. 

If antenatal hand expressing is right for you, make sure you get a demonstration or have your technique checked. Research shows that women who have  a healthcare professional teach antenatal hand expression have a higher rate of successful expression than women who learn on their own through information sheets or videos. Some care providers will provide you with the necessary equipment, while others may not and you will need to purchase or source independently. Booking a breastfeeding planning session with your local International Board Certified Lactation Consultant (IBCLC) if you want more support with antenatal hand expressing is also a great step to take. 

Equipment, collecting, storing and transporting colostrum

Keep your freshly expressed colostrum in the syringe, with the cap on, in the fridge, add to it over 24 hours and then freeze. If you are only getting small amounts, that is okay too. Once each syringe is filled or you have collected as much as you can within the 24 hours, label the syringe with your full name, date and time it was expressed so that when it comes time to use the colostrum, you will defrost the earliest colostrum first. 

• Bring the frozen syringe in a labelled container and ask the hospital staff to freeze this for you. 
• Don’t put the frozen colostrum in the fridge immediately, as this means that any colostrum will be thawed and must be used within 24 hours of thawing. 

• To protect all the nutritional properties in the colostrum, thaw it slowly in the fridge or use warm water in a clean mug, gently swirling the syringe to mix any separated fats. Avoid thawing the colostrum in boiling water or microwaves to preserve the beneficial components. 
• Discard any unused colostrum after 24 hours.
• Tip: Smaller volumes will defrost more quickly; a one ml syringe thaw more quickly than a ten ml syringe. 

Six ways to use expressed colostrum after the birth of your baby

Whenever I meet a family who has brought frozen colostrum into the hospital with them, I light up with excitement. It means we have options and a head start if breastfeeding gets tricky. Knowing what to do with your colostrum and how to use it if needed is also important. Here are six common and easy ways to use any expressed colostrum: 

• The Special Care Nursery or Neonatal Intensive Care Unit will want to feed your baby any available colostrum if you and your baby are separated after birth
• Offer colostrum to your baby before breastfeeding if your baby is sleepy or not interested in feeding.
• Offer colostrum after a breastfeed; this is particularly helpful for lower birth weight babies, if you have had gestational diabetes and/or if your baby seems hungry or fussy after breastfeeding.
• Colostrum can be used as a backup plan instead of breastfeeding if your nipples are too sore from breastfeeding; in this case, it is essential to continue expressing to stimulate your milk supply.
• Having a few mls of colostrum to give to your baby during cluster feeding, generally seen on the second and third nights after birth, can help reduce the chances of introducing non-medically indicated infant formula.
• If there is no need to feed the expressed colostrum to your baby, you can add it to their bath water as long as it is within its safe-to-use period (as above). Colostrum has healing and antibacterial properties that can benefit your baby’s sensitive skin. 

Continuing hand expressing once your baby has arrived

Hand expressing is gentle enough to do regularly until your supply increases, generally around 72 hours post-birth. Hand expressing can be done after each breastfeed to give your baby more colostrum if needed, and it is also a great way to gently support your milk supply increasing by removing milk from the breast (aka supply and demand). Hand expressing is also a helpful tool during periods of engorgement, when the breasts feel very firm and filled with milk. Hand expressing when you are engorged or full will allow you to soften the breast a little, making latching your baby a little easier. 

I love promoting antenatal hand expression as there are so many benefits. It can be a really empowering and tangible experience for those who want to prepare for their breastfeeding journey. Hand expressing can be very helpful after your baby has arrived to either help stimulate your breastmilk (more gently than a breast pump) or to feel some relief when your breasts feel uncomfortably full throughout your breastfeeding journey. 

References

1. McLeish, J., Bick, D., Beake, S., Chang, Y. S., & Tham, K. (2017). Antenatal breast expression in women with diabetes: Outcomes from a retrospective cohort study. Journal of Human Lactation, 33(3), 540-547.
2. Fewtrell, M. S., Loh, K. L., Blake, A., Ridout, A., Hawdon, J., & Williams, J. E. (2012). Randomized, double-blind trial of antenatal expressing and breast milk feeding: Effects on the mother and breastfeeding outcomes. Journal of Human Lactation, 28(2), 161-166. 
3. Nissen, E., Lilja, G., Widström, A. M., & Uvnäs-Moberg, K. (2018). Expression of breast milk in pregnant women. International Breastfeeding Journal, 13(1), 6. 
4. Thomson, G., Dykes, F., McCourt, C., Sandall, J., & Balaam, M. C. (2016). Pregnant women’s perceptions and experiences of routine antenatal enquiry for domestic abuse. Journal of Perinatal Education, 25(1), 32-42.
5. Jolly, K., Ingram, L., Khan, K. S., Deeks, J. J., Freemantle, N., & MacArthur, C. (2012). A systematic review of peer support for breastfeeding continuation: Metaregression analysis of the effect of setting, intensity, and timing. BMJ (Clinical research ed.), 344, d8287. 
6. Forster, D. A., McLachlan, H. L., Davey, M. A., Amir, L. H., Gold, L., Small, R., Mortensen, K., & Oats, J. (2017). Antenatal expression of colostrum for improving breastfeeding outcomes. Cochrane Database of Systematic Reviews, 1, CD012008. 

Breastfeeding is a beautiful and natural way for a parent to nourish their baby, fostering a strong bond and providing vital nutrients. However, there are times when pumping breast milk becomes necessary and beneficial to a breastfeeding routine. In this article, we’ll explore when, how, and why you should consider pumping from the perspective of a lactation consultant.

When to Introduce Pumping

Ideally, parents and babies should establish breastfeeding without interventions during the first six weeks. This period allows supply and demand to find their natural balance, which is crucial for both short and long-term milk production. However, there are scenarios when early pumping is required:

1. Low Birth Weight/Preterm Baby: Babies with low birth weight or born prematurely may tire quickly and struggle to meet their caloric needs at the breast. If a parent experiences more than 10% weight loss in their newborn within 48 hours, supplementation with breast milk or formula may be necessary. Pumping can help reduce the need for formula and stimulate milk supply.

2. Sucking Issues: Some babies have small mouths or low birth weight, making it challenging to maintain strong suction throughout a feed.

3. Resting Sore Nipples: If latching and having the baby drinking directly from the breast is causing persistent and increasing trauma to the skin, sometimes bringing in 24-48 hours of pumping to give the nipples a rest can be helpful. It is key that any latching issues are addressed within this time to avoid further damage and to help get mum and baby back to direct breastfeeding as soon as possible.

4. Illness: Jaundice, while common, may require pumped breast milk to boost calorie intake if it reaches concerning levels. Babies with low blood sugar, particularly those born to parents with gestational diabetes or extreme birth weights, may also need pumping to stabilize their sugar levels.

5. Genuine Low Supply: Parents with a history of low supply or specific risk factors may need to introduce pumping to support their breastfeeding journey.

6. Triple Feeding: Some parents may need to include pumping in a triple feeding routine, which can be physically and emotionally demanding. Triple feeding consists of breastfeeding, topping up the baby with either pumped milk or formula (or both), and pumping after the baby has had their feed.

How to Pump

Pumping should typically start within 24 hours of birth. Hospitals often provide guidance on pump usage and flange sizing, though having your own hospital-grade breast pump is an option. Pumping should occur after a breastfeed or, for babies in the Special Care Nursery (SCN), just before a feed for the freshest milk. Pumping sessions should last no more than 30 minutes to allow time for breast refilling between 3-hour feeds, common in triple feeding plans.

Here are some essential pumping tips:

1. Between 6-8 pumps per day are recommended, depending on your baby’s unique needs and feeding plan.

2. Double pumping stimulates more oxytocin and yields higher milk production.

3. Ensure the flange fits comfortably around your nipple, without pulling in the areola.

4. Avoid excessive suction, which can cause pain and swelling.

5. Use the stimulate feature on the pump to encourage oxytocin flow and boost milk supply.

6. Switch to a maintenance cycle once milk flow is established or the breastfeeding patent is collecting 10 ml or more per pump session/ or day five postpartum (whichever comes first).

Pumping Tips for Oxytocin and Milk Supply

To enhance oxytocin production and milk supply, try these techniques:

1. Double pump to save time and stimulate more oxytocin.

2. Gently massage your breasts to stimulate oxytocin and encourage better milk flow.

3. Use a hands-free pumping bra for convenience.

4. Never use excessively strong suction.

5. Relax while pumping, and have a drink and a snack such as a nutritious lactation cookie.

6. Visualize your milk flowing, which can help stimulate oxytocin.

7. Listen to soothing audio, such as a podcast or guided meditation, to relax your mind.

Type of Pump

Make sure you are using a hospital-grade pump, and I recommend wearable models for their discreet flexibility. Many of my clients are very happy when they invest in an Embody double wearable electric pump by Youha. Use code JWPCARE for 10% off the entire YOUHA range.

Pumping Tips to Avoid Oversupply

Introducing pumping too early (within the first six weeks) when not medically necessary can lead to oversupply. This excess milk can cause problems like a forceful letdown or an increased risk of lumps, inflammation, and mastitis.

Avoid pumping more than about 60 millilitres from each breast in the early days. The recommended amount increases when your baby is over six months or if you’re pumping at work.

Pumping to Replace a Breastfeed

When considering pumping to replace a breastfeed, it’s essential to choose the right teat and bottle. Ensure that the bottle provides a seamless latch and consider paced bottle feeding, especially for younger babies. This method reduces digestive discomfort, overfeeding, and the risk of bottle preference.

Pumping can be a valuable tool in your breastfeeding journey, helping you overcome various challenges and ensuring your baby receives the nourishment they need. With the right timing, techniques, and equipment, pumping can complement your breastfeeding experience while maintaining a healthy supply. Always consult with a lactation consultant for personalized advice to ensure the best results for you and your baby.

Breastfeeding Positions:

• Reclined Cradle Hold

This position is very intuitive for mum and baby and is generally the most common position for mother-baby dyads once breastfeeding is established. 

Baby’s weight is spread over mum’s torso, rather than being concentrated in her forearms which tire quickly during long feeding sessions. For a newborn, you would generally have their body firmly across your chest – think horizontal line.

Mum can choose to recline as far back as she likes, and this position works great in bed and on the couch. Partners often comment on how comfortable their breastfeeding parent looks in this position compared to other feeding positions.

• Cross Cradle Hold

This is the most commonly taught breastfeeding position in hospitals – however, there is evidence that lifting and shaping the breast can cause up to four times more nipple pain. Because of the increased risk of nipple trauma using this technique, it is essential that parents learning to breastfeed or who are experiencing nipple pain are looking for the four points of contact; discussed below. 

• Underarm hold

Ideal for twins once feeding is established and each baby is getting a good latch. Also suitable for smaller babies. I find this position doesn’t work well if your baby is average or above-average birth weight (>3.3 kg) as they quickly run out of room, and are generally heavier to support with the wrist. Be very mindful that shoulders do not slump forward, I find this posture can be very straining on the back, neck and shoulders. More pillows are required with this position, and this leads to difficulty feeding outside of the house.

• Side-lying

This position works extremely well to support postpartum recovery, and also for night feeding.

I also love trying this position when the baby is particularly fussy at the breast, as they are much calmer when lying down. Side-lying can be a great position to try when the baby is distracted and just before nap/sleep time. 

Mother positioning

Ideally semi-reclined/laid back, and well supported with firm yet comfortable pillows. In early postpartum, the feet should be elevated where possible. Hips should be aligned, shoulders rolled back and the spine should be straight to avoid excess muscle strain and tension. 

Baby positioning

Four points of contact (Thompson Method) or Symmetrical-Face-Breast-Bury (Gestalt Breastfeeding) are what mums should be looking for:

1. Chin buried into the breast, this will trigger the baby to vacuum the nipple into their mouth. 
2. + 3 Each cheek pressed into the breast symmetrically – see if the top and bottom cheek are pressed into the mother’s breast evenly. 

      4. Nose should be flush with the breast – there is no need to pull the breast tissue away from the baby’s nose to support breathing. 

Baby-led vs Mother-led attachment

Baby-led attachment usually starts to occur naturally as mum and baby grow in confidence throughout their breastfeeding journey. In the early days, a breast crawl will help to support the neural pathways in the baby’s brain when learning how to breastfeed. Mother-led attachment occurs in the cross-cradle position and overrides the natural instincts of both mother and baby.

Baby-led attachment allows the baby’s instincts to guide the way by supporting the baby’s body as the mother is in a reclined or laid-back position, and the baby’s mouth is placed opposite the nipple (not nose to nipple as taught in the cross-cradle position). 

Resources

The Memo x JWP Four Breastfeeding Positions To Try

The Memo x JWP Signs Of A Good Latch