My Suggestions for Keeping Babies safe During Hot Weather:
1.) Offer the breast more frequently.
2.) Keep yourself very hydrated.
3.) Offer a bit of extra water to infants that are solid food eating age, but no water for exclusively breastfeeding infants.
4.) Cover any waterproof mattress covers with cotton or absorbent sheets.
5.) Put your baby down for naps in just a diaper.
6.) Try to make trips outside during the cooler parts of the day.
7.) Use a shade on a car window to protect your baby from direct sunlight.
Emergency heat levels: Use a fan or AC. Don't put the fan directly on the baby, just direct it close by to circulate the air. If you have no AC then use damp hand towels to keep baby cool, but not cold.
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DON'TS for Hot Weather:
Do not thin down formula or breastmilk bottles.
Do not leave your baby in a car for any amount of time unattended, not matter the temperature.
Do not leave your baby in a stroller for prolonged times.
Do not cover the stroller with a blanket, that can reduce hot air circulation.
Do not use fluffy mattresses/blankets that baby can sink into.

​Serena Meyer RN IBCLC

​Bay Area Breastfeeding Support
Serena Meyer, RN, IBCLC, RLC
IBCLC-reg. 11113721 RN- reg.95048954                                   
(510) 612-4000 Fax 510 275-0331

RE:   Lactation Accommodation                     

To Whom it May Concern,

It is common and standard clinician practice to recommend that breastfeeding parents express milk a minimum of every three hours to maintain a full supply of breastmilk. This generally is covered during the two breaks offered during an 8 hour shift and a full 30 minutes during lunch. Many mother's pump at 9am, 12, and 3pm. The accommodation part of this conversation is that a ten minute break is not long enough to fully empty out a breast during pumping. Offering an additional ten minutes on the regularly scheduled break time (20 total, twice a day) is reasonable, and allows for cleaning, wiping down surfaces and storing breastmilk. This additional time, on top of normal breaks is not required to be paid. 

All breastfeeding people in California are afforded the same protection of our laws that outline the basics of reasonable accommodation. 

In California reasonable accommodation has to do with offering pumping breaks, a private area to pump with a door (not a bathroom stall), and a clean place for lactating individuals to express breastmilk. 

The current American Academy of Pediatrics has extended the minimum requirement for breastfeeding to age two years: "The AAP outlines its recommendations and evidence of significant health benefits to infant and mother within an updated policy statement and technical report, both titled, “Breastfeeding and the Use of Human Milk” Published in the July 2022 issue of Pediatrics and available online June 27. The updates include a recommendation to support parents who choose to breastfeed their infant to age 2 and beyond." Full article here: https://www.aap.org/en/patient-care/breastfeeding/policies-on-breastfeeding/

The CDC outlines supporting a minimum of 2 years of breastmilk. That can be found here: https://www.cdc.gov/breastfeeding/faq/index.htm
Thus support for lactation needs to continue until the time of weaning. 

The Academy of Breastfeeding Protocol 7:
https://www.bfmed.org/protocols
"Recommendations Model maternity policy supportive of breastfeeding Policy.
1. This institution promotes breastfeeding considering that it is the biological norm for the human mother and infant (dyad) and that artificial feeding and early weaning carries considerable maternal and infant health risks1–5,7–14 (1).6"

Workplace actions that fail to support breastfeeding mothers also by virtue of decreased pumping options necessitate the use of formula which increases the health risks to infants. 

The full protections of California Laws regarding Lactation are listed here in full: https://www.dir.ca.gov/dlse/Lactation_Accommodation.htm#:~:text=Does%20my%20employer%20have%20to,are%20expressing%20milk%20in%20private. Quotes below.

"Does my employer have to provide me with a place to express breast milk?
A.     Yes, your employer must provide you with the use of a room or other location, other than a bathroom, in close proximity to your work area, shielded from view, and free from intrusion while you are expressing milk in private. This may include the place where the employee normally works if it otherwise meets the requirements. The lactation room or location must be safe, clean, and free from hazardous materials, as defined in Labor Code section 6382, contain a surface to place a breast pump and personal items, contain a place to sit and have access to electricity or alternative devices, including but not limited to, extension cords or charging stations needed to operate an electric or battery-powered breast pump. Access to a sink with running water and a refrigerator suitable for storing milk, in close proximity to the employee’s workspace must also be provided by the employer."

"5.     Q.     What happens if my employer does not provide me with the opportunity to take a break for lactation purposes?
A.     If you feel your employer is not providing you with adequate break time and/or a place to express milk as provided for in Labor Code section 1030, you may file a wage claim to recover one hour of premium pay at the employee’s regular rate of pay for each violation. See https://www.dir.ca.gov/dlse/HowToFileWageClaim.htm "

Additionally, a mother may also file a report/claim with the Labor Commissioner’s Bureau of Field Enforcement (BOFE) at the BOFE office nearest her place of employment should a workplace be unwilling to offer legal accommodation requests. http://www.dir.ca.gov/dlse/HowToReportViolationtoBOFE.htm
"The Labor Commissioner’s Office may, after an inspection, issue to an employer who violates any provision of this chapter, a civil citation ($100.00 for each day an employee is denied a break or adequate space to express milk) that may be contested in accordance with the procedure outlined in Labor Code Section 1197.1 (Labor Code Section 1033)"

In addition, any employee who is a victim of retaliation for either asserting or attempting to assert a right to lactation accommodation or for complaining to the Labor Commissioner about the failure of an employer to provide this accommodation may file a retaliation claim pursuant to Labor Code Section 98.7. An employee must file a retaliation claim with the Labor Commissioner’s Office within a year of the retaliation. 
See here:  https://www.dir.ca.gov/dlse/HowToFileRetaliationComplaint

Serena Meyer RN IBCLC

Whether this is your first child or second child, I want to take a moment to welcome you here to this space.  Some of you may access this article before your infant arrives, and some of you after. Learning about breastfeeding and how to create a smooth feeding relationship is important at any stage.

So when we are thinking about breastfeeding success sometimes our families have other ideas about what that means, and their suggestions may conflict with what you have learned or what your goals are. It’s important for me to assert that surrounding yourself with supportive people who aren’t busy telling you horror stories is critical to success. It’s really sad that your cousin’s friend’s daughter wouldn’t breastfeed and only took formula, but that really has nothing to do with you and your journey. The same goes for your bestfriend’s torn up nipples; not really about you and just serves to increase worry.

What’s real versus what’s not real is this:
Infants need to eat often and they will yell if that doesn’t happen. Your job as a parent is to offer to breastfeed every time your baby seems hungry whether that is a cluster of feeds that occurs many times over two hours, or on a rhythm of every 2-3 hours, including nights.

Scheduling feedings is good for adults but bad for babies. They need to eat way more than you might think. This means when your baby is brand new they communicate their hunger by squirming around, trying to eat their hand, trying to latch to your husbands ear - basically anytime they go poop or pee they made room for more milk. I try to tell people if the infant is awake at all it’s an early feeding opportunity.Babies need to be held and placing them in direct contact with your skin will enhance breastfeeding/feeding behaviors. Immediately after breastfeeding/chestfeeding your baby’s expectation is to be on your body. That doesn’t change much over the next few months. Everyone wants to swaddle a baby and put them down, babies don’t want that though. If there is a layer of clothes between you and your baby while they are feeding, how do they know they are in the right place? Many times they act confused, or don’t open their mouth wide enough.

Infants grow and thrive on an exclusive breastmilk diet. Your milk has everything your baby needs, including immune system support! The milk changes to meet the needs of your baby. Studies show that as an infant ages, the components of breastmilk change. For an example as the quantity of milk goes down like when you have a weaning child, the immune properties go up. This absolutely doesn't meant that you should withhold food if you have a low supply. It just means that your labor making milk is important. Formula is a tool and I don't feel like its helpful to demonize it.
​
Breastfeeding has never been solely about breastmilk transfer. It is about meeting the emotional needs of the infant at the breast/chest. Soothing and reassuring your baby. Teaching your baby who they are, in relation to who you are. With breastfeeding/chestfeeding my goal is to help parents build and emotionally  intact infant. It can be done many ways and you will have your own version.

Breastfeeding doesn’t have to be painful, but you might be a little bit sore for the first few weeks. Real pain with feeding means something is wrong. So when people share that their nipples were bloody at first and then they toughened up what I am hearing is: “I didn’t know what I was doing, but I started to get better, and finally my latching stopped hurting my nipples.”

My question to you as a mother/parent is, why not just learn how to do it without the cracked nipples and pain the first time? I know, It’s a good question right? :)

Anatomy of the Breast
What do you know about your breasts/chest? I have found that most people never really think about the breasts/chest in relation to their biological purpose. They are mostly just with us along for the ride, filling out our clothes with no real purpose until it comes to feeding.  During pregnancy the glandular tissue starts to change because of hormones. They become tender, they fill out, and you may see more veins develop on your breasts, and upper chest area.

Breast changes at the beginning of pregnancy tend to be glandular and important to function and making milk, breast changes towards the end of pregnancy are mostly padding or fatty tissue. The important part of breast/chest changes is that they are normal and we expect them. It is during this time that you may experience the breast/chest changing position or being lower placed. You might hear friends say that breastfeeding makes breasts sagging but it’s not breastfeeding- its actual pregnancy that does that.
The human breast/chest area comes in many sizes and shapes. A small breast can make just as much as a larger one. What we are hopeful to see is breast growth during pregnancy and more veining on the outsides. If you skin is darker you might not notice it. You will notice darkening of the areola, and some women notice more pronounced Montgomery glands. Those help lubricate the outside of the nipple. Some people see the kertin plugs in the breast which look like crusty skin on the tip of the nipple. That’s normal!

Here is a picture of the breast.
Notice the grape like clusters depicted in the inside of the breast- those are the part of the breast/glandular tissue that make the milk. The pathway to the nipple from the areolar clusters is called a duct. They are small tubes, and carry the milk. There are many convoluted paths to the breast and they weave through the breast. There isn’t a straight pathway to the nipple. Some of the breast is fat, some is the working part of the breast which I like to describe as the engine of the breast!

​(c) Copyright 2023 Serena Meyer RN IBCLC