We have compiled a
list of 20 commonly asked questions here for the benefit of our
followers! Please refer to this amazing compilation before asking your
breastfeeding questions!
(Contributed by Former Volunteer-Administrator Alyssa Michelle Martin for This Milk Matters)
1. How do I post a Q/pic?
To have question posted to TMM, simply post it on our wall. We will repost all breastfeeding related questions to our main wall as soon as we can. You can also e-mail thismilkmatters.org@gmail.com if you would like to remain anonymous, or to have us post your nursing photos to our Milk Team albums.
2.What is thrush? How is it treated?
Thrush is a yeast infection that can be passed back and forth from mom’s nipples to baby’s mouth, and even appear on baby’s bum. It is a fungal infection, and sometimes difficult to treat. Common symptoms are sore, cracked, itchy nipples that seem to have a yellowy discharge and white patches in baby’s mouth, on the cheeks, or tongue. It usually occurs when baby or mother is taking antibiotics (and not counteracting with probiotics such as a pill or natural forms like yogurt), but can happen on it’s own. A doctor can prescribe an antifungal for both you and baby that can be applied a few times a day. More natural remedies include washing your clothes and bras in white vinegar to help stop spreading it back to you, using lansinoh on your nipples, and airing out your nipples to the sun as much as possible. Probiotics are usually suggested even if you are not on an antibiotic, as well as reducing your yeast and sugar intake. Gentian violet is often suggested, but stains absolutely everything a bright purple, so be careful. Recent studies have also shown possible negative side effects if used for a long period of time.
La Leche League has a very informative article on how to tell if you have thrush, and common treatments.
http://www.lalecheleague.org/faq/thrush.html
3. What is mastitis/clogged duct? How do I treat it?
A clogged duct is an obstruction in the milk flow that usually shows up as a lump in your breast. It can be painful, or the area just tender and red. It usually reduces in size and pain after nursing. Common treatments include frequent nursing, massaging the affected area, and a hot compress to help relieve pain and stimulate let down. Massaging in a hot shower is also helpful.
Mastitis is an infection of the breast. Many women report having flu-like symptoms (achy, fever, exhaustion) as well as tenderness and red streaks spreading outward from the affected area. Treatment is similar to that of a clogged duct, but fever should be monitored. Any fever lasting 24 hours should be reported to your physician. The link below is a great resource from KellyMom.
http://kellymom.com/bf/concerns/mother/mastitis/
4. What is hind/foremilk? How do I make my milk fattier?
Foremilk is the more watery milk that is first expressed during a feeding, or pumping. It looks a bit like skim cow’s milk. It is mostly water to help quench thirst. The longer the baby nurses (or the longer you express/pump) the more fat is in the milk. The fattier milk is thicker and called hindmilk. Each time baby nurses or you pump, both milks are present. If you pump, you may notice that your milk separates and the hindmilk floats to the top. Some mothers worry about having enough fat in their milk. It is important to remember that your milk is designed to fit perfectly your baby’s needs. Over time, your body will increase the fat and calorie content in your milk naturally to satisfy your growing baby. Unlike with formula fed babies, there is no need to feed them more milk, as your body naturally adjusts the contents of your milk.http://thetruthaboutbreastfeeding.com/2009/03/03/where-does-fore-milk-end-and-hind-milk-begin-and-does-it-actually-matter/
5. I think I have low supply! How do I know baby is getting enough?
More and more moms are worried about low supply. It is estimated that in no more than 3% of women worldwide is this the case. If your baby has at least 6-8 wet diapers a day (poopy diapers are NOT an indicator of supply), gains weight steadily, and seems satisfied at the end of a meal, then you should not be worried about supply unless you suspect other medical issues. Most pediatricians incorrectly use the AAP formula chart, and not the WHO breastfeeding chart. (This link is to the WHO chart which you may feel to print out to bring to your baby’s next Dr visit http://www.who.int/nutrition/media_page/en/index.html) When baby is born, after the delivery of the placenta, your body’s hormones change and cause your body to start producing milk. It can take 5-7 or even 9 days for your milk to fully come in. Until then, colostrum is all your baby’s tiny tummy needs.
If you are worried about supply because your breasts feel “empty” and you no longer experience engorgement between feedings, do not worry. Your body adjusts to exactly the right amount of milk your baby needs. Once your baby starts to sleep through the night, your body will make less milk while you sleep, and make up for it by meeting the demands of your baby during the day when he or she is awake.
If your baby is suddenly nursing more often or for longer periods of time, he or she may be experiencing a growth spurt. This article by KellyMom explains growth spurts in more detail. http://kellymom.com/bf/normal/growth-spurts/
If you are still worried about low supply, and would like tips on increasing it, please refer to question 6, “How do I build up my supply?”.
6. How do I build up my supply?
There are many ways to increase your supply. The most important and basic ways are making sure you are drinking enough water (at least 160oz a day, anything with caffeine does not count, as it actually dehydrates the body) and eating enough. Dieting can often cause low supply because the body isn’t taking in enough calories. Foods like oatmeal (steel cut, instant does not work as well), flaxseed (comes in seeds similar to oatmeal, or as an oil), and brewers yeast (found in beer (especially dark, and including NON-alcoholic), powder, and pill form). You can use oatmeal, flax seed, and brewers yeast to make some delicious lactation cookies here. (chocolate chip:http://www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346, peanutbutter chocolate chip: http://www.drmomma.org/2010/08/lactation-cookies-recipe-increasing.html , gluten free: http://greenplatedinners.com/2012/10/25/gluten-free-lactation-cookies/ )
Fenugreek is often recommended, but can cause an upset tummy or gas in both baby and mom, and also makes you smell like maple syrup.
If you have a pump, spending an extra 5-10 mins pumping after a feeding can increase supply, as well as adding in a pumping session during the day, before you go to bed, or in the middle of the night. The first few times you pump, you may not see results. But the stimulation is telling your body to increase production.
This article has other great suggestions on increasing supply, as well as how to tell if your supply is low. http://www.breastfeedingbasics.com/articles/increasing-your-milk-supply
7. How much milk should I leave for my baby at daycare/with my sitter?
The general rule of thumb is that a baby will eat 1-1.5oz for every hour between a feeding. So, about 3-5oz every three hours. This article from KellyMom should offer some tips on the amount of milk you should leave, and even includes a tool to calculate about how much milk your baby will probably need for the time you are gone. http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/
8. I just found out I was pregnant with my second, and am still breastfeeding my first. My OB says I can’t keep breastfeeding, but my first isn’t ready to wean! Can I tandem nurse pregnant, or is it too dangerous?
There are no studies that have shown any significant increase in risk when deciding to breastfeed while pregnant. Mothers who are experiencing high risk pregnancies may be asked to wean due to uterine contractions that may occur while nursing, but there is not much medical fact behind stopping. Uterine contractions occur on their own and during sexual activity and are part of the natural process of getting a mother’s body ready for birth.
You might notice a change in your milk such as colour or taste, and that sometimes causes the child to wean. Some children who wean decide to start nursing again after the baby is born.
A drop in supply due to hormonal changes can also occur, and baby’s weight should be monitored closely if under one year.
LLLI has some great tips on how to have a successful nursing experience while pregnant and also tandem nursing. http://www.lalecheleague.org/faq/bfpregnant.html
9. What is a lip/tongue tie?
A lip or tongue tie is where the lip or tongue is connected in a place that it is not normally connected. Rarely are tongue or lip ties looked for in babies, and they are not usually found unless there is a problem with proper latching in breastfeeding mothers. A tongue tie can prevent baby from being able to properly suck and get milk from the nipple. A lip tie can make it difficult for baby’s upper lip to extend outward over the areola in a proper latch. This website has great information on different lip ties and an in depth FAQ of what a tongue tie is, if it is a significant problem, and how it can be treated. http://www.tonguetie.net/index.php?option=com_content&task=view&id=7&Itemid=8
KellyMom also has several articles on the issue here: http://kellymom.com/health/baby-health/bfhelp-tonguetie/
10. Help! Why wont my baby nurse?! Is it a nursing strike? Is she weaning at 6 months?!?!
The most important thing to remember is to never make nursing or food a stressful or negative experience. That can be difficult when baby refuses to nurse. It is very unlikely that a baby will wean him or herself before one year of age, and the average age to wean is between 2 and 5 years (according to WHO). If a baby does consistantly refuse to nurse before age one, baby will need to be bottle or cup fed expressed breastmilk or formula through the first year.
If you feel like your baby is refusing the breast because of preferring the ease of a bottle (commonly referred to as nipple confusion), try a ‘nursing holiday’. Spend a whole day with baby in bed skin to skin, nursing as often as possible. Try to eliminate bottle use unless absolutely necessary (such as when you need to be away or at work), and nurse on demand when you are together. If baby is old enough, you can also try using a sippycup or a cup with a straw instead of a bottle.
If baby has started solids and has suddenly lost interest in nursing, be sure to offer nursing first, then food as ‘dessert’. Remember, ‘food before one is just for fun!’ as babies still receive most of their nutrients from breastmilk or formula through the first year.
Some babies, usually starting around 5 months, feel they may be missing time exploring and playing by taking the time to nurse. You can help them stay focused by nursing in a quiet, dark room or by getting a nursing necklace that is safe for them to look at or touch while nursing.
Try to make nursing always a positive experience. If baby is refusing the breast, do not try to force your baby to nurse. Reward your baby for being close to you, latching even if incorrectly, and for any time they nurse by talking to them in a calming, positive voice.
Kellymom has a great article on how to get your baby back to breast. http://kellymom.com/health/baby-health/bfhelp-tonguetie/
11. What laws protect my right to pump at work?
Federal law protects your right to pump at work. It requires that all employers who employ 50 or more workers, or workers that normally receive paid or unpaid breaks, be given as much time as needed to pump. The law states that if regular breaks are paid, that you must also be paid for your regular break, even if used for pumping. If your pumping time exceeds your regular break time, you are still allowed to pump, but may be required to ‘clock out’. Your employer must provide you with a clean, private place (other than a bathroom) with a lock that has an outlet and must make a reasonable attempt to provide a fridge. This link can give you both the federal law to print out to show your employer, and the additional laws for each state. http://breastfeedinglaw.com/
12. What are the laws protecting my right to NIP(Nurse in Public)?
Almost every state in the US provides you with the right to NIP without negative legal ramifications against you, and prevents you from harassment. Most laws state you are allowed to NIP any place you are legally allowed to be, such as a restaurant, park, and shopping mall. You do not have the right to breastfeed at a private residence that is not your own unless the owner gives consent for you to be there. Each state has a slightly different law, and I encourage you to please know your rights. www.breastfeedinglaw.com has every state and some US territories. If your state protects your right to NIP and you are ever harassed, please call and report the incident to 1-800-NIP-FREE.
13. I’m taking drug x, is it safe to take while nursing?
KellyMom offers an extensive list of drugs approved by the AAP for nursing and pregnant mothers. http://kellymom.com/bf/can-i-breastfeed/meds/aap-approved-meds/
14. I’m all stuffed up, but I know I can’t take sudafed. What can I take for a cold instead?
While a lot of OTC medicines are considered either unsafe or could inhibit milk supply, there are a lot of natural remedies available. Eating garlic (raw is best, but pill or powder work too), making sure you are hydrated (at least 160 oz of water daily), and increasing your Vitamin C intake (through a pill or by fruit or fruit juices) are good ways to start. Congestion can be cleared out by a nasal saline (salt water) solution, or steam (sitting in the bathroom with a hot shower going). If your baby also has a cold, you may find that nursing in a steamy room may help clear out your baby’s nose enough to breastfeed better. This article by KellyMom has more tips and tricks to ease the symptoms.
http://kellymom.com/bf/can-i-breastfeed/meds/cold-remedy/
15. I am going out tonight? Am I allowed to drink? Do I have to pump and dump the next ___ hours?
Several studies have shown that drinking in moderation is perfectly safe while breastfeeding. The average person can metabolize one alcoholic beverage per hour. KellyMom’s rule of thumb is ‘if you are sober enough to drive, you are sober enough to breastfeed.’ If you find yourself wanting to enjoy more than one drink per hour, it is suggested that you do not breastfeed and instead give baby a bottle or cup of already expressed breastmilk. There is no need to ‘pump and dump’ (throw away your milk) unless you are pumping to make up for a missed feeding. Pumping in itself will not get rid of the alcohol. As long as the alcohol is in your bloodstream, it will be in your milk.
16. I am leaking/not leaking at ___weeks. Does this mean I’ll have a good supply/over supply/no supply/run out?
Leaking during pregnancy, even as early as the second trimester, is completely normal. Not leaking is also normal. Neither indicate what your future supply will be like. The early milk that you leak in pregnancy is called colostrum. It is a yellowy colour and all your baby needs the first few days of life until your milk comes in. Baby’s stomach is tiny when they are born and the few drops you think seem minimal are packed with nutrition and antibodies that are just right for your baby’s tummy and getting it ready for digestion of your milk. It is perfectly normal for your milk to take 5-7 or even 9 days to come in. There is no need to supplement formula. Just continue to nurse 8-12 times every 24 hour period, not letting baby go longer than four hours without feeding, but usually feeding every one and a half to three hours. Breast milk is made to digest quickly in a newborn, and the idea of a four hour feeding schedule comes from formula babies because it takes a lot longer for baby to digest it. In the early weeks, it is acceptable and even expected to wake baby to nurse if it has been longer than four hours, especially at night. Breastfeeding is built on a supply and demand system. The more baby nurses, the more milk you will make.
KellyMom gives a more in depth explanation on hormone levels and how milk production works.
http://kellymom.com/pregnancy/bf-prep/milkproduction/
17. I have to quit nursing because of a medicine I need to take for medical reasons. How do I dry up?
If you find yourself, for whatever reason, having to suddenly wean your baby, first congratulate yourself for being successful for as long as you have done it. A few months or even just a few days has given your baby a great headstart in nutrition. If you have time, try to wean baby one feeding at a time as this will be less painful than stopping suddenly. If you must wean immediately, there are several natural remedies you can take. Peppermint is a natural way to decrease supply or overproduction.Benadryl, in small doses, has also been recommended as it can lower supply. Tylenol for a few days while engorgement is most painful, can be used to help with the tenderness.
Contrary to popular belief, binding your breasts with a tight sports bra or ace wrap is not a safe idea and can cause severe pain along with mastitis and clogged ducts. Cold cabbage leaves applied to your breasts can help relieve some of the pain of engorgement. If you must, hand express just enough to feel comfortable, or else you will just continue telling your body to produce more.
http://www.bflrc.com/ljs/breastfeeding/dryupfst.htm and http://www.breastfeed.com/weaning-breastfeeding/stopping-breastfeeding-side-effects are two articles that can give you a more in depth look at weaning and drying up your milk supply.
Sometimes Drs mistakenly believe there are no safe drug alternatives to take for certain mecical issues, such as depression. KellyMom's list of drugs that are safe to talke while pregnant and/or breastfeeding may give you a safe drug option that may work for you. http://kellymom.com/bf/can-i-breastfeed/meds/aap-approved-meds/
18. What is good to snack on between meals while breastfeeding?
Fruits such as strawberries, apples, and bananas, provide a quick energy boost between meals. Lactation cookies with oats, flaxseed, and brewer’s yeast are also a great choice. They help increase production, provide a nutritious snack choice, and are delicious! (chocolate chip:http://www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346, peanutbutter chocolate chip: http://www.drmomma.org/2010/08/lactation-cookies-recipe-increasing.html , gluten free: http://greenplatedinners.com/2012/10/25/gluten-free-lactation-cookies/ )
19. How do I store milk once it’s pumped?
Once you pump your milk, there are several ways to store it. The average recommendation is that milk can be stored at room temperature up to 8 hours, although personal experience and some studies have shown it is safe to stay at room temperature for up to 12 hours. Milk in the fridge can last 5-8 days. Milk can also be combined from several pumping sessions throughout the day to store in larger quantities in the freezer. Milk can be stored in a mini freezer or the door of a freezer safely for about 3 months, in a regular two door fridge with separate freezer for 6, or in a deep freezer (chest freezer) for up to a year. Please always be sure to label your milk with the earliest date and time that the milk was pumped, and it is always recommended that you smell your milk to make sure it isn’t sour before feeding your baby. A baby will NOT drink sour milk, so if baby is refusing a bottle, that could be the reason.
The LLLI guidelines for milk storage can be found here for reference. http://www.llli.org/faq/milkstorage.html
20. What is an sns? What is it used for?
SNS stands for Supplemental Nursing System. Usually it is a long tube connecting a syringe or bag of milk to the mother’s nipple. It is often used by mothers with little or no supply. The SNS allows baby to nurse and stimulate further milk production while also getting enough milk.
(Contributed by Former Volunteer-Administrator Alyssa Michelle Martin for This Milk Matters)
1. How do I post a Q/pic?
To have question posted to TMM, simply post it on our wall. We will repost all breastfeeding related questions to our main wall as soon as we can. You can also e-mail thismilkmatters.org@gmail.com if you would like to remain anonymous, or to have us post your nursing photos to our Milk Team albums.
2.What is thrush? How is it treated?
Thrush is a yeast infection that can be passed back and forth from mom’s nipples to baby’s mouth, and even appear on baby’s bum. It is a fungal infection, and sometimes difficult to treat. Common symptoms are sore, cracked, itchy nipples that seem to have a yellowy discharge and white patches in baby’s mouth, on the cheeks, or tongue. It usually occurs when baby or mother is taking antibiotics (and not counteracting with probiotics such as a pill or natural forms like yogurt), but can happen on it’s own. A doctor can prescribe an antifungal for both you and baby that can be applied a few times a day. More natural remedies include washing your clothes and bras in white vinegar to help stop spreading it back to you, using lansinoh on your nipples, and airing out your nipples to the sun as much as possible. Probiotics are usually suggested even if you are not on an antibiotic, as well as reducing your yeast and sugar intake. Gentian violet is often suggested, but stains absolutely everything a bright purple, so be careful. Recent studies have also shown possible negative side effects if used for a long period of time.
La Leche League has a very informative article on how to tell if you have thrush, and common treatments.
http://www.lalecheleague.org/faq/thrush.html
3. What is mastitis/clogged duct? How do I treat it?
A clogged duct is an obstruction in the milk flow that usually shows up as a lump in your breast. It can be painful, or the area just tender and red. It usually reduces in size and pain after nursing. Common treatments include frequent nursing, massaging the affected area, and a hot compress to help relieve pain and stimulate let down. Massaging in a hot shower is also helpful.
Mastitis is an infection of the breast. Many women report having flu-like symptoms (achy, fever, exhaustion) as well as tenderness and red streaks spreading outward from the affected area. Treatment is similar to that of a clogged duct, but fever should be monitored. Any fever lasting 24 hours should be reported to your physician. The link below is a great resource from KellyMom.
http://kellymom.com/bf/concerns/mother/mastitis/
4. What is hind/foremilk? How do I make my milk fattier?
Foremilk is the more watery milk that is first expressed during a feeding, or pumping. It looks a bit like skim cow’s milk. It is mostly water to help quench thirst. The longer the baby nurses (or the longer you express/pump) the more fat is in the milk. The fattier milk is thicker and called hindmilk. Each time baby nurses or you pump, both milks are present. If you pump, you may notice that your milk separates and the hindmilk floats to the top. Some mothers worry about having enough fat in their milk. It is important to remember that your milk is designed to fit perfectly your baby’s needs. Over time, your body will increase the fat and calorie content in your milk naturally to satisfy your growing baby. Unlike with formula fed babies, there is no need to feed them more milk, as your body naturally adjusts the contents of your milk.http://thetruthaboutbreastfeeding.com/2009/03/03/where-does-fore-milk-end-and-hind-milk-begin-and-does-it-actually-matter/
5. I think I have low supply! How do I know baby is getting enough?
More and more moms are worried about low supply. It is estimated that in no more than 3% of women worldwide is this the case. If your baby has at least 6-8 wet diapers a day (poopy diapers are NOT an indicator of supply), gains weight steadily, and seems satisfied at the end of a meal, then you should not be worried about supply unless you suspect other medical issues. Most pediatricians incorrectly use the AAP formula chart, and not the WHO breastfeeding chart. (This link is to the WHO chart which you may feel to print out to bring to your baby’s next Dr visit http://www.who.int/nutrition/media_page/en/index.html) When baby is born, after the delivery of the placenta, your body’s hormones change and cause your body to start producing milk. It can take 5-7 or even 9 days for your milk to fully come in. Until then, colostrum is all your baby’s tiny tummy needs.
If you are worried about supply because your breasts feel “empty” and you no longer experience engorgement between feedings, do not worry. Your body adjusts to exactly the right amount of milk your baby needs. Once your baby starts to sleep through the night, your body will make less milk while you sleep, and make up for it by meeting the demands of your baby during the day when he or she is awake.
If your baby is suddenly nursing more often or for longer periods of time, he or she may be experiencing a growth spurt. This article by KellyMom explains growth spurts in more detail. http://kellymom.com/bf/normal/growth-spurts/
If you are still worried about low supply, and would like tips on increasing it, please refer to question 6, “How do I build up my supply?”.
6. How do I build up my supply?
There are many ways to increase your supply. The most important and basic ways are making sure you are drinking enough water (at least 160oz a day, anything with caffeine does not count, as it actually dehydrates the body) and eating enough. Dieting can often cause low supply because the body isn’t taking in enough calories. Foods like oatmeal (steel cut, instant does not work as well), flaxseed (comes in seeds similar to oatmeal, or as an oil), and brewers yeast (found in beer (especially dark, and including NON-alcoholic), powder, and pill form). You can use oatmeal, flax seed, and brewers yeast to make some delicious lactation cookies here. (chocolate chip:http://www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346, peanutbutter chocolate chip: http://www.drmomma.org/2010/08/lactation-cookies-recipe-increasing.html , gluten free: http://greenplatedinners.com/2012/10/25/gluten-free-lactation-cookies/ )
Fenugreek is often recommended, but can cause an upset tummy or gas in both baby and mom, and also makes you smell like maple syrup.
If you have a pump, spending an extra 5-10 mins pumping after a feeding can increase supply, as well as adding in a pumping session during the day, before you go to bed, or in the middle of the night. The first few times you pump, you may not see results. But the stimulation is telling your body to increase production.
This article has other great suggestions on increasing supply, as well as how to tell if your supply is low. http://www.breastfeedingbasics.com/articles/increasing-your-milk-supply
7. How much milk should I leave for my baby at daycare/with my sitter?
The general rule of thumb is that a baby will eat 1-1.5oz for every hour between a feeding. So, about 3-5oz every three hours. This article from KellyMom should offer some tips on the amount of milk you should leave, and even includes a tool to calculate about how much milk your baby will probably need for the time you are gone. http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/
8. I just found out I was pregnant with my second, and am still breastfeeding my first. My OB says I can’t keep breastfeeding, but my first isn’t ready to wean! Can I tandem nurse pregnant, or is it too dangerous?
There are no studies that have shown any significant increase in risk when deciding to breastfeed while pregnant. Mothers who are experiencing high risk pregnancies may be asked to wean due to uterine contractions that may occur while nursing, but there is not much medical fact behind stopping. Uterine contractions occur on their own and during sexual activity and are part of the natural process of getting a mother’s body ready for birth.
You might notice a change in your milk such as colour or taste, and that sometimes causes the child to wean. Some children who wean decide to start nursing again after the baby is born.
A drop in supply due to hormonal changes can also occur, and baby’s weight should be monitored closely if under one year.
LLLI has some great tips on how to have a successful nursing experience while pregnant and also tandem nursing. http://www.lalecheleague.org/faq/bfpregnant.html
9. What is a lip/tongue tie?
A lip or tongue tie is where the lip or tongue is connected in a place that it is not normally connected. Rarely are tongue or lip ties looked for in babies, and they are not usually found unless there is a problem with proper latching in breastfeeding mothers. A tongue tie can prevent baby from being able to properly suck and get milk from the nipple. A lip tie can make it difficult for baby’s upper lip to extend outward over the areola in a proper latch. This website has great information on different lip ties and an in depth FAQ of what a tongue tie is, if it is a significant problem, and how it can be treated. http://www.tonguetie.net/index.php?option=com_content&task=view&id=7&Itemid=8
KellyMom also has several articles on the issue here: http://kellymom.com/health/baby-health/bfhelp-tonguetie/
10. Help! Why wont my baby nurse?! Is it a nursing strike? Is she weaning at 6 months?!?!
The most important thing to remember is to never make nursing or food a stressful or negative experience. That can be difficult when baby refuses to nurse. It is very unlikely that a baby will wean him or herself before one year of age, and the average age to wean is between 2 and 5 years (according to WHO). If a baby does consistantly refuse to nurse before age one, baby will need to be bottle or cup fed expressed breastmilk or formula through the first year.
If you feel like your baby is refusing the breast because of preferring the ease of a bottle (commonly referred to as nipple confusion), try a ‘nursing holiday’. Spend a whole day with baby in bed skin to skin, nursing as often as possible. Try to eliminate bottle use unless absolutely necessary (such as when you need to be away or at work), and nurse on demand when you are together. If baby is old enough, you can also try using a sippycup or a cup with a straw instead of a bottle.
If baby has started solids and has suddenly lost interest in nursing, be sure to offer nursing first, then food as ‘dessert’. Remember, ‘food before one is just for fun!’ as babies still receive most of their nutrients from breastmilk or formula through the first year.
Some babies, usually starting around 5 months, feel they may be missing time exploring and playing by taking the time to nurse. You can help them stay focused by nursing in a quiet, dark room or by getting a nursing necklace that is safe for them to look at or touch while nursing.
Try to make nursing always a positive experience. If baby is refusing the breast, do not try to force your baby to nurse. Reward your baby for being close to you, latching even if incorrectly, and for any time they nurse by talking to them in a calming, positive voice.
Kellymom has a great article on how to get your baby back to breast. http://kellymom.com/health/baby-health/bfhelp-tonguetie/
11. What laws protect my right to pump at work?
Federal law protects your right to pump at work. It requires that all employers who employ 50 or more workers, or workers that normally receive paid or unpaid breaks, be given as much time as needed to pump. The law states that if regular breaks are paid, that you must also be paid for your regular break, even if used for pumping. If your pumping time exceeds your regular break time, you are still allowed to pump, but may be required to ‘clock out’. Your employer must provide you with a clean, private place (other than a bathroom) with a lock that has an outlet and must make a reasonable attempt to provide a fridge. This link can give you both the federal law to print out to show your employer, and the additional laws for each state. http://breastfeedinglaw.com/
12. What are the laws protecting my right to NIP(Nurse in Public)?
Almost every state in the US provides you with the right to NIP without negative legal ramifications against you, and prevents you from harassment. Most laws state you are allowed to NIP any place you are legally allowed to be, such as a restaurant, park, and shopping mall. You do not have the right to breastfeed at a private residence that is not your own unless the owner gives consent for you to be there. Each state has a slightly different law, and I encourage you to please know your rights. www.breastfeedinglaw.com has every state and some US territories. If your state protects your right to NIP and you are ever harassed, please call and report the incident to 1-800-NIP-FREE.
13. I’m taking drug x, is it safe to take while nursing?
KellyMom offers an extensive list of drugs approved by the AAP for nursing and pregnant mothers. http://kellymom.com/bf/can-i-breastfeed/meds/aap-approved-meds/
14. I’m all stuffed up, but I know I can’t take sudafed. What can I take for a cold instead?
While a lot of OTC medicines are considered either unsafe or could inhibit milk supply, there are a lot of natural remedies available. Eating garlic (raw is best, but pill or powder work too), making sure you are hydrated (at least 160 oz of water daily), and increasing your Vitamin C intake (through a pill or by fruit or fruit juices) are good ways to start. Congestion can be cleared out by a nasal saline (salt water) solution, or steam (sitting in the bathroom with a hot shower going). If your baby also has a cold, you may find that nursing in a steamy room may help clear out your baby’s nose enough to breastfeed better. This article by KellyMom has more tips and tricks to ease the symptoms.
http://kellymom.com/bf/can-i-breastfeed/meds/cold-remedy/
15. I am going out tonight? Am I allowed to drink? Do I have to pump and dump the next ___ hours?
Several studies have shown that drinking in moderation is perfectly safe while breastfeeding. The average person can metabolize one alcoholic beverage per hour. KellyMom’s rule of thumb is ‘if you are sober enough to drive, you are sober enough to breastfeed.’ If you find yourself wanting to enjoy more than one drink per hour, it is suggested that you do not breastfeed and instead give baby a bottle or cup of already expressed breastmilk. There is no need to ‘pump and dump’ (throw away your milk) unless you are pumping to make up for a missed feeding. Pumping in itself will not get rid of the alcohol. As long as the alcohol is in your bloodstream, it will be in your milk.
16. I am leaking/not leaking at ___weeks. Does this mean I’ll have a good supply/over supply/no supply/run out?
Leaking during pregnancy, even as early as the second trimester, is completely normal. Not leaking is also normal. Neither indicate what your future supply will be like. The early milk that you leak in pregnancy is called colostrum. It is a yellowy colour and all your baby needs the first few days of life until your milk comes in. Baby’s stomach is tiny when they are born and the few drops you think seem minimal are packed with nutrition and antibodies that are just right for your baby’s tummy and getting it ready for digestion of your milk. It is perfectly normal for your milk to take 5-7 or even 9 days to come in. There is no need to supplement formula. Just continue to nurse 8-12 times every 24 hour period, not letting baby go longer than four hours without feeding, but usually feeding every one and a half to three hours. Breast milk is made to digest quickly in a newborn, and the idea of a four hour feeding schedule comes from formula babies because it takes a lot longer for baby to digest it. In the early weeks, it is acceptable and even expected to wake baby to nurse if it has been longer than four hours, especially at night. Breastfeeding is built on a supply and demand system. The more baby nurses, the more milk you will make.
KellyMom gives a more in depth explanation on hormone levels and how milk production works.
http://kellymom.com/pregnancy/bf-prep/milkproduction/
17. I have to quit nursing because of a medicine I need to take for medical reasons. How do I dry up?
If you find yourself, for whatever reason, having to suddenly wean your baby, first congratulate yourself for being successful for as long as you have done it. A few months or even just a few days has given your baby a great headstart in nutrition. If you have time, try to wean baby one feeding at a time as this will be less painful than stopping suddenly. If you must wean immediately, there are several natural remedies you can take. Peppermint is a natural way to decrease supply or overproduction.Benadryl, in small doses, has also been recommended as it can lower supply. Tylenol for a few days while engorgement is most painful, can be used to help with the tenderness.
Contrary to popular belief, binding your breasts with a tight sports bra or ace wrap is not a safe idea and can cause severe pain along with mastitis and clogged ducts. Cold cabbage leaves applied to your breasts can help relieve some of the pain of engorgement. If you must, hand express just enough to feel comfortable, or else you will just continue telling your body to produce more.
http://www.bflrc.com/ljs/breastfeeding/dryupfst.htm and http://www.breastfeed.com/weaning-breastfeeding/stopping-breastfeeding-side-effects are two articles that can give you a more in depth look at weaning and drying up your milk supply.
Sometimes Drs mistakenly believe there are no safe drug alternatives to take for certain mecical issues, such as depression. KellyMom's list of drugs that are safe to talke while pregnant and/or breastfeeding may give you a safe drug option that may work for you. http://kellymom.com/bf/can-i-breastfeed/meds/aap-approved-meds/
18. What is good to snack on between meals while breastfeeding?
Fruits such as strawberries, apples, and bananas, provide a quick energy boost between meals. Lactation cookies with oats, flaxseed, and brewer’s yeast are also a great choice. They help increase production, provide a nutritious snack choice, and are delicious! (chocolate chip:http://www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346, peanutbutter chocolate chip: http://www.drmomma.org/2010/08/lactation-cookies-recipe-increasing.html , gluten free: http://greenplatedinners.com/2012/10/25/gluten-free-lactation-cookies/ )
19. How do I store milk once it’s pumped?
Once you pump your milk, there are several ways to store it. The average recommendation is that milk can be stored at room temperature up to 8 hours, although personal experience and some studies have shown it is safe to stay at room temperature for up to 12 hours. Milk in the fridge can last 5-8 days. Milk can also be combined from several pumping sessions throughout the day to store in larger quantities in the freezer. Milk can be stored in a mini freezer or the door of a freezer safely for about 3 months, in a regular two door fridge with separate freezer for 6, or in a deep freezer (chest freezer) for up to a year. Please always be sure to label your milk with the earliest date and time that the milk was pumped, and it is always recommended that you smell your milk to make sure it isn’t sour before feeding your baby. A baby will NOT drink sour milk, so if baby is refusing a bottle, that could be the reason.
The LLLI guidelines for milk storage can be found here for reference. http://www.llli.org/faq/milkstorage.html
20. What is an sns? What is it used for?
SNS stands for Supplemental Nursing System. Usually it is a long tube connecting a syringe or bag of milk to the mother’s nipple. It is often used by mothers with little or no supply. The SNS allows baby to nurse and stimulate further milk production while also getting enough milk.
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