Tata Tuesday Chat - 8/5 with Lea Rivera Todaro (LClea)

BumpJackie

Happy Tata Tuesday!

Today, from 1-2pm EST, Lea Rivera Todaro will be in THIS thread to answer all your breastfeeding questions! Her username is LClea.

By taking part in the conversation on this thread, you're automatically entered to win! We’ll pick three winners per week, and each winner receives one prize pack. Here’s what you could take home:

• A Prize Pack from Boob-olution’s sponsor, Boppy (Original Slipcovered Pillows, Toy Prize Pack)
• Baby K’Tan Prize Pack (Baby Carrier, Burp Cloth, Baby T-Shirt and Baby Hat)
• Ingrid & Isabel Prize Pack (Drop Cup Nursing Bra, Crossover Nursing Cami, and Cami Bra)

A little bit about Lea:

Lea Rivera Todaro is a mom of two. She successfully defended her Doctorate in Educational Psychology and is a DONA birth doula and International Board Certified Lactation Consultant. Lea uses her extensive background in research, education and birth work to provide a wraparound of continuous care to families. She works with moms and birth support partner(s) to develop an environment at home or in the hospital that reflects their beliefs and expectations. She will set up a schedule of postpartum support that is shaped by the client's personal needs and she will remain available through those critical years of zero to three. If you are seeking infant feeding support and advice, Lea will work to come to you and help you achieve your goals in regards to feeding your child.

See you at 1pm EST!

mommaofmultiples

Awesome!  I have a question: I am wondering if it is worth it to continue my 5A extra pump session.  My daughter is 18 weeks old and I have been back to work for 6 weeks.  My daughter has been exclusively breastfed.  Now that I am back to work I pump four times a day.  Once at 5A (this has always been just to have a freezer stash) and three times at work.  When I first went back to work, I pumped exactly what she needed in 3 pumps (9 oz) and the 5A pump was extra.  Now my daughter consumes 12 ounces and for a couple weeks I was able to pump 12 ounces in three pump sessions at work.  Now I need the 5A pump to make 12 ounces.  I am back down to pumping 9 ounces in 3 pump sessions at work.  I am exhausted from getting up at 5A to pump.  Should I keep this extra pump session or should I drop the 5A pump session and slowly use my freezer stash (~200 ounces) to bridge the deficit? 

LClea

Welcome @mommaofmultiples.  This is a great question.  That 5A pump is a hard one and with 200 ounces in the freezer I have to ask what is your long term goal for providing breastmilk?  Also, is it possible that your care provider is giving your daughter a little too much milk during the day thus creating a perception of "not keeping up?"  

tubbbytelly

Hello. My 4mo is constantly pulling off and making my nipple sore before the milk comes in, or she wanders off after the milk comes in...I don't know what to do since I know she is not getting enough and is therefore hungry very soon after and the cycle repeats!

sjc8187

I have a question, it's something thats been burning in my mind since I found out I was pregnant in May. I have a 6 month old breastfed son, and I am 18 weeks 3 days with boy/girl twins, I am so worried on how I will be able to breast feed 3 babies under 1. The twins will be newborns and my son will be about 11 months. I don't know how I will cope with lack of sleep and feeding around the clock. Should I consider pumping so my husband can help?

LClea

Welcome @tubbbytelly!  Nursing a 4 month old is so much more different than a young newborn!  That awareness that there are things around them is just fascinating, but maybe annoying to mama.  So some of what you may be seeing is normal development.  On the other hand you may also want to check is she gaining weight?  Making plenty of diapers still?  If so then be patient and she should settle back into nursing more quietly, or you can give her a nursing necklace to play with to keep her focused at the task at hand.  If her weight has dropped and she really is not eating enough then consider the possibility of over active let down in which case feeding from only one side in a more reclined position may be helpful.

sjc8187

Also if it's not too much to ask another question, last pregnancy I didnt make a lot of milk, and after I had given birth, the first few weeks I felt like he wasnt getting enough and he was constantly on the breast. What can I do during pregnancy, to increase my milk supply while still breastfeeding my 6 month old?

jennie0218

Thank you for helping out!! Im going to be a new mom and am nervous about latching. Any helpful suggestions would be awesome

LClea

Congratulations @sjc8187 that certainly is a house full of nurslings!  The first thing to remember is that just like breastfeeding a 2 month old is different from breastfeeding a 6 month old.  Breastfeeding a nearly 1 year old is different from 6 months.  His needs/interest may be significantly lower once the twins are born.  

Also, bear in mind that the twins will, within the first month, be on a tandem feeding pattern or "schedule" which will give you time in between to nurse and snuggle with the older child.  If you would like to consider pumping so your husband can help I would suggest doing so for the older child if he is still waking in the night so you can focus on the twins' needs.  

Remember with 3 under 2 you are really going to want a lot of tangible hands on support in the home.  Reach out to family and friends. Consider in home help if possible - post partum doulas are great for this, or a college/high school student who can entertain the toddler while you rest and feed the twins.

aeracine

I have to go on a 5 day business trip in about 2 months. My son is 7 months now, so he will be about 9 months when I'm away. I pump three times a day at work and barely get enough for the bottles he needs while at day care. Do you have any tips for storing up enough breastmilk for the 5-6 day trip? I am estimating that I will need about 150 ounces. I have about 50 in the freezer right now. I've started pumping after his first morning feeding on weekends, but that is only giving me about 3 ounces each session.

LClea

The amount of milk you make in the early days has a lot to do with your birth process -- IV fluids, blood loss to name the big ones -- all impact breastmilk production.  I am leary of giving you direct advice on increasing milk supply in pregnancy without knowing your full history and how this pregnancy is going.  If you would like to contact me offline please feel free to do so and we can chat in more depth about your concerns.

mrsmusser13

Good afternoon, I had breast augmentation in 2007 (implant under the muscle) and am now exclusively breast feeding my 3 week old son. My milk is coming in very well and he nurses regularly in addition to one pump session a day for storage purposes. While I feel he has a great latch on the left side my right breast is very sore most of the time. Because the whole breast hurts (not just the nipple) I keep an eye out for a clogged duct but that doesn't seem to be the problem. Could he be latching differently from one side to the other or could there be an issue because of the implant?

sjc8187

I have my sister already on board so hopefully I can succeed at breastfeeding 3! Thank you for the support and much needed advice

zygadloa

Hi!  My son was born at 42 weeks (11 days overdue) and ended up in the NICU for 2 weeks with severe sepsis.  I couldn't hold/feed him for the first five days and went home after 48 hours with a pump.  After he came home I struggled with supply issues (and supplemented) until I finally gave up and went to strictly formula at 3 months old.  We are now expecting baby #2 and I guess I'm wondering what I can do differently this time around.  I would love to exclusively breastfeed and I'm hoping my supply issues with my son were related to stress/not latching right away, etc.  What do you think?

ars195

Do you have any tips or ideas for someone who had a breast reduction 4 years ago?  A couple of OB's and nurse practitioners have said I should be fine but just wondering if you have seen success with anything specific things? 

LClea

@jennie0218 it is my pleasure!  So the basics of latching that I can type are....

Start nipple to nose.
Bring the baby to breast after the baby opens wide.

Do not move the breast to try and "catch" the wide mouth.  Think of your breasts as the baby's table...don't move the table.

The baby should be at the breast in a nice long stretched position.  Not c-curved around your body with their chin tucked in.  Humans don't eat that way

Also, sore nipples are one thing as the tissue adjusts.  BUT, you should never crack or bleed!!!

abbyleigh86

I am a FTM, due in 4 weeks and I was wondering about nursing bras. I've heard that I should buy nursing bras that are up to two cup sizes bigger than what I wear now for when milk comes in! Is that true?! Also, is it correct that wearing the wrong size nursing bra can cause engorgement and other issues?

LClea

@twolittledogs the answer is usually yes!  But every baby is different.  I thought I knew everything after breastfeeding my first for 3 years, but my second threw me the tongue tie curve ball.  I think what second and third and fourth mom's have easier is the knowledge that no matter how hard it might be RIGHT NOW it isn't forever and that it does get easier.

sjc8187

ok, I did lose a lot of blood because I had woke up in the middle of the night to placenta abruption, I had no clue that could impact milk supply! I will definitely contact off line to inform you better if you have time

jennie0218

Good question about the bras!!

LClea

aeracine in your case a temporary round of Mother's Milk Tea or other herbal galactagogue may be helpful in increasing your supply to increase the amount pumped.  Just remember that like any medication your should check with your health care provider or trained herbalist before starting herbal supplements (E.G., Fenugreek is botanically related to peanuts and so peanut allergic women should not take herbal supplements containing fenugreek)

LClea

zygadloa it sounds very much like your supply issues were related to separation, stress and lack of good support.  The first thing to remember is this baby is probably going to be very different.  Second, if you find yourself in a situation of being separated then start pumping within 6 hours of delivery and pump every 3 hours no matter what.  You won't get a lot )or any) and that is  fine you really want to just make your body know that milk is wanted and desired.  Third, if you find that your milk has not come in by day 3 or 4 reach out to a LLLL or IBCLC near you.  You can find one by going to the ILCA.org website or IBLCE.org website or LLLI.org 

jennie0218

Thank you for the advice on latching. I think i just get nervouse that he wont.

LClea

ars195 breast reductions are very tricky.  Your doctor no matter how "good a job" they did removed mammary glands.  The best protocol for breast reduction is to feed on demand and pump every 3 hours for the first 2 weeks.  Also work closely with a lactation consultant (IBCLC) if possible.  You are going to want to monitor baby's weight gain, find ways of supplementing at breast and also monitor your health for possible mastitis.  It isn't impossible to breastfeed with a breast reduction, but a lot of prenatal planning is important.  The best place to get support and information is BFAR.org (breastfeeding after reduction).  Good luck and remember that no matter what you do you are doing the right thing for you and your baby.

catherk21

I have a 6 week old who makes a "clicking" noise when she feeds.  We had our struggles (used a shield for the first 2 weeks) but then things got on track.  She doesn't seem to open her mouth very wide and I think our positioning could be better.  I have a very hard let down (hurts a lot) and produce a lot of milk.  She is gaining weight wonderfully!  Should I be worried about the clicking noise?  I do have sore nipples, some days are worse than others, but I am managing.

LClea

abbyleigh86 I generally recommend purchasing one nursing bra and one nursing tank for the first week.  After that shopping for new bras and shirts are a great reason to get out of the house for short excursions.  Also you will have a much better idea of how much larger you are going to be.  Remember your milk doesn't transition (engorgement) until about day 3 or 4 so that will be the largest you are going to be, but that is very temporary and your breasts will be slightly more "normal" within 14 days.

jwittwer

Does breast feeding using a shield impact milk supply? It seems to be the only way I can get my daughter to nurse (she's gaining weight and having the correct amount of dirty diapers). Or do you have tips to help wean her off the shield?

perfectlove09

My 19 month old is still nursing. There isn't much there, I'm 19 weeks pregnant. If she keeps nursing until #2 comes will she end up taking all of the colostrum that's intended for the newer babe?

graciroga

My question is in regards to amount my LO should have when I'm away. I currently pump since I have been back to work but I'm worried that my LO is not drinking enough. He's almost 5mos and drinking 3 5oz bottles in the day. He has been exclusively BF. How can I know when he needs more?

LClea

mrsmusser13 interesting question.  My suspicion is that there may be more adhesions on that side to the implant.  I would recommend trying some stretches of the pectoral muscles to see if that doesn't alleviate some of the discomfort.  This is what I'm thinking of in terms of stretching: https://www.stretchify.com/wp-content/uploads/2013/07/doorway-chest-stretch.jpg  or Downward Facing Dog if you do yoga.

jennie0218

Thats a good question about milk supply. What are thoughts avout lactation cookies?

bowlwoman

Hi, glad I saw the post from our BMB board moderator. I have a quick question. I have two daughters, 6 and 7, that I breastfed for a year each. I'm pregnant with #3, but it's been a few years since I've been to this particular rodeo. Have any recommendations changed in the past 5-6 years that I might need to be aware of? 

Also, starting breastfeeding again WILL be like riding a bike, right? It'll be easy to get up to speed?

LClea

gracirogajennie0218 lactation cookies are tasty -- generally oatmeal raisin/chocolate chip with brewer's yeast.  I don't think they work usually though.  I have had good experiences with Motherlove More Milk Plus and More Milk Special Blend, but again remember to speak to someone who is a trained herbalist to make sure it is right for you.

JunkieBrewster

I currently take Humira, Immuran and Prednisone. Some studies say it is safe to BF, some say it is not. The makers of the drugs all say NO. How do you know which source to actually believe?

Changing my medication is not an option.

jennie0218

Good idea and thank you for all the helpful information

LClea

bowlwoman  well sort of like riding a bike.  Definitely more like a rodeo!  As you know every baby is different so who knows what curve balls number 3 will send you. Overall none of the recommendations have changed...breastfeed frequently, for as long as the baby wants.  My usual recommendation to mom's is that if you aren't sure what the baby wants and it isn't obvious (poop up the back) then put them back on the boob until you two figure it out.  The biggest change in the last few years is that if you are going to need/want a breast pump call your insurance company!  They will provide one.

AthenaNabi

Someone told me that even though I am going to be staying home with my baby so I probably will always be with the baby to breastfeed him, I still need to sometimes feed him from a bottle so he gets use to because otherwise he will refuse to take a bottle later and I will never be able to leave him alone. Is this true or just a wives tale?

-Athena

vgutierrez504

I'm a FTM and I'm excited that I've been able to exclusively breastfeed my 5 week old baby. She has gained a lot of weight and produce enough diapers to let me know that she's eatingn enough buuuuuuut
When I use my double electric pump I've noticed that my right side pumps only 1oz and my left side I get 2.5oz in a 5minute session.
I've tried to latch my daughter more often on my right side to see if I can increase the supply but I haven't seen improvement.
Any suggestion on what to do? Or what can possibly be happening?

bowlwoman

Thanks for the info. I'm a working mom this time around (working 100% from home), but I do envision more pumping in my future than I did with the girls. Do you have a pump recommendation? I had a Medela Freestyle last time.

zygadloa

Thank you so much!  I really hope so   Hoping for an easier birth this time around!

LClea

JunkieBrewster there are two sources of expert opinion on medications and breastfeeding. The first is Thomas Hale's research center in Texas..you can find them at infantrisk.com.  I recommend calling them and talking with them personally.  They are very very helpful and are the people most of us "experts" go to when we don't have the answer to a question.  The other source is LACTMED, which is a free database you can read on your own.  For any mother who has to take a medication or needs to start one I recommend downloading the app so you can talk with your doctor from a place of knowledge...https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm