Tata Tuesday 8/13, 1-3pm ET with Nancy Mohrbacher (LC Nancy)

KelKAT624 · August 2013

I am looking forward to playing sports again at month 6. I currently pump 3x a day, but am worried that I might have some engorgement prior to and during activity. If in addition to my normal pumping, if I do a short pump prior to activity, will that then stimulate my body to make more milk? I don't necessarily want to create more, just make it so it's not painful when I am exercising.

LCNancy · August 2013

mjsonnon said:

My son is 6 months old and I have recently started experiencing cracked nipples and a little bleeding, which I did not experience before. Are there any factors that could have resulted in this sudden change? Could this be due to him teething?I have been putting lanolin on it. Do you have any other suggestions to help with the dryness? Thanks!

Teething could most definitely play a role in your cracked nipples and bleeding. The most important way to help prevent this is to make sure your baby latches deeply. Take special care that he opens wide when latching and stays on deeply throughout the feeding. Another product that helps with dryness is the Ameda ComfortGel pads, which you wear in your bra between feedings like a breast pad.

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leilaleigh · August 2013

My daughter is 1 week and 3 days old. A week ago, I was given a nipple shield by the hospital lactation consultant when I had to come in to get a blood patch done to alleviate a spinal headache. The severe pain came at the same time that my milk came in, I was extremely engorged and could not pump or get her to latch on. She went 24 hours with out a BM and about 12 hours without a pee so we stated supplementing with formula because there was no choice. The nipple shield worked and we were finally able to breastfeed again and teh engorgement has gone down.

Now I am finding out that she is not getting enough milk. Her weight gain for the past week was low. I was only getting 10-30 ml per breast when pumping a few days ago. I started pumping after feedings and now I am up to about 30-40 ml per side. I feel that the shield is limiting her ability to get enough milk. She nearly refuses to latch on without it now, and when she does her latch is poor because she has become accustomed to the artificial nipples from the shield and bottles. Also, I think that my nipples are smaller (only stick out about 1/2 in) so she is having trouble getting a good latch.

What can I do to get rid of this shield and boost my milk supply?

thanks for your help!

Wish82 · August 2013

Hi Nancy! It's so nice to have your expertise. Any thoughts on when/how to eat BF babes on a schedule? My LO will be 2 months tomorrow and he's starting to get into a little bit of a routine. I'd like to start guiding him into a schedule by using his cues. Thanks!

windyfairy · August 2013

My baby was born on July 23rd. At birth, they said he weighed 8 pounds and 15 ounces. He didn't look like a 9 pound baby (he's 18 inches tall, and we've had a 9 pounder, before). I think that his birth weight was inflated, because I'd had 3 liters of IV fluids in the 12 hours before his birth. The hospital didn't make a big deal out of his weight "loss", but they're trying to get their baby friendly rating, so they're really trying to push breast feeding. At his check up, last week, he only weighed seven pounds and four ounces. The doctor knows that this is the 5th baby I've nursed, so only casually mentioned supplementing with formula, but didn't come right out and recommend it. The baby is wetting and pooping as he should be. You hear him swallowing when nursing, and he gets nice and limp when he falls asleep after nursing. Am I wrong for not being too concerned with his supposed "weight loss"? Our last child, a daughter, went through the same thing, only she had jaundice on top of it, and was fine.

LCNancy · August 2013

familyhoward said:

I am pregnant right now with baby #4. I have always had issues with flat nipples and have never successfully nursed long term. (Exclusively pumped with my 3 kids for 6-8 months each) What are the chances of not having those issues this time around? Or is there anything I can do to make my chances for latching better?

I highly recommend using laid-back positions after birth to make latching easier for your baby. You can read about it at: https://www.nancymohrbacher.com/blog/2010/10/11/some-ins-and-outs-of-laid-back-breastfeeding.html In these positions, gravity works in harmony with your baby's inborn feeding reflexes to make latching easier. You may also want to avoid using pacifiers and bottles in the early weeks, so your baby gets lots of practice at breastfeeding first. I remember a story one LC told me about a mother she worked with who had Paget's disease, an unusual type of breast cancer, which led to one of your nipple/areola being surgically removed. After she got pregnant, the mother asked the LC what to do, since she wanted to breastfeed. The LC told her "Let's not tell the baby." After birth, the baby latched onto the breast with no nipple and areola and was able to get milk through the mother's incision. Babies latch onto necks, shoulders, all kinds of things without nipples. You just need to use the best possible latching dynamics. It may also help to work with a board-certified lactation consultant. Exclusive pumping is triple the work of direct breastfeeding. I don't blame you for wanting to make breastfeeding work. Best of luck!

jegoffin · August 2013

My 4 week old is having difficulty gaining weight. She lost alot of weight in the first weekish-about 17 percent. We are still about 8 oz under birth weight but she has been steadily gaining for about 2 weeks. She nurses well and has plenty of diapers but is still gaining on the slow side. We are giving about 2-3oz of pumped milked per day to help her out. Will she eventually stop needing the extra milk? She is not taking everything I pump per day. Also, are there any ways to increase the caloric content of my milk?

LCNancy · August 2013

cjoyand said:

Hi Nancy! My son is almost 9 months old. He doesn't have much interest in nursing long enough to get a full meal (what I consider 5oz). He nurses for about 5 minutes total during 3 nursing sessions. Then his 4th and final nursing session he nurses for about an hour to fall asleep at night. I have to supplement with bottles of breastmilk after he nurses during the day to ensure he is getting enough breastmilk. I also give him about a 2oz bottle following two meals to make sure he gets close to 24oz a day. I am happy to continue nursing but it is becoming more difficult as I have to continue to pump. Having to prepare a bottle following a nursing session is getting more stressful too. He will accept the bottle immediately and finish 2-3oz from a bottle after nursing. He is quick to finish nursing and sit up to see what's going on around him. He complains when I sit down in the rocker to nurse him. He seems to be ready; to give up the breast. What is the best method for my son and for myself to begin weaning? Could I continue nursing just at bedtime? How long should this process take? Thanks!

I disagree that 5 oz. is a "full feeding" at 9 months. As babies take solid foods, they need less milk. Also, before solids are started, most breastfed babies average 3-4 oz. per feeding. Plus, as babies get older, they get more milk more quickly. In other words, your baby probably already gets a "full feeding" in the 5 minutes he breastfeeds, which is why he seems done then (he is!). The fact that he takes milk from the bottle does not mean he didn't get enough milk, as babies typically overfeed on bottles. Your baby's behavior is absolutely typical for this age and isn't a sign that he's ready for weaning. It sounds like you've been working way too hard, which is probably why you're feeling stressed! My guess is that your routine will be much easier if you just nurse him whenever he wants and stop giving bottles. Try that for a try for a while and see what happens. You can give him a cup of water with meals. If he is really hungry or thirsty, he will simply eat and drink more then. You don't have to monitor so closely everything he eats and drinks. Healthy babies do best when they can self-regulate their feedings. Regarding bedtime, many babies enjoy nursing to sleep. You can continue to nurse at this feeding for as long as you like. I hope this helps!

LCNancy · August 2013

capinjen152 said:

Glad to have a LC available. Can you tell us what paths to take to become a lactation consultant? We only have one in my area (rural) and think we could benefit from adding more, especially bilingual support.

How wonderful that you're interested in becoming a lactation consultant! The pathways to this career are listed on the website of our accrediting organization, the International Board of Lactation Consultant Examiners. You can read about them at: https://www.iblce.org/preparing-for-ibclc-certification One easy way to begin might be to consider becoming a volunteer Breastfeeding USA Counselor. This is a new mother-to-mother organization that offers online training. Once accredited, you receive 500 breastfeeding consultancy hours per year, one of the requirements for becoming board certified. You can read about Breastfeeding USA accreditation at: https://breastfeedingusa.org/content/becoming-breastfeeding-counselor

LCNancy · August 2013

katiejones07 said:

i have a question which i hope that you can answer for me. when i was younger i had my nipples pierced. they are out and healed (have been for 4 years) but now that i am about to give birth to our first child, i'm a little nervous that something might go wrong. have you encountered this before? and if so, did any milk come out of the old scars? could i be at a higher risk for getting thrush or other bacterial infections?

Congratulations on your pregnancy! There are have some articles and studies published about breastfeeding mothers who've had nipple piercings. Some women in this situation have had no breastfeeding problems at all. There are a couple of cases of issues with scar tissue preventing milk flow. Keep in mind that if even one of your breasts is working well, that should be enough. Mothers exclusively breastfeed twins, triplets, and even quadruplets. So one working breast is really all you need. (I also know this from my own personal experience, as I have only one breast that functions normally.)

ShutterbugLisa · August 2013

Should I take my breast pump and nursing pillow to the hospital when I deliver?

LCNancy · August 2013

kmvw said:

I am going back to work in two weeks and am concerned that LO isn't on any real schedule as far as eating. I bf and pump to start building up my reserve, she does get a bottle every once in a while so she is used to eating from a bottle. At times she goes three hours between feeding and other times its like any hour, hour and a half. Is there any way to know how many bottles/ ounces she will go through in a day? How do I go about getting her on more of a schedule? LO will be six weeks on Thursday, thank you!

Buchanana said:

I am heading back to work and my daughter is breasted. The day care warmed her milk the other day because she won't take it unless it is very warm. She didn't take the first bottle so they poured all 4.5 oz out. Could they have refrigerated the milk to use another feeding??

LCNancy · August 2013

If your baby refused the warmed milk completely, it could be refrigerated and saved for the next feeding. If she took any of it, saving the milk is not recommended, because baby's saliva mixes with it. Unfortunately, there is no real research on this issue, so most err on the side of discarding the milk. I wish I had better news! :-(

LCNancy · August 2013

Dlrbills4me said:

I work full-time and have used up any extra bags of milk I accumulated while home on maternity/family leave. What is the best way to go about establishing a stock pile of extra bags of milk, so that I can have them available for unforeseen circumstances?

Also, I have read conflicting articles, but I would love to know the details of when it is safe to nurse after having a glass of wine.

Thanks!

If you are working full time and want to pump extra milk, you have the option of pumping on the days you're home. The best time is usually about an hour after the first morning nursing. If you wait at least 30 min. after feedings, you'll get more milk to store than if you pump right after feeding. Regarding nursing and alcohol, it is not a problem to breastfeed after having a glass of wine. There have been no issues found in nursing babies when mothers drink moderately. For mothers who want to avoid their baby getting even a tiny amount of alcohol through their milk, drink the wine right after a feeding. Within 2-3 hours, all the alcohol is out of your milk anyway. There's no need to pump, as alcohol automatically leaves your milk as it leaves your bloodsream.

Cat435 · August 2013

Hi Nancy,

I have a 6.5 week old (my first) and am going back to work at 12 weeks. I have a few questions mostly on pumping:

1. She is starting to sleep longer at night (one night it was 7 hrs between feedings! but that is a rare record..she typically goes 3-5 hrs between feedings). I really would like to take advantage of times when she lets me get uninterrupted sleep, but I am wondering if sleeping that long at night would cause clogged ducts and/or decrease milk supply. This is especially a thought as I move towards the coming weeks when I hear she will start to really sleep through the night. She still goes 3-4 hrs between feedings during the day. Would I need to get up to pump or enjoy the sleep?

2. Am I at risk of creating a risky over supply by pumping before I go back to work? How much pumping would you say is safe when I am still at home and feeding her from my breast at each feeding?

3. If someone else bottle feeds her breast milk for one feeding at night, do I still have to get up and pump or can I enjoy the sleep? This would maybe happen one or two feedings per week.

4. during pregnancy i took flaxseed oil supplements to help with constipation. The ped said they think it is fine for me to keep taking it, but it sounded like an uninformed answer. Do you have an opinion of this?

5. I have heard that breast milk looses some of its nutritional value in the bagging and freezing process - antibodies sticking to the bags, etc. Is this true, and is there anything I can do to maintain as much of the nutritional value as possible?

6. Do you have an opinion of breast pump wipes used in lieu of washing in a sink? I have some friends that do that when they are at work and I am skeptical.

7. Is there any food I should avoid that could affect milk supply? I have heard that caffeine can negatively affect supply. Anything that would increase supply?

Thanks!

LCNancy · August 2013

ds3644a said:

Current 26 wks pregnant and still breastfeeding my 23 month old son. I have read that as you enter the third trimester your milk supply will dry out. Is this true?

Typically, milk turns to colostrum and decreases dramatically in volume at around 4-5 months of pregnancy. However, there will still be milk there. With my oldest son, who I nursed through my second pregnancy, as time passed his appetite for solid foods increased noticeably. That's one way to tell.

LCNancy · August 2013

jackersCU said:

My little girl is 14 weeks old and she still likes to nurse every 1.5-2 hours. Is she nursing for comfort or for food if it's that close together? I don't really mind but just curious. Thanks!

Your daughter's nursing pattern is well within the normal range, and my opinion is that she is most likely nursing for food. As along as she is growing and gaining weight well, you can trust that she knows what she needs. Nursing patterns are often influenced by a physical difference among women called "breast storage capacity." If you'd like to learn more about this, you can read about it at: https://www.nancymohrbacher.com/blog/tag/magic-number

BbyCarter13 · August 2013

Ok, this may be completely out there but has there been any research on any connection between the side of the body a mom has her IV in during labor and the side that baby prefers to nurse on? I had my IV on my right side and LO only 'likes' to nurse on the right. I have discussed this with a few of my friends and they say it is the same with their LO's. It doesn't matter if they are left or right handed. It only seems to be connected to the side that the IV is on.

Ridgebackmom · August 2013

Is it possible baby misses me on Monday after I've BF all weekend and then he's back to bottles on Mondays? My mother noticed the last 2 Mondays he's been cranky
TIA

Great questions on here ladies!! We could all use a little help with what works best!

LCNancy · August 2013

courtneyheiser said:

My son is four weeks now and breastfeeding has been a struggle, as it was with my first son as well. He lost a lot of weight at the beginning so I started pumping and bottle feeding on top of nursing because I did not want to supplement with formula. Now I mostly pump and bottle feed throughout the day and nurse at night but I still do not seem to produce enough to keep up with him. If I pump every two hours I usually get around 2 oz total but he can take a 4 oz bottle every 3(ish) hours! Is it normal for him to be eating this much? Also, I am going back to work in two weeks and I know I need to start storing BM, but everything I pump, he eats. I am taking fenugreek but haven't noticed a huge difference. Is there anything else I can be doing to help with production? Thank you for the help!

I'm sorry you've had so many breastfeeding struggles! Typical feeding volumes are 3-4 oz in breastfeeding babies. Regarding your milk production, it is determined by how fully and how often you drain your breasts. For most mothers, pumping 6-8x/day will maintain milk production. Pumping fewer times will cause it to decrease and pumping more times will cause it to increase. If you want to give your supply a boost, try pumping every hour during your waking hours for a week, and you'll see a gradual increase. When you get to 30-35 oz/day, that's the most you'll ever need, and then you can cut back to the 6-8x/day to maintain. It may also help to use the hands-on pumping techniques, which may yield more milk at each pump and drain you more fully. You can read about this at: https://breastfeedingusa.org/content/article/pump-more-milk-use-hands-pumping

LCNancy · August 2013

Ridgebackmom said:

Is it possible baby misses me on Monday after I've BF all weekend and then he's back to bottles on Mondays? My mother noticed the last 2 Mondays he's been cranky
TIA
Great questions on here ladies!! We could all use a little help with what works best!

Yes, i think that's very possible. Although I'm sure it's not easy to hear, it sounds like he definitely loves his mom!

MagsMayMommy · August 2013

Hi Nancy. Thanks for taking our questions!

I have a 15 month old who is still a frequent nurser, especially when teething. We bedshare because she will not fall to sleep without nursing and often wakes up when her sleep cycle ends. She typically comfort nurses a lot through the night. My husband and I are interested in having more children, but I still haven't had a period post-partum. Do you have any recommendations for helping this along aside from total weaning? I hope to let my child self-wean as much as possible, but some days I feel like maybe I should try to help her along if possible.

LCNancy · August 2013

Melissa 4637 said:

My two week old son has been in a bad mood for two days now and wants to nurse constantly. Is he going through a growth spurt, or could he just be soothing himself? Should I let him nurse whenever he wants? (Every 1/2 hour when he is awake)

At this age, this is most definitely a growth spurt. This is how babies adjust your milk production as needed. By nursing him every half hour, this gives your body the right signals to increase your milk production to meet his needs. You can't go wrong by doing that. He's a lucky boy that you are working so hard to give him the best! :-)

LCNancy · August 2013

JenniferW268 said:

I am so glad that I checked this board today. I think it's about time to give up I am a little over 9 months pp and have been BFing/pumping at work/supplementing with one bottle per day for 2 months because my supply is tanking. I tried upping my supply by increasing the amount of pumping sessions/drinking more water/drinking mother's milk tea/taking fenugreek and it is not doing a thing. Yesterday I pumped a total of 6oz while at work (4 pumps!!!) just now I pumped 1/2oz from each side and the last pump was 3 hours prior. Even when she BF at home she seems uninterested, unless it is her bedtime nursing session, then she is happy to take comfort in it before bed. I have felt in the past few months that it has been time to give it up, but I pushed through because I really want to get to a year. I just think now there is nothing more I can do . . . 1/2 oz out of a pumping session, it's almost hard to justify the time/frustration/bags that I have to lug to work/stress. Any help is appreciated, even if the answer is that it's time to give up.

It is normal for milk production to decrease between 6 and 12 months, because as babies take solid foods, they need less milk. Milk production is not affected by how much you drink (despite popular belief). What determines your milk production is how many times per day the milk is removed from your breast and how fully it is removed. It may be that your baby is sleeping more at night and has dropped night feedings, which can affect this. Count how many milk removals per day you have now (breastfeeds plus pumps). For most moms, 6-8 will maintain milk supply. Fewer will cause it to decrease and more will cause it to increase. Also, keep in mind that breastfeeding doesn't have to be all or nothing. Most working moms stop pumping somewhere between 9-12 mo but continue to breastfeed at home. Stopping pumping doesn't mean you have to stop breastfeeding. Any amount of breastfeeding will allow you to get to your one-year goal, and you and your baby will both benefit from that. I hope this helps! Best of luck!

LCNancy · August 2013

KelKAT624 said:

I am looking forward to playing sports again at month 6. I currently pump 3x a day, but am worried that I might have some engorgement prior to and during activity. If in addition to my normal pumping, if I do a short pump prior to activity, will that then stimulate my body to make more milk? I don't necessarily want to create more, just make it so it's not painful when I am exercising.

Adding one extra pumping will not cause your body to produce more milk. Assuming baby is not breastfeeding, most women find it takes more than 8 pumps/day to see an increase in production, 6-8 to maintain, and less than 6 will cause a gradual decrease. Does this help?

Fruitcove7 · August 2013

beccah480 said:

I am due in October and plan to breastfeed for at least the first year, assuming all goes well. Between book, classes, webinars, etc. can you recommend the most effecient, affordable, worth-while ways to a first-time mom like myself to prepare for breastfeeding? What are the best tools to have on hand once the baby is born (book names, websites, etc.)? I luckily have a great network of nursing moms within my friends and family. Also, it seems like each nursing mom that I know goes through a period of just extremely trying time in the first few weeks of nursing. It almost seems like unless you are absolutely deteremined or know to contact a consultant, you have a high likelihood of giving up during this period. Is this common outside of my circle too? Is there anything that can be done to prevent/avoid going through this rough time?

This is the same in my group of friends. Most give up quickly. I want to do everything I can to ensure that I can BF for the first year. Good Luck!

stgn01 · August 2013

Hi Nancy. I have 2 questions. I'm trying to wean DS by the time he is 1 year old He's been EBF from the beginning. He is nursing 4 times a day right now and I'm thinking that I will cut out a feeding every 2 weeks or so. Does this sounds like a gentle way to do it? Any other suggestions?

Also, he only nurses for about 5 minutes total. I feed from both sides every time. If I can get at leat 5 minutes, I feel ok about it but I'm hoping he gets enough. Is this long enough for a 10+ month baby? He is just such a distractable baby! Thanks!

LCNancy · August 2013

leilaleigh said:

My daughter is 1 week and 3 days old. A week ago, I was given a nipple shield by the hospital lactation consultant when I had to come in to get a blood patch done to alleviate a spinal headache. The severe pain came at the same time that my milk came in, I was extremely engorged and could not pump or get her to latch on. She went 24 hours with out a BM and about 12 hours without a pee so we stated supplementing with formula because there was no choice. The nipple shield worked and we were finally able to breastfeed again and teh engorgement has gone down.

Now I am finding out that she is not getting enough milk. Her weight gain for the past week was low. I was only getting 10-30 ml per breast when pumping a few days ago. I started pumping after feedings and now I am up to about 30-40 ml per side. I feel that the shield is limiting her ability to get enough milk. She nearly refuses to latch on without it now, and when she does her latch is poor because she has become accustomed to the artificial nipples from the shield and bottles. Also, I think that my nipples are smaller (only stick out about 1/2 in) so she is having trouble getting a good latch.

What can I do to get rid of this shield and boost my milk supply?

thanks for your help!

You're most welcome! I'm sorry you've had such a difficult start with breastfeeding. My best suggestion is to make an appointment with a private practice lactation consultant, who can evaluate everything that's going on and help you come up with a game plan tailored to your situation. You can find one in your area by going to www.ilca.org, click on Find a Lactation Consultant and enter your zip code. There is a reason your baby is not feeding effectively and that needs to be determined and addressed. The sooner you get help, the easier it is to solve the problem.

LCNancy · August 2013

ShutterbugLisa said:

Should I take my breast pump and nursing pillow to the hospital when I deliver?

No need. If a breast pump is needed, the hospital will provide one. And the best way to start breastfeeding after birth is not sitting up straight with your baby on a pillow, but leaning back (hospital beds conveniently recline) and using laid-back feeding positions. You can read more about this at: https://www.nancymohrbacher.com/blog/2010/10/11/some-ins-and-outs-of-laid-back-breastfeeding.html

Lear450 · August 2013

Lear450

2:53PM in Breastfeeding

my son is 11 days old. he loves to nurse and I would love to. with the help of a lactation consultant I am no longer engorged and milk ducts aren't clogged however I have ameda premium pump, even purchased additional sized flanges. when I pump I get 1/2 ounce after 20 minutes and this is after pumping on both sides. when he nurses he gets very little and was losing weight.. ive had no choice but to supplement formula. is there a way to get milk to letdown now? can I still get this to work?

Ridgebackmom · August 2013

Thanks, LCNancy!

LCNancy · August 2013

Cat435 said:

Hi Nancy,

I have a 6.5 week old (my first) and am going back to work at 12 weeks. I have a few questions mostly on pumping:

1. She is starting to sleep longer at night (one night it was 7 hrs between feedings! but that is a rare record..she typically goes 3-5 hrs between feedings). I really would like to take advantage of times when she lets me get uninterrupted sleep, but I am wondering if sleeping that long at night would cause clogged ducts and/or decrease milk supply. This is especially a thought as I move towards the coming weeks when I hear she will start to really sleep through the night. She still goes 3-4 hrs between feedings during the day. Would I need to get up to pump or enjoy the sleep?

2. Am I at risk of creating a risky over supply by pumping before I go back to work? How much pumping would you say is safe when I am still at home and feeding her from my breast at each feeding?

3. If someone else bottle feeds her breast milk for one feeding at night, do I still have to get up and pump or can I enjoy the sleep? This would maybe happen one or two feedings per week.

4. during pregnancy i took flaxseed oil supplements to help with constipation. The ped said they think it is fine for me to keep taking it, but it sounded like an uninformed answer. Do you have an opinion of this?

5. I have heard that breast milk looses some of its nutritional value in the bagging and freezing process - antibodies sticking to the bags, etc. Is this true, and is there anything I can do to maintain as much of the nutritional value as possible?

6. Do you have an opinion of breast pump wipes used in lieu of washing in a sink? I have some friends that do that when they are at work and I am skeptical.

7. Is there any food I should avoid that could affect milk supply? I have heard that caffeine can negatively affect supply. Anything that would increase supply?

You have a lot of questions! 1) You don't need to pump (or wake your baby to feed) unless you get really uncomfortable 2) Pumping once or twice a day will not trigger an oversupply in most mothers 3) Once or twice a week should not cause supply issues, but if it was every day, it would 4) flaxseeds are not a problem during breastfeeding; they are a food and there are no foods you must avoid while nursing 5) a good strategy is to give as much fresh/refrigeratred milk as possible (use what you pump one day the next day) and save the frozen milk for emergencies; freezing kills the live cells in the milk 6) I would be concerned about residue left from the wipes, but I have not read any research on them 7) caffeine in moderation (1-2 cups of coffee is fine) but you want to avoid too much sage or peppermint. A little is not a problem.

Thanks!

LCNancy · August 2013

jegoffin said:

My 4 week old is having difficulty gaining weight. She lost alot of weight in the first weekish-about 17 percent. We are still about 8 oz under birth weight but she has been steadily gaining for about 2 weeks. She nurses well and has plenty of diapers but is still gaining on the slow side. We are giving about 2-3oz of pumped milked per day to help her out. Will she eventually stop needing the extra milk? She is not taking everything I pump per day. Also, are there any ways to increase the caloric content of my milk?

I recommend you see a board-certified lactation consultant as soon as possible. You can find one in your area by going to www.ilca.org, click on Find a Lactation Consultant, and enter your zip code. The problem is not the caloric content of your milk, but something is not going well and you need to figure out what and how to best address it. An in-person evaluation by an IBCLC should tell you what you need to know. Best of luck!

LCNancy · August 2013

stgn01 said:

Hi Nancy. I have 2 questions. I'm trying to wean DS by the time he is 1 year old He's been EBF from the beginning. He is nursing 4 times a day right now and I'm thinking that I will cut out a feeding every 2 weeks or so. Does this sounds like a gentle way to do it? Any other suggestions?

Also, he only nurses for about 5 minutes total. I feed from both sides every time. If I can get at leat 5 minutes, I feel ok about it but I'm hoping he gets enough. Is this long enough for a 10+ month baby? He is just such a distractable baby! Thanks!

Being distractible is a normal part of breastfeeding at this age. Most 10+ old babies have also gotten so efficient that they are done in 5 minutes. Your weaning plan sounds fine. If you wait until one year to do it, though, there's no need to substitute formula for breastfeeding, you can just go to any type of milk you prefer. Up to you.

LCNancy · August 2013

MagsMayMommy said:

Hi Nancy. Thanks for taking our questions!

I have a 15 month old who is still a frequent nurser, especially when teething. We bedshare because she will not fall to sleep without nursing and often wakes up when her sleep cycle ends. She typically comfort nurses a lot through the night. My husband and I are interested in having more children, but I still haven't had a period post-partum. Do you have any recommendations for helping this along aside from total weaning? I hope to let my child self-wean as much as possible, but some days I feel like maybe I should try to help her along if possible.

Every woman's biochemistry is a different. For your fertility to return, you need to decrease the number of breastfeedings per day until you reach your own individual threshhold. This will happen eventually. It's up to you if you want to help it along. Best of luck!

Lear450 · August 2013

my son is 11 days old. he loves to nurse and I would love to. with the help of a lactation consultant I am no longer engorged and milk ducts aren't clogged however I have ameda premium pump, even purchased additional sized flanges. when I pump I get 1/2 ounce after 20 minutes and this is after pumping on both sides. when he nurses he gets very little and was losing weight.. ive had no choice but to supplement formula. is there a way to get milk to letdown now? can I still get this to work?

LCNancy · August 2013

Lear450 said:

Lear450
2:53PM in Breastfeeding
my son is 11 days old. he loves to nurse and I would love to. with the help of a lactation consultant I am no longer engorged and milk ducts aren't clogged however I have ameda premium pump, even purchased additional sized flanges. when I pump I get 1/2 ounce after 20 minutes and this is after pumping on both sides. when he nurses he gets very little and was losing weight.. ive had no choice but to supplement formula. is there a way to get milk to letdown now? can I still get this to work?

Milk supply is based on how many times per day your milk is removed and how well it is removed. You don't say how many times per day you're breastfeeding or pumping. For most moms, 6-8x/day will maintain milk production, fewer will cause it to decrease, and more will cause it to increase. One thing you could try is to pump every hour during your waking hours. After a few days you should see noticeably more milk. I suggest seeing the LC again to try to figure out if your baby is breastfeeding efficiently or if the problem is with your milk production. Best of luck!

JenniferW268 · August 2013

Thanks so much for your advice and support!

familyhoward · August 2013

Yes thank you! Reading all the answers was well worth the time here!!! :-)

KelKAT624 · August 2013

LCNancy said:

KelKAT624 said:

I am looking forward to playing sports again at month 6. I currently pump 3x a day, but am worried that I might have some engorgement prior to and during activity. If in addition to my normal pumping, if I do a short pump prior to activity, will that then stimulate my body to make more milk? I don't necessarily want to create more, just make it so it's not painful when I am exercising.

Adding one extra pumping will not cause your body to produce more milk. Assuming baby is not breastfeeding, most women find it takes more than 8 pumps/day to see an increase in production, 6-8 to maintain, and less than 6 will cause a gradual decrease. Does this help?

Yes! Thank you, Nancy!

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