Tata Thursday chat - 8/28 with Irene Zoppi

BumpJackie · August 2014

Ain't no better day than Tata THURSDAY!

Today, from 1-2pm EST, lactation consultant Irene Zoppi will be in THIS thread to answer all your breastfeeding questions! Her username is LCIrene.

By taking part in the conversation on this thread, you're automatically entered to win! We’ll pick one winner - here’s what you could take home:

Medela Prize Pack (Tender Care Lanolin, Quick Clean Breastmilk Removal Soap, Disposable Nursing Pads)

A little bit about Irene:

Irene Zoppi, RN, MSN, IBCLC, joined Medela in 1999 as a clinician for the Breastfeeding Division. She currently serves as a Clinical Education Specialist focusing on advocacy outreach. In this role, Irene acts as a vital resource for groups assisting breastfeeding mothers and infants. She has been frequently interviewed on radio and online regarding breastfeeding issues for mothers and clinicians.

See you at 1pm EST!

kiersto · August 2014

I breastfed exclusly for 2.5 month then started switching to pumping and bottles to be able to go back to work. Month 5 starts the first of september and I'm losing a lot of production. it takes 6 hours or more to have full enough breast to pull 5 oz out of each one. I tried pumping every 2 hours, and all I got was less then 1 oz from both each time and very sore nipples. I also use heating pads to try to help quicken the production, but thats not helping either. I should also note that I found out I was pregnant again last week. What can I do to get my production back up?

Khalenkamp · August 2014

I've developed mastitis in my biggest producing breast. I've been pumping to drain it but my supply has decreased substantially. I used to pump 2-3oz from each breast and now I can only get .5-1oz total. Could this be caused by the antibiotics? Will it go back up? I've tried skin to skin, pumping and feeding every hr to 2hrs, hot compress, and I still can't feed my baby enough. Also in the pumping stage I thing my baby experiences nipple confusion. Could this be possible at 4 weeks or is it just my low supply? Please help! I've been so stressed and feel like the worlds worst mother

ftm

liongrl87 · August 2014

I was pumping my breastmilk out because my baby wouldnt latch on to me, but because i got so busy with other things i had to switch to formula and i stopped pumping, how do i get my milk back so i can give my baby breastmilk?

vinividivici · August 2014

Lately while nursing my 5 week old will sound as though he's gasping while swallowing and will sometimes become frustrated and unlatch. I figured my supply might have established by now and if it was a forceful letdown it should have been an issue in the beginning as opposed to now, correct? Is this normal 5 weeks in, or is there something I should be doing differently?

LCIrene · August 2014

Khalenkamp said:

I've developed mastitis in my biggest producing breast. I've been pumping to drain it but my supply has decreased substantially. I used to pump 2-3oz from each breast and now I can only get .5-1oz total. Could this be caused by the antibiotics? Will it go back up? I've tried skin to skin, pumping and feeding every hr to 2hrs, hot compress, and I still can't feed my baby enough. Also in the pumping stage I thing my baby experiences nipple confusion. Could this be possible at 4 weeks or is it just my low supply? Please help! I've been so stressed and feel like the worlds worst mother ftm

I am so sorry you are experiencing so many issues trying to feed your little one! You need to know you are doing an awesome job. Keep pumping but perhaps you need a larger size breast shield. You may find it helpful to seek advice professional help with sizing as well to manage why your little one is preferring one breast over the other. Mastitis may make your milk taste more salty to your baby-perhaps that's why he is refusing one side. Please try to connect with a lactation professional in your area, call your local hospital for assistance or reach out to a La Leche League volunteer. Wishing you well.

jwittwer · August 2014

My 7 week daughter will only nurse if I use breast shields, otherwise she won't latch at all. Is this something that would affect my supply? Should I try to ean her, or are these shields okay to use the entire time I breastfeed her? Any advice or tips would be greatly appreciated!

mommaofmultiples · August 2014

Hello and thanks for doing an extra Tata talk!

I have two questions:

1) Once I went back to work, My EBF used to take 4 oz every 3 hours while at home with granny or nanny. Now at 5 months old (this Saturday) daycare says she seems hungry all the time. Knowing the tendency for daycare providers to over feed I still send the same amount but asked them to feed her 2 oz every 1.5 hours. Does this sound ok?

2) I know once breastmilk is thawed it is only good for 24 hours. But if I use it in food and then freeze the food for later, will the breastmilk have gone bad?

Thanks!

LCIrene · August 2014

liongrl87 said:

I was pumping my breastmilk out because my baby wouldnt latch on to me, but because i got so busy with other things i had to switch to formula and i stopped pumping, how do i get my milk back so i can give my baby breastmilk

Milk supply is driven by the frequency of how often you drain your breasts. Simply put, start pumping again - you may wish to rent a hospital grade pump to ensure proper draining. It's not possible to know if pumping alone will work for you - for example, if it's been a lengthy time since you stopped pumping. You may wish to contact a local lactation professional for the specific guidance you may need. Good luck! Your baby has already received lots of your breast milk!

Dovey81 · August 2014

I'm in the same situation as Kiersto-except it's because my LO has gone on a long nursing strike. He won't nurse except at night, most of the time, and he's 5 months old. Don't want to lose my supply:-(

sjc8187 · August 2014

Hi Irene,
I was wondering, when breastfeeding, I tend to crave sweets, more than I ever do when pregnant or not pregnant and I always feel hungry. I gain more weight when breastfeeding than I do in pregnancy. My question is, what can I do to curb those craving and increase my milk supply. I mean the cravings are THAT bad!

LCIrene · August 2014

vinividivici said:

Lately while nursing my 5 week old will sound as though he's gasping while swallowing and will sometimes become frustrated and unlatch. I figured my supply might have established by now and if it was a forceful letdown it should have been an issue in the beginning as opposed to now, correct? Is this normal 5 weeks in, or is there something I should be doing differently?

You may be still be experiencing a forceful milk ejection. Try nursing your son with him in a more upright position. He may be able to handle the amount of milk he is getting a bit better.

LCIrene · August 2014

jwittwer said:

My 7 week daughter will only nurse if I use breast shields, otherwise she won't latch at all. Is this something that would affect my supply? Should I try to ean her, or are these shields okay to use the entire time I breastfeed her? Any advice or tips would be greatly appreciated!

Glad to hear you are still nursing while using the nipple shields. Some infants do take longer to transition away from the shields. You may try this though....start nursing-nurse for a few minutes then take her off your breast and see if she will then relatch without the shield. It's perfectly fine to continue to nurse with the shields.

mhodges5 · August 2014

I have a one month old baby lately she has been waking up at night to feed every hour I'm not sure if she is maybe just snacking or if I don't have a good enough milk supply sue also eats every 2 hrs during the day. Last night I tried giving her formula and she slept 3 hrs after that she seems very fussy during the day as well.

mandy3ou · August 2014

Hi! My question is that I'm going back to work in a couple weeks. I have been working or building a supply of breast milk to use. However, when I pump I often get 5oz from one breast and 2 from the other. How can I begin to get more from the other one?

LCIrene · August 2014

jfresh said:

Hello and welcome @LCIrene! I think my 2 year old toddler and I are both feeling ready to wean. He still asks and I don't mind offering but there are times when I say yes yes in a few and we never get around to nursing, then I realize that night that we never ended up BFing that day. So at this point we're at some days 1-2 sessions and some days with none. Can we continue like this? How do I know if he's actually getting anything (I've never felt my letdown, ever)? I think a lot of it for him is for comfort so I'm not sure if he'd stop even if there was little to no milk coming out. But he does still ask and I'm open to continuing until he's 3 so I'm not exactly sure how to proceed.

What a lovely relationship you have with your son! He knows the comfort you are giving him by breastfeeding - he loves you and breastfeeding even if infrequently. It is perfectly fine to continue to nurse in the manner you have identified...as long as desired by you and your family.

Rhimariepierce · August 2014

My son is now almost 5 months old and eating a lot my production is down in the dumpster. I can't seem to get it up. I eat all the foods that are supposed to help with it. I have been pumping more often and for longer periods of time. Also letting him nurse as he wants to and I am making less and less milk I used to get 4-6 ounces out of each breast now I'm lucky to get 2-3 ounces. I desperately need help. I'm almost out of my freezer stash and can't provide enough for him.

LCIrene · August 2014

Bliz1712 said:

When I pump I get different consistencies with each side. Sometimes one side is more watery and lighter colored, and I'm assuming that's the fore/hind milk difference. I have been just mixing these both together and freezing them in 4oz increments. Should I be concerned when I go to use them that there could be a major imbalance? Should I be doing it differenty?

It shouldn't be an issue to mix or not mix the pumped milk you obtain. In 24 hours, healthy babies get what they need in quantity and calories while direct breastfeeding. If your little one is growing well and gaining weight normally-breastfeeding and pumping are going well.

asha1788 · August 2014

I went back to work, part time at home & part time at the office, in June, LO was approx. 3 months. Then in July I went back to work full time in the office. The LO is currently 5 months. Since then my supply is slowly decreasing and I am "pulling teeth" it feels like to maintain and pump enough for the next day. I am barely and I mean barely and sometimes pumping short of enough for the next day. I also have a 4 day conference I have to attend in October where I will be completely away from the baby. I need to save up about another 100 oz to ensure she has enough milk while I am gone. I do exclusively BF when I am at home with the baby in the evenings and on the weekends.

What are some tips to help increase my supply so I can make sure I pump enough for the next day and am able to put away milk in the freezer so I have enough come October?

LCIrene · August 2014

mommaofmultiples said:

Hello and thanks for doing an extra Tata talk! I have two questions:

1) Once I went back to work, My EBF used to take 4 oz every 3 hours while at home with granny or nanny. Now at 5 months old (this Saturday) daycare says she seems hungry all the time. Knowing the tendency for daycare providers to over feed I still send the same amount but asked them to feed her 2 oz every 1.5 hours. Does this sound ok?

2) I know once breastmilk is thawed it is only good for 24 hours. But if I use it in food and then freeze the food for later, will the breastmilk have gone bad?

Thanks!

Your suggested amounts to feed your little one while at daycare sound reasonable. Preparing less volume in the bottles you send is a great suggestion...

There is a lot about breastmilk that has not been studied - we just don't yet have all the answers as to how long breastmilk might 'be good for.' It is generally agreed upon that foods (and breastmilk) should not be re-frozen once thawed. Again, little research in this area though.

jwittwer · August 2014

One more question--

My daughter is sleeping 6-8 hours over night (I know, I'm so lucky!). During this time, I usually sleep as well. Will going this long between feedings/pumping affect my supply? Or should I be waking myself up to pump while she sleeps?

LMRmommy14 · August 2014

My son is 6 months old and he has developed thrush again! It seems we have been battling this for months. We've tried antibiotics to no avail and gentian violet which works . Are there any tips for avoiding or preventing us both from getting thrush?

TommysGirl56 · August 2014

I have 5 month old twins. Their pediatrician has continuously had me supplement more and more. I use a combination of pumped milk (as much as I can manage to pump) and Neosure, both fortified to 24 calories/ ounce. In addition to nursing on demand, each twin gets a total of 6 ounces/ day of supplement. I have a few question about this.

First, is it true that 10-20% of women are unable to produce enough breastmilk? This is what the pediatrician told me when he was suggesting I increase supplements. He feels they are not gaining weight fast enough. (Average weight gain has been slightly less than 0.5 ounce/ day).

Secondly, is there anyway to ever stop these supplements and EBF?

LCIrene · August 2014

Dovey81 said:

I'm in the same situation as Kiersto-except it's because my LO has gone on a long nursing strike. He won't nurse except at night, most of the time, and he's 5 months old. Don't want to lose my supply:-(

You're doing a great job! Keep nursing whenever your son wants to....and keep pumping!

LCIrene · August 2014

jwittwer said:

One more question--

My daughter is sleeping 6-8 hours over night (I know, I'm so lucky!). During this time, I usually sleep as well. Will going this long between feedings/pumping affect my supply? Or should I be waking myself up to pump while she sleeps?

Great to hear you're getting some much need sleep! Not breastfeeding for long hours might make a difference if your little one was a newborn of a 4-5months old. You'll know yout LO is getting enough if he is gaining weight appropriately.

LCIrene · August 2014

mhodges5 said:

I have a one month old baby lately she has been waking up at night to feed every hour I'm not sure if she is maybe just snacking or if I don't have a good enough milk supply sue also eats every 2 hrs during the day. Last night I tried giving her formula and she slept 3 hrs after that she seems very fussy during the day as well.

Your baby may be experiencing a growth spurt and want to eat more often for a few days. You can feel confidant that your milk supply is adequate if she is peeing, having soiled diapers and is gaining weight. Healthy babies drive a mother's milk supply themselves by breastfeeding. Breastfeed your daughter when she is hungry and she will do all the work.

LCIrene · August 2014

LMRmommy14 said:

My son is 6 months old and he has developed thrush again! It seems we have been battling this for months. We've tried antibiotics to no avail and gentian violet which works . Are there any tips for avoiding or preventing us both from getting thrush?

Sounds like you have been getting great assistance to treat the thrush. Are both of you being treated? Mothers and infants can continue to re-infect one another.

sjc8187 · August 2014

Not sure if you were able to see my question @LCIrene ??

BumpJackie · August 2014

Thanks everyone for participating in our final live chat with an LC in August!

And, of course, a BIG thank you to @LCIrene for answering all of our questions! Winner will be announced shortly

sjc8187 · August 2014

I was skipped over, not sure if she realized it was a serious question but it's ok. I'll research some more and see if I can find out the answer.

LCIrene · August 2014

TommysGirl56 said:

I have 5 month old twins. Their pediatrician has continuously had me supplement more and more. I use a combination of pumped milk (as much as I can manage to pump) and Neosure, both fortified to 24 calories/ ounce. In addition to nursing on demand, each twin gets a total of 6 ounces/ day of supplement. I have a few question about this.

First, is it true that 10-20% of women are unable to produce enough breastmilk? This is what the pediatrician told me when he was suggesting I increase supplements. He feels they are not gaining weight fast enough. (Average weight gain has been slightly less than 0.5 ounce/ day).

Secondly, is there anyway to ever stop these supplements and EBF?

Congratulations on your twins - what a lot of work! You should be congratulated for what you have already accomplished. Breastfeeding is the normal way to feed healthy infants...otherwise, as a species we would not have survived! There are women that may not be able to produce sufficient quantities of breastmilk to exclusively breastfeed - for example if they have had any type of breast surgery. Healthy sucking babies drive their mother's milk supply. But what often happens is mother's doubt their bodies are capable of doing what they are supposed to. If they think they are not producing enough, they supplement and that down regulates milk production. Thinking they are not making enough milk for their infant is the number one reason mothers stop nursing. I encourage you to continue your dialogue with your pediatrician about using supplements though - especially if your twins were born early. Wishing you continued success with breastfeeding. Your twins have already received a lot of your breastmilk!

TommysGirl56 · August 2014

Thank you for your response, Irene!

asha1788 · August 2014

@LCIrene you missed my question as well.

LCIrene · August 2014

mandy3ou said:

Hi! My question is that I'm going back to work in a couple weeks. I have been working or building a supply of breast milk to use. However, when I pump I often get 5oz from one breast and 2 from the other. How can I begin to get more from the other one?

This is a common occurrence for many women: are bodies are just not symmetrical. Research has shown that most women have one breast that produces more than the other. There may be nothing unusual about what you are experiencing. You can try to pump more frequently on the side that is not producing as much...but you may always see a difference in sides and production.

LCIrene · August 2014

asha1788 said:

I went back to work, part time at home & part time at the office, in June, LO was approx. 3 months. Then in July I went back to work full time in the office. The LO is currently 5 months. Since then my supply is slowly decreasing and I am "pulling teeth" it feels like to maintain and pump enough for the next day. I am barely and I mean barely and sometimes pumping short of enough for the next day. I also have a 4 day conference I have to attend in October where I will be completely away from the baby. I need to save up about another 100 oz to ensure she has enough milk while I am gone. I do exclusively BF when I am at home with the baby in the evenings and on the weekends.
What are some tips to help increase my supply so I can make sure I pump enough for the next day and am able to put away milk in the freezer so I have enough come October?

What a great job you are doing to maintain your supply! Many mothers comment on a decrease supply when returning to work. You may wish to try the following; try to 'squeeze in' another pumping (or two) during the day. This is very hard to do when working but frequent expressing (or breastfeeding) is what drives the milk supply. If you can, set your alarm and try to pump once during the night. Also, try pumping after your LO has nursed. Your breast shield sizes may also need to be re-evaluated - this is often the reason for a down regulation in milk supply. Lastly, you may wish to rent a hospital-grade pump for a few weeks-they are so much more efficient that personal use - double electric pumps.

LCIrene · August 2014

Rhimariepierce said:

My son is now almost 5 months old and eating a lot my production is down in the dumpster. I can't seem to get it up. I eat all the foods that are supposed to help with it. I have been pumping more often and for longer periods of time. Also letting him nurse as he wants to and I am making less and less milk I used to get 4-6 ounces out of each breast now I'm lucky to get 2-3 ounces. I desperately need help. I'm almost out of my freezer stash and can't provide enough for him.

You've done an awesome job breastfeeding your son exclusively for five months! If you're pumping a lot, you may need to have your breastshields re-fitted. Breast shield sizing does change over the course of lactation; improperly fitted breastshields may down regulate milk supply. Wishing you well.

dirteehippie · August 2014

I breastfeed out of the larger producing and I pump the smaller. She just hurts on the side and it never changes. I guess I'm too sensitive?

asha1788 · August 2014

@LCIrene Thank you for the tips. I do currently use a hospital grade pump through WIC. I also have met with a LC to have the breastshields sized properly and have fixed that problem.

I currently am taking the supplement called Milky. I found that it worked better then fenugreek by itself or Fenugreek and Blessed Thistle. Do you have any suggestions on other supplements to try? I am not sure if you are familiar with Milky, would I be able to take additional Fenugreek along with this?

LCIrene · August 2014

sjc8187 said:

Hi Irene,
I was wondering, when breastfeeding, I tend to crave sweets, more than I ever do when pregnant or not pregnant and I always feel hungry. I gain more weight when breastfeeding than I do in pregnancy. My question is, what can I do to curb those craving and increase my milk supply. I mean the cravings are THAT bad!

It takes a lot of energy in the form of calories to produce breastmilk. Consequently, most women notice they loose weight while nursing. Have you thought to explore this issue with your physician?

asha1788 · August 2014

@sjc8187 and @LCIrene

I experienced the same with my first LO, it was worse then in pregnancy and I was supplementing with my first LO as well. I do not have the severe cravings this time with BF but I do not lose weight and am struggling to not gain weight.

LMRmommy14 · August 2014

Yes we are both being treated.

Tata Thursday chat - 8/28 with Irene Zoppi

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