14 Real Breastfeeding Questions On Itchy Nipples, Periods, & More, Answered By An Expert
Breastfeeding can be a hard, isolating, and emotional journey, which is why it's so important to have a community of supporters. Romper has launched a new Facebook breastfeeding community, Breastfeeding TBH, in an effort to help make feeding another human being with your own body a little easier. Every day, readers ask questions because, let's face it, breastfeeding is complicated. Each week, Romper will be speaking with a lactation consultant to answer as many of these questions as possible.
It doesn't take a science degree to be a pro at breastfeeding, but it feels like it sometimes. Between trying to figure out what is leaking out of your nipples to regulating your milk supply, it's incredibly overwhelming when you realize how awesome your body is (hello, you're feeding a human being with it), but you have no idea what it's doing half the time. It's like realizing you can somehow diffuse a bomb, but now you don't know what those bomb parts are or how it works or how you even got this skill.
I got you covered. I reached out to Bethany Jacobs, lactation counselor and owner of Latched & Attached to answer your questions about all of the crazy things your body is doing while breastfeeding. If you want more support, Jacobs's Facebook page for Latched & Attached is a great place to start as well as her free Facebook support group, Breastfeeding Support with Latched & Attached. If you need a more personal approach, Jacobs is available for counseling on all of your lactation needs and is available worldwide via phone, Skype, and email.
1. Itchy Nipples During Weaning
I've been nursing my daughter for 17 months and we are down to just one nursing session in the middle of the night. The issue I'm having is that my nipples are really, really itchy. Does this happen when weaning?
Although itchy nipples may not be a textbook side effect of weaning, Jacobs says that it can happen. "We don’t know all the exact answers, but most researchers believe that it has to do with your hormone levels," she said. "Remember that your hormones have been pretty crazy since you got pregnant, so that’s over two years of wacky hormones. As you nurse less, the hormones prolactin and oxytocin are trying to find their balance in your bodies before getting kicked out — the battle of the hormones can cause all sorts of weird symptoms."
Jacobs notes that itchy nipples aren't necessarily a concern, but you should keep an eye on them in case any other symptoms pop up so you can let your doctor know. "I would think that within the next few weeks as your hormones balance out that symptoms like this might vanish."
2. Choking While Nursing
My 2-month-old granddaughter chokes so often while breastfeeding. She coughs and makes weird noises while choking. My daughter is worried. Is this common? Why does it happen and what can she do?
Jacobs says this is more common than you think, but you don't have to be alarmed. "It's most likely due to a forceful letdown," she says. "You might notice other indicators of a strong or forceful letdown like her pulling off the breast suddenly, appearing conflicted whether to latch or not, bobbing her head back and forth around the breast, or a clicking noise when nursing."
But don't worry, this doesn't last forever. "A mother’s milk supply usually regulates around 12 weeks and many moms will report that they notice a change," Jacobs says. "As milk supply regulates, many times your letdown becomes less forceful. It is also something that is easier for older babies to deal with for simple physical reasons like their mouth has grown larger."
"In the meantime, and if she maintains a forceful letdown, there are few things she can do to help the baby out, like feeding while mom is in a reclined or laying down position," she says. "The theory here is to use gravity to help slow down the flow. If mom laying down isn’t an option, try to get baby in a more upright position. She can also take breaks and pace their feedings with burps in between or pump or hand express for two to three minutes before each feeding to prevent that real forceful letdown in the beginning. If a forceful letdown continues, your daughter can work towards ways to reduce her supply like feeding one side at a time for certain blocks of time (for example, left side only for two hours and alternating in two hour blocks from there)."
3. Gassy & Fussy Baby
I have an almost 4-week-old and I am wondering if anyone else has had any issues with drinking caffeine or eating certain foods and it having an effect on the baby? He seems to cry a lot and has a lot of gas.
"Caffeine can be found in mother’s milk, however research has shown that it really doesn’t have a huge effect on baby. Usually this kind of behavior points to something else," Jacobs says. "There is one thing that is usually the culprit of a breastfed baby’s upset belly at this age — dairy. To be more specific, it’s the whey protein in dairy. A baby’s body is, many times, not prepared to digest this protein and it causes them to have an upset stomach which makes them gassy and fussy. This shouldn’t be confused with lactose intolerance because it has nothing to do with lactose and everything to do with the whey protein in dairy."
Jacobs suggests cutting out all dairy from your diet to see if it makes a difference. She notes that you can typically start to see a difference after a week or two, but it can take over a month for it to get out of your's and your baby's system.
4. Weaning A Toddler
I'm ready to wean my toddler. He is 22 months old, has never taken a bottle or pacifier, and he doesn't suck his thumb or have any identifiable comfort item. He naps at day care well, but at home he absolutely must nurse to go to sleep. But my supply has taken a major dip, and this makes him frustrated and restless, switching from left to right and twiddling the other nipple when he's not sucking on it. This delays sleep, and is extremely uncomfortable for me. I am ready to be done. I've tried letting him cry it out, which has hit and miss results. He tries his hardest to get under my shirt and get to my breasts. What can I do to break the habit?
"Weaning can be a difficult thing for both mom and child," Jacobs says. "For toddlers, it can sometimes be especially hard because they know what they are looking for and asking for, but when they don’t get it, their feelings are hurt. He is too little to reason, but you can try and tell him that there is “no more milk” gently and move on."
However, for you and your child's sake, Jacobs suggest the easiest way to end the nursing relationship is to change his sleep routine altogether. "Have someone else put him to sleep," she says. "It doesn't mean forever, it just means for now while you are weaning. If he gets upset and this, in turn, upsets you, try to go where you can’t hear what’s going on. The most important thing is to be consistent. You don’t want to confuse him by giving in some nights and not others. If you are done, which it sounds like you are, then you have to draw the line in the sand and be firm with your decision. 22 months of breastfeeding is wonderful and you have nothing to feel guilty about." Jacobs also suggests that if having someone else put your child to bed isn't an option, change up the routine itself. "Changing the motions can eliminate a lot of the expectation which is where the fight comes from many times," she says.
5. Leaking Orange Colostrum
I'm 25 weeks pregnant with my first child and have been producing colostrum since my 17th week. Some days I leak a lot and some days it's hardly noticeable. Today I noticed that the colostrum coming from my left breast was a very bright, dark, golden orange when it's normally a clear milky yellow color. I expressed a little from my right breast and it's normal colored. Should I be concerned or bring this up with my doctor?
No concerns necessary. "Most women that notice their colostrum during pregnancy see clear, yellow, white, or orange thick liquid coming from their nipples," Jacobs says. "As you get closer to baby’s arrival date, you may notice more changes in color or amount. All are normal physiological responses to pregnancy while your breasts are getting ready to do what they were meant to."
6. Breasts Don't Feel As Firm
I am exclusively breastfeeding my 1-month-old. My breasts have always been firm and full of milk, however the last two days my breasts feel very empty and flabby. My baby seems to still get milk from them but he has been feeding more. Is he getting enough to eat? Is this normal for my breasts to feel like this?
"You have just experienced the beauty of your female body regulating your milk supply," Jacobs says. "For many women, it can take up to 12 weeks for this to happen. When it first happens and our breasts don’t feel firm, we get nervous that it means nothing is in there which is totally not the case. You are now producing exactly what you need which prevents your breasts from getting that super full feeling." She also notes that an added benefit of feeling less full is that you are much less susceptible to plugged ducts and mastitis.
"To make sure baby is getting enough milk we have to focus on the output," Jacobs says. "At 1 month old, we like to see at least five to six wet diapers per day. As long as he is peeing and putting on weight you are good to go. We don’t focus on bowel movements as much because some breastfed babies can go seven to ten days without pooping." She also notes that you can't nurse too much and that nursing on demand is the best way to make sure baby gets what he needs and that your milk supply stays where it needs to be.
7. Baby Nurses Over Eating
I have an almost 16-month-old who still nurses when he's home with me. His favorite time to do it is right when he gets home from day care. Of course I want him happy so I do it but then he barely eats dinner. Does my breast milk provide enough nutrients to fill him and give him what he needs to grow? I wonder because he's in the 50th percentile for height and weight. He's healthy and perfect according to his doctor. I just wonder if I'm not helping him grow by nursing instead of him actually eating.
"Your breast milk might be filling him up close to dinner, but it isn’t preventing him from growing," Jacobs says. "Remember how nutrient packed it is. It’s also hard to say if that is what is actually preventing him from eating his dinner and it might take some experimenting to understand if he is just not a great dinner eater or if he is feeling full. If he isn’t asking for food later or acting hungry, I wouldn’t worry too much about it."
However, Jacobs does have some suggestions. "The first is to try and distract him after he gets home from day care. During that time you usually nurse him, be sure to shower him with attention — get on the floor and play with him or do an activity together. The second would be to offer dinner a little later and see if that makes a difference." But she insists that if his doctor is happy where he is at and you're happy to continue nursing him, don't think for a minute you are depriving him.
8. Baby Refusing Bottle
My son is 3 months old and up until now has had no problem switching between bottle and breast. I'm supposed to go back to work within the next week or so and is all of a sudden rejecting the bottle. Could it be that he's too tired or that it was frozen milk?
"It’s not likely that the frozen milk is what’s making the difference, but the only way to find out is to offer him fresh milk and see," Jacobs says. "I would also suggest letting someone else give him the bottle while you leave the room. If that still fails, you might try a different brand of bottle to see if he has turned on the shape, texture or flow of a certain nipple and be sure you are offering the bottle slightly before your son gets actively hungry. He might take to it more when he is just starting to feel a little hungry, about 20 minutes before his normal feeding."
Jacobs also suggests trying cup feeding if bottle feeding continues to fail. "Admittedly, it can take a bit more work because of the level of concentration throughout the whole feeding, but most babies take to it quite well," she says. "They sell fancy cups that are made specifically for feeding infants, but a shot glass (cleaned and sterilized) or another small cup you have at home, like a medicine cup, also work fine."
9. Pumping More From Left Breast Than Right
When I pump I get two or more ounces from my left breast, but only half an ounce from my right. I nurse my baby on both sides almost every time and when he wants to comfort nurse I only put him on the right breast. I'm taking a fenugreek supplement to increase my milk supply, but it isn't helping much. Is there anything I can do to fix this?
One big thing to remember? "We never use pumping as a true indication of our supply," Jacobs says. "It varies from woman to woman and even one breast to the other on how they respond to a pump. With that being said, this is really very normal. Many women lovingly refer to one breast as the overachiever and the other as the underachiever — it’s all dependent on your breast tissue and the makeup of milk ducts in each breast. We can’t get hung up on the number of ounces."
Jacobs says that if your baby is satisfied while nursing, there's no need to worry. If your baby isn't satisfied, you can work on your milk production and supply. "When working on your supply, (I’m not a huge proponent of supplements) I suggest increasing nipple stimulation by nursing, massaging or pumping — especially power pumping," she says. "The more often you do that, the more your body will get the memo to produce more," she says. She also mentions staying hydrated and drinking plenty of water.
10. Mirena Affecting Milk Supply
It's been seven hours since I've gotten the Mirena implant and I have yet to have a milk let down. I have nothing and breastfeeding was going so smoothly up until now. Is this normal?
"Birth control is so tricky because it varies from woman to woman. Is the Mirena safe? Yes. Should the Mirena impact milk supply? No. Have I seen it impact milk supply in breastfeeding moms? Yes," Jacob says. "If you have only had supply issues since having the IUD put in, then it would seem that it’s the problem. This goes for any kind of birth control — when starting a certain birth control, watch your supply closely. If it dips or ceases, your birth control might be to blame." Jacobs says that birth control plays around with hormones and, although it’s a different set of hormones that dictate milk supply, it can have effects on breastfeeding. "I would suggest talking to your doctor and exploring some other options because obviously the Mirena is a little different," she says.
11. Baby Is Gassy & Constipated
I have a 5-week-old and I breastfeed and sometimes supplement. This week, I have been exclusively breastfeeding, but for the past two days, my baby has been gassy, constipated, and fussy. Is that normal in breastfed babies?
"Constipation is near impossible for breastfed babies," Jacobs says. "However, if baby appears to be struggling to poop or just hasn’t pooped in a few days, there is nothing to be worried about. Breastfed babies can go seven to ten days without having a bowel movement. It is also common for babies to appear to struggle while pooping, but the struggle is mostly between them and their own anal muscles as they learn to use them."
"Fussing and gassiness are never normal, and there are certainly times there is cause for alarm, but most of the time it is as simple as something in mom’s diet," she says. "However, depending on the formula you’ve used in the past, you would probably see the same effects if it was a dairy based formula. Be sure to burp baby and eliminate gas on that end as much as possible."
Jacobs also says to look for signs that baby is satisfied after a feeding, focusing mainly on wet diapers, at least five to six per day. Also, watch their weight gain and if they are content. But she notes that it never hurts to talk to your pediatrician just to be sure and ease your mind.
12. Air In Storage Bags
I pump and store the milk in freezer. No one ever told me to get the air out of the bags when I stored it and I have a lot in the freezer now. Will the air affect my milk?
"There are a few reasons some people suggest getting all the air out of the bag. First is the fear of freezer burn — I’m not a scientist and cannot attest to the research that proves this, but some say leaving the air in the bag raises your chances of freezer burn," Jacobs says. "Freezer burn can dehydrate foods and can alter their taste, hence the fear of freezer burn on breast milk. After a lot of research on my own, the only solid reason I can tell you that it is recommended to remove air from the bag before freezing is because milk expands a lot when you freeze it. With the air in the bag, some of them may burst." Jacobs says you can absolutely still use the milk, but in the future you might want to push the air out to avoid a mess.
13. Baby Not Satisfied With Slow Let Down
When I put my baby to my breast, he pulls away and cries after the let down happens because he is hungry and my milk comes out too slow. It seems like I can only fill him up with bottles, but then it prevents me from saving bottles when I need them. While he's breastfeeding, I pump the breast, but I always end up having to feed him what I just pumped. What can I do?
"A slow or delayed letdown is typically a physiological response that your mind helps to control. Meaning your stress about your letdown is probably making your letdown slower and more difficult for you," Jacobs says. "If you can, try to distract yourself from not thinking about your letdown."
She suggests that if the issue has less to do with your letdown and more to do with his preference of flow, there are are a couple of things she recommends. "First, get a warm compress to put on your breast before you start nursing. When baby starts nursing, you can move the warm compress under your arm or on your back, just below your shoulder blade. This warms you up from the outside in and helps that milk to flow smoothly through the ducts," Jacobs says. "Second, massage your breast while nursing (once you remove that warm compress). Again, this can increase your milk flow and get it out just a little quicker.Do what you can, but try not to stress over it." She also says to let your baby nurse as much as he can because that will enhance his latch which will also get your milk flowing better and faster.
14. Baby Lost Weight During Period
I just went through my first period and almost lost my milk supply, and my baby lost over a pound during it. How do I get through my period and ovulation without losing my milk?
"The dreaded return of your period — it is normal to see a drop in milk supply, something that is reported by most breastfeeding moms upon the return of menses," Jacobs says. "The best thing you can do to keep your milk supply up during menstruation and ovulation is nursing on demand," Jacobs says. "Baby is probably going to want to nurse more and that’s okay — let him nurse as much as he wants. If you are a pumping mom, add an extra two to three sessions per day or add one power pumping session in. This should help to compensate for the dip in your supply." She also recommends drinking a lot of water to stay hydrated and eating extra protein, especially protein that is rich in iron, to help with your milk production.