14 Real Breastfeeding Questions On Milk Storage, Let-Down, & 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.
Moments after being wheeled into the recovery room following the birth of my daughter, a nurse brought my little bundle to me and asked, "Do you want to try and nurse her?" I said yes, but hesitated a minute before saying, "but, I didn't read any books on this."
The nurse looked at me, laughed, and said, "What's to read? Here, just put her to your breast and see what happens."
Although there are some techniques to breastfeeding, I'll never forget how much that nurse helped me. She instantly took away my fear and panic. She knew that I may have issues, but she wasn't going to let me freak out before I had even tried. It's been two years and I still think about that moment all the time.
You don't have to read a book to breastfeed, but you're probably still going to have some questions. I reached out to International Board Certified Lactation Consultant Tori Sproat to answer your questions on breastfeeding. Sproat owns Tiny Tummies Lactation Services in Jacksonville, North Carolina and offers outpatient lactation care for moms who need some help. You can check out the Tiny Tummies Facebook for even more information.
1. Baby Won't Take Bottle Or Sippy Cup
My baby is 5 months old and exclusively breastfed. She took the bottle well up until about 3 months old. She was only ever bottle fed with breast milk when I wasn't home. Now she doesn't want any bottle, pacifier, or sippy cup near her when I'm gone. I know she won't starve herself, but I would like advice on how to help her feed from someone else.
You are absolutely right — your baby will not starve herself. Sproat recommends trying a few alternative feeding methods like cup feeding, finger feeding, or even dropper feeding. "Feedings while separated from the breastfeeding parent do not have to come from a bottle," she says. "Just remember that consistency is key and celebrate every step towards your goal."
Sproat also suggests that if you find a bottle that works, you should utilize the paced bottle feeding method to help avoid flow preference and reinforce healthy eating habits.
2. Genetic Breastfeeding Issues
I will be a first time mom come October, and I really have my heart set on breastfeeding. My grandmother told me that she tried to breastfeed my dad and couldn't because she had something in her milk that was harmful, or could poison my dad. She told me it was genetic but she couldn't remember the name of it. I have never heard anything like this.
"The most likely condition being referenced is a rather uncommon condition called galactosemia," Sproat says. "Thankfully, there is testing for this now." Sproat suggests discussing the potential for this condition with your healthcare providers so you can come up with a plan of action. "Typically families whose babies are born with this condition are not aware of it and do initiate breastfeeding prior to discovery, but the most likely possibility is that your baby will not have it and your goals of breastfeeding are safe."
3. Weaning Off Of Formula
I had a NICU baby who was fed my pumped milk as well as supplemented one ounce of formula at each feeding. We are home and I want to go back to breastfeeding alone. Is that possible? She still latches on but it's like it's not fast enough.
"First, I would encourage you to discuss with your medical team if the continued supplementation is necessary," Sproat says. She also suggests that you may benefit from seeing an IBCLC to help you with transitioning back to breast. "Until that appointment, I would encourage you to utilize the paced bottle feeding technique as it slows the flow and encourages baby to build the oral muscular development needed for breastfeeding, speech, and beyond."
4. Forceful Let-Down
I suspect I may have a forceful let-down. My 6-week-old chokes, coughs, and sputters at the breast, and I can see milk leak from his mouth. He often arches his back, pulling away from me, and unlatches frequently. But I think he can handle it because during his night feeding, when he is tired and all business, he eats great. Any tips on what I can do? I've read about block feeding but I'm afraid it will affect my supply.
"Currently, block feeding is a 'last resort' method due to supply concerns," Sproat says. "One thing you may want to try is laid back breastfeeding as it helps slow the flow and baby often can latch more deeply. If this is still not helpful, please find an IBCLC in your area."
5. Refreezing Milk Used For Baby Food
I'm making homemade baby food and want to mix in my breast milk. Can I thaw out some of my freezer stash and mix it with the puree and refreeze the puree and milk mix?
"While this has not been officially tested for this purpose, you can thaw and refreeze breast milk one time," Sproat says. "Think of milk banks — their process is to collect frozen milk, thaw and homogenize it, then pasteurize and refreeze." She also notes that there is research from North Carolina State showing that the current milk storage guidelines are quite conservative and the research did verify that refreezing is safe.
6. Adding Fresh Milk To Refrigerated Milk
If I pumped some milk a few days ago and put it in the refrigerator, and now I have fresh milk pumped for a feeding later tonight, can I combine the milk?
"They may be combined once they are at the same temperature, though it is best to be mindful that the date you need to use for this milk is the oldest pumping date," Sproat says. "Be mindful that the current storage guidelines are based on old studies and averages, so it is quite conservative, but you should always smell and taste test milk before giving it to baby."
7. Pump & Dump After Beer
If I drink one beer while breastfeeding, do I then need to pump and dump, even if it’s hours after?
This is a very common concern, and there have never been concrete guidelines on the issue. "Just like urinating does not remove alcohol from the blood stream, pumping and dumping does not remove alcohol from your milk," she says. "The current most conservative guideline for alcohol and breastfeeding is one drink per hour is fine, while abstaining from breastfeeding 1 hour for each additional drink." For example, if you do have one drink in an hour (a drink is defined as a 1-ounce shot, 4 ounces of wine, or 8 ounces of beer), you don't need to interrupt your breastfeeding schedule. But if you had two drinks from 5:00 p.m. to 6:00 p.m., you would not want to breastfeed again until 7:00 p.m.
"The safest time to nurse is when you first begin drinking as it takes some time for the alcohol to reach a peak in your bloodstream," Sproat says. "Pumping only comes into play should you experience engorgement and need relief. An occasional drink is no reason to pour your hard earned milk down the drain." She notes that moderation is the most important factor here as well as the safety of your baby (if you're intoxicated, you probably shouldn't walk around with the baby or hold them). Sproat also says that if you have been drinking, you are not safe to share your bed with your baby.
8. Baby Struggling With Bowel Movements
I have an (almost) 5 month old daughter. We struggled to get my supply up for the first couple of months of her life. Now all of a sudden, her stool is crazy. At first it seemed acidic, then it was mucus like, now it's a lime green color. She was having bowels every three or four days, and now it's three or four times per day. Her doctor keeps pushing block feeding. This will be our third time doing it. I stopped pumping. Is there anything else I can do? I'm afraid I'm going to deplete my supply to nothing if I stick with this block schedule.
You've been working hard, but Sproat recommends seeing an IBCLC now to make sure transfer is good and baby is deeply latching. "There is research indicating that what appears to be an allergy response in baby may actually be an allergy response in mom that her body’s cells, in an effort to protect baby, send to her infant to fortify it’s immune system," Sproat says. "You may benefit from an anti-inflammatory diet and if that is not effective within two weeks, then discuss allergy concerns with your medical team. Laid back breastfeeding may also be helpful if fast flow is the concern."
9. Breasts Producing Different Milk
Is there a reason one of my breast is producing really water-like milk while the other is very thick and rich looking? I always switch sides.
"The milk we produce can come in many forms and colors, it’s truly fascinating," Sproat says. "Each breast is its own independent factory. Just because one seems to be making thicker milk than another does not mean the milk of one breast is nutritionally deficient compared to the other." Sproat also says that recent research suggests that our bodies know if we are feeding a boy or a girl and tailors milk to a baby's particular needs. (As if you needed more proof your body was amazing.)
10. Drinking Coffee While Breastfeeding
Is it bad to drink coffee while breastfeeding?
"Just like alcohol, moderation is key here," Sproat says. "Too much of anything, including water, is not a good thing." Sproat agrees that trying to adult without coffee is pretty much impossible, so per Dr. Thomas Hale’s recommendations at Infant Risk, you should just monitor your baby for side effects and try not to consume caffeine late in the day. "If you’re looking for an energy boost, vitamin D is great and so is exercise. Going for a walk each day can improve your energy levels substantially," she says.
11. Breastfeeding After Having CMV
I was wondering if it's OK to breastfeed if I've been previously diagnosed with cytomegalovirus. I read online that you can pass it through breast milk. I had testing done, but it was in a gray area where they couldn't tell if I currently have it or if it's old because I have both antibodies showing up. They tested my baby (I'm 26 weeks pregnant) and it came back negative. My OB-GYN told me to ask my pediatrician if I could, but I was just wondering if you had any information.
Sproat recommends that for something of this nature, you should call the Infant Risk Center hotline and ask them what the latest research indicates for breastfeeding and your particular virus.
12. Introducing A Pacifier To A Breastfed Baby
My son is 3 weeks old and I exclusively breastfeed him, but he's been nursing frequently this last week or so. I felt like he was using me as a pacifier, so today I bought him one so he isn't constantly nursing. I was wondering if any other breastfeeding moms use pacifiers because I'm scared of nipple confusion.
"Many parents worry about nipple confusion with pacifiers," Sproat says. "The reason most lactation professionals discourage them is due to concerns of missing early hunger cues if utilizing one and then not feeding baby until they are very hungry and angry, which is harder to do." She notes that it sounds like your baby has hit the three week growth spurt and that you can read up on the Wonder Weeks so you can learn when your baby is more apt to have fussy weeks. "You can also utilize a baby carrier while your baby is in this cluster feeding stage so you are free to move about your home and be with your other children, too," Sproat says.
13. Allergies During Breastfeeding
I'm 36 weeks pregnant and concerned about allergies. My husband had a bad peanut allergy and I usually don't eat them anymore just so he's not around it. But I was wondering how you find out if your newborn has the same allergy? I'm afraid if I by chance accidentally ate something with peanut products then on her first feeding she might have a terrible reaction or worse.
"This is definitely something to be aware of, and something to discuss with your medical team," Sproat says. "If you do not have a history of allergy then it may be OK to try and monitor for reactions. The good news is that the amount coming through the breast is heavily filtered so it’s a bit more diluted and your colostrum will help line the baby’s gut with sIGA, which acts like a bouncer in the gut, protecting them from invaders."
14. Baby Going Several Days Without A Bowel Movement
My son is 5 1/2 weeks old and is exclusively breastfeeding, but will go five or six days without a bowel movement. He spits up and acts like his belly is hurting some, but not every time. He is having plenty of wet diapers. Is this normal?
"While it is within the realm of “normal” for some babies to go a few days between bowel movements, I stand by the thought that normal is only a cycle on a washing machine," Sproat says. "It sounds like your parental spidey senses are tingling, so you may want to consider working with an IBCLC to make sure that transfer is adequate for baby." She also notes that while she doesn't know enough about your particular case, in similar cases massaging the breast before feedings and feeding while the parent was upright or laid back did help with this issue.