Breastfeeding can be a hard, isolating, and emotional journey, which is why it's so important to have support. That's why Romper launched a Facebook breastfeeding community, Breastfeeding TBH — 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, and each week in Rack Facts, Romper speaks with a lactation consultant to answer as many of those questions as possible. After all, everyone can use a little expert help, especially when it comes to feeding your kid.
My daughter just turned 2 years old, which means I have begun Googling outrageous things like, "What happens if my baby sucks on a wipe?" for 24 months of my life. (Longer if you count pregnancy.) Parenting is full of questions anyway, but when you add in breastfeeding, there's a whole lot more time spent on Google.
How many times have you read "not recommended for breastfeeding moms" or heard that something you were doing was going to affect your milk supply? Dozens, right? And even when you think you've got it all figured out, you still worry that the medicine you're taking for thrush will make your baby sick or that working out will somehow tank your supply. But have no fear, Lori Isenstadt, an International Board Certified Lactation Consultant with over 25 years of experience is here to answer your questions. Isenstadt owns a private lactation consulting practice called All About Breastfeeding where she meets with moms on an individual basis to help with their breastfeeding issues. She also hosts a podcast, All About Breastfeeding, and has a great website full of resources to educate and advocate for breastfeeding mamas. In short, she's the support system all breastfeeding moms need and she's way better than Google.
1. Increasing Breast Pump Output
I have to go back to work next week. I am breastfeeding and pumping, but my problem is that when I pump, I barely get anything. It takes me three to four hours to get 4 ounces and I'm fighting for those. I am taking fenugreek and Mother's Milk tea to help produce more. What else can I do?
Sounds like you aren’t having a problem producing milk, just removing it from your breast. “Try pumping twice a day, both sides at the same time, for 15 minutes after the two early feeds of the day,” Isenstadt says. She notes that the volume you collect now is considered “leftover” milk and once you have an average supply, it’s normal for you to only pump around half an ounce or one full ounce after breastfeeding. “If you pump twice a day and collect one ounce each time, after seven days, you will have about 14 ounces, which is around three to four bottles,” she says.
Isenstadt also suggests using a hospital grade pump and making sure that you’re currently using the right size flanges for your pump to ensure proper output. You can try hand expressing your milk as well. “I have worked with many moms who have problems letting down to a pump, but do really well with hand expression,” she says. Her website has a great handout about hand expressing milk if you want more information.
2. Preventing Babies From Overeating
I am going back to work next week and from 8 a.m. to 5 p.m. every day. We bottle feed breast milk to our 8-week-old. How do I make sure he is not overeating?
“The most common sign of a baby overeating is the spitting up of large volumes of milk rather than just a tablespoon or two,” Isenstadt says. If you want to make sure this doesn’t happen, she suggests practicing a technique called upright and paced feeding. “Sit your baby in an upright position, just like you would if he were sitting at a table drinking from a cup," Isenstadt says. "Wait for your baby to open his mouth wide and place the nipple in his mouth, keeping the bottle held in a horizontal position for most of the feeding. After each ounce, take the bottle out of his mouth and give him a minute or two before offering another ounce. Continue doing this, allowing for rest and burp time in between each ounce,” she says. Isenstadt suggests that this type of feeding routine will greatly reduce the possibility of overfeeding him.
3. Breastfeeding Only At Night & Baby Is Still Hungry
I don't pump throughout the day and only breastfeed my son at night and through the night. Am I producing enough milk for him if I'm not pumping throughout the day?
According to Isenstadt, every feeding your baby takes from a bottle should be replaced by pumping both breasts for 15 minutes, otherwise your supply decreases. “When you don’t pump on a regular basis like this, it is very likely you will not have enough milk for your baby during the evening hours and through the night," she says. "His sign of wanting a bottle after a daytime breastfeeding is a clear sign you are not producing enough milk. If you want to make more milk, you have to remove it more frequently, either by the baby or your pump."
4. Chronic Clogged Ducts
I suffer from two to three clogged ducts daily. I have been mindful of what I'm wearing to ensure that nothing is too tight or restricting, my baby breastfeeds, and I pump frequently as well. Heat, Motrin, massage, and lecithin are not working.
It’s time to see a lactation consultant, mama. “Chronic clogged ducts on a daily basis are a red flag,” Isenstadt says. “That is abnormal and a signal to us that you need the professional help of an IBCLC. Chronic clogged ducts are usually a sign of inefficient or infrequent milk removal, an oversupply of milk (which means you’re making more milk than your baby needs), or too much pressure on your breast tissue.”
Isenstadt also notes that your baby should be gaining weight well, your baby’s latch should be pain-free, and you should not have soreness, cracks, or bleeding of your nipples. Also, make sure you are removing your milk on a regular basis. “With newborns and infants, this is about seven to nine times per day,” she says. “Be sure you have a good fitting bra, do not spend long periods of time with your baby laying on your chest, and don’t sleep in a way that puts lots of pressure on your breast tissue.” Because you are suffering and this is a chronic issue, Isenstadt urges you to seek a professional to figure out what’s wrong.
5. Working Out While Breastfeeding
My baby is 6 months old and I plan to breastfeed until he is 1 year old. I am thinking of going back to Orangetheory Fitness, an interval training workout. Will I lose my milk supply if I start working out?
Your milk supply is safe. “Regular exercise in moderation, such as what you will be doing at Orangetheory, is excellent for you," Isenstadt says. "It will not affect your milk supply."
6. Baby Uninterested In Breastfeeding After Solid Food
My daughter is 7 months old and eats stage three baby food three times a day and one snack per day. She was nursing seven times a day, but I now I have to push her to even nurse three times a day. She latches, drinks for two minutes, rolls and wiggles off, looks around, smiles at her siblings, and latches off. She latched herself back on and repeated this latching on and off six times in one feeding.
"Once you begin feeding your baby solid foods, you always want to be sure that you are breastfeeding her first and then offering solids second," Isenstadt says. "If she is only breastfeeding three times a day and staying there for only two minutes, you are at risk for a major drop in your supply." She also notes that your supply may already be quite low and that could be a reason your baby is losing interest. "For each missed breastfeeding, pump both sides for 15 minutes to increase your supply. After doing this for a week, your supply should have increased quite a bit and you will likely notice that she is nursing more."
7. How To Treat Thrush
I believe my 2-week-old has thrush. Is there anything safe I can do right now? I'd like to avoid nystatin or other harsh treatments, but I don't know if giving baby anything except milk at this age is advisable.
Your little one may actually not have thrush at all. "Thrush is one of the most common misdiagnosed ailments of new mothers who are suffering from nipple and breast pain," Isenstadt says. "You will want to seek professional help from an IBCLC to be sure all the signs of good latch and your baby breastfeeding normally are in place."
But until you speak to a professional, Isenstadt suggests a vinegar rinse on your nipples which may help decrease the pain. Mix one tablespoon of white vinegar and one cup of water in a spray bottle and mist the solution on your nipples after each feeding. Her website also has information on self-care tips that can prevent yeast growth.
8. Nurse's Schedule Leaves No Room For Pumping
I'm a full-time nurse and because I have to work the weekend shift by myself, I end up so engorged that I can barely lift my arms. As the only nurse, I can't just disappear and pump, but it's so painful. What can I do?
Isenstadt has worked with many nurses, so she understands the position you are in. "One thing that can help is to think in terms of quick pumping sessions rather than waiting for a time that you can devote 20 whole minutes to pumping," she says. "Some tips are to purchase a car adapter and a hands-free bra so that you can pump on your way to and from work, purchase an extra pumping kit so that you don’t have to worry about cleaning your parts in between pumps, and you should be able to pump a full 15 minutes during a lunch break."
Isenstadt also notes that many nurses use a hands-free bra to pump for a few minutes when they are sitting down and charting. The problem is that if you are truly unable to pump frequently during your shift, your supply will suffer. "Speaking with your employer about pulling in a nurse from another department twice a day to allow you to pump before and after your lunch break should be an option," Isenstadt says. She also recommends learning about your rights as a breastfeeding and pumping employee.
9. Finding Time To Pump
When is a good time to pump? After your baby eats, while your baby eats, or when your baby's asleep?
"You always want to pump after your baby has had a good feeding," Isenstadt says. "Pump within a half hour after a feeding so you don't reduce the volume too much before the next feeding, and you can also experiment with removing your baby from your breast if you feel like they are just comfort nursing. This will give you an opportunity to pump."
10. Milk Supply Decreasing
I have a 6-week-old at home and over the past three days, it seems my milk supply has gone down a lot. I eat oatmeal in the morning, I limit myself to one 10 ounce cup of coffee a day, and pump in between feedings. I am also using a nipple guard as he is tiny and I have large nipples. Could this be the reason I'm losing my milk supply?
You should be proud of yourself for working so hard, mama. "Eating oatmeal is great fiber and a good food for you, so keep that up," Isenstadt says. "But it is unlikely that the amount of coffee you are drinking is causing your supply to decrease. Your lowered supply may be stemming from poor milk transfer when using the nipple shield. The first thing you want to do is rent a good scale for 24 hours and weigh your baby before and after each feeding for 24 hours. This will let you know if he is transferring a normal volume." Isenstadt recommends using this resource to find out how much breast milk your baby should be getting each day. If you find that your baby is not receiving enough, you will want to reach out to an IBCLC to figure out why your supply is low.
11. How To Stop Pumping
I'm a first-time mom and I would like to stop pumping, but I don't really know how to go about it. I've done it for a month, but want to stop so I can work on my body and the supplements I would be taking recommend not breastfeeding. But this morning I had lumps on my breast so I pumped and they are gone now. Any tips?
"I often give this advice when it comes to weaning from the pump — gradually and with love," Isenstadt says. "Your breasts do not do well with abrupt changes, so you never want to go cold turkey and one day be pumping and the next day just stop. This puts you at risk for clogged ducts that may turn into a breast infection."
If you want to dry up as quickly as possible, sh suggests doing several different things at one time. "Wrap your breasts in green cabbage leaves, leaving your nipples exposed. When the cabbage gets warm and limp, throw it away and put on fresh, cold leaves. Keep this routine up during the entire weaning process," she says. "You can also take 40 drops of liquid sage four times a day. Both the cabbage and the sage help to dry up the milk in your breast tissue." Isenstadt recommends doing both of those things in addition to a gradual decrease in the amount of times a day you pump. "Drop one pump a day and decrease the time on the pump until you can go eight or more hours without pumping and have no lumps," she says. Her website also has more information on drying up your milk supply.
12. Improper Latch & Low Supply
I'm having a really hard time getting my supply up. I've stared taking fenugreek, blessed thistle, and Mother's Milk tea. I'm also having a hard time with my daughter latching properly and have tried to re-position her lips, but nothing works. I'm getting very discouraged and depressed.
"It can be so discouraging when you are trying your very best to breastfeed your baby and it is not going so well," Isenstadt says. "But the first six weeks are the most important weeks to help build your supply. Your first priority is to get help with proper position and latch as this is the best way to help increase your supply. Taking supplements will not help you much if your baby is not breastfeeding effectively." She suggests that, while you are waiting to see an IBCLC, you can start pumping after each time your baby breastfeeds.
Isenstadt notes that this will provide additional stimulation to help increase your supply. She also recommends not being shy about asking for help. "Many new mothers need help with the early days of breastfeeding. Give yourself the gift of experienced help so you don’t have to be discouraged and depressed."
13. Increasing Supply With Supplements & Food
How long does it take to increase supply after taking fennel, thistle, and eating lactation cookies and oatmeal?
Food and supplements really don't matter if you have a supply issue. "Generally speaking, if you have no health issues that create difficulty in making enough milk for your baby, your supply should increase each day," Isenstadt says. "With a baby breastfeeding well, or using a hospital grade pump, your supply should increase. Over the course of two weeks, your supply should be meeting your baby's needs." Isenstadt suggests that if this doesn't happen, you will want to reach out to a professional to see what the issue is.
14. Still Producing Milk After Weaning
I breastfed for the first 10 months of my baby's life and she is now 13 months old. I had no trouble with pain while attempting to dry up my milk supply, but it never really dried up. I checked to see if I was dried up and colostrum came out.
"While I can see how surprising it can be for you once you have weaned, it is very common to be able to hand express milk out for weeks and months afterwards," Isenstadt says.
15. One Breast Produces More Milk Than The Other
I use a double electric pump and nurse on both sides, but my right breast produces way more then my left. This morning I pumped and massaged both breasts for 25 minutes, but the right breast produced 8 ounces and the left produced 4 ounces. At this point, I am worried my left breast will dry up.
Don't worry, this is totally normal. "It is very, very common for one breast to make more than the other," Isenstadt says. "As long as you are making enough between both breasts to meet your baby's needs, you are doing fine. To be able to pump 12 ounces is about three times as much as the average mom can pump, so there is no reason for you to worry at this point about your left side drying up."