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.
Parenting is wrought with uncertainty and it starts from the very moment you find out you're pregnant. If you're breastfeeding, the questions seem to pile on even more. It's not enough to figure out which bottles you're going to buy; you also have to figure out how to squeeze an extra pumping session into your work day, how much milk to leave so you can spend more than two hours away from your baby, and the science behind making breast milk so you can come up with a solution as to why you're no longer pumping enough for your baby.
Basically, there's a lot of math. And a lot of worry, fear, and exhaustion. International Board Certified Lactation Consultant (IBCLC) Kristen Gourley understands and believes that supporting breastfeeding moms equals breastfeeding success. Gourley works with Lactation Link, which offers in-home consultations in the greater Utah Valley area, but she also teaches online, on-demand, comprehensive video classes. Their expertise covers everything from learning how to breastfeed to pumping efficiently so you can go back to work. Head to Lactation Link's Facebook or Instagram to join the community.
1. Backpack Carrier Causing Digestion Issues
Can backpack carriers cause digestive problems, like straining to poo the next day with babies? I exclusively breastfeed and it always seems like the next day she has blood in her stool. It hurts when she eats, but I don't see any blood when I leak.
"Sounds like there’s a lot going on here," Gourley says, noting that baby carriers shouldn't cause digestive problems in baby, especially if baby is in a good position like "froggy" legs with knees above their bottom. "Blood in baby’s stool can be from straining, but can also be an indicator of food sensitivities as well," she says. "If you have clogged ducts or damaged nipples, it’s possible for baby to ingest some of your blood, but it generally would be darker in baby’s stool if you saw it at all." Gourley suggests talking to your pediatrician to rule out any health issues, as well as an IBCLC for help with nipple pain because, as she says, "breastfeeding shouldn't hurt."
2. Sore Nipples
I'm a first-time mom to a beautiful baby boy. He's 5 weeks now and although we've struggled with his latch, I think we've got that down. I'm struggling now with sore nipples — they're very sensitive to the touch. When my bra or even my shirt rubs against my nipples, it feels like a raw burning feeling. They're not hot, and not more red than I'd expect them to be normally (like from breastfeeding). My baby doesn't show any white in his mouth, nor do I on my nipples. Any ideas? I'm at a loss here since I don't have any other symptoms.
"It’s possible that there’s an underlying infection (bacterial or fungal), or that you just haven’t quite perfected the latch yet," Gourley says. "In cases of persistent nipple pain, it’s always a good idea to see an IBCLC to rule out any issues that can be taken care of, and also check in with your doctor to rule out any infection."
3. Slow Weight Gain With Tongue Tie
My little one is 3 weeks old and exclusively breastfed, but hasn't gotten back up to her birth weight. I noticed a tongue tie very soon after she was born, but I didn't think it was affecting breastfeeding as I haven't been having any pain. Occasionally she will begin with a poor latch, but it can always be corrected and we continue as normal. I can see and hear her swallow milk, I can feel my let-downs, I can see milk in the corners of her mouth, her wet and dirty diapers appear adequate — everything appears to be OK besides her slow weight gain. I've expressed my thoughts that she may be a slow gainer, but her pediatrician is concerned that she hasn't made it back to birth weight at this point. She has an appointment in a few days for a consultation and possibly to correct the tongue tie, but I'm nervous that this won't change anything. Could it be that its truly posing a problem in breastfeeding, even though everything appears OK?
"It is definitely possible that you could not have pain with a tongue tie, but that baby would still be having trouble removing enough milk," Gourley says. "It is concerning that baby is not yet back to birth weight, so I’m glad to hear that you’ll be getting another opinion about the tongue tie." She suggests seeing an IBCLC as well, because it's great to have breastfeeding help and support when introducing a newly functioning tongue. "Your IBCLC can also help you identify how much milk baby is taking in during a feed and create a care plan to keep your supply up and make sure baby is getting enough to eat," Gourley says.
4. No Period While Breastfeeding
How common is it to not have a period while breastfeeding? My baby will be 4 months old soon and I have yet to have a period. I'm on birth control and I have taken pregnancy tests, but they've all been negative.
According to Gourley, this is very common. "Most women don’t see a return to fertility until after six months postpartum," she says. "This is even true if you are on hormonal birth control. Continue to take your pill as directed to prevent pregnancy, and enjoy this time of no period."
5. Traveling & Pumping
My son is 4.5 months old and exclusively breastfed. My husband and I are going on a weekend trip for a wedding and leaving the baby with my parents. How much frozen milk will I need for at least two days? Also, how often will I need to pump [while away] to feel comfortable? And will I be able to save the milk, and travel with it on the plane?
Gourley says that while you are away from baby, you’ll need to pump at least as often as your baby would eat, so probably around eight times per day. "Try to pump at around the same time he would normally be eating if you were with him," she suggests. "You can save the milk you pump, just ask the hotel for a refrigerator for your room and have a cooler to transport your milk home." According to the TSA guidelines, it's OK to carry breast milk on, but Gourley says they may need to do a quick swab test on it. "In general, breastfed babies take around 25 ounces per day. So, you’ll need probably 50 to 60 ounces for your baby if you are away for 48 hours. You might want to leave a little extra just in case," she says.
6. Melatonin While Breastfeeding
Is it safe to take melatonin while breastfeeding?
"Because melatonin is a hormone that is naturally produced by your body, there shouldn’t be an issue with taking it," Gourley says. "That said, it does pass into your milk and it is known that naturally occurring melatonin helps baby develop his circadian rhythm. It would be best to talk with your doctor and your baby’s doctor to ensure safety, as taking melatonin all the time can decrease your body’s natural ability to make it."
7. Pregnant & Breastfeeding
My son is 8.5 months old. I'd been noticing a decrease in my supply the past couple weeks and wasn't sure why. Well I just found out I'm pregnant with baby number two, so I was wondering if that could be the reason for the decrease? In what ways does pregnancy change breast milk? Any other advice on breastfeeding while pregnant?
According to Gourley, your supply is very often affected by pregnancy. "When it comes to hormones, pregnancy hormones almost always win," she says. "You may notice your supply will continue to lower and during the second trimester, you’ll begin to produce colostrum just like you would even if you weren’t breastfeeding your older child." Gourley adds that sometimes when your supply decreases, it can taste a little salty and the colostrum tastes a little different than your mature milk. "Some toddlers don't care, but others will take the opportunity to self-wean," she says. "Depending on how much your supply lowers, you may need to be extra careful that your older baby is getting enough milk and food. Talk to your pediatrician if you are concerned."
8. Constipated Baby
I have been exclusively breastfeeding my baby for five months now. Lately, he has been getting constipated more often, going two to three days without pooping. I know it's normal for breastfed babies not to poop everyday, but I see him struggling trying to and he cries or gets fussy when he can't. Any suggestions on what could be wrong ? Something I could change? He doesn't have a doctor visit for a couple of weeks.
"If his poop has the consistency of toothpaste or softer when he does go, it’s not true constipation," Gourley says. "Sometimes babies don’t like the few days in between poops and have a hard time figuring out how to go, but it’s not likely to be in your diet, especially if it has manifested recently." If your baby has started solids, Gourley says this is the common issue. She also adds that the best way to get baby to poop is to nurse more often and keep baby moving. Lots of free play and tummy time on the floor can help.
9. Pumping Output Decreases
I have a 12-month-old who is still nursing. I used to pump three times a day and get 20 ounces while at work. Now I am only getting 12 ounces on a good day when I pump two to three times. How can I get my supply up?
"It’s possible he’s taking less when he’s nursing directly, even if he seems like he wants more from the bottle while at day care, and that’s being reflected in your pumping output now," Gourley says. "There are other possible situations as well — hormones from your menstrual cycle affecting supply, birth control that you may be using, or you just may need to add in another pumping session." She adds that many moms are not able to get an average of 6.5 ounces per pumping session, so your body may be adjusting because it doesn't think it needs to make as much. "You're doing lots of great things, but the bottom line is to stimulate as much as possible," she says. "If you are able to add in a fourth pumping session, that may really help or help him to take in a little less at day care and maybe increase the amount of solids he takes to make up for it."
10. Breastfeeding With Oxycodone
My daughter just had a baby three weeks ago. She smokes cigarettes and is taking oxycodone for her C-section. The baby is very fussy and doesn't sleep. I have a friend that pumps and stores breast milk, but she is on a low dose of Zoloft. Do you know which is worst? Baby having oxycodone and cigarettes or my friend's milk?
"Zoloft is considered OK to take while breastfeeding and it’s one of the most common antidepressants prescribed to postpartum mothers," Gourley says. "Oxycodone is common to be prescribed after C-sections and most babies are okay with moms taking it, too. It’s much more common for baby to be more sleepy while mom is on oxycodone than never sleeping. It is, however, common for babies of parents to smoke to be fussy. While nicotine does pass into breast milk, the biggest issue is the risk of secondhand smoke to the baby. If baby is not able to breathe well, it can affect feeding and sleeping."
11. Starting Rice Cereal
My son is 4 months old and I just started him on rice cereal. I've been mixing it with breast milk so it tastes familiar, but I feel like he's eating a ton of it. Could this just be a growth spurt? Or is it normal for them to eat a lot? How much do you usually start them out on? I'm a first time mom so I don't know a whole lot.
Gourley notes that it’s possible it’s a growth spurt, but some babies take to solids very quickly and some take time. "Breast milk (or formula) needs to be the primary nutrition for the first year, and it’s not really necessary to start solids until around 6 months old," she says. "Make sure that baby is only having solids at this point about once per day, and that you’re still nursing before offering solids."
12. Baby Doesn't Sleep Through The Night
My little one was sleeping so good until he was about 4 to 5 months old. Now he is 6 months old and still can not sleep. I can not seem to get him to sleep longer than three hour stretches. I have tried nursing, rocking him, self-soothing, and laying him in his crib still awake. Nothing seems to work. What other ways could I try to help him sleep longer through the night?
"It is very common for babies to go through cycles of sleeping well and not sleeping well," Gourley says. "It’s a phase, and sleeping long stretches is a developmental milestone. I know it’s tiring, but at 6 months old, it is normal for baby to legitimately need to nurse for nutrition during the night, and babies have no other way but to call for a parent when they are tired, sad, scared, cold, hot, or anything else. Hang in there. It won't last forever."
13. Supply Dropped After Sickness
I'm currently getting over a sickness and a stomach bug. I couldn't eat anything for two days and just started eating toast today. Fluids were small sips as I couldn't keep it down either. Since last night, all my baby seemed to do is cry. I tried nursing him a lot, so I'm wondering if my supply is lower? How long does it take to get back to normal?
"It’s possible your supply lowered some over that time, but most moms who experience a lowering after illness find that it rebounds quickly after getting back to regular eating and nursing very often," Gourley says. "Try to spend the day relaxing with baby near you and nursing him as often as you can."
14. Newborn Spitting Up
My 4 week old has been going through an intense cluster feeding phase. She will eat and eat, then spit up all of it in one intense puke, at least 2 to 4 ounces at a time. I am afraid she could almost drown. It doesn't happen every feeding and sometimes not for 20 to 40 minutes after she eats. I hate to stop her from eating because it doesn't always happen and she could really be hungry. I try and use a pump on the opposite side thinking my let-down is too forceful, but I have also tried feeding her "natural style" laying on my belly, but she doesn't feed well that way. She has continually gained weight, so I know she is clearly getting enough to eat. Any advice?
Gourley suggests that you try hand expressing just a bit to "let some air out of the balloon," so it’s not rushing as quickly when your milk lets down. "If she’s happy and growing, spitting up large amounts can be normal, but continue to feed on demand," she says. "If you don’t notice any improvement, it could be time to see an IBCLC to make sure it’s really oversupply and to get it under control so you and baby can be more comfortable."
15. Giving Up Pumping
So I have been breastfeeding for just over 16 months, and I love every part of it except for pumping. I work full time, second shift on a set schedule. I have been pumping five to six times per day for 15 of these months. I'm so ready to stop pumping, but I still want to to be able to nurse my son when I'm home with him on the weekends and in the morning. If I stop pumping at work, will my supply dry up at night so that I can't nurse on the weekends in the evening?
"Your supply will likely lower if you stop pumping, but there will still be milk there," Gourley says. "Many babies at that age are OK with a supply drop and will continue to want to nurse often. If baby does get upset at a slightly lowered supply, you can always add back in pumping sessions (but it could be just one instead of five to six) to help appease." Gourley adds that breastfeeding isn't all or nothing and many moms may stop pumping at work after 12 months, but still breastfeed on demand without any issue.
16. Baby's Losing Weight
My 4 month old is exclusively breastfed. She was weighed at her 2-month-old wellness check and weighed 9.3 pounds. She just had her 4 month checkup and only weighs 8.11 pounds. She has no issue nursing or latching, plenty of wet and dirty diapers, nurses about five to seven minutes every hour or so, is fed on demand, and I also pump. Her weight loss is a huge concern, but I hate to supplement and feel really discouraged. Our pediatrician told us to try and bottle feed an ounce of my breast milk before every feeding, and come back in a week for a weight check. Any other advice?
Gourley agrees that the weight loss is concerning. "I’d highly recommend seeing an IBCLC to have a full feeding assessment to see if any reasons for weight loss can be pinpointed," she says. "If baby truly is getting enough of your milk to grow, but isn’t actually growing, then it could point to an underlying medical issue. This is not common, though, so consulting with an IBCLC will be a great way to ensure your baby thrives."