17 Real Breastfeeding Questions On Breast Surgery, Twins, & More, Answered By An Expert
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.
I had a love/hate relationship with breastfeeding. I loved the time alone with my daughter, the guilt-free excuse of saying, "we're going to go lay down in the bedroom to nurse", and the 3 a.m. snuggles on the couch. But I also hated that every time she was hungry, I had to stop what I was doing, like cooking dinner or taking a shower. I hated that when she got older, she would pop off the breast every three seconds to play, expecting my boobs to become her endless buffet. I hated feeling like my body no longer belonged to me.
I think that's pretty normal, but there's a lot of things they say are normal about breastfeeding that feel anything but. I spoke to Briana Violand, International Board Certified Lactation Consultant and owner of Northcoast Lactation Services to get the skinny on all of the "this doesn't feel normal" parts of breastfeeding. You can follow Violand on the Northcoast Lactation Services Facebook page or you can contact her for a telephone consult.
1. Baby In Low Weight Percentile
I have an exclusively breastfed 6-month-old. I thought everything was going great with breastfeeding, and he also just started solids and is doing really well with that. But we went in for our well visit recently and his weight is in the 11th percentile. He doesn't look skinny or anything to me, but I am concerned. What should I do?
"I would make sure the doctor is using a growth chart from the World Health Organization so that they reflect the normal growth of the breastfed baby," Violand says. "Babies grow quickly during the first four months of life and start slowing down after that. The average breastfed baby will double their birth weight by 6 months old and usually triple by a year old." But she also notes that if your son's growth rate has been consistent and doing well, the actual percentiles are irrelevant. "Growth charts are helpful at times, but they can also be confusing to some and cause undue stress and worrying. As long as the doctor is satisfied with the baby’s weight gain and he is continuing to be on the same growing curve that he has been on, I wouldn’t worry," Violand says.
2. Zoloft While Breastfeeding
I'm pregnant with my second and would like to try breastfeeding again since I was unsuccessful with the first. However, I take Zoloft. Although most doctors say it's safe, I would like some actual testimonials. Did you see any negative reactions in your clients’ babies?
Violand says one of the first things you should do once you're home from the hospital is to get in touch with an International Board Certified Lactation Consultant since you had trouble breastfeeding your first baby. An IBCLC will be able to help you find success nursing your second child.
As for taking Zoloft, Violand notes that the Infant Risk Center classifies Zoloft as an L1 drug, which is the safest category to take while breastfeeding. "I would recommend calling the Infant Risk Center and asking them all the questions that are concerning you," she says. "In my experience, I have not seen any negative reactions in any of the babies that I have helped. I would of course monitor as usual and document any reactions."
3. Weaning Instead Of Tandem Nursing
Any advice on weaning a child off breast milk before second child arrives or how to go about it? How much time should I allow before the second child is born? I don't really want to tandem nurse.
"Gradually weaning the older child can help both mother and child," Violand says. "The gradual weaning process will allow the mother to slow her milk supply and production and avoid painful fullness in the breasts and also mastitis." Violand notes that this also gives your child time to gradually adjust to less time breastfeeding, but you should be prepared for your older child to have an interest in breastfeeding again once the new baby is born. "You will have to anticipate and offer distractions such as extra hugs and cuddles, sippy cup of water or milk, snacks, reading books, one on one time, and more," Violand says.
Depending on your child's age, weaning may take extra effort or time. Violand notes that if your child is less than a year old, you should substitute breastfeeding with food or another chosen method and wait three days before dropping another session until your child is weaned. If your baby is 1-year-old or older, don't offer the breast, but don't refuse it either. Just offer more distractions so your baby doesn't notice that they aren't breastfeeding and shorten any current nursing sessions.
4. Replacing Comfort Nursing With Pacifiers
My baby is 8 weeks old and tends to comfort feed quite often. We also co-sleep, which I am wanting to break. I do believe breaking the comfort nursing and co-sleeping will go hand in hand. She, however, won't take the normal size pacifiers. I've thought about trying the small preemie ones since they are closer to the size of my nipple. Have any moms tried that or have any advice on how to stop comfort nursing?
"Babies that are 8 weeks old still have the need to nurse often, comfort feed, and be close to mom," Violand says. "Most babies will breastfeed to sleep and then wake again one to three times throughout the night for roughly the first year. Finding a pacifier that is more like your nipple is a great idea, but at just 8 weeks of age, I would recommend feeding on demand — putting baby to breast whenever she shows at feeding cues." It can be a rough time right now, but Violand says that it will get easier, she will eventually go to sleep on her own, and comfort nursing is normal. It will all pass.
5. Painkillers While Breastfeeding
Can I use pain killers while breastfeeding my 9-month-old? I have a second degree burn and am in lots of pain.
"Depending on what pain killer you are speaking of, usually they are safe to take while breastfeeding," Violand says. "I love the Infant Risk Center and have called them numerous times myself with questions about medications. They also have an app you can purchase that is a great resource."
6. Using Breast Milk For Diaper Rash
Has anyone tried using breast milk to help a diaper rash? How long does it take before you see any improvements? How often should I treat it?
"Breast milk and coconut oil can help heal all sorts of things," Violand says. She recommends re-applying after every diaper change for results.
7. Milk Is Orange & Yellow When Pumping
I started to pump and I am noticing my milk is a yellow/orange color. Is that normal?
Absolutely. Violand says this is totally normal. "If you are pumping very early postpartum, your milk will be a darker yellow or orange because of the colostrum," she says. Violand also notes that your breast milk can change color just by what you have eaten, like if you've eaten a lot of greens, your milk could have a green tint to it. Your milk can also change color when it transitions to mature milk. Color changes are totally normal.
8. Freezer Stash Turning Green
I just went to my freezer and saw that some of my milk that I had pump turned green. Is that normal?
"Sometimes when we eat certain foods, it can change the color of our breast milk," Violand says. "I wouldn’t worry and just do the smell test if you are concerned. Babies will not drink the milk if it is spoiled anyhow."
9. Not Pumping Enough When Away From Baby
My son is 2 months old and he's been exclusively breastfed with the exception of pumped milk for dad to help out once a day. I've had to go away for two days for work and have been pumping every three hours to keep up my supply. I can barely make it that long because my breasts are getting so full, but when I pump, I can barely manage an ounce after 20 minutes, even with some massaging. I didn't have this issue with my first son nor is it an issue at home, but my second is a bigger kid and I guess he just eats more. Are there suggestions to making pumping more successful when away?
Violand suggests pumping at the times that your son would usually be nursing and continue to massage while pumping. "Check and make sure the pump parts are fitting properly and also maybe replace some pieces depending on how old the pump is, as this could be causing some suction problems," she says. "You could also try using a warm compress ten minutes before you pump to help get the milk flowing, look at some pictures of your baby, and relax."
10. Starting Pumping While Nursing
I'm a first-time mom and my baby boy will be 4 weeks old on Monday. I was going to start pumping this weekend so others could help with feedings and me and my husband could get a date night. Any suggestions for starting pumping along with breastfeeding?
"Try pumping after the first feeding in the morning as this is usually when you are at your fullest and this will give you the most output," Violand says. "You could also pump after any breastfeeding sessions and store that milk as well." She also recommends having the caregiver for your baby come over and give the bottle so that your little one gets used to someone else feeding them. "Try storing the milk in small increments like 2 to 3 ounce bags or bottles so that no breast milk is wasted during that feeding."
11. Baby Going Longer Than 4 Hours At Day Care Without Nursing
My baby is 2 months old today and exclusively breastfed. I'm getting ready to go back to work and my husband has been practicing bottle feeding. He has only taken a bottle once and since then, he refuses it. We've tried all the different kinds as well, and have done all of the tricks. I'm a bit anxious about him going to daycare without being able to bottle feed, but I will be able to feed him at lunch so he will only go around four hours without feeding. My main concern is, what do I do when it's longer than four hours?
You are not alone — this is a common concern. "It can be difficult trying to get your baby to take a bottle, especially if you have never really introduced one before," Violand says. "Sometimes it just takes some time. Have you offered the baby freshly pumped breast milk? Sometimes babies will take it better initially when it is fresh off the tap, but warming up the breast milk a little tends to help as well." Violand suggests researching paced bottle feeding as it's essential to getting your baby to take a bottle and will also keep them happy at the breast.
12. Supplemented Baby Refuses To Breastfeed
My daughter is almost 3 months old now and I've been supplementing with Enfamil. My supply has gone down so much. I don't even get half an ounce when I pump now. She refuses to latch, she tastes my milk, gags on it, and gives me a nasty look. She's been doing this for the past three weeks. Please help. I'm afraid I'll be out of milk by the time she decides to latch.
"I’m wondering why you feel you need to supplement at all. Are there other reasons for low milk supply?" Violand says. When supplementing, you should also be pumping every time the baby gets a bottle to keep up your milk supply and production. "You can also try power pumping, pump for 20 minutes, then take a break for ten minutes, pump again for ten minutes, and so on for one hour," she says, nothing that this can help boost your supply and tell your body to make more milk.
13. Getting Supply Up After Being Sick
I am a month postpartum. I exclusively breastfed for two weeks, but I got sick and I was told I couldn't for the duration of my medicine. My milk supply was already low, I was barely making enough for baby, and I've been pumping off and on (hard when recovering), but my milk is pretty much gone. Now that I can, she won't latch. I want my supply to come back so I can give her breast milk. What can I do to get it back?
Breastfeeding as much as possible is the best way to get your milk supply up according to Violand. "I would suggest doing lots of skin to skin time with baby as this can help signal supply, too. Get into bed with baby and do skin to skin and let the baby nurse as often as she wants for as long as she wants and stay there for the day. If you feel that baby is not content and is crying, you can supplement with your choice, but I would nurse, nurse, nurse," she says. "You can also add in a power pumping session (pump for 20 minutes, break for ten minutes, pump again for ten minutes, and repeat for one hour) and this could also help with supply."
For future questions and concerns about medications while breastfeeding, Violand recommends calling the Infant Risk Center. "I would call them today and see if the medication you were on previously would have been safe," she says.
14. Does Having A Breast Reduction Affect Milk Production?
I just had my first baby and my previous breast size problem has been exacerbated. I really want to get a reduction, but I definitely want to have one or two more children. I just want to know if it really affects the milk production or if it's safe.
"Unfortunately, getting a breast reduction could potentially have a negative effect on your milk production," Violand says. "Breast reduction surgery could involve removing milk-making glands and this could affect the volume of milk you produce. It could also involve incisions that disrupt critical nerve pathways for good milk flow." Violand recommends holding off on the surgery until after you are done having children just to be completely safe.
15. Pumping Output Dropping With Twins
I exclusively pump for my 8-month-old twins. They were preemies and unfortunately just never got the hang of breastfeeding. In the beginning, up until a couple of months ago, I would pump 50 or more ounces a day. We have never supplemented. All of a sudden, I am only producing 40 ounces a day if I'm lucky. I haven't dropped pumps, I stay hydrated, and I've never had a problem like this. I have tried power pumping and it doesn't work. I spend about 6 hours total at the pump every single day. Over the past week, my supply has plummeted even more. What do I do? I don't want to switch to formula, but it seems that supply and demand is just not working for me. I know I'm capable of producing much more, I just don't know what I'm doing wrong.
"I think maybe you are pumping too much, honestly," Violand says. "Pump as often as they eat and massage during the pumping session as well to maximize output." She notes that studies show that hand expressing after pumping can get you upwards of 75 percent more output. "Your period can have an affect on your production as well, but it shouldn’t have a continual decrease in supply. Also, having stress and anxiety can cause you to produce less, so try to relax." Violand recommends getting involved with some twin mom groups and pumping groups on Facebook for real mom advice as well as replacing all of the little pump parts, like your valves and flanges.
16. Baby Going A Week Without A Bowel Movement
My baby is 6 weeks old and I've been exclusively breastfeeding. He has been having normal bowel movements, four to six times a day, and now he's having trouble. He hasn't pooped since this past Friday. Has anyone else had this happen to their babies?
"Is he having adequate pee diapers? It is normal for breastfed babies to go days without having a bowel movement and then have an explosion one day," Violand says. "As long as the baby’s bowel movements are soft when he has them, the baby nurses well at the breast, gains weight well, and is generally a content baby, then there is no real issue." If you want to give your baby some extra relief, Violand suggests bicycling his legs, rubbing his tummy, or gripe water.
17. Producing Milk After A C-section
I'm 34 weeks pregnant and wondering if I can make my breast milk come in faster. I will be having a C-section and with my previous one, my milk didn't come in for a week. Thankfully, the hospital had donor breast milk, but now I live in a different state and they don't have it. I don't want my baby having formula, so is there anything I can do before the C-section to have my milk come in faster?
Violand suggests that if you are having a normal, healthy pregnancy, you can start hand expressing and collecting colostrum, but you should consult your OB-GYN first. "I would also ask to speak with a lactation consultant in the hospital as soon as you get in your room," she says. "Speak with the lactation consultant about your concerns and she can go over your options because you may not have a problem this time around and your milk could come in sooner with this baby."