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.
When I decided I was going to try pumping, my baby was only a week or so old — and I had no idea what I was doing. I think I fed her one morning and then randomly decided to start pumping, getting about 5 ounces in 20 minutes. I had no idea what this meant. Were my breasts literally overflowing with milk? Did I pick the right time to pump? Should I always pump at the same time? Why is my breast pump talking to me? (I know I'm not the only one who heard stuff coming from that thing. Right?)
Breastfeeding may be "natural," but pumping definitely doesn't feel like it. When you have no idea what you're really doing or how to make a pumping schedule, things can also get a little complicated. (Oh, hi oversupply.) But that's what the experts are for. Certified Lactation Counselor Gina Ciagne works with Lansinoh, one of the leading companies for breastfeeding products, and answered 17 of your real questions on pumping, milk blisters, and your baby's weight gain. As always, you should reach out to a lactation consultant for a detailed assessment of your specific situation, but in the meantime, these answers can provide you with some peace of mind.
1. Baby Shows A Preference For Formula
I think my son prefers formula over my breast milk. Is that possible? My supply is low, so I had to supplement. In the past couple of days, he will drink a bottle of formula really fast, but not a bottle of my breast milk. He eats breast milk slower and in smaller amounts. For example, he took over an hour to drink 3 ounces of breast milk and wouldn't sleep long. But earlier in the day, he drank 4 ounces of formula in 30 minutes and slept for four hours. Am I doing something wrong? Is my milk bad?
Ciagne says that while it's possible your baby prefers formula over breast milk, it doesn't necessarily mean he thinks your breast milk is bad. "Rather, it could be that he prefers it for some other reason, like the way it is warmed," she says. "Do you warm your breast milk to the same temperature as the formula? He doesn’t need to necessarily ingest as much breast milk as formula and could be drinking enough to where he is satisfied."
Ciagne also notes that it is a misnomer that formula will make baby sleep longer than breast milk. "I can understand why you would see that as the case since he slept for longer with the formula," she says. "It could be related, but could also be that it was a different situation that caused him to sleep longer." She recommends that you pump regularly to stimulate your breasts to keep up your production. "Even if you can only pump for a few minutes, that is better than not pumping at all and that, in addition to breastfeeding your baby, will be helpful in reestablishing your supply."
2. Creating A Breast Milk Stash
I'm trying to establish a breast milk stash. My daughter is 7 weeks old and does well on both bottle and breast, but I like to have my parents feed her sometimes. If they aren't feeding her, then she's on the breast exclusively. I've asked a friend who had a big freezer milk stash and exclusively breastfeeds. She suggested I pump before bed, but I've also read that I should pump after a feeding and when I try that, I get nothing. Sometimes I fear I'm losing my supply.
"When you are pumping, you are tricking your body into thinking it is a baby, so sometimes it takes a little time and patience for your body to respond to the pump," Ciagne says. "It is recommended to pump after baby has nursed not only for getting any milk left behind, but also so your body gets additional stimulation to produce more milk." She recommends you try a gentle massage before and during pumping and wrap a warmed Lansinoh Thera Pearl Breast Therapy Pack ($14) around the pump flange — it has been shown to encourage more milk to flow.
"You can also pump in between feedings, too, and many moms have found that pumping after they have had a stretch of rest or relaxation tends to lead to more milk pumped," Ciagne says. "As long as you are in touch with your baby’s healthcare provider and she is growing and developing and meeting her weight goals, it sounds like your supply is doing well. It is understandable to worry, but keep baby at the breast as often as you are and pump only when you need to." She also suggests that you pump when your baby is being fed with expressed breast milk, as your body needs that regular stimulation to keep producing milk — if you skip a pumping or stimulation session, your body will conserve.
3. Milk Supply After Period
I just got my period after eight months postpartum. Any tips or tricks for keeping my milk supply up? My nipples are raw from little man trying with little success, and he refuses to take a bottle at all.
"Feeding baby on demand is the best way to keep up your supply, especially after the return of your period," Ciagne says. "The hormonal shifts when you have your period or ovulating can cause soreness and usually both sides will be sore. Some moms whose babies are older can feel like baby is scraping or gnawing on their skin, which can also be uncomfortable, even if it seems like baby hasn’t adjusted their latch."
According to Ciagne, some moms get relief from the soreness by taking evening primrose oil or a calcium/magnesium supplement. She also suggests that using HPA Lanolin after nursing can ease the discomfort as well, and it is safe for your baby and doesn’t have to be removed prior to breastfeeding.
"Be sure to check in with your healthcare provider before using these supplements or oils," Ciagne adds. "Lansinoh Soothies Gel Pads ($10) are another option for moist wound healing, and the nipple shields can also be useful in this situation, but they should be used for short term and under the supervision of a lactation consultant. Ideally, let baby nurse as long as he wishes, but if you are noticing a shallow latch, unlatch him and re-latch."
4. Creating A Pumping Schedule
I'm getting ready to start working Tuesday and I work a 12-hour night shift. How often do I need to pump to keep my supply up for my son? He's 7 months. He does not eat the same amount every day. Some days he'll eat only a couple times a day, and some days he'll eat like 15 times a day. I will also be feeding him when I'm home.
Ciagne says you should pump to replicate your baby’s feeding schedule but, ideally, you would pump every two to three hours so you can express your milk, but also to relieve any swelling from milk build up. She also says to continue nursing when you're together, as baby is ideally the best way to keep up your supply.
5. Bloody Stool, But No Allergy
My son will be 12 weeks this week and he is exclusively breastfed. I've been dairy-free for two and a half weeks now and my son is still having bloody stool. It started as just a little and now he will sometimes have a lot. It doesn't make sense though; he's a completely happy baby that smiles and talks all the time, sleeps seven hours at night, and has no signs of allergy or intolerance other than the blood. He recently started spitting up a bit after eating, but not projectile. I cut eggs out of my diet two days ago, but still found a ton of blood this morning after fairly normal stools yesterday. My biggest fear is long term effects, if any. Our doctor is optimistic he will outgrow it, but I would love to know this isn't harming him horribly internally.
"It is good to be in touch with your healthcare provider as this continues, and you may wish to also meet with a lactation consultant to discuss your specific situation," Ciagne says. She shares that there are a few different things you should know about bloody stool and notes that you can vary your feeding positions to see if that helps with spitting up. "Be sure to burp him throughout the feeding so you can get out any gas or air he may have gotten while nursing,."
6. Supply Dropping At 2 Months
My baby boy is 2 months and my milk supply is decreasing; it takes me a whole day to make 4 ounces. Mind you, that's what he takes in one bottle. He is my first child, so all of this is new for me. What can I do to build up my supply?
According to Ciagne, feeding baby on demand, and at regular intervals, is important in keeping up your supply. "If someone else feeds baby, be sure to pump when that is happening so your body gets the regular stimulation it needs to keep making milk," she says. "What is pumped out, or ingested by baby when nursing, the body will replenish." Ciagne also recommends using gentle massage before and during nursing or pumping to encourage milk flow.
7. Thinking Of Supplementing
My 10 pound, 11-week-old baby is in the fifth percentile on the growth charts, but my doctor is not concerned to the point of supplementation. I see several of my friends' same-aged babies sleeping six to eight hours through the night, but I am up every two and a half to three and a half hours feeding my little guy. I'm exhausted and worried about starting work next week. I'm considering feeding him formula before bed so he can get a longer stretch of sleep (and pumping so I don't wreck my supply). Any thoughts or suggestions?
Don't panic, as this is pretty common. According to Ciagne, it is normal for babies to not sleep through the night at this age and often for months after. "I know it is exhausting, but he will lengthen his sleeping period," she says. "The good news is that nursing so frequently is keeping up your supply and also helping him grow and develop." She notes that formula does not always mean more sleep and because you will need to pump to keep stimulating your breasts, it is not always the way to get more rest. Ciagne recommends the lying down nursing position so you and your baby can be in a more restful position, even if you're still breastfeeding.
"It is good that he is not in the position to need to supplement," she adds, but agrees that it's hard not to compare your baby to other babies, even though they are all different. "We know its tough now, but it does get better and every day as he gets bigger, it is going to lengthen out. As you mentioned, be sure to pump when baby is being fed by someone else so your body keeps making milk."
8. Baby Nurses Only At Night
For about a month now, my 3.5-month-old son refuses to nurse during the day — he pulls away as soon as I offer the breast. So I've been pumping and giving him bottles, but I'm producing just enough to keep him fed, not enough to get any stored. I'm just pumping as he eats. During the night he nurses fine and will dreamfeed, but as soon as the sun is up, he stops. I don't know how much longer I can exclusively breastfeed if he keeps this up.
"This is called reverse cycling and it is normal, though it can be frustrating," Ciagne says. She recommends implementing some tips for reverse cycling. "It is great you are also pumping — keep that up so your body gets the stimulation it needs to keep making milk," she says. "If this doesn’t get better, you can meet with a lactation consultant to discuss more options."
9. Replenishing Supply After Medication
I was recently sick and the doctor prescribed Bactrim for 10 days for the infection. He told me I wouldn't be able to nurse my 5-month-old for the entire 10 days. Although I've tried to pump and dump at least twice a day to keep up my milk supply, I just haven't had the time. What can I do to replenish my milk supply? I pumped this morning and just about cried when I couldn't even pump 1 ounce. Does this mean this is the end of breastfeeding for me? I've been nursing for two years — my 2-year-old son and then continued on to nurse my 5-month-old daughter.
"It is important to pump as much as you can to regularly stimulate your breasts to keep up your production," Ciagne says. "Even if you can only pump for a few minutes, that is better than not pumping at all and that, in addition to nursing your baby, will be helpful in reestablishing your supply." She also suggests meeting with a lactation consultant to talk about your specific situation so you can get a full assessment and solution. "All is not lost, so in the meantime, keep nursing as often as you and baby are together. Baby, in general, is the best way to maintain your supply." Ciagne recommends using a gentle massage before and during pumping, along with Lansinoh Thera Pearl Breast Therapy Packs ($14) warmed and wrapped around your pump flange. These have been shown to also elicit more milk.
10. Baby Refusing Breast
I had to resume work when my baby was 5 weeks old, so I have had to express breast milk for him consistently. When he was about 3 months old, I didn't produce much milk, so I had to add supplementation and around 4 months, he didn't want any expressed milk. Now he's 5 months old and doesn't want anything to do with my breast. What can I do? My breasts are already reducing in size and milk. He eats well, but I wouldn't mind if he'd still breastfeed.
Ciagne suggests that it might be time to see a lactation consultant to assess your situation, but in the meantime, you should continue pumping to keep your milk up. "Keep offering him the breast, but don’t force him," she adds. "Try to do a let-down before you latch him on with the pump, just enough to get the milk to be present, and then latch him on." Ciagne also recommends using a gentle massage before and during nursing so your baby gets the milk flow.
"One of the reasons why babies sometimes reject the breast and prefer the bottle is that they don’t have to work to get the milk out like they do when at the breast," she says. "Using a nipple like the Natural Wave Nipple ($5) can be helpful as it allows baby to use the same sucking actions as when at the breast and baby controls the flow."
11. Giving Up Pumping
My daughter is almost 15 months old and is transitioning to only eating table foods. I'm still breastfeeding her at night during the week, mornings, and nights on the weekends. I'd like to continue that until she self weans. I'm still pumping twice a day, but it's really now becoming just for storage and I'm running out of room to store it all. And honestly, I'm tired of pumping. Can I stop pumping and still keep my supply for her nursing sessions?
It's amazing how your body recognizes that your baby needs milk. According to Ciagne, if you are still breastfeeding her, your body will adjust to make the amount of milk she needs based on what she is removing. "You can gently and slowly wean from pumping, but don’t do it all of a sudden if possible," she says. "Then just go ahead and rely on the nursing at the breast."
12. Babies And Food Sensitivities
When my son was about 2 months old, we went through a very fussy time at night. I looked at my diet and associated it with dairy. Recently, I have wondered if spicy foods and oranges are causing issues, too. My son is 6 months old. Is there an age that they grow out of any sensitivities? Is there anything I can do to try to help him get over the sensitivity?
"It is best to consult with your baby’s healthcare provider about the sensitivities he is experiencing," Ciagne says. "Doing the elimination to check for the culprits is a great idea and if you notice those things seem to make it worse, it is best to avoid them. They do tend to grow out of sensitivities, but every baby and every body is different, so it is not something we can say for certain."
13. Using Frozen Breast Milk Before Elimination Diet
I have a 13-week-old boy that I have been exclusively breastfeeding for about 11 of those weeks. We have recently had to put him on soy formula to rule out cow's milk protein sensitivity and it has made a huge difference in his behavior. I have a freezer full of milk and am still pumping. My pediatrician says we could slowly reintroduce the breast milk to him, but I'm afraid of all his symptoms coming back.
Ciagne recommends following the advice of your doctor because it is ideal for your baby to have breast milk as it was made specifically for him. "Slowly reintroduce it and monitor his behavior," she suggests. "It could be as he grows that his sensitivity lessens."
14. Milk Expresses Out Of Only 1 Duct
When I pump, my left side produces way more milk than my right. Milk sprays out of about seven to eight milk ducts on the left, but literally only one on the right. It feels like both sides are full. I've tried the warm compresses and massaging beforehand and still only one duct works. Any advice?
"It is normal that your two breasts are different and behave differently," Ciagne says. "It does not mean there is anything wrong, rather, it is just your anatomy and that is OK. Don’t neglect the right side and keep nursing on that side, as well as on the left." She suggests starting on the right side and trying not to limit time at the breast so it gets all the stimulation it needs and so your baby will drain it, telling your body to replenish it with more milk. If you're still worried, Ciagne recommends reaching out to a lactation consultant.
15. Baby Refuses Bottle
My daughter is 3.5 months old and is exclusively breastfeed. I have tried since she was 6 weeks old to get her to take a bottle and pacifier and she refuses. I have tried literally every brand of bottle and nipple — she just screams. I've tried nipple shields to transition her from my nipple to bottle nipples. I've tried leaving the room, leaving the house, and having other people give her bottles. She even went several hours after her scheduled feeding time without milk because she refused the bottle. I need to go back to work when she is 6 months old. Do you have any suggestions to get her to take a bottle?
"Babies are used to sucking in a certain way when they are nursing that is natural and enables let-down," Ciagne says. "When using certain artificial nipples, the milk pours out and baby doesn’t have to work to get it to let-down at the breast. This can be confusing and can cause a preference for the nipple." She recommends that if you haven't already, try the Lansinoh Natural Wave Nipple ($5). It enables babies to use the same sucking actions as when at the breast, and research showed that babies were able to go back and forth between bottle and breast when mom and baby were apart. "You could also consider a straw cup or sippy cup as breastfed babies sometimes do well with those when they just don’t like a bottle and nipple," Ciagne adds.
16. Milk Blisters
I think I have a milk blister or bleb. It is pretty painful, but I continue to nurse my 3-month-old son. Is this normal? How do I alleviate it?
"It’s great and important for you to keep nursing despite this issue," Ciagne says. You can try some common tips on how to handle a milk blister, but Ciagne notes that if you get a fever or notice inflammation or redness, swelling, oozing, or pus from the blister, it's best to consult with your doctor.
17. Baby Not Having Bowel Movements
I have a 6-week-old baby and I only breastfeed her. There's been several times where she's taken a long time to poop. The first time it happened was after 11 days. I thought it would go back to normal, but now it has been four days and still no poop. I read somewhere that breastfed babies take longer to poop because they absolve most of the nutrition of mom's milk. Is this true? Should I do anything to help her?
Ciagne recommends getting in touch with your baby's healthcare provider for an assessment. "Is baby gaining weight well and otherwise alert? Is baby having frequent wet diapers? Breastfed babies tend to poop a little more than other babies because human milk is more easily digested than formula but, again, this can vary because every baby and body is different," she says.