21 Real Breastfeeding Questions On Bipolar Disorder, Lactose Intolerance, & 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.
Prenatal breastfeeding classes are one of those things I read about in pamphlets before I had my daughter, but never really thought about attending. In fact, I didn't attend any childbirth or breastfeeding classes. I assumed I would just know what to do when the time came, and forcing myself to worry about the "what ifs" was going to send me into anxious territory.
But the truth is, some education on breastfeeding can be incredibly beneficial before you give birth. It's like studying for a potential test; you don't have to become an expert, but it's nice to know what to expect and some basics on breastfeeding before you attempt it. Because trust me, you're going to have some questions. International Board Certified Lactation Consultant Kate Fresso tells Romper that support groups and breastfeeding classes can be a huge help for any nursing moms, but she's also answering your real questions to give you even more valuable information. (But nobody can adequately explain to you how much you'll be covered in your own milk, so just kind of halfway prepare for that.)
1. Pumping After Relatching
I finally got my 10-day-old baby to finally relatch. I had been pumping every day beforehand to give her breast milk, but now that she’s back on the breast, do I relax while she’s sleeping or should I continue pumping? When’s the right time to pump now?
Way to go mama. Fresso says now, you need to be sure she is actively feeding. "Listen for bursts of swallows, followed by a rest, and then more swallows again," she says. "It sounds like a 'kah' sound. Other signs of effective transfer are that your breasts should feel softer after a feeding and your baby should be relaxed, not rooting or chewing her hands." Fresso notes that if you're confident she's nursing well, it's OK to just continue nursing her and not pump.
2. Nursing Strike After Period
My son is 7 months old and exclusively breastfed. I just got my first period two weeks ago and the day I got it, he went on a nursing strike. He absolutely refused to nurse, so I assumed my hormones changed the taste or something. It only took five days for him to deplete my frozen milk supply. I would pump between feedings just for others to feed him, but I have not been able to get any milk from pumping and he is still refusing to nurse; I had to switch to formula. I don't mind not being able to breastfeed him directly, but I would like to get my supply back and become more successful at pumping. Any advice is appreciated.
"Your supply should have returned within a few days if the dip was related to your cycle," Fresso says. "My first advice would be to check your pump to make sure it’s working correctly. Do the tubes have gunk in them? Have you ever replaced the membranes? One thing you can try is a manual pump or even hand expression. Aim for every three hours during the day, and one overnight if you can manage it."
Fresso also suggests that you keep trying to get your baby to latch again. "Persistence and patience are key," she says. "Try to catch him when he’s sleepy, or just waking up from a nap, and sneak in there. He may just latch."
Has anyone experienced increased milk supply with Reglan? I've tried everything — oatmeal, fenugreek, mother's milk tea, breastfeeding cookies, pumping (it doesn't work for me, I can only express), dark beer, massages, hot towels — you name it, I've tried it. I'm trying not to get my hopes up, but my baby’s formula has been making her constipated and I just want to breastfeed her, but I don't produce enough.
"Unfortunately, Reglan can have some pretty scary side effects. I don’t usually recommend it to moms," Fresso says. "The best way to deal with low milk supply is to figure out what could be causing it. There are many different reasons that it can happen, and many different treatments. I recommend reading Making More Milk and contacting a knowledgeable IBCLC in your area to help you target what could be causing your supply issues."
In the meantime, Fresso recommends reading about milk sharing. "Lots of moms have extra milk for a variety of reasons; they may have oversupply or they may have pumped and stored a lot of milk before finding out their baby had an allergy," she says. You might be able to find milk in your area to give your baby.
4. Pain In Nipple
I'm a new mom, and I've been breastfeeding my newborn for the last two weeks. Everything has been going great, except for the last couple days. My left nipple is extremely sore out of nowhere. I've been following all the recommendations about proper latching and positioning, but when he latches on, it feels like someone is trying to pierce my nipple; I'll even feel a sharp pain that goes into my breast. After a minute or so, this pain goes away and I can continue without issues. There isn't any visible cracking or bleeding. Is this normal? What can I do to make the pain go away?
According to Fresso, pain like this isn't normal. "It’s tough to say what might be causing this without seeing you nurse your baby in person, but it sounds like you might have a bleb, or a milk blister," she says. "Look for any little white dots on your nipple and also feel your breast for clogs. It would feel like a little pea under the skin." Fresso also notes that laid-back breastfeeding may also help.
5. Baby Stops Nursing At Let-Down
I’m a new mom to a 7 week old. Lately he's been nursing until let-down, then he'll stop (except at night, then he nurses as he normally does). Since he isn't getting full, he's nursing often. Should I be concerned? What do I do to fix this?
"Are you sure he’s not getting full? He might just be getting more efficient and able to empty you more quickly," Fresso says. "The frequent nursing could be related to a growth spurt, which is also common at this age. If you haven’t had any issues until now, and this is the only thing that has changed, then it’s likely that these two things are going on." Fresso says it's important to make sure your baby is gaining enough weight and that he is draining your breasts. If he's not, you'll want to contact an IBCLC for an in-person consultation.
My milk has recently dried up. I was wondering if I could get some tips on relactating.
According to Fresso, depending on how old your baby is, (how long you have been lactating), how long since you’ve stopped breastfeeding, and why your milk dried up, it could be very possible to relactate. "One thing you can do is to start pumping or hand expressing. The more stimulation (demand), the more likely you will be to start producing again (supply). Aim for eight to 12 pumps in a 24 hour period, and use hands on pumping techniques," she says. "Galactagogues could help, but they are not a one size fits all solution, and you may want to contact an IBCLC to help you figure out if they would be right for you. Good support is key."
7. Pumping When Back At Work
How often should I pump since I'm going back to work next week?
"I usually advise about three times in a typical 9 a.m. to 5 p.m. work day," Fresso says. "So, you should pump or breastfeed your baby right before you leave for work, and then aim for a mid-morning pump, a lunchtime pump, and then a mid-afternoon pump. Then breastfeed or pump as soon as you’re reunited with baby, and continue to feed throughout the evening and night as usual." Because this is based on a 9 a.m. to 5 p.m. day, just adjust for your own schedule if your time varies.
8. Worrying About Supply
Why do I have this feeling that I don't have enough supply? Is there a specific medicine, supplement, or vitamin that I can take for me to produce more breast milk?
"Let me assure you that everybody has this feeling sometimes. And I mean everybody," Fresso says. "Rather than looking for something to take to make more milk, which might not even be necessary, you should build confidence in your body and familiarize yourself with the signs that your baby is getting enough."
According to Fresso, you can check to make sure your baby is gaining appropriately, around half an ounce to one ounce per day, as well as seeing enough stools. "At least three poops bigger than a quarter in the first month, then it may slow down a little, but not too much," she says. You can also check to make sure your baby is satisfied after a feeding — they should be calm and relaxed, not rooting or chewing on their hands. If you still need a confidence boost, Fresso recommends finding a support group.
9. Establishing A Pumping Routine
My little one is 2 months old and exclusively breastfed. She breastfeeds and drinks bottles of breast milk. I recently just went back to work and I am trying to pump at least twice during my eight hour shift. But if we are super busy, I sometimes don't have time to pump. I want to keep breastfeeding, but I can’t seem to get a good routine going.
"It’s really hard in some jobs to take time out to pump," Fresso says, but she notes that you are entitled by law to take pump breaks, no matter how tough it may be. "My practical advice is that more frequent, shorter pump breaks can be better for your supply than less frequent, longer ones," she says. "Rather than trying to get one or two 30 minutes out of your shift to pump, it’s better to try for three ten to 15 minute sessions." Fresso also suggests keeping all of your pump parts assembled and in a cooler bag with an ice pack so you don't have to take them apart and put them back together every time.
10. Bipolar Medication & Breastfeeding
I recently started taking Lithium again for my bipolar disorder, and was told that there's a chance I won't be able to breastfeed because of it; I'm still eight months pregnant. Basically it's something that just depends on if baby's doctor is comfortable with it, because while it's not extremely dangerous, there is a chance of Lithium toxification occurring, which means you have to pay careful attention to whether baby is seeming sick or not. I can't stop taking my medicine either, because bipolar disorder puts you at high risk for postpartum depression or psychosis. I'm just wondering if other moms have dealt with this.
Fresso recommends finding a doctor that is knowledgeable and supportive of breastfeeding so they can closely monitor you and your baby. There's been some information available that Lithium while breastfeeding is not contraindicated, but it's still a good idea to find someone who can help.
11. Nursing An Older Child
I had my children very close. While I was pregnant with my daughter, my milk dried up and I had to stop nursing my son. I had wanted to pump for my son once the baby was born, but I am having trouble with pumping. However, my son has shown interest in nursing again now that he sees his sister doing it, but I'm afraid to let him start again so I always tell him no. Has anyone successfully started nursing an "older" child again? Is it possible to tandem nurse them?
"It’s totally possible, as long as he hasn’t forgotten how to latch," Fresso says. "Let him give it a try and see how it goes. Make sure your new baby is latched and feeding first, and then let him try."
12. Breast Augmentation & Breastfeeding
I had breast augmentation back in 2012 and the incision is located around my nipple. Any chance I will be successful at breastfeeding?
You definitely have a chance. "When the nipple is removed, the milk ducts are severed and the nerves may be damaged. Ducts can recanalize, or grow back together, over time," Fresso says. She notes that it would be worthwhile to do a one-on-one prenatal visit with an IBCLC to go over your history and come up with a breastfeeding plan.
13. Toddler Waking Frequently At Night To Nurse
My 13 month old is exclusively breastfed and has only slept through the night twice in her life. She naps great and she goes to bed at 7 p.m. and wakes up at 6:30 a.m. But most nights, she wakes two to three times and refuses to go back to sleep without nursing. She can wake as much as six to eight times if she isn't feeling well. Any suggestions on us getting better sleep at night?
"Waking at night is the biological norm, but I can see how this gets tiring after a year," Fresso says. It might be time to try some night weaning, but if something that you're trying isn't working, don't push it, she notes. Step back for a few days and try something else.
14. Toddler Nursing A Lot
My daughter is almost 18 months old and still nurses a lot. Not as much as before, but it’s still a lot. She eats plenty and she's definitely healthy but is this normal? Sometimes it's two or three times a day, more at night, and other days she's nursing six or more times a day.
"This is definitely normal and it's OK as long as both of you are happy. Breastfeeding a toddler has so many benefits like immunity, comfort, and bonding," Fresso says. "And as you can see, toddlers usually want to do things on their own terms, so it’s completely normal for her to have days here and there where she wants to nurse more frequently. Nurse on, mama."
15. Leaking Colostrum During Pregnancy
I am 34 weeks pregnant with my first child. I have been leaking colostrum once in a while (only like a drop or so) since about 28 to 30 weeks. However, in the last couple of days, I have been leaking more than normal and when I squeeze my breasts, a lot comes out of each one. Is that a sign that my daughter could come early or is it normal for my production to pick up around now?
"Leaking is normal during pregnancy, and is not a sign of preterm labor or that your baby will come early," Fresso says. "You can save that colostrum that is coming out in a small container or a syringe and put it in your freezer to bring to the hospital with you, but I would recommend holding off on too much stimulation if you don’t want to deal with a lot of leaking."
16. Switching To Formula For Work
What is the best way for my baby to drink formula? She's 4 months old and I have been breastfeeding her, but now I have to go to work.
First thing to note is that you don't have to give up breastfeeding just because you're going back to work. "Lots of moms pump while at work, leaving breast milk in a bottle for their babies, and breastfeed as usual while not at work. Your milk will provide her with all the nutrients she needs, plus protect her from illness while she’s with the caregiver," Fresso says. "But if you've decided that you don't want to pump, some moms have found it possible to give formula to their baby while they are with their caregiver and continue breastfeeding baby once they are home." It's worth nothing that your supply could dip if you take this route since you'll be going longer periods of time without removing any milk.
"If you’re going to introduce formula or bottles, you might want to start slowly so that you can be sure baby tolerates it well before you go back," Fresso says. "Try giving a bottle or two of formula each day, about a week before you have to return to work."
17. Increasing Supply
My son is 5 months old and his growth and weight are great. I exclusively breastfeed and have been back to work for three weeks now, pumping every three hours. The problem is, I am barely pumping anything. I'm lucky if I get 1.5 ounces each time, but usually it’s just 1 ounce total. So in a day, I barely get enough for one feeding. I’ve gone through the small freezer stash I had from maternity leave and need tips on how to increase the amount I pump. I've replaced all the parts in my pump, I eat oatmeal for breakfast almost everyday, and I also drink about 120 ounces of water.
"Based on how you describe your baby’s growth, it sounds like your supply is good, so it seems that it’s the pump causing the issue," Fresso says. "Some moms do have trouble responding to the pump. Assuming your pump is in good working condition, there are some things that can help while you're pumping. Try looking at pictures or videos of your baby while pumping, try hands-on pumping techniques, using a manual pump, or hand expressing instead of an electric pump."
18. Baby Has Milk Allergy
My son is 5 weeks old and just got diagnosed with a milk allergy. How hard is it to cut dairy out of my diet cold turkey? Any tips on doing so?
"Some people have a harder time cutting out dairy than others (depends on how much of a cheese lover you are), but I have heard from a lot of moms that it has been easier than they thought it would be," Fresso says. "There are a lot of good substitutes for dairy available now, it just takes some getting used to."
19. Surgery & Breastfeeding
What happens with breastfeeding and surgery? What does the anesthesiologist say about breastfeeding after you get out of surgery? How long until you can breastfeed again? I have surgery scheduled and my 1 year old is exclusively breastfed. I tried to pump with a double electric pump, but was not able to get much.
"Generally, it’s OK to breastfeed after most surgeries," Fresso says. "The drugs in most anesthesia are short acting; once you wake up, they’re out of your system, which is why you wake up." If you need more reassurance, Fresso recommends contact the Infant Risk Center.
20. Does Breastfeeding Hurt At First?
I'm about to have my first baby and I am bound and determined to breastfeed. Will my first experience of breastfeeding hurt like crazy?
"It shouldn’t," Fresso says. "Some soreness can be normal, since you’re using a body part ten or more times a day that you haven’t been using previously, but toe-curling pain signifies that something isn’t right and you should contact a professional." She recommends taking a prenatal breastfeeding class or scheduling a consultation with an IBCLC.
21. Lactose Intolerance & Breastfeeding
I'm wanting to know if it's possible to breastfeed a baby who is lactose intolerant. I'm lactose intolerant and so is my SO, so we're betting that the baby will be too. I know that my milk will be super personalized for him, but I'm still wary.
According to Fresso, congenital lactose intolerance is extremely rare — 2 to 3 percent of babies — and there is no hereditary connection; lactose intolerance usually develops in older kids and adults. "More common is a milk protein allergy, but this is also not genetic," she says. "The bottom line? You most likely don’t have to worry based on your own lactose intolerance."