Can You Nurse With Crohn's & Other Nursing Qs

Breastfeeding can be a hard, isolating, and emotional journey, which is why it's so important to have a community of supporters. Romper has launched a new Facebook breastfeeding community, Breastfeeding TBH, in an effort 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. Each week, Romper will be speaking with a lactation consultant to answer as many of these questions as possible.

If there's one thing breastfeeding advocates wish they could share more of with the world, it's science-backed evidence and research. There is so much misinformation out there about breastfeeding that it borderlines on scary. Moms are concerned that they aren't pumping enough milk, moms are eliminating foods out of their diet in an effort to help their fussy baby, and moms are going crazy trying to figure out what they're doing wrong (when actually, nothing is wrong).

That's why it's always best to take your questions to the experts. International Board Certified Lactation Consultant Sarah Lester from Naturally the Best Lactation Services believes in science and is answering your 24 pressing questions on everything from gassy babies to birth control so you can be informed, confident, and happy in your breastfeeding journey.


Gassy Baby Gets No Relief

Gabriel Blaj/Fotolia

My second baby is 3 months old and exclusively breastfed. Ever since she was a few weeks old, she's suffered with really bad gas. Her belly hurts a lot and it affects her naps and especially her night sleep. I've done every possible gas remedy out there. We've even taken her to a pediatric chiropractor. At this point I'm wondering if I should just find a sensitive formula, if I should try formula until she’s 6 months old and then reintroduce breast milk while pumping to maintain my supply, or if I should just stick it out. Any advice?

"Babies, especially those with gas issues, seem to benefit a lot from tummy time," Lester says and she notes that tummy time also helps them reach necessary milestones important for development.

"I would also recommend working with an IBCLC well versed in tongue ties as sometimes what appears as diet related is really a tethered oral tissue which is inhibiting baby’s latch and causing them to take in air at the breast," Lestery says. "In turn, this is distending their tummies on the sides and making them downright miserable." According to Lester, if these symptoms are tie related, once they are released, your baby is totally different and you can resume your regular diet. "I always recommend for mom to get on a good probiotic as well, for her gut healing, and baby’s."


Weaning A 4 Year Old

I am trying to wean my almost 4 year old. I am having surgery in April and have to stop breastfeeding, plus I feel it is time to. My issue is my daughter is so addicted to breastfeeding that she cries uncontrollably if I turn her away, and I eventually give in. This is also how she falls asleep at night. I need tips on how to stay strong enough to turn her away.

"At this age, she is definitely aware and has the ability to understand and compromise," Lester says. "Have a talk with her about it; she is probably a lot smarter and intuitive than you think." Lester also notes that there are some children's books you can read to her, like Sally Weans from Night Nursing by Lesli D. Mitchell MSW.


Booby Blues

How do I deal with the "the booby blues?" I’ve had to stop breastfeeding. It's only been a couple of days, and I feel so guilty and depressed for stopping. I loved breastfeeding, but it's for medical reasons so I know it's for the best. I just feel so bad giving him formula, plus my breast hurts. Any advice?

"You’ll still need to express for comfort to avoid engorgement, like cold cabbage leaves changed every two hours," Lester says. "If you do not want to wean, it’s important to discuss your medical issue with an IBCLC as many medicines and procedures do not require weaning at all."


Cough Medicine While Breastfeeding

My little one is 3 months old and I'm currently breastfeeding. My baby caught a cold at day care, and now we keep passing it back and forth. Is there anything I can do or take that won't make my supply drop or dry up?

Lester says that most medications are safe, but you should definitely talk to your doctor. "Depending on your symptoms, you could likely get away with a pain reliever such as ibuprofen," she says. "If it’s congestion, a neti pot does wonders, or even Afrin for a day or two."


Crohn's Disease & Milk Supply

This is my third pregnancy, and I'm expecting twins. I've tried to breastfeed with my two previous children and I struggled with a low milk supply. I was diagnosed with Crohn's disease two years ago and wanted to know if a medical condition such as Crohn's could affect my milk supply?

"While some providers might say that breastfeeding is contraindicated with an autoimmune disorder, there is no evidence to back this up," Lester says. "The biggest concern would be ensuring the thyroid and insulin levels are functioning at normal levels, sufficient for proper milk making, and that would be achieved by testing insulin, TSH, free T3, T3, free T4, and T4 and ensuring that these are sufficient for lactation. Hormones should be tested as soon as possible after birth, six weeks, three months, and 14 months."


Creating A Feeding & Pumping Schedule


I’m going to be breastfeeding and pumping when this baby is born, and I’m trying to find a good schedule to help my milk supply stay up; I struggled with this with my last baby. What is an average feeding and pumping schedule?

"You’ll need to pump or nurse at least every two to three hours," Lester says. "Breast compressions can help as well." She recommends that you establish breastfeeding first and then consider adding a pumping session or two after the first six weeks. "Babies are born with a very high suck need, and that corresponds with your low milk volume," she says. "Both level out together, and that’s Mother Nature’s way of building a supply. Once breastfeeding is established, a power pumping session a few times a week can help you get a small stash."


Fenugreek Capsules

Has anyone had good results taking fenugreek capsules for milk supply? If so, how many milligrams did you take a day? I've read that if I don't smell like maple syrup that I'm not taking enough of it, but I'm already taking the suggested 3500 milligrams per day. (And I don't smell like syrup that I know of.) I'm also drinking raspberry leaf tea. Any good results likely?

"I’m not a fan of fenugreek. It can give baby a tummy ache and for some moms, supply is actually lowered," Lester says. "The biggest way to increase supply is to pump, express, or nurse more. If baby has an insufficient latch, supply will suffer because milk is sitting in the breast and not allowing mom’s brain to signal for more milk to be made." Lester recommends finding an IBCLC to increase your supply and notes that it's rare to hear of fenugreek increasing your supply on its own. "Typically it's combined with an increase in pumping or nursing, which is the true reason for the increase in supply," she says.


Nursing & Supplementing

Since my son was born, he's had a near perfect latch and I've been able to produce the milk he needs, but I was told my milk doesn't have enough fat to fill him up or make him gain weight. (When he was exclusively breastfed, the pediatrician was concerned because he wasn't gaining weight properly.) So we started supplementing with formula and I was pumping so that he had bottles with half formula and half breast milk, but pumping was putting way too much stress on me so I decided to quit pumping and just feed him when I was home and he was hungry. That has been going pretty well for about a week now, but my concern is, how long will my body keep producing if I only feed him from my breast once or twice a day? I'm not ready to give up breastfeeding.

"The more that you supplement, without pumping, the less milk you will make," Lester says. "Only nursing once or twice a day is certainly better than not nursing at all, however, it will not sustain your supply." She highly recommends seeing an IBCLC because being told your milk wasn't fatty enough is often just a myth and an indication of a transfer issue. "Your milk is perfect for your baby," she says.


Baby Refuses Breast

I have a 6-month-old baby and she is on day two of refusing to nurse. She used to refuse the bottle, but now she takes it like a champ. I offer my breast every time for about five minutes before she just cries bloody murder and I give her the bottle. She has two teeth and bit me twice, so maybe I scared her with my scream? How can I get her back to the breast? Pumping is killing me.

"I would take a day and have a nursing vacation, if possible, and offer her the breast nonstop. At this point, she knows that all she has to do is protest for a few minutes and she will get the bottle," Lester says. "I would take a bath together, relax, and only offer the breast. She may fuss and fight for a little bit, but she will not go hungry. She will come around." Lester also says to make sure that when she does take a bottle, she has to work to keep the milk in the nipple. Make sure when she does take a bottle that she’s having to work to keep the milk in the nipple; this practice is called paced feeding.


Depo Shot Affecting Milk Supply

I have been breastfeeding and partial bottle feeding my now 5-month-old girl. I got on the depo shot a month ago and I've noticed a huge decrease in my milk supply; it is so upsetting. My OB-GYN said depo wouldn't interfere with my breastfeeding, and clearly it has. Is this normal? What can I do to increase my milk supply? Is it even possible now?

"Unfortunately, the depo shot can decrease milk supply," Lester says. "I would increase your pumping and latching, as the more milk you remove from the breasts, the more milk your body will make." According to Lester, if you've seen a sharp decrease in supply, she wouldn't recommend continuing with the shot. "Since it’s a shot, we have to wait for it to wear off. I would recommend looking into something such as a mini-pill which you can stop taking as soon as you notice a dip in supply," she says.


White Wound After Baby Bites Breast

My son is 10 months old and is starting to bite while feeding now. I've read all tips on the other posts similar to mine, but nothing is working. The other day he bit my nipple and it started bleeding. Now it's healing, but there's a kind of thin white layer on top of the open wound. Is that an infection? Should I not let him nurse on that side until it helps?

"Sounds like a blister or scab that’s healing," Lester says. "If you’ve ever gone swimming with a scab, you’ll notice that it turns kind of white from being wet and soaked. This sounds normal for the healing process with a scab that is getting a lot of moisture."


When To Give Up Pumping


My 4 month old and I are well established with breastfeeding now. I have been pumping since my milk hit and have an impressive supply stashed in the deep freezer, probably a month’s worth. When would it be a good idea to stop pumping? The only time he takes a bottle is pumped milk at night when his daddy is home and I pump enough milk for that in one session. His daddy works nights so it's only two to three bottles a week. I am just tired of having a relationship with the pump.

Lester says you only have to pump for missed feeds. "If you are pump dependent, I would likely wean the sessions down a couple minutes at a time so as to not risk clogged ducts," she says.


Different Pumping Outputs Between Breasts

In my left boob I'm pumping out .5 to 1 ounce, sometimes it'll go up to 2 ounces but it’s rare. In my right boob, I'm pumping 2 to 3 ounces. Is this normal?

"Yes, it is very normal to pump more on one side than the other, and in fact, most moms pump more on their right side than on the left," Lester says.


Power Pumping

I have a question about power pumping. My daughter is 4 months old. Is it too late for me to try this technique? I understand you can trick your body into thinking you need more milk. Will this work at 18 weeks postpartum?

Lester notes that it's never too late to try power pumping. Try it a couple to a few times a week.


Relactating After NICU Stay

My son will be 3 weeks old on Monday. We had a rough start in the hospital and I barely saw him at all for the first week of his life due to me having infections and him being in the NICU. I really wanted to breastfeed him, but pumping was difficult when I was constantly having fevers and shakes and when I did see him, I couldn't get him to latch. I am feeling better now, but I think my milk dried up. Do I have any chance of breastfeeding now? Is it possible to get my milk supply to come back?

"You definitely have the ability to get your milk back," Lester says. "Find a good IBCLC who can help you in this process and in the meantime, start pumping every three hours during the day with a four to five hour stretch at night (to mimic when baby is eating) with hands on pumping." She recommends that you cut holes in an old sports bra to fit your flanges and then use your free hands to massage the breasts. "Continue this until you see an IBCLC who will assist you in continuing to increase supply as well as helping baby get back to the breast," Lester says.


Pumping With Thrush

My baby gave me thrush. I'm going back to work in two days and was planning on pumping. But I was hoping for some real life advice on pumping with thrush and milk storing. I've read that I cannot freeze this milk until the infection is cleared, but he can consume it without issue?

Thrush is no fun, but Lester says you need to be sure that's what you're suffering from and not vasospasms. "If you have thrush, baby will, too and will experience white in cheeks and on gums. If it is thrush, you will need to sterilize all pump parts after every use," she says. "I would sterilize all bottles and pacifiers with every use, any reusable nursing pads, clothes, sheets, and other items in hot water." As far as your milk goes, Lester recommends tagging them separately and not using them anymore once your infection is cleared. But you should see your IBCLC to ensure that this is actually thrush and not milk tongue and vasospasms, which are deep shooting breast pains caused from a bad latch.


Tripled Birth Weight With Nursing & Food

My baby has been exclusively breastfed for almost five months. We recently started letting our daughter sample some puréed foods, one meal a day. Our daughter is almost 6 months old now and has almost tripled her birth weight to 18 pounds; she has been steadily gaining since birth. She is also still nursing about 10 times a day for every two to three hours. Is this rapid weight gain and this nursing frequency normal? I was told it should have slowed down by now. Did the weight gain slow down with the addition of more solid meals? She is also not very active (hates tummy time and rolling), and has only begun to work on sitting up.

It's pretty easy to worry, but try not to fret. "As she becomes more active, you will see the weight gain starting to slow. Your baby sounds perfect," Lester says.


Baby Treats Breast As Pacifier

Dmytro Mykhailov/Fotolia

My baby is 3 months old and exclusively breastfeed. She will not take a pacifier or a bottle. The problem I'm having now is that she uses me as a pacifier at night since we co-sleep; it’s starting to become a problem. How do I fix this? If she's using me as pacifier, does this mean she's overeating?

According to Lester, pacifiers were created for the bottle fed baby as replacement nipples, so, for a breastfed baby, the nipple is the pacifier. "We are the original pacifier," she says. "This sounds like normal behavior considering her age and your sleeping arrangement. It’s called breastsleeping. This does not mean she’s overeating, it simply means she is comfort sucking because you are her comfort source."

Lester notes that if this is not something that you want to do, you can consider moving baby to a bedside bassinet so she is less likely to roll over and root for the breast.


Claritin While Nursing

I normally take Claritin for my allergies, but I’m worried it will affect my milk supply. What should I take for allergies?

"According to the Infant Risk Center, Claritin is an L1, meaning it’s safe to take while breastfeeding any age of baby," Lester says.


Milk Coming Out Of Baby's Nose

My baby will be 5 months old soon. For the past three to four weeks, when I nurse she has had milk coming out of her nose. It wasn't bad at first, but today it was like a waterfall. It gets to the point where she gets frustrated from trying to breathe and pops off screaming. Milk coming out of her nose happens every single time I nurse her now and gets me upset to the point where I want to quit. What can I do?

"Ensure that baby is nursing in an upright position, that she has no congestion, and see an IBCLC to have baby checked for any midline defects such as a submucosal cleft," Lester says.


Choosing A Breast Pump

What is the best breast pump to use? I used a cheap one from Walmart with my son, but it left me feeling full of milk and it was such a hassle to keep clean and was so loud I had to pump before I went anywhere.

There are many breast pumps on the market and, according to Lester, each mom reacts differently to different pumps. "My clients rave about the Spectra S1 (battery pack) and S2 (wall plug) and I have personal, positive experience with it as well," she says. "Some moms, however, don’t respond well to a Spectra and prefer something different. One thing that I do love about the Spectra US brand is that they are World Health Organization code compliant, meaning they do not advertise or idealize bottle feeding for infants. They do not market their bottles or bottle nipples, they only provide high quality items, and they always promote the importance of breastfeeding." Lester also says that another important thing to consider is a pump that is included with your health insurance policy when choosing one.


One Breast Produces More

I have been nursing my son for 9 months now and have even been lucky enough to donate quite a bit of milk to some other mamas in need. I am a working mom and pump once a day at work now. My question is, one side produces almost twice as much as the other. Any ideas on getting each side to even out? I know I'm producing enough, but my son clearly favors the side that produces more.

"This is very normal and most moms actually produce more on one side than the other," Lester says. "You can do some hands on pumping to see if that helps, but I would not be worried. Thank you for helping to feed other babies."


Gatorade While Breastfeeding

Is drinking Gatorade safe while breastfeeding?

Chug away, mama. "It is safe," Lester says.


Weaning To A Sippy Cup


I am planning on weaning my 8 month old off the breast to a sippy cup. Any pointers?

"Slow and steady wins the race; continue offering, but don’t be frustrated if she doesn’t take to it immediately," Lester says. "Breastfeeding is far more than just food, you are her comfort source and she likely prefers the closeness to you and the time with you that breastfeeding provides."