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33 Breastfeeding Questions On Dehydration, Night Wakings, & More, Answered By Experts

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.

Whether you love breastfeeding or hate it, one thing is certain — it's pretty amazing what breastfeeding entails. I mean, you're keeping another human alive and well with your breasts. In fact, you're doing more than just nourishing your baby, you're helping them to thrive.

But that doesn't mean you aren't filled with questions. That whole "keeping another human alive with your breasts" can get complicated when you need to go to work, when you're having surgery, or when you're not getting any sleep at night. But that's what the experts are for. I took your questions to a few lactation consultants to get their advice, tips, and suggestions so you can make breastfeeding not only work for you, but help you and your baby thrive at the same time.

1

Choosing Bottles For Breastfed Baby

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Which baby bottles are best for breastfeeding moms? My boyfriend wants to continue to help feed our son at night before bed, but right now my son hates the bottle we are using and fights to take it. Is there a good bottle that is like my breast?

Lactation consultant Dr. Kameelah Phillips, who is currently in the process of getting her International Board Certified Lactation Consultant certificate, often tells parents there might be some trial and error when switching to a bottle. "You may have to try a few options until you find your baby’s preferred bottle," she says. "Keeping in mind cost, materials, and availability, I have seen good outcomes with the Playtex Drop-Ins and the Tommee Tippee bottles. Both can minimize the amount of air your baby ingests (too much can lead to fussiness) and both nipples closely resemble the breast. The wide mouth and breast like design also make Philips Avent a good option."

2

Using UpSpring Tablets To Increase Supply

I take care of my brother, so I had to stay by his side for about three days and couldn't breastfeed. My supply decreased significantly in that time and I'm having no luck getting it back up. I ordered some UpSpring MilkFlow tablets and was just wondering if anyone has taken these and noticed a difference.

Before you start using products to increase your milk supply, Phillips suggests you try some other options. "The lack of feeding or pumping has signaled to your body to decrease milk production because the breasts were not being regularly emptied," she says. "Before introducing a galactagogue (herbs used to increase milk supply) try things like minimizing separation, offering both breasts during each feed, pumping after nursing, and increasing daily feedings."

If you do use a galactagogue, Phillips notes that it may help, but success varies and there's no guarantee that you'll see an increase. "Galactagogues often work best when you use them along with increased feedings. Some women notice a change within 24 to 72 hours, while others take up to two weeks before noticing an improvement," she says. She also warns that there could be potential digestive side effects for your baby when you use any galactagogues.

3

Nursing Cause Dehydration

Can nursing cause dehydration?

Phillips notes that if you're eating and drinking regularly, nursing probably isn't the cause of your dehydration. It's more likely that as a mom, you're busy and caught up with other things and forget to take care of yourself which can lead to dehydration. "If you are feeling thirsty then you should drink to satisfy this thirst," Phillips says. "You should not over-hydrate; just listen to your body and drink when you are thirsty."

4

Trouble Producing Enough Milk

I am currently breastfeeding and supplementing my almost 4-week-old daughter. She latches amazing, prefers the boob, and I'm loving the bonding experience. However, my body clearly is confused and doesn't understand how to produce more than half an ounce at a time. Any tips or advice?

It sounds like you're working incredibly hard, so be sure to applaud yourself for that, but you also may be stressing yourself out. "It sounds like this may have been an issue before and you have exhausted some commonly recommended methods to improve your supply and are working with specialists in this area," Phillips says. "I would caution against drinking too much water as this can have a negative effect on your supply. Also know that for many women, the pump is not reflective of their true supply. Outside of pharmacotherapy (you will need a prescription from your doctor) and decreasing your fluid intake, please know that you are doing your best and supplementation is OK. Allow your baby to have what your body can offer her and enjoy the other benefits of breastfeeding."

5

Baby Fusses During Day Feedings

My 3 month old is strictly breastfed. During the day he gets fussy (waiting to eat) so I latch him on and, while eating, he has random outbursts of whining or crying a little. Anything I can do about it?

Phillips says your thought is very plausible, especially since he only does this during the day time. "Note the behavior in relation to nap time for better confirmation," she says. "Major nursing concerns, such as an improper latch leading to choking or reflux would likely cause this behavior with most feedings."

But babies are also known for getting distracted while nursing and may show their frustration by crying, turning their head, sitting up, and more. Phillips suggests that he may be having random outbursts for no real reason. "Unlike an adult, babies are sometimes unable to focus on their meal. As long as he is otherwise nursing normally, I would expect for him to outgrow this stage," she says.

6

Bottles & Pacifiers

I'm pregnant right now, but I know I want to breastfeed. I have to go back to work after my leave is up, so I'm wondering which bottles and pacifiers are best for her.

Phillips notes that it can be very difficult to know which bottles and pacifiers your children will prefer. "I suggest adding at least three different breastfeeding-friendly bottles and pacifiers to your baby registry," she says. "This will allow you to try various options without the investment. When you find the bottle and pacifier your baby prefers, then you can invest in purchasing more. Most importantly, I would forgo bottles and pacifiers until your breast feeding is well established."

7

Eliminating Dairy Because Of Blood In Baby's Stool

Have any other moms had to eliminate dairy because they found blood in their baby’s stool?

Don't panic yet. Bloody stool may or may not be a dairy related symptom. "Dairy related sensitivities also include increased fussiness and gassiness, skin rash or irritation, and increased spit up," Phillips says. "Food sensitivities can manifest in minutes to hours. Breastfed babies often show signs within four to 24 hours after exposure." Phillips notes that bloody stool should also be the evaluated with the baby’s pediatrician. "I suggest a discussion with your pediatrician prior to eliminating a food group," she says. "Until a dairy protein allergy is confirmed, I would not discard the saved milk. I would encourage mothers to seek out a milk bank for donation prior to discarding the stored milk."

8

No Bowel Movements For 1 Week

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My daughter is breastfed with formula supplement, is 1 month old, and has gone a week without pooping. She is not fussy, but she is spitting up a bit more. I’ve tried tummy massages, anal stimulation, warm baths, and leg movements. What can I do?

"Constipation is based on firmness of poop and signs of discomfort from your baby. If you say that she is comfortable, then it is unlikely she is constipated," Phillips says. "It is important to realize that poop patterns will vary between exclusively breastfed, formula-fed, and breast and formula supplemented babies. Some breastfed babies can go a week without pooping. The type of formula can also influence this pattern." Phillips recommends talking to your baby's pediatrician if they become irritable, develop a tender or bloated belly, projectile vomit, have bloody stools, or have no bowel movement after a week so that you can be sure your baby is OK. She also notes that many pediatricians do not recommend anal stimulation as it can cause harm and is unnecessary.

9

Dealing With Oversupply

I'd like to know first hand what's worked for other moms [to help with over supply]. Block feeding makes me engorged. I have to pump at least twice a day because I'm engorged and going back to work this weekend and need bottles on hand. He hates to side lay and he kicks too much for football hold.

This can be incredibly frustrating, especially if you were worried about a low milk supply. But New York City-based labor and postpartum doula and lactation consultant Megan Davidson notes that what works for your own body is very individual and if you have found that block feeding does not feel right, you should not do it. For some, it works, but for others, it can cause more problems than it fixes. (And the fact that she's helped over 1100 families with breastfeeding support means she knows her stuff.)

"In terms of nursing your baby with an oversupply and overactive letdown, the most comfortable positions for both of you are more likely a laid-back position (leaning back with your baby on top of you) or getting him in a more upright position (in a seated position with his bum on your legs and his back more straight)," Davidson suggests. Trying these might be helpful as well as going back to work. "Many people have a change in supply when they are pumping more and nursing less," she says. "It could be that your return to work takes care of the oversupply, but if not, you will need to continue pumping (both when you area way from him at work and if your supply is still causing engorgement)."

10

Babysitter Overfeeding Baby

I work six days a week, five of them for no more than five hours. I provide four 4 ounce bottles just in case, but I feel like the babysitter is over feeding my baby. He always finishes all of the bottles, but all day he spits up. Is she feeding him too much?

"If your babysitter is with him for less than five hours and is feeding him 16 ounces of milk in that period of time, I would agree that it sounds like he is being overfed," Davidson says. "No baby needs to be taking in 16 ounces of milk in under five hours." She adds that the range for exclusively breastfed babies is between about 20 to 30 ounces in 24 hours. By counting the number of times per day that your baby nurses and dividing 25 ounces by that number, you will get a general sense of how much your baby should eat in a feeding.

11

Pain While Using A Nipple Shield

I have been using a nipple shield since my son was born and he is almost 8 weeks old. I have seen a lactation specialist and have a smaller nipple shield which helped a bunch, but now I have pain off and on when using it. My son will not latch without one. The specialist said she liked the way he was feeding. I was wondering why sometimes it won't hurt with a shield and other times it will. Is it maybe because I am still healing from cracked nipples from when I had the wrong size shield on?

"It is definitely possible that the pain you are feeling is from any wounds that are still on your nipples or it could be that sometimes the baby is not latching as well as other times," Davidson says. "If he has a very tight or shallow latch, even with the nipple shield, you could be feeling some pain. When you feel pain, you might want to unlatch the baby and try latching him again, focusing on getting the deepest latch possible. If that does not seem to fix it and the pain persists even as your nipples heal, you might want to follow up with your lactation specialist again or ask another lactation consultant to check in."

12

Flu Symptoms & Nursing

First time mom here with an 8-week-old — she is breastfed with some formula occasionally. Today I have been feeling flu like symptoms, and wanted to know how to keep her healthy if I'm breastfeeding. Also, my breasts are so tender even after feeding, pumping, anything. It almost feels like they are engorged. I was wondering if this has anything to do with being sick, or if it's something completely different.

If your symptoms are the flu or some other illness, nursing your baby is actually the best thing you can do. Davidson notes that the antibodies in your breast milk will help protect your baby from getting sick, so keep it up. You should also maintain good hand hygiene and avoid kissing your baby on her hands or face as a precaution. "That said, the tenderness and sensation of swelling in your breasts when combined with feeling flu-like could also point to mastitis (an inflammation in your breasts)," Davidson says. Fevers are common with mastitis and antibiotics might be needed to help treat the inflammation. Following up with your doctor is recommended. In the meantime, definitely keep nursing your baby and pumping as that is helpful with mastitis also."

13

Baby Cries Whenever Put Down

I have a 3 month old who is strictly breastfed. I can't even put her down without her screaming and her face turning purple. I want to let her cry, but I don't want her to stop latching. Any advice would be great.

It sounds like you have a healthy, thriving breastfed baby, but it is really challenging to feel like your baby can not be put down and it can be overwhelming to feel needed 24/7, Davidson sayss. Is she having a hard time being put down during the day or at night? Are you setting her down when she is tired and ready to sleep or is she crying when she is awake and wanting to be with you?

"For daytime attachment, the answer to this problem might be baby wearing to free your hands while still holding your baby," Davidson says. "If this is a nighttime problem, cry it out strategies are one option and/or you can explore non-cry it out options too."

Davidson also says that if you are currently nursing at night regularly, night weaning your baby might change your supply and affect your baby's breastfeeding during the day. Your breasts will most likely require some pumping to adjust to a new nursing schedule.

"No matter what you decide, remember that holding your baby, nursing her, and parenting her in the way that feels right for you, whatever that is, can not spoil a 3 month old. She will continue to grow and change tremendously in the weeks and months to come," Davidson says.

14

Baby Pooping Less Often On Breast Milk Than Formula

My baby went from pooping a lot since we started supplementing with formula to pooping not as much as he used to as we wean him off of the formula to exclusively breastfeed. Is there anything that I can eat that will help him?

Less poop doesn't always mean there's a problem, according to Davidson. "It can be normal for breastfeeding babies to poop as little as once a week," she says. "Is your baby showing signs of distress from the change in his pooping patterns? Being constipated and distressed is very different from simply pooping less than he used to." Davidson notes that breast milk and formula can be very different for babies to process and it may simply be that he is not producing as much poop now. "Without knowing more details about you and your baby, I can’t recommend you change anything about your diet or his," she adds.

15

Hip Pain While Breastfeeding

I am 24, athletic, pretty healthy, and I am still breastfeeding my 6 month old. When I lay on either side at any given time, I have terrible hip pain. What could this be? Is it related to breastfeeding?

Probably not. Davidson says that your hip pain could be caused by any number of things, but breastfeeding is not likely the cause. "Your pain might be left over from the pregnancy or the birth," she says. "If you’ve already spoken to your doctor, a great option would be to see a physical therapist who specializes in pelvic pain."

16

Breastfeeding Changes When Baby Reaches 6 Months

I have an almost 6 month old that I've been exclusively breastfeeding and it is starting to get tricky again. I am wondering if this is normal at this time. Does the baby go through growth spurts or teething issues at this age?

"Some babies become more distracted, go through growth spurts, are more fussy at the breast while teething, or temporarily refuse the breast around 6 months old," Davidson says. She notes that this could be a short phase, but it could also be a change on your end. "Have you started doing anything new with your diet? Did you recently start taking birth control pills or start using other hormone based contraceptives? Are you getting your period (perhaps for the first time)? Is it possible you are pregnant? It is possible that your milk supply has changed related to one of these things (or something else) and your baby might be reacting to that. If this behavior continues you might want to see a local lactation consultant so an expert can more closely examine the situation and help you get back on track in your nursing relationship."

Davidson also notes that when you start exploring the transition to solid foods, you might want to consider the baby-led weaning method. Baby led weaning means giving your baby safe sized pieces of food and letting them explore feeding themselves as they become developmentally ready to do so. But even as they start to eat solids, their nutritional needs are still met with lots of breastfeeding (or formula feeding) throughout the first year of life.

17

Getting Baby Back To The Breast

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I breastfed my little one for three weeks and then was put on an antibiotic that made me dry up. He's now 10 weeks old and having issues with formula, so I want to start breastfeeding again. Any suggestions on how to get my milk back?

According to International Board Certified Lactation Consultant Leigh Anne O'Connor, there are a couple of different strategies you can use. "If he's willing, you can try to latch your baby back to the breast. If that doesn't work, you can use a Supplemental Nursing System — this is a tube at the breast, much like a tiny soft straw, where your baby is getting supplemented at the breast. The stimulation of the breast will help to bring in your milk," she says. O'Connor also notes that you can rent a pump to help stimulate your breasts as well as take galactagogues. She also suggests that you would benefit from a consultation with an IBCLC who has experience with relactation.

18

Introducing Bottles

How often do you introduce baby to a bottle of expressed milk? I tried to go on date night the other night and my 2-month-old only drank about 2.5 ounces and didn't seem to like the bottle, but breastfed immediately when I returned like she was starving.

Don't worry, mama. 2.5 ounces while you were on a date is an appropriate amount. O'Connor says that many babies just like the entire experience of breastfeeding over drinking milk from a bottle. They like to be in your arms, feel you, smell you, hear you, and control the milk flow. She suggests that if you want a bottle in the mix, try using a truly slow flow bottle. Your baby should also be more upright while drinking from a bottle and someone other than mom should give it to them for best results. "There are so many bottles on the market and not all babies like bottles," O'Connor says. "You my have to experiment with various styles and brands."

19

Painful Nipple

My 6 month old had a tongue tie fixed when he was very young and we haven’t had any problems with his latch since. But now my right nipple has a searing pain. It looks normal, but it burns constantly. I’m pretty sure it isn’t thrush, and I see no bleb or blister. What could be wrong with it?

"It is hard to say, much depends on how old your baby is and how long ago the tongue was released," O'Connor says. "It could be that the tongue is still tightly attached and as your baby has grown, his tongue is moving in a restricted manner. If the cream does not work, do not use it. You may want to check with a breastfeeding friendly dermatologist."

20

No Longer Feeling Letdown Reflex

A few weeks ago, I stopped getting the letdown feeling when I nurse or pump. I'm still producing, but don't get that sensation anymore. Should I be concerned my daughter isn't getting enough of my milk? She is almost 8 months old and has been eating baby food and cereal for almost two months in addition to nursing.

"You do not need to feel a letdown to have a letdown," O'Connor says. "Often, your body comes into a balance where you do not need to feel letdowns or feel full in order to make plenty of milk. When starting solids be sure to keep nursing as the first year, the bulk of your baby’s nutrition comes from your milk."

21

Treating Reflux Naturally

My baby is 5 weeks old and is suffering from reflux. She is exclusively breastfed and I'm looking for natural and/or homeopathic remedies to treat her. I just left the doctor and they first suggested formula then prescribed Zantac. I had to use Zantac on my son when he was an infant and it caused constipation which had to be treated with Miralax and all in all did not end well. I'm hoping to avoid pharmaceuticals. I have read that I need to cut out all dairy and I've also been told that drinking apple cider vinegar with mother can help.

O'Connor says that it's important to clarify if your baby actually has GERD or is being diagnosed with the catchall phrase of reflux. "GERD (gastrointestinal reflux disease) is serious and many babies do not have GERD. I have found that often two things help with “reflux” — bodywork, either craniosacral therapy or chiropractic. This is because the baby could have some misalignment which can affect swallowing and/or digestion," O'Connor says. "Bringing alignment and release often fixes the 'reflux.' The other solution is one you mentioned, looking at your diet. Eliminating one food category at a time can help and dairy is a good first start."

22

White Particles In Stored Milk

My baby is 4 months old and I have been building up my freezer stash of pumped milk for the past three months. I just now started to use some and noticed that one of the bags has little white particles in it when thawed. I tried swirling it thinking it was the fat that separated, but couldn't get it to mix in. Does this mean it went bad? It didn't smell bad, but I didn't taste it.

Your milk is most likely fine. "Those fatty lumps can be challenging to mix in," O'Connor says. "Try massaging the bag of milk."

23

Contact Dermatitis On The Areola

Have any moms dealt with contact dermatitis on the areola? If so, how did they find relief? Does it ever go away?

"Contact dermatitis is from contact with a substance that creates the itchy rash," O'Connor says. "If that is the case, make sure you are no longer making contact with this substance. If you are not sure, it is important to see a breastfeeding friendly dermatologist." She also suggests that you continue to use the nipple shields if they help you and to sterilize them every time, along with any other objects that come in contact with the rash.

24

Stored Milk While Taking Medication

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I am starting to use my frozen stash of breast milk to make room for more. I am using the first milk I have pumped and I had a C-section, so I took pain medication. I'm worried about her getting that medication all over again. Any advice?

"Chances are that you are only using a small amount of this milk and the majority is fresh milk," O'Connor says. "Unless your baby has a reaction to the milk, it's safe to use."

25

Dealing With Inverted Nipples

Any tips or recommendations for moms with inverted nipples?

"With inverted nipples, sometimes a baby can pull the nipple out and sometimes the mom can manually pull the nipple out," O'Connor says. "Some moms find that using a nipple shield temporarily can help. Once the baby gets going, the nipple will pull out."

26

3 Month Old Wakes To Nurse At Night

I’m a first time mom and exclusively breastfeeding. My daughter is 3 months old and she still doesn’t sleep through the night. She wakes up every two hours just to eat then goes right to sleep. Any advice to get her to sleep through the night? Is that normal that she still wakes up every two hours at night just to eat?

According to O'Connor, it is very normal for a 3 month old to nurse frequently at night. She notes that some moms find that nursing frequently in the evening can help and if your baby is within arms' reach, she may sleep longer stretches. "Try not to compare your baby to other babies," O'Connor says. "Some babies will sleep long stretches from an early age and others take much longer to sleep through the night. For you, find some strategies to get rest, like going to bed early a few nights a week, laying down to nurse your baby, and napping when your baby naps."

27

Breastfeeding After Anesthesia

My daughter is now 7 months old and is exclusively breastfed, other than some introduction of cereal and purees during the last month. At the end of December, I will be having knee surgery to repair my ACL, which is an outpatient procedure, but does require general anesthesia. I am finding a lot of different information as to when it is safe to breastfeed following the procedure, pumping and dumping, etc. I do have a freezer stash and am prepared in that regard. Obviously I will be consulting further with my doctor and will do as she advises, but I'm interested in hearing more about undergoing a procedure requiring anesthesia while breastfeeding and how to handle it.

According to Carrie DiStefano, International Board Certified Lactation Consultant and owner of Olympia Lactation, a practice serving breastfeeding families in the Olympia, Washington area, the recommendation from the Academy of Breastfeeding Medicine is that babies 7 months and older are safe to breastfeed after general anesthesia once Mom is alert, stable, and able to hold her baby. "If you wanted to be extra cautious, you could pump and discard the milk once you are alert instead of breastfeeding and then offer baby the breast at the next feeding," DiStefano says. "However, this step is most likely unnecessary. There are different types of anesthesia, and while the majority are considered compatible with breastfeeding once Mom is alert, to obtain the most accurate information would be to identify the specific drug that will be used and check its compatibility in a publication called Medication and Mother’s Milk by Thomas W. Hale, Ph.D. Many physicians have a copy or you could contact a local lactation consultant for information as well."

28

Nipple Falls Out Of Baby's Mouth While Nursing

I have a 3 month old that latched great the first two days of breastfeeding, but hasn’t latched well since. She nurses for a few swallows and then stops. Is there a way to get my nipple firmer so that it doesn’t fall out of her mouth? It seems like she sucks and then they shrink and fall out of her mouth.

"It sounds like your daughter may either have a shallow latch, or possibly be responding to a strong letdown," DiStefano says. "The latch ideally will be with baby having a wide open mouth, like a yawn, and taking in all of the nipple and a lot of the areola as well. You can try to sandwich your breast using your thumb and forefinger in a 'C' hold just outside of the areola to help baby latch on to more of the breast tissue. Even if the nipple retracts some, there should be enough breast tissue in your daughter’s mouth to continue the feed."

DiStefano notes that if your baby is latching on to your nipple only, it may be more difficult for her to sustain a latch. If a strong letdown is the problem, the flow of your milk may be too much for her to handle at once. "You could try feeding in a position called laid back breastfeeding as gravity works in your favor to help control the flow of the letdown," she suggests. "Also, the inability to sustain a latch could also be a sign of oral restriction in baby’s mouth. If you are not finding success with these suggestions, I would encourage you to seek out an IBCLC to have the latch and suck assessed."

29

Pumping Output Decreased

I pumped from the time my daughter was born and built up a pretty decent stash. Once I did, I quit pumping regularly for about a month or so, but of course my stash has ran out and now it's so hard for me to pump, it's like my milk won't let down whenever I pump. It takes me like 20 minutes to get half of an ounce. I used to be able to pump like five to six ounces in 10 minutes. Now I'm struggling to get 3 ounces in 30 minutes. Any tips?

"Some women don’t respond well to pumping, especially if it’s been awhile since you last pumped," DiStefano says. "Often it’s mental and your body is not easily having a letdown for the pump — just for the baby. My suggestion would be to latch baby on one breast and try pumping the other while she’s actively feeding on the opposite side. You may need to do that for a few sessions to train your body to have a letdown for your pump."

DiStefano also suggests alternating sides with every other feeding so that each breast is adapting to the pump stimulation. "Don't pump more than 15 minutes at a time. If at the 15 minute mark you don't have the volume you were expecting, hand express for a few minutes. Moms often find that hand expression is helpful in increasing the amount expressed after pumping. DiStefano says you can also try a hands-on pumping technique to try and increase your output, too.

30

Feeding Baby Pumped Colostrum

I have a large supply of frozen milk because I started pumping right after my daughter’s birth, so I have bags of colostrum-rich breast milk. I am starting to go back to work, leaving my baby with my husband and grandma so they will be giving her bottles of breast milk. I usually pump before I leave so they have a fresh bottle, but I would like to start using the frozen supply so that I can rotate the oldest out. If breast milk is constantly changing depending on the needs of the baby, will the early breast milk that I have stored (even the colostrum rich) be sufficient for my baby now that she is 3 months old? I know any breast milk is good, but I'm a little confused on what to do in this instance.

"You can absolutely use milk pumped at different stages to feed your baby with now," DiStefano says. "While the milk does change in composition, it is still the optimal food for your baby as it is designed for her. Breast milk even changes throughout the day, having more or less fat depending on the time you pumped, so even the colostrum rich milk will be beneficial for her." She notes that one of the more specific changes to your milk may be that if you ever had a cold and pumped, your body created antibodies which are passed along in your milk. You can think of that type of milk as just extra protection for your baby.

31

Pain After Nursing

I am exclusively breastfeeding my 2 month old. He was born at 33 weeks, so the first two weeks I was only pumping. About three weeks into breastfeeding, my breast started hurting a lot for about 30 minutes after breastfeeding him. The pain is like on the outer edges of my breast. My nipples also stay fully erect and hurt like when you are cold, but applying heat doesn't really help, it just goes away eventually. My doctor said unless I have chills and/or a fever, it's nothing to worry about. I have checked with a lactation specialist to verify baby's latch isn't the problem, but nobody seems to give me helpful advice. Is this normal? It's just making breastfeeding so stressful.

"It sounds like you may be having a vasospasm, which means the blood flow is restricted to the nipple. The pain can present itself in the nipple or be a shooting pain to other areas of the breast as you describe," DiStefano says. "If you are applying heat to the area of pain, you may try using some light heat or use a cloth to cover the nipple as soon as baby comes off the breast. The change in temperature from warm mouth to cool air may be causing your nipple to stay erect as well as contributing to the pain you are experiencing."

32

Pain While Weaning

My little one is 13 months old and we are starting to wean. My breasts are extremely painful. No redness, but dang, this hurts. Any suggestions to help with pain?

"Without seeing the baby feed and having more information, there could be a variety of reasons why your breasts are having pain," DiStefano says. "If the milk flow or supply has decreased due to less frequent feedings, baby may be tugging at the breast to try to illicit another letdown or get more milk. That tugging may be causing you to have pain." Is it possible that you're pregnant? DiStefano notes that many women find breastfeeding painful when they are in the early stages of pregnancy due to increased nipple sensitivity.

"If you are getting engorged due to less frequent feeds and that is causing you pain, you could try ice packs and/or hand express to comfort levels. Hand express just enough to relieve the pressure, but not enough to remove all the milk which would tell your body to make more milk," she says.

33

Wearing A Bra To Bed

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I am wondering how other breastfeeding mothers feel about wearing a bra to bed? I have heard some people say you need to wear one and others say that you shouldn't. If you don't, how do you keep from leaking?

This is really just a matter of preference. According to DiStefano, some moms wear a bra to sleep and use nursing pads to help with leaking while others don't wear a bra so they have less clothes to fuss with in the middle of the night. "There are nursing bras specifically for overnight and sleeping," DiStefano says. "The material is often softer and may or may not have traditional hook closure. If you find yourself leaking overnight, you may feel that wearing a sleeping bra with breast pads is your best option until you no longer experience leaking overnight. If you are uncomfortable wearing a bra overnight and are leaking, you could also try sleeping with a towel underneath you to catch any milk."