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.
The emotional ups and downs of breastfeeding are compounded when you're struggling with health issues. Whether you're wondering if you can breastfeed after an MRI, just got home from the Newborn Intensive Care Unit (NICU), or have the stomach flu (my sympathies), you probably want to know how your situation affects breastfeeding. It's always great to ask your doctor, but if they're not as helpful as you'd like, know that lactation specialists always show up — as a shoulder to cry on or the world's best cheerleaders. In fact, if you hit any bump on the breastfeeding-brick road, your best bet is to find an International Board Certified Lactation Consultant (IBCLC) near you. Of course, having a newborn can make it tough to leave the house. The good news is that an increasing number of IBCLCs now offer online services. Don't forget your friendly neighborhood birth center, either — doulas often have lactation training, too.
Romper spoke with four experts who understand that breastfeeding is a relationship of powerful importance to you and your baby. Their message is simple: Take care of yourself, but don't let illness abbreviate this special time if you're not ready to call it quits. Kristin Gourley, IBCLC, who offers online consultations at Lactation Link, tackles nursing in the days after magnetic resonance imaging (MRI). Tania Archbold B.Sc, IBCLC, of Mother's Nectar Lactation Services in Guelph, Ontario, addresses bouncing back from a "not-so-supportive" NICU, and Caitlin Novak, Certified Lactation Counselor (CLC) of The Doula Circle in Colorado Springs, Colorado, talks safe breast milk storage. Finally, Briana Violand, IBCLC, of NorthCoast Lactation Services in Amherst, Ohio, talks returning to breastfeeding post-surgery. All real questions, asked by you — real breastfeeding moms.
1. Breastfeeding After An MRI
In 2015, I had a benign brain tumor removed from my pituitary gland, and I have a checkup this Thursday. That means I'll have an MRI done on my brain with contrast to see if the tumor is back. Doctors tell me to pump and dump for 24 hours, but everything I've read online says not to interrupt breastfeeding. My son is 2 months old on Monday. Does anyone know if I can continue nursing?
First off, more power to you for taking care of your health. I'm glad you're getting your MRI as scheduled.
However, you're correct that the doctors might not have all the facts. As Gourley tells Romper, "The vast majority of scans, including those with contrast, are safe while breastfeeding. The ones that aren't safe are generally radioactive isotopes, like those used to specifically scan the thyroid." In other words, unless your contrast is radioactive — and you should absolutely check that it's not — there's no need to pump and dump.
A recent article in the Canadian Family Physician backs Gourley up here. In it, Jack Newman, MD, explained that the common doctor's recommendation to stop nursing for 24 to 48 hours after an MRI is not based on any evidence, and that contrast mediums makes their way into breast milk only in vanishingly small amounts.
"You can call the InfantRisk Center, experts on medications and breast milk, if you know the name of the contrast that will be used for more specific information about your situation," says Gourley. It's a good idea to give the organization a call and report their advice to your doctors, before going against medical advice.
2. Trying To Conceive While Exclusively Pumping
I've been exclusively pumping for my 9-month-old daughter since she was born (we had trouble latching). I still haven't had my first period since giving birth. The problem is that my husband and I would like to try very soon for another baby. My doctor suggested I cut down to only pumping three times a day, so I have been doing that for about a month and still no luck... My husband and I have discussed possibly stopping pumping. I just really would like to keep exclusively giving my daughter breast milk for the first year. Any advice?
Congratulations on baby number one, and here's hoping you'll soon see baby number two. Trying to conceive while breastfeeding is complex, but by no means impossible.
According to Gourley, your doctor is correct that pumping less will reduce fertility-suppressing hormones, but it's hard to predict how your body will react. She suggests experimenting with your pumping schedule to encourage your ovuation cycle's return.
"Some women find that dropping night feedings can instigate a return of fertility," Gourley explains. She goes on to say that while a few women will have to wait until after weaning, most will be able to conceive after any "abrupt change in breastfeeding patterns." However, cutting back as you already have — to three pumping sessions — might still work out if you give it time.
"Also, consider that it's possible to get pregnant before your first postpartum period (since you ovulate before bleeding)," notes Gourley. If you're having unprotected sex, it's possible to get pregnant without realizing.
3. Bouncing Back After NICU
My baby is 5 months old. She spent her first month in a not-so-supportive NICU. Now she will only take a bottle, and even after seeing a lactation consultant, she screams at the breast after a minute or two.
I'm so sorry this happened to you. The NICU is a terrifying experience for any mom, and I'm glad your baby is home now.
"Getting a baby back to the breast/chest can be a difficult and long process if they have been bottle feeding for months," explains Archbold. However, with a little trial and error, and lots of patience, you can get back to where you want to be.
"The first step is to spend as much time skin-to-skin as possible," according to Archbold, so snuggle up, preferably topless. Let your baby smell your skin and feel your heart. "You can even start by bottle feeding skin-to-skin if she is resistant to being in that position ... taking a bath together is another nice way to reintroduce the idea of breastfeeding." Babywearing also fosters closeness. Archbold explains your next steps:
"After she has had her bottle, but before she is asleep, offer your breast/chest instead of a soother for comfort sucking. Some babies will take to this more quickly than others. Gentle persistence without forcing anything is the key. Let her come to you. Don't force the nipple in her mouth ... Once she is rooting and attempting to latch, you can start to cut the bottle feeds a little bit short ... So, if she normally takes 200 milliliters, stop after 150 milliliters and offer the breast/chest for the rest."
It sounds like breastfeeding is important to you, so don't give up yet. A good lactation specialist will have lots of tricks up their sleeve (Archbold notes that tube feeding could also help you make the transition, and that while early stages are hard, breastfeeding will get easier with time). However, this isn't something you can go alone. At each transition point, you should check in with a knowledgeable supporter. An IBCLC is best, but Archbold also recommends reaching out for peer help at La Leche League or visiting a Women, Infants, and Children (WIC) breastfeeding clinic. Best of luck to you.
4. Pumping and Milk Supply
When I nurse my 4-month old son, he seems to be satisfied and can go two and a half to three hours before wanting to nurse again. Normally, when I pump, I'll get anywhere between 4 to 6 ounces from each breast. But for the past couple of days, I have only been getting about 5 ounces altogether. I really don't want to give him formula, but I'm worried my breastfeeding days might be ending soon. Is there anything I can do to get my supply back up before it's completely gone?
"Pump output is not always a good indicator of milk supply," explains Archbold. "At around the 4-month mark, milk supply tends to regulate, and people who had oversupply in the beginning may now have a supply that meets their baby's needs. Breastfeeding on demand, and through the night when you are together on evenings and weekends is critical."
Also, make sure your baby's daytime caregivers aren't overusing the bottle. According to Archbold, a baby typically needs only about 1 ounce of milk per hour of separation — so seven hours of separation would be 7 ounces total (and also, Kevin Bacon). Pump frequently while you're at work if possible, and check that your pump is in good condition. Keep in mind too that milk output temporarily decreases with the return of your menstrual cycle.
Because there's a lot that could be going on here, I suggest you visit an IBCLC, if only for some much-needed reassurance — consider an online appointment if it's more convenient. Based on your question, you may be jumping to a conclusion — that you won't be able to breastfeed much longer — prematurely. That's totally understandable, of course. Supply issues are nerve wracking. However, as long as your baby is healthy and still gaining weight, you're likely still on the right track.
5. Breastfeeding Post-Surgery
I have a 12-week old baby girl and recently had surgery. I was out of commission for a week. During that time I had to pump and discard. I had some stored milk, but we ran out and started to supplement. The meds have severely reduced my milk supply, I think. I'm pumping about 2 to 3 ounces combined. Can I get my milk supply back to normal? Or should I stick with formula?
"So sorry about your surgery and having to pump and dump your precious breast milk," writes Violand in an email to Romper. "To get your milk supply back to normal, you need to be emptying the breast very frequently. Nurse, nurse, nurse that baby, pump after you breastfeed your baby, and add in a pump during the day or night while baby is sleeping."
It sounds like a lot, I know, but you can't overfeed a breastfed baby, or bring him to breast too much.
Violand also wants to make sure you're eating and drinking enough — you need a protein-rich snack every two hours when nursing — and suggests trying some galactagogues to boot. She recommends fenugreek, blessed thistle, and alfalfa, as well as Mother's Milk tea (which is delicious, in my humble opinion). Also, be sure to check that any post-surgery medications you might be taking are safe for breastfeeding, and don't be afraid to ask your doctor for an alternative medicine, if not. Since you're likely still recovering, put your friends and family to work on the house chores and cooking while you focus on boosting your milk supply. Netflix and nurse, then nap, then nurse.
6. Supply & Demand
How do I up my supply? I've tried fenugreek, but it doesn't seem to help. Is there another supplement or tip I can try? We are exclusively pumping.
Beyond the advice above, there's plenty left to try. Violand advises you to nurse, nurse, nurse, and pump while baby's sleeping, to stimulate your breasts. Also, check your pump for wear and tear (they don't last forever), and consider renting a hospital-grade device.
Novak recommends that anyone who's exclusively pumping speak with a lactation consultant, if you haven't already, because, let's face it, pumping is complicated. Novak also suggests trying the hands-on pumping technique to give yourself a beneficial breast massage — you can read more about the technique on Kelly Mom. "Relaxation and objects that help you visualize/smell/sense your baby are also helpful," writes Novak. So in addition to breast massage, consider booking an actual massage, or taking a long tub soak. You deserve it.
7. Breast Milk In A Hot Car
Hello! I forgot a bottle of breast milk in my car just now. It was in there for two hours and wasn't in a cooler. It's hot out today. It's no longer good, correct?
This kind of question is exactly why I love being a mom with internet access. Can you imagine life without? Shiver.
To answer your question, Novak cites the Academy of Breastfeeding Medicine's Protocol Number 8 — Human Milk Storage Information. You can read the complete protocol online, but basically, breast milk can be stored between 27 degrees Celsius/80 degrees Fahrenheit and 32 degrees Celsius/89 degrees Fahrenheit for a maximum of four hours or so.
"If you have concerns after smelling or tasting the milk, you may want to dispose of the milk instead of giving it to your baby," suggests Novak.
8. Sleep Medication Safety
Are any sleep medications safe to take while breastfeeding?
One of the many amazing things about breastfeeding? What a great job your body does of filtering out toxins. As you may have seen in the MRI question above, very little contrast winds up in milk, and the same is true for many medications — even alcohol barely shows up in breast milk, according to Kelly Mom. But you do have to pay attention to how you feel. Ask your doctor for whatever you need, but if any medication makes you loopy, do be extra careful when handling your baby (I know you will, but it bears mentioning).
"There are many medications that are safe to take while breastfeeding in which very little, if any, gets passed to the baby. I would contact the InfantRisk Center to set your mind at ease," says Violand. She also suggests having someone at home to help with your baby whenever your are taking medications that make you sleepy.
9. When Baby Bites
My son will be a year old in two weeks. He has been biting during every single feeding since his top four teeth came in. I've tried taking away the breast and telling him no, I've tried tapping his mouth with my finger after removing my breast, but neither one works. What else can I do before I try to just stop nursing altogether?
Happy birthday to your son! Now, let's see what we can do about that chomping.
"Is he consistently biting at the same time during a feeding?" Gourley asks. "It is most common for babies to bite when milk flow is slow."
She explains that if your son bites at the beginning of a feed, you could try inducing letdown prior to latch with some hand expression. If he's biting in the middle of a feed (an unpleasant surprise, I'm sure), she suggests watching his swallows and noticing when they slow down — you can unlatch him and try the other side before he has the chance to bite.
"He may not completely understand that you don't like the biting," says Gourley. "Or he may see how it gets a reaction from you and he enjoys that — but it doesn't take away from the fact that it hurts! Prevention is better than consequences when it comes to infant and toddler discipline."
Gourley also notes if you're reading a book, looking at your phone, or watching television, baby might be trying to get your attention. So if you're multi-tasking, keep your eyes on him as much as possible. In my opinion, podcasts make great company.
10. One-Sided Milk
I'm 37 weeks pregnant with my second child. I exclusively breastfed my first child. I would prefer to exclusively breastfeed again. My milk has started coming in heavy on the right side, but I have almost no milk coming in on the left. Will I still be able to breastfeed? Is there anything I can do in order to help my milk come in better on the left side?
"There's milk there, I promise!" Gourley writes in an email to Romper. "You may notice more colostrum on one side or the other, but whether you feel it or are able to express it doesn't necessarily indicate anything about how much milk you'll have after birth."
It's a great sign that you were able to exclusively breastfeed once before, and for Gourley, odds are good that things will go well again. As always, putting the baby to your breast is the best way to encourage your supply. Until she's born, try not to project too much into the future (easier said than done, I know). Take a few deep breaths, and treat yourself to something nice. It's unlikely that your left breast is actually sluggish — it's probably just gearing up. So don't worry, mama.
11. Nipple Tugging, Leaning Backwards, & Other Baby 'Gymnurstics'
For the past several weeks, my exclusively breastfed 8-month-old daughter digs her hand into my breast, pushing herself backwards while nursing, taking my nipple with her. This does not ever feel good. I try placing her hand elsewhere, to not give her this leverage, but she immediately digs it right back in. Do you have any suggestions to erase this habit?
According to Archbold, your baby is probably pressing on your breast to get the milk flowing faster. She's thirsty — and getting more clever every day.
"Ahh. The joys of nursing a mobile baby," writes Archbold. "As babies get better control of their arms and legs they start all sorts of fun 'gymnurstics' ... Holding her hand, giving her a toy to play with, or wearing a chunky necklace for her to fiddle with are all ways to keep her distracted."
Archbold also notes that your daughter is old enough now that you can explain what hurts you — gently, of course. Even if baby doesn't understand the words, she'll catch your meaning from your tone. "Setting boundaries is an important part of your relationship with your baby. These early stages can be tricky, but as your relationship grows it will get easier," Archbold assures you.
Gymnurstics is now my new favorite word.
12. Nursing A Stomach Flu
I may have the stomach flu and I'm wondering if I should breastfeed my son. I also pump and freeze my milk. Will the milk I produce today be OK for him to drink in a couple days? Today his diaper looked like diarrhea. I am a first-time mother, he doesn't have a fever, cough, or other symptoms. As for me, yesterday I had ALL the symptoms, but today I am feeling a lot better.
Well, flu season just arrived, and it sounds like you caught it early. Luckily, whether you have the flu or not, your breast milk is just fine. In fact, it's chock full of antibodies specific to this very virus — which makes it better than fine. Archbold explains:
"It is safe to breastfeed and safe to feed him the milk you pumped earlier. Your body is making antibodies to whatever virus or bacteria you were exposed to."
If your baby does get sick, know that breast milk is still the easiest food for him to digest — and good for him, too. In fact, your breast milk can help your baby get over an illness if he does catch yours, because it's pretty much magic. Archbold advises contacting your doctor if your little one shows signs of dehydration. Otherwise, you're good to go. Here's hoping you both feel completely better soon.
13. Balancing Full-Time Work & Pumping
I love breastfeeding my baby boy, but I work full time and it's time consuming. I'd keep doing it if I could figure a way to keep my supply up while only doing so when I'm home nights and weekends. I've been exclusively breastfeeding for five and a half months now. Can you tell me if it's possible to keep enough supply for only feeding at night and on weekends, or is there a quicker routine? I already use three complete sets of flanges and valves and wash them all when I get home. Please help!
Oh, dear. I absolutely hear your sense of overwhelm. Archbold points out that due to awesome Canadian maternity leave policies — reading about them in The Globe and Mail turned me green with envy — she doesn't run into many parents returning to work so soon.
However, she does note that after five and a half months of nursing (congratulations on that, too!), your supply is well established. While everyone's body responds to pumping differently, Archbold worries that not pumping at all may lead to health issues for you:
"It would take a few weeks of gradually ramping down your pumping schedule so your supply has time to adjust in order not to feel overly full at work. Not emptying your breasts regularly can lead to blocked ducts and/or mastitis. That being said, some people's bodies do adjust well. Watch yourself and express to comfort, if possible."
Archbold notes that your baby is almost old enough to start solids. That means he could have a combination of formula and solids at day care, allowing you to only breastfeed when you're together. "While you might not be able to maintain a full supply while only breastfeeding at home, breastfeeding even part time is giving your son a lot of the immunological and other health benefits of breastfeeding," she notes. So if you're just feeling exhausted and done, you might have an option there.
As for making pumping less arduous, you're already using three sets of flanges, which is smart. That way, you don't have to spend excessive time cleaning your supplies at work. To ease your routine, Archbold suggests limiting your pumping time: "Even five to 10 minutes a session are better than nothing. Do you have a private office? Would it be possible to pump while working on paperwork?"
This is a tough problem, and one many American women face on a daily basis. Pumping is time consuming, but you have a right to do it. I suggest talking to your boss about delegating some of your responsibilities to others for a while, or providing you with longer breaks. You love breastfeeding, so contact a lactation consultant. They'll be happy to give you more tips on balancing pumping, work, and life. Take care.
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