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.
Baby teeth, day care, fenugreek — it's clear from this week's questions that breastfeeding is a life skill that often requires some serious know-how. In my weeks postpartum, I often blamed (and honestly, still do blame) my mistakes on 'mommy brain.' But what if mommy brain is just the result of information overload? Here to help you wade through the supplements and galactagogues, the supply issues and legal issues, is a team of specialists who know what you're going through.
Josie Bouchier, Holistic Health for The Whole Woman and expert at The Tot, talks safely switching to a vegan diet while nursing.
Andie B. Schwartz, M.Ed., RD, LD, CLC, of Happy Family's Happy Mama Milk Mentor program — a completely free online service for moms with questions about nursing — discusses day care, infant constipation, and issues with getting disability coverage for hyperprolactinemia.
Stephanie Nguyen, RN, MSN, WHNP-C, IBCLC and The Bump contributor, has the lowdown on fenugreek, supplements, and the immune-boosting powers of breast milk.
Finally, Linda M. Hanna, RNC, MSN/Ed., IBCLC, and founder of My Nursing Coach — a mobile breastfeeding practice in Los Angeles providing in-home and online breastfeeding and postpartum support — talks exhaustion, Upspring Milk Flow, and pumping for a family member's baby. With My Nursing Coach, Los Angeles moms can get a home-visit from a lactation consultant or postpartum specialist, and moms across the country can receive advice by phone, video chat, or private message.
Let's get started.
1. Going Vegan While Breastfeeding
I have a question for the moms with the knowledge of vegan and vegetarian eating. Is it alright to start a vegetarian or vegan lifestyle while breastfeeding? My baby is 9 months. I'm looking to getting healthier and losing a little bit more weight, but I don't want to go on a diet and I know vegetarian eating helps with that.
Bouchier explains that the determining factor here is supply. "If your breast milk supply matches your baby's demand, and you've never had an issue with low supply, then I don't see a problem with switching to a vegan or vegetarian diet as long as you take care to eat plenty of plant-based protein, healthy fats, and carbs."
However, animal protein is the best way to nourish your blood, according to Bouchier, which from a Chinese medicine perspective is what helps you produce enough milk. If you're concerned about a low milk supply but still want to follow a plant-based diet, she suggests getting to know your way around the world's galactagogues.
"One of the best galactagogues is garlic," Bouchier explains. "Others include fenugreek, milk thistle, alfalfa, whole grains, leafy greens, papaya, fennel, nuts, and seeds."
2. A Nap-Time Nightmare
I need some help. My 5-month-old always falls asleep nursing, but wakes the moment I put her down. I give her the 20 or so minutes to let her get into a deep sleep, but it doesn't seem to matter. If by chance she does stay asleep after being laid down, its only for 20 to 30 minutes before she wakes again. She just started day care two days a week and needs to nap on her own, as they aren't going to hold her. Please help.
Day care is definitely an adjustment — for mom and baby both. The good news is that babies will adjust when given love and time. "Kudos to you for breastfeeding five months so far," writes Andie B. Schwartz, M.Ed., RD, LD, CLC, of Happy Family's Happy Mama Milk Mentor program. "I know this seems like a never-ending cycle, but there is definitely hope on the horizon. I’m not sure how long this has been going on, but babies sometimes fall asleep at the breast when milk flow is slow or when they’re only temporarily satisfied. Depending on the point of the feeding she’s falling asleep, it could be one of these reasons — or even a combination:
"1. Some mothers have a lot of milk, but the milk flow may slow down later in the feed, and this is when the baby may fall asleep.
2. She’s satisfied at that point of the feeding, but when taken off, she wants to switch to the other side. It’s possible that she needs more spaced out feedings earlier in the day.
3. She’s going through a growth spurt and is looking to cluster or bunch-feed; meaning a desire to nurse back to back several times during certain times of the day/night.
4. She could be going through a type of separation anxiety from being away from you (and the breast) with the new daycare routine. Babies are creatures of habit and any change in their routine can cause unusual or more needy behaviors."
So what can you do? Schwartz says there are a few things you can try.
"1. Ensure she is latching appropriately. A shallow or poor latch may result in slower milk flow (no matter how much milk you produce) and this can make her fall asleep more easily. Happy Mama Milk Mentors suggest these helpful tips for latching issues.
2. Make sure your baby is getting enough milk. Listen/watch for suck, suck, swallow; watch her weight, and wet and dirty diapers.
3. When she begins falling asleep, try compressing your breast or massage your breast to help increase milk flow a bit. Start at the outer edges of the breast and slowly, gently work your way towards the nipple.
4. Switch sides when she falls asleep. You can continue going back and forth between your breasts until you feel she has gotten enough milk.
5. Provide a lot of cuddle time, including skin-to-skin, and more time at the breast when you’re together."
3. Disability For Hyperprolactinemia
I am suffering from hyperprolactinemia, which causes extreme oversupply. No amount of restricting nursing or pumping sessions has regulated my supply. I've been working with my doctor and a lactation consultant since my son was born 8 months ago — my doctor determined that because it's necessary or me to express breast milk every 30 to 45 minutes or face engorgement and reoccurring mastitis, that it's best for me to take a leave of absence from work until January. In January, my son will be 1 and I will be in a position to wean him and receive hormone therapy in an attempt to stop this lactation issue.
My leave was approved by my employer as they are unable to accommodate my need to pump every 30 to 45 minutes — which I completely understand. It's impossible to expect me to only work 2 hours of an 8-hour shift. The company that manages leave of absences into disability claims denied my disability benefits because "breastfeeding is your choice." I find it asinine that I would be expected to report for work five days a week to spend 6 hours pumping, when leave is given to my male counterparts for things like asthma and a broken toe. I am at a loss, I cannot support my family financially and have been put in a very difficult position by my employer and this third-party company. The deadline for my appeal is tomorrow and I just don't know what else to do. Any advice you guys may have would mean so much to me.
Thanks so much for posting this question. The way the world views breastfeeding is often completely backwards, and this is one example. Unfortunately, there's no easy fix, but I suggest advocating for yourself as much as you can. Get your doctor to write to this third-party company, even if you're past your deadline to appeal. Here's what Schwartz has to say:
"First off, I completely admire your commitment to breastfeeding and going above and beyond for him! You are a true breastfeeding champion! Secondly, shame on the disability company and your employer for backing you into this corner. Although legal issues around breastfeeding are not my expertise, I do believe the 'Break Time for Nursing Mothers' law could be your ally. There are definitely legal rights in place for you that go beyond their statement that 'breastfeeding is your choice.' Additionally, since you have a medical condition and reoccurring mastitis, this seems to fit perfectly into what constitutes a disability versus a choice. I don’t want you to be in financial trouble, but I would definitely recommend for you to appeal and use the 'Break Time for Nursing Mothers' law to back up that it’s a LAW not a choice! Stay strong, mama!"
4. Breastfeeding A Constipated Baby
I need advice from everyone... I have a 1-month-old baby. She has been constipated for four days and her doctor switched her to formula already. I also breastfeed her. Does anyone know of anything that might help? Thank you.
"First, let’s define what constipation means for a one-month old baby," writes Schwartz. "Many parents worry that their babies are constipated if they don’t have their daily stool. However, typically after one month of age, their stool frequency may drop from daily stools, to going a few days or so without a stool. Additionally, every baby has their own bowel movements and formula-fed babies tend to pass stools less frequently than exclusively-breastfed babies. As long as your baby is passing soft stools then it may be normal, but if your baby is straining and having difficulty passing a bowel movement and/or is passing hard, pebble-like stools, that would be a cause for concern. I’m not sure which new formula you’re using, but if this one seems to be working well for your little one other than the constipation, switching again may not eliminate the problem."
Schwartz suggests increasing your baby's intake of breast milk if possible, because breast milk contains pre- and probiotics helpful to digestion. You can also purchase infant pre- and probiotics to add to formula, she notes. Schwartz also recommends The American Academy of Pediatrics' advice on working through constipation with a little apple or pear juice. Finally, bicycling your baby's legs can also help move things along. If nothing seems to help, she recommends visiting your pediatrician to rule out other potential issues.
5. Taking Fenugreek Pills To Up Supply
So I am a first-time mom and am learning as I go. I am wanting to exclusively breastfeed, but I am not producing enough to meet my little one's needs. My doctor recommended fenugreek pills but I'm nervous about possible side effects on me and my baby. Has anyone else tried them? Did you experience side effects? Can you recommend something else to take to help my supply? I'm just looking for more opinions and options before I go buy anything.
I'm all for trying supplements, but it's important to clear anything you take with your doctor first. Another potential problem with supplements is simply that they might not work (they're not always thoroughly tested). If you're interested in taking fenugreek, ask your local neighborhood lactation consultant — or other moms — which brands they recommend.
Stephanie Nguyen, RN, MSN, WHNP-C, IBCLC and The Bump contributor explains that fenugreek is a galactagogue, or a food commonly known to increase milk supply, adding that fenugreek and other supplements for nursing moms usually have only minimal side effects. Nguyen also advises checking out the safety record of any medication or supplement you take at LactMed ToxNet Database.
She also makes the very important point that you should try to get to the bottom of your low-supply problem. "In most cases, extra pumping (especially with a hospital grade rental pump) is going to be the best way to increase your supply. Try meeting with a local IBCLC to determine the cause of your low supply and how best you can improve it."
6. Doubting The Powers Of Breast Milk
My breast milk seems... lacking. My 2-month-old has been sick at 6 weeks and is sick again, at 2 months. Breast milk is supposed to be this magical immune boosting liquid gold, but I'm up at night with my 2-month-old, crying because he has the common cold and I'm suctioning his nose every hour or so. He has 2 older siblings, one who has been slightly congested, so he probably got it from that sibling, but my 2-month-old's doctor said everything is just fine and it will pass. I'm really not buying that. My breast milk is supposed to be amazing! Has anyone else dealt with this sort of thing? Has anyone else doubted their breast milk's super powers? Also, we exclusively breastfeed, on demand, and my 2-month-old is growing and not having any issues besides this common cold.
"Breast milk is amazing and has many immune-boosting properties! It is one of the best reasons to breastfeed your baby," explains Nguyen. "However, this doesn’t mean that your baby will never get sick. When you are sick or exposed to a virus (like a cold), your body creates antibodies against the virus making you sick. These antibodies are then transferred to baby through breast milk, giving them extra protection from getting sick. When you have other kiddos in the house or baby is in a childcare setting, they may be exposed to germs that you (mom) are not exposed to. So ... baby isn’t getting an extra immune boost from breast milk to these germs because you haven’t been exposed to make antibodies against them."
One possible solution? Shake hands with all the parents at day care, every day. (Just kidding. Who has time for that?) Actually, what Nguyen advises is illness prevention:
"The best thing you can do to prevent your little one from getting sick is basic cold/flu prevention 101. Sanitize with an alcohol-based hand sanitizer before holding baby and make sure your kids use hand sanitizer as soon as they get in the car from school or before entering your home. Resist touching baby’s eyes and nose as much as possible (resist picking those boogers!), as these are the most common routes of transmission for viruses. I also recommend having a designated area for shoes/school stuff to stay when your kids come home from school. Take off shoes, empty backpacks and store any school stuff in an area away from baby’s things. This will help keep school germs from spreading throughout your home."
7. Dealing With Baby Teeth
My 9-month-old has two teeth on the bottom that have been there about a month now. The last few days however she has started biting me while feeding. Hard enough for me to be brought to tears. I am not ready to stop breastfeeding yet. Is there anything I can do? I've taken her off the boob with a firm NO and put it away and she will cry for a few seconds, but then go about her business. Is this just a phase? Maybe she's getting another tooth? Any advice is appreciated!
Ouch. Luckily, Nguyen has some pretty actionable advice, depending on when baby's biting:
"Try to see if you can pinpoint a certain time in the nursing session that baby bites. Is it at the beginning of the feed? This usually indicates that baby is trying to trigger a let-down or attempting to get the milk to flow faster. Does it happen in the middle of the feeding? This could indicate the same problem — baby wants more milk faster. It can also mean that baby is getting bored or distracted during nursing. Does it happen at the end of a feeding? This can mean that baby is done and you can take her off and end the feeding."
Once you figure out when your baby is biting, what can you do to stop it? "Try keeping baby engaged in the feeding other ways," suggests Nguyen. "Talking to her or singing to her and letting her play with a toy or nursing necklace while nursing can help prevent her from getting bored. Massaging the breast and making sure the milk is flowing throughout the nursing session can also help for babies who want the milk to flow faster. When baby bites, take her off the breast and give her something else to chew on. Giving baby a big reaction (yelling or crying out from the biting) can often be counterproductive, making some babies bite more because they think your reaction is funny or making other babies resist nursing because they are frightened.
Nguyen reassures moms that "biting is a phase that only lasts a few days or weeks and most babies don’t bite forever."
8. Walking, Nursing, & Chewing Gum At The Same Time
I'm a second-time mom, but first time being able to successfully breastfeed/nurse. I was wondering if there was tips on how to breastfeed in public? Such as how to walk and nurse?
"Practice! Learning to breastfeed is hard and feeling comfortable with your nursing technique can take time," explains Nguyen. "First, try practicing nursing without any pillows, latching baby on, and then bringing your arm around to cradle and support his weight. Once you have the hang of that, add in your nursing cover if you plan on using one while nursing in public (you’ll want baby to feel comfortable nursing with a cover). You can then try practicing standing and nursing while walking around the house. For moms who are new to nursing, don’t be afraid to try nursing in different positions and moving around while nursing. You have all day to nurse and try new things and usually after a few tries, you’ll find something new that works for you!"
The way Nguyen puts it, learning to nurse, walk, and chew gum at the same time sounds fun. Make a game of it. Also, pick out a nursing cover you really like — some, like this one from The Tot, are lovely.
9. Motivating Words For A Mom New To Breastfeeding
Hi, I am an expecting mother that is practically due anytime now. I am so set on breastfeeding but have so much anxiety going into this journey just because of horror stories I've heard from other mothers that have attempted breastfeeding. I do feel I will be dedicated and determined, although I'm so worried about the first few days before the milk comes in. I'm sure we all have seen the horror news clips on babies accidentally starving to death waiting for breast milk. Any experiences/stories/motivational words would be much appreciated. The problem is I don't have many people close to me that have breastfed, so this is all so new and foreign to me, but I am willing to do what I need to in order to give my baby the best nutrition there is!
"We are always sorry to hear stories from mommies to be about the anxiety related to breastfeeding," explains Linda M. Hanna, RNC, MSN/Ed., IBCLC, and founder of My Nursing Coach. "Although there are some stories that can cause new parents concerns and fears related to feeding their own baby, we can say without hesitation that most mother/baby dyads navigate their way through the first few days, even the very tough nights, and find a breastfeeding relationship that is pleasurable and fun.
"It is full of ups and downs that tie you and bind you unlike any other relationships you will have. There may even be initial pain and soreness with the first few days of nursing, but there are solutions and remedies and plans, as well as a team of support people that will guide you and support you through the journey. There doesn’t have to a horror story for you."
Hanna recommends educating yourself before birth, and gathering any supplies you might need in advance. Creating a breastfeeding plan can also help you feel more prepared.
Hanna suggests talking to other moms about "what really happened that derailed their experience so you can avoid pitfalls and be prepared for anything that comes at you. Have back up plans decided upon before the birth so if you are faced with unexpected outcomes, you don’t have to bail on all your plans and feel as if you have lost any control."
Lastly, Hanna advises:
"Remember to expect the unexpected and that way you will not feel afraid or lose your voice when you are asked to change your course. Most birth and breastfeeding stories end with a wonderful outcome and when and if something does veer off of your personal plan, all of your preparation will protect you from feeling overwhelmed and scared. Call for support when you get home with your baby and stay in touch with your pediatrician’s office and your lactation team."
10. Feeling Like A Human Pacifier
Currently have a baby girl who is 8 months old and has been exclusively breastfed since birth. I have been a stay-at-home mom since I had her but with the holidays coming and us being tight on our money, I have thought about getting a job since stores will be hiring, but I can't get my daughter to take a bottle. I have bought all kids of bottles and she just refuses to drink from them. I have pumped and put my breast milk inside the bottle instead of formula, but not even that works. She is so attached to my breast that she also will not go to sleep without it being inside her mouth. I'm her human pacifier I think. I need suggestions.
"Congratulations on being a successful breastfeeding family," Hanna says. "Eight months is a wonderful amount of time to have exclusively fed your baby. By this time you have probably introduced some solid foods and will be advancing the baby’s diet little by little. Most lactation consultants suggest switching right over to a sippy cup and abandoning the bottle completely. Nurse in the morning when you both wake and then again after the breakfast meal.
"If you leave for work, make sure you leave enough milk in each bottle, probably about 4 to 5 ounces for an 8-month-old baby. Warm the milk and pour it into a sippy two-handle cup and have your day care provider offer the cup and all of the meals as well as before naps if the baby is interested. When you arrive back at home, nurse again for all the rest of the feedings the baby needs.
"If the baby likes to nurse to sleep and you are happy with that arrangement, then continue to do that until you are all ready for some sleep guidance and training. Everyone has to learn together. When you offer a baby the breast to help them sleep, that is what they learn and know and are comfortable with. The baby can always learn new things and new ways to be comforted to sleep. For example, you can introduce a “lovie"/blanket for sleep transition support for the baby to use for calming and comforting. Before you know it, the baby will take cups when you are away, nurse when you are home, and if you need to completely transition off the breast at 1 year or 1.5 years, you may be able to do that without using the bottle at all."
11. 12-Hour Shifts & Pumping
I'm going back to work very soon and I'm concerned about having to pump. I have a freezer stash saved up, but as a registered nurse and working 12-hour shifts, I just don't know if I'll have the time! Obviously breaks are mandatory and required by law, but nurses sometimes don't get those breaks.
"A working mom has a lot on her mind," writes Hanna (and she's so right). "Being a nurse is also going to add some stress to your pumping plan due to the time limitations put upon you when you are on a busy unit and have limited time breaks in your 12-hour shift. However, with good planning on your regular shifts and friends who can help cover for you, you may find the work and pump plan is actually manageable. You may find breaking up your day with three full pump sessions is better than taking short breaks through the day. Talk to your manager and see if your breaks can be combined to allow you to have more time at each pump session which can yield more milk and decrease your stress.
"When you are ready to make the transition, see if you can work every other day instead of two or three days blocked together. Initially it may seem hard, but when it comes to maintaining a good supply it is actually easier. Start your herbal supplements to make more milk two weeks before you return to work and then you can stockpile your milk to use while you are away. Malunggay and Goats Rue are needed to help increase your supply. Add healthy snacks and galactagogue foods will also help. You can take Shatavari, and other grains, alfalfa and barley as well to make sure you are getting more milk when you pump.
"Research how to pump properly to increase your yield and make sure you are using the best pump to reach your goals. You need to eat well and drink plenty when you are at the workplace, so pack your lunch and snacks the night before you are due to work so you are never compromised at work. Then enjoy your shift knowing your baby is OK and you are making as much milk as possible."
Additionally, it may be helpful to review your pumping rights at work. Best of luck.
12. Period Vs. Milk Supply
Hello! I'm looking for some help. My supply decreases significantly when I am on my period. It stays that way for almost a whole week. What can I do to help it? I already take a calcium magnesium supplement.
I was super curious about this one. Here's what Hanna has to say:
"The normal fluctuations in milk supply can be exaggerated when the hormones of lactation are intercepted by the hormones for menstruation. It is not uncommon for you to experience deep dives in your volume two days before the menstruation starts and as many as three-to-five days during the bleeding cycle. To protect the volume, continue to take the herbal supplements that help increase your supply through the month and double up on these when you are heading towards the beginning of the bleeding cycle. Malunggay, Goats Rue, blessed thistle, and Shatavari should be taken daily. Adding in healthy fats and oats, grains and barley, hops, and brewer's yeast in standard quantities can be very beneficial to maintaining a robust supply. During the menstrual cycle, extra minutes of nursing or pumping can also result in lower dips in the total number of ounces pumped in 24 hours. Good luck."
13. Dealing With Total Exhaustion
I have a 6-month-old baby. I have been breastfeeding him and I pump every four hours since day one but I’m SO tired all the time. What can I take or drink to pick me up for the day that won’t affect breast milk? I’ve tried coffee, but it doesn’t do much to be honest. Help!
Oh man. This is another wish-I-had-a-magic wand situation. Here's hoping you'll have a chance to get more rest soon. Until then, Hanna notes:
"We don’t usually suggest pumping with every feeding because it can be quite tiring, though it can also help maintain a good volume. As far as pick ups to help you stay focused and have enough energy to get through the day, we usually suggest a healthy diet with snacks, smoothies, and blended drinks with kale and protein powder and a walking or moving plan that involves some type of mild-to-moderate exercise plan with your baby, to drive your endorphins up."
Hanna suggests options like a mommy and me yoga class or a swimming program. "Walking or light weight training can be very beneficial and will improve your energy level. Maybe its time to come up with a different pumping plan that allows you some time off from doing something related to making more milk. If you need a large supply of milk in the freezer, consider pumping only a few times a day, but lengthening the pumping time by five-to-seven minutes. You can try drinking Dandelion Tea Blend, which is non-caffeinated and a great coffee-type drink replacement that will also help with milk volume and just feel good going down, hot or cold."
I want to add to the exercise list — stroller workouts and meetups. They're usually happening in your neighborhood park, and they're lots of fun. While it might sound counterintuitive to exercise when you're tired, it's actually a really effective energy boost.
As for diet, you know a high-fiber diet is a good one, and oatmeal is a well-known galactagogue. If you don't have time to make it (or just don't like oatmeal), try Pure Growth's oatmeal bites. Also remember to drink lots of water.
14. Pumping For A Family Member's Baby
I have nursed my son for 12 months. He still nurses at nap time and bedtime and through the night. My brother recently asked me to pump for his baby as they are having breastfeeding troubles and are not ready to supplement with formula. I am happy to do this, but I've never responded well to the pump, nor did I ever pump for my son. What can I do to increase my output on the pump? Is all hope lost because my son is older? Thank you!
"It’s wonderful that you are able to provide milk for your baby and your extended family. What a wonderful connection you will have to your niece or nephew forever, as one of the people in their life that contributed to their growth and development," notes Hanna. "Some moms do struggle with pumping and do not find the experience pleasant or rewarding as they do not yield much volume. The first thing is to make sure you are using a hospital-grade pump such as Medela Symphony, or a Spectra pump. Then make sure you are pumping at the time of day that has the highest milk volume. For some lactating moms, that is morning, while others get more milk at 10 p.m. See what works best for you. Try to use the techniques such as breast massage and compression and maybe stimulate before with a warm compress. Maybe you will yield more milk if you pump right after a nursing session.
"Also consider taking herbals such as Shatavari, or fenugreek to increase milk ejection reflex (MER) ... It is a little trickier as you get closer to one year, but you may still find you are a good producer and can even get more than your son needs each day. Any milk you can provide for your brother's baby will be greatly appreciated and every drop counts."
15. Upspring Milk Flow & Increasing Your Supply
Hi, I was wondering if anyone has tried Upspring Milk Flow to increase their milk supply and if so, did it work and how long before seeing results. I had a good amount at first, (enough to freeze), and now it has seemed to slow down and I had to use the frozen milk.
If you plan to supplement with herbs or vitamins, be sure to talk to your lactation specialist and pediatrician about the best, and safest, combinations of these products. Upspring Milk Flow uses fenugreek, blessed thistle, and other common herbs to increase supply.
"Upspring, as well as other herbal supplements, can be very helpful in increasing milk production. The right combination of herbals needs to be taken to allow for the best results. Generally speaking, Goat's Rue and Malunggay are known to help with volume while other supplements help with milk ejection, and fat content and consistency and quality."
In terms of how long it will take to see results, Hanna notes that most women see a change within three to four days. She goes on:
"If you are not getting the expected results, you may have to add in other herbs and try some other tricks to increase supply. One thing that is very important to remember is that your milk supply can wax and wane due to many variables, and volume and quality can change based on external influences as well as stress, work, diet and exercise. If you experience any milk fluctuations, get back on your healthy meal plan, and fluid and snack plan, add in extra minutes of nursing and pumping, and try to get more rest and sleep. Your body is going to go through many changes during postpartum and especially the first six months. Try not to be too hard on yourself. These changes are actually very normal and very common."
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