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.
I breastfed my baby girl for nearly 10 months. The reason I switched to formula had nothing to do with my physical health, my milk supply, or my baby's demands. In fact, breastfeeding had been going supremely well, and there were no issues. Instead, I was simply ready to be done. I hated being used as a pacifier, I wanted my body back, and I was tired of my energetic baby using me as her water fountain, expecting me to leave one boob hanging out of my tank top all day for her to breastfeed from at leisure.
But try telling that to the judgmental moms. It's a tough world, motherhood, and people are quick to offer you their advice and judgment in the same breath, steadfastly refusing to believe that your choices make any sense. When it comes to breastfeeding, those issues seem to be compounded, filled with people who think they know everything and people who refuse to let you do things your own way.
One person you can trust on advice? An International Board Certified Lactation Consultant (IBCLC). A member of Medela’s Clinical Education team, Maria Lennon, CNM, IBCLC, is answering your real breastfeeding questions on everything from vasospasms to lipase. At Medela, she develops breastfeeding educational materials for mothers and health care professionals, which means she really knows her stuff (and is all about empowering you to know it, too). You can find more information from Medela on their Facebook, Instagram and Twitter.
1. Treating PPD While Breastfeeding
My daughter just turned 8 months old and is exclusively breastfed. I was just diagnosed with postpartum depression (PPD) and my doctor prescribed me Paxil, which is an anti-anxiety/antidepressant. They said it has the least side effects for baby and usually does cross over, but I’m afraid to start taking it. Is it OK to take this and still breastfeed? Any natural remedies for PPD so I can continue to exclusively breastfeed?
"Bravo to you for reaching out for help. PPD is a fairly common condition affecting mothers after they give birth, and can occur at any time during the first year," Lennon says. "The sooner you get help, the sooner you’ll feel better and can enjoy motherhood to its fullest. Regarding medication, it is important to have a conversation with your physician and raise your questions and concerns with him or her. Many medications have been well-studied, and there are excellent resources available for mothers and clinicians who want to know more about how medications interact with breastfeeding." If you want information on specific antidepressants and breastfeeding, Lennon recommends checking out The Infant Risk Center or downloading two apps — Mommy Meds for Mothers or Infant Risk for Health Care Professionals.
Want more good news? According to Lennon, while continuing to breastfeed, your body releases oxytocin and other hormones that reduce stress and anxiety and encourage special bonding with your baby. But that doesn't mean breastfeeding will solve your PPD. Be sure to talk to your doctor to figure out what works best for you. Whether you continue breastfeeding or not, know that your mental health matters.
2. Treating Mastitis
Has anyone had mastitis? I woke up with a very sore spot on the side of my breast and now I've got a fever of 100.7 and just feel awful. Is there any way to get rid of it without antibiotics, or do I need to go to the doctor? Will pumping on that side help or do I risk making it worse by causing oversupply?
Lennon notes that when milk flow is obstructed or blocked in some way, a plugged duct may occur, which can cause a sore spot, a reddened area, and/or a painful lump on the breast. "Nursing can be uncomfortable on that breast, but don’t stop," she says. "It’s important to breastfeed frequently (nurse on the affected breast first), gently massage the sore area towards the nipple, and drain the breast well while breastfeeding or using a breast pump."
To aid in treating the plugged duct, Lennon recites a phrase she and other IBCLCs say often — "Heat, rest, and an empty breast." Hopefully with some TLC for several feedings, the plugged duct will resolve and you’ll feel much better.
"Mastitis can occur if the milk is not removed, the duct remains plugged, and inflammation and/or infection sets in," Lennon says. "If the pain, swelling, and redness is more intense, you may have feel like you have the flu and develop a temperature around 101.3 Fahrenheit (38.5 Celsius). Since you’re experiencing some of these symptoms, you should contact your healthcare provider and he or she will determine if antibiotics are needed."
Lennon says the things that can lead to plugged ducts or mastitis include not feeding frequently enough, not emptying your breasts well, wearing constricting clothing, or your baby not feeding effectively. Cracked nipples allow bacteria to enter the breast and can cause infection, too.
"Once you’re feeling better, you may want to reach out to a board-certified lactation consultant to determine if your baby is latched on correctly and removing your milk effectively," she adds.
3. Infected Duct & Milk Supply
Out of nowhere Monday, my milk supply drastically decreased. I was able to feed my daughter and still pump 4 to 6 ounces. I was only needing to feed her on one side at a time, but now I'm feeding her on both sides and she is still hungry. I also have an infected duct. Suggestions?
"Without knowing your daughter’s age and other details, it is hard to say exactly what is happening. If your daughter fed to satisfaction, is growing well, and you could pump 4 to 6 ounces, then you may not have a milk supply issue," Lennon says.
She notes that one reason your baby might be breastfeeding more frequently is that she's going through a growth spurt. "This is entirely normal. Several times during the first year, your baby may breastfeed more and act fussier than usual. Just go ahead and feed her, cuddle with her, and in a day or two, she will slack off as your milk supply increases a bit."
Your plugged duct may influence your supply, too. According to Lennon, if you have a plugged duct, that could cause a change in the taste in the milk and/or a dip in your milk supply.
"When babies are going through developmental advances such as teething, holding a rattle, or learning to crawl, they often are fussy and want to nurse more frequently," Lennon says. "Sometimes, if your baby is close to 6 months of age, she may be showing signs that she’s ready for solid food. There are lots of reasons that babies may want to nurse frequently. Just try to read your baby’s cues and follow her lead. Often, your baby knows exactly what she needs."
4. Thrush & Its Causes
What is thrush and what causes it? It sounds super scary and I'd love to hear all the feedback please.
"Thrush doesn't have to be scary once you know the facts. Oral thrush is a harmless and common yeast infection that can grow on the mucus membranes of the baby’s mouth and on the skin surrounding the nipple and areola," Lennon explains. "It is usually caused by an overgrowth of yeast. If you or your baby have taken antibiotics, or if you have had a yeast infection, an imbalance can occur and either you or your baby can develop thrush. It’s important to remember that both you and your baby need to receive treatment to get rid of thrush once and for all."
5. Mastitis Affecting Milk Supply
I had a nasty cold and the next day, I got a particularly quick and bad case of mastitis. Antibiotics are making me feel really sick, so I'm struggling to eat and I'm aching and in so much pain. What I worried about is that this has been going on a couple of days and since last night, my 13-week-old exclusively breastfed baby has been fussing and wanting to nurse all the time. Am I not making enough milk for her?
"Mastitis is tough, but hopefully you’re through the worst of it. You probably feel crummy and it can be painful to breastfeed. Hang in there," Lennon says. "There is light at the end of the tunnel. You will get through this, but it’s important to take care of yourself so that you can get well. Rest and relaxation will support your recovery and can help protect your supply."
Lennon also notes that having mastitis can temporarily decrease your supply a bit, so it’s most important to continue breastfeeding and allow your baby to breastfeed as often as she wants to heal your breasts and maintain your milk supply.
"Be sure to follow up with your healthcare provider to make certain the antibiotics have taken care of the infection," Lennon adds. "It may be helpful to touch base with a board-certified lactation consultant to make certain your baby is nursing effectively and to give you suggestions to prevent a recurrence. Hope you feel better soon."
Are vasospasms common? Are moms who experience them successful with breastfeeding for a significant amount of time? This is my third child and I was unsuccessful with breastfeeding with my first two. I also had a breast reduction 13 years ago. I was told that my baby wouldn't be able to breastfeed because of his cleft diagnosis, but after his surgery, he's been doing well. However, I had the vasospasms before his surgery, but now it's 10 times more intense; I'm guessing his new latch had something to do with it. I'm almost in tears. I was put on two medicines and Zyrtec, as well as taking Motherlove's More Milk Plus and using heat. How else can I deal with vasospasms? It's so painful.
"Congratulations on pushing through some incredible challenges and continuing to exclusively breastfeed your son," Lennon says. "Your story is inspiring." When it comes to vasospasms, Lennon notes that this is a rather rare condition that's "extremely painful, and I’m sure it’s been excruciating at times." She notes that some mothers have found relief with certain medications and continued to breastfeed; others have found that medications weren't as effective and had to reassess breastfeeding goals.
But since you're already working with a medical professional, Lennon says you're in the right place. "Together, you and she/he can explore your options and come to a decision that is right for you and your little one. Have you tried using an electric breast pump? Do you experience the same pain when you pump? Many moms continue to exclusively feed breast milk, even if not directly at the breast," she adds. "You have already accomplished so much; you should be proud of yourself and your own strength. You truly are a warrior mom."
7. Transitioning To Hypoallergenic Formula
My son is 3 months old, exclusively breastfed, and has had various digestive problems since birth. He has consistently gained weight (he weighs 14 pounds, 13.5 ounces today) and had hyperactive bowel sounds, but also problems with infrequent bowel movement. Today the doctor told me she wants me to switch from breastfeeding to hypoallergenic formula. I'm frustrated because they pretty much dismissed the idea of me trying dietary changes and just seem to be pushing formula. Is there a restrictive diet plan that helps when babies have digestive trouble?
"From your baby’s weight gain since birth, it seems as if you’ve done a terrific job with exclusive breastfeeding — you deserve a pat on the back," Lennon says. "You may want to consider observing your son’s bowel movements and overall digestive response after you eat certain foods, such as dairy, soy, or wheat. Consider keeping a food journal to track and pinpoint possible sensitivities that may inform a diet change that might help."
Not knowing your son’s exact situation, Lennon says she's not able to comment specifically, but it sounds as if you may benefit from having a heart-to-heart conversation with your baby’s doctor. "You could tell her/him how you feel about breastfeeding, and together maybe you and she/he can explore options and alternatives they may be willing to try," she suggests. "You can also consider seeking a second opinion."
If your baby is put on formula, Lennon recommends that you use a hospital-grade electric breast pump to maintain your milk supply until the time he can try breast milk again. "It’s important that you have confidence in your child’s doctor and feel comfortable with the treatment plan. You’re on the right track, and best of luck," she adds.
8. Baby Refuses Solid Foods
My son has been exclusively breastfed since birth and his doctor told me he can start eating baby foods. But I've tried everything and he refuses it all; he starts crying and spits it out. He won't take anything other than my boob, and I was wondering what I could try. I don't want him falling behind on weight gain because he refuses to eat.
"Babies are individuals — they have their likes and dislikes. They grow and mature at different rates," Lennon explains. "The American Academy of Pediatrics and the World Health Organization recommend that babies be exclusively breastfed for six months and that they can begin trying solid foods around that time. Just as you’ve been reading your baby’s feeding cues related to breastfeeding, the same goes for eating additional foods."
According to Lennon, you should look for signs of developmental readiness. Is your baby sitting up without assistance? Is he grabbing your spoon and putting it in his mouth? While the second half of the first year is a great time to introduce new foods, breast milk will still be the focus of his feedings. "Continue to offer different foods from time to time, let him have a taste of what’s on your plate, and take him to the pediatrician to monitor his growth and development. Mealtime will soon become a fun time," she adds.
9. Thawed Breast Milk Smells & Tastes Sour
I am exclusively breastfeeding my 4-month-old and have been storing milk for emergencies. I took a bag the other day and thawed it under running water. It took about three to four minutes to thaw and get to room temperature, but when I smelled it and tasted it, it was awful. It had a sour finish. I opened two more and the same thing happened. I froze this milk as soon as I pumped it, so what's going on?
According to Lennon, this is very common and you don't have to toss that milk. You've worked too hard to pump it.
"Some moms notice that after thawing frozen breast milk, it smells soapy or even sour. This is normal. Breast milk contains lipase, a beneficial enzyme that helps break down fats in the milk so that the baby can digest fat-soluble nutrients and fatty acids," she explains. "Will your baby take the thawed breast milk? Most babies do not mind the taste, but if your baby happens to have a discriminating palate, you can scald the breast milk before freezing it." Lennon notes that scalding the milk means heating fresh breast milk to 180 degrees Fahrenheit on the stove until "tiny bubbles form around the edge of the pot or pan. Don’t bring it to a boil," she adds. "Milk that has been scalded before freezing will not have a sour or soapy smell when thawed."
10. Boosting Milk Supply After Illness
I recently got sick and it cut my milk supply down like crazy. I was wanting to know what techniques or food/drinks I could use to help boost it back up.
"It’s not unusual for moms to notice a dip in supply after being sick," Lennon says, but unfortunately, there's no magic food or drink to increase it. Instead, there are some steps you can take to build it back up. "First, feed more frequently and try to pump after you breastfeed," she suggests. "Supply responds to demand. If you demand more, your body will make more. Pumping in addition to breastfeeding sends a message to your body that more breast milk is needed. To the extent you are able, reduce your stress and try to relax, and finally, ask for help. A board-certified lactation consultant can help you come out of a breastfeeding rough patch." For more information, Lennon recommends checking out a Medela video on increasing your milk supply.
11. Milk Blister & Vasospasms
My daughter is almost 4 months old and I've been breastfeeding and supplementing from the beginning. About four weeks ago, I noticed a white dot at the tip of my nipple accompanied by shooting pain that begins at the nipple, then radiates into the breast tissue. I read online that it may be a milk blister and possible vasospasms, so I tried hot showers, warm compresses, lanolin, and olive oil to name a few. I've been prescribed an antibacterial ointment, which didn't work, and then 10 days of Diflucan. I saw a different doctor and she was quite dismissive. It's been almost a month now and I've tried pumping and positioning my baby several different ways, as well as all the other things mentioned above. I'm just so frustrated. It's painful all the time, not just when she latches, although that's the worst pain of it. It's to the point where I cringe if she even brushes against my right breast. The white tip is still there and gets whiter during and immediately after breastfeeding.
"It is challenging enough to experience pain while breastfeeding and pumping. It makes it harder when there isn’t a clear solution in sight," Lennon says. "From your description of the problem, there may be a couple of things happening. As you mentioned, you could possibly have a nipple bleb or blister, or you may be having vasospasms. If you haven’t already, reach out to a board-certified lactation consultant. Both conditions are not very common, and many health professionals are not aware of how they affect breastfeeding. Board-certified lactation consultants are trained to address a wide range of breastfeeding issues, including some lesser-known ones. It is important to stay connected with your healthcare provider during the process, but getting another opinion might help."