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Breastfeeding Support

Anne-Marie R.
ANNE-MARIE R.
International Board Certified Lactation Consultant
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Join Anne-Marie Rohrberg, IBCLC to talk about weaning, pumping, supply issues and more!

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ANNE-MARIE ADDED A NEW COMMENT!
Amount and latch
LARA

I have two questions. 1) My 2 mo daughter takes 5-6 ounces per feeding of expressed breast milk 3x per day plus nurses about 2.5-3 hrs per day (8-10 times). When I've weighed her before and after feeding, it looks like she gets anywhere from 2-4 ounces each time. So I calculate she gets about 40 ounces per day. Should I worry about her eating so much? Her weight is only 40th percentile so she's not gaining too much.

2) She makes a smacking noise sometimes when she nurses but her mouth seems to be staying closed around the breast. I think she may be doing what she does with bottles and it's something about her tongue movement. Is there anything I can do to improve the latch other than just making her re-attach? It doesn't seem to be hurting me too much but I'm afraid it's not stimulating the breast enough or getting her enough milk. (We've tried lots of different kinds of bottles to minimize preference and giving them up isn't an option since I've gone back to work.) Thanks!

Anne-Marie
ANNE-MARIE

Hi Lara,

If her weight gain is going well, I wouldn't worry about how many ounces
she is taking. It varies from day to day and from feeding from feeding. If
the smacking noise is new with bottle use, I agree it may be how she uses
her tongue. I have seen it with babies after starting to use a pacifier.
They still take in the same amount, but it can cause a little soreness.
Bottles don't require the tongue to come out as far, and so they can push
up more to the roof of the mouth. If you've weighed her recently, then the
2-4 ounces is great. If it's been awhile and you want to check in, have
another pre and post feed weight check to be sure her intake is the same it
has been.

There are so many bottles that all say they are the best. It seems the
best one is the one the baby does best with. I like a wide base to help
keep a nice wide mouth, but there is no need to go and buy more.

Anne-Marie

LARA

Thank you!!

AMY

Hi Lara ,
I gave birth 4 days ago... I am wanting to breastfeed .. I was biting my daughter to the breast in the hospital and when we got home... my breast have became engorged and I have tried pumping but only alittle milk has come out my breast got sore so I stop ... what should I do ? Will I be able to breast feed?

ANNE-MARIE ADDED A NEW COMMENT!
Thrush and Supply
MISHELL, PARENT OF 3 YEAR OLD, 3 YEAR OLD, 3 YEAR OLD, 3 YEAR OLD

Hi, is there any tips on preventing Thrush if you have had it once already? And any pointers to increase milk supply? Thank you!

KATHERINE

Following

Anne-Marie
ANNE-MARIE

Mishell,

Washing bras and towels in hot water and a vinegar rinse helps keep thrush
at bay. Also washing or throwing away nursing pads every day. If you
pump, boiling or microwaving your pump parts at least every few days is a
good idea. Having thrush once may not mean you'll ever have it again. We
all have the Candida yeast - but it's the overgrowth that causes the
problems.
Eating probiotics (acidophilus) or yogurt can help keep things in balance
too. If it seems to be a problem and keeps recurring, limiting your intake
of sugar and alcohol is a good idea.

Anne-Marie

AMANDA

Coconut oil on your nipples is good too. Its an anti microbial as well as a good moisturizer

MISHELL

Thank you!

ANNE-MARIE ADDED A NEW COMMENT!
Boob Boycott
ALIYAH, PARENT OF 3 YEAR OLD

My four month old LO has (for the last three weeks) been on boob boycott. He cries when he sees the nipple approach his face and won't stop till he has his thumb. He'll suck on his thumb quite happily but the breast makes him cry - it's so heart wrenching. He'll only nurse when he's half asleep. What do I do?

Anne-Marie
ANNE-MARIE

Aliyah,

Oh no - that's a hard thing to happen. Have you started any new
medications that may have changed milk taste? Could there be a chance he
is teething? If he's crying - stop and soothe him another way. Keep
offering your breast whenever he seems content to take it. See if you can
think of anything else that has changed for him, just starting bottles
(flow preference?), new soap or detergent? Hopefully he is still getting
lots of milk to keep him growing, but keep an eye on his diapers for at
last 6 wet in 24 hours.

Anne-Marie

ALIYAH

Thanks Anne-Marie!

I haven't started any medications but we do think he's been teething. He has started bottles but he cries initially when that's offered but he's much worse with the breast.

ANNE-MARIE ADDED A NEW COMMENT!
Our Q&A is now over.
TINYHOOD, PARENT OF 4 YEAR OLD

Thank you, Anne-Marie! Anne-Marie offers a variety of in-person breastfeeding services in the Metrowest and Central areas outside of Boston. Check out her profile for more info.

Anne-Marie
ANNE-MARIE

Good luck to all you new moms. You're all doing great!
Anne-Marie

ANNE-MARIE ADDED A NEW COMMENT!
Weaning a 15 month old whos can't have milk?
AMBER, PARENT OF 6 YEAR OLD, 4 YEAR OLD

Weaning a 15 month old who can't have milk?Any tips what to do with my daughter who's allergic to or intolerant to cows milk? I am just going back to work so all she's had is breastmilk and some very watered down juice. I am afraid I'm not pumping enough to keep up while I'm at work and I don't want her to miss any nutrition that's she's getting from me.

Anne-Marie
ANNE-MARIE

Hi Amber,
I would say mostly plain water is great, along with healthy whole foods and
your milk. If you want to give her some other type of milk, there are a
lot of cow milk substitutes available like coconut and almond milk that you
could try. I wouldn't worry about her not having cow's milk. She will get
her protein and fats from other foods and your milk.
Anne-Marie

AMBER

Thank you. It just makes me nervous with her not getting as much milk when I'm at work. She makes up for it at night she's been nursing 3/4 times a night again. I am really wishing I didn't have to go back to work I'm exhausted all the time again.

ANNE-MARIE ADDED A NEW COMMENT!
How to wean?
JENNY, PARENT OF 3 YEAR OLD

Hi! My daughter is 11 mos old. I currently breastfeed in the morning and at bedtime and pump at work during the day. She takes two 3-4 oz of breastmilk at daycare (although sometimes its less and sometimes outright refuses a bottle). I want to start weaning once she turns 1. I fear the bedtime feed is a comfort thing for her when I start to wean. We used to do bottle at bedtime when she was around 3 mos and she was super fussy so then i switched to breastfeeding, and at the same time did sleep training, and haven't gone back to a bottle once she started sleeping through the night. Also, there are times when she's practically falling asleep during the bedtime feed.

1) What do I do for the bedtime and morning weans? Do I offer her a bottle instead? I'm also trying to transition out of bottles into sippy cups. Do I give her a sippy cup of milk?
2) What do I do if she refuses the milk or is fussy? I'm particularly concerned for bedtime since nursing was a way to calm/settle her for bedtime.

Thanks!
Jenny

CARA

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KATRINA

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MELISSA

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Anne-Marie
ANNE-MARIE

Hi Jenny,
Another consideration is to start "weaning" her while she is at daycare, and continue with the morning and bedtime feedings. As she drops one bottle (one per week or so), you can drop that one pumping. That will give you time to decrease your pumping and see if she will accept a sippy cup.

Once you have weaned from daytime breastmilk, I would start with the morning feeding. Start by offering a sippy cup with a softer top, but if she refuses you can still use a bottle. I would leave the bedtime for last, maybe keep this one a little longer, since it sounds like she falls asleep very quickly breastfeeding and it may be a peaceful and easy way to transition to bed. I would not give her a sippy cup or bottle to go to bed, but instead a snack and a drink (however she will take it) and then to sleep by rocking or walking or some music.
Anne-Marie

ANNE-MARIE ADDED A NEW COMMENT!
distraction
EMILY, PARENT OF 3 YEAR OLD

hello,

my duaghter is 4months old and there are times when i know she is hungry but she is too distracted to truly nurse. she will eat for 5min and then abruptly pull off to talk to me or to look at a noise she heard. when it is doable i will feed her in a soothing area but this is not always an option. also my daughter will take a bottle but my husband and my sister informed me that the first few minutes she will just scream and move her head side to side. we are using a slow flow bottle and we have not had issues in the past this just started about 1m ago....
one other question is it common for one breast to produce more milk than another?
thank you

Emily

Anne-Marie
ANNE-MARIE

Hi Emily
Four months is a very typical time for babies to get distracted - when you
can nurse without distractions, but know that if it's a busy time, she may
make up for it during the evening, night, or a quieter time in the day.
Each feeding is different and some will be bigger than others. And yes -
one breast almost always makes more than the other. Sometimes double.
It's totally normal.
Anne-Marie

ANNE-MARIE ADDED A NEW COMMENT!
Pumping
COURTNEY, PARENT OF 6 YEAR OLD, 5 YEAR OLD

Hi, I have a one week old baby and I'd like to start pumping once a day so I have milk for him if I need to leave him with my husband or a sitter. When is it a good idea to start pumping? What time of day is best? When should I introduce a bottle? I had a really hard time getting my other two kids to take bottles because I waited until they were around 4-5 months to try a bottle. I'd like to avoid that this time around. Thanks!

Anne-Marie
ANNE-MARIE

Hi Courtney,
You can start pumping any time you'd like, probably after 2 weeks just to give yourself time to settle in to being a new parent. Most people get the most milk when they pump in the morning, so pumping after the first morning feeding is a good one to try. Ideally it's recommended to wait until 3-4 weeks to introduce a bottle, when breastfeeding is established. When feeding from a bottle, chose a slow flow nipple so your baby isn't looking for a fast flow when feeding from the breast. Good luck!
Anne-Marie

ANNE-MARIE ADDED A NEW COMMENT!
Breastfeeding while pregnant
AMANDA

I'm pregnant with #2 but still breastfeeding my barely 6 month old. (Surprise baby!) I'm struggling with a lot of nausea, especially during let down and nursing. Is it common for pregnant nursing mothers to have their morning/all day sickness intensified during nursing? And do you have any suggestions for coping?

Anne-Marie
ANNE-MARIE

Hi Amanda,
Yes, some moms do notice that nausea worsens during letdown and
breastfeeding - though overall have said it helped at other times aside
from these. See if there is any position that seems better, especially one
that does not put pressure on your belly, like side lying or sitting up at
your side.
If a small snack like crackers helps have that before or during feedings,
whatever makes you feel better. Maybe sips of ginger tea? Try some
different foods or drinks to see if any help.
Your milk production normally will decrease with your pregnancy, so your
baby may be ready for some solids soon.
Congratulations to you -
Anne-Marie

ANNE-MARIE ADDED A NEW COMMENT!
Weaning
MELISSA

I want to wean my son he is 5 months, I dont want do it abruptly, but I dont know how to start. He is already supplements with formula, so the question is how can I do this without him wanting to causing a clogged milk duct or any other weaning discomfort. 😊

Anne-Marie
ANNE-MARIE

Hi Melissa,
It's best to start with one feeding at a time, possibly one per week.
There are some great ideas in this article from Kelly Mom on weaning

http://kellymom.com/ages/weaning/wean-how/weaning-techniques/

To avoid plugged ducts go slowly when you drop a feeding, and if you are
very very full, pump or hand express just enough milk to be comfortable.
Removing much more will tell your body to make more, and in this case you
will want to be making less.
Anne-Marie