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Breastfeeding Support

Liz S.
LIZ S.
Lactation Consultant
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Our live Q&A with Lactation Consultant Liz Scheuerman is happening right now! Ask a question and get expert advice on pumping, weaning, supply issues and more.

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LIZ ADDED A NEW COMMENT!
Nipple/breast pain
JILLIAN, PARENT OF 3 YEAR OLD

Hi Liz (and mamas!). I do a combo of breastfeeding and pumping for my 6wk old little lady, and have been fighting my way through an evolution of pain since day one. At first it was cracked nipples (healed with creams, air & time)... then reoccurring plugged ducts (resolved with massage, heat, and more frequent feedings)... then sharp burning itching breast pain (improved with diflucan and nystatin cream but not totally resolved)... now what appears to be hardened tender montgomery glands at the base of my nipples that soften with heat but kill during feedings/pumping... and also the sharp pains are returning and the breast tissue is starting to appear discolored (I don't believe I currently have any plugged ducts). My lac consultant says her latch is good, and my LO is gaining weight rapidly. I'm waiting for another appt with my doctor. My question I guess is just a blanket: do you have any advice?? I've never been much of a complainer, but I'm starting to really go crazy over here!

Liz
LIZ

Hi Jillian!
You're absolutely not a complainer! The pain you have experienced really tells me that something is not right. That kind of continued pain is not normal. Has anyone (who's well trained) done a thorough oral exam on your baby?

JILLIAN

I'm not sure how thorough her exams have been, but I can tell you that our lac consultant said she wasn't tongue tied, but our pediatrician said she was moderately so (tho he didn't feel she needed it released). She chokes and coughs quiet often when feeding from both our ComoTomo Slow flow bottle, and my breast (even toward the end of breastfeeding sessions). She has no signs of thrust according to 2 pediatricians, but was treated prophylactically.

Liz
LIZ

I would suggest having another set of eyes on her tongue. If the pediatrician suspected a tongue tie, and you are having such difficulty, having an expert assess her tongue would be very helpful. I would really recommend it! What part of the country are you in?

Our Q&A is now over.
TINYHOOD, PARENT OF 4 YEAR OLD

Thank you, Liz! Liz and Mama’s Grace Lactation Services offer a variety of breastfeeding services in the Baltimore, MD area. Check out her profile for more info!

Weaning Too Early and Supply
LISA, PARENT OF 4 YEAR OLD

Hi Liz!
I breastfed my first two children until they were 12mo with no problem. I now have a 6 month old who is nursing and getting a few bottles of pumped milk everyday (basically to make sure he's eating enough.) I few weeks ago I had surgery and wasn't able to nurse him so I pumped three times a day for a few days. He had no trouble at all going back to breastfeeding and my supply seemed fine. A few days later I again needed to avoid nursing him because I needed 6 days of steroids. He now refuses to nurse even when he's hungriest in the morning. My supply has drastically dipped in a matter of a few days even though I continue to pump. What can I do to get him nursing again and get my supply back?! As far as I can tell the steroid, prednisone, shouldn't affect the taste or amount of my milk.
Thank you!

LIZ ADDED A NEW COMMENT!
Milk amount
LUCINDA, PARENT OF 13 YEAR OLD, 4 YEAR OLD

I pump and feed on demand he is 8 months old. I am wondering if what I pump is what he takes when he feeds on demand? I usually pump anywhere from 3-6oz and 4-5 oz being avg. should I be worried of my milk output? He currently eats 3 solid meals a day too. Another mom I spoke to pumps 8-10 oz.

Thanks

Liz
LIZ

Hi Lucinda!
Every mom has a little bit of a different milk capacity. What you pump is only an indication of how much you can pump, not necessarily how much the baby takes each time. Your milk output sounds just fine. Is your baby gaining weight well?

LUCINDA

Great to hear! His weight gain so far isn't a problem. My concern sometimes is when I'm away for school I won't be able to keep up with what he takes and my stash of pumped milk. In a bottle he can take 6-7oz.

Liz
LIZ

How often are you at school? Can you pump while you're away from him?

LUCINDA

I got I school 9 hrs once a week

Liz
LIZ

Ok, and are you able to pump during that time?

LUCINDA

I do pump twice while I'm at school but for the two times I pump I don't produce enough to make up for what he used. I was thinking of supplementing with formula.

Liz
LIZ

Before supplementing with formula, you may want to try maximizing your milk supply with pumping. I'd encourage you to sneak in some extra pumpings on your home days and save that milk for the baby when you're at school. Make sense?

LUCINDA

It makes sense, even if I pump 2 oz it will build up some supply. I can attempt to do that while I am home. Thank you for your advice

LIZ ADDED A NEW COMMENT!
Losing supply
MELISSA, PARENT OF 4 YEAR OLD

My LO is 6 months this week, I am a full-time working mom who tries to pump 3 times a day! 2 at best. One side only supplies 1oz while the other supplies around 5/6 oz a session. I have begun to supplement but just minimally. He is a grazer and eats every 2 to 3 hours daily about 3 to 4 ounces . His nighttime routine mirrors the day- He usually wakes up every 2 to 3 hours for night feedings. I'm afraid that his frequent night feedings are due to my low supply, (very lopsided) Is there something I need to do differently or should I just start supplementing more? Are these night feedings irregular? Help!

-Lost with too many variables

Liz
LIZ

Hi Melissa!
Believe it or not, nighttime feedings are very normal! Like you mentioned, we have to look at all variables because every mom & baby are different. However, many babies wake throughout the night for nutrition but also for comfort. It's important to respond to those needs. Are you nursing or bottle feeding at night?

MELISSA

Nursing, and on the one side that provides the most. He is always content after a feeding. Typically I try to get him to nurse on the lower supply one for the bedtime routine, however if he is too sleepy/hungry he won't. We also feed him step 1 solids twice a day- last one around 4/5ish.

Liz
LIZ

Ok, that sounds pretty normal. You could add in some power pumping on the lower yield side, but it sounds like what you're experiencing is normal :)

MELISSA

Great! Thank you!

Liz
LIZ

Absolutely, Melissa!

LIZ ADDED A NEW COMMENT!
Pumping at Work
LAURA, PARENT OF 3 YEAR OLD

Hi, I have a three month old and am returning to work next week. I work 10-11 hour days 5 days a week. My baby only eats on one side when I nurse and she eats every 2-3 hours during the day. In order to pump enough during the workday I think I will need to pump both sides per session. At night and in the morning, I will continue to nurse. My question is if I pump both sides at work, but only nurse on one side at a time at home, could that lead to clogged ducts and mastitis?

Liz
LIZ

Hi Laura!
I don't think it will. Generally speaking, babies are better at removing milk than a pump is, and with the stress of work, many moms see a dip in their supply. Because of that, double pumping is ideal while you're at work.

SARAH

I had this exact situation: until my daughter was 11 months, I fed only one side per feeding (specifically to manage oversupply) but went back to work at 12 weeks and had to pump both sides at once because of time. I had mastitis when my daughter was a week old, so I was really worried, but it turned out fine! I pumped three times during the work day for a long time, and I do think that helped because it meant I was pumping every 3 hours or so. Once she started sleeping through the night, I also would sometimes pump after bedtime, especially if she had only nursed one side between pickup and bedtime. (Last pumping session to 6 am the next day was just too long.) Good luck with the return to work; I promise it gets easier after a few weeks!

LAURA

Hi Liz, thank you for your help! I will continue with my plan and hope for the best.

LAURA

Hi Sarah, thanks for offering your personal experience! I feel a lot better now about returning to work and pumping. I definitely feel reassured now! :)

Liz
LIZ

Absolutely Laura! And thanks Sarah for chiming in!

Hey mamas!
LIZ, PARENT OF 2 YEAR OLD

Hey mamas! I'm really enjoying answering your questions. Head over to my Facebook page at www.facebook.com/mamasgrace after the evening is ended- I'll be sharing lots of helpful information in the coming weeks! I'll also be sharing helpful tips on my Instagram account :) You're all amazing mamas! Make sure you know that!

LIZ ADDED A NEW COMMENT!
Baby #2
A, PARENT OF 5 YEAR OLD, 3 YEAR OLD

Hello, I am currently 26 weeks pregnant with baby #2. My older son will be 2 in a few weeks. When I gave birth to my 1st (via c-section) I began pumping immediately after my c-section (my son was in NICU) and then actually nursed by that night. My son had a great latch right away and everything seemed great. I had a really bad cough when he was born and was given cough medicine in the hospital. I believe now that the cough medicine (intended to dry up sinuses) effected my milk supply. I breastfed exclusively for the first 3.5 weeks, however after daily weigh ins at the pediatrician, there was a lot of concern over my son continuing to lose weight. I finally agreed to supplement with formula around 1 month old. I continued with a combination of formula, pumped milk, and nursing for 7 months but it was tough. I had REALLY low supply. By the end, I was getting maybe 10 oz a day pumping every few hours. I have no way of knowing for sure it was the cold medicine that effected my supply so I'm starting to be concerned about having supply issues again with the new baby. Are there any things I can do now or right after (other than avoiding cough meds!) to help with my supply? Is it typical that someone with a low supply with one pregnancy will automatically have supply issues in the future?
Thanks!

Liz
LIZ

Hi there!
Congratulations on #2! Many moms who have supply issues with their first baby go on to have a good supply with the second. It really depends on why your supply was low. Some ways you can prepare- keep your baby skin to skin as much as possible. Offer frequent breastfeedings & ask for lactation help as soon as possible. Do frequent hand expression in the early days-- research has shown that to drastically increase milk production. At any point in the early days, if you're concerned, ask to see a LC & start pumping.
If you have a repeat c-section, ask them to allow skin to skin time immediately after delivery. Best wishes to you!!

A

I will be having a repeat c-section and hope to have skin to skin immediately. That was the plan with #1 but he was having trouble breathing and was taken away pretty quickly. They did however send a LC to post-op to show me how to use the pump and get me pumping immediately. They also had someone bringing my pumped colostrum to the NICU until I was able to get there to be with him and get him on the breast. Should hand expression in the early days be done just by hand or using my hand to help express while pumping?

Liz
LIZ

I would do hand expression in combination with pumping if the baby isn't nursing well.

A

Okay, thank you so much! Obviously the hope is this baby can stay with me and get immediate skin-to-skin and that I'll be able to nurse immediately with success but I appreciate the advice so I can be prepared just incase! I think I was naive the first time around and never really thought to prepare for the "what ifs"...

Liz
LIZ

Absolutely!

LIZ ADDED A NEW COMMENT!
slower let down
LAUREN, PARENT OF 6 YEAR OLD, 4 YEAR OLD

My daughter is now 9 months and compared to when she was younger, I feel like it takes forever for let down. I have been back at work pumping 3 times a day since she was 3 months. We started on solids a few months ago, but are moving pretty slowly. I usually only end up breastfeeding once a day, at nighttime before bed. She is constantly switching from breast to breast and let down is taking forever, if it happens at all. She doesn't seem to be too mad about it... but I am wondering if she would sleep better if she could get more breast milk before bed. Is this normal? Is there something I can do to speed up let down? Thank you!

Liz
LIZ

Hi Lauren!
It's quite normal for you to feel like your letdown is slower as the baby gets older. Sometimes, though, it can be caused by stress, medication, smoking, or alcohol. Do you feel tense when she nurses?

Before you start nursing, I'd encourage you to try some relaxation techniques such as deep breathing. Try to do some breast massage/hand expression and listen to relaxing music. That all can help tremendously. I'd also encourage a warm compress which can help open your milk ducts.

LIZ ADDED A NEW COMMENT!
Weaning
MAREE, PARENT OF 4 YEAR OLD

My 15 month old is still nursing. He's taking whole milk, but when I'm around him he just wants to nurse all day. I'm exhausted. Sometimes I just wanna cry bc I'm so overwhelmed by it. I'm not getting any sleep at night bc he's pretty much using me as a pacifier, and if I try to refuse he screams until his face turns red :-(.

He doesn't fall asleep unless I nurse him, and we are still cosleeping. Last night I had to sleep in the living room bc I just couldn't take it anymore. He's always on my boob. Either his hands are down my shirt and he has a fit if I remove them, or he wants to nurse. :-( I'm so ready to wean him.

But, how?!?!

Thanks in advance

Liz
LIZ

Maree,
This is a hard one! It sounds like your baby still needs to nurse for both comfort and nutrition. I know it's so hard on you though! A few questions:
Are you away from the baby during the day?
When you cosleep, are you ever able to fall asleep while he's nursing?
And finally, have you ever just tried to snuggle him instead of nursing?