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Breastfeeding Support

Katy L.
KATY L.
Lactation Consultant
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Join our live Q&A with Katy Linda, IBCLC, ask a question and get expert advice on pumping, weaning, supply issues and more.

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Message Katy
KATY ADDED A NEW COMMENT!
Issues feeding breast milk at day care past one year
KEREN, PARENT OF 4 YEAR OLD

Hi Katy,

I work full time and have fed exclusively breast milk (plus solids) for my son's first year. He turned one last month and is transitioning to the toddler room at day care.

I have great respect and affection for the center, but they say they can't allow my son to drink cold breast milk out of a sippy cup (that I provide) at lunch around other kids because the other kids might grab his cup. All the other kids are given sippy cups of cold cow's milk. Bottles are not allowed in the toddler room.

I am not sure but I think the reason for this caution around breast milk is that it is a bodily fluid and must be handled as such. Infants are held and fed one-on-one from warmed bottles under a year of age. The student-teacher ratio is higher in the toddler room and they can't provide that kind of one-on-one attention when feeding.

This set-up means my son doesn't get the milk in the context he does best with it and just plays with the cup and spills milk everywhere or just falls asleep without being offered any breast milk. How can I approach this issue with the day care? Apparently they've never encountered a parent wishing to have them feed breast milk over one year of age. I want my son to drink breast milk at day care but ever since he started spending time in the toddler room, he hasnt been getting ANY.

Thanks for any advice you might have!

Katy
KATY

Hi Keren,

It may be best to contact your local La Leche League group and see what other mothers have done as these regulations will vary from state to state and I'm not sure of where you are located. You can request that they just give him water, which is what I often hear of happening here. There is no need for cow's milk for your little one, especially if he is still nursing.

Good luck!!

KEREN

Thanks! We're in Pennsylvania. The center is also NAEYC accredited and I've been trying to find applicable policies. All I can find seems to be in support of nursing mothers so I'm not sure what the disconnect is. I'm no legal scholar, though.

I have gone to a local la leche league meeting and I'm sure they'll help if they can. He has been getting water. I just hope we're nursing enough for him to get what he needs outside of day care. How would I know if he's getting the appropriate amount of milk?

KATY ADDED A NEW COMMENT!
Pumping for comfort
LORI, PARENT OF 4 YEAR OLD

My 7 month old is eating three meals a day now and nursing less often and/or for a shorter amount of time. I'm not sure my breasts are always emptied. I think I need to pump for comfort until my body adjusts, but I'm not sure how to pump for comfort. I always seem to end up emptying and I don't want to create an oversupply.

Katy
KATY

Hi Lori, Try pumping for just a minute or two, and see how that feels. If you need to pump for 3 - 4 that's an option as well. The whole idea of pumping for comfort is to pump for a very short amount of time just to get a little bit of milk.

Good luck!

KATY ADDED A NEW COMMENT!
Qs about reflux, introducing formula
MEREDITH, PARENT OF 3 YEAR OLD

Hi Katy,

I have a four month old daughter who has been exclusively breast fed up to this point. I have two questions for you:
1. She has reflux and spits up quite a bit after every feed. Any tips for feeding a baby who has reflux to make her more comfortable and reduce the amount of spit up? Do you know if bottle vs breast can make a difference?
2. During her first two months I was able to produce more breast milk than she would eat, but over the last month her appetite seems to have increased and I am needing to supplement with frozen breast milk. The reflux doesn't help either as she seems to spit up much of what I give her and then wants more! Unfortunately, I'm almost out of frozen breast milk and will need to begin supplementing with formula soon. Any tips for how to introduce formula to an EBF 4-month old? Should I try to mix the formula with breast milk? Or feed the formula only as a supplement after breast feeding if she is demanding more?

Thank you!

Katy
KATY

Hi Meredith,

Reflux can be so complicated. Have you seen an IBCLC to see if there are things you can do to make feeding better for your daughter? I'd be happy to help you find someone in your area. I would hate to give you bad advice based on general thoughts without seeing her given the situation, it may make things worse instead of better.

For pumping, you can try a few different things to increase supply. If you have a pump with a letdown button, after the milk stops flowing, hit that again to trigger a 2nd let down. Make sure your flanges fit you well. It is not uncommon to need a different size than what they come with. Also, if you haven't changed the valves and/or membranes recently that is a great place to troubleshoot the pump.

It's generally not recommended to mix breastmilk and formula as that means you have to follow formula guidelines and you may end up throwing away breastmilk.

Good luck!!

KATY ADDED A NEW COMMENT!
Troubleshooting Decreased Supply - Flange Fit?
SUSAN, PARENT OF 4 YEAR OLD

Hi,

I am recently back to work (new job!) after a 4 week break, which was preceeded by working the old job for 8 weeks after coming back from maternity leave. While at the old gig, after a shaky start I was pumping a little bit more than my baby needed every day. At the new gig, I've had quite a bit of trouble pumping enough and have started dipping into my supply on a daily basis. I've just started taking fenugreek (3 pills 3x per day) in the hopes that will help but haven't seen an effect yet. I'm thinking it may be stress-related, given the new gig, as my breasts don't seem empties even after a long pumping session and I can easily hand-express another 1/2 oz from each. I'm wondering, could it also be the flange size? I've always used the standard flange that came with my Medala Pump in Style, but I just read that flange size may change over time. It does seem that I've gotten more flexible over time and more tissue fills the flange, so I'm considering downgrading a size. Does that sounds like a reasonable line of thought? Any other tips for increasing supply? I was pumping 2x per day and started pumping 3x, but that really didn't work for me. Besides being much more time consuming, I still got the same amount of milk, just spread over 3 sessions instead of 2. Thanks!

Katy
KATY

Hi Sue, Flange fit could absolutely be a concern. You can also try some hands on pumping, where you are massaging your breasts while you are pumping, to increase output. Also - it may be wise to try changing out your pump's valves/membranes to make sure it is functioning well. Also - Fenugreek isn't always the best choice. Check out www.lowmilksupply.org for more options on herbs to increase your supply. Good luck!!

KATY ADDED A NEW COMMENT!
Bottle refusal
MARY KATE, PARENT OF 6 YEAR OLD, 3 YEAR OLD, 2 YEAR OLD

Hi! My 4.5 month old is EBF and has never taken a bottle (except once when she was 6 weeks old). I just went back to work and she has been largely refusing it (not screaming - she puts in in her mouth and will take a little tiny bit but she's almost confused as to what it's for). Any suggestions as to how to get her on board? This week (my first week back), she's only taking about 1 ounce while I'm gone from 9-5. She's feeding 2x in the morning before I leave and then 2-3x when I get home before bed. She's then still sleeping through the night from about 8:30-7:15. She's wetting plenty of diapers but I eventually need her to take the bottle!

Thanks!

Katy
KATY

Hi Mary Kate! Have you tried multiple types of bottles? The old fashioned style nipples are often best for transitioning between the breast and bottle (Dr Brown's Narrow, Evenflo Twist, etc). Sometimes catching them just before they wake up and trying to feed them a bottle when they are sleepy and in a reflexive state can help them take a bottle without realizing they are taking a bottle, which makes the transition easier. If none of that works, this Haberman feeder sometimes is a good transitional tool - https://www.amazon.com/Medela-Special-Feeder-Collection-Container/dp/B000X4JDH4

Good luck!

KATY ADDED A NEW COMMENT!
Night Weaning
SARAH, PARENT OF 4 YEAR OLD

Hi Katy,
My son is 9 months old and is still waking 2x a night and looking to be breast fed. I am pretty sure at this point it is just for comfort because he falls asleep shortly after I go in and feed him. We have tried to have dad go in and give bink and rock but this sometimes just makes him even more upset and cranky. So my question is how do I wean him at night?

Thanks in advance :)

Sarah

Katy
KATY

Hi Sarah, my favorite night weaning resource is Dr Jay Gordon's Good Nights. It's a gentle approach to cutting down on night feedings. Though at 9 months waking 2x per night is totally normal. There is a lot of great info on normal infant sleep on my Pinterest board here - https://www.pinterest.com/katylinda/infant-sleep/

Good luck!

KATY ADDED A NEW COMMENT!
Bad latch on one side?
ELISE

My son (second child) is six weeks old and breastfeeding is going pretty well. One issue is that his latch on the left side is really uncomfortable for the first minute or so and then is fine. The right side is totally comfortable. If it's relevant, I have a fast let-down and large breasts.
Thanks in advance for any advice!

Katy
KATY

Hi Elise!

I'm sorry to hear that you're struggling with your left side. Latching is one of those things that is really hard to try to figure out over the internet! I have a pinterest board on latching tips and tricks that may be useful for you - https://www.pinterest.com/katylinda/latching-tips-and-tricks/

This video in particular may help - https://www.pinterest.com/pin/226728162467593588/

If that doesn't work, send me a message with your zipcode and I will help you find an IBCLC in your area who can help.

Good luck!!

KATY ADDED A NEW COMMENT!
Preparing for weaning at 12 months
COURTNEY, PARENT OF 4 YEAR OLD, 13 MONTH OLD

My LO is almost 10 months and I'm starting to think about the best way to prepare him for cow's milk once he hits his birthday. What are your suggestions for transitoning from breastmilk to cow's milk since breastmilk is a lot thinner and sweeter than whole milk? Also, once he starts on cow's milk, should it be a 1:1 replacement or will cow's milk satiate him longer? Currently, he nurses or has a bottle 4x/ day and he eats 3 meals/ day. Thank you!

Katy
KATY

Hi Cortney,

The current recommendations are 16 - 24 oz of cow's milk per day, so a little less than what we suggest for breastmilk. Some moms find mixing cow's milk into the breastmilk bottles their baby takes already works. There are also some great tips here: http://kellymom.com/nutrition/starting-solids/toddler-foods/

Good luck!

KATY ADDED A NEW COMMENT!
Pumping schedule - back at work
MEGHAN, PARENT OF 3 YEAR OLD, 2 YEAR OLD

Thank you for your expertise, Katy! I just returned to work and don't have a lot of confidence in my pumping (am I doing it frequently enough? Am I producing enough?).

I pump the amount of times to match my baby eats, and am just barely getting what I need for the next day. I'd prefer to nurse on the weekends, if possible.

Is this schedule ok for a 5 month old who eats 5oz, 5-6 times/ day?

7am: nurse
10am: pump
1pm: pump
3:30pm: pump (don't get much)
5:30/6pm: nurse
8pm: pump (hardly get anything. do I need to move this a bit later? Our baby doesn't have a night feeding)

How do I know when to drop down from 3 to 2 pumping sessions?

Many thanks!
Meghan

Katy
KATY

Hi Meghan,

It sounds like you're doing a good job keeping par with your baby. If you can push the 8pm pumping session back an hour or two you may have better results. Typically moms drop a pumping session when you are getting more milk than you want for the next day. Good luck!

KATY ADDED A NEW COMMENT!
Increasing supply!
NICOLE, PARENT OF 3 YEAR OLD

My LO is about to be 5 months old and I'm back at work. Initially I was able to keep up with the 3- 5oz bottles of breast milk I left for the day while I'm at work. But, I'm only pumping 2-4 (4 is rare) ounces a session while away. Any tips to up my supply? I nurse AM & PM. Pump for the 3 feedings I'm missing and an extra pump before bed!

Should I add an extra session in while away? Someone mentioned pumping before the first feeding?? Help! Thanks!

Katy
KATY

Hi Nicole! If you haven't changed out the membranes and/or valves on your pump, that may help you increase your supply a bit. You can also play with the pump settings. If your pump has a let down button, after the milk has slowed from the initial let down you can press the let down button again and trigger another let down which should help you increase your output as well. If you can use your hands to massage your breasts you should empty them better as well. You can always add in another session if you need to. I hope that helps!! Good luck!