Your Lactation Questions Answered: Part 3

 Alright, here it is. The final answers for the Q&A from my mom the Lactation Consultant. You can read the previous three posts here >> recommendations >>> part one >>> part two.
If for some reason your question didn’t get answered I apologize. We tried to get everyone’s but there is of course the chance we missed one. Email me at angela@runlikekale.com

 Lactation Questions & Answers

Q: My son is 10 months old, weighing 20lbs at his 9 months appointment, and is drinking around 25oz a day. I have been EP since he was two weeks old due to latch issues. I have never been able to get my supply up and have always had supplement with 1 bottle of formula a day. Now my supply is dwindling even more. I have tried power pumping and adding pumps but the result is only sore nipples. Any suggestions? Or is the end near?
 
A: You have done a wonderful job. When we pump and do not put the baby to the breast the hormones in lactation are not as elevated and therefore, our milk does eventually dry up. You can contact your doctor as there is a hormonal nasal spray that some are willing to prescribe. There are also herbs and prescriptions that they can prescribed. Here are some resources:
Breastfeedingonline.com (articles from Jack Newman, etc.)
 
 
Q: My little girl is 7 (almost 8 months) and reverse cycles since I work. She will only eat about 4 ounces of pumped milk while I’m at work (8 hours), but will eat a lot of solids. Then nurses quite a bit throughout the night. Is that okay? She eats a ton of food, and I’ve always heard “food before 1 is just for fun”.
A: This sounds very normal. The baby is probably wanting the bonding and comfort that you give her with breastfeeding since you are working during the day.
Some babies are more interested in solids than others. 
 
Q: How can I try and increase my supply if I’m pregnant?
I got a little surprise becoming pregnant when my son was 2 1/2 months old (he is now 5 months old) and he and the new baby will be less than a year apart. 

I have had to start doing formula and breastmilk to keep him full. I feel like I’ve tried everything from power pumping to supplements. Is my supply just going to continue to diminish due to my hormones?

A: Yes, pregnancy hormones can.
Always check with your ob-gyn first about breast feeding during pregnancy and taking any herbs to increase milk supply.
Kellymom.com has articles on breastfeeding during pregnancy. If you read the reference section there are other resources.
ILCA had a webnar about increasing milk supply during pregnancy discussing pregnancy mammary development foods and herbs. You have to be carefully about taking herbs during certain trimesters during the pregnancy.
Do you have any breastfeeding book recommendations that talk about good foods to consume for lactation? I do not. I used ILCA webnars, kellymom.com, and the other resources that Angela posted.
 
Q: I haven’t started breastfeeding yet (I’m 36 weeks pregnant) but any basic starting tips would be amazing! I don’t even know where to start or what to expect. How to get my milk supply up right away.
A: See the previous articles about newborn period >> here and here.
Q:How to protect nipples? – I’ve heard that can be painful.
A: Nipple care: getting a good latch,  put colostrum or breast milk on the nipples after breast feeding.  Some women like lanolin nipple cream (Can’t be allergic to wool to use it). It can be used before and after breast feeding. Some women like olive oil.
Q: How to prevent mastitis?
A: Mastitis prevention: if you get a cracked nipple contact your physician if you are unable to get it to heal within a few days. There are over-the-counter and topical prescriptions out there that work well. If you get a plugged duct: kellymom.com is a good resource on how to work the plugged duct out.
Q: Is it ok to pump the first few weeks? I’ve heard that can create an over supply later on.
A: I’m for pumping in the first week as it creates more prolactin receptor cites. After you get through engorgement, adjust pumping schedule to how much you want to store. If you stay home, I would pump once a day. That is 30 bottles in one month that you have available. Store in 2 to 4 ounces approximately as it is easier to thaw and you won’t waste as much. If you are returning to work, are you at a job you can pump at? how much time do you have off and how many bottles do you want stored. If you pump once in the morning for 20 to 30 minutes after a breast feeding and do the same in the eveing, that is 60 bottles in a month. That is easy to do and you don’t build to much of an over supply. I wouldn’t pump more than 3 times a day for storage purposes.
 
Q: Also, after pumping, does your milk come back in right away?
By the time I nurse her, burp her, get her to sleep, and then pump, she starts to wake up to eat again. So I don’t know if I should be pumping. emptying all the milk? Will she have enough when she wakes back up? Baby is 3 weeks old.
A: Our breasts are never truly empty. Are you pumping immediately after the breast feeding? Are you pumping afterward for storage? Or, because the pediatrician wants you to supplement the baby? How many times a day are you pumping?
 
 
Q: I have been breastfeeding for 10.5 months exclusively and it has had it’s fair share of challenges. I would say our biggest challenge over the last 5 months has been his curiosity and activeness. Unless I bring him home to a dark quiet room, we can’t have a nursing session. Anywhere else he will just a minute and then be trying to get down to explore. It makes visiting and going out very difficult. Any suggestions on helping him focus?
A: He sounds like a normal curious 10.5 month old.
Q: Also, when does nurse, he falls asleep usually fairly quickly and then will nurse for 40 minutes. He is hard to remove. Is nursing this long on one side or am I compromising my milk?
A: No.
Q: I’m afraid all he ever gets is thin milk. 
A: 40 minutes of effective nursing on one breast should result in the infant getting hindmilk.  Kellymom.com references Peter Harmann’s group on foremilk and hindmilk information.
Q: I exclusively breastfeed my 6 month old (just starting solids) and I haven’t been consistent with pumping. When pumping after a nursing session I might get a couple of ounces at this point. If I consistently pump once everyday at the same time could it increase my supply? Or would I need to do it more often?
A: Yes, it might take a week or two or more, but only  need to pump at that one time, after a breast feeding.
Thank you all for sending in your lactation questions and for participating in these series. I hope it was helpful. Nursing can be hard, but you’re not alone.

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