Your Lactation Questions Answered: Part 2

I asked for followers to submit there lactation questions for my mom (the lactation specialist) to answer.

This first post is just a general list of resources and recommendations: good websites, things for feeding right after birth, pumping, life span of milk, how much to feed your new baby, foods that are known to increase and decrease milk supply. You can read that post >> here.

Here are the second set of answers. You can read the first Q & A here. The rest will be answered later in a separate post.

**Disclaimer: I do the newborn period in the hospital, so that is what I am most familiar with. I cannot prescribe. Anything I recommend, follow up with your physician first, as he/she knows you and your baby specifically.**

Lactation Questions and Answers:

Q: What should you do for milk blisters? How long should they take to heal? 
A: Call for a breast check. Let your OB-Gyn look at them.  They can determine what to do with them. It depends on what the blisters  look like as to what they do.

Q: I’ve noticed my milk supply has slowed since starting birth control and going back to work 😏 I’m still pumping and nursing at night what are some ways I can get my milk supply back up? 

A: You can rent a hospital grade symphony double electric pump.  Power Pumping to increase milk supply is an option. It’s like mimicking cluster feeding. A baby cluster feeds at growth spurts to increase milk supply. Watch a movie and pump off and on during the move: use a double pump for 10 to 15 minutes, then rest for 15 to 30 minutes, then pump, then rest, like a baby does at growths spurts to increase milk supply. Do this several days in a row. Prolactin is higher at night. So, evenings are better, if possible.

If you do not have any dietary restrictions, increase the protein in the diet, the dark green veggies, foods high in iron. Start your day off with a big bowl of steel cut oatmeal. Drink lots of water.
You can talk to your doctor about taking fenugreek (9 pills per day) or goats rue ( 6 pills per day) for 2 to 3 weeks or other prescription options. But do not take fenugreek if you are allergic to peanuts, have hay fever, asthma, or allergic to chick peas (hummus).
A Physician can also check prolactin levels, if they feel the need.

Q: What’s your number one tip for a new mom nursing at the hospital? Should you bring your preferred formula to the hospital in case baby doesn’t latch/feed?

Yes. If you think you might want to supplement then at the hospital, you can say that you are going to “breast and bottle feed”. You may never even use the formula, but they won’t hassle you if you say you’re doing breast and bottle. 

While in the hospital, breastfeed every 2 to 3 hours for 8 to 12 times in 24 hours, hand express for five minutes or you can breast pump for 15 minutes after breast feeding, and kangaroo care in between breast feedings until the milk comes in. In the hospital, if the baby is breast feeding well, you do not have to breast pump at night afterward unless you just want to. Some people take longer to get there milk in those first few days and this is just a suggestion that can help.

Once the milk is in, adjust your pumping schedule at home to how much milk you want to store. As in, pumping once or twice a day after a breast feeding. I wouldn’t pump more then three times a day for storage, if everything is going well with the breast feeding. Otherwise, you may battle an oversupply. Then, when pumping for storage, once the milk is in, increase the breast pumping to 20-30 minutes.

Q: Best foods to eat while breastfeeding? Any foods to avoid?

Foods to increase milk supply. If you are allergic or have dietary restrictions do not eat them. Always, ask your doctor, first: increase the protein in your diet, the dark green vegetables (folic acid), foods high in iron.
Do not eat alfalfa if you have autoimmune disorders or lupus in the family.
Do not take fenugreek if you are allergic to peanuts, have hay fever, asthma, or allergic to chick peas (hummus).

Steel cut oatmeal in the morning with some form of protein increases milk supply.
Nuts that increase milk supply: Almonds, cashews, macadamia nuts, peanuts. Barley releases prolactin: grapenuts, malt shakes, malto-meal.

Coconut, dandelion greens, malunggay, apricots, avocados, asparagus, basil, beets, black pepper, nutritional yeast, brown rice, carrots, hummus, chicory, barley based coffee substitutes, coconut, dates, dill, fenugreek, flax, garlic, ginger, natural ginger ale, goats rue, granola bars with oats and almonds, green beans, green leafy vegetables, green papaya cooked, hops, kelp (high in iodine: so don’t eat if issues with iodine), lentils, malt, marjoram, milk,  milk thistle, millet, mung bean, natural root beers, nettle leaf, onions, peas, black sesame seeds, spinach, turmeric, water cress, yams, salmon, white horse radish, red clover (not fermented red clover).

Avoid: Sage will dry your milk supply up. If you chew spearmint gum every day for a week it will decrease your milk supply by an ounce. If you take sudafed around the clock or Benadryl around the clock it  will dry your milk supply up.

 

Q: Can circumcision at birth affect breastfeeding? Best foods for lactation?
A: Some babies do not want to eat for 12 hours after a circumcision. If this turns out to be the case, do not stress. Attempt to feed, hand express and spoon feed colostrum or pump for 15 minutes after the attempted breast feeding. Bring your pump to the hospital.

For lactation foods read this previous post.

Q: Are there specific foods mom should avoid to help with gas pains in EBF babies?
A: For some: dairy, legumes, broccoli, cabbage. But, not always.

Q: What are your top breast pump recommendations?

A: As an LC, I am not allowed to make a brand preference. 

Q: Is it better for baby to sleep through the night or for me to breastfeed him? My baby is ~4 months old, 15lbs.
Baby is down to waking just once per night, and my pediatrician says he needs to start sleeping through the night soon–essentially advising me to start sleep training. I could probably wean him from that midnight feeding, but I’m afraid doing so will diminish my supply even more (I recently went back to work, can’t pump enough to meet his needs anymore and have started supplementing with formula). I’d love the sleep, but it’s such a rare opportunity to breastfeed him that I really don’t mind waking with him!

A: Bonding time is very important for mother and baby. Babies are humans and each has it’s own feeding schedule and likes and dislikes. Nighttime feeds are great bonding times for mom and baby. If you enjoy the time with your baby at night, then, by all means feed him at night. He enjoys it.

QLove this! And super jelly of you having your momma!! Not sure I have a question. But I’ll try to form one.
Mark is 5 months, weighs over 17 pounds. He started sleeping the night through at around 4 weeks. Then around 4 months he started going through sleep regression. Now he wakes once or twice a night. He typically sleeps 8-9 hours before waking up his first time. He goes to bed at 6. I’ve stopped pumping since I never know when he will wake up. I used to pump in the morning and I would try at work. I breastfeed him in the am, pm after daycare and then every Saturday and Sunday. Pediatrician says he’s growing just fine so we can keep doing what we are doing.

However I wonder if and when I’m going to dry up. I no longer peak at night time. Probably cause I feed him at least once. But I don’t pump at work anymore, SUPER hard to find time, and I also don’t leak there either. You’d think I’d be leaking. But yet he’s getting enough food. Clearly. I mean he is growing. Should I make a better attempt to pump? I guess that’s all my question. But any feedback from your momma would be great!

I agree with your Pediatrician. I wouldn’t change a thing. It’s working.  And, Mark is getting some breast milk, which is great. You have to make breastfeeding fit your life.  And, it sounds like what you are doing is going well for you and Mark. You’re doing a great job and make right choices.  When a baby breast feeds prolactin brings our milk in and oxytocin gets it out. So, eventually over time, if we don’t breastfeed or pump, the milk isn’t going let down at those times that we used to breast feed/pump at, and that’s just your body adjusting. 

Q: My daughter is almost 4 mo and about 15-16 lbs (we’ll find out for sure next week). I pump 4/7 weekday meals bc I work 6a-6p in the military. She nurses at ~1a, 5a, and 7p and gets bottles at 8a, 11a, 1:30p, and 4:30p, but on the weekends she just nurses on demand. Right now she gets what I pump in her bottles…about 4.5-5oz per bottle each meal. How do I know when to bump it up?

Also, she still gets one feed around 1am. She wakes up for it about half the time, and the other half I wake up and feed her because I’m so full. I don’t think she needs to eat in the middle of the night and I’d love to drop it. Would bumping up her daytime bottles likely help her to sleep through the night? What are some strategies to help me get through the night without emptying my breasts? I currently pump at 9:30 to help build my freezer stash, but am still very full at 1am!

A: Thank you for your military service and defending our country. My husband’s family is retired military.
If your daughter still acts hungry, you can increase the feeding amount. But, always check with your Pediatrician first as he/she knows your baby best. 

This is my ballpark rule of thumb: 10 ml per pound. {1 ounce = 30ml}  So, if the baby weighs 16 pound, then 160 ml = 5.33 ounce per 8 feedings in 24 hours which = 42.67 ounces in 24 hours. If the baby eats 6 feedings  in 24 hours then,  7.11 ounces per feeding.

If the baby eats 7 feedings in 24 hours = 6.1 ounces per feeding in 24 hours. If the baby acts hungry, feed more then ball park volume.  And there again, the baby may eat less and be growing just fine. If increasing volume, slowly increase her volume so she doesn’t throw it all up and see if that helps her eliminate the 01 am feeding.  For, the 01 am skipped feeding, some people pump off just enough to make the breast comfortable and get it to slowly decrease over a 3 to 7 day period. If you choose not to pump and just ignore the discomfort, it’s usually only for a few days, just keep an eye out for plugged ducts.

Q: My son had reflux since he was little and I was told by a lactation consultant to only feed one side at a time per feeding and only for 10 minutes max so I feel like doing that he’s formed a habit of snacking so now he doesn’t take full feeds he only feeds 3 to 5 minutes each side if that and isn’t sleeping through the night yet and I suspect that’s why because he’s not getting enough to eat during the day. My question is is there a way to break this habit? Baby is  almost 7 months about 16lbs.

With reflux, normally I have someone pump off most of the foremilk (pump 4 to 6 minutes) and feed around 30 minutes so they are getting the hindmilk or until done of active nutritive feeding.
Foremilk (the more “watery” milk that the baby gets at the begining) has a higher lactose content and less fat than the hindmilk. Although babies are rarely, if ever, actually lactose intolerant, a high volume of lactose can overwhelm a baby’s digestive system. When there bodies don’t have enough lactase to break down all the lactose, the excess lactose can cause gassiness and discomfort. Great resources here and here.

I, then, have them hold the baby up against their chest, after the feeding or, at a 45-60 degree angle for 30 minutes to 1 hour to let the food digest. Babies with reflux need to be maintained in a more upright posture, both during and after feeds. It is recommended that horizontal feeding be avoided.  If the baby throws up and still acts hungry, refeed as the baby will usually hold the hind milk down.

Since I haven’t seen a feeding, I can’t tell if you have an oversupply and he is getting only foremilk and it is digesting faster. So, he’s hungry more frequently.  With an oversupply, you need to pump off some foremilk, first. There are things you can do to decrease a milk supply, if this is the problem.

Or, if you have a lower milk supply. Your milk supply volume may be lower and so he has to eat more frequently to get the total volume in 24 hours.  So, it may be hard to break the habit if the volume is lower.

 

Thanks again for submitting your lactation questions, I hope this was helpful.

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