Breastfeeding Q & A
We all know nursing can be a very sensitive subject. There are so many different opinions and experiences that are thrown at you when the topic is brought up. Everyone seems to have their own techniques and products that worked best for them. Almost every week at the store, we have a newly nursing mother running in looking for nipple cream or a nursing cover. They also stop to tell us about how hard nursing is and wonder why nobody ever talks about it!
Below is an informative Q and A with Nancy Held, VP of Clinical and Education Services and one of the owners of DayOne Centers. She is also a certified lactation consultant. She gives us useful tips and insight on her most commonly asked questions. Also, listed below are Sprout customers’ favorite organic and natural products used to help them get by with dry nipples (ouch!) and staying comfortable while breastfeeding.
Q&A with Nancy Held, RN, MS, IBCLC:
What are common problems people come to you with?
We see lots of families at 3-5 days postpartum with concerns related to sore nipples, engorgement, low milk supply, slow weight gain, jaundiced, sleepy baby, twins, preemies, latch on problems, and moms with history of breast surgery.
We also see many moms at 3 and 6 weeks, times when growth spurts, gas and fussiness happen. At 3-4 months, many moms come in to talk about making a plan for going back to work and pumping. At 4-6 months, the concerns seem to be low milk supply and distracted babies. At 6-12 months, issues come up such as biting, weaning and breastfeeding while pregnant with a second baby.
Do I think some people “just can’t breastfeed”?
Yes, there are some women who physically don’t make milk due to issues concerning breast reduction surgery, or conditions such as Polycystic Ovarian Syndrome (PCOS) or underdeveloped breast tissue. Milk production is very complex system with lots of hormonal interplay so there are legitimate reasons breastfeeding is challenging for some moms.
Some babies have tremendous difficulty in latching onto the breast. There are many tricks of the trade that lactation consultants utilize that many times coax babies onto the breast but every now and then even we are stumped. These moms may pump and give their baby their milk by bottle.
On the other hand, just because a family member has had issues breastfeeding, there is no reason to expect that a new mom will have similar issues. The family members may not have received support or were given incorrect information that sabotaged their breastfeeding experience.
What are the benefits of breast milk?
The list of benefits of breastmilk seems to grow longer every month as scientists discover more and more things breastmilk can do! Here are just a few:
Breastfed babies have less stomach and respiratory illnesses, ear infections, allergies, SIDS, obesity and meningitis than do bottle fed babies and their mothers experience lower rates of breast and ovarian cancer as well as less postpartum depression.
How long do you think people should ideally breastfeed for?
The American Academy of Pediatrics recommends women breastfeed for at least a year and the World Health Organization recommends up to two years and beyond if it works for mom and baby. Unfortunately, with the current length of maternity leaves in the US, it becomes very difficult for most women to reach these goals. One of the main reasons women stop breastfeeding is because they go back to work and their workplace isn’t conducive to pumping or maintaining their milk supply. Ultimately, the ideal length of time a mom and baby should breastfeed is up to the mom, her baby and her partner, because it needs to work for everyone.
What are my best tips to help increase milk production?
Low milk supply is something we are seeing more and more of these days. No one is sure why but there is definitely an increase in the number of women who are struggling with making enough milk.
Since milk production is based on the principle of supply and demand, the first recommendation is always to increase the demand- meaning try feeding more frequently, have lots of skin to skin contact with the baby (which has been shown to increase milk production), pump after as many feeds as possible for a few days or a week to jump start your supply (and consider renting a hospital grade pump for a week to help).
You may also consider taking supplements such as Fenugreek and/or More Milk Plus to help increase Prolactin and increase milk production. In addition, some foods have been shown to help increase milk production such as steel cut oats, and most foods high in fiber. There is a great website with lots of other suggestions: http://www.lowmilksupply.org/
Many moms find breastfeeding an extremely stressful experience. What can I say to ease their minds?
Ask for help! I am always surprised at how long some women wait to ask for help- trying everything they can read online first. Babies are very unique and so are their breastfeeding issues so working one on one with an expert should make a difference and decrease stress quickly. Lactation consultants train for over 2500 hours just to learn how to help breastfeeding women, so take advantage of their expertise!
Also, just knowing the first few weeks of breastfeeding are the most challenging/stressful as you get to know your baby, recover from childbirth, are sleep deprived and hormonal gives you perspective. It can only get better!
At DayOne, you provide a scale for new parents to use. How often do you think people should be weighing their babies?
Scales can be reassuring to parents who wonder if their baby is gaining weight but they can also make some parents neurotic if they weigh their baby too frequently. Unless you pump, weighing a baby before and after a feed is the only weigh to know exactly how much the baby took at the breast. We find them helpful for the mom who doesn’t believe her baby could be getting enough milk because they feed very quickly or do something different than what the books say.
If there is a concern that the baby isn’t gaining appropriately, many moms weigh every 2-3 days for a week or so until the baby is back on track.
If all is well, technically, the weights that happen at pediatrician appointments are all that are necessary. However, many moms are curious as to what their baby weighs in between doctor visits so they weigh them once a week when they come in for new parent groups or workshops.
What is your favorite/most successful breastfeeding position and why?
My favorite breastfeeding position is the one the mom and baby finds most comfortable. Regardless of what I think or what books suggest, if something is working well for a mom and baby, that’s the best position!
If returning to work, when should I start pumping to build up a good supply of milk?
I recommend starting to pump to store about 3-4 weeks before they return to work. Many women pump once a day, in the morning after the first feed (6-8am) and start their milk bank with those bottles. If they are going to use a bottle of expressed milk that day, they could pump again and use that milk, leaving the first bottle in the freezer.
Many women set a goal of having about 20 bags of milk stored in their freezer before they go back to work. This is so they have something to fall back on if they don’t have a chance to pump as often as they thought they would at work or if the baby experiences a growth spurt. If they pump one bottle a day to store, they can build this milk bank in 20 days. On the other hand, if they aren’t going back to work for 3-4 months, they could pump a few times a week and accomplish the same goal. DayOne offers a great workshop every month called All About Pumping, in which we go into lots of details on the tips and tricks of collecting and storing breastmilk.
If feeding baby pumped milk in a bottle, how many ounces should I give them vs. breastfeeding?
Infant feeding requirements are based on a baby’s weight. If your baby weighs 8 pounds, they would need a lot less milk than if your baby weighs 14 pounds. We have this chart on DayOne’s website which allows you to look up exactly how much milk your baby needs in 24 hours based on their weight, then divide that number by how many feeds you do in 24 hours and that will tell you how much milk your baby needs per feeding given their current weight.
How long can pumped milk stay in the fridge and freezer?
In general, freshly pumped milk can stay out on the counter at room temperature for 6-8 hours, in the fridge for 3-5 days and in the freezer for 3-6 months, depending on how cold your freezer is. If you have a freestanding freezer, breastmilk will be good for a year!
What is the greatest advice you have ever offered/and received?
It may seem bizarre for a lactation consultant to say the best advice they ever gave was to encourage a mom to stop breastfeeding but I think it’s true. Sometimes, lactation consultants need to be able to remind a mom what is important- a fun, healthy baby and mom. When breastfeeding or trying to increase milk production becomes tortuous, there comes a time when someone needs to say enough is enough. Many times these are the moms that are the most grateful for our advice!
Below are some of Sprout’s favorite breast feeding tools:
Blessed Nest Nursing Pillow: The all natural buckwheat fill conforms to any shape, creating a soothing nursing experience. The buckwheat is contained in a canvas shell, with a removable 100% organic cotton twill and french terry cover for easy washing. We love this nursing pillow also as a great place to lay your baby on their back or mid-tummy for tummy time.
Earth Mama Baby Angel Nipple Butter: Great to help soothe sore and cracked nipples. This plant based balm is also certified vegan and does not have to be washed off before nursing. Made of organic calendula, cocoa butter, shea butter and mango butter and Manufactured in USA. Also great for babies chapped lips!
Organic Cotton Nursing Cover: This cover has boning throughout the neckline that allows you and your baby to maintain eye contact while providing air circulation. It also doubles as a sunshade for car seats and strollers. All fabrics are 100% organic.
Organic Aden and Anais Swaddle Blankets: They are great to use if you are on the go and have forgotten your nursing cover. Not only are they light weight but a great size, perfect to throw over your shoulder and breast feed.