“Let Love Flo” Infant Feeding Q&A With An IBCLC

The Leakies with Shari Criso, MSN,RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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We’ve asked Shari Criso to share her answers to Leakies questions about feeding their babies. If you have any questions you’d like to ask Shari, leave a comment!

Hi Shari,

My baby is due in about a month and I’ll be returning to work full time at 6 weeks postpartum. I heard that I’ll need to introduce a bottle right away for my baby to accept one. But then I heard that if you introduce it too soon my baby will have nipple confusion. I’m confused now. When and how often should my baby be given a bottle while I’m on maternity leave? Is there anything Any clarity you can offer would be great, thank you!

Jamie, Nipple confused in California

 

Hi Jamie,

Congratulations on the upcoming arrival of your little angel! The question about when to introduce your breastfed baby to a bottle is one that can be confusing with the enormous difference of opinion that is out there even among lactation experts. Some will say that you should wait at least 6 weeks before introducing any artificial nipple to your breastfeeding baby due to the potential risk of “nipple confusion” or preference for the bottle over the breast…while other advice will encourage you to introduce it much earlier so to avoid rejection of the bottle. In my experience, waiting too long to introduce the bottle to your breastfed baby does increase the chance of rejection and this is really difficult on a mom who needs to return to work. By 3 weeks most babies will develop a “nipple preference” either way. The advice that I always give to my breastfeeding who want to introduce a bottle, is to wait until your milk has fully come in and when your baby is breastfeeding well and regularly without any issues. This timing can vary for different moms. Some will achieve this as early as a week or two after birth. When this happens I encourage mom to pump or hand express a small amount each day (no more than 1⁄2 ounce) and then feed it to the baby in a bottle. After that they can finish the feeding at the breast. You are not replacing the feeding, but rather you are consistently introducing the bottle to the baby early when the baby is more likely to accept it and less likely to reject it. This should be done daily until the baby is 6 weeks old. Then you can pump and replace a full feeding if you choose to. This method is very effective in supporting a breastfed baby to accept a bottle, while at the same time continuing to breastfeed without issues and interfering with your milk supply. For more information and instructions there is an entire chapter about this in my full online class “Simply Breastfeeding” on my website. I hope this helps!

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Dear Shari,

With my first 2 babies I had horrible oversupply and developed mastitis within the first two weeks postpartum and the recurring frequently throughout the first few months. It was horrible. I’m so afraid of it happening again, is there anything I can do to avoid it? The idea of battling mastitis off and on for the next few months is enough to make me not want to breastfeed this time around even though I really want to. While I’m so grateful to have plenty of milk for my babies even though my first two had slight tongue ties, I’m really afraid of dealing with mastitis again. Please help me.

Ready to quit, again,

Lisa, in Florida

 

Hi Lisa,

I am sorry that you struggled so much with your prior breastfeeding experiences! It can be so difficult and stressful when you are trying so hard and encountering so many challenges! Most breastfeeding moms do not fully understand just how difficult it can be to have TOO MUCH milk and the ensuing issues like mastitis that can occur, unless they are experiencing it. In my experience, oversupply can sometimes be more difficult of an issue than under supply, although neither are easy! There are a couple of things that I would recommend. First, make sure that you are not pumping in the early days and weeks to empty the breast after the feedings. This is a BIG mistake that moms make or are encouraged to do, and this can lead to oversupply. Also, feeding your newborn on one side at a time will help to bring down your supply quicker. Lastly, one of the most common reasons for mastitis that I see is constriction or pressure on the breast tissue from improperly fit bras or the use of underwire bras, especially early on and when the breast is full and engorged. This extra pressure on the full breast can cause plugged ducts and inflammation, which can lead to mastitis. Nursing frequently, warm compresses, not pumping, and avoiding pressure on the breast, will all help to normalize your supply and hopefully prevent you from developing mastitis. See this video for further information on the issue of “oversupply” that may help. Good luck to you!!

Shari's Q&A- image1

Hi Shari,

Is it possible to not make much milk? With my son I was looking forward to breastfeeding but it just didn’t work out. I was heartbroken, I had tried so hard, used a system to supplement at the breast, had my son’s slight tongue tie revised, ate oatmeal every day, did everything I could find to do. I saw an IBCLC and she told me I may not have enough milk making tissue. My breasts aren’t very small but they aren’t very round or close together and they never changed in pregnancy or even after giving birth. I couldn’t express any milk with a pump, well, never more than a few drops and hand expression wasn’t any better. Breastfeeding is really important to me but I can’t handle seeing my baby lose weight when they should be gaining and it was really hard to see that I was failing my baby while hearing from everywhere that breast is best and I just needed to try harder. Could I be too broken to feed my baby? Is there anything I can do this time?

Thank you for taking time to answer. Heartbroken Heather from West Virginia

 

Hi Heather,

First of all, you are not broken! I can feel your heartbreak in not being able to breastfeed your baby the way you wanted to. It can be very frustrating and even depressing to try everything you know and still not be able to produce enough milk for your baby. To answer your question…Yes, unfortunately it is possible for a mom to not make much milk and this can be caused by a variety of reasons. This could be caused by hormonal issues that exist and go untreated (such as PCOS or Thyroid dysfunction)…it can be caused by failure to establish an adequate milk supply after birth from improper latch, formula supplementation, or even an undiagnosed tongue tie in the baby, etc…and it can also be caused by a condition call Insufficient Glandular Tissue (IGT) where the breast does not have enough glandular tissue to produce a full milk supply. This is something that can be identified during pregnancy, but cannot be determined until after the baby is born and all attempts to produce a full supply are unsuccessful. As a mom that is experiencing this it can be so difficult to keep hearing people offering advice on the very things that you have been trying all along! There are some things to try and consider all with the support and advice of an experienced Lactation Consultant. There are medications and herbs (such as Goat’s Rue) that can sometimes help. Make sure you are addressing and treating any underlying hormonal conditions with your practitioner that may be possible. Lastly, whatever amount of breast milk you are able to produce is still going to benefit your little one. It is definitely not all or nothing! If you are producing some breast milk, you may choose use a supplemental nursing system to deliver the supplementation (donor milk, infant formula, etc…) to the baby and continue to breastfeed at the breast. This can also be done if you are not producing any breast milk but still want to maintain the physical closeness of the act of breastfeeding. Either way always remember that this is not your fault! You are a great mom regardless of HOW or WHAT you feed your baby…and the most important thing that you can ever provide to your child is your love, which is always abundant and overflowing!! For more information, see this video clip. Sending you lots of love!

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Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters.
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