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

This post made possible by the support of EvenFlo Feeding

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!

My little 4 month old is refusing to take bottles. I’ve started taking him to daycare, and he is refusing bottles, not even taking a full ounce while he’s there for 6-7 hours. When we’re together he’s still drinking well from the breast and nursing frequently at night. His weight is good and we’ve had no issues other than this. I’m worried about him becoming dehydrated during the day. What can I do and what can I tell the daycare to do?

Mama to a hungry but stubborn baby.

Hi Mama,

I totally feel your pain and the anxiety that comes when your breastfed baby refuses the bottle and does not eat when you are not around. I had one myself! Reading your question, my first thought is that this transition may take a little time for not only you to get used to leaving but for your little guy to get into a new routine, new people, and a NEW way of eating! This is one of the reasons that I really recommend introducing your breastfed baby to a bottle earlier than most will (like within the first 2 weeks!) which makes this transition much easier. I actually have an entire chapter dedicated to this very thing in my online breastfeeding class “Simply Breastfeeding” because I know there are so many moms that need to return to work and this issue can be so distressing. I know that is not helping you now…so my best advice is this: First, try different types of nipples to see if there is one that he will take over another. Try offering the milk cold instead of warm. Sometimes this can also make a difference (not exactly sure why, but it worked with my own and other mamas I have worked with). Try feeding him in different positions instead of cradling him. Holding him outward and distracting him by moving around, staring at a picture on the wall, etc. Try an infant feeding cup. YES…babies can be fed through a cup and don’t need to take an artificial nipple! Lastly, if all of these things fail don’t stress. This may just take a little time and a few more feedings during the time you’re home and at night. Let him co-sleep with you and try to get as many feedings in that you can while you are together. Watch wet diapers, signs of dehydration and weight loss. If all seems normal, just let it be and allow your baby to adjust at his own pace. In the meantime, you should still continue to pump on schedule as to not decrease your supply and also not get too engorged while you are away.

I hope this helps and that things start to smooth out very soon for you!

Xoxo,
Shari

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Dear Shari,

I am 7 weeks with my 3rd and my son is 8 months old today, so I am still nursing very much so for nutritional purposes. He doesn’t like solids, of course, so I’m lucky if he eats 1 additional solid meal per day. I have noticed a drop in my supply already, just now I was up to nurse him and it took a good 10 minutes before he got a let down and they definitely aren’t as strong. Please tell me it won’t drop any further than it is now, I want to tandem, I nursed my daughter until 22 months so him and I would both be devastated if it just went away!!

You’ve been so encouraging before, thank you!

Not ready to stop!

Dear Not Ready To Stop,

First, congratulations on your new pregnancy! Having you children close in age has many benefits and can also present certain challenges as you are experiencing, however this does NOT need to be the end of your breastfeeding relationship with your older child. Many, many mothers are able to continue breastfeeding safely during pregnancy and way beyond, going on to tandem after birth. Most moms will have a decrease in their milk supply during pregnancy. This is especially common in the second trimester but can start as early as the first. It is thought that increased levels of Progesterone during pregnancy is what causes the milk supply to drop. This typically begins to resolve towards the 3rd trimester and especially at birth when the placenta is delivered and prolactin levels rise. AS always, it is important to continue to offer the breast to your nursling frequently and not decreasing “demand.” This will only add to your decreased production. Co-sleeping and night feedings can help here. Be careful on any herbal supplements that you are considering as they may help your supply, but they are not all safe during pregnancy. Always consult your doctor, midwife, and lactation consultant. The decreased supply may actually encourage your little one to start taking mores solids, as he will naturally be hungrier. This is fine as long as your are getting in at least 3-4 feedings per 24 hours. Take this opportunity to experiment with new and yummy foods, and keep trying even if he rejects it at first. It can take 5-7 “rejections” of a certain food before a child will accept and even learn to love it. As always, monitor wet diapers, signs of dehydration, weight loss, etc. Most of all, try not to stress. This is temporary and your milk WILL come back so that you can go on to provide for both of your babies! 

All the best to you and your family.

Good luck,
Shari

Dear Shari,

My little is almost 6 months old. My supply has taken a huge turn for the worse. I am barely producing anything. I Had a huge over-supply in the beginning. This has all started about a month ago. I know that you are supposed to adjust and pump more of what baby needs close to 3mo plus. Well I started doing that. Was pumping like 20-25 ounces a day.. Then it decreased to 10-15 and now I’m at 1-6… The past two days have been around 2 ounces the whole day. I have done pretty much everything I have read to do. I have also switched pumps. I have tried switching flanges. Replaced membranes, replaced hoses. I know stress is a horrible killer for your supply. I honestly am not stressing. I do not feel stressed, do not feel worried. I have a freezer full of milk so I know my little girl will have momma milk for a while longer even if I am done producing. I just would like to know if I am done ya know. I have tried nursing her more too. Day before yesterday I nursed her more and she didn’t seem satisfied at all. Today I nursed her more and she seemed fine. What is going on?

I appreciate any light you can shed on this!

Dwindling supply and hungry baby.

Hello Dwindling,

It sounds like you are trying to pump in addition to fully nursing your baby at the breast. It is completely normal for milk supply to fluctuate and for there to be times when your supply may seem lower. This will naturally happen as your child ages and also during times of growth spurts when they are eating ALL THAT YOU HAVE! That will of course leave less to be pumped. Normal growth spurts occur around 2-3 weeks, 6 weeks, 3 months, and 6 months. There is also a very common decrease that happens around 6 months postpartum for many moms. This can be due to hormonal changes, the return of you period, nursing less frequently, returning to work, introduction to solid foods, etc. I talk about this a lot in my online class “Breast Pump & Briefcases,” as it is something that so many breastfeeding and pumping mothers face. It is important to understand that while there may be times where you are able to produce way more than your baby is eating (which leads to being able to pump a lot of extra feedings for storage or donation…like your freezer full of milk), there will be other times where you may just be making exactly what your baby needs in the moment and not any more. This is not abnormal, and also not a problem as long as you feel that your baby is getting what she needs at the breast (which it sounds like she it). Your pumping and storing may have to take a back seat until the growth spurt is over. This will usually pass within a few days of concentration and baby led feedings. Small but frequent feedings whenever the baby wants to go back to the breast without supplementing, will usually have your supply back within a few days. Delaying feedings or supplementing with your freezer supply or formula during theses times will have the opposite effect, delaying the decrease or decreasing it further. This is SO important to understand. There are also foods like oatmeal and herbal supplements like Fenugreek that can help during these times, but I would always consult a Lactation Consultant before using anything. 

I hope this helps you and congrats on doing such a great job feeding your little girl!

Much love,
Shari

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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. You can find her on Facebook or her own personal site.

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

This post made possible by the support of EvenFlo Feeding

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!

Dear Shari,

I started breastfeeding my son when he was first born but we had a lot of difficulties and ended up switching to formula. He’s 2 months old now and I don’t think I have any breastmilk left but I’m really sad about stopping. Is there any way I can get him back on the breast and get my supply up for him? Is that possible or should I just accept that I screwed up?

Sad but hopeful

I am so sorry that you had so much difficulty.  This is unfortunately not uncommon and there are so many moms that face the same challenges having them stop breastfeeding way before they want to. You DID NOT screw up!  You did the best that you could with the information and support that you had.  This is not your fault although I know how disappointing it is. There are two questions you are asking here…One, is it possible after 2 months to get your baby back on the breast from the bottle, and two, can I increase my supply to go back to exclusive or partial breastfeeding?  The answer to both of these questions is YES…but it will take some work and the right support.  If you have been pumping and feeding your baby a combination of breast milk and formula, increasing your supply back up to exclusive breast milk is very doable.  It will require frequent pumping and/or feeding (possibly with a supplemental nursing system) and also supplements that can help to increase your supply.  If you have not been pumping at all, re-establishing your supply or “relactation” is possible but will also require work with pumping, feeding and supplements for you.  Getting your bottle fed baby back on the breast after 2 months is possible although not always.  I highly recommend that you seek out an experienced IBCLC that has worked with moms in this situation before and get the proper counseling and support.  This is not something to do on your own, as time is really of the essence if you want to have the best chance at success.  Lastly, there are lots of moms that exclusively pump and are still able to feed their babies breast milk even though they are not nursing at the breast.  Of course your baby will greatly benefit from this for as long as you are able to do it and for as much or as little as you are able to provide.  This is a third option to consider.

For those moms that are trying to make that final transition back to exclusive breastfeeding, here is a great video clip from my WebTV Show on “Weaning off formula back to exclusive breastfeeding” 

Dear Shari,

I was hoping you could tell me what could be causing me to feel nauseous when I nurse? It’s really bad at night, but always there when she nurses?! Is this normal? Will it go away? It is really putting a damper on breastfeeding because I feel sick every time.

Please help!

Feeling sick to my stomach

Hi…I know this feeling that you are describing since I had it myself when both of my babies nursed!  It is amazing how everyone feels different when they breastfeed.  Very often moms will have some sort of sensation or reaction to their milk letting-down.  It can feel different in different moms, and if you don’t feel anything it does not mean that you are not getting a let down…don’t go there!  This can be felt as nausea, which is usually caused by the hormones that are released when your baby begins to suckle.  Moms may feel something like nausea, slight dizziness, lightheaded, tingling,  etc… at the onset of the feeding and then it will subside as the baby continues to feed.  As I said this is not the same for everyone and it sounds like you may be feeling it the whole time. There is not much that you can really do about this since it is hormonal.  You may want to try a hard candy, closing your eyes and relaxing with the feeding, or maybe some fresh air or a fan, etc… Also, make sure that you are not hungry or that your blood sugar is not low, which will also cause you to feel nauseous, just as it can during pregnancy!  I wish that I had more to offer except that this is quite normal AND it may not last.  Your body (and your baby) is changing every day.  What you are experiencing one day may be completely different the next.  Hope it resolves and you can enjoy the experience a bit more.

Here is a video about relieving nausea (or morning sickness) in pregnancy…although the hormones that are causing it are different, the conversation about hypoglycemia may be helpful and especially for all the pregnant mamas out there. 

Dear Shari,

I am 12 weeks pregnant with my second babe. With my son I wasn’t able to breastfeed, my supply never came in. I tried oatmeal, mother’s milk tea, and lots of water. But nothing helped. I really want to breastfeed with this one. Does anyone have any advice or suggestions that could help this time around? Anything I can do beforehand to make sure my supply comes in?

Thank you so much for your help.

Concerned but hopeful in the midwest.

Hi…It is great that you are asking these questions NOW in preparation for your baby’s arrival.  Way too often, moms will wait until their baby is born to educate themselves or try to find the support that they need.  This can be difficult when you have just given birth, trying to breastfeed and care for a newborn!  To answer this question it is important to identify what actually happened last time, identify any underlying medical issues, and also be cautious in comparing one experience with the next.  So yes there are real situations that can cause your milk to not either be delayed in coming in, have a decrease in supply, or not come in at all.  You need to discuss this with your doctor or midwife (and also consult with an IBCLC) to make sure that underlying causes are identified and addressed if they exist such as a hypothyroid, or IGT for example.  Sometimes the birth itself can be a cause for a delayed or insufficient supply…large blood loss, retained placental fragments, etc…can cause this among other things. Lastly, it is important to remember that while it is very possible to have a real situation with insufficient milk supply, my experience is that MOST issues are either perceived or created from the concern and then the unnecessary supplementation.  It is SO important to understand that your milk will take days to come in, that the drops of colostrum that you are producing is all your baby will need, and that babies are not really supposed to eat large volumes of milk in the first few days and are supposed to lose weight!  This misinformation and misunderstanding, mostly in the medical community, is what creates fear and doubt for moms and causes unnecessary supplementation, decreased feedings at the breast, and can cause the exact issue you are trying to cure.  Most importantly, get the information you need and really understand what is happening and what is not.  Yes the teas and the supplements can be helpful, but without the knowledge it will not make much of a difference.  One of the best ways to prepare yourself for success is to watch my online breastfeeding class “Simply Breastfeeding” where I go over this discussion on milk supply in the first week as well as so much more!

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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.