Dear Kathleen- Nursing strikes, biting, low weight gain, and painful breastfeeding in pregnancy

We receive hundreds of emails and messages daily from Leakies looking for help and information in their breastfeeding journey.  As so many seek support from us, we are so honored to have the support of Kathleen Huggins, IBCLC and author of The Nursing Mothers’ Companion.  Kathleen is jumping on board with The Leaky Boob to have a regular article answering Leaky questions every month.  The questions will be selected from the huge pool we get in every day to try and help cover the wide range of topics about which Leakies are asking.  These questions are from real moms and represent hundreds of requests for more information in the past few weeks.  Please understand that this is simply the professional opinion of one International Board Certified Lactation Consultant in an informal setting and is not intended to replace the care of a health care provider.  Kathleen is offering support and information, not diagnosing or prescribing treatment.  For your health and safety, please seek the care of a qualified physician and/or IBCLC.  Kathleen does have limited availability for phone or online consultations, see her website  for more information.

Bfing tip low supply sleep on it

Dear Kathleen,

I need help!! I struggled to breastfeed my now 10 month old. After 3 months of struggle we made it and he has been breastfeeding beautifully. I work long hours and pump at work but have had a great supply. I just returned from a 5 day trip where I pumped and dumped and during that time my milk supply went from 24 oz a day to less then 15. Now my baby latches but cries after about 5 min on each side. He calms with expressed milk in a bottle. What do I do now to increase my supply back? I wanted to make it to a year and am heartbroken that I may have to stop sooner!! Help!!

Desperately yours,

Heartbroken for Milk

 

Hi there Heartbroken for Milk,

So sorry about your difficulty.  There are several things you can do.  First of all, I would make sure that you are using the best possible pump, like a Hygeia. If you don’t have a strong pump, you might consider either getting one or renting a clinical grade pump, like a Symphony, or an Ameda Platinum.  I would be sure that between pumpings and nursings that your breasts are being drained at least 7 times each 24 hours.  Having your breasts emptied less than this will keep your supply at the level it is at now.  The other thing I would suggest is More Milk Plus from Motherlove Herbals.  If you go to their website, you may be able to find a local distributor or order it directly from Motherlove.  This herbal product contains fenugreek and three other milk stimulating herbs.  Keep in mind that teas are a weak form of any herb and may not help much.  For a a short while you may also want to nurse before offering solids and once your supply increases, you can offer solids first, but again try to keep the number of nursings remain at a minimum of seven per 24 hours.  If your baby wakes in the night, welcome those nursings for now.

Best wishes too you!

Kathleen

 

Dear Kathleen,

My 10 month old bit me and I yelped, which made her cry. That was 6 days ago and since then she’s completely refused to nurse. She was exclusively breastfed before introducing solids and has never had formula. She won’t take a bottle and will only drink water from a sippy cup. I tried offering expressed breastmilk in an open cup but she wouldn’t have it. I’ve been mixing express breastmilk into her food but that’s all she’s been having. My supply is going and I can only pump a few oz a day. I’ve tried nursing her asleep, warm baths, skin-to-skin, everything, but she still refuses. Everything I’ve read says 10 months is too early to wean and that nursing strikes are temporary, but every day I feel more hopeless. I offer every couple of hours. She has three meals a day. I’m worried she’s missing out on essential nutrition, and even if I had to give formula I don’t know how I’d get it into her. I miss breastfeeding so much, I just want it back. 

Thank you for your help,

Not Ready to Wean

 

Dear Not Ready to Wean,

Tough situation!  At this point, be sure that you are expressing milk at least 7 times each 24 hours with an excellent pump to keep your production high.  You are certainly been doing the right things with co-bathing and lots of skin to skin.  I would offer your milk with an ordinary cup rather than a sippy cup with your guidance and see if she prefers that over the sippy cup.  I would also suggests seeing if she will nurse while asleep or very sleepy maybe while you lie down together in a darkened room.  Final words, hang in there.  Nursing strikes usually end as suddenly as they begin!

Good luck!

Kathleen

 

Dear Kathleen,

My son is 8 1/2 months and exclusively breast fed, and the last couple months has a side preference when he wants to relax or fall asleep. He has 6 teeth and is still in the teething process. My problem is, he bit his preferred nipple 3 times in 24 hours, drawing blood the first couple times. Now, I am trying to give it some time to heal, but he has a total meltdown when I don’t let him nurse on that side! 

Any suggestions to help him through this while I attempt to heal would be much appreciated! 

Sincerely,

Wounded Nipple

 

Dear Wounded,

I hope that you are expressing your milk very often with an excellent pump, at least 7 times each 24 hours.  I would also suggest feeding on that side using other positions that irritate the wounded nipple less, like “football” hold or having him straddle your thigh and then come onto the breast.  If the nipple is open after 5 days, it may then be time for an antibiotic as bites can easily become infected and then not only are they slow to heal, but you can also develop mastitis.  There are other healing remedies like Motherlove’s Nipple Cream which you may be able to find if you visist Motherlove’s website.  It contains several healing herbs and can work quickly unless there is already bacteria in the wound.  Also, you may want to learn more about biting.  If you visit my website, Kathlenhggins.com, I have a blog about “biting”.  This needs to stop!

Kathleen

 

Dear Kathleen,

I still breastfeed my just 2 year old and am 15 weeks pregnant. Breastfeeding is now VERY painful contributed by a very poor latch I think (there are teeth marks left behind on my nipples). It is no longer pleasant for me and I find myself feeling anger and resentment during feeding. The problem is my toddler is not ready to stop, she feeds on waking and before sleeps so it in entrenched in those routines. No amount of distraction, food or drink offerings or cuddles can stop endless sobbing and clawing at me. I’m at a loss.  

Thank you, 

Unpleasant Breastfeeding

 

Hi Unpleasant Breastfeeding,

There are a few things you can try.  First of all it is very common for nipples to be tender during pregnancy.  They may improve as your pregnancy continues.  With that and the marks from your toddlers teeth, it is no surprise that you are suffering through nursings!  There is nothing that can be done about your pregnancy nipple soreness, but you can help the problem with your toddler’s latch. Because the baby’s mouth tends to drag down the breast tissue, it may be important to lift her upwards by using a pillow and lifting your breast upward.    Experiment with other nursing positions to see which positions are more comfortable and which  avoid letting her chin rest on her chest, trying to get her head tilted back a little more.  Try and offer your breast with the nipple pointing downward and wait for a wide open mouth before latching. Feel free to use lanolin after nursings.

With all that being said, if you are still wanting to stop nursing, you can do that too! If you are only nursing in the morning and just before sleep, you and your partner can both help out.  She really is mostly weaned at this point!

For now, I would suggest tackling just one nursing at a time.  When she wakes, start of new routine of an early breakfast and some sort of play or other activity. Without telling her  ”No”, let her know you are “saving the milk” until nap time, using whatever words she understands. Think of all the things she loves to do and substitute any of those things, Once you have that morning one gone, pick another, maybe the nighttime or nap time nursing. One the week-end, or in the evening, let your partner work his magic, with you out of sight.  Go take a walk. Perhaps Dad can help her off to sleep at night by making a new routine, like reading a book and rocking him for awhile.   A bath, a story and more rocking can certainly be a new way to distract her and soon you will have weaned. On the other hand, maybe one nursing a day is pleasant for the both of you.

See how changing the latch works. Move slowly on this, taking the nursings out just one at a time over a period of time until you are feeling better and she is adjusting.

Best wishes!

Kathleen

Dear Kathleen,

I have a soon to be 5 months old infant who is breastfed since birth and the biggest challenge is his weight, he only weighs less than 13 lbs and his birth weight was 6 lbs 12 oz. I’ve fed him every 2 hours and now sometimes 3 hrs to 4. When I pump I only produced 2 oz total from both breasts which the pediatrician isn’t happy and is very concerned that he’s probably not getting enough milk.  He spit up a lot, lots of urinations and some common bowel movements but his doctor isn’t satisfied and we keep having to go back for a weekly or biweekly weight check and now the doctor wants me to start giving him rice cereal now which I’d rather wait til he is 6 months old so I dont know what to do.  I don’t want to do formula. This is my 4th child and my 3rd child to breastfeed.  With my last 2 children I breastfed and did produced good amount of milk but this time I’m not sure if I’m producing enough milk which is very discouraging for me.  I took fenugreek for 3 months but I wished I had known I should have taken blessed thistle along with fenugreek.  Any suggestion on how I can increase my milk supply? Could it be his latch?  It still hurts when he latches on and sucks on my nipples.  I’m trying to stay positive but I feet like a failure that my baby is probably not getting enough milk from me because of his very low weight for his age.  With my other two nurslings I had a wonderful lactation consultant but that was 7 years ago and we have moved, I don’t even know how to find a good consultant.  Please help!

Yours truly,

Worried but hopeful

 

Hi Worried,

It’s understandable that you are worried, when I plot out your baby on the World Health Organizations Breastfed Infant Growth Charts, which you can find on line, I see that we was born on the 15th %tile and he seems to now be on the 3rd %tile.  I think you can offer him more calories without having to resort to formula.  I don’t know when you are pumping in relation to a nursing, so that doesn’t help me much.  Your baby needs more milk which has more calories, so I agree that cereal is not the answer.

I would suggest a few things.  First of all, you need to aim for 7-8 nursings each 24 hours. I would not allow the baby to go without nursing for 3-4 hours.  Watch for early hunger cues, like finger sucking and offer your breast whenever you notice this.  If your baby uses a pacifier, I would put it away.  Welcome night time feedings as mothers produce more milk in the night time.  If he sleeps through the night, I would wake him before you go to bed, or even wake him after five hours of sleep.  During the day and evening, I would try and double pump after most of these nursings for 5-10 minutes and offer him that milk after the next nursing.  This milk will be very high in calories and help him gain more weight.  While not knowing what pump you have, be sure that it is a good one, like a Medela or Hygeia or you could even rent a clinical grade pump for awhile if you have doubts about the pump you are using.  If your nipples are larger than a penny, be sure to use a larger sized flange, like a size 27mm.

Next, I would add a strong herbal galactagogue, like More Milk Plus from Motherlove Herbals.  If you go to their website, you may be able to find a local distributor or order it directly from Motherlove.  It contains, fenugreek, Blessed Thistle, and two other milk stimulating herbs.  It usually takes 48-72 hours to kick in.  A second herb you can add is GoLacta.  Go to their website for ordering information, Using both of these together can really boost your supply.  At this point, I would like to see a daily weight gain of 1/2 ounce per day.  That is normal for this age.

If your periods have already resumed, you may see that your supply lessens between the time you ovulate and when your period resumes.  If that is the case, you can take 1000 mgms of Calcium and 500 mgms of magnesium every day until your period starts.  I am assuming that you are not on any estrogen containing birth control which definitely lessens milk supply,

If your baby is spitting up, that suggests reflux to me which can cause some babies to limit their nursings.  I would avoid any of the following the following foods and beverages; these include chocolate, all citrus fruits and their juices (including strawberry, pineapple and kiwi), the gassy veggies like onion (onion powder), garlic (garlic powder), peppers, cucumbers, cauliflower, cabbage, broccoli, and Brussels sprouts.  It may be your baby is reacting to the foods you’re eating, eliminating the most likely culprits first and then testing them by adding them back one at a time could help you figure out if one of these are the cause.  If this baby has the same Daddy as the others, and they had colic symptoms, you might also consider a trial off of all cow milk products for a short while to see if that helps with the spitting up.  Cow milk products can be an allergen which runs in certain families.

Lastly, if you want to find a lactation consultant, go to ILCA.org and scroll down to “Find a Lactation Consultant”, enter your info and some name should pop up.  If you have private insurance, they should cover the cost.

Best wishes to you and your baby!

Kathleen

Kathleen-HigginsKathleen Huggins RN IBCLC, has a Master’s Degree in Perinatal Nursing from U.C. San  Francisco, founded the Breastfeeding Warmline, opened one of the first breastfeeding clinics in  the United States, and has been helping breastfeeding mothers professionally for 33 years.  Kathleen  authored The Nursing Mother’s Companion in 1986 followed by The Nursing Mother’s Guide to Weaning.  Kathleen has also co-authored Nursing Mother, Working Mother with Gale Pryor, Twenty Five Things Every Breastfeeding Mother Should Know and The Nursing Mothers’ Breastfeeding Diary with best-friend, Jan Ellen Brown.  The Nursing Mothers’ Companion has also been translated into Spanish.  Mother of two now grown children, Kathleen retired from hospital work in 2004 and after beating breast cancer opened and currently runs Simply MaMa, her own maternity and breastfeeding boutique.  She continues to support breastfeeding mothers through her store’s “breastaurant,” online at The Leaky Boob, and in private consultations.  
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What your uterus wants you to know about breastfeeding

by Jessica Martin-Weber

I’ve tried to have a positive perspective on having my period but try as I might, I really just find it annoying, uncomfortable, and inconvenient.  It’s not that I don’t celebrate being a woman, it’s just that particular time of the month doesn’t inspire me to celebrate it just then.  I hate having my period.  But that doesn’t mean I hate my uterus, in fact, I love it.  My uterus has lost 6 babies and ached with the loss.  My uterus has carried 6 beautiful babies, held them as they grew, held onto them when my body wasn’t sure about going through with it, and pushed them out when it was time.  I kind of admire my uterus and I’m grateful for it even though about once a month I’d like it to find a temporary residence.  Uteruses are strong.

I don’t think I’m alone in the love/hate uterus relationship.  Perhaps the idea of celebrating your moon-flow, AKA period, sounds like asking you to dance around with joy at the prospect of wearing diapers, your fat jeans, revisiting 10th grade acne, and trying to munch celery through insatiable chocolate cravings while huddled in the fetal position with a hot pad on your lower belly watching your trusty old “Friends” or “Buffy” DVDs.  Except for the DVDs you’d probably rather go wait for 8 hours in line at DPS for your next fantastically freakish driver license head shot.  Yours never turn out fantastically freakish?  Great, that’s just me.  Fine, you’d rather pull your eyelashes out one by one or the proverbial go see your dentist.

However you feel about your uterus, breastfeeding does a uterus good.  Seriously, the way the whole thing works isn’t just good for baby, it’s usually good for mom too and right off the bat it starts with being good for your uterus.

newborn breastfeeding

 

If your uterus could talk (it can grow babies, why not talk?), here’s would your uterus would want you to know about breastfeeding:

 

It can save your life.

Potentially in more ways than one. But what really makes your uterus happy is that putting your baby to suckle at your breast stimulates the release of oxytocin in your brain which helps your uterus to clamp down.  That initial latch of your wee babe strengthens the natural contractions and if you haven’t already, helps you expel the placenta and make sure you don’t bleed to death.  It can help prevent a postpartum hemorrhage.  But don’t worry if your baby doesn’t want to breastfeed right after birth (give them a break, it was an eventful occasion, being born), this continues to work for as long as it takes for your uterus to reduce to it’s normal non gestating size.  Every time you put your brand new baby to your breast and endure a wave of contractions you may curse, swear, stomp your foot, breathe through clenched teeth hissing at your partner that next time HE’S having the baby but those painful afterbirth contractions that your nursing babe brings on are important.  And yes, it does get more painful with subsequent babies but it still does the job.  Hate it all you want but it is way better than hemorrhaging and it’s the body’s perfect way to make sure you’re safe and around for a long time.

 

 It helps you heal.

Along with signaling to the uterus it’s time to shrink back down, breastfeeding can help mom rest.  For many women, life just doesn’t let them have the time they need to really heal and that open wound in their uterus doesn’t get the rest it needs which can lead to mom becoming anemic, fatigued, sore, and taking longer to heal.  While there’s always a lot to do, breastfeeding can help busy moms take a load off in those early weeks with a hungry baby forcing them to sit and be still long enough to work on a good latch and fill up that little tummy.  Taking time to have skin to skin and foster the breastfeeding relationship, moms can reduce their healing time.  And because it can help reduce postpartum bleeding and menstrual bleeding, some women will experience a natural rise in iron levels which will be a real energy boost.

 

It can delay fertility.

With my last baby, my 6th full term pregnancy, I got a break from my monthly flow until 20 months postpartum.  Including pregnancy, that was almost 30 months off.  I’m not going to lie, I didn’t miss it one single bit.  This isn’t a guarantee but the majority of women experience a delay in the return of their fertility if they exclusively breastfeed (meaning no supplementation).  When baby is fed only at the mother’s breast the maternal body suppresses fertility to focus on continuing to grow this little person.  This would mean no period sometimes until full weaning happens though any time solid foods, supplementation, or artificial nipples are introduced it’s possible a woman’s cycle will return.  Sometimes that can be thrown off, usually if artificial nipples are used (yeah, even with bottles of the mother’s own pumped milk) but sometimes even if the mother only ever breastfeeds directly from the tap her cycle may return in the postpartum period.  But for those that experience suppressed fertility due to breastfeeding, it can be a nice break from their regular menstrual cycle.  Because there are no guarantees though, unless you are hoping to get pregnant again shortly after having your baby, some kind of birth control measures would be wise.

 

It can help with endometriosis and may help reduce cancer risks.

Because it is common for a woman’s menstrual cycle to be delayed while breastfeeding, women that have endometriosis may experience a stabilizing of the progression of their condition.  Causation or correlation, studies show that women that breastfeed have lower incidence of developing uterine, endometrial or ovarian cancer. 

 

Breastfeeding is no magic bullet that will save you, you may breastfeed and still get cancer, you may breastfeed and still experience a retained placenta or postpartum hemorrhage, you may breastfeed and struggle with endometriosis or have your fertility return right away.  But hey, a chance that you could get a break and make your uterus happy?  If you can, it could be a chance worth taking!

 

 

 

 

 

 

 

 

 

 

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Normalizing breastfeeding flying the friendly skies- Delta says yes

 

20140307-071439.jpg

Worried about what it would be like to sit next to a woman breastfeeding on a plane?
It would look like this.

When the internet exploded with the news that Delta airlines had informed a woman that asked on twitter if she could breastfeed on their aircraft during an upcoming 6 hour flight she was facing with her 10 week old sides were immediately drawn.  The response was incredible with some joining in supporting a woman’s right to breastfeed anywhere they have the right to be with their child, others defending the airline’s right to have poorly trained employees or to have no official policy on the matter, some ranting on how disgusting/inappropriate/unnecessary it was to breastfeed, a few wondering why the woman even asked, a startling number saying individuals advocating for breastfeeding rights were bullying the multimillion dollar company, and a handful mocking those that challenged the corporation to move beyond a basic PR apology (that sounded more like “sorry you got upset” rather than “sorry we screwed up”) to have an official breastfeeding policy expressed on their website and their employees trained accordingly.  It was both awesome and overwhelming to watch.

Isn't this tweet a gem?  Unfortunately, it wasn't the only one like this.

Isn’t this tweet a gem? Unfortunately, it wasn’t the only one like this.

So when I realized just a few days later that the flight I was taking exactly one week after I wrote this post about the situation was actually on Delta rather than the airline I usually fly (Southwest) I laughed at the irony.  And got a little nervous.  I booked my flight through Orbitz weeks before and had simply looked for the least expensive option to get The Piano Man, Sugarbaby, and me to where we needed to be by the time we needed to be there.  I honestly would probably have avoided the airline if everything had happened before I booked my ticket.

But I’m glad I ended up on that ironic flight to Chicago on Delta.  Because the time honored tradition of protesting treatment and policies that are not benefiting the people still helps influence decision makers and though the venue may have changed to online rather than physical protests, the impact has not.  The airline worked on their apology and even better, they added this to their website:

Delta Breastfeeding policy on website copy

Which meant I was totally comfortable doing this:

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Normalizing breastfeeding flying the friendly skies- Delta says no

by Jessica Martin-Weber

*UPDATE as of 2.05pm 02.21.14  at the end of this post.*

I speak often about normalizing breastfeeding and what that would mean.  Sometimes this seems like a ridiculous topic, like normalizing breathing, eating, walking, or human decency.  Or like normalizing mammalian behaviors.  It just seems so… obvious.  Why in the world would you have to normalize something so… normal?

But the reality is that in many ways, though it is touted, preached, and at times elevated, in many ways breastfeeding isn’t normal.  Like it or not, I see a very real need for our culture to embrace breastfeeding as normal.  The reasons are many and I won’t go into them here right now but if breastfeeding was normal I know this twitter exchange would not have happened.

 

Delta airlines doesn't want moms to feed their babies without a cover.

Delta airlines doesn’t want moms to feed their babies without a cover.

Um, yikes.  Also, that pumping suggestion?  Completely unrealistic.  If she has to feed her baby every two hours, she’s going to have to empty her breast every two hours.  Which means she would need to pump 3 times on that flight AND give a bottle.  Wouldn’t it just be easier and less distracting if she wasn’t trying to juggle a bottle, a pump, and a baby in her handful of square inches on the plane?  Wouldn’t it be much less intrusive for everyone if she simply put her baby on her breast?

This is why breastfeeding needs to be normalized, as silly as that may sound.  It is also why discrimination against mothers, regardless of how they feed their children, needs to stop.  This isn’t even the first time that Delta has run into issues violating laws protecting breastfeeding, way back in 2006 the airline kicked a mother that refused to cover to feed her daughter off her flight.  She sued and they paid.  But apparently, they haven’t learned.  The Georgia based airline seems to be unaware of the law protecting breastfeeding not only in their home state, but the majority of the country as well:

Georgia Code – Health – Title 31, Section 31-1-9

The breast-feeding of a baby is an important and basic act of nurture which should be encouraged in the interests of maternal and child health. A mother may breast-feed her baby in any location where the mother and baby are otherwise authorized to be.

I’ve only flown Delta once with my nursling and thankfully had no issues but I was anxious the whole time knowing the airline’s irresponsible, anti-family past.  Since then, I intentionally only fly airlines that are clearly supportive of breastfeeding such as Southwest Airlines and not only have I had no problems, I’ve been encouraged with friendly smiles, extra water and snacks, and supportive conversations.

What has been your experience with breastfeeding and flying?  What airlines have you traveled with that were supportive of you feeding your baby as you saw fit?

*Edited to add*

I have seen numerous comments on Facebook and twitter asking why the mother asked, that she shouldn’t have asked. While I agree that she shouldn’t HAVE to ask, certainly we can all understand why she did.

This mother did nothing wrong by asking for clarification on the airline’s breastfeeding policy.  Going in prepared when traveling with an infant is perfectly reasonable and unfortunately, with the number of breastfeeding discrimination incidents in this country, a mother would have good reason to be concerned.  Please stop acting like she was wrong to ask. Our culture CLEARLY has issues when it comes to breastfeeding, she did nothing wrong in trying to be prepared. Asking was well within her right and understandable given the number of times mothers are harassed for feeding their babies. This very airline has even gone so far as to kick a woman OFF one of their flights for feeding her child. Stop with the victim blaming please. 

I understand asking, unfortunately there have been enough bad experiences to make moms want to be prepared. This same airline was sued a few years ago for kicking a breastfeeding mom off a flight for not covering.

*UPDATE* The @Delta account on Twitter responded to the storm of tweets questioning the breastfeeding policy @DeltaAssist told @Classichippie.

Delta's other verified account responds

Delta’s other verified account responds

So I asked what they were going to do about it.  They replied:

Don't worry, they apologized.

Don’t worry, they apologized.

An apology is great and an important first step.  But there’s nothing to ensure such discrimination won’t happen again.

That's nice but not good enough.

That’s nice but not good enough.

One anonymous current employee shared that they receive absolutely no training about how to handle to treat breastfeeding mothers or of the airline’s breastfeeding policy.  This employee has experienced that such lack of training can result in an employee making a misstep such as @DeltaAssist apparently did and then be terminated as a result.  This hardly seems professional or fair.  The employees and the customers deserve better treatment.  I hope the social media representative keeps their job and is instrumental in helping the company implement a successful training program for all Delta employees in support of ending breastfeeding discrimination.

But perhaps the issue really isn’t about breastfeeding discrimination at all and rather a low view of woman as being little more than sex objects?  Thanks to @KellyKautz for this capture demonstrating that the airline is more than willing to encourage women to flaunt their breasts as long as they aren’t covered by a feed baby.

Screen capture by @KellyKautz of two tweets regarding women's breast by Delta social media representatives less than an hour apart.

Screen capture by @KellyKautz of two tweets regarding women’s breast by Delta social media representatives less than an hour apart.

 

 *UPDATE 2.05pm PST on 02.21.14

@ClassicHippie tweeted that she has not seen an apology from the airline.

Delta breastfeeding policy twitter fake apology

 

 

Delta breastfeeding policy twitter apology

What do you think?  What can Delta now do to communicate a clear family friendly policy that supports breastfeeding and trains their employees (including their social media representatives) accordingly?

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Dear Kathleen- Too much and not enough, weaning and supply during monthly cycle

We receive hundreds of emails and messages daily from Leakies looking for help and information in their breastfeeding journey.  As so many seek support from us, we are so honored to have the support of Kathleen Huggins, IBCLC and author of The Nursing Mothers’ Companion.  Kathleen is jumping on board with The Leaky Boob to have a regular article answering Leaky questions every month.  The questions will be selected from the huge pool we get in every day to try and help cover the wide range of topics about which Leakies are asking.  These questions are from real moms and represent hundreds of requests for more information in the past few weeks.  Please understand that this is simply the professional opinion of one International Board Certified Lactation Consultant in an informal setting and is not intended to replace the care of a health care provider.  Kathleen is offering support and information, not diagnosing or prescribing treatment.  For your health and safety, please seek the care of a qualified physician and/or IBCLC.  Kathleen does have limited availability for phone or online consultations, see her website  for more information.
Dear Kathleen,
 
I have weaned my nursling, it has been 7 days since his last feed and lefty still isn’t getting with the program!  I have a lumpy, very sore, left breast and am unsure what to do.  Is this normal?  What can I do to relieve the pain and discomfort?
 
Thank you!
 
Lumpy Lefty

 

Hi there Lumpy,

Yes, it can take while for both breasts to involute after weaning, even if weaning was gradual.  Your left breast will soften soon, but in the meantime you can try the following suggestions.  You will want to try and avoid any breast stimulation to either breast.  This means taking backward showers or tub baths, avoiding heat to the breast and any stimulation during lovemaking.  You can use Tylenol or ibuprofen to ease any discomfort. Some mothers use cool packs on the breasts for 10-15 minutes a few times a day and some even place chilled cabbage in their bras to help with the swelling and discomfort.  While some mothers chose to express milk from the breasts, this may provide temporary relief, but that will most likely lengthen the total time it takes to dry up completely.

To speed the softening, you can drink sage or peppermint tea.  Earth Mama Angel Baby sells their “Organic No More Tea” which contains these herbs or you can buy dried sage leaves in most health food grocery stores.  Steep a couple of teaspoons of sage in boiled water storing it in your refrigerator.  Drink 2 to 3 cups a day for up to three days.  None of these herbs should not be used if you may be pregnant.  Most mothers do nothing other than wearing a supportive bra and giving it a bit more time.  Please know that it is quite normal for mothers to be able to express drops of milk for many months after weaning.

Feel better soon!
Kathleen
Dear Kathleen,I’m on the verge of tears, disappointed in myself.  My little guy is 4 months old and I returned to work last month, we are exclusively breastfeeding and I pump when I’m at work.  This month my monthly cycle returned and I’m experiencing a drop in my milk supply with it.  Is this normal?  Why is this happening?  I feel so bad, I can’t pump nearly as much as I could before and sometimes he seems very frustrated at the breast.  Will my supply come back up when my period ends?  Is there anything I can do?  I’m having to use the milk I have stored and I’m afraid that if my supply doesn’t come back up I won’t be able to keep up with my son’s needs. Even if it does come back up after my period, if it’s going to be like this every month I’m really concerned that I won’t have enough of my milk when I’m at work and that he’s going to wean early if he’s frustrated even at the breast.  Please help!Sincerely,

Could Cry

Hello Could Cry,

I am so sorry that you are worried and upset!  Let’s see what we can do.  I am hoping that you are getting in at least 7 nursing and pumping each 24 hours and that you are using the best pump possible.  If you are not using a Hygeia or another pump with strong suction such as a rental pump, I would suggest that you try and get one.  I know that many insurance carriers that are providing pumps to nursing mothers, but many are offering mothers poor quality pumps.  For an example, the Ameda pump has very low suction unless you are using it as a single pump.Try to nurse right before leaving for work every day and be sure that you care giver doesn’t feed the baby for two hours before your expected return.  In that way you can nurse just as soon as you get home.  Some mothers find that their babies are simply being overfed while they are apart. Your baby only needs about 1 1/2 ounces per hour for a good feeding at this age.  That means that if it has been 2 hours since the last feed, he will only need 3 ounces by bottle.  If your care provider is overfeeding the baby, let her know that the doctor has recommended that amount.  Using a slower flow nipple can also help slow the feeding and leave your baby a bit more satisfied.When you are home with the baby, try to nurse more often.  Keep in mind that babies at this age do not give early hunger cues.  If your baby uses a pacifier, put it away and offer the breast when you see finger sucking and it has been 2 hours or more since the last feeding. Welcome night time feeds, as nursing in the night increases your milk making hormones the most. When at home you can also pump right after any of your morning nursings and use that milk to feed the freezer.

Milk Supply Drop with OvulationYes, when a mother begins ovulating, it is common for milk production to decline somewhat until the next period starts up again.  With that being said, you can try taking 1000 mgms of calcium and 500 mgms of magnesium every day once you have ovulated and until your period returns.  You can also use herbs to stimulate your production, so long as your breasts are being drained 7 times a day.  Fenugreek can be found in any health food store and the lactation dose is 3 capsules three times a day, not what is written on the bottle.  For a stronger herbal remedy, I recommend More Milk Plus from Mother Love Herbals.  You can visit their website and find a local distributor.  More Milk Plus contains fenugreek and three other milk stimulating herbs.I do hope this has been helpful to you and that you find ways to continue nursing for as long as you and the baby like.

Best wishes,

Kathleen

Kathleen-HigginsKathleen Huggins RN IBCLC, has a Master’s Degree in Perinatal Nursing from U.C. San  Francisco, founded the Breastfeeding Warmline, opened one of the first breastfeeding clinics in  the United States, and has been helping breastfeeding mothers professionally for 33 years.  Kathleen  authored The Nursing Mother’s Companion in 1986 followed by The Nursing Mother’s Guide to Weaning.  Kathleen has also co-authored Nursing Mother, Working Mother with Gale Pryor, Twenty Five Things Every Breastfeeding Mother Should Know and The Nursing Mothers’ Breastfeeding Diary with best-friend, Jan Ellen Brown.  The Nursing Mothers’ Companion has also been translated into Spanish.  Mother of two now grown children, Kathleen retired from hospital work in 2004 and after beating breast cancer opened and currently runs Simply MaMa, her own maternity and breastfeeding boutique.  She continues to support breastfeeding mothers through her store’s “breastaurant,” online at The Leaky Boob, and in private consultations.  
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Guest Post from Suzanne of The Fearless Formula Feeder- Mean People Suck.

I’m happy to share this guest post from Suzanne Barston the a blogger and author of BOTTLED UP.  Suzanne writes over at the Fearless Formula Feeder, a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents.  I asked to cross post her article because I thought it was well written and offered a perspective that should touch all of our humanity about how we treat others in the name of a cause.  My friendship with Suzanne has been growing and I deeply respect her, the work she does, and her heart because while it may seem at first glance that she and I are on opposite ends of the spectrum, we are, in fact, more similar than we are different.  I highly encourage my readers to quietly spend some time on her website and Facebook page listening and learning.  To genuinely support you have to first listen to what those needing support actually need and don’t assume you know better than they.  This article was originally published here.  ~Jessica

by Suzanne Barston

Back in the 90’s, before the age of memes, bumper stickers were the best of sending the world (or at least the person stuck behind you in traffic) a message about your political leanings, philosophy, or the status of your child’s “Good Citizenship” in school. People got seriously creative with these little strips of adhesive, but there was one that seemed to be strike a chord with the folks I typically associated with. The Birkenstocks-wearing, Ani-DiFranco-listening, liberal-arts-major types. The message that seemed to be stuck to the back of everyone’s used Volvo was this:

41NqAZthp0L

Mean People Suck.

Catchy, isn’t it?

But what I’ve realized in my late thirties is that mean people do more than just “suck”. The screw things up for the rest of us, in serious, systemic ways. They are the cops who brutalize minor offenders based on the color of their skin; the politicians who refuse to see the human side of their voting record, the instigators of road rage. And in the parenting world, they are the women who perpetuate the mommy wars (such a stupid and patronizing term, for a stupid and patronizing problem).

The thing is, mommy “wars” may be stupid, but their effect is far-reaching and profound. They make us believe we need to take sides, choose a team, thus dividing us and making it ridiculously easy to conquer us. And by conquering us, I mean keeping us from fighting collectively for better family leave, better maternal health care, better resources and options for our children and ourselves. We’re so busy trying to prove we’re an Alpha Female, conveniently forgetting that alpha males are generally assholes.

Speaking of Alpha Females, there’s a woman who has built up an impressive following on the Internet who I’ve tried to avoid giving airtime for the past year or so, after a few run-ins that made it clear her only motivation in life is to fight. I’ve tried thinking about her in a new-agey way, considering what made her the way she is, and trying to feel sympathy for her anger and vitriol rather than letting her make me act in turn. But when Jessica from the Leaky Boob – a woman I admire greatly and am proud to consider a friend – reached out to me about this Alpha person’s latest assault, I agreed to speak up.

I agreed to speak up because my friendship with Jessica is based on everything that this other person is trying her damndest to destroy. Jessica runs one of the most respected and beloved communities for breastfeeding women. I run a modest but pretty vocal community of people who take issue with the current state of breastfeeding promotion (as well as people who are totally cool with breastfeeding promotion, but ended up using formula for whatever reason and are willing to put up with the constant drama and debate because they have few other communities where they feel safe asking questions about formula feeding). We’re part of an informal community of breastfeeding advocates (and me, although I do consider myself a breastfeeding advocate, albeit a strange hybrid of one) where we discuss ways to better serve all mothers and provide REAL support and education. It’s actually really awesome to see how women can work together to find solutions even when they come from opposite ends of the parenting spectrum.

The Alpha individual operates on the premise that working relationships (and friendships) like this cannot – or should not – exist. Her page and blog are consistently dedicated to making fun of those who haven’t lived up to her own personal standards. Her work wouldn’t be worth mentioning at all, except for the fact that she has gotten the seal of approval from several notable breastfeeding researchers and advocates, including James Akre, who writes regular (and strikingly misogynist) guest posts for her blog. The woman knows how to get page views and Facebook likes. You have to admire her for that.

But in the immortal words of Stan Lee (and as I keep telling my Marvel comic-obsessed son), with great power comes great responsibility. And when someone with a fair share of public attention does something incredibly harmful, not only to a movement (those invested in creating a more supportive environment among mothers) but more importantly to an individual, that is an abuse of power, and seriously irresponsible.

Here are the facts: The blogger in question stole a photo of a woman in an emotional moment and used it to promote her recurring message that formula feeding parents are lazy and un-invested in their children. The photo was of a woman hooked up to wires, looking at least semi-unconscious, with a baby being held up to her breast. The blogger superimposed the word “obsessed” on the photo, meant in a “positive” way, as in, yes; this woman was obsessed with breastfeeding, which was a good thing because it meant she was properly dedicated. Unlike the rest of you nitwits.

The thing is, that was the antithesis of what this photo meant to the mom featured in it. This was, for her, a memory of something she went through with her child. I don’t know if that memory was positive or negative or something in between, as most postpartum memories are when something goes awry. It’s not my business to know. It’s hers. She didn’t intend for her image to be used this way. We don’t know the backstory behind the image, which I’m sure is human and flawed and beautiful and complicated.

But bloggers like the Alpha person are not complicated. They are simple. They are mean. And mean people suck.

They suck the life out of images like this; make them fodder for a contrived mommy war. They suck the life out of breastfeeding advocacy efforts, because they perpetuate the myth of the “breastapo” by becoming a caricature of that concept.  They suck the joy out of parenting, by making it a competition. They suck the intelligence and nuance out of what could be a productive debate between people who genuinely care about maternal and child health. And they suck the energy out of bloggers like Jessica and myself, who resent that we feel forced into a corner and made to confront this type of bottom-feeding behavior, when we could be focusing our collective efforts on something more productive.

Alpha types will always exist, these parasites that feed on fear, loneliness and feelings of inferiority. But parasites can be stopped if their food source is cut off. That’s why we are asking both of our communities to stop engaging. Don’t be a food source. Don’t visit her site. Don’t comment on the Facebook page, even if it’s to fight back against the hate. Just don’t engage.

If you see people you respect at risk of an infestation, let them know the true nature of the beast. Speak up when respected advocates are partnering with her or linking to her work. Let those around you know that this type of behavior does not advocate breastfeeding; it advocates bullying, shaming and hate.

And if you see one of her memes, post one of your own. One from a time before the internet allowed the best and worst of humanity to be distributed worldwide: Mean People Suck. Because they do.

Mean-People-Breed-Bumper-Sticker-(5567)

 

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Tough Love Breastfeeding Support, AKA bullying, and the case of the stolen photo

by Jessica Martin-Weber

Sometimes tough love is necessary, sometimes people getting in your face, calling you names, and yelling at you totally works as motivation.  Usually motivation to punch them in the throat but hey it’s motivation.  Entire “reality” TV shows have been built on this premise: you can scream troubled teens onto the right path, personal trainers can belittle overweight individuals into exercise and healthy eating, and business moguels can rant apprentices into savvy executives.  In spite of all the studies that show that shaming doesn’t actually provide any kind of lasting intrinsic motivation, countless parents, self-help gurus, educators, and others in positions of influence and authority resort to shaming in a desperate attempt to inspire positive change.  Sometimes tough love really isn’t tough love, it’s a power trip down false-sense-of-superiority lane.

Even those purporting to support families.  Birth, breastfeeding, and, ironically, gentle parenting advocates, far too often resort to shaming other parents.  Because that makes sense, something negative is going to have a lasting, positive impact.  Undermining parents’ confidence surely is going to result in change for the better, right?

Wrong.

It may get your website page views, it may increase your “talking about” numbers on Facebook, it may even get people pinning your content on Pinterest.  But helping people?  Not likely.  Inspiring them to do something different?  Maybe but that may just be to ignore any information or support because it all starts to feel like an attack.  I’m not talking about guilt here (though wishing guilt on people is just nasty) but rather intentionally belittling, mocking, and dismissing others in order to induce shame and build a false sense of superiority.  Guilt is one’s own feeling and sense of grief over perceived wrongdoing (sometimes legit, other times not) so believing that what they did was wrong, shame is one’s own feeling and sense of grief over their personal ability of perceived wrongdoing (sometimes legit, other times not) so believing that who they are is wrong. Shaming is intentionally trying to make someone not only feel guilt but to internalize it as believing that somehow they are bad/lazy/stupid/unloving/pathetic/unloveable/worthless as a result.  Ultimately, shaming comes from a desire to see someone feel bad about themselves.

It’s disgusting.  And it doesn’t work to motivate people to change their actions.  It isn’t education, it isn’t support, it is really nothing more than abuse.

I’ve shared before that I’m not really passionate about breastfeeding.  I mean, I am, but I’m not actually passionate about breastfeeding.  What I am passionate about is people and personally, I don’t see how you can actually be passionate about breastfeeding but not be passionate about people.  To do so would mean that you care less about people than you do about being heard as right.  Do you know what happens with that kind of passion?  It hurts people and detracts from the message you are trying to promote.  That kind of passion becomes easy to dismiss at best, damaging at worst.

The Leaky Boob isn’t about that kind of passion.  The information, images, stories, and interactions we share are meant to inspire and encourage people. While we can’t control nor are we responsible for the emotions of others, we don’t intentionally try to manipulate others’ feelings.  Underlying everything at TLB is respect and the belief that with genuine support and information, women are perfectly capable as mothers to make the best decisions for their families based on the information and resources available to them in their individual circumstances.  We don’t assume to know what that looks like for anyone.

So it was with horror that we discovered an image of one of our own volunteer admins originally shared on The Leaky Boob Facebook page and then on theleakyboob.com had been turned into a vehicle intended to shame, belittle, and attack certain mothers.  An image that was shared to inspire and encourage, to give someone the platform to share their own personal story and breastfeeding journey, had been used as a vile expression of superiority intended to hurt others.  Words were applied to this image communicating the very opposite of what TLB and Serena, the woman pictured, stand for as a community.  Without permission, Serena’s image was used to spread a message she in no way condones aligning her with those that would bully others.

This message is not approved TAP serena

I’m not going to lie, I am incensed.  For my friend, for my community, and for those hurt by this image, I am outraged. Disgusted.

Mean people suck.  My friend Suzie at the Fearless Formula Feeder breaks it down beautifully.

The person that perverted this image stole Serena’s photo and manipulated it in order to send a shaming message to formula feeders.  In a statement to me Serena expressed that she felt violated and used.  Not only that, but as a woman that has both breastfed and formula fed, Serena’s own image was used to attack a group of women to which she belongs as well.

When I opened FB this morning to a message from a concerned friend with a link to this meme I was shocked. Shocked that MY photo, a photo of a tender moment, could be used in such a hateful, disparaging way. To see that it was posted 28 weeks ago only makes it worse. All this time MY photo has been circulating with such a hurtful message, a message that I would NEVER propagate. Belittling or negating someone else’s breastfeeding issues or choices is not beneficial for anyone. As mothers we all do what we believe is best for our children. Even though our opinions may differ due to choice or circumstance. I am not a breastfeeding martyr, I have used formula in conjunction with breastfeeding when needed. What was important was that I was able to mother my son in the way I wanted to, due to the SUPPORT I received. Support is something that was lacking in the making of this meme. I do not condone the use of my photo in this way.  ~Serena Tremblay

 

As far as we can tell, the image was originally posted to The Alpha Parent’s Pinterest board “Dear Formula Feeder,” don’t go check it out, it is a virtual collection of putrid hate filled shaming refuse.  Nobody needs to see that.  There has been no response to our two email attempts requesting the image be removed and destroyed (and never shared again) and so Serena has followed Pinterest guidelines to have the graphic removed.  We have tried to utilize respectful means and the proper channels to have this image removed and do believe that Pinterest will not allow the copyright violation to remain.  Still, simply having that image erased from Pinterest won’t be enough.  It has been seen and discussed in some circles, it’s message cutting and hurting and not helping anyone.  The Leaky Boob stands behind Serena that this graphic is not a message we condone.   The Leaky Boob, including Serena and all the volunteer admins hold to a very different set of values:

TLB creed

It is rare that I single anybody out for how they run their own website and social media presence.  I respect that there are different styles and a variety of people are attracted to those style distinctives.  I don’t have to get it or agree.  But this has gone too far.  Stealing an image and putting words to it that are directly opposed to the intent of the owner of the photo.  Standing against the oppression of others is part of my passion for people, so I have raised my voice to express concern and even outrage when I have seen supposed breastfeeding advocates resort to shaming in general and specifically with this same offender.  It is not the first time I have vocally opposed messages coming from The Alpha Parent and I agree with Amy West’s assessment of TAP’s “brand” of support.  This time though a line has been crossed and while I have long not tolerated any abusive messages in the name of “supporting breastfeeding” within The Leaky Boob community, now I am taking stand against any and all expressions of shaming in the name of breastfeeding advocacy outside of my own little space.

Why am I sharing this with you?  What can you do about it?  If you’re reading this and have made it this far you probably care at least a little about how babies are fed, the information moms receive, have an interest in parenting support, or at the very least watch online interactions with a passing interest.  To those ends then, consider how you are promoting shaming messages targeting others.  Here are some simple steps you can take to not contribute to the type of interactions that do nothing to make our world a better place.

  1. Don’t share or spread memes that mock, belittle, or promote the shaming of anyone.  This isn’t just a breastfeeding/formula feeding issue.  This is a human issue.
  2. Before you use an image, be sure you have permission and don’t create memes and graphics that mock, belittle, or promote the shaming of anyone.
  3. Question every image you see and the message attached with it, particularly online.  Everything may not be what it seems.
  4. If you “like” or follow any personality that regularly engages in such messaging, unlike and unfollow them.  Take away their audience and don’t align yourself with the hate they are communicating.
  5. NEVER share materials, even if they seem supportive, from a source that you can not verify as free of mocking, belittling, or the promotion of shaming.  Many of the breastfeeding support and education sources I follow share materials from The Alpha Parent because some of her content, particularly her older stuff, is pretty decent.  Every time I see one of these resources share content from her I cringe, it’s like leading lambs to the slaughter.  I loved her “anatomy of the toddler brain” post from a while back but there is no way I’ll share that with my audience, it would be irresponsible of me to do so.  Share responsibly.
  6. Ignore them.  It is tempting to take a stand and engage in heated arguments with those that thrive on putting down others, particularly online, but truth be told, ignoring them is far more effective in shutting them up.  Don’t engage.
  7. Consistently share and interact with messages that promote true support and eventually the attraction of the fight will fade.  Offer supportive support and if you find you are tempted to go on the attack, ask yourself why and what insecurities could be motivating you to do so.

I won’t be linking to The Alpha Parent here but I do encourage you to look through your social media channels and remove The Alpha Parent from your playlist if she is there.  My intent is not to shame The Alpha Parent or cause her any harm and I hope that she finds her own happiness that doesn’t depend on a false sense of superiority.  I hope we all can.

 

 

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Dear Kathleen- on nipple damage healing and pumping

We receive hundreds of emails and messages daily from Leakies looking for help and information in their breastfeeding journey.  As so many seek support from us, we are so honored to have the support of Kathleen Huggins, IBCLC and author of The Nursing Mothers’ Companion.  Kathleen is jumping on board with The Leaky Boob to have a regular article answering Leaky questions every month.  The questions will be selected from the huge pool we get in every day to try and help cover the wide range of topics about which Leakies are asking.  These questions are from real moms and represent hundreds of requests for more information in the past few weeks.  Please understand that this is simply the professional opinion of one International Board Certified Lactation Consultant in an informal setting and is not intended to replace the care of a health care provider.  Kathleen is offering support and information, not diagnosing or prescribing treatment.  For your health and safety, please seek the care of a qualified physician and/or IBCLC.  Kathleen does have limited availability for phone or online consultations, see her website for more information.

Dear Kathleen,

My nipples are a wreck following a shallow latch and then thrush with my 8 week old.  After working with an IBCLC that helped fix my daughter’s latch and take care of the thrush, things are improving.  However, my nipples are still cracked and bleeding and I think they just need a break to heal.  The IBCLC I work with suggested I just pump for a little bit until I’m healed and I’m ok with that.  I feel like I’m a bit lacking in the pumping department though and only got 4 ounces the first time I tried with a hospital grade double electric pump and my daughter downed that pretty quickly.  How often should I be pumping to keep up my supply?  How long should I expect healing to take?  How do I pick a bottle that won’t encourage my daughter to prefer the bottle over me?

Thank you so much for your help!

Sore Nipples 

 

Hello Sore Nipples!  I am so sorry to hear that you are still struggling at this point in time! Sounds like you have been through a rough go.  Yes, you and your L.C. are on the right track.  A break from any more trauma is certainly in order.  I am happy to hear that you have a clinical grade pump.  I do hope you have the right size flanges for more comfortable pumpings and for removing the most amount of milk possible.  If your nipples are swelling very much in the tunnel, I would suggest getting the next size flange for more comfortable and effective pumping. Another product, “Pumping Pals”, slipped into any flange, makes pumping even more comfortable and for some moms even more efficient.  You might want to visit their website to see what I mean.  The company is very helpful in getting you the right size flanges to use in your kit and they are fairly inexpensive. With that being said, still many pumps still leave quite a bit of milk on the breast.  For that reason, I suggest “Hands-on Pumping”, that is using your hands to help remove the most milk possible at each pumping.  Please watch Dr. Jane Morton on Stanford University’s website on breastfeeding issue and see her mini-lecture and video of hands-on pumping.

I would like to talk to you more about the condition of your nipples.  If your nipples are still cracked, I would like you to consider treating them with an oral antibiotic.  Mothers with injured nipples longer than 5 days are at a much greater risk of developing mastitis; 75% of moms with open nipples go on the develop a breast infection because of the bacteria in the open areas.  And this seems much more common during the cold weather months.  There was a great study done by two Canadian physicians some time ago that showed the consequences of wounded nipples that were untreated leading to mastitis.  Also, nipples are more difficult to heal when they are infected with bacteria.  For both of those reasons, I suggest speaking with your midwife or doctor about getting treatment for at least 10-14 days.  I don’t think most doctors are aware of this connection, but with your nipples being in this shape so late in the game, I am convinced they are colonized with bacteria.  Yes, I am sure that this makes you worry about yeast, but yeast is much easier to treat than a case of mastitis, which can also lessen your overall milk production.

Mastitis risk with damaged nipples

I do think that getting 4 ounces is about what a baby at this age requires at each feeding.  You will want to aim for about 8 pumpings each 24 hours.  If you are not getting at least 3-4 ounces when you pump, you may want to also consider using some herbs.  You can use fenugreek capsules that are available at most any health food store, 3 caps three times a day. This is probably different that the dose given on the bottle.  I actually find that mothers do quite well using Mother Love’s More Milk Plus, a combination of milk stimulating herbs.  You can visit their website and see if there is a local distributor or order them on-line directly from Mother Love. Nursing teas are a very weak form of any herb, so I don’t recommend them as the primary way to stimulate higher milk production.

Babies typically down a bottle in no time flat and may still act hungry!  This can lead parents to believe that the baby may need more milk.  Four ounces with a slow flow nipple, might help some but keep in mind that many nipples that are labeled as slow flow, really aren’t!  Hopefully, the baby takes 5-10 minutes to drink 4 ounces of milk. There is an old saying, “It takes 20 minutes for the brain to know when the stomach is full!”  So true!  If you are very worried that the baby will come to fall in love with the bottle flow, you might reconsider and have one nursing every 24 hours, but I leave that to your discretion. I think for most babies, if there is a healthy supply of milk, they should return to the breast without too much of a problem.

I wish you every success and very soon!  You are quite a determined mom!

Best wishes,

Kathleen

Kathleen-HigginsKathleen Huggins RN IBCLC, has a Master’s Degree in Perinatal Nursing from U.C. San  Francisco, founded the Breastfeeding Warmline, opened one of the first breastfeeding clinics in  the United States, and has been helping breastfeeding mothers professionally for 33 years.  Kathleen  authored The Nursing Mother’s Companion in 1986 followed by The Nursing Mother’s Guide to Weaning.  Kathleen has also co-authored Nursing Mother, Working Mother with Gale Pryor, Twenty Five Things Every Breastfeeding Mother Should Know and The Nursing Mothers’ Breastfeeding Diary with best-friend, Jan Ellen Brown.  The Nursing Mothers’ Companion has also been translated into Spanish.  Mother of two now grown children, Kathleen retired from hospital work in 2004 and after beating breast cancer opened and currently runs Simply MaMa, her own maternity and breastfeeding boutique.  She continues to support breastfeeding mothers through her store’s “breastaurant,” online at The Leaky Boob, and in private consultations.  
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Dear Kathleen- on breastfeeding moms and nutrition

Daily, we receive hundreds of emails and messages from Leakies looking for help and information in their breastfeeding journey.  As so many seek support from us, we are so honored to have the support of Kathleen Huggins, IBCLC and author of The Nursing Mothers’ Companion.  Kathleen is jumping on board with The Leaky Boob to have a regular article answering Leaky questions every month.  The questions will be selected from the huge pool we get in every day to try and help cover the wide range of topics about which Leakies are asking.  These questions are from real moms and represent hundreds of requests for more information in the past two weeks.  Please understand that this is simply the professional opinion of one International Board Certified Lactation Consultant in an informal setting and is not intended to replace the care of a health care provider.  Kathleen is offering support and information, not diagnosing or prescribing treatment.  For your health and safety, please seek the care of a qualified physician and/or IBCLC.  Kathleen does have limited availability for phone or online consultations, see her website for more information.

 

Dear Kathleen,

Somebody recently mentioned breastfeeding moms having poor quality milk because they eat junk.  I am feeding my 6 week old but I don’t eat particularly healthy and I am worried now that my milk may not be as good as I first thought and she may be missing out on vital nutrients – I will of course start eating much healthier (every time I feed I crave something sweet) but I am worried that for the first 6 weeks of her life she was not getting the best milk. Any advice would be greatly appreciated.

Thanks in advance.

Sincerely,

Not a Health Nut

 

 

Dear Not a Health Nut,

Hello!  This is a great question and one that I am sure many mothers wonder about.  The bottom line is that that the quality of your milk is generally not affected by your diet.  Mothers who live in poverty stricken areas around the world and here in the U.S. are able to provide nutritious milk to their infants.

Many mothers find that their appetite is low right after giving birth. Eating small nutritious snacks throughout the day will provide sufficient calories for you.  The fat stores accumulated during pregnancy will provide some additional reserves.

With that being said, eating nutritious foods will help you feel good and maintain your health. Try and avoid eating “empty calorie” foods like sodas, candy and chips! A poor diet will not effect milk production but is more likely continue at your own expense, leading to fatigue and listlessness! To Dieting during the early weeks is not recommended; as most mothers who are eating nutritious foods will gradually lose the weight they gained during pregnancy.

There is no set number of calories that is necessary during lactation.  In the past, there was a recommendation of eating 500 calories above a mother’s regular diet but now this is not thought to be the case.  On the other hand, some mothers, like those who are nursing multiples may need additional calories.  Most mothers supporting nursing multiple babies may need more calories but in many of these cases, she may naturally feel more hungry.

Nutrition and breastfeeding

Dieting

It is not advisable to begin a weight loss program until after two months post partum and weight loss should be limited to 1-2 pounds per week.  Low carb diets are also not recommended as they can cause some dehydration, constipation, fatigue and sleeping problems.

Vitamin and Mineral Supplements for Mothers

It is recommended that mothers get 1000 mgms of calcium (calcium carbonate, being the least expensive with the highest concentration)per day.  This can also be achieved by drinking 3 glasses of milk per day or having several servings of cheese or yogurt.  If you don’t like milk or cow’s milk products, you can either take a calcium supplement or eat other calcium rich foods each day.  These include goat milk or cheese, bone containing canned fish, whole grains or whole grain flours, nuts, seeds and dried fruits.  Green leafy vegetables, with the exception of brocolli, are poorly absorbed. Other calcium rich foods include tofu or soy milk or cheeses, and lime based corn tortillas.

If you eat a vegan diet, which excludes egg and milk products, it is recommended that up to 4 mgms of vitamin B12 be taken daily to avoid deficiencies.  While mothers can take a supplement she can also include foods rich in this vitamin.   These include goat milk and/or cheese, canned fish, whole grains and whole grain flours, green leafy vegetables, nuts, seeds, and dry fruits.  Also, tofu or soy cheese, tortillas made with lime-processed corn.

Iron supplements may be necessary if you are anemic following the birth of your baby for your own health.  Some mothers develop vitamin B deficiencies, experiencing depression, irritability, impared concentration, loss of appetite, and tingling or burning feet.  A daily B complex supplement or taking Brewer’s yeast mixed with juice or milk can reverse these symptoms.

Supplements for Babies

Vitamin D, actually a hormone produced by sunshine is now recommended for breastfed babies.  This vitamin is important for several reasons.  It promotes the absorption of calcium in the baby’s intestinal tract. It is also an important part of a baby’s immune system keeping the baby less prone to infection.  Most recently, a lack of vitamin D has been associated with rickets, a bone softening disease.  There is also an association of low vitamin D with Type-1 diabetes, multiple sclerosis, rheumatoid arthritis and cancer.

Many babies are born already vitamin D deficient. While babies can get vitamin D from sunlight, assuring that they get enough is complicated by the latitude, season, altitude, weather, time of day, air pollution, and how much skin is exposed and whether sun screen is applied.  While a baby who is exposed to sunlight for 30 minutes per week wearing only a diaper or for two hours a week fully clothed without a hat.  Some babies in higher latitudes need even more light.

Because sun exposure is associated with skin cancer later in life, the American Academy of Pediatrics now recommends that all breastfed babies receive 400 International Units of vitamin D throughout childhood.  Formula fed babies do not need this supplement.  Most formulations of vitamin D are combined with other vitamin preparations which are unnecessary for the breastfed baby and may be difficult to give to the baby.  One company, Carlson Laboratories, offers a vitamin D supplement, Baby Ddrops and are available at health food stores and on-line pharmacies.  The baby only requires a single drop, which can be placed on the mother’s nipple for easy ingestion.

Best  wishes to you and your baby!

Kathleen

 

 

Kathleen-Higgins Kathleen Huggins RN IBCLC, has a Master’s Degree in Perinatal Nursing from U.C. San  Francisco, founded the Breastfeeding Warmline, opened one of the first breastfeeding clinics in  the United States, and has been helping breastfeeding mothers professionally for 33 years.  Kathleen  authored The Nursing Mother’s Companion in 1986 followed by The Nursing Mother’s Guide to Weaning.  Kathleen has also co-authored Nursing Mother, Working Mother with Gale Pryor, Twenty Five Things Every Breastfeeding Mother Should Know and The Nursing Mothers’ Breastfeeding Diary with best-friend, Jan Ellen Brown.  The Nursing Mothers’ Companion has also been translated into Spanish.  Mother of two now grown children, Kathleen retired from hospital work in 2004 and after beating breast cancer opened and currently runs Simply MaMa, her own maternity and breastfeeding boutique.  She continues to support breastfeeding mothers through her store’s “breastaurant,” online at The Leaky Boob, and in private consultations.  
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Why I am not passionate about breastfeeding

by Jessica Martin-Weber
TLB creed

“How did you become so passionate about breastfeeding?”

This question comes up often.  For a while I would hem and haw an answer, stringing together some words that were an attempt at sounding intelligent and reasonable as to why I would have created and continue to run The Leaky Boob.  Awkward and fumbling, I hoped it covered the truth.

I’m not passionate about breastfeeding.

My second daughter received formula starting at 4.5 months and by 5 months was completely formula fed.  The reasons are hardly the point of me sharing this fact.  It was, we believed, the right thing for our family at the time and, like these things are want to be, complicated.

I never felt guilty about it, never even thought about feeling guilty about it.  It just was.  I’d like to say she was perfectly healthy and no issues what so ever but that wasn’t our experience.  Between reflux that took months to resolve, constipation issues that took just as long and several expensive experiments, and then RSV, pneumonia, strep throat, multiple ear infections, and more than I care to recount, her first year was more difficult than I had ever anticipated.  Formula didn’t make it better, much it was exasperated by formula.  Still, through all that, guilt about stopping breastfeeding never occurred to me.  Nor did anger, bitterness, or even hurt.  I was sad, disappointed that it didn’t work for us but that didn’t last long and there wasn’t really anything I could do about it.  Fighting like hell to be able to breastfeed had taken a toll and I was confident that giving it up was actually better for my daughter and I by that point.

I was right.

Later, when I shared my story with someone they comforted me, telling me dealing with that guilt must have been hard.  Strange, I thought, why would I feel guilty?  In that moment and many moments later as I reflected on the guilt I didn’t have, my confidence in my parenting and decision making began to erode a bit.  Already struggling with postpartum depression, this little chink in the foundation of my parenting led to me believing that I was not fit to be a mother.  It wasn’t this person’s fault but I entered a place of shadows and shame, afraid that I couldn’t trust myself to make decisions for my children.

Time, therapy, medication, and some really good friends supporting me by encouraging me to see that I was not, in fact, a horrible mother, helped me turn things around.  Through that though, I began to understand something far more important than breastmilk or formula: confidence isn’t being right, confidence is more than believing in yourself to do the right thing, confidence is having peace with who you are even when you make mistakes.  With my confidence growing again, I moved forward with my husband, embracing that doing the right thing for our family wouldn’t always be an issue of black and white, A and B, or left and right, but rather a sensitivity for all parties involved doing the best we could with whatever circumstances we would face with whatever resources, information, and understanding we had available at the time.

My next baby was breastfed, up until 18 months we had an easy, simple breastfeeding relationship that working full time and caring for 2 other children only complimented, never hindered.  Weaning with her came unexpectedly when the single most difficult and devastating parenting experience we have encountered to date hit us: the sexual abuse of our two eldest by a very dear friend.

It was tempting to unravel in that time and in many ways I did.  But our daughters needed me.  Faking it often, I attempted confidence even as I asked how could I let this happen, how could I not see the signs, how could I… have failed so badly?

More time, therapy, and really incredible friends supporting us, we got through the investigation, trial, and agonizing fragmentation of our family.  Each step was in uncharted and sometimes lonely waters with swells of failure sweeping over me.  There was grief, pain, hurt, bitterness, doubt, and anger, so much anger.  My confidence wavered and so did my husband’s.  We considered a cabin in Montana and cutting off the outside world.

Our daughters didn’t need Montana though, they didn’t need to go off the grid and be isolated.  What our daughters needed most was someone, something to be a safe landing place for them.  That was us.  There was never a moment that I was sure we were doing everything right as we walked the path in search of justice and healing and there were plenty of people telling us how we should be doing it or how we were doing it wrong.  In the midst of the pain, grief, and anger, the truth we had learned before became an anchor along with our faith and love: confidence is having peace with who you are even when you make mistakes.  Our daughters needed us to have confidence to help them land softly.  There was space for us to be honest about our insecurities and fear but the greatest gift we could give our children along with our love was to have peace in our ability to love them well even through this.

Today, 9 years later, I know my husband and I are not perfect parents, we’ve made choices that we would change if we were to have the chance to make them again.  Maybe I would fight harder to be able to breastfeed my second baby longer.  Maybe I would have feed us all with better food.  Maybe I would have done things differently in our relationship with our daughters’ attacker.  Maybe I would handle the abuse another way.  Maybe.  I don’t really know.  But I do know that having peace in who we are, holding on to peace even as it shreds in my hands pounded by guilt, bitterness, and anger, helped our daughters find peace in who they are.  Together, we found healing.

Any more when I am asked why I’m so passionate about breastfeeding I tell the asker the truth: it’s not breastfeeding I’m passionate about.  I support moms in breastfeeding because of the gift of confidence breastfeeding can be.  Maybe it won’t be for everyone but for many it is, it was for me and so this is one way I can offer support.  The science and relationship bonding are compelling on their own but they aren’t why I talk about breastfeeding so much.  By not apologizing for our bodies, not suppressing our bodies, and having peace in who we are and how we are can help mothers find the confidence they are going to need for the really tough parts of parenting.  Feeding their children, be it breastmilk or formula, is one of the very first steps all parents must take, undermining their confidence there is insidious and damaging.  People that are confident are more free to love, learn, and live with joy.  Babies with confident parents have a place to land softly no matter what life throws at them.  I’m not passionate about breastfeeding, I never have been.  People are my passion.  People start out as babies.  Babies are cared for by parents.  Parents are people.

This may not make me popular in some circles, I don’t mind.  But I believe that having a hurt, angry, bitter mother struggling with their own confidence and ability to parent is far, far worse than feeding a baby formula could ever be.  I think breastmilk is great but I think caring for people is even greater.  The benefits of confident parenting far outweigh the risks.

I would never tell a woman, or anyone, what to do with their body nor what to do with their child.  Respecting their ability and responsibility in making the right decision for themselves and their family based on the circumstances they face with the information and resources available to them at that time means I don’t know what they should do.  All I can do is offer support, information, and encourage them to embrace their confidence and move forward with peace.

This is why at The Leaky Boob we believe:

Feed the baby, care for the mother, support the family.

But if you need some help or support to feed your baby how you want: we are here.

If you need help with how to correctly mix and prepare a formula bottle: we are here.

If you need help with breastfeeding: we are here.

If you need help going back to work and continuing to breastfeed: we are here.

If you need help weaning (at any age): we are here.

If you need help starting solids: we are here.

If you just want to talk: we are here.

 

Walk in confidence, live with peace, land softly.

 

Community.  Support.  TLB.

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