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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Breastfeeding beyond Infancy in Developed Countries

By Star Rodriguez for The Leaky [email protected]@b
This post made possible in part by the generous support of Motherlove Herbal Company.
Breastfeeding beyond 12 months

Imagine a mom breastfeeding a baby.  Now imagine her breastfeeding a toddler.  Now a preschooler.  Do you feel uncomfortable with any of those images?  When do you start to feel a little weird?

In developed countries where breastfeeding duration is low and where nursing in public isn’t seen as often, it’s pretty normal to have a point where you begin to feel a little uncomfortable with thinking about breastfeeding a child.  After all, there are a multitude of foods and drink available readily and safely in developed countries, so why on Earth would someone need or want to nurse, say, a three or four year old child?

First, it’s helpful to understand what our natural weaning age probably is.  Katherine Dettwyler, Phd, professor of anthropology looked at natural weaning ages of animals and came up with five possible ranges.  First, she looked at when permanent molars come in, a normal weaning time for primates.  That puts the range at five to six years old for human kids.  Animals also often wean babies based on when they reach about a third of their adult body weight.  This puts human kiddos at four to seven years old.  With some primates, though, adult body size and not weight is the true test; our children would wean naturally, then, somewhere between the end of the second year and the end of the third year.  Some mammals nurse until their babies have tripled or quadrupled birth weight; this would mean human babies would naturally wean somewhere between two to three years old.  Finally, many mammals wean after the baby has been alive for about six times the length of gestation.  Therefore, human babies would breastfeed around four to five years.

Clearly, most of us are not breastfeeding our children until they are six or seven years old in developed countries where they have a plethora of other foods and many social activities.  However, there are a lot of women who quietly report to me that they nursed to two or three years, although they don’t tell their friends or extended families, because “they’d think I was crazy!”  More often than that, I get moms calling me, asking me how long babies should nurse, and what the benefits are to nursing beyond a year.

Sadly, there aren’t a lot of studies on breastfeeding beyond infancy in the developed world.  I’ve been told that this is because there aren’t a lot of women who continue beyond that, and, statistically, that is very true.  I see Leakies every day discussing breastfeeding beyond a year, and there are articles and websites that mention it regularly.  So I think there are more moms out there doing it than we often admit, but it might be difficult to gather them up in one place for a study.

That all said, we can surmise a few things from studies in less developed areas and what we already know about breastfeeding and breastmilk.

First, breastfeeding can foster independence.  Yes, you read that correctly.  Children are learning to be independent, especially through toddlerhood.  I am aware of this every day as my three year old rushes to tell me, “I do it!” and gets incredibly mad if I try to help her, or if she needs help.  Children still are dependent on their primary caregivers, though.  Nursing meets a lot of their dependent, nurturing needs and can help them to feel as though they are able to express their independence while knowing that they are able to be comforted and close to their mothers when they need to be.

Breastfeeding also provides antibodies.  How many toddlers and preschoolers stick everything in their mouths, as often as they can?  How many have no concept of personal hygiene, picking their noses, eating food off the floor, sneezing in the faces of others, and so on?  By continuing to breastfeed, you are continuing to provide them with immune protection tailored to the environment that they are in.  It won’t stop them from ever getting sick, but it can be helpful to some viruses.

Breastmilk remains tailored to the child and is often something that children can take in even when they are ill and not holding much else down.  The calories and fat in breastmilk are not empty calories like many other easily held down liquids (like lemon lime sodas, ginger ales, etc.)

Breastfeeding has analgesic properties to it.  Think about how often young children get bumps, bruises, and owies.  Carrying around something that can help them to feel better about those is a wonderful thing.

As far as moms are concerned, many of the wonderful things that breastfeeding does for mothers are dose related.  For instance, the longer women breastfeed over their lifetime, the more their breast cancer risk is reduced, and that’s certainly not the only health benefit that is tied to duration.  Further, mothers who continue breastfeeding continue to produce milk and subsequently burn a few extra calories, too.  Who couldn’t use, say, an extra cookie a day?

At the end of the day, the length of time that a mother/baby dyad decides to continue breastfeeding is a very personal thing.  Despite the fact that we live in a developed society where extended breastfeeding may not be necessary for survival, it can be a meaningful and beneficial thing to moms and babies.

________________________________

How do you feel about breastfeeding beyond the first year?  

How do you personally determine the duration of breastfeeding with your own children?

How much has cultural expectations impacted how long you were/are willing to breastfeed?

_______________________________

breastfeedingStar Rodriguez is an International Board Certified Lactation Consultant, student, and mother of two in Minnesota.  She has done private practice work, worked with WIC, and now works in a hospital setting.  She is available for online consulting and in-person consults in the Brainerd Lakes area.  She can be reached through the Facebook page of Lactastic Services or you can find more information at www.lactastic.com.
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Weaning the Breastfed Baby

by Star Rodriguez, IBCLC for The Leaky Boob
this post made possible by the generous support of Fairhaven Health.

breastfeeding latch

In my practice, I do prenatal consults.  During these, almost 100% of the time, people ask me, “So, how long am I supposed to do this, anyway?”  I typically tell pregnant moms and their families that the American Academy of Pediatrics recommends that you exclusively nurse for 6 months, continuing until at least a year once complimentary foods are introduced.  The World Health Organization recommends nursing until two years of age.  However, I always caution my families that breastfeeding is a very personal thing between a mother and baby dyad and that people typically have an idea of when they are done nursing.  This may vary from what you thought it would be while pregnant, or what it was during other breastfeeding relationships.

There are two different types of weaning.  Baby initiated weaning and mother initiated weaning.  Baby initiated weaning is probably the easiest way to do it.  The baby generally gradually starts nursing less and less until baby just eventually stops.  It’s easy for baby and easy for mom.  Well, mostly.  With either baby initiated weaning or mother initiated, there can be some sad feelings when the breastfeeding relationship ends.  Check out the post on weaning ceremonies to find ways to celebrate the nursing relationship.

A word of caution: some babies exhibit behaviors that we call nursing strikes.  Nursing strikes are not cues to wean.  They are when a baby who is normally fine with breastfeeding, or happy at the breast, will suddenly refuse it and become fussy, often in the first year.  This is typically not a baby signaling intent to wean.  It is usually linked to something like illness, teething, an increase in social behavior, or something like that.  True baby initiated weaning is not usually accompanied by an unhappy baby.

With mother initiated weaning the mother decides, for some reason, to cease breastfeeding.  This is a little harder on most babies, because typical breastfed babies like to nurse.  It is not, however, as hard as some people make it out to be.  I have had patients tell me that they cannot possibly nurse their babies because it will be a very difficult endeavor to wean them.  Trust that if you decide you are done breastfeeding, at any age you can stop, and you will probably not have to spend millions in therapy because of it.

I rarely recommend weaning cold turkey (where you just stop weaning, with no gradual step down.)    There are a few reasons why this is a bad plan in most circumstances.  First, babies don’t often take well to this.  If you suddenly stop breastfeeding and give babies just bottles, most of them will be a little confused and a lot upset.  Secondly, it’s not great for Mom, either.  Moms that wean suddenly often experience engorgement (again!) and can experience plugged ducts and infections.  It’s just not a lot of fun.

There are, however, some medical reasons that you may need to wean cold turkey.  First, make sure that this isn’t something that will only interrupt breastfeeding short term.  If it is, you may be able to pump and dump during that time and resume nursing after if you would like.  If it is a long term thing, though, try not to feel guilty or upset.  Many of these reasons for needing to wean are serious emergencies to one’s mental or physical health, and in those circumstances, do not worry about the short term effects to your baby.  No, it is not ideal.  But your baby will not benefit as much from gradual diminishment of breastfeeding as they will from a healthy parent.  If you are in pain from sudden weaning, you can express a little milk when you are uncomfortable until your milk begins to dry up.  You may be able to use other things to help your milk dry up faster, but if you have weaned for a medical reason, you should always check with your medical provider first.

In lieu of needing to wean immediately, most in the breastfeeding community favor the gradual approach.  In this, you replace one feeding, beginning with the least favorite, with something else.  For a baby that is nursing as a form of primary nourishment, such as those that are under a year, you will have to replace that feeding with an equal source of nourishment.  For most babies, this will be formula or expressed breastmilk.  Hopefully, your baby will accept another method of feeding already, but, if not, be sure to keep an open mind.  You may offer the new type of feeding; someone else may offer it; and you can think of various different ways to give your baby nourishment (bottle, cup, sippy cup, syringe, etc., depending on age.)  If you have an older child who is receiving her primary nourishment from other foods, like most nursing toddlers, you can offer things like water (or another liquid) from a cup, a snack, or some kind of redirection.  You can also explain to your child – “We aren’t going to nurse right now, so we’re going to do (whatever) instead.”  Older children may not ask for it, and, if that happens, it is probably better to just not say anything at all.

After you have taken out that first, least important feeding, wait a few days or weeks (base this on the comfort of you and your baby – if your breasts are feeling overfull, or your child is not handling the transition well, you should wait a little longer until you adjust) and remove the next feeding.  That should be the new least important one.  (When I discuss the least important feedings, I mean the one the baby is the least attached to.  For example, often, the most important feeding is right before bedtime, and the least is during the day at some point.  Your mileage may vary, though.)  Again, wait until your breasts and baby have adjusted, and then repeat as needed.  You may find that partial weaning, where you remove some feedings while still allowing others, may be an option, too, if you are weaning for non-medical reasons.

During the time that you are weaning your baby, remember to be gentle on them – and you!  As I stated before, weaning can be an emotional experience for everyone, and the emotions may vary, a lot.  Some people feel happy and disappointed all at once.  Whatever you feel is ok.  Give your child lots of cuddles and kisses during this time.  You will both benefit from this and it will ease the transition.  When it is time to wean, whenever that is for you and your child, many moms discover that the relationship they have with their child changes some and while it is normal to miss what you had, new ways of bonding and sharing time together will emerge for you both to enjoy.

 _________________________

How old was your baby when you weaned?  How did you feel?

_________________________

 

 

 

 

 

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12 Weaning Ceremonies


Breastfeeding can be such a sacred time in our lives. While we cherish the breastfeeding journey, it is rare in our culture to commemorate the end of breastfeeding with little more than a note in the baby book. If breastfeeding was important to you, consider celebrating your experiences and remembering this special transition with a weaning ceremony.

Your weaning ceremony can serve multiple purposes. If you choose to involve your child, it can be an event to mark the end of nursing – something that mother and child gently discuss and plan in anticipation of weaning. For mothers and their partners, a weaning ceremony is a way to honor the transition from breastfeeding to nursing beyond the breast, and all of the emotions that accompany that change.

Some children may not benefit from a definite, marked end to the nursing relationship. If a slow, natural end to breastfeeding is more comfortable for your child, you can still hold a quiet ceremony by yourself, with your spouse, or with other mothers who can understand and support you through this transition. Don’t be afraid to mourn the end of breastfeeding – it is a normal and healthy response to this change. But after you’ve given yourself time to mourn, consciously meditate on the joys of mothering a child who has weaned. A weaning ceremony can help you mindfully navigate this change.

Below are 12 weaning ceremony ideas that you can adapt to meet your own needs and those of your nursling. If you have other ceremony ideas, please share them in the comments so I can add them to the list.

    1. Write your nursling a letter. Include anything you’d like to share about your nursing relationship, what this change means to you, your hopes and dreams for them, etc. I found two examples of weaning letters: one at Mothering.com, the other from a Jewish mother at ritualwell.
    2. Anoint yourself with herbs for weaning. Herbs can help with physical discomfort and emotional healing. Kellymom lists several herbs to help decrease milk supply, including sage and peppermint. Earth Mama Angel Baby makes a No More Milk tea that includes some of these herbs. And because you will experience a drop in prolactin levels during weaning, it may also help to prepare yourself with herbal remedies for depression.(1) Herbs to help alleviate depression that are safe to use while breastfeeding include St. Johnís wort, Evening primrose oil, Motherwort, and Blessed thistle.(2)
    3. Write your breastfeeding story. Start with those milky newborn memories – the pursed lips nursing even after they’ve unlatched, sleepy rooting at all hours of the day and night, the newness of life and the awe of continuing to grow your baby with your own body. Continue on through infancy – those milky smiles, dive bombing for your breast, the day your little one first starts babbling or signing in a recognizable way for milk. Write about the joys of breastfeeding past infancy – nursing gymnastics, manners, nursing away every hurt, the special words and phrases you and your nursling share.(3) Share the highs and lows of your nursing experience and the emotions you’ve gone through along the way. Here are two stories to get you started: one at Kellymom, another at La Leche League International.
    4. Throw a weaning party. For little ones who need a celebration to mark the occasion of weaning, consider having an intimate party – just you and your nursling and partner. Make special foods, bake a cake, whatever makes it special for your family. Here is an example of a weaning party.
    5. Write a book. Create a personal book for your child about their breastfeeding journey, their babyhood, and their transition into a “big kid.”
    6. Hold a special ceremony for your nursling.Sometimes breastfeeding pairs need to wean when neither mama nor child is ready. In these situations, a special ceremony may help mark the day of weaning, helping the child clearly see the end of nursing while beginning the grieving process for both in a bittersweet way.Jessica of The Leaky [email protected]@b was pregnant, gaining very little weight, and felt pressured by her care providers to wean. To help give closure to her 21 month old nursling, Jessica, her husband, and the big sisters all wrote a special note for the nursling. After eating a special meal together, the family gathered around a candle. Jessica invited her nursling to climb into her lap for one last nursing session. As her nursling snuggled in, the family read their letters to the child. They also gave her several sweet gifts. When she was finished nursing, she blew out the candle.

      While your weaning ceremony will be memorable and sweet, be prepared for nurslings to continue to ask to nurse. They simply do not understand what it means to wean forever, and you will very likely have to soothe many tears in the weeks to come (as Jessica did).

    7. Give yourself (and/or your child) a gift. Find something special that represents this transition. I highly recommend Hollyday Designs breastmilk jewelry – it is beautiful.
    8. Create a breastfeeding scrapbook. Gather pictures and/or video of you and your little one snuggling and nursing and compile them into a keepsake scrapbook (a virtual one or one that you can hold).
    9. Go on a date. Take your nursling somewhere special. Make it an event that represents how “grown up” they are.
    10. Tell your child their nursing story. Regardless of whether you write it down, tell your little one about your nursing journey as you’ve lived it. Telling them this story over the years will help normalize breastfeeding for them, and it will help you both retain sweet memories from their nursing years.
    11. Choose a special time to be together. If you or your little one are missing a regular nursing time, find something special you can do together every day at that time instead. Think about snuggling, reading, yoga, meditation, art, or some other activity you will both enjoy. For as long as you need to throughout and after the weaning process, take a few moments at the beginning of your special time to check in with yourself and truly be present with your child.
    12. Design your own ritual.Several cultures and religions have weaning ceremonies. Research them and design a ceremony that will be meaningful to your family. Here are a few resources to get you started:

Did you do something to mark the end of your breastfeeding relationship? Please share in the comments.

Footnotes:
(1) From Kellymom: “Prolactin, the hormone that stimulates milk production, also brings with it a feeling of well-being, calmness and relaxation. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely that you will experience adverse effects.”
(2) Safe herb list found here. It also says that St. Johnís wort should not be taken in conjunction with any other depression medication.
(3) And if you’d like to share your nursing past infancy story, consider submitting it to my series. See my Contributor Guidelines page for more details.

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Dionna is a lawyer turned work at home mama of two amazing kids, Kieran and Ailia. You can normally find Dionna over at Code Name: Mama where she shares information, resources, and her thoughts on natural parenting and life with little ones. Dionna is also cofounder of Natural Parents Network and NursingFreedom.org, and author of For My Children: A Mother’s Journal of Memories, Wishes, and Wisdom.
Connect with Dionna on Facebook, Twitter, and Pinterest!

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