Picking Bottle Nipples for the Breastfed Baby

With Amy Peterson, IBCLC

This post made possible by the support of EvenFlo Feeding

Brand-Ad_29APR16________________________

Lots of breastfed babies will also use a bottle. Most of us have heard that introducing a bottle can potentially have a negative impact on the breastfeeding relationship. But thankfully, we can control these risks.

Lower risks

Latch:  The way your baby latches on the breast needs to be similar to the bottle. Look at your baby while s/he is feeding at your breast.  Notice how the bottom lip flares, and the top lip rests in a neutral position. Observe how the corners of the mouth seal on the breast, and how milk doesn’t leak from the lips while baby feeds. Pull down baby’s lip slightly and see the baby’s tongue cup or curves around your nipple. We look for these same characteristics when baby sucks on a bottle nipple.

gradual wide leaking bad

Not a good latch: Averted gaze (no eye contact), top lip rolled in, leaking at corners, latched more toward the tip.

wide abrupt good no leak

Decent Latch: Eye contact, flared lips, deep latch near collar of bottle, relaxed posture, no leaking at corners.

 

Flow preference: You want your baby to prefer the flow of your breast over the flow of a bottle. There is no standard flow rate for bottle nipples, so you might have to try more than one bottle to find a similar swallow pattern. Most babies will use a slow flow nipple, but slow flow isn’t best for every baby–match your own flow. For detailed information, Balancing Breast and Bottle lists bottle flow rates in Appendix C.

Milk supply:  Anytime the baby takes 2 ounces from the bottle, ideally you will be able to pump this amount so your body knows how much your baby is taking and can maintain your supply. But don’t worry if you don’t pump exactly what your baby eats every time, baby is likely more effective at removing milk from your breast than a pump will be. Adding a pumping session may be necessary to ensure you’re producing the amount needed for your child’s bottle feed.

 

breastfeeding and bottle feeding

Good latch: Eye contact, flared top and bottom lips, no leaking, medium depth latch, relaxed posture.

 

Reduce risks by picking a nipple shape

One way to reduce bottle risks is in choosing the nipple shape we use to bottle-feed our baby.

Nipples have three general shapes: narrow, wide-abrupt, and wide-gradual.  

bottle nipple - narrowbottle nipple - wide abruptFullSizeRender

Narrow neck nipples fit narrow neck bottles, and most have a gradual transition from nipple length to base where the baby’s lips can slide easily to latch deeply.

Wide neck nipples fit wide neck bottles.  Wide, abrupt shapes have an abrupt transition (like a 90 degree angle) between the nipple length and nipple base. Make sure your baby is able to rest their lips opened widely on the nipple base, not suck on the nipple length like a straw. Also, make sure your baby is able to fully seal the lips without gaps in the corners of the mouth.

Wide, gradual shapes gradually blend from the nipple length to the base. This shape may help the baby’s lips to rest on a portion of the base, and help the lips to form a complete seal. Make sure your baby is able to keep the nipple inserted deeply during feeding, rather than sliding down to the tip of the nipple.

 

Best does not exist

Different bottle nipple shapes work for different babies. One bottle will not be best for all babies, but you can find which bottle is best for your baby.  Therefore, beware of marketing and packaging claims. You’ve probably noticed many bottles claim to be best for breastfed babies, or to look just like the breast. But neither of these statements matters. How your baby latches onto the bottle nipple matters, not the packaging claims. You have found the right nipple when the nipple tip reaches deeply into the baby’s mouth; tongue cups the nipple; lips open widely and rest on a portion of the base; lips form a complete seal.

Additionally, now that you know that one bottle will not be best for every baby, don’t be swayed when you hear which bottle is “best” from other moms; what’s best for their baby might be terrible for your baby. You will need to look at your baby’s latch and then decide.

Picking bottle nipples - evenflo cobranded

Buying bottles

If you are having trouble finding a bottle your baby accepts, make sure you have tried all three types: narrow, wide-abrupt, and wide-gradual.  A lot of moms tend to buy various bottles marketed for breastfed babies, and then end up with a bunch of wide-abrupt shapes. Make sure you try the other shapes.

Chances are you will own more than one type of bottle, either bottles you have experimented with, or baby shower gifts that your baby can’t achieve a good latch with. Don’t despair.  As your baby grows, the mouth grows as well.  Nipples that do not work for young babies often work well when the baby’s mouth is bigger, say 4 months or so. Feel free to try the other nipples you have when your baby is older, and check the latch again.

________________________

Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.
Share

Pumping Breastmilk and What You Need To Know

By Amy Peterson, IBCLC

This article made possible by the generous support of Earth Mama Angel Baby.

earth-mama-angel-baby-2016

Not every mom needs to pump. When baby is with mom for feedings and transferring milk effectively, there is no need to pump. But there are times when pumping breastmilk is important:

  •      Baby needs more milk (a supplement for one or more feeds)
  •      Mom wants to increase her supply
  •      Mom and baby are apart for feedings, such as when mom is at work or school
  •      Mom wants to have someone else participate in feedings
  •      Anytime mom will miss a feeding

In these circumstances, using a breast pump helps maintain or increase the milk supply for future feedings, and the pumped milk offers the perfect food for baby. This article touches on choosing between the different types of breast pumps, general pumping guidelines, and tips for increasing milk supply if necessary.

When possible, choose a pump that meets your unique situation. If you’ll only miss a feed or two each week, a manual pump or single electric is plenty. If you need to pump for several feedings a day, a high quality, double electric pump is a better choice.  If your baby is hospitalized or you need to dedicate time to increasing your supply, a hospital grade/rental pump is the best choice.

You can get a breast pump from many different places: box stores (Babies ‘R Us, Target, WalMart, etc.), online, a friend, thrift store, or possibly through your insurance company. Buying a used breast pump or borrowing a pump is usually not recommended. Most brands are considered single user items. These pumps do not control for the transfer of bacteria or germs between the pump motor and the milk, putting the baby’s health at risk. If you know the pump brand has a closed system, you could consider purchasing a new collection kit with tubing. Even so, you may not know if the pump is working less effectively than when purchased new, potentially putting your supply at risk.

earth-mama-angel-baby-2016-2

It is also important to note that not all women respond well to pumps and not all pumps work equally well for every lactating individual. This is why we have options. There are various contributing aspects that may impact how well a pump performs such as flange size, suction strength, type of suction, etc. If a pump is not working well for you it is possible that another would. Some breasts prefer one pump over another and some breasts prefer manual expression.

Most breast pumps have two settings. One button controls the vacuum, and the other button controls how fast the pump cycles (sucks). These settings let you fine tune the pump to mimic your baby’s suction and rhythm. For maximum milk production, use the highest comfortable suction. Use a fast cycling rate until your milk flows, then adjust to your comfort level; this mimics how your baby sucks before and after a let-down. A few brands of breast pumps have a built in feature that begins with fast cycling and adjusts slower. Some moms find they have better milk flow when they reset the button and continue with fast cycling.

Here are some general pumping guidelines to get you started:

  •      Pump for any feeding you will miss. Your milk supply is based on supply and demand, and pumping for each missed feeding tells your body to keep producing milk during that time.
  •      Pump the amount of milk your baby needs.  For example, if your baby takes 3 ounces of milk, pump 3 ounces total (1 ½ ounces from each breast).  If you pump what you need in 4 minutes—you can stop pumping.
  •      Pump between feedings to build a bottle. You can combine the milk from several pumping sessions to make a larger bottle of milk.
  •      Pump at night or in the early morning hours when your supply is highest.
  •      A gentle breast massage routine, called hands-on pumping, has been proven effective in increasing the amount of milk a mom can pump. Check it out here.

For moms who are not able to pump enough milk and who want to increase their supply, there are additional pumping tips:

  •      Pump until your milk stops flowing, and then pump two more minutes. This limited extra pumping is enough to tell your breasts to make more.
  •      Pump more often. Leave your pump set up (where your toddler can’t reach it!). Pump for 5-10 minutes once or twice an hour.
  •      Use the hands-on pumping technique listed here and above.
  •      Know that pumping alone may not increase your milk supply. Work with a breastfeeding helper who is knowledgeable about other targeted methods to boost supply.
  •      While you work on increasing your milk supply, feed your baby. You can combine your breastmilk with donor milk or formula to be sure your baby is getting enough. Some moms choose to feed breastmilk separate from formula to avoid wasting any breastmilk if baby doesn’t finish the bottle. As long as your guestimate is cautious, it is safe to mix; the milks will mix in baby’s belly anyway.

While pumping is an important aspect for many families in reaching their breastfeeding goals, how much is pumped is not a reliable sign of milk production. As with most areas of parenting, take your cues from your baby. When baby is growing well and reaching milestones within range then how much you pump doesn’t need to be a concern. If you see signs of dehydration or poor weight gain, speak with your child’s healthcare provider.

________________________

earth-mama-angel-baby-nov-2016

Happy pumping mamas! You’ve totally got this and we’ve teamed up with Earth Mama Angel Baby to support you in your pumping journey with a giveaway of Earth Mama Angel Baby’s Milk-to-Go kit for Leakies in the USA. A $40 retail value, this kit includes:

One pair of Booby Tubes® (one pair) for cold or warm therapeutic use, 1 box of Organic Milkmaid Tea (16 tea bags) a fragrant comforting blend that supports healthy breast milk production, safe Natural Nipple Butter (1 fl. oz.), Happy Mama Body Wash (1.67 fl. oz.), one Eco-friendly Reusable Insulated Bag, and a tasty recipe for Organic Milkmaid French Vanilla Chai.

Use the widget below to be entered!

________________________

a Rafflecopter giveaway

Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.

 

 

Share

TLB Comic: Boobs Here, Boobs There, Boobs EVERYWHERE! + Bonus Frame

by Jennie Bernstein

Unknown-1

____________________

Unknown

Share

Call for speakers- MILK: An Infant Feeding Conference, 2016

Milk Conference banner

Calling for submissions from clinicians, scholars, researchers, students, artists, mothers, fathers, and others familiar with infant feeding from clinical and social perspectives. Submissions of a wide variety are welcome, including research presentations, theoretical papers, academic papers, creative submissions including personal essays, social commentary, literature, and performance art for the 2016 Milk Conference.

Milk: An Infant Feeding Conference 2016 will be held November 11-12 in Costa Mesa, California and is open to health care providers and consumers alike aiming to a create a bridge building experience that educates and supports infant feeding by changing the conversation both systemically and sociologically.

The theme chosen for 2016  Milk: An Infant Feeding Conference is Nourish. Exploring how infant feeding provides not only physical nourishment with a look at the nutritional composition involved, we will be unpacking just how feeding our babies nourishes our minds, our families, attachment, confidence, partnerships, public health, education, and other social factors.

We are looking for presentations on topics related to infant feeding and maternal health including but not limited to: continuity of care and infant nutrition, the diagnoses and care of physiological barriers to breastfeeding, sociological barriers involved in infant feeding, anthropological perspectives of infant nutrition, analysis of marketing in the maternal baby industry, conscientious marketing, exploration of infant feeding and child nutrition controversies, policies in the workplace for family support and breastfeeding, politics of infant feeding and policy making, postpartum depression and mental health research related to infant feeding, infant feeding practices in subsequent children, sociological family support and infant and child nutrition, infant feeding education, infant nutrition in public health, feeding multiples, managing maternal health issues through breastfeeding, nonviolent communication strategies for supporting infant feeding, developing infant feeding support products, immediate postpartum infant feeding support, the impact of birth interventions on maternal breastfeeding goals, maternal and pediatric allergies and infant nutrition, premature infants and nutrition, feminism and infant feeding, natural duration breastfeeding, weaning, infant nutrition and sleep, partner support and education, breastfeeding after breast reduction, socioeconomic and racial disparities in infant feeding support, breastmilk pumping, inducing lactation and relactation, the role of infant nutrition in relation to dental care, and the future of infant nutrition support.

To submit to speak at Milk 2016, please use this form.

 

Share

Receiving Breastfeeding and Pumping Support Online and Over the Phone

by Linda Zager

600x200 Banner Ameda

In today’s busy world moms cannot always find time to meet with a lactation professional in-person when support is needed. These professionals can be far away, only have office hours at limited times and let’s be honest, when you have a newborn it can be near impossible to even get dressed let alone making it out of the house. But there is hope! Breastfeeding moms can receive support by reaching out by phone and speaking with a Lactation Consultant, nurse or a member of the breastfeeding community regarding breastfeeding or pumping concerns. Phone triage is a first step to resolving some breastfeeding issues. Mom’s face frustration caused by inconsistent information about breastfeeding and often, the unique personality of the baby is not taken into consideration.

Amanda, ParentCare smaller

 

Families can experience stress once they bring their baby home from the hospital. There may be questions surrounding breastfeeding and learning to “read” the newest addition to their family.  A phone conversation can dispel common myths. Offering a small amount of education and lending an empathetic ear goes a long way. By listening carefully, a lactation professional will be capable of addressing some issues by phone. Offering mom different ideas of how to resolve simple issues can also empower moms! Follow up is often necessary to assess if the advice resolved the issue.  The lactation professional may detect a more complicated issue that cannot be addressed over the phone, and in that case, the mom will be referred to a skilled Lactation Specialist for an in-person assessment.

The challenge for those who are providing support to breastfeeding women over the phone will be to distinguish between the mothers and babies whose situations are uncomplicated and those who will need the special assistance of a skilled International Board Certified Lactation Consultant(IBCLC). Proper assessment of the breastfeeding process requires an understanding of how the anatomy, physiology and psychology of how the mom and infant interact during lactation. Conducting a thorough history of the breastfeeding woman’s pregnancy, labor and delivery and postpartum period can shed light on any complications that could affect breastfeeding.

 

Pumping moms can seek advice over the phone to resolve problems they are experiencing with breast pumping. All Moms are unique and may have different experiences when using a breast pump. Not all breast pumps are made to operate in the same manner and one type of breast pump can work very well for one woman and poorly for another. Therefore the person offering advice on pumping by phone requires education on various types of breast pumps, which pump is best for the reason mom is using it, basics of pumping and suggestions to help stimulate a milk letdown. Moms need to be directed to READ the instruction manual of their breast pump and not assume it works like her friends or the one she used 3 years ago. Mom needs to be patient with her body as it adapts to a breast pump to express her milk. The first few pumping sessions should be looked at as practice. Pumping is very different than nursing a baby and a body needs to adapt to this difference. Pumping should never be a painful experience. If a mom is stating pumping is painful, factors such as flange size, suction pressure and pumping technique must be reviewed with her.

Lynn, ParentCare smaller

 

Karen, ParentCare smaller

 

At Ameda, we have ParentCare Specialists available that are knowledgeable in the basics of pumping and how the Ameda breast pump functions. The representatives are responsible for thorough troubleshooting of the Ameda breast pump if an issue occurs so the mom has a positive pumping experience. If a ParentCare Specialist cannot resolve the issue, the mom’s case file is escalated to one of our IBCLC’s for assistance. And that is where I come in, I am a RN and IBCLC. I assist moms with both breastfeeding and pumping issues using phone triage to find a resolution to an issue. A mom who finds breastfeeding support during her motherhood journey can reach her goal of feeding her baby breast milk – a truly special gift.

 

Linda, IBCLC2 smallerLinda Zager, RN, IBCLC
I’ve been an RN for 37 years, working in various hospital positions from Intensive Care to Hemodialysis/Plasmapheresis, Maternal Child Care and finally Lactation Consulting, my true calling in life. I have been an IBCLC for 23 years working with moms/babies in their homes and in the hospital. I left hospital work and now work as Ameda, Inc.’s Nurse Clinician/Lactation Consultant in the ParentCare division. I speak with mothers all over the country when they require resolution to breastfeeding/pumping issues.
Share

Lactation Consultant Licensure in the United States

By Stephanie Rodriguez-Moser, IBCLC, RLC

Breastfeeding newborn

On July 3rd of 2014, something very exciting happened in the lactation world. Rhode Island passed a bill that would allow International Board Certified Lactation Consultants (IBCLCs) to be licensed providers.   A surprising number of people have no idea that this occurred, or what it means for professionals, mothers, and babies.

Licensure is something that lactation consultants have been working towards for a long time. Breastfeeding support has many faces, and this can lead to a lot of confusion for those looking for lactation services. The Massachusetts Breastfeeding Coalition has a wonderful document that goes into all of the credentials out there and what they mean, what they stand for, and what kind of services they provide. If you click on that link and download the PDF, you will see that it is really, really long.   There are 14 types of lactation help listed, and several of them use a “L” and “C” in the name, even though they all have different standards of what they are, what they do, and what their scope of practice is.

Currently, anyone practicing breastfeeding care can call themselves a lactation consultant. It’s not a protected term. This can be a problem, because a mom who thinks she is getting help from a qualified, trained professional might actually be getting help from a lay person. While I firmly believe that there is a need for many types of lactation support and assistance, I just as passionately believe that mothers have the right and need to know the training of the people that are helping them. Generally speaking, IBCLCs are the most qualified to be engaging in clinical care of the mother/infant dyad as breastfeeding is concerned. Most of the other certificates or certifications are qualified to provide education and basic counseling.

Licensure of IBCLCs protects mothers. It provides a way for mothers to know that the person they are seeking out has met the standard of qualifications dictated by the International Board of Lactation Consultant Examiners (IBLCE). This includes lactation specific training, college coursework, clinical hours, passing a comprehensive exam, and regular recertification. A licensed body means that mothers would have a board to file a complaint with if the IBCLC damaged their breastfeeding relationship or acted in an unprofessional or unethical manner.

This would also help IBCLCs be placed in more areas. There are many “lactation deserts” out there, where help and support is difficult or impossible to come by. This isn’t due to lack of IBCLCs, but it is due to lack of job opportunities and reimbursement options. The Affordable Care Act was great for breastfeeding support, but failed to define who was a trained lactation care provider that was eligible for reimbursement. IBCLCs that are non-nurses, not advanced practice nurses, et cetera, are not seen as billable licensed providers for lactation care in many states – especially through Medicaid. Hospitals and clinics are therefore often skittish about hiring someone for lactation care alone, as reimbursement can be a problem. Private practice providers have a difficult time getting insurance companies to see them as reimbursable. WIC clinics often don’t have the budget to hire IBCLCs as stand alone IBCLCs, especially in smaller areas. This leads to women in minority and/or socioeconomically challenged areas not having available help, despite the fact that these are the women facing some of the biggest challenges with breastfeeding.

We all want mothers to be supported in their unique breastfeeding goals, be that a year (or more!) or a month or even a day. Access to qualified care is one of the best ways to make this happen – and licensure is a big part of that. I encourage you to find a way to get involved in licensure efforts in your state. As someone who is chairing a licensure effort, I can assure you – we need a lot of help! Please find your state’s information below and see what you can do.

(If your state is not listed or is listed incorrectly and you know the licensure contact information for it, please let us know. We would love to include them!)

Colorado

Florida

Georgia and More for Georgia

Massachusets

Minnesota

Pennsylvania

New York

North Carolina

Utah

Is your state missing? Please contact your state breastfeeding coalition to ask what they are doing for advocacy in your area!

 

Starbaby Star Rodriguez, IBCLC, RLC is a provider in the Central Lakes, MN area.  She provides services online at Lactastic Services and in person.  She also blogs for The Leaky [email protected]@b and volunteers her services to loss mothers at Stillbirthday.

 

Share

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.  
Share

Dear Kathleen- Leakies ask an IBCLC

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,

After pumping, is it ok to feed the baby that milk and then if baby doesn’t finish to save the rest by putting it in the fridge?

Thanks!

Bewildered in pumping land

 

 

Hi Bewildered!

Pretty hard to work to express milk for your baby and then have to toss it out!  Some health care providers say to dump partially drank bottles, or give it at the next feeding.  I think that placing back an unfinished bottle of breast milk back into the refrigerator is just fine. I would suggest removing the nipple and screwing on a clean lid to keep the bacteria from the baby’s mouth to a minimum.  By using a fresh nipple for the next feed you will keep more germs from mixing in with that bottle of milk. I would recommend using the milk within the next 24 hours.  One very small study of just a few moms found that milk could be placed in the refrigerator for up to 36 hours at 4-6 degree Centigrade.  Storing milk in the back of the refrigerator is recommended. If you use the milk a second time, and there is still leftover milk, it is probably best to dump it out.  When milk has gone bad, it does have a rancid smell.

When pumping or feeding your baby a bottle, be sure to always start by washing your hands well.  Also, make sure that all of the pump parts are washed thoroughly in warm soapy water or in a dishwasher and if wet, left to dry on a clean paper towel. Also, try and store just small amount of milk for your baby; maybe just 2-3 ounces per bag or bottle. In that way, there will be less leftover milk to deal with.Hi Bewildered!  Pretty hard to work to express milk for your baby and then have to toss it out!  Some health care providers say to dump partially drank bottles, or give it at the next feeding, but I think that placing back an unfinished bottle of breast milk back into the refrigerator is just fine. I would suggest removing the nipple and screwing on a clean lid to keep the bacteria from the baby’s mouth to a minimum.  By using a fresh nipple for the next feed you will keep more germs from mixing in with that bottle of milk. I would recommend using the milk within the next 24 hours.  One very small study of just a few moms found that milk could be placed in the refrigerator for up to 36 hours at 4-6 degree Centigrade.  Storing milk in the back of the refrigerator is recommended. If you use the milk a second time, and there is still leftover milk, it is probably best to dump it out.  When milk has gone bad, it does have a rancid smell.

Happy pumping,

Kathleen

 

TLB meme breastmilk storage

 

Dear Kathleen,

As a first time mommy (I have a two week old girl), I’m really struggling to seek out why things to happen and don’t happen… maybe you can help? 

To make a long story short, I wanted to nurse my little one since day one she was born. However, I have flat nipples so not only was it extremely painful when she would latch on, but it was also challenging, frustrating and depressing because I refused to even give her a bit of formula. The pain was so strong when she would latch that I would cry every single time and I knew she could feel my frustration because she would stop and look at me. I even dreaded watching the clock because I knew that in a few minutes it was going to be time to nurse again. As the days passed, my baby lost almost 3 pounds under her birth weight because I thought she was getting enough milk from me but it turns out I was barely making any. That made me so sad; I felt like a HORRIBLE mother so because I wanted her to get better, my husband and I decided we give her formula. After she gained a few pounds (almost back to her birth weight), I tried nursing her AND giving her formula but she would no longer latch on to me. She obviously likes the bottle nipple better because she can actually latch on without struggling. I tried everything I could. I’ve tried pumping and nothing comes out. Maybe one drop– if not, two. I’m honestly broken yet content she’s healthy once again. I’ve humbly given up on nursing because my husband and I feel it’s the healthiest decision for her and I. She won’t get frustrated and I won’t dread seeing her precious innocent face. We’re just bottle feeding her now but a lot of questions are going through my mind such as will be baby still be healthy with formula?

I did everything I could and I STILL am. Even though my milk is drying, I’m striving to keep it going by taking some pills that will help my milk come down. I’m doing this with the hope that once my milk comes down FULLY, I’ll be able to pump and mix it with her formula. 

I welcome your advice and encouragement. 

Love,

Disappointed but hopeful

 

 

Hello Disappointed,

I am sorry that you didn’t get the help you needed and suffered so much both physically and emotionally.  Unfortunately at this point, with your milk nearly gone, you need to make a final decision.

I do have questions for you, but in this Q&A format, I can only wonder.  Did your breasts grew during pregnancy?  Is less than an inch of space between them?  If the answers to these questions is no, then you may have insufficient glandular tissue which limits the amount of milk that can be produced.  That could explain the initial weight loss.

Yes, you can relactate but that takes a lot of time and effort and, in my opinion, you need to make a commitment to either go full steam ahead or let it go.  If you decide to relactate, you will need a rental grade pump and pump at least 8 times every 24 hours including during the night, using a double pump kit for about 15-20 minutes.   While some people may suggest teas, cookies and other herbs such as fenugreek, I think you need bigger guns!  You should consider taking the medication Motilium (Domperidone) that is available through compounding pharmacies with a prescription from your OB or midwife. If you are going to get some, I would suggest getting a month’s worth to start.  The typical starting dose is 30 mgms three times a day but can be increased to 40 mgms four times a day.  You can read more about taking Motilium on Dr. Jack Newman’s website.  Understand that pills, or herbs alone will not restart your production.  Your breasts must be stimulated and drained at least eight times each 24 hours.

If you start the Motilium and want to get more, it may be less expensive ordering it on-line through a New Zealand pharmacy.  There is a less expensive version, Domperon (a generic) that is $.12 per pill.  Under the care of your health care provider and with a prescription you can order Domperon online and delivery takes about 10-14 days to get a shipment.

Being only 2 weeks into this, unless you have insufficient glandular tissue, I think you could bring back your supply with the medication and pumping.  If you decide to move forward and your milk supply is equal to what your baby requires, about 3-4 ounces per feeding, I would urge you to consider an appointment with an experienced lactation consultant. Who knows, your baby may be able to nurse completely or with a formula supplement!

While breastmilk is the biological norm for human infants, your baby needs food and formula will provide her with the nutrition she needs.  What are missing are the live cells that protect her from illness and certain other factors in breast milk that protect against other conditions. As you are finding out, formula is also quite expensive.

While nursing is a loving and bonding experience, you can capture some of this with bottle-feeding. Please be sure to always hold your baby for feedings.  It isn’t long before babies can hold their own bottles and so many bottle-feeding parents take advantage of this.  Bottle-feeding requires both hands and I believe a majority of mothers hand over the bottle to the baby as soon as the baby can hold his own bottle. I think this allows the baby to bond with the bottle instead of their parents.  This may also be the reason that so many bottle-fed babies become overfed and overweight.  Parents simply fill the bottles to the top and the baby just sucks it down.  Consider trying baby-led bottle feeding if you need to continue with bottles and here’s some information about bottle feeding the breastfed baby.

So now the decision is up to you.  I know you will decide what is right for you and your baby, no matter which way you go.

All the best,

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.  

 

 

Share

IBCLCs, Negative Experiences, and Self-Advocacy

 

 

This post made possible in part by the generous support of Boba, makers of the Boba Baby Carrier.

Jessica and Sugarbaby Bfing

When my daughter was entering the 2nd grade at our local public school, we were all enthusiastic about the coming year.  She loved school, loved learning, loved everything about it.  But just a few short weeks into the school year things we drastically different.  She cried all the time, she hated going to school, she started struggling with school work, and every day she complained that her tummy hurt and she was too sick to go to school.  We were confused.  What had happened to our little girl?

It quickly became apparent that while there were multiple issues going on that I won’t go into here except to say there were some technical difficulties and an adjustment period that needed to happen.  Still, there was one particular issue that emerged as being critical: she didn’t like her teacher.  Believing we need to encourage her to work with people, even ones she didn’t like, The Piano Man and I tried to help her navigate this relationship.  This proved to be more challenging than we expected because, as it turned out, we didn’t like her either.  She simply wasn’t the kind of person we thought would be teaching second grade.  Or teaching at all.  Grough, grumpy, rarely smiled, she came across as cold and distant.  Suddenly, challenges our daughter had previously felt empowered to tackle loomed as impossible mountains.  Intimidated by the one she thought was there to guide and support her in facing these challenges, she withdrew and began to give up.

We tried to work with the school and the teacher but in a short amount of time we felt we needed to explore other options and ended up transferring schools.  It was that, or risk killing our daughter’s love for learning and that simply wasn’t something we were willing to sacrifice.

When we visited the new school Earth Baby was nervous about meeting the 2nd grade teacher.  Gripping my hand she whispered “I don’t like 2nd grade teachers, they are mean.”  I was surprised she had already jumped to a conclusion about a group of people based on her experience with just one of that group.  Given that she was 7 at the time, I probably shouldn’t have been surprised at such an immature response but I felt that we had worked hard to help our children understand how individuals can be so different.  Encouraging her to remember that Miss B. would be a person first, a 2nd grade teacher second, we met with the teacher.  Gentle, kind, friendly, and very warm, Miss B. proved to be the opposite of the previous 2nd grade teacher and Earth Baby ended up flourishing in her class.  Inspired with hope and confidence, Earth Baby made a lifelong friend in her teacher (and is seeing her this summer) and not only met but surpassed her goals for the year with an enflamed love of learning.  Interestingly enough, now she will talk about how wonderful 2nd grade teachers are and being a teacher is in her top 5 career options.

Why am I sharing this story on a breastfeeding site?  Moms often come to TLB looking for breastfeeding support. The support they are looking for is usually just about what is normal in breastfeeding journeys, the mom-to-mom support of experience and camaraderie.  Sometimes it’s for issues that are outside of normal and require more expertise support and help.  It isn’t uncommon for a Leaky and/or one of the admin to recommend seeing an IBCLC (International Board Certified Lactation Consultant) for experienced and trained support.  These experts are usually the most equipped to help moms with true lactation problems having gone through intense training and having to comply to regular board standards in their continuing education and certification.  Just as often, someone then shares their negative experience with an IBCLC.  Frustrated and hurt, these women sometimes share that an IBCLC almost ruined their breastfeeding relationship with misinformation, intimidating and overwhelming directions, and sometimes down right bullying.

Find the right IBCLC

From these comments it sometimes sounds as though they fear all IBCLCs will be just like the negative experience they had.  Hurt and discouraged by the one or two individuals they encountered in the profession, they are unsure they can trust anyone with the title and position.  Like my daughter felt unsure about 2nd grade teachers, these moms are skeptical of the entire IBCLC profession, not because they don’t know that they are all different people but because they may believe that what they didn’t like is actually expected to be a part of the profession.  As if the consultants are trained to support that way.  Just as with any profession, there are individuals within the lactation consultant profession that are rude, unsupportive, not helpful, judgmental, dismissive, and misinformed. Thankfully, most I’ve met go into supporting breastfeeding moms because they genuinely care and want to help moms reach their breastfeeding goals.  The IBCLCs I’ve interacted with understand the vulnerable nature of that time in a mother’s life and the importance of providing the right kind of support.  Most IBCLCs aren’t in the profession to push an agenda or tell moms what to do, they genuinely seek to provide legitimate support unique to each mothers’ needs.  Sure, I’ve met a few that seemed burned out and dogmatic just like my daughter’s first second grade teacher, but just like most 2nd grade teachers actually enjoy children and teaching, so most IBCLCs aim to provide sincere information and assistance.  I encourage moms that need lactation support to move on from someone that isn’t supportive to find someone that’s a better fit.   It’s that, or risk not reaching your breastfeeding goals and that simply isn’t something we should be willing to sacrifice without a fight.

I am aware that for many, a second choice, let alone a third or fourth, isn’t readily available.  Financial restrictions, local availability, and even cultural support from family and friends can make it difficult to find someone.  Sometimes, shoot, maybe often, the support you need will find you in unexpected places such as the internet or a new friend.  Moms may have to try other paths for lactation support such as virtual appointments via the web or attending a local breastfeeding support group or even reading articles online.  Whatever it takes, pushing on to find the support you need may be work but you and your baby are worth it.

You don’t have to be stuck with a professional providing inadequate support.  In the end, you are the biggest advocate for you and your child and if advocating for you both means moving on to find the assistance you need, you won’t regret doing so.  As Leaky and IBCLC Jackie Rauch shared:

I will sometimes tell my clients the story of me seeking her out just to let them know that even the people with the knowledge need to seek out help from people with the knowledge. If you are not getting the help you need, keep looking!

You never know, you may find the one that helps you turn it all around and inspires you with hope and confidence.

Need a lactation consultant?  This site can help you find one.

______________________________

What about you?  What has your experience with an IBCLC or other lactation professional been like?  Did you have to find someone else for better support at some point?  Did an IBCLC or other lactation professional help you in your breastfeeding journey?  Check out the conversation we’re having on this very topic over on The Leaky [email protected]@b Facebook page

______________________________

Share

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?

_________________________

 

 

 

 

 

Share