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.  

 

 

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Kathleen Huggins “The Nursing Mother’s Companion” Giveaway

Kathleen Huggins, RN, MS, IBCLC is the author of “The Nursing Mother’s Companion” and several other books.  She has been caring for nursing mothers and their babies for the past 30 years.  Kathleen started one of the first breastfeeding clinics in the U.S. in 1982.  She also co-founded the San Luis Obispo “Breastfeeding Warmline” at that time, counseling thousands of breastfeeding families.  In 1985, she authored the best-selling “The Nursing Mother’s Companion” updating it every 5 years and has sold more than 1,000,000 copies.

For this Giveaway, Kathleen is offering a 60-90 minute phone consultation (a $120 value) for a mother in need of breastfeeding assistance as well as an autographed copy of “The Nursing Mother’s Companion.”

Kathleen HigginsTLB:  Kathleen, getting to meet and talk with you has been an exciting honor for me.  Your book, “The Nursing Mother’s Companion” has been very influential not only in my own breastfeeding journey but as I help encourage others.  Having you active in our community is a real pleasure; I appreciate the care and wisdom you extend to the Leakies.  As what get to know you, what would you like the readers to know about you?

Kathleen:  I started my career with breastfeeding mothers in Napa, California, in the 1970’s as an R.N. in the Newborn Nursery.  Even though I had no children, it was my job to take the babies from the nursery out to their mothers and help them with nursing as best I could.  While in graduate school, I was pregnant with my firstborn child, Kate.  While I knew that I would breastfeed, I had no idea how difficult the early weeks of nursing her could and would be!  I suffered with injured nipples that led to a severe mastitis and ultimately, a breast abscess that required hospitalization and surgery.  I dealt with two drains in my breast and had to wait several weeks before they completely healed.  Frankly, over the next several months, it was all I could talk about!  But happily, I returned back to school, finished my master’s degree in Perinatal Nursing and continued to nurse my sweet baby Kate well into her second year of life. When I completed my degree, we moved to San Luis Obispo, California and the nursing staff at the hospital sent me to each and every nursing mother who was struggling with nursing.  Ultimately, I attended one of the first Lactation Consultant Programs at U.C.L.A.  Then something strange happened… Mothers began calling the hospital to speak with me, and some even just showed up on the unit to see me in person for more help.  That was the start of my real education!  Soon after, another L.C. and I started the “Breastfeeding Warmline” a 24/7 phone line for mothers needing help.  Soon, thereafter, the SLO Breastfeeding Clinic was born, where I saw thousands of nursing mothers over three decades.

TLB:  Please share a bit as to what inspired you to write your first book and all the books that have followed in The Nursing Mother’s Companion series.  What was your inspiration?

Kathleen:  One day I assisted a new mother in the Breastfeeding Clinic with a latch problem.  She told me as our session was ending, that I should write a book as there weren’t any books that helped her as she thought I had.  Later that evening, I told my husband Brad about what this mother had said.  He replied, “Yes, you should write a book.  Make it like a car manual!  I then thought about it for a couple of minutes, took out a piece of paper and wrote out the outline for “The Nursing Mother’s Companion.”  Starting with the early days of nursing and continuing on as the nursing relationship grows over time, I wrote every single day on a yellow legal pad fearing that if I stopped for even a day, I would never finish!  After finding a publisher, and with the crazy success of “The Nursing Mother’s Companion,” several years later I co-authored “The Nursing Mother’s Guide to Weaning,” “Nursing Mother, Working Mother,” “Twenty-five Things Every Nursing Mother Should Know,” and “The Nursing Mother’s Breastfeeding Diary.”

TLB:  Along with writing, you have a private practice and a store.  Tell us more about what you’re doing these days and how you juggle it all.

Kathleen:  In 2003, I found a cancerous lump in my breast and underwent a year of treatment.  I had just opened a maternity store in beautiful downtown San Luis Obispo and thankfully with the success of The Warmline and the Breastfeeding Clinic, the program grew and I had several wonderful L.C.’s who kept those services going strong.  Ultimately, the 120 year old county hospital was shut down, but another entity took on all of the breastfeeding services.  When I was well, I decided to spend more time in the maternity store and expand it to include “everything baby.”  I continue answering mothers’ calls on “The Warmline” and seeing mothers in our “Breastaurant” for breastfeeding assistance.  My wonderful husband, Brad, gets all of the credit for continuing on with all that I do.  He is my rock!

TLB:  How did you decide to become an IBCLC and how did your own breastfeeding journey influence how you care for mothers and babies?

Kathleen:  After the difficult start I had nursing Kate, nine years later I became pregnant again with my son, John.  As I looked down at him as his head emerged from my body, I yelled out, OMG!  He is so tongue-tied! (Frankly, one of the worst I had ever seen!)  He struggled with being able to latch, caused much nipple pain and was unable to get any milk from my breasts.  After a few days of pumping so he could feed, we had the frenulum clipped.  I will never forget the Pediatric Dentist saying “like letting a bird out of a cage!  John did much better after a few more days but then went on to develop severe colic vomiting and bloody diarrhea.  I struggled trying to figure out why he suffered so and several weeks later, I realized that he had a wheat allergy, later confirmed by a Pediatric Allergist.  I also decided with John to watch what normal weaning was like.  Needless to say, John announced just before his 4th birthday, that he was going to “wean.”  By that time he only nursed to go to sleep.  After his 4th birthday party, he came to me for his bedtime nursing and I questioned him about his weaning.  His response? “I was just joking!”  John enjoyed his final nursing on his 5th birthday. I credit both Kate and John with becoming a successful nursing mother and knowing just how special nursing can be.

TLB:  What is your favorite part about supporting breastfeeding moms?  What tips do you have for anyone offering support to the breastfeeding mother, even if they aren’t a trained lactation support professional such as an IBCLC?

Kathleen:  Of course, it feels good to take a mother from tears to happy nursing!  Mother-to-mother support certainly can be very helpful, especially when a mother has experienced a similar situation.  With that being said, I do see sometimes that the lack of a complete history and not knowing everything about a situation can lead to unhelpful or inappropriate advice.  While breastfeeding can be a wonderful experience, I get to see some complicated and difficult situations that require more than cheerleading.  Situations like poor feeding, low milk production, and nipple injury calls for experienced professional help.  Getting help from the well-wisher may delay a diagnosis and treatment, so don’t ever overlook that a mother in trouble may need eyes and hands-on help.  What all moms can keep in mind in offering mother-to-mother support is that their encouragement is valuable, even if it is to encourage seeing a more experienced and trained lactation professional.  Just knowing that she’s not alone can be all a mom needs to find the confidence to get help and reach her breastfeeding goals.

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Kathleen is giving away a 60-90 minute phone consultation along with an autographed copy of “The Nursing Mother’s Companion” to one lucky Leakie.

UnknownCurrently Leakies can find Kathleen’s books in bookstores everywhere, including online sites like amazon.com.

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Good luck to everyone!  Please use the widget below to be entered.  The giveaway is open from November 15, 2013 through November 21, 2013.  A big thanks to Kathleen for her ongoing support of TLB and breastfeeding women everywhere!

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