Ask an Expert: Breastfeeding and Type 1 Diabetes

Fan Question: I am a type 1 diabetic and EBF my 2-mo-old DD. Before and during pregnancy I had tight control of my blood sugar but now one minute my sugar is high and the next it’s low. Is high sugar bad for the baby? Should I not be breastfeeding at all? I want to do what’s best.

NANCY MOHRBACHER, IBCLC: As you know, type 1 diabetics don’t produce the hormone insulin, so they need daily insulin replacement to prevent their blood sugar from becoming dangerously high. Your blood sugar level doesn’t affect the amount of sugar in your milk. In fact, breastfeeding is the best thing you can do, because EBF reduces your baby’s risk of developing type 1 diabetes. As far as you’re concerned, breastfeeding increases insulin sensitivity, which is a plus. Most moms need less insulin while they’re breastfeeding. It may help to keep your blood sugar stable if you have a protein-and-carb snack each time you feed your DD, as blood sugar often dips about an hour later. When it’s time to wean, doing it as gradually as possible may help make maintaining blood-sugar control easier.
unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: I’m Afraid She Isn’t Getting Enough

Fan Question: My daughter was 5 weeks early and spent 9 days in the NICU. I pumped and then we began breastfeeding but she latched only for a short time, which we followed with bottles. A month later she’s latching better, but even if she nurses for a while, she still seems hungry and may take a 2 oz bottle. I’d like to EBF, but I am afraid she is not getting enough.

NANCY MOHRBACHER, IBCLC: Breastfeeding is in large part a confidence game. Keep in mind that babies’ feeding patterns differ when fed by breast and bottle. If a breastfeeding baby acts hungry, just go back and forth from breast to breast as many times as she wants. Unlike a bottle, your breasts are never empty. It’s not uncommon for a baby this age (your baby is now a full-term newborn) to spend the whole evening nursing. Try just going with it. The shortest distance between where you are now and EBF is to devote a few days to keeping your baby on the breast as much as possible. You will know she’s getting enough milk if her number of wet diapers and poops per day stays the same and if your breasts feel comfortable. (If she isn’t taking enough you would feel fuller and fuller over time.) If you want more reassurance, arrange for weight checks at her MD’s office or rent a Medela BabyWeigh scale for a week and do daily weight checks at home. (Go to http://www.medelabreastfeedingus.com/bnnsearch, enter your zip code, click on the “Rent Products” tab, and then on BabyWeigh Scale.) Babies younger than 3 months typically gain about an ounce per day. If needed, you can also eliminate bottles and reinforce breastfeeding by supplementing her at the breast. For help with this, consult a lactation consultant near you by going to www.ilca.org, click on the “Find a Lactation Consultant” link, and enter your zip code. I know you can do it! 
unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: Dairy and Elimination Diets

I’ve been on a dairy elimination diet for several months. What is the best way to determine if by baby still reacts to dairy? Are there certain dairy products (cheese, butter, cream) that are easier for the transition back to dairy?

NANCY MOHRBACHER, IBCLC: The good news about a dairy sensitivity is that most babies outgrow it by about 6 months, some sooner. The most reliable way to know if your baby still reacts to dairy is to do a challenge. This means you consume dairy and watch for a reaction, which should occur with 24 hours. If baby reacts, you need to wait longer to introduce dairy back into your diet. Typically, babies react to the protein in dairy, so butter (which is mostly fat) is a good place to start. Cheese and yogurt tend to produce less of a reaction because they have undergone processing. If you try one of these dairy products and see no reaction, a glass of straight cow’s milk should tell you for sure whether or not your baby is ready for you to go back to your regular diet.
unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: Oversupply and Block Feeding

I’m a first-time mother who has been struggling with breastfeeding for 6 months. First I thought my daughter’s constant pulling off and crying were due to low milk supply but when I took fenugreek, it got worse. I wonder if our issue might be oversupply. Is it too late to fix this problem?
NANCY MOHRBACHER, IBCLC: I’m sorry you two have had such a rough time! Your experience is proof that there really CAN be too much of a good thing. It’s definitely not too late! Many mothers end up with oversupply when they’re too diligent about pumping. How can you be sure of the cause of your problem? Your baby’s weight gain will tell you. If she is gaining twice or more the expected weight gain of 1 oz. per day during her first 4 months, it’s time to consider bringing down your milk production. If her weight gain is average, instead, consider it a milk-flow issue and adjust your nursing position so gravity gives her more control over the flow. See my blog post, The Dos and Don’ts of Block Feeding, for the specifics about these strategies.
unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: Frustrated at the Breast

Fan Question: Sometimes my baby gets frustrated at the breast and won’t latch on. I’ve been breaking down and giving him a bottle of formula. What else can I do?

NANCY MOHRBACHER, IBCLC: What a worry! The most important thing is not to let your breast become a battleground. If your baby is fussy, walk him, rock him, and comfort him in other ways rather that fighting at the breast or giving the bottle. What may help after he calms is to get into a semi-reclined position (try the position you use to watch TV), and lay him tummy down on your body. That triggers your baby’s inborn feeding reflexes, and he should start to bob around looking for the breast. This can even work when he’s drowsy or in a light sleep, which you can recognize by eyes moving under eyelids or other movements. These more natural breastfeeding positions often make it easier for babies to latch. Plus baby’s full frontal contact with you is calming and acts like a GPS, telling him where he is and what to do. To read more about this, see my blog post on laid-back breastfeeding.

unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: Should I Wake My Baby to Eat?

Fan Question: My first baby will be born soon and I’m wondering if I should wake my baby to nurse at night or if I should wait until he wakes to breastfeed.

NANCY MOHRBACHER, IBCLC: The answer is “it depends.” You need to know first if your baby is feeding effectively. His weight check at 2 weeks should answer that question. If his weight gain is good (at birth weight or gaining about 1 oz. per day), you can stop paying attention to the time and wait for him to wake you at night. During the first 2 weeks, it’s fine if your newborn sleeps for one 4- to 5-hour stretch, as long as he is nursing at least 8 times during the rest of the day. If your baby is gaining weight well, you don’t have to worry about the other details. Once he’s proven that he’s an effective feeder, you can trust your baby to let you know when he needs to feed. If a healthy baby sleeps a lot at night, he will just “cluster nurse” during the day to make up for lost time. Good luck!

unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: Can I Breastfeed While Pregnant?

Fan Question: I’m 9 weeks pregnant and have a nursing 17-month-old. Is it safe to breastfeed through a pregnancy?
NANCY MOHRBACHER, IBCLC: Some women wean during pregnancy, but you don’t have to. There is no evidence that breastfeeding is harmful in any way to you or your unborn baby. The only caution is if you’re at risk for a premature birth. The mild uterine contractions that breastfeeding can cause may be of concern if there is a risk of going into labor early. In this case, you’ve probably been told to abstain from sex until after delivery, as orgasm has the same effect. If your pregnancy is not high risk enough to require you to avoid sex, you should be fine to keep breastfeeding.
unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: Pumping and Working

Fan Question: I’m a first-time mom. My baby is one month old and I go back to work in a month. When should I pump and how can I store milk for work if my baby takes a bottle every day?
NANCY MOHRBACHER, IBCLC: Great questions! The best time to pump when you’re home with baby is usually about 30 to 60 minutes after the first feeding that you’re up for the day. Most moms have more available milk in the morning. Once your baby is taking the bottle well, you don’t have to give it every day. Every other day or even every third day is usually enough to prevent her from forgetting how. Another strategy that can help is rather than giving a full feeding from the bottle, give just an ounce or so. There are two advantages to giving a “snack” rather than a “meal.” It is less likely to affect your baby’s breastfeeding pattern, which helps you build your milk supply, and it means you have more milk to store for your return to work. Keep in mind that you don’t need gobs of milk. You just need enough milk for your first day back and a small reserve to cover the unexpected. At work, you should be able to pump each day what your baby needs for the next day. For realistic pumping expectations, see my post, How Much Milk Should You Expect to Pump? Best of luck!
unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Ask an Expert: Do I Need a Nipple Shield?

Fan Question: I’m expecting my first baby and have gotten so much conflicting advice. Do I need to buy a nipple shield or other products to prevent or treat nipple pain?
NANCY MOHRBACHER, IBCLC: Congratulations! That conflicting advice can be a real bear! In answer to your question, treating nipple pain with products is not the best first step. Nipple pain is usually a symptom of a shallow latch, which you can adjust to eliminate the pain. A shallow latch can also reduce milk flow to your baby. Feel in your own mouth for where the roof of your mouth turns from hard to soft. It’s near that area, nicknamed the “comfort zone,” that your nipple needs to reach in your baby’s mouth to avoid or relieve pain. During the years I worked as an LC in private practice, I found that just a small tweak in how the baby latched was usually enough to go from painful to comfortable breastfeeding. Scroll down on the Multimedia page of my website to see an animated video of one strategy for getting a deeper latch. If you can’t relieve the pain on your own, rather than turning to products, see a board-certified lactation consultant, who can also check you and your baby for other treatable causes of nipple pain.
unnamedNancy Mohrbacher, IBCLC, FILCA is a board-certified lactation consultant in the Chicago area who has been helping breastfeeding families since 1982. Her books for professionals are used worldwide. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, and her tiny problem-solving guide, Breastfeeding Solutions In 2013, Nancy released her Breastfeeding Solutions smartphone app (available for Android and iPhones) to give mothers a quick, go-everywhere source of breastfeeding help. Nancy speaks at events around the world.

Breastfeeding Without Family Support

By Badass Jordan

My name is Jordan and I’m a pretty badass breastfeeder! I wanted to share my story so far to hopefully encourage other young mums to keep going! I’m 21 and have not long had my first baby. My daughter may only be seven weeks old but they have been such hard work! Battling reflux and oversupply, along with a tiny 5lb baby and a not very supportive partner and most of the family.

jordan

When I gave birth to bubs she was placed immediately on my chest and we latched without a problem. It was wonderful and definitely the best thing I have ever done! We were kept in overnight due to my needing surgery and her tiny weight at full term. We battled through that first awful night alone in a strange place. The hospital weren’t incredibly supportive or encouraging but listened when I shouted for her. Her tiny mouth was too small for my huge nipple! We soon got there with the help of a tiny syringe and hand expressing. Come morning we were doing brilliantly.

The second night was horrible. She cried and cried and struggled to latch. I expressed and again used the syringe just so she would eat. We made it.

The first two weeks were fine, we found our rhythm and followed her lead.

Before I knew it, my partner had gone from super supportive (making me drinks, helping with housework) to a lazy sod who slept until lunch time and did nothing to help me. I had to beg him to change her nappy so I could have a quick shower. His mother insisted that I express and give bubs the bottle so that ‘we can have a go’. I refused point blank.

Things carried on like this for the next few weeks. I refused to allow bubs to go anywhere without me. My mum was the only one who supported me and appreciated what I was trying to do. She breastfed me as long as she could stand and hated that she stopped so soon.

My mother in law next demanded that she was to take my daughter out for the day and that she was telling my partner a week in advance so that I would ‘have time to get over it’. I was understandably livid! It is not a case of not trusting her, it is a case of exclusively breastfeeding my daughter and so needing to be near her all the time! I offered to go with her but she refused ‘I was trying to kill two birds with one stone’. I’ll never know what that was supposed to mean.

I felt that I was being pushed from all around to bottle feed but my daughter is not a toy! She is not there for everyone to ‘have a go’. She is a teeny tiny person who deserves the best start that I can provide for her and I love our breastfeeding relationship. As a young mum it is tempting to listen to older women and their advice and doubt everything that you are doing. Especially when you’re told continually that it’s wrong! However I have pushed on and at our last health visitor checkup, bubs weighed a fabulous 8lbs 8 at six weeks, and our latch is perfect, along with her weight gain.

Due to the oversupply I do have to express, which I am donating to our local hospital for mothers who cannot!

I just wanted to share this as I know other young women are so put off thinking they won’t get much support. I have had minimal support and so much against me and I am more determined than ever to push on for as long as I can go. This Facebook page is such a source of encouragement and support.

Thank you so much for taking the time to read this and for all of your posts and information!