Ask an Expert: Keep Calm and Latch On

By Wendy Wisner, IBCLC

Fan Question :

“My baby is three weeks old. I have struggled to get her to latch. She was born three weeks ago by c-section. I have been trying to protect my supply by pumping (as much as I can) but I can’t keep up with her and have to supplement with formula. Is it too late for her to learn how to latch? Will I ever make more milk? I hear about women stock piling in the freezer and I can’t even keep up with my newborn.”

Hi Mama.  It sounds like you’ve had a rough start!  You are absolutely doing the right thing by pumping to keep up your supply until your baby can latch.  If you aren’t using a hospital grade pump, go out and get one.  Almost all mothers find that they are able to pump more milk with a hospital grade pump.  Even just renting one for a month or two can work wonders.  Ameda, Medela, and Hygeia are three companies that make these pumps.  You can call the companies to find out about local rentals (they are too expensive to purchase).  Also make sure that your pump flange is fitting you correctly (here is a good explanation of how to know this).  An ill-fitting flange can decrease the amount of milk that is produced.  Finally, make sure that you are emptying your breasts frequently – the more frequently you empty them, the more milk you will make.  Aiming for 10 pumps per 24 hours would be ideal, but 8 or 9 pumps per 24 hours is good too.  Do your best, take the pumping day by day, and be gentle with yourself.  It’s not an easy task to take care of a baby and pump.  For more milk supply tips, I highly recommend the book (available in electronic form as well) Making More Milk, by Diana West and Linda Marasco.  There is also great info in that book on herbs and foods suitable for increasing milk supply.

In answer to your question about latching, it is never too late!  Babies are born with natural reflexes and instincts to breastfeed.  It takes many months (and perhaps years) for these instincts to go away.  Your baby wants to breastfeed!

This article has some detailed tips on how to tap into these instincts.  But in a nutshell, try latching your baby when she is in a calm state, not too hungry, not too full.  Strip her down to her diaper, and hold her skin-to-skin and belly-to-belly with you.  In this state, where your bodies are touching, and she is smelling you and your milk, she is very likely to begin to look for the breast.  She might bob her head around, searching.  You can gently guide her, or let her do it herself.  Do whatever feels right.  And give it time.  It could take three minutes or thirty minutes.  As long as she is content, let her be there, and help her figure it out.

Even beyond these latching attempts, spend a lot of time skin-to-skin with her.  Let her sleep on you, wake up on you.  Ditch the pacifiers, if you are using them, and see if she will suckle at your breast for comfort.  Comfort sucking is one of the first ways that non-latching babies come back to the breast.  If you are using bottles to feed her, make sure you are using the slowest flow nipple, and try to find a wide-base one that requires your baby to open wide while she sucks.  Keep the flow slow by holding the bottle horizontally, and give the baby lots of breaks while you bottle feed her.  These tips will help make bottle feeding a bit more like breastfeeding so that your baby won’t begin to prefer the bottle.

If you need further help, call a lactation consultant (IBCLC) and set up a meeting!  In-person help would be invaluable in a case like this!
unnamedWendy Wisner is a Board Certified Lactation Consultant (IBCLC), writer, and mother of two amazing boys.  In addition to her work with breastfeeding moms, she has published two books of poems, and a handful of articles about mothering and breastfeeding.  She blogs at www.nursememama.com.

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I Will Not Wean My 3 Year Old

I’ve heard that I should have weaned Jack before Exley came along. I have heard that I am raising a spoiled brat by breastfeeding my toddler. I have heard that it’s disgusting, that he’s too old, that he’ll have psychological problems. I’ve heard that I’m doing it for my own needs and not his.

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Whenever we leave the house I keep Exley in the wrap. It has been complicated continuing to nurse Jack on demand since my breasts are covered by the wrap. Jack’s nursing has increased since the birth of his little brother. He has shown me that he needs me more than ever. He has shown me that now is not the right time to make major changes. It’s important to me that we make this work. I found that I can slide Exley slightly to one side and pull my boob out the opposite side. Jack can latch on and sit on my lap. It’s not pretty. It’s not like those photos you see of women breastfeeding in a meadow. This is not a photo shoot. This is my life. This is real. This is me and my 2 sons hobbling our way into a new normal. It’s sloppy. It’s awkward. It’s the most important thing I do. Every single day.

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I will work to make room on my lap for Jack. I will work to make him feel welcome at my breast. I will work to make him feel that the safest place to him on earth hasn’t been completely taken away. This is not easy. I’ve been hanging on by a thread to my breastfeeding relationship with Jack since I got pregnant. I’ve struggled with everything from pregnancy hormones, to breast pain, to sever nursing aversion, to plain old touched out. This isn’t the way to do it. It’s just our way. I will continue to work until it doesn’t work anymore. And then we will figure out our new way. But I will not wean my 3 year old.

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Abby Theuring, MSW

Ask an Expert: Alcohol and Breastfeeding

By Nancy Mohrbacher, IBCLC, FILCA

Fan Question:

“How long after you consume alcohol should you pump and dump? Do you have to pump and dump if you consume water with said alcohol? How much water?”

As long as you drink moderately (1 or 2 glasses of beer or wine), there’s no reason to pump and dump. Occasional exposure to alcohol in your milk is not harmful to your baby. If you feel strongly that you don’t want your baby exposed to any alcohol, you can simply allow time for it to clear from your system. The alcohol from 1 glass of beer or wine is out of the milk of a 120 lb. woman within 2 to 3 hours. (In other words, if you have a drink right after nursing, there may be no alcohol in your milk by the time you nurse again.) You don’t need to pump for alcohol to pass out of your milk. Alcohol leaves your milk automatically as your blood alcohol levels go down. If you have a stronger drink or more than 1 glass of beer or wine, it takes longer for your milk to be completely free of alcohol. But keep in mind occasional exposure to alcohol is not a concern. Drinking water with the alcohol makes no difference. Obviously, if you’re really drunk, you shouldn’t be caring for your baby no matter how baby is fed.

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.