Breastfeeding Q&A with a Lactation Consultant

Prior to having kids we assumed breastfeeding came easily to moms. Milk: We’ve got it, they need it. How hard could it be?

As it turns out, it’s not quite so simple. First, your milk has to come in which, for moms of preemies or those who’ve had C-sections can be a bit trying. Then, you have to get your baby to learn to latch correctly. Then, you have to make sure they’re getting enough milk to consistently gain weight–which, for many new moms, means feeding them every two-ish hours for the first few weeks.

With all of that to consider, it’s no wonder our mom friends had warned us: Breastfeeding is something of a science.

But because we know all the benefits of breast milk, we were determined to make it work. (And no, we’re not hating on moms who choose the formula route–our philosophy has always been that you have to do what works for you, and enables you to be the best mom possible to your little love bugs.)

Here is everything you need to know about breastfeeding:

1. Is it true that certain foods can help promote milk supply?

There are no studies that show eating certain foods will increase milk supply. The body works on a supply and demand basis. The more often you remove milk from the body, the more milk your body will make. 

2. How important is it to feed from both breasts at every feeding?

Feeding from one or two breasts largely depends on your storage capacity. Although mothers will make about the same amount of milk in a 24 hour period, the amount a mother makes at each feeding will vary greatly. Mothers who have a large storage capacity may be able to feed their babies on one side and may be able to feed their babies fewer times each day. While the mother with a low storage capacity will have to nurse on both sides and she may have to feed her baby more frequently. 

3. We have friends whose babies eat every three hours and others who eat every one to one and a half. Is there a normal frequency by age?

It’s always important to keep in mind that the baby drives the milk production. The frequency of feedings depends on two things. The mother’s storage capacity and the baby’s desire and comfort when it comes to volume of feedings, will determine the number of feedings per day. Some babies enjoy smaller, more frequent feedings, while others are happy to take in more. Due to the wide range of storage capacity and infant’s eating habits, it’s important to allow the baby to determine how long and how often they feed. Keep that baby in the driver’s seat!

4. Is there an ideal amount of time each breastfeeding session should last or is it different for every woman?

I love to remind new mothers that they gave birth to a human, not a robot! There is no specific length of time a baby should nurse. Moms and babies need to find their own rhythm. In the early days, I like to show mothers what nutritive and non-nutritive suckling looks like. If feedings are really long, a mother may be able to take the baby off the breast if the non-nutritive sucking is going on for a long time.

5. What are some things to try if your supply is low?

The best way to attack low milk supply is by increasing stimulation to the breast. Increasing the number of times a baby feeds or pumping directly after feedings is the best way to boost milk production. Extra stimulation along with good hydration can also contribute to an increase in production. Although many suggest herbs and foods, there is no conclusive evidence that these work. If mom’s milk supply is low because she has low prolactin level, medications like Reglan and Domperidone could help. If a mother’s milk production is low because of Insufficient Glandular Tissue, the supply may never increase to an adequate level.  A mother suffering from low milk supply should seek the help of an nternational Board Certified Lactation Consultant (IBCLC). There are a variety of management and hormonal possibilities to evaluate.

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6. How do you balance introducing solids with breastfeeding? Should you pump when your baby eats solids to keep your supply up for a while?

It is recommended to introduce solids at about six months. The most important thing to remember is that this should be a gradual process and it shouldn’t be stressful. Keep in mind that a switch doesn’t go off at six months and your baby immediately needs more food. Watch for your baby’s developmental signs of readiness such as sitting up on their own, the ability to grab and put food in their mouths, and the loss of the tongue thrust when you put food in their mouths. If you do a gradual introduction, there will be no harmful impact on your supply. Whenever I’ve worked with a mother suffering from low milk supply because of too many solids, they’ve typically started solids too soon and offered too much. The baby should start taking in more food and a little less milk at about nine months. Think of it as practicing to eat, not so much about how much is going in!

7. How do you know when your baby has eaten enough?

Part of being a new mother is learning how to read your baby. You’d be amazed at how much a baby can tell us. Here are a few signs that the baby is full:

• The baby is relaxed after feedings 
• The baby has plenty of wet and poopy diapers
• The baby is gaining weight

8. Are there certain foods I should be avoiding or increasing while breastfeeding?

There is no need to avoid certain foods when you’re breastfeeding. Breastfeeding allows for your baby to be exposed to a variety of food proteins and tastes. No need to eat a bland diet. There was a study done that showed us that babies actually preferred the milk that smelled and tasted like garlic! Only a small percentage of babies have an allergy to a certain food protein which is typically dairy or soy.

9. If my baby is spitting up a lot, does it mean he/she is getting too much milk, or that I have an oversupply?

Many moms can be concerned when a baby spits up. In some cases, offering more frequent burping will remedy the situation. If a mother has an overactive letdown reflex or has too much milk, the baby may spit up from having to gulp down their meals. Taking the baby off during the letdown may help until the baby is older and can handle the flow better. Some mothers find leaning back while nursing can slow the flow. As mother’s milk supply stabilizes over the first four to six weeks, they will find that the baby handles the milk flow easily. If mothers feel like the baby is spitting more than a “normal” amount, they can contact their doctor for an evaluation. But, in most cases, spit up is more of a laundry issue than a medical issue.

10. What is the recommendation for a woman who does have an oversupply?

Having an oversupply of milk can be uncomfortable for mom and baby. Can you imagine always feeling engorged and leaking everywhere you turn? These mothers are at an increased risk for plugged ducts and mastitis. These babies aren’t having a great time either. Think of a breastfeed like a fancy meal. You have your soup, salad, meat and potatoes, and your dessert. When a mother has too much milk, the baby has a hard time getting to the dessert portion of the meal. This leads to a low fat, high lactose diet. They’ll gain a lot of weight, but they will be fussy and want food more frequently. Some mothers can just nurse on one breast to remedy the situation. Others may benefit from what we call blocked feedings. They will nurse on the same breast for two feedings in a row. The other breast will become very full and that causes the production to slow. In time, the supply will lower to meet the babies needs more appropriately. Other mothers may choose a process where they completely drain the breast in the morning about one hour before the baby’s first feeding. This sets the volume of milk at each feed for the rest of the day. She can gradually decrease the amount of milk she takes out in the morning to reduce her supply gradually.

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