ADC’s Kyla Carlson, RN, MSN, CPNP, IBCLC, is an International Board-Certified Lactation Consultant. Here she provides answers to the most common lactation/breastfeeding questions.
A: Maintaining and increasing a milk supply is done through the frequent emptying of the breast, every 3-4 hours. This can be done by directly breast feeding or pumping. Pumping after directly breast feeding is sometimes needed to stimulate your milk supply. Depending on mom’s health history, certain supplements can also be taken to increase your supply.
Q: My baby falls asleep while nursing and then seems hungry after feeding. How do I get my baby to feed better?
A: Typically, babies are comforted being next to mom and fall asleep easily with nursing. It is very important to wake your baby during breastfeeding so baby nurses well. You should have a goal of about 15 minutes of good active nursing (usually on each breast). Your breast should feel lighter after feeding. Emptying the breast is important for baby’s weight gain as well as maintaining your milk supply. If the baby is mostly sleeping during a feed, then baby is likely not transferring enough milk and can burn more calories than they are getting. You should hear good swallows during nursing. Some good ways to wake your baby are:
- getting baby undressed,
- rubbing his/her hands, feet or back,
- taking baby off the breast, waking baby and then reoffering the breast.
A: This is typically due to a poor latch that has caused damage to the skin. Ensure baby opens his/her mouth really big before offering the breast. Your baby’s lips should be nice and flared, and baby should have the nipple and some areola in their mouth with nursing. Sometimes other issues like tongue tie can be causing pain.
A: Many medications are safe to take while breastfeeding, however many medications are also not safe to take while nursing. Please call your child’s pediatrician or a lactation consultant and we can discuss if it is safe to breastfeed on a certain medication.
A: Weight gain is the best indicator that your baby is getting enough milk. When you come for you baby’s well check, we closely monitor weight gain. If there is concern that baby is not gaining enough weight, then it will be discussed at the well check. Another indicator for baby getting enough milk (without weighing the baby) is monitoring wet and dirty diapers in a 24-hour period.
If there is concern that baby is not getting enough milk, we can bring you in for a lactation appointment. During the appointment, we can do pre and post feeding weights. This tells us how much milk the baby is transferring from the breast and if baby is getting enough milk. If you are concerned, please schedule a lactation appointment today!
Tips for breastfeeding moms:
Ways to wake baby when s/he falls asleep with nursing:
- Take off baby’s clothes
- Change his/her diaper
- Rub his/her back, legs, arms, head with nursing
- Gently rub a damp cool wet washcloth on his/her back
How to store pumped milk:
- Freshly pumped milk is good at room temperature for up to 4 hours (if it has not touched your baby’s mouth yet).
- Freshly pumped milk is good in the refrigerator for 4-5 days
- Pumped milk can be frozen for 6 months or can be kept in a deep freezer for 12 months
- Previously frozen milk is good in the refrigerator for 24 hours
- Make sure to date the milk after pumping so you know how old it is!
How to help with skin breakdown on mom’s breast:
- First make sure baby has a good deep latch
- If baby has a poor or shallow latch, break the seal with your little finger and relatch. Do not power through the pain- a poor latch can cause more damage
- After nursing, hand express some milk and rub it on your nipple and areola, this can help with healing
- Hydrogel pads applied to the area can help a lot
- Do not use ice to the area as this can decrease milk production
- Nipple shields are sometimes indicated. There are pros and cons to using these, please talk with a lactation consultant for help with this
Breastfeeding is a journey. It can feel isolating and exhausting at times. We encourage breastfeeding moms to try to have a support system that you can surround yourself with. If you are struggling, please reach out to a lactation consultant for help and support.