13 Real Breastfeeding Questions On Smoking, Drinking, & More, Answered By An Expert

My step kids are coming to visit in a few months and it will be the first time they meet their baby sister. I exclusively breastfeed my baby and I’m wondering how to explain breastfeeding to them. Neither of them were breastfed and their half siblings whom they live with are formula fed so they have never seen breastfeeding.

"It isn’t unusual for children who haven’t been breastfed or seen breastfeeding to ask questions or act curious about the act when they see it," O'Malley says. She recommends engaging your stepchildren in your family while you breastfeed, making it a time when you can all relax and connect while listening to music, reading a book, or even watching a show. "This demonstrates that it is an inclusive time and it also helps normalize the practice so they will grow up thinking that breastfeeding is a part of life."

My daughter is 5 months old and has all of a sudden started waking in the middle of the night for a feeding; she has been sleeping through the night since she was 2 months old. I have tried giving her cereal and breast milk right before bed for her to be full but she still wakes up just out of the blue. Any ideas?

Unfortunately, there is no easy answer here. "5 month old babies are growing and changing rapidly," O'Malley says. "With all of this excitement, it should not be a surprise that your little one is up, wanting to nurse halfway through the night." But O'Malley says it's also important to note that the term "sleeping through the night" does not mean your baby is sleeping for ten hours at a time without waking.

In fact, she not only is it normal for breastfed babies to wake frequently, especially during a growth spurt, and indicate a need to nurse, but research has shown no link between feeding a baby cereal and better sleep at bedtime. "Don't worry," O'Malley says. "There will be time when your baby will sleep through the night. And, work with your partner on this. Breastfeeding a baby takes a lot of work — using a bottle to feed breast milk can allow you to rest while your partner wakes for baby."

My left breast is producing way less milk than my right. I try my baby on the left but he seems to just prefer the right breast and they are considerably different in size. I was just wondering after I finish breastfeeding will my breasts return to their normal size or will I just have to deal with having one that is way bigger than the other?

"If you’re really concerned, you should check with your healthcare provider or a lactation consultant," O'Malley says. "In the meantime, please know that this is common." O'Malley's team at Medela actually dedicated a whole blog post to this very topic.

"The short answer — there are a lot of reasons that breasts vary in size more during breastfeeding, including (but not limited to) the mother’s preference or the baby’s preference to breastfeed on one side or let-down that differs between breasts." O'Malley also offers some quick fixes, like starting feedings on the less productive or smaller breast, as well as pumping on that breast after feedings. Medela's blog post also offers more tips.

My friend is really pregnant — like past her due date — and she's still smoking cigarettes. She wants to breastfeed, but I'm worried about her baby. Could something bad happen to the baby if she doesn't quit? Should I advise her to use formula if she refuses to stop smoking?

"Smoking is a challenging habit to break. Even the most committed individuals experience relapses," O'Malley says. "Since your friend has stated her desire to breastfeed, you can let her know that smoking has been shown to lower breast milk supply. Whether she has been able to quit or she’s still working on it, she should still try to breastfeed." O'Malley also notes that smoking around babies makes them more prone to a number of health conditions, like ear infections and pneumonia.

"As her friend, you should first offer your support as she makes plans to quit smoking. A resource I love is Smoke Free Women, developed by U.S. Department of Health and Human Services National Institutes of Health National Cancer Institute, it provides quitting information, support and resources for women, including women who are pregnant," O'Malley says.

My son is 2 weeks old at this time and breastfeeding has been going great so far. The problem is I start school soon, and I'm in class from 8 a.m. to 2 p.m. I was told by the director of education that they would have nowhere for me to pump while I am there. My son eats almost every hour to maybe two hours right now. What can I do or say to make them allow me to do it? She acted like I could leave and do it on breaks but they are only 10 mins long and where would I go except for my car? I can't do that.

"The transition back to work is a time when all moms need support," O'Malley says. "I recommend checking the laws in Texas. It could be that your employer is responsible for allowing you breaks and a space (that is not a bathroom) to pump breast milk." She suggests finding more information about your breastfeeding rights in your state at Medela's website and, once you have that information, create a plan to support your goal.

O'Malley also suggests talking to other moms on staff as a great resource. "You might ask how someone else handled this very situation and she might have some great tips. I think it is important to anticipate potential questions or concerns and plan to have an answer. This will help alleviate your boss’s concerns," she says.

Is it bad to drink beer while breastfeeding? If I do end up drinking how long would I have to wait to be able to breastfeed my baby?

O'Malley notes that many want a hard and fast answer to this question, but it's not quite that simple. "Here's what I can offer — when you’re breastfeeding, there are two great ways to enjoy a drink and feed your baby breast milk. You can have a drink immediately after nursing, or you can offer a baby a bottle of previously expressed breast milk." She also says it's important to remember that alcohol dehydrates the body so it is important to drink a lot of water after you have a drink to make sure there is no disruption to your milk supply.

I'm looking for some advice about antidepressants/mood stabilizers while breastfeeding. I'm gonna be honest, I probably shouldn't go without medication, but I don't want to start taking it again and have to stop breastfeeding. I was diagnosed six years ago with bipolar disorder, borderline personality disorder, PTSD, and of course depression. I went for my six week checkup this week and the doctor did the postpartum depression test — I scored 22/30 and she said I really need to be put back on something. I'd like to think I'm strong enough to do this on my own, but if I was being honest with myself I know I need the help. Is it normal to struggle with this decision? What medication can I take that won’t affect the breastfeeding process? Should I just try to tough it out?

"A mom’s mental wellbeing is as vital to her child as her physical strength," O'Malley says. "We should not minimize the value of staying well." She says there are a number of options that have been studied for quite a while and are relatively safe for baby while you’re breastfeeding, but every mother’s needs with respect to mental health are specific to her own circumstances.

O'Malley encourages you to reconnect with your obstetrician to identify a psychiatrist that specializes in maternal mental health to identify the right option for you. She also suggests the Infant Risk Center, which focuses on medication safety during pregnancy and lactation, as another great resource.

Is it normal to get a weird feeling in the pit of your stomach while breastfeeding/pumping? I get like that worried feeling when I start and then it fades.

"There is a possibility that the feelings you’re experiencing are the result of a syndrome called Dysphoric Milk Ejection Reflex," O'Malley says. She notes that moms with this condition experience abrupt dysphoria or negative emotions that continues for a few minutes immediately before let-down occurs. It's a physiological response (not a psychological response) that appears to be tied to a sudden decrease in the brain chemical dopamine immediately before milk let-down. But O'Malley suggests that if you have concerns or questions, you should seek advice from a healthcare provider for treatment options that might be available.

I'm expecting my second child and due to me getting a breast reduction at 15, I did not breastfeed when I had my first child at 19. However now at 26, I'm really crossing my fingers that I will be able to when my baby arrives. Honestly if I can't, I'll be devastated. Is it an issue to breastfeed after a reduction? Are there any tips or tricks to making it work?

Try not to fret too much, O'Malley says that women who have undergone breast and nipple surgery have a lot of options when it comes to breastfeeding. "I recommend visiting Breastfeeding After Breast and Nipple Surgeries, the site dedicated to offering support and resources for women like you," she says.

She also follows up by saying that your best chance of achieving your breastfeeding goal is by creating a strong support system to help you once baby is born. Connecting with your partner, making sure they are on board before the birth, and mapping out the resources available in your community, like a certified lactation consultant, a breastfeeding warm line, your own healthcare providers, and meetings of the local La Leche League, can help. "Knowing where to turn for help when you face challenges will make it easier for you to get through them," O'Malley says.

I'm flying to New York and it’s a six hour trip with a 20 month old and my 3 month old. My 3 month old is exclusively breastfed. I’m wondering what the best carrier for breastfeeding is. I've tried the sash mei tai but she screams while she's in it.

While she wishes you luck and a calm journey (I second this), O'Malley says she can't recommend a specific carrier for traveling. "It all depends on you, your child and your families’ needs," she says, adding that there are I am also no carriers are approved by the FAA for in-flight use.

My 4 month old daughter is a comfort nurser. She is constantly latched on, which for the most part is not a problem during the day, but at night it worries me because she just uses me as a pacifier. I don't sleep at all because I am terrified that she's going to get too close and not be able to breathe, so I wake up and check on her all night. She will not take a pacifier and if I try to slip away, even when she's in a dead sleep, most of the time she wakes up. Any advice?

You must be exhausted. "Infants nurse for both nutrition and comfort," O'Malley says. "If your infant is growing and gaining weight appropriately, her behavior demonstrates her desire for comfort nursing. You’re right that letting her stay latched while you are asleep is not the best advice and potentially unsafe." O'Malley suggests that you continue doing what you have been doing and try breaking the suction with your finger while she is latched. "If she wakes, try again. She loves having you near, so is there a way you can move her crib to your room and beside your bed? She may just need to know you are close by," she says.

My baby is 2 months old and he's tongue tied. I don't want to cause him any pain so we opted to not have it released. (My older son is also tongue tied and he has no problems.) But the last week or so has been pretty painful to nurse and I was wondering if you had any suggestions to get through the pain.

O'Malley notes that it is difficult for her to propose a solution without seeing your son and his latch in person. But she says that the procedure for releasing a tongue tie is a quick, relatively painless procedure that can be done on an outpatient basis in the physician’s office.

My little one is 5 months old and has been exclusively breastfed since birth. He started sleeping through the night by 3.5 months and sometimes I would wake up after six hours to pump to keep up my milk supply, but lately I am just too tired to and would rather sleep when I can. I am wondering what this will do to my supply. Would it decrease it?

"It is true that demand helps maintain supply, but there are a few things to consider," O'Malley says. "Are you returning to work and need to build up a supply of breast milk? If so, you might want to power through and continue to maintain that session." But O'Malley also notes that as your baby gets older, his needs change and how your body meets those needs also changes, so dropping that session might be less of an issue, but it's important to note that skipping this session might reduce your supply.