16 Real Nursing Questions Answered By An Expert

My infant will be 4 weeks old on Thursday. I started out breastfeeding, but went back in the hospital 24 hours after being home, and wasn't able to breastfeed for more than two days. He's been drinking formula since, but I am still trying to pump every three hours. My problem is, I am only getting maybe around one ounce combined from both sides by the end of the day. I am also taking the pill "More Milk Plus" and going on two and a half weeks with that and my output has not increased. What else can I do?

"You are doing the right thing by trying to pump every three hours," Chamblin says. "If you aren’t already doing it, use a double electric pump and if you can, arrange to rent a hospital-grade breast pump. If you’re still not seeing an increase in your milk supply, reach out to a board-certified lactation consultant." Chamblin adds that ,while it might not help to hear right now, it's best not to fret or stress. You're taking productive steps now, so have faith in that. "Stay hydrated and stay connected — you are not in this alone," she says. "Talk to your partner, your family, and friends. Ask for help. Stress can make it harder to breastfeed and reaching out is a way to reduce it."

I find the milk that I freeze tastes different. Not sour or bad, but not the same as fresh milk. Is there a reason why or something I am doing when freezing it to cause this to happen?

"Breast milk is such a dynamic substance," Chamblin says. "So many factors can impact how it tastes, smells, and looks. What you consume, including food, beverages, and if you were taking any supplements or medications, changes the flavor of your milk, as does freezing and thawing breast milk." Chamblin says that some moms notice that milk has an unpleasant smell, often described as soapy or sour, once it's been defrosted. This is actually normal — breast milk contains lipase, an important enzyme with many benefits (for some it can taste sour). The sour taste or smell might be off-putting for us, but according to Chamblin, most babies don’t mind it.

I exclusively breastfeed my son who is just over 2 weeks old. Last night he was fighting his sleep and we both only got about two hours of sleep. Today, he is extremely fussy and I am having trouble getting him to eat on his regular schedule that he is used to eating on at this point. I'm at a loss.

According to Chamblin, newborns, especially in the first few weeks, are getting accustomed to living outside of the womb, learning to eat, and learning to sleep. Although most babies eat every few hours, she notes that there is little else that is consistent or regular about an infant’s behavior during the fourth trimester. Instead of worrying about a schedule, try to focus on a strong latch and bonding with your infant.

We had our iron levels checked and found out that I am anemic and so is my 9 month old. Should I stop breastfeeding him?

"Anemia is a challenge that some breastfeeding moms face," Chamblin says. "It sounds like your healthcare provider recommended having your levels checked, so it is important to listen to the recommendation that he or she provided." She notes that breastfeeding does not need to end because you and your child have low iron levels. "Many moms have success continuing to breastfeed while iron is supplemented," she says. "Again, the direction provided to you and your son by your healthcare provider should be the first step. If you have additional questions about breastfeeding, call a board-certified lactation consultant."

I have an exclusively breastfed 7 month old who hasn't slept through the night a day in her life. She wakes up every three hours still (sometimes less) and it is really starting to affect me. She eats baby food and nurses before bed, but refuses a bottle with cereal from anyone. I've been co-sleeping thinking that would help, but she still tosses and turns and constantly wants to nurse. If I put a pacifier in, she screams. Any advice on how I can help her to achieve a better night’s sleep?

These nights are hard, but Chamblin says there's one thing to keep in mind — this is temporary. There will be a time that your baby will sleep through the night and not need you so frequently. "Unfortunately, 7 months is an age where so much is changing, almost every day. Restless nights are often the norm and not the exception," she says. "Many parents notice their children are teething, starting to crawl and might even be experiencing separation anxiety. All of these exciting milestones make slumber somewhat challenging." Chamblin says that sometimes babies at this age are more aware of their surroundings and might wake at night to play or need your attention for reassurance. She doesn't recommend ignoring your baby or letting her cry it out, however.

"You may put her to the breast and, if she’s hungry, she will breastfeed for a few minutes and then fall asleep and you will be able to lay her down. Or, you may choose to hold her and soothe her with your voice, then try to lay her back down and pat her back to relax her," Chamblin says. "Cereal in a bottle with breast milk will not help your daughter sleep longer (consider that myth debunked). If she is comfort nursing, there might be some behavioral interventions to consider to break the habit."

My daughter is 3 weeks old and we have been struggling with low milk supply and her weight gain. The lactation consultant at the pediatrician told me to start taking fenugreek — three capsules four times a day. I haven't noticed a big change in my supply, but the last three days I have noticed myself and the baby to be much more gassy, and her bowel movements have changed from four to five per day, to now only once in a three day period. Mylicon seems to help her gas, but I'm wondering if it could be the fenugreek. Ever heard of this causing gas and constipation?

"Despite herbal remedies such as fenugreek being recommended by health professionals, they ought to be used with caution," Chamblin says. "Reported side effects are rare, but include maple-like odor in sweat, milk, and urine, diarrhea, and increased asthmatic symptoms. Reach out to your lactation consultant or provider for guidance."

I have a 10-month-old that is breastfed, but also eats solids. For the past two and a half months, she's been pushing off me and trying to just feed off the nipple. I thought it was teething and then an ear infection, but ear is healed and it's going on too long now. I don't want to stop nursing, but it's agony. Do you have any suggestions on how I can make this stop? Or at least how to heal my nipples?

"This behavior may be signs that your baby is weaning from breastfeeding, called self-weaning," Chamblin says. "She is becoming more active and interested in her surroundings. A few suggestions to maintain her breastfeeding interest may be to offer your breast before feeding her solids, rather than solids first. You also may want to try to breastfeed in a quiet area of your home that limits the amount of distractions. Sometimes this isn’t possible with a family, but your baby will show an interest to continue breastfeeding when she’s hungry, and if your supply has been maintained." Chamblin also recommends bringing your baby to your breast before mealtimes, nap times, and bedtime. If she doesn't show an interest or gives up after a few minutes, don't force her to stay on the breast. Chamblin says you can let her explore a bit.

Still, it's good to reach out because breastfeeding shouldn't hurt, according to Chamblin. "It sounds like there are two problems — your pain and your duaghter's latch. For your pain, try using a hydrogel pad," she says.

I'm exclusively breastfeeding my 6-month-old and would like to have another baby soon. Does breastfeeding prevent ovulation?

"Some research has shown that exclusive breastfeeding (no supplementing) can prevent pregnancy if you gave birth fewer than six months prior and haven’t had your period," Chamblin says. "However, it is not a reliable birth control method or a rule for fertility. We know that planning a family is incredibly personal, but it is worth noting that there are known risks associated with shorter spaces between siblings (fewer than 18 months), like preterm birth and low birth weight."

I'm breastfeeding my third child and need suggestions on night time wear. I hate wearing a nursing bra to bed, especially since I wear a wired nursing bra all day, but of course without a bra, my shirt is completely soaked and crusty by morning.

This is a common question for a lot of breastfeeding moms. Chamblin says that Medela now has a nursing sleep bra for those who want comfortable nighttime wear. "Nursing sleep bras are a great in-between option for breastfeeding moms because they offer light support and allow breasts to be easily accessed when you need it most, in the dark, when you’re waking up and trying to encourage a hungry, sleepy baby to latch," she says.

My son is almost 12 weeks old and we've exclusively breastfed. We've had to use a nipple shield since day one until two days ago when he refused to use it. We have no problems with latch, surprisingly, however every few minutes he pulls his head back while almost biting down and yanks away. It hurts, like he's purposely trying to see how far he can stretch it or something. Why is he doing this and how can I get him to stop?

"If you’re saying that he pulls back now that you’ve stopped using a nipple shield, it actually may indicate a low milk supply," Chamblin says. "Use of a nipple shield may be helpful so your baby stays on the breast, but latching with a nipple shield is more shallow of a latch than one without it. If you are trying to stop using the nipple shield, it may be helpful to let him breastfeed on your first side with it, and then remove it before latching him to your second breast." Chamblin notes that at his age, he shouldn't need to continue using a nipple shield and he has the capability to stay latched to your breast better than when he was first born. If you can, she recommends meeting with a board-certified lactation consultant or reaching out to one online through Medela's Ask the LC.

My baby is barely over a month old and I'm having trouble with a forceful let-down, and I'm afraid one of these times my baby will stop breathing. I've tried many different things — pumping before feeding, keeping her in an upright position when feeding, and I unlatch her throughout feeding to burp her. Is there anything else I could be doing to help? And what’s the best way to aid her when choking or gagging? My first instinct is to pat her back, but is this the best way to help? I don't want to give up breastfeeding and I don't want to be afraid to feed my baby.

Chamblin notes that oversupply and its effects on a good breastfeeding experience are not mentioned very often. "Your baby’s response to your fast flow is to pull off your breast, but another way babies cope with flow issues is to clamp down on the nipple. Either way, it’s not solving your problem," she says. "It is often suggested to express a little milk before latching your baby, but this is ill-advised. Expressing milk before breastfeeding actually causes the reverse outcome because removing milk actually tells your body to make more milk." Chamblin suggests a simple way to handle your fast flow — cup your breast and with your palm press gently inward on the outer side of your breast before latching and during the entire feeding. By pressing on your breast, you can slow your flow so your baby doesn’t pull off or clamp down in response to your fast flow.

I had a C-section at 32 weeks and was able to pump a little bit, but now I get nothing at all. I have been continuing to pump with no results. I went to see the babes in NICU and pumped as soon as we got back to our room, but still nothing. I haven't been able to eat yet, so could that be a cause?

Chamblin says you’ll get the best advice from a healthcare professional who sees you in person. If you can, she recommends that you ask for a lactation consultant to join you in the NICU and offer support and direction as you work to build your supply for your twins. "Colostrum is very important for your preterm babies as it provides protection against respiratory and intestinal infections," Chamblin says. "Don’t get discouraged when you don’t pump any milk or very little milk. Continuing to pump seven times in 24 hours with a double-electric hospital-grade breast pump after you are discharged from the hospital will offer you the most stimulation for increasing your supply. A supportive team, including a lactation consultant and other healthcare providers can also help create a strong start with breastfeeding."

Is it OK to diet while breastfeeding? I'm starting Pilates and yoga this week, and intend to eat healthier. Is it OK to cut calories since breastfeeding burns about 500 a day?

"Pilates and yoga are great ways to rebuild your body’s strength and support your stamina," Chamblin says. But she notes that it's important to make sure you eat a diverse and balanced diet to ensure that you have enough energy and nutrients to produce enough breast milk. "It is necessary to have at least 1500 calories daily to not impact your supply — the composition of your milk remains relatively the same. If your supply dips, increasing your calories to 1500 usually brings back your supply," Chamblin says.

I'm a first time mom and my baby is 9 weeks old. I've been asked a lot lately if I've been putting cereal in her bottle yet ,and my boyfriend is telling me to do it too. They know I breastfeed. The only time she gets a bottle is when I'm at work and she eats fine. Should I be giving her cereal in her bottle? She sleeps all night and she's gaining weight fine.

"Good for you for trusting your instincts and questioning this unwanted advice (which is so common when you become a mother)," Chamblin says. "There is no benefit to adding cereal to an infant’s bottle. This is an old wives’ tale that has stubbornly stuck around despite being proved wrong."

Any tips on weaning and moving to regular cow’s milk?

"Weaning is a process that depends a lot on the personalities of mom and baby," Chamblin says. "But there are some tips that can help like dropping a feeding, and not offering to nurse, but not refusing if your child asks." Chamblin also says that another approach is to plan distractions when you anticipate nursing and even shorten the duration of nursing sessions. "Remember there is no one way or single solution to make weaning happen. It has to be right for both of you," she says.

My baby is 14 weeks old and we have used a nipple shield since birth. I've been back to work for three weeks now, so she's been doing bottles everyday while I'm away. Now she has started to latch, pull off, and repeat, along with refusing the breast shield. My nipples are small and she has a hard time latching. Is this normal? Should I push her to keep trying to latch without the shield?

"While it would be best not to continue using the nipple shield, if she’ll take the breast with it, then use it," Chamblin says. "However, seek the assistance of an experienced lactation consultant to work towards weaning off the shield — an older baby usually doesn’t need it." She notes that sometimes bottle feeding interrupts with latch because bottles offer a faster flow than directly from breast. According to Chamblin, by pacing the bottle feeding, your baby will be able to readily latch again. "Paced bottle feeding is drawing the nipple out of your baby’s mouth after a few sucks to pause and allow your baby to breathe and to rest for a few seconds before giving the bottle back," she says. "Repeating this pacing throughout the feeding can cause your baby to successfully go from breast to bottle and bottle to breast."

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