Life

HillLander/Fotolia

11 Real Breastfeeding Questions On Thrush, Pumping, & More, Answered By Experts

by Kelly Mullen-McWilliams

Breastfeeding can be a hard, isolating, and emotional journey, which is why it's so important to have support. That's why Romper launched a Facebook breastfeeding community, Breastfeeding TBH — to help make feeding another human being with your own body a little easier. Every day readers ask questions because, let's face it, breastfeeding is complicated, and each week in Rack Facts, Romper speaks with a lactation consultant to answer as many of those questions as possible. After all, everyone can use a little expert help, especially when it comes to feeding your kid.

On this edition of Rack Facts, the theme is definitely stress. When work and school are getting you down, how do you keep up your supply and manage complex pumping schedules? How do you store milk when you only have access to a tiny fridge? And when disaster strikes — a nasty infection that lands you in the hospital, for instance — can you pick up breastfeeding where you left off?

In a perfect world, all moms would spend their breastfeeding days lounging in a hammock beneath the Hawaiian sun. In real life, we're often juggling a million responsibilities all at once. That's where Leigh Anne O'Connor, International Board Certified Lactation Consultant (IBCLC), and media liaison of La Leche League New York, comes in with a few helpful tips for moms dealing with thrush, stress, and more. Helen Anderson, Chief Lactation Officer at Fairhaven Health and founder of Milkies, addresses weaning, milk storage, and breast pumps. Finally, Melanie Silverman, Chief Clinical Officer for Pacify, a mobile app that gives new moms video access to lactation consultants, dietitians, and nurses 24/7, discusses your ideal breastfeeding schedule, and looking out for your supply when stress rears its ugly head. Happy feedings.

1Dealing With Painful Thrush

I have a question. My baby just got diagnosed with thrush and my left nipple hurts so bad. Every time she gets ready to eat on that side, I cringe. It was bearable for a couple of days but now it almost makes me queasy. It’s only one side. Could I just pump from one side and feed off the other? Also, what is the quickest way to get my nipple healed?

For me, thrush is right up there with mastitis on the list of major breastfeeding challenges, so know that you truly have my sympathies, and that you're absolutely a breastfeeding superhero. O'Connor offers some sage advice. First, she says, you want to make absolutely sure that your symptoms are due to thrush, a condition that's often confused with other issues. "If it is thrush, the treatment ... is typically 14 days of anti-fungal for both mom and baby," she explains. And to answer your question: yes, you totally can pump on just one side.

"If it is one-sided, it's possible to exclusively pump on that side, but you need to boil every part of the bottle, pump, pacifiers, and anything that your baby puts in her mouth after each session (obviously except your nipple)," says O'Connor.

As for healing your nipple, she recommends using over-the-counter Gentian violet to help speed your recovery. "You paint the inside of your baby's mouth just before nursing so that her mouth and your nipple are purple," she says. In case you're wondering, O'Connor says yep, Gentian violet will stain whatever it touches, so don't be surprised if your bathroom looks like the oompa-loompas paid you a visit. Just use a 1 percent solution, once a day.

Rooting out thrush isn't easy, in part becasue you have to completley treat it in both your baby and in yourself, or you'll keep passing it back and forth. "Yeast is a challenging beast to heal," says O'Conner. Here's hoping you'll feel better soon.

2When You're Ready To Wean

I need help or advice on how to start weaning my son. He will be one next month and I want to start the process, but I have no idea where to start. Thank you.

"Good for you mama," says Anderson. "You made it to one year and ready to wean. You got this — just start slow by replacing one feeding per day with a solid food or other drink."

Usually, she says, moms pick the midday feeding because your breasts are fullest in the morning, and evening breastfeeding is part of the bedtime routine.

"If you are transitioning to a bottle or sippy cup, let your son choose his own. He will be excited about using it and may not notice the missing feeds," Anderson explains. "Get ready to cuddle if your son misses the closeness of breastfeeding, and you can also let dad take on more cuddling as you wean."

Congratulations. Weaning truly is a milestone, when you know it's time.

3Don't Bottle Up Your Feelings

I have a 6-month-old son who is exclusively breastfed (EBF). He used to take a bottle perfectly fine from anyone once in a while. We haven’t given him one in a few months since he hasn’t been left with anyone and we haven’t gone anywhere where I couldn’t nurse him. We recently left him with his grandma and he refused to take a bottle! Now we cannot get him to take one at all! Not sure what to do to get him to take one so we can eventually be able to get a night out!

Every mama needs a night out on the town now and then. It's good for you, which means it's good for your baby, too. According to O'Connor, it's not unusual for babies to refuse bottles, because they're so different from breasts. But don't despair. Here are a few tips:

"Have the person giving him a bottle be sure to keep the baby upright and the bottle more horizontal," she explains. "The carer can wear the baby in a carrier — or rock in a chair or on a large yoga ball — as the movement may sway the baby to take the bottle. At 6 months of age, a baby can take a cup with a straw. The action of sucking on a straw is closer to the action a baby uses at the breast. You may also have the carer offer the bottle while your baby is sleepy."

If all else fails, says O'Connor, the worst-case scenario here isn't actually so bad. Because your baby is older, your grandmother can simply feed him solid foods while you enjoy date night. Just nurse him before you leave, and then again, right after.

Psychologically, I know it's hard to leave your baby with someone else, especially if that caregiver's feeding of him isn't going as planned. But take the plunge. It will get easier with time. As an aside: how cool is it that sipping from a straw is closer to breastfeeding than tugging on a bottle? The more you know...

4Less Than Pumped

Hello! I am currently nursing and pumping for work. I have the Medela Pump In Style. It has stopped working like it did originally. It gets milk all in the flange and of course the suction is not near what it was. Any ideas? Thank you.

"It's tough when your pump doesn't work like it should," says Anderson. (Truer words were never spoken.) Here's what you should know about your Medela:

"The Medela pumps have a unique design with a thin membrane that needs to cover the holes the milk comes out of to fill your bottles," Anderson explains. "This membrane is flexible and fragile so it can move out of the way of your milk, but it is also easily damaged. Check the small, white membrane for cracks or fraying and replace it if showing signs of wear. If the membrane is damaged, your pump cannot create effective suction and empty your breasts."

If you wind up looking for a new pump, Anderson suggests checking out Haakaa’s Silicone Breast Pump, which she says is "known for being very easy to use and reliable." Also, you can try the Milkies Milk Saver and Milk Trays.

"I invented the Milk Saver to catch every drop of milk for more efficient (and stress-free) pumping while the Milk Trays provide flexibility for moms to pump ahead of time if needed," says Anderson. Cool, right?

5Recovering From Hospitalization

I have been in the hospital with a nasty infection for a week. I had really only been nursing my son, who is 8 months old, to sleep and nap. Now he wants nothing to do with my breasts or hardly me, for that matter. I am still very weak and can’t pick him up or hold him if he’s squirmy (all the time).

This is so hard, but babies are adaptable, and it will get better. In the meantime, don't be afraid to ask for help from family and friends, and don't feel like you need to be the only person holding your baby all the time either. The most important thing now is to focus on your physical recovery. If family and friends aren't around, you might consider reaching out to a postpartum doula.

"I hope you are feeling better; being hospitalized when you have an 8-month-old must be difficult," says Anderson. "If you have been out of the house for a few days, your son may have developed a new routine so feeling a little disconnected is normal."

Because you've been away for a week, she advises giving him another week to adjust to you being home. "Hold your son when he is winding down and less squirmy, only if you feel strong enough to keep him safe. Focus on your recovery and find easy activities to do together like laying on the floor playing with cars or other toys. Offer the breast before each meal and keep a casual attitude about breastfeeding. If you feel stressed, he will pick up on it and be less likely to start nursing again. Good luck!"

6Weaning Before A Trip

My 14-month-old is still breastfed and nurses frequently through the night. Because of this, he sleeps in bed with my husband and me. I didn't have any intention of stopping, but my husband and I decided we want to take a trip with just our oldest in a couple months. We want my mother-in-law to watch him, but I know she won't if he's not weaned and sleeping in his own bed. Also, the only way he falls asleep now is at the breast. Does anyone have any tips on how to wean him and get him in his own room?

"14 months?! Wow, nice job!" Anderson says. "Keep in mind there is no right time to wean. The rule is: stop breastfeeding when one or both of you want to. If that time is in a couple of months, great. If you want to wait, that's OK, too. Remember that breastfeeding doesn't last long, and it's up to you when to stop."

Don't let circumstances pressure you into weaning, because that could be a recipe for regret. However, if you do feel that now is the right time, Anderson suggests beginning to transition right away. You can start by putting him in his own bed for naps, she says, and by spending "more time in his room when he's not sleeping — playing, reading, and exploring.

"Play 'bedtime' and let your son get under his blankets, [while] you read a story and turn out the light," she advises. "At night, let your son relax, but not fall asleep at the breast. There are some nights he may have difficulty settling down without the breast. On those nights, your husband can take on the nighttime rituals, read, and snuggle with your son until a new routine is established."

Happy travels.

7Managing Supply & Demand

Due to an oversupply of milk, I have been pumping and bottle feeding my almost 4-month-old since she was about 1.5-months old. However, my supply has evened out and I would like to try to get her back on the breast. She nurses perfectly at night, but refuses during the day. I absolutely hate pumping, and I'm afraid if I can't get her back on the breast completely I might just throw in the towel. Does anyone have any suggestions on how to get a baby back on the breast after bottle feeding? I really don't want to quit breastfeeding, but between this and her dairy/soy protein sensitivities, I'm getting worn down fast!

"To get your baby back to the breast, there are a few things you can try," says O'Connor. "Make sure the bottles she uses are truly slow — it should take 15 to 20 minutes to finish a bottle of 3 to 4 ounces." During the day, O'Connor suggests nursing her in a dark, quiet room. (For me, blackout curtains are key at this age.)

In addition to keeping the room dark and soothing, O'Connor says that some babies will take the breast better with movement. You can nurse in a rocking chair, on a bouncy ball, or while wearing your baby, facing you. It may also be helpful to offer your baby the bottle for a minute, and then switch her over to the breast, she says.

8Storage Wars

I just returned back to work this past week and I pump about three to four times in a 10-hour shift. I don't have enough fridge space to leave it in the little bottles I pump into, so I was using a reusable water bottle to store it in. When I get home, I put it into storage bags and freeze it right away, as I nurse when I'm with my baby. One day, I forgot the bottle and used my reusable Nalgene water bottle. Both bottles are sterilized before milk was added. My question is, is it OK to store it in those? I feel like when I thawed the milk I stored in them for the day at day care, it almost smelled sour. I follow all the “breast milk rules” for storage and thawing and consumption. I just feel like it smells sour ... my little one is also having a hard time taking a bottle, and I fear it may be the milk and not the bottle. Does breast milk have an odor? Any suggestions or tips?

For a unique storage solution, check out Milkies Milk Trays. I haven't tried them myself, but they look super space-friendly. Here's what O'Connor has to say:

"Some moms have high lipase in their milk, and if frozen it gets a bad smell," she explains. "Some babies do not mind, but others do. If you are using the milk within seven to eight days, you do not need to freeze it. If you do need to freeze it, you will want to scald it before freezing. Scalding is when you heat the milk to just before boiling — small bubbles start to form — this should kill the lipase without harming the nutrients in the milk."

9Motivation To Keep Going

Hi y’all. I really need some support. First-time mom to a 5-month-old. I’ve been stressed a lot lately because of work and college classes. I’m an exclusive-pumping mom but my supply has plummeted and my son’s milk stash is depleting. It saddens me that we may have to supplement soon. I’ve been researching the ins and outs of breastfeeding. I know about oatmeal, supply and demand, herbal enhancers, but what I’m really looking for is good ol’ “pick-me-ups” and support. Being that I can’t really talk to my family about this, it’s hard to get self-motivated and really be strict with revamping my supply. The last thing I want to do is give up, and I just need some encouragement. Thank you all, we’re on this journey together!

As a new mom, I found that joining a local, in-person mom's group was absolutely amazing. About half were breastfeeding, and half weren't, but every one of them was supportive of each member of the group, because we all knew how hard the early months can be. My suggestion is to find such a group on Facebook or through community boards, and tell them exactly what you need. I know you can do this!

On the practical side, O'Connor advises checking the valves on your pump because they do wear out, and to be mindful of not over-feeding your baby, or letting others overfeed, either.

"There is no need to increase the flow of the bottle — that is all marketing," she says. "Stick with slow-flow bottles. Some people find that using a hospital-grade pump is a 'game changer' in that they get more milk." In addition, be sure you're pumping at least once in the middle of the night or early morning hours, she says. And adding a few more pumping sessions to the schedule won't hurt either. "Offer skin-to-skin with your baby — this can increase your milk."

As for stress, it certainly doesn't make breastfeeding any easier. Ask your partner to pick up some slack, if possible, and schedule time for self-care. Breastfeeding, for however long you can, is a gift to your baby, so know that you're truly engaged in a worthwhile pursuit.

10Stress Levels Spiking At Work

My stress levels have spiked over work, practicum, and evening classes, and because of this my supply has plummeted, even with my pumping schedule. My 5-month old seems to be going through a growth spurt, and his freezer stash is running low. It’s scaring me to think I may have to supplement with formula. I don’t want to, because I’ve always wanted him to be breastfed. What is a quick way to boost my supply? And any other suggestions would be great! Needing some encouragement please!

"This is an excellent question and a frequent one from Pacify's breastfeeding moms," explains Silverman of Pacify. "The quickest way to boost your supply is to add one or two short pumping sessions, maybe eight to 10 minutes, to your current pumping schedule."

Practice deep breathing and breast massage before you start pumping, she suggests, and engage in as much skin-to-skin contact as you can. Holding your baby close isn't just comforting to both of you, it's great for supply, too.

"Please take comfort knowing that you have supplied a robust milk supply for your baby for the past five months," she says. "Your body can make milk and even increase the amount you are producing. I know you can do it!"

11Building Your Breastfeeding Schedule

I have an 11-month-old I've been breastfeeding since day one. He still breastfeeds, but takes a good amount of solids now as well. I pump three to four times at work, and I was wondering if anyone has ever dropped the daytime pumping sessions and only breastfed in the morning and evening. I love nursing and I don't want to give it up, but pumping is a pain in the butt and I'm only pumping about 8 ounces a day at this point! I'm worried giving it up though will mess with my milk supply.

"Congratulations on breastfeeding for 11 months," says Silverman. 'That is something to celebrate. And I love seeing that he is taking a good amount of solids at this age. The answer to your breastfeeding question is yes, you can absolutely breastfeed in the morning and evening only. Since you pump three to four times at work, it's important to slowly wean yourself from the pump. I suggest dropping one pumping session every five to seven days. This is a gradual weaning process and important to prevent uncomfortable engorgement. Please continue to breastfeed morning and evening when you are with your baby and your milk should remain. Good luck!"

Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.