Breastfeeding

Sally Wendkos Olds literally wrote the book on breastfeeding — The Complete Book of Breastfeeding that is. It's newly revised and full of solid info for breastfeeding moms. Today Sally is joined by Laura Marks, MD, a pediatrician who co-wrote the book, to serve as our experts for the Expert Q&A series. Thanks Sally and Laura!

 

Here are the questions submitted by readers here on the blog, via facebook and e-mail, followed by Sally and Laura's answers:

 

Why am I hearing it's bad to use a used breast pump? Is it really bad if you get new tubes, filters and everything else? Hospitals and rental places let multiple people do it all the time, as long as each person has new tubes and holders.

 

The only type of pump that can be used by more than one woman is the kind designed with special barriers to prevent contamination from one user to another. Hospital-grade electric pumps have this, as do a few commercial pumps. Hygeia II states that its piston-driven personal-use electric pump has been FDA-cleared for use by more than one mother, each of whom needs to have her own accessory kit, the only part of the pump that touches her body or breast milk.

 

Is there anything I can do/use to prep myself for breastfeeding before birth?

You don't have to do anything during pregnancy to prepare your breasts for nursing, unless you have inverted nipples, in which case you may want to wear special plastic breast shells. These shells, also known as shields or milk cups, exert a constant gentle and painless pressure that gradually draws out a flat or inverted nipple. You can find them through your childbirth or breastfeeding education organization, through a catalog, or online. They are different from the rubbery nipple shields that are sometimes advised for sore nipples, but which should not be used. Women with inverted nipples used to be advised to do exercises during pregnancy, but this is no longer recommended.

 

Do supplements/teas/vitamins work to increase breastfeeding supply? If so, which ones? Any other ways to up supply besides actually nursing more often?

 

There's no hard evidence that supplements, teas, or vitamins help to increase a mom's milk supply, but many women swear by specific preparations. Most of them can't hurt, but if you're thinking of using herbal tea, stick to reliable brands and drink in moderation. Just because something is natural doesn't mean that it's safe. Always check with your doctor before using anything. Meanwhile, remember that the best way to increase your milk supply is to keep removing milk from your breasts, primarily from frequent breastfeeding, and also from pumping.

When do you quit trying to breastfeed? I was told to stop at 2 weeks and go to pumping only so that we knew how much my daughter was really getting due to failure to thrive. I think now that if I had stayed with direct versus pumping I may have had success and that my milk was just late to come in, but the inefficiencies of a pump over an actual baby stalled it. But obviously, at some point you have to admit that it really isn't going to work for some reason. How do you know where that point is, and when to keep pushing?

 

Even if you have to give your baby supplements of formula to help her gain weight, you should continue nursing as often as you can for the first couple of months. Even the best breast pump is not as efficient as a vigorously suckling baby in stimulating the breasts and thus increasing milk supply. Current recommendations include giving the supplement first so the baby is not so wildly hungry and will be more likely to nurse.

 

How is it possible that I can breastfeed my 15-month-old only once a day, when before I would get too engorged to go that long between feedings?

Breastfeeding is the ultimate example of supply meeting demand. As your breastfeeding schedule changes with your baby's development, your breasts adapt. Your 15-month-old is now eating solid foods and not needing as large a supply of milk, so your breasts respond by producing less milk.

 

What changes will happen to my body when I completely wean my baby? Will my weight be affected? Will my hormone levels shift? Also–how might my weight be affected when I stop nursing? I know I won't be using as many calories, but are there also hormonal changes that may affect my weight when I stop nursing?

When you stop breastfeeding, your body will undergo a number of physiological changes as your hormonal balance reverts to what it was before you became pregnant. As soon as you added foods other than breast milk to your child's diet, it became easier for you to become pregnant again. If you have not already adopted a method of birth control and if you don't want to conceive right away, you'll now need to use some means of contraception.