Got milk? | Fit Pregnancy

Got milk?

All about that Milk Supply

Maybe it's bikini season or maybe it's the good bra sale coming up at Nordstrom's but everybody's thinking about breasts. Got a lot of questions this week about breastfeeding, milk supply, weaning and whether mom can eat sushi or use caffeine to get rid of cellulite (really?) when breastfeeding. One reader broke her collarbone and is looking for a no-hands double pump. Another partied too hard in Miami, did the ol' pump-and-dump for a couple of weeks and now her baby doesn't want the breast anymore. A few are having trouble with babies who prefer the bottle to the breast. What's a mother to do?

Let's get our priorities straight here—Sushi. Go for it. Kathy, my lactation consultant buddy says the pregnancy-worries about sushi don't apply to breastfeeding. You can eat sushi in the delivery room if you want. She also says a topical cellulite cream with caffeine is probably OK, too, as absorption through the skin, into the bloodstream and milk supply is unlikely. Personally—and this is not medical advice here—if mothers weren't meant to consume caffeine when breastfeeding, then all babies would sleep through the night. That just seems like common sense, but I know some babies are so sensitive to their mother's diets that a cup of coffee will keep baby up all night cramming for finals.

What about drinking? Our Miami party-mom pumped for two weeks then couldn't get her baby back to the breast. Oh, Miami, that was way too long. You don't need to pump-and-dump if you've only had a drink or two. If you're feeling at all drunk, wait a few hours then offer the breast. Very little alcohol gets into the milk. On the other hand, if you've really been hitting the bottle, the general rule of thumb is wait three hours for every drink you have. Pump a supply before you go partying to have available. Of course, drinking has other problems associated with it. Drunk moms don't do a great job of parenting and if you're worried you might nod off while breastfeeding, you increase risks of harming your baby.

One reader who's been nursing for 12 weeks is finding that her milk supply isn't quite adequate. Despite pumping and nursing, her baby is still hungry. Babies have a big growth spurt at 12 weeks and need longer, more frequent feedings. That means Mom needs more fluids and a little more food for a while too. It's all about supply and demand. As long as Mom's calorie and fluid intake are adequate, her breasts will respond to baby's needs. Breasts are really smart that way. Baby needs more milk? Oh, OK, give me a few days and I'll make more. If your supply is seriously low though, go see your doctor or a lactation consultant for help. There are prescription and over the counter remedies that help. Many lactation consultants recommend fenugreek (in capsule form) to help increase milk supply in as little as 24-72 hours. Women have been using it since Biblical times with a lot of success.

On the other side, one reader wants to start weaning her 7-month baby so she doesn't become so engorged at night. Her baby's sleeping through the night, she's uncomfortable and thinking about throwing in the towel to avoid nighttime pumping. Hang on for a while Mom. Breast is best for the first year but sore, leaky breasts that keep a girl up at night make for an exhausted, cranky mom in the morning. That law of supply and demand works for you too. It won't take more than a few nights with a towel on your chest (and maybe some ibuprofen) for your breasts to get the message you don't need that night time supply. Then you'll be able to continue nursing for the full-recommended year without feeling like a nighttime water balloon.

What if you've been sharing the feeding load with the bottle and your milk supply is dwindling? Your breasts will make the amount of milk you tell them to. You might have to tell them loudly though. Kathy recommends when pumping that you keep the pump going for a couple of minutes after your milk quits flowing to send the message you need more. It won't take long before your breasts send along a fresh supply. Offer the breast to baby (who is way more efficient at draining them than the pump) more frequently too.

It's easier for baby to get milk from a bottle than the breast. It requires less suction and work. Though most prefer the taste of breast milk to formula, when given the option of an easy supply to one they have to work a little for, many will hit the bottle. So what if you want them back on the breast? Quit giving the bottle. Offer the breast exclusively and soon they'll get hungry enough and give in. Some moms never give the baby a bottle but leave that for dad and the babysitter.

But what if you're just plain done? What if you want to wean before that first birthday? If breastfeeding isn't working for you on a practical basis and you feel like you're ready to wean—Hey, you know better than anybody what's right for you. Sure, you'll get some attitude but who cares. They're your boobs, it's your body and that's your baby. 'Nuff said. I weaned my youngest when she was three months old because I got sick. Really sick. God awful, nasty sick. The kind that involved serious surgeries, drugs and radiation. And still, I got "the look" and wagging fingers from a few who thought breast is best no matter what. Well guess what? Sometimes it isn't. So there. You do what you think is best. It doesn't take long for breasts to get the message they're not needed anymore. If you gradually decrease feedings, weaning will be more comfortable for you and your baby. Try eliminating one feeding at a time over the course of several weeks, if possible.

This is a good time to pitch the wonders of lactation consultants—nurses with extra training and certification who specialize in breastfeeding. And not just newborns. They know all there is to know about nursing older babies, pumping, transitioning back to work and weaning. They know what drugs you can take and what foods to avoid. They're breastfeeding gurus. Broke your collarbone and need a hands-free double pump? They're your girls. Call them. Go online to the International Lactation Consultant Association website to find one in your area. They're every nursing mother's breast friend. Oh, sorry about that, I couldn't resist the pun.

Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.

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