We’d like to introduce the fabulous lactation consultant at MILKALICIOUS Breastfeeding Boutique, JENNIFER RITCHIE. Jennifer and her co-founder JENNIFER KUSIMER are committed to increasing long-term breastfeeding rates by offering breastfeeding support to new mothers. Both founders of Milkalicious are certified through UCSD as Lactation Professionals, and Jennifer Ritchie is currently the Vice President of the Orange County Breastfeeding Coalition.
Milkalicious has offered to host an online forum to answer all your breastfeeding questions this week. Please post any related questions or concerns here.

Tags: breastfeeding, lactation, milkalicious

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My son won't take a bottle. He is now 6 months old, just starting solids, and I'm considering introducing a sippy cup. Is it ok to off it with water or should it still be breastmilk (I HATE to see breastmilk dribbled out of his mouth)? Also, what type of cup would you recommend to use with such a young baby (my 2 year old didn't start a sippy cup until much later)?
First of all, thank you for your help. I've seen a lactation consultant and have been in touch with LLL, but I'm still having problems. The pain is minor compared with the initial weeks, when I was cracked/bleeding. My doctor prescribed a nipple ointment that helped tremendously and I still use it when I get sore. The doctor checked for thrush and that wasn't the issue. My left breast is the one that still gets painful. It looks slightly flattened when my son comes off, but as far as I can tell, his latch is good. I make sure his lips are flanged and I take him off when his sucking slows. The nipple still gets sore, though, almost a raw feeling. It is always red. I guess the best way to describe it is pinched. I don't ususally "top off" with formula because my son seems satisfied with his feeding. He's either content or he falls asleep. I'd appreciate any other advice!

Jennifer Ritchie said:
Hi Laura,
I am worried about the "painful" comment. Can you expand on that? The best way to supplement is by doing a "top off", letting your baby nurse on both breasts and then offering a bottle. If you replace a feed with a bottle of formula, you are loosing out on that much needed nipple stimulation.

Let me know about that pain!

Best Regards,
Jennifer

Laura Renauld said:
As I mentioned in an earlier post, I am alternately nursing and formula-feeding. Which is the better way to keep/increase my milk supply (short of pumping, which I have no time for): Should I nurse a bit at every feeding and then immediately supplement OR should I allow my son to completely nurse for a feeding and then supplement the next feeding? (Note: it is too painful to fully nurse and supplement at every feeding.)
Hi Laura,
I am going to recommend that you try a nipple shield. If your nipple is flattened, your baby may be compressing your nipple to slow the flow, or may have a high arch. A nipple shield will add structure and force the tongue to go down and forward. You can buy a 24mm nipple shield at any local Target, or on-line. When you get it, here is how you put it on. Flip it like a sombrero, center it on the nipple, and the nipple will pop in. Do not use any creams or ointments on the nipple, because it will make the shield slide.

If this takes the pain away, maybe you can breastfeed more often, and it will increase your supply. As far as the supplementation, just do it when you feel your baby needs it.

Good luck!
Jennifer Ritchie
Milkalicious

Laura Renauld said:
First of all, thank you for your help. I've seen a lactation consultant and have been in touch with LLL, but I'm still having problems. The pain is minor compared with the initial weeks, when I was cracked/bleeding. My doctor prescribed a nipple ointment that helped tremendously and I still use it when I get sore. The doctor checked for thrush and that wasn't the issue. My left breast is the one that still gets painful. It looks slightly flattened when my son comes off, but as far as I can tell, his latch is good. I make sure his lips are flanged and I take him off when his sucking slows. The nipple still gets sore, though, almost a raw feeling. It is always red. I guess the best way to describe it is pinched. I don't ususally "top off" with formula because my son seems satisfied with his feeding. He's either content or he falls asleep. I'd appreciate any other advice!
Jennifer Ritchie said:
Hi Laura,
I am worried about the "painful" comment. Can you expand on that? The best way to supplement is by doing a "top off", letting your baby nurse on both breasts and then offering a bottle. If you replace a feed with a bottle of formula, you are loosing out on that much needed nipple stimulation.

Let me know about that pain!

Best Regards,
Jennifer

Laura Renauld said:
As I mentioned in an earlier post, I am alternately nursing and formula-feeding. Which is the better way to keep/increase my milk supply (short of pumping, which I have no time for): Should I nurse a bit at every feeding and then immediately supplement OR should I allow my son to completely nurse for a feeding and then supplement the next feeding? (Note: it is too painful to fully nurse and supplement at every feeding.)
Hi Becky,
Congratulations, I am here for you whenever you have questions!

Best Regards,
Jennifer Ritchie
Milkalicious

Angela York (Yamamoto) said:
Congratulations on your pregnancy. We just had our second homebirth May 24. Loved it again :0)

Becky L Maher said:
I am Due July 9 2009 (planning a Home birth) just wanted to make contact so if I have any questions I can contact you ! Also reading over other questions others have asked may be very helpful!
Thanks,
Becky
Hi Pam,
It is very common for night nursings to increase around this age because of those darn molars. They take about 4 months to come in, and after they break through the gums, you will notice a longer sleep pattern. The twins will also be distracted during the day, so if you would like to keep up your milk supply, you could fit in one pumping session during nap time (if possible). What is the twins current weight?

Best Regards,
Jennifer Ritchie
Milkalicious

Pam said:
Hello,
I am breastfeeding twins (age 1 year), and they aren't very interested in daytime breastfeeding. They feed at 1 p.m. and 7 p.m. But then they nurse through the night--at 11 p.m., 2 p.m., and 5 a.m. I don't want to discourage breastfeeding in general, but I would love to not be nursing them so much in the night. Is there a way to discourage this while maintaining the daytime feedings?
Also, how much formula or cow's milk should I be given them, considering how little they nurse during the day?

Thank you!

Pam
Thanks... but what about how to get enough pumped for even the first day back?

Jennifer Ritchie said:
Hi Kendra,
There is nothing more discouraging than pumping and not getting a lot of volume. What you are doing right now is trying to take any EXTRA milk that you have in your breasts and store it. When you return to work you will REPLACE a feed with a pumping. There is a big difference, and the difference will be the volume. You will get a lot more volume when you pump to replace a feed, therefore you will have extra to freeze. Just get some rest and be with your baby right now, you will have plenty of time to pump when you go back to work.

Good luck to you!

Jennifer Ritchie
Milkalicious

Ronda, I have a 14month old that I nursed till the day he turned 13mo. At one year he nursed once at 6a, 6p and at night. I began to wean out morning and evening and that is when my period returned. At exactly 13mo I stopped the night nursing (we both were ready since he made a smooth transition) and sure enough I'm now pregnant! My grandmother sweared by the "nursing = birth control", and now I truly believe that too.

Hope that helps and good luck to you!
Laura

Rhonda D Dnyder said:
Hi! I have a 13-month-old daughter who is breastfed. She is down to once-a-day before bed and she's eating tons of solids and drinking vit. D milk. Anyway, my husband and I want to get pregnant again soon (I'm 34), and it just doesn't seem to be happening yet. My periods have been regular since March. Do you think I'm not ovulating? This was mentioned to me recently, that I may need to stop BF before I'll start ovulating again. What do you think?
Hi Jennifer,

I am really curious about donating breast milk. I have been looking on the internet for information about this subject, but everything that I have found is for the woman/baby receiving the donated milk. Who can donate milk? When? Can you point me toward more information about when it would be appropriate for a mother to donate milk?

Thank you,

Leslie
My daughter is now 4 weeks and had no problems latching on and gaining immediate weight. I seem to be producing too much milk though. She coughs and gags it down and frequently spits up volume. I went to the specialist at our hospital and was given new positions to try and instructed not to pump and to only offer the same breast in 3 hour slots. Most of this worked, however, I am very lopsided with my left breast always too full, and she never empties it completely so it gets engorged often. She seems to prefer the smaller breast and is beginning to reject the left. Is there a way to decrease the volume on one breast only? I had to pump when I had to go for a meeting last week and while I pumped both breasts, the left produced 4 oz in no time and after 20 min I could only get 2 oz out of the right so the left is almost twice the volume.
Hello T,
What you have is Oversupply and / or Forceful Milk Ejection Reflex. Based on what you are telling me, I am going to recommend that you try a nipple shield. Right now the only way to slow the flow is to pinch or pull off. The nipple shield only has 4 openings, and your baby will be able to stop the flow by simply lifting her tongue. You can buy a 24mm nipple shield at any local Target, or on-line. When you get it, here is how you put it on. Flip it like a sombrero, center it on the nipple, and the nipple will pop in. Do not use any creams or ointments on the nipple, because it will make the shield slide.

It is also very common for one breast to make more than the other. One of mine makes twice as much as the other!

Best Regards,
Jennifer Ritchie
Milkalicious

T Leigh said:
My daughter is now 4 weeks and had no problems latching on and gaining immediate weight. I seem to be producing too much milk though. She coughs and gags it down and frequently spits up volume. I went to the specialist at our hospital and was given new positions to try and instructed not to pump and to only offer the same breast in 3 hour slots. Most of this worked, however, I am very lopsided with my left breast always too full, and she never empties it completely so it gets engorged often. She seems to prefer the smaller breast and is beginning to reject the left. Is there a way to decrease the volume on one breast only? I had to pump when I had to go for a meeting last week and while I pumped both breasts, the left produced 4 oz in no time and after 20 min I could only get 2 oz out of the right so the left is almost twice the volume.
Hello Kendra,
You can try to fit in as many pumping sessions as possible before your first day back to work, or you can always supplement with formula for one day.

Best Regards,
Jennifer

Kendra Skeene said:
Thanks... but what about how to get enough pumped for even the first day back?
Jennifer Ritchie said:
Hi Kendra,
There is nothing more discouraging than pumping and not getting a lot of volume. What you are doing right now is trying to take any EXTRA milk that you have in your breasts and store it. When you return to work you will REPLACE a feed with a pumping. There is a big difference, and the difference will be the volume. You will get a lot more volume when you pump to replace a feed, therefore you will have extra to freeze. Just get some rest and be with your baby right now, you will have plenty of time to pump when you go back to work.
Good luck to you!
Jennifer Ritchie
Milkalicious

Hi Kate,
We are big fans of the Born Free Sippy Cup, and we have had success using this with babies that won't take a bottle. Because the baby is over 6 months, water can be helpful in avoiding constipation, so feel free to fill it with water!

Best Regards,
Jennifer Ritchie
Milkalicious

Kate Awad said:
My son won't take a bottle. He is now 6 months old, just starting solids, and I'm considering introducing a sippy cup. Is it ok to off it with water or should it still be breastmilk (I HATE to see breastmilk dribbled out of his mouth)? Also, what type of cup would you recommend to use with such a young baby (my 2 year old didn't start a sippy cup until much later)?

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