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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i was wondering about any tips and tricks for pumping milk.
im getting about an ounce per breast each time i pump.
i also wonder how long it takes to get the milk back once pumped if the baby wants to feed quickly after pumping
Hi Laura,
I am so sorry you had difficulty breastfeeding, it is not easy for any of us in the beginning! I am so proud of you for continuing breastfeeding while doing the supplementation. You are already a great mom!! Breastfeeding is physical and hormonal, so you will need to keep up the nipple stimulation to keep up your milk supply. Do you own a double electric breast pump? If so, I would recommend pumping if you are feeding your baby on the breast less than 8 times every 24 hours.

I would also recommend taking a Galactogogue. This can be a food, herb, or drug that help boost your milk supply. Galactogogue foods include: oatmeal (not instant) brown rice, and beans; Galactogogue herbs include fenugreek , blended thistle, and goads rue, and Galactogogues drugs include Motilum and Reglan. The company Motherlove sells a special blend of these herbs in a liquid and capsule form, and many of my clients have had success using it. The two most common Galactogogue drugs are metoclopramide (Reglan) and domperidone (Motilium). Both work by raising prolactin, but Reglan does cross the blood brain barrier and can cause depression. Domperidone does not have this problem. If you have more questions regarding this, let me know.

I would also suggest doing breast compressions while he is on the breast. That will help with the flow, and may help so he doesn't have to suck so vigorously. Increasing your supply will also help with this.

Best Regards,
Jennifer Ritchie
Milkalicious
www.milkalicious.org

Laura Renauld said:
My son is 10 weeks old. We had difficulty nursing at first and he lost too much of his birth weight so we have been nursing and formula-feeding, alternately, ever since. I was never able to build my milk supply up enough to breastfeed exclusively. Two questions:
1. Will I be able to continue this feeding routine for the long-term or will my milk supply eventually dwindle?
2. When he nurses, he has to suck vigourously the whole time. My milk does not flow on its own. Is this a result of our initial trouble or is this a problem with me that will occur again with my next child?
Here are some pumping tips:
1. Lubricate the areola with a nipple cream to help with the friction, and make pumping more comfortable.
2. Make sure your flanges (the part that looks like a cone) are not too small. If any of your nipple touches the sides of the flange while pumping, it can lead to decreased milk output, pain, and plugged ducts.
2. Pumps are wonderful, but they are a machine. What you pump is not an accurate gauge of what your baby is getting, so don't get discouraged.
3. The best time to pump is directly after a feed. Your baby will never fully empty the breast, and your breasts will be full at the next feeding time. Your body will also start producing more milk as soon as it is removed.

Hope that helps!
Jennifer Ritchie
Milkalicious



gabrielle said:
i was wondering about any tips and tricks for pumping milk.
im getting about an ounce per breast each time i pump.
i also wonder how long it takes to get the milk back once pumped if the baby wants to feed quickly after pumping
Hi Kelly,
A couple quick questions: How old is the baby, what was the birth weight and todays weight.

Thanks!
Jennifer
Milkalicious


JT said:
Sometimes if the flow is too fast for a baby they will bob off the breast to catch their breath. You can lean back in the chair while feeding to stop it from flowing so fast by using gravity against it. Your breasts don't have to change size to produce enough milk. With your second baby your body is more efficient at knowing exactly how much milk to produce so you might not have the same surplus you did with your first baby but if you breastfeed often and on demand you should not have a prob producing enough milk. Make sure you pump each time you give the baby a bottle to keep up the supply.

Kelly Martell Scovel said:
When I had my son 3 years ago, I was overflowing with milk. My breasts went from a B to about a D and I had no problem breastfeeding and did so for about a year. Now, with my 3 month old daughter, I have barely ANY milk, and I don't feel I have done anything different. I am trying to only give her 3oz. of formula a day, but most days it ends up being 6oz. (two bottles) She is very frantic when she breastfeeds, and pulls herself off every couple seconds. I know the milk is coming out because when she pulls away it shoots out! I just want to know what I can do to make more milk for her, and how to encourage her to relax.
Hi Jennifer,
Here are some studies for you to review:

Allen LH. Maternal micronutrient malnutrition: Effects on breast milk and infant nutrition, and priorities for intervention. SCN News 11:21-27, 1994.
http://www.linkagesproject.org/media/publications/frequently%20aske...

Dewey KG. Energy and protein requirements during lactation. Annual Review of Nutrition 17:19-36, 1997.
http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.nutr.17...

González-Cossío T, Habicht J-P, Rasmussen KM, Delgado HL. Impact of food supplementation during lactation on infant breast-milk intake and on the proportion of infants exclusively breast-fed. Journal of Nutrition 128:1692-1702, 1998.

Brown KH, Dewey KG. Relationships between maternal nutritional status and milk energy output of women in developing countries. In: Mechanisms Regulating Lactation and Infant Nutrient Utilization (Picciano MF and Lonnerdal B, eds.), pp. 77-95. Wiley-Liss: New York, 1992.

Krasovec K, Labbok MH, Queenan JT. (eds). Breastfeeding and borderline malnutrition in women. Journal of Tropical Pediatrics 37 (suppl 1), 1991.

Institute of Medicine. Nutrition during Lactation. National Academy Press: Washington, DC, 1991.

Best Regards,
Jennifer

Jennifer L. Hensley said:
Do you have links to the studies that show maternal nutrition and hydration have nothing to do with the quality or quantity of breastmilk?

Jennifer Ritchie said:
Hello Jacqueline,
Believe it or not, the amount of milk that a woman makes is most dependent on regular milk removal from the breast, not really influenced by a mothers nutrition and water intake. There is little to no scientific evidence to support the effect of a mothers nutrition on the amount of milk she produces. This helps explain how a mother is able to nourish their babies even under terrible conditions. Breastfeeding is demand and supply, so not enough nipple stimulation and empting of the breast can lead to a sudden drop in supply. We also experience a natural decrease in prolactin levels 2 weeks after we give birth. If a drop in supply is noticed, and the mom is putting the baby to breast 8 or more times every 24 hours, I would recommend Galactogogues. What the heck is a Galactogogue? This can be a food, herb, or drug that help boost your milk supply. Galactogogue foods include: oatmeal (not instant) brown rice, and beans; Galactogogue herbs include fenugreek , blended thistle, and goads rue, and Galactogogues drugs include Motilum and Reglan. The company Motherlove sells a special blend of these herbs in a liquid and capsule form, and many of my clients have had success using it. The two most common Galactogogue drugs are metoclopramide (Reglan) and domperidone (Motilium). Both work by raising prolactin, but Reglan does cross the blood brain barrier and can cause depression. Domperidone does not have this problem.

Hope that helps solve the mystery!

Best Regards,
Jennifer Ritchie
Milkalicious
www.milkalicious.org
i breastfed my first son for 7 months. i had to stop because i was working too much and i wasnt able to keep up my milk supply. it has been 2 years since i had my son and i now have a newborn daughter who i would also love to breastfeed for the same amount of time but this time my right nipple is torn, i can see flesh and blood. its sore all day, through feedings and all. it closes up with in the hours of feeding but everytime i nurse he it reopens and its extremely painful. is there anything i can do to heal my torn nipple to make breastfeeding joyful again?
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.)
My son is 7 weeks old, and I've been trying to pump for about 3 weeks now to store up a milk supply for when I go back to work in a couple more weeks. I know that while I'm home with him, my son is getting enough milk. He wets tons of diapers each day, and is gaining weight adequately, but he's not overweight.

The problem I'm having is that I don't have a large storage capacity, so he is nursing what feels like all day long... there isn't really an opportunity for me to pump much during the day. When I do pump in the morning when I am most full (pumping one breast while he nurses the other), he decides he wants more and starts getting fussy because I've pumped some of his breakfast away. I have tried pumping while he naps, but again his nap may only be an hour long and so when he's ready to nurse, there's not enough there for him. My last option is to pump after I put him down to bed for the night, but then I'm lucky if a get a half ounce, AND I lose sleep since I'm not going to sleep when he does - he still gets up to nurse 3 times a night, for an hour each time, so I prefer to go to sleep as soon as he does so I get some sleep.

Even on a good day when everything goes perfect, I'm lucky to get 2 ounces of milk to freeze.

My concern is that I won't have enough stored up for him once I have to go back to work, and I don't even know how much he's getting each day to know how much he needs. I'm also concerned that once I am pumping at work, if I'm not able to pump as much as he eats, I'll quickly run out of what little stored milk I manage to stock, and won't have enough to leave him when I go to work.

I've been trying to read tips online at places like kellymom but so far nothing seems to be much help... like I said above, advice like "pump in the morning" does me no good because he nurses a lot each morning and doesn't leave me anything to pump (I've been trying to nurse him to sleep for close to 2 hours already this morning so he would nap and I could pump, but so far no luck on the sleep).

Suggestions?
I have a nursing 16-month-old with a mouthful of teeth, but she's not actually biting. I think it's the rubbing of her teeth on my nipples that is so painful. It hurts to nurse, but it's bearable. It's really painful to have anything touch my nipples when not nursing - even a soft bra. I travelled recently for five days and by the end of the trip - bliss! The pain was completely gone. But as soon as I returned, within two nursing sessions it was back.

I'm not prepared to stop nursing yet - and neither it she! However, everything I can find online deals specifically with biting. Any suggestions? I met with a lactation consultant, who basically said I should stop, that we've gone as long as we could.
Hello,

My daughter is 8 weeks old as of yesterday. We have been battling thrush for almost 6 weeks. We have tried three rounds of nystatin for her and nothing. This week we have also tried the gentian violet and her mouth has definitely cleared up, but I am still having the shooting pains through my breasts which is a symptom of thrush. We are on our 3rd day of our gentian violet treatment today and we have been painting the baby's mouth as well as my nipples. I feel like she is getting better, but my symptoms are not. I am so frustrated because I have tried everything - garlic, grapeseed extract (drinking it), probiotics, acidophilus... you name it and I've done it with no luck. Can you offer any advice? Please help!
I have read a Dr. Jack Newman book that suggests an all-purpose nipple oinment which is a mixture of several topical creams (you may need a prescription), but i think these creams together have a healing quality for cracked nipples and irritation. You may want to just search the internet for "Dr. Jack Newman's All Purpose Nipple Ointment" and I believe you will find what you are looking for.

julie mascorro said:
i breastfed my first son for 7 months. i had to stop because i was working too much and i wasnt able to keep up my milk supply. it has been 2 years since i had my son and i now have a newborn daughter who i would also love to breastfeed for the same amount of time but this time my right nipple is torn, i can see flesh and blood. its sore all day, through feedings and all. it closes up with in the hours of feeding but everytime i nurse he it reopens and its extremely painful. is there anything i can do to heal my torn nipple to make breastfeeding joyful again?
Neither of the links have adequate data for my question.

Jennifer Ritchie said:
Hi Jennifer,
Here are some studies for you to review:

Allen LH. Maternal micronutrient malnutrition: Effects on breast milk and infant nutrition, and priorities for intervention. SCN News 11:21-27, 1994.
http://www.linkagesproject.org/media/publications/frequently%20aske...

Dewey KG. Energy and protein requirements during lactation. Annual Review of Nutrition 17:19-36, 1997.
http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.nutr.17...

González-Cossío T, Habicht J-P, Rasmussen KM, Delgado HL. Impact of food supplementation during lactation on infant breast-milk intake and on the proportion of infants exclusively breast-fed. Journal of Nutrition 128:1692-1702, 1998.

Brown KH, Dewey KG. Relationships between maternal nutritional status and milk energy output of women in developing countries. In: Mechanisms Regulating Lactation and Infant Nutrient Utilization (Picciano MF and Lonnerdal B, eds.), pp. 77-95. Wiley-Liss: New York, 1992.

Krasovec K, Labbok MH, Queenan JT. (eds). Breastfeeding and borderline malnutrition in women. Journal of Tropical Pediatrics 37 (suppl 1), 1991.

Institute of Medicine. Nutrition during Lactation. National Academy Press: Washington, DC, 1991.

Best Regards,
Jennifer

Jennifer L. Hensley said:
Do you have links to the studies that show maternal nutrition and hydration have nothing to do with the quality or quantity of breastmilk?

Jennifer Ritchie said:
Hello Jacqueline,
Believe it or not, the amount of milk that a woman makes is most dependent on regular milk removal from the breast, not really influenced by a mothers nutrition and water intake. There is little to no scientific evidence to support the effect of a mothers nutrition on the amount of milk she produces. This helps explain how a mother is able to nourish their babies even under terrible conditions. Breastfeeding is demand and supply, so not enough nipple stimulation and empting of the breast can lead to a sudden drop in supply. We also experience a natural decrease in prolactin levels 2 weeks after we give birth. If a drop in supply is noticed, and the mom is putting the baby to breast 8 or more times every 24 hours, I would recommend Galactogogues. What the heck is a Galactogogue? This can be a food, herb, or drug that help boost your milk supply. Galactogogue foods include: oatmeal (not instant) brown rice, and beans; Galactogogue herbs include fenugreek , blended thistle, and goads rue, and Galactogogues drugs include Motilum and Reglan. The company Motherlove sells a special blend of these herbs in a liquid and capsule form, and many of my clients have had success using it. The two most common Galactogogue drugs are metoclopramide (Reglan) and domperidone (Motilium). Both work by raising prolactin, but Reglan does cross the blood brain barrier and can cause depression. Domperidone does not have this problem.

Hope that helps solve the mystery!

Best Regards,
Jennifer Ritchie
Milkalicious
www.milkalicious.org

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