Ask Milkalicious, Lactation Experts

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Permalink Reply by Jennifer L. Hensley on June 22, 2009 at 11:36am

And it's not like it's guaranteed you'd make enough or continue to make enough prolactin to suppress ovulation--you can start to ovulate at any time, and you wouldn't know it because you menstruate after you ovulate.

Jennifer Ritchie said:

Hello Rhonda,
The hormone that prevents you from ovulating while you are breastfeeding is prolactin. Since you are only breastfeeding once a day, you are not producing enough prolactin to suppress ovulation. Therefore, there is nothing telling me that breastfeeding as you are now will keep you from getting pregnant. If you want to cut out that last feeding, just do a little soul searching first. You do not want to regret your decision.

Hope that helps!
Jennifer Ritchie
Milkalicious

Laura Ramirez said:

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?

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Permalink Reply by Jennifer Ritchie on June 24, 2009 at 9:08am

Hello Bonnie,
You are absolutely correct about milk composition changing to meet a babies needs based on their age. Colostrum is high in immunoglobulins and protein, yielding to a relatively dilute state by the first month. I know how hard it can be to have resistance when it comes to breastfeeding, but here is some SERIOUS ammunition.

1. The American Academy of Pediatrics recommends that all mothers breastfeed their infants for a minimum of one year, and the World Heath Organization recommends breastfeeding for two years and beyond.
2. Studies show higher death rates for babies not fed human milk, and could prevent 720 infant deaths a year in the US alone (Chen, 2004)
3. Human milk protects a baby from infectious diseases and reduces the chance of respiratory and digestive infections (Labbok, 1998)
4. Breastfeeding has been associated with a higher IQ of between 5 and 11 points (Anderson 1999)
5. Breastfeeding promotes optimal development of the oral cavity, and will reduce the risk of sleep apnea in adulthood (Palmer, 2004)
6. From 6 to 12 months of age, the infant receives 3/4 or more of his nutrient needs from human milk.
7. Breastfed babies are less picky when eating solid food, because of the changing experience in taste and odor that are not provided in the formula fed baby.
8. The USDA stated that a minimum of $3.6 billion dollars would be saved per year if breastfeeding rates were increased.

Bonnie, by breastfeeding you are doing what is best for your son, you are saving the government money, and you are saving the environment by not discarding all of the waste that comes with formula feeding. Keep up the good work!

Best Regards,
Jennifer Ritchie
Milkalicious

Bonnie Pankratz said:

Hi, I have recently read that breast milk changes as your baby grows. That when your baby is first born, you make milk that is especially designed for infants and once your baby is older, your body makes milk especially for toddlers. Even if your baby is premature, you make milk designed especially for premies. Is this true? And if it is, what about the milk changes? I'm especially interested in knowing what makes the perfect design for "toddler milk". I find myself trying to gather ammunition that I can use towards my mother-in-law when she makes comments about my son being too old to breastfeed. He's only 9 months right now, so the journey ahead looks long and bleak.
Thanks so much,
Bonnie.

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Permalink Reply by kami mcgladrey on June 24, 2009 at 5:52pm

I had a preemie 6 months ago and have had an issue with recurring mastitis. I get a breast infection every 4 weeks and am wondering what I can do to stay healthy. I had to exclusively pump for the first 2 months and now I pump once in the morning and breastfeed the rest of the time.

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Permalink Reply by Heather Lea TenEyck on June 25, 2009 at 2:11am

Jennifer,

Thank you for answering my questions...but you missed one. I am interested in knowing what I can do to massively boost my milk supply. My last baby, though she had perfect latch, just wasn't getting enough milk from me. She lost so much weight (beyond the 8 or 10%)...that coupled with the PPD (which I mentioned before) caused me to be so frustrated and I gave up. It was one of the hardest decisions in my life bc I swore I was going to make BF work with my fourth (most recent) baby. When it didn't work out, I can remember being engorged and just sobbing for days. It was actually traumatic thinking back on it. But with every baby it just seems like I'm not producing enough. My milk comes in normally (around third day)...I drink lots of fluid...try to eat right...I even drank a "mother's milk" tea and took a fenugreek supplement...still didn't produce much.

Am I just one of those mothers not destined to BF exclusively? It really breaks my heart. I have 6 sisters that all breast feed and it is so hard...especially when I'm pulling a bottle of formula out of my bag for my baby while one (or more) of my sisters are BF.

I read another post about a mother who wanted to be a breastmilk donor...is it possible to get breastmilk for my baby or is that for babies with issues or health problems?

Thanks again for answering my questions!

Jennifer Ritchie said:

Hi Heather,
Anxiety runs in my family, and I am a breastfeeding mom that takes 150mg of Zoloft. I know how hard it is to juggle all of our responsibilities as moms, and continue to breastfeed. I clear all medications with my reference book "Medications and Mothers Milk" by Tomas Hale. All SSRI's are compatible with breastfeeding, per Dr. Hale, but some are better than others due to the 1/2 life of the drug. Zoloft and Paxil are the best to take, and I have uploaded .PDF files of the drug information for you. I have also included the information on Xanax.

In addition, it is possible to re-lactate while taking your SSRI. Here is a link to Dr. Jack Newman's protocol http://www.asklenore.info/breastfeeding/induced_lactation/accelerat...

Best Regards,
Jennifer Ritchie
Milkalicious

Heather Lea TenEyck said:

I have serious depression issues which are greatly aggravated by postpartum and breastfeeding hormones. I have 4 kids and not made it past 6 weeks of BF with any of them bc of the depression (I also had issues with having too little milk production which I attributed to PPD). It gets so bad that I can't stand anything touching my skin (and a host of other conditions: hot flashes, fatigue, restlessness, insomnia, etc). I am interested in knowing (if we are blessed with another child) what, if anything, I can do to make it possible to BF for a long period of time. My OB put me on Zoloft (only) and this did not solve the issues and because it is the only proven safe AD, I didn't try anything else. This same issue has caused my sister-in-law to stop breastfeeding. She has actually been to a gynecological endocrinologist who ran the gamut of testing and everything came out "normal"...but still she suffers (even though she stopped BF about 2 months ago).
I am also interested in knowing if lactation can be re-started (my baby is now seven months old)? I know I would have to go off of my depression medicine (Zoloft, Seroquel, and Xanax) but if you are able to give me advice on the above issue, that may not be a problem.
Thank you so much!!

• ▶ Reply

Permalink Reply by Jennifer Ritchie on June 25, 2009 at 11:11am

Hello Heather,
Breastfeeding is physical and hormonal, so if you are getting enough nipple stimulation (8 or more times every 24 hours) you may have a issue with your hormone levels. To boost your milk supply, I would recommend taking a Galactogogue, specifically one that has been studied for it's effectiveness. A Galactogogue will boost your prolactin (hormone) levels, and will increase your milk supply. The two most common Galactogogue drugs are metoclopramide (Reglan) and domperidone (Motilium). They have been studied and are proven to boost your prolactin levels. Both work by raising prolactin, but Reglan does cross the blood brain barrier and can cause depression, so I would not recommend it. Domperidone does not have this problem, but it is not FDA approved for increasing your milk supply, only for GI discomfort. But, looking at the research, this would be the most effective solution for you. I have attached Dr. Thomas Hale's data on the drug, and how it works. He calls Motilium "the ideal Galactogogue". If you want more information on this, including dosage information, please email me at jen@milkalicious.org.

Best Regards,
Jennifer

Heather Lea TenEyck said:

Jennifer,
Thank you for answering my questions...but you missed one. I am interested in knowing what I can do to massively boost my milk supply. My last baby, though she had perfect latch, just wasn't getting enough milk from me. She lost so much weight (beyond the 8 or 10%)...that coupled with the PPD (which I mentioned before) caused me to be so frustrated and I gave up. It was one of the hardest decisions in my life bc I swore I was going to make BF work with my fourth (most recent) baby. When it didn't work out, I can remember being engorged and just sobbing for days. It was actually traumatic thinking back on it. But with every baby it just seems like I'm not producing enough. My milk comes in normally (around third day)...I drink lots of fluid...try to eat right...I even drank a "mother's milk" tea and took a fenugreek supplement...still didn't produce much. Am I just one of those mothers not destined to BF exclusively? It really breaks my heart. I have 6 sisters that all breast feed and it is so hard...especially when I'm pulling a bottle of formula out of my bag for my baby while one (or more) of my sisters are BF.
I read another post about a mother who wanted to be a breastmilk donor...is it possible to get breastmilk for my baby or is that for babies with issues or health problems?

Thanks again for answering my questions!

Jennifer Ritchie said:

Hi Heather,
Anxiety runs in my family, and I am a breastfeeding mom that takes 150mg of Zoloft. I know how hard it is to juggle all of our responsibilities as moms, and continue to breastfeed. I clear all medications with my reference book "Medications and Mothers Milk" by Tomas Hale. All SSRI's are compatible with breastfeeding, per Dr. Hale, but some are better than others due to the 1/2 life of the drug. Zoloft and Paxil are the best to take, and I have uploaded .PDF files of the drug information for you. I have also included the information on Xanax.
In addition, it is possible to re-lactate while taking your SSRI. Here is a link to Dr. Jack Newman's protocol http://www.asklenore.info/breastfeeding/induced_lactation/accelerat... Best Regards, Jennifer Ritchie
Milkalicious

Heather Lea TenEyck said:

I have serious depression issues which are greatly aggravated by postpartum and breastfeeding hormones. I have 4 kids and not made it past 6 weeks of BF with any of them bc of the depression (I also had issues with having too little milk production which I attributed to PPD). It gets so bad that I can't stand anything touching my skin (and a host of other conditions: hot flashes, fatigue, restlessness, insomnia, etc). I am interested in knowing (if we are blessed with another child) what, if anything, I can do to make it possible to BF for a long period of time. My OB put me on Zoloft (only) and this did not solve the issues and because it is the only proven safe AD, I didn't try anything else. This same issue has caused my sister-in-law to stop breastfeeding. She has actually been to a gynecological endocrinologist who ran the gamut of testing and everything came out "normal"...but still she suffers (even though she stopped BF about 2 months ago).
I am also interested in knowing if lactation can be re-started (my baby is now seven months old)? I know I would have to go off of my depression medicine (Zoloft, Seroquel, and Xanax) but if you are able to give me advice on the above issue, that may not be a problem.
Thank you so much!!

Attachments:

• Motilium.pdf, 82 KB
• Fenugreek.pdf, 72 KB

• ▶ Reply

Permalink Reply by Jennifer Ritchie on June 25, 2009 at 11:16am

Hello Kami,
What treatment plan do you follow for the mastitis? Do you find that you get a lot of plugged ducts? Do you feed often while lying down? I want to get to the root of the problem.

Thanks!
Jennifer Ritchie
Milkalicious

kami mcgladrey said:

I had a preemie 6 months ago and have had an issue with recurring mastitis. I get a breast infection every 4 weeks and am wondering what I can do to stay healthy. I had to exclusively pump for the first 2 months and now I pump once in the morning and breastfeed the rest of the time.

• ▶ Reply

Permalink Reply by Janet Mermel on July 1, 2009 at 6:51am

Is it necessary while breastfeeding to also supplement water from bottles? I heard that babies need to drink water because they get thirsty, and breastmilk is not enough. Which bottles are best for newborns?

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Permalink Reply by Jennifer Ritchie on July 2, 2009 at 9:03am

Hello Janet,
The American Academy of Pediatrics and the World Health Organization recommends exclusive breastfeeding for approximately the first six months. Breastmilk gives your baby everything it needs, so you do not have to give water as a supplement. In addition, the best bottle for a breastfed baby would be a wide mouth nipple, like the Playtex Nurser. It is inexpensive and BPA free.

Best Regards,
Jennifer
Milkalicious

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