27 Breastfeeding Questions Answered by an International Board Certified Lactation Consultant

Two moms holding their babies

Breastfeeding is a beautiful and essential aspect of a mother's journey, but it often comes with various questions, concerns, and challenges. To address these issues and provide new moms with vital information and guidance, Momcozy recently organized an illuminating webinar, Nursing and Pumping Basics for New Moms, featuring Dr. Colette Wiseman, MD, IBCLC, a renowned breastfeeding expert. 

Dr. Wiseman's profile

The event, a key initiative of Momcozy’s Breastfeeding Support Program, attracted over 400 eager attendees, all seeking to establish a solid foundation in nursing and pumping for their newborns.

Nutrition Concerns

A critical topic that arose during the webinar was the importance of Vitamin D supplements for babies. Dr. Wiseman emphasized the significance of this supplementation, especially for breastfed babies, to prevent the risk of developing bone diseases such as Rickets due to Vitamin D deficiency.

Attendees expressed confusion and concern regarding vitamin intake, particularly those who hadn't received prior guidance on the necessity of Vitamin D for their babies. Dr. Wiseman clarified the guidelines from the American Association of Pediatrics and emphasized its importance fo babies.

Top Nutrition Questions Answered 

  1. If I take vitamin D supplements does that negate the need for baby or do they still need them? 

Studies show that if mom takes 6400IU of Vitamin D per day, that is enough to get baby’s levels up!  It’s a big dose but it’s safe for mom!

  1. Are there any foods to avoid to eat while breastfeeding? 

There are no food restrictions, in fact the more variety you eat, the more flavors your baby will experience through your breast milk, and they may be a less picky eater!

  1. My baby will be 6 weeks, does she still need vitamin d drops?

Yes, babies need 400 IU of Vitamin D daily through 12 months, then 600 IU after that. Once they are eating solids well they may be able to get the vitamin D through the solids. Referral: American Association of Pediatrics

Latching and Nursing Techniques

Latching issues, a common concern for new moms, were extensively covered. Attendees sought advice on nipple shields, dealing with lip-tied babies, and managing nipple pain caused by shallow latches. Dr. Wiseman provided valuable insights and strategies, including weaning off nipple shields gradually, addressing lip-tie concerns, and employing techniques for painless unlatching to ensure a comfortable nursing experience for both mother and baby.

Top Latching & Nursing Questions Answered

  1. I had to use a nipple shield because my nipples were flat. How do I know when to stop using them or what can I do to get my baby to latch on just my breast? 

After a few weeks, sometimes a nipple shield can be weaned slowly. To wean a nipple shield, start offering the breast without the shield and see if baby will take it.  If they refuse, try using the shield, then removing it after 5 minutes and try again.  If you have flat nipples, try squeezing the breast a little to help your nipple “pop out” so that baby can grasp it. Remember, baby doesn’t put their lips directly on the nipple but on the areola. Many moms are able to successfully breastfeed even with flat nipples! 

  1. What is the best way to unlatch a baby if you’re having nipple pain and can tell it’s not a deep latch?  

To unlatch your baby, put your pinky finger or pointer finger in the corner of their mouth and make sure you get it between their gums. The further back you get your finger, the bigger they will open their mouth so that your nipple doesn’t get sqeezed painfully between their gums as they come off the breast. 

  1. I've heard when you change the baby from one side to the other while feeding, you should first burp the baby for around 20 minutes. Would you suggest this?  

I recommend burping the baby for a few minutes between breasts. You do not HAVE to get a burp.  Put them upright and see if they will burp with some patting. Sometimes a burp does not happen. 20 minutes seems a bit long to me for a burping session!  3-4 minutes is what most moms do. 

  1. Are there positions that are better for babies with tongue ties?

If there is a severe tongue tie affecting breastfeeding, it may need to be released by a professional to see real improvement. In the meantime, I sometimes have mom try a laid-back position which uses gravity to help baby to open their mouth wider. 

  1. What about if I’m having twins? Do I alternate the babies? 

For twin nursing, most moms will either assign one breast to each baby or alternate the babies each feeding, whichever is simplest for them. 

Milk Supply and Baby's Well-being

The topic of milk supply and its management garnered significant attention. Attendees inquired about colostrum production, timing for milk 'coming in,' and concerns about low milk supply. Dr. Wiseman elucidated the normal timeline for milk production, advised on methods to maintain and boost supply, and addressed concerns about low production, emphasizing the importance of frequent emptying sessions.

Top Milk Supply and Baby Well-Being Questions Answered

  1. How long does it typically take for first time moms to start producing milk? 

Most mom’s milk “Comes in” by day 3-5 but you will have colostrum before that which is all your baby needs. It’s normal for baby to be fussy and feed a lot before your milk comes in - it’s healthy and helps tell your body to bring in your milk supply!

  1. This will be my third attempt at breastfeeding, what’s the best way to keep up your supply? 

Frequent emptying is the best way!  Especially in the first 1-2 weeks to establish your supply.  8-10 times per day is a normal number of nursing/pumping sessions in the first few weeks.

  1. Does anyone have suggestions for a slacker breast? I was overproducing on one side and now that same side is not producing enough. I’m concerned. 

Everyone has one side that produces less!  You can try starting baby on the lower producing side each feeding to stimulate it more to produce milk. But usually the other side will compensate by increasing supply, so it’s just a cosmetic issue!

  1. Lactation Snacks - Do you encourage the use of lactation cookies/snacks - do they work? 

There is no scientific evidence that lactation cookies help, but if you like them and they taste good, go for it!  

  1. Should you attempt to pump colostrum before giving birth? 

I recommend trying to hand express colostrum starting at 36 weeks with your OB’s approval. 

  1. Is it normal to only get 1.5-2 oz total in a pumping session at 2 months postpartum?

Normal production is 24-30oz per 24 hours. If you pump every 3 hours instead of a feeding, a normal supply would be 3-4oz of milk.  But it’s hard to judge supply on just one pumping session because it’s really about your 24 hour production. 

  1. How long should it take for supply to replenish after emptying?

Your body makes milk continuously like a dripping faucet!  It produces about 1oz per hour total.  3 hours after a feeding, your breasts will usually have 3-4 ounces of milk in them.  

  1. What do you do meanwhile you wait for your milk to come in?  

When you deliver, you will have colostrum in your breasts already and that will be all that baby needs.  Feedings are just a few mililiters each in the first few days!  Just put baby to the breast 8-10 or more times a day and let them remove the nutritious colostrum and that will help your mature milk to come in. 

  1. How do you know if your baby is constipated?  

Please discuss with your pediatrician! Constipation is passage of hard stools.  Breast fed babies often go 2-3 weeks without a poop and if they are gaining weight and well appearing then that is totally normal!

General Breastfeeding and Nursing Queries

Participants sought guidance on diverse breastfeeding scenarios, including dealing with family negativity, managing breastfeeding twins, handling nipple ointment choices, and potential complications post-augmentation surgery. The webinar also delved into various general questions, such as dealing with engorgement, managing sleeping schedules, and identifying hunger versus comfort nursing. Attendees found solace in Dr. Wiseman’s comprehensive responses, which offered clarity and direction in handling different breastfeeding situations.

Top Breastfeeding Questions

  1. My baby goes 10 hours overnight now, he is only 3 months, should I be waking him to feed during the night? 

Once a baby is back to their birth weight (which usually happens in the first two weeks) and they are healthy and gaining weight well, most pediatricians will say it is safe to let them sleep as long as they want. 

  1. How do I deal with milk blebs?

You can apply some hydrocortisone ointment a few times a day after breastfeeding. Sunflower lecithin 3 times a day may also help make your milk less thick. 

  1. I don’t have a feeding schedule, I feed on demand, is that okay?

I always recommend on demand feeding!  It’s wonderful when mom can just respond to baby’s needs and not try to put them on a parent-led schedule.  

  1. How often should I burp baby when breastfeeding?

Burp your baby half way through each feeding - for example after the first breast, or half way through a bottle feeding. 

  1. Can I become pregnant again while I am breastfeeding my baby? 

It is possible to ovulate and get pregnant during breastfeeding.  If you follow these 3 rules then breastfeeding is 98% effective birth control:  1 - exclusively breastfeeding and no breaks more than 4-6 hours between sessions; 2 - baby is less than 6 months old; 3 - you have not had your period.  Otherwise you may ovulate and get pregnant. If you do not want to become pregnant then you should consider an additional method of birth control to be sure.  After 6 months it is easier to become pregnant if you desire while still breastfeeding. 

  1. Can you do golden hour if you’re having a c-section? Also, do you have tips for moms who are having a c-section that may not be able to have a golden hour?

Yes, most women who have a C-section can do the gold hour of holding baby and offering the breast.  Moms who have an epidural can still hold their baby easily immediately after birth.  If mom is not able to hold baby immediately for any reason, partner or dad or family can do skin to skin which still has many benefits for baby - stabilizing their body temperature, blood sugar and heart rate. 

  1. How long is best to breastfeed? 

The World Health Organization recommends 2 years!  And the American Association of Pediatrics recommends at least 1 year with complementary foods introduced at 4-6 months. 

  1. I started breast feeding way late in the game. How do I encourage my baby to breast feed? I went back to work, and now he just wants the bottle. 

Getting baby back to breast: I recommend lots of low pressure skin to skin time. Offer the breast frequently for 5-10 minutes at a time, but stop if baby gets upset or if you get upset. Some women find a nipple shield can make baby more interested in the breast if they have bottle preference. 

  1. How do you recommend dealing with negativity regarding breast feeding from family/friends? 

First, be confident that you are doing the right thing for your baby and only you can make the decision how to feed your baby best. Thank them for their input and then do what you feel is best for your family.  Do not feel like you need to justify your choices or explain yourself to your family.  If your family truly seems open to education about the benefits of breastfeeding, send them some articles to read from the American Association of Pediatrics. It can help to get your doctor or lactation consultant on your side too, to give you helpful information to share with your family. 

  1. What exactly is considered and over supplier ? 

Oversupply is producing more than your baby needs. This may mean that you are pumping every day and building up milk in the freezer.  Severe oversupply is more than 10-20oz extra per day and can cause a lot of problems like blocked ducts and mastitis. 

Final Thoughts

The webinar offered invaluable insights and advice, assuring new moms that breastfeeding experiences can vary greatly and that seeking guidance and support from experts is crucial. Dr. Wiseman’s expertise and understanding brought clarity to numerous complexities and uncertainties surrounding breastfeeding and pumping, empowering attendees to embark on this rewarding journey with confidence and knowledge.

For more information on breastfeeding education, click here.

Dr. Colette Wiseman (IBCLC, MD)
Dr. Wiseman is a renowned expert in the field of lactation. In addition to lactation, she is board certified in internal and emergency medicine after completing medical school at the University of Chicago and a five year residency at UCLA. Today, she has three children and supports moms through her private lactation business and role as an ER physician. Additionally, Dr. Wiseman is a moderator for Breastfeeding USA, Torrance — an area support group.

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