breastfeeding q & a with about.com lactation consultant

A couple of weeks ago, I had the opportunity to meet Melissa Nagin, a NY-based Lactation Consultant and About.com’s breastfeeding expert.  In an effort to get more information on breastfeeding for Baby Bunchers, I asked her the following questions:

Baby Bunching: Do you have any tips for moms who have children close together – specifically, how to carve out time for nursing an infant when you have a toddler running circles around you? 

Melissa: There are actually many different ways to deal with taking time to nurse when you have an active toddler. As unrealistic as it may sound now, finding quiet-time activities for the toddler is a great place to start. Before your baby is even born, purchase a whole new stash of coloring books, fresh crayons, stickers, puzzles...anything that seems fresh and new will be much more exciting to your toddler and will most likely hold their attention better than something they've seen a thousand times. Also, I have never been opposed to turning on Sesame Street to ensure that I can get something done, so if a mom has a newborn and a toddler and really needs some time to relax, there's nothing wrong with turning on a little PBS!

Baby Bunching: Are there any must-have products that you know of that making nursing easier?  Nature provides the boobs, but what accessories can you recommend?

Melissa: With all of the products on the market, it can get very overwhelming to figure out what to buy. To start, you'll need a supportive pillow so that the baby is right at breast height for nursings and if you're modest about nursing in public, you may want to purchase a cover-up – there are quite few available on the market.  But the best product that I recommend for any nursing mom, is a breast pump -- my favorite is the Playtex Embrace (if you're going back to work or will pump frequently) or the Petite (for more occasional use)--so you can really feel like you're taking a break, yet still providing your breast milk.  Breast pumps do not have to be an expensive purchase. The Playtex products that I mentioned are under $200 and the one of the most comfortable, efficient pumps out there. 

Baby Bunching: Give us the lowdown on whether what mom eats really matters for baby.  I've had everyone from lactation consultants to OB/GYNs to pediatricians give me different answer on whether or not mom's diet really even affects baby's gassiness or digestive issues. What's the real deal

Melissa: I always tell my moms to eat anything and everything that they want, in moderation, of course! 

There are really only two reasons why a breastfed baby should have excessive gassiness...One, mom isn't keeping him/her on one breast for long enough to get to the hindmilk. The foremilk is very high in lactose, so if she switches too soon, the baby is going to get a lot of lactose which can contribute to crampiness/gassiness.  However, if the baby stays on the same breast for an entire feed, he's going to get the perfect balance of foremilk and hindmilk and the lactose and the fat together will be much more comfortable in that tiny tummy. Two, cow's milk...some babies have a sensitivity to the protein in cow's milk, so if mom has a diet replete with this kind of dairy, and the baby is susceptible, mom is going to end up with a very uncomfortable and gassy baby. If you suspect that this might be the case – please note that it takes a good 10 days or so to clear out of both mom and baby's systems, so don't be surprised if you go cold turkey and don't see a change for a good week or so. So, all of the wives' tales about broccoli, onions, garlic, spicy foods can be dismissed -- Eat well!  Don't eat food with no taste!!

Baby Bunching: Many Baby Bunchers are still nursing when they get pregnant.  How do you forge through the fatigue and nausea of the first trimester and continue breastfeeding?  Are there any special considerations or tips you'd like to share? 

Melissa: A lot depends on your child's breastfeeding patterns. If he/she is willing, nurse in bed and have him take a nap with you.  If you're nauseous and vomiting, the most important thing is to stay as hydrated as possible.  You're still trying to maintain a milk supply, sustain a pregnancy, and feel alive, so dehydration is something we really want to avoid.  I always recommend stocking up on a lot of crystallized ginger, ginger tea, even ginger ale.  Sea Bands are also great for keeping nausea at bay.  It may be tough for the first trimester, but it will get better and you can still maintain a breastfeeding relationship for as long as you want, although your milk will change again around the 5th month of pregnancy, so you may notice changes in your child's nursing behavior.

Baby Bunching: What about tandem nursing?  Do you recommend it?  What are your suggestions for making it work? 

Melissa: Tandem nursing is a wonderful way to continue your nursing relationship with your older child while starting anew with your baby. If a mom is interested in it, power to her! I recommend doing whatever mom wants to do. Sometimes the older child is only nursing in the morning and at night before the baby arrives, but then regresses and wants to feed every time the baby does...This is very normal and mom should just go with it. As soon as the older child realizes that baby is here to stay and settles into a routine again, she'll probably go back to her old habits.

[Author's note: And, given that I am now breastfeeding a baby with reflux.  I asked her one last self-interested question - maybe some of you are interested...]

Baby Bunching: Can you provide tips for breastfeeding a baby with reflux?

Melissa: Babies with reflux should be checked by their pediatrician, but some little techniques that can help ease the discomfort are nursing in a more upright position and hand-expressing before a feeding, if mom is very full.  Hand-expressing can help because sometimes the foremilk combined with a strong let-down can really disturb a baby with reflux, so taking away a lot of the foremilk can help that.

Comments

[Oli's mom]

The info. was helpful, although I personally disagree with the Playtex Embrace pump advertisement. By the time my baby was 5 mos. I had burned out 2 Playtex motors, I solely pumped (dad wanted to bond as well), and finally broke down and bought a Medela. I did not get the high end model, I purchased the mid price model ($319), after having spent close to $200 on 2 Playtex models. With the second baby due, my Medela is still operating well and I changed the tubing out. I plan to try to nurse this baby; but, if not possible I will again be pumping for the next year.

[geekymummy]

I second the medela if you are going to be pumping a lot. I went back to work when my babies were 3 months old, both times, and my trusty medela pump in style is still going strong, having been used for 9 months 3-4x per day with my first, and going on 6 months with my second. Don't skimp on a breast pump if you plan to provide all of your babies milk that way. Even 300+ dollars is way cheaper than the amount of formula you would buy.

[Jenny P]

I'd like to give a plug for the "My Brest Friend" nursing pillow. It's the stupidest name ever, but makes it soooo much easier to position baby correctly than the Boppy. It also provides back support.

Also, I'd like to point out that if you're not going back to work and money is tight, a breast pump is totally optional. You don't need one if you're going to be the one watching your baby 24/7. If you're not willing to be on a two-hour leash for six months, you can also get a cheapo ($25) manual pump for occasional use.

Also, my personal breastfeeding strategy is to set up my nursing station in the playroom. Big'n has all his toys to play with, and can roam freely while still keeping an eye on me. When he's feeling cuddly, he climbs up on the end table next to me or sits on the arm of the rocker. The baby's four months old and this strategy has totally worked for us.

[Natalie @ Naddy's Blog]

I tandem nurse, and it has been sooo worth it. It was rough getting through pregancy at times (Adventures in Tandem Nursing, by Hillary Flower, was helpful reading) but now in some ways it makes things easier... when I have a hungry baby and a tired fussy toddler, I can calm them both down at once. And it provides a great way for them to bond as they both nurse.