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A Lactation Counselor’s Breastfeeding Answers to Soothe Your Weary Mind (and Your Weary Nipples)

Like many mothers out there, breastfeeding didn’t come easily to me. I fretted about everything: Is she getting enough milk? Why is she nursing so often? Why does it hurt so much when everything I’ve read told me it shouldn’t hurt? Am I eating the right things? Are my boobs destined to look like missiles from now on? In a fit of defeat, I contacted a lactation consultant, and that decision made all the difference in the world.

For this post, I teamed up with a fabulously talented friend, Melanie Van Oy, to answer all those questions and concerns you may have when it comes to nourishing your baby. Like myself, Melanie is a speech language pathologist who specializes in working with infants and pediatric patients with feeding and swallowing difficulties. But she has a secret weapon — she is also a certified lactation counselor! 

breastfeeding answers

Can I prevent mastitis? What are the early signs?

Mastitis is somewhat preventable. It has to do with how much milk you are producing and how much you are emptying. Feed baby as often as he needs — and forget about feeding the freezer, especially at first. The important thing to remember is there is nothing wrong with your milk. Keep feeding or pumping through the pain!

The early signs are red, tender spots on the breast followed by fever and chills. See your physician or health care provider as early as you can, and keep feeding that baby!

What does a good latch look like?

A good latch can look different at various stages of infancy. In early infancy, a good latch may look like a mouth full of areola (the dark tissue around the nipple), baby’s nose touching the breast, and a widely opened mouth. The nipple should be up on the top of the palate so baby is not flicking the nipple up to the top of his mouth. If this is happening, you may hear a clicking sound while he is feeding.

Can diet/exercise affect my supply?

Taking care of yourself is wildly important while you are breastfeeding; however, putting undue strain on your body can negatively affect your supply. If you were working out regularly before baby was born, continue as soon as you feel able and have clearance from your physician. If you were fairly sedentary prior to delivery, be sure to consult your provider and ease your way into a new diet or exercise regimen! 

Remember to continue your prenatal vitamin throughout your breastfeeding experience. Eat a variety of healthy foods, and expect to feel ravenous during those early weeks.

Is it supposed to hurt? Feel uncomfortable?

A common question without a concise answer. Basically, it’s different for every woman! Some women do not experience any pain at all. Hopefully, this is you! There are also mothers who, understandably so, have soreness due to increased stimulation of their poor nipples in a fashion they are simply not accustomed to. It’s highly important to remember stimulation should NOT lead to broken down, cracked, or bleeding nipples. Inspect them after each feeding. At the first sign of breakdown or blisters, get on the horn to your nearest and friendliest lactation consultant. A little help could alter your entire experience!

I had a boob reduction/augmentation. Can I breastfeed?

The short answer is YES, you should definitely try! A boob job is not a death sentence for breastfeeding. But, the longer answer is it’s not always guaranteed. Your body produces milk based on hormones, which are stimulated based on the sensation your brain receives from nerves. Many times during a reduction or augmentation, nerves are damaged. They can regrow, but it takes a very long time. If you’ve had any kind of surgery and wish to breastfeed, don’t be afraid to give it a shot!

My baby is nursing very frequently. Is this normal?

Most likely! This is always a great discussion to have with a lactation consultant or provider who can integrate the details of your personal experience into an answer. Human milk is made up of some pretty awesome stuff, which babies digest fairly easily. This means they digest and absorb nutrients quickly. Pair speedy digestion with tiny little tummies not able to handle significant volume, and you may find yourself nursing frequently. 

Let me leave you with this: If you’re feeding around the clock (think every hour on the hour), please don’t wait to have a discussion with a lactation consultant! You want to make sure baby really is using that time to get what is needed from you in an efficient manner.

I feel like my baby coughs or chokes during the letdown. Can I do anything to help him? Should I be worried?

Some women mirror Niagara Falls when they let down while others may more closely resemble a babbling brook. For those resembling the former, try pumping through just the first part of letdown or reclining so that baby is sucking “uphill” to slow the flow. Another option may be to remove him from the breast when you feel the tingle of the letdown and catch the renegade milk in a washcloth for a few seconds before bringing baby back to the breast. Sometimes babies just need to grow a bit older and wiser to manage an active letdown. Don’t worry; it WILL get better.

However, if you consistently notice coughing, choking, watery eyes, oral spillage of milk, wide eyes or other sounds of stress, color changes (think blotchy skin), or gurgly/wet vocal quality following a feed, please discuss with your pediatrician. These symptoms may indicate your baby is aspirating, or getting milk in his trachea and/or lungs during feeding.

I’m worried he isn’t getting enough. How the heck do I know?

When babies are hungry, they are tense and may seem agitated. After they feed, you will see their fists relax and go limp. They should look “milk drunk” after feeding!

Many times you can hear a baby swallowing while nursing. When his sucks become smaller and not as wide, you will no longer hear him swallowing. Now the decision is yours: To be or not to be a pacifier? It’s up to you, mama.

In addition, you will probably feel hard or “full” before a feeding. If this is the case and you feel empty after a feeding, rest assured he has had a successful feeding. You might help baby along by doing small massages or breast compressions while he is at the breast. This increases his access to milk and subsequently fills his belly!

Finally, baby should make 8-10 wet diapers and a couple poopy diapers per day. You may see less poo, but you should never see fewer wet diapers. Wet diapers are a telltale indicator he is getting enough from you!

Your doctor or pediatrician is a GREAT resource! The office has a scale, and it’s always accurate. If you’re concerned about how much milk baby is receiving, please call and pop in for a weight check. If baby is gaining nicely, you can give yourself a pat on the back! If not, call that friendly lactation consultant to troubleshoot what may be happening. He or she can also help you perform a “weigh feed weigh” in which you weigh before a feed, feed your baby, then weigh afterwards. That should tell you almost exactly how much your baby drank.

I feel like this is supposed to be natural and easy, and I can’t do it. I feel like failure. 

I always tell my moms: It’s absolutely natural, but — especially for first-time moms — it’s something you and baby will both learn and get the hang of as you go. It’s not always hard, and it’s not always easy, but you CAN do it. Reach out for the help you need. If you don’t receive the help you need, ask again or find someone else who may be able to guide you. There’s nothing wrong with seeking a second opinion. 

Are there any products you feel are must-haves for a first-time breastfeeding mom?

No, not really. Each woman develops her own preferences. I do, however, recommend finding some pillows you like and a spot you favor, and feeding the same way every time when getting started! Lanolin might be helpful post-feeding, but it is greasy and may stain clothing.

What is a tongue/lip tie, and how does it impact breastfeeding?

A tongue tie is when an unusually short, thick, or tight band of tissue (lingual frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. A lip tie is when the upper lip is tethered to the upper gum by a thick band of tissue. Both restrict the movement of the tongue or lip. Of the two, a tounge tie is the most impactful when breastfeeding. Babies who are tongue-tied may have problems affecting a secure latch to the breast and may overcompensate by increased suction. This leads to nipple damage and pain.

When baby can no longer maintain latch through suction, you may notice a click and a slight loss of suction, or the baby may completely detach from the breast. This may not only cause pain, but also affect the baby’s ability to adequately drain the breast, leading to supply issues.

In very young infants, both are easily correctable, so schedule an appointment with an ENT or pediatric dentist for a consultation! Be sure to check with your lactation consultant — a tongue tie may not be the issue hindering your success in breastfeeding!

I’m an older mom. Will my age impact my supply?

Remember — milk production is based almost entirely on hormones, whether you’re 19 or 45. Know the biggest predictor of supply is stimulation and milk removal. If you want more milk, more stimulation and more frequent milk removal is in order! A friendly tip: Stimulate (nurse or pump) more often, not for longer periods of time.

Will it get easier with time?

Absolutely! The learning that occurs between mom and new baby at the beginning usually lasts two to four weeks. After this learning curve, mom and baby know exactly what to do. I promise, the harder work — if it’s hard at all — is at the beginning.

I’ve heard of nipple confusion. Should I avoid pacifiers and bottles in the beginning? If so, for how long?

Babies born full term definitely develop a preference pretty quickly. Nipple confusion has gotten a bad rap over the years, in my opinion. Babies are smart; they’re not confused. That hard, silicone nipple offers instant gratification far easier than the breast. But, I promise your baby will prefer the breast and the closeness to you over to a synthetic nipple if given the choice.

So, stick with the breast exclusively for at least two to four weeks. After week three or four, introduce the bottle for one feeding per day. The goal is for him to go back and forth easily. Pacifiers are a great tool; however, they have been linked to shorter duration of breastfeeding and even the exclusivity of it — meaning formula was used more often after introduction of a pacifier. It may be mom or caregiver just wasn’t reading baby’s cues of hunger. If baby is crying, try to determine why, rather than plugging that hole! But remember it’s okay to do just that from time to time — especially if you know he recently fed well.

My nips are on fire. What can I use to heal them that is safe for baby? 

First, be sure you have a proper latch. If you don’t, it won’t matter what kind of balm, oil, salve, or witch’s brew you use. My best advice would be to dab a little breastmilk (for its antibiotic properties) on your nipples, let them dry, and rub on some lanolin. Then, let those puppies air dry as much as possible! If you notice cracking or bleeding, see your healthcare provider to ensure there’s no infection.

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