We are thrilled to have Naya Weber, certified lactation consultant returning to Love Child today. An expert in her field and self-described, boob nerd, she settles nerves and clarifies so many misconceptions surrounding breastfeeding. Naya’s own difficult journey with breastfeeding is what eventually led her to becoming a lactation consultant. You may remember Naya from her first piece on Love Child, Breastfeeding Tips From A Lactation Consultant where she shared tips and cleared up misconceptions about beginning breastfeeding. But once your baby latches or you settle into pumping, the questions don’t stop! We obsess over hind milk vs fore milk, block feeding, and poop colors! As a follow up to her first piece, Naya is back today to answer all of our frequently asked questions with a few suggestions of her favorite resources to bookmark…done! Photo by Heather Gallagher
By Naya Weber
One thing I’ve learned as a lactation consultant and mother is that there is a LOT of information out there. Unfortunately, not all of it is current, evidence-based, or supportive of a breastfeeding relationship. Some of my favorite sites to find good information on lactation include Kellymom, La Leche League, and Breastfeeding USA. Bookmark these on your phone and visit them instead of asking Dr. Google your question at 3am. It’ll save you a lot of trouble. Remember that it’s okay to need help with breastfeeding or bottle feeding, even if it isn’t your first baby. Each experience is different – think of it as learning to dance with a new partner. There will be a period of time where you step on each other’s feet, but you’ll soon be dancing beautifully in time to the music. You and your baby are learning to work together.
Hind and Fore Milk – what’s the deal?
This is a concern of a number of my clients and it seems to come in waves – perhaps after a social media post? Fore milk refers to the milk that flows at the start of a feed, while hind milk is a term used for milk that flows at the end of a feed. Hind milk is typically has a higher fat content than milk that flows initially. Some parents are concerned that their infant is not getting enough of the milk at the end of the feed, and really want to focus on making sure that plenty of the fatty stuff gets to their nursling. Sounds simple, right? Not quite. Every lactating person has a different rate of when the higher-fat milk starts to outweigh the more watery stuff. The change is very gradual and it can vary from feed to feed. The best way to ensure that baby gets as much of the fattier milk as possible is to allow a baby to actively feed on one breast for as long as possible. Because each baby varies in the amount of time it takes to receive their fill of the higher-fat milk at the end of the feeding, it is important not to switch breasts while baby is actively nursing – the only exception to this is if your lactation consultant or pediatrician has directed you otherwise.
Did you ever think that discussing your baby’s dirty diapers would be acceptable dinner conversation with other parent friends? Me neither. A breastfed baby’s poop is usually yellow and loose (soft to runny), and seedy or curdy. If your baby is getting supplemented with formula, their stool may be a little less loose (think peanut butter consistency), and may be more tan or brown. Green stool can be possible with both breastfed and formula babies and it isn’t necessarily a cause for concern. If a mom has a diet high in leafy greens or food with green coloring, it can result in green stool for her breastfed baby. Consistent green and frothy diapers can be a sign of not getting enough hindmilk, usually due to a very strong letdown or oversupply with mom. Consistent green or bloody stool can be sensitivity to something in mom’s diet. The occasional green diaper is not necessarily cause for concern, but as always, reach out to your pediatrician if you suspect sensitivity or your lactation consultant if it’s an issue with feeding.
Block Feeding vs Switching Sides
In the early days and weeks of breastfeeding, you may find your baby only needs to feed on one side before being satisfied. As your breastmilk volume regulates, you may notice that your infant will feed on the second side for a few minutes. It’s very common for a baby to drain one breast and then need a little bit from the second side to top off. Many babies are two breast babies, while some are satisfied and gaining weight well on one. Block feeding is a way to manage lactation for a person with an oversupply. Having an abundance of milk is a blessing and a curse – there is plenty of milk, but one is more prone to plugged ducts, engorgement, and mastitis. If you suspect you have an oversupply of milk, please contact a lactation consultant or other breastfeeding support person for guidance on lactation management.
This has become a hot topic among some lactation professionals. It is difficult to assess an oral restriction (such as a tongue or lip tie) without an in-depth assessment. There is so much more to tongue tie than whether baby can stick their tongue out! Despite having a lingual restriction, some infants do a great job of feeding – they’re transferring adequate milk volume in an appropriate amount of time, mom is not in pain from the latch, and things seem to be going well. Possible long-term effects of a tongue tie can include difficulty with solids, speech issues, and dental issues. While there is no way to know for sure whether an infant should have a tongue tie corrected, it is a good idea to speak to several health care professionals about short and long term effects; these include your lactation consultant, pediatrician, pediatric dentist, and/or pediatric ENT.
When To Introduce A Bottle
The best time to introduce a bottle to baby is between four and six weeks. By that point, breastfeeding should be well established and it would be a great time to have your partner offer baby a bottle of your expressed breastmilk. Look for bottles that have a wide base and wide nipples – similar to what your breast looks like. As the lactating parent, it can be difficult to get baby to take a bottle from you; this is a great time to get your partner or family involved with feeding. However, if your infant requires supplements as part of a feeding plan, bottles may be introduced sooner than four to six weeks. Using a paced bottle feeding method can help baby transition smoothly between bottle and breast. It mimics breast behavior with a bottle and works to reduce the risk of a nipple preference.
The Truth Behind Food and Meds While Breastfeeding
Here’s a little nugget of information for you: in general there is NO particular food that a breastfeeding mother must avoid. The only exception to this would be if her infant shows a very obvious reaction to it – the usual culprit here is cows milk protein. If there is a family history of sensitivity to cows milk protein, it may be a good idea for mom to limit her dairy intake or even avoid it altogether. If there’s no history of food allergies or sensitivities, then there is no reason to remove that food from your diet. Even a woman with a less than perfect diet makes the most optimal food for her child – Mother Nature is very forgiving!
When it comes to caffeine and alcohol, remember that both must be broken down and metabolized by your digestive system and liver, and then goes into your bloodstream. It’s important to remember that breastmilk contains what passes through your blood, not what’s in your digestive system. Even then, it is okay to treat yourself to a glass of wine or a cup of coffee if you need it. Studies have shown that alcohol and coffee in moderation does not affect breastmilk supply. Very small amounts of alcohol and caffeine travel through your breastmilk.
In general, most medications are compatible with breastfeeding and pumping. Small amounts of medications can transfer to baby through you milk, but it is quite low. There are some medications that can pose safety issues when lactating, but there are usually more compatible substitutions that can be made. It is a good idea to check with your child’s health care provider in addition to your own to determine the impact of certain medications online. Checking LactMed (an online database maintained by the National Library of Medicine) or reaching out to the Infant Risk Center (an actual hotline run under the guidance of Dr. Thomas Hale) are also great ways to know the impact of a medication when lactating. While these resources cannot tell you whether to take a medication or not, they can make you aware of information such as half life or effects on lactation, so you can make the best possible decision for yourself and your baby!
Naya Weber is an International Board Certified Lactation Consultant and self-described boob nerd. She lives in southwest Austin with her husband and two sons. In her spare time, she enjoys reading, shopping, and occasionally writes the blog Lactivist in Louboutins. She is on the board for the Central Texas Breastfeeding Coalition, works for Mothers’ Milk Bank at Austin, and a volunteer leader for Partners in Parenting. You can follow her on Instagram, Facebook, or visit her website to learn more about her services.