Will nipple piercings impact breastfeeding? Every body is different in how it reacts to taking out the jewelry out prior to breastfeeding. Just like with pierced ears, some of us will have the hole scar closed, the scar may partially close, or it could stay open for years and never have a problem sticking jewelry in and out at whim. Often the longer the time since the piercings were initially placed the better the outcome as the nipple has had time to properly heal. Common concerns may include nerve damage that impacts milk let down or scarring that prevents the milk from leaving the nipple. On the other hand, the extra holes created by the piercings could lead to a faster milk flow! (which some infants struggle to manage while others do just fine with). If the nipple pores have scarred shut, the breast may be able to make milk but it may not be able to exit from the nipple. This can lead to plugged ducts and mastitis. If the nerves have been damaged, the breast may make milk in the early days or weeks after delivery, but without the nerve impulse the breast will make less and less milk with time, even with all the herbs and quality pumping and efficient baby. Because our bodies are not perfectly symmetrical, some may have a problem on one side and not both. Some have no problem at all. We don’t know what your body is going to do and it cannot be predicted prior to birth. If your
Breastfeeding with the nipple jewelry in place is never recommended as it can make it difficult for the infant to latch-on correctly, increases the risk of choking on loose or dislodged jewelry, and can damage the inside of the baby’s mouth. If you are going to take your jewelry in and out every feeding, make sure you are being extremely careful with hand washing and jewelry sanitizing to reduce the risk of infection. Best practice says take the piercings out for the entirety of your breastfeeding journey. Many go on to successfully with pierced nipples, but if you’re having any problems or concerns, see a lactation consultant such as myself. For more of my thoughts on nipple piercings and breastfeeding, click here to check out my YouTube video
Breastfeeding has unique challenges at every age. You’d think after a combined total of 46 months of breastfeeding between my two girls I would have no stress, concerns or issues. Nope. Every child is an individual with their own virtues and vices. Every stage of breastfeeding has its own challenges and rewards.
In the toddler stage, I never worry about milk supply or if she’s getting enough milk. I know there’s milk. And at 19 months, Peach’s nutrition is coming from the family foods provided at meals and snacks. She’s getting a well balanced diet with multiple foods in each food group. Breast milk for her fills in nutritional gaps and provides immune boosting protection. I don’t worry about pumping. I retired my trusty pump almost 4 months ago. Shes (finally)(mostly) sleeping through the night and were both enjoying the rest. The biggest concern in the toddler phase is boundaries. How long and often can/should she have access to the breast? What to do when she asks for the breast and for whatever reason it’s not appropriate to feed at the moment?
There is no right or wrong answer to this question. It comes down to what is best and what works for your family. Some will continue to nurse on demand and others will limit to certain times of day. Both of which are good choices. Both also mean continued breastfeeding and neither option necessarily means you’re ready to wean. But it can be difficult to process through how to manage these boundaries and navigate your next stage of development. Especially as toddlers are learning to ask for things and control their environment. And then tantrum or act out of frustration when they don’t get their way. If you’re struggling with this stage, I have phone consultations available to help find what works for your family.
While your young baby is supposed to gain on average an ounce a day (30gm), weight gain slows as baby ages. From 4-6 months babies should only gain 3-4 ounces per week (90-120gm) and from 6-12 months babies should only gain 1-2 ounces per week (30-60gm). If you have been tracking baby’s weight gain and see the scale slowing down, don’t be alarmed if your baby is older. Continue to watch for lots of wet diapers and consistent pooping. Trust your baby and trust your body.
Some times we can sabotage our own milk supply from little things that we don’t understand will make a difference. Here are the top ways to accidentally drop your milk supply:
😳Putting baby on a feeding schedule in the first 3-4 months
😳Watching the clock instead of feeding baby on demand
😳Sleep training in the first 3-4 months after birth
😳Waiting for your breasts/chest to feel full to pump or feed
😳Not pumping when baby is getting a bottle
😳Letting partner feed a bottle in the middle of the night to get more sleep (and not getting up to pump)
😳”Topping off baby” after feeding, especially during the witching hour phase. (I’m not talking about when supplementing is necessary or if you’re on a triple feeding plan because of true low supply or baby weight gain. Supplementing after breastfeeding can be needed, but you would also be pumping at that time)
😳 Not pumping enough when returning to work
😳Using the wrong size pump flanges
😳Using a poor quality pump (insurance companies have to provide you with one, but that doesn’t mean they’ll give you one of quality)
😳Going back on hormonal birth control at your 6 week postpartum checkup
😳Taking nasal decongestants or allergy medications
While these seem like normal recommendations from many parent groups or even your health care providers, these subtle things can sabotage milk supply. Your body works on a demand and supply basis. The more you empty or demand from the breast/chest, the more milk it will make. Want to increase supply? Increase the number of milk removals, give young infants free access to feed on demand, and watch out for medications, hormones, of pumping traps that can sabotage your success.
Were you told by your pediatrician to give your baby vitamin D drops? Vitamin D is absolutely critical strong bones, because it helps the body use calcium from the diet. Traditionally, vitamin D deficiency has been associated with rickets, a disease where the bone tissue doesn’t mineralize properly, leading to soft bones and skeletal deformities. Recent research also tells us that vitamin D is key in maintaining our immune systems for regulating both infection and inflammatory pathways. If you shun the sun, have a milk allergy, or follow a strict vegan diet, you may be at risk for vitamin D deficiency. Known as the sunshine vitamin, vitamin D is produced by the body in response to skin being exposed to sunlight. It is also occurs naturally in a few foods like certain fish, fish liver oils, egg yolks, and fortified dairy and grain products.
Our bodies are designed to make very large amounts of vitamin D through exposure to the sun (10,000—20,000 IU in 24 hours, after 15—20 minutes of summer-sun exposure in a bathing suit/45—60 minutes of exposure for those with darker skin tones). However, in an effort to decrease our risk of skin cancer from over exposure to the sun, we’ve limited our ability to keep our vitamin D status at a normal level from absorbing it directly from the best source. That said, those living where clouds often cover the sky or in cities with polluted air quality will have a hard time getting sun exposure for natural vitamin D. People with darker skin tones are more likely to have low levels of vitamin D, as well, due to the increased pigment in their skin. They require nearly four times the length of sun exposure in order to penetrate the skin to manufacture vitamin D.
Vitamin D is essential for babies. Your pediatrician cannot tell you to put your baby in the sun, even though that is the best source of vitamin D, because of the risks of skin cancer. So they should have advised you to give your baby 400 IU of vitamin D each day, usually given by drops in the mouth.
All formulas sold in the United States have at least 400 IU/L of vitamin D; so if your baby is drinking 32 ounces of formula, vitamin D supplementation is not needed.
But what about from breast milk? Human milk is a very poor source of vitamin D, usually containing less than 50 IU per quart. This is why the AAP recommends all breastfed infants be supplemented. This does not mean there is anything wrong with the milk, but an issue in the recommended amount of vitamin D the lactating parent should be taking. This goes back to the sunlight recommendation. If you were getting 15-45 minutes of sunlight (depending on how dark your skin tone is) 3-4 times per week, your body would have plenty of natural vitamin D to pass through your milk to your baby. Many who live in the US either don’t live in a location where that’s possible year round (hi, Chicago in January) or maybe can’t get out in the sun because of needing to work. The Academy of Breastfeeding Medicine (a global organisation) recommends that “The breastfeeding infant should receive vitamin D supplementation for a year, beginning shortly after birth in doses of 10–20 lg/day (400–800 IU/day) (LOE IB). This supplement should be cholecalciferol, vitamin D3, because of superior absorption unless a vegetable source such as ergocaliferol vitamin D2, is desired. … Vitamin D also may be delivered adequately through human milk.” Research has shown that as long as you as the lactating parent is taking 6,400 IU of vitamin D daily, there is no need to supplement the baby as your milk will have adequate amounts.
An IUD is a form of birth control that’s put into your uterus to prevent pregnancy. One of the most common forms of birth control, it’s long-term, reversible, and considered one of the most effective birth control methods. Many doctors will encourage new mothers to have them placed between 4-6 weeks postpartum checkup to prevent pregnancies too close together. The Paragard IUD is wrapped in copper and doesn’t have hormones. The Mirena, Kyleena, Liletta, and Skyla IUDs use the hormone progestin to prevent pregnancy. Be aware that each IUD has a different amount of progestin. They are not created equal. Progestin is also the hormone found in the mini pill.
Hormonal IUDs and the mini pill are often recommended by doctors as the best form of birth control for breastfeeding mothers because most of the research that is available says that they don’t impact breast milk supply. And many who use these methods don’t experience any drop in supply. For some, though, both the mini pill and the hormonal IUDs will drop breast milk supply, some times drastically. Every body is sensitive to different levels of hormones. If you have an IUD placed and notice a drop in supply, the only way to increase supply again is to remove the IUD. Increased pumping or herbal supplements will usually not be enough to increase supply again because you’re working against hormones. The only way to rebound supply would be to remove the IUD. If you’re considering a hormonal based IUD and aren’t sure if your supply will drop, consider taking a few rounds of the mini pill (progestin only) which is the same hormone as the IUD. If your supply drops, you only have to stop taking the pill and your supply will rebound much quicker.
Did you use a hormone based birth control? Did you notice a change in your breast milk supply?
For the first six months after birth, baby is supposed to be on an exclusive breast milk diet. At six months and beyond your breast milk goes through a major change. The volume of milk slowly drops because baby is eating and drinking other foods. They may also be sleeping longer at night and are more active during the day. Your milk is super smart and shifts with this drop to have more antibodies and a higher fat content. The breast makes milk based on how it is emptied and what your hormones are doing based on how old baby is. Your hormones are also shifting and you may start your monthly cycle again. Many experience a further dip in supply around the time with their period. If you’re exclusively breastfeeding, you may notice baby pulling or tugging on your nipple or using their hands to beat your chest while feeding. If you’re pumping, you may slowly start to see less milk each pump session. Usually months 5-7 are the hardest from a baby behavior perspective and it settles out again as baby eats more table food and your hormones adjust. If breastfeeding is your goal, just keep offering the breast and pumping often.
Absolutely everything you put on or in your body had a risk/benefit. Some things have more research and information and somethings are newer and were still discovering them. Nitrates, for instance, which are found in processed meats are known to cause colon cancer. Yet many people routinely consume them without a second thought. Starbucks had a sign at every store saying they know some of their products are known to cause cancer and to be aware of the risks. Fenugreek is not supposed to be taken during breastfeeding if you’re on thyroid medications, but many are unaware of the risk because they haven’t researched it and still drink teas and eat products containing it. We’re still researching and learning about marijuana and CBD in the breastfeeding population and haven’t figured out long term recommendations. Still, some chose to weigh the benefits to their unique story and still consume it while breastfeeding
Did you know the American Academy of Pediatrics and the Academy of Breastfeeding Medicine have completely opposite, yet compatible, protocols for safe sleep? AAP discourages bed-sharing while ABM supports it. My role is to educate you on both recommendations and help support whichever decision you make, while also taking your unique situation in mind. If you have a formula and breastfeeding preemie, I’m going to tell you to follow the AAP guidelines as the risk of SIDS is too great in your circumstance. If you have an exclusively breastfed, full term, healthy newborn, you can absolutely bed share when done safely and correctly and I will teach you how to do that.
My role as a lactation consultant is to educate you in what we do know and the most current information and support you in whatever decision you decide to make. The same goes for the COVID-19 vaccine. Yes, there is limited research and information, but from what experts do know, they are considering it safe while breastfeeding but to still make an informed choice for you and your family. Whether you chose to be vaccinated or not is a personal choice between you, your family and your health care team. As with anything you put in your body, it is a risk/benefit decision based on your medical and family history and risk of exposure. I completely understand if in your community you have limited risk and exposure to people potentially infected with COVID and you’re choosing to wait and see. I fully support your decision to seek more information and see evidence and research. I also fully support you if you chose to be vaccinated and continue breastfeeding. When we have more information I will continue to update what I present and how I educate.
It’s common for a toddler, or an even older child, to ask to breastfeed after a new sibling is born. Toddlers who were weaned immediately before or during pregnancy may be especially curious. Many just want to know if you’ll say yes – or they may just want your attention or “babied” themselves. Continuing to breastfeed, or letting them try to breastfeed again after weaning, can ease the transition of gaining a sibling. They are less likely to be jealous of the baby who is always with mommy if they can nurse alongside them. Nursing your older child once the new baby arrives can reduce engorgement when colostrum transitions to mature milk and can protect milk production if your newborn is not feeding effectively. If you say yes to a weaned child, many will just touch, lick or kiss the nipple, some will have forgotten the mechanics of how to breastfeed and won’t have further interest. Others can successfully breastfeed again. If you are happy to nurse your toddler, go for it. If it is overwhelming, it is still your body and you get to decide when and for how long toddler is allowed to breastfeed. You may prefer nursing your baby and your toddler separately or together. Breastfeeding is normal and it is normal for children to be curious and want to breastfeed at 2, 3, or even 4 years old.
When you give birth your body will continue to produce colostrum, with milk becoming plentiful after around 3-5 days. As with your first baby, breastfeed at least 8-12 times per day to establish your milk supply. Some will feed their newborn baby first or encourage the older sibling to nurse less until breastfeeding has been well established to ensure the newborn has full access to breast milk. Look out for feeding cues and give your newborn unrestricted breast access to help ensure they get plenty of milk.
Some times if your toddler is breastfeeding frequently, they may lose interest in solid foods for a while from increased milk intake. They may have looser stools. This is normal and should regulate with time.
It can take a while before your body adapts to the needs of two different feeders. You may feel lopsided if one breast drains more than the other. Eventually things will even out and you’ll find your rhythm. Alternating breasts for each feed helps with development of newborn vision and keeps the size of your breasts balanced. However, some mums find that giving a toddler his ‘own side’ works for them.
You will not run out of milk, your body will make more to accommodate however many nurslings there are.
It is normal for let-down not to feel as strong as baby gets older. Some of us never feel let-down, and some stop feeling the let-down sensation as time goes by. This does not necessarily indicate that let-down is not taking place. Remember, just because you don’t feel it or it feels different over time, or any mean it’s not happening.
Signs of let-down include:
• Uterine cramping during letdown in the first week postpartum
• Baby’s sucking pattern changes from a quick suck-suck to a rhythmic suck-swallow pattern as milk begins to flow
• Feeling of calm, relaxation, sleepiness or drowsiness.
• Sudden thirst
• Leaking from the other breast
• Tingling, pins and needles sensation, itching, nausea, headaches, or negative emotions
Things that can be the cause of a slow or inhibited let-down:
• History of breast surgery where nerve damage that can interfere with let-down.
• In extreme situations of stress or crisis, the release of extra adrenaline in can reduce or block the hormones which affect let-down from a fight or flight response
• Sometimes a cycle is created, where baby fusses and pulls off because the let-down is slow, which makes mom tense up, which makes the let-down even slower, etc.
• It’s normal to have a harder time letting down for the pump than baby.
Later into your breastfeeding journey, you may notice it takes longer to trigger a let-down. This is common and what works early on may change over time.
Check for possible causes:
• Worn pump parts that need replaced. Replace the valves and membranes often. Check for worn tubing.
• Make sure you’re pumping with the correct flange size. Nipples may become more elastic over time and a different size may be used.
• Starting your period or are you possibly pregnant? Both can decrease milk production and impact let-downs.
• New hormonal birth control or medication? These may impact supply.
• Check your body. Tension, pain, cold, fatigued or anxiety may block the neurochemical pathways required for milk let-downs.
Tips to trigger let down:
• Try a different pump or flange size
• Use heat, breast massage/compressions, or vibrations to prompt milk flow
• Orgasm. The same hormone released during orgasm also causes let down. Studies show having an orgasm can help let down
• Relax. Use slow, deep breaths and meditation
• Singing or humming can also speed let-down
• Gently massage your breasts. Stroke your breast towards the nipple with the flat of your hand or edge of a finger. Gently roll your nipple between your fingers
• Watch videos of your baby. Smell their clothing. Remember the feeling of let down
• Use all of your senses to facilitate let-down. Concentrate on the sight, sound, smell and feel of your baby.
• Take a warm shower or bath prior to nursing
• If you are in any pain, consider taking a pain reliever about 30 minutes before you feeding. Pain can cause stress and inhibit let-down.
• Choose a calm, less distracting setting
• Turn on music or a tv show that you enjoy
• Skin to skin contact with your baby: Undress baby to their diaper and yourself from the waist up. Stay like this for 1-2 hours prior to a feeding
• Eat a favorite snack and drink a comforting beverage like warm tea
• Get comfortable. Sit in a comfy chair or lay in bed. You should be in a comfortable position
• Switch nurse: move baby back and forth frequently between breasts until let-down occurs
• Visualization. Take several deep breaths and close your eyes as you begin. Try to visualize and “feel” what the let-down response feels like for you (if you normally feel anything). Imagine milk flowing or use images of waterfalls. An excellent book on visualization techniques is Mind Over Labor by Carl Jones.
• Distraction: watch TV, read, talk to a friend, don’t watch the pump bottles.
• One study has shown that the moms of hospitalized babies who listened to guided relaxation or soothing music while pumping had an increased pumping output. When mom listened to a recording that included both music and guided relaxation while pumping, in addition to looking at photos of her baby, pumping output was increased even more. In this study, the interventions led to moms producing 2-3 times their normal pumping output. Milk fat content also increased for these moms in the early days of the study. (Reference: Keith DR, Weaver BS, Vogel RL. The effect of music-based listening interventions on the volume, fat content, and caloric content of breast milk-produced by mothers of premature and critically ill infants. Adv Neonatal Care. 2012 Apr;12(2):112-9.)
