Tag: extended breastfeeding

Do I need to give my breastfeeding toddler cow’s milk or switch to cow’s milk when they turn one?

- Julie Matheney

If you’re still breastfeeding into toddlerhood, no. The World Health Organization recommends breastfeeding until 2 years old. After 2, you can wean to water and table foods or to any kind of milk per your family’s choice. If you’ve decided to wean between 1-2 years, yes and no. Cow’s milk provides a convenient source of a lot of nutrients, including calcium, protein, potassium and vitamin D that are important for building bone and brain development. But if your toddler won’t drink it, has an allergy or intolerance, or your family follows a vegan lifestyle, a well-planned diet can provide these nutrients too. According to the USDA, children ages 2-3 need two servings of dairy per day (milk, yogurt, cheese, or calcium-fortified non-dairy beverage), children age 4-8 need two and a half, and kids 9+ need three. Can you use a milk alternative such as soy, almond or oat? Yes, but they’re not one-for-one swaps. For instance, almond and rice milk have only 1 gram of protein per serving, compared to 8 grams in cow’s.

When choosing a non-dairy milk, make sure it’s fortified with calcium and vitamin D. Homemade versions won’t have this fortification. Shake milk substitutes well before serving, the calcium settles on the bottom. Look for varieties labeled “unsweetened” as many milk alternatives contain lots of added sugar! If you’re choosing not to offer your toddler cow’s milk, make sure they’re getting a wide variety of fruits, vegetables, beans, grains and protein to get them the vitamins, minerals, fats and protein they need for growth. When in doubt, discuss nutrition with a pediatric dietician

Milk is a very convenient source of calcium, but not essential. It is recommended that a 1-3 year old child have 700mg (2-3 servings) of calcium per day. Eating a diet rich in beans, tofu, spinach, kale, broccoli, kiwi, figs, brown rice, oatmeal and certain fish such as salmon can give your child just as much calcium as drinking milk. No one ever “has” to drink milk. Human milk contains less calcium than cow’s milk, but the calcium in human milk has over twice the bioavailability of the calcium in cow’s milk. Increasing your calcium intake does not increase the calcium in your milk – your milk always has the right amount of calcium for your baby. Getting adequate calcium in your diet is recommended because if you’re not getting enough, your body will take calcium from your bones to provide to your baby, making you more prone to bone fractures. However as soon as you wean, your body regains bone mass and your bones will actually be stronger than before. 

Human milk averages 5.9-10.1 mg/oz calcium. 67% of this calcium is absorbed by the body. 

Whole milk contains 36.4 mg/oz calcium. 25-30% of cow’s milk is absorbed by the body.

Infant formulas contain 15.6 mg/oz calcium; toddler formulas contain 24-27 mg/oz calcium. Extra calcium is added to infant formulas because of the lower bioavailability of the calcium from formulas as compared to human milk (they aim for baby to absorb the same amount of calcium as would be absorbed from breastmilk).

Toddler formulas have come on the market in recent years touting that they’re great nutrition for the 12+ month group. In reality, it’s all clever marketing. If you supplement baby with formula, there’s no need to switch to a toddler formula at 12+ months. In the second year of life, growth slows. Your toddler doesn’t gain weight or length as quickly as they did right after birth.

If you’re still breastfeeding, your milk adjusts to this based on how toddler nurses; how the breast is emptied tells your body what kind of milk to make. When breast milk is the primary diet, like in the first 6 months, your milk is made for growth and immunity. When your toddler is taking lots of table foods and nursing, your milk is made for development and immunity.

At 1 you don’t need a fancy toddler formula or cow’s milk. If you’re exclusively formula feeding, switching to whole cow’s milk is fine. While cow’s milk is a convenient source of calcium, protein, fats, and vitamin D, there’s no need to switch to that, either. As long as your child takes a wide variety in their diet and has a good source of calcium (yogurt, cheese, dark leafy greens like spinach, fortified cereals or juice, soybeans, etc), just choose what you offer your child wisely. If you’re still breastfeeding, know your child is getting good nutrition from your milk suited to their growing needs. If you’re concerned about your toddlers diet or they don’t eat a wide variety, consult your pediatrician or a pediatric nutritionist for advice and help.

Empty breasts make milk faster than full breasts

- Julie Matheney

FULL/EMPTY BREASTS

While it seems counterintuitive, the emptier your breasts are, the faster they make milk. A full bread has no place to store or hold the milk, so milk production slows to prevent plugged ducts and breast discomfort. Cluster feeding on an emptier breast actually tells the body to make more milk at a faster rate!! Some incorrectly assume you have to wait for the breast to “fill up” before feeding your baby or for pumping while at work. This will eventually lead to less milk, as a fuller breast tells your body baby isn’t eating very often and to slow milk production. The more frequent you empty the breast, the higher the fat content in that milk and the faster milk is made. The longer often you wait and the fuller the breast, the higher the water content in that milk and the slower your body will make milk overall.

W atch the baby, not the clock. Breasts may feel really full between feedings in the first few weeks after birth, but they’re also not supposed to stay engorged. There will come a time when they stay soft and don’t feel full between feedings or pumping, so waiting for that as a cue to feed will also sabotage your supply. Don’t be alarmed when your breasts no longer feel full between feeding. You’re entering a new stage where you’ll still make plenty of milk for your baby as long as you’re routinely emptying that milk. Trust your body. Trust your baby.

My baby’s weight gain is slowing

- Julie Matheney

WEIGHT GAIN

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.

Breast milk supply drop at six months

- Julie Matheney

SIX MONTH DROP

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.

Why does my baby grab, pull, and pinch my breast?

- Julie Matheney

A newborn’s hands are a tool that the baby uses to find and latch on to the nipple, rather than something to be restrained and held out of the way. In utero, babies often bring their hands to their face in preparation to swallow amniotic fluid, which helps them practice swallowing for after birth. Young babies use their hands to push and pull the breast to shape the breast and provide easier access to the nipple. Their hands on your breast releases oxytocin and also helps the nipple erect and evert. Newborns and young infants also use their hands to push the breast away, possibly to get a better visual sense of the location of the nipple as it is a darker color than the breast. They may feel the nipple with their hand, and use the hand as a guide to bring their mouth to the nipple.

Kneading, squeezing, patting, twiddling, pinching, biting, touching your face and pulling hair and so many more behaviors. Older babies, especially around 5-6 months, do this for two reasons: to help stimulate a let down/increase the flow of milk AND because they’re exploring the world around them. Much like the early days, touching the breast and even twiddling the other nipple help release oxytocin to send more milk or increase the flow of milk. You may notice baby does this more often when you’re on your period or in the late afternoon and evening when supply naturally dips. Many breastfeeding behaviors are a phase, older babies or toddlers like to experiment with what they can do while breastfeeding. If a specific behavior is only mildly annoying, then one option is to wait and see if the novelty wears off on its own. If you don’t like the behavior, give baby a toy or something else to hold while at the breast or cover the other breast with a blanket or your shirt. Wear a necklace or scarf they can play with. Sing a song or read them a book to distract them. Don’t be too quick to hide baby’s hands. They do serve a purpose.

Forever milk

- Julie Matheney

Did you know that you will ALWAYS be able to make milk? You’ve had the milk making glands in your breasts since puberty. They’re like little empty clusters of balloons at the back of the breast. Pregnancy activates your milk making hormones, allowing the glands to expand and start filling with milk between 16-20 weeks gestation. In the early days after birth, the more stimulation the breast has (from feeding or pumping), the more the milk making glands and their corresponding hormone receptors multiply. The milk balloons fill and empty milk multiple times per feeding.

After at least 40 days of not expressing any milk, once you completely wean, your milk making balloons deflate and become dormant, like before pregnancy. But they aren’t dead. Pregnancy and breastfeeding hormones caused a permanent change in your body. Your milk making glands will FOREVER remember how to make milk. They can ALWAYS make milk again, no matter how long it has been. They just need enough of the right stimulation to turn on and start filling again. Some times years after breastfeeding a mother may feel the tingle of let down if she hears a baby cry. Or she may leak if her partner does enough nipple stimulation. There are grandmothers in other cultures who bring back milk to breastfeed their grandchildren! Our bodies are AMAZING!! Now you know!

Depression with weaning

- Julie Matheney

Weaning blues. If postpartum depression weren’t enough, it’s also possible to have depression and mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle or love hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of post partum depression and aids in bonding with baby. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being, calmness and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moodiness, sadness or even anger. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely that you will experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away in a few weeks. Dropping no more than one feeding per week is a gentle way to wean and adjust to shifting hormones. People who are forced to wean before they are ready (or for reasons beyond their control) and those with a history of depression are also more likely to experience depression after weaning. Even for those who are ready to wean and doing so gradually, there may still be a sense of loss and sadness. Your breastfeeding relationship has been a major part of your parenting journey and it is understandable that you’ll feel a wide range of emotions.