Breastfeeding Questions, Answered

Ame Odom, an international board certified lactation consultant with Pediatricians of Dallas and founder of Cookies & Milk Lactation, has been a go-to for all of our breastfeeding questions since we first launched Miracle Milkookies. Here, she answers our most commonly asked breastfeeding questions.

Ame is also a regular guest on The Mom Insider, where she answers specific questions for the mamas in our community. We’d love for you to join us there for an upcoming live Q&A with Ame!

What is the best way to stimulate milk supply before after baby is born? 

Ame: The most critical thing is making sure that there is a regular routine of milk removal and stimulation going on within the first 2 hours after baby is born. In situations where baby is whisked off to the NICU right away and you don’t get that critical skin to skin time, you can still do hand expression. What you do in the first 2 hours, first 24 hours, and first 7 days after baby arrives makes a huge impact on your longterm feeding success. There needs to be a regular routine of milk stimulation and removal going on right away. For mamas going back to work. I recommend pumping after 1 or 2 breastfeeds a day starting at 7-10 days postpartum.

I’m working full time and pumping. What is the best way to increase milk supply for my baby?  

Ame: I would increase exposure to baby’s breastfeeding relationship. Floor play with baby, pick him/her up more often throughout the day (or on the weekends) to create more stimulation. Try applying the Haakaa (more gentle than a pump) on the ride home from work in the car. Also make sure you are eating enough. Something dangerous we do is ignore signals that our body is hungry. Make sure we’re eating enough and drinking enough water. Reduce stress as much as possible. There are a ton of herbs out there to try, lactation cookies, oats, nuts, etc. Make sure that you’re feeding your body enough food. Calories are so important!

My baby is only feeding on one side. What can I do to get my baby to feed on both sides?

If it’s a newer baby and you have tried multiple strategies to get baby over to the side that you prefer for them to go on, it might be worth reaching out to Baby Begin. It might not be feeding related at all. The baby might have tight muscle bands in the neck and may need some work. A lot of it has to do with baby’s uterine positioning. If baby was always facing one direction, that could be a sign that baby might need some therapeutic work. A company like Baby Begin is a good place to start. Another reason could be feeding related- maybe the nipple on one side is different from the other, so the baby might prefer one nipple to the other. How fast your milk is coming out (pressure) how much pressure is being built up in your breast to push that milk out.

What is the best way to pump and take bottles on the go?

Ame: Pumped fresh milk can stay room temp for 4-6 hours! Milk is also good in a cooler pack with a frozen ice pack for up to 24 hours.

My baby sometimes only feeds on one breast per session. Should I make sure to feed from both?

Ame: This could sometimes be a perfectly normal method of feeding. If everyone is happy and thriving with this schedule, I call it block feeding, then no need to do both breasts.

Is it normal to have a reduction in milk? I have a 3.5 week old and my milk has been coming fine but all of the sudden I feel empty more often. What should I do?

Ame: Different factors can alter milk supply or the perception of milk supply. For the first 2 weeks of life, your milk is always there just waiting for retrieval! After that sometimes your body requires your baby’s stimulation to let the milk down. Keep nursing!

My little one has all of the sudden started grunting and pulling off while feeding. What should I do? She is only 3 weeks!

Ame: There are 1 or 2 very different reasons for this behavior. The first is a fast or heavy let down, like 4-6 water guns shooting the back of your throat, so she’s pulling back or away to self regulate. Or 2, it’s a normal newborn response to pull back on the nipple to signal the body to have another let down or to get it to eventually produce more milk.

I’m a first time mom in a few weeks! How will I know I’m producing enough and the baby is feeding well? Is there a ‘guideline’ to go by of the amount of time to feed per side?

Ame: You’ll know within the first several days, hopefully you have a good lactation consultation and pediatrician guiding and support you! Weight, diaper counts and baby satisfaction are sure signs. I always recommend 20 min per breast, on demand until milk comes in (if baby wants to eat an hour switch every 20 min – this is before milk comes in). Once your milk comes in, it should be every 2-3 hours, 15-20 min per breast per meal time. Good luck new mama!

Will exercising decrease my milk production?

Ame: Extreme workouts combined with dieting have been shown to have an effect on breastmilk production. This would be something considered on a case by case basis. If you try to do insanity workout 3 times a day, your milk supply could show signs of effect within a day or two. You can always just listen to your body. Light to moderate exercise is recommended along with a healthy diet and fluid rehydration, once your OB has cleared you to do so!

My baby is 8 weeks. I am starting to sleep train and feed bigger meals during the day. How do I make more milk during the day and less at night?

Ame: Wow, sleep training at 8 weeks, you’re my hero! It’s awesome how at different stages your body adapts to the baby’s changing needs. Don’t worry about this normal transition! Increasing your milk supply happens overall, it’s non-specific and really difficult to specify when. Prolactin is a major hormone responsible for making breast milk, this hormone recharges like a circadian rhythm, so in the morning all of us women are fuller and ready to feed!

How often should I be pumping if I am back at work?

Ame: Try to pump every time the baby would be breastfeeding at a minimum. Another good rule is to pump every time baby is eating away from you. Pediatricians of Dallas posted a blog I wrote in early spring with a sample work/pump schedule you might find helpful!

What is the best way to wash bottles/pump parts?

Ame: Wash bottles on the top rack of the dishwasher. All other parts, follow manufacturer guidelines. Some can also be put in the dishwasher (i.e.. flanges) others should be hand washed with mild soap and water and left to air dry.

How do you get your supply back after losing it after being sick?

Ame: Rest, rehydrate, keep nursing and pumping through, your body will catch up!

My little guy had some serious latch issues from the get-go. I started pumping and feeding him bottles and when I would try to breastfeed, he would get really upset. I started to exclusively pump but recently noticed I’m not producing as much milk, so much so that I have to supplement with formula. If I start breastfeeding again more often, can it possibly help?

Ame: If you once had a better milk supply, then yes, I do believe it might help. Simulation could be the difference. It would be awesome if a dedicated lactation consultant could help you get him back at breast with possibly the aid of a nipple shield to help with the transition.

Can I get botox while breastfeeding?

Ame: When injected properly and directly into the muscle, the toxin does not enter systemic circulation. Waiting a few hours for the toxin to dissipate would all but eliminate any risk to the infant. Also, avoid use of generic or unknown sources of botulinum toxin.

What is the best way to wean my baby?  

Ame: It’s typically easier to wean the later we are into the postpartum phase. If you have a heavy supply and you’re early in postpartum, you have to be reallyslow and safe to avoid getting mastitis. You might hear you can take an antihistamine like Sudafed or wrap your breasts to reduce your milk supply, but these methods are not safe. I have a set schedule/protocol for weaning. It’s something you can’t decide it’s Monday and I want to stop Friday. It can take several weeks. You need to give your body time to back off on milk-production. It’s a matter of significantly reducing or eliminating one feeding session every three to five days. 

Does eating too much sugar affect breast milk? And can this also contribute to a cranky baby?

Ame: Too much sugar more likely has to do with a reaction in your body more than baby. I have not heard any substantiated reports of sugar contributing negatively to baby.

For more breastfeeding questions and answers, you can check out Ame’s instagram page @ameodomibclc or book a consult with her virtually or in person through her company, Cookies & Milk Lactation! You can also join us on The Mom Insider to chat with Ame and other experts like her!

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