Expert Q&A: Lactation Consultant

Breastfeeding can be one of the most challenging yet rewarding aspects of new motherhood. But at times there can be so many questions around breastfeeding that it can feel overwhelming. We sat down with Judy Teibloom-Mishkin, founding partner of Lactation Partners in Chicago to answer some of the most frequently asked questions we get in our group sessions.

Keep reading to a few quick-fire answers to help you make the most out of your breastfeeding experience.

Tell us a bit about yourself and your experience:

I am a maternal child RN and an IBCLC (International Board of Lactation Consultant Examiner) for 30 years now which I cannot believe! I am a founding partner of Lactation Partners, a private practice doing in-home and tele consultations for mothers. I am a mom to 3 sons and I love my work. I’m aghast that we still don’t have Federally mandated parental leave in this country and think we do a lousy job supporting new families.

I have never breastfed, but I’ve heard it’s extremely painful. What helps ease the pain? Are there any tips or techniques that can ensure less pain in the beginning?

All women’s nipples go through some amount of toughening, but a good latch (on the areola vs the nipple), active eating to keep the tongue moving in a healthy pattern, and a little TLC following every feed can go a long way. That TLC includes applying a drop of expressed breastmilk followed by a product (like Lansinoh Lanolin Nipple Cream).

How long should I feed on each breast?

The average newborn sucks actively for 15 minutes per breast, sometimes 20 minutes. Be careful because minutes spent on breast does not equal actively eating as baby’s flutter suck in their sleep and breasts are designed to soothe babies as well as feed them.

How do I know if my baby is getting a sufficient amount of breast milk? My milk supply is low when I pump.

Weight gain will tell you ultimately; working with an IBCLC and doing a weighted feed will help give you an idea of how much your baby is eating at breast.

How do I deal with excess milk?

If the question is how to manage an oversupply that requires the help of an IBCLC and is fairly individualized.

What’s the best way to treat mastitis?

You must keep the milk moving out of the breast either by feeding or pumping, antibiotics to treat the infection, or heat or cool compresses to soothe the breast. I am a big fan of submerging the breast in a bath tub with Epsom salts.

Can you breastfeed with implants?

Absolutely!

What are some tricks for waking a baby up to eat?

Lie them on a hard flat surface, change their diaper, take them down to their diaper.

When do you stop breastfeeding on-demand?

I prefer to call it breastfeeding responsively That is a highly individual decision based on a family’s style and value system and I never tell anyone what to do with their bodies or their lives.

What’s a good age to introduce a pacifier while breastfeeding?

Once breastfeeding is established, I’m a fan of using a pacifier in a discriminating way, i.e. when a baby needs to suck but not eat and a mother needs a break. Not all babies like pacifiers however so keep that in mind.

How does drinking coffee affect my breastmilk? Can I drink coffee? How do I schedule it?

Most women can drink caffeine while breastfeeding as long as they do so in moderation.

How can I enjoy a drink or two while breastfeeding?

There’s evidence to prove that alcohol is metabolized out of breast milk at the same rate it’s metabolized out of the bloodstream so if you would responsibly drive a car, you can breastfeed. Best to eat while drinking and pace yourself.

What foods can you eat to increase your milk supply?

Brewer’s yeast is good for milk supply and can be found in many lactation recipes. Flax seed and oatmeal as well. These are ‘soft’ things to increase supply, anecdotal, and will never replace frequent and full emptying of the breast.

What supplements or herbs can you eat to increase your milk supply?

There’s a world of supplements; two well known ones are fenugreek seed and shatavari, which we have a study to demonstrate it increases prolactin levels.

Will introducing a bottle cause baby to reject the breast?

We recommend that you introduce bottles between 4 - 6 weeks once breastfeeding is well established and that you use a paced bottle feeding technique for best practice.

What’s the best way to introduce a bottle?

The first time you do anything new it’s best to ‘practice’ when the baby is happy, relaxed and not too hungry. Practice with a 1oz ‘snack’ some time before you attempt an entire feeding.

Is there a certain bottle you recommend for breastfeed babies?

I’m a big fan of Lansinoh’s Momma Bottle.

My baby won’t latch onto a bottle, any suggestions?

Don’t engage in a power struggle, you won’t win. Here are a few other options: sleep on a blanket and wrap the bottle in it, try when sleepy, try playing with it, try with your baby lying on their side on the changing table or while moving.

Any tips for breastfeeding while pregnant?

You can absolutely breastfeed while pregnant and don’t need to change how you feed.

For more information on Lactation Partners, visit https://lactationpartners.com/.