Dear Andi… Breastfeeding Q & A with Andrea Mansor, LC {Part 2}

It’s National Breastfeeding Month, and we are continuing our series with Board Certified Lactation Consultant (and Scottsdale mom/grandma!) Andrea Mansor. If you missed our first Q & A, you can find it here. This time around Andrea (aka “Dear Andi”) is talking about weaning a newborn off a nipple shield and concerns about milk being slow to come in. 

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Dear Andi,

What is the best way to approach weaning a 4 week old off of a nipple shield? It’s frustrating and defeating.

Erica

I understand your frustration, Erica. While the shield can be helpful to get a baby latched it does have its challenges when trying to wean baby off of it. My best advice is to not give up! Start by trying the feeding without the shield. If baby becomes too fussy and you are frustrated, use the shield. Learning something new will have its challenges and this is a new challenge to your baby. Some frustration is expected but try not to let a battle ensue. That will only make the experience more frustrating for both of you.

If you must use the shield, after baby is partially into the feeding and has pulled your nipple into the shield and started the milk flowing, try quickly removing the shield and bringing baby right back to the breast. Try different times of the day; some mothers have told me they were most successful when baby was sleepy during nighttime feeds. Other moms have reported their babies were most successful and willing to try when alert and hungry.

While the shield is intended to serve as a temporary aid to breastfeeding, in some cases mothers report they have had to continue using the shield for most if not all of their breastfeeding sessions. If that is the case, always remember to observe for signs of adequate milk transfer: 6-8 wet diapers daily, frequent stools, and adequate weight gain. Mothers who use a shield have often had to put in additional effort to breastfeed and I compliment you on both your efforts and success in feeding your baby your own breast milk.

Dear Andi,

I had a c-section last time and my milk took 6 days to come in. Then I struggled with having enough. I’m pregnant again; how can I prepare for better success this time?

Michelle

Congratulations on your pregnancy, Michelle. You are being proactive in asking these questions now and I can sense how important this is to you. I am sorry you had difficulties on your attempts to breastfeed your first baby. That is sometimes the case. With a first baby, everything including breastfeeding is new and often mothers feel overwhelmed. Coupled with recovering from a C-section moms can feel additional stress and apprehension wondering if baby is “getting enough”. Initiation of breastfeeding is sometimes delayed after a c-section due to feelings of nausea, pain, and fatigue after a long or difficult labor. It is not unusual for there to be a delay in bringing in the transitional milk.

The good news is, even though you struggled with having enough milk, mothers typically bring in more milk the second time than the first. So your efforts with your first baby may make breastfeeding more successful this time. I would encourage you to focus on this as a new experience with anticipation that early and frequent breast stimulation will have the greatest impact on your supply. If you have a repeat c-section, try to get baby to the breast as soon after birth as possible and as frequently as possible. In the first 24 hrs babies are usually very sleepy. After their first day, however, it is important to try to breastfeed at least 8 to 10 times in a 24 hr day.

If baby can’t or won’t latch, early and frequent pumping with a hospital grade pump would be important to help stimulate the hormones of lactation in your body which contribute to a good supply. Understand the signs of milk transfer: sufficient wet and dirty diapers and appropriate weight gain (remember most babies do lose some weight before mom’s milk comes in). While in the hospital, please ask for help and/or a latch check so you know baby is latching on correctly and deeply. When you get home, with two children to care for it is important to have help so you can allow your body to rest and recover from giving birth while focusing on the process of breastfeeding.

To sum it up, early and frequent breastfeeding on demand with baby latched deeply on the breast has the greatest impact on your supply.

Do you have breastfeeding questions for Andrea (Andi)? Leave your questions in the comments below. We can’t promise that every one will get answered, but we’ll add them to our list for future Dear Andi posts.

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Andrea Mansor has been assisting mothers and babies with breastfeeding for 15 years, first as an RN working in Obstetrics then as a Board Certified Lactation Consultant since the year 2000. She and her husband George have lived in the Valley for more than 30 years and raised their family in the same Scottsdale home since 1985. The mother of four grown children and grandmother of two (with two more on the way!) Andrea finds immense satisfaction in helping young mothers. She has facilitated a new mom/baby support group for the past 8 years. Andrea encourages mothers to ‘get to know their babies’ and ‘be in the moment’ as they navigate the challenges of motherhood and breastfeeding.