Dear Andi… Breastfeeding Q & A with Andrea Mansor, LC {Part 1}

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It’s National Breastfeeding Month as well as World Breastfeeding Week, and we are honored to present a three-part series with Board Certified Lactation Consultant (and Scottsdale mom/grandma!) Andrea Mansor. Andrea is answering breastfeeding questions submitted by you, our readers, and we hope that her expertise helps not only those who asked, but those who are encountering some of the same questions themselves.

With a little nod to “Dear Abby”, let’s kick off our first Q & A – this time featuring a mom who wants to build up a stored milk supply in preparation for returning to work, and another with questions about night-waking and weaning an older baby. 

Take it away, Andi! 🙂

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Dear Andi,

How and when should I create a milk stockpile so I can return to work (or enjoy a night out without baby)?

Jessie

Your question is a common one, Jessie. When breastfeeding mothers anticipate going back to work there is the frequent concern of building a supply for feedings while away from baby. I like to encourage mothers to “be in the moment” so when a baby first delivers and in the first few weeks of his/her life, I think it is best to focus on establishing the breastfeeding. Although there is always the awareness of going back to work, most mothers are home for 6 to 12 weeks.

Mature milk is established at about two weeks and babies often hit their first growth spurt at three weeks of age. During this important time, frequent on demand breastfeeding will help to ensure a good milk supply. Once baby is about four weeks old, it is a good time to introduce a bottle and begin to adjust to using the pump you will use when returning to work. Not all pumps are the same. Just as you might wear a different pair of shoes to go to the mall than to climb a mountain, the equipment needs to be suited to the challenge at hand. I would encourage you to choose a double electric breastpump as you may find it more efficient and time saving.

Whatever pump you decide on, it most likely will not be as good at expressing milk as your baby is. Your body may need some time to get acquainted with the pump. Begin by finding “opportunities” to pump. For instance if baby has a longer nap time during the day you may take advantage of that by pumping while baby is asleep. If you complete a breastfeeding session and baby has only fed on one breast, you may try pumping the other side. As you begin to express enough milk for a feeding, have someone else feed baby the milk by bottle. Try to find a bottle that has a nipple shaped fairly similar to your own and that does not allow the milk to flow too fast. Remember you still want baby to return to the breast.

When you return to work make pumping an important part of your work day. If you haven’t already done so, speak with your employer re. the importance of pumping several times throughout the day (at least as frequently as baby will be feeding) and how this can be accommodated. Some mothers will return to work mid week so they have time to work out the unexpected surprises that may come up. When mothers first start back to work there can be additional stress and that can have an impact on milk letdown. So when you are home with your baby, after work and on weekends, again be in the moment and breastfeed on demand. Not only will this help maintain your supply but you and baby will both enjoy the closeness breastfeeding offers.

Dear Andi,

I am still nursing my ten-month-old and she has started an extra night time session (now nursing twice at night). Is this okay? How do I know when I should wean?

Melissa

Melissa, congratulations on successful breastfeeding! This is a special time in your life and while waking for nighttime feedings can be tiring breastfeeding will not last forever. After raising four children, I realize how fleeting the baby days truly are and my advice to all moms is to be in the moment.

Your ten-month-old is starting another nighttime breastfeeding session and you are wondering if this is okay. This could be occurring because of changes in her sleep patterns causing her to wake at night. Babies as young as nine months can begin to have partial awakenings from non-dream sleep causing the baby to cry and/or appear confused. The familiar comfort of breastfeeding may help her to fall back into a deeper stage of sleep.

Babies who go to sleep overtired are more likely to awaken during the night. Establishing bedtime routines and ensuring baby is getting enough daily nap time may help her to sleep better at night. Have there been any recent changes at home that may be influencing her nighttime sleep? Is she teething? At ten months babies become increasingly active and may need more calories. A quick trip to the pediatrician for a weight check can reassure you that she is gaining weight appropriately. If not, she may need some additional calories during the day.The reasons for your daughter’s need for another feeding may be hard to pinpoint but answering to her need through providing your calming touch will help her to feel safe and secure.

In answer to your next question, there is no set time to wean. The American Academy of Pediatrics recommends breastfeeding for the first year of a baby’s life and beyond if mom and baby so choose. If baby is weaned from the breast before one year he or she would require supplemental expressed breastmilk or formula until one year of age.  Every mother’s goal for breastfeeding is unique to her own circumstances and beliefs. Some moms want to breastfeed until they go back to work or baby starts solids. Others would like to breastfeed until baby is 2 years of age or beyond.

Is there a right or wrong? No, as it is up to mom and baby to choose what is best for them. Some babies self wean earlier than mom planned and mother feels sad about the weaning process. Some babies go on “nursing strikes” only to resume breastfeeding again in a few days to weeks. If mom continues to pump to maintain her supply breastfeeding can successfully continue. When you do decide to wean, if at all possible, weaning should be done slowly to allow the breasts to adjust and not become engorged. The ideal weaning allows for both the physical and emotional adjustments that often accompany it.

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.

6 COMMENTS

  1. Thanks for all of the advice. I have a two month old and plan to give her breastmilk for up to 18 months if I can, but I am so nervous about when she starts teething. I know it can be done but are there any tried and true ways to prevent/discourage biting?

    • Hi Farzana! Thanks for the comment! I’ll pass it on to Andrea for a future post (and I’ll tell you personally that my first had teeth at four months and I nursed her until fourteen months – it’s totally doable and not as scary as it sounds 🙂 )

  2. I just found out that we’re expecting twins (this is my second pregnancy) in early March! I’m still nursing my 15-month-old son, and I hope and plan to nurse the twins when they arrive. Do you have any advice for nursing twins, or any books you’d recommend on the topic? Do you recommend tandem nursing for all/almost all feedings?

    Also, my son seems pretty committed to nursing. I have him down to nursing just before and after naps and bed–and usually one time during the night. But he asks for it more often. When do you recommend I wean him (I was thinking around 18 months, to give me a few months “off” before the twins–and before my belly gets too huge!), and do you have any suggestions for easing the transition?

    Thanks!

    • Thanks for the comment, Lynn! I will pass it on to Andrea for a future post. You’re in luck, though – she already wrote a detailed response to another mama about nursing twins, so you’ll see that in the next couple weeks. I’ll still forward your question and hopefully we’ll get a chance to fun the second part (weaning a toddler) in a future post. Congrats on your pregnancy!

  3. Hi Andrea
    My son is almost 3 months now and has started sleeping longer hours at night, normally only waking once to feed between 7pm and 7am. He usually wakes around 3am. I am having to wake up to pump at least once around 12:30-1am and then wake again to feed him at 3am. I have heard that my body should eventually get used to his routein and then I will only need to wake once to feed him with out getting engorged. Is this true, or will I need to continue to pump in the middle of the night to keep my milk supply up? Thanks!

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