Expert / 1 August, 2018 / Vanessa Christie

Lactation Consultant Vanessa Christie Answers Your Questions on Breastfeeding

To celebrate National Breastfeeding week we’ve gathered up the questions and answers from our live Twitter chat with Lactation Consultant Vanessa Christie. Some really interesting questions from our readers!

Why does breastfeeding help a new mum lose weight? If I don’t breastfeed, what are the implications on my own body? I realise the implications for my baby.

It takes energy to make milk so you do use more calories when you are lactating. The hormones involved in breastfeeding also help to contract the womb back down to its original size more quickly. In regards to other things – there’s a strong body of evidence that breastfeeding can reduce a woman’s risk of certain conditions such as cervical and breast cancers & osteoporosis amongst others. It’s not to say that just because you breastfeed these things will never happen but it lowers your overall risk and the longer a woman breastfeeds for the greater effect it has been shown to have.

Do I have to avoid certain foods when breastfeeding, i.e. onions and chillies?

No, in general there is no reason to do this. Some mums anecdotally say that their baby reacts to certain foods but this is very individual. If you are ever worried then keep a food diary and note your baby’s behaviour, what’s in the nappies and so on to see if there’s any pattern. Some babies can be intolerant (and on a more extreme end – allergic) to certain things in your diet and the most common thing is cow’s milk protein from anything dairy that you may be eating.

What’s best, a shop bought pump or hospital grade for daily use? What’s the difference?

Hospital grade are stronger and generally stimulate the breasts more to produce milk, so are most important if building up milk supply is the key reason for pumping. Many mums get on absolutely fine with a standard electric or hand pump once they have an established supply. There are new style pumps around too based on vacuum suction pressure (just one single unit of silicone) that lots of mums are finding really easy and quick to use, so it may be worth looking into those too.

How much alcohol can I drink before I pump and dump, what’s the general rule? 

It takes roughly 3 hours for every unit of alcohol drunk to be absorbed and metabolised in your milk. It is perfectly safe to drink a unit towards the end of a feed to then maximise the time until another feed my happen – it takes at least 30 minutes for it to hit your milk once it’s got into your body. If your baby wakes unexpectedly early then it is ok to feed them as long as it isn’t happen on a regular basis! If you have 2 or more units then generally best to wait at least 6-8 hrs afterwards before feeding. Pump in the meantime, not to get the alcohol out of your system (it doesn’t work like that) but purely to keep yourself comfortable and prevent risk of mastitis. Also really important not to bed share if you’ve been drinking.

Is it true, the bigger the breasts the more supply? Is it mainly women with small cup sizes that have trouble with supply?

No, interestingly that’s not true at all. It’s to do with how much ductal tissue itself vs fatty tissue is in the breast. A woman with small breasts might have less ductal tissue but this just means that a baby may feed on average a little more frequently as the mother is not able to store as much at any one time as a mother who has more capacity to store milk.

Is breastfeeding supposed to hurt at first? It makes sense that your nipples have to adjust.

It is very normal for it to feel tender at first but it should never be a grit-your-teeth sweary type of pain that causes trauma to the skin. This shows that something is wrong with the latch. If you’re in pain and someone tells you it looks fine then go and get another opinion!

Is it generally the case that breastfed babies do not sleep through the night? I want to continue to BF but I also need sleep! My baby is 6 months in a couple weeks.

I have worked with 1000s of babies (I estimated about 7000 a little while ago) and I promise you that breastfeeding or bottle feeding, some babies will wake frequently, others a few times and others not at all by 6 months because babies wake up for many more reasons than just food. It can help to look at your routine during the day and what sleep associations your baby may have and gently work on those to encourage longer periods of sleep. Lack of sleep is so tough, I hear you!

I am thinking of introducing a bottle and expressing, are there any bottles better than others that you would recommend?

There’s no straight answer to that one as every parent/baby seems to take to different bottles in different ways! If you are continuing to put the baby on the breast then I tend to find that bottles with slightly longer teats and narrower bases are helpful as the baby can take more of the teat into the mouth (a little like taking a full mouthful of breast). The teats that are shorter and have a wider base may look more like a breast, but once inside the mouth aren’t anything like it!

And speaking of expressing, when should I do this in our routine? Before or after breastfeeding the baby?

Definitely afterwards so that your baby has the milk they need for that feed. If you express at a regular time each day then your body will soon pick up on the extra messages it’s getting and respond with more milk accordingly. Some mums also pump at the same time as they are feeding off the other breast. Check out the new silicone vacuum pressure pumps that are on the market as lots of mums are finding these easier to use and are able to keep their hands mostly free!

What are your thoughts on nipple shields? I’m a week in and my nipples are SO sore!

Ouch poor you! The most common cause of sore nipples is not having a great latch. Using a shield can help the immediate pain to a degree but won’t solve the cause of the problem. Get some specialist help to ensure your baby is latching as well as possible. If sorting out your baby’s position on your body and their attachment to the nipple isn’t helping the pain, then do ensure there isn’t a sneaky tongue tie that might be causing it. Take pain killers and a use a good nipple healing cream. If it gets so bad that you can’t bear to feed (even with a shield) then try giving them a break for 48 hours and express for every feed (not only to have milk for your baby but also to keep up your supply and prevent mastitis until you feel that you’re healing and are more confident to try again.

My last baby was dairy intolerant, should I ditch dairy ahead of giving birth later this year? Will that help clear my supply in case my second baby suffers too?

If you can bear to ditch the dairy (we’re lucky as there are so many good alternatives around now) then it’s not going to hurt. There is thought to be some degree of genetic link but this is not to say your baby will definitely have the same issues at all. It takes at least a few weeks for the cow’s milk protein to clear from your system so it could be a good idea to start off dairy free and then re-introduce it when your baby is 4-6 weeks and see if there is any reaction – hopefully not!

I’m due next month and I wanted to know your thoughts on colostrum harvesting – is this something I should do?

I think it’s a great idea – it is a great confidence booster knowing that you have some stored up if necessary for the early days and helps you learn the process of hand expressing which can come in very handy. It’s only advised from 37 weeks onwards and if you are having a low risk pregnancy. It’s particularly helpful if a mum has diabetes as there is an increased chance the baby may have a lower blood sugar level in the early days and may need some extra colostrum.

Can illness be passed through breastmilk? I.e the common cold, flu, or tummy bugs?

Your baby won’t get sick if you are unwell, through drinking your breastmilk. It actually has the opposite effect as your baby will receive the antibodies your body is making to fight off your illness, so will lessen the risk for your baby.

One breast seems to produce more than the other no matter how hard I try and pump the left or put baby to breast, I can feel and know it’s always less full. Is this normal?

Having a ‘super boob’ is very normal. As long as your baby is gaining weight well then it’s nothing to worry about. You may look a little lop-sided but this is temporary and when you stop feeding they will go back to being the same size. Breasts are never the same size and can produce different quantities. I breastfed almost with one only as the other didn’t produce much.

I seem to have a poor supply, my baby is 5 weeks and I have been topping up with formula – what do I do?

If you have been told that things ‘look fine’ I would go and see a specialist breastfeeding counsellor or IBCLC to check the latch and how your baby is transferring milk – when this isn’t effective it is the most common cause of low milk supply. If a baby isn’t feeding too often it will also have an impact on supply – this becomes an increasing issue when more and more formula is then required. Having an assessment to ensure the latch is good and then expressing after feeds with a good pump to increase stimulation is key as well. Once your supply increases this way the formula top ups can be reduced. Relaxing and looking after yourself as much as you can also really helps. If you’re still concerned, keep looking for answers as there may be something more significant going on such as your medical history and/or current health or a hidden tongue tie to name a few. Good luck.

With special thanks to Vanessa Christie, Lactation Consultant.
Email: vanessac@vanessachristie.com