1. Does dairy affect the baby?
First of all: A fussy baby does not mean a nursing mom needs to change what she eats. In fact, lactose intolerance in breastfed babies is very rare. Fussiness is more often related to breastfeeding technique, says Toronto paediatrician Jack Newman. Even so, when my first baby was hard to settle after a feed, and my midwife ruled out latch and supply issues, she suggested I cut back on dairy—scientific proof aside. I tried it for a few months and noticed a difference. “Cow’s milk protein can be hard to digest,” says Anita Arora, a lactation consultant in Milton, Ont. Keep a food diary to help you figure out if there’s a pattern. (It can take two weeks to eliminate cow’s milk protein from your system, and note that lactose-free products are not necessarily free of cow’s milk proteins.) You may be able to phase dairy back in after a while—some babies outgrow their sensitivity by six to 18 months.
2. Can soothers and bottles cause nipple confusion?
Waiting six weeks to introduce artificial nipples to my newborn felt like an impossible length of time for my boobs to be the only source of sucking. Then I developed a cracked nipple that was so severe, I started noticing blood in my baby’s diaper (she had ingested my blood during nursing). I was relieved when my midwife uttered the glorious words, “Time to take a nipple vacation.” To give my boobs a chance to heal, I pumped and bottle-fed. While it is very important for a newborn to imprint on his mother’s nipples and adapt to flow rates from the breast (it’s less work to suck on a bottle), there are bottles and pacifiers that are designed to more closely mimic breastfeeding, says Arora. Moms should work with a pro to remedy any problems while maintaining their milk supply. If you’re lucky, your baby will switch back and forth between bottles, binkies and the real deal with no issues.
3. Do lactation teas and cookies really work?
With my youngest child, fluctuations in my thyroid affected my milk production, so I turned to the herbs fenugreek and blessed thistle to boost my supply. “We don’t know if these herbs actually increase milk “supply,” says Newman. “They seem to, and many mothers swear by their effect, but the placebo effect of any medication is very powerful.” The website lowmilksupply.org is a good resource.
4. If my baby is nursing constantly, does this mean I’m not making enough milk for him?
Unlike with bottles, you can’t really measure how much milk your baby is getting while breastfeeding. So I stressed out whenever one of my kids suddenly wanted to nurse more frequently. “A baby who is feeding more often doesn’t mean a mom has low milk supply,” reassures Arora. “Babies go through growth spurts or cluster feeds, or just want to be soothed and be near their moms.” Once you’ve checked there’s adequate weight gain and enough wet and dirty diapers, just go with the flow and feed on demand. “Any time is a good time to breastfeed a baby,” says Jo-Anne Elder-Gomes, a La Leche League leader in Fredericton. Even at midnight, 2 a.m., 4 a.m. and 6 a.m. It’s an exhausting schedule, but it’s totally normal—and it won’t be like this forever. You and your baby will soon find a more sustainable equilibrium.
5. Is it safe to have a drink or two?
The short answer is yes, if you wait a few hours to nurse. After a glass of wine at a friend’s wedding, I once pumped and dumped my milk, sobbing while I watched it swirl down the sink drain. Turns out, all this did was relieve my boobs—it didn’t mean I was ready to breastfeed again. “Pumping and dumping doesn’t reduce the amount of alcohol in the milk—it needs to clear over time like it does from the bloodstream,” explains Lisa Sutherland, a midwife in Vancouver. Waiting two hours after consuming alcohol is safest.
6. Can I drink coffee?
The thought of giving up my tea and coffee habit when I had never been more tired was terrifying. My midwife reassured me I could still have a couple of cups a day. There is no evidence to show caffeine decreases breastmilk production, though some infants can get irritable if mom drinks more than the recommended amount (two or three cups, or 16 to 24 ounces, a day). “Levels of caffeine in breastmilk peak one to two hours after ingestion,” says Arora. Be mindful of your own caffeine intake: You want to stay hydrated while feeding, and if you’re hopped up on caffeine, there’s no way you’ll be able to follow the advice of everyone telling you to sleep when the baby sleeps.
7. Does cold medicine affect the baby?
It is important to be careful with cold medicines while breastfeeding, because they often contain more than one ingredient, explains Sutherland. “Regular Tylenol and Advil are both safe to take as directed, while ingredients like pseudoephedrine and antihistamines, as found in some combination cold and flu medications, can reduce milk supply and cause drowsiness in babies, especially in the first few months of feeding.” When in doubt, it’s a good idea to consult a reliable source like a pharmacist or a certified lactation consultant, suggests Elder-Gomes. There are also call-in helplines like Motherisk (1-877-439-2744 or motherisk.org) that can provide advice. Natural remedies (like saline sprays and zinc lozenges) used in moderation are very compatible with breastfeeding, but rest and hydration are always the best bet.
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