Why do babies bite? 

There’s no universal reason for why a baby might give biting a try, but there are a few common ones:

• Curiosity: It might seem like an overly simple answer, but babies aren’t born knowing what’s going to hurt others, and they’re fascinated by the world around them. While it isn’t uncommon for babies to try a few experimental nips, it’s unusual for it to turn into a habit.
• Teething: One of the ways babies seek to ease the pressure on their swollen gums during teething is by biting down.
• Cold or ear infection: These conditions can make it harder to swallow, and if your baby is having trouble swallowing while feeding, they may inadvertently bite down.
• To get your attention: Once your baby has tried it out, there’s a good chance your little one will have noticed that biting gets a strong reaction from you, so if they’re feeling a little ignored, they may use the tools at their disposal.

How can I prevent biting? 

Depending on why your baby is biting during breastfeeding, there are a few different ways you can work to discourage making biting into a habit. First, if you think an ear infection or cold might be the culprit, holding them in a more upright position for nursing can help, and making sure to use a bulb syringe to keep their nose from being too stuffy during feedings can also help to prevent accidents while riding out their illness.

During teething, if your baby is coping with teething pain by biting, and is older than 6 months, offering cool, complementary foods like yogurt or chilled applesauce can give both of you a little relief until teething pains start to subside.

Those can be good strategies for specific types of biting, but when biting while nursing starts to become a habit, a more direct way of addressing the problem is needed. When a baby is nursing, their lower teeth are covered by their tongue, and most of the nursing motion is done with the lower jaw, so even though the upper teeth rest on the breast, when a baby is actively nursing, they can’t be biting – sucking needs to end before they is physically able to bite.

This means that if you have a regular biter on your hands, the fact that it’s impossible to suck and bite at the same time can help you know ahead of time when a bite is coming. When that rush of hungry feeding is done, and the nipple slips forward in your baby’s mouth, and they pulls back to bite, you can slide your fingers between their gums at the corner of their mouth, to stop them from biting down, and then offer a replacement, like a teething ring, to bite into.

Another way of discouraging biting before it begins is to hold your baby closer to your breast for feeding. If they has to reach to latch on, it’s much easier to pull back and bite, but if they is right up close to your breast, it’s much less likely.

How should I respond to a bite? 

It makes sense to jump when something new and startling – like a bite on your areola – happens, but one of the best ways to discourage future bites is to respond calmly and blandly. If your baby does bite while nursing, strong reactions, from anger to pain to amusement can all be incentives for them to want to try again another time. Instead, try pulling back, calmly saying “no biting,” and stopping feeding them for a few minutes if the feeding session just started, or waiting until the next feeding time if they has been feeding for a while.

Reviewed by the Ovia Health Clinical Team

Sources

• “Breastfeeding after your baby gets teeth.” HealthyChildren. American Academy of Pediatrics, September 8 2015. Web.
• “Breastfeeding: My baby is biting me.” nct. NCT, August 2016. Web.
• “Do I need to stop breastfeeding when my baby gets teeth?” La Leche League. La Leche League, January 10 2016. Web.
• “What should I do if my baby bites me?” La Leche League. La Leche League, November 16 2016. Web.

Is hormonal birth control safe during breastfeeding?

Yes. No negative health effects have been seen in babies whose parents use hormonal birth control while breastfeeding, so there’s nothing dangerous about using hormonal birth control during this time. Breastfeeding also does not change the effectiveness of hormonal birth control.

Concerns about hormonal birth control during breastfeeding are mostly focused on whether hormonal birth control containing estrogen reduces the amount of milk that the body produces. The research on the subject is conflicting. Some do report a drop in milk production when taking estrogen-including hormonal birth control, especially those who previously had trouble breastfeeding, had certain medical or pregnancy conditions, or had a preterm delivery. Because of these unknowns, most healthcare providers recommend using a different type of birth control until the end of breastfeeding.

Other types of birth control

Most major health organizations generally consider progestin-only hormonal birth control methods to be safe for breastfeeding mothers. These low-risk options include the mini pill, hormonal IUDs, the Nexplanon implant, and the Depo-Provera injection. When it comes to IUDs, you may be given the option of having one inserted immediately after giving birth. Current research suggests that the Nexplanon implant, the copper IUD, and progestin-only IUDs are safe for breastfeeding parents and their infants in this scenario. You can also opt for IUD placement at your 6-week postpartum appointment or further down the road. IUDs are an excellent long-term option for birth control. If you’re worried about any hormones impacting your supply, you can also do a trial of the mini-pill for a month or two before selecting a longer-term option.

Reviewed by the Ovia Health Clinical Team

Read more

Birth Control: Methods, types and options

The IUD: Everything you need to know

Sources

• E. Espey, et al. “Effect of progestin compared with combined oral contraceptive pills on lactation: a randomized controlled trial.” Obstetrics and Gynecology. 119(1): 5-13. Web. January 2012.
• Family Physicians Inquiries Network. “Combined Oral Contraceptives for Mothers Who Are Breastfeeding.” American Family Physician. 72(7): 1303-1304. Web. October 1, 2005.
• J.J. Kelsey. “Hormonal contraception and lactation.” Journal of Human Lactation. 12(4): 315-8. Web. December 1996.
• La Leche League International. “The Breastfeeding Answer Book.” March 2012 Update, Web.
• Mayo Clinic Staff. “Minipill (progestin-only birth control pill).” Mayo Clinic. Mayo Clinic, November 24, 2014. Web.
• Victoria Nichols-Johnson. “The Breastfeeding Dyad and Contraception.” Breastfeeding Abstracts. 21(2): 11-12.
• “Hormonal and nonhormonal birth control during breastfeeding.” National Center for Biotechnology Information. Cochrane Database of Systematic Reviews: Plain Language Summaries, March 2, 2015. Web.

Hormonal effects 

One of the most obvious effects breastfeeding can have on sex drive is the effect on a new mom’s hormones. After giving birth, and in preparation for breastfeeding, the body starts to produce a larger amount of the hormones oxytocin and prolactin, and a smaller amount of the hormones estrogen and progesterone than usual. This hormonal shift can have a variety of different effects that can have an impact on sexual desire, including:

• Increased oxytocin: The increased oxytocin levels that come with breastfeeding can impact your libido in many ways. It’s a key hormone for maternal bonding, which is crucial during this time, but can cause new moms to have little time, energy, or desire left for sex, and can also lead to enough cuddles to leave mom feeling “over-touched” before Baby is even in bed for the night. The most visible effect of increased oxytocin is the milk ejection reflex, which can be triggered by orgasm, and can lead to leaking breasts during intercourse.
• 
  
  Decreased estrogen: The decreased amount of estrogen in the body during breastfeeding, and especially before the first menstrual period after birth has been linked with decreased sexual desire and increased vaginal dryness, which can make intercourse uncomfortable.

It’s true that, during breastfeeding, many women experience a decrease in or absence of sexual desire, but not all breastfeeding women experience a drop in sex drive. In fact, one 1966 study found that the 24 women observed in it experienced an increase in libido. While that’s not a typical result, and studies generally show a tendency towards a drop in sex drive with breastfeeding, it does illustrate the truth that many women don’t experience a lack of desire during breastfeeding. Like other areas of pregnancy, birth, and postpartum recovery, each woman’s body is different, and will have unique, individual reactions to these major life changes.

Related effects

Breastfeeding definitely isn’t the only thing that might be having an impact on a new mom’s sex drive. Tiredness is a big component of reduced sex drive, and breastfeeding can add to fatigue, especially if breastfeeding means you’re the one responsible for most nighttime wakings. Experiencing baby blues or postpartum depression have both also been shown to have a significant impact on postpartum libido.

The truth is, taking care of a newborn is tiring in exciting new ways you may have never even thought of before, and there are many different ways that this change can affect your life and your moods, both inside the bedroom and out. It’s important to remember that this is only temporary, and your libido will return in full force as your life starts to settle into its new routines. Furthermore, studies show that after a drop in desire during breastfeeding, you can look forward to a statistically-likely upswing in your sex drive after weaning.

Reviewed by the Ovia Health Clinical Team

 
Sources

• E.M. Alder, A. Cook, D. Davidson, C. West, J. Bancroft. “Hormones, mood and sexuality in lactating women.” British Journal of Psychiatry. 148: 74-9. Web.January 1986.
• M.D. Avery, L. Duckett, C.R. Franzich. “The experience of sexuality during breastfeeding among primiparous women.” Journal of Midwifery and Women’s Health. 45(3): 227-37. Web. May-June 2000.
• G. Barratt, E. Pendry, J. Peacock, C. Victor, R. Thakar, I. Mayonda. “Women’s sexual health after childbirth.” British Journal of Obstetrics and Gynaecology. 107(2): 186-95. Web. February 2000.
• M.A. DeJudicibus, M.P. McCabe. “Psychological factors and the sexuality of pregnant and postpartum women.” Journal of Sex Research. 39(2): 94-103. Web. May 2002.
• C. Forster, S. Abraham, A. Taylor, D. Llewellyn-Jones. “Psychological and sexual changes after the cessation of breastfeeding.” Obstetrics and Gynecology. 84(5): 872-6. Web. November 1994.
• C.M. Glazener. “Sexual function after childbirth: women’s experiences, persistent morbidity and lack of professional recognition.” British Journal of Obstetrics and Gynaecology. 104(3): 330-5. Web. March 1997.
• Viola Polomeno. “Sex and Breastfeeding: An Educational Perspective.” Journal of Perinatal Education. 8(1): 30-40. Web. Winter 1999.
• K.M. Robson, H.A. Brant, R. Kumar. “Maternal sexuality during first pregnancy and after childbirth.” British Journal of Obstetrics and Gynaecology. 88(9): 882-9. Web. September 1981.
• “Not in the Mood.” New Beginnings. 18(2): 67-68. Web. March-April 2001.
• “Will breastfeeding affect my sex drive?” Parents. Meredith Women’s Network, 2009. Web.

When is it safe to breastfeed through pregnancy? 

In most pregnancies, there’s no reason you can’t continue breastfeeding as long as you’re eating a wide variety of healthy foods, getting enough energy to support yourself, your nursling, and your fetus while staying well-hydrated. However, in cases where you have a history of preterm birth, or are otherwise at risk for preterm delivery, your healthcare provider might recommend weaning away from breastfeeding during pregnancy, since breastfeeding releases oxytocin, a hormone that can cause contractions. Most of the time, even a history of preterm labor doesn’t mean there’s anything to worry about, but it’s still important to keep in close touch with your doctor about whether it’s the right time to be breastfeeding.

The fact that breastfeeding can trigger contractions mostly only becomes a consideration after the first trimester, so even if you have a history of preterm delivery, you can take a little time to wean slowly, and to go to a healthcare provider and confirm your pregnancy before making a decision.

Why else might breastfeeding end during pregnancy?

Even if you want to keep breastfeeding during pregnancy, and your healthcare provider agrees that it’s a safe and healthy choice for your family, there are other reasons why breastfeeding might end during pregnancy. For one thing, during pregnancy, breastfeeding just isn’t all that comfortable. Especially in the first and second trimesters, nipple soreness and breast tenderness can make breastfeeding extremely uncomfortable, though many women who do continue breastfeeding report that the painful feeding subsides later in pregnancy. Beyond that, the fatigue that can come with pregnancy can leave not much energy left over for breastfeeding.

Beyond that, there’s always the possibility that your baby will wean themselves as your pregnancy goes on, too. At a certain point, mid-way through the second trimester, breast milk starts to change to prepare to nourish a newborn, and to produce the colostrum that will be your new baby’s first meal. This milk will still be perfectly healthy for your older baby, but as it changes, the flavor may shift a little, and your child may become less interested in nursing. Around the same time, your body may start producing a bit less milk. This may not be a problem if you have an older baby or toddler, but for young children, this drop in milk may make it necessary to supplement with formula until after your new baby is born.

Tandem nursing 

If you do continue to breastfeed throughout pregnancy, it’s also possible to keep breastfeeding your older child after you give birth to your newborn. It may not seem practical, especially if you experience a significant drop in milk during pregnancy, but after giving birth, the body can more easily regulate to meet the new demand. Tandem nursing does take more energy than just nursing one child, but many families find that it can be a great way to ease the transition of bringing a new baby into the family when the older child isn’t so old at all!

Reviewed by the Ovia Health Clinical Team

Sources

• Shannon K. Laughlin-Tommaso. “Is it safe to continue breast-feeding if I’m pregnant with another child?” Mayo Clinic. Mayo Clinic, April 28 2015. Web.
• “I’m Pregnant and Still Nursing My Toddler–Must I Wean Now?” La Leche League International. La Leche League International, January 9 2016. Web.
• “Nursing During Pregnancy.” Healthy Children. American Academy of Pediatrics, November 21 2015. Web.
• “Nursing Through Pregnancy and Beyond: Is It Really Possible?” New Beginnings. 24(5): 230-233. Web. September-October 2007.

Which illnesses can be passed on through breast milk?

Not only are most illnesses not passed on through breast milk, but the antibodies produced to fight illnesses are passed on, which means that breastfeeding when you’re sick could help keep your baby healthier than staying away while an illness runs its course. Certain conditions, however, can be passed on to a baby during nursing. These include diseases that are transmitted through the bloodstream like HIV, or are highly contagious, like untreated tuberculosis.

Despite some advice to the contrary, it is safe to breastfeed if you have food poisoning unless bacteria has crossed over into the blood. As long as food poisoning is limited to vomiting, cramps, and diarrhea, breastfeeding is still perfectly healthy, though you may want to check in with your healthcare provider if symptoms worsen. 

Why else might an illness limit nursing?

Nursing during an illness is safe, but being sick can cause a drop in milk supply that can make nursing harder. Additionally, some of the medications used to fight illness can either limit milk supply or be transmitted through breast milk and have either negative or unknown effects on the baby. Just like with medication during pregnancy, a lot of information about medication during breastfeeding is still unknown, since it’s difficult to study the effects.

Decongestants containing pseudoephedrine and cough syrups and cough drops containing menthol have both been shown to cause a drop in your body’s milk production. Different medications stay in your system for different amounts of time, so if you’re prescribed something, it’s worth talking to your healthcare provider about how long a medication lingers in your bloodstream. Depending on the medication, your provider may also suggest timing your medications for just after a feeding, so your body has the greatest possible amount of time to process the medication before the next feeding.

Reviewed by the Ovia Health Clinical Team

Sources

• Committee on Drugs. “The Transfer of Drugs and Other Chemicals into Human Milk.” Pediatrics. 126(20): 404. Web. September 2001.
• Gwen Gotsch. “Maternal Medications and Breastfeeding.” New Beginnings. 17(2): 55-56. Web. March-April 2000.
• Mayo Clinic Staff. “Breast-feeding and medications: What’s safe?” Mayo Clinic. Mayo Clinic, July 30 2015. Web.
• “Can I breastfeed my baby if I am sick?” La Leche League International. La Leche League International, January 9 2016. Web.
• “Is it safe to breastfeed if I have diarrhoea and vomiting?” NHS. Gov.UK, May 30 2015. Web.
• “When should a mother avoid breastfeeding?” Centers for Disease Control and Prevention. US Department of Health and Human Services, November 18 2015. Web.

Still, there are a few specific foods that could cause problems during breastfeeding, and a few others that probably won’t, but have gotten a lot of bad press over the years.

Caffeine

More than anything else on the ‘potentially banned’ list, caffeine is one of those substances many new moms of newborns have a hard time doing without. Having to cut down on sleeping longer than 3 hours at a time and losing caffeine can seem practically unfair. Fortunately, medical resources from the Mayo Clinic to the American Academy of Pediatrics agree that there’s no harm in drinking a moderate amount of caffeinated beverages like coffee or tea while breastfeeding. Though caffeine can be transmitted through breast milk, only a small amount is transmitted, which isn’t dangerous, but can lead to fussiness.

For most babies, the moderate amount recommended, 2 to 3 servings per day, won’t even have any significant effects. Some babies may be more sensitive to caffeine, especially when they’re young, so if you start to notice some extra fussiness from your baby after drinking your morning cup of coffee and nursing, you can decide how to moderate your intake in the way that works best for your family. That might mean anything from cutting caffeine out altogether to just switching to half-caf. Timing breastfeeding so that the first cup of the day comes just after a feeding can help with any effects of caffeine as well.

Alcohol

One substance that’s a little more controversial than caffeine is alcohol. Both the Mayo Clinic and the American Academy of Pediatrics recommend limiting alcohol consumption during breastfeeding because the level of alcohol in breast milk generally mirrors the amount of alcohol in the bloodstream, and there is no level of alcohol in breast milk that’s considered safe. This means that it’s safest to wait 2 to 3 hours after having a serving of alcohol before breastfeeding. If you have more than one serving of alcohol, a safe rule is to wait to breastfeed at least 2 additional hours for each drink. On the other hand, though, the March of Dimes recommends against drinking alcohol while breastfeeding entirely. They also suggest that women who do drink alcohol during breastfeeding limit drinking to two alcoholic drinks per week, and wait at least 2 hours after having a drink before breastfeeding.

The fact that the alcohol in breast milk mirrors the alcohol content in the blood means that pumping milk after drinking, or “pumping and dumping”, isn’t necessary, and won’t help clear the alcohol out any more quickly.

Fish

There’s a lot to love about fish – it’s a high-quality protein, rich in omega-3s and other nutrients, and it can be an important part of a healthy diet for a breastfeeding mother and baby. It’s also well-known for containing trace amounts of mercury and other heavy metals due to pollution. For this reason, the U.S. Food and Drug Administration recommends limiting the amount of fish and shellfish you eat while breastfeeding to about two servings (8 to 12 ounces) a week, and to cut certain large, ocean fish out of your diet entirely. These fish are:

• Shark
• Swordfish
• King mackerel
• Tilefish from the Gulf of Mexico

The FDA also recommends limiting white (albacore) tuna to 6 ounces per week.

They also recommend checking for local advisories and warnings before buying or eating local seafood, and following the same recommendations for young children, but with smaller portions.

Garlic and other strong flavors

Some breastfeeding advocates and authorities recommend avoiding certain foods, especially highly spiced, flavorful, or garlic-filled dishes, but there is no evidence that babies are fussier with these foods in their systems. Although only a small amount of research has been done on the subject, it looks like the impact that different flavors can have on breastfeeding are based on a baby’s preferences and tastes. Some babies may dislike certain strong flavors when they show up in breast milk, but others may love them. Allergies from breastfeeding are very rare.

In fact, the strong flavors in breast milk might be beneficial to Baby. It’s been suggested that the variations in flavors can help to prepare babies for the eventual massive variations in table foods when they’re older. It’s certainly not a guarantee against later picky eating, but every little bit helps, right?

Citrus fruit is another food that has been recommended against during breastfeeding in the past. While it’s not impossible that eating a lot of citrus while breastfeeding could cause or add to diaper rash, studies have found no evidence that it will. In fact, the Mayo Clinic suggests eating citrus fruits during breastfeeding, since the vitamin C helps the body to absorb the iron it needs during breastfeeding.

Reviewed by the Ovia Health Clinical Team

Sources

• Julie Mennella. “Alcohol’s Effect on Lactation.” National Institute of Alcohol Abuse and Alcoholism. National Institutes of Health. Web.
• “Breastmilk and your diet.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.
• “Fish: what pregnant women and parents should know.” U.S. Food and Drug Administration. U.S. Department of Health and Human Services, June 2014. Web.
• “Food and Beverages not Likely to Make Breast-fed Babies Fussy.” Loyola Medicine. Loyola University Health System, February 12 2013. Web.
• “How a healthy diet helps you breastfeed.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.
• “Keeping breast milk safe and healthy.” March of Dimes. March of Dimes, May 2016. Web.
• “Things to avoid while breastfeeding.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.
• “What about alcohol and breastfeeding?” La Leche League International. La Leche League International, December 19 2015. Web.

Pumping basics 

No matter what kind of pumping schedule you need to set up for your family, there are a few guidelines that can help any pumping schedule run more smoothly. First, just having a schedule is important. This is true whether you’re feeding your baby on a specific schedule or feeding on-demand. This is because it’s a lot easier to push back or forget a pumping session during a busy day than it is to forget to feed a crying baby at feeding time. Having a schedule means having time, at least theoretically, set aside for pumping, which can make a huge difference when it comes to making sure the pumping process goes smoothly. More than that, your body works better with routines, just like your baby does, which means that establishing a pumping schedule can help ensure that when you do have (or carve out) time to pump, it’s a productive pumping session, and not one that leaves you feeling discouraged.

It can feel uncomfortable, or even counterintuitive, but if you’re having trouble producing or pumping as much milk as you’d like to, adding more pumping time is a good rule of thumb. It doesn’t always feel like a good use of time, especially if you’re not getting much milk from it, but the added stimulation will help signal to your body that more milk is needed. More frequent, shorter pumping sessions, instead of fewer, longer ones mimics the pattern of cluster feeding that babies go through just before growth spurts, when they need more milk to keep up with their speedy growth.

Finally, feeding schedules change, and one of the most important ways that they change is related to shifts in feeding patterns as babies grow. Whether you’re exclusively pumping or just pumping when you’re not right there with your baby, ideally, it’s a good idea to pump about as many times as they feeds during a day. That’s not always possible, and not being able to pump quite as often as Baby eats doesn’t mean you won’t have a perfectly successful pumping experience, but as often as they eats is a good goal to work towards. If you have a newborn, this might mean fitting in pumping sessions every 2 to 3 hours, or about 8 to 12 times in a 24-hour day. For an older baby or a toddler, that might look more like 3 to 6 times a day during the daytime, and none or only one at night.

More than that, while schedules are important to have, like every other part of parenting, they’re also subject to change based on your little one’s whims, the weather, fate, chance, or a strong passing breeze, and being able to be flexible about yours in whatever way makes the most sense for you will help you and Baby out immensely. Especially as they grows older, and starts eating more and more complementary foods, sticking to a strict schedule may start to become less important to you.

Pumping around returning to work 

Depending on where you work, you may have the legally protected right to unpaid time and a private space for pumping throughout the first year of your baby’s life, but even if you’re legally entitled to this time, scheduling it into a workday can be tricky. On the other hand, some employers go above and beyond the legal minimum they’re required to offer – in either case, it’s important to talk to your employer or HR representative ahead of time, to find out what time and space you’ll have for pumping at work.

Current regulations in the US say that companies with 50 or more employees are required to give you the time and space to pump in order to feed your baby. This is unpaid time, although you can also use paid lunch or breaks for this purpose. However, there are exceptions under the law for exempt employees. A sample pumping schedule for the mother of a young baby in a workplace that guarantees the chance to pump might include:

• Breastfeeding your baby right before work
• A 30-minute break to pump around 10
• Another pumping break around 1, during lunch
• A final pumping break around 3
• Breastfeeding after work on-demand

This schedule might then reduce down to two, and then one pumping session during the day as the baby grows.

If you work for a company with fewer than 50 employees, that doesn’t offer alternative arrangements for pumping, though, things can get tricky. If lunch is the only significant amount of time during your workday for pumping, it’s especially important to nurse or pump directly before and after work. If a long commute gets in the way of doing so, you may be able to pump in the car directly before leaving for work, after driving to work but before going in to your job, after leaving work but before heading home, or after arriving home before heading in.

Pumping while breastfeeding 

Pumping as often as your baby eats is really only practical when you’re either exclusively pumping or pumping when you’re away from your baby. If you’re pumping to try to build up your supply of stored milk, but you’re breastfeeding at the same time, other strategies, like pumping the breast your baby isn’t feeding from, pumping after a feeding, or pumping a few times a day in the middle of the biggest gaps between feedings may be more effective. If you’re pumping while breastfeeding, and are hoping to boost the amount of milk your body is producing, adding an extra pumping session either late at night or in the early morning can help, even if your baby isn’t waking up at these times.

On the other hand, if you’re breastfeeding and pumping and your baby is still waking up regularly during the night, nighttime can be a good time to let go of the schedule a little. By only pumping after waking up with your baby during the night, you can encourage milk production without giving up one of the most powerful assets in a parent’s back pocket – sleep. 

Pumping with a newborn in the NICU

Pumping with a newborn in the NICU can be very emotionally challenging, but it can have immense rewards, both for mom and baby. Breast milk can help premature and sick babies fight off illness, and pumping can help parents feel more in control, like they’re doing something concrete to help their babies. Just like pumping to feed any newborn, a schedule of pumping times that are 2 to 3 hours apart, or 8 to 12 times a day, is ideal. However, especially after giving birth to a premature baby, it can take a little extra time for your body to start producing enough milk. This can be difficult, but it shouldn’t be a reason to stop trying.

The early breast milk that is produced for premature babies is slightly different from other breast milk in that it’s high in protein and minerals, packed with antibodies, and is generally full of nutrients to help promote growth and health.

Hospitals generally have pumps you can use there, and the hospital is a great place to start to get the hang of pumping, since you’re right near nurses and lactation consultants who can help walk you through the process and offer any help you might need.

Reviewed by the Ovia Health Clinical Team

Sources

• Mayo Clinic Staff. “Breast-feeding and pumping: 7 tips for success.” Mayo Clinic. Mayo Clinic, April 8 2015. Web.
• “Providing Breastmilk for Premature and Ill Newborns.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.

Why does decreased milk supply happen?

Decreased milk supply can happen for any number of different reasons, and often is totally reversible, with a little time, patience, and creativity. Common reasons you might be experiencing a decrease in supply include:

• Hormonal changes: Like your period returning. Sometimes, the return of your period can cause a drop in milk, either during menstruation or continuing after your period ends. In other cases, parents report that their babies breastfeed less during menstruation, causing a drop in supply due to the drop in demand.
• Physical changes: Changes in your body like illnesses can cause a temporary drop in milk production. Some medications you might take to treat an illness, including certain over-the-counter cold medications, can also affect milk supply.
• Emotional changes: Stress can have a negative impact on milk supply, and having a baby can be stressful! It’s not always easy to find a way to slow down and take some time to yourself with a baby, especially if you’re breastfeeding, but finding a way to relax can have a big positive impact on breastfeeding.
• Changes in schedule: Some changes to your breastfeeding patterns, like returning to work, or Baby starting to sleep through the night, are out of your control, but unfortunately, they can still affect your milk supply. Stimulation is what prompts your body to produce milk, and increasingly long periods of time without it can definitely lead to smaller supply.
• Lack of stimulation: Breast stimulation, and emptying the breasts of milk, are the factors that signal to the body that it’s time to produce more. Supplemental formula feeding for longer periods of time, offering a pacifier instead of a breast for comfort between feeding times, or the end of a growth spurt leading to a decrease in feeding times can all cause supply to go down.

What can I do about decreased supply?

In many cases, it’s possible to boost supply after it starts to fall, but it can take some time, so it’s important not to give up if you don’t see results right away. There are a few ways you can help encourage your body to produce more milk, and one of the most underrated, important ones is to make sure you’re as healthy as you can be. This means making sure you’re eating a healthy, balanced diet, getting all the hydration you need, and getting as much sleep as it’s possible for you to get with a new baby.

Beyond general health, the most effective strategy for boosting your milk supply is letting your body know that there’s a demand for more milk by increasing breast stimulation. There are a few different strategies for doing this, some of which may be more or less effective for your family’s schedule.

• Cluster feeding: When a baby naturally cluster feeds, or feeds more often and in shorter bursts during or leading up to a growth spurt, it signals to the body that it’s time to start producing more milk. You can help to create that same effect in a few different ways. You can use a breast pump to do some cluster pumping, or just offer your baby the chance to comfort feed instead of using a pacifier when your child is upset. If your little one isn’t used to frequent feedings like this, or is easily distracted when not feeding hungrily, you can try having these added feedings somewhere dim and quiet.
• Finish it off: If your little one is done feeding before your breasts are empty, but you’re still trying to boost supply, try pumping out what’s left. If left in the breast, the protein in leftover milk can suppress your milk supply.
• By hand: If sore or cracked nipples make you reluctant to add extra pumping to your schedule, you can try hand-expressing milk between feeding sessions, to add stimulation in a more gentle way.
• Pump it up: Pumping milk when your breasts start to feel full, even if your baby isn’t nearby, or isn’t hungry, can encourage your body to produce more. If you’re going to be away from your baby for a significant amount of the day, like, for example, for work, if you have the chance to pump every 3 or 4 hours or so, that can make a huge difference. Keeping the pump on for 5 to 10 minutes after your body stops producing milk may also help, as can massaging your breast as you pump.
• But in reverse: It can be a tiring option, so it may be best to save for a last resort, but if you’re having trouble keeping your supply up after going back to work, you can try reverse-cycle feeding for a while. This means feeding your baby most meals during the night. This serves the double-purpose of keeping your milk supply up by having lots of feeding times while you’re home, and also by cutting down on the amount they need to be fed expressed milk during the day.

There are plenty of natural remedies that have been discussed as ways of boosting milk supply, but one of the most widespread and widely approved of ones is oatmeal. There is no scientific proof that eating oatmeal will boost milk supply, but there are a wealth of first-hand accounts of women who have found it helpful. This is thought to be because of the high amounts of iron in oatmeal, since new moms are often low on iron after delivery. Since oatmeal is healthy and doesn’t have any negative side effects (except potentially for people with celiac disease), there’s no harm in trying it out. Oat milk, oat flour, and oatmeal cookies also might be helpful for boosting milk supply.

For very low supply, some prescription drugs have been known to help increase milk production. These medications do have potential side effects, and are only available by prescription. If you’re interested in trying a medication to help increase supply, you can talk to your healthcare provider about whether or not they’re right for your situation and your body. 

Is my milk supply really decreased?

Finally, a lot of the time, it’s easy to start to worry about a drop in milk supply when, in reality, nothing is wrong at all. As long as your baby is gaining weight, and producing a normal amount of dirty and wet diapers, your supply is probably fine. Signs like not feeling the letdown of milk or engorgement of the breast as strongly or as often aren’t necessarily signs of a problem at all, and may just mean that your body is getting used to breastfeeding. If you’re not sure if you’re experiencing a decrease in supply, your doctor or your baby’s pediatrician may be able to help you figure out if anything out of the ordinary is going on.

If you have questions about your health or your child’s, Ovia’s team of skilled nurses are available by in-app chat, and can send personalized advice right to your phone.

Reviewed by the Ovia Health Clinical Team

Sources

• Elana Pearl Ben-Joseph. “Breastfeeding FAQs: Supply and Demand.” KidsHealth. The Nemours Foundation, February 2015. Web.
• Elizabeth LaFleur. “What causes low milk supply during breast-feeding?” Mayo Clinic. Mayo Clinic, September 22 2015. Web.
• Decreased milk supply.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.
• “How can I increase my milk supply?” La Leche League International. La Leche League International, June 21 2011. Web.
• “Supply and demand.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.

What TSA and international regulations allow 

Both the TSA in the US and the European Commission’s department of Mobility and Transport limit liquids that are allowed in passengers’ carry-on bags to an approximately equal amount – 3.4 ounces allowed by the TSA and 100 ml allowed by Mobility and Transport. Different countries have different regulations for liquids allowed on airplanes, but this amount is fairly standard. It’s also pretty limited, but in the US, breast milk, like baby food, is an exception to the rules against liquids, although it does have to be declared to and searched by the TSA.

Breast milk is exempted under the rule against carrying liquids or gels onto an airplane, but gel ice packs used to keep that breast milk fresh in a cooler are not. Gel ice packs that are frozen solid are sometimes but not always allowed through, since they can melt back into their gel state. To avoid risking running into an argument over ice packs, you can use hard-sided ice packs or fill plastic bags with ice that can be thrown out before going through security and then refilled by a restaurant beyond the gate.

For very long flights, or to avoid having to change the ice, it’s also possible to pack breast milk with dry ice. Dry ice may be necessary to keep breast milk frozen on flights lasting longer than 12 hours, but it can also be a dangerous substance, so if you’re considering using it, always make sure to wear heavy gloves, glasses or goggles, and to only handle dry ice using tongs.

Declaring breast milk may involve calling the airline ahead of time, as well as telling the gate agent that it’s there directly when you reach security. Separate breast milk from other liquids in preparation. When you’ve declared your breast milk, the TSA or airport security agent will send it through the X-ray machine. The TSA’s website reports that there are no proven negative effects to X-raying breast milk. However, if you feel uncomfortable letting breast milk be X-rayed, it is within your rights to request an alternate search. Instead of X-raying breast milk, an agent may search you more thoroughly, including a pat down and a bag search. Many of these regulations also apply to baby food for when your baby is a little bit older, and ready to move into the next stage of development.

A breast pump doesn’t count as your carry-on bag because it falls into the category of medical equipment. However, the cooler used to carry breast milk generally will count as a carry-on.

TSA regulations allow for carrying breast milk even if you’re not traveling with your child, but airports in the European Union only allow breast milk in larger quantities than 100 ml if you’re traveling with your child. Other countries like Japan, Australia, Brazil, and the United Arab Emirates have policies closer to that of the European Union than the US. If you’re traveling internationally, you can make your trip run much more smoothly by calling the airline you’re flying with to check the specific regulations and policies ahead of time.

Trouble with the TSA

Although the TSA regulations state that it’s fine to bring breast milk onto airplanes as long as it has been properly searched, there are still cases where parents run into problems while traveling, often because the security agents they meet may not be familiar with the regulations surrounding breast milk. While it isn’t always possible to avoid these situations, calling the airline you’ll be flying ahead of time to confirm the rules and regulations surrounding flying with breast milk and printing out a copy of TSA guidelines can help you avoid or navigate difficult situations.

Sources

• Robyn Roche-Paull. “Traveling with Breast Milk.” Breastfeeding Today. La Leche League, May 7 2016. Web.
• “10 Tips for Traveling with Breast Milk.” Children’s MD. Children’s Hospital, St. Louis, February 25 2013. Web.
• “Liquids, aerosols and gels.” European Commission. European Commission, November 18 2016. Web.
• “Liquids Rule.” Transportation Security Administration. Department of Homeland Security. Web.
• “Traveling with Breast Milk.” Children’s Hospital of Philadelphia. Children’s Hospital of Philadelphia, 2016. Web.
• “Traveling with Children.” Transportation Security Administration. Department of Homeland Security. Web.
• “Travel Recommendations for the Nursing Mother.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, June 17 2015. Web.

The immune system benefits that are transmitted through breast milk don’t have a definite end-date, which makes answering the question of a cut-off date difficult. During the first few months of their lives, babies’ immune systems are the most immature, and so may benefit the most from the shared immunity that comes from breastfeeding. Shared immunities and antibodies can still help protect older babies and toddlers as they grow, though. Additionally, breast milk has antimicrobial components that help to fight against infections.

After parents start to introduce complementary foods and early solids, usually around 6 months old, breast milk consumption often starts to go down on its own, although some babies continue to feed as much as before. Every family who breastfeeds is unique. Whether you and Baby breastfeed right up until the switch from breast milk to cow’s milk at age one or beyond, or the switch happens before a year old as Baby transitions to formula, having breastfed will always be an important early chapter in your lives together, and as your baby grows, you’ll find different ways to keep them growing steadily and healthily.

Reviewed by the Ovia Health Clinical Team

Sources

• American Academy of Pediatrics Policy Statement. “Breastfeeding and the Use of Human Milk.” Pediatrics. 129(3). Web. March 2012. Web.
• “Breastfeeding: Frequently Asked Questions.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, June 16 2015. Web.
• “How long should a mother breastfeed?” La Leche League International. La Leche League International, January 9 2016. Web.
• “How to decide when to stop breastfeeding.” NCT. NCT, 2016. Web.
• “Learning to breastfeed.” Women’s Health. Department of Health and Human Services. Web.