10 Questions with a Lactation Consultant

Breastfeeding can be hard. Some of us have tried it and had no problems at all, but going through parenting boards and Facebook groups and mommy blogs, it seems to be one part of motherhood that so many of us had no idea would be so challenging. From problems with latching to concerns about over or under production to finding the right technique, it’s not as straight forward as we all once thought it would be. So we caught up with professional Lactation Consultant Rose Le Blanc (IBCLC, CPD) www.roseleblanc.com to ask the questions you know you want to know about breastfeeding.

photo: Benjamin Magaña
photo: Benjamin Magaña

1. Why is breastfeeding so hard?

We never see women breastfeeding any more. Long ago when we lived in close-knit communities, women and girls were surrounded by breastfeeding women most of their lives – consistently seeing the latching, positions and techniques involved. Our society is now so removed from breastfeeding women, that often times when women have their first baby and begin breastfeeding, they feel at a loss as to how to latch and manage a feed. The confidence is not there, and this is mostly because they are doing it/seeing it for the first time. I think this is one reason; other reasons include hospital births where c-sections, use of narcotics and hours of intravenous fluids are the new normal. Such situations set up babies for a slower start, with less access to the breast and more trouble latching. Babies are born swollen with these intravenous fluids and are weighed within minutes of birth only to lose most of the fluids in their diaper later on. These early weigh-ins are often the reason in the next 1 to 3 days for higher than normal percentages of weight loss, leading to unnecessary introduction of supplements in the hospital. I see this all the time!

2. Most people don’t hear about the difficulty until they’re actually about to have a baby or are starting to try to breastfeed, why is it such a well kept secret?

There is a lot of focus on the pregnancy and labour/delivery. I think it’s mostly because of the fear around labour and delivery, the unknown of when it’s going to happen and how it is going to feel. Many assume that their bodies are made for breastfeeding ,so there shouldn’t be any problems/questions – it should just happen.

I think this also goes back to our culture of not seeing breastfeeding on a regular basis. When we don’t see it, we don’t think about it.

3. What may hinder the ability to breastfeed?

Besides the issues that come about from my answers to question #1, about 50 per cent of my clients have babies with a tongue tie. Others babies have tight jaws likely due to birth which restricts their ability to open wide at the breast, causing nipple pain and sometimes decreasing milk supply leading to inefficient transfer of milk. Most of my clients have multiple reasons for their difficulties, and this is where my job becomes similar to an investigator – working to find all the pieces of the puzzle to solve the case. Once the case is solved, we figure out together what the most suitable plan is based on the client’s breastfeeding goals.

4. Does age – specifically ‘advanced maternal age’ have anything to do with how well I will be able to breastfeed? 

I don’t believe age is an issue. I’ve had clients of all ages and anecdotally, I can say there is no correlation between age and milk supply, for example. I also think it is dangerous when LC’s make such assumptions because, as I said earlier, there are usually multiple reasons for the breastfeeding problem. When we focus on age (something we can do nothing about), it takes away from the pieces that we can solve.

5. Is it true that a breast reduction or implants will affect your ability to breastfeed?

Sometimes they cause problems with supply and sometimes all goes fine. It really depends on whether major glands were damaged or not. Often times it is how the surgery is done – incisions furthest from the nipple and smallest are best. I don’t like to prejudge about the situation when first see a mom. What is most important is watching a breastfeed to see what the baby is doing at the breast – drinking well or not so well and why gives me the most information.

6. What helps bring up milk supply?

Babies are the best at maintaining good milk supply. Feeding on demand with both breasts at each feed – when your baby is showing hunger cues (hands to mouth, smacking lips, licking lips) is the best way to maintain good milk supply. It is normal to experience a number of growth spurts in the first year and with these growths spurts comes a baby that is feeding more frequently. Frequent feeds bring an increase in milk supply. If you feel like you don’t have enough, simply managing the feed differently can bring on more – compressing your breasts and offering multiple sides during feeds. If this doesn’t work, seeking help from a good LC is important.

7. What might hurt milk supply – is there any food, or over-the-counter medications to avoid?

Oral antihistamines, oral decongestants such as pseudoephedrine (sudafed) and hormonal birth control can cause a decrease in supply. In general, if you have a cold or allergies when breastfeeding try to use medications that can be taken as a nasal spray, eye drops or ointment. With birth control, it’s best to go with a non-hormonal option while breastfeeding, such as a barrier method or copper IUD. Otherwise, most medications are safe to take. A good place to check to be sure your medication is safe to take while breastfeeding or won’t affect milk supply is motherisk.org

8. Is there anything I can do to help save my breasts from the effects of breastfeeding?

Studies have shown that it is the breast changes that occur during pregnancy along with genetics that cause the shape/size of your breasts post-breastfeeding, not breastfeeding itself. However, there is hope as the pectoral muscles are what support and control the way your breasts hang. Working your pectoral muscles more with weights and natural movement when your body is ready can help bring your breasts back to their pre-baby state. Also, avoiding underwire and heavily padded bras can help avoid gravity’s pull on your breasts. Such bras take away the work and natural loads your pectoral muscles are meant to do and support leaving these muscles to atrophy. When muscles are no longer used, the tissues they support (the breasts in this case) lose the elasticity they once had.

9. Does breastfeeding really help lose the baby weight?

For most women breastfeeding does help them lose baby weight, but certainly not all. Studies show that our bodies burn approximately 20 calories per ounce of breast milk produced. So, if a baby eats 20-30 ounces a day, that’s anywhere between 400-600 calories burned. Much of it depends on your metabolism and how fit you were before pregnancy. This said, I always say to my clients to be gentle with your body and give it time to heal, especially in the first year after birth. Walking and carrying your baby are great exercises to do. Jumping back into a workout routine too early, particularly one that is high impact and/or core focused can damage your pelvic floor.

10. If I have problems breastfeeding one baby, does it mean I won’t be able to breastfeed my next?

With each pregnancy brings growth of more milk glands, and so typically more milk is produced after each consecutive pregnancy. The mature milk often comes in earlier within the first week with the second child as well – helping you get off to good start. It’s certainly worth giving it another try with that extra boost of milk. However, every baby is different – latch, use of tongue and sensitivity to changes in flow. You never know what you’re going to get! 🙂

rose-le-blanc-colourRose Le Blanc is a Lactation Consultant (IBCLC, CPD)
She can be reached for appointments and consulting at 416-454-5307, and offers a free, no obligation phone consultation. She has worked with the renowned lactation expert, Dr. Jack Newman and together they developed a clear and concise resource guide app for breastfeeding families and Lactation Consultants, Physicians, Nurses and Midwives who support breastfeeding families. Visit the site for more details. www.roseleblanc.com

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