Dear Lactation Consultant:

I love my in-laws but I am not looking forward to the pressure I anticipate from them when it comes to breast feeding. They are older, from another country, did not breast feed their five children and already I am hearing talk about buying a scale so we know how much weight the baby is gaining since we will not be able to see what the baby is getting from my breasts.  What should I do so I don’t insult them?

Marina Maravilla
Glendale, CA

Dear Marina:

Yours is a very common concern and I understand your anxiety.  I often find asking your pediatrician or lactation consultant to spend a few minutes with your in-laws to discuss their interest in their grandchild’s feeding, which hopefully will make them more comfortable.  Take them to a prenatal breastfeeding class with you, if you do not feel they are imposing on your private time.

Dear Lactation Consultant:

I am so confused. I just came out of my local Babies R Us unsuccessful in my intent to purchase a breast pump.  There are so many available that I didn’t know which one to get. Prices vary greatly and I know some manufacturers tend to be more reliable than others, but I am totally confused. I know I want an electric pump, but other than that, I am lost as to which is the best.  What would you recommend?

Jane Penshaw
The Woodlands, TX

Dear Jane:

I don’t blame you for your confusion.  What you need to do is ask yourself the following questions:

• 1. What is the purpose for pumping?
  •     a; are you returning to work or school and will need to be pumping at least several times a day, all week long?
    
  •     b; will you be pumping so baby gets a bottle a day and perhaps an occasional extra one?
    
• 2:  What is your budget?
  
• 3:  Have you contacted your health insurance to see if they will cover any part of the pump cost?  Some companies will reimburse you for rental pumps only.  Other companies will reimburse for “expendible goods” (purchased pumps), so you definitely want to check on this before investing.
  
• 4:  Does your employer have a lactation program?  More and more companies have programs that include pump rentals. In Los Angeles, for example, The Dept. of Water and Power has a program where they will give the employer or spouse a rental pump to use as long as she is working and breastfeeding.  What a great deal!

Dear Lactation Consultant:

My baby is 3 weeks old and has become extremely fussy over the last week.  She gets very hungry, latches well, but after 3 or 4 minutes starts wriggling and pulling.  I take her off because she is hurting me and relatch her but she’ll continue to do herky-jerky nursing (I hear her swallowing so I know she is getting milk) for about another 3-4 minutes, then she pulls off and cries uncontrollably.  I have tried burping her, sometimes as long as 10 minutes and sometimes I will get a burp (dry) but most of the time she spits up a lot.  After calming her (this usually takes about 10-20 minutes) she goes to the other breast without fussing, for about 15 minutes.  She usually falls asleep, but I feel it’s important to burp her and the burp is usually spit up. She does go back to sleep after that.  Her poops are always green and she poops at every nursing.  She only takes cat naps and wants to eat every hour to hour and a half.  We are going to see the pediatrician next week but I thought I’d ask you first because you have been so helpful when I have called you with questions in the past. I’m glad you have the blog up and running now so I don’t always have to call you.

Sincerely,

Susan Sweet,
Great Neck, New York

Dear Susan:

First of all, you never have to feel guilty for calling me with questions, but I also like the blog because it is a way to share common concerns with all our readers. From what you are describing and from other questions we have discussed before (foamy poop, blood in her stool)  it sounds like your baby may have a true dairy protein allergy.  Although not always the case, it is usually hereditary, so if there is a family history of such an allergy, it would make my assumption more likely.

Dear Lactation Consultant:

I have a real problem. I have checked out your website and I feel you are the kind of person I can talk to about it. Please do not judge me like so many others have. I am pregnant with baby #3. I am a smoker and did not breast feed my other 2 children because I was told by their doctor that it was bad for them. But thinking I might want to try this time. I took a breast feeding class where I learned it would be healthier for the baby to be breast fed than not to be. I asked the pediatrician and he said absolutely not so I was wondering if you had anything to back up the breast feeding teacher’s comment. I emailed her but she has not gotten back to me yet.

Kay Lewis
Brooklyn, NY

Dear Kay:

There is plenty of evidence that breastfeeding is even more important for babies of smoking moms since the breastmilk can improve some of the ill effects of second hand smoke. The protection provided by breastmilk will hopefully prevent against asthma, pneumonia, ear infections and even SIDS, all of which babies of mothers who smoke are of greater risk of. Your baby will develop appropriate immune responses to protect her and these responses can only be gotten from breastmilk, not from formula.

Dear Lactation Consultant:

I am expecting my second child any day now and although I successfully breastfed my first for one year, my one major problem was chronic mastitis. There were no lactation services in my local area but I have since moved and there will be help available this time, yet I am still very nervous. Last time my doctor kept giving me antibiotics, which after a while were not even working and I am afraid they may have had an effect on my son as well. I really do not want a repeat of this situation this time. What do you think I should do to prevent a repeat?

Lynn Rice
Saskatchewan, Canada

Dear Lynn:

Take a deep breath and be thankful you are now living in an area where you will be able to get lactation assistance. It can mean all the difference to you and you should try not to worry.

I have a few questions to ask you that might shed some light as to why you had recurring mastitis:

Dear Lactation Consultant:

I am due to have my baby in about a month and everything I have been taught in my breast feeding class, (which, by the way, I did not take in the hospital I will be delivering at because I was warned by friends not to,) encourages putting the baby to the breast immediately after it is born, unless there is a medical reason not to. When we went on the hospital tour, we were told that the baby goes to the nursery after delivery and that I will not be able to breast feed until we are in our post-recovery room. What can I do to keep my baby in the delivery room so I can breast feed?

Amee Ashton
Washington, D.C.

Dear Amee:

You are asking for an answer I am often asked, but one which is difficult to reply to without repercussions, as every hospital has their own policies when it comes to how long the baby can stay with you after delivery. If the hospital is baby-friendly, there is no issue, as the baby will remain with you for at least an hour, but otherwise it be anything from what you might experience to 15-20 minutes to a full hour. Working in Los Angeles, where most hospitals allow babies to breastfeed immediately after birth, it is indeed frustrating to hear of your situation. Research has shown over and again that encouraging good breastfeeding, which includes getting off to a good start quickly after delivery, putting the baby to the breast skin to skin and allowing the baby to remain that way for as long as possible will lead to success at the breast when the baby has become interested after they recover from the labor experience, which may be as long as 72 hours later.