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Top 5 Questions Lactation Consultants Hear

Written by Carla Shirer


Posted on June 02 2019

Our very own in house lactation consultant in LA, Carla, shares her boobalicious knowledge with our clients.  I asked her what questions she gets asked.  Remember, she gets asked by people InRealLife, who are standing in front of her, so, listen to yourself and find an InRealLife consultant or your doctor or midwiffe if you are concerned.

And, a word on breastfeeding-it's your choice.  Most moms we meet want to try to nurse their baby, and we encourage that. AND we counsel moms daily assuring them that they are not a bad mother if nursing doesn't work for them.  Momming is hard enough without feeling shame or failure.  

Happy and healthy mom is best for baby.

#1 My milk has not come in, should I use a breast pump?

Should you?  Sure, no reason not to.  And no reason to panic either. Stimulation of breasts through the baby sucking or the pumping action of a breast pump helps bring in your milk.  Let baby suck, especially in the beginning, because breast is where they're going to get the colostrum.

The first 24 hours are when your breasts produce colostrum-a superfood which is a yellow, sticky fluid that builds a strong immune system, coats the digestive tract, acts as a laxative, prevents jaundice--kick starts the liver, and is a complete protein meal. Good stuff.  

#2 Is my baby getting enough milk?

Your baby's stomach is approximately the size of its fist. A good way to measure intake and output is to count wet and dirty diapers. The old saying "What goes in must come out" is a true adage. 4-6 wet diapers and 2 dirty diapers is a good count for newborns.

Again, every baby is different. Is your baby gaining weight?  The above is a guide, not a rule. 

#3 My baby seems hungry after I nurse should I supplement with formula? 

This is a complex question and depends on different factors.

If your baby is not gaining weight as your doctor thinks is appropriate than the answer is yes, yes and yes and just ignore anyone who looks at you askance.  They apparently do not have enough of their own business to mind.  Feeding your baby is best. 

Consider these factors. Some moms are instructed to nurse for 15 minutes on each breast. This is flawed advice. The first 15 minutes the milk is foremilk which is thin and pale blue. It is satisfying the baby's thirst. The next 15 minutes is the hind milk which is golden, thick and rich. This is satisfying the baby's hunger. It is packed with much-needed calories and nutrition. So let baby empty one side before moving on, or they will not get the hind milk. How long does that take?  Again, it's different for each mom.  Thirty minutes is average.

Some well meaning people will tell you that supplementing with a bottle can cause nipple confusion where the baby refuses to take the breast. And, this can happen. The nipple on a bottle can be like a fire hose. The baby just presses it with his tongue and fluid pours out. So, pick your nips - make sure that the nipples are slow flow to avoid nipple confusion. See.  That was easy, eh?

#4 When do I use a breast pump?

So, when or why?  Most moms ask "When?" and what they really are asking is "Why?"

There are several times when you can use a breast pump if you want to.  Just one of the many places in parenting where there is not a right or a wrong time or place, there is a time and a place that works for you. 

When to pump is up to you-some people pump on one side while baby is nursing on the other-you are just sitting there after all.  If you are away from baby, then pumping when baby is feeding, to continue milk supply, is a good way  to go.

Here are reasons Why you might want to pump:

One reason to use a breast pump is to preserve the supply of breast milk. A secondary reason is to increase the amount of milk produced. A third reason is to have extra milk available for another family member to feed the baby. It's wise to freeze some breast milk for future use, you never know, and having it on hand can be great.

#5 Does breast milk go bad?

Breast milk is fine at room temperature for 5 hours. Just remember the rule of 5's. 5 hours at room temperature, 5 days in the refrigerator, five months in the freezer.

In a formula, bacteria starts forming at room temperature within the first hour and should be discarded after two hours at room temperature. 

#6 Can I wear an underwire bra while breastfeeding?

You can......

Most authorities say "no".

This is because, if Oprah is correct (and, she often is) in her statement that 85% of all women are wearing the wrong size bra, then we're guessing that that number increases to 99% when pregnant or nursing!  Seriously. 

So, if you are in that 99% and are wearing the wrong size and the underwire is pressing on breast tissue, then No, you should not be wearing that bra. An underwire should be against the chest wall and NOT pressing against breast tissue. Underwire pressing against breast tissue can cause painful mastitis which can lead to an infection or clogged ducts. And we would wish those on no one. A new mom's life is complicated enough.  So, easier than saying "Get properly fit", people simply say "No underwires!"  


Got another question for Carla? Find us on FB or IG or if you're in LA come visit her in our LA shop-schedule a time by emailing hello@momstheword.com; come in IRL, get set and styled with nursing tops and dresses and post-partum pants and schedule a mini complementary consultation too!

Nursing consultants play an invaluable role in the lives of many parents.  Most doctors have never taken a course or class on breastfeeding.  Truth.  Crazy. Our Carla is a trained and certified lactation consultant.



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