Cygnus Lactation Services: Breastfeeding Q & A

How can moms bring in enough breastmilk to feed twins?

Many people are surprised to hear that moms can exclusively feed twins (or even triplets!) without needing to supplement with formula. The truth is, in the absence of medical problems, mothers’ bodies are quite capable of bringing in a full milk supply for both babies!
Key factors in establishing a full milk supply are nursing the babies early (as soon after birth as possible, preferably within the first hour) and often (8 – 12 times for each baby ). During the early days after birth, your milk supply will increase rapidly based on how often and how thoroughly your breasts are drained.
If the babies receive supplements during this time, it can interfere with your body’s ‘assumption’ of the amount of milk your babies need. Milk production is finely balanced based on demand. If either baby does need to be supplemented with formula for any reason, then it is very important that the mother use a hospital grade breastpump to drain the breasts and stimulate milk production in the baby’s place.
If babies are not able to nurse directly in the early days, then it is very important for mom to have access to a full-size hospital grade breastpump as quickly as possible after birth, so that she can stimulate her milk production. Early and frequent pumping is just as important as early and frequent nursing in cases where either baby is unable to go to the breast!
As babies grow, the breasts will adjust the milk supply level based on their needs! Feeding twins becomes easier as time goes on, especially if both babies can be nursed at the same time. Finding a good support person to help with positioning and technique is especially valuable for moms of twins!


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Previous question:

Can my baby be allergic to my milk?


The short answer to this question is: No! A baby who was allergic to his mother’s milk would have also reacted to his mother’s amniotic fluid and would not have survived the pregnancy. It is physically impossible for a baby to be ‘allergic’ to his or her mother’s milk!

That being said, it IS very possible for a baby to react to certain foods that her mother has eaten! Babies who are sensitive to something in their mother’s diet may develop skin rashes, unhappy / colicky behavior, or blood and/ or mucus in their stools. While there may be other causes for these symptoms, it’s usually a good idea to take a look at mom’s diet. One of the most common sensitivities that babies have is to cow’s milk (or other dairy products) in mom’s diet. Because dairy is so prevalent in our diet, it can take a few weeks of avoiding dairy before it is totally out of your system. If you suspect that it may be causing a problem for your baby, be patient for at least two weeks after eliminating it from your diet to see an improvement in your baby (sometimes improvement will be much faster). Aside from dairy, other common food allergens include soy, nuts, peanuts, and citrus.

The most important thing to keep in mind is that most babies do not react to the proteins that pass into their mother’s milk. Only a minority of babies have this problem.

Some adults who have trouble eating dairy products confuse lactose-intolerance with dairy allergy. These are actually two very different things. Lactose intolerance often occurs as we age and our bodies lose the enzymes necessary to properly digest lactose. This results in feeling gassy and bloated after eating dairy products. Because many babies are naturally gassy and sometimes uncomfortable, it has often been mistakenly assumed that babies can be lactose intolerant as well. This is also not true! Lactose is the main sugar used in brain development, and is very important to infants! Infants are born with plenty of the enzyme (lactase) needed to metabolize lactose. It is only as we age that some of us lose the ability to produce this enzyme – primarily because it is no longer needed past infancy.

There are certain conditions under which babies can get an overload of lactose in breastmilk, that can cause some discomfort and ‘explosive’ stools, but this is generally a temporary condition and will correct itself over time. This can happen when babies get too much ‘foremilk’ (the first milk out of the breast) without getting enough ‘hindmilk’ (the higher fat-content milk that comes as the baby continues to nurse on the breast). The best way to avoid this is by allowing the baby to finish one breast before offering the other, rather than switching sides based on time. Lactose overload can also occur following some illnesses or antibiotics, when the gut is slightly damaged and has a hard time keeping up the proper enzyme levels. This will correct itself with time and does not require weaning or special formulas.





Copyright 2006 Cygnus Lactation Services

February's question was:
“Should I continue to breastfeed if I’m sick?”
This question was posted before, but is worth a repeat this time of year!

This is a question that arises frequently, no matter what the season. The good news is that the answer is almost always “YES!”

When you have been exposed to a virus, whether a ‘common cold’, “the flu”, or “the stomach flu”, your body begins to produce antibodies to the virus – even before you begin to have symptoms! This is the good news.

The bad news is that you also begin to shed viruses… even before you show any symptoms of being ill. What this means is that your baby has already been exposed to whatever virus you have picked up, before you were even aware that you were coming down with something!

The BEST thing for your baby, then, is to continue to breastfeed so that your baby will have the full benefit of all of the antibodies that your body has already been creating against that specific virus! In fact, the worst possible time to withhold your breastmilk from your baby is when you have an illness – because your baby has already been exposed, and without these antibodies is at a much higher risk of becoming seriously ill.

So, while your baby may in fact catch the virus you are carrying, their illness will likely be much shorter and milder… and they may in fact escape illness altogether due to the antibodies you are providing to them through your breastmilk!

Be sure to care for yourself as much as possible during your illness. Drink lots of fluids and get lots of rest. Contact your doctor immediately if you are unable to keep fluids down or are running a high fever. Many medications, including most antibiotics are compatible with breastfeeding – be sure to check with your doctor, pharmacist, or lactation consultant regarding information for a specific medication.

Breastfeeding during illness can be the easiest way to continue to feed and comfort your baby while caring for yourself… and it is also the best possible protection for your baby!


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January's Question was:
How can I get my baby back to breast after I’ve had to stop breastfeeding for a period of time?

There are many factors that can affect this return, including the age of your baby, and your overall milk supply. If you’ve been able to maintain your milk supply through pumping, then the process will be much easier. If you’ve temporarily weaned, and have not maintained your milk supply, then the process will be a little more complicated – but can still be done!

Skin-to-skin – plan to take some time to just cuddle your baby, skin-to-skin. Make sure the room is warm enough for you both to be comfortable, and snuggle the baby against your bare chest, with the baby only wearing a diaper. You can drape a blanket over the two of you if you desire. Do not try to latch your baby during this time – rather just enjoy the time of closeness. If your baby tries to latch on, then allow them to do so – but don’t try to force anything!

Use infant massage techniques to help relax and calm your baby. When they are relaxed and content they may start showing feeding interest at the breast.

Baby may be most receptive to returning to the breast when they are sleepy and content. Sometimes holding them at the breast once they are already asleep will trigger the reflexes of nursing and they will latch on.

The WORST time to attempt this is when the baby is very hungry! When they are tired and hungry they do not want to do things differently than they have been doing them. Attempts at breastfeeding now may cause the baby to rebel more vigorously at the breast in the future.

Work to increase your milk supply. If you suspect that your supply is low, contact a lactation consultant (IBCLC) in your area, and work with them to find the best way to increase your milk supply. Babies are naturally most willing to go where abundant milk is!

Learn ways of supplementing your baby AT the breast if low milk supply is an issue. There are often great ways of transitioning a baby back to breast while also working on increasing your milk supply.

If you and your baby continue to struggle, contact a lactation consultant (IBCLC) who can work with your and your baby together to get feeding back on track for both of you!


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December's question was:

Why does my milk sometimes appear watery or an odd color?

Human milk looks very different from the homogenized & pasteurized cow’s milk that we are often used to seeing. Because baby humans have very different needs from baby cows, this is not surprising! Human milk varies in fat content from mother to mother, and also by time of day, time since the baby last fed, etc… this is why your milk may look different at different times. Also, when milk is allowed to sit for any length of time, the cream will naturally rise to the top. The color of human milk also varies, and can change slightly depending on what mom has been eating. Normal human milk often appears blue-ish or yellow or orange… but can take on a variety of different hues, especially if mom has eaten foods with artificial colorings in them! (Kool-aid can often dramatically change the appearance of breastmilk!) Regardless of the appearance of color, you milk is still perfect for your baby!!



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Novemeber's Question was:

Does it really matter which breastpump I use to increase my milk supply?
Yes, it is important to use the right type of pump for your particular situation. Ideally, the best way to raise your milk supply is by having your baby nurse more frequently, but there are times when this is not possible – perhaps your baby was born very early and is not yet able to breastfeed, you are separated from your baby, or your baby is not able to efficiently drain the breast. In these circumstances, a pump can be used to protect and increase your milk supply, but it is important to use a good quality pump. Hospital grade rental pumps are often the best option especially in the early days of lactation if the baby is not able to go to the breast. These pumps have the proper suctions and speeds to help increase milk supplies while also keeping mom comfortable. Suction is NOT the most important factor when looking at a breastpump. In fact, more suction does NOT equal more milk – and suction that is too high can cause pain and even damage mom’s nipples. What is more important is a smooth suction and release, and the proper number of cycles (sucks/releases) per minute. When babies feed at the breast, they tend to average about 65 sucks/ minute. Ideally the pump you use should be able to match this, and also have an adjustable suction setting that allows for adequate but comfortable suction.
Many inexpensive breastpumps have much lower cycle speeds. While the suction may be adequate, the cycles may be as low as 10-15 per minute. This does not trigger the appropriate let-down response in the breast, and therefore does not allow the breast to thoroughly drain. This, in turn, will result in a drop in milk supply. This type of pump may work for some women on an occasional basis, but when used regularly will not protect a mother’s milk supply, and will likely decrease it dramatically.
When looking for the right pump for you, it is best to talk to someone knowledgeable about your situation and the various pumps – preferably a lactation consultant. Questions that you be discussed are:
How often are you planning to pump?
Why are you pumping – is it just for a night out, or is it because your baby is unable to go to breast?
What are the features of the pumps you are considering?
How many cycles per minute does the pump provide? Is this adjustable?
Matching the best pump to your situation is very important for your long-term breastfeeding success!



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October's question was:

My doctor told me that the breastmilk offered no benefits for the baby after 6 months – is this true?

No – this is not true! Beware anytime you hear that breastmilk ceases having benefits after a particular amount of time (3 mos., 6 mos., 1 year, 18 mos. Etc.). How long you choose to breastfeed your baby is an individual decision, but please be assured that as long as you are breastfeeding, your baby is reaping important benefits from your milk! The American Academy of Pediatrics recommends breastfeeding your baby exclusively (meaning no other food or supplements) for 6 mos., before introducing solids… and continuing to breastfeed for at least the first year – and beyond if comfortable for you and your baby. The immunities provided by your breastmilk change over time depending on what you and your baby are exposed to. There are also factors in your milk that help mature your baby’s own immune system as well! Your milk becomes higher in calories over time to continue to meet your baby’s energy demands, and your milk is always easily and completely digestible. Breastmilk also lines and protects your baby’s intestinal tract against a variety of harmful bacteria, helping to prevent diarrhea and tummy upsets.


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