Frequently Asked Questions about Milk Production

How does milk production change over the course of lactation?

For the first few days, up to and including the point at which mom’s milk “comes in,” milk production does not depend upon milk being removed from the breast. After those first few days, it is necessary for milk to be regularly removed from the breast (via baby or pump) to continue milk production. The breasts will begin to shut down milk production within several days if milk is not regularly and effectively removed.

Foremilk and hindmilk – what does this mean?


The breast only makes one type of milk (which has a relatively high fat content). Because of the mechanics of milk release, the amount of fat in the milk available to baby gradually changes as a feed progresses. As milk is produced in the breast, the fat globules in the milk tend to stick to each other and to the walls of the alveoli (where the milk is made). Between feedings, milk collects in the breasts and gradually moves out toward the nipple, leaving more and more of the fat “stuck” further back in the milk ducts. The more time between milk removal (feeding or expression), the lower the fat content of the milk available to baby at the beginning of the feeding.

Latching and Positioning Resources


No matter what latch and positioning look like, the true measure is in the answers to these two questions:

Is it effective?
Is it comfortable?

Even if latch and positioning look perfect (and, yes, even if a lactation consultant told you they were fine), pain and/or ineffective milk transfer indicate that there is a problem somewhere, and the first suspect is ineffective latch/positioning.

Lactation yoga …side-lying nursing without getting up to switch sides

If you’ve mastered the art of side-lying to nurse, then the next trick is to be able to nurse off the top breast so that you don’t have to change sides of the bed at night. If you co-sleep and breastfeed, then I’m sure you’ve had an experience like mine at some point. You’re all snuggled in, warmly and cozily cuddled with your baby. You are breastfeeding in the side-lying position and drowse off to sleep. waking a while later to find that baby is hungry again, and unfortunately the most convenient breast is the least full one.

Breastfeeding Logs

Under normal circumstances it is not necessary to use a breastfeeding log. However, some mothers feel more comfortable in the beginning if they are keeping track of nursings and diapers. Most mothers will benefit from the safety net of using a log for the first week or so until they and their baby’s health care provider are reassured that breastfeeding is going well and that baby’s weight gain pattern is adequate.

Frequent nursing

Image credit: Jerry Bunkers on flickr

First of all, do know that frequent nursing is normal and expected in the early months – most newborns need to nurse at least 8 – 12 times per day. Frequent nursing is also needed — to avoid/reduce engorgement in the early days, to nourish and grow a baby who has a stomach the size of his fist but who needs to double his weight within 5-6 months, to establish a good milk supply for mom, and to help a baby who has been cradled close and warm inside mom for 9 months adjust to life in the outside world. Frequent nursing may sometimes be a warning sign of inefficient milk transfer or low milk supply, but if baby has good diaper output, is gaining well and is generally happy and healthy, then the frequent nursing is unlikely to be a sign of a problem.

Growth spurts

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Most babies go through several growth spurts (also called frequency days) during the first 12 months. During a growth spurt, breastfed babies nurse more often than usual (sometimes as often as every hour) and often act fussier than usual. The increase in baby’s milk intake during growth spurts is temporary. Physical growth is not the only reason that babies may have a temporary need for increased nursing. Babies often exhibit the same type of behavior (increased nursing with or without increased fussiness) when they are working on developmental advances such as rolling over, crawling, walking or talking. Mom’s milk is for growing the brain as well as the body!

The Distractible Baby

Latch on, suck a moment, pull off… latch on, suck a moment, pull off. Nurse a minute, pull away to smile at mom. Nurse a minute, pull away to see who just walked in the room. Nurse a minute, pull away to listen to the TV. Nurse a moment, pull away because the dog wagged his tail. Sound familiar??

Reverse Cycling

What is reverse cycling?

Reverse cycling is when baby nurses frequently at night and less frequently during the day.

Breastfeeding Your Toddler: What to expect

© Julia Shilova -

Are you considering breastfeeding your baby into toddlerhood and wondering how the breastfeeding relationship will change? Are you wondering if your toddler is trying to wean, or wondering why your toddler is suddenly breastfeeding round the clock? Here are a few observations on typical toddler breastfeeding behavior. As always, the way your particular baby approaches nursing will also depend on her unique personality.

Breastfeeding and Fertility

How can I use breastfeeding to prevent pregnancy?

The Exclusive Breastfeeding method of birth control is also called the Lactational Amenorrhea Method of birth control, or LAM. Lactational amenorrhea refers to the natural postpartum infertility that occurs when a woman is not menstruating due to breastfeeding. Many mothers receive conflicting information on the subject of breastfeeding and fertility.

Getting Pregnant While Breastfeeding

Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond, published by La Leche League International

So you’re breastfeeding and dreaming of a new baby? Good news! Lots of moms are able to conceive a new baby without having to wean their current nursling. Let’s look at seven of the most common questions.
1. Do I have to wean in order to get pregnant?

Let-down Reflex: Too slow?

It is normal for let-down not to feel as strong as your baby gets older. Some mothers never feel let-down, and some stop feeling the let-down sensation as time goes by. This does not necessarily indicate that let-down is not taking place.

Breastfeeding in Public

Breastfeeding in public tends to be controversial. However, if a bottle-fed baby can have her dinner in public, why shouldn’t a breastfed baby have the same rights? I have certainly never seen a public restroom that I would like to feed my baby in! And I’m certainly not going to stay cooped up at home all the time because I’m afraid that my baby will get hungry while we’re gone

Breastfeeding: Legal Issues

Breastfeeding and the Law from La Leche League International. Information on breastfeeding legislation, breastfeeding and family law, extended breastfeeding, breastfeeding in the workplace and more.

Jury Duty?

A call to jury duty can be very worrisome for mothers who stay at home with their young children, particularly those who are breastfeeding infants. Breastfeeding mothers who work and pump for their child will probably have reliable childcare available, but may be worried about whether she would be allowed sufficient time for pumping.

Breastfeeding & Jury Duty – My Experience

I recently completed a week of jury duty service (8/16-20/04) while breastfeeding, and I wanted to share my experience, in case it may help others dealing with the same situation in the future. My daughter, Juliana, was born 5/29/04, and I’m still on maternity leave (as yet undecided as to whether I’m going back to work). I’ve been pumping periodically since she was about a month old, to build up a supply of milk for when I leave the house by myself (to run errands, work out at the gym, etc.), but I’d only ever pumped at home, and not on any sort of regular schedule.

Breastfeeding and Speech Development

Since breastfeeding promotes normal development of the face and mouth, it would make sense that breastfeeding would enhance speech development and help to prevent speech problems. The research on this topic is mixed. Several studies have shown breastfeeding to enhance speech development and speech clarity, and others have shown no speech differences between breastfeeding and bottle-feeding.

Average Weight Gain for Breastfed Babies

© Miroslav Beneda -

A few things to keep in mind when evaluating weight gain

A 5-7% weight loss during the first 3-4 days after birth is normal. A 10% weight loss is sometimes considered normal, but this amount of weight loss is a sign that the breastfeeding needs to be evaluated. It’s a good idea to have a routine weight check at 5 days (baby should be gaining rather than losing weight by day 5), so that any developing problems can be caught and remedied early.

Increasing Low Milk Supply

Image credit: koadmunkee on flickr

First of all, is your milk supply really low? Often, mothers think that their milk supply is low when it really isn’t. If your baby is gaining weight well on breastmilk alone, then you do not have a problem with milk supply. It’s important to note that the feel of the breast, the behavior of your baby, the frequency of nursing, the sensation of let-down, or the amount you pump are not valid ways to determine if you have enough milk for your baby.

My breasts feel empty! Has my milk supply decreased?

It is normal for a mother’s breasts to begin to feel less full, soft, even empty, after the first 6-12 weeks.

Many mothers have concerns about milk supply after the early weeks because they notice a drop in pumped amounts or they notice that their breasts feel “soft” or “empty”. It is normal for your breasts to feel mostly soft after the first weeks, although if there has been a long stretch without nursing or pumping they might feel a little full and heavy.

Average Growth Patterns of Breastfed Babies


A growth chart isn’t a test, where you are striving to get your baby into the 100th percentile. The growth charts show us the statistical distribution of weight, height , etc. in a particular set of babies (or children or adults). So if a baby is in the 50th percentile for weight on the CDC charts, it means that half of the babies of the same age in the US are heavier and half are lighter; if a baby is in the 10th percentile for height, then 90% of babies of the same age in the US are taller and 10% are shorter.

Lopsided! What can I do?

Most women notice differences in milk supply, pumping output, milk flow and/or size between breasts. As with many other things (foot size, ring size, eyesight, etc.) asymmetry is normal in humans. In some women the difference between breasts is hardly noticeable; in others it is very noticeable. There is every variation in between. This is not…

How might I increase baby’s weight gain?

© Miroslav Beneda -

It is recommended that you work with your pediatrician and a board certified lactation consultant if your baby is having weight gain problems. First, it’s important to determine if baby is having a genuine problem with weight gain. Following is a quick sketch of some things to look into when baby is not gaining well.

Breastfeeding after a Cesarean Birth

© Martin Valigursky -

Educate yourself and arrange for breastfeeding help

Find a La Leche League group near you! Try to attend at least one meeting before your baby is born. Ask questions!

Talk to the lactation consultant (LC)–assuming your hospital has one on staff–and ask that she meet with you as soon as you get out of the operating room. She can help you position your baby as painlessly as possible. If an LC is not available, ask one of the nurses and/or have your partner or another helper available to help out.

I’m Made of Mama’s Milk

This is a picture board book about the experience of a toddler breastfeeding. It is written from her perspective, in simple rhymes, with real, soft-focused photos as illustration. In effect it is a book for toddlers “by” a toddler. It even has a special interactive surprise at the end of the book (a reflecting foil as a mirror), which all toddlers will love.

The “What to Expect” Series

The first editions of the books (I’ve read through the pregnancy, first year and toddler books), give lip service to breastfeeding in the early months (though much of the info is quite outdated), but gets less and less supportive of breastfeeding as babies pass 6 months. Weaning is suggested well before 12 months. The authors also advocate letting baby cry (to do otherwise is “cowardly”) and are very much against co-sleeping. Here is a quote from What to Expect the First Year (first edition):

Mini-Reviews – Parenting & Sleep (various books)

I was really disappointed by this as this book is written by one of Australia’s biggest selling infant and child health authors who normally has a lot of good things to say. Loads of experience and common sense in a lot of things thanks to many years as a child health nurse. HOWEVER…she does mention controlled crying as a valid option for sleep problems and somehow she has gotten the idea that it is okay to wean after 9 months which doesn’t follow the Australian guidelines at all. Australia follows WHO policy. She doesn’t say what she would feed the baby between 9-12 months. I know from reading her book on infant nutrition that she is very relaxed about many things [which can be good or bad depending on what you want to give your baby!].

Mini-Reviews – Nutrition (various books)

Child of Mine focuses on meal-time atmosphere, mistakes parents make in forcing kids to eat, eat foods in regimented ways (must eat vegetables before bread, etc), and long-term ill-effects of messing with the child’s normal food-intake regulations.

Stillen sich Babys unter zw�lf Monaten selbst ab?

Echtes Selbst-Abstillen kommt sehr selten vor, bevor ein Baby zw�lf Monate alt ist. Allerdings h�rt man ziemlich oft, dass eine Mutter erz�hlt, ihr Kind habe sich mit neun oder zehn Monaten selbst abgestillt. Wie passt das zusammen?

Кърмене на бебе над 1 година

Въпреки, че има малко изследвания, правени върху деца, които са кърмени над 2 години, наличната информация посочва, че кърменето продължава да е ценен хранителен източник и предпазва от заболявания докато кърменето продължава.


Несмотря на то, что существует мало исследований о кормлении грудью детей старше 2 лет, доступная информация указывает, что кормление грудью продолжает быть ценным источником питания и защиты от болезней, пока кормление грудью продолжается.

Beneficios de la lactancia prolongada

El término “lactancia prolongada” se utiliza cuando el niño amamantado es mayor de 12 meses de edad. En este artículo, a dichos niños les llamamos “pequeños lactantes”.

Los pequeños lactantes se benefician NUTRICIONALMENTE:

Предно и задно мляко

След като се стартира рефлекса на потичане на млякото (чрез сукането на бебето или чрез изпомпване), млякото се стича по каналчетата докато достигне до бебето. По време на стичането производството не е по-бързо, само притокът е по-бърз. По време на едно хранене има няколко стичания, въпреки, че майката усеща само първото.

Как се образува млякото?

Производството на мляко не започва като процес на търсене и предлагане. По време на бременността и през първите дни след раждането, образуването на кърма е хормонално регулирано. Нарича се ендокринна контролна система. Ако подходящите хормони са налице, майката ще има коластра от средата на бременността (Лактогенеза I) и нейното мляко ще увеличи количеството си (Лактогенеза II) около 30-40 часа след раждането.

Смягчение Давлением

Медики все чаще замечают, что у матерей, которые получили во время родов многочисленные внутривенные вливания, отеки после родов уходят позже, чем обычно. Эта повышенная отечность в ранний послеродовой период усиливает нагрубание, увеличивает плотность тканей в пространстве за ареолой, изменяет форму соска и мешает комфортному, эффективному прикладыванию ребенка к груди.

Die Ernährung gestillter Kleinkinder

Bei den meisten Informationen, die man zur Ernährung von Kleinkindern findet, wird davon ausgegangen, dass das Kind nicht mehr gestillt wird und hauptsächlich feste Nahrung zu sich nimmt. Daher haben viele Mütter gestillter Kleinkinder (vor allem derjenigen, die noch nicht viel feste Nahrung essen) eine Menge Fragen dazu, wie sie diese Ratschläge dem Bedarf ihres Kindes anpassen sollen.

Amamantando a un bebe mayor de un año

Estás considerando la posibilidad de amamantar a tu bebe más allá del año, y te preocupa la forma en que se desarrollará la relación de lactancia? Te preguntas si tu hijo está por destetarse, o por qué causa parece que mamara durante todo el día? Aquí encontrarás algunas observaciones relativas al comportamiento típico del bebe mayorcito respecto a la lactancia. Por supuesto, la forma en que tu bebe se relaciona con la lactancia dependerá de su personalidad única.

History of Breastfeeding

OK, other that the fact that breastfeeding started with the first baby, have you ever wondered how breastfeeding and infant feeding practices have changed through the ages? Here are some articles on this subject.

Breastfeeding: the Numbers

US National Breastfeeding Rates. This shows the percentage of babies who received any breastmilk at all (at the breast or via alternative methods).

What percentage of moms breastfeed their babies? How long do they breastfeed? These questions have interested me, and prompted me to look for research that has been done and keep track of it year to year. I’m posting the results of my efforts here, for the benefit of anyone else who might be interested.

Ross Labs breastfeeding statistics

According to information published by Ross Labs (Ross Products Division, Abbott Laboratories)…

From 1955 to 1971, there was a progressive decline in breastfeeding, followed by a resurgence in its incidence and duration through 1982.

Following is information that has been reported by Ross. Keep in mind that the rates here, unless othewise noted, are for any breastfeeding, rather than exclusive breastfeeding.

Breastfeeding Quotes

“If a multinational company developed a product that was a nutritionally balanced and delicious food, a wonder drug that both prevented and treated disease, cost almost nothing to produce and could be delivered in quantities controlled by the consumers’ needs, the very announcement of their find would send their shares rocketing to the top of the stock market. The scientists who developed the product would win prizes and the wealth and influence of everyone involved would increase dramatically. Women have been producing such a miraculous substance, breastmilk, since the beginning of human existence…”

A Father Reveals Things He Has Learned From His Children

There is no such thing as childproofing your house.

A four-year-old’s voice is louder than 200 adults in a crowded restaurant.

Quiet does not necessarily mean don’t worry.

When you hear the toilet flush and the words, “Uh-oh” it’s already too late.

Play dough and microwave should never be used in the same sentence.

Legos will pass through the digestive tract of a four-year-old.

A Message From A Busy One Year Old

Please expect me to be busy. That is my developmental job. Please remember that I don’t need to do things well, I just need to do them. I like it when you tell me what I am doing, not how well or how poorly I am doing it. If you keep telling me that I do things well, that I am smart or cute or brave or spunky, I get mixed up and I think I have to act those special ways to please you. When you tell me what I am doing, when you say, “Andrew is climbing on the sofa,” I feel loved for being who I am and the age I am.

On Starting Solids

“In the beginning, all you have to cram into the baby is milk and vitamins, but one day the pediatrician will say, ‘Now you may start the baby on mashed banana.’ Or baby cereals. Or something mushy. Here again, it is easy enough for the pediatrician to say it. He doesn’t have to come and get it into the baby. That’s your department. Should you feed him the mashed banana BEFORE he drinks his milk, when he’s very hungry and therefore much more likely to try something new?

Announcing the new Toddler Miracle Diet!

Over the years you may have noticed that most 2 year olds are trim. It came to me one day over a cup of grapefruit juice and a carrot that perhaps their diet is the reason.

After consultation with pediatricians, x-ray technicians and distraught mothers, I was able to formulate this new diet. It is inexpensive and offers great variety and sufficient quantity. ENJOY!!

Message From A Two Year Old

Please be glad that I’m growing up, even though I am doing my separating by acting contrary and stubborn and by saying no thirty-seven hundred times a day.

Please let me continue to be dependent on you even though I act very independent and say, “I don’t want you.” I still need to be held some and protected.

Elephant Recipe

Dice elephant into small pieces. This should take about 2 months. Add enough brown gravy to cover. Season to taste. Cook over fire for 4 weeks. This will serve 3,800 people. If more are expected, add 2 rabbits, but only if necessary. Most people do not like to find a hare in their stew.

Handy Tips

Stuff a miniature marshmallow in the bottom of a sugar cone to prevent ice cream drips.

Use a meat baster to “squeeze” your pancake batter onto the hot griddle and you’ll get perfectly shaped pancakes every time.

To keep potatoes from budding, place an apple in the bag with the potatoes.

Expressions for women on high-stress days

You – Off my planet.
Not the brightest crayon in the box now, are we?
Well, this day was a total waste of makeup.
Errors have been made. Others will be blamed.
And your crybaby whiny opinion would be…?
I’m not crazy, I’ve just been in a very bad mood for 30 years.
Allow me to introduce my selves.
Sarcasm is just one more service we offer.
Whatever kind of look you were going for, you

What Really Matters

A philosophy professor stood before his class and had some items in front of him. When class began, wordlessly he picked up a large empty mayonnaise jar and proceeded to fill it with rocks, rocks about 2 inches in diameter. He then asked the students if the jar was full? They agreed that it was.


Age 3: She looks at herself and sees a Queen.

Age 8: She looks at herself and sees Cinderella.

Age 15: She looks at herself and sees an Ugly Sister (Mum I can’t go to school looking like this!)

Mom is taking a bath

Dear Kids,

Don’t be alarmed; the world isn’t coming to an end. I am simply taking a bath. It will take about 30 minutes and will involve soap and water.

Yes, I know how to swim. Even if I didn’t, forcing myself to drown in a half-inch of lukewarm water is more work than I’ve got energy for. (Which reminds me, I’m all for science projects, but the next time you want to see if Play-Doh floats, use cold water.)

Evolution of a Mom

Yes, parenthood changes everything.
But parenthood also changes with each baby.

Here are some of the ways having a second and third child differs from having your first:

The First Parent

Whenever your kids are out of control, you can take comfort from the thought that even God’s omnipotence did not extend to his kids.

After creating heaven and earth, God created Adam and Eve.

And the first thing God said to them was: “Don’t.”

When God Created Moms

When the good Lord was creating mothers,
He was into His sixth day of overtime, when an angel appeared and said,

“You’re doing a lot of fiddling around on this one.”

And the Lord said, “Have you read the spec on this one? She has to be completely washable, but not plastic; have 180 moveable parts, all replaceable; run on black coffee and leftovers; have a lap that disappears when she stands up; a kiss that can cure anything from a broken leg to a disappointed love affair; and six pair of hands.”

Job Opening

JOB DESCRIPTION: Long term team players needed for challenging permanent work in an often chaotic environment. Candidates must possess excellent communication skills and be willing to work various hours, which will include evenings and weekends and frequent 24 hour shifts on call. Some overnight travel required, including trips to primitive camping sites on rainy weekends and endless sports tournaments in faraway cities. Travel expenses not reimbursed. Extensive courier duties also required.

Just Once More

I’d like to be pregnant just once more. I’d like to see a plus sign
on a pregnancy test and do a dance of joy on the bathroom floor.
I’d like to tell my husband, “We did it,” and see the joy on his face.
I’d like to walk with my secret in those early months,
a proud grin on my mouth,
inexplicable to those who do not know.
I’d like to take prenatal vitamins every day.
Just once more,

New Survivor Show

Have you heard about the next planned “Survivor” show?

6 men will be dropped on an island with 1 van and 4 kids each, for 6 weeks.

Each kid plays two sports and either takes music or dance classes.

Parenting Quotes

“God could not be everywhere, so he created mothers.”
—– Jewish proverb

“If you plan for one year, plant rice. If you plan for 10 years, plant a tree. If you plan for 100 years, educate a child.”
—– Chinese proverb

Poems and quotes on parenting

A Mother’s Prayer

Dear Lord, It’s such a hectic day,
With little time to stop and pray,
For Life’s been anything but calm,
Since You called me to be a Mom,
Running errands, matching socks,
Building dreams with matching blocks,
Cooking, cleaning, finding shoes,

Time for Bed

Mom and Dad were watching TV when Mom said, “I’m tired, and it’s getting late. I think I’ll go to bed.”

She went to the kitchen to make sandwiches for the next day’s lunches, rinsed out the popcorn bowls, took meat out of the freezer for supper the following evening, checked the cereal box levels, filled the sugar container, put spoons and bowls on the table and started the coffee pot for brewing the next morning.

A substitute for natural pregnancy…

A substitute for natural pregnancy has been developed by Breed Bronson, Inc., makers of Infantill formula and other baby products. The YOUterus/Plus-centa unit was introduced in pharmacies and discount stores nationwide today.

How will breastfeeding affect my morning sickness?

There is a plus and a minus to report. First it must be said that for some moms, breastfeeding sessions can trigger a sensation of nausea over and above regular morning sickness. Let-down in particular can bring on a feeling of nausea. On the plus side, many moms seem to suffer less morning sickness over all when they are breastfeeding. Indeed, some moms say that when they weaned the morning sickness hit the roof. (Does breastfeeding really reduce morning sickness? Sure seems that way, but only a study can tell us for sure.)

Breastfeeding during labor

Nursing naturally increases oxytocin levels, and so can speed labor once it starts. Nipple stimulation is often suggested as a natural alternative to pitocin, and so this is just another option for a mom who is nursing. Nursing will also speed delivery of the placenta.

Will tandem breastfeeding spread germs between my children?

No special measures are normally needed as far as hygiene and the sharing of the breasts. Normal baths and showers will suffice. There is no reason to clean the nipple area between children and, as always during lactation, use of soap on the nipple is not recommended except under special circumstances.

Sore nipples and agitation during pregnancy

Many mothers experience nipple soreness when breastfeeding during pregnancy. Others report feelings of restlessness and irritation while nursing. This varies widely from mother to mother and is due mainly to hormonal changes. Soreness may also be associated with decreased milk supply later into the pregnancy, latch issues, thrush, etc.

Will pregnancy cause my child to wean prematurely?

It may feel strange to think of your breastfeeding relationship as vulnerable to the influences of pregnancy. As parents there are so many things that we cannot control. Starting with pregnancy, the new baby will change family life in many unexpected ways, some more welcome than others. If you can, open yourself to the various possibilities and trust that you and your older child can make it through no matter what. Remember, your fundamental relationship with your older child is not at stake.

Will I like tandem breastfeeding? Is worth the trouble?

Like everything else when a new baby first arrives, tandem nursing tends to be intense and unpredictable. Chances are it will be a godsend in many ways: helping with engorgement, helping meet the older child’s needs and the baby’s needs simultaneously, keeping the older child’s immunity up (so less illness, and shorter illnesses), providing incomparable nutrition for the older child, and providing a quick fix for temper tantrums. Moms who can comfortably nurse both children lying down may actually get to nap!

How does tandem breastfeeding affect sibling rivalry?

Many tandem nursing mothers say that “reduced sibling rivalry” is one of the biggest advantages of tandem nursing. Some nurslings hold hands while they nurse and prefer to nurse together. But it is important to bear in mind that some emotional upheaval is natural when a toddler is getting used to a new baby in the house.

What positions are best for tandem breastfeeding?

To find your best arrangement you will need to experiment and to try a variety of pillows (including a U-shaped nursing pillow). The positioning that works best is likely to change as your baby grows. Following are some options to consider:

Does my newborn always need to breastfeed first?

Although you may be advised to make sure the newborn always nurses first, this advice usually only holds for the first few days until your milk “comes in.” Prior to this point your breasts are making colostrum for the newborn (and it will transition into “mature milk” in the early weeks).

Nipple soreness and engorgement after birth

During pregnancy, nipple pain is generally caused by hormones. By contrast, if you notice nipple pain in the early days after your baby is born, you should assume there is a problem in need of a solution. Although nipple pain in the early days (usually peaking at 3-7 days postpartum) is common, it is not necessarily normal.

Nutrition for mom while pregnant & breastfeeding or tandem breastfeeding

If a mother is reasonably well-nourished her body can continue to meet her own needs and the needs of both her unborn child/infant and the older nursling. This is especially true if the older nursling is at least a year old when mom gets pregnant. In some cases, the health care provider may recommend that the mother consume more calories and/or take prenatal vitamins (but it’s unwise to take more than one a day).

Is it safe to breastfeed during pregnancy?

Yes, in most cases. At this time no medical study has been done on the safety of breastfeeding during pregnancy so it is impossible to list any definitive contraindications. If you are having a complicated pregnancy, such as lost weight, bleeding, or signs of preterm labor, you should problem-solve your individual situation with your caregiver.

Adventures in Tandem Nursing: Table of Contents

Foreword by Peggy O’Mara Introduction PART ONE: THE ADVENTURE BEGINS CHAPTER 1 PREGNANT PAUSE: TO NURSE ON OR NOT? Weighing the Needs on Both Sides of the Breast What’s the “Natural” Thing to Do? How Will I Ever Make a Decision? CHAPTER 2 REST AND SELF-CARE Self-Care Daytime Rest Restful Nights CHAPTER 3 DISCOMFORTS WHILE […]

Adventures in Tandem Nursing: From the back cover…

Can a mother produce enough milk for two children? How can weaning be accomplished without causing jealousy? Is breastfeeding safe during pregnancy? How do you arrange a toddler and a newborn at the breast, anyway? There is no doubt about it – when breastfeeding and pregnancy overlap, the questions abound! In this, the first full-length […]

What if a “weaned” child asks to breastfeed again?

Excerpted with permission from Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond by Hilary Flower La Leche League International, ©LLLI 2003 ISBN: 0912500972 “Mommy, can I have some num-num?” These unexpected overtures can happen weeks or months after the child weaned; classic triggers are the return of milk in late pregnancy or the birth […]

What if I lose weight in the first trimester (while breastfeeding and pregnant)?

Excerpted with permission from Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond by Hilary Flower La Leche League International, ©LLLI 2003 ISBN: 0912500972 Now this is a tricky question. Of course if early pregnancy nausea has dampened your appetite, and especially if vomiting occurs frequently, it is common to gain weight slowly or even […]

The nature of breastfeeding contractions

Excerpted with permission from Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond by Hilary Flower La Leche League International, ©LLLI 2003 ISBN: 0912500972 The hormone oxytocin is often considered to be at the crux of any potential connection between breastfeeding and adverse pregnancy outcomes. When a child suckles, oxytocin is released. Oxytocin is the […]

What are miscarriage and preterm labor experts saying?

Lesley Regan, PhD, MD, heads the Miscarriage Clinic at St. Mary’s Hospital in London, the largest referral unit in Europe, and is the author of Miscarriage: What every woman should know. She was surprised to hear that anyone considers issues related to miscarriage to be reasons for weaning. She added:

Pregnancy Complications while Breastfeeding

When the pregnancy is complicated decisions become more complicated, too. When faced with weight loss, unexplained bleeding, threatened preterm labor or twin pregnancies, the mothers who contributed to this book have made a variety of different choices including: immediate weaning, initiation of gradual weaning, taking a “wait and see” approach, reducing nursing to a lower level in order to continue, and nursing on. It’s a heart-wrenching position to be in. One mother said she felt as though she was forced to choose between the baby at her breast and the baby in her womb. It takes courage to make these decisions and mothers deserve support for this unenviable responsibility.

Oatmeal for increasing milk supply

Eating a bowl of oatmeal for breakfast each morning is a frequently heard recommendation for increasing milk supply. Although there is no scientific evidence regarding oatmeal and milk supply, oatmeal does seem to work for some. Many working moms have noticed that on the days they eat oatmeal for breakfast, they can pump more milk than on the days they eat something else. In some countries, “traditional wisdom” recommends eating oatmeal as a way to increase milk supply. A number of lactation consultants recommend eating oatmeal as a way to increase supply.

Häufig gestellte Fragen zum Tandemstillen: Ist das Stillen während der Schwangerschaft ungefährlich?

Ja, in den meisten Fällen. Bisher sind keine klinischen Studien zur Sicherheit des Stillens während der Schwangerschaft durchgeführt worden, so dass es unmöglich ist, eine Liste eindeutiger Gegenanzeigen zu erstellen. Wenn Sie in der Schwangerschaft Komplikationen erlebt haben, wie z.B. Gewichtsabnahme, Blutungen oder Anzeichen vorzeitiger Wehen, sollten Sie Ihre Situation mit Ihrem Arzt bzw. Ihrer Hebamme besprechen. Unter den jeweiligen Umständen können Sie dann entscheiden, ob Sie weiterhin stillen, vermindert stillen oder abstillen möchten.

Häufig gestellte Fragen zum Tandemstillen: Ernährung der Mutter

mmer daran denken: Schwangerschaft und Stillzeit sind gesunde Phasen in einem Frauenleben, kein Krankheitszustand!
Bei der Ernährung besonders zu berücksichtigen (für schwangere Stillende und Tandemstillende)

Wenn eine Mutter wohlgenährt ist, kann ihr Körper sowohl ihre eigenen als auch die Bedürfnisse des ungeborenen Kindes bzw. Säuglings und des älteren Stillkindes erfüllen. Das gilt besonders dann, wenn das ältere Stillkind zu Beginn der zweiten Schwangerschaft mindestens ein Jahr alt ist. In manchen Fällen kann der Arzt oder die Hebamme empfehlen, dass die Mutter mehr Kalorien aufnimmt und/oder Vitaminpräparate für Schwangere einnimmt.

Häufig gestellte Fragen zum Tandemstillen: Schmerzende Brustwarzen und geschwollenes Drüsengewebe nach der Geburt

Während der Schwangerschaft werden schmerzende Brustwarzen in der Regel durch Hormone verursacht. Wenn Sie dagegen in den ersten Tagen nach der Geburt des Babys Schmerzen bemerken, können Sie davon ausgehen, dass es sich um ein Problem handelt, das behoben werden muss. Auch wenn schmerzende Brustwarzen in den ersten Tagen häufig sind (am stärksten meist um den 3. bis 7. Tag nach der Geburt herum), so sind sie nicht unbedingt normal. Ein häufiges Problem, das zu schmerzenden Brustwarzen führt, ist das ineffektive Anlegen. Auch wenn Sie Erfahrung mit dem Stillen haben – Ihr Neugeborenes hat sie nicht, und Sie beide müssen das erfolgreiche Anlegen erst gemeinsam einüben.

Häufig gestellte Fragen zum Tandemstillen: Muss das Neugeborene immer zuerst gestillt werden?

Auch wenn Ihnen dazu geraten wird, das Neugeborene immer zuerst zu stillen, so gilt dieser Rat doch meist nur für die ersten Tage, bis die Milchproduktion in Gang kommt. Davor produzieren Ihre Brüste Kolostrum für das Neugeborene (das in den ersten Wochen dann zur reifen Milch übergeht). Dieses „flüssige Gold“ ist reich an Immunfaktoren und Wirkstoffen, die den Darm des Neugeborenen auf die nachfolgende Milch vorbereiten. Da die Kolostrumproduktion nach der Geburt begrenzt ist, ist es wichtig, darauf zu achten, dass das Neugeborene zuerst trinkt und seinen Bedarf decken kann.

Häufig gestellte Fragen zum Tandemstillen: Wie wirkt sich das Tandemstillen auf die Geschwisterrivalität aus?

Viele Mütter sagen, dass eine „geringere Geschwisterrivalität“ einer der Hauptvorteile des Tandemstillens ist. Manche Stillkinder halten sich beim Stillen an den Händen und stillen vorzugsweise gemeinsam. Trotzdem ist es wichtig, nicht zu vergessen, dass eine gewisse emotionale Unruhe normal ist, wenn sich ein Kleinkind an ein neues Baby im Haus gewöhnen muss.

Häufig gestellte Fragen zum Tandemstillen: Werde ich das Tandemstillen mögen? Lohnt es sich?

Wie alles andere auch nach der Geburt eines Babys wird das Tandemstillen zunächst eher sehr intensiv und unberechenbar sein. Höchstwahrscheinlich wird es aus verschiedenen Gründen sehr hilfreich sein: Milchstaus lassen sich damit verhindern; es ist einfacher, dem älteren Kind und dem Neugeborenen gleichzeitig gerecht zu werden; die Immunität des älteren Kindes wird gefördert (also weniger bzw. kürzere Krankheiten); Bereitstellung einer einzigartigen Nahrungsquelle für das ältere Kind und eine schnelle Lösung für Wutanfälle. Mütter, die in der Lage sind, bequem liegend beide Kinder zu stillen, haben vielleicht sogar Gelegenheit zu einem kurzen Nickerchen!

Häufig gestellte Fragen zum Tandemstillen: Wie kann ich auf kritische Bemerkungen reagieren?

Zunächst ist es wichtig, sich stets darauf zu besinnen, dass Ihre Stillbeziehung nur Sie und Ihr Kind etwas angeht. Auch wenn jeder ein Recht auf eine eigene Meinung hat, brauchen Sie Ihre Entscheidungen weder verteidigen noch erklären.

Nach dieser Vorbemerkung ist es ebenfalls wichtig zu verstehen, dass die meisten Menschen, die kritisch klingen, einfach wenig Erfahrung mit diesem Thema haben. Schließlich geraten die meisten tandemstillenden Mütter „einfach so“ in diese Lage – Tandemstillen wird normalerweise von einer Mutter nicht von Anfang an eingeplant.

Häufig gestellte Fragen zum Tandemstillen: Schmerzende Brustwarzen und Unruhe während der Schwangerschaft

Vielen Frauen tun beim Stillen während der Schwangerschaft die Brustwarzen weh. Andere fühlen sich beim Stillen rastlos und gereizt. Diese Befindlichkeiten sind von Mutter zu Mutter sehr unterschiedlich und hauptsächlich durch hormonelle Veränderungen bedingt. Schmerzen können auch mit einer geringeren Milchproduktion in der fortgeschrittenen Schwangerschaft, mit der Saughaltung des Kindes, Hefepilz-Infektionen usw. einhergehen.

Häufig gestellte Fragen zum Tandemstillen: Werden durch das Tandemstillen Keime zwischen meinen Kindern übertragen?

Normalerweise sind keine besonderen Hygienemaßnahmen bei der gemeinsamen „Nutzung“ der Brüste erforderlich. Gewöhnliches Baden und Duschen sind ausreichend. Es gibt keinen Grund, den Brustwarzenbereich zwischen den Kindern zu säubern, und wie immer in der Stillzeit wird die Verwendung von Seife an den Brustwarzen nicht empfohlen, sofern keine besonderen Umstände vorliegen.

Häufig gestellte Fragen zum Tandemstillen: Wie verändert sich die Muttermilch?

Die meisten Mütter, die während der Schwangerschaft stillen, bemerken eine Abnahme der Milchproduktion etwa in der Mitte der Schwangerschaft, wobei dies auch schon im ersten Monat eintreten kann. Während der Schwangerschaft verändert sich die reife Milch auch immer mehr zum Kolostrum, welches bei der Geburt vorhanden ist. Die Milchproduktion kann gegen Ende der Schwangerschaft zunehmen, wenn die Kolostrumproduktion einsetzt.

Häufig gestellte Fragen zum Tandemstillen: Stillen unter den Wehen

Das Stillen erhöht auf natürliche Weise die Oxytocinkonzentration und kann so die Wehen beschleunigen, wenn diese eingesetzt haben. Die Stimulation der Brustwarzen wird oft als natürliche Alternative zur Gabe von wehenanregenden Mitteln (Pitocin) vorgeschlagen und stellt somit für stillende Mütter eine weitere Option dar. Durch Stillen wird die Ausstoßung der Plazenta ebenfalls beschleunigt.

Häufig gestellte Fragen zum Tandemstillen: Wie wirkt sich das Stillen auf die Schwangerschaftsübelkeit aus?

Hier gibt es gute und schlechte Nachrichten. Zuerst ist festzuhalten, dass bei einigen Müttern durch eine Stillsitzung sehr heftige Übelkeit ausgelöst werden kann. Insbesondere der Milcheinschuss kann Übelkeitsgefühle auslösen. Andererseits verspüren viele Mütter insgesamt weniger Übelkeit, wenn sie stillen. Es gibt sogar Berichte von Müttern, die besagen, dass nach dem Abstillen die Übelkeit ihren Höhepunkt erreichte. (Verringert das Stillen tatsächlich die Schwangerschaftsübelkeit? Es sieht so aus – aber eine klare Antwort kann nur eine entsprechende Studie geben.)

Tandem Breastfeeding: Suggestion for breastfeeding education & discussion

This exercise could be used by anyone conducting a breastfeeding education class or support group meeting.

Meg Sondey, a volunteer counselor for a breastfeeding support group, created this exercise using the book Adventures in Tandem Nursing: Breastfeeding during Pregnancy and Beyond by Hilary Flower. Meg uses this exercise for a meeting that focuses on toddlers. She says:

Myths vs Facts: Breastfeeding During Pregnancy and Tandem Nursing

Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond, published by La Leche League International in July 2003

You have probably heard most of these common statements circulating about breastfeeding during pregnancy and tandem nursing. I set out to test their veracity, and was surprised by what I found! Test the currency of your own knowledge: which statements are myth, fact, or simply unknown?
1. “At 24 weeks gestation, the uterus changes in such a way that breastfeeding goes from being safe to risky.” …MYTH or FACT?

Breastmilk Composition

This is pretty much a list of links right now. I always have to search a bit when someone asks a question on this subject, so I’m putting everything in one place to make it easier to find. If I get some time, I hope to compile a lot of this info into one document.

What affects the amount of fat or calories in mom’s milk?

The average calorie content of human milk is 22 kcal/oz. Caloric content varies widely throughout each feeding and the day, however, due to changing fat content. The amount of fat in human milk changes dramatically during each feeding and throughout the day, since fat content depends on the degree of emptyness of the breast (empty breast = high fat, full breast = low fat). The average fat content of human milk is 1.2 grams/oz.

Commentary on formulas supplemented with DHA & ARA

Denny has talked to us about the pediatrician that stated the fatty acid additives in Lipil are exactly the same as what is in breast milk. This sounds like he or she has just attended an inservice by a formula salesman and is parroting back the buzz words used to dupe health care providers into recommending the formula! Actually these fatty acids are nothing like what is in breast milk and pose a number of known and unknown risks to the infants who consume them.

Formula Companies and Free Gifts

Many health professionals today would say they support breastfeeding yet our actions speak louder than words. What message do we send to consumers of health care when we, the health care professional, distribute free formula to patients during their prenatal course, hospitalization and upon discharge? The US health care system is fraught with promotion of infant formula, a practice that needs to be discontinued.

Immune factors in human milk

In human milk, there is a complex system of antimicrobial factors… most of the factors are produced throughout lactation… Antibodies are present in human milk throughout lactation…
source: Nutrition During Lactation (1991, Institute of Medicine, p. 134-37)

What should I know about infant formula?

Parents consider giving their babies formula for many reasons. In the vast majority of cases, formula is not medically necessary – moms use it purely by choice. At other times, mom may believe that her milk supply is low (and thus think that formula is needed) when her supply is just fine. If you feel that your baby genuinely has a need for formula supplementation (or your baby’s doctor has suggested or recommended it), then contact a lactation consultant (preferably IBCLC) for guidance. A good lactation consultant can assess the need for supplementation and guide you in the use of supplements so as to preserve the nursing relationship. Here is some information on how to find a lactation consultant.

Is it safe to use cow’s milk or other milks as a supplement to breastfeeding?

In general, only breastmilk or formula should be used if your baby is less than six months old.

Between six and twelve months, supplementing with solids (instead of formula) or very small amounts of cow, goat, soy or rice milk is less of a problem, as long as baby is still nursing for the majority of milk intake and baby is not allergic. However, babies under a year are more at risk for allergic reactions (see below) so it can be a good idea to wait.

Religious Fasting and Breastfeeding

Breastfeeding research tells us that short-term fasting (not eating) will not decrease milk supply, but that severe dehydration can decrease milk supply. Fasting does affect the biochemical/nutrient content of breastmilk to a certain extent.

Do breastfeeding mothers need extra calories or fluids?

Do breastfeeding mothers need extra calories?

In general, you should simply listen to your body and eat to appetite – this is usually all you need to do to get the calories you need. When exclusively nursing a young baby, it is very common to feel hungry much of the time… listen to your body. Mothers of older babies may feel hungrier when baby temporarily increases his or her milk intake (for example, during a growth spurt)… again, listen to your body. Counting calories is rarely necessary unless you are having problems maintaining a healthy weight.

How does a mother’s diet affect her milk?

The short answer to this question is NO – you do not need to maintain a perfect diet in order to provide quality milk for your baby. In fact, research tells us that the quality of a mother’s diet has little influence on her milk. Nature is very forgiving – mother’s milk is designed to provide for and protect baby even in times of hardship and famine. A poor diet is more likely to affect the mother than her breastfed baby.

Can a nursing mother eat this food? FAQs

Is there a list of foods that I should avoid while breastfeeding?

There are NO foods that a mother should avoid simply because she is breastfeeding. It is generally recommended that you eat whatever you like, whenever you like, in the amounts that you like and continue to do this unless you notice an obvious reaction in your baby to a particular food. There is no such thing as a “LIST OF FOODS THAT BREASTFEEDING MOTHERS SHOULD NOT EAT” because most nursing moms can eat anything they want, and because the babies who are sensitive to certain foods are each unique – what bothers one may not bother another. If you have a family history of allergies and think your baby might be allergic, you might want to avoid certain foods, but again, this would be different for every child.

Herbal weight loss products and breastfeeding

Many herbal weight loss products contain some form of ephedra. It might be listed in the ingredients as Ma Huang, Ephedra sinica, Sida cordifolia, ephedra, ephedrine group alkaloids, ephedrine, etc. Some of the weight loss products that have contained ephedra include Metabolife, Herbalife, OmniTrim, Trim Easy, Diet Pep, MetaboSafe, geniCiL, AM-300, power drinks like Ultimate Orange, etc.

Low carb diets and breastfeeding

High protein, low carbohydrate diets like the Atkins diet and the South Beach diet are very popular. These diets can be helpful for diabetics and people with gluten intolerance. In these diets, protein and high fat foods are not restricted; vegetables are limited. The main difference between Atkins and South Beach seems to be that the South Beach diet is less structured and emphasizes eating healthier, mostly unsaturated fats.

Can I diet while breastfeeding?

Six guidelines for safe dieting during lactation

Wait until your baby is two months old before dieting
It’s best not to do anything consciously to lose weight until after the second month. This gives your body enough time to successfully establish a healthy milk supply that is less likely to be adversely affected if your caloric intake is restricted. Breastfeeding your baby, on average, burns 200-500 calories per day (above what you needed to maintain your pre-pregnancy weight) — so keep in mind that even without a weight loss program you are burning extra calories.

Vegetarian Diets and Breastfeeding

A vegetarian or vegan mother does not need to take any special dietary precautions as long as she is maintaining a diet with adequate amounts of vitamin B12, calcium and zinc. This is something that mom needs to do for herself, even if she is not breastfeeding.

If you are avoiding meat but eating any other type of animal protein (eggs, milk, cheese or other dairy products, fish, poultry) you will normally get enough vitamin B12.

Guidelines for offering juice to babies

Babies under six months should not be given juice. According to the American Academy of Pediatrics Committee on Nutrition, “There is no nutritional indication to feed juice to infants younger than 6 months. Offering juice before solid foods are introduced into the diet could risk having juice replace breast milk or infant formula in the diet.” The American Academy of Pediatrics Section on Breastfeeding notes: “During the first 6 months of age, even in hot climates, water and juice are unnecessary for breastfed infants and may introduce contaminants or allergens.”

Guidelines for offering water to breastfed babies

Exclusively breastfed babies do not need additional water – breastmilk is 88% water and supplies all the fluids that your baby needs, even when the weather is very hot or dry. This article offers guidelines for offering supplemental water to babies and toddlers at different ages.

Finger Foods

Older babies who are just starting solids may prefer chunkier finger foods, instead of mashed or moistened food. The baby who starts solids at 6 months or older doesn’t need pureed or liquefied foods. You may want to just start with finger foods, and let her mostly feed herself.

Is baby’s risk for type I diabetes increased if solids are introduced before 3 months or after 6 months?

Many parents have been concerned about the news reports suggesting that too-early or too-late introduction of solids might increase baby’s risk for type I diabetes. A couple of research studies in 2003 examined timing of introduction of cereals and how this might affect an at-risk baby’s risk for type I diabetes. Following is more information on these studies…

Following is a link to an abstract for one study on type I diabetes and introduction of solids that appeared in the Journal of the American Medical Association:

How do we get started with solids?

If baby refuses solids, try again later (maybe a week or two), and maybe with a different food. Some babies who are prone to food allergies may refuse solids until 8-9 months or even longer.
Should solids replace breastmilk?

Will giving formula or solids at night help baby to sleep better?

The idea that solids will help your baby sleep is an old wives’ tale that has been disproven by medical studies. Feeding your baby solids or formula in an attempt to make baby sleep longer is not a good idea for several reasons:

There’s no evidence that it will help. Some babies will sleep worse, due to reactions to the formula or solids (tummy ache, etc. are not uncommon), particularly if baby is younger than around 6 months. Two studies have indicated that adding solids to the diet does not cause babies to sleep longer. These studies found no difference in the sleep patterns of babies who received solids before bedtime when compared to babies who were not given solids. Here are the two studies:

Is baby is ready for solid foods? (Developmental signs of readiness)

What do the experts say?

Health experts and breastfeeding experts agree that it’s best to wait until your baby is around six months old before offering solid foods. The American Academy of Pediatrics, the World Health Organization, and many other health organizations recommend that babies be exclusively breastfed (no cereal, juice or other foods) for the first 6 months of life. Some doctors may recommend delaying solids for the first year if there is a family history of allergies. I’m not going into the many health benefits of delaying solids here; see Why Delay Solids? for more information.

Anemia No More

Sierra was diagnosed with anemia when she was seven months, one week old – her level was 9.1. I was told to give her iron supplements three times a day, but after doing a lot of research I decided not to. The side effects of the iron seemed too severe since her iron levels were not very low, and she has a very delicate tummy!


Do nursing mothers need additional calcium?

No. Pregnant and nursing mothers do not need additional calcium other than that normally required for their age group. The Institute of Medicine recommends that nursing mothers over the age of 18 consume 1,000 mg. of calcium daily — the same as other adults.

DHA supplements for breastfeeding mothers

At present, there is a major marketing effort aimed at getting pregnant and breastfeeding women to take DHA supplements (the same supplements that are being marketed in the newer baby formulas).

Here’s a quick rundown on what DHA is: Mammals do not manufacture their own polyunsaturated fatty acids. Two of the polyunsaturated fatty acids, Omega-6 (linoleic acid is the primary source) and Omega-3 (alpha-linolenic acid is the primary source), are considered to be essential fatty acids (EFAs) and have numerous health benefits. Deficiencies of either of these essential fatty acids are extremely rare in the United States and Canada. We convert these essential fatty acids in our bodies to other needed fatty acids, which we can also get from food sources. Gamma-linolenic acid (GLA) and arachidonic acid (ARA) are made from linoleic acid; and alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are made from alpha-linolenic acid.

Is Iron-Supplementation Necessary?

Healthy, full-term babies have enough iron stores in their bodies to last for at least the first six months. The current research indicates that a baby’s iron stores should last between six and twelve months, depending upon the baby.

The iron in breastmilk is better absorbed than that from other sources. The vitamin C and high lactose levels in breastmilk aid in iron absorption.

Lecithin treatment for recurrent plugged ducts

Lecithin has been recommended to combat recurrent plugged ducts. The usual recommended dosage for recurrent plugged ducts is 3600-4800 mg lecithin per day, or 1 capsule (1200 milligram) 3-4 times per day. After a week or two with no blockage, mom can reduce the dosage by one capsule. If there is no blockage within another 2 weeks she can reduce it again by one. Mom may need to continue taking 1-2 capsules per day if stopping the lecithin leads to additional plugged ducts.

Who needs vitamin B12 supplements?

Infants of well-nourished mothers with adequate vitamin B12 intake do not need vitamin B12 supplements.

It is recommended that mothers who do not eat animal proteins or who are otherwise at risk for vitamin B12 deficiency get adequate amounts of vitamin B12 during pregnancy and lactation via supplements or fortified foods.

There is No Doctrine for Attachment Parenting: Being AP is a Frame of Mind!

Since the beginning of civilized time, parents have been drawn together by the common bonds of parenting philosophies, forming communities of mutual support and information based upon those principles. The evolution of Internet bulletin boards and email lists has expanded our interaction capabilities exponentially, nearly eliminating the previous geographical limitations of parenting communities. Now parents from all countries and cultures are able to participate in parenting discussions, and many have found that they naturally gravitate to the large online parenting community bound together by the concept of Attachment Parenting (AP).

Infant Potty Training and Attachment Parenting

Infant potty training is about a gentle, natural and loving method of communication and toilet learning. In most societies where Attachment Parenting has been practiced for centuries, this method of infant toileting is used. Because of this, I consider it to be another element of AP and refer to it as the sixth Baby B – after Dr. Sears’ 5 Baby B’s:

When I am a Grandmother

When I am a Grandmother I shall have a purple sling
And carry my grandbabies around the block and to the market.
I shall adorn my fingers with amethysts, my feet with shoes of fuchsia,
And wear a pale pink hat with cabbage roses.


The last fading beams of sunlight filter in through the window as I sit here holding the tiny body of my first grandchild. The warmth of her body envelopes mine, and I cuddle her close to my chest, her ear pressed against my breast, the beating of my heart a soft and gentle reassuring song playing to her in the land of dreams.

Building Your Child’s Self-Esteem

When a baby finds that her signals are validated and responded to appropriately—that troubles are soothed and pleasure enhanced—she begins to sense that her feelings, expressions, of her very being, are of value and important. A baby learns that she counts for something. This is the foundation of the development of self-esteem—a combination of who you are, how you feel about yourself, and what you think about your future potential.

Are you feeling overwhelmed by your child’s intense needs?

But how much intense parenting they need, possibly including frequent nursing, in the second year depends for the most part on their inborn timetable for emotional development. As parents we can slow down emotional growth by leaving needs unmet. But there is nothing extra we can do to speed it up. …your investment in your toddler who seems to be ‘always attached’ will pay off when the time for independence does come.
— Norma Jane Bumgarner in “Mothering Your Nursing Toddler”

Wakeful 4 Month Olds

One of the concerns I have about some parenting books and pediatricians who give advice about sleeping infants is this: Baby starts sleeping through the night at, say, about 3 months — or at least sleeping 5 to 6 hours. Suddenly around 4 months, little Buford starts waking up at night to nurse. Mom is understandably distressed. Some books say “it’s a bad habit that must be stopped.” Her pediatrician says essentially the same thing. Someone else points out that since the baby slept through the night at 3 months, it is OBVIOUS that the baby CAN sleep and isn’t hungry. The book goes on to talk about how the baby is now manipulating the mother. The pediatrician says he’s big enough to go without eating at night. Grandma tells her to let Buford cry it out. So does the book. There may be different ways, but in essence, don’t pick him up and feed him….

Breastfeeding to Sleep and Other Comfort Nursing

"You are not a pacifier; you are a Mom. You are the sun, the moon, the earth, you are liquid love, you are warmth, you are security, you are comfort in the very deepest aspect of the meaning of comfort.... but you are not a pacifier!" -- Paula Yount

Many moms feel guilty for nursing their baby to sleep. Nursing your baby to sleep is not a bad thing to do! It’s very normal and developmentally appropriate for babies to nurse to sleep and to wake 1-3 times during the night for the first year or so. Some babies don’t do this, but they are the exception, not the rule. Many children, if given the choice, prefer to nurse to sleep through the second year and beyond. Nursing is obviously designed to comfort baby and to help baby sleep, and I’ve never seen a convincing reason why mothers shouldn’t use this wonderful “tool” that we’ve been given.

Co-sleeping and Bed-sharing

Co-sleeping essentially means sleeping in close proximity to your child. It may be in the same bed or just in the same room. Let’s talk about the advantages and safety issues.

Got Sleep?

It just occurred to me that I have not had a “full night” (decent night??) sleep in 27 or so years!!!!

All these sleep questions made me think about when I last got a “full night” – or what one might call *decent* night sleep…. and I had to go all the way back to BEFORE I was married… yes, you got that right… before I married.

Sleeping Through the Night

It’s so common for mothers to worry when their babies don’t sleep through the night. After all, everyone knows they’re “supposed to.” Some doctors recommend nighttime weaning and “cry it out” methods if your baby is not sleeping through the night by 6 months or even earlier. Even when the mom herself has no problems with baby nursing at night, she still worries that this is a problem, since American society seem to consider it one. There are books all over the bookstores with advice on solving so-called “sleep problems.”

Studies on normal infant sleep

Probably one of the main reasons that babies who don’t sleep through the night are such a big issue is that parents don’t have realistic expectations of the sleep patterns of babies. Babies were designed to wake up often at night to feed and cuddle, and keep in mind that many adults wake during the night, too. If our expectations for babies were not so different from our babies’ expectations for themselves, much of this “problem” might disappear.

Logo design contest entries

We’ve had some great entries for the logo design contest, so I wanted to showcase some of them here. I would like to thank the designers for all their hard work. It was really hard to choose a winner, but we will be announcing the winner soon!

“Is it for me?” Tips for Making Your Decision about Breastfeeding during Pregnancy and Tandem Nursing

Find some other tandem mamas. Hearing about a range of experiences can help you decide if tandem nursing might be for you, and a support network of tandem mamas will serve you well as you go along. One place to start is your La Leche League group. You can find local groups internationally at You can also find tandem-nursing moms on the message boards.

Tandem Breastfeeding: How Doulas Can Help

Birth and breastfeeding. They go hand in hand. What about when they overlap? What kind of support might a mother need from her doula if she is pregnant and breastfeeding? Answer? A lot! I researched many aspects of breastfeeding during pregnancy for my new book, Adventures in Tandem Nursing: Breastfeeding during Pregnancy and Beyond, published by La Leche League International in July 2003. As a doula you can play a very important role for breastfeeding and pregnant mothers in your care…

How Tandem Nursing Birthed Me as a Mother of Two

Here’s the picture. My distraught two-and-a-half year old daughter is insisting on nursing, lying down “like a baby,” on a favorite spot on the bedroom floor. I know that if I can just nurse her down to sleep this temper tantrum will be over. I realize that my best bet is to lie down and nurse her on the lower breast. This way I can stack my three-week old son on top of her and he can nurse my upper breast.

Love, Limits and Tandem Nursing

If your breastfeeding relationship comes under strain for whatever reason, adjustments may be necessary. Be aware of some red flags that may indicate your breastfeeding relationship needs your help:

Wie sicher ist das Stillen während einer Schwangerschaft?

Viele Mütter werden wieder schwanger, während sie noch stillen. Sie stehen vor der Frage, ob das Stillen eine Fehlgeburt oder Frühgeburt auslösen kann oder ob sie ohne Gefährdung des Ungeborenen weiterstillen können. Hilary Flower ist dieser Frage nachgegangen.

A New Look at the Safety of Breastfeeding During Pregnancy

Are you ready to try to conceive your second child, but still enjoying a breastfeeding relationship with your firstborn? Or perhaps you are breastfeeding your child over a kicking baby belly? If so you are not alone—far from it. In a study of 179 mothers who had breastfed for at least six months, 61% had also breastfed during a subsequent pregnancy.1 Of these, 38% went on to nurse both newborn and toddler postpartum, an arrangement known as “tandem nursing.”

Breastfeeding Agitation

Breastfeeding agitation is no fun, and pregnancy seems to be a particularly common time for breastfeeding agitation to strike (affecting roughly one-third of pregnant and breastfeeding mothers). Some pregnant mothers can tell you exactly what week the agitation set in for them, and although it differs from woman to woman, mid-pregnancy seems to be a common time of onset. Many women find that the agitation abates in late pregnancy, while others find that this is when it’s most intense.

Adventures in Tandem Nursing: Book Reviews

“For parents who decide that weaning can wait, a sometimes inevitable result is a new pregnancy while the toddler is still nursing. This new step in the adventure of parenting brings a new set of questions and challenges, and Flower’s book provides an invaluable resource.”

Adventures in Tandem Nursing: About the author

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Nursing Two FAQ Myths vs. Facts Articles Resource Materials Useful Links Adventures in
Gentle Discipline

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About the author

Hilary Dervin Flower lives in Florida with her three children. She holds a B.A. in English from the University of Virginia and an M.A. in Geology from the University of California, Santa Barbara. Tandem nursing her children provided the passion and curiosity that fueled her pursuit of this subject. Adventures in Tandem Nursing is her first book. She is also the author of Adventures in Gentle Discipline. Her essays have appeared in many magazine, including Mothering, Hip Mama, New Beginnings, Leaven, The Mother, Midwifery Today, Natural Parenting and APA News.

How Breast Milk Protects Newborns

Doctors have long known that infants who are breast-fed contract fewer infections than do those who are given formula. Until fairly recently, most physicians presumed that breast-fed children fared better simply because milk supplied directly from the breast is free of bacteria. Formula, which must often be mixed with water and placed in bottles, can become contaminated easily. Yet even infants who receive sterilized formula suffer from more meningitis and infection of the gut, ear, respiratory tract and urinary tract than do breast-fed youngsters.

Breastfeeding and Guilt

One of the most powerful arguments many health professionals, government agencies and formula company manufacturers make for not promoting and supporting breastfeeding is that we should “not make the mother feel guilty for not breastfeeding”. Even some strong breastfeeding advocates are disarmed by this “not making mothers feel guilty” ploy.

A Farewell to Arms – and Legs … and Feet …

A Farewell to Arms – and Legs … and Feet …

You’ve stroked his downy hair as he dreamed his first baby dreams in your arms. You’ve clung to the edge of the bed while his little body somehow took up all the room. You’ve slept your sweetest sleep while he nestled so cozily in your arms. And you’ve barely caught a wink while sleep transformed him into a future World cup soccer star.

The Sandman Cometh: Sound Solutions for a Satisfying Sleep

In this chapter we will bring you answers to questions we’ve been asked by family bed parents about ways to get a better night’s sleep. If you have a nighttime woe from the family bed, you’ll probably find a solution to it here.

Q: In three months we’re expecting our second child, and our two-year-old son is still in bed with us. I don’t think he’s ready to move into his own bed yet, and I really don’t mind if he stays. But I don’t know how we can make it work with two kids and two parents. What should we do?

Too much milk: Sage and other herbs for decreasing milk supply

This is best used only if you are in the process of weaning, though it may also be used in extreme cases of oversupply when the usual measures are not effective. Be careful with this if you are not in the weaning process! Don’t overdo it once you’re seeing some results.

To use dried sage (Salvia officinalis) for reducing milk supply, take 1/4 teaspoon of sage 3x per day for 1-3 days. You can mix the sage in vegetable juice (for example, V-8), but it won’t mix well into other juices. You can also mix it into other foods. If you don’t like the taste of sage, try putting it into a tiny piece of sandwich and swallowing it whole – peanut butter or something else a bit sticky seems to work best for holding the sage in place. Tear off the corner of the sandwich containing the sage (it should be a very small section) and swallow it without chewing (that’s why you need a very small section).

Oil of Oregano for thrush?

I do not recommend that breastfeeding mothers use oil of oregano to treat thrush…

Oil of oregano (Origanum vulgare L.) is sometimes suggested for treatment of thrush (candida/yeast). The recommendations I have seen for the use of oil of oregano for thrush treatment include topical use of the oil on baby’s feet and mother’s nipples and internal use of the oil by the mother.

Natural treatments for nursing moms

Although many medications are compatible with breastfeeding, it’s always a good idea to minimize the use of medications when nursing. Following are various natural treatments for nursing moms that I have collected.

Keep in mind that herbal and other “natural” treatments in general are not without risk for nursing moms – herbs can be just as pharmacologically active as meds from the pharmacy. Before using any herbal treatment, investigate whether it is safe for nursing moms.

Herbs and Breastfeeding: References

Most herbal treatments have not been thoroughly researched, particularly in regard to lactation. Herbs are drugs, and some caution is necessary. It is possible for anyone (mother or baby) to have an allergic reaction to just about anything. Watch your baby closely for any adverse reactions if you take any herb or medicine.

Herbal safety for nursing moms

It is possible for anyone (mother or baby) to have an allergic reaction to just about anything. Watch your baby closely for any adverse reactions if you take any herb or medication.

Keep in mind that most herbal treatments have not been thoroughly researched, particularly in regard to lactation. “Natural” substances are not automatically safe! Herbs are drugs, so it is necessary to use caution when using them.

Breastfeeding and Thyroid Problems: FAQ

Is it safe for a mom with thyroid disease to breastfeed?

Yes. Even if mom’s thyroid levels are not controlled by medication (or are in the process of being controlled) it is safe for mom to breastfeed her baby.

Breastfeeding and Vaccines

According to the US Centers for Disease Control document General Recommendations on Immunization (February 8, 2002) [PDF version for printing]:

“Neither inactivated nor live vaccines administered to a lactating woman affect the safety of breast-feeding for mothers or infants. Breast-feeding does not adversely affect immunization and is not a contraindication for any vaccine. Limited data indicate that breast-feeding can enhance the response to certain vaccine antigens. Breast-fed infants should be vaccinated according to routine recommended schedules.

Do mom’s vaccines protect her breastfed baby?

Many moms wonder whether their babies will be protected from any illness that mom has been immunized against as long as breastfeeding continues. Breastfeeding will enhance baby’s response to immunizations that he receives, however, breastfeeding will not act as a substitute for immunization.

Prescription drugs used for increasing milk supply

The presence of an appropriate level of the hormone prolactin permits lactation to proceed normally. When a mother has low prolactin levels, milk supply may be affected. Prolactin levels are primarily regulated by inhibition: the presence of prolactin-inhibiting factors (dopamine is the principal one) keep prolactin levels in check. The drugs used for increasing milk supply work by blocking dopamine, which results in an increase in prolactin levels. These drugs do not work in all women and would not be expected to increase milk production in a woman who already has normal (high) prolactin levels.

Lactation Risk Categories

Drug which has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant. Controlled studies in breastfeeding women fail to demonstrate a risk to the infant and the possibility of harm to the breastfeeding infant is remote; or the product is not orally bioavailable in an infant.

Breastfeeding when baby has surgery

Many times, when baby is scheduled to undergo surgery, the mother is told “no breastfeeding after midnight the night before surgery” or “no breastfeeding less than 8 hours prior to surgery.” Many moms are understandably concerned about this, since withholding nursing from a baby or young child for this amount of time will frequently result in a miserable time for all concerned. Not only is baby hungry, but mom and baby’s most useful comforting tool – nursing – is also gone.

My baby is sick – should I continue to breastfeed?

Absolutely! Anytime a sick baby is able to take anything by mouth, it should be his mother’s milk. Mom’s milk provides antibodies specifically tailored to fight baby’s illness, and is quickly and easily digested.

Temporary weaning, besides depriving baby of antibodies to fight the illness and the most easily digestible food source available, can make life miserable for both mother and baby. Nursing is extremely comforting to an ill baby and a major part of the healing process. Mom would have to pump to maintain milk supply and then there would still be some risk that supply would drop somewhat. Not pumping would put mom at risk for breast infection and extreme discomfort.

Perchlorate in Breastmilk

What is perchlorate? Perchlorate is a salt that is found naturally in some areas of the world, and is also manufactured for various purposes. One of the perchlorate salts, ammonium perchlorate, is used as an oxidizer to help solid rocket fuel burn. Per the US Environmental Protection Agency, “Most of the perchlorate manufactured in the United States is used as the primary ingredient of solid rocket propellant. Wastes from the manufacture and improper disposal of perchlorate-containing chemicals are increasingly being discovered in soil and water.” Another perchlorate salt, potassium perchlorate, was used therapeutically for many years to treat certain types of hyperthyroidism.

PBDEs in Breastmilk

There has been a large amount of press about studies that have detected flame retardant chemicals (polybrominated diphenyl ether, or PBDE) in the breastmilk of American and Canadian women. Following are links with more information.