The Tot Q&A: Breastfeeding Help

Are you a nursing mom or mom-to-be with breastfeeding questions? In honor of World Breastfeeding Week (Aug. 1st-7th) we asked you to send in your questions on breastfeeding to be answered by our chief lactation expert Rebecca Agi, MS, IBCLC of @BestMilkLA.


Q: If my baby falls asleep while breastfeeding, does he need to be burped?

A: Great question! Burping is not a requirement, especially if the baby is sound asleep. Breastfed babies tend to take in less air than bottle-fed babies, so as long as the baby seems comfortable, there’s no need to wake him up for a burp.

Q: How can I get an adequate supply for my 8 week old twins? For reasons out of my control they’ve been on formula for most the time and I want to breastfeed them so desperately.

A: Luckily breastfeeding is not an all-or-nothing process! Any amount of breast milk the twins get is beneficial. To increase your milk supply, you’ll want to stimulate the breasts by breastfeeding or pumping more often. The emptier the breasts, the more they’ll refill. You can try nursing one baby at a time or even both if you’re feeling brave. The more stimulation, the better! Achieving a full milk production at this point may take some individualized care, so I highly recommend reaching out to a lactation consultant in your area to come up with a plan that’s fit for you!

Q: My baby just turned one this past week. Food has been a struggle, because he rejects a lot of it. We talked to speech specialist and with some techniques and patience he’s been eating bits more and more. He mostly nurses, that’s where he spends most of the day. Should we just keep doing what we’re doing and see if there’s progress following our plan for a few months?

A: Happy Birthday to your tot! It sounds like you’re making some progress so definitely continue doing what you’re doing and offering different foods each day. I also recommend eating together. Remember, children are copycats, so if they see you trying new foods, there’s a stronger chance they’ll try it too.

Q: I will be a stay at home mom for a while and exclusively breastfeeding. I’d like to start her on bottles after she’s 1 – can I wait till she’s around 9 months to start pumping more and building a stash so she has breast milk for 2 years?

A: Congratulations and great job on committing to exclusive breastfeeding! You can definitely start pumping around 9 months if your goal is to build a stash of milk in the refrigerator or freezer. It’s hard to say if your baby will accept a bottle or not, but most exclusively breastfed babies will strongly refuse a bottle at first if you wait too long to introduce it. My tips for getting a breastfed baby to take a bottle include: having someone else offer it, experimenting with different nipples and bottles, and not waiting until the baby is too hungry since that can result in extra fussiness. If your baby refuses the bottle altogether, you can always try cup-feeding. You can also add extra breast milk to pureed foods for an extra boost of nutrition.

Q: I’ve breastfeeding my son for 9 months now…any advice on the weaning process before I go back to work when he’s one? At 11 months I plan to start trying to only nurse in the AM and PM as when I’m at work/he’s at daycare I obviously can’t nurse him. I was also going to give him almond milk as I’ve been told by my pediatrician that as long as his calcium intake is good there is no concern…what are your thoughts on this? Thanks so much

A: Amazing job making it this far! Cutting out a mid-day feed is a good first-move since morning and evening feeds are usually the last to go. I always recommend taking a slow and steady approach to weaning if possible. You can do this by eliminating one feeding every 3-7 days before dropping the next. This approach allows your milk supply to decrease slowly, without feeling fullness and discomfort. If you do feel engorged, express just enough milk until you’re comfortable. As for the almond milk, if you’re pediatrician says it ok, go for it!

Q: Any tips for mothers expecting twins who may be looking to exclusively pump versus combing pumping and nursing?

A: Great questions and good job for planning ahead! I highly recommend contacting your insurance company to see which pumps are covered under your plan. Since you’re expecting twins, a double electric hospital-grade breast pump would be the best option for you. Hospital-grade pumps

Q: What is your recommendation for starting solids, my daughter is 4 months old and kind of slow gaining weight due to food allergy issues. She is exclusively breastfed!

A: Great job on exclusively breastfeeding! Readiness to begin solids is based on two factors: the baby’s developmental readiness and maturity of the digestive tract. The American Academy of Pediatrics and World health Organization both recommend introducing solids around 6 months of age, but there are certain cases when solids are introduced earlier. If you think your tot might be ready, or if she is gaining weight very slowly, I recommend discussing it with your tot’s pediatrician to figure out the best plan of action!

Q: I breastfed both my boys and after breast surgery to remove tumors, I was told it will be almost impossible to breastfeed my 3rd on the way. I’m devastated and don’t know what to do. Does anyone know if I can look where to get breast milk from and is it safe to do so for my baby?

A: There are a bunch of different factors to take into account including: how many years have passed since the procedure/surgery, whether or not you have sensation in the breast and nipple, where the incisions were made, whether one or both breasts were affected by the surgery etc. Some women who go through breast surgery, lumpectomy, tumor removal or single mastectomy are still able to produce enough milk to meet their baby’s needs. The main concern is whether or not milk ducts and major nerves were cut or damaged. The only way to know if you’ll produce enough breast milk is to try! Having your baby’s weight monitored closely will help determine whether you’re producing enough or not. If you aren’t, donor milk is the next best option. I encourage you to check out Human Milk Banking Association of North America. HMBANA is a nonprofit milk bank that screens and pasteurizes all donor milk prior to dispensing it. I wish you so much luck!

Q: Hey! New mom here who is trying hard not to get super emotional about not being able to breast feed. My baby girl won’t latch so I’ve tried pumping and can only pump about 1-3 ounces (both breasts combined) a session so I’m having to feed her breast milk and formula. Any advice on how to increase milk supply?

A: Emotions are completely normal right now! My first recommendation for increasing milk supply is always to increase frequency of breastfeeding and/or pumping since increasing breast stimulation is a proven method to help increase milk supply. The emptier the breast, the faster the body makes milk to replace it! Believe it or not, your milk production actually sounds very good, especially if your baby is in the first 1-2 weeks of life. Keep offering the breast and experimenting with different nursing positions. You can get there!

Q: I’m nursing a 21 month old and I really would like to start weaning her. She’s definitely not ready as I have become a source of comfort & confidence for her when she’s upset or in a new environment. I need to stop because my hormones r getting super messed up (existing thyroid issue) and I’ve just started working. I feel selfish for wanting to wean for my own reasons but I originally was aiming for 2 years anyways. Any pointers/process I can adopt that wont be traumatizing for her? Last thing I want is for her to feel rejected or abandoned.

A: Don’t feel selfish, you’ve been nursing for 21 months! You literally deserve a gold medal. You can start by not offering and not refusing. For some kids this won’t make a big difference (they’ll just ask for it) but if you don’t offer, nursing won’t be on her mind and may get you both closer to weaning. I like recommending this approach since it takes into account the child’s needs. Good luck!

Q: I have exclusively given breastmilk to my baby… breastfed at first until he weaned himself around 8 months. I’ve been pumping ever since. With my frozen stash running out and me not producing as much as he intakes daily, I’ll have to supplement the last month. I’m giving breastmilk until 1 year and I have enough to keep it exclusive until 11 months. What is your recommendation for supplementing? Organic formula, cows milk, goats milk? I’ll be mixing breastmilk with whatever I choose. Trying to weigh my options!

A: Congrats on making it this far! The American Academy of Pediatrics recommends no cow milk until after the first birthday. Just to be safe, this is something you may want to discuss with your baby’s doctor.

Q: Is it better use a hospital grade pump (bought or rented) than a regular pump because it’s better for your milk supply? Is it true that when a baby is a newborn you should wake them up in the middle of the night to feed if they don’t get up naturally or that if you let them sleep you should still get up and pump?

A: Hospital grade pumps are designed to help establish milk production while regular electric breast pumps are useful for mothers who are breastfeeding but also want the option to pump. During the first few weeks of life (and especially until your baby is back at birth weight) you’ll want to feed every 2-3 hours or each time baby shows signs of hunger. Aim for a minimum of 8-10 feedings per 24 hours, although more is always better!

Q: How do you wean a baby off breastfeeding, I plan to breast feed till 1 year, but I’m not sure when to start weaning and how?

A: You can continue breastfeeding as long as is mutually desired! There are different approaches to weaning, but slow and stead is always my recommendation. When the time comes, you can start by eliminating one feeding every 3-7 days before dropping the next. This approach allows your milk supply to decrease slowly, without feeling fullness and discomfort. Just remember, babies continue to benefit from breast milk even after 12 months.

Q: I have been exclusively breastfeeding my 3-month old and she has been sleeping through the night. I return to work in 2 weeks and will only be able to nurse at night and on weekends (and pumping during the day). Her first meal of the day is at 8am. Should I try to incorporate a ‘dream feed’ either before I go to bed or in the morning before I go to work to keep supply up? Or will I be ok if I pump during the times she eats? Thanks!

A: Great question! You’ll definitely want to take full advantage of the time you have together, which means nursing before and after work. You’ll also want to continue pumping as often as she feeds when you’re away from each other. Remember to set reminders for pumping on your phone or work computer and wear two-piece outfits to make pumping manageable and doable at the office. Good luck on the transition. You got this!

Q: How do I know if my 4 month old baby is feeding for comfort or hunger during the hourly wake ups we’re having overnight currently? And how do I reduce the overnight feeds as he gets older?

A: Babies can regress on their nighttime sleep stretches for lots of reasons including teething, illness and development (to name a few). There’s so much to discuss when it comes to infant sleep and breastfeeding so I recommend looking into Elizabeth Pantley’s book “The No-Cry Sleep Solution” for a realistic, breastfeeding-friendly look at infant sleep.

Q: My baby girl is drinking a lot less milk since she started solids. Is it normal for her to drink less than half of what she usually drinks in a day? She’s eating 3 times a day now though.

A: Thanks for your question! Its hard to say if 3 times per day is enough since other factors need to be taken into account, but I encourage you to continue breastfeeding on demand, as your milk is still her primary source of nutrition until about 1 year. Just do your best to follow your baby’s cues!

Q: I’ve got a 16 month daughter who I still breastfeed at night before she goes to bed. I’ve just recently dropped her morning breastfeed. She eats well, but refuses any other milk, and always has done – cows milk or formula. Can I drop her night feed? It would mean she would have no milk apart from in her cereal in the morning. Thanks

A: Sounds like you’re doing a fabulous job! According to the American Academy of Pediatrics, 1 year olds can get enough calcium and vitamin D from 8-12oz. of cow’s milk per day. If you’re worried your tot isn’t getting enough, you can offer other dairy products like yogurt or cheese. In terms of when to drop the night feed, that completely up to you and her!

Q: I have an 8 month old baby who now uses feeding for comfort and to help him fall asleep. I wanted to start weaning him before going back to work when he turns 1. Any suggestions as to how to go about this? I’ve tried so many different types of bottles/nipples but he won’t take any of them. He will have a little bit from a cup but I’m afraid it’s not enough.

A: So much of getting a breastfed baby to take a bottle is about patience and persistence! I always recommend having someone else offer the bottle. A breastfed baby will often refuse the bottle if he knows that mom is around and available for nursing. Also, don’t wait until the baby’s hungry to offer it since hungry baby = fussy baby. Lastly, Patience and persistence is everything so if it doesn’t work today, you can always try again tomorrow!