An OB Shares Her Patient's Questions About Breastfeeding

by Michele Brown, OB/GYN

Here's What You'll Find Below:  • Common pumping problems
  • Increasing your milk supply
  • Plugged ducts
  • Latching baby
  • Weaning to bottles

As an OB, my patients ask me just as many questions about breastfeeding as they ask about pregnancy itself. I don't mind at all because it is such an important topic. Over the years, I have scribbled many of these questions in my notebook so that I could research the most current information for new mothers eager to learn how to feed their babies the natural way.

Before writing this article, I interviewed the head lactation consultant, Ms. Renate Abstoss at Stamford Hospital in Connecticut, to get a second opinion and gather her responses. Ms. Abstoss sat for the First International Board Exam for Lactation Consultants in 1985 and has continuously worked in the field since that time in California, New York, Germany, Austria, Switzerland, and Connecticut. She was the first lactation consultant appointed as State Certified Teacher for Bavarian Midwifery schools.

There are probably many variations of responses to these questions so please consider this information helpful, but not absolute. I welcome any additional "pearls" from other lactation consultants or experienced moms so we can share the knowledge and promote the best nutritional health for babies everywhere.

What Are the Most Common Problems Women Encounter When Pumping?

Dwindling milk supply is probably the foremost problem that women encounter when pumping milk. This can be attributed to many different factors:

• Infrequent pumping: A working woman should try and pump every 3 hours for 10 to 15 minutes or at least for every missed feeding.
• Inefficient pumping: Pump being used may have inadequate pressure or not enough cycles per minute causing a decrease in the milk supply.
• Lack of time at the breast: When mom is home from work, she should try and breast feed the baby to stimulate milk production. For convenience, babies may be bottle fed too frequently.
• Painful nipples: This can be due to a bad pump due to excessive suction pressure, pumping for too long a period of time, or poor latch when the baby does breast feed.
• Fatigue and exhaustion: The stress of taking care of a newborn along with pressure from work and home can result in exhaustion and fatigue which can decrease the milk supply.

How Do I Increase My Milk Supply?

There are several medications and herbal products available to help with increasing the milk supply. To increase an existing milk supply, one can take two herbal supplements in combination -- fenugreek and blessed thistle, both of which are available in health food stores and have no known contraindications.

The prescription drugs Metoclopramide and Domperidone, both of which were designed as stomach medications, increase prolactin production in the brain. The medication Domperidone, (Motlium) is not approved for use in the United States and the FDA has issued warnings against the use of this drug as a galactagogue because in higher dosages, when given intravenously, Domperidooe it was associated with cardiac arrhythmias and cardiac arrest.