Frozen Milk Running Out. Suggestions?

QUESTION

Dear Lactation Consultant,
I have a 9-month-old and have been breastfeeding since day one. She typically takes 4 feedings a day; two of which include 6-ounce bottles that I pump at work. She also eats three babyfood meals and one snack.

Recently I have had trouble pumping the full six ounces and want to know if she still needs this much or is she tapering off to 3 feedings. I have been supplementing with frozen milk but will run out soon. Any suggestions?

Thanks.
Keri

ANSWER

Hi Keri,
She may be tapering off on her breastmilk intake since she has been on solids for several months now. If she is only taking milk four times a day, and two of those feedings are pumped milk and not milk taken at the breast, then you aren't getting a lot of breast stimulation at this time. Maintaining your supply when you are working and pumping and your baby is only nursing twice a day is going to become more of a challenge as time goes on.

It is inevitable that your supply will diminish as your baby spends less time at the breast. Babies who use the breast for comfort (nursing at nap and bedtime, when they bump their knee, when they are upset, etc.) tend to nurse more frequently and wean later than babies who are self soothers. Self soothers are babies who use thumbs, pacifiers, security blankets, or a combination of these to comfort themselves and to help them drift off to sleep. These babies tend to lose interest in nursing once they become mobile and are eating significant amounts of solids.

It sounds like your baby is in the process of weaning herself, and if this pattern continues, chances are that she will be pretty much weaned by the time she reaches a year of age. Babies who are still nursing often at a year typically will continue nursing well into toddlerhood, but none of this is written in stone -- every baby is an individual.

Breastmilk is a very complete food for at least the first six months of life. From 6-12 months, an "educational diet" is recommended. This means that others foods gradually begin to provide for nutritional needs that milk alone can no longer provide, and your baby gets used to different tastes and textures as well. Breastmilk or formula should be the main source of calories up till the end of the first year, and should still constitute about 75% of her diet at 12 months (25% solids).Since human milk is the most nutrient dense food you can give your baby, solids should be started slowly and not over-emphasized in the first year when the baby's brain is still growing so quickly. From 13-24 months, the complementary diet increases until by 18 months, 50% of the diet should be milk (preferably breastmilk) and 50% solids. By 24 months, toddlers should still have about 20% of their nutritional needs met in the form of milk, and about 80% by solids.

In your situation, I would try to make sure that she gets the majority of her calories from milk, and not rely on more and more solids to fill her up if she doesn't seem satisfied. If you don't want to use formula, you could try pumping or nursing more often in order to meet her need for milk. If you aren't able to produce enough milk, then I would supplement with some formula for a few months until she is ready for cow's milk.

It's wonderful that you have been able to provide your little girl with the benefits of breastmilk for this long, even with the challenges of returning to work. I hope that she continues nursing until you are both ready to wean, and that you feel good about the fact that you were able to get her off to such a good start in life!

-- Anne, IBCLC

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.