Ask B&K
Ask B&K is dedicated to answer some common questions that people ask us. We encourage you to look below for answers we have written. If you have a question you would like to ask us just click the submit a question button.
Counseling a Working Mother: Workplace Pumping and Embarrassment
September 30, 2011
Message:
Dear Barbara and Kay,
I have a client who has returned to work. Her baby was born 5/6/11. She is a PhD at a university. She asked about pumping frequency at work and the effects on supply if she skips a pumping. We discussed the implications of regular milk removal. Breastfeeding is very important to her.
Her workday consists of many meetings with colleagues (all men). Her real question was how to tell her colleagues that she would need to step out periodically to go pump. She does not want to be perceived as not doing her job and would rather not tell them anything. I suggested that she pump before meetings and at breaks. She still feels as if she may be late returning to meetings after breaks and does not want to explain this to them.
Do you have any suggestions for this woman? She really feels as though she has no support at work. Read the rest of this entry »
14 Month Old Breastfeeding Baby Refuses Solid Food
August 2, 2011
Message: I have a client who has a baby boy who is 14 months old. He is exclusively breastfed, but he refuses all kind of solid food. The mother has tried almost everything. He appears a little overweight. She asks if she has to wean him? Read the rest of this entry »
Issues With Donating Used Breast Pumps
July 12, 2011
Question:
What are the issues involved in donating used breast pumps?
I work with a mother support group. We have a policy against accepting used pump donations. Since we can’t take used pumps, what do you usually suggest that she do with the pump she is finished using? Read the rest of this entry »
Mastitis and a Breastfeeding, Teething Toddler
April 19, 2011
Question:
I am an LC, but this question is actually about a problem I am experiencing personally. I have a 20 month-old who nurses well. Over the course of a few hours I recently came down with fever and chills and the bottom area of my left breast became inflamed and sore. Breastfeeding does not feel uncomfortable, and in fact, feels normal. After resting overnight, my fever and chills were gone, but my breast remained tender and pink underneath. I am taking garlic, echinacea and vitamin C. This episode began on Thursday early evening. It is now Saturday afternoon, and I am wondering if I need to take antibiotics. Since fever and chills are gone isn’t this sign that my body is on the mend? Am I still at risk for abscess by not treating with medications? Read the rest of this entry »
A Pregnant Woman with Persistent Breast Mass
April 7, 2011
Question:
A woman has contacted me because she has what appears to be a plugged duct or mastitis during her pregnancy. This is her second pregnancy. She is not nursing an older child. She is 34 weeks along and has had a red, hard spot below her nipple for 6 weeks.
She has seen her OB and a breast specialist. The breast specialist is saying that this is a normal change during pregnancy. The breast specialist did try to aspirate fluid from the lump, but there was no fluid. The woman has taken two courses of antibiotics. She is returning to her OB and the breast specialist. I suggested she also contact an LC. I also passed along information on treating plugged ducts and mastitis. At this point it does not appear to be mastitis because she does not have a fever.
What she is really interested in knowing is whether this is at all common. She had supply issues with her first baby and is worried that this situation will negatively impact nursing her second baby.
Read the rest of this entry »
Breastfed infant with sudden onset of “crayon orange” colored stools
February 15, 2011
Question:
I have a client who has a 20 day old newborn. Stools have been described as crayon orange for the last 24 hrs. Weight is 400 grams over birth. Blood tests indicate normal bilirubin levels. The exclusively breastfeeding baby is slightly yellow in color. No new medications since birth for mom or babe. Mom is finishing prenatal vitamins and iron supplement (which was initiated at 4.5 months of pregnancy). I have tried to find literature on same and have not found a good resource. Can you assist me in directing me to a good resource for this client to determine if this is of concern or not. Thanks.
Marni Hicks, Public Health Nurse, R.N., B.S.N. Read the rest of this entry »
Physiological Feed Volumes for Infants Requiring Supplementation on Days 1-4
November 1, 2010
Question:
Dear Barbara and Kay:
My facility has guidelines re: newborn stomach capacity for infants requiring supplementing. Day 1: 5-7 ml, Day 2: 12-17 ml, Day 3: 22-27 ml, Day 4: a whopping 60-87 ml!!
I am looking for scientific evidence to support my claim that the current amount recommended for Day 4 is too much for most newborns. Can you provide your guidelines and any other references? Read the rest of this entry »
Nasal Regurgitation of Milk While Feeding or Burping
October 25, 2010
Question:
I attended your lecture in Christchurch, New Zealand 2010. You mentioned a baby who experienced milk coming out of his nose when breastfeeding or burping. I have a client with a baby who is experiencing this issue. Can you please comment?
Yvonne Martin
Biting, high palate, poor feeding in 37 weeker
August 13, 2010
Question:
Message: Hi, I have enjoyed hearing both of you talk at conferences through the years, and feel I’ve learned so much from you both. I have a mom and baby I am working with that has me puzzled. Baby was only 5-11 at delivery, 37.5 weeks, and was on bottles for the first two weeks while mom pumped. Great milk supply. He does not have a tongue tie, but has issues extending his tongue. We tried a nipple shield, and without, he’ll do fine occasionally and then resort to biting again. Mom has discovered that she can get him on in the semi-reclining (nurturing?) position, but then he bites with the upper gum. He has a high palate, could this be the cause of him biting with the upper gum? The only thing I could think of. She does have ‘smallish’ nipples, which gives him less to get his tongue under. She is very determined and I want to help her succeed. Any suggestions??
Suzy Adams, RN, BSN, IBCLC
Read the rest of this entry »
Breast Pumping After Breast Augmentation Surgery
May 17, 2010
Question:
I am a IBCLC at Stanford and my co-worker asked me a question that I could not answer for sure. She asked: Can a mom who had breast augmentation with incisions under the areola or under the breast pump as a mom would without a history of augmentation? I have had many new moms with such histories pump without a problem, meaning no apparent damage, and most were able to get colostrum. Some moved on to pump transitional milk. I think her question was more in regards to risk of breast damage with pumping? What are your thoughts on this?
Barbara Dodson, IBCLC
