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.
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
Mom with Engorged Extra Breast Tissue
April 15, 2010
Question
I saw a postpartum woman today with her 5 day-old baby. At about 16-20 weeks into her pregnancy the woman noticed a large lump in her left axilla. Her OB/GYN doctor recommended a biopsy—results showed benign breast tissue. The area continued to grow with the pregnancy and today is roughly the size of a golfball. Milk leaks from the site of entry of the biopsy (which was done in November 2009). No supernumerary nipple is evident. She has a similar but smaller tissue lump in her right axilla. She is incredibly frustrated with the leaking in her armpit. She asked about weaning and wants to take a pill to speed up the process. She said she was committed to breastfeeding until the leaking from the axilla occurred. Can she shut production down in that area only? What do you recommend?
Heather Henry, BSN, RN, IBCLC
A Case of Low Milk Production in a Mother with a History of Breast Augmentation, Stroke, and a Clotting Disorder
February 8, 2010
Question
I have a client who had breast augmentation in 2001 with incisions under her arms. She said her breasts were a B-cup size and she was “not in proportion” as the reason for the cosmetic surgery. During a medical history, she reported she had previous “mini strokes” at age 21 while on hormonal birth control. Genetic testing revealed a clotting disorder and several mutant genes. Lovenox was prescribed for the clotting disorder.
The mother stated the reason for the consultation as “low milk supply – cannot pump much milk.” Her baby was 2 oz. below birth weight at 15 days of age. A weight check after breastfeeding from both breasts indicated an intake of approximately 2 oz (58 cc). Pumping after breastfeeding yielded another 1 oz (28 cc). The mother has added pumping with the hospital-grade pump but still does not have a full milk supply. The baby is gaining weight and is more content now with supplementation of expressed breast milk and formula.
Do you think the clotting disorder could be related to her low milk production?
Deborah Ehrhardt, BA, IBCLC
Skin flaking from the nipple into pumped milk
December 15, 2009
Question
We have an African American mother pumping for her preterm baby. The nursery nurse noticed black flecks in the milk. The nursery nurse was concerned so she did not give the mother’s milk to infant. I thought maybe it was her skin flaking off while pumping. I suggested the mother use a larger breast flange while pumping. What are you thoughts on this?
Breastfeeding following lumpectomy and radiation therapy for breast cancer
October 13, 2009
Question
I am a physical therapist, childbirth educator and lactation counselor from Israel, temporarily residing in the States. I have a question about breastfeeding after radiation therapy for breast cancer. The woman is 42 years old. She has a 7 year old son whom she breastfed for 2 years. Her milk supply was high during that lactation. She is now 17 weeks pregnant. A year ago she had breast cancer in her left breast and had a lumpectomy, radiation and some lymph nodes removed. The “affected” breast has not grown as the other one has during pregnancy. Read the rest of this entry »
Birth Trauma, Tongue-tie, and Low Milk Supply
September 23, 2009
Question
I am currently assisting a 38-year old first time mom with an 8-day old term infant. Baby was born in a Baby Friendly hospital facility and weighed 8 lb 3 oz (3712 g). On day 8, infant weighs 8 lb (3627 g). Read the rest of this entry »
Infant’s Retracted Upper Lip and Maternal Nipple Trauma
September 15, 2009
Question:
I am struggling to assist a woman with a newborn, 4 days old who is causing trauma to the nipple. The issue appears to be the infant’s curling upper lip. The baby’s upper labial frenulum is tight and the lip is difficult to uncurl while on breast. Mom’s nipples are small; her breast and areola large. Baby takes best with cigarette type hold on areola. I can get baby in good position, but mom cannot get baby on without pain on top of breast where lip curls in. Mom is coming in today for follow-up after discharge.
Cynthia Sales
Flavor and Odor Changes in Stored Human Milk
September 11, 2009
Question:
I work at a small rural hospital in beautiful NW Montana, and lead a Mother/Baby Group weekly. I get a lot of breastfeeding questions, and one which has come up more than once recently, and which I have not been able to find an answer for is about breast milk that has been frozen and then thawed to use when the mom has to work. The baby will refuse to drink the thawed, warmed milk, supposedly because of an enzyme, or something similar, in the milk which makes it tastes bitter. I reviewed the mother’s procedures for storing the expressed milk, and then how it is thawed and warmed, and she seems to be following the correct procedure. I have never heard of this before recently, and now I have had a couple of moms ask me about it. Can you shed any light on this for me, and is there any solution to it?
Thank you so much,
Debbi Foss, RN, Lactation Specialist Read the rest of this entry »
Placenta Accreta and Complications of Lactation
August 26, 2009
Question: I am working with a mom, 2 weeks post partum who has placenta acreta. Her baby is in NICU. She has very little milk. The doctors are hoping that the placenta will reabsorb and we are wondering if she keeps pumping if there is a chance that she might begin producing milk later on. I am wondering if you have worked with a mother with this problem before. It’s my first time.
Jean Geurkink, IBCLC Read the rest of this entry »
