My 10 month old babe has started to come over (she’s been walking for about two months now). She starts to nurse, and then as soon as my milk drops she fusses to get up and walks away, happy as a clam I might add. Is this normal? Is she playing some nursing game that I don’t know about? I can’t find anything about it online. She only wants to really nurse at night, or if I catch her in a groggy state after a nap. Otherwise, it’s the routine above. Any info or suggestions? I don’t want to shoo her away if she really wants it. Is it a phase? Any thoughts you or others might have would be greatly appreciated!

My reply:

My thoughts are that it’s perfectly normal — that your daughter is excited about everything else going on in her day and is too busy to nurse. Her coming to you until the milk lets down is just her making sure it’s there if she needs it! She’s checking in and reconnecting with you briefly before she goes off to explore something else. It’s giving her the self-confidence and assurance to explore her world.

You’re doing the right thing by nursing at night and trying to catch her at other times that she is receptive, like when she just wakes up from a nap. If you want to encourage more nursing during the day, you could try the bathtub as a relaxing setting (skin-to-skin contact can help too), using a sling (if she enjoys that), or going into a darkened room.

One helpful resource is the book Mothering Your Nursing Toddler by Norma Jane Bumgarner.

What has your experience with toddler nursing been? Did your nursling’s level of interest in breastfeeding wax and wane over time? Did a period of reduced interest in breastfeeding lead to weaning? How did you handle any changes in nursing interest? Leave a comment!

Post from: Breastfeeding 1-2-3

My 10 month old son is not really biting me while nursing, but clamping down with his two new top teeth. Each of my nipples have sores in the shape of his teeth. I believe he is nursing the way he always has, but now that he has teeth he is clamping with teeth instead of gums. I do not want to wean him! What should I do? Both of my nipples are really hurting!

What advice do you have that might help this mother? What was your experience with nursing a baby with teeth? Leave a comment!

Post from: Breastfeeding 1-2-3

My husband was supposed to feed the baby with my breastmilk while I was away but I came home too early and now, the baby would not bottlefeed. He probably sensed me. Unfortunately, the breastmilk got wasted. So how do I prevent something like this from happening again? Likewise, how do we get the baby to bottlefeed even when I’m around?

I know lots of women have struggled with this issue, whether it’s just the occasional bottle of breast milk while mom’s away or the need for baby to take a bottle during the day when mom goes back to work full-time.

How did you get your baby to take a bottle (even when you’re around)? If you found something that worked better than bottle feeding, what are some alternatives?

Post from: Breastfeeding 1-2-3

I am an IBCLC and currently searching for information or testimonials on weaning from the supplementary nursing system. Once the line is introduced mothers and babies do seem to become dependent on it and knowing the best way to remove it from the breastfeeding situation seems to be as elusive as the scarlet pimpernel. Could someone assist me please to help these mothers? Thank you.

If you used a supplemental nursing system or you are a lactation professional who has helped mothers with an SNS, please share your experience by leaving a comment! Feel free to leave links to other valuable resources as well.

Post from: Breastfeeding 1-2-3

Q: “Hi, I’m hoping that you, or someone you know can help. I’m a tandem nursing mom to my 2 1/2 year old and my 12 week old. I never had any nursing issues or problems with my first. I am currently suffering from mastitis for the second time in 4 weeks! On top of that, my 2 year old was just diagnosed with Herpangina (a form of Hand, Foot, and Mouth) virus. I guess it’s very contagious by saliva and I’m praying that my 12 week old doesn’t get it. My pediatrician completely frowns on tandem nursing, so I kind of left this little detail out when we just saw her for my son’s herpangina.

When he started getting sick, I immediately started cleaning my breasts/nipples after he nursed to protect the baby. My OB said that actually cleaning the nipple could cause mastitis!?

Did I actually cause the mastitis this second time? How can I protect my infant from the Herpangina? What am I doing wrong this time to get Mastitis twice since I never got it with my first child? What can I do differently to avoid getting it again? Thank you so much for any advice you can give!”

A: First off, congratulations on your 12-week-old! I’m sorry to hear you have endured repeated bouts of mastitis this time around. Mastitis can be very debilitating and has a nasty way of kicking you when you’re already down. You should be very proud of yourself for working through both cases and continuing to tandem nurse.

Recurrent Mastitis

Let’s address each of your questions separately. Did you cause the second bout of mastitis? It’s true that mothers are generally advised not to wash their nipples with soap because the soap can remove essential oils from the surface of the breast. I doubt though that washing your nipples caused the second bout of mastitis. When a case of mastitis comes closely on the heels of a previous bout of mastitis, it’s likely that the first case never really went away and the “second case” is really just a second flaring-up of the first. When battling mastitis, it’s important to rest-rest-rest and nurse-nurse-nurse. If you take antibiotics to treat the mastitis, it is imperative that you take the full prescribed course of antibiotics and you do not stop taking the pills once you start feeling better.

Spreading Germs

How can you protect your infant from the herpangina? It’s fine to rinse your nipples with plain water, and for a little added protection from virus transmission you could express some breast milk onto your nipples and let the milk air dry. Breast milk has antiviral and antibacterial properties. However, KellyMom says it’s really not necessary to take any special precautions to prevent the spread of germs between nurslings (with the exception of thrush):

By the time symptoms occur in a viral illness, the two nurslings will have been in close contact for days (both in the home and at the breast), and thus the well child will have already been exposed to the illness. In addition, your breasts will have already started to produce antibodies specifically for that illness. These antibodies will help the sick child get well quicker and will also help protect your other child from illness….

Washing the breasts between nurslings might even reduce the breasts’ exposure to the pathogens and therefore reduce the breasts’ efficiency at manufacturing antibodies.

Avoiding Mastitis

What can you do differently to avoid getting mastitis again? As I said, breast infections kick us when we’re down, so the key is to stay otherwise healthy and (reasonably!) well-rested. Follow these ten tips for breast health.

Share Your Experience

How have other mothers dealt with mastitis? Have any other tandem nursing mothers dealt with viruses? Leave a comment!

Post from: Breastfeeding 1-2-3

Jen wrote:

I am very tired of our sleeping arrangements. My husband is so tired of them that he actually has opted out entirely and just sleeps in another bedroom by himself. I don’t know how to move away from cosleeping now, with my 22-month old daughter, without letting her cry it out, which I’m apparently not willing to do.

I miss sleeping with my husband. My daughter still wakes up to nurse occasionally at night, and that disturbs his sleep and leaves him working at a lower capacity all day the next day, which means more time away from home. He does everything he can to maximize time at home, and if that means sleeping by himself, he does it.

I would love to move my daughter to her own bed. My son got moved to his own bed at some point, but it took a long time to transition him. He sometimes sleeps with me and my daughter, but not often. Usually just if he wets his bed. I never change sheets in the middle of the night!

I loved cosleeping with both of my kids, and my husband has gone along with it because I loved it so much, but was not willing to tolerate broken sleep so slept elsewhere. I’m ready to sleep with him again, and I’m ready for my daughter to be in her own bed (in our room), but I don’t know how to do it in a gentle fashion.

I’m very frustrated about this right now.

What are some gentle ways to handle night-time parenting and moving away from co-sleeping?

Post from: Breastfeeding 1-2-3

Q: My 12 month old son is used to being nursed to sleep, but with three teeth coming in at once, he is now also a dedicated biter.

He bites me so often and so hard that I have had to limit his nursing sessions for the first time. His first birthday ended in hysterical screaming all night… he couldn’t sleep without the breast, but can’t seem to feed without biting. It’s been like this for days.

I have been firmly telling him “no” and taking him off the breast when he does this, I have offered him cold things to chew on. Giving him infants’ paracetamol for his teeth seems to help a little, but it’s really not a permanent solution!!

Unfortunately, the only other advice I have received on this topic is to either bite him back or wean him… neither of which suits either my parenting plan or appeals to logic.

A: Steph, I’m sorry to hear that you’re getting bitten! That must be very distressing for you. Good for you for exploring gentle ways to get him to stop. I hope I can help by affirming what you’re already doing and offering some other things to try, and maybe some other moms will share some tips in the comments too!

Before we scare new mothers away from breastfeeding, first let’s reiterate that many if not most babies do not bite, and of those that do, for many it’s a one-time incident that does not cause injury and does not get repeated.

If a baby does bite, what should you do?

~ A bite might make you yelp involuntarily, but do not purposely yell at or frighten your child as this could cause a nursing strike (a refusal by the child to nurse at all). While it’s easier said than done, keep your reaction to a minimum so your baby doesn’t bite again just to see a repeat performance of your reaction.

~ If you can help it, don’t pull the baby off the breast without breaking the latch or you might risk damage to the nipple. As you state a firm “no” or “no biting,” break the latch by inserting a pinky finger in the corner of the baby’s mouth. Alternatively (and counter-intuitively), you can try pulling the baby into the breast or gently plugging the baby’s nose. Blocking the airway briefly will prompt the baby to open his mouth to breathe.

~ Analyze when in the nursing session the bite occurred. If the bite took place at the end of a nursing session, consider your child a great communicator — he’s certainly found a crystal clear way to tell you he’s done! He’s also given you a good clue about how to stop further biting. The key is to watch him at the breast during each feeding and anticipate when he is poised to bite again. In particular, watch for tension in the jaw that might signal a bite. As the baby stops sucking vigorously and begins to start pacifying, drifting off to sleep or showing other signs of boredom such as playing with his hands or turning his head to look around the room, gently break the latch. If he protests, you can consider switching sides and letting him continue to nurse as long as he’s actively suckling.

~ If you’re nursing your baby to sleep and he won’t settle without the breast, try the gentle-removal technique from The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night. Essentially that technique involves breaking the latch repeatedly until the child settles to sleep without being on the breast.

~ If the biting is happening as your child is drifting off to sleep, consider changing up the sleep routine or adding in new elements. For a while I used a “white noise” alarm clock that played sounds of the forest, brook or ocean. My daughter began to associate those noises with going to sleep and was more likely to settle once the latch was broken. Some babies, particularly older ones, might accept a change in the sleep routine altogether such as: nurse first then rock in the rocking chair, sing songs, rest in the bed together etc.

~ If the bite happened at the beginning of the nursing session, run through the possible causes for the biting such as teething or frustration with waiting for letdown.

~ If a baby is teething, have him chew on a cold well-rinsed wash cloth before a nursing session to numb his gums. It can help to keep a supply of wash cloths in the freezer for this purpose. Over the counter pain medications and homeopathic teething tablets are options too.

~ If you think your baby is biting over frustration waiting for the milk to letdown, try hand-expressing or pumping just enough to get the milk to letdown before starting the nursing session.

~ If a baby is biting at the beginning of the nursing session and still needs to nurse again, you may obviously have reservations about putting the baby back to the breast. Stay vigilant in watching for signs of biting and keep your pinky finger poised to break the latch. If your baby bites and you break the latch, consider waiting a few moments before allowing the baby to nurse again. The older the child, the longer the wait and the greater the separation, i.e. for a 4-month-old a brief “no biting” and breaking of the latch might be sufficient. For an 8-month-old, you might break the latch and set the child down next to you or sit him up in your lap, just momentarily. For a one-year-old, you could stand him up on the floor next to you with a quick, “No biting. Biting hurts mommy. You can nurse again when you are ready to be gentle.” I’m talking a matter of seconds. You don’t have to wait for the child to show any acknowledgement or remorse. The point is not to frustrate or punish the child but rather to associate biting with the natural consequence of being removed from the breast and from the comfort of mom’s arms for a moment.

~ Praise your baby’s good behavior at the breast. In addition to creating a negative association with biting, create a positive association with not biting! Recognize your child with praise and kisses when he pops off the breast properly.

Moms, leave a comment if you have a tip for Steph. What are some gentle ways to deal with biting?

Post from: Breastfeeding 1-2-3

Q: I found you on breastfeeding123.com’s “Fostering Independence in the Breastfed Child” and I must say that I like your blog. I have a question on Attachment Parenting. Do you have a problem that your child is too “attached” if you follow AP approach? Will they become too dependent on you?

A: I’m glad you enjoyed that post and thanks for writing to me! Your question is a very interesting one.

The quick and dirty answer is no, the attachment-parented child does not become too attached or dependent. I can say that with confidence simply because attachment parenting does not set out to create dependence. Attachment parenting is not “helicopter parenting” or “hover mothering.” It’s not about doing everything for the child or seeking to keep the child dependent upon the parent. In fact, parents like me who practice attachment parenting find that the opposite is true. When children create a healthy attachment to their parents, they feel more confident and secure. With that self-assurance, children feel free to explore their world, becoming more independent because they know that they can return to the security of an attached and loving parent.

So, we know what attachment parenting is not. What is it then? It’s an instinctive, intuitive approach to satisfying a child’s needs (as distinguished from a child’s “wants” — attachment parenting is not permissive parenting either). The best way I can explain it is to give examples from my own parenting at various stages.

Attachment parenting my baby. In the first year, attachment parenting my baby meant listening to her cues and responding to her cries. I did that by keeping her close to me–holding her in my arms, carrying her in a sling, co-sleeping–without worrying about “spoiling” her. A baby needs as much love and attention as possible, and a parent’s investment during a child’s infancy will pay off tremendous dividends as the child grows. That’s not to say that I found attachment parenting at all difficult. My natural instinct was to respond to my child’s cries. I felt a physical response to the crying and it benefited me and my baby to respond to those cries. As I bonded with my baby and got to know her, I learned to read her cues before she had to resort to crying to communicate her needs to me.

Breastfeeding helped with attachment parenting my baby, but it certainly isn’t necessary. Attachment parenting is a general philosophy of parenting, not a rigid set of rules. It means something different for every family and each family can apply the principles that work best in that family dynamic.

Attachment parenting my toddler. Once my baby grew into a toddler, attachment parenting translated into gentle discipline. That meant no spanking, yelling at or shaming my child. It meant putting away temptations, keeping my child fed/well-rested/entertained, and re-directing her attention from forbidden activities.

My first toddler never really had a “terrible two’s” stage because breastfeeding stopped every tantrum in its tracks. Toddler nursing allowed my toddler comfort and time to settle down. Once the need for a tantrum passed, we could talk through whatever it was that precipitated the need to nurse.

At the toddler stage, I started to see more and more of a difference between my mothering and the non-attachment parenting style of some of my friends. When my child needed to be near me during playgroup, I stayed with her. I could tell that other mothers disapproved, but I felt sure that not pushing my child to an unnatural and early independence would pay off with greater independence later. Sure enough, my child grew more and more independent over the next few years. The same transformation happened when I refused to make my daughter “cry-it-out” at night. Through gentle sleep techniques she eventually started sleeping better and asked for her own bed. All along I have enjoyed attachment parenting and now I’m enjoying some of its more tangible rewards.

Attachment parenting my preschooler. Attachment parenting my preschooler meant preparing her for school by taking a parent-toddler class first. Then I chose a school that aligned with my parenting style and suited my child’s needs and personality (not the school that was cheapest, closest or offered the longest hours away from me).

Gentle discipline continues, although I must admit I’m challenged at each new developmental stage. Whining is particularly annoying but I’ve learned to ask my daughter to rephrase, “But Mom, I want it now!” to “Please may I have that?” (She may or may not get the object of her desires, but she definitely learns how to ask nicely!)

If you want to read what the experts have to say about attachment parenting, I recommend The Attachment Parenting Book by William Sears, M.D. and Martha Sears, R.N. (or see the attachment parenting chapter in The Baby Book).

What do you think, readers? Do you apply attachment parenting principles in your life? How has your parenting style affected your child’s emotional and social development?

Post from: Breastfeeding 1-2-3

Q: I could use some weaning advice for mothers who have been feeding on demand. I just cannot work all day and nurse all night. I am truly at the end of my tether.

A: Good for you for breastfeeding your baby on demand for a full year! When you start to resent nursing, it signifies that it’s time to make a change. Your needs matter and you certainly do not want to transfer any resentment to the baby.

As you begin cutting back on nursing sessions you may find one of three things happens: (1) the baby happily accepts alternatives to breastfeeding and the weaning proceeds smoothly, (2) the baby resists weaning and you decide it’s easier to keep nursing than to continue efforts to wean, or (3) you cut back on some of the nursing sessions and discover you are content to continue breastfeeding at that level of frequency. Those are all good options because in the end you’ve made a decision with which you are comfortable. Remember that partial weaning is an option and breastfeeding does not have to be an all-or-nothing proposition unless you want it to be.

The book How Weaning Happens by Diane Bengson offers a great deal of discussion on the philosophy of weaning and includes a chapter on weaning tips and techniques. The The Nursing Mother’s Guide to Weaning (new edition out coming out this April) by Kathleen Huggins is another option but frankly, I think mothers who are truly looking for weaning advice are frustrated by both of these books. The books are great if you’re looking for the inspiration to continue nursing or you just want to guide your child gently through a combination of mother-led and child-led weaning. For more practical tips, try:

~ Kellymom’s resources on weaning

~ La Leche League’s Frequently Asked Questions (FAQ) on weaning

~ My thoughts on gentle night-weaning

Here are some tips to get you started. Rule number one for weaning is proceed slowly. That allows the baby to adapt gradually and helps the mother avoid engorgement, plugged ducts and mastitis.

Many mothers make a lot of initial progress by following the simple principle of “don’t offer, don’t refuse.” You may find that you were initiating some of the nursing sessions yourself, either because you recognized the need or it was convenient for you to nurse at that time (I confess to having nursed my child so that I could get through a telephone conversation uninterrupted!) If you do not offer to nurse, you may find your child is willing to go longer between each nursing session. Then when the child finally does ask to nurse, you do not refuse because you know you’ve already made some progress in weaning.

For further progress, continue by eliminating the easiest feeding to drop and save the hardest (the one the baby wants the most) for last. I suspect for your baby the hardest nursing sessions to drop may be the first one when you get home from work and the last one before your baby goes to sleep.

Cut back on one feeding at a time, waiting 4-7 days in between. Talk to your doctor about what to substitute for the dropped feeding. For example, for children over age one you might decide to offer a cup of whole milk (no need to use a bottle at this age if you do not wish to do so) or some solid food. If the baby wants to nurse for comfort rather than to satisfy hunger or thirst, you can try another type of distraction such as cuddling, reading a book, or dancing to some music. I found that my child often wanted to nurse when she was bored or needed help with a transition from one activity to another. It helped tremendously to keep her engaged in fun activities and to have something new to offer after the last activity ended. “Oh, are you done playing with the blocks? Would you like to read a story or go outside for a walk?”

Some mothers find that it helps to avoid the situations or locations in which you typically would have nursed. If you always nursed in the rocking chair or on the couch and your child asks to nurse every time you sit down in that place, consider finding a new place to sit or even remaining on your feet. It might be easier said than done, but it’s better than struggling with a child who wants to nurse as you always nursed before.

Another way to cut back on nursings for older babies is to use delay tactics. Some babies may not be ready and able to wait for a nursing session, but you can try saying “We’ll nurse when we get to the car” or “Yes you can nurse in just a minute when I’m done cooking.” There’s a bit of debate about how to handle the next nursing session if you’ve successfully distracted the child from nursing right away. Personally, I felt that if I said we’d nurse when we got home, it was important to follow through and offer to nurse when we got home. Others feel that if the child completely forgets about nursing once you reach home, there’s no need to follow through. If you don’t offer at that time, certainly it would be important not to refuse the next nursing. “Of course you can nurse honey. I remember that we talked about nursing when we got home.”

When I needed to cut back on nursing sessions with my toddler, she had a hard time cutting out the number of nursing sessions so instead we worked on shortening the length of time we nursed at each session. We agreed that she could nurse for the length of time that it took me to sing two “ABC” alphabet songs. As the songs ended, she needed a final warning that it was time to stop nursing and I would say “Three, two, one, done. Pop off please!” She was able to comply with those restrictions much more easily than restrictions on when she could nurse. It was easier for her to hear “Yes you can nurse for a little while” than to hear “Yes you can nurse in a little while.”

Each nursing mother and child will find the best combination of substitution with food or drink, distraction, delay of nursing and shortening of nursing sessions.

Does anyone else have any thoughts and advice on weaning? What worked for you?

Post from: Breastfeeding 1-2-3

Q: Do you believe in toddler nursing and why?

A: I’m nursing my two-year-old toddler and I’ve already written a lot about toddler nursing. So, readers, I leave it up to you. Please de-lurk and leave a comment about whether or not you believe in toddler nursing and why.

(Feel free to use a false name and fake email address like my favorite: sorry@dontpostit.com, but know that then you’ll miss out on email notices of any other comments). Help out the anonymous reader and help make this the most commented-on post so far! Thanks and Happy De-lurking Week!

Post from: Breastfeeding 1-2-3