We were lucky enough to have Kristine Kovach, one of Austin’s best Lactation Consultants, answer some questions about breastfeeding!


What’s the scoop on avoiding an underwire bra while lactating?


Not everyone needs to avoid every bra.


While it’s important not to stress and press on the changing tissues during the early days of breastfeeding ( I often encourage new moms to only invest in several medium and large jogging bras for those first few leaky weeks) as you return to work and need a better look as well as more support, an underwire may be just fine for you.


A great fit is the priority. This is the time; 4-8 weeks postpartum, when the body has begun to adjust. Spend the money and time to visit a bra-fitting expert. The Austin area has several women’s boutiques and breastfeeding supply stores where you can get the individual attention you need.


A poorly chosen underwire that “slips up” and pinches/compresses delicate tissues can lead to blocked ducts and general discomfort. Many women who take the time to choose their “back to reality bra” have no issues with wearing an underwire. You’ll certainly know fairly quickly if you’re one of the very few who can’t wear a traditional support bra and may have to explore other options.


It’s an investment to get great foundational pieces and it’s worth it. If someone wants to pamper you after birth (and they should), ask for a gift certificate and maybe even a sitter while you go take this time for yourself. The perfect nursing bra isn’t really something to shop for during pregnancy, you will go through a sometimes impressive array of sizes before nursing is well established–so, keep an open mind and put this on your “to do” , not your “TOO DUE” list.


Is frozen milk good for 24 hrs from the time it comes out of the freezer or from the it is actually thawed?


Breastmilk that’s been frozen can be stored in your refrigerator for 5 DAYS. If it’s going straight from freezer to diaper bag or counter top, it would be vulnerable to bacterial contamination only 5 HOURS after it thawed.


Easily and conservatively put:


Expressed Breastmilk can be stored

  • 5 hours at room temperature (normal room temp, not a hot car in a Texas summer)
  • 5 days in the refrigerator
  • 5 months in the freezer

If in doubt, sniff. Human milk is as obvious as any mammal’s milk when it’s gone bad.


Preventing plugged ducts while weaning?


If plugged ducts have been recurring during the entire length of nursing, a lecithin supplement has been shown to help reduce this issue. That makes sense as lecithin is an emulsifier used in cow’s milk to make it sMOOther 🙂


There are also other homeopathic approaches, some as simple as increasing water intake to acupuncture that really seem to help… In more extreme cases there is also long term, low-dose traditional antibiotic use.


Being careful not to “over pump” during weaning is important, too. Some women send a mixed message to their breasts when they don’t like that “full feeling ” and continue to stimulate with double electric pumps, especially. `Minimal pumping and gradual stepping down is the wisest approach. If you know you want to be done with breastfeeding in June– start stepping down in April!


How to effectively wean without problems?


Wean gradually.  (see above)


That’s the easiest on everyone. Some of the saddest calls I get are from moms who want the baby weaned at EXACTLY  one year. When I ask them how long away that is, some have said “Oh, he turns one this coming weekend!” and they’ve done nothing to reduce their current nursing schedule.


That seems a little stark: Happy Birthday, Honey! No more Milk for YOU!!”


It helps if the baby is well and no other big changes are on the horizon. Begin by eliminating the most “MEH” feeds of the day– the one(s) your kiddo doesn’t really ask for. Instead, go to the park, for a walk, have a special snack, get a new ball or active toy to distract.


“Don’t offer, don’t ask” should be your new motto during this weaning process. Early am and late night feeds are often the last to go and I’ll bet my last dollar we all know people who indulged those last sweet feedings for months… YEARS beyond when their nosy relative/neighbor thought they did. I’ve been doing this work for a LONG, long time–believe it or not, I don’t get many calls about difficulty weaning (less than 2-3 questions a year out of hundreds) so, don’t let it concern you disproportionately. In our busy world, most kids wean too fast–before mom is ready!


How to prevent recurrent mastitis/yeast?


Mostly try to avoid getting them initially. Seriously- take a good prenatal breastfeeding class, get out of the bed and feed, get several experienced staff/friends to watch you feed, and expect your nipple not to exit the baby’s mouth pinched or creased. Don’t accept and suffer with damage and soreness to the nipples–that’s a portal for bacteria and often the genesis of Mastitis (infection of the internal breast tissue). Don’t let anyone say “it’s supposed to hurt”.


Tender? Yes.
Scabbing? Damage? No.


There are too many variables to discuss every way to best manage recurrent mastitis in this forum. Cabbage compresses, diet change, postion and latch help, learning not to press a thumb/fingers deeply into the breast while feeding, not sleeping in a certain way that aggravates the problem, not sleeping in a restrictive bra, weaning from nipple shields, better pump flange fit–all can matter when addressing mastitis.


Yeast is a separate beast 🙂


In our climate, with the use/over-use of antibiotics and a gender-wide love of chocolates/sweets, bready treats, yeast (candida) can be rampant. If you know you or your infant need anibiotics, offset their impact with probiotics and simple home approaches like pouring a cap full of white vinegar over each nipple for a few seconds before your daily shower. Keep your sugar intake low and seek broad spectrum topical and possibly perscriptive care for both you and your child if either shows yeast symptoms.


Thorough, timely treatment of BOTH parties in the symbiotic relationship of breastfeeding is essential when dealing with yeast. Treat the baby as you treat yourself, even if the pediatrician doesn’t see yeast in the mouth. Diaper rash, a hoarse cry and fussy gassy behavior are very often overlooked as signs of candida in infants and children. Consider toys, pacifiers, bottles, pump parts, bath towels, etc as a source for transmission of fungus and bacteria. I once saw a family that could not shake yeast. The mother suspected her two year old as the source and so she was treated simultaneously with her parents and infant sibling, but in the end their lovable Labrador was the real culprit–his floppy ears were full of yeast. Toddler pets puppy, then pets baby, vicious cycle ensues.


Keep speaking up if your infection/pain isn’t being addressed. Seek a different opinion and trust your gut if you feel nursing isn’t going well. Check out the forums on KellyMom.com and do a little research at reputable breastfeeding sites like Dr. Jack Newman’s and the La Leche League.


Is lactation support covered by the new healthcare law?


It is SUPPOSED to be, and by and large people seem to be getting more help than in the past. It’s best to do your homework ahead of time. Call your insurance company during pregnancy and inquire about pumps, prenatal classes an post birth support. Some companies allow up to 6 visits with a Lactation consultant post partum! Asking questions like “What pump brands do you offer?” is preferable to “Do you give new moms a pump?” If you meet resistance it’s often helpful to get your OB, Midwife or Pedi on your side. A diagnosis and an insurance code (they love their codes!) can make a big difference in getting help.


In the end, your healthy baby saves everyone money and that’s inarguable.


Happy Nursing!


For questions or to set up a consultation you can email us or call (512) 542-3354.

Kristina Juarez-Bridges

Kristine Kovach

Kristine has been a Board Certified Lactation Consultant in private practice and varied clinical settings since 1999.  She has helped over 10,000 nursing families achieve a workable and enjoyable nursing experience with confidence and peace.

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