After many months of living with restrictions on activities many of us normally enjoy, the latter half of 2021 has seen a return to some of the things we had been unable to do during the Covid-19 pandemic.
While some families really enjoyed the opportunity of being able to spend more time with their babies and children during the various restrictions, mothers who had a new baby during 2020 and early 2021 sometimes felt isolated and without the support they would normally have had. Now it can be fun to finally experience taking your child out to activities and groups, and for the babies to experience things they had not been able to do before.
One of the most difficult things for families during the months of lockdown was not being able to visit relatives and friends and missing the get-togethers and celebrations that we normally look forward to, and for many it’s now so important to be able to meet up again.
It can be useful to remember that, while friends and relatives are longing to meet the new arrival, babies who have not been used to larger gatherings and meeting lots of people can sometimes be upset if they are held by too many new faces. So, if you go to big get-togethers or to stay with relatives, you may want to explain what you’re comfortable with when it comes to your baby. Also, if you normally share a bed with your baby, check the new sleeping arrangements for safety, making sure there are no dangerous gaps, saggy mattresses, or too warm covers. You can read more about safer sleep here.
Travelling
Breastfed babies are very portable and if you are able to travel to meet up with friends and family, then breastmilk makes the best travel food. You don’t have to worry about taking feeding equipment as your milk will always be available if your baby gets tired or hungry, or your journey is delayed. If you are travelling by car and your baby gets fractious or is hungry you can find somewhere to stop for a cuddle break and nurse. When using public transport, a baby sling can be useful when getting on buses and trains and can provide a discreet way to breastfeed if you wanted.
Breastfeeding has an added advantage when travelling by plane, as feeding during take-off and landing helps equalise the pressure in your baby’s ears. If you feel like you need some privacy and are travelling with another adult they might use a newspaper to create a screen between you and others. As long as you are complying with seatbelt rules, airlines should support a woman’s right to breastfeed. If a member of the crew objects you could ask them to check if this is the airline’s policy, pointing out that a crying baby will be far more upsetting than a happily nursing one. You can read more about travelling with your baby here.
Holiday Weaning
If you go away for a holiday break, visit relatives or have friends round, that often means extra work and activities. You may find yourself rushing around buying extra food and getting ready for guests. At various times of the year, if you have older children, there may well be concerts and shows to attend or a lot of parties to go to, or you may have extra shopping to do. At other times, when family parties or activities may be evening affairs, other people may not understand why you don’t want to leave your baby at home. It’s often assumed that you can “leave them with a bottle of expressed milk” and while this is something that may work for some babies, many mothers have been surprised to realise they really don’t want to be apart from their baby and that they prefer to take them with them. That’s quite natural and taking your little one along may help to give a positive message to others that it’s ok to take baby with you. If the host expresses surprise at an extra guest you might say “We come as a pair at the moment”!
At family get-togethers you may find that others are eager to hold the baby and times when the baby might have breastfed are spread out. You may find you are rushing around looking after guests instead of sitting down and breastfeeding. As a result, by the time the holiday or busy period is over, some women find that their milk production has declined due to decreased feeding and the baby may fuss at the breast. It may feel like you have “lost” your milk or the baby is weaning. A few days spent keeping the baby close to you and offering extra nursing time are usually what is needed to bring milk production back to normal.
To avoid a possible drop in milk production you might consider taking your baby with you on shopping trips and to parties or offering extra feeds when at home. Wearing your baby in a sling or wrap is very useful when you have guests. It enables you to keep your baby from being passed from one person to the next and becoming overstimulated.
If you are having a party or family gathering, it will help you to stay focused on your baby’s needs if you accept offers of help or ask for help from the guests. You might ask visitors to bring food contributions instead of making all the meals yourself. It can be helpful to keep a list of things that need doing on the fridge and if someone offers to help you can suggest something from it.
Longer intervals between feeds and some missed nursings may not seem significant, but holiday weaning can creep up and surprise you. It’s also important for you to make sure your breasts don’t get too full with delayed feeds while travelling or busy with activities. If you start to feel overly full, or get a sore, uncomfortable patch on your breast you might be developing a plugged duct which, if not addressed, could lead to a breast infection or even mastitis. You can read more about rectifying this here.
Although it’s often called “holiday weaning” it can also happen around festivities, birthdays or other special events, and even when you’re moving house. Whenever you and your baby are busy and distracted, if there are visitors or you have to make a business trip, holiday weaning could occur. Being aware of it and trying to ensure that activities, attention from others and distractions don’t inadvertently lead to less breastfeeds can help to avoid difficulties.
Holidays and protection against illness
Breastmilk provides a safe and convenient food wherever you are throughout celebrations and holidays. It offers valuable protection against bugs and viruses, which is especially relevant when you are spending time with others. Your body starts making antibodies in your breastmilk around 20 minutes after being exposed to a virus, for instance after being sneezed on. Similarly, if you develop a stomach bug, you rapidly pass on immunity to the baby.[1]
This has been important during the pandemic situation, and breastfeeding continues to be the best means of protecting a baby from getting sick, or of reducing the severity of a baby’s illness if a baby does become ill. If someone who is breastfeeding becomes ill, it is important not to interrupt breastfeeding unless it becomes medically necessary. When any member of the family has been exposed, the infant has been exposed. Any interruption of breastfeeding may actually increase the infant’s risk of becoming ill and even of becoming severely ill.
Mothers who become too ill to breastfeed should be supported in expressing or pumping so that the baby can still be given their milk.[2] You can read about the importance of breastfeeding during the coronavirus pandemic here.
If you need to take medication at any time you are breastfeeding, you may want to check with a doctor or pharmacist what the best choice is to ensure that the baby is safe. Generally, if a medication is safe for a baby to take, it is the best choice when breastfeeding. Medications may get into breastmilk by crossing from blood into the alveoli, but generally in very small amounts (less than 1%). Depending on the drug, a small amount in breastmilk may not be harmful to a baby, but alternative drugs compatible with breastfeeding are usually available. Breastfeeding is more than just food and it’s important to consider the risks of stopping breastfeeding, even temporarily. Substituting formula will deprive the baby of antibodies and immune factors which are protecting against illness and could have an impact on your supply.[3]
Some medications can make a baby drowsy, so there may be a need to wake the baby up to feed; some studies have also shown that certain cold and flu remedies cause a drop in milk production.[4] While Ibuprofen can be used, aspirin should be avoided. LLL Leaders can offer further information on this subject and another good source is the Breastfeeding Network.[5]
Do certain foods need to be avoided?
Get-togethers are a time to enjoy sharing meals, but nursing mothers and parents sometimes worry about the effect that the things they eat may have on their baby. For instance, it is sometimes thought that if you eat foods that make you feel gassy, such as broccoli or cabbage, this will make the baby gassy. Gas from your intestinal tract cannot pass into your blood and deposit itself into the breast for your baby to drink, but some of the proteins from digested food do enter the blood and may then pass into your milk. Some babies may be sensitive to a particular protein and react with wind and fussiness. If you notice that your baby seems to have an obvious reaction every time you eat a certain food, then it can be useful to try to eliminate that food from your diet for a while to see if things improve.
However, for most fussy and gassy babies, the problem is caused by some source other than breastmilk. Allergic reactions to substances in breastmilk may also manifest as skin, respiratory and intestinal problems. If a family has a known history of an allergy to a specific food, you may sometimes be advised to avoid that food during breastfeeding. However, more recent research shows this may not be necessary. In particular, it used to be thought that avoiding peanuts until a child was around three years old helped prevent peanut allergies, but later research seems to indicate that avoiding peanuts during pregnancy or breastfeeding does not help to prevent peanut allergies in a child.[6]
On the whole, you should feel free to eat whatever you like, as the majority of babies do not have any problems with food proteins. You can find more information about your diet and breastfeeding here. You can also read more about breastfeeding and food allergies and intolerances here.
Alcohol and breastfeeding
During social occasions there may be alcoholic drinks on offer. Breastfeeding mothers often receive conflicting advice about whether alcohol consumption can cause harm to their baby. Research indicates that alcohol levels in breastmilk closely parallel blood alcohol levels and, although drinking substantial amounts of alcohol regularly can have an impact on your milk supply and can lead to poor weight gain and motor development in your baby, occasional moderate drinking is not considered harmful for nursing babies.
The effects of alcohol on the breastfeeding baby are directly related to the amount the mother consumes, but other factors also need to be considered, such as the baby’s age (newborns have immature livers and will be more affected while an older baby can metabolise alcohol more quickly), a mother’s weight (a heavier person metabolises alcohol more quickly), and whether alcohol is taken with food (this decreases absorption into the blood stream).
Alcohol passes freely into breastmilk and has been found to peak about 30 to 60 minutes after consumption, 60 to 90 minutes when taken with food. As alcohol leaves the bloodstream, it leaves breastmilk too. It takes a 140 pound woman (10 stone, or about 63.5kg) about two to three hours to eliminate from her body the alcohol present in one serving of beer or wine; the more alcohol is consumed, the longer it takes for it to be eliminated.
Since alcohol is not “trapped” in breastmilk (it returns to the bloodstream as your blood alcohol level declines), pumping and dumping will not remove it or speed up elimination from the body. Neither will drinking a lot of water, resting or drinking coffee. If you want to minimise the alcohol your baby gets, you can try nursing right before having a drink and then wait until your body has metabolised all the alcohol (about two hours for each drink consumed). Babies often seem to want to nurse more in the hours afterwards.
If you are intoxicated you should not breastfeed until you are completely sober, at which time most of the alcohol will have left your blood. You should not bed share with your baby as your natural reflexes will be affected.6
If you want to drink but are concerned about the effect it might have on your baby, expressed breastmilk could be stored to use for the occasion. It may be necessary to express for comfort during the hours you are not feeding, discarding the milk. You can read more about breastfeeding and alcohol here.
Dealing with Criticism
After so long apart from relatives and friends some parents are finding that their longed-for reunion is being overshadowed by lack of understanding or criticism of their child-rearing decisions. You may feel worried about visits for fear you will have to defend the way you interact with your child, particularly with regard to breastfeeding, sleeping arrangements and discipline. Relatives who have not had the benefit of seeing how caring for your baby is working for you can sometimes voice objections, especially if they made different decisions themselves. Sometimes this is because they think they are helping and sometimes it’s because they don’t want to think they might have done things differently.
It’s tempting to get into a huge discussion about it which can end up spoiling the visit as they get defensive, and you end up annoyed. It can be easier just to respond to any criticism by saying something like “I’m glad that worked for you but this is working really well for us” or “I’ll bear that in mind, but we are both very happy with the way things are at the moment”. “That doesn’t seem quite right for me just now” or just “Isn’t it great, we are really enjoying the way things are right now, aren’t we lucky”, may all help advert tense discussions.
It’s easier to close down the conversation with a positive remark than get into a row! As long as you and your baby are happy with things then you know it’s right for you. You can read more about dealing with criticism here.
Celebrate breastfeeding
Let friends and family members know that you cherish your breastfeeding relationship and if they want to help give them a task, not the baby. If they ask to feed the baby, tell them, “Thank you, but I’m breastfeeding.”
If you get asked if you are still breastfeeding you can say, “Yes, isn’t it lovely?” and if anyone asks how long you plan to breastfeed the answer could be “probably about another 15 minutes on this side” or “I’ll let you know when I find out.”
Written by Anna Burbidge on behalf of La Leche League GB, November 2021.
[1] http://www.breastfeeding-and-medication.co.uk/
[2] https://www.llli.org/breastfeeding-childbirth-and-covid-19/
[3] https://www.laleche.org.uk/when-a-mother-is-ill/
[4] Dr Tom Hale PhD, “Medications and Mothers Milk”, 2012 and Aljazaf K. et al.: “Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk.”, Br J Clin Pharmacol. 2003 Jul; 56(1):18-24. (https://www.ncbi.nlm.nih.gov/pubmed/12848771?dopt=Abstract)
[5] For more detailed information on medications and breastfeeding go to www.breastfeedingnetwork.org.uk or www.breastfeeding-and-medication.co.uk
[6] Thompson RL et al.: “Peanut sensitisation and allergy: influence of early life exposure to peanuts”, British Journal of Nutrition, Volume 103, Issue 9, May 2010, pp. 1278-1286. (https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/peanut-sensitisation-and-allergy-influence-of-early-life-exposure-to-peanuts/5AF1E6FE88AC6AE6B73E5F3F8B9415A4)