Meet SDBFC's Newest IBCLC - Golnar Fakhrai

We are so thrilled to introduce you to our newest lactation consultant at SDBFC! Golnar joined us on April 21, 2025 and (after a rigorous training period) will start seeing her own clients on June 2, 2025  

Here is our interview with Golnar.  We can't wait for you all to meet her!

Golnar, tell us about yourself!

Although I was born and raised in San Diego, I spent most of my adult life in Los Angeles, where I studied film, and earned my MFA from the American Film Institute. In the years that followed, I filmed narrative as well as documentary pieces, which allowed me to have life experiences I never would have imagined, like spending months immersed in the world of a southern shrimping community, and spending days out at sea documenting the fishermen at work. In Sept 2020, my husband and I moved down to San Diego to be closer to family, prior to welcoming our daughter in 2021. We have lived here since, and I love watching her grow up in this vast city, that has so much for us to explore.

Check out Golnar’s bio page

What inspired you to become a lactation consultant?

I was lucky enough to have a handful of friends who had kids around the same time I did. Distance kept us apart physically, but during those middle of the night feeds, it gave me solace that I knew I wasn’t the only one awake, trying to feed my baby. Those first few weeks were such a struggle for me, trying to learn how to latch, not knowing if I was doing it right or if my baby was getting enough, and feeling so much pain each time my daughter would nurse. Every single friend I spoke with was having difficulties of some kind when it came to breastfeeding, which was a surprise because it’s not something commonly talked about in social settings. I thought it was easy for everyone, and was blaming myself for having such a hard time with it. One of my friends went to see an LC, and I could hear in her voice how much it helped her. So, I saw one myself, and after several visits I was so grateful I did. In the months that followed, being able to provide that support for others became a passion of mine, and from the moment I decided to pursue this new career there was no looking back.

What are you most excited about working for the SDBFC?

Everyone needs a village, and every village will look different. From the moment I walked into SDBFC in the fall of 2023, I knew it was a special place. I was able to learn from women who are not only incredibly knowledgeable in this field, but who have deep compassion, and provide quality care to everyone who walks through the door. I’m excited to be a part of this incredibly supportive team, to have the opportunity to help parents navigate a vulnerable time in a welcoming space, and to be part of the village of every client I get to support during their journey.

What are your top 3 tips for a brand new chest/breastfeeding parent?

1. Remember to breathe. So much is happening so fast right now, and your brain probably feels like it has a million tabs open. Pause. Take a deep breath, and slowly exhale. Just one minute can help regulate your system.

2. As often as you can, have skin to skin contact with your baby. A lot of us have heard to do this right after the baby is born, but the benefits don’t end once you get home. Spend those first few weeks with your shirts off, cuddled up with your beautiful baby under a blanket.

3. Don’t forget to hydrate! Breastmilk is mostly made of water, so your body needs to be hydrated to maintain your supply. This can come from a combination of drinking fluids, and eating foods that contain a lot of water, like watermelon, strawberries, and citrus fruits.

Welcome to the team, Golnar!

May 2025 Milk Drive

The San Diego Breastfeeding Center, in collaboration with UC Health Milk Bank, is thrilled to announce their first ever Milk Drive on May 3, 2025 at the San Diego Breastfeeding Center. We hope you will join us!

What is a Milk Drive? 

When babies are born prematurely, breast milk is vital for improved growth and health  outcomes. A Milk Drive ensures donor milk is accessible to fragile infants whose mothers may not be yet producing milk or may not be able to produce enough. It is an opportunity to educate communities about milk banking, build connections with staff and other milk donors, and support the ‘Pump It Forward’ campaign. In partnership with UC Health Milk Bank, there will be a blood screening station for preapproved donors and a milk collection station for all donors who have registered on the portal. It will be a family-friendly event that will offer free goodies, fun activities for children, and giveaways for the whole family. All are welcome!

Donor FAQs 

1. Can I bring milk to donate to the Milk Drive?  

Yes, if you are an approved or pending approval donor, please bring your milk. All approved and pending donors will receive detailed information on how to bring transport their milk and will have been screened.  

2.What do I need to do prior to the event?  

Sign up on the portal at ucmilkbank.ucsd.edu and click the yellow "Donate milk" button to start the process. Donors will receive all information regarding their donation and how to prepare prior to the event. 

3. Is there a minimum or maximum amount of milk I can donate at the Milk Drive? 

Our donors will be educated via the portal beforehand, but in case you are asked, there is 100 ounce minimum for first time donors and not minimum or maximum donation amount for already approved donors with a subsequent donation. 

4.What if I want to donate milk, but I can't attend the Milk Drive?  

Donors can reach out to the donor coordinators via the portal and we will set up a day/time for a milk drop off at the milk bank (3636 Gateway Center Dr.) 

5. Do I need to RSVP?

Yes, please! RSVP: https://forms.office.com/r/CvfbTZi5uj 

Any questions, please reach out via our email address: ucmilkbank@heatlh.ucsd.edu or phone: 858-249-MILK (6455)

General Donor Questions 

1.Where does the milk go? 

Your milk will be pasteurized, tested, and sent to fragile NICU babies and other babies in need. 

2.Who does the milk help? 

The milk helps the most vulnerable babies especially very low birth weight, premature, and ill infants. 

3.What if I am taking medications? 

Most medications you take are safe with donation however please reach out to your donor coordinator with specific questions. 

4.What if I live outside of San Diego? 

No problem! We send you a lab requisition form to have your labs drawn at a location near you and then will provide you with shipping material and arrange for FedEx to pick up the milk from your home. 

5.Why do I need a blood test? 

To ensure the safety of the milk. We test for infectious diseases that can be passed to the baby through the milk. 

6.What if my milk doesn’t have enough calories? 

This is very unlikely but even if your milk is low in calories our milk techs can mix the milk with higher-calorie milk so it will be sufficient for NICU babies. Every drop counts. 

7.What milk do you accept? 

We can accept milk that has been expressed up to your baby’s 2nd birthday. 

8.How long can the milk be in my freezer? 

Your milk can be frozen for up to 8 months.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

Witching Hour vs Colic

Originally published on May 22, 2014; Revised March 28, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

Welcoming a new baby into your life is an incredible experience, but it can also come with challenges—especially when it comes to fussiness and crying. One of the most confusing and exhausting parts of early parenthood is dealing with periods of intense crying, sometimes called “colic” or the “witching hours.” While both involve periods of crying and discomfort, colic tends to be more prolonged and difficult to soothe compared to the witching hours. While it can be overwhelming, understanding these behaviors can make it easier to navigate and find ways to soothe your little one. 

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

What Are the Witching Hours?

The witching hours are a period of increased fussiness that almost all babies experience, usually occurring in the late afternoon and evening. It often begins around 2 to 3 weeks of age, peaks around 6 weeks, and typically fades by 3 months. During this time, your baby may want to cluster feed—feeding frequently for short periods and seeming fussier than usual. It might feel like your baby doesn’t know what they want: they may latch on to nurse for a few minutes, fall asleep, and then wake up shortly after, wanting to feed again. It’s also common for babies to give hunger cues but then pull off the breast and cry. 

Why Do the Witching Hours Happen?

While we can’t know for sure why babies have these fussy periods, there are a few theories that may explain it:

• Lower Milk Supply: Many parents notice that their milk supply naturally decreases a bit as the day goes on. This is completely normal and doesn’t mean you aren’t producing enough milk. However, a slower milk flow can make babies feel frustrated and want to nurse more frequently.

• Overstimulation: After a long day full of new sights, sounds, and experiences, your baby may feel overwhelmed and unable to settle. This can be especially true if your household gets busier in the evening, with partners coming home, older siblings returning from school, and dinner being prepared.

• Normal Developmental Phases: Babies are constantly growing and changing, and some developmental leaps may make them a bit fussier as they adjust.

What Can You Do to Help Your Baby During the Witching Hours?

While you may not be able to eliminate fussiness completely, there are plenty of strategies to make this period easier for both you and your baby:

• Feed Frequently: Offer the chest/breast often, even if it feels like they just ate. Cluster feeding is normal and sucking helps to calm your baby’s nervous system. 

• Babywearing: Learning to nurse in a carrier can be a game changer. Wearing your baby keeps them close and soothed while giving you the freedom to move around and get things done (ie feed yourself!)

• Prepare Ahead of Time: Consider making dinner earlier in the day or having easy meals ready to go, so you’re not stressed about cooking during your baby’s fussy period.

• Fresh Air and Movement: Taking a walk with your baby in a carrier or stroller can help both of you reset. The fresh air and gentle motion can be incredibly calming.

• Ask for Help: Don’t hesitate to let your partner or support person step in. Sometimes you need a break to recharge, and that’s okay!

What Is Colic?

Colic is different from the witching hours and is typically defined as crying that lasts off and on for more than three hours a day, at least three days a week, for three weeks or longer. Colicky crying is often more intense and harder to soothe, and babies may show signs of physical discomfort like arching their back, tensing their legs, or appearing gassy. Colic usually starts in the first few weeks and resolves once the root cause(s) has been identified.

What Causes Colic?

There’s no definitive answer to what causes colic, but some possible factors include:

• Oversupply or Forceful Letdown: An abundant milk supply or fast flow can cause a baby to gulp air, leading to gas and discomfort.

• Foremilk-Hindmilk Imbalance: Too much lower-calorie foremilk and not enough higher-calorie hindmilk can upset a baby’s stomach, causing gassiness.

• Oral Ties: Tongue-tie or lip-tie can make it difficult for a baby to latch well, leading to swallowing air during feedings and difficulties getting enough at each feeding session.

• Dietary Sensitivities: Sometimes, something in the parent’s diet (like dairy, soy, gluten, or egg) might affect the baby’s digestion.  

• Antibiotic Use and Gut Inflammation: If the baby or lactating parent has recently taken antibiotics, it may disrupt the baby’s gut microbiome, leading to digestive discomfort and increased fussiness.

How Can You Help a Colicky Baby?

• Adjust Chest/Breastfeeding Positions: Try laid-back chest/breastfeeding to slow down your milk flow and help your baby pace themselves more effectively while feeding.

• Keep a Food Journal: Track your diet and your baby’s symptoms to see if any specific foods seem to trigger fussiness. We can help identify trigger foods or root causes of gut inflammation and discomfort during a functional nutrition appointment. (Click here to find out more information about these functional nutrition appointments)

• Seek Support: An International Board Certified Lactation Consultant (IBCLC) can help identify potential issues like oversupply, oral ties, or feeding challenges. (Click here for more details on the types of lactation appointments we offer!)

Most importantly, remember that this phase will pass. The witching hour typically resolves by 3 months as babies become less sensitive to their environments. Colic can often be remedied as soon as the root cause(s) is identified and addressed. It’s completely normal to feel stressed and overwhelmed, but you don’t have to go through it alone. Reach out for support from your partner, family, friends, and professionals who can help you navigate this challenging time.

If you’re feeling unsure about your baby’s feeding patterns, fussiness, or gut discomfort, know that you’re not alone—we’re here to help! Our team of experienced lactation consultants and functional nutrition experts is ready to support you. Whether you need guidance on soothing techniques, feeding adjustments, or identifying root causes of discomfort, we’re here to provide personalized care. Schedule a one-on-one appointment with one of our lactation consultants or functional nutrition counselors for expert advice tailored to your baby’s unique needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

I’ve Had My Baby - Now What?: Breastfeeding During the First Week

Originally published on Jan 24, 2014; Revised Feb 22, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

Welcome to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of chest/breastfeeding your new baby.  

Today we would like to talk about that first week after your baby has arrived.  Chest/breastfeeding can often seem overwhelming and  unfamiliar.  New parents often receive a *huge* amount of differing advice from many well-intentioned people, which can be incredibly confusing and discouraging.  Below is a quick guideline to what “normal” chest/breastfeeding looks like, as well as some examples of when things aren’t going as they should and when you might want to seek help.

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

How often should my new baby be eating and how long should each feeding take?

A newborn needs to feed 8 or more times in 24 hours.  It’s especially important in the early days to feed your baby “on demand”, or whenever the baby shows signs of hunger, regardless of when baby ate last.  If your baby is not asking to eat every 2-3 hours, or 8 or more times in 24 hours, it is important to wake the baby to feed him/her, until they have regained their birth weight.  A feeding session typically takes approximately 30-45 minutes, and both breasts should be offered during this time.  It’s important to keep the baby actively feeding during those 30-45 minutes.

How do I know my baby is getting enough milk?

A great way to be sure baby is getting enough breastmilk is to keep a physical log of all feedings (start time and length), as well as all pees and poops. A baby who is taking enough milk will be feeding 8 or more times in 24 hours, for 30-45 minutes, and having 1 pee diaper and 1 poop diaper per day of life, until day 5.  For example, on day 1, baby should be having 1 pee and 1 poop diaper, day 2, 2 of each, etc.  After day 5, baby should be having 5 or so of each per day.  A baby who is getting enough should be satisfied for approximately an hour or two after feeding.  However, most babies will cluster feed for a 4-5 hour period during the day, when they may want to eat more frequently.  This is normal baby behavior!

How much milk does my baby actually need?

A baby needs very little milk per feeding during their first few days of life.  This is because they’re born full of meconium, which are those first few poops.  This is a perfect fit for you, as your first milk, colostrum, is low in volume.  The small amount you make is just the right amount for your baby.  The amount your baby needs slowly increases, and as your milk makes the transition from the low volume colostrum, to the higher volume mature milk between day 3 and day 5, your baby’s needs go up as well.  Nature works beautifully!

I need to supplement my baby, what are my options?

Sometimes, a baby may need to be supplemented with additional milk.  There are many reasons for this - a baby has jaundice,  is not latching well, there is a delay in the parent’s milk “coming in”, etc.  When supplementation is necessary, it’s important to remember that you can use your own pumped milk.  If you aren’t able to pump the amount you need, you can use donor milk instead.  Formula is the last resort option.  There are various methods to supplement your baby as well.  You can supplement your baby at your chest/breast using a supplemental nursing system, you can finger feed your baby, or cup/spoon feed your baby.  A slow flow bottle is always an option as well and a lactation consultant can show you how to feed your baby a bottle in a chest/breastfeeding-friendly manner.

Holy moly,  my boobs are like rocks!  They hurt and I can’t get baby latched on, what can I do?

As  your milk transitions from the low volume first milk, to the higher volume mature milk, it is common for your chest/breasts to feel full and sometimes experience engorgement.  Engorgement occurs when the chest/breasts fill up with so much milk that they become hard and  uncomfortable.  It can sometimes be difficult to get the milk flowing and baby sometimes has a hard time latching on.  

Some tricks to latch your baby on during this time are:

• Pump or hand express for a few moments before latching your baby to soften your chest/breasts and get milk moving

• Use warm compresses or take a shower just before feeding

• Use cold compresses in between feedings to reduce inflammation.  

  If you still  feel incredibly uncomfortable after your baby feeds, you can pump or hand express some additional milk - but it is important to only pump to comfort as you don’t want to send the message to your body to make even more milk.  

  Please be aware that if you begin to run a high fever, have flu-like symptoms, and hot or red spots on your chest/breast, you may be developing a breast infection (mastitis) and it’s important to seek medical attention immediately.  

Why do my nipples hurt and what can I do to heal them?

It’s normal for all parents to feel some initial nipple tenderness and discomfort in the first days and weeks of chest/breastfeeding.  Anything beyond tenderness is a sign that something may not be going right, especially if there is any tissue breakdown, damage, cracks or bleeding.  If you experience any of these, please seek the help of a lactation consultant.  Great healing items are organic coconut oil and hydrogels, or soothing gels, sold by many different companies and available at big box stores.  The best prevention for sore nipples is a good latch. If you are having trouble finding a correct latch, give us a call!

When should I seek help?

There may be times when things aren’t going the way they should.  Our IBCLCs can absolutely help you with all of this!  Some signs that you might need some additional help:

• Damaged/cracked/bleeding nipples.

• Baby isn’t gaining weight/parent’s milk hasn’t “come in” by day 5.

• You suspect your baby is tongue-tied.

• Baby isn’t peeing or stooling the amount that they should.

• Breast infection/Breast abscess

• Oversupply

• Extremely fussy/gassy baby

If you’re unsure about your baby’s latch, milk intake, or feeding patterns, know that you’re not alone—we’re here to help!

The first week of breastfeeding comes with many changes, and it’s completely normal to have questions or concerns along the way. Whether you need guidance on positioning, reassurance about your baby’s feeding cues, or support with any challenges that arise, our team is here to provide the care and expertise you deserve. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your baby’s unique needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

Is My Baby Getting Enough Milk? A Guide to Breastmilk Intake For the First Year

Published on February 22, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

One of the most common questions we get asked by clients is, “How much breastmilk does my baby need?” Whether your baby is breastfed, bottle-fed, or combination-fed, their breastmilk (and/or formula) intake stays fairly consistent during the first six months. However, after solids are introduced, it can get a bit confusing to determine how much milk they still need. 

To help clear up the confusion, we’ve put together this month-by-month guide so you can feel confident about your baby’s nutritional needs throughout their first year.

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

Month-by-Month Breastmilk Intake Guide

While every baby is unique, their milk intake generally follows a predictable pattern during the first year. These patterns are based on factors like age, weight, growth spurts, and the introduction of solid foods. In the newborn stage, babies eat frequently as their tiny stomachs grow and adjust. By a few months old, their feedings become more efficient and predictable. Around six months, solids are introduced, but breastmilk or formula remains their primary source of nutrition. As babies near their first birthday, they gradually rely more on solid foods, though milk is still an essential part of their diet.

0-2 weeks (what to expect)

• Small stomach capacity and frequent feedings (8-12 times per day).

• Milk increases drastically over the first 2 weeks 

• Average intake (on average): 

• Week 1: 5ml/feeding for Day 1; 10-15ml/feeding for Day 2; 15-30ml/feeding Day 3; 30-45ml/feeding Days 4-7

• Week 2: 60ml/feeding Days 8-10; 60-90ml/feeding Days 11-14

Additional blog articles about this stage:

I’ve Had My Baby - Now What? Breastfeeding During the First Week

I’ve Had My Baby - Now What? Breastfeeding During the Second Week

2 weeks - 12 weeks (what to expect)

• Increased milk production and more predictable feeding patterns - Roughly every 3 hours during the day, cluster feeding in the evening, and then starting to get longer stretches in the middle of the night.

• Growth spurts around 2 weeks, 4 weeks, 6 weeks, and 3 months - more cluster feeding and less sleeping for a few days.

• Average intake (based on weight).  Divide the total daily amount by the number of feedings to figure out how much baby needs per feeding.

• 6lbs - 16oz-20oz per day

• 7lbs - 18oz-22oz per day

• 8lbs - 20oz-24oz per day

• 9lbs - 22oz-26oz per day

• 10lbs - 24oz-28oz per day

• 11lbs - 26oz-30oz per day

• 12lbs - 28oz-32oz per day

• 13lbs+ - 30oz-32oz per day

Additional blog articles about this stage:

I’ve Had My Baby - Now What? Breastfeeding During the Weeks 3-6

I’ve Had My Baby - Now What? Breastfeeding During Months 2-6

3-6 Months (what to expect)

• Quicker chest/breastfeeding and bottle feeding sessions - babies are no nonsense with feeding.  They are more efficient and are very interested in everything that is going on around them.

• Potentially distracted while feeding during the day, which may cause them to wake more at night to feed.  

• Average milk (and/or formula) intake continues to be based on the baby's weight: same as above.

Additional blog articles about this stage:

I’ve Had My Baby - Now What? Breastfeeding During Months 2-6

6-9 Months (what to expect)

• Introduction of solid foods, but breast milk (and/or formula) remains primary nutrition

• Average milk (and/or formula) intake continues to be based on the baby's weight: same as above.

Additional blog articles about this stage:

Breastfeeding the Older Baby - What to Expect at 6-9 months

9-12 Months (what to expect)

• Increased independence with solids and possible decrease in nursing frequency

• As babies increase their solids frequency and intake amount, the amount of breastmilk (and/or formula) starts to decrease

• Average intake: 24 oz/day, decreasing slowly to about 12oz/day by 12 months (if the baby is eating 3 full meals with snacks by this age)

• Since breastmilk (or formula) intake varies based on solid food consumption, monitoring your baby's weight can help guide you to determine their milk needs. On average, babies gain 2-3 oz per week at this stage.

Additional blog articles about this stage:

Breastfeeding the Older Baby - What to Expect at 9-12 months

If you’re feeling unsure about how much breastmilk (and/or formula) your baby needs or how to balance breastfeeding/chestfeeding with solids, you’re not alone—we’re here to help!

As your baby grows, their milk intake and feeding patterns will continue to evolve, but you don’t have to navigate these changes alone. Whether you’re wondering if your baby is getting enough milk, adjusting to the introduction of solids, or trying to find the right balance between nursing and bottle-feeding, we’re here to support you. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your baby’s unique needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

I’ve Had My Baby - Now What? Breastfeeding During months 2 through 6.

Originally published on June 24, 2014; Revised Feb 22, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

Welcome back to our series, I’ve Had My Baby - Now What?  

Today, let’s talk about what chest/breastfeeding looks like during months 2 through 6. By now, you and your baby have gotten to know each other, and feeding is likely feeling more familiar. This stage brings exciting changes—longer stretches between feedings, more efficient nursing, and a growing baby who is becoming more interactive. But with these changes, you might also have questions about milk supply, feeding routines, or what’s normal as your baby becomes more active. Below, we’ll explore what to expect during this stage, how to adapt to your baby’s evolving needs, and when to seek support if you need it. 

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

What does normal chest/breastfeeding look like in months 2-6?  How often should my baby be eating, and how long should feedings take?

This can vary from baby to baby - the most important thing is that your baby is having lots of wet and dirty diapers and gaining weight appropriately.  Some babies may have started taking in more at each feeding, and spacing them out more, while some may still be eating every 2-3 hours.  If you’re lucky, your baby may have dropped a feeding or two at night, and may make up for it during the day.  Other babies become much more distracted during daytime feedings around 4 months, so continuing those nighttime feedings are crucial for baby to get enough over a 24 hour period.

How much weight should my baby be gaining at this age? Is their weight gain expected to slow during this time?

Around 4 months, babies weight gain does start to slow down.  Up until 4 months, babies should be gaining about 6-8 ounces per week.  At 4 months, this drops to 4-5 oz per week, and then again at 6 months, when we expect baby to gain about 2-3oz per week.  This is important for parents to know so that they don’t worry if they see their baby’s weight gain slow around 4 months of age.  Make sure that your pediatrician is using the WHO charts for weight gain, which is for chest/breastfed babies.  

Suddenly my baby seems too distracted to eat!  Is this normal, and what can I do to get my baby to feed better?

At around 4 months of age, babies start to learn that there is a whole big world out there - and suddenly, *everything* is more exciting than chest/breastfeeding!  Dogs barking, a ceiling fan, someone else in the room. Some ways to help your baby focus while nursing are:

• Feed baby in a quiet and dark room

• Nurse in a carrier

• Let your baby play with something soft and crinkly while nursing.  

  Also, this is definitely NOT a time to start night weaning or sleep training, as these distracted kiddos often need those nighttime feedings to keep gaining weight appropriately.  Also, it’s important to remember that this is really normal behavior - and usually fades around 6 months of age.

I’m getting ready to go back to work - how can I make sure that I’ll be able to pump what my baby needs when I’m away from him/her?

This can be a stressful time for nursing parents - there are definitely some things you can do to help protect your chest/breastfeeding relationship when you return to work.

• Know your rights! Federal law protects your right to pump at work for a reasonable amount of time and in a private space.  

• Do some research ahead of time and talk to your human resources department - find out where the pumping area is, how close it is to your desk or workspace, what equipment you’ll need.  

• Talk to your caregiver about paced bottle feeding and how much milk your baby actually needs per bottle

• Read up on ways to help maximize your output while you’re pumping at work.

My baby still wakes often to eat at night, even at 6 months of age - is this normal behavior?

It is absolutely normal behavior!  By this stage, babies may be sleeping for longer stretches in the first part of the night, but may still wake after that to feed.  By this age, a baby needs anywhere from 28-32 oz in 24 hours and if your baby is too distracted to feed well during the day, they may wake more at night to make up for it.  If you hear your baby gulping during feedings at night, or your baby won’t settle without nursing, it is very likely that they still need the feedings throughout the night.  If the frequent wakings are taking a toll on your mental sanity, co-sleeping and side-lying chest/breastfeeding are great ways to get some extra rest.  If you are uncomfortable with co-sleeping, you can set your alarm for 15 minutes after beginning to chest/breastfeed your baby, and then wake up and place your baby back into their own bed.  If your baby is waking up *very* frequently, every hour, and is very uncomfortable and difficult to soothe, it could be something else that’s causing the restlessness - possibly gut discomfort and/or a sensitivity to something in your diet. Definitely reach out to us for assistance!

My 4-month-old baby will not sleep!  What’s happened to my baby that used to sleep??

The 4-month-sleep regression is a real thing and can wreak havoc on a mom’s sanity.  At 4 months, babies are going through huge developmental milestones.  They have suddenly become aware of all that is going on around them and their excitement about this can interrupt their sleep.  It’s important to keep in mind that this is temporary stage, you will sleep again…. we promise!

My baby is approaching 6 months and I’m starting to think about solids.  How will I know that my baby is ready?

It is definitely recommended to wait until your baby is at least six months of age before offering solid foods – even longer if your baby doesn’t seem ready.  Some of the signs of readiness are being able to sit up on their own unassisted and losing their tongue thrust reflex, so that they don’t automatically push food out of their mouth.  Another sign is when the baby has developed their “pincer grasp”, which is when they can use their fingers to pick up objects.

When I do start solids, what is an appropriate amount to start out with?

Your baby will need a very small amount at the beginning - only about a tablespoon once per day.  The first food doesn’t have to be a grain cereal, either - as many doctors have previously recommended.  Avocados are a perfect first food for your baby.  Remember the saying “food before one is just for fun” – your baby should be getting their total nutrition from your milk (and/or formula) – so the solids you offer them now are just for practice.   As the baby gets older, you can start to add in additional meals and snacks.

How can I be sure that my milk supply won’t suffer once I start feeding my baby solids?

The rule for solids is always – milk first, then food.  You should always chest/breastfeed first and then offer your baby solids.  You want to be sure that baby is still taking a full feeding at chest/breast to both ensure he/she is getting all the calories and nutrition he/she needs, as well as maintaining your milk supply.  If you start to replace chest/breastfeeding sessions with solid meals, you most likely will notice a dip in your supply.

Struggling with your 2-6mo baby’s distracted feedings, frequent night waking, or slow weight gain? We’ve got you covered!

It can be incredibly frustrating when you're unsure if your baby is getting enough milk, especially when dealing with feeding distractions or interrupted sleep. If you're concerned about your baby’s growth, feeding patterns, or just need more confidence in your breastfeeding journey, we’re here to help. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your baby’s unique needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

Breastfeeding the Older Baby: What to Expect at 9-12 Months

Originally published on May 1, 2016; Revised Feb 22, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

Welcome back to our blog series, Breastfeeding the Older Baby – What to Expect.

Today, let's talk about what to expect when chest/breastfeeding your older baby between 9 and 12 months. As your little one becomes more mobile and curious about the world, nursing can start to look a bit different—sometimes acrobatic, sometimes distracted, but still an important source of nourishment and comfort. Parents often wonder how breastmilk fits into their baby’s expanding diet and whether changes in feeding patterns are normal. Below, we’ll explore what to expect during this stage, what’s typical, and when you might want to reach out for support.

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

What does chest/breastfeeding look like in months 9-12? How often should my baby be eating and how long should feedings take?

Breastmilk (and/or formula) continues to be your baby’s primary source of nutrition until his/her first birthday. Some babies will continue to space out their nursing sessions as they approach this milestone birthday, nursing 4-5 times during the day, and once or more during the night. As your little one begins to explore the tastes and textures of more solid foods and consume more of them at each sitting,  you may notice your little one beginning to nurse less frequently in response to their increased intake of solid foods. As long as your baby is continuing to have five or more wet diapers each day, gains an average of 2-3oz per week, and seems satisfied and content after nursing sessions, then your little one is most likely getting enough nutrition while chest/breastfeeding.

 

When will my baby begin to drop his/her nighttime feeding sessions and sleep through the night?

Such a great question, and one that’s frequently on parents’ minds! When will my baby sleep longer at night? The short answer is - every baby is different. Babies wake throughout the night for varying reasons, including hunger, a need for comfort, a disruption in their sleep cycle, a need for a diaper change, sickness, teething, etc. Chest/breastfeeding often meets more than one of baby’s needs, so it’s easy to fall into the routine of nursing your little one back to sleep. There is absolutely nothing wrong with responding to your little one’s needs by nursing them! If you are happy with your nighttime routine, no need to make significant changes in order to cope with outside pressure and recommendations to “train” your baby to sleep longer at night. That being said, if you find yourself becoming frustrated with nighttime wakings and overtired during the day due to lack of sleep at night, then it might be time to take a closer look at your nighttime routine to make a plan for improving your quality of sleep.

I’ve heard people mention teaching chest/breastfeeding manners to older babies. How does that work?

It’s never too early to start teaching your little one age-appropriate manners. Just as we prompt our toddlers for “the magic word” when they ask for something, older babies can learn to be polite when chest/breastfeeding. Teaching your little one a few basic signs from American Sign Language can be very beneficial in setting the stage for chest/breastfeeding manners. The signs for milk, more, and please are fairly basic and many babies pick up on them quickly. Once your little one has mastered the sign for milk, you can calmly remind them to sign milk when hungry instead of pulling your shirt down or crying out in frustration. Positive reinforcement will go a long way to reinforce the idea that you would like baby to sign milk when hungry rather than clawing at your chest. Baby will also be calmer and happier, seeing you sign milk, showing them you hear and understand their need and are going to chest/breastfeed them soon.

 

My baby has been refusing to nurse, could he/she be self-weaning?

If your baby has been refusing to chest/breastfeed for several nursing sessions or days in a row, then it’s more likely that you and your little one are experiencing a nursing strike, rather than self-weaning. It is very uncommon for a baby to self-wean before their first birthday. As we have said before, babies need milk to be their primary source of nutrition right up until their first birthday. Also, self-weaning is usually a gradual process, where as a nursing strike is characterized by a sudden and complete disinterest and refusal to chest/breastfeed. Nursing strikes are common in older babies and can be in response to teething, distraction, illness, bottle-preference, and other developmental milestones. Tips for surviving a nursing strike and encouraging baby to nurse again are:

• Always offer breastmilk before any solids during baby’s first year of life. If baby won’t nurse, you can offer baby expressed milk in a sippy cup, to ensure baby’s nutritional needs are being met.

• Limit or eliminate bottles and pacifiers. Only use bottles when baby is separated from you and then put baby back to chest/breast when baby is with you.

• If distractibility seems to be playing a role in baby’s refusal to nurse, try wearing a nursing necklace to keep baby’s attention focused on nursing. You can also try giving baby a small toy to hold during feeding sessions, nursing in a quiet room, and nursing baby in a baby carrier.

If you feel your milk supply has decreased, and this has led to the nursing strike, then it is a good idea to make an appointment with a Lactation Consultant to come up with a chest/breastfeeding plan to help you increase your supply and meet baby’s needs moving forward.

If you’re wondering how breastfeeding will change as your baby becomes more independent, you’re in good company!

Every baby transitions through this stage a little differently, and it’s completely normal to have questions about nursing frequency, distracted feedings, or how breastmilk fits into your little one’s growing diet. Whether you need reassurance, tips for managing changes, or support in meeting your breastfeeding goals, we’re here to guide you every step of the way. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your baby’s unique needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

 About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

Supporting Tricare Families Through Insurance Challenges: Introducing our Low-Cost Clinic

Published on February 10, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

At the San Diego Breastfeeding Center, we are dedicated to providing compassionate and expert care for families during their chest/breastfeeding journeys. It is with heavy hearts and sincere regret that we share an important update about our services.

Due to ongoing delays from TriWest in countersigning our contract, we are no longer able to provide insurance-covered appointments to Tricare families. This decision was not made lightly. We held out as long as we possibly could, hoping to avoid any gap in care. 

We deeply understand how difficult and frustrating this situation is for our military families, and we remain committed to supporting them through this transition.

Introducing SDBFC’s Low-Cost Clinic 

To help bridge this gap, we’ve added a low-cost clinic option for Tricare families. This affordable clinic is also available to families with insurance we do not accept, such as Kaiser, HMOs other than UCSD Managed Care, or MediCal, who may be unable to afford the cost of our one-on-one consultations.

Unlike our free support group, this clinic offers guidance from an IBCLC to provide a more in-depth and skilled assessment, as well as an individualized plan of care. 

These 90-minute sessions cost $49 and include:

• Oral exams (when needed)

• Weighted feeds

• Individualized care for latch, positioning, pain, and milk supply

Group size is limited to three families to ensure personalized attention.

Free Friday Support Group

We also continue to offer our free weekly support group led by Valori Sharp, our experienced lactation educator. This group provides general advice and weight checks in a supportive community setting.

Thank You for Your Understanding and Support

We are always looking for thoughtful ways to adapt and continue providing quality lactation care at accessible prices for our local San Diego families. The introduction of our new low-cost clinic has not only provided a much-needed solution for Tricare families but has also opened the door for many other local families with insurance we do not accept. 

Your family’s health and well-being remain our top priority, and we are proud to find creative solutions to support you.  We remain dedicated to serving you and advocating for better healthcare access for all families.

Due to their complex nature, all bottle feeding, pumping flange fittings, and functional nutrition appointments will only be available as private one-on-one consultations.

About SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

The Secret Link Between Liver Health and Milk Supply

Published: Jan 25, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

When we think about lactation, we often focus on the chest/breasts themselves, but did you know that the liver plays a central role in your body’s ability to produce milk? This powerhouse organ helps regulate hormones such as estrogen, androgens, and insulin—all of which play an important role in milk production. It also manages inflammation, ensuring that your body’s systems work in harmony. But disruptions in liver function—often linked to conditions like insulin resistance, PCOS, or leaky gut—can impact milk supply and make chest/breastfeeding more challenging.

Let’s explore the liver’s role in lactation, how insulin helps prepare your body during pregnancy and postpartum, and practical ways to support your liver and overall health for the most robust milk supply possible!

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

Why Insulin is Important During Pregnancy and Postpartum

Insulin does more than regulate blood sugar; it’s also a critical hormone for lactation. During pregnancy, insulin helps build mammary gland tissue, laying the foundation for milk production. This is especially important in late pregnancy when your body prepares for making milk.

After birth, insulin sensitivity helps regulate prolactin, the hormone responsible for milk production. If your insulin sensitivity is low—a common issue with conditions like PCOS or gestational diabetes—it can delay lactogenesis (the onset of milk production) or result in a lower milk supply. Ensuring optimal insulin function during pregnancy and postpartum is essential for a robust milk supply and positive chest/breastfeeding outcomes.

How PCOS and Insulin Resistance Impact Lactation

Polycystic ovary syndrome (PCOS) and insulin resistance are common conditions that can significantly impact insulin sensitivity, liver function, and ultimately lactation. In PCOS, hormonal imbalances often lead to higher levels of androgens, which can interfere with ovulation and milk production. Additionally, insulin resistance—a hallmark of PCOS—can impair the liver’s ability to use insulin efficiently. This creates a feedback loop of heightened inflammation, poor blood sugar regulation, and disrupted hormone balance.

For chest/breastfeeding parents, these issues can delay or reduce milk supply. The liver’s role in processing insulin and hormones becomes even more critical in mitigating these effects. Supporting liver health can help break this cycle, improve hormonal regulation, and promote an easier lactation experience.

How to Support Liver and Gut Health for Lactation

The good news is that there are evidence-based strategies you can implement to support your liver’s function and improve insulin sensitivity. By making small, manageable changes to your diet and lifestyle, you can create a healthier foundation for lactation and overall well-being. If you’re unsure how to make these accommodations, working with a functional nutrition counselor, like Robin, can be a helpful step.

1.  Prioritize a Low-Carb, High-Fiber Diet

Your liver and gut are closely connected through the gut-liver axis, meaning that improving one often supports the other. Here are practical ways to nurture both:

• Focus on low-starch vegetables to support liver health and reduce blood sugar spikes.  These tend to be the veggies that grow above ground, like leafy greens, zucchini, and asparagus.

• Incorporate fiber-rich foods such as berries, flaxseeds, chia seeds, and non-starchy vegetables to promote gut health and improve insulin sensitivity.

• Minimize refined sugars and highly processed carbs that can contribute to insulin resistance.

• Include healthy fats like avocado, olive oil, and fatty fish to reduce inflammation and support hormone production.

2. Engage in Regular Physical Activity

• Activities like walking, yoga, or strength training improve insulin sensitivity, reduce systemic inflammation, and support the liver’s ability to metabolize fat and hormones.

• Aim for 20-30 minutes of moderate exercise most days, adjusting intensity based on how far along you are in your pregnancy and postpartum recovery stage.

• Focus on physical activities that you enjoy and look forward to, so it doesn’t feel like a chore.

• Incorporate your baby into physical activity, such as stroller walks, babywearing yoga, parent-and-me fitness classes, or hanging out on a playmat while you do a quick YouTube workout, so you don’t have to find childcare.

3. Consider Liver- and Gut-Supportive Herbs and Supplements

If you're currently using an herbal blend to support your milk supply, you may already be consuming some of these ingredients, as many herbs recommended for boosting milk supply also support liver function. (WOW, right?)

*** Before starting any new supplements, it's important to consult with someone who is knowledgeable about herbs and supplements—someone who can guide you on how they might interact with anything you're already taking, and help determine which ones are most suitable for your body.

• Milk thistle: Known for enhancing liver detoxification and repair.

• Turmeric: Contains curcumin, which has anti-inflammatory and liver-protective effects.

• Artichoke extract: Promotes bile production and overall liver function.

• Collagen or bone broth: Helps repair the gut lining and supports gut health.

• L-glutamine: An amino acid that supports intestinal integrity and reduces gut inflammation.

4. Keep On Lactating

• Producing milk for at least six months significantly improves blood sugar levels and reduces the risk of insulin resistance long term. 

• Chest/breastfeeding not only benefits your baby but also promotes lasting metabolic health and supports your body’s hormonal balance during the postpartum period. 

• Additionally, lactating for longer than six months may help you build a more robust milk supply with each consecutive baby, setting the stage for smoother chest/breastfeeding experiences in the future.

Supporting Your Liver, Gut, and Hormones for a Robust Milk Supply

Taking care of your liver and gut health can be a gentle way to support your body in balancing hormones and managing inflammation—both of which play important roles in lactation. Small adjustments to your diet, movement, and supplements can have a meaningful impact on your milk supply and chest/breastfeeding experience.

If you're facing challenges with low milk production, please know that you're not alone. Every chest/breastfeeding journey is unique, and it’s okay to feel uncertain or frustrated at times. If you suspect underlying health concerns like PCOS, insulin resistance, or gut issues, making a functional nutrition appointment can be a helpful step toward understanding what’s going on and finding the support you need. Your body is doing its best, and with the right care and guidance, you can make progress toward the breastfeeding experience you hope for.

Ready to Support Your Milk Supply?

Whether you're pregnant and looking to become more insulin sensitive or postpartum and facing challenges with milk production, Robin Kaplan, Functional Nutrition Counselor, is here to help. Robin can guide you through personalized nutrition plans and gentle lifestyle adjustments to support your liver, gut, and hormones, optimizing your body's ability to produce milk and manage inflammation.

Reach out today to schedule your one-on-one appointment with Robin (consider a virtual appointment, if you don’t live in San Diego!) and take the next step toward a more nourishing and confident chest/breastfeeding experience. Your body’s potential is greater than you may think, and Robin’s compassionate, individualized care can help you unlock it.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

Common Concerns While Breastfeeding - What is That Knot in My Breast?

Originally published on June 29, 2011; Revised Dec 30, 2024

Author: Robin Kaplan, M.Ed, IBCLC, FNC

Ever woken up from a deep sleep to find that an area of your chest/breast is tender, a little red, and pretty uncomfortable?  Upon further investigation, there may be a lump where the pain is radiating from?  How did this happen?  Should you be concerned?  In most cases, there is little need for concern.  Most likely, it is a pesky plugged (clogged) duct.  While this condition is often painful and frustrating, it’s usually manageable with some self-care and support.

So, what exactly are plugged (clogged) ducts, why do they happen, and what can you do to resolve them? Let’s break it down!

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

Why Do Plugged Ducts Happen? 

There are several reasons why milk ducts can become plugged:

• Infrequent or Skipped Feedings: Skipping feedings/pumping sessions or your baby sleeping for a longer stretch than your chest/breasts are used to can cause milk stasis. Milk stasis refers to a condition where milk is not effectively removed from the chest/breast, causing it to accumulate and remain stagnant in the milk ducts. This stagnation can lead to increased pressure, inflammation, and eventually a plugged duct if not addressed promptly.  

• Pump inefficiency: Using an incorrect flange size or a pump that doesn’t effectively remove your milk can increase your chances of a plugged duct

• Poor Latch: If your baby is having latching difficulties, milk may not be efficiently removed.

• Pressure on the Chest/Breast: Underwire bras, tight clothing, or even sleeping in certain positions can sometimes contribute to clogged ducts.

• Stress, Fatigue, or Illness: Lack of sleep, emotional stress, or getting sick can all impact milk flow and immunity.

How to Resolve Plugged Ducts 

The good news is that most plugged ducts can be resolved with some simple strategies:

1. Frequent and Effective Nursing or Pumping: Feed your baby often, starting on the affected side, or pump at regular, frequent intervals.

2. Ensure Proper Pump Fit and Technique: Make sure you're using the correct flange size for your pump and watch reliable YouTube tutorials on optimal pumping techniques to ensure effective milk removal.

3. Gentle Chest/Breast Massage: Apply gentle compressions while feeding/pumping to help move the blockage. Use your fingertips to apply light, circular motions starting from the outside of the chest/breast and moving toward the nipple. Avoid deep or aggressive massage, as this can worsen inflammation and discomfort.  Therapeutic breast massage can also be very helpful.

4. Dangle Feeding: Lean over your baby while nursing to let gravity assist in clearing the duct.

5. Cold Compresses: Apply cold compresses (like frozen peas) to the swollen area for 20 minutes in between feedings to help reduce swelling. 

6. Self-Care: Rest, stay hydrated, and eat immune-supporting foods to help minimize inflammation. (Check out last month’s blog post about boosting your immune system!)

What If Plugged Ducts Keep Happening? 

If plugged ducts become a recurring issue, it’s time to dig deeper:

• Meet with a Lactation Consultant: SDBFC’s lactation experts can help identify and resolve the root cause. This can range from addressing tongue/lip ties, troubleshooting your pump situation, or diving into your medical history to determine what’s causing chronic chest/breast inflammation.

• Choline Supplementation: Incorporating choline can help disperse milk's fat particles more evenly, preventing them from clumping together and forming clogs. Starting recommended dosage is 500mg/day and can be increased, if necessary.

• Therapeutic Ultrasound: Therapeutic ultrasound helps clear plugged ducts by using high-frequency sound waves to generate gentle heat within the chest/breast tissue, which can effectively break down milk blockages, increase blood flow to the area, and promote milk flow through the ducts.

When to Seek Help 

If the lump doesn’t improve within 24-48 hours, or if you develop flu-like symptoms, fever, or increased redness and swelling, contact your lactation consultant or healthcare provider. These could be signs of mastitis, which may require additional recommendations or medical treatment. Check out our article on Mastitis for additional remedies/treatments.

If you still have questions about remedying plugged (clogged) ducts, we are just a consult away!

Plugged ducts can be a painful (temporary) interruption in your chest/breastfeeding journey, but with early intervention and proper care, they’re usually resolved quickly. Don’t hesitate to reach out to our lactation consultants if you need extra support. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your chest/breastfeeding and pumping journey. 

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.