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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

I breastfeed my 1-month-old son and recently during every feeding he ends up choking. Milk starts to pour out of his nose. Eventually, he gets fed up with choking and he quits eating. What am I doing wrong? Could my milk flow be to fast? Is there anything I can do? Now he is very congested and has trouble breathing while laying on his back. (I have to use the nose suction a lot during the night.) Could this be related? Last night I started feeding him my breast milk through a bottle. Is this OK? (He did not choke once.) And, how do I travel with breast milk in a bottle?

It sounds like you have a wonderful, powerful letdown reflex. Your sonwill grow into it! Meanwhile, when your milk first lets down, you may wishtoremove him from the breasts for a few minutes until the flow slows. You cancatch the milk in a bottle or a towel. When you put him back to the breast,use the football hold, with his feet tucked under your arm and his head moreupright so he can help control the flow easier. Place your hand behind hisshoulders to help support him at the breast, without touching the back ofhis head. Allow him to tip his head slightly back as he eats. This will alsohelp with his congestion. It will make feeding easier. When babies arecongested I find they relax and eat better in the football hold. It ispreferable to adjust his feeding at your breast rather than giving a bottleright now. Fix the breastfeeding! He will get better at it every day.Babies remove milk much better than pumps, and nursing makes life mucheasier for you.

You may want to find a local La Leche League group toattend as well, so that you can be supported and learn more about thisspecial way of feeding. If you choose to travel with your milk in a bottle,it must be kept cool in some kind of container with ice packs. It is muchhandier to travel with it in your breasts! You may also want to slightlyelevate the head of the mattress when he is in his bed, or put him down onhis right side to rest. This is sometimes helpful with congestion. Talk toyour physician about some saline nose drops to help him as well.

Ann Calandro, RNC, IBCLC"

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