Just when we thought we were coming out of the crazy world of 2020 and 2021, 2022 hits us with a formula shortage. I’m here to answer the most common questions that I am hearing about the formula shortage. 

Why? “Current shortages have been largely caused by supply chain issues and the recent recall of several baby formula products over concerns about contamination.” Basically, there are only a few companies that make baby formula for the big brand names as well as store brand formulas. Unfortunately, if one of these companies has problems, it can lead to massive disruption in production for lots of different brands. In this case, it’s Abbott, and they’re sorry .

What are families supposed to do? 
Well that depends. If you’re already breastfeeding or pumping, continue to do so to the extent that you’re able. If you are having difficulty breastfeeding or pumping, please contact a certified lactation consultant asap to make a plan to get things on the right track. Issues such as painful breastfeeding, painful pumping, low supply, and others, can be solved by working with an expert who knows how to solve them! 


If you’ve been buying retail formula, I know it’s tempting to stock up on formula when you see it in stock, but I recommend that you buy only what you need for 10 to 14 days. Stocking up on formula only adds to the shortage on the shelves for other families. 
If you have been using WIC to obtain formula, North Carolina is now allowing WIC families to use their waivers for different brands of formula according to what they are able to find on the shelves.
You can try to find your formula at smaller local retailers or online. 
Importantly, you can use a different brand of formula than what you have been using. Most babies tolerate a change in formula without difficulty, if the formula is the same type that they have been taking. I also recommend that you make only the amount that the baby needs at that time, to minimize waste. 
 
It is very important that parents avoid trying to make the can of formula last longer by diluting the formula with extra water when they mix it. Mixing the formula in any way other than what the directions on the can say can be very dangerous to the baby. If the baby is on a specialized formula, or you just can’t find any formula at all, please contact the baby’s medical provider asap. 

What about donor milk?
There is one certified milk bank in North Carolina, and obtaining milk through the bank is difficult and expensive. The milk is primarily used for babies in the NICU or medically fragile babies, and a prescription is required. 
Another option is casual milk sharing. 
But is it safe to feed my baby someone else’s breast milk? 
Mothers have been sharing breast milk since the beginning of babies. The better you know the donor, the more likely the donated milk will meet your standards. Start with close friends and family to see if there is anyone who has extra milk that they can share with you. To be sure the donated milk is free from bacteria and viruses, you can pasteurize the milk at home. Please click here for detailed instructions for how to safely prepare donated breast milk. 

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I am very excited to now provide expert breastfeeding help at the office of Carolina Pediatrics of the Triad! 
If you are looking for a pediatrician for your new baby, Carolina Pediatrics is now the only pediatric office in Greensboro offering Lactation Consultation services. 
Carolina Pediatrics understands the importance of on-site breastfeeding help, and they have opened up office space for Greensboro Lactation Consultants to see families at the first weight check, or whenever concerns arise. Appointments are available on Monday, Tuesday, and Thursday mornings, and drop-ins are welcome. 
Call, text, or email if you'd like breastfeeding help at Carolina Pediatrics. 

Got (Enough) Milk?
As a Lactation Consultant, I have been asked everything under the sun that has anything to do with breastfeeding, from “can I drink some coffee?” to “can I nurse with a pierced nipple?” to “how does a pump work?” But by far, the most common question I get is, “am I making enough milk for my baby?” Weighing the baby over time is the best way to know if the baby is getting enough milk, but it’s impossible to weigh the baby every feeding or every day. There are some other great ways, besides weighing the baby, to know that breastfeeding is going well.
Here are 5 tips to help you know if your baby is getting enough breast milk:

1. You are feeding your baby very frequently, every time your baby acts hungry. If you are feeding your baby every time your baby acts hungry, 8 to 12 times (or more) every day, even if your baby just finished a meal, you are getting off to a great start. By offering very frequent, on-demand, unlimited feedings at an early age, you are making sure that your baby gets all the milk he or she needs, as well as triggering your body to make lots of milk in the coming weeks and months. Every time your baby latches, your baby is telling your breasts to make more milk. More feeds in the early days results in more milk in the coming months.
But how will you know that your baby has a good latch and is actually getting milk?...
     
2. You can hear your baby swallowing. All that chugging? That is the sound of your baby getting lots of milk. If you can hear your baby swallow frequently from day 5 on, you can be sure that your baby is drinking. Babies who are getting plenty of milk from breastfeeding will suck once or twice, then swallow, and they will repeat this suck, swallow pattern until…
     
3. Your baby is content and relaxed after a feeding. Babies are usually tense when they are showing hunger cues. Before the feeding, many babies have their fists clenched up and their arms pulled in tight to their bodies. As the feeding progresses, and you hear frequent swallowing, watch your baby’s arm and hand. The arm and hand will began to loosen and relax, and the fingers will splay open. A hungry baby will pull their arm in if you (gently) pull the hand away from the body. A full, satisfied baby will have a relaxed arm and hand, and when you lift the hand away from the baby’s body, the arm will drop like a wet noodle. The baby’s arm is a good gauge as to how satisfied the baby is after eating.
Your baby needs to have a wide mouth and a deep latch to make sure that he or she is getting enough milk. If your baby has a shallow latch, you could experience sore, painful nipples and engorgement. Another good sign that your baby is getting enough milk is that…

4. Your breasts and nipples are not in pain. Some women feel their breasts fill up every feeding, and some women don’t feel the filling as much. If you generally feel your breasts fill up with milk, and your breasts get softer during a feeding, this is a good sign that your baby is getting lots of milk.
In the early days and weeks of breastfeeding, a little discomfort and tugging on the nipples is common, but toe-curling pain is not normal. If your nipples hurt so much that it takes your breath away, get someone to help you adjust your baby’s latch. Healthy, comfortable nipples are a sign that your baby is latched well.
Besides frequent feeds, lots of swallowing, a content baby, and comfortable nipples, there is one other thing to look for…

5. Pees and poops What comes out of your baby says a lot about what went in your baby. If your baby is having lots of wet diapers and at least a few yellow poops every day, AND you are experiencing ALL of the above, you can be confident that your baby is getting plenty of milk and that your body is making enough.

Bonus Tips! Things that do NOT mean that your baby is starving:
1. Frequent feeding. If it seems like your baby wants to eat all the time, see tip #1 above. This is not a sign that your baby is starving, it is normal for your baby to want to feed very frequently, which ensures that your baby gets fed enough and your body makes enough. More sucking = more milk!

​2. Your friend’s baby takes more formula than you pump for your baby. You be you. Moms are valuable teachers for each other, but comparing your baby to another baby isn’t always a good idea. Babies who drink formula require more than babies who take breast milk. Use the tips above to be sure, and when in doubt, it’s always ok to call for a weight check.
If you aren’t seeing all 5 signs that your baby is getting enough milk, or if you have any concerns about it, call your baby’s pediatrician or an IBCLC and get some help. 
Nurse on, mama!

Help! Breastfeeding is Painful! Is Something Wrong?
The early days and weeks of breastfeeding can be difficult as mom’s hormones are shifting dramatically and she is getting less sleep than she is used to. Sore nipples can make the adjustment even more stressful. Some well-meaning friends or family members might tell moms that they need to “toughen up” their nipples, or advise them to give up and just bottle-feed. If your nipples are hurting, it is important to find the cause of the pain and to make the necessary adjustments so you can continue breastfeeding.
Discomfort in the early days of breastfeeding is not uncommon and might be normal, as long as it is mild, it lasts only a few seconds at the beginning of a feeding, and the nipples look normal after feeding. Toe-curling pain that lasts throughout the feeding and/ or between feeds, and nipples that are misshapen, white, scabbed, or cracked are not normal. Moms who are experiencing these things are encouraged to seek help from an IBCLC right away.
Most of the time, sore nipples can be resolved by making some adjustments in how the baby is positioned at the breast. The vast majority of nipple pain is caused by positioning and latch errors. Sometimes, small adjustments can make a big difference in mom’s comfort!
Could My Baby Have Tongue-Tie?
If you are experiencing pain while breastfeeding, it is important to seek help from an IBCLC who can help you with positioning, evaluate your baby’s latch, and evaluate your baby for anatomical variances such as tongue or lip-tie. If your baby does have a tongue or lip-tie, and you are having breastfeeding difficulties, there are some very affective treatment options that your IBCLC can discuss with you. Sometimes a tongue-tie is hard to see. Sometimes, a baby might have an obvious-looking tongue-tie, but a full evaluation is necessary to make sure there are not other problems going on.
 
If it’s Not Tongue-Tie, What Could it Be?
Some other things that can cause severe nipple pain include Raynaud’s Syndrome, skin conditions, or infection. The baby may have difficulty with sucking and require suck training. Some babies have misalignment that causes sucking difficulties, and can be helped by a specialist in Cranio-sacral therapy.
If you are hurting, get help right away! There is no need to continue suffering, when an IBCLC can help you find out what the problem is and what to do about it.