Expert: Sally Wendkos Olds - 5/1/2008

Question
Hi Sally, I have a strange situation, I think. I had no big problem starting to breastfeed and have had no supply issues until very recently. My baby is 10 1/2 months old, chubby, loves trying all new foods and I put him to the breast often. I really want to continue feeding him until at least 1 year but my supply seemed to quite quickly just drop off. I have tried pumping (and still am)(I have a hospital grade pump) which became mildly painful but more frustrating. I have tried fenugreek and blessed thistle, which worked quite well but I read that its effects could wear off, so I started taking less. Now I have one nipple that is SO sore. I thought the baby was biting, but now I realize it is sore even when not feeding. There is no obvious nipple trauma. The baby does not have any teeth yet but bites on everything. There is NO pain on the other side. He does seem to be latching less deeply on this side but this is the side that has tended to produce much more milk throughout. Incidently this is the side that, before baby, was always my smaller breast. I change the breast pads regularly. This side, only, has periodically hurt for maybe a couple of weeks, but this seems to be the worst pain so far. Could there be an infection even if there is no visual sign? This nipple is a little bit drier. I got my period at about eight months. There, that is as much info as I can think of which might help you assess:)
One other question, is it because of the breastfeeding that I have ZERO sex drive? Obviously, the period has returned and everything seems physically back to normal "down there", except for a very strange, for me, inability to orgasm from sex..... Thank God for the internet:)  Thank you, too, in advance.    Alex.

Answer
Dear Alex,

First, congratulations for giving your son the best start in life by breastfeeding him!

Then, to the easier question: In my book (see below) I have an entire chapter about sex and lactation. (I also deal with this situation in another book I wrote: THE ETERNAL GARDEN: SEASONS OF OUR SEXUALITY, about sexual phases throughout life.) Your situation is a very normal one -- lack of interest in sex is quite common among nursing women. It does come back, though! If you had orgasms before you started to nurse, you will almost certainly have them again. Meanwhile, I'll attach a few suggestions that may help.

As far as your nipple pain is concerned, I wonder whether you have checked for thrush. If you and the baby both have that, both of you will have to be treated. If you have ruled that out, I would suggest seeing your obstetrician if she/he is knowledgeable about lactation. If not, see a lactation consultant first, and then if she cnnot diagnose your problem, then go to your o.b. to see whether there is in fact an infection or other problem with your breast. As you can imagine, it's hard to diagnose long-distance, and it's unusual for a nipple to become sore after nursing as long as you have. Whenever anything in our bodies is unusual, it's wise to check it out to be sure there's no medical problem.

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with Laura M. Marks,
M.D.
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Keeping Romance Center Stage
• Make at-home dates ahead of time with your partner. These are evenings when you’re not available for company, when you take your phone off the hook or let your answering machine pick up, when you set aside time just for each other. You need this relaxed time together, whether you use it for talking, for a relaxing massage or hot bath, or for an evening of watching a special TV show or maybe an erotic videocassette.
  These evenings at home can, of course, be wonderful times for making love. While planning ahead for lovemaking may seem unromantic at first, it’s worth noting that in our society marriage is the only structure that demands spontaneous sex. Dating couples and extramarital lovers know they have to plan ahead to see each other—and they usually find the planning itself erotic. Married couples can have an “affair” with each other, too. You may be able to phone or e-mail each other during the day, or leave romantic notes where your partner will see them.
• Invite your partner to enjoy the sensuousness of parenting by bringing him into bed, bare-chested, while you are nursing the baby, and following feeding sessions with three-way cuddling, or by taking family baths together. This brings the father into the family circle and enables you as sensitive parents to transmit a warm, comforting sensuality without being inappropriately seductive.
• Be flexible. If before the baby arrived, you usually made love at bedtime, planning your day differently now may help you get together more happily. Some couples like to make love in the early morning after the baby’s first nursing of the day. Some partners are able to get home for lunch at a time when their babies conveniently take a nap.
  One husband who had felt ignored because his wife was always asleep by the time he got into bed with her after the 11 o’clock news finally realized that he could get into bed with her at about 8:30, snuggle for a while, and make love. Then, after she went to sleep, he would get out of bed to watch the news.
• Even though you are nursing, you can still leave your baby for short periods of time. Once the course of breastfeeding has been established, many couples plan an evening out once a week so that they can enjoy each other’s company in a more carefree way. This need not be anything more elaborate than a trip to a movie or a nearby ice cream shop—but can, if you’re feeling extravagant, include a few hours at a local motel.
  It’s best if you can plan to go out at a time when your baby usually sleeps, but if there is no “usually,” you can nurse your baby just before you leave and then leave him or her with a competent sitter—possibly a student nurse, an older woman, or a college student, if no grandparent is available. Once your milk supply is well established (usually by the end of the second month), you should be able to be away from your baby during feeding time by leaving a bottle that contains your own milk, which you’ve either hand-expressed or pumped earlier in the day.
  While you and your partner are renewing your relationship, your baby can be learning to trust other people besides the two of you. As Margaret Mead told me (Sally Olds), babies are most likely to develop into well-adjusted human beings when they are cared for “by many warm, friendly people”—as long as most of these loved people remain in the infants’ lives.
• Disruptions of the dinner hour seem to hit some men harder than anything else. You can minimize these by waiting to prepare dinner until right after a feeding. Then if you and your partner pitch in together, you might be able to cook and eat dinner before your baby needs you again. Or Dad may take over dinner preparations for a while, even if his “taking over” means taking out.
  No matter how much of a gourmet you may have been before the birth of your baby, be prepared for drastic changes in your eating habits, at least for the first few months, when your baby’s schedule is apt to be irregular. The best kind of meal for now is one that involves a minimum amount of preparation—a casserole that can be put together whenever one of you has the time, fish that can be broiled quickly, or a salad or stew that won’t mind waiting. If you have access to good, nutritious take-out food and can afford the extra expense (along with paper plates), this is the time to splurge.
• The simplest meal can take on a romantic aura if you eat by candlelight on your good china (which is no harder to wash than your everyday ware).
• If you’re used to having an occasional drink before or with dinner with your partner, you don’t need to give it up. It’s probably best to time your cocktail hour to come soon after a feeding. You can enjoy a quiet interlude for the two of you over a glass of wine while you’re catching up with each other on the events of both your days.
• If your baby sleeps in the same bed with you, you need to show a little ingenuity. Bed is not the only place where lovemaking can take place. Why else was the rug in front of the fireplace invented? Or you might slip quietly out to a guest bed, a living room couch, or any other welcoming surface while your baby is asleep.
  One couple whose two-year-old daughter continued to fall asleep every night in their bed would wait until she was sleeping and then tiptoe out to her room and make love in her bed. They would sometimes put on music before their daughter went to sleep and let it continue to play to drown out any sounds they might make. In these child-rearing years some parents who work hard at finding the time and the place to make love get an added excitement from the illicit feeling that reminds them of their teenage years, when they would “make out” out of their parents’ sight.
• Pay attention to yourself. Your baby will think you’re beautiful no matter what, but you’ll feel better about yourself and show your partner that you care about his opinion if you can do some minimal grooming feats shortly before you expect him home. You might expend the energy to run a comb through your hair and put on a shirt that doesn’t carry that unmistakable perfume of spit-up milk.
  If you’re ordinarily small-breasted, you might enjoy dressing seductively during the time you’re nursing, when you’re more bosomy than you have ever been before. If you’re less thrilled about your added pounds and curves, you’ll feel and look more attractive if you buy one or two flattering outfits to fit your current figure (see Chapter 8).
• If you’re eager to resume sexual relations, don’t be shy about letting your partner know. He may be waiting for a signal from you. If you couldn’t care less, you may want to go along to please him. Reaching orgasm is often less important than the physical closeness of sex. While women more often seem to be comforted by being held lovingly, men tend to find genitally oriented sexual activity comforting and life-enhancing.

Also, you might try experimenting sexually with other positions, other activities. You might find something new to be exciting. Some women find fantasizing to be arousing -- you're free to go anywhere in your mind!