My baby’s head tilts/turns to one side

Some times babies come out with a preference to turn their head to one side. This may simply be from how they were positioned in utero. Babies who sat really low in the pelvis or who have short moms with no space in the belly tend to be much more cramped and you can often see how they were positioned inside when they’re on the outside. A head turn preference or tilt can also be caused from birth trauma, like from a forceps/vacuum delivery or a really long pushing stage where baby was in the birth canal at a certain angle for a long time.

A mild head turn preference usually works itself out with lots of tummy time and the natural stretching that occurs outside the womb with position changes. It’s why rotating breasts is important to get baby moving in all directions. When baby is sleeping on their back, be sure to rotate which direction their head is laying to naturally help stretch out those neck muscles.

If you notice a consistent head tilt or turn that doesn’t go away in a few weeks or if it’s impacting feeding, there are multiple professionals that have additional training to help: specialized occupational and physical therapists, pediatric chiropractors, osteopaths and craniosacral therapists can work with your baby to help bring symmetry back to the body and release tension in baby’s muscles. If left unaddressed, it can potentially contribute to colic, increase flat spots on the head, or lead to torticolis.

Growth charts for breastfed babies

Growth charts are used to compare the growth of your child compared to thousands of other children of the same age and gender to track their growth OVER TIME. If you took 100 babies and lined them up by weight, where would your baby fall in line? If they fall in the 36th percentile, for example, they weigh more than 36 babies but less than 64 babies. The goal isn’t for every baby to be in a top percentile, like a grade. The goal is for baby to stay around their percentile while they grow over time.

Growth patterns differ between breastfed and formula-fed babies and there are different growth charts to track growth depending on how baby is being fed. Beginning around 3 months of age weight gain is generally lower for breastfed babies than for that of formula-fed babies. For the first 3 months of age, the WHO growth charts show a somewhat faster rate of weight gain than the CDC charts. After about 3 months of age, WHO growth charts show a slower rate of growth than the CDC growth charts. Because formula-fed infants tend to gain weight more rapidly after age 3 months, they may be more likely to cross upward in percentiles on the WHO growth charts. In general, we like to see a baby staying on their growth curve.

Growth charts are not intended to be used as a sole diagnostic instrument. Instead, growth charts are tools that contribute to forming an overall clinical impression for the baby being measured. This does help guide us to determine if feeding is in general going well and if adjustments need made. If your baby is losing percentiles or significantly dropping off their curve, and your goal is breastfeeding, a good pediatrician won’t just tell you to supplement. They’ll also refer you to a lactation consultant to help figure out why. Is it a supply issue, a feeding issue or both?!

Is my baby tongue tied?

Full movement of the tongue is needed for normal feeding, swallowing, chewing, speech, and breathing. The tongue needs to be able to move:

👅 In and out (and stay out for an extended period of time when breast or bottle feeding). The tongue should be able to protrude past the lower lip without any tension on the tongue. The tongue tip should be round or square and not notched or heart shaped.

👅 Side to side (enough to eventually clear food from the back molars). The ability to move the tongue side to side helps move food to the teeth for chewing.

👅 Up and down (the MIDDLE of the tongue being able to move up and down is actually what is needed for a baby to be successful at the breast). If your pediatrician told you your baby could stick their tongue out so there was no tie but didn’t check how the middle of the tongue moves didn’t actually assess your baby for a tie and doesn’t understand how the tongue needs to move for your baby to feed.

If the tongue cannot do these movements, it can have a chain reaction to limit or negatively impact other systems, including the respiratory system. Snoring in a baby is never normal. Open mouth posture except for when baby is sick is not normal.

Having a visible frenulum does not necessarily mean the tongue is tied. If the tongue has a frenulum but it still allows the tongue to move in all directions, it is not tied. A visual inspection from a picture or video is not enough to diagnose a tie. Only a hands on assessment where the tongue movement is challenged in all directions is enough to tell us whether or not the tongue is tied.

Tongue tied, now what?!

Once a tongue tie has been identified it’s often recommended that the tissue forming the frenulum be clipped, revised, or released. This it’s not always a magic wand to fixing all of the breast-feeding or bottlefeeding issues that a baby is experiencing. There are three components that need to happen for a baby to be able to effectively feed: strength, range of motion, and coordination of the muscles of the lips, tongue, and cheeks. For a baby that has good strength and range of motion of the tongue but the tie is restricting the ability for the tongue to move in all directions, having the time released often is an overnight miracle cure to many of the issues seen with feeding.

However, for those babies that also have a head turn preferences, low tone or high tension in the body, reduced strength and difficulties coordinating their mouth muscles, just having the ties released alone is not an instant fix. Some may even find that feeding gets worse before it gets better. Other therapies and specialists may need to be seen in order to be able to get feeding back on track and optimal. This may include chiropractors, cranial sacral therapist, physical and occupational or speech therapist as well suck training or oral motor exercises. Make sure whoever you are seeing who feels like you baby is tied is making the appropriate referrals and setting up realistic expectations based on what your baby can and cannot do.

Will my breasts sag after I wean?

Breasts are made of a network of ducts, covered by a layer of fatty tissue. During pregnancy, estrogen and progesterone enlarge the milk ducts and multiply the glandular tissue that produces milk. After birth, these two hormones drop and allow prolactin and oxytocin to rise. Prolactin is the hormone responsible for milk production and oxytocin releases milk into the ducts. When you wean from breastfeeding, it may take several months for the prolactin levels to return to normal (which is why many of us can still hand express milk for a long time). However, once you stop breastfeeding, the milk making structures actually self-destruct – a process that involves massive cellular suicide, and the removal of the debris. Approximately six months after weaning, the milk-producing tissue is replaced with fatty tissue. If you return to your pre-pregnancy weight, your breasts most likely will return to the same size. They may not be as “perky” because the skin is a bit more stretched and the connective and fatty tissues in the breasts often shifts during pregnancy and breastfeeding. While our breasts may look smaller after weaning most of us can expect that our breasts will return to a similar size as they were pre-pregnancy. They’re not a little more lived in and well loved.

Breast storage capacity

Breasts are made of a network of ducts, covered by a layer of fatty tissue. Breast size doesn’t indicate the number of ducts you have. A small breast and a large breast could actually have the same number of ducts and the same milk capacity (the amount of milk a breast can make and store at any given time) A breast with a small milk capacity can make plenty of milk to feed baby, but needs emptied more frequently to maintain milk supply. Think of milk capacity like cups. If you as an adult need to drink 64oz of water in a day and you have an 8oz cup, you need 8 cups a day to get what you need. If you have a 16oz cup, you only need 4 cups. But if your cup is 2oz, you need to drink 32 cups to get what you need. It’s is a similar principle for babies and boobies. Those with a smaller storage capacity in the breast need to empty more frequently to tell the body to make more milk. And they may also have to feed over night longer to maintain supply. I would not expect someone with a very small capacity to pump 6-8 ounces in a pump session (although it can totally happen!!!!).

🔑 A small storage capacity is some one who makes 1-2oz per feeding. Their babies often want to feed every 1-2 hours.
🔑 A typical storage capacity (what the majority have) is making 2-4oz every 2-4 hours. The body makes about an ounce per hour.
🔑 A large supply is making 4-6oz every 2-4 hours.
🔑 A robust supply is making 6+oz every 2-4 hours and this is usually for those with twins or are using the Haakaa or pumping a lot

Parenting is hard work

Being a parent is hands down one of the hardest things I’ve ever done. Being a breastfeeding parent waking up for cumulative years for MOTN feedings while being a working mom added sleep deprivation. Pair that with grief over multiple miscarriages and losing my mom to brain cancer while pregnant with Peach and I was a big ball of postpartum depression and anxiety. I am not posting this for sympathy. I’m posting this because you’re not alone in doing hard things. And feeling hard feelings. Being a parent (and breastfeeding) isn’t always the glamourous screen shot seen on social media. It’s raw and gritty and smelly and hard. And you’re not alone. I see you and all the work you’re putting in to feed your baby and stay level. Keep going. I’ve found for me being able to admit I’m in a hard spot, grieving, lost expectations is actually what helps me keep my sanity and start to get the help I need. Don’t give up on a hard day. Reach out for help. You’re not alone.

Teas to boost milk supply

  • One of the most common and traditional ways of boosting milk supply is through drinking herbal teas. Tea is an easy way to reap the benefits from powerful herbs while staying well hydrated. The primary herbs with reported lactogenic properties include alfalfa, blessed thistle, fennel, fenugreek, goat’s rue, milk thistle, and stinging nettle. While these products are considered safe for consumption in amounts traditionally found in food, remember that many herbs could still clinically be classified as drugs. In fact, many commercial drugs originated from herbs. You should use the same care when taking an herb as you would in taking an over-the-counter or prescription drug. Some herbs and supplements are known to interact with medications, and some infants can be sensitive to what you’re ingesting. Fenugreek, for example, can negatively interact with thyroid medications and decrease blood sugar, so should be avoided if you have hypothyroidism. It can also make mom and baby gassy. When considering drinking milk boosting teas, such as Mother’s Milk Tea, you usually need to drink at least 3-5 cups per day to really have it make any true difference on milk supply. Taking a pill form of an herb is a much more potent way to boost supply. As with any supplement, speak with your health care provider and/or an IBCLC to make sure the teas or herbs you want to take are appropriate for your individual situation as everyone responds differently to them.