Author: Julie Matheney

Feeding babies has been my passion since I was ten years old. Almost twenty years ago, I pursued becoming a speech therapist to work with babies in the Neonatal Intensive Care Unit. In working in that setting, I realized I wanted a more intimate approach to working alongside families as they struggled to feed their babies. I became a board certified lactation consultant and have really fallen in love with what I do. There’s nothing better than empowering families to reach their feeding goals, wherever they are in their journey, whether it’s exclusive breastfeeding, combo feeding, pumping or bottle feeding. I offer prenatal breastfeeding classes, virtual, office and home consultations. I can assess for tongue or lip ties, educate on pumps to maximize pumping sessions, transition baby to bottle in preparation for parents going back to work, help increase or decrease milk supply, and assist with all breastfeeding challenges.

How much milk do I need in my freezer stash?

- Julie Matheney

“The stash” is actually a modern concept that’s only a few years old. Prior to 2010 and the Affordable Care Act where anyone on an insurance plan can qualify for a free pump, very few people were doing consistent pumping unless there was a reason: a NICU stay for baby or going back to work for mom. Once more parents started getting pumps, freezer stashes because a hot thing to promote. In reality, you never need to pump if you’re exclusively breastfeeding and with your baby all the time. You don’t need a massive freezer stash to successfully breast milk feed your baby. You only need enough in the stash for the first time you’re away from baby, as the expectation is you would pump while you’re away to replace that milk. If you are breastfeeding baby and pumping milk that is going into a stash, you actually have an over supply.

For the first few weeks after delivery, the body usually makes more milk than baby needs because the body knows baby is going through cluster feeding and growth spurts. Young babies usually only take about 65-80% of what’s in the breast at any given feeding, so it’s possible to move this milk to a Haakaa, milk collector or pump. Prior to these inventions, most people just left that milk in the breast and let supply naturally regulate to what the baby was feeding. If you’re actively moving this milk and not immediately feeding it back to baby, you’re creating more milk than baby needs (over supply).

Now I’m a lactation consultant. I understand that not everyone who is pumping has an over supply. There are many people who need to pump to feed the baby with that milk that day. And there are many reasons to pump and stash milk. If you’re concerned about how effectively baby is feeding at the breast or you unique milk supply, work with an IBCLC lactation consultant to figure out if your concerns.

#pumpingtips #milkstash #breastmilkstash #breastmilksupply #breastmilkstorage

Babies have 7 senses

- Julie Matheney

We have 7 senses. They aren’t all fully developed at birth:
👁 Vision. Babies have very poor vision with no depth perception. They can see about 8-10” away, the distance from the breast to your face. They prefer high contrast, like your areola compared to your breast.
👂🏻 Hearing. At birth, fluid in the ear may affect baby’s hearing, but usually clears in a few days. They know your voice and prefer it above all others.
👃🏽 Newborns have a fully developed sense of smell. Your amniotic fluid changes smell based on what you ate and your hormones. Those little bumps that developed around your areola secrete and oil that smells like your amniotic fluid, helping baby locate dinner. Your body odor also become stronger to help baby know it’s you for bonding. You’re supposed to be stinky.
👅 Taste. While breast milk constantly changes flavor based on what you eat, and has a similar flavor to your amniotic fluid, baby’s sense of taste isn’t fully developed at birth. Flavors are much stronger for them and they prefer sweet to bitter or sour.
✋🏿 Touch. Touch is very powerful and can elicit reflexes in the baby to help them survive. Touching baby’s mouth gets them to root for a good latch. Touching the roof of their mouth triggers a sucking reflex which helps them feed. Being held in skin to skin contact regulates their heart rate, respiratory rate, blood sugar and temperature.
🤜🏼🤛🏼Proprioception. The body awareness sense which tells us where our body parts are in relationship to each other. It also gives us information about how much force to use, allowing us to grab the object we want without crushing it. This sense is developed by experience over their first year of life. Reflexive movements in response to movement and sensory input help lay the foundation for posture and motor planning later on.
🎡Vestibular. This sense is all about balance and movement, which tells us where our body is in space. It is the first sense to be fully developed by 6 months gestation. It is the unifying system in our brain that modifies and coordinates information received from other systems. An overactive vestibular system can result in an intolerance to movement.
#thesenses #senseofself

Postpartum Hormone Shifts

- Julie Matheney

When the placenta is delivered, estrogen levels drop. While breastfeeding, periods may not return for several months because the hormone that causes you to make milk, prolactin, also stops you from ovulating and having your period. Breastfeeding, though, can cause hormonal fluctuations that can some times catalyze additional hormonal imbalance symptoms. Breastfeeding mimics menopause due to the production of the milk-producing hormone, prolactin, temporarily blocking estrogen production, which keeps your estrogen levels low and prevents your period from occurring. Around 2-3 months postpartum, hormones begin to reset to pre-pregnancy levels. However, the stress hormone cortisol can increase, and in combination with lack of sleep, melatonin decreases (and, as a result, serotonin) and these hormone changes can negatively impact mood. For most, prolactin levels drop around 6 months postpartum as baby takes more solids and sleeps longer and periods may start again. These hormone shifts can have crazy symptoms. And if you’ve suffered from a hormone imbalance prior to pregnancy, there’s a good chance it’ll come back once this shift happens. Some times just understanding the hormone shift can help you cope. Some times you’ll need to be seen by a health care provider to figure out your exact imbalance to work on strategies, therapies, nutrition or medications to bring you back to balance.

#postpartummooddisorder #postpartumjourney #poatpartumdepression #hormonebalance #moodswings #motherhood #motherhoodinthewild

Coffee and breast milk

- Julie Matheney

Caffeine While Breastfeeding: What You Need to Know

Understanding Caffeine and Breastfeeding

Caffeine is a common component of many beverages and foods, such as coffee, tea, soft drinks, chocolate, and certain medications. As a breastfeeding mother, it's natural to wonder how your caffeine intake might affect your baby and your milk supply.

How Caffeine Affects Breastfed Babies

When you consume caffeine, a small amount passes into your breast milk. Most babies metabolize caffeine slowly, especially newborns and premature infants, which means it can accumulate in their systems. The effects of caffeine on babies can vary, but here are some key points:

1. **Sensitivity**:
- Newborns are particularly sensitive to caffeine. High levels in their system may lead to irritability, wakefulness, and fussiness.
- Older infants metabolize caffeine more efficiently, reducing the likelihood of noticeable effects.

2. **Accumulation**:
- Caffeine can accumulate in a baby's system if consumed in large amounts by the mother, leading to overstimulation and sleep disturbances.

3. **Variability**:
- Sensitivity to caffeine varies among infants. Some may be more tolerant, while others may show signs of sensitivity even at lower maternal intake levels.

#### Recommended Caffeine Intake for Breastfeeding Mothers

Moderation is key. According to health experts, a moderate amount of caffeine is generally considered safe for breastfeeding mothers:

- **Daily Limit**: Up to 300 milligrams per day, roughly equivalent to 2-3 cups of coffee, is typically considered safe. However, it's essential to consider all sources of caffeine, including tea, chocolate, and soft drinks.

Managing Caffeine Intake

Here are some tips to help manage your caffeine intake while breastfeeding:

1. **Monitor Baby's Reaction**:
- Pay attention to your baby’s behavior. If you notice increased fussiness, difficulty sleeping, or irritability, it might be worth reducing your caffeine intake.

2. **Spread Out Consumption**:
- Spread your caffeine intake throughout the day rather than consuming it all at once. This can help minimize potential effects on your baby.

3. **Choose Alternatives**:
- Consider switching to decaffeinated coffee or tea, herbal teas (ensure they are safe for breastfeeding), or other non-caffeinated beverages to reduce your overall intake.

4. **Read Labels**:
- Be mindful of hidden caffeine in foods, energy drinks, and medications.

5. **Stay Hydrated**:
- Drink plenty of water to stay hydrated, which can also help manage any potential effects of caffeine.

While moderate caffeine consumption is generally safe during breastfeeding, it's crucial to observe your baby’s reactions and adjust your intake if necessary. If you have any concerns or questions about caffeine and breastfeeding, consulting with a healthcare provider or lactation consultant can provide personalized guidance and support.

 

There are also coffee alternatives like Rasa Coffee that can give a similar feeling without the caffeine and some blends can still be safe while breastfeeding. Always check the herbs you are consuming prior to taking them as some are not safe while breastfeeding.

Cup Feeding: An Alternative to Bottles

- Julie Matheney

Cup feeding is an alternative method to bottle feeding that involves using a small cup to feed a baby, typically with expressed breast milk or formula. This method can be particularly useful in certain situations and offers several benefits. Here’s a comprehensive look at cup feeding and its importance.

What is Cup Feeding?

Cup feeding involves using a small, open cup to feed a baby. The baby sips or laps the milk from the cup, much like how an adult would drink. This method is often recommended for newborns, especially preterm infants, or when direct breastfeeding is not possible.

When is Cup Feeding Used?

Cup feeding can be an appropriate option in several scenarios:

- **Premature Babies**: For babies born prematurely who may have difficulty latching onto the breast.

- **Transitioning from Tube Feeding**: To help babies transition from nasogastric tube feeding to oral feeding.

- **Temporary Separation**: When the mother is temporarily unable to breastfeed due to medical reasons or separation.

- **Avoiding Nipple Confusion**: To prevent nipple confusion in breastfed babies who need supplementation.

Benefits of Cup Feeding

Preserves Breastfeeding Skills: Unlike bottle feeding, which can cause nipple confusion, cup feeding allows babies to maintain their breastfeeding suckling patterns. This makes it easier for them to transition back to the breast

Encourages Natural Feeding Behaviors: Babies can control the pace of their feeding, similar to breastfeeding. This can reduce the risk of overfeeding and helps babies develop their feeding cues

Avoids Nipple Confusion: Since cup feeding doesn’t involve artificial nipples, it helps avoid nipple confusion, making it easier for the baby to switch between breast and cup

Promotes Oral Development: The use of cup feeding supports the development of the baby's oral muscles, which are important for speech and eating solid foods later on

Simple and Accessible: Cup feeding requires minimal equipment – just a small cup. It’s easy to clean and sterilize, making it a hygienic option

How to Cup Feed a Baby

Cup feeding requires patience and proper technique to ensure the baby feeds safely and effectively. Here’s how to do it:

Prepare the Cup: Use a small, clean cup. A medicine cup or a small shot glass works well. Fill the cup with a small amount of breast milk or formula

Hold the Baby Upright: Position the baby in an upright, seated position. Support their head and neck with one hand

Offer the Cup: Hold the cup at the baby’s lips, tilting it just enough so that the milk touches their lips. Allow the baby to lap or sip the milk at their own pace. Do not pour the milk into the baby’s mouth, as this can cause choking

Take Breaks: Give the baby time to swallow and breathe. Watch for their cues to know when they need a break or are full

Burp the Baby: After feeding, gently burp the baby to release any swallowed air

Safety Considerations

- **Supervision**: Always supervise your baby closely during cup feeding to prevent choking.

- **Hygiene**: Ensure the cup is thoroughly cleaned and sterilized before each use.

- **Small Amounts**: Start with small amounts of milk to avoid spillage and waste.

Cup feeding can be an excellent alternative to bottle feeding, offering numerous benefits for both the baby and the mother. It supports breastfeeding efforts, promotes natural feeding behaviors, and aids in the baby's oral development. With proper technique and patience, cup feeding can be a successful and rewarding feeding method. If you’re considering cup feeding, consulting with a lactation consultant or pediatrician can provide additional guidance and support.

The Importance of Lubrication While Pumping

- Julie Matheney

Breastfeeding can be a rewarding but challenging journey, especially when it comes to using a breast pump. One often overlooked aspect that can significantly enhance your pumping experience is lubrication. Here's why lubrication is essential while using a breast pump:

1. **Prevents Nipple Damage**: Dry pumping can lead to friction, which may cause nipple soreness, cracking, and irritation. Using a lubricant can help reduce this friction, keeping your nipples healthy and comfortable.

2. **Enhances Comfort**: Lubrication can make the pumping process much more comfortable. A smoother, less abrasive experience means you’re more likely to stick with your pumping routine, ensuring your baby gets the nourishment they need.

3. **Improves Suction Efficiency**: A properly lubricated nipple can help create a better seal with the pump flange. This can enhance the efficiency of the pump, allowing for better milk extraction in less time.

4. **Reduces Pumping Time**: When the pump is working efficiently and comfortably, you may find that your pumping sessions take less time. This can be a significant benefit for busy moms juggling multiple responsibilities.

5. **Prevents Plugged Ducts**: Consistent lubrication can help maintain a steady flow of milk and prevent issues such as plugged ducts, which can be painful and may lead to mastitis if not addressed.

### How to Properly Lubricate

1. **Choose a Safe Lubricant**: Opt for a nipple-friendly lubricant such as medical-grade lanolin, coconut oil, or a water-based lubricant specifically designed for breastfeeding. Avoid using lotions or products with fragrances and additives.

2. **Apply Before Pumping**: Before you start pumping, apply a small amount of the lubricant to your nipples and the inner part of the pump flange. Ensure even coverage without over-applying.

3. **Reapply as Needed**: If you’re pumping for extended periods, you may need to reapply the lubricant to maintain comfort and efficiency.

4. **Keep Clean**: Ensure that your pump parts are clean before applying the lubricant. Proper hygiene can prevent infections and ensure the longevity of your pump.

5. **Consult a Professional**: If you’re unsure about which lubricant to use or how to apply it, consult a lactation consultant for personalized advice and recommendations.

Incorporating lubrication into your pumping routine can make a significant difference in your comfort and efficiency. By taking this simple step, you can ensure a more pleasant and productive pumping experience, ultimately supporting your breastfeeding goals and your baby’s health.

Milk Blebs or Blisters

- Julie Matheney

Managing a milk bleb (also known as a milk blister) can be uncomfortable, but there are effective ways to address it. Here are steps to help manage and treat a milk bleb:

🤱🏽Frequent Nursing: Continue breastfeeding frequently to keep milk flowing and prevent further blockages. Start nursing on the affected side first to ensure thorough drainage.

🤱🏼Proper Latch: Ensure your baby has a proper latch to prevent friction and irritation that can contribute to milk blebs. Change your feeding position to have baby’s mouth come from a different angle to the bleb

❤️‍🔥Warm Compresses: Apply a warm, moist compress to the affected nipple before nursing or pumping. This can help soften the bleb and promote milk flow.

👐🏼Gentle Massage: Gently massage the area around the bleb while breastfeeding or pumping to help clear the blockage. Be careful not to cause additional irritation.

🌦️Soak in Warm Water: Soak your nipple in warm water mixed with a little Epsom salt. This can help reduce inflammation and soften the skin.

🫒Olive or Coconut Oil: Apply a small amount of oil to the nipple to soften the skin and make it easier to remove the bleb.

⚔️Avoid popping it with a needle as this can increase your risk of infection.

🩹Antibiotic Ointment: For persistent or painful blebs, contact your healthcare provider and ask for a prescription of triamcinolone cream .

🥑Stay Hydrated and Healthy**: Maintain good hydration and a balanced diet to support overall health and effective milk production.

🤱🏽Consult a Lactation Consultant: If milk blebs are recurrent or particularly painful, consult a lactation consultant for personalized advice and support.

Always ensure good hygiene, wash your hands before touching your breasts, and keep your nipples clean and dry. If you experience persistent pain, signs of infection, or recurring blebs, seek medical advice promptly.

The rooting reflex

- Julie Matheney

The rooting reflex (RR) is a fascinating developmental milestone that begins even before birth and continues to evolve during infancy. RR is an automatic response in newborns characterized by turning their head toward a touch on their cheek or mouth. When you stroke or touch your baby's cheek or the corner of their mouth, they will instinctively turn their head in that direction, open their mouth, and make sucking motions. By turning towards a

touch, babies instinctively position themselves to find their food source and initiate feeding

The RR starts to develop in utero, typically around the 32nd week of pregnancy. During this time, baby's neurological and sensory systems are maturing rapidly. Once baby is born, the rooting reflex becomes more pronounced and functional. Immediately after birth, and often during the first few weeks of life, you can observe your baby's natural response to touch on their cheek or around their mouth. It’s a reflex, so this is also why they will try to root and latch to dad’s nose or even to grandma’s chest.

The RR is at its strongest during the newborn phase, the first 0-3 months. Babies rely heavily on this reflex to initiate feeding, whether at the breast or with a bottle. As baby's neurological system continues to mature, the rooting reflex gradually integrates with other feeding skills. By around 4 to 6 months of age, babies start to gain more head control and may rely less on the rooting reflex for feeding.

You can actively support baby's RR by:

- Positioning baby close during feeding. Their chin and cheeks should be physical touching your breast and your fingers can touch their cheeks during bottle feeding

- Let baby lay on both of their sides during tummy time, not just on their belly. As the floor triggers the reflex, it helps not only integrate it, but also will eventually help with rolling over and finding toys

- Being responsive to your baby's cues and feeding needs, especially during the early weeks and months.

Have you noticed the rooting reflex in your baby? Share your experiences and insights in the comments below! 💬🍼 #RootingReflex #NewbornDevelopment #ParentingJourney

Pace bottle feeding

- Julie Matheney

**What is Paced Bottle Feeding?**

Pace(d) bottle feeding is a responsive feeding technique designed to mirror the slower, more controlled flow of breastfeeding. The idea is to allow babies to feed at their own pace, promoting better digestion, reduced gas, and helping to prevent overfeeding. There are a few things about how it’s being taught to families with older babies, though, that have always bothered me as NICU trained SLP.

Pace bottle feeding was originally used and taught in the NICU setting with preemie babies for before their suck, swallow, breathe coordination was fully developed. We needed to be in charge of the bottle, because babies born before their due date lack maturity for self pacing and are at a higher risk of fatigue and other medical issues like aspiration and bradycardia/tachycardia from feeding.

Pace bottle feeding is often shown as baby sitting upright with the bottle nipple only half full of milk. Caregivers are encouraged to tip the bottle down frequently every few swallows to slow baby down. The bottle is also removed at regular intervals for burping. This can work fine for the first week or two while baby is learning to feed, but there are a few flaws to this.

📌I’m not a fan of half full nipples. Air mixed with milk is what increases swallowing air which can cause reflux and digestive discomfort. I recommend keeping the nipple full

📌Externally pacing the baby is fine in the initial weeks after birth, but we really want baby pacing themselves. If they are constantly chugging from the bottle, that’s a bottle issue. Decrease the level or nipple or change bottles to find a flow that allows baby to take breaks when they want to

📌An upright position is fine for babies 3+ months, but I see so many newborns hunched or scrunched in this position, which leads to pressure on the belly. Having baby in an upright side lying position mimics being at the breast and allows a long, straight torso for easier digestion

📌Yes!!!! We want baby to pace their feedings. That means it would take a similar amount of time as the breast: 15-30 minutes for the first 6-8 weeks and then to match the time at the breast after that it can range from 5-30 depending on how fast mom’s let down is.

How Paced Bottle Feeding has been taught:

👶🏻Hold Baby Upright: Sit baby in a semi-upright position to reduce air intake and reflux

🍼Controlled Bottle Angle: Hold the bottle horizontally, allowing milk to fill the nipple (some are taught to only fill it half way) but not flow freely.

🧭Pause and Check-In: Offer short breaks during feeding to gauge baby's cues for hunger or fullness.

💡Encourage Sucking Reflex: Let baby control the pace of feeding by actively sucking to draw milk, rather than having milk continuously drip.

🔮Observe Cues: Watch for signs of satiety (e.g., slowing down, turning away) to know when baby is full.

Benefits of Paced Feeding:

- **Supports Digestion:** Reduces the risk of overfeeding and minimizes gas and spit-up.

- **Mimics Breastfeeding:** Helps babies develop a natural feeding rhythm similar to breastfeeding.

- **Promotes Self-Regulation:** Encourages babies to eat until they are satisfied, rather than finishing a bottle due to continuous milk flow.

**When to Use Paced Bottle Feeding:**

- **Breastfeeding Transition:** Ideal for young babies who are both breastfed and bottle-fed to maintain consistency in feeding patterns.

- **Preventing Overfeeding:** Helps prevent babies from overeating by allowing them to control the pace.

- **Bonding and Interaction:** Fosters a closer feeding experience between caregiver and baby.

**Final Thoughts:**

Paced bottle feeding is not just about feeding; it's about creating a nurturing and responsive feeding environment for your baby. By tuning into your baby's cues and allowing them to guide the feeding process, you can support healthy growth and development while fostering a positive feeding relationship.

Have you tried paced bottle feeding with your baby? Share your experiences and tips below! 💬🍼 #PacedFeeding #ParentingTips #BabyCare