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.

Baby poop: Should my baby be pooping daily?

- Julie Matheney

While some things we hear about babies are common, that doesn’t mean they are normal. The idea that breastfed babies don’t need to poop daily has been normalized, but in reality, isn’t true!! The idea that there’s very little waste produced from breast milk is not based on scientific evidence and can actually prevent finding the true reason for baby’s lack of poop. 

In the newborn stage, prior to 6 weeks, pooping tells us if baby is getting the appropriate volumes of milk from the breast. Many times when a newborn isn’t pooping, it’s a sign they’re not getting enough breast milk. As you increase milk volumes, baby starts to poop! Decreased milk intake can happen when baby has a tongue tie and can’t efficiently move milk from the breast, if feedings are scheduled (waiting for every 3 hours) or if baby is being sleep trained too early. Low milk supply can be caused by retained placenta, thyroid or hormone disorders or when there is a breast surgical history like a reduction. 

Constipation can have other root causes. 

🧬For some, it may be that their digestive biome is not ideal… things like antibiotics given to mom during pregnancy/birth or antibiotics given to baby shortly after birth shift the biome where it doesn’t ideally absorb and process milk. Introduction of formula also changes the gut microbiome. Some babies may have difficulty digesting certain formulas and may struggle with pooping until the right one is found. 

💃🏻Not getting enough movement, tummy time or being in one position for too long (sitting in positioning devices like a dockatot for hours a day) decreases movement through the gut. Allergies and intolerances are another culprit. 🦷Babies who are teething may have a temporary change and miss a day or two and then return to daily stooling. 

🤢Illness, change of environment (maybe a holiday/ move of house), change of daily rhythm etc can all play a role, and temporary changes are to be expected.

Every person is unique and so there isn’t any “one size fits all” reason why an infant may be struggling with constipation/infrequent stooling. If you baby isn’t pooping regularly, an IBCLC can help figure out what may be going on and refer you to the right specialist as needed. 

What can I eat to make breast milk?

- Julie Matheney

Prolactin is hormone responsible for making breast milk. We know that when you’re breastfeeding, you need about 300-500 extra calories to supoort making nutrition for your baby. You’re still eating for two!! There are foods with phytoestrogens which help boost and support your natural prolactin levels.

There are several main classes of phytoestrogens. Lignans are part of plant cell walls and found in fiber-rich foods like berries, seeds (flaxseeds), grains, nuts, and fruits. Two other phytoestrogen classes are isoflavones and coumestans. Isoflavones are present in berries, grains, and nuts, but are most abundant in soybeans and other legumes. Coumestans are found in legumes like split peas, lima and pinto beans. Eating these will naturally increase prolactin which in turn helps support making milk
🌾We all know oats are the go-to for increasing supply. They are rich in plant estrogens and beta-glucan. But other grains like brown rice, barley, and quinoa work as well!
🧄Garlic! It will definitely flavor you milk, but research shows babies love the flavor and often suck more in response and it’s been shown to increase milk supply
🌱Fennel: Raw or cooked, fennel seeds can be added to a recipe, or drunk as a tea. There are also many lactation specific supplements that include fennel in pill form for a more concentrated dose
🥬Dark Leafy greens like spinach, kale, collard greens, and broccoli. And yes, you can eat broccoli while breastfeeding. 🥦
🌻Seeds: Sesame seeds, flax seeds, and chia seeds are all super boosters of making milk and can be added to baked goods and smoothies very easily
🍓Berries: Get a phytoestrogen boost with fruits like strawberries, cranberries, and raspberries.
🌰Nuts: Almonds are high in linoleic acid and known to be the most lactogenic nut. Packed with healthy fats and antioxidants, Vitamin E and omega-3, walnuts, cashews, and pistachios are all good choices. Snack on raw or roasted nuts, add them to cookies, smoothies, and salads.
🍏🍇🍍🥥🥑🥦🥒🫑🥕🧄🧅🍠🍞🧀🍳🥩🍔🥗🍪🥛

Why is my breastfed baby losing weight?

- Julie Matheney

While maternal nipple pain and damage are classic signs of tongue tie in baby, I have seen many cases where the mother reports absolutely no pain with breast-feeding. These babies tend to have very high palates and some times a weak suck (not always). The actual nipple in most cases is large and long and goes up into the palate where the tongue tends not to be able to pinch it as much. There may be creasing of the nipple, but usually not the classic damage seen with other presentations of tongue tie. These mother‘s bodies often compensate with a fast let down and over supply of milk. These babies trigger let down easily and the mothers body responds with freely flowing milk. Baby drinks from the fountain without learning how to stimulate the breast and empty it on their or or learning how to trigger new let downs. These babies often gain weight well or even faster than expected until around 3-4 months when they unexpectedly drop off the growth curve and mom feels like her supply suddenly drops. Symptoms often include clicking at the breast (caused by that high palate and the fast flow of milk) which in turn increases the risk of reflux, colic and gassiness. Moms also complain that they need to constantly hold or shape the breast or baby loses the latch. These ties often go undiagnosed and many of these babies are switched to bottles and formula as the supply continues to decrease from the baby inefficiently moving milk from the breast which can also coincide with mother going back to work. If she is using a poor quality pump or the wrong size flanges and not moving milk well with the pump, she’ll often blame herself for the low supply.

Do I have thrush?

- Julie Matheney

Has your nipple looked white after feeding or pumping? The blood vessels have gone into spasm and are not letting blood through. When the nipple gets pinched, the arteries spasm and stop letting blood through. As the pinch is released, blood starts to flow, and it results in pain. Some say it feels like fire or ice. Others describe it as a burning, slicing, or pins and needles. It often gets misdiagnosed as thrush but will not respond to medications.

It can be caused by a bad latch, but also from undiagnosed tongue tie and using a pump flange that’s too big. For people prone to vasospasm, the repetitive act of feeding or pumping in combination with the abrupt drop in temperature when baby unlatches or the pump stops is enough to trigger a spasm.

🌻Watch for a deep latch every time
🌻Have baby assessed for tongue tie
🌻Check your flange size. If you’re maxing our the suction on the pump, your flange is too big. When too much areola is drawn into the tunnel, the areola swells shut around the nipple and causes the spasm.

Other tips:
🤲🏼Gently massaging, rubbing, or pinching the nipple helps. Immediately cover your nipples with your shirt/bra/nursing pad, then gently rub or massage them through the fabric.
🔥 Use dry heat like a lavender pillow, microwaveable rice/barley/flax pack, hand warmer/Hot Hands immediately after baby unlatches or you stop pumping. Leave heat on for a few minutes until the pain subsides.
🌸Limit or avoid caffeine
🌸Some research indicates hormonal birth control pills increase the risk of vasospasm.
🌸The main supplement that seems to help with vasospasm is vitamin B6. Dr Jack Newman suggests 100 mg of B6 twice day, as part of a B vitamin complex.
🌸Calcium plays an important role in blood vessel dilation. Magnesium helps in calcium regulation. Taking cal/mag often helps with vasospasm.
🌸For chronic, painful vasospasm that does not respond to other strategies, some doctors may prescribe a short course of the rx Nifedipine.

Breast changes

- Julie Matheney

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, estrogen and progesterone drop and prolactin and oxytocin rise. Prolactin makes milk production and oxytocin releases it into the ducts. Extra blood and fluid fill the breast just after birth to supoort your body adding hormone receptors in the breast to make milk. The blood and fluid surrounds the ducts and this extra pressure is what makes your breasts feel full between feeding. This blood and fluid reabsorb around 6-8 weeks once supply is established and you won’t feel that full/soft feeling except when you go a really long time between feeding or pumping. Breasts go back to prepregnancy size when supply regulates around 11-14 weeks but continue to make milk. When you wean from breastfeeding, it can take several months for prolactin levels to return to baseline (which is why you may still see milk for months after weaning). Once you stop breastfeeding, the milk making structures actually self-destruct – a process that involves massive cellular suicide, and the removal of the debris. Around 6 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 they 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 just a little more lived in and well loved.

How many minutes should baby breastfeed for?

- Julie Matheney


15 minutes per side is a recipe for baking, not breastfeeding. Not every baby needs 15 minutes per side. Some babies take a full feeding in only a few minutes minutes, and from just one breast per feeding. Other babies may feed for a few minutes off each side. Older, more distractible babies are efficient eaters with more important things to do than state at your chest. They may graze at the boob a few minutes at a time or want to go back and forth from side to side.

Other babies may be boob barnacles and need much longer at the breast. Or they may want to be at the breast for more than just nutrition: teething, growth spurts, you going back to work, developmental leaps, sickness. Being on your body brings healing, comfort and stability while they’re going through all kinds of rapid changes and growth. Being on you for an hour or more is the best medicine to what ails them.

The only time we should be limiting time at the breast is in NICU with premature babies where fatigue is a factor or under the direction of a lactation consultant because of true low supply, tongue tie or other oral motor disfunction while on a triple feeding plan. This would be a temporary plan because of a true lactation issue.

In general, you know baby is getting enough breast milk when you have a pain free latch where the nipple goes in and out of baby’s mouth the same shape. You can hear baby swallow and don’t need to keep them awake at the breast for them to continue feeding. Baby should be making lots of heavy wet diapers and pooping daily or every other day. They also gain weight to their own curve and are a similar size of your unique family genetics.

If your baby typically latches for you, and feeds well, and refuses to latch, they most likely are done. Follow your baby’s lead and get to know their feeding habits. Trust your baby and trust your body. If you’re concerned about how your baby is feeding, schedule and appointment with a breastfeeding expert: an IBCLC lactation consultant.

The seven senses

- Julie Matheney

We have 7 senses, not 5, but not all of them are fully developed at birth:

  1. 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 also don’t have very good color perception and prefer high contrast, like your areola compared to your breast. Over the first few months, babies may have uncoordinated eye movements and may even appear cross-eyed.
  2. Hearing. At birth, fluid in the ear canal and middle ear may affect your baby’s hearing. This fluid usually clears in a few days, and after that your newborn can hear fairly well. Babies actually do have fully developed hearing, but they are still learning to process and interpret what they hear. They know your voice and prefer it above all others. They also know your language and can distinguish it from other forgiven languages. A song or book they heard while in utero will also be preferred to a new one they’ve never heard before. 
  3. Smell. Babies 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 changes and become more pungent to help baby know it’s you and bond to you as caregiver. Avoid washing in strong soaps or using a lot of deodorants and perfumes. You’re supposed to be stinky. 
  4. Taste. While breast milk constantly changes in flavor based on what you eat, and has a similar flavor profile to what you ate during pregnancy and flavored your amniotic fluid, baby’s sense of taste isn’t fully developed at birth. Flavors are much stronger for them and they prefer sweet (which is most like the sweetness of breast milk) to bitter or sour. 
  5. Touch. This is one of the strongest sense at birth. 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. They know they’re on an adult who will protect, defend and care for them. Do not underestimate the power of infant touch. 
  6. Proprioception. The body awareness sense which tells us where our body parts 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 and babies need to use all of their other senses to mature these skills over their first year of life and beyond. Reflexive movements in response to movement and sensory input help lay the foundation for posture and motor planning later on.
  7. 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. Some babies, especially if premature, can be very sensitive to our handling and have difficulties going from one position to another. They can get easily unsettled with diaper changes and switching breasts. When a baby has an overactive vestibular system, they can displays gravitational insecurity and an intolerance to movement. Working with physical and occupational therapy can work through vestibule disorders. 

Tongue tie post release: what to expect

- Julie Matheney

WHAT TO EXPECT POST TONGUE TIE RELEASE  

My baby had their tongue tie released, what should I expect? First, having a tongue tie released isn’t always a magix fix to breastfeeding issues. While 80% of mothers do report a significant decrease in reported nipple pain after the procedure, there is still a recovery and healing proceess that needs to take place. That tongue has been like that since 8 weeks gestation and depending on how baby has learned to use their tongue, some relearning is necessary. 

Do I need to do stretches on my baby’s tongue after a release? There are conflicting answers, and it seems like every provider has a different one, which gets really confusing. The biggest concern is reattachment, which defeats the purpose of the release and for some, reattachment means re-release. 

Every baby is unique, as is their healing post release. When you have a tongue that is strong and coordinated but range of motion is limited because of the frenulum, the stretches, exercises and wound care management are different than a tongue that is super weak and disorganized. I have found in my practice that tongues that are super strong pre-release do much better post release and tend to need much less wound care management to keep the tongue from reattaching. They also need fewer oral motor exercises to get baby back to breast. The tongue was already functioning as it should, it was just anchored by the frenulum. When you have a weak tongue where range of motion was poor to begin with, they tend to need much more suck training/exercises, and without stretching, the tongue will reattach because of how the tongue rests on the floor of the mouth instead of up on the palate during healing. Body work is essential for these babes as the tension and weakness is usually though the whole system. Bodywork, suck training and lactation support are still crucial for the few days to weeks after the release is done. 

But what should you expect as a parent.

Day 1-3 your baby will feel sore and tender. They may be fussier than usual. A white patch will form where the surgery was done. Baby may have difficulty latching to bottle or breast, so have an alternative feeding plan ready such as cup or finger feeding. 

For the first week, baby is relearning how to use their tongue. Your provider should talk to you about stretches to do several times a day to help prevent the tongue from reattching. Our body likes to heal together so this is very important. Some minor bleeding may occur, but if you see lots of blood notify your provier right away. Pain management is often needed for the first few days, but many babies can taper off of this. 

From week 2-4, the white patch will shrink and may turn yellow as it heals. Some babies will see a small to drastic reduction in their symptoms at this point. Many babies will still need bodywork or lactation suppot. 

Natural remedies can include frozen breast milk chips that you can use to numb the area. This is especially helpful for very small babies when you don’t want to use an OTC rememfdy. 

Coconut oil is often recommended to lubricate the wound and for use during the stretches. A little goes a long way.

There are natural remedies that some parents find helpful such as arnica or camellia. And infant’s children tylenol can also be helpful. Mae sure to talk to your provider and your pediatrician for the correct dosage which is done by age and weight. 

Lots of snuggles, skin to skin time, and baby wearing can be helpful. Keep time at the breast pleasant and if you’re having trouble feeding, make sure to reach out as soon as possible for help.

Tricky Posterior Tongue Ties

- Julie Matheney

Some times even the best lactation consultants and feeding therapists can miss a posterior tongue tie in the immediate days or weeks after birth. Having a frenulum under the tongue doesn’t automatically mean it’s tied. A long, stretchy frenulum that allows full movement of the tongue is normal and not something that needs released. However, sometimes a frenulum can allow the front of the tongue to do what it needs to, but still be tied at the back. These are what I can tricky posterior ties. Mom may have lots of milk and baby transfers well from the breast in the early days or weeks post delivery. Mom may have no nipple pain or damage whatsoever. Only they come back a month later with new symptoms like slow weight gain or feeling like there breast isn’t emptying. Why is that?

Mom’s body often compensates well during the early weeks post delivery. The uterus doesn’t tell the breasts how many babies came out. So her body goes into overdrive to make more milk than needed from the start. As time moves on, the body figures out how much milk to make and drops supply to just what is being emptied. A baby that rode on mom’s robust post delivery flow may all of a sudden start to struggle at the breast as supply regulates. Based on how the anatomy is, there may never have been nipple pain or damage. If the baby has a high palate where the front of the tongue can still move well and mom has a large nipple that fills baby’s mouth well, the nipple may come out creased or pinched, but without pain. The anatomy on one or both sides masked the tie while baby was small. 


If breastfeeding was going well in the beginning, but symptoms start to pop up later, working with a qualified lactation consultant can help figure out what’s going on. And some times that means finding a posterior tie that was originally missed where a release is necessary to get feeding back on track. 

Causes for mastitis

- Julie Matheney

Did you know mastitis may be related to your posture?

Fluid dynamics is the science of how fluids move in our bodies. All of put bodily fluids are supposed to be free-flowing and unobstructed for optimal health. Milk is a fluid that flows through ever narrowing ducts and pores. Lymph is a fluid throughout your body (and breasts) that helps transport waste from cells and tissues in your body to help flush it from your system. It also helps reabsorb milk that doesn’t get emptied to baby/pump. Anything that increases resistance of the movement of these fluids increases the likelihood of plugged ducts or mastitis. Causes for increased resistance:
⭐️ Breast implants or reduction causing scar tissue in the breast
⭐️ Sleeping in the same posture especially on your side where you put pressure on the breast for extended periods of time
⭐️ Tight fitting clothing/bras that constrict movement of milk and lymph between feedings
⭐️ Shoulder injuries where there is inflammation or scar tissue
⭐️ Neck injuries or issues with neck mobility
⭐️ Tension in your body from stress or poor posture for extended periods of time during breastfeeding (bringing yourself to the baby)
⭐️ Not moving the body enough/sitting for prolonged periods of time in the same position
⭐️ Increased overall inflammation in the body such as from infection or excessive fluids from IVs used during labor and delivery or from immune disorders
⭐️ Having very large, heavy breasts which act more like an appendage where milk and fluid can fill the lower quadrant of the breast and have difficulties moving out again

What can you do?
❤️ Shake your breasts!! Get that fluid moving manually with your hands
❤️ Lean over and dangle your breasts to reduce pressure on them and help them free flow
❤️ Practicing yoga works well, especially with poses like downward dog where you’re changing the orientation of the fluid in your breast related to gravity.
❤️ Avoid restrictive clothing and bras
❤️ Get a massage!! Having hands on the body helps get the fluid inside moving in the right direction
❤️ See my video for lymphatic drainage massage