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.

Do I need to give my breastfeeding toddler cow’s milk or switch to cow’s milk when they turn one?

- Julie Matheney

If you’re still breastfeeding into toddlerhood, no. The World Health Organization recommends breastfeeding until 2 years old. After 2, you can wean to water and table foods or to any kind of milk per your family’s choice. If you’ve decided to wean between 1-2 years, yes and no. Cow’s milk provides a convenient source of a lot of nutrients, including calcium, protein, potassium and vitamin D that are important for building bone and brain development. But if your toddler won’t drink it, has an allergy or intolerance, or your family follows a vegan lifestyle, a well-planned diet can provide these nutrients too. According to the USDA, children ages 2-3 need two servings of dairy per day (milk, yogurt, cheese, or calcium-fortified non-dairy beverage), children age 4-8 need two and a half, and kids 9+ need three. Can you use a milk alternative such as soy, almond or oat? Yes, but they’re not one-for-one swaps. For instance, almond and rice milk have only 1 gram of protein per serving, compared to 8 grams in cow’s.

When choosing a non-dairy milk, make sure it’s fortified with calcium and vitamin D. Homemade versions won’t have this fortification. Shake milk substitutes well before serving, the calcium settles on the bottom. Look for varieties labeled “unsweetened” as many milk alternatives contain lots of added sugar! If you’re choosing not to offer your toddler cow’s milk, make sure they’re getting a wide variety of fruits, vegetables, beans, grains and protein to get them the vitamins, minerals, fats and protein they need for growth. When in doubt, discuss nutrition with a pediatric dietician

Milk is a very convenient source of calcium, but not essential. It is recommended that a 1-3 year old child have 700mg (2-3 servings) of calcium per day. Eating a diet rich in beans, tofu, spinach, kale, broccoli, kiwi, figs, brown rice, oatmeal and certain fish such as salmon can give your child just as much calcium as drinking milk. No one ever “has” to drink milk. Human milk contains less calcium than cow’s milk, but the calcium in human milk has over twice the bioavailability of the calcium in cow’s milk. Increasing your calcium intake does not increase the calcium in your milk – your milk always has the right amount of calcium for your baby. Getting adequate calcium in your diet is recommended because if you’re not getting enough, your body will take calcium from your bones to provide to your baby, making you more prone to bone fractures. However as soon as you wean, your body regains bone mass and your bones will actually be stronger than before. 

Human milk averages 5.9-10.1 mg/oz calcium. 67% of this calcium is absorbed by the body. 

Whole milk contains 36.4 mg/oz calcium. 25-30% of cow’s milk is absorbed by the body.

Infant formulas contain 15.6 mg/oz calcium; toddler formulas contain 24-27 mg/oz calcium. Extra calcium is added to infant formulas because of the lower bioavailability of the calcium from formulas as compared to human milk (they aim for baby to absorb the same amount of calcium as would be absorbed from breastmilk).

Toddler formulas have come on the market in recent years touting that they’re great nutrition for the 12+ month group. In reality, it’s all clever marketing. If you supplement baby with formula, there’s no need to switch to a toddler formula at 12+ months. In the second year of life, growth slows. Your toddler doesn’t gain weight or length as quickly as they did right after birth.

If you’re still breastfeeding, your milk adjusts to this based on how toddler nurses; how the breast is emptied tells your body what kind of milk to make. When breast milk is the primary diet, like in the first 6 months, your milk is made for growth and immunity. When your toddler is taking lots of table foods and nursing, your milk is made for development and immunity.

At 1 you don’t need a fancy toddler formula or cow’s milk. If you’re exclusively formula feeding, switching to whole cow’s milk is fine. While cow’s milk is a convenient source of calcium, protein, fats, and vitamin D, there’s no need to switch to that, either. As long as your child takes a wide variety in their diet and has a good source of calcium (yogurt, cheese, dark leafy greens like spinach, fortified cereals or juice, soybeans, etc), just choose what you offer your child wisely. If you’re still breastfeeding, know your child is getting good nutrition from your milk suited to their growing needs. If you’re concerned about your toddlers diet or they don’t eat a wide variety, consult your pediatrician or a pediatric nutritionist for advice and help.

Oatmeal and breast milk

- Julie Matheney

OATMEAL

Oatmeal is commonly recommended to breastfeeding parents as a breast milk booster. Many report pumping more milk on the days they have oatmeal for breakfast instead of something else. 

🥣Oatmeal is a good source of iron. Anemia/low iron levels can result in a decreased milk supply as breast milk is made from your blood. 

🥣Oatmeal is a comfort food. Comfort foods tend to encourage let-down which boosts milk supply.

🥣Many of the herbs known to increase milk supply also decrease cholesterol levels. Herbs that both increase milk and decrease cholesterol include fenugreek and alfalfa, which are found in many lactation products. Oat bran, found in oatmeal, can help lower cholesterol

But you don’t HAVE to eat oatmeal to make breast milk. I’ve known more than a few moms who are choking down oats even if they hate them. There are other things you can eat that are just as supportive. 

🥬Eating foods high in iron or being supplemented with iron can help you make more milk. Especially if you had a large blood loss at birth or tend to be anemic. High iron foods include beans (they won’t make your baby gassy), dark leafy greens, red meats, dried fruits like raisins and apricots. 

🥄Flax seed and chia seeds can work just as well as oats. They can be added to cookie recipes, used as an egg substitute in homemade breads, and are tasty and filling in smoothies. 

🥕Here’s another list of seemingly random foods that are actually known to boost milk supply: Garlic, carrots, barley, asparagus, brown rice, apricots, salmon, sweet potato, almonds, moringa, chickpeas, lentils, beets, tofu, watermelon, and grapefruit.

Herbs and supplements while breastfeeding

- Julie Matheney

Herbs. Supplements. Boobie boosting bars and milk making teas. There’s a lot of products on the market now to help increase your milk supply. Vitamin C is great for preventing a cold, but too much can give you diarrhea. Iron is amazing for keeping you from going anemic and feeling weak, but too much makes you constipated. Fenugreek is known to help boost milk supply, but if you’re on thyroid medication, are hypoglycemic, or have a peanut allergy you shouldn’t take it. Every person is different in how they respond to herbs and even foods. I’m not opposed to lactation supportive products. But if you’re going to buy any of those products guaranteed to help you pump gallons of milk a day, here’s my best advice:
💡Do your research. Know what’s in it and any possible side effects
💊If you’re taking any prescription medications ask a pharmacist about drug/herb interactions.
💉Start with the smallest dose possible and gradually increase the amount you’re taking
🧪Don’t add in 10 different supplements at once. If you have a bad reaction you won’t know which one is from. Start with one at a time.
🩺Try them at home and first thing in the morning, on a weekday before you go back to work if possible. You wouldn’t want to have a bad reaction at work or when the doctors office or pharmacy are likely to be closed.
🧫We all can have different reactions and side effects to herbs and supplements. Some women find that taking fenugreek has the opposite effect and drops milk supply. Some women may notice an increase in gassiness in baby with certain herbs. If you notice any weird side effects, stop taking the supplement.
🤱🏽There is no replacement for frequently removing milk from the breast. The best way to make milk is to frequently feed your or pump your milk from your breasts
🔑If you’re struggling with low supply, schedule an appointment with an IBCLC to help get to the real root of the supply issue and form a plan to get back on track.
🗓If you take something for 3 days and don’t see a milk increase, most likely the herb isn’t effective for you. If you see a decrease within 3 days, stop taking it.

Some of my favorite places for herbs while breastfeeding:

https://mountainroseherbs.com The best place for raw herbs

https://wearerasa.com Amazing adaptogenic coffee alternatives

https://milksta.com The best taste ever. I love these products

https://www.motherlove.com Great herbal supplements specifically for lactation

https://www.legendairymilk.com Quality lactation supplements.

Sudden breast milk supply drop

- Julie Matheney

Breastfeeding going well and all of a sudden you feel like your milk is gone? Go pee on a stick. A drastic drop in milk supply when breastfeeding has been going well can be a sign of pregnancy, even if your period hasn’t come back yet. Research shows it is safe to continue breastfeeding while pregnant and does not increase the risk of miscarriage. So there no reason to wean unless you’re a high risk pregnancy (if you are told by your health care provider that you can’t have sex, you shouldn’t breastfeed. If it’s safe to have sex, it’s safe to continue breastfeeding.) If so you are not alone—far from it.

Key points to remember when breastfeeding and pregnant:

• Milk will shift from mature milk back to colostrum around 14-20 weeks of your pregnancy to prepare for the birth. Babies under 6 months may not get enough milk from the breast alone while toddler eating solids may do fine. Monitor weight gain for babies under 1 year

• Colostrum is saltier than mature milk. Some nurslings are fine with the taste shift and others may self wean

• Aim for a total of about 600 to 800 extra calories — 300 for the fetus and 300 to 500 for milk production.

• Nipples may become extremely tender during pregnancy, especially at the beginning, due to hormone changes

• Breastfeeding aversion while pregnant is normal (feelings of stress or anxiety or wanting to stop breastfeeding)

• If your toddler always nurses to sleep, you may want to find other sleep routines to make putting older one to sleep easier when you have the new baby.

• As your belly grows, you may need to experiment with new breastfeeding positions.

Can I eat sushi while breastfeeding?

- Julie Matheney

While there are foods you should not eat while pregnant, all bets are off while breastfeeding. When pregnant, food goes from your mouth, to your stomach, to your intestines, to your blood stream when it goes directly to your developing baby through the umbilical cord.

Undercooked/raw fish like sushi, hot dogs, lunch meats, and unpasteurized milk (certain cheeses) increases the risks of exposure to certain types of bacteria during pregnancy. Listeria, a bacteria that causes listeriosis, is a type of food poisoning that can pose a serious health risk for you and baby. You are at a higher risk of getting listeriosis when pregnant and passing that bacteria directly to baby via your blood. When breastfeeding, food goes from your mouth, to your stomach, to your intestines, to your blood stream, to your breast milk, to your baby’s stomach and finally to their blood stream. The process is much longer. Foods that may make you sick from food poisoning will make you feel sick, but won’t usually cause the same symptoms in baby because the process to their blood stream is so much longer. While your baby may have individual food sensitivities, there is no master list. You can eat the lunch meat, hot dogs, sushi, soft cheeses, cabbage, beans, and coffee to your hearts content.

How to use my Spectra Breast Pump: Maximizing settings, suction and cycle levels

- Julie Matheney

Different stages of pumping require different pump settings. The wonderful thing about the Spectra pumps is their cycle variability.

Check out my video on YouTube for how to set and use the Spectra pump.

Colostrum is thick and sticky. Pumps are great for stimulating milk but they’re not the best at removing it from the breast and it can be very frustrating to pump and not see anything filling the bottles. Don’t be discouraged. Stimulation is super important in the early days after birth and the work will pay off. hand expression is the key to emptying colostrum when pumping. The pump will do a good job to stimulate your hormones to make milk and your hands will help empty it.

If you’re engorged or have an oversupply, you may need to pump to relieve the pressure in your breasts. Using the pump wisely can reduce your engorgment while not causing you to make too much milk and perpetuate your problem.

You can also pump to increase milk supply by pumping for an extra 5 minutes after milk stops flowing to signal to your body that it needs to produce more milk. If you’re breastfeeding and pumping after, aim for a 10-15 minute pump. If you’re exclusively pumping, shoot for a 30 minute pump.

Whether you’re pumping at work to maintain supply or trying to increase your supply, using the settings on the Spectra can help you reach your goals. Have you played around with your settings? What works for one person may not work for another. Try alternating back and forth between the settings and play around with the suction and cycle levels. If you need to have the suction cranked to the top, you’re most likely using too large of a flange.

Everyone responds differently to pumps. Play around the settings and cycles. What works for one person may not work for every person. Make sure your suction level is comfortable and you’re using the correct sized flange. If you have to crank the suction all the way up, you’re pumping with a flange that’s too large. Pumping should be comfortable. You should not have pain or damage from pumping. If you have any pain or damage, try a different range size, shape or cushion and try lowering the suction. If you’ve been pumping on a particular set of settings and start to notice a decrease in supply or suction, change the soft pieces of the pump like the duckbill or membranes and the tubing.

Breastfeeding weaning

- Julie Matheney

There is no right or wrong age, it is completely up to you. Breast milk does not lose nutritional value (ever), so you get to decide how long you want to breastfeed. You also get to decide when you stop and all reasons for wanting to stop are valid. It is OK to wean for your emotional or mental well being and you do not have to justify your choices of how you feed your baby to anyone.

The age of your baby and how quickly you want to wean can play a role in how you wean.

Be prepared that some may experience mood changes and feelings of depression when weaning as your oxytocin and other hormones are dropping to stop milk production. If you need a specific plan to help you quickly wean, schedule a consultation with me to develop a plan that works for you.

Tips for gentle weaning:

✏️Start when your baby has already naturally started to wean, ex. only a quick snack before nap or waking up at 2am to pacify to sleep

✏️If transitioning from breast milk to formula, you can add formula to your breast milk bottles in slowly increasing amounts to make the transition easier on baby’s tummy (ex mix 2oz of breast milk with 1oz of prepared formula for several days, then mix 1.5oz each if breast milk and formula for a few days, then 2oz of formula with 1oz of breast milk)

✏️Don’t offer, don’t refuse

✏️Wear clothing that makes accessing the breast/chest more difficult.

✏️Distract child with favorite activities or offer alternatives like a favorite snack

✏️Change your routine

✏️Postpone: “After we play”

✏️Shortening the length of feeding or space feedings out

✏️Talk to your toddler about weaning. Older children (2 years and up) can be part of the process by talking to them about what is happening.

✏️Alternate between offering bottles and the breast

✏️Be consistent – this is a hard one but it can be even more confusing to your baby if you allow them to nurse one time and not the next.

✏️Lots of cuddles. Your breast/chest is more than just food but also a great source of comfort. Showing them you are still a source of that comfort despite not nursing is incredibly important

Ways to quickly wean:

⚓️Empty the breast only to comfort, trying not to stimulate the breast to make more milk

⚓️Breast gymnastics/“milk shakes” often to keep milk from sitting in the breast and clogging the ducts

⚓️Epsom salt soaks of the entire breast for soothing

⚓️Drinking 2-4 cups of sage or peppermint tea per day

⚓️Green cabbage leaves in the bra until they are soggy and then replacing the leaves

⚓️Cabocream (an alternative to the cabbage leaves

⚓️Cold packs on the breasts after feeding or pumping to reduce swelling

⚓️Starting on a hormone based birth control, especially The Pill (estrogen based) will drop supply

⚓️A last resort would be to take an antihistamine like Benadryl or Claritin-D as these are also notorious for dropping milk supply. This should be done with caution and under the direction of your primary care physician

True SELF-weaning by the baby before a year old is very uncommon. In fact, it is unusual for a baby to wean before 18-24 months unless something else going on (work, inefficient feeding, tongue tie, etc). A self weaning child is typically well over a year old (more commonly over 2 years) and getting most nutrition from solids, drinking well from a cup, and has been cutting back on nursing gradually.

Reasons a baby under a year may be perceived to self wean:

🔑Solids were introduced too soon

🔑Scheduled feedings/sleep training/pacifier use (all decrease time a baby would naturally want to be at the breast/chest)

🔑Lactating parent loses a lot of weight fast which can decrease milk supply

🔑Medications or hormonal birth control which will decrease supply

🔑Lactating parent is pregnant

🔑Baby taking lots of solids before one (human milk should be the primary nutrition source through one year of age)

Empty breasts make milk faster than full breasts

- Julie Matheney

FULL/EMPTY BREASTS

While it seems counterintuitive, the emptier your breasts are, the faster they make milk. A full bread has no place to store or hold the milk, so milk production slows to prevent plugged ducts and breast discomfort. Cluster feeding on an emptier breast actually tells the body to make more milk at a faster rate!! Some incorrectly assume you have to wait for the breast to “fill up” before feeding your baby or for pumping while at work. This will eventually lead to less milk, as a fuller breast tells your body baby isn’t eating very often and to slow milk production. The more frequent you empty the breast, the higher the fat content in that milk and the faster milk is made. The longer often you wait and the fuller the breast, the higher the water content in that milk and the slower your body will make milk overall.

W atch the baby, not the clock. Breasts may feel really full between feedings in the first few weeks after birth, but they’re also not supposed to stay engorged. There will come a time when they stay soft and don’t feel full between feedings or pumping, so waiting for that as a cue to feed will also sabotage your supply. Don’t be alarmed when your breasts no longer feel full between feeding. You’re entering a new stage where you’ll still make plenty of milk for your baby as long as you’re routinely emptying that milk. Trust your body. Trust your baby.

The science vs the art of breastfeeding

- Julie Matheney

SCIENCE AND ART

Breastfeeding is the perfect blend of science and art. There are basic principles that apply, but within those principles is a lot of variation

🔬Science says you should switch which breast you start with at each feeding to keep milk supply balanced

🎨Art says this mom always starts left to try to increase supply on the slacker boob while that mom only feeds one breast per feeding. This mom needs to block feed and that mom offers whatever breast passes the boob shake fullness test

🔬Science says babies should poop at least once a day

🎨Art says some babies poop every time they sit in the car seat and others in the bathtub🤷🏽‍♀️ Some babies poop after every feeding and others have just one a day (or every other day)

🔬Science says eat whatever you want

🎨Art says one can eat dairy without a problem for baby and for another it causes a rash and digestive upset in baby

🔬Science says having baby in a good position will get you a deep latch.

🎨Art says you over here love koala hold a rolled up wash cloth supporting your breast to help reduce reflux. While you over there do better in cross cradle sitting up.

🔬Science says as baby ages they can sleep in longer stretches at night

🎨Art says many babies still wake up 1-3 times a night to nurse until 18 months and need help from an adult to transition back to sleep

🔬By understanding the science behind breastfeeding, we can understand typical patterns of behavior which helps guide us when things aren’t going well.

🎨By appreciating the art of breastfeeding, we can celebrate the unique differences of every feeding baby within its own family dynamic.

🔬If you’re struggling with the science of breastfeeding, find help.

🎨If breastfeeding is going well, appreciate the art of your own masterpiece that you’re creating with your little one.