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.

Dropping breast milk supply

- Julie Matheney

Feel like your breast milk supply is dropping? It may be normal. The uterus doesn’t tell the breasts how many babies came out. Immediately after birth, hormones cause the breast to go into overdrive to try to figure out how many babies were born…to feed them ALL.

The breast makes milk by being emptied and learns your babies habits and how much milk it needs to make with time and experience. In the early weeks your breasts have extra blood and fluid support to help your breast tissue make milk. This is what makes you aware of the filling and emptying of milk. This extra fluid support goes away around 6-8 weeks and you’ll no longer feel that full/soft feeling. By 10-14 weeks your breasts become more EFFICIENT and only want to make what is routinely emptied. Your breasts will go back to prepregnancy size. You may stop leaking (if you leaked) and not be able to pump as much. That’s NORMAL.

Your body doesn’t want to make milk that isn’t needed. You biological body doesn’t know what a freezer is or that you’re trying to collect that leaking milk for later. Your body wants to be as efficient as possible and make only what is being routinely removed from the breast. It costs your body energy to make milk: about 20 calories per ounce of milk made. Your body doesn’t want to burn calories to make milk that’s not being regularly emptied so it can use those calories for things like your brain function. Because mom brain is real.

So before you reach for formula thinking you don’t have enough milk. Realize that when everything is going normal your milk supply is supposed to regulate and your breast aren’t supposed to stay engorged and full forever. Your body is efficient. As long as baby continues to make good wet and dirty diapers, has a pain free latch where you’re hearing baby swallow, feeding baby in demand and not to the clock, and baby gains weight over time, you body is just doing what it’s supposed to do. You can always increase supply by feeding or pumping more often and decrease supply by feeding or pumping less.

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#normalizebreastfeeding #normalizenormalbodies #postpartumbody #milksupply #milksupplyissues #makingmilk

Low breast milk supply

- Julie Matheney

Whether it’s 3, 5, or 10% of the population, there are people that struggle to or never make a full breast milk supply. From 1 month to 1 year, exclusively breastfed babies average 25oz of breast milk per day. True low milk supply means making less than this when the breasts are stimulated every 1-3 hours day and night. Chronic low milk supply is linked to either a greater health concern or something out of your control which you cannot change or fix with cookies, teas or even sometimes medications and pumping.

🗝Low milk supply that can be increased with time and support:

💡Baby not feeding efficiently from lack of oral motor skill or tongue tie

💡Taking certain prescription medications with a side effect of dropping milk (Sudafed, Benadryl, antibiotics)

💡Not feeding or pumping enough, especially over night

💡Scheduled feedings or over use of a pacifier

💡Birth. Many medications designed to help you labor and deliver actually inhibit baby from latching and feeding effectively for hours to days after birth. Hemorrhage or birth trauma can also cause low supply in the beginning

💡Supplementing, especially in the two weeks after birth

🗝Reasons for chronic low milk supply that may increase even with maximal support:

💡Insufficient glandular tissue (IGT). Breasts never developed during puberty and look tubular or widely spaced. Signs of IGT include breasts did not grow in puberty, or increase in size during pregnancy. No engorgement in the week after birth

💡Uncontrolled or undiagnosed thyroid disorder

💡Uncontrolled diabetes

💡Hormone or endocrine disorders, including severe PCOS

💡Hormonal birth control placed/used too soon after delivery

💡Breast or nipple surgery, augmentation, reduction, trauma

💡Nipple piercing that scars shut instead of staying open

There is a mistaken belief that prescription galactagogues, teas, or herbs can cure ANY chronic low milk supply. Before self-prescribing or taking Domperidone, Reglan, fenugreek, or any other lactation supplement, consider having your serum prolactin levels tested and a full evaluation by a skilled lactation consultant. Continue to follow @lalactation for strategies of breastfeeding with chronic low milk supply.

#lowmilksupplyawarenessday #igtandlowmilksupplysupportgroup #igtandlowmilksupply #igt #lowmilksupply #lowsupply #normalizebf #normalizebreastfeeding #worldbreastfeedingweek #wbfw #chestfeeding #sns #atbreastsupplementation #breastfeeding #bf #ibclc #bottlefeeding #donormilk #mixedfed #pacedbottlefeeding #triplefeeding #breastfeedingproblems #breastfeeding #supplementalnursingsystem #postpartum #breastpump #milkbank #lactationcookie #lactation #galactagogues

How much milk should I leave my breastfed baby?

- Julie Matheney 1 Comment

How many ounces should I leave if I’m exclusively breastfeeding but need to leave my baby a bottle?

The answer is: that depends. Some babies are grazers. They like smaller, more frequent feedings to keep their tummy from being too full or uncomfortable. Their feedings can range from 1-3 ounces and they may feed 10 or more times a day. Other babies are bingers. They like a big, full tummy and may take 3-5 or even occasionally 6 ounces but not as often. They may feed only 6-8 times a day and have longer sleep stretches. Their tummy doesn’t mind being stretched fuller and their bodies tell them it’s ok to go longer between feedings.

The question is: how many feedings do they get in 24 hours? From one month to one year, babies take between 19-32 ounces of breast milk a day. The average is 25 ounces in 24 hours. There’s a range because babies eat more or less depending on the activities of the day, growth spurts, teething, and even babies emotionally eat sometimes. In general, take 25 and divide it by the number of feedings they average in any given day. Also take into account that growth slows between 6-12 months and baby should be eating table foods, so you don’t need to increase the ounces in the bottle during that time. If your baby took 4 Oz bottles at 4 months, 4 Oz bottles are still appropriate at 9 months because they’re also begging for the food right off your plate in addition to what you’re putting on their tray.

You are what you eat, and so is your baby

- Julie Matheney

Did you know that not only do the volumes of milk produced by the left and right breast differ, the milk made in the left breast can also taste different than that made in the right… during the same feeding!!

What you eat used to change the flavor of your amniotic fluid, exposing baby when they were a fetus to the profile of your diet, preparing them for the flavors they would later experience in your breast milk. Eating a wide variety in your diet while you’re pregnant and breastfeeding exposes your little one to a wide variety of flavors, getting them used to the spices, herbs and tastes of food they will be given when they start table food eaten by your family. The more of a particular food you eat, research says, the better the chance your baby will also like to eat that food.

Eating allergenic foods during pregnancy also protects baby from food allergies, especially if you continue to eat them while breastfeeding suggests new research. So far, there is no evidence that avoiding certain foods while breastfeeding helps prevent baby from developing allergies or asthma. The exception to that might be eczema: avoiding certain foods may reduce the risk of eczema. Allergy studies are challenging because of many factors, including food introduction, genetics, and maternal diet. Most studies conclude that exclusive breastfeeding (even as little as one month) lessens how often some allergies occur. Evidence also suggests that exclusive breastfeeding during the first four months may offer protection against certain types of allergic diseases including cow’s milk allergy and atopic dermatitis. So while oatmeal 24/7 may help increase your milk supply, switch it up for baby’s sake (and yours!!)

Why I will answer some lactation questions and not others

- Julie Matheney

Why I’ll answer some lactation questions and not others via social media.
Breastfeeding is well studied and the field of lactation has developed standards of care. There is best practice in lactation, and then there is personalization. Example: Most breastfed babies take a full feeding in 20-30 minutes (10-15 minutes on each side). Some need only 5 minutes. Others take 60. There is the majority of what is considered “average” or “typical”, but in reality there is still a wide range of “normal". There are topics in lactation that are universal for all people: offer one breast first. If baby is still hungry, offer the second breast. Breastfeeding should not be painful. Positioning is key for a deep latch. These are the kinds of answers I will freely dole out on social media all day long. They apply to every breastfeeding journey.

Some answers need to be individualized and often more information is needed before I can give you the correct answer. In order to give the in-depth answer, I need a signed medical consent, just like at your doctor’s office. This protects the privacy of your information and lets me reach out to other health care providers, like your pediatrician, should the need arise. I need a full medical and birth history as these can change my recommendation. For instance, the biggest questions I get are about low milk supply. The blanket answer I can give over social media is best practice: empty the breasts frequently at least every 2-3 hours day and night with either your baby or a high quality pump. Why can’t I give advice beyond that? If you have an allergy, a thyroid condition, a hormonal issue, recommending herbs or supplements could decrease your supply, cause an allergic reaction, or have an unwanted interaction with your medications. You could be taking a medication or using a birth control method that is causing the low milk supply and nothing I suggest would fix the supply issue until the medication or birth control is stopped. Your baby could have a tongue tie, you could be pumping with the wrong sized flange, your baby could have an immature suck, you could just be positioning your baby wrong, that nipple shield could be interfering with your sensitivity to baby’s suck, or SO MANY OTHER REASONS. I can’t give you the correct plan of care without having specific questions answered. And I can’t do that without spending some quality time with you.

You deserve the best possible answer and the correct information. If you’re struggling with breastfeeding and need some help, there is help available!!! If you have a general question, hit me up all day any day! If you need more than a generic answer, put yourself first and book an appointment with me for some specific attention and TLC.

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Why does my baby grab, pull, and pinch my breast?

- Julie Matheney

A newborn’s hands are a tool that the baby uses to find and latch on to the nipple, rather than something to be restrained and held out of the way. In utero, babies often bring their hands to their face in preparation to swallow amniotic fluid, which helps them practice swallowing for after birth. Young babies use their hands to push and pull the breast to shape the breast and provide easier access to the nipple. Their hands on your breast releases oxytocin and also helps the nipple erect and evert. Newborns and young infants also use their hands to push the breast away, possibly to get a better visual sense of the location of the nipple as it is a darker color than the breast. They may feel the nipple with their hand, and use the hand as a guide to bring their mouth to the nipple.

Kneading, squeezing, patting, twiddling, pinching, biting, touching your face and pulling hair and so many more behaviors. Older babies, especially around 5-6 months, do this for two reasons: to help stimulate a let down/increase the flow of milk AND because they’re exploring the world around them. Much like the early days, touching the breast and even twiddling the other nipple help release oxytocin to send more milk or increase the flow of milk. You may notice baby does this more often when you’re on your period or in the late afternoon and evening when supply naturally dips. Many breastfeeding behaviors are a phase, older babies or toddlers like to experiment with what they can do while breastfeeding. If a specific behavior is only mildly annoying, then one option is to wait and see if the novelty wears off on its own. If you don’t like the behavior, give baby a toy or something else to hold while at the breast or cover the other breast with a blanket or your shirt. Wear a necklace or scarf they can play with. Sing a song or read them a book to distract them. Don’t be too quick to hide baby’s hands. They do serve a purpose.

How can I make more breast milk?

- Julie Matheney

The best way to lose weight is to be in a calorie deficit. Choosing the right foods, protein, fruits and vegetables with moderation of carbs, sugars and starches is guaranteed for most to lose extra pounds. Sure, exercise helps. It helps burn calories, again contributing to calorie deficit. But exercise alone won’t help you lose weight if you’re still eating a high calorie diet. Sure, going vegetarian or vegan or doing Weight Watchers or Atkins or any other “diet” helps. It helps you monitor intake to be in a calorie deficit. But even on any diet plan, if you’re not following it correctly and still eating high amounts of foods you won’t lose weight. Certain people do better on certain diets or with specific exercise programs because of how their specific body handles and processes food, vitamins, stress, movement, and all of the other factors like environment and genetics. Finding a nutritionist, weight loss coach, or personal trainer helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: calorie deficit is the number one way to lose weight.

The best way to make breast milk is to empty breast milk. Whether that’s your baby or a high quality breast pump, moving milk multiple times a day tells the body to make more milk. The more often milk is removed, the faster it is made. Sure, supplements help. They support your thyroid and blood with the extra nutrients and hormones needed to produce milk. But supplements alone is no replacement for moving milk. You can take the best lactation bars and drink all the tea you want, but without emptying the breast every few hours routinely I wouldn’t expect the majority of us to make enough milk to feed baby. Sure, hydration and nutrition are important. It takes calories to make calories and hydration help with that process. But even the research shows women who are malnourished in famine torn countries make plenty of milk for their babies when baby is allowed unrestricted access to the breast. Yes, adding in chia seed, flax seed, oats, nuts and nut butters, and coconut water helps make milk. Certain people do better on certain herbs and foods because of how their specific body handles and processes food, vitamins, stress, hormones, and all of the other factors like anatomy and genetics. Finding a lactation consultant, peer counselor, or trained doula helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: emptying milk from the breast is the number one way to make breast milk.

Pumping while away from baby helps maintain your supply

Where are you getting your feeding advice from?

- Julie Matheney

Feeding “advice” we would never tell an adult:

⌚️It hasn’t been 3 hours yet. You can’t possibly be hungry again

⏱It hasn’t been 3 hours yet. You can’t possibly be thirsty again.

🧊You need to drink all 64oz of your daily water intake in 4 equally portioned cups. If you can’t drink 16 ounces in one sitting, something is wrong with you.

🍽Clean plate club. Finish everything on your plate regardless of how full your stomach feels.

🍏Eat food purely for their nutritional value. 🍦Never have food simply for the comfort or enjoyment of it.

🔦Eat alone in a dark room and never with anyone else

💡How could you get so distracted while eating? Focus and pay attention.

🪑Eat until you’re done then leave the table immediately. Don’t hang out at the table for longer than needed.

🛌Never eat a bed time snack

🛏Wake up in the middle of the night thirsty? Too bad. Go back to bed you can have some water in the morning

⏰You have 15 minutes to eat. Tic toc. When the clock hits 15 you need to stop whether you’re done or not

🍴3 meals, 2 snacks. That’s it. 7, 9, 12, 3 and 5. Hungry or thirsty at a different time? Here’s a pen cap to chew on

🍔There’s only one way to eat and if you don’t eat like me and my family you’re doing it wrong

Do you get where I’m going here? Too often we analyze the science of breastfeeding instead of considering the art of feeding and eating. We try to make a literal formula for how our baby should eat when some times we have to appreciate feeding for what it is: an enjoyable and pleasurable sensory experience that is social and includes more than just calorie intake.

Cluster feeding

- Julie Matheney

CLUSTER FEEDING. Two words when paired together that drive fear and trembling to parents. Cluster feeding is NORMAL for ALL breastfed babies. It has nothing to do with your supply. It has nothing to do with the clock. It has nothing to do with what you’re eating or drinking or those supplements you just took. It may not even have anything to even do with being hungry. Babies typically cluster feed in the afternoon/evening. When your milk supply naturally and appropriately dips. When your milk is a smaller water concentration with a higher fat content. As long as baby is happy to feed the rest of the day, is making plenty of wet and dirty diapers, is content and sleeping routinely between feedings, and gaining weight over time, DON’T BLAME THE BOOB!! Even if baby seems like they want to feed constantly. Cluster feeding is normal. It typically happens MORE when baby is going through a growth spurt (body growing), developmental leap (mind/skills growing), or teething/illness. Why does baby want the breast more?

• Preparing for a longer sleep: Some babies just prefer to fill up on milk for a few hours before a longer sleep.

• Milk flow is slower at night: Some babies nurse longer to fill up due to the slower flow.

• A growth spurt: they usually occur around 3, 6, and 8weeks of age.

• They need of comfort. Breast milk has hormones to develop baby’s circadian rhythm. At nighttime baby may just seek comfort to help them sleep.

• Developmental leap: Mental and emotional growth spurts when they acquire new skills.

• Baby is sick, thirsty, or teething: breast feeding is a pain reliever, medicine and hydration all in one

Know that it’s normal. Be patient through the process. Be prepared with snacks and water for yourself, a comfy spot, a good pillow for support and the remote and your phone charger close by to get you through. You’re not alone and it doesn’t last forever!!

How to build a breast milk stash

- Julie Matheney

You don’t need to have a stash. If you want to exclusively breastfeed and are never away from your baby, you don’t need any milk in your freezer. You don’t need a huge stash if you’re going to be gone from baby. It’s nice to have stored up milk, but that milk is extra milk. Feed the baby, not the freezer. You only need enough milk for when you’re away from baby. If you’re only going to be gone for 2-3 hours, you may not need any milk at all. Feed your baby immediately before you leave. If baby becomes fussy before you get home, have your caregiver take baby on a walk, distract with toys or use a pacifier and feed them as soon as you walk in the door. If you’re going to be gone more than 3 hours, you only need to have enough milk for the time you’re gone. Optimally if baby is being fed by bottle, to maintain your milk supply, you should be pumping, thus replacing the milk from your stash that was used.

There are several ways to build your stash

🍼Passively collect with a milk catcher like a Lacticup or Milkies Milk Saver. No extra work needed, this works great in the early weeks if you leak

🍼Use manual silicone breast pump like the Haakaa. While these look passive, the vacuum created does stimulate the breast and can increase leaking and milk supply

🍼If you have a large to very large storage capacity and only feed from one breast at a time, pump the other breast during or after feeding baby

🍼Pump with a double electric pump, after breastfeeding, for 10-15 minutes. Only expect to get 1/4-1 ounce as this is “left over” milk that your baby doesn’t need.

🍼Pump with a double electric pump in between breastfeedings when you think baby may take a longer nap. Aim to pump half way between when you think baby will want to feed again. If you think baby will go 2 hours, pump after an hour, etc. try not to pump too close to the next feed as baby may get fussy at the slower flow of milk.

Remember:

🥛Decide how often and how much you want to pump/collect. Know that the more you empty, the more you will make as you’re telling your body baby needs that milk.

🥛Too much pumping or frequently changing your pump routine does increase your risk of plugged ducts and mastitis

🥛You can combine 24 hours of milk into one batch

🥛Breastfed babies usually only need 2-4 ounces every 2-4 hours. Aim to leave 1-1.5 ounces for every hour you’re gone