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 wearing doesn’t replace tummy time

- Julie Matheney

While baby wearing and tummy time offer unique benefits, they are not mutually exclusive. In fact, they complement each other in promoting a well-rounded approach to infant development:

Muscle Development: Tummy time strengthens specific muscle groups needed for crawling and overall physical development. Baby wearing, meanwhile, supports muscle tone and posture by providing a secure and ergonomic position.

Emotional Bonding: Both activities promote emotional bonding and security, albeit in different ways. Baby wearing satisfies a baby's need for closeness and comfort, while tummy time encourages independence and exploration within a safe environment.

Variety of Stimulation: Alternating between baby wearing and tummy time exposes infants to diverse sensory and motor experiences, which are essential for holistic development.

In summary, incorporating both baby wearing and tummy time into a baby's routine ensures comprehensive support for their physical, emotional, and cognitive development. Each activity offers unique advantages that contribute to a well-rounded and enriched infancy.

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 renovation

- Julie Matheney

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. If baby isn’t able to self pace once they are over 2-3 weeks, consider changing the bottle flow level to a slower flow or changing types of bottles. If you’re struggling to find the right bottle system for your baby, find a local IBCLC lactation consultant or feeding therapist to work with  

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

Fortifying breast milk for preemie baby

- Julie Matheney

Title: The Importance of Human Milk Fortification for Breastfed Preemie Babies

In the delicate world of premature babies, every ounce of care and nutrition matters profoundly. For mothers of preemies who choose to breastfeed, human milk fortification emerges as a vital intervention that can significantly impact the health and development of their fragile infants.

Breast milk is undoubtedly the gold standard for infant nutrition, offering a unique blend of nutrients, antibodies, and growth factors that promote optimal growth and immunity. However, many families with preterm infants typically 31-33 weekers) may be told their breast milk isn’t nutritionally adequate and they either need to supplement baby with formula or a human milk fortifier. It’s not that your milk is inadequate, it’s that babies born early miss out on a surge of nutrient absorption that normally would have occurred during the third trimester. Preemies have higher nutrient requirements, especially for protein, minerals like calcium and phosphorus, and certain vitamins like vitamin D. They should have been getting these nutrients from your placenta which takes these nutrients from your blood and bones. A preemie’s gastrointestinal tract is also very immature, less efficient at processing nutrients and more prone to distress. Preemies who experience medical complications including infection, respiratory disorders, surgeries, and stress, experience an increase in metabolism and increased caloric demand. So babies born prematurely have multiple reasons for needing more nutrients than an otherwise healthy full-term baby. Human milk fortifiers are designed to supplement breast milk with these essential nutrients to match the specific needs of premature infants, supporting their growth and development, that they missed.

Currently there are two main types of human milk fortifier available. The first is made using cow-based protein. It comes as either a powder or liquid which get added to pumped breast milk. The second fortifier is actually made of donated human milk from other pumping mothers. The only manufacturer of human based fortifier in the US currently is Prolacta Bioscience, and is only available to hospitals. Donated milk is modified into a frozen liquid concentrate which is added to pumped milk in the NICU.

Premature infants often struggle with catching up to the growth milestones of full-term babies. Fortifying breast milk helps enhance calorie intake and nutrient absorption, aiding in weight gain and promoting more rapid growth without increasing the volume of milk intake.

Preterm infants are at increased risk of various health complications, including necrotizing enterocolitis (NEC) and developmental delays. Fortified breast milk has been shown to lower the incidence of NEC and other serious conditions by providing a more robust nutritional profile.

Adequate nutrition during the neonatal period is critical for preventing long-term health problems such as neurodevelopmental impairments and metabolic disorders. Fortifying breast milk ensures that preemies receive the essential nutrients necessary for optimal brain and organ development.

Human milk fortification enables mothers to continue breastfeeding while meeting their preemie's unique nutritional needs. This approach supports the emotional and physiological benefits of breastfeeding while addressing the challenges posed by premature birth.

How long after birth they need to be supplemented depends upon many factors, including baby’s gestational age at birth, medical condition, nutritional status, and the individual practices of the NICU team your baby worked with. It’s very common for NICU graduates to require special nutrients for weeks to months after going home. This might be as simple as adding small amounts of over-the-counter preemie formula to pumped milk, adding in a few bottles of preemie formula each day, or as complex as using specialized prescription formulas. 

Ultimately, human milk fortification represents a critical component of neonatal care for premature infants. It empowers mothers to provide the best nutrition possible for their preemies, supporting their babies' health and development during this vulnerable stage of life. Healthcare providers play a pivotal role in guiding mothers through the process of human milk fortification, offering education and support to optimize outcomes for these tiny fighters.

By recognizing the importance of fortifying breast milk for preemie babies, we can enhance the quality of care and improve the long-term health prospects of these resilient little ones. Every drop of fortified breast milk signifies a step forward in nurturing and protecting the smallest members of our communities.

The composition of breast milk undergoes significant changes to meet the evolving nutritional needs of infants as they grow. The differences between preterm (colostrum and transitional milk) and mature breast milk are particularly important for understanding how mothers can support the unique requirements of preterm babies. Here's a breakdown of these differences:

**1. Protein Content:**

   - Preterm Breast Milk: Higher in protein, specifically whey protein, which is easier for preterm infants to digest.

   - Mature Breast Milk: Lower in total protein compared to preterm milk, with a higher proportion of casein protein.

**2. Fat Composition:**

   - Preterm Breast Milk: Contains more medium-chain fatty acids and higher levels of essential fatty acids like DHA (docosahexaenoic acid) and ARA (arachidonic acid), which are crucial for brain and visual development.

   - Mature Breast Milk: Higher in long-chain fatty acids, reflecting the changing needs of the growing infant.

**3. Carbohydrates:**

   - Preterm Breast Milk: Contains higher levels of lactose and oligosaccharides, providing readily available energy for the developing preterm baby.

   - Mature Breast Milk: Still rich in lactose but with a slightly lower concentration compared to preterm milk.

**4. Minerals and Vitamins:**

   - Preterm Breast Milk: Generally higher concentrations of certain minerals like calcium, phosphorus, and zinc to support bone and overall growth.

   - Mature Breast Milk: Adequate levels of minerals and vitamins tailored to the needs of a growing infant.

**5. Immunological Factors:**

   - Preterm Breast Milk: Richer in immunoglobulins (especially secretory IgA) and other immune factors to bolster the preterm baby's immature immune system and protect against infections.

   - Mature Breast Milk: Continues to provide valuable immunological support but at levels adjusted for the older infant's immune needs.

**6. Growth Factors:**

   - Preterm Breast Milk: Higher levels of growth factors like insulin-like growth factor (IGF) to support rapid growth and development.

   - Mature Breast Milk: Contains growth factors in appropriate proportions to sustain healthy growth without promoting excessive weight gain.

**7. Micronutrients:**

   - Preterm Breast Milk: Often supplemented with higher levels of vitamins and minerals to meet the increased requirements of preterm infants.

   - Mature Breast Milk: Provides sufficient micronutrients for the needs of older infants, although additional supplementation may be necessary depending on the infant's diet.

Understanding these differences underscores the importance of tailored nutrition for preterm infants. While human milk is always beneficial, preterm breast milk offers a specialized blend of nutrients and bioactive components uniquely suited to support the growth and development of premature babies during the critical early stages of life. As preterm infants transition to mature breast milk, the composition adjusts to meet their changing nutritional demands, ensuring optimal health and development as they continue to thrive on mother's milk.

 

Baby wearing and Tummy Time

- Julie Matheney
IMG_2355

I love babywearing!! Humans are carry mammals and there are so many benefits to baby wearing! Baby wearing is great for bonding and convenience. Being held close to a caregiver’s body can help regulate a baby’s physiological systems, such as heart rate, temperature, and breathing. This can contribute to overall health and well-being. It also provides opportunities for baby to lift their head and neck and rotate them from side to side. It’s also one of the first tummy time activities we can do starting at birth! Laying flat on your back and having your newborn on their tummy is baby wearing at its most basic and a great place to start promoting tummy time. BUT babywearing (in a carrier or with a wrap or sling) is not a substitute for tummy time. It should be used to COMPLIMENT it. Both activities offer distinct benefits for your baby’s development. Tummy time helps strengthen the muscles in a baby’s neck, shoulders, arms, and back. This is crucial for achieving milestones such as lifting the head, rolling over, crawling, and eventually walking. It allows free movement of all of the major muscle groups as well as opportunities to move against gravity. While baby wearing, the trunk and shoulders are relatively supported and doesn’t allow baby to engage those muscles for strengthening. Being on their tummy allows babies to explore their surroundings from a different perspective. They can practice reaching and grasping objects, which enhances their visual and sensory development. On the other hand, baby wearing provides comfort and closeness, promoting emotional security and allowing caregivers to multitask while keeping baby content. It’s also a great way to help baby sleep longer in a contact nap!!

While baby wearing and tummy time offer unique benefits, they are not mutually exclusive. In fact, they complement each other in promoting a well-rounded approach to infant development.

#tummytime #tummytimeactivities #babywearing #babywrap #babywrapping #babywraps #babysling #skintoskinbaby


Let's delve into the distinct benefits of baby wearing and tummy time for infants:

**Benefits of Baby Wearing:**

1. **Bonding and Attachment:** Baby wearing fosters a strong bond between the caregiver and the baby. The close physical contact promotes feelings of security and comfort, which are crucial for emotional development.

2. **Convenience:** Carrying a baby in a carrier or wrap allows caregivers to have their hands free for other tasks while keeping the baby close. This can be especially helpful for parents who need to move around or engage in activities throughout the day.

3. **Regulation of Body Systems:**

4. **Observational Learning:** Babies in carriers are often at adult eye level, which can enhance their cognitive development through observing and interacting with the world around them.

**Benefits of Tummy Time:**

1. **Development of Motor Skills:** Tummy time helps strengthen the muscles in a baby's neck, shoulders, arms, and back. This is crucial for achieving milestones such as lifting the head, rolling over, crawling, and eventually walking.

2. **Prevention of Flat Head Syndrome:** Regular tummy time reduces the risk of flat spots developing on a baby's head, which can occur when they spend too much time on their backs.

3. **Visual and Sensory Stimulation:** Being on their tummy allows babies to explore their surroundings from a different perspective. They can practice reaching and grasping objects, which enhances their visual and sensory development.

4. **Encouragement of Independence:** Tummy time encourages babies to start exploring their own body movements and space, which is essential for developing independence and confidence.

**Complementary Relationship:**

While baby wearing and tummy time offer unique benefits, they are not mutually exclusive. In fact, they complement each other in promoting a well-rounded approach to infant development:

Muscle Development: Tummy time strengthens specific muscle groups needed for crawling and overall physical development. Baby wearing, meanwhile, supports muscle tone and posture by providing a secure and ergonomic position.

Emotional Bonding: Both activities promote emotional bonding and security, albeit in different ways. Baby wearing satisfies a baby's need for closeness and comfort, while tummy time encourages independence and exploration within a safe environment.

Variety of Stimulation: Alternating between baby wearing and tummy time exposes infants to diverse sensory and motor experiences, which are essential for holistic development.

In summary, incorporating both baby wearing and tummy time into a baby's routine ensures comprehensive support for their physical, emotional, and cognitive development. Each activity offers unique advantages that contribute to a well-rounded and enriched infancy.

Helping baby learn to roll

- Julie Matheney

🌟 **Encouraging Baby to Roll from Belly to Back**

Rolling from belly to back is a milestone that typically emerges around 4 to 6 months of age. Here are some tips to help your little one master this movement:

1. **Set the Stage:** Choose a time when your baby is alert and in a good mood. Lay down a soft blanket or mat on the floor to create a comfortable and safe space.

2. **Engage and Encourage:** Get down to your baby's level and interact with them. Use colorful toys or objects to capture their interest. Your presence and encouragement can motivate them to explore.

3. **Positioning:** Place your baby on their tummy with their arms forward and elbows bent. This position can help them push up and eventually roll.

4. **Use Gentle Guidance:** Gently lift one of your baby's arms and guide them to shift their weight to the side. This action can initiate the rolling motion.

5. **Provide Support:** Place a hand on your baby's hip or thigh to offer light support as they start to roll. This reassurance can help them feel secure as they learn the movement.

6. **Cheer Them On:** Use positive reinforcement with a smile and encouraging words. Celebrate small successes and progress to keep your baby motivated.

7. **Practice Consistently:** Incorporate tummy time into your daily routine. Regular practice allows your baby to build strength and coordination over time.

Remember, every baby develops at their own pace. If your baby isn't rolling yet, be patient and continue to provide opportunities for them to explore and learn. Consult your pediatrician if you have concerns about your baby's development.

Let's cheer on those little milestones together! 🌈💕

Fortifying breast milk for preemie baby

- Julie Matheney

In the delicate world of premature babies, every ounce of care and nutrition matters profoundly. For mothers of preemies who choose to breastfeed, human milk fortification emerges as a vital intervention that can significantly impact the health and development of their fragile infants.

Breast milk is undoubtedly the gold standard for infant nutrition, offering a unique blend of nutrients, antibodies, and growth factors that promote optimal growth and immunity. However, many families with preterm infants typically 31-33 weekers) may be told their breast milk isn’t nutritionally adequate and they either need to supplement baby with formula or a human milk fortifier. It’s not that your milk is inadequate, it’s that babies born early miss out on a surge of nutrient absorption that normally would have occurred during the third trimester. Preemies have higher nutrient requirements, especially for protein, minerals like calcium and phosphorus, and certain vitamins like vitamin D. They should have been getting these nutrients from your placenta which takes these nutrients from your blood and bones. A preemie’s gastrointestinal tract is also very immature, less efficient at processing nutrients and more prone to distress. Preemies who experience medical complications including infection, respiratory disorders, surgeries, and stress, experience an increase in metabolism and increased caloric demand. So babies born prematurely have multiple reasons for needing more nutrients than an otherwise healthy full-term baby. Human milk fortifiers are designed to supplement breast milk with these essential nutrients to match the specific needs of premature infants, supporting their growth and development, that they missed.

Currently there are two main types of human milk fortifier available. The first is made using cow-based protein. It comes as either a powder or liquid which get added to pumped breast milk. The second fortifier is actually made of donated human milk from other pumping mothers. The only manufacturer of human based fortifier in the US currently is Prolacta Bioscience, and is only available to hospitals. Donated milk is modified into a frozen liquid concentrate which is added to pumped milk in the NICU.

Premature infants often struggle with catching up to the growth milestones of full-term babies. Fortifying breast milk helps enhance calorie intake and nutrient absorption, aiding in weight gain and promoting more rapid growth without increasing the volume of milk intake.

Preterm infants are at increased risk of various health complications, including necrotizing enterocolitis (NEC) and developmental delays. Fortified breast milk has been shown to lower the incidence of NEC and other serious conditions by providing a more robust nutritional profile.

Adequate nutrition during the neonatal period is critical for preventing long-term health problems such as neurodevelopmental impairments and metabolic disorders. Fortifying breast milk ensures that preemies receive the essential nutrients necessary for optimal brain and organ development.

Human milk fortification enables mothers to continue breastfeeding while meeting their preemie's unique nutritional needs. This approach supports the emotional and physiological benefits of breastfeeding while addressing the challenges posed by premature birth.

How long after birth they need to be supplemented depends upon many factors, including baby’s gestational age at birth, medical condition, nutritional status, and the individual practices of the NICU team your baby worked with. It’s very common for NICU graduates to require special nutrients for weeks to months after going home. This might be as simple as adding small amounts of over-the-counter preemie formula to pumped milk, adding in a few bottles of preemie formula each day, or as complex as using specialized prescription formulas. 

Ultimately, human milk fortification represents a critical component of neonatal care for premature infants. It empowers mothers to provide the best nutrition possible for their preemies, supporting their babies' health and development during this vulnerable stage of life. Healthcare providers play a pivotal role in guiding mothers through the process of human milk fortification, offering education and support to optimize outcomes for these tiny fighters.

By recognizing the importance of fortifying breast milk for preemie babies, we can enhance the quality of care and improve the long-term health prospects of these resilient little ones. Every drop of fortified breast milk signifies a step forward in nurturing and protecting the smallest members of our communities.

The composition of breast milk undergoes significant changes to meet the evolving nutritional needs of infants as they grow. The differences between preterm (colostrum and transitional milk) and mature breast milk are particularly important for understanding how mothers can support the unique requirements of preterm babies. Here's a breakdown of these differences:

**1. Protein Content:**

   - Preterm Breast Milk: Higher in protein, specifically whey protein, which is easier for preterm infants to digest.

   - Mature Breast Milk: Lower in total protein compared to preterm milk, with a higher proportion of casein protein.

**2. Fat Composition:**

   - Preterm Breast Milk: Contains more medium-chain fatty acids and higher levels of essential fatty acids like DHA (docosahexaenoic acid) and ARA (arachidonic acid), which are crucial for brain and visual development.

   - Mature Breast Milk: Higher in long-chain fatty acids, reflecting the changing needs of the growing infant.

**3. Carbohydrates:**

   - Preterm Breast Milk: Contains higher levels of lactose and oligosaccharides, providing readily available energy for the developing preterm baby.

   - Mature Breast Milk: Still rich in lactose but with a slightly lower concentration compared to preterm milk.

**4. Minerals and Vitamins:**

   - Preterm Breast Milk: Generally higher concentrations of certain minerals like calcium, phosphorus, and zinc to support bone and overall growth.

   - Mature Breast Milk: Adequate levels of minerals and vitamins tailored to the needs of a growing infant.

**5. Immunological Factors:**

   - Preterm Breast Milk: Richer in immunoglobulins (especially secretory IgA) and other immune factors to bolster the preterm baby's immature immune system and protect against infections.

   - Mature Breast Milk: Continues to provide valuable immunological support but at levels adjusted for the older infant's immune needs.

**6. Growth Factors:**

   - Preterm Breast Milk: Higher levels of growth factors like insulin-like growth factor (IGF) to support rapid growth and development.

   - Mature Breast Milk: Contains growth factors in appropriate proportions to sustain healthy growth without promoting excessive weight gain.

**7. Micronutrients:**

   - Preterm Breast Milk: Often supplemented with higher levels of vitamins and minerals to meet the increased requirements of preterm infants.

   - Mature Breast Milk: Provides sufficient micronutrients for the needs of older infants, although additional supplementation may be necessary depending on the infant's diet.

Understanding these differences underscores the importance of tailored nutrition for preterm infants. While human milk is always beneficial, preterm breast milk offers a specialized blend of nutrients and bioactive components uniquely suited to support the growth and development of premature babies during the critical early stages of life. As preterm infants transition to mature breast milk, the composition adjusts to meet their changing nutritional demands, ensuring optimal health and development as they continue to thrive on mother's milk.

How to wean a toddler

- Julie Matheney

Weaning a toddler from breastfeeding is a gradual process that requires patience and sensitivity. Here's a guide to help you navigate this transition:

### Assess Readiness:

- Determine if both you and your toddler are ready for weaning. Look for signs that your toddler is becoming less interested in breastfeeding or is ready to try other foods and drinks.

### Plan Gradual Steps:

1. **Introduce Alternative Milk or Drinks**:

   - Start offering your toddler cow's milk or a suitable alternative if they are over 1 year old. Gradually replace breastfeeds with milk in a cup. Cow’s milk is a good source of fat and calcium, but never needed if your toddler eats a well balanced diet with other foods rich in fat and calcium.

2. **Adjust Feeding Schedule**:

   - Gradually reduce the number of breastfeeding sessions. Start by dropping one feed at a time, perhaps beginning with daytime feeds before tackling bedtime or morning feeds.

3. **Don’t offer, don’t refuse**:

   - Don’t offer the breast at routine times, but when starting the weaning process, don’t refuse when asked. Eventually this will turn into distract, delay, and don’t sit down!

4. **Distraction and Substitution**:

   - Engage your toddler in other activities or offer comfort in different ways when they ask to breastfeed. Substitute breastfeeding with a favorite toy, book, or snack.

5. **Gradual Shortening of Feeds**:

   - If your toddler is used to long breastfeeding sessions, try gently shortening the duration of each feed over time. Set a timer and when it dings, it’s time to stop. Start the timer at your usual nursing length and shorten the time each day.

6. **Discuss this with your toddler!**:

   - Toddlers understand more than you think. Have a discussion with them about why you’re stopping in language they can understand. This is a good chance to introduce the concept of bodily autonomy and consent. Read a book that talks about weaning, like The Booby Moon, and talk about it together.

7. **Cover your nipples and reduce access**:

   - Wearing clothing like sports bras and high neck shirts and dresses can help reduce access. For older toddlers or preschoolers, some will cover their nipples with bandaids and say either their nipples hurt or their boobies are broken, whichever language resonantes best with your child.

### Address Emotional Needs:

- Understand that weaning can be an emotional process for both you and your toddler. Offer extra cuddles, reassurance, and comfort during this transition.

### Be Consistent and Patient:

- Create a plan you feel you can carry out and stick to it. Once you establish a rule about breastfeeding, don’t change it. Especially for tantrums. If you give in, this only reinforces that your toddler just has to escalate the tantrum and you’ll give in to their demands. If you don’t want to cold turkey wean, come up with a plan with gradual steps that you fell comfortable enforcing.

### Night Weaning:

- Night weaning can be a separate process. Gradually reduce nighttime feeds or comfort your toddler in other ways if they wake up seeking breastfeeding.

### Celebrate Milestones:

- Celebrate each step achieved towards weaning. Praise your toddler for being a big boy or girl and trying new ways of getting comfort.

### Seek Support:

- Talk to other moms, friends, or a healthcare professional if you need guidance or emotional support during the weaning process.

### Final Transition:

- Once breastfeeding is fully phased out, celebrate this milestone together and focus on the new ways you can bond with your toddler.

Remember, weaning is a personal journey that varies for every child and parent. The key is to approach it with love, patience, and understanding.

Having a baby means you are a targeted market.

- Julie Matheney

Where did 10,000 steps a day to better health come from? The 10,000 steps concept was initially formulated in Japan in the lead-up to the 1964 Tokyo Olympics. Because the Japanese character for “10,000” looks like a person walking, the company called its device the 10,000-step meter. Thus the 10,000 steps a day was not based on science, but a marketing strategy to sell step counters. Modern research has actually shown that 4,00-7,500 steps a day can be just as beneficial to health and a more realistic goal without discouraging people from walking fewer steps than the elite 10,000.

So what does this have to do with breastfeeding? You are being marketed to. Almost everything related to infant sleep and feeding (bottle AND breast) is a pitch to get you to buy something in your sleep deprived state at 2am from Amazon. Don’t fall for the marketing. Is the bottle marketed to look like a breast? Yes!! But in my experience the ones that look like a boob often don’t promote a breast-like latch at all. A cookie guaranteed to make milk? A cookie is just a cookie if you’re not actively moving that milk. A crib guaranteed to help baby sleep longer? It may work for some, but at what cost to development and the breast milk supply…

Yes, it is a fantastic time to be alive. We have more gadgets and gizmos than any other time in history. Some are amazing miracles of science and some are just downright times money suckers that will end up in the back of the closet to gather dust. If a products works for you, awesome!! Not every item will work for every family or every baby. Because we are all unique individuals

Nipple piercings and breastfeeding

- Julie Matheney

Will nipple piercings impact breastfeeding? In my experience, the majority of people who’ve had a piercing will have absolutely ZERO issues with breastfeeding. But every body is different in how it reacts to taking out the jewelry out prior to breastfeeding. Just like with pierced ears,  occasionally the hole left by jewelry will scar closed, or partially closed, which can inhibit milk from coming out certain nipple pores. Often, the longer the time since the piercings were initially placed the better the outcome as the nipple has had time to properly heal. Other concerns may include nerve damage (the piercing happened to go through right at the nerve and damages it) that impacts milk let down or extra holes created by the piercings that lead to milk coming out of unexpected places! I have (rarely) seen mastitis and abscesses from previous nipple piercings, but that is NOT common.

Breastfeeding with the nipple jewelry in place is never recommended as it can make it difficult for the infant to latch-on correctly, increases the risk of choking on loose or dislodged jewelry, and can damage the inside of the baby’s mouth. If you are going to take your jewelry in and out every feeding, make sure you are being extremely careful with hand washing and jewelry sanitizing to reduce the risk of infection. Best practice says take the piercings out for the entirety of your breastfeeding journey. Laid back breastfeeding positions and extra nursing pads to catch the excess milk can help. You may also need to find which direction your baby needs to face if you notice leaking milk from additional holes created by the piercing if they are not in baby’s mouth. Many women go on to breastfeed successfully with a history of pierced nipples, but if you’re having any problems or have concerns, see an IBCLC lactation consultant.