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.

What can I take for a headache or pain while breastfeeding?

- Julie Matheney

I have a headache but am also breastfeeding. What can I safely take for me and my baby? Well, first, if you have a headache, start by drinking water. I see many new mothers who are breastfeeding who are not getting adequate nutrition and specifically hydration because of focusing on their little one. If you have a new onset headache, before reaching for the medicine cabinet, start by hydrating. Water, coconut water, soups or births, and High water fruits and vegetables like melon , pineapple, oranges or citrus fruits and cucumber, lettuce, and celery. If that doesn’t do the trick , there are safe medications to take. Dr Thomas Hale wrote the textbook on medication and breastmilk and categorizes them into 5 categories:

  • L1 safest
  • L2 safer
  • L3 probably safe
  • L4 possibly hazardous
  • And L5 hazardous.

If you have pain, such as a headache, body aches, pain post delivery or a fever, there are safe medications. 

Ibuprofen, Advil, and Motrin are all nonsterioial anti-inflammatory analgesics (NSAIDs), and considered L1 or preferred medications. Panadol, acetaminophen or Tylenol are pain relievers that are considered L1 and safe while breastfeeding. Aspirin, ASA, is considered an L2 medication. While L2 medications are typically considered safe while breastfeeding, Aspirin use  can lead to a condition in babies and children called Reye Syndrome which has been associated with brain and liver damage. Aleve (also known as Naproxen) is considered an L3 and while the AAP-approved it for nursing mothers, Dr Hale states it should be used with caution due to its long half-life and its potential effect on baby’s cardiovascular system, kidneys and GI tract. Use of  Aleve should be short-term, infrequent or occasional use which would still be considered compatible with breastfeeding. 

Ibuprofen or acetaminophen are better choices over aspirin and naproxen for pain relief in lactating women and you would want to discuss the risks and benefits of aspirin If your physician has prescribed this for you based on your unique medical history. 

Codeine is an L3 medication and not generally recommended while breastfeeding. If it is essential, and only where there is no alternative, it should be at the lowest effective dose for the shorted possible duration and you should stop taking it and seek medical attention if you notice side effects in your baby such as breathing problems, lethargy, poor feeding, drowsiness or slow heart beat. 

If you have another medication that you take for fever or pain, you can ask the IBCLC lactation consultant you’re working with to check out it’s safety in the Hale’s Medications and Mother’s Milk textbook, on you can search the LactMed database on the internet. You can also call Infant Risk which is a help center for questions about breastfeeding, infants and medications. If you are in the USA, The phone number for the call center is 1(806) 352-2519 and is open from 8 AM to 5PM Central Standard Time to answer your questions.

Aversion to breastfeeding while pregnant

- Julie Matheney

Some times breastfeeding isn't enjoyable

Breastfeeding aversion while pregnant is not uncommon, but it’s certainly not commonly discussed. Hormonal changes and sensitivities absolutely affect how a breastfeeding mother experiences nursing

  • Hormonal Shifts: Increases in hormones, especially progesterone, can influence sensory experiences. This may contribute to heightened sensitivity or discomfort in the nipples and breasts from anatomical changes that happen during pregnancy to prepare for new baby
  • Changes in Milk Composition: As your body prepares for new baby, breast milk shifts back to colostrum, usually by the end of the first trimester. Colostrum is thicker, saltier, and flows slower than mature milk which may change how an older nursling sucks at the breast, heightening sensitivities
  • Nursing Aversion and Pregnancy: Nursing aversion or agitation during pregnancy is where a mother experiences discomfort, irritation, or negative feelings while breastfeeding. It's thought to be related to hormonal fluctuations and changes in nipple sensitivity. I’ve interviewed many mothers who report that, only while they are latched, they have violent thoughts related to the nursling for how intense they experience these negative feelings and sensations 
  • Emotional Factors: Pregnancy itself can bring a range of emotions and physical discomfort. Stress, fatigue, or concerns about the upcoming birth and new baby can contribute to feelings of aversion during breastfeeding

If you're experiencing breastfeeding aversion while pregnant and find it challenging, know you are not alone and this is a very common experience 

  • Communication: Openly communicate with your partner and healthcare provider about your feelings. Sharing your experience can provide support and understanding.
  • Self-Care: Prioritize self-care to manage stress and fatigue. Ensure you're getting adequate rest, staying hydrated, and engaging in activities that bring you comfort.
  • Alternative Feeding Options: If breastfeeding becomes too uncomfortable, explore alternative feeding options such as expressing milk or gradually introducing other sources of nutrition.

It's crucial to seek guidance from your healthcare provider or a lactation consultant for personalized advice based on your specific situation. They can offer support, address concerns, and help you make informed decisions about breastfeeding during pregnancy.

Best way to burp a baby

- Julie Matheney

Burping your little one might seem like a simple task, but oh, the sweet relief it brings!

Newborns and infants are more prone to swallowing air during feeding, whether from breastfeeding or bottle-feeding. Burping helps release trapped air in a baby's stomach, reducing discomfort caused by gas bubbles.  Burping helps expel this swallowed air, promoting better digestion and reducing the likelihood of colic or gassiness. Burping can reduce the chances of gastroesophageal reflux (spitting up) in babies. By expelling air, it minimizes the likelihood of stomach contents moving back into the esophagus.

There is no right or wrong way to burp your baby. There’s also no air in the breast, so some breastfed babies may or may not give you a good burp after feeding. Find your rhythm with a gentle, rhythmic patting motion. Experiment with different positions – over the shoulder or sitting upright – to discover your baby's burping sweet spot. Every baby is unique, so don't be afraid to try different burping techniques. I prefer sitting them on your lap with the burp cloth over your hand because you will wear spit up less than when they’re are over the shoulder, plus you can see their face.

Some may prefer a back pat, while others might respond better to a gentle bounce. Patting young babies may trigger the startle reflex or if they’re over full increase the chance of spitting up, so sometimes just moving baby into different positions after feeding, including promoting side lying on their left side, can help aid in getting the air out without causing increased discomfort.

 

To watch me burping a baby in several positions click here To watch me burping a baby in several positions click here 

Peppermint and Breast Milk Supply

- Julie Matheney
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Peppermint is a popular flavor during the festive Christmas season, and it’s often found in candies, teas, and other treats. While peppermint is generally considered safe for consumption, there is a traditional belief that it may have an impact on milk supply.

Some people claim that peppermint, particularly in the form of peppermint tea, might potentially decrease milk supply. However, scientific evidence is limited and has yet to support this as true. A 2020 study found that Menthol did suppress milk production in mice. Menthol is a chemical naturally found in peppermint and other mint plants, but it can also be made in a lab. Anecdotally, people do report a drop after eating large amounts of peppermint. It’s essential to note that individual responses can vary, and not every breastfeeder will experience a noticeable effect on milk supply when consuming peppermint.

If you’re breastfeeding, enjoy your peppermint mocha during the holiday season. Pay attention to your body’s response, and if you have concerns about your milk supply, consult with an IBCLC lactation consultant for personalized advice.

I believe the REAL reason why we see supply drop at the holidays isn’t the peppermint consumption, but being off normal schedules and routines, traveling, and having the baby be passed from grandma to aunt to friend where hunger cues are being missed and feedings delayed. In general, maintaining a well-balanced diet, staying hydrated, and responding to your baby’s feeding cues are crucial factors in supporting a healthy breast milk supply. Enjoying holiday treats in moderation, including those with peppermint.

#peppermintmocha #peppermint #breastfeedinghelp #milksupply #milksupplybooster #weaningbaby #milksupplyproblems

Can you overfeed a breastfed baby?

- Julie Matheney

Can you overfeed a baby? The answer is absolutely yes. You have a tiny human with a tiny human stomach. All of our stomachs can stretch to hold more capacity than what we actually need to take. The question is, is over eating a problem? We’ll take a look at this and strategies to understanding if whether your baby is over feeding and if it’s a problem or not.

Now we all know that it is very easy to overfeed from a bottle. Bottles have a hole in them that are instant and constant and absolutely yes, many bottle fed babies are over fed. Many times parents are watching the volume in the bottle instead of watching the baby for baby’s cues that they are ready stop. It also takes 20 minutes for the stomach to tell the brain that it’s full, so it is very easy for babies to take the large volume in a short amount of time and eat more than their stomach needs to, before the brain knows that it’s full. The mouth can still be hungry while the stomach is full so babies may show cues that they are still wanting to suck which parents interpret as cues that Baby wants to continue to feed, and because the stomach can stretch and hold more than it needs to, parents often overfeed from a bottle.

The big question is, can babies overfeed at the breast? The breast works different than a bottle. The breast needs to be stimulated to release milk and milk is released in multiple waves that take time to be triggered. Most young babies will take 15 to 30 minutes at the breast, which allows their tummy time to tell the brain that it’s full. As they age and become more efficient; they learn to listen to their stomach to help guide when to stop feeding.

It is still possible to overfeed at the breast. We usually see this for two reasons: either from the mother side or from the baby side.

On the mother side, the most common reason for overfeeding is the mother has an over supply of milk. There are several reasons for having an oversupply. First, it may be caused by using a Haakaa or a breast pump and overstimulating the breast to make more milk than it needs. This also drives up the letdown response, which makes milk flow faster than if the baby were just feeding at the breast without the over supply. In this case, baby takes too much milk too fast. Mother may also have an oversupply being driven by certain medications. The most common medication I see driving over supply is Zoloft. There are also different medical conditions that can be the reason for an oversupply such as a prolactinoma, which is a pituitary gland tumor, or uncontrolled thyroid disorders.  This would be diagnosed by a physician after bloodwork and other medical imaging. Lastly, some new parents who don’t have as much experience with babies may also interpret every cue as a hunger cue. Some babies are totally willing to keep eating even if they are full. If you offer me a cheesecake, I will totally eat the cheesecake even if I don’t need it. Some babies are also like this, they will always latch when offered the breast. Every time baby is put down to sleep in the crib, they cry. Or they sleep for 10 minutes and cry to be picked up. But these cues get misinterpreted as the baby is still hungry and the baby is put back to breast. Some babies are very willing to go back to breast and keep feeding.

Overfeeding  could also be on the baby side. Certain tongue ties will stimulate the breast into an over supply. These babies often use a quick suckle pattern which initiates the let down reflex from how the nipple is stimulated. These cases are complicated in that the tongue may be restricted in a way that the mother doesn’t have much nipple pain or damage, but her body is compensating for the baby not having full range of motion of the tongue. Babies with reflux may also over feed at the breast. They often want to nurse more to keep swallowing, which helps keep milk in the stomach. Breastmilk is a pain reliever and many babies with reflux learn that they would rather be swallowing milk down than bringing it back up as reflux. So frequently feeding helps them swallow more often, but it becomes a vicious cycle.

When does overfeeding actually become a problem? If baby is having a lot of negative symptoms related to feeding, and over feeding is determined to be part of the root, addressing the reason WHY there is overfeeding would be appropriate.

If the baby has digestive discomfort, and has a lot of reflux/excessive spit up/projectile vomiting with pain, severe gas or digestive pain, we would want to address over supply or other issues, causing this discomfort. If the baby is having green, frothy/foamy or watery poops, this is also a sign of too much milk too fast. These kinds of watery or green poops may be a sign of lactose overload, where baby is accessible too much foremilk due to an oversupply.

Another symptom to watch for that would lead us to believe overfeeding is a problem would be baby coughing, choking, or leaking milk during the feeding. If the baby just physically cannot keep up and is constantly struggling during the feeding, there would be a reason why we would want to reduce milk supply to help baby feel more comfortable at the breast. Although this may also be a symptom pointing back to a tongue tie driving the over supply, so just bringing supply down would not necessarily be the best answer in this case. We would want to determine if the oversupply is causing the coughing and choking or if an inefficient tongue is contributing to baby not being able to swallow efficiently.

Babies gaining weight too quickly or faster than expected can also be a symptom that baby is being overfed, however, this is my symptom of least concerned. If the baby is gaining happily with no digestive discomfort, poops are a normal color and consistency, and is not leaking, coughing, or choking during feedings, fast weight gain alone would not be a concern. Many typically feeding babies with mothers with a normal supply can gain weight quicker than anticipated and then level off in weight once they become more active or distracted.

Yes, it is occasionally possible for breastfed babies to overfeed. If there there are symptoms happening (recurrent plugged ducts and mastitis for mother from an over supply, nipple pain and damage, coughing/choking baby, digestive discomfort or concerns with poop), working with an IBCLC lactation consultant can help determine what the root is (excessive pumping, medications, tongue tie, reflux, etc) to help balance the dyad for happier feeding.

How to increase supply on a slacker boob

- Julie Matheney
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Slacker boob, AKA “shitty titty”, is the way some breastfeeding parents refer to one breast producing less milk than the other. It's important to note that breast milk production can naturally vary between breasts, and having one breast that seems to produce less milk doesn't necessarily indicate a problem. 70% of us naturally make more milk on the right side due to asymmetries in our anatomy! Breasts can have different storage capacities and respond differently to the baby's nursing patterns.

Factors such as latch quality, frequency of nursing, and hormonal fluctuations can influence milk supply. In some cases, a perceived difference in milk production might be due to variations in the baby's sucking efficiency or preference for one breast over the other.

Here are some strategies for dealing with your lower producing side:

⭐️Frequent Nursing: Ensure that baby nurses more frequently on the slacker side. Start with that side a little more often and use it as the pacification boob.

⭐️Switch Nursing: Alternate between breasts during a single feeding session, starting with the slacker side. This encourages more thorough draining of the breast and signals your body to produce more milk.

⭐️Pump After Feedings: After breastfeeding, consider pumping on the slacker side for an additional 10-15 minutes. This can help to fully empty the breast and signal your body to produce more milk.

⭐️Breast Massage and Compression: During breastfeeding or pumping, use breast massage and compression techniques. Gently massage the breast from the back down to the front and compress it to help express more milk.

⭐️Hydration and Nutrition: Stay well-hydrated and maintain a balanced diet rich in nutrients. Proper nutrition is essential for optimal milk production.

⭐️Comfortable Latching: Ensure that your baby is latching well on the slacker side. A proper latch helps the baby effectively remove milk from the breast.

⭐️Consult with a Lactation Consultant: If you're struggling with milk supply imbalances, seek guidance from a lactation consultant such as myself. I am available for virtual and in person consultations and have worked with families all over the world. Finding a local ibclc lactation consultant  can assess your breastfeeding technique, provide personalized advice, and address any specific concerns.

Remember that breastfeeding is a dynamic process, and milk supply can fluctuate throughout the day. If you have persistent concerns about milk supply or notice significant differences between your breasts, consulting with a healthcare professional or a lactation consultant is recommended for personalized support.

Alcohol and breastfeeding

- Julie Matheney

Current scientific research, including studies published in reputable journals such as 'Journal of Human Lactation,' supports the idea that moderate alcohol consumption is generally considered acceptable during breastfeeding. The key is understanding the timing of alcohol metabolism and its presence in breast milk. A study published in the "Journal of Pediatrics" found that alcohol concentrations in breast milk peaked around 30 to 60 minutes after consumption and gradually declined thereafter. If you’ve had one standard drink, that alcohol should be completely out of your milk 2-3 hours after you drank it. Research suggests that waiting a few hours after consuming alcohol before breastfeeding can significantly reduce the amount present in breast milk.

It is generally considered acceptable that breastfeeding mothers can typically enjoy up to one standard drink per day without compromising the well-being of their infants. A standard drink, equivalent to approximately 14 grams of pure alcohol,  would equal a 5-ounce glass of wine, a 12-ounce beer, or a 1.5-ounce shot of distilled spirits.

Understanding the timing of alcohol metabolism is crucial. Waiting a few hours after consuming alcohol before breastfeeding allows for a decline in alcohol concentrations in breast milk. If there's a need to breastfeed within this waiting period, pumping and storing milk in advance can be a practical solution.

Do be mindful of individual factors and how they impact alcohol consumption while breastfeeding—metabolism, body weight, and other personal characteristics. Mothers are encouraged to consider these factors when making choices about alcohol consumption during breastfeeding. If there are uncertainties or unique circumstances, our team is here to provide personalized guidance and support.

At LA Lactation, we believe in empowering mothers with knowledge to make informed decisions that prioritize the health and well-being of both mother and baby. For any questions or concerns, feel free to reach out. Your can email [email protected] 🌟🤱 #LALactation #BreastfeedingGuidance #EvidenceBasedSupport"

Postpartum Rage: It may also be grief

- Julie Matheney
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Social media is filled with pictures of overflowing bottles and serene mothers cradling their content newborns to their breast. For many, though, the breastfeeding journey may not be what was planned for or expected, leading to intense emotions that go beyond frustration. Postpartum mood disorders, including postpartum rage, are on the rise. Postpartum rage, characterized by intense, often unexplained anger, can be heightened when breastfeeding expectations are unmet. It's crucial to recognize that this anger may, in fact, be a form of grieving as well. Whether hindered by physical challenges, birth trauma, societal pressures, or other unforeseen medical complications, the gap between expectations and reality can be a source of profound sorrow. Acknowledging breastfeeding rage as a potential facet of grief allows for a deeper understanding of these complex emotions. Seeking support, both emotionally and professionally, becomes paramount in navigating through these feelings.

#BreastfeedingRage #GrievingProcess #MotherhoodRealities #BreastfeedingGrief #MotherhoodJourney #SupportEachOther

Toddler Breastfeeding

- Julie Matheney

Breastfeeding toddlers offers a range of benefits that extend beyond infancy, contributing to the overall health and well-being of the child. One notable advantage is the continued nutritional support provided by breast milk. As toddlers transition to a more varied diet, breast milk remains a valuable source of essential nutrients, offering a balance of proteins, fats, and antibodies tailored to the child's needs.

Moreover, breastfeeding fosters a strong emotional bond between the toddler and the mother. The act of nursing provides comfort, security, and a sense of connection, promoting the child's emotional development. This nurturing aspect of breastfeeding can be especially beneficial during times of stress, illness, or significant developmental milestones.

Breast milk adapts to meet the changing nutritional requirements of a growing toddler, offering a dynamic source of antibodies that help bolster the child's immune system. This immune support is particularly valuable as toddlers explore their environment, encountering new germs and pathogens.

The act of breastfeeding also promotes optimal oral and facial development in toddlers. The natural sucking motion required during breastfeeding contributes to the development of facial muscles, jaw alignment, and palate shape, potentially reducing the risk of orthodontic issues later in life.

Beyond the physical benefits, extended breastfeeding can support a smooth transition into more independent eating habits. Toddlers who breastfeed often exhibit a greater acceptance of a variety of flavors and textures in their diet. Breastfeeding can serve as a bridge between the comfort of nursing and the exploration of new foods.

In conclusion, breastfeeding toddlers offers a multitude of benefits encompassing nutritional, emotional, and developmental aspects. The continued provision of breast milk aligns with the evolving needs of the growing child, fostering a strong parent-child bond and contributing to the overall health and well-being of the toddler.