When we know better, we do better. In my generation, pediatricians generally recommended weaning babies from their bottles by two years of age. Today professional organizations recommend weaning 100% off the bottle by no later than 14 months unless there is a medical reason to continue the bottle. Many of my feeding specialist colleagues recommend bottle weaning by 12 months.

Reasons to wean the bottle around a year:
Contributes to tooth decay
⭐️ May impact speech and feeding skills with prolonged use
⭐️ May contribute to how the face, teeth, palate and other oral structures are formed (or misformed)
⭐️ Prolongs an immature suck pattern in the mouth beyond when developmentally appropriate

This does not mean you need to wean from the breast at one. The muscles and way the muscles are used with breast vs bottle are completely different.
In fact:
⭐️ Breastfeeding promotes good formation of the face, palate and teeth
⭐️ Does not increase the risk of dental decay
⭐️ Introduces baby to a wide variety of flavors which makes them more prone to trying those same foods in their solid forms

Natural weaning is the biological process of gradually decreasing milk supply as baby gets older. This process starts around 7-9 months as baby takes more solid foods and progresses toward sleeping longer stretches at night. It ends when baby finally weans (which may not be until 2-3 years old!!). Natural weaning doesn’t mean that you need to wean baby from the breast. Decreasing milk supply doesn’t mean you’re at risk of losing your supply, either. Your breast is designed to match the stage of development your baby is in.

Milk supply iss highest from month 1-6 when baby is going through multiple growth spurts. They need to double their birth weight by 6 months. Milk is also the only food in their diet. Therefore, your milk supply is supposed to be at its highest to meet their nutritional needs. From 6-12 months, weight gain slows but their need for milk volume needs remain stable. It is natural as baby transitions from a full milk diet to a milk+solids diet to then a solids+milk diet that breast milk supply will shift along with it. Your milk supply varies compared to baby’s solids intake and there is a wide range of normal based on your individual baby. Some babies love solids and eat them in large quantities many times a day. Other babies continue on a mostly milk diet until almost 1 year. At 12 months, milk finally takes a back seat to solids, but still fills in nutritional gaps and acts like medicine against illness. From 12 months on there continues to be a wide range of normal for milk supply depending on your child’s eating and feeding habits. Some babies continue to nurse occasionally over night while others seem to become boob barnacles again and would happily stay on the breast all day, every day.

So what does this mean? If you’re exclusively breastfeeding you may not notice anything. You can continue to bring baby to breast for as long and often as baby wants. You may notice baby spacing out feedings or not nursing as long. They may want the breast more when teething or going through growth spurts or developmental leaps. They have days with little interest in the breast.

Moms who pump (either exclusively or because of work) report overflowing milk in the early weeks, often able to pump 4-6 or even 8-10 ounces in a morning pump session. By 4 months supply regulates and mom gets about 3-5 ounces per pump in place of a feeding. By 9 or 10 months it can feel like your trying to wring out a wet rag to get even 2-4 ounces a pump session. As long as baby has unrestricted access to the breast when your not working and you still have a regular pump routine in place no intervention is usually needed. Every journey is supposed to look different because it is your unique journey.

Did you know mastitis may be related to your posture?!?

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

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

Did you know that many of us will notice a supply drop right before our period is going to start and lasts through the period? This is caused by hormone shifts in your body. During this time, as supply dips, the milk flow slows and the milk can taste saltier than normal. Some babies become frustrated with this change. They may grab the nipple with their mouth and shake their head back and forth. Pop on and off the breast. Knead or beat the breast with their hands or become extra fussy at the breast. They may even cluster feed and act as if they’re still hungry. They’re trying all the strategies to get your milk to flow how they prefer. This is a temporary dip but can be surprising the first time it happens. Remember: this dip can happen once or twice before you actually have a period as your hormones are shifting back into baby making mode. If your baby is older than 6 months and eating lots of solids, you may not notice a difference. The strongest behaviors are seen under 6 months when babies need an exclusive milk diet. You may also notice the dip if you’re a pumper.
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What can you do about it? Knowing it can happen is the first step. Stay well hydrated and eat quality nutrition. Many find adding in a calcium/magnesium supplement (1000mg of calcium/500mg magnesium per day split into 3-4 “doses”) can help combat the drop. Others find adding in lactation specific herbs or supportive foods help. Iron rich foods like dark leafy greens and red meat and milk making foods like oatmeal, almonds and fennel can really help. Keep offering the breast or pumping frequently. It will get better and your supply will come back up as soon as your hormones shift again after your period. It usually only lasts a few days.
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When did your period come back? Did you notice a supply dip?

Did you know that many of us will notice a supply drop right before our period is going to start and lasts through the period? This is caused by hormone shifts in your body. During this time, as supply dips, the milk flow slows and the milk can taste saltier than normal. Some babies become frustrated with this change. They may grab the nipple with their mouth and shake their head back and forth. Pop on and off the breast. Knead or beat the breast with their hands or become extra fussy at the breast. They may even cluster feed and act as if they’re still hungry. They’re trying all the strategies to get your milk to flow how they prefer. This is a temporary dip but can be surprising the first time it happens. Remember: this dip can happen once or twice before you actually have a period as your hormones are shifting back into baby making mode. If your baby is older than 6 months and eating lots of solids, you may not notice a difference. The strongest behaviors are seen under 6 months when babies need an exclusive milk diet. You may also notice the dip if you’re a pumper.
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What can you do about it? Knowing it can happen is the first step. Stay well hydrated and eat quality nutrition. Many find adding in a calcium/magnesium supplement (1000mg of calcium/500mg magnesium per day split into 3-4 “doses”) can help combat the drop. Others find adding in lactation specific herbs or supportive foods help. Iron rich foods like dark leafy greens and red meat and milk making foods like oatmeal, almonds and fennel can really help. Keep offering the breast or pumping frequently. It will get better and your supply will come back up as soon as your hormones shift again after your period. It usually only lasts a few days.
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When did your period come back? Did you notice a supply dip?

Did you know that many of us will notice a supply drop right before our period is going to start and lasts through the period? This is caused by hormone shifts in your body. During this time, as supply dips, the milk flow slows and the milk can taste saltier than normal. Some babies become frustrated with this change. They may grab the nipple with their mouth and shake their head back and forth. Pop on and off the breast. Knead or beat the breast with their hands or become extra fussy at the breast. They may even cluster feed and act as if they’re still hungry. They’re trying all the strategies to get your milk to flow how they prefer. This is a temporary dip but can be surprising the first time it happens. Remember: this dip can happen once or twice before you actually have a period as your hormones are shifting back into baby making mode. If your baby is older than 6 months and eating lots of solids, you may not notice a difference. The strongest behaviors are seen under 6 months when babies need an exclusive milk diet. You may also notice the dip if you’re a pumper.
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What can you do about it? Knowing it can happen is the first step. Stay well hydrated and eat quality nutrition. Many find adding in a calcium/magnesium supplement (1000mg of calcium/500mg magnesium per day split into 3-4 “doses”) can help combat the drop. Others find adding in lactation specific herbs or supportive foods help. Iron rich foods like dark leafy greens and red meat and milk making foods like oatmeal, almonds and fennel can really help. Keep offering the breast or pumping frequently. It will get better and your supply will come back up as soon as your hormones shift again after your period. It usually only lasts a few days.
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When did your period come back? Did you notice a supply dip?

The Haakaa and similar manual pumps are extremely popular. I used one for the first few months after Peach was born. They typically suction on the opposite breast while feeding to collect “leaking” milk. It’s not an actual pump, but it does create a vacuum that removes milk from the breast. Like any product, it can be a wonderful tool or inadvertently cause problems.

⭐️Caution: milk collected in a tool like this tends to be “drip milk”, meaning high water content and low fat. It can be good to relieve engorgment or pull off milk if baby is sleeping longer, but you’ll want to mix it with other pumped milk to ensure a good fat content.
🌀Use hand compression while it collects or hand express after to help pull fat into that milk.

⭐️Caution: more so than breast shells or milk collectors that passively sit in the bra, the suction adds extra stimulation and can increase milk supply, to the point of an oversupply. The extra milk pulled off during feeding tells the body that baby is REALLY hungry and eating all the milk that is actually feeding the freezer. The body makes more and more milk. This can result in an overactive let down which causes baby to cough, choke, and pull off the breast while you spray milk in their face.

⭐️For some the focus shifts from what the baby is doing to what the other breast is/isn’t doing. Instead of enjoying baby, you’re obsessed with the silicone bobble dangling from your boob. And an active baby may kick it off and make a mess.

⭐️Those who don’t drip a lot it may wrongly believe there is something wrong with milk supply and have unnecessary concern. This is especially true if you were used to high yield in the first weeks after birth and once your supply regulates you only see drops collected. Many panic at this drop when that’s actually normal.
🌀Accounting for every drop may make you feel like you’re failing at feeding. Even if baby is getting plenty of milk and feeding fine.

⭐️For those with a true low supply, the Haakaa may be taking milk from the other breast that baby actually needs to grow. Sometimes baby needs that milk and not the freezer.

On the flip side, the Haakaa and other silicone pumps can be a wonderful tool. They can be a huge relief to reduce engorgment. Did you know you can suction two of them on while you’re in the shower to reduce engorgment and help keep milk moving? Or collect last minute milk before you leave for work? I’ve found they help pull out colostrum while baby is feeding better than an electric pump. they’re super handy for getting rid of a plugged duct or nipple blebs. For someone with a low milk supply, this tool could be the difference between supplementing your own milk vs formula. It can mean freedom from an electric pump while creating a stash for going back to work. Some see this as their way of giving back through milk donation. It is a fabulous tool to use for hand expression. It’s just the right shape and size for hand expressing milk when you don’t have an electric pump or don’t want to drag a pump with you. It’s easy for traveling, with no extra parts to lose or clean.

Understanding the tool is the most important thing. If you have an overactive let down and choking baby, consider reducing your Haakaa use. If you’re struggling with an oversupply, know that the Haakaa may be your problem. If you’re 4-6 months into your journey you may not collect as much as you used to when baby was 2 or 3 months old.

Breastfeeding babies tend to move through 3 sucking stages:

• Stimulation: A quick, light suck often done at the beginning of a feeding to stimulate a let down. The tongue cups the breast and baby’s lower jaw moves up and down while the tongue moves quickly. Breastfeeding hormones are released when nerves close to the nipple are triggered, and milk will usually begin to flow within 1-2 minutes. This may be mimicked by the “massage” or “stimulation” mode on your pump.

• Active feeding. Once the milk lets down (milk ejection reflex), baby should swallow every 1-3 sucks. This is active feeding. The lower jaw moves up and down rhythmically and drops just a little lower when the swallow actually happens. You might hear the swallow sound like a “puh” or “kuh”. Baby may take occasional breaks during active feeding to catch their breath. This is the “expression” or slower mode on the pump

• Flutter sucking. Towards the end of the feed, sucking slows down, jaw movements get less pronounced, there are fewer swallows, and baby may fall asleep or unlatch. Some call the fluttery sucking movements at the end of the feed “flutter sucking”. It’s a form of comfort nursing to help baby transition to sleep. Minimal milk is being transferred at this time and it’s ok to unlatch your baby is you are no longer hearing baby swallow.

Babies may alternate between these sucking phases several times during a single feeding. By changing the settings in your pump several times during a feeding session, you can get the pump to mimic how a baby would feel at the breast, triggering your body to let down and make more milk for the pump. If newborn baby is always using a stimualtion or flutter suck and you’re not hearing many swallows, work with an IBCLC to help figure out why and get baby feeding efficiently at the breast.

Pregnancy affects levels of estrogen and progesterone in your body. These hormones get the breasts ready for lactation and are responsible the breast changes you may experience. Estrogen stimulates growth of the breast duct cells and generates the secretion of prolactin, the milk making hormone. Prolactin stimulates breast enlargement and milk production. Progesterone supports the formation and growth of milk-producing cells within the glands of the breasts. In the 2nd trimester, estrogen levels continue to rise. Milk ducts continue to develop, making the breasts feel heavy or full. Some need to purchase a larger bra at this time as you can increase one cup size or several. A few days after birth when milk transitions from colostrum to mature milk, breasts can engorge and grow even more. For several weeks, breasts will feel full between feedings and soft after feeding. Eventually they will feel soft all the time and start to shrink back to pre-pregnancy size. Some breasts will stay large and some will shrink back significantly. Sometimes one can reduce in size and the other stay large.

I usually recommend not purchasing a bunch of bras while pregnant. You don’t know what size you’ll end up being and may waste money on expensive bras you won’t wear. Bralettes, nursing tanks with built in shelf bras, or soft wireless bras that have a lot of stretch can be helpful while your body is constantly changing. Once you’re several months into nursing, breasts may stabilize in size until you completely wean. Now it’s time to be re-measured for the support your girls deserve.