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.

 

Breast vs Bottle Feeding

- Julie Matheney

Did you know that babies use completely different muscles to feed from the breast than from a bottle? They use more of their tongue and jaw at the breast and more lips and cheeks on a bottle. Breastfeeding is also a more complex feeding process where a vacuum is made in baby’s mouth from the tongue forming a seal against the roof of their mouth. Babies don’t need to create as strong a vacuum in the mouth to still bottle feee, as they can compress the nipple and milk still flows.

Bottle feeding is not a developmental skill. There is no age when a baby needs to take a bottle if breastfeeding is going well. Historically, babies went from breast to cup. Bottles are a relatively new invention with the formation of rubber nipples. It is developmentally appropriate to start open cup drinking by 6 months. That means if you’ve been exclusively breastfeeding and need to go back to work or your baby is starting table foods, you can skip the bottle and go straight for a cup. Starting with a small cup, like a medicine cup, shot glass, or @ezpzfun Tiny Cup are great ways to start. Your baby has been watching you drink from a cup for months and understands how it works. Straw cups are also great at this age and many babies will get the hang of it in a few tries. Using a straw cup like the Honey Bear has the advantage of you being able to squeeze the milk up to baby to teach baby how to get the milk by sucking.

When did you start cup feeding? Want to learn more? I have many videos of cup and straw feeding on my YouTube channel. Link in bio!

Want to learn more? Consider taking my parent class, LATCHED

 

#cupfeeding #cupfeedingbaby #honeybear #honeybearstrawcup #6monthsold #6monthsbaby #6monthsoldbaby #breastfeeding

Weaning from a nipple shield

- Julie Matheney

Nipple shields are a commonly used tool in the lactation world. They may help a premature baby latch to give the baby time to mature and learn how to suck, prevent nipple damage from a tied baby, or be used when a nipple is flat/inverted (either from normal anatomical variations or because the breast is fluid overloaded from interventions during birth).  While there are many benefits to using a shield, are also risks, like the potential for decreased milk supply. Hopefully if you were given a shield, you were also given an exit strategy for weaning off of it. With any tool, make sure the reason you were given one has been addressed (giving a premature baby time to grow, doing oral motor exercises and a tie release, education that fluids during labor and delivery can temporarily make breast tissue swell and make nipples look shorter or flatter than they naturally are, etc). When you are ready to wean from one there are multiple strategies to help:

💡Start with the shield on and take it off after the first let down once baby is not as hungry/use it on the first side and not on the second side

💡Try without the shield once a day during daylight hours when baby is happy and not too hungry. Catching early hunger cues is imperative. If they’re crying, try a different time

💡Start in skin to skin. Taking a bath together can help. Try to be as relaxed as possible

💡Try to erect and evert your nipple. Use reverse pressure softening (RPS, see highlight reel), a pump or stimulate your nipples with your hands before attempting to latch

💡Help baby latch with laid back nursing, supporting the breast in a “C” or sandwich hold, or the flipple. Make sure baby’s chin and cheeks are physically touching the breast as much as possible

💡Hand express to get milk flowing to keep baby interested

💡Relax and be patient. Babies can feel your energy. The more you can see it as fun practice, the less pressure you’ll put on yourself and your baby

💡Try a different shield like the Lovi or Dr Brown’s which are thinner and give you more stimulation

Breastfeeding Rage

- Julie Matheney

Navigating the realm of breastfeeding grief is a poignant journey that many mothers undergo, a journey often unspoken. Whether faced with unexpected hurdles, feelings of inadequacy, or the necessity of early weaning, the emotional weight can be profound. The image of the envisioned breastfeeding experience might clash with reality, evoking a sense of loss. In these moments, seeking support becomes paramount. Opening up to friends, family, or professionals allows for a healing dialogue. It's crucial to validate these emotions, understanding that not every breastfeeding journey follows the expected path. Every mother's experience is unique, and the love and dedication as a parent remain the constant, irrespective of the breastfeeding narrative. Let's cultivate a compassionate space for sharing these experiences and supporting one another through the intricacies of breastfeeding grief. 💙🌸

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

Can you overfeed a breastfed baby?

- Julie Matheney
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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 much breast milk does a newborn need?

- Julie Matheney

For the first few months after delivery, when hormones are balanced and the breast is well stimulated, the breast makes lots of milk. Research shows at any given feeding, breastfed babies take 65-80% of the available milk in the breast. When feeding is well established, most babies eat until they are full, not until the breast is “emptied”. In fact, the breast is constantly making milk and can never truly be emptied. Your body knows a young baby is growing quickly and frequently cluster feeding, so your body has milk available all the time. This is why people can create a stash. They are pumping the extra milk that baby leaves behind.

Efficient and frequent milk removals helps to produce more milk quickly. The extent to which the breast is drained during a feed is what research has shown to drive milk production. The more often a breast has milk moved from it, the faster milk is made to replace that milk. The longer you go between feedings, the slower milk is eventually is made. Breastmilk fat/calorie content is also driven by a similar mechanism. The fuller the breast, the lower the fat content of the milk; the body thinks baby is dehydrated and focuses on hydration. The more often milk is moved, the higher the fat content of the milk; your body knows baby is in a growth spurt or needs higher fat to help sleep. If you go multiple days with fuller breasts where less milk is being moved, supply will drop to protect the breast from sitting milk which has a higher risk of inflammation that causes plugs and mastitis.

As baby ages, this extra milk goes away and your body makes what baby is routinely taking. Because your body AND your baby become more efficient. If you think baby isn’t moving milk well, and supply is suffering for it, it is important to address it as early as possible.

Research: https://publications.aap.org/pediatrics/article-abstract/117/3/e387/68590/Volume-and-Frequency-of-Breastfeedings-and-Fat?redirectedFrom=PDF

#breastfeeding #breastfeedingsupport  #lactationconsultant #lactation #milkproduction #pregnancy #postpartum