Does breast shape impact making milk?

We come in all different shapes and sizes, and so do our breasts/chests. They can be large, petite, round, tubular, wide, narrow, symmetrical, uneven, teardrop shaped, or droopy. All of these types of breasts/chest are normal.

The size of your breasts/chest is based upon the amount of fatty tissue in it. Those with smaller breasts have less fatty tissue, and those with larger breasts have more fatty tissue. The fatty tissue doesn’t make breast milk. Glandular tissue inside the fatty tissue produces the breast milk.

Unlike fat, the amount of milk-making tissue in your breasts is not necessarily related to the size of your breasts. People with all different breast sizes are fully capable of producing a healthy supply of breast milk for their babies.

Smaller breasts does not necessarily mean smaller milk supply. As long as the small size is not related to hypoplastic breasts (not enough glandular tissue), there shouldn’t be an issue. While you may have to breastfeed more often due to the amount of breast milk that your breasts can hold, you can still successfully produce enough milk.

Breastfeeding with large breasts has its own unique challenges, usually related to position and how to hold or support the breast. Side lying or rolling a towel to put underneath the breast to lift it can be very helpful. Some worry that their breasts will block baby’s nose. Pulling baby in the opposite direction of the breast and compressing the breast from the back can help pop baby’s nose up off the breast. If your baby’s nose gets blocked while nursing, they will open their mouth and let go of the breast so they can breathe.

If you were told your breasts were too big or too small to breastfeed, I am so sorry. Your body is perfect just the way it is.

If you’re concerned that you’re not producing enough milk, pay attention to your baby’s wet diapers and bowel movements. Generally, small infrequent bowel movements or less than six wet diapers a day, are cause for concern. Contact a lactation consultant (🙋🏽‍♀️)right away.

Why does my breast milk supply drop during my period?

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. As supply dips, the milk flow slows. Research shows that the composition of breast milk changes around ovulation (mid-cycle). The levels of sodium and chloride in the milk go up while lactose (milk sugar) and potassium go down. So, the breast milk becomes saltier and less sweet during this time. 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.

Also around the time of ovulation and just before the start of your period, estrogen and progesterone levels change which can affect your breasts and your breast milk. When estrogen and progesterone levels go up, it can make your breasts feel full and tender.

Higher estrogen levels can also interfere with milk production. Studies also show that calcium levels in the blood go down after ovulation. The lower level of calcium may also contribute to the drop in the milk supply. Lower levels of calcium may also cause your nipples to feel sore, making breastfeeding during your period uncomfortable or sometimes painful.

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.

Having your period start again may not have any effect on your baby or your milk supply. Some babies continue to breastfeed well. Others will not like the taste of the breast milk or the drop in the amount of breast milk that can happen when your period returns. Your baby may:

  • Become fussier than normal
  • Want to breastfeed more due to the lower milk supply
  • Breastfeed less because there is less breast milk and it tastes different
  • Nursing strike

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.

Word to the wise: You can release an egg from your ovary (ovulate) before your period returns. If you’re involved in an intimate relationship, and you’re not using birth control, you can get pregnant again without ever getting your first period even while you’re breastfeeding. If you notice a very drastic drop in milk supply, consider taking a pregnancy test.

Maternal vaccines and breastfeeding

Did you know babies routinely get antibodies to anything you’ve been vaccinate against? Babies get temporary disease protection from you in this way. When you are vaccinated, your body has an immune response that makes antibodies to what you were vaccinated against. Antibodies are then secreted in breast milk to your baby. The type and quantity of these antibodies, and whether they provide any protection for baby after they are swallowed, are dependent on the vaccine received and maternal factors that influence immune system function such as genes, age and health.

Antibodies in breast milk have not been shown to reduce baby’s response to their own immunizations. However, some studies suggest that breast milk may improve baby’s immune response to some of the vaccines they receive.

If you do decide to be vaccinated while breastfeeding, there is no need to pump and dump your milk. Or to stop breastfeeding for any amount of time. When considering the vaccine, or any medication, most want to know whether a dangerous amount of a substance will be filtered into our milk and cause harm to our baby. For most drugs, so little gets to the baby that there’s really very little theoretical risk. Even if a drug or vaccine does end up in breastmilk, anything that goes through breastmilk also then has to go through baby’s gut before reaching baby’s bloodstream. The mRNA molecules in the Pfizer or Moderna vaccines, if they made it into your milk, would have to survive baby’s stomach acid first.

While breastfeeding, it is highly unlikely that an intact lipid from the vaccine would enter your blood stream and be passed directly into your milk. If it does, it is even less likely that either the intact nanoparticle or mRNA could be transferred into your milk. In the unlikely event that mRNA is present in your milk, it would first go through baby’s digestive system and would be unlikely to have any biological effects. The vaccine is supposed to trigger an immune response in your body. It helps your body recognize the virus when you’re exposed and fights the virus early, reducing the severity and length of illness. Once your immune system recognizes the SARS-CoV-2, the virus that causes Covid-19, antibodies are made to protect you and those antibodies may pass into the breastmilk. Researchers have already found Covid antibodies in the breastmilk of previously infected women, though they don’t know yet how much protection these antibodies give babies.

Choosing to be vaccinated is a personal risk/benefit decision to be made between you and your health care providers. If you do chose to be vaccinated with the COVID vaccines, there is no need to pump and dump for concerns of your milk harming your baby.

The Second Night

Second Night Syndrome : What absolutely every parent should be warned about in pregnancy.

Second night syndrome. I hate the word syndrome. It implies something is wrong. For nine months your baby has been in your belly. Heard your voice. Felt your body move. Listened to the rush of your blood flow past and heard the gurgle of food digesting. Their existence controlled by the cycles of your body. Then the intensity of labor and delivery propels them into a new world that sounds, smells, and moves differently. The sheer exertion of being born often makes babies as tired as their mothers. It is typical for babies to have a deep recovery sleep about 2 hours after birth (after their 1st breastfeed).

On the second night, however, most babies will want to frequently nurse. This helps with two transitions: meconium to soft, seedy yellow poops and colostrum to mature milk. This cluster feeding catches many parents by surprise and leaves them wondering if baby is starving. Unless baby is not latched well or efficiently feeding, this is normal and the cluster feeding will help transition your milk.

Many babies, though, don’t want to be put down during this process. Each time you put them on the breast they nurses for a little bit, go back to sleep and then cry when placed in the crib. A lot of moms are convinced it is because their milk isn’t “in” yet, and baby is starving. It isn’t that, baby’s awareness that the most comforting place is at the breast. It’s the closest to “home”. This is pretty universal among babies. When baby drifts off to sleep at the breast after a good feed, break the suction and take your nipple gently out of their mouth.

This is also protective of SIDS. You’re exhausted from labor and delivery and just want to sleep. But night time is when newborns are most vulnerable to respiratory complications and SIDS. By waking you frequently at night, you are waking frequently to check on the well being of your baby when they’re at their greatest risk of infant death. Waking regularly at night for the first few months to feed also helps babies from getting into too deep of a sleep state which can cause them to stop breathing. Instead of seeing the loss of sleep as a negative for you, consider the positive reason it has for baby.

Don’t try to burp baby, just snuggle baby until they fall into a deep sleep where they won’t be disturbed by being moved. Babies go into a light sleep state (REM) first, and then cycle in and out of REM and deep sleep about every ½ hour or so. If they start to root and act as though they want to go back to breast, that’s fine… this is their way of comforting. During deep sleep, baby’s breathing is very quiet and regular, and there is no movement beneath the eyelids. That is the time to put them down.

Second night syndrome. As described above, when all is going well it is normal for baby’s to cluster feed on the second night to help milk transition and poop out meconium. Some babies do not efficiently feed, though, and intervention may be necessary.

🩺Medical interventions and pain relief during labor and delivery, maternal health complications like PCOS, uncontrolled diabetes or hypothyroidism, or large blood loss during delivery may delay the transition of your milk.

🧸If your baby not latched well, has a tongue tie, or hasn’t figured out how to coordinate sucking to actually transfer milk from the breast, intervention may also be necessary.

🖐🏽The first line of defense is hand expressing your milk frequently. Hands are better at expressing colostrum than a pump, although a pump is a great way to stimulate milk to be made.

🥄Dripping your milk into baby’s mouth from a spoon or small syringe can help jump start the feeding process.

❓If you have any doubt about either your milk supply or your baby’s ability to breastfeed well, reach out to a qualified IBCLC ASAP to get to the root issue and get you back on track.

♥️There is no shame in supplementing your baby if needed during this time of learning. Remember, you can always use your milk first by using your hands or a pump if baby hasn’t figured it out yet.

Do I need to night wean because of cavities?

Were you told by your dentist to night wean your breastfed baby for concerns of it causing cavities? Extensive research has proven that there is no link between breastfeeding (nighttime or otherwise) and cavities. Breastfed babies can get cavities, though, so good dental hygiene is still needed.

Over three dozen studies have proven that cavities found in toddlers and young children (also called caries) were not caused by nursing – breastmilk is not cariogenic – but by an infectious disease classified as Early Childhood Caries (ECC). Furthermore, according to the National Institute of Dental and Craniofacial Research (NIDCR), breastfed children are less likely to develop ECC than children who are bottle-fed, and population-based studies do not support a link between prolonged breast­feeding and ECC.

According to La Leche League International (LLLI), “Breast­feeding is typically assumed to be a cause of dental caries because no distinctions are made between the different compositions of human milk and infant formula or cow’s milk, and between the different mechanisms of nursing at the breast [with the nipple at the back of the mouth, not allowing for breastmilk to pool around the teeth] and sucking on a bottle with an artificial teat. We have only to consider the overwhelming majority of breastfed toddlers with healthy teeth to know that there must be other factors involved.”

The Centers for Disease Control (CDC) also stopped using the terms “bottle-mouth” and “nursing caries” in 1994, thereby acknowledging early childhood caries as an infectious disease not caused by breast- or bottle-feeding. Most current studies now focus on the true causes of cavities in children, contributing factors, and prevention or cures.

Early Childhood Caries (ECC) appears on teeth as white spots, plaque deposits, or brown decay and can lead to teeth chipping or breaking in children under five. They are formed by bacteria sitting on the teeth which feed off of the sugars found in formula, juice, milk, and food. These and other factors, such as the frequency of feedings, oral hygiene, medications, other medical and dental conditions, determine the risk of your child developing a cavity. Once the pattern of decay begins, though, it can be extensive.

The CDC and the dental and medical communities consider ECC to be the most prevalent infectious disease of American children (5-8 times more common than asthma). Approximately 8.4 percent of all children will develop at least one decayed tooth by age two, and 40.4 percent by age five. Of these cases, 47 percent of children between the ages of two and nine never receive treatment. According to the CDC, “Untreated decay in children can result in chronic pain and early tooth loss … failure to thrive, inability to concentrate at or absence from school, reduced self-esteem, and psychosocial problems.”

While researchers have recognized S. mutans as the primary bacteria responsible for ECC, there are other surprising risk factors which make children more susceptible to cavities than others. Significantly high correlations have been found between ECC and pregnancy complications, traumatic birth, and cesarean sections. Other risk factors on the maternal side which increase the risk of ECC include maternal diabetes, kidney disease, and viral or bacterial infection. Babies born prematurely, with Rh incompatibility, allergies, gastroenteritis, malnutrition, infectious diseases, and chronic diarrhea are also at increased risk of cavities. Diets high in sugar AND/OR salt (such as French fries and chips), iron deficiency, pacifier sucking, and prenatal exposure to lead are also ECC risk factors.

Along with these risk factors, what can cause cavities are nighttime bottles and not brushing teeth before bed once baby has teeth, and especially if they are also eating solid foods. Bottles allow liquids to pool in baby’s mouth and sit on baby’s teeth for long periods of time. Breastmilk doesn’t pool in the same way because milk only flows when baby is actively sucking. When baby is latched appropriately to actually express breastmilk, it enters the baby’s mouth behind the teeth. If the baby is actively sucking then he is also swallowing, so breast milk doesn’t sit in baby’s mouth like it can with bottles. Sugars from table foods can sit on the teeth and bacteria in saliva uses these sugars to produce acid, which in turn causes tooth decay. Actively brushing baby’s teeth twice a day helps reduce these sugars from sitting on the teeth.

So no need to night wean for cavities… but if you need the sleep I completely understand.

When can you take your child to the dentist for the first time? As soon as they have teeth! This is Peachy’s first cleaning at 19 months. We went a little later than when I took her sister for the first time, but #COVID. I highly recommend finding a pediatric dentist who have staff that are highly trained with working on tiny tots. It will make the experience so much better. Having movies on the ceiling didn’t hurt 😉

If Goldilocks Needed a Breast Pump

IF GOLDILOCKS PUMPED

What pump do you have? What size flange are you using? The answer can make a huge difference in pumping success.

Not all pumps are created equal. Prior to the ACA, there were few pump choices. Once laws said people needed to be provided with a breast pump, and insurance would fit the bill, lots of companies flooded the market with pumps. Not all of them are good, and some will even sabotage your supply. You want a pump with a good motor in it that has lots of variability in the cycle (how fast or slow it pumps) and suction (how strong it sucks).

You also need to be mindful of the flange you’re pumping on. Most companies will send a standard 24mm flange. Sometimes they’ll send a larger size as well. In reality nipples, and thus flanges, are not one size fits all. And in my practice I hardly EVER use the 24 or bigger flanges. For almost all of my families we’re sizing down. Some times significantly smaller.

Flanges are the horn shaped part that actually touch the breast. The fit of the flange can make or break your pumping experience. Too small and friction can cause pain and even damage (and pain makes it difficult for milk to let down). Too large and the breast may not be stimulated well, which inhibits your let down to have milk flow. When too much areola is pulled into the flange, the tissue swells around the nipple pores and can prevent milk from efficiently emptying from the breast, resulting in plugged ducts, pain, tissue breakdown, and eventually a reduced milk supply. Using too large of a flange from the beginning may even prevent you from bringing in a full milk supply. Do you ever pump for 20+ minutes and still feel like there’s milk in there? Most likely too large of a flange. The stimulation from the pump is triggering you to make more milk, but the size of the flange is preventing you from emptying that milk efficiently. Poor flange fit can also impact the suction of your pump and how well it functions with your body. If you have the suction all the way to the highest level and aren’t emptying well, you flange is too big.

Flange fit tips:

Some of the flanges I tried

🗝Flange fit isn’t based on your breast or areola size, it is JUST the size of the nipple and how it changes with suction. Some nipples are dense and don’t stretch much. Some are super elastic and swell a lot. How your nipple responds to suction can make a difference in which flange you select and if other products are needed to happy pump

🗝Proper fit isn’t as simple as measuring your nipple, but it’s a start. See a trained IBCLC to help if you haven’t found the right fit or are struggling with poor output, pain/damage, or plugged ducts

🗝A small amount of space around your nipple in the flange tunnel is good. There should be no space around the areola or in the larger bell part of the flange. If your breast tissue recoils back into the horn part of the flange with every cycle, the flange is too large. If the tissue is white where the tunnel meets the horn, the flange is too small

🗝Pain or blanching means it’s the wrong size

🗝Nipples rubbing against the sides of the flange tunnel mean fit needs to be improved and there is a risk of pain and damage

🗝There should only be a small amount of areola pulled in the flange tunnel space. The bell or horn part will have most of the areola held back so it doesn’t get pulled into the tunnel

🗝The nipple tip shouldn’t hit the back of the flange. This means you have an elastic nipple. Sizing up isn’t necessarily the right answer. Using a pump insert, cushion like @beaugenmom or @pumpinpalofficial may be a better solution

🗝Evaluate as you pump. You can changing flange size mid-pump to improve comfort if you’re between sizes. You may also need to change the flange size the longer you pump. Our nipples can become more elastic and larger or smaller with time.

🗝Every nipple is unique and each side may use a different size (or shape/brand!). There are all kinds of flange sizes, inserts, and cushions to improve the pump experience

Why can’t I put my baby down to sleep?

SLEEP IN THE FOURTH TRIMESTER

I was going back through pictures when peach was a tiny baby. I have so many pictures of her sleeping on me. Babies don’t like to be put down, especially in the first 3-4 months. All their instincts and reflexes are designed to get them on a body. Their neurological system is immature at birth and still needs time to develop. Being on your body:

🧠 Accelerates Brain Development: Holding baby on your body increases the development of essential neural pathways, which accelerates brain maturation

🧘🏽‍♀️ Calms, Soothes & Reduces Stress: Having your baby on your body soothes baby so much that babies’ cortisol levels (stress hormone) are measurably lowered after only 20 minutes of being held skin to skin. Babies who are held cry less

🛌 Improves Quality of Sleep: Development of mature brain function in infants depends on the quality of their sleep cycling. During skin to skin, most infants fall asleep easier and achieve “Quiet Sleep” for longer

⚖️Stimulates Digestion & Weight Gain: Reduces cortisol and somatostatin in babies, allowing for better absorption and digestion of nutrients. With a reduction of these hormones, baby’s bodies preserve brown fat (the healthy fat baby was born with), helping to maintain birth weight and maintain body temperature. As a result, baby’s body does not have to burn its own fat stores to stay warm, leading to in better weight gain

💪🏻 Enhances Immune System: Your mature immune system passes antibodies through your skin to baby. Being on your skin also increases baby’s skin hydration

❤️Synchronizes Heart Rate + Breathing: You are a pace maker and a respirator. Your body sets the pace for baby’s body

🔑Promotes Psychological Well-Being: As our babies touch our skin, oxytocin levels rise and stress hormones fall, causing us adults to relax

🥛Milk production: Placing baby in skin to skin on your body for 1 hour a day will show an immediate increase in milk supply

🔥Regulation of Body Temperature: Woman’s breast tissue regulates a baby’s temperature, and can either cool OR heat, a man’s breast tissue only heats baby. Female is thermostat and male is radiator

How often should I breastfeed or pump?

BREAST STORAGE CAPACITY

The size of your breast has nothing to do with the amount of milk you will make. The size of your breast is determined by the amount of fatty tissue in the breast. The amount of milk you will make is determined by the amount of glandular tissue in the breast that makes milk. This glandular tissue starts growing during puberty. It increases during pregnancy and is part of what accounts for the increase in breast size during pregnancy. Everyone’s storage capacity is different.. just like every breast size is different. However breast size does NOT equal breast storage.

Small capacity: Approx 2-3 ounces per feeding/pump. Baby may need frequent feedings: 10-12 per day. Baby usually takes both breasts and may want each breast twice. Parent feels uncomfortable quickly between feedings and sees a supply drop with more than 3-4 hours between feedings

Medium capacity: Approx 3-4 oz per feeding/pump. Baby may feed 8+ times per day. Baby may take one breast or both breasts each feeding. Parent feels uncomfortable and see a supply drop with more than 4-5 hours between feedings

Large capacity: Approx 4-6 oz per feeding/pump. Baby may feed 6+ times per day. Baby may only take one breast per feeding. Parent may go up to 6 hours without seeing a drop in supply

XLarge capacity: 8+ oz per feeding/pump. Baby may feed 6+ times per day. Baby may only take one breast and parent may still feel full in that breast. Some babies may be gassy from higher foremilk intake as they may not drain the breast fully. Parent may go 6+ hours without seeing a supply drop. Parent may still feel uncomfortable between feedings depending on how quickly the milk fills the breast

All capacities have the same ability to feed baby well as long as the breast is routinely being emptied.

Do I need a breast milk stash?

NO STASH NEEDED

If breastfeeding is going well and you’re planning on being home with your baby or only gone for a few hours at a time there is no need to have a huge freezer stash. Having milk in the freezer is a nice security, especially is your have to work or will be away from your baby. But if you’re always with your baby or are only gone for a short while, there is no need to have a stash.

Having the right stash for your family means having enough stashed for when you’re away from your baby. If you’re gone for one feeding, you only need one feeding worth of milk. If you’re gone 2-3 feedings, you need 2-3 feedings worth of milk. If your baby is being bottle feeding while you’re away, you would pump while you’re gone to tell your body the milk is needed. That milk then becomes the stash for the next time that you’re gone.

If you want to have a big stash, great!!! You can absolutely have that as an option. Just don’t feel pressured from other people’s journeys on social media to have something you may not need or use. I’ve had several moms who spent countless hours pumping and stashing only to have to donate or throw out the milk stash because they never used it and it was going to expire. I’ve also had several moms who thought you had to have a stash and were relieved to know they didn’t! Do what is best for you and your baby and not based off of anyone else.

You’ve got this. Trust your body. Trust your baby.

Can I breastfeed while sick with COVID?

Breast milk for COVID+ mothers contains protective antibodies and no live virus.

There are multiple studies being conducted on breastfeeding mothers who are COVID+. What happens to their milk? A recent multi-institutional research team led by University of Idaho found that breastfeeding women who have COVID-19 transfer milk-borne antibodies to their babies without passing along the virus.

It was a small study where researchers analyzed 37 milk samples submitted by 18 women diagnosed with COVID-19.

🦠None of the milk samples were found to contain the virus

🦠2/3 of the samples did contain two antibodies specific to the virus.

🦠The results indicate that it is safe for moms to continue to breastfeed during a COVID-19 infection with proper precautions.

If you’re actively sick with COVID and still breastfeeding:

🧼 Wash your hands before feeding your baby or pumping

😷 Wear a mask while feeding to prevent coughing directly on your baby

💧 Drink plenty of water

😴 Rest and sleep to let your body heal

💊 Taking Vitamin C, D and zinc have been found to be very beneficial