Breastfeeding is a medical and Heath issue. It should be treated as such

Breastfeeding issues are medical problems. I wish health care providers would understand this. When a parent wants to breast/chestfeed, but is running into challenges, those challenges need to be taken seriously, just as if they were complaining about any other health or medical issue.

Feeding your baby from your body should not be painful. Our bodies are designed to feed our babies, so when there is pain there is always a reason. Pain tells us that something needs fixed. It may be as simple as the position and latch or as complex as a tongue tie. At no point should healthcare providers accept tissue damage as normal. If they are telling you it’s fine and part of the process, please get a second opinion.

When everything is going well, our bodies are designed to provide plenty of milk for our babies. If you are not making enough milk for your baby while seemingly doing all the right things, we should find the root (IGT? Wrong pump flange? Not pumping enough? Medications? Hemorrhage at birth?).

Baby unable to latch? Popping on and off? Babies are born to feed. All of their reflexes and instincts are designed to get them to latch and feed. If baby is struggling at the breast, there is always a reason. Rarely will we not find the root if we dig deep and long enough.

When there is pain, damage, low milk supply or a non-latching baby, interventions are often needed. These are medical interventions that should be overseen by an IBCLC who has lactation specific training to make sure the correct tool for the correct cause of the issue is being used. And getting the best, most accurate information for that individual family. If a family chooses not to breastfeed because of these issues, that is their choice and should be supported to the fullest. If your health care providers are not taking your concerns seriously, find another health care provider

Fluid dynamics

Milk is a liquid. And it obviously flows like a liquid. Have you ever sprayed your baby in the face from milk that flows too fast during let down? Have you ever been concerned with how fast or slow your milk seems to flow in any given feeding or pump session?

Did you know the breast is like a tree inside? With lots of lobes at the back of the breast that funnel down through milk ducts to fewer nipple pores at the front? The flow of your milk is impacted by multiple things. One of the biggest things to impact how your milk flows is your unique breast anatomy.

🌳Everyone has a different number of milk making lobes, also known as alveoli. These lobes are connected to your blood steam, because milk is made from nutrients in your blood. Oxytocin triggers contractions of the lobes to release milk down your milk ducts

🌴The length and diameter of the ducts play a role in how quickly milk goes from where it is made to the baby.

🌲The viscosity, or thickness, of your milk can slow down or speed up milk flow. This viscosity can change from feeding to feeding depending on many factors. Many will take sunflower lethicin to thin their milk (keep the fat from sticking) to help speed up milk flow and reduce the risk of the milk fat sticking in the ducts and causing plugged ducts

🎄How dense or elastic your breast tissue is contributes to flow rate.

Your body and your anatomy is unique. Milk production or how milk is made in the breast is not the same for every person. If you’re struggling with making or releasing milk to your baby, schedule a consultation to figure out why and develop an individualized plan that works for your anatomy.

FIL: How breast milk is actually made

Milk production is controlled by how often milk is being emptied from the breast. An empty breast makes milk faster than a full breast. The more you empty, the more you make. This is because milk production is being controlled in the breast by a substance called the feedback inhibitor of lactation, or FIL (a polypeptide), which is present in the milk itself. Sometimes one breast stops making milk while the other breast continues (in some cases of slacker boob), for example if a baby nurses on only one side. This is because of the local control of milk production independently within each breast. If milk is not removed, the FIL builds up in the milk and stops the cells from making any more milk. This protects the breast from things like clogged ducts and mastitis. If breast milk is emptied from the breast, the inhibitor is also removed, and making milk resumes. Milk removal can be done by the baby or a pump
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The amount of milk that is produced is determined by the amount of FIL in the milk, which is driven by how much and how often the baby or a pump removes milk from the breast. Emptier breasts have less FIL and make milk faster. Full breasts have more FIL and make milk slower. This mechanism is especially important for continuing to make milk after 11-14 weeks when hormones shift and milk making is completely determined by how much milk is being emptied from the breast.

Immune boosting power of breast milk

🍀Doctors have long known that infants who are breast-fed get fewer infections because babies gain extra protection from antibodies and live immune cells found in human milk.
🍀Research shows every tsp of breastmilk has 3,000,000 germ killing cells in it. Even one teaspoon a day is giving baby some immune protection!
🍀Once ingested, live molecules and cells in the milk help to prevent microorganisms from penetrating the baby’s body tissues.
🍀Some of the immune molecules bind to viruses/bacteria/germs in the digestive tract, preventing them from getting into the rest of the body.
🍀Certain immune cells in human milk attack viruses and bacteria directly. Another set produces chemicals that stimulate baby’s own immune response.
🍀The most impressive amount of immune cells are found in colostrum.
🍀Several studies suggest human milk may induce an infant’s immune system to mature more quickly than with formula
🍀Some of the immune factors in breastmilk increase in concentration as baby gets older and nurses less, so older babies continue to benefit from breast milk
🍀Remember, freezing kills some of the live immune factors of breastmilk even though the nutrition (vitamins, protein, fat) is maintained. Offer fresh breast milk whenever possible.
🍀Research is showing that if you’ve had COVID or the COVID vaccine, your milk will pass antibodies to your baby to protect them from getting it!

Weaning schedule

There are many ways to wean and you get to decide how you’d like to wean for your family. I recently had a client who wanted to gradually wean her 6 month old and needed a structured plan to help navigate the process. This is by no means meant to be for everyone, but I thought some one else may find it helpful if it sounds similar to your pumping or feeding experience and you’re looking for some guidance. You can always reach out for a consultation and we can work on a plan that’s individualized to work for you!

Week one: Monday to Thursday:

6:30am – Breastfeed (about 15 mins)
7:00am – Pump 15 minutes
10:00am – Pump 15 minutes
1:00pm – Pump 15 minutes
4:00pm – Pump 15 minutes
6:30pm – Breastfeed (5-10 mins)
8:30pm – Pump 15 minutes

Week one Friday to Sunday:

6:30am – Breastfeed (about 15 mins)
7:00am – Pump 12 minutes
10:00am – Pump 12 minutes
1:00pm – Pump 12 minutes
4:00pm – Pump 12 minutes
6:30pm – Breastfeed (5-10 mins)
8:30pm – Pump 12 minutes

Week two Monday to Thursday

6:30am – Breastfeed (about 15 mins)
8:00am – Pump 10 minutes
11:00am – Pump 10 minutes
3:00pm – Pump 10 minutes
6:30pm – Breastfeed (5-10 mins)
9:00pm – Pump 10 minutes

Week two Friday to Sunday 6:30am – Breastfeed (about 15 mins)
9:00am – Pump 10 minutes
12:30pm – Pump 10 minutes
3:30pm – Pump 10 minutes
6:30pm – Breastfeed (5-10 mins)
9:00pm – Pump 10 minutes

Week three Monday to Thursday
6:30am – Breastfeed (about 15 mins)
9:00am – Pump 5 minutes
12:30pm – Pump 5 minutes
3:30pm – Pump 5 minutes
6:30pm – Breastfeed (5-10 mins)
9:00pm – Pump 5 minutes

Week three Friday to Sunday
6:30am – Breastfeed (about 15 mins)
10:00am – Pump 5 minutes
2:00pm – Pump 5 minutes
6:30pm – Breastfeed (5-10 mins)
9:00pm – Pump 5 minutes

Week four Monday to Thursday 6:30am – Breastfeed (about 15 mins)
10:00am – Pump only to relieve discomfort
3:00pm – Pump only to relieve discomfort
6:30pm – Breastfeed (5-10 mins)
9:00pm – Pump only to relieve discomfort

Week four Friday to Sunday. 6:30am – Breastfeed (about 15 mins)
11:00am – Pump only to relieve discomfort
Afternoon – Pump only to relieve discomfort
6:30pm – Breastfeed (5-10 mins)
9:00pm – Pump only to relieve discomfort

Week five
6:30am breastfeed if desired
Pump once or twice only to relieve comfort
6:30pm breastfeed if desired

Breast pump flange size

Having the right pump flange size can make all the difference in your pumping journey. Most pumps come standard with a 24mm and possibly a 27/28mm flange(s). Did you know I’ve only recommended the 28mm flange twice in the last 3 years? And the 24mm only maybe a dozen times out of hundreds of moms? The majority of the people I woke with need a 17, 19, or 21mm flange and often need a cushion to make it a half size. Too much areola in the tunnel can cause swelling that doesn’t let your milk empty efficiently, leading to plugged ducts and a drop in milk supply. (Ever pump but still feel like there’s milk in the breast? Most likely your flange is too big) Measuring your nipples can give you an idea of what size flange you’ll need. Use a ruler at the base of your nipple (not the areola!) and find the diameter. Add ~3mm and that’s a good place to start. Pumping should feel comfortable with no pain or rubbing of your nipples in the tunnel. It’s like trying to find the perfect shoe. It may take trying a few sizes to get the right fit, but trust me, it’s worth it!! Have you measured your nipples yet? Did you know there are still too many lactation consultants (especially in the hospital) who don’t know there are other sized flanges? There are lots of products (inserts, cushions, different shapes and sizes) to help make your pumping experience so much better.

So why wasn’t this considered when pump companies were making flanges? I read some where the original reason they made 24 and 28mm was for the size of baby’s mouth, not nipple size!

Do you nipples stretch a lot and swell into the tunnel? We call those elastic nipples. You may do really well with something like the Beaugen Mom Cushions which help hold the areola back. Or the Pumpin Pal flanges which have a different shape to help with the stretch.

What size flange do you use?

Oxytocin

Oxytocin is the hormone responsible for making milk eject or “let down” during feeding and pumping. Milk is constantly being made and collected in little sacs (alveoli) at the back of the breast. When the breast and nipple are stimulated during feeding, oxytocin makes the cells around the alveoli contract in what’s called the milk ejection reflex (MER). This makes the milk that is already in the breast flow for baby.

You can train yourself to have MER through your senses and feelings, such as when you touch, smell or see your baby, hear baby cry, or think lovingly about them. If you are in severe pain, anxious, or emotionally upset, the oxytocin reflex may become inhibited, and milk may suddenly stop flowing well. With support, and recognition, once you feel comfortable and baby continues to breastfeed, the milk will flow again.

Signs that the oxytocin reflex is active:

• Tingling sensation in the breast before or during a feed

• Milk starts to drop when you think of baby or hear crying

• Milk flowing from the other breast when baby is sucking

• Milk sprays from the breast if baby unlatches

• Slow deep sucks and swallowing by the baby, indicating milk is flowing

• Uterine cramping in the first week after delivery

• Thirst during a feed.

If one or more of these signs are present, the reflex is working. However, if they are not present, it does not mean that the reflex is not active. Not every one feels or is aware of these sensations.

Breastfeeding isn’t the only way to get a dose of oxytocin. If you can feel milk in your breasts but are having trouble letting the milk down, try this:

◦ Keep baby in skin to skin contact for 1-2 hours prior to feeding or pumping

◦ Do yoga. A small 2013 study found after 1 month of yoga, people had higher oxytocin levels

◦ Listen to music. Multiple studies have found that listening to music naturally boosts oxytocin. This can be especially helpful when pumping at work

◦ Meditate. This helps reduce stress which increases oxytocin

◦ Touch. Physical touch releases oxytocin. This can be from cuddling, hugging or touching another person you love or getting a massage

◦ Laugh! Laughter really is the best medicine

◦ Sex. This is a hard one depending on where you’re at in your postpartum journey, but orgasm is a key way to boost oxytocin

◦ Pet you pet! Animal touch can release oxytocin just like human touch can

◦ Oxytocin nasal spray. Struggling with severe anxiety and nothing else is working? A prescription for an oxytocin nasal spray can help trigger let downs

Friendly breastfeeding reminders

👉🏼Pumping is NEVER an indication of supply

👉🏼Chances are you will need a pump flange size that didn’t come with your pump (We don’t all wear a 36C, why would pump companies expect us all to have the same nipple size?)

👉🏼You can NEVER empty the breast. It constantly makes milk. It takes at least 40 days of no stimulation for the breast to stop making milk

👉🏼Nipple damage is not normal. It is always a sign of something: Shallow latch. Tongue tie. Wrong size flange.

👉🏼Breasts/chest are NOT supposed to stay engorged

👉🏼That full feeling between feedings goes away around 6-8 weeks

👉🏼Babies become efficient feeders, so a 3 month old may get a full feeding in 5 minutes even if they fed for 30 as a newborn

👉🏼Some times they’ll want one side. Sometimes they’ll want both. Sometimes they want both sides multiple times 🤷🏽‍♀️

👉🏼This is eating. We may want a snack, a buffet, a meal, a treat, dessert or a thirst quencher. Same goes at the breast

👉🏼Some leak, some don’t. Leaking is not an indication of supply. Leaking may slow or stop at any point and is NOT an indication that you’re losing supply

👉🏼Not everyone feels their let down. Many stop feeling their let down with time.

👉🏼The longer you go between feedings the higher the water content of your milk. The shorter you go between feeding the smaller the volume but the higher the fat concentration

👉🏼Every baby feeds differently

👉🏼Your body is amazing!!!!

👉🏼Trust your body. Trust your baby

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#breastfeeding #breastfeedingisbeautiful #breastfeedingtips #motherdaughter #motherhoodunplugged #lactationconsultant #lactationsupport

Oatmeal and breast milk

OATMEAL

Oatmeal is commonly recommended to breastfeeding parents as a breast milk booster. Many report pumping more milk on the days they have oatmeal for breakfast instead of something else. 

🥣Oatmeal is a good source of iron. Anemia/low iron levels can result in a decreased milk supply as breast milk is made from your blood. 

🥣Oatmeal is a comfort food. Comfort foods tend to encourage let-down which boosts milk supply.

🥣Many of the herbs known to increase milk supply also decrease cholesterol levels. Herbs that both increase milk and decrease cholesterol include fenugreek and alfalfa, which are found in many lactation products. Oat bran, found in oatmeal, can help lower cholesterol

But you don’t HAVE to eat oatmeal to make breast milk. I’ve known more than a few moms who are choking down oats even if they hate them. There are other things you can eat that are just as supportive. 

🥬Eating foods high in iron or being supplemented with iron can help you make more milk. Especially if you had a large blood loss at birth or tend to be anemic. High iron foods include beans (they won’t make your baby gassy), dark leafy greens, red meats, dried fruits like raisins and apricots. 

🥄Flax seed and chia seeds can work just as well as oats. They can be added to cookie recipes, used as an egg substitute in homemade breads, and are tasty and filling in smoothies. 

🥕Here’s another list of seemingly random foods that are actually known to boost milk supply: Garlic, carrots, barley, asparagus, brown rice, apricots, salmon, sweet potato, almonds, moringa, chickpeas, lentils, beets, tofu, watermelon, and grapefruit.

Herbs and supplements while breastfeeding

Herbs. Supplements. Boobie boosting bars and milk making teas. There’s a lot of products on the market now to help increase your milk supply. Vitamin C is great for preventing a cold, but too much can give you diarrhea. Iron is amazing for keeping you from going anemic and feeling weak, but too much makes you constipated. Fenugreek is known to help boost milk supply, but if you’re on thyroid medication, are hypoglycemic, or have a peanut allergy you shouldn’t take it. Every person is different in how they respond to herbs and even foods. I’m not opposed to lactation supportive products. But if you’re going to buy any of those products guaranteed to help you pump gallons of milk a day, here’s my best advice:
💡Do your research. Know what’s in it and any possible side effects
💊If you’re taking any prescription medications ask a pharmacist about drug/herb interactions.
💉Start with the smallest dose possible and gradually increase the amount you’re taking
🧪Don’t add in 10 different supplements at once. If you have a bad reaction you won’t know which one is from. Start with one at a time.
🩺Try them at home and first thing in the morning, on a weekday before you go back to work if possible. You wouldn’t want to have a bad reaction at work or when the doctors office or pharmacy are likely to be closed.
🧫We all can have different reactions and side effects to herbs and supplements. Some women find that taking fenugreek has the opposite effect and drops milk supply. Some women may notice an increase in gassiness in baby with certain herbs. If you notice any weird side effects, stop taking the supplement.
🤱🏽There is no replacement for frequently removing milk from the breast. The best way to make milk is to frequently feed your or pump your milk from your breasts
🔑If you’re struggling with low supply, schedule an appointment with an IBCLC to help get to the real root of the supply issue and form a plan to get back on track.
🗓If you take something for 3 days and don’t see a milk increase, most likely the herb isn’t effective for you. If you see a decrease within 3 days, stop taking it.

Some of my favorite places for herbs while breastfeeding:

https://mountainroseherbs.com The best place for raw herbs

https://wearerasa.com Amazing adaptogenic coffee alternatives

https://milksta.com The best taste ever. I love these products

https://www.motherlove.com Great herbal supplements specifically for lactation

https://www.legendairymilk.com Quality lactation supplements.