Category: Uncategorized

Birth control and dropping milk supply

- Julie Matheney

Any birth control with a hormone in it can drop your milk supply. Hormones in birth control pills prevent pregnancy by:

  • Stopping or reducing ovulation (the release of an egg from an ovary).
  • Thickening cervical mucus to keep sperm from entering the uterus.
  • Thinning the lining of the uterus so that a fertilized egg is less likely to attach. 

The Pill (estrogen and progestin) tricks your body to think is pregnant so it won’t ovulate. Estrogen based pills will drastically drop milk supply, just like pregnancy does, and should be avoided while breastfeeding unless your weaning. Hormonal IUDs (Mirena, etc), arm implants (Nexplanon, etc), and the mini pill (progestin only) are often recommended as the best form of BC while breastfeeding because most research says that they don’t impact milk supply. Many who use these methods don’t experience any supply drop. For some, though, any hormone based BC will drop milk supply, some times drastically. Every body is sensitive to different levels of hormones. If you have an IUD or arm implant placed and notice a drop in supply, the only way to increase supply again is to remove them. Increased pumping or herbal supplements will usually not be enough to increase supply again because you’re working against hormones. If you’re considering a hormonal based IUD and aren’t sure if your supply will drop, consider taking a few rounds of the mini pill (progestin only) which is the same hormone in the IUD and implant. If your supply drops, you only have to stop taking the pill and your supply will rebound much quicker. 

Benefits of skin to skin contact for newborns

- Julie Matheney

SKIN TO SKIN 

Babies are needy. The need to be on your body and all of their instincts and reflexes are designed to get them there. Their neurological system is immature at birth and still needs 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. And, remarkably, their pain is reduced when held skin to skin

😴 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 easily, and achieve what is called “Quiet Sleep”, a natural deep sleep for 60 minutes or more

💉Enhances Immune System:

Baby’s immune system is stimulated when placed skin to skin. Your mature immune system passes antibodies through your skin to baby. Being on your skin also increases baby’s skin hydration, which provides a protective barrier from harmful bacteria entering baby’s skin

⚖️Stimulates Digestion & Weight Gain:

Skin to skin contact reduces cortisol and somatostatin in babies, allowing for better absorption and digestion of nutrients, while decreasing gastrointestinal problems. With a reduction of these hormones, baby’s bodies preserve brown fat (the healthy fat babies are born with), helping to maintain birth weight and keep a warm body temperature. As a result, baby’s body does not have to burn its own fat stores to stay warm, resulting in better weight gain. After just one hour of skin to skin, the infant’s digestive system is restored to the right balance for optimal GI function

When I’m your body, baby’s body learns to self-regulate, resulting in a regular and stable heartbeat and breathing pattern

❤️ Synchronizes Heart Rate + Breathing:

Weaning blues: why do I feel so emotional from weaning baby from the breast?

- Julie Matheney

If postpartum depression weren’t enough, it’s also possible to be depressed and have mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of postpartum depression. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moody, sad or even angry. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely to experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away once hormones stabilize. Some will also feel relieved and happy once it’s over and they can move on into the next stage of parenting. And that’s OK, too!!

If you are weaning and experiencing mood swings, you’re not alone! Remember, it takes at LEAST a full 40 days for those with an established milk supply to no longer see milk when they hand express or stimulate the breast. Your milk making cells are going through a cellular death called involution where they literally change from milk making cells back into breast fat cells. Some find it takes 1-3 period cycles after weaning for their hormones to reset and feel “back to baseline” which coincides with when this process is complete. It will get better!!

Some times being aware that this is a hormone shift and not something in your head is enough to bring peace in the process. Find your coping mechanisms. Reflect on your journey. There are herbs and supplements that can help in the process (set up a consultation to discuss which ones are right for you as they are NOT one size fits all). And if needed, seek professional counseling. 

Pregnancy and breastfeeding

- Julie Matheney

If you’re still breastfeeding and become pregnant, your mature breastmilk will transition back to colostrum around the end of the first trimester in preparation for whenever the new baby is born. By 4 months gestation, the placenta is large enough to suppress most milk production. Your body will prioritize your fetus over your nursling in terms of milk and produce the appropriate milk for the more vulnerable child. Colostrum is a high protein, laxative milk to help newborns poop out meconium. It is saltier in taste and thicker in consistency. Many older babies don’t care if it tastes different, but some will and may wean themselves. The supply is not likely to be able to support an infant 10 months old and younger. But if the older infant (11+ months) or toddler is eating solids and drinking other liquids, those babies may not care if they are getting milk or “dry nursing” until the next baby comes. Some choose to supplement younger babies with donor milk or may transition to formula until the new baby arrives and then continue to tandem feed with their own breastmilk again. 

Pregnancy hormones can make breasts and nipples more sensitive and uncomfortable. And these sensations often will make one want to wean or experience a nursing aversion. Toddlers may still aggressively want to nurse and it’s ok to put boundaries on your nursing. 

The typical things recommended to increase supply (additional feeding/pumping, herbs and supplements, etc.) are not appropriate and are ineffective since the placenta will continue to increase in size. Hormones supported by the placenta are what impact milk production and there’s not much you can do to combat the hormone shift as it’s needed to support the pregnancy. 

Hunger cues for baby

- Julie Matheney

How do I know my baby is hunger and not just fussy, has a wet diaper, or is lonely and wants to be picked up? Babies have a limited communication repertoire when they are first born. Every cue can look the same. It does get better with time as you learn your baby and your baby grows and matures. In general, young babies go through stereotypical phases of hunger cues. Some times we can miss these cues when the baby is swaddled or in a crib or bassinet away from where we are. 

Early

  • Licking or smacking their lips
  • Opening and closing their mouth
  • Sucking on their lips, tongue, hands, fingers, or anything within reach
  • Time to get your breastfeeding pillow and grab a snack and some water!

Active

  • Rooting around and attempting to latch on anything nearby their mouth
  • Hitting you on the arm or chest repeatedly and/or grabbing at your clothing
  • Trying to get into a nursing position 
  • Fidgeting/squirming
  • Becoming fussy
  • Breathing fast: get ready for them to start crying!
  • This is the best time to latch!

Late

  • Crying
  • Moving their head frantically from side to side
  • You’ll need to calm the baby before attempting to latch!

Many newborns are very sleepy after birth and may actually need to eat more often than they exhibit hunger cues. Newborns should be offered the breast anytime they cue hunger, which can be between 1-3 hours since the beginning of the last feeding. Watch the baby and not the clock. Don’t make the baby “wait” until some mythical hour to be fed. Feed the baby when the baby is hungry. 

Hand sucking is not as reliable an indicator of hunger as baby ages. Starting at around 6-8 weeks, baby will begin to gain more control over their hands and will begin to explore their mouth and everything else in their environment with their hands. Babies also suck on their hands during teething. Symptoms of teething can sometimes occur weeks and even months before the first tooth erupts.

My baby is waking at night: Is this normal?

- Julie Matheney

There are many reasons why your baby would wake more often to feed at night. Regardless of what you find online or from well meaning family and friends, there is no specific, developmental weight or age when a child no longer needs to feed overnight. There is no scientific or medical standard or recommendations for when a baby no longer needs nutrition at night. Society also says babies shouldn’t need tended to at night time and that we should teach them, often from a ridiculously early age, not to need us at night. In reality, we are not in control and neither are our babies. We’re in a mutual relationship where we are learning what our babies need and when they need it. Reasons why babies wake to feed over night:

💡Growth spurts

💡Developmental leap

💡You were gone at work and they missed you or want breast milk straight from the breast

💡Teething

💡They were distracted during the day because the world is an amazing place to learn in and they’re making up for calories over night 

💡Sickness

💡They had a bad dream or are scared without you

💡Because they’re human

Per current research, 78% of babies wake up at least once a night and 60% of waking to feed until 1 year (Brown, 2015). That’s NORMAL. Between 12-18 months your toddler may still occasionally wake to feed. Or they may just need an adult to help them transition back to sleep. It’s not until 24 months that the human baby has matured enough to not consistently need an adult to help them transition back to sleep over night and should be getting all of their calories during day time hours. 

Physiological Flexion

- Julie Matheney

We know that active muscle tone begins to develop at around 36 weeks gestation. Between 36-40 weeks, the baby is curled up in a smaller and smaller space, developing stronger muscles by pushing up against the ever constructing walls of the uterus. Babies born at gestational term have a tightness to their bodies called physiological flexion from being in this position. Physiological flexion provides some passive stability for the newborn baby to use as their learning to move around a world that is impacted by gravity. Because of this flexion, and being in that tight space, many babies come out with tension in their bodies and sometimes asymmetries in how their body moves or looks. Many also will have a head turn preference to one side based on how they sat inside your body. How a baby was born, how long the pushing stage was, and interventions like forceps and vacuums can also cause tension in baby’s body which can in turn impact breastfeeding. This can make the head, neck and shoulders or jaws tight which in turn can make for a chompy/clamping or shallow latch. Or for a baby that’s not comfortable feeding on one side or in certain positions. 

I recommend a lot of oral motor and body exercises for the babies I see in my practice to help stretch them out and release that tension after birth. Whenever exercises are being done, it’s best to do them on a calm, happy baby. If your baby starts calm and becomes agitated or doesn’t tolerate the exercise, stop!! You’re either doing the stretches too hard or the baby isn’t ready for that exercise. Something else is going on that needs addressed first. We don’t want to cause an aversion or unnecessary stress. Don’t just push through. This is part of respecting your baby’s cues. If a provider is having you do exercises and your baby is always crying or fussy, speak with your provider about how to modify the activity to match baby’s skill level. 

Exercise and breastfeeding

- Julie Matheney

Yes, you can work out while breastfeeding and still maintain a good milk supply!! While exercise in and of itself won’t impact milk supply, going too far into calorie deficit is what can drop milk supply for some. Nurse baby or pump just before exercising to avoid the uncomfortable feeling of engorgement or fullness during your workout. Some find wearing a tight sports bra can put pressure on the breast and increase the risk of plugged ducts for some. If that’s the case for you, just make sure to shake your breasts and do a little lymphatic drainage massage immediately post work out when you take your bra off. Post-exercise, lactic acid levels in your breast milk may temporarily change. Studies have shown that lactic acid levels in breast milk are significantly elevated for up to 90 minutes after MAXIMAL or exhaustive exercise, which may change the flavor of milk (but not the nutrients). BUT research has not shown a noticeable increase in lactic acid buildup after moderate exercise (50% & 75% intensity). Most studies have found no difference in acceptance of the breast, even after maximum intensity exercise.

Struggling to make it to the gym? There is also a lot of pressure on “bouncing back” after having a baby. Take your time and don’t look at other peoples journeys. It took you 9 months to grow the baby and it can take time to feel like your new normal and get into a workout routine. In the beginning, especially when recovering from birth and caring for baby, you may have less time and stamina for working out. You’re not alone. Start with a shorter or gentler exercise and add duration/difficulty over time. Prioritize your overall well-being — including your mental health — over a societal expectation to look or be something that may not even be realistic. And remember: breastfeeding is exercise. You burn about 20 calories for every ounce of breast milk you express (either from feeding or pumping). That adds up to an average of 500 extra burned calories a day, which is equivalent to:

1 hour of rock climbing 🧗‍♂️

1 hour pedaling a bike 🚴🏻 at 13-14mph  

2 hours of water aerobics 🏊🏼‍♀️

1 hour of rowing 🚣‍♀️ at a moderate pace

30 minutes of stair climbing 🧗‍♀️

50 minutes of jumping rope 👟

1 hour of steady lap swimming 🏊🏼‍♀️

45 minutes of hiking 🥾

30 minutes of 🥋 martial arts

30 minutes of cross country ⛷ skiing

1 hour of down hill ⛷ skiing

Pump flange fit: I feel like there’s still milk in my breast after pumping

- Julie Matheney

Flanges are the horn shaped part that actually touch the breast. 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. They can’t send every flange size they make as that would be expensive and create too much waste. But they don’t always make it clear that the flanges that come with the pump are not one size fits all. And in my practice I hardly EVER use the 24 or bigger flanges unless we’re using a silicone insert. For almost all of my families we’re sizing down. Some times significantly smaller. 

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. 

Breastfeeding and exercise

- Julie Matheney

Yes, you can work out while breastfeeding and still maintain a good milk supply!! While exercise in and of itself won’t impact milk supply, going too far into calorie deficit is what can drop milk supply for some. Nurse baby or pump just before exercising to avoid the uncomfortable feeling of engorgement or fullness during your workout. Some find wearing a tight sports bra can put pressure on the breast and increase the risk of plugged ducts for some. If that’s the case for you, just make sure to shake your breasts and do a little lymphatic drainage massage immediately post work out when you take your bra off. Post-exercise, lactic acid levels in your breast milk may temporarily change. Studies have shown that lactic acid levels in breast milk are significantly elevated for up to 90 minutes after MAXIMAL or exhaustive exercise, which may change the flavor of milk (but not the nutrients). BUT research has not shown a noticeable increase in lactic acid buildup after moderate exercise (50% & 75% intensity). Most studies have found no difference in acceptance of the breast, even after maximum intensity exercise.

Struggling to make it to the gym? There is also a lot of pressure on “bouncing back” after having a baby. Take your time and don’t look at other peoples journeys. It took you 9 months to grow the baby and it can take time to feel like your new normal and get into a workout routine. In the beginning, especially when recovering from birth and caring for baby, you may have less time and stamina for working out. You’re not alone. Start with a shorter or gentler exercise and add duration/difficulty over time. Prioritize your overall well-being — including your mental health — over a societal expectation to look or be something that may not even be realistic. And remember: breastfeeding is exercise. You burn about 20 calories for every ounce of breast milk you express (either from feeding or pumping). That adds up to an average of 500 extra burned calories a day, which is equivalent to:

1 hour of rock climbing

1 hour pedaling a bike at 13-14mph 

2 hours of water aerobics

1 hour of rowing at a moderate pace

30 minutes of stair climbing

50 minutes of jumping rope

1 hour of steady lap swimming 

45 minutes of hiking

30 minutes of martial arts

30 minutes of cross country skiing

1 hour of down hill skiing