Category: Uncategorized

Post Release Tongue Tie Stretches

- Julie Matheney

After a tongue-tie release, the body naturally tries to heal by closing the wound. The problem? If the tissue heals incorrectly, it can “reattach”, leading to restricted movement again. Stretches help:
✔️ Keep the wound open long enough for it to heal with full mobility.
✔️ Prevent scar tissue from forming too tightly.
✔️ Encourage proper tongue function for feeding, swallowing, and speech development.
Without stretches, there’s a risk that the frenulum will regrow to short or tight, making the procedure less effective.

There’s no universal standard, but most providers follow these general recommendations:

Start within a few hours post-procedure – many providers will have you wait a few hours, but start stretches same day

Frequency: Most protocols recommend stretches every 4–6 hours for 3–4 weeks post-release. I don’t recommend stretching overnight if baby is sleeping well. Stretch before bed and again in the morning

Some providers believe stretches are critical to preventing reattachment, while others suggest the body may naturally heal well without them. Every baby heals differently, so it’s best to follow your provider’s specific recommendations. A knowledgeable lactation consultant can also help guide in wound healing

Wound care is just one piece of the puzzle. To help your baby get the most out of their release:
✔️ Lactation support – A consultant can help improve latch and feeding
✔️ Bodywork – Chiropractic, craniosacral therapy, or occupational therapy can help with tension
✔️ Oral exercises – If needed, speech or feeding therapy can help strengthen tongue movement

I first saw this standing stretch by @drchelseapinto and is a great way to promote healing and mobility while reducing stress for the baby

What was your stretching protocol like?
#tonguetie #babyoralcare #tonguetierelease

Why is my breast milk supply decreasing?

- Julie Matheney
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One of the coolest things about breast milk? Your milk volumes adjust to meet baby’s growth! But milk volumes don’t just keep going up forever—they follow a natural pattern of increasing, leveling off, and then gradually decreasing as solids take center stage.

Weeks 1–6: The Build-Up Phase
🥛Newborns start with tiny tummies—think 5–7 mL (a teaspoon!) per feeding in the first days.
🥛By week 1, they take in 1–2 oz per feeding (about 10–20 oz per day) to help them regain their birth weight
🥛By week 2–4, intake increases to 2–3 oz per feeding and we calculate milk needs by weight: Babies typically take 2.5 oz per pound of body weight per day, maxing out around 24–30 oz per day for most babies. A 7# baby needs less milk than a 10# baby. Most babies have several weeks of cluster feeding to get your body to slowly increase supply to reach your max

Weeks 6–6 Months: The Plateau
⏰Around 4–6 weeks, milk volume stabilizes! Your baby will likely continue taking 24–30 oz per day with little change until solids are well established.
⏰There is a range because everyone’s calorie count in their unique milk is different! Unlike formula which is a standard 20 calories per ounce, breast milk can range from 16-32 calories per ounce!!

6–12 Months: Gradual Decrease
🥕As solids become a bigger part of the diet, total milk intake may dip slightly (closer to 20–24 oz per day by 9–12 months)
🥝Some babies still drink more, some less—it’s all about how quickly solids become the main event

After 12 Months: Milk Becomes a Side Dish
👧🏽Around the first birthday, breast milk intake gradually decreases as table foods provide most of the nutrition
👧🏻Many toddlers still nurse several times a day (or just for comfort), but total intake is often 16–20 oz per day or even less

💡 Key Takeaways:
✔️ Watch your baby for their own optimal growth. How old they are and how much they weigh do play a role in milk needs
✔️ Everyone makes milk tailored to their own baby. It’s ok to see milk volumes fluctuate and even decrease with time
✔️ Babies don’t need more and more milk forever—your body adjusts milk composition instead!

#milksupply #makingmilk #breastmilk #breastmilkstash #breastmilksupply

Breast Milk is Alive

- Julie Matheney
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Breast Milk: The Original Superfood (And It’s ALIVE!)

Breast milk isn’t just food—it’s a living, dynamic substance packed with everything your baby needs to grow, thrive, and fight off illness. Unlike formula, which stays the same in every bottle, breast milk adapts in real-time to meet your baby’s needs. Let’s break down the science behind this liquid gold!

1️⃣ Cells That Fight & Protect

Your milk is loaded with live immune cells that work like tiny superheroes:

• 🦠 Macrophages – Literally eat up harmful bacteria and viruses, helping protect your baby from infections.

• 🩸 Stem Cells – Thought to help with tissue repair and development.

• 🛡 Antibodies (IgA, IgG, IgM, etc.) – Coat your baby’s gut and respiratory tract, blocking germs before they can cause illness.

2️⃣ Enzymes That Aid Digestion

Breast milk is made to be easier to digest than formula, thanks to built-in enzymes that help break down and absorb nutrients:

• 🏗 Lipase – Breaks down fats for easy absorption and brain development.

• 🍽 Amylase – Helps digest carbohydrates, even before baby eats solids.

• 💪 Proteases – Assist in breaking down proteins into smaller, more absorbable pieces.

3️⃣ Perfectly Balanced Micronutrients

Breast milk contains everything your baby needs in just the right amounts:

• 🧠 DHA & ARA – Essential fatty acids for brain and eye development.

• 🔋 Lactose – The main carbohydrate in breast milk, providing steady energy for growth.

• 💖 Iron & Zinc – Small amounts, but in a highly bioavailable form (meaning baby absorbs it better than from formula).

4️⃣ Prebiotics & Good Bacteria

Breast milk contains oligosaccharides (HMOs) that feed the good bacteria in your baby’s gut, building a strong microbiome and boosting immunity!

5️⃣ Always Changing to Meet Baby’s Needs

• Your milk changes throughout the day—higher fat in the evening, more watery in the heat.

• It even adjusts when your baby is sick—your body picks up germs from baby’s saliva and produces more antibodies on demand!

💡 Key Takeaways:

✔️ Breast milk isn’t just food—it’s ALIVE with immune cells, enzymes, and good bacteria.

✔️ It’s packed with perfectly balanced nutrients designed for your baby’s growth.

✔️ It adapts in real-time to keep your baby healthy!

When at all possible, prioritize feeding fresh milk first. Even if you have a massive freezer stash, feed fresh when possible.

COVID 19 and Breast Milk Supply

- Julie Matheney

Breastfeeding offers numerous benefits to both infants and mothers, providing essential nutrients and antibodies that protect against various illnesses. During the COVID-19 pandemic, these benefits were well studied and found to be significant.

Breastfeeding During COVID-19 Infection

The World Health Organization (WHO) recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue breastfeeding. The benefits of breastfeeding substantially outweigh the potential risks of transmission. Mothers are advised to practice respiratory hygiene, including wearing a mask during feeding, wash hands before and after touching the baby, and routinely clean and disinfect surfaces.

Similarly, the Centers for Disease Control and Prevention (CDC) supports breastfeeding for mothers with COVID-19, emphasizing that breast milk is the best source of nutrition for most infants. Mothers should follow appropriate precautions, such as wearing a mask and practicing hand hygiene, to prevent the spread of the virus to the infant.

Impact of COVID-19 on Breast Milk Supply

COVID-19 infection can influence breast milk production. A study published in the journal Clinical and Experimental Obstetrics & Gynecology found that 68.8% of mothers experienced a decrease in breast milk production following COVID-19 infection, with the lowest production occurring during the second week after infection. However, milk supply gradually increased thereafter.

Other studies have reported similar findings. For instance, research indicated that 75% of women faced difficulties breastfeeding during the pandemic, with 66% attributing these challenges to concerns about COVID-19 transmission to their children.

Supporting Breastfeeding Mothers During Illness

Mothers who are ill, including those with COVID-19, may notice a temporary drop in milk supply. To support and maintain breastfeeding during illness:

• Continue Frequent Breastfeeding or Pumping: Regular breastfeeding or expressing milk stimulates production and helps maintain supply.

• Stay Hydrated and Well-Nourished: Adequate fluid intake and nutrition are vital for milk production.

• Rest and Seek Support: Resting and seeking assistance with household tasks can help mothers conserve energy for breastfeeding.

• Consult Healthcare Providers: Lactation consultants or healthcare providers can offer guidance and support tailored to individual needs.

It’s important to note that while some mothers may experience a decrease in milk supply during illness, this reduction is often temporary. With appropriate support and measures, mothers can continue to provide the benefits of breastfeeding to their infants during and after illness.

  1. Centers for Disease Control and Prevention. (2020). Care for breastfeeding women: Interim guidance on breastfeeding and breast milk feeds in the context of COVID-19. CDC. https://stacks.cdc.gov/view/cdc/85197
  2. International Journal of Clinical and Experimental Obstetrics & Gynecology. (2024). Impact of COVID-19 on breastfeeding mothers and milk supply: A clinical study. IMR Press. https://www.imrpress.com/journal/CEOG/51/7/10.31083/j.ceog5107158
  3. Pooni, R., Pandita, A., Austin, T., & Desai, P. (2022). The impact of the COVID-19 pandemic on breastfeeding initiation, continuation, and support: A systematic review. International Breastfeeding Journal, 17(1), 1-14. https://pmc.ncbi.nlm.nih.gov/articles/PMC9819154
  4. World Health Organization. (2020). Breastfeeding and COVID-19. WHO. https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19
  5. Australian Breastfeeding Association. (2020). Breastfeeding and COVID-19. https://www.breastfeeding.asn.au/resources/breastfeeding-and-covid-19

Why is my colostrum or breast milk brown? Rusty Pipe Syndrome

- Julie Matheney

Rusty Pipe Syndrome: When Your Milk Looks… Weird

So, you’re eagerly waiting for your milk to transition from colostrum to transitional milk, and—bam!—it suddenly has a pink or brownish tint. This sounds like rusty pipe syndrome, a totally harmless (and temporary!) quirk of early breastfeeding

Rusty Pipe Syndrome

• Happens when small amounts of blood mix with colostrum or early milk

• The name comes from the way it looks—kind of like water from an old pipe when you first turn it on

• Most common in first-time parents and usually resolves within a few days

WHY?!

Your milk-making factory (aka your mammary glands) goes through a huge increase in blood flow and development during pregnancy. Sometimes, tiny capillaries break as your body gears up for milk production, leading to that rusty tint.

Is It Safe for Baby?

Yep! Blood in milk isn’t harmful to your baby. Some babies may have slightly darker stools (or even spit up a little pink), but it’s not a cause for concern

How Long Does It Last?

Typically, it clears up within a few days as your milk transitions. If it lasts longer than a week or gets worse, it’s worth checking in with a lactation consultant or healthcare provider to rule out other causes

Important Note if You’re Pumping!

If you see blood in your milk after the first week or two of breastfeeding—especially if you’re pumping—it’s not rusty pipe syndrome. It’s usually due to:

• Pumping with the wrong flange size (too big)

• Suction set too high, causing nipple trauma

• Other causes like cracked nipples or irritation

If that’s happening, check your pump settings, make sure your flange size is correct, and reach out for support if needed!

When to Call for Help:

• If the discoloration persists beyond a week.

• If you notice a lot of fresh, bright red blood (which could indicate a nipple injury).

• If you have pain, swelling, or flu-like symptoms (which could mean an infection like mastitis).

Rusty pipe syndrome looks alarming, but it’s just one of those weird, normal things about breastfeeding. Your milk is still liquid gold, and your baby will be just fine!

Have you experienced this? Let me know in the comments! ⬇️

Low Milk Supply: When the root cause is Insufficient Glandular Tissue (IGT)

- Julie Matheney

Insufficient glandular tissue (IGT), also known as breast hypoplasia, occurs when the breast does not develop enough milk-producing glandular tissue during puberty or pregnancy. While the exact causes aren’t always clear, several factors are known or suspected to contribute to IGT:

Known or Suspected Causes of IGT:

1. Hormonal and Endocrine Conditions

• Polycystic Ovary Syndrome (PCOS) – May interfere with breast development due to hormonal imbalances.

• Thyroid Disorders – Hypothyroidism or Hashimoto’s can impact lactation by affecting prolactin and milk production.

• Diabetes (Type 1, Type 2, or Gestational) – Insulin resistance may impact glandular tissue development.

• Insufficient Pregnancy Hormone Exposure – Conditions like luteal phase defects or low progesterone can impact breast growth.

2. Genetic Factors

• Some individuals may have inherited a tendency toward underdeveloped glandular tissue.

• Syndromes like Turner Syndrome or Congenital Adrenal Hyperplasia may be associated with atypical breast development.

3. Breast Anatomy and Developmental Factors

• Hypoplastic (Underdeveloped) Breasts – Characterized by widely spaced, tubular, or asymmetrical breasts.

• Absence of Normal Breast Changes in Pregnancy – Lack of growth or tenderness may indicate limited glandular tissue.

4. Exposure to Endocrine Disruptors

• Chemicals such as BPA, phthalates, or pesticides may interfere with normal breast tissue development.

5. Surgical or Physical Trauma

• Breast Reduction or Augmentation Surgery – May remove or damage glandular tissue.

• Chest Trauma or Radiation Therapy – Can affect breast development, especially if occurring before puberty.

6. Unexplained or Multifactorial Causes

• Some cases of IGT have no clear cause, and it may result from a combination of genetic, hormonal, and environmental influences.

Implications for Breastfeeding

• People with IGT may have difficulty producing a full milk supply but can still breastfeed with supplementation if needed.

• Milk supply varies – Some with mild IGT can produce nearly enough milk, while others may struggle to produce any.

• Hormonal support (e.g., domperidone, metformin, or thyroid treatment) may help in some cases.

Managing breastfeeding with insufficient glandular tissue (IGT) can be challenging, but with the right strategies, many parents can still have a meaningful breastfeeding experience. The key is maximizing milk production, supplementing if needed, and protecting the breastfeeding relationship.

Strategies for Managing Breastfeeding with IGT

1. Maximize Milk Production

While IGT means fewer milk-producing glands, some strategies may help optimize output:

• Frequent, Effective Milk Removal – Nursing at least 10–12 times per day in the early weeks can stimulate any available glandular tissue.

• Pumping After Feeds – Using a high-quality double electric pump (or a hospital-grade pump) can help increase stimulation

• Breast Compressions – While nursing or pumping, gentle compression helps drain the breast more effectively.

• Skin-to-Skin Contact – Holding baby skin-to-skin can boost oxytocin and encourage more nursing sessions.

2. Consider Galactagogues (With Caution)

Some people with IGT find that certain medications or supplements help—but results vary:

• Prescription Medications

• Domperidone (where available) may increase prolactin levels and help some people with IGT.

• Metformin (often used for PCOS) may improve insulin sensitivity and support milk production.

• Thyroid medication (if hypothyroidism is present) can improve supply.

• Herbal Supplements (effects vary)

• Goat’s rue may support mammary tissue growth.

• Moringa, shatavari, or fenugreek may help, but response is unpredictable.

• Lecithin or sunflower lecithin can help prevent clogged ducts in those producing small amounts of milk.

⚠️ Note: Galactagogues are most effective when paired with frequent, effective milk removal. They won’t create glandular tissue where none exists.

3. Use an Effective Supplementation Plan

• Supplement as Needed – Many parents with IGT need to supplement to meet their baby’s needs.

• Consider an At-Breast Supplementer (SNS) – A supplemental nursing system (like an SNS or homemade tube system) allows baby to receive extra milk at the breast, maintaining the nursing relationship.

• Paced Bottle Feeding – If bottle-feeding, using paced feeding techniques helps maintain breastfeeding cues and prevents preference for fast milk flow.

4. Set Realistic Expectations and Find Support

• Define Breastfeeding Success for You – Some parents with IGT produce 10–50% of their baby’s needs, while others make little or no milk. Any amount of milk provides benefits!

• Lactation Consultant Support – Working with an IBCLC experienced in IGT can help tailor a feeding plan.

• Mental Health Matters – The emotional side of low milk supply is real. Find support from a lactation consultant, therapist, or peer group (like an IGT-specific support group).

5. Explore Alternative Feeding Options if Needed

• Exclusive Pumping – Some parents find this works better for their situation.

• Donor Milk – If supplementation is needed and human milk is a priority, donor milk (from a milk bank or trusted source) may be an option.

• Formula – If needed, formula is a tool that supports your baby’s nutrition, and using it doesn’t mean failure.

Final Thoughts

• Breastfeeding with IGT is possible but often looks different than the standard experience.

• Success isn’t just about ounces—maintaining the bond, offering comfort nursing, and doing what works for your family is just as important.

• Fed is best, but supported is better! Finding a provider who understands IGT can make all the difference.

Weighing baby before and after feeding to see how much they ate

- Julie Matheney

Pre- and Post-Breastfeeding Weight Checks: When, Why, and How to Do Them Correctly

Weighing a baby before and after a feeding—can be a useful tool in lactation care. But it’s not something every breastfeeding dyad needs. When used appropriately, pre- and post-feed weight checks can provide valuable insight into milk transfer. When used excessively or with improper technique, they can cause unnecessary anxiety.

When Should You Do Pre- and Post-Feed Weights?
• Concerns about milk transfer – If a baby is struggling to gain weight, feeding frequently but still showing signs of inadequate intake, or has signs of ineffective sucking.
• Premature or medically fragile infant– Babies with medical conditions may need closer monitoring to ensure they’re taking in enough milk.
• Suspected low supply or oversupply – Understanding how much milk a baby is transferring can help guide supplementation or block feeding strategies.
• Tracking feeding progress – In cases where parents need reassurance that their baby is getting enough, occasional test weights can provide peace of mind.

How to Perform a Pre- and Post-Feed Weight Check
1. Use a highly sensitive, hospital-grade scale – The scale should measure in grams, not just ounces, to detect small changes.

Why Precision Matters: Choosing the Right Scale

A hospital-grade scale with accuracy to 2-5 grams is essential because breastfed babies often transfer small but meaningful amounts of milk, especially in the first 3-4 weeks after. Since 1 gram = 1 mL of milk, a scale that only measures in ounces (where 1 oz = ~28.35 grams) lacks the precision needed to assess intake accurately. For example, if a baby transfers 20 mL (20 grams), a scale that rounds to the nearest 0.5 oz (15 grams) or full ounce (30 grams) may fail to detect intake entirely or overestimate by nearly 50%, leading to unnecessary concern or false reassurance. A highly sensitive scale ensures accurate tracking and better feeding decisions. The reason I prefer grams is the calculation is much more complicated when in pounds and ounces since it’s a scale of 16. If your scale says 6.5 pounds, that’s not 6 pounds 5 ounces. That’s 6 pounds and half a pound which is 8 ounces. Like when you order turkey at the deli. A quarter pound is 4 ounces. Your scale needs to acyuallly say pounds and ounces. And even then, that’s too much math for my brain.

2. Weigh baby in just a dry diaperClothing, blankets, and even a hat can change the reading.
3. Take the pre-feed weight – Place baby on the scale before feeding and record the weight in grams.
4. Breastfeed as usual – No adjustments, just a normal feeding session.
5. Take the post-feed weight – Weigh baby again immediately after the feed, using the same conditions (same dry diaper, no clothing added or removed).
6. Calculate the intake – The difference between the post-feed and pre-feed weights in grams equals the amount of milk transferred in milliliters (1 gram = 1 mL of milk). So let’s say the scale says 3.500 grams before baby feeds and then 3.560 grams after baby feeds. 3.560 minus 3.500 is 60. So the baby took 60grams. 30 grams is 1oz.

Things to Keep in Mind
• One feeding is just one data point – Milk intake varies throughout the day, so a single test weight doesn’t tell the full story.
• Not every baby needs it – If a baby is gaining well, feeding effectively, and meeting milestones, routine pre- and post-feed weights aren’t necessary.
• Weight fluctuations are normal – A few grams of variation from movement, diaper wetness, or scale sensitivity is expected

Pre- and post-feed weight checks are a valuable tool when used appropriately, but they should always be interpreted in the context of the baby’s overall growth, diaper output, and feeding behaviors. When in doubt, working with a skilled lactation consultant can help determine if and when they’re needed!

Insufficient Glandular Tissue and lack of breast milk

- Julie Matheney

Insufficient glandular tissue (IGT), also known as breast hypoplasia, occurs when the breast does not develop enough milk-producing glandular tissue during puberty or pregnancy. While the exact causes aren’t always clear, several factors are known or suspected to contribute to IGT:

Known or Suspected Causes of IGT:

1. Hormonal and Endocrine Conditions

• Polycystic Ovary Syndrome (PCOS) – May interfere with breast development due to hormonal imbalances.

• Thyroid Disorders – Hypothyroidism or Hashimoto’s can impact lactation by affecting prolactin and milk production.

• Diabetes (Type 1, Type 2, or Gestational) – Insulin resistance may impact glandular tissue development.

• Insufficient Pregnancy Hormone Exposure – Conditions like luteal phase defects or low progesterone can impact breast growth.

2. Genetic Factors

• Some individuals may have inherited a tendency toward underdeveloped glandular tissue.

• Syndromes like Turner Syndrome or Congenital Adrenal Hyperplasia may be associated with atypical breast development.

3. Breast Anatomy and Developmental Factors

• Hypoplastic (Underdeveloped) Breasts – Characterized by widely spaced, tubular, or asymmetrical breasts.

• Absence of Normal Breast Changes in Pregnancy – Lack of growth or tenderness may indicate limited glandular tissue.

4. Exposure to Endocrine Disruptors

• Chemicals such as BPA, phthalates, or pesticides may interfere with normal breast tissue development.

5. Surgical or Physical Trauma

• Breast Reduction or Augmentation Surgery – May remove or damage glandular tissue.

• Chest Trauma or Radiation Therapy – Can affect breast development, especially if occurring before puberty.

6. Unexplained or Multifactorial Causes

• Some cases of IGT have no clear cause, and it may result from a combination of genetic, hormonal, and environmental influences.

Implications for Breastfeeding

• People with IGT may have difficulty producing a full milk supply but can still breastfeed with supplementation if needed.

• Milk supply varies – Some with mild IGT can produce nearly enough milk, while others may struggle to produce any.

• Hormonal support (e.g., domperidone, metformin, or thyroid treatment) may help in some cases.

Managing breastfeeding with insufficient glandular tissue (IGT) can be challenging, but with the right strategies, many parents can still have a meaningful breastfeeding experience. The key is maximizing milk production, supplementing if needed, and protecting the breastfeeding relationship.

Strategies for Managing Breastfeeding with IGT

1. Maximize Milk Production

While IGT means fewer milk-producing glands, some strategies may help optimize output:

• Frequent, Effective Milk Removal – Nursing at least 10–12 times per day in the early weeks can stimulate any available glandular tissue.

• Pumping After Feeds – Using a high-quality double electric pump (or a hospital-grade pump) can help increase stimulation

• Breast Compressions – While nursing or pumping, gentle compression helps drain the breast more effectively.

• Skin-to-Skin Contact – Holding baby skin-to-skin can boost oxytocin and encourage more nursing sessions.

2. Consider Galactagogues (With Caution)

Some people with IGT find that certain medications or supplements help—but results vary:

• Prescription Medications

• Domperidone (where available) may increase prolactin levels and help some people with IGT.

• Metformin (often used for PCOS) may improve insulin sensitivity and support milk production.

• Thyroid medication (if hypothyroidism is present) can improve supply.

• Herbal Supplements (effects vary)

• Goat’s rue may support mammary tissue growth.

• Moringa, shatavari, or fenugreek may help, but response is unpredictable.

• Lecithin or sunflower lecithin can help prevent clogged ducts in those producing small amounts of milk.

⚠️ Note: Galactagogues are most effective when paired with frequent, effective milk removal. They won’t create glandular tissue where none exists.

3. Use an Effective Supplementation Plan

• Supplement as Needed – Many parents with IGT need to supplement to meet their baby’s needs.

• Consider an At-Breast Supplementer (SNS) – A supplemental nursing system (like an SNS or homemade tube system) allows baby to receive extra milk at the breast, maintaining the nursing relationship.

• Paced Bottle Feeding – If bottle-feeding, using paced feeding techniques helps maintain breastfeeding cues and prevents preference for fast milk flow.

4. Set Realistic Expectations and Find Support

• Define Breastfeeding Success for You – Some parents with IGT produce 10–50% of their baby’s needs, while others make little or no milk. Any amount of milk provides benefits!

• Lactation Consultant Support – Working with an IBCLC experienced in IGT can help tailor a feeding plan.

• Mental Health Matters – The emotional side of low milk supply is real. Find support from a lactation consultant, therapist, or peer group (like an IGT-specific support group).

5. Explore Alternative Feeding Options if Needed

• Exclusive Pumping – Some parents find this works better for their situation.

• Donor Milk – If supplementation is needed and human milk is a priority, donor milk (from a milk bank or trusted source) may be an option.

• Formula – If needed, formula is a tool that supports your baby’s nutrition, and using it doesn’t mean failure.

Final Thoughts

• Breastfeeding with IGT is possible but often looks different than the standard experience.

• Success isn’t just about ounces—maintaining the bond, offering comfort nursing, and doing what works for your family is just as important.

• Fed is best, but supported is better! Finding a provider who understands IGT can make all the difference.

Dysphoric Milk Ejection Reflex (DMER) vs Intrusive Thoughts

- Julie Matheney

Dysphoric Milk Ejection Reflex (D-MER) and intrusive thoughts can both be distressing experiences during breastfeeding, but they are distinct phenomena with different causes and characteristics. Here’s a breakdown of each, how they overlap, and how they differ:

What Is D-MER?

• Definition: D-MER is a physiological response to milk ejection (letdown) characterized by a sudden wave of negative emotions, such as sadness, anxiety, or anger.

• Cause: Thought to be linked to a sudden drop in dopamine during the letdown reflex, which is necessary to release prolactin for milk production.

• Key Features:

• Emotions are fleeting, lasting 30 seconds to 2 minutes during or just before milk letdown.

• The feelings are tied directly to the act of breastfeeding or pumping, not external triggers.

• Mothers often describe it as a “doom-like” sensation.

• The feelings fade as the breastfeeding session progresses.

What Are Intrusive Thoughts During Breastfeeding?

• Definition: Intrusive thoughts are unwanted, involuntary thoughts or mental images that can be distressing. They often focus on fears of harm to the baby, inadequacy, or catastrophic events.

• Cause: Typically linked to postpartum mental health conditions like anxiety, depression, or obsessive-compulsive disorder

• Key Features:

• Can occur at any time, not just during breastfeeding

• Not tied to a physiological reflex but rather psychological or emotional stress.

• The thoughts can feel persistent and overwhelming, even if they are fleeting.

• Often accompanied by feelings of guilt or shame for having the thoughts.

Key Differences Between D-MER and Intrusive Thoughts

Aspect D-MER Intrusive Thoughts

Trigger Milk letdown reflex. Psychological or emotional stress.

Duration Brief (30 seconds to 2 minutes). Can last minutes or longer; may recur.

Emotion Type Sudden, generalized dysphoria (sadness, anxiety, dread). Specific fears, often irrational (e.g., harm to baby).

Connection to Actions Does not provoke specific thoughts or fears of acting on emotions. May involve fears of acting on thoughts, though this is rare.

Cause Hormonal (dopamine drop during letdown). Psychological (linked to postpartum mental health).

Overlap Between D-MER and Intrusive Thoughts

Both can occur during breastfeeding and may contribute to a mother feeling overwhelmed or questioning her ability to cope. However, the underlying mechanisms are different, and the strategies for addressing them vary.

Red Flags to Distinguish Intrusive Thoughts From D-MER

1. When They Occur:

• If the distress arises only during milk letdown and fades quickly, it is likely D-MER.

• If it occurs outside of feeding or is tied to specific scenarios, it is likely intrusive thoughts.

2. Content:

• D-MER involves generalized dysphoria, not specific fears or scenarios.

• Intrusive thoughts often have vivid, specific, and sometimes graphic content.

3. Level of Distress:

• D-MER causes emotional discomfort but usually not panic or deep guilt.

• Intrusive thoughts can be deeply distressing, triggering anxiety or obsessive worry.

4. Impact on Bonding or Functioning:

• D-MER is unlikely to affect overall bonding with the baby.

• Intrusive thoughts may lead to avoidance of certain situations (e.g., not wanting to be alone with the baby).

How to Manage D-MER vs. Intrusive Thoughts

• For D-MER:

• Understanding It: Knowing it is a hormonal reflex can ease guilt or fear.

• Stay Hydrated and Eat Regularly: Stable blood sugar may help.

• Monitor Triggers: Some mothers find stress or caffeine can worsen symptoms.

• Seek Support: Talking to a lactation consultant who is familiar with D-MER can provide reassurance.

• For Intrusive Thoughts:

• Therapy: Cognitive-behavioral therapy (CBT) can help manage anxiety and reframe intrusive thoughts.

• Medication: Antidepressants or anti-anxiety medications may be helpful if symptoms are severe.

• Mindfulness Techniques: Grounding exercises can help reduce the impact of intrusive thoughts

• Talk About It: Sharing these thoughts with a trusted friend, partner, or therapist can help normalize the experience and reduce shame.

When to Seek Professional Help

• If you are unsure whether you’re experiencing D-MER or intrusive thoughts, consult a lactation consultant or mental health professional.

• Seek immediate help if you feel like you might act on harmful thoughts or if the distress is impacting your ability to care for your baby or yourself.

Remember

Neither D-MER nor intrusive thoughts mean you are a bad parent. Both are challenges that can be managed with the right support, and seeking help is a sign of strength, not weakness. You’re not alone in this.

Dysphoric Milk Ejection Reflex (D-MER) and intrusive thoughts during breastfeeding are both distressing experiences, but they stem from different causes. D-MER is a physiological response to the letdown reflex caused by a sudden drop in dopamine. It brings on a brief wave of negative emotions—like sadness, anxiety, or dread—that last for a minute or two during or just before milk letdown. These feelings are tied directly to breastfeeding or pumping and fade quickly, without involving specific fears or scenarios. In contrast, intrusive thoughts are unwanted, involuntary mental images or ideas, often tied to fears of harm or inadequacy. They are psychological in origin, often linked to postpartum anxiety or depression, and may occur at any time, not just during breastfeeding.

While D-MER is hormonally driven and passes quickly, intrusive thoughts can feel persistent and distressing, sometimes interfering with bonding or daily life. If your experience involves fleeting negative emotions solely during letdown, it may be D-MER. However, if the thoughts are vivid, specific, and provoke intense guilt or fear—particularly if they feel constant or unmanageable—it could indicate a postpartum mental health condition. In either case, reaching out to a lactation consultant or mental health professional can provide clarity and support, helping you navigate these challenges without judgment.

Intrusive thoughts as a new parent

- Julie Matheney

Intrusive thoughts while breastfeeding are more common than many people realize and can be deeply distressing for parents who experience them. These thoughts often come out of nowhere, feel unwanted, and can cause feelings of guilt or fear. Here’s a breakdown of where they come from, what’s normal, and when to seek help:

What Are Intrusive Thoughts?

• Definition: Intrusive thoughts are unwanted, involuntary thoughts or images that pop into your mind. They can be bizarre, scary, or even disturbing.

• Common in New Parenthood: They often revolve around fears of harming your baby (accidentally or intentionally), your baby being harmed by others, or catastrophic events (e.g., dropping your baby or suffocating them during sleep).

Where Do Intrusive Thoughts Come From?

1. Hormonal Changes:

• Postpartum hormone shifts (like drops in estrogen and progesterone) can affect mood and thought patterns.

• Oxytocin, the “bonding hormone,” can heighten your emotional sensitivity and awareness, making you hyper-alert to perceived dangers.

2. Sleep Deprivation:

• Lack of sleep impacts mental health and increases anxiety, which can lead to more intrusive thoughts.

3. Heightened Responsibility:

• The intense responsibility of caring for a newborn can trigger fears about your ability to protect and care for them.

4. Postpartum Mental Health Conditions:

• Intrusive thoughts are common in postpartum anxiety (PPA), postpartum depression (PPD), or postpartum obsessive-compulsive disorder (PPOCD).

5. Evolutionary Factors:

• Some researchers believe intrusive thoughts are an evolutionary “alarm system” designed to make parents vigilant about their baby’s safety.

What’s Normal vs. Concerning?

Normal Intrusive Thoughts:

• Brief and fleeting.

• Recognized as irrational or not aligned with your values.

• Do not lead to actions.

Red Flags:

• Thoughts are persistent and distressing, interfering with your ability to function or bond with your baby.

• You feel like you might act on the thoughts or cannot separate yourself from them.

• They are accompanied by other symptoms of postpartum mental health issues, such as:

• Intense anxiety or panic attacks.

• Feeling emotionally disconnected from your baby.

• Hopelessness, worthlessness, or excessive guilt.

• Difficulty eating, sleeping, or concentrating.

When to Seek Help

If intrusive thoughts are causing significant distress or you feel unsafe, reaching out to a healthcare provider is essential. Support options include:

• Therapy: Cognitive-behavioral therapy (CBT) is especially effective for managing intrusive thoughts.

• Medication: Antidepressants or anti-anxiety medications may help in severe cases.

• Support Groups: Postpartum mental health groups can normalize your experience and provide coping strategies.

• Lactation Consultant: If breastfeeding itself feels like a trigger, a lactation consultant can help identify ways to make the experience more comfortable and manageable.

Tips for Managing Intrusive Thoughts

• Acknowledge and Label the Thoughts: Recognize them as intrusive, not reflective of your true feelings.

• Practice Self-Compassion: You are not a bad parent for having these thoughts. They are not your fault.

• Talk to Someone: Confiding in a trusted friend, partner, or therapist can ease the shame and isolation.

• Grounding Techniques: Mindfulness, breathing exercises, or engaging in sensory activities (like holding a warm cup of tea) can redirect your focus.

• Prioritize Sleep and Nutrition: Even small improvements in self-care can make a big difference.

Intrusive thoughts can feel scary, but they don’t define you as a parent. With support and care, they can be managed and often resolved. You’re not alone, and help is available.