Category: Uncategorized

Weaning from a nipple shield

- Julie Matheney

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

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

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

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

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

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

💡Hand express to get milk flowing to keep baby interested

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

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

Breastfeeding Rage

- Julie Matheney

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

Social media is filled with pictures of overflowing bottles and serene mothers cradling their content newborns to their breast. For many, though, the breastfeeding journey may not be what was planned for or expected, leading to intense emotions that go beyond frustration. Postpartum mood disorders, including postpartum rage, are on the rise. Postpartum rage, characterized by intense, often unexplained anger, can be heightened when breastfeeding expectations are unmet. It's crucial to recognize that this anger may, in fact, be a form of grieving as well. Whether hindered by physical challenges, birth trauma, societal pressures, or other unforeseen medical complications, the gap between expectations and reality can be a source of profound sorrow. Acknowledging breastfeeding rage as a potential facet of grief allows for a deeper understanding of these complex emotions. Seeking support, both emotionally and professionally, becomes paramount in navigating through these feelings.

#BreastfeedingRage #GrievingProcess #MotherhoodRealities #BreastfeedingGrief #MotherhoodJourney #SupportEachOther

Can you overfeed a breastfed baby?

- Julie Matheney
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Can you overfeed a baby? The answer is absolutely yes. You have a tiny human with a tiny human stomach. All of our stomachs can stretch to hold more capacity than what we actually need to take. The question is, is over eating a problem? We’ll take a look at this and strategies to understanding if whether your baby is over feeding and if it’s a problem or not.

Now we all know that it is very easy to overfeed from a bottle. Bottles have a hole in them that are instant and constant and absolutely yes, many bottle fed babies are over fed. Many times parents are watching the volume in the bottle instead of watching the baby for baby’s cues that they are ready stop. It also takes 20 minutes for the stomach to tell the brain that it’s full, so it is very easy for babies to take the large volume in a short amount of time and eat more than their stomach needs to, before the brain knows that it’s full. The mouth can still be hungry while the stomach is full so babies may show cues that they are still wanting to suck which parents interpret as cues that Baby wants to continue to feed, and because the stomach can stretch and hold more than it needs to, parents often overfeed from a bottle.

The big question is, can babies overfeed at the breast? The breast works different than a bottle. The breast needs to be stimulated to release milk and milk is released in multiple waves that take time to be triggered. Most young babies will take 15 to 30 minutes at the breast, which allows their tummy time to tell the brain that it’s full. As they age and become more efficient; they learn to listen to their stomach to help guide when to stop feeding.

It is still possible to overfeed at the breast. We usually see this for two reasons: either from the mother side or from the baby side.

On the mother side, the most common reason for overfeeding is the mother has an over supply of milk. There are several reasons for having an oversupply. First, it may be caused by using a Haakaa or a breast pump and overstimulating the breast to make more milk than it needs. This also drives up the letdown response, which makes milk flow faster than if the baby were just feeding at the breast without the over supply. In this case, baby takes too much milk too fast. Mother may also have an oversupply being driven by certain medications. The most common medication I see driving over supply is Zoloft. There are also different medical conditions that can be the reason for an oversupply such as a prolactinoma, which is a pituitary gland tumor, or uncontrolled thyroid disorders.  This would be diagnosed by a physician after bloodwork and other medical imaging. Lastly, some new parents who don’t have as much experience with babies may also interpret every cue as a hunger cue. Some babies are totally willing to keep eating even if they are full. If you offer me a cheesecake, I will totally eat the cheesecake even if I don’t need it. Some babies are also like this, they will always latch when offered the breast. Every time baby is put down to sleep in the crib, they cry. Or they sleep for 10 minutes and cry to be picked up. But these cues get misinterpreted as the baby is still hungry and the baby is put back to breast. Some babies are very willing to go back to breast and keep feeding.

Overfeeding  could also be on the baby side. Certain tongue ties will stimulate the breast into an over supply. These babies often use a quick suckle pattern which initiates the let down reflex from how the nipple is stimulated. These cases are complicated in that the tongue may be restricted in a way that the mother doesn’t have much nipple pain or damage, but her body is compensating for the baby not having full range of motion of the tongue. Babies with reflux may also over feed at the breast. They often want to nurse more to keep swallowing, which helps keep milk in the stomach. Breastmilk is a pain reliever and many babies with reflux learn that they would rather be swallowing milk down than bringing it back up as reflux. So frequently feeding helps them swallow more often, but it becomes a vicious cycle.

When does overfeeding actually become a problem? If baby is having a lot of negative symptoms related to feeding, and over feeding is determined to be part of the root, addressing the reason WHY there is overfeeding would be appropriate.

If the baby has digestive discomfort, and has a lot of reflux/excessive spit up/projectile vomiting with pain, severe gas or digestive pain, we would want to address over supply or other issues, causing this discomfort. If the baby is having green, frothy/foamy or watery poops, this is also a sign of too much milk too fast. These kinds of watery or green poops may be a sign of lactose overload, where baby is accessible too much foremilk due to an oversupply.

Another symptom to watch for that would lead us to believe overfeeding is a problem would be baby coughing, choking, or leaking milk during the feeding. If the baby just physically cannot keep up and is constantly struggling during the feeding, there would be a reason why we would want to reduce milk supply to help baby feel more comfortable at the breast. Although this may also be a symptom pointing back to a tongue tie driving the over supply, so just bringing supply down would not necessarily be the best answer in this case. We would want to determine if the oversupply is causing the coughing and choking or if an inefficient tongue is contributing to baby not being able to swallow efficiently.

Babies gaining weight too quickly or faster than expected can also be a symptom that baby is being overfed, however, this is my symptom of least concerned. If the baby is gaining happily with no digestive discomfort, poops are a normal color and consistency, and is not leaking, coughing, or choking during feedings, fast weight gain alone would not be a concern. Many typically feeding babies with mothers with a normal supply can gain weight quicker than anticipated and then level off in weight once they become more active or distracted.

Yes, it is occasionally possible for breastfed babies to overfeed. If there there are symptoms happening (recurrent plugged ducts and mastitis for mother from an over supply, nipple pain and damage, coughing/choking baby, digestive discomfort or concerns with poop), working with an IBCLC lactation consultant can help determine what the root is (excessive pumping, medications, tongue tie, reflux, etc) to help balance the dyad for happier feeding.

How much breast milk does a newborn need?

- Julie Matheney

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

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

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

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

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

Will peppermint drop my milk supply?

- Julie Matheney
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Peppermint is a popular flavor during the festive Christmas season, and it's often found in candies, teas, and other treats. While peppermint is generally considered safe for consumption, there is a traditional belief that it may have an impact on milk supply.

Some people claim that peppermint, particularly in the form of peppermint tea, might potentially decrease milk supply. However, scientific evidence is limited and has yet to support this as true. A 2020 study found that Menthol did suppress milk production in mice. Menthol is a chemical naturally found in peppermint and other mint plants, but it can also be made in a lab. It's essential to note that individual responses can vary, and not every breastfeeder will experience a noticeable effect on milk supply when consuming peppermint.

If you're breastfeeding, enjoy your peppermint mocha during the holiday season. Pay attention to your body's response, and if you have concerns about your milk supply, consult with an IBCLC lactation consultant for personalized advice.

I believe the REAL reason why we see supply drop at the holidays isn’t the peppermint consumption, but being off normal schedules and routines, traveling, and having the baby be passed from grandma to aunt to friend where hunger cues are being missed and feedings delayed. In general, maintaining a well-balanced diet, staying hydrated, and responding to your baby's feeding cues are crucial factors in supporting a healthy breast milk supply. Enjoying holiday treats in moderation, including those with peppermint.

Do I need to pump overnight to maintain milk supply?

- Julie Matheney
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There is a science in how breast milk is made and maintained. The MOTN is when hormones are highest for making milk. Milk removals overnight drives a fuller supply all day long. Strong sucking at the breast overnight also plays a role in delaying periods from returning. Periods have their own cyclical impact on milk supply. The biological body is expecting to directly feed the baby. It doesn’t know we live in a modern era with pumps and freezers. When milk is not being moved, your body correctly assumes the baby is being fed by some other source and drops milk supply to protect the breast from plugs and infection. 

Tiny babies have tiny bellies that need to be fed day and night. As baby grows, so does the size of their stomach. There is no magic weight or age when a baby should stop feeding overnight. There is no scientific evidence to back that up. What we do know is the majority of breastfed babies are nursing at least once a night, if not 2-4 times, until after the first birthday. 

Producing breast milk is about demand and supply. What you move is what you’ll make. If you stop moving milk, your body thinks that milk is no longer needed, and decreases milk production. If your supply is constantly being moved, your body keeps producing more milk. While there is a science behind making milk, your body is art and your anatomy is unique to you. Some breasts have a large storage capacity and can hold more milk before seeing a drop in supply while others hold need milk moved more often to maintain supply. There are some people who can go 6-8  or even 10 hours and still maintain a full supply while others will see a drop when going more than 3-4 hours between feeding and pumping.

Feeding (or pumping) over night and milk supply are linked. If you’re making adequate milk during the day while sleeping long stretches at night, AWESOME!! If you’re going long stretches at night and day supply is dipping, that may be contributing. 

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Sudden Breast Milk Supply Drop

- Julie Matheney
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Occasionally I’ll hear of moms who had a well established milk supply and all of a sudden their supply drops. What can cause a late onset decreased milk supply?

🤰🏽Pregnancy. Milk supply drops during pregnancy because of hormone shifts to protect and grow the fetus. Domperidone or other milk making herbs/medications and more pumping or feeding will not work to increase supply

💊Hormonal birth control (pill including progestin only pill, IUD, etc)

🤱🏽Breastfeeding on only one side at a feeding or “block feeding” to correct an oversupply if done too long or with a small storage capacity

💊Some medications can decrease the milk supply (antihistamines, decongestants). Certain herbs in excess or as essential oils can, too (too much peppermint or sage)

🛌 Sleep training. Babies are supposed to wake often at night for the first 3 months and continue to frequently wake through 6 months and occasionally wake there after to feed. Night nursing keeps milk hormones high for making supply and sleep training prior to 3 months can sabotage milk supply

😷Blocked ducts/mastitis as well as any illness with a fever may decrease the milk supply

🍼Giving bottles can very much decrease the milk supply if you’re not pumping to replace those feeds. When at all possible, pump whenever baby is getting a bottle, regardless of if it is formula or breast milk being given

🎡”Overdoing it”. Anything that interrupts feeding baby on demand, including too many visitors, too many errands, or making baby wait to feed by the clock

🚿An “abundant milk supply” associated with a less than “ideal” latch. The milk flows into baby’s mouth with little participation of baby. Baby may often choke while breastfeeding, especially during a strong let down. A tongue tie is a common cause of a baby having a less than “ideal” latch and can be a significant cause of late onset decreased milk supply even there were no feeding problems early on. Baby was riding an over abundant supply instead of stimulating milk supply
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#milksupply #milksupplybooster #breastmilkbooster #breastmilksupply #breastmilkmagic

Breastsleeping

- Julie Matheney
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Let’s talk about co-sleeping and bed sharing. The recommendations from the American Academy of Pediatrics and the Safe to Sleep program for a safe sleep environment include:
💡Baby on his/her back
💡Use a firm sleep surface
💡Room-sharing without bed-sharing
💡Avoid soft bedding
💡Avoid overheating.
Additional recommendations from the AAP to reduce SIDS include:
💡Avoid exposure to smoke, alcohol, marijuana, and illicit drugs
💡Breastfeed your baby
💡Immunize
💡Use a pacifier

The Academy of Breastfeeding Medicine had a protocol for safe sleep and co-sleeping/bedsharing which is highly protective of SIDS called “breastsleeping”; baby feeds at the breast during the night. When mom and a full term, healthy baby share a firm mattress (not a couch or water bed) with no blankets or pillows that could possibly cover baby’s head or face and mom’s body forms a “C” shape around baby’s body, this position is safe and protective of baby and allows for optimal breastfeeding over night.

This allows baby to sleep on their back next to mom when not directly breastfeeding. This is for healthy babies. Babies should be unswaddled to avoid overheating and moms with long hair should be tied up. Older siblings or children should not sleep with babies under a year. Any smoking, nicotine or marijuana, is a high risk factor for SIDS.
Ever single aspect needs to be followed or it negates safe sleep.
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#cosleeping #bedsharing #safesleep
#breastsleeping #breastsleep

How can I toughen up my nipples for breastfeeding?

- Julie Matheney
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Were you told nipple pain and damage were normal while breastfeeding and your nipples just needed to “toughen up”? Whoever told you that does not understand basic anatomy. Nipples, are made from elastic, erectile tissue (the same tissue from a cellular level as the penis!) They are designed to erect and evert with stimulation and shrink back down after feeding. They physically CANNOT callous. They can crack and bleed and blister. They can have skin slough off. They can get infected. Some can become desensitized or used to stimulation with time. But they can NEVER “toughen up”. If you have a calloused nipple, I would see a dermatologist or breast specialist ASAP.

Babies mouths have two areas: the hard, bony palate up front (including where the teeth will go), a.k.a. the danger zone, and the soft palate at the back of the mouth just in front of where that little hangy downy thing is, a.k.a. the safe zone. One of the reasons a nipple erects, everts, and stretches is to help to get it in the safe zone.

When a baby is latched correctly, the nipple tip stretches back to where the palate is soft, this the tongue massages the nipple to express milk. If baby has a shallow latch, the tongue pinches the nipple tip against the hard roof of the mouth and the friction causes damage. This also happens when there is a tongue tie. Instead of the middle of the tongue massaging the nipple, the middle of the tongue is anchored to the floor of the mouth and the tongue tip flicks the nipple, or the middle of the tongue where the restriction is pinches the nipple against the bony palate.

Nipples are perfectly designed to withstand breastfeeding because of their anatomical design Other than temporary tenderness in the first few days, there should be no pain. Except when your baby shark is teething and bites you. But that’s a totally different post. Need to heal your nipples fast?  Watch my YouTube video on the best strategies Need to heal your nipples fast?  Watch my YouTube video on the best strategies 

 

If you’re struggling to latch your baby, consider taking my Latched class  Click here to enroll today! If you’re struggling to latch your baby, consider taking my Latched class  Click here to enroll today! 

#nippledamage #breastfeedingpain #breastfeedingsupport #breastfeedingtips

Tongue tie with no nipple pain

- Julie Matheney
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While maternal nipple pain and damage are classic signs of tongue tie in baby, I have seen many cases where the mother reports absolutely no pain with breast-feeding. These babies tend to have very high palates and some times a weak suck (not always). The actual nipple in most cases is large and long and goes up into the palate where the tongue tends not to be able to pinch it as much. There may be creasing of the nipple, but usually not the classic damage seen with other presentations of tongue tie. These mother‘s bodies often compensate with a fast let down and over supply of milk. These babies trigger let down easily and the mothers body responds with freely flowing milk. Baby drinks from the fountain without learning how to stimulate the breast and empty it on their or or learning how to trigger new let downs. These babies often gain weight well or even faster than expected until around 3-4 months when they unexpectedly drop off the growth curve and mom feels like her supply suddenly drops. Symptoms often include clicking at the breast (caused by that high palate and the fast flow of milk) which in turn increases the risk of reflux, colic and gassiness. Moms also complain that they need to constantly hold or shape the breast or baby loses the latch. These ties often go undiagnosed and many of these babies are switched to bottles and formula as the supply continues to decrease from the baby inefficiently moving milk from the breast which can also coincide with mother going back to work. If she is using a poor quality pump or the wrong size flanges and not moving milk well with the pump, she’ll often blame herself for the low supply.

To learn more about tongue tie and what to do about them, take my parent class Tied & Untied. Click here to enroll Tied & Untied. Click here to enroll 
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#tonguetie #tonguetied #tonguetiebabies #breastfeedingproblems #milksupplyissues #milksupplyproblems #milksupplybooster