Don’t fall for the marketing. There are so many bottle systems out there that are marketing themselves as “just like the breast” and even “shaped like the breast”. In truth the ones that look like a boob often function the least like it.The good news is there are some really good bottles out there that even though they don’t work LIKE the breast, they can PROMOTE a latch similar to it to help baby go back and forth between the two.
There are many bottles marketed as “most like breast.” The bottle part may “look” like a breast, but the nipple typically has a wide neck and and short nipple, which is how some nipples look like at rest before a baby latches. I call these shoulder nipples. The baby tends to latch just to the short nipple in a straw-like latch because they can’t latch deeply to the wide base (breast tissue expands and fills baby’s mouth, but the rigid silicone of the bottle nipple doesn’t). If baby’s lips are super rounded and there’s dimpling in baby’s cheeks while they suck, they are in a shallow latch. They may still pull milk from the bottle, but this shallow latch back at the breast results in painful nipples and leas efficient feeding.
Bottle nipples that have a more gradual slope from tip to base and a cylindrical shape are preferred for all babies, whether breastfeeding or not. Why cylindrical? We want your nipple to go in and out of baby’s mouth round. If your nipple is coming out pinched, creases, or flat, we’re talking about improving a shallow latch or releasing a tongue tie. Bottle nipples that are lipstick shaped, flat, creased, or pointed are going to promote incorrect sucking patterns which can transfer back to breast. Now hear me on this: while a round, tapered nipple are optimal, there are times when a different shape nipple is appropriate, especially if they’re the only shape baby will successfully take. We want all babies to have a wide latch to the bottle for more efficient feeding and better use of their facial muscles for skill development. I usually prefer the narrow neck to the wider versions for the majority of babies, as it helps promote better lip flanging, although some babies they will do just fine on the wider version. If your baby is struggling to take a round, tapered nipple, please seek the help of a qualified and specially trained IBCLC lactation consultant, occupational or speech therapist.
When a baby is at the breast, they create a vacuum in their mouth with negative pressure by making a seal with their tongue to the palate. They then use positive pressure by compressing the breast as their tongue moves in a wave like pattern from front to back called peristalsis. Positive and negative pressure are essential for a baby to efficiently feed from the breast. They need to maintain the tongue protruded over the bottom gun line and in that vacuum seal through the duration of the feeding, and the middle of the tongue needs to pump up and down to help compress out milk. This is why babies with tongue ties can struggle to feed both breast and/or bottle. Bottles work totally different than the breast and many only need the compression piece for baby to move milk. Some bottle nipples do a better job of approximating the breastfeeding latch and do require more suction in order to remove the milk. In general, bottles that require a combination of suction and compression to remove milk better promote breast feeding by using a more natural and functional sucking pattern. Those systems that use compression only promote a chomping sucking pattern or the baby squeezes the nipple harder to move milk, which can make it difficult (and painful) when transitioning back to breast.
What nipple “level” should my baby take? Nipple flow levels are not standardized across the bottle industry. Each company has their own set rate and it is completely different from company to company.A level one will flow simple tell different across every brand of bottle. What is “slow” on one nipple can be very fast compared to “slow” on a different nipple. Britt Pados has done multiple research studies that measure flow rates. Turns out there are some brands “Slow” that are actually faster than other brands “Level 3” . Remember: don’t fall for the marketing. If your baby is coughing, choking, leaking milk or struggling to drinking from a nipple, try going to a slower flow nipple in the same brand and if that doesn’t work, switch brands. Do you ever need to go up a nipple level? No. They are marketing nipple levels by age like Carter’s does with onesies. If it fits, use it. No need to level up if your baby is content. Ever.
From a lactation perspective, we generally want breastfed babies to use a nipple that matches the flow of their mothers milk back at that breast. This is USUALLY the slowest flowing nipple (remember, this will vary from brand to brand). We want them to take a bottle slowly since breastfeeding is usually a slow process, and we want them to actively suck to get milk out. Although for those with a fast let down or over supply of milk, it’s totally fine to use a faster flow nipple that matches the speed at which your baby takes the breast.
Babies are masters at compensating to feed. They learn very quickly what works and what doesn’t to get milk. But sometimes this comes at the cost of them compensating with their muscles which can lead to symptoms like lip blisters, two tone lips, lots of gassiness and reflux. Clicking while swallowing, leaking milk, coughing and eating too fast are all symptoms that something isn’t right: either with the nipple shape, flow level or their latch OR something else may be going on in their mouth like a tongue and lip tie. If baby is doing well with their bottle and you have no concerns, keep doing what you’re doing! No need to start fresh and buy new. Some babies do a really nice job of going back and forth from breast to bottle, despite requiring different mechanics. If you are seeing any red flags and something doesn’t feel right about your baby’sbottle feeding skills, either breast or bottle, schedule a consultation. There is help and guidance for you to get things back on track.
There is nothing worse than being sick. It’s even harder when you still need to breastfeed when all you want to do is sleep and there’s nothing that sounds good to eat or drink. So what can you take get help feel better fast? There are still safe medications and herbs/supplements. Thomas Hale wrote the textbook on medications and breast milk and categorized medications as follows: L1 Safest L2 Safer L3 Probably safe L4 Possibly hazardous L5 Hazardous
🤒Pain and fever 👍🏼Ibuprofen (Motrin/advil), acetaminophen (Tylenol), and paracetamol (L1) are safe to take while breastfeeding. 👎🏻Aspirin (L2) can pass into human milk and cause a serious condition called Reye’s syndrome in baby. Reye’s syndrome is associated with brain and liver damage. 👎🏻Use of codeine is not recommended while breastfeeding. If essential, and only where there is no alternative, it should be at the lowest effective dose, for the shortest possible duration and you should stop taking it and seek medical advice, if you notices side effects in baby such as:
Bradycardia (slow heart beat)
🤧Sinus congestion 👍🏼Saline rinse L1 👍🏼Afrin and Nasacort L3 Because these medicines are not absorbed well from the nasal passages, they don’t have the same effect on milk supply that decongestants taken by mouth can have. 👎🏻Pseudoephedrine L3 Medications containing pseudoephedrine (Sudafed, Zyrtec D) — use with caution because they can decrease milk supply
😮💨Cough/chest congestion 👍🏼Guaifenesin (Robitussin/Mucinex) L2 👍🏼Dextromethorphan (Robitussin DM/Delsym) L3 The amounts of dextromethorphan and its active metabolite in breastmilk are very low and are not expected to affect the nursing infant. It is best to avoid the use of products with a high alcohol content while nursing.
Not sure if the medications you want to take is safe? Call Infant Risk at 806-352-2519
Kellymom.com also is a phenomenal resource for safe things you can take and do while sick and breastfeeding
The food you eat and the water you drink do not magically go directly to your breast milk. What you eat and drink goes first to your stomach to be broken down and then into your intestines to be absorbed and processed. Your digestive system breaks nutrients into parts small enough for your body to absorb and use for energy, growth, and cell repair. The muscles of the small intestine mix food with digestive juices from the pancreas, liver, and intestine. Special cells in the walls of the small intestine absorb water and the digested nutrients into your bloodstream. Your blood carries molecule-sized components such as simple sugars (carbohydrates), amino acids, white blood cells, enzymes, water, fat, and proteins throughout your body. As blood passes by the breasts, milk glands pull out these nutrients for milk production and pass some of them to your baby. Not all molecules are small enough to pass through into milk. (That’s why some medications are safe to take while breastfeeding and some are not. Molecules that are too big can’t get into the milk while really small molecules can.)
Nuts, seeds, beans, and grains all have plant based proteins. Meat and dairy are animal based proteins. Both plant and animal proteins carried in your blood can make it into your milk. Sometimes these proteins can affect baby’s digestive system, causing symptoms like reflux, gas, colic, and blood or mucus in the poops from iritations to baby’s intestinal lining. Diary proteins are the most common cause of upset in the stomach, however research suggests that the proportion of exclusively breastfed infants who are actually allergic to something in their mother’s milk is very small. Fussiness and gas alone are not enough to diagnose a cow milk protein allergy.
In general, there are NO foods that need to be avoided because you’re breastfeeding. Every baby is different in the foods they are sensitive to. IF your baby always seems to have a reaction when you eat a certain food or a large amount of a certain type of food, cutting back on it or cutting it out temporarily may be helpful.
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.
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!
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
Breathing fast: get ready for them to start crying!
This is the best time to latch!
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.
You were probably told breastfeeding would be this incredible biological postpartum weight loss plan. While that may be true for about 1/3 of people, most of us hold on to our weight regardless of how much boob juice we make. When you breastfeed, fat cells stored in your body during pregnancy and calories from your diet fuel milk production. Your body burns about 20 calories for each ounce of milk you make. Which is why you need an extra 300-500 calories a day. After an immediate postpartum weight loss of about 15#, it tends to be gradual — about 1–2 pounds a month for the first six months after childbirth and more slowly after that point. It often takes 6-9 months to lose pregnancy weight.
Why are you not losing the baby weight?
🧁 I don’t know about you, but I was hungrier breastfeeding than pregnant. You’re still eating for two only your second party is bigger now than when they were in your belly. Breastfeeding cravings are real.
🧁 Lactation cookies? Let’s be honest, a cookie is still a cookie whether or not it helps with your supply. Eating lots of bars, cookies, power drinks and teas with sugar or honey are not going to help with weight.
😵💫Stress: Research has also found that elevated cortisol levels (the stress hormone) have been associated with weight retention in the first 12 months postpartum
😴 Lack of sleep: Research shows when we don’t get consistent sleep, our hunger hormone (ghrelin) gets triggered and our satiety hormone (leptin) dips, increasing appetite. Scientists at the University of California also found that sleep-deprived people tend to reach for higher-calories foods compared to those who are well-rested.
🩸Hormones: Prolactin, your milk making hormone, is also sometimes called the “fat-storing hormone”. High levels of prolactin can result in weight gain. And they are at their highest while breastfeeding. While more research on prolactin is needed, we hypothesize that our bodies undergo metabolic adaptations to hold onto excess fat as “insurance” for baby. Meaning, if you were to find yourself in a famine, you body has what it needs for baby.
🔑Remember: there is waaaay too much pressure to “bounce back” after having a baby. Your body is epic and lovely and just pushed a tiny human being out. Your body is going through so many changes and there are physiological things at play that can be beyond your control. Trust your body. Trust your baby. Love your body.
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.
Breasts are made of a network of ducts, covered by a layer of fatty tissue. During pregnancy, estrogen and progesterone enlarge the milk ducts and multiply the glandular tissue that produces milk. After birth, estrogen and progesterone drop and prolactin and oxytocin rise. Prolactin makes milk production and oxytocin releases it into the ducts. Extra blood and fluid fill the breast just after birth to supoort your body adding hormone receptors in the breast to make milk. The blood and fluid surrounds the ducts and this extra pressure is what makes your breasts feel full between feeding. This blood and fluid reabsorb around 6-8 weeks once supply is established and you won’t feel that full/soft feeling except when you go a really long time between feeding or pumping. Breasts go back to prepregnancy size when supply regulates around 11-14 weeks but continue to make milk. When you wean from breastfeeding, it can take several months for prolactin levels to return to baseline (which is why you may still see milk for months after weaning). Once you stop breastfeeding, the milk making structures actually self-destruct – a process that involves massive cellular suicide, and the removal of the debris. Around 6 months after weaning, the milk-producing tissue is replaced with fatty tissue. If you return to your pre-pregnancy weight, your breasts most likely will return to the same size. They may not be as “perky” because the skin is a bit more stretched and the connective and fatty tissues in the breasts often shifts during pregnancy and breastfeeding. While they may look smaller after weaning most of us can expect that our breasts will return to a similar size as they were pre-pregnancy. They’re just a little more lived in and well loved.
Some times even the best lactation consultants and feeding therapists can miss a posterior tongue tie in the immediate days or weeks after birth. Having a frenulum under the tongue doesn’t automatically mean it’s tied. A long, stretchy frenulum that allows full movement of the tongue is normal and not something that needs released. However, sometimes a frenulum can allow the front of the tongue to do what it needs to, but still be tied at the back. These are what I can tricky posterior ties. Mom may have lots of milk and baby transfers well from the breast in the early days or weeks post delivery. Mom may have no nipple pain or damage whatsoever. Only they come back a month later with new symptoms like slow weight gain or feeling like there breast isn’t emptying. Why is that?
Mom’s body often compensates well during the early weeks post delivery. The uterus doesn’t tell the breasts how many babies came out. So her body goes into overdrive to make more milk than needed from the start. As time moves on, the body figures out how much milk to make and drops supply to just what is being emptied. A baby that rode on mom’s robust post delivery flow may all of a sudden start to struggle at the breast as supply regulates. Based on how the anatomy is, there may never have been nipple pain or damage. If the baby has a high palate where the front of the tongue can still move well and mom has a large nipple that fills baby’s mouth well, the nipple may come out creased or pinched, but without pain. The anatomy on one or both sides masked the tie while baby was small.
If breastfeeding was going well in the beginning, but symptoms start to pop up later, working with a qualified lactation consultant can help figure out what’s going on. And some times that means finding a posterior tie that was originally missed where a release is necessary to get feeding back on track.
Did you know mastitis may be related to your posture?
Fluid dynamics is the science of how fluids move in our bodies. All of put bodily fluids are supposed to be free-flowing and unobstructed for optimal health. Milk is a fluid that flows through ever narrowing ducts and pores. Lymph is a fluid throughout your body (and breasts) that helps transport waste from cells and tissues in your body to help flush it from your system. It also helps reabsorb milk that doesn’t get emptied to baby/pump. Anything that increases resistance of the movement of these fluids increases the likelihood of plugged ducts or mastitis. Causes for increased resistance: ⭐️ Breast implants or reduction causing scar tissue in the breast ⭐️ Sleeping in the same posture especially on your side where you put pressure on the breast for extended periods of time ⭐️ Tight fitting clothing/bras that constrict movement of milk and lymph between feedings ⭐️ Shoulder injuries where there is inflammation or scar tissue ⭐️ Neck injuries or issues with neck mobility ⭐️ Tension in your body from stress or poor posture for extended periods of time during breastfeeding (bringing yourself to the baby) ⭐️ Not moving the body enough/sitting for prolonged periods of time in the same position ⭐️ Increased overall inflammation in the body such as from infection or excessive fluids from IVs used during labor and delivery or from immune disorders ⭐️ Having very large, heavy breasts which act more like an appendage where milk and fluid can fill the lower quadrant of the breast and have difficulties moving out again
What can you do? ❤️ Shake your breasts!! Get that fluid moving manually with your hands ❤️ Lean over and dangle your breasts to reduce pressure on them and help them free flow ❤️ Practicing yoga works well, especially with poses like downward dog where you’re changing the orientation of the fluid in your breast related to gravity. ❤️ Avoid restrictive clothing and bras ❤️ Get a massage!! Having hands on the body helps get the fluid inside moving in the right direction ❤️ See my video for lymphatic drainage massage
A person with sore, cracked nipples will do absolutely anything to bring relief to the pain and heal the damage. Sterile, medical grade manuka honey is one of the most unique and beneficial forms of honey in the world. And one of the best remedies for long standing injured nipples. Research shows that not only does honey have potent antibacterial properties which can prevent infection but it also stimulates the growth of new tissue and formation of blood cells, promoting the healing of wounds. Rich in anti-oxidants, anti-bacterial and anti-inflammatory properties, manuka honey can be used between feedings to heal nipples fast. But don’t run out to Vons or Kroger yet. This is not honey you buy in the bread aisle at the grocery store. Medical grade manuka honey has been irradiated to destroy any botulism spores and is completely safe to use with nursing a newborn.
Clover or flower honey like in the cute honey bear you put in your tea is not safe for your baby. Babies under 12 months should not be given honey, because honey contains bacteria that an infant’s developing digestive system can’t handle. Eating honey can cause your baby to become ill with a condition called infant botulism. You want to look for sterile or medical grade manuka honey, like what is found in Medi-honey paste or dressings.
Have cracked nipples? Lactation Hub has the correct honey you need to heal your nipples quickly.