Forever milk

Did you know that you will ALWAYS be able to make milk? You’ve had the milk making glands in your breasts since puberty. They’re like little empty clusters of balloons at the back of the breast. Pregnancy activates your milk making hormones, allowing the glands to expand and start filling with milk between 16-20 weeks gestation. In the early days after birth, the more stimulation the breast has (from feeding or pumping), the more the milk making glands and their corresponding hormone receptors multiply. The milk balloons fill and empty milk multiple times per feeding.

After at least 40 days of not expressing any milk, once you completely wean, your milk making balloons deflate and become dormant, like before pregnancy. But they aren’t dead. Pregnancy and breastfeeding hormones caused a permanent change in your body. Your milk making glands will FOREVER remember how to make milk. They can ALWAYS make milk again, no matter how long it has been. They just need enough of the right stimulation to turn on and start filling again. Some times years after breastfeeding a mother may feel the tingle of let down if she hears a baby cry. Or she may leak if her partner does enough nipple stimulation. There are grandmothers in other cultures who bring back milk to breastfeed their grandchildren! Our bodies are AMAZING!! Now you know!

Nipple shields

Not all nipple shields are created equal. Nipple shields are a great tool that can be used to help baby latch and stay latched, help you heal from nipple damage or trauma, or transition baby back to breast from using a bottle. Nipple shields are a great tool and can be used as long as needed. There are risks to long term use, the biggest one is a decrease in milk supply if baby isn’t able to trigger let downs or remove milk efficiently. If you weren’t given a plan for transitioning off the shield, a qualified lactation consultant can help!

Best Parenting Advice

Put them in water or take them outside. This is the best parenting advice I’ve ever been given. When breastfeeding has been established (baby is making good wet and dirty diapers, generally pain free latch, and gaining weight), there will be times when baby will be super fussy and refuse the boob. Many misinterpret this as having low milk supply or something wrong with the breast. Don’t be so quick to blame yourself or to supplement with a bottle. I guarantee you there will be times when you have no idea what to do to stop your baby from crying. The boob won’t work. Changing the diaper won’t work. Burping and rocking and shushing won’t work. I guarantee you there will be times when you will cry right along with your baby and feel helpless to soothe them (or yourself).

When the breast doesn’t work: put them in water or take them outside. It works. When your baby is falling to pieces for no apparent reason and the usual tricks don’t work, go outside or get in water. It works on adults, too!!

Cabbage for engorgment

Cabbage is not just for Cole slaw. Did you know that cabbage leaves have been used for decades to help reduce breast engorgement? A handful of studies have shown that placing a chilled green cabbage leaf against the breast has been effective to reduce breast swelling and pain. It is suspected that the compounds found in the plant leaves have strong anti-inflammatory properties that help improve blood flow, decrease swelling, and allow milk to flow more freely.


Using Cabbage Leaves for Engorgement:

✏️Chill the cabbage, green cabbages are best

✏️Wash off one or two inner leaves, be mindful to remove any dirt, pesticides or residue

✏️Gently pat dry with a towel

✏️Crush the center stem for maximum potency

✏️Wrap a leaf around the affected area of the breast, exposing the nipple when possible.

✏️Use a bra or lose wrap to hold the leaves in place

✏️Leave for 20 minutes

✏️Discard the leaves

✏️Cautions:20 minutes seems to be for most the right amount of time

✏️Repeat no more than 1-2 times a day for engorgement, as cabbage leaves used more often can actually decrease milk supply!

✏️This process is also used for weaning breast milk, such as when quick weaning is needed or when mothers are done breastfeeding.

Can I empty my breast?

Did you know that you will ALWAYS be able to make milk? You’ve had the milk making glands in your breasts since puberty. They’re like little empty clusters of balloons at the back of the breast. Pregnancy activates your milk making hormones, allowing the glands to expand and start filling with milk between 16-20 weeks gestation. In the early days after birth, the more stimulation the breast has (from feeding or pumping), the more the milk making glands and their corresponding hormone receptors multiply. The milk balloons fill and empty milk multiple times per feeding.

After at least 40 days of not expressing any milk, once you completely wean, your milk making balloons deflate and become dormant, like before pregnancy. But they aren’t dead. Pregnancy and breastfeeding hormones caused a permanent change in your body. Your milk making glands will FOREVER remember how to make milk. They can ALWAYS make milk again, no matter how long it has been. They just need enough of the right stimulation to turn on and start filling again. Some times years after breastfeeding a mother may feel the tingle of let down if she hears a baby cry. Or she may leak if her partner does enough nipple stimulation. There are grandmothers in other cultures who bring back milk to breastfeed their grandchildren! Our bodies are AMAZING!! Now you know!

Sunflower lethicin and plugged ducts

Lecithin is used in food to provide a smooth, moist texture and to keep ingredients from separating. Lecithin can naturally be found in green vegetables, red meat, and eggs. Commercial preparations are often made from soybeans, egg yolks, or animal products. It is also commonly used in eye drops, skin moisturizers, and food emulsifiers (agents that keep ingredients from separating).

Sunflower lethicin, a specific kind of lethicin, is often taken during breastfeeding to reduce plugged ducts or to help increase milk flow. Sunflower lethicin is thought to reduce the “stickiness” of breast milk by thinning out the fats in the milk and keeping them from clumping together. There are no known contraindications for breast-feeding, and lecithin is “generally recognized as safe” by the FDA. However, people with a preexisting tendency to depression may become depressed if taking high doses of lecithin. While very rare, if you begin to have a fish-like odor while taking high doses of lethicin, stop taking it immediately and notify your physician, as this is a serious sign of liver damage. As there is no recommended daily allowance for lecithin, there is no established dosing for lecithin supplements. Different brands might have different amounts of lecithin in each pill or capsule, so be sure to read labels very carefully before taking lecithin or any other dietary supplement. Per Kellymom.com, the maximum dosage recommended for recurrent plugged ducts is 4,800mg/day. As always, consult with your doctor before trying any dietary supplements while pregnant or breast-feeding.

Why should I see an IBCLC or lactation consultant

If you broke your foot you wouldn’t go to your local nail salon to have your pedicurist look at it. Yes, they work with feet. I just wouldn’t trust their expert opinion on whether I need a cast or some physical therapy. If my car engine was making smoke and my gauges were outside the appropriate ranges, you wouldn’t go to the car wash to have it looked at. Yes, they work with cars. I just wouldn’t trust their expert opinion on whether my engine block is cracked or not. So why when we’re having lactation problems do we turn to mom groups or even pediatricians? Yes, moms have babies. Yes, pediatricians work with babies. But neither are the experts in lactation (ok, occasionally a pediatrician will seek additional training, but honestly it’s rare). To become a board certified lactation consultant, you need to take advanced college level coursework specifically in human lactation. You need to spend hundreds to thousands of hours being directly mentored by someone who already is board certified. And you have to pass a FOUR HOUR board exam. To be board certified. IBCLCs spend thousands of dollars and years of their lives training to become experts in breasts, babies, and feeding. If you’re struggling, please find the correct help. There’s a lot of bad information out there that may inadvertently sabotage your breastfeeding journey without you even being aware.

Comparison will steal your peace

Too often we look around to see what everyone else is doing and it makes us feel incomplete, incompetent, like we’re doing something wrong or not doing enough. We see the success of others in parenting, sleep training, their milk supply, pumping, whatever, and it makes us feel like we’ve failed. Comparison is the number one way to have your joy and peace stolen. Stop looking at Becky over there with her oversupply and thinking your normal supply is inadequate for your content and growing baby. Stop looking at Gina over there whose baby has slept through the night since two months and thinking there’s something wrong with your happy child. Stop comparing your tiny but mighty that looks like the rest of your flock to my giant giraffe babies that look like the rest of my herd. You’re not getting a grade. Breastfeeding is not a pass/fail activity. Trust your baby. Trust your body. You’ve got this.

What do my Labor and Delivery have to do with breastfeeding?

All babies are born with innate instincts and reflex to get them to the breast soon after birth. Every baby, when placed skin to skin on their mother immediately after birth, will do the breast crawl and have a first latch within approximately 60 minutes of delivery, even medicated or c-section births. In the first 24 hours, babies are often sleepy. Waking for brief periods to feed and go back to sleep. The second day (and usually the second night) is when babies make up for the first day after delivery, ravenously cluster feeding for hours, much to the dismay of now extremely fatigued parents. But your labor has more of an impact on breastfeeding than you may realize.



We learning and understanding how our bodies prepare for breastfeeding during pregnancy, how what happens during labor and birth sets the stage for breastfeeding, and how the first minutes and hours after birth can have a lasting impact on the entire breastfeeding journey. The way baby is born  powerfully influences the first hours and days of breastfeeding. Unmedicated, vaginal birth sets the stage for problem-free breastfeeding, where biology, instinct and reflex can take center stage. In contrast, a complicated, intervention-intensive labor and birth increases the risk of problems.

How long you labor is really out of your control. The length of your labor may actually increase breastfeeding difficulty. For really long labors (over 24 hours), pushing for 4 hours or more, or very intense short labors, both you and baby may be so exhausted that rest and recovery take precedence over breastfeeding. Baby may be too tired to breastfeed often in the first few days, which increases your risk of not stimulating the breast well which in turn delays colostrum transitioning to mature milk and can decrease the overall volume your breast may be able to make in the future. Long, medically intervened labors also usually mean increased bags of IV fluids, which can cause excess fluid in your body which in turn delays the transition of colostrum to mature milk up to 10-12 days. It can also cause your hand, feet, and breasts to swell with extra fluid, called third spacing, which can make latching baby a challenge. (See my videos on Instagram about reverse pressure softening for help with this).

Events surrounding birth can inadvertently sabotage breastfeeding, as birth is supposed to be a well orchestrated series of events and hormone releases, setting you up for successful breastfeeding. Many of the birthing practices that are considered almost routine (induction, epidurals, separation of the mother and her baby for cleaning, weighing and foot printing) interfere with this hormonal dance resulting in poorer breastfeeding outcomes.

The routine progression of hormonal changes during  labor and birth perfectly prepares the body to breastfeed immediately after birth. During labor, oxytocin surges are responsible for increasingly stronger and more effective contractions. As oxytocin goes up, and the pain that accompanies the strong contractions increases, endorphins are released. High levels of endorphins help you cope with painful contractions and contribute to their becoming more instinctive. As the baby moves down the birth canal, almost ready to be born, catecholamines are released. The surge in catecholamines creates an energy boost and allows the baby is born with high levels of catecholamines as well (; ). This results in a vigorous, alert baby and an energized mother ready to breastfeed for the first time.

 

Skin to skin contact immediately after birth helps these same hormones continue to work in preparation of the first breastfeeding moment. Baby’s body weight on mom’s uterus, baby hand and head movements on her body, and then baby sucking at the breast stimulate even more oxytocin release (). Oxytocin helps the placenta separate and contracts the uterus further, preventing excessive bleeding. After birth, high levels of catecholamine in the baby insure alertness for the breast crawl and first latch. The endorphins present in mom pass on to baby through her breast milk, helping the baby stay calm and relaxed. After the first feeding, these hormones peak and allow both mother and baby 

Prolactin and oxytocin, the. milk making hormones, are released by baby’s sucking at the breast. Prolactin makes milk and oxytocin causes your letdown or release of milk. Prolactin, AKA “the love hormone”, is responsible for nurturing behaviors. Oxytocin makes you feel relaxed, sleepy, or calm feelings during milk letdown. 

All Labor pain-relief drugs have been shown to delay the onset of milk production and increase the risk of breastfeeding difficulties. This was well documented in a 2014 study by Lind et al. Pitocin, unlike naturally occurring oxytocin, does not cross the blood/brain barrier. As a result, the pituitary is not stimulated to release endorphins. Without the pain-relieving help of abundant endorphins, people who are induced with pitocin are more likely to require epidurals. In a vicious cycle, whenever an epidural is given and all pain is removed, naturally occurring oxytocin levels drop, requiring increased amounts of pitocin to continue contractions (Lieberman & O’Donoghue, 2002). Without the high levels of oxytocin and endorphins that would normally be released, a surge in catecholamines does not occur immediately before birth. This hormonal disruption during labor results in women giving birth with relatively low levels of naturally occurring oxytocin, endorphins, and catecholamines. Consequently, the outcome of low hormonal levels is a less responsive mother and baby which in turn impacts vigor at the breast ().

The medication used in the epidural does, in fact, “get to the baby.” Epidural narcotics or anesthetic drugs cross the placenta and can be found in cord blood. More research is needed, but we are starting to learn the neurobehavioral effects of medicated deliveries. Babies exposed to epidurals have a higher risk of have difficulty with latching on and an uncoordinated suck/swallow response for hours or days after birth (; ). Epidurals are also documented to lengthen the second stage of Labor and increase the likelihood of needing a C-section. The trauma of c-section birth, versus the natural positioning of coming through the birth canal, can make it painful for baby to assume the natural, instinctive positioning for breastfeeding and can make it difficult to latch. 

Elective induction of labor is also a risk to breastfeeding because of the potential of added intervention and the increased likelihood of the baby being born prematurely. The more premature a baby is, even at 37-38 weeks, the more immature and uncoordinated sucking and swallowing can be. Babies practice the coordination of sucking and swallowing in utero without expiation to feed, so the longer they are able to practice in utero, the more coordinated and ready they are to feed at birth.

So now what? You’ve had the baby and had a long, medicated delivery. Knowledge is power. You cannot change your birth story, but you can influence your breastfeeding journey.

  • Keep baby in skin to skin contact as long dn often as possible to help restore your oxytocin levels. Every 60 minutes 1-2x/day has been found to exponentially increase milk supply
  • Offer the breast frequent and often. Work on getting baby into a good position to ensure a deep latch
  • If you are separated from your baby or baby is super sleepy, hand express and/or start pumping. You will want to hand express or pump every 2-3 hours during the day and every 3-4 hours at night. You will get more colostrum from hand expression than pumping int he first three days, but pumping will help stimulate the nipples. Don’t be discouraged if you see little milk from a pump. The stimulation is needed until baby is able to latch
  • Stay hydrated and eat good foods full of protein
  • Use a paced bottle feeding technique and try not to over feed baby if you need to supplement. Always supplement with your own milk first, followed by formula. Babies need very little milk in the first 3 days.
  • Find lactation help as soon as possible to help create a plan to get breastfeeding back on track
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Natural Weaning from the Breast

NATURAL WEANING

Natural weaning is the biological process of gradually decreasing milk supply as baby gets older. This process starts around 7-9 months as baby takes more solid foods and progresses toward sleeping longer stretches at night. It ends when baby finally weans (which may not be until 2-3 years old!!). Natural weaning doesn’t mean that you need to wean baby from the breast. Decreasing milk supply doesn’t mean you’re at risk of losing your supply, either. Your breast is designed to match the stage of development your baby is in. 

Milk supply iss highest from month 1-6 when baby is going through multiple growth spurts. They need to double their birth weight by 6 months. Milk is also the only food in their diet.  Therefore, your milk supply is supposed to be at its highest to meet their nutritional needs. From 6-12 months, weight gain slows but their need for milk volume needs remain stable. It is natural as baby transitions from a full milk diet to a milk+solids diet to then a solids+milk diet that breast milk supply will shift along with it. Your milk supply varies compared to baby’s solids intake and there is a wide range of normal based on your individual baby. Some babies love solids and eat them in large quantities many times a day. Other babies continue on a mostly milk diet until almost 1 year.  At 12 months, milk finally takes a back seat to solids, but still fills in nutritional gaps and acts like medicine against illness. From 12 months on there continues to be a wide range of normal for milk supply depending on your child’s eating and feeding habits. Some babies continue to nurse occasionally over night while others seem to become boob barnacles again and would happily stay on the breast all day, every day.

So what does this mean? If you’re exclusively breastfeeding you may not notice anything.  You can continue to bring baby to breast for as long and often as baby wants. You may notice baby spacing out feedings or not nursing as long. They may want the breast more when teething or going through growth spurts or developmental leaps. They have days with little interest in the breast. 

Moms who pump (either exclusively or because of work) report overflowing milk in the early weeks, often able to pump 4-6 or even 8-10 ounces in a morning pump session. By 4 months supply regulates and mom gets about 3-5 ounces per pump in place of a feeding. By 9 or 10 months it can feel like your trying to wring out a wet rag to get even 2-4 ounces a pump session. As long as baby has unrestricted access to the breast when your not working and you still have a regular pump routine in place no intervention is usually needed. Every journey is supposed to look different because it is your unique journey.

Photo Credit Jermaine Love
@jermainelove44