B-R-C.
Welcome to Feeding Frenzy, a podcast brought to you by the
Breastfeeding Resource Center. The BRC is a nonprofit
organization in Abingdon, Pennsylvania. We're here to
provide support on various parenting topics to help you
get through the roller coaster ride of parenting. I'm your
host, Collette Acker. Let's take this journey together.
Welcome to this edition of the BRC's Feeding Frenzy, where we
talk about breastfeeding, chestfeeding, and all kinds of
parenting topics. You know, the BRC opened its doors in 2003. And
the goal was to provide expert lactation care. We've grown
quite a bit since those early years. And now we typically see
about 40 families a week. So there's a lot of experience
within the BRC walls. And today I have with me, Louisa
Brandenburger, and Jen Sheave, who have been IBCLCs for 14
years and have worked with me here at the BRC for all of that
time. Welcome, Jen, and welcome, Louisa.
Thanks for having us.
Thanks for having us, Collette.
Sure. So what I wanted to talk about was the typical reasons
people come into the BRC. And I feel like when I think about
that, there's top five that show up in my head, although there
are plenty more. I want to talk about those.
Absolutely.
So I think the most common is sore nipples. Yep. Yep. So what
kind of what kind of things do you guys see that people run
into what's causing the pain?
First and foremost is latching positioning. I really feel that
some people have an idea in their head for what it is that
they are supposed to be doing and then the way that they go
about doing it, they have a hard time actually practicing it. So
for them to be able to be taught the better way, I always want to
say correct because it's like some families feel when you use
correct or incorrect that they're doing something wrong.
And we always say that it's a learning curve.
I think a lot of people have this idea that as seen on TV,
breastfeeding and I think for newborns, it's not as seen on
TV. And I think they're also used to what they, you know,
learned in the hospital. And once you're at day five, six,
seven, things have changed and we have to change along with our
babies.
Yeah, and we come from a bottle feeding culture, so we don't see
it done. And I remember teaching prenatal classes for years. And
one of the questions I said, well, how many of you have ever
seen a woman breastfeed? And in the big years and years ago,
there was hardly any, then there started to be more hands. And I
say, how many of you have seen five or more women breastfeeding?
Nobody would raise their hand. So we don't know what it looks
like is a big problem. So that's primarily, especially in the
hospital setting, we work on latch and positioning, but we
always tweak it here too. That's the first thing we want to we
make sure that's good before we move on to anything else. So
what are some other reasons they're sore? Well, I think the
big one that we hear a lot about are some oral anomalies,
probably. Tongue ties is a big one. There's a lot of families
who come in asking, my nipples hurt. It does my baby have a
tongue tie. I think it's just out there so much. Yeah, with
social media and the internet, people are jumping to that. When
there can be so many other things in the baby's mouth that
could be impacting it. We have short tongues, we have big
we have those high palates and all kinds of different things.
So it's not always a tongue tie. But yeah, different structures
in the mouth can impact and sometimes it's just fixing the
latch and positioning. That right. Yes, it's everything.
People think, oh, it's a short shallow latch. It's because my
baby has a tongue tie. And when you tuck that baby in, lo and
behold, there's no pain. Or that lipstick. That's a big one. You
have that lipstick shaped nipple after nursing people just
assume it's a tongue tie. And a lot of times it's just tucking
that baby in a little closer and getting them on the right angle.
And even as simple as something of continuing to hold and
support the breast. Sometimes some families don't realize that
is a big important thing. They'll hold the breast, support
the breast, shape the breast, but as soon as baby gets on, they
let go and then everything changes. Right. Especially when
they're large. Yes. So we talk about the baby side. What about
the mom side? Something that most people don't realize is
nipples do come in different sizes. Oh, yeah, many different
many different sizes and shapes. And obviously babies come in
different sizes and shapes too. So sometimes their mouths are
tiny, and they are not able to fit the nipple all the way in
or they can fit the nipple in but not enough in order to
really get that milk moving.
Yeah, there. And then you have your flat, your short, you're
really long, the ones you can hang your hat on. You know, the
various shapes of the nipples can really impact the latch.
Let me say square peg round hole. You know, you can't they
just don't fit together yet. And they eventually do. But in those
early days, sometimes. And that's rare. Yeah, you know,
right. Most of the time. Yeah. You know, for species survival.
Yeah. We do match up. Yeah, we do match up. But yeah, and then
there's also inverted nipples that can make things difficult.
And you have true inversion where they're really tucked in
and there's skin holding them in. Yeah. And then you have the
ones who if you fiddle with them correctly, they'll join us.
And some of that is just from birth if someone was induced and
it's been they were filled with all kinds of fluids and their
nipples become flat and they think oh, I've inverted nipples
and then I see them I'm like, they're not inverted. Maybe in
the hospital they were or flat. Yeah, you see that a lot when
they're pumped with lots of fluid during labor if they've
had long extended labor and they were in the hospital the entire
time there when their ankles are completely swollen. So are there
are areolas and I look at angles all the time in a concert. I'm
like, so I wonder what the breasts are going to look like
if that's what your ankles looks like you're wearing flip flops
in December. Yeah, your poor feet. And then there's some
other issues first with sore nipples, which could be some
type of infection. So what do we see there? Sometimes we see
we see yeast, but you know, fresh, we don't see a lot of
fresh, you know, maybe in the summer months a little bit more
often. Yeah, August. Yeah, a wet bathing suit. I just think
yeast likes to thrive in warm, dark environments. Yes, that's
what I meant. Yeah, so we see that in August and sometimes in
the winter months if people are all bundled up in a lot of
clothes. Yeah, but it's not as I don't see it as often as we
used to for some reason. Yeah, I could count on probably both
hands. How many times I've seen it in the last year, maybe
probiotics. Yeah, more people are using maybe. Yeah, who knows?
Although it's very quick to be diagnosed as Yeah, yes,
absolutely. Yeah. So with the yeast, it's typically bilateral.
And the baby may have symptoms. They're super duper itchy. Yeah,
they hurt. Yeah. All the time. It's non intermittent pain.
And latch on pain is crazy bad. Yeah. Where the other the
bacterial infection can be similar. Sure mastitis can be
I mean, on the nipples. Absolutely. Yeah. Just had some
last week. They were a little. Yeah, it's really hard to tell
the difference between the yeast and bacterial infection but
with they're both extreme extremely painful. And I, I
don't think we see either of those but that something that
goes into the category of sore nipples and the other reason
people are sore is all the pumping, right? Yeah. Too hard.
Like their vacuum is up too hard. They think they have to
turn it up higher to make it work more effectively when in
fact that is not the case at all. I tell them it doesn't have
to be on hot. You're not a better woman if it's up to high
you just, you know, pump for comfort. So we're just we just
want it so bad. Yeah, they just turn it really high and it winds
up biting them in the butt a little bit, especially if they
don't see much happening when they are pumping they think
they need to turn it up higher. Yeah. Sometimes they're not
aware of how long they need to pump for everybody thinks that
they need to continue pumping as long as the pump is running as
well. So that's not. Oh yeah, you hear 3045 minutes. Yeah,
don't stay with a wrong size flange. Really? Yeah. And that
goes along with the variance in nipple sizes. So it's just
coming out that we're, you know, having this variety of different
size shields where we used to have three. Right. Yes. Three or
four. Four. Four in total. Now we have like 15 to 20. Starting
at 10 up to 36. 36 and many in between. So I think the
realization came that nipples come in different sizes, but
yeah, pumping with the wrong size breast shield is going to
cause a lot of pain. So I usually say to them, how do I
know it's the right one? I'm like, it feels good and it gets
all the milk out. Right. Or feels okay. Putting your nipples
into a machine that plugs into the wall is not really good.
Inviting of a thought, but it shouldn't hurt. So yeah, so
nipples a variety of reasons for that, but that's the biggest
reason I feel like people come here. What's another one?
The sore nipples? No. Another reason that they come in. Their
baby won't latch. Or they can't get their baby to latch or their
baby's refusing to latch. It's a little bit of both. Yeah,
that's the hardest. And if it happens early on, you know, and
they're pumping already, they're already on the crazy roller
coaster of pumping and bottle feeding. And what happens when
you start that? The baby gets overfed. And they're like,
the baby gets overfed. The baby gets used to the fast flow.
The baby, you know, it's just, that's so hard to turn that
around sometimes. And they don't, they don't trust
themselves. They don't trust their baby. Right. And their
baby's screaming at them. And their baby doesn't like them.
And it's so hard. They take it personally, because they're
screaming at their breast. And it's not, it's not that they're
upset with the breast. I just want to eat and I want it now.
And I want it the way I want it. Yeah. And I find a lot of the
times that when you see a baby refusing early on, they weren't
breastfeeding well before that. Right. They learn pretty
quickly. When I go here, and I don't get what I need, I'm gonna
start fighting it. I don't want to do it. So we have that early
on breast refusal. What are some other reasons that they are
refusing besides not getting enough milk?
How they are latching there. So it's just like what they're not
like you were talking about. So like the the bad latch, they're
not getting a whole lot at the breast. And just like how
they're being held at the breast. Sometimes that makes an
effect on babies too, just if they're not feeling supported
and comfortable. And that's a lot of the things that I go over
with with the families as well, too. I see sometimes how moms
are holding their babies and their legs are kind of like out
and dangling and little details that are not realized of the
completely supporting a baby bringing their them in so their
feet can touch something affects what it is that they're doing at
the breast too. So they can have a bad latch and then their
intake at the breast is low. So they get frustrated.
I remember someone at a conference saying, you know, to
tuck in the legs and support the whole body. She goes, could you
imagine hanging from a balcony and someone's putting a
sandwich in your mouth? Yes, not going to enjoy that meal very
much. Yes, we have too many bottles. The baby's not
positioned well. They're getting mad. They're uncomfortable.
They're not able to get the milk. Or if it's actually a supply
problem where there is not enough milk available and they
get angry. And you see those babies come off the breast,
they'll come back on try again, they'll yank their heads off.
They're like, what the heck? Where's the milk? So and then
sometimes what about those early babies? Yeah, we see babies
born, you know, 37 weeks, 36 weeks, they're just not prepared
or capable of breastfeeding. They're really sleepy babies,
not not all but some. They're really sleepy. They're hard to
keep engaged. And so we're parents are spending, you know,
20, 30 minutes of just keeping the baby awake to get them to
stay engaged, which can be really frustrating. More for the
parent, the baby at that point sometimes is perfectly fine
taking in half an ounce and falling asleep. And life is fine.
And we know as you know, lactation consultants and parents
that our babies need more than that. And so that can be really
really frustrating for a parent like I have milk and he won't
take it. Yeah, and it's not because they don't want to
they're just they always showed they should still be like
swimming around inside the belly, you know, still be inside
they shouldn't have to be out here doing this. They shouldn't
have to suck, swallow and breathe and they shouldn't have
to you know, hey, mom, dad, feed me. They don't know how to do
that stuff. Yeah, too young. Yep. It's like asking a seven
year old to drive a car. Right. Right. They might try. Yeah.
I can't see you over the drive. The steering wheel. Yeah, so
sore nipples, baby won't latch. What you know, what are some
tips that you use to get babies to latch? Increase that supply.
Yeah, make sure there's milk available. So when they get
there, they're rewarded. Yeah. Yeah. So if it's a low supply
issue, like the ultimate goal is to get the baby onto the
breast for most families. And when we're putting a baby to the
breast where the supply is low, they're going to get
frustrated. So ultimately, first step in the process is to make
sure you work on getting that supply up. Because in turn, you
will have a baby willing and happy to go to the breast
because there's more milk coming out when they're there.
Absolutely. Nobody wants to do work without getting reward.
Yeah. And sometimes it's just fixing the latch and the
positioning that they're on well and they get milk. And what
about nipple shields? They're appropriate for some babies. Not
all. You know, sometimes they're especially sometimes
those early babies, the ones we were just talking about that
are sleepy and tired and aren't engaged. Sometimes we can pop
a shield on and it really engages that baby. It kind of
gets them to stay active longer at the breast, which is
ultimately the goal. Like Gemma was saying, sometimes just
sneaking a little milk in that shield can also be helpful. And
I can't tell you last time I had a family who was using a
shield at three, four, five, six, seven months. It's not all
that typical, at least in my experience. Usually in the
early days, sometimes they're really helpful. They get a bad
name. Yeah. And they have a bad rap and people think they're
horrible. And listen, at the beginning when it starts
working, you're like, this is amazing. And then a couple of
weeks into you're like, I hate this thing. Yeah. And there
usually comes a time where we can kind of pull away the
shield and it's just it's a short term help for some babies.
And that's the key. I think we need to tell parents about
short term. And I think in the outpatient setting, I waste
more than I actually use. I'm like, let's try a shield. Nope.
That didn't work. Never mind. Yes. But yeah, so which always
makes me think in the hospital setting where it's harder to
tell if the baby's latched well and able to get milk, you know,
how many times are we giving it to the parent and it's not a
good match. Right. Yeah. Especially in the hospital
setting because the colostrum and there's not milk
necessarily flowing easily compared to once the milk is
really increased. Sometimes there's a half an inch between
the mom's tip of the nipple and the shield. How does the milk
jump through it? Right. Exactly. Yeah. I want to make
different nipple shields to accommodate different, right.
Different nipples. Yes. Next. Next on the agenda. Mark it on
my calendar. And so we have sore nipples, breast refusal,
production and removal problems. So that's kind of a
mouthful. What do we mean by that? It's kind of a little, it
could be supply is low or the baby can't get the available
milk out. So it kind of goes either way and they're handled
a little differently. We look at them in a different way. If
supply is low, what are we, you know, we're looking at the, it
all goes back to latch and positioning and getting
stimulation. And if supply is low and we have a baby who's
really frustrated at the breast, we still keep them at the
breast, but we often will kind of pop in some pumping to kind
of get some sustained good stimulation for mom. Yeah. I
think the key thing is, is like if we have a baby who's not
gaining weight, it's not always a low milk supply problem.
No, not at all. It could be that the baby can't get the milk,
but milk is available. Right. Or it's there isn't enough milk
available and we have to work on the parent side to get the
milk supply going. So I didn't want to put in the category of
baby not gaining. This was sort of, is it a production
problem or a milk removal problem? Right. Yeah. But you
see both sides. So what do you guys do for low milk supply?
I try to keep the baby at the breast as often as I can, just
for confidence for mom, time at the breast for the baby.
We always go back to the, you know, number one rule is feed
your baby. Number two is preserve your supply. And
they're just like some basics. So we're getting that baby to
the breast, I think is important to keep them acclimated
to the breast. If they're getting milk or not, we still
want to keep the baby at the breast. And then I think we
start putting in a little bit of pumping some skin to skin,
things like that can be really, really helpful to build supply.
Yeah. What about supplementing directly at the breast? Because
in the other method, we are talking about breastfeeding,
supplementing, and then pumping. So it's that triple
feeding thing that everybody knows isn't sustainable long
term. So like how soon would you bring one of those families
back to check in on things? Oh, pretty quick. Within a few days.
Within a couple days. Before a week. Yeah. Yeah.
Just it's not that forever plan. Those words come out of my
mouth. This is not the forever plan. Yeah. But we're going to
see if we can boost up supply. As supply goes up, it gets
easier and easier to get the baby back on the breast or put
the baby on the breast with an SNS, which kind of pulls out
the pumping part. Yeah. The supplemental nursing system
allows you to supplement directly at the breast and the
baby stimulates the breast, gets extra milk, so remains more
active and does the job of the pump. In hopes of mom being
able to cut out pumping. Yeah. So she doesn't have to do that
triple feeding. It has to be a great breast feeder. And so
when you're in a situation of a baby who doesn't feed well, one
of those supplementers don't always work. What do you say
about people just breastfeed more? That'll do it. We have to
evaluate what baby's capability is. If the baby is capable.
And mom's supply. Yeah. Both of them. If it's really low. If
it's really low, then that's not sustainable because yes, mom
and baby can keep breastfeeding, absolutely, but what's
happening? What's baby taking in? The baby's going to be
connected to the breast 24 seven, if that's the case, and
that's not sustainable either. And maybe not getting all the
milk. Yeah. See, the baby on there all the time who's not
getting all the milk. So that's where our scale comes into
play. And I have, you know, heard of some people like, we
don't need a scale because, you know, you have all these other
things that you should be able to look at. And I'm like, it is
a piece of the puzzle, but it is an awesome piece of the
puzzle. And it might be, you know, it allows us to create a
plan that's appropriate for them. Absolutely. Have you had
babies who are gulping up a storm? You hear them across the
room and you pop them on the scale and they take like point
two. Yes. What happened? Yeah. So those babies are the really
quiet baby. And you're like, I don't think this kid got milk.
And then you put them on the scale and they took 1.4 and
you're like, you're really good. Stealthy. Yeah. So babies can
fool us. I've been fooled. And so I love to do the pre and
post weight checks to add that piece of the puzzle to help make
a plan that's good for this particular family. I think that's a lot of
families whose babies going back to, you know, not gaining and
things like that. The question is, well, how much do I
supplement? And I think that also makes it, it just gives us an
idea. You have a baby who's getting, you know, 0.1 at the breast or a
baby who's getting 0.8 at the breast. It doesn't seem like that
much, but that comes into play when you're supplementing.
Absolutely. And to give them a rough idea of how much the baby
will need. I always think of a family who has like a five or six
day old and they've gone to the pediatrician and there's weight
loss and they say, give two ounces after every feeding. And
they are so upset because the baby won't take it. And they
think they're doing something wrong or not feeding the baby
appropriately when it's just not, you know, that wasn't a good amount.
They need a half an ounce. Right. Yes. And they're fine.
And I do that talk, how, when and how much to supplement where
to health care professionals just for that reason.
You're giving a number and you don't even know how much this
kid is taking. So are you giving a number that's an entire
feeds worth or are you giving a supplement? You know, that'll
give them until they keep going. Doesn't necessarily apply to
every baby. And I had a family who was finger feeding and they
were told to keep going until the baby pierces her lips, not
even a certain amount. So, until they throw up, just keep feeding
them. So we've heard that too, essentially for 15 minutes,
however much they can take in 15 minutes. I'm like, do you know
how much I can eat in 15 minutes? That's one of my favorites, the 15 minute one.
15 and 15. I hope he's not listening to the podcast.
Yeah. So the supplementation plan when there's low milk production
is, you know, it's vital to understand what the baby's capable of doing.
And what about those babies who can't get milk? What do we do with them?
What are we looking for? How can we help them?
Looking in their mouth. Yeah. Just looking at their mouth, looking at
the whole picture. Yeah. So we do it with every baby, but
oral assessment. Is there anything going on that
makes, like if the mother's milk supply is good and this baby can't get milk,
what the heck is going on with the transfer?
And so part of here at the BRC, besides us,
we have an occupational therapist here who's,
and we have other resources in our area. One of our upcoming podcasts is with a
physical therapist who works with babies who are struggling to get milk.
So sometimes we can't fix everything. We even
refer on to somebody else, but we'll save all that
fun info for the next one. So we have sore nipples, breast refusal,
production or removal problems. What about the fussy baby?
See a lot of those. I saw one of those today. And what do parents blame?
Themselves. And breastfeeding. And breastfeeding and their milk supply.
And what they're eating. Are they eating something?
It's always something that they're doing wrong.
Yeah. Which is really sad. Because it's not,
sometimes it's nobody's fault. It's just the situation or like you still go back.
Latching positioning. A mom who has like, a parent who has way too much milk and
this baby is goburi, goburi, goburi and like spitting up.
Like some simple positioning changes can make it
that much more pleasant of a feeding session. And we now have this
not so fussy baby or not an overly gaining baby or you know, lots of
it's just management. The oversupply is you know, sort of an easy one in most
cases where we can reduce the milk production
and help this baby manage it a little better. And sometimes it's a natural
overproduction and sometimes it's induced. Yes.
We are so hyped about pumping these days. Everyone gets a pump.
Instagram. Yeah. And when can I start pumping? When can I?
Little do they know. No one says I love pumping.
So I think sometimes we're terrified. We have horrible maternity leave.
We're stockpiling our freezer full of milk. Because what if?
What if? What if? I don't know what if. What if? That's what I'm saying.
All of the what ifs. So I think oversupply is a big one.
Whether it's natural or self-induced. And then of course there's the opposite.
They're like I don't know the baby's not burping. Something's wrong.
You know, baby's colicky. And then you pop the kid on the scale and you're like
maybe it's not enough milk. Yeah. They look very similar sometimes.
The oversupply and undersupply. They're fussy and miserable.
Feeding frequently. You know, there's so many
similarities between the two. And we again, that internet, we just had a mom and
support group. It was like well I think it was oversupply. So I started block
feeding and I was like. But was the baby really gaining? But the baby wasn't gaining well.
That's the main difference between is baby's weight gain.
Yeah. Look at the numbers on the scale. If it's double the norm, yes. We will work on
your oversupply. If it is normal weight gain, it is not oversupply.
Yeah. Something else is going on. Yeah. What about food intolerances and allergies?
You hear about diet. I stopped eating this. I stopped eating that.
I think things have just, we've learned a lot since I know when I had my children
and what I could, could and could not eat.
Everybody comes in and oh my baby's fussy so I stopped dairy. My mom said,
family had today, is like I stopped dairy because and I'm like but why?
Because her baby was fussy. This baby, but you know, it's, I don't think it's that.
And it's usually not. It's. Well and we're hearing less and less
about stopping to eat broccoli. Right. Yes. You know. Thankfully.
Thankfully. Yeah. So. Because there's no chunks of broccoli coming up.
That's what I say. You know. There's big giant pieces of fiber coming through your breast
now that's making your baby gassy. Yes. So I mean that those diet things seem
to have almost gone away. Yes. But yeah, people know about the dairy intolerance.
But they're going to that first. Yeah. I feel like. I like dairy way too much to do that.
Yeah. Ice cream, cheese. It's delicious. Yeah. So if you don't need to do that.
That would be great. But sometimes I've even seen other food allergies. I have a picture of this
baby. He just looks miserable. He's got a rash all over his body. He wasn't gaining weight.
And he had several food intolerances and allergies. So it was dairy and wheat
was causing the problem. And it can really impact them negatively even with weight gain.
They're not just gassy and fussy. I think we see with moms too. There's a lot of
people who have to go on that you don't have wheat and they have celiacs and they're vegetarian.
And then you say to them, so we have all these things that we can't eat anyway. And then we add
on don't eat dairy. And for some people that is all their protein sources. Exactly. Is from dairy.
Is from dairy. So that's why I always say don't want to. Because I think people are limiting
their diets more and more because I think we know more now. And it's hard enough because most moms
were making sure that they are eating because they're so focused on their baby that sometimes
they're not. So to take away. That quick, easy cheese stick. Exactly. Yeah. Or yogurt. If they
don't have to do it. Yeah. Right. And then there's the other thing. The problem with
problems associated with reflux or if they're diagnosed with GERD. We see those babies like
they're miserable. They really are. And they start biting at the breast. So that may be. And we
ought to add that to the breast refusal is usually like at seven or eight weeks if they've been
suffering from it. They start backing off. It's like I want to eat. No I don't. Yes I do. It hurts.
I want to. It'll make me feel better. No I can't. They're just back and backing on and off the
breast. Uncomfortable. Yeah. They want to eat. They just can't tolerate it. Or they eat and they're
just screaming afterwards. They're in so much pain. Yeah. So but you look at you know oversupply,
undersupply GERD. They're crying during feedings after feedings. You know so trying to figure out
which one that is. And if you go to the dairy first it may not resolve any of those other things.
And that again it's a quick measure of the intake. Use that scale. Determine is it oversupply,
undersupply or is this kid self-limiting because he's in pain. So the fussy baby there's all kinds
of things. Or and parents you say oh my baby has colic. That doesn't happen that much anymore.
You know and if you if you look up colic it's like we don't know what it is. You say it's a symptom
of something. But every parent knows it's a GI distress. This kid is like pulling up the legs
screaming. It happens after feeding. So I think this oversupply, undersupply, food intolerance and
GERD is a huge part of the of the colic issue. So what's the final one? And I think Jen you came up
with this final one. I did come up with this one because this is one that does tend to come up quite often. So it's
normal development changes and their impact on breastfeeding. So we look through the different
stages that babies go through from the start and the expectations of how things are going to proceed
as they start to get older. So what they start with as they grow it's developmental changes.
Forever changing. Forever changing. So what is said in the hospital when it's done in the hospital
is not going to be done even at like two weeks. Even at a week. So expect changes. Expect things to
to just kind of keep developing as the baby's developing. So yeah I think that's why I like
people to keep coming back because even what we told them two or three weeks ago is going to be
different now. And I feel like people don't trust themselves to just follow their baby. Yeah and so
like checking in and seeing what the changes are. I love. Well and it's so interesting that you talk
about the hospital versus a week out. So we also do hospital work and we've always said it's two
different jobs. Yes. Hospital LC, outpatient LC, two entirely different jobs. And what we say in the
hospital may not be applicable. Be applicable on day four or five. Yeah. So that quick. Yeah it
changes a lot. So that's the one thing in the newborn stage. What else in the newborn stage are
we seeing that like changes and freaks people out? Well that onset of copious milk is it's very
different on day one of life to once you've had that onset of milk day three four five whenever
it is. You're like oh breastfeeding was going swimmingly it was great baby latched all was
good. And then you have these full breasts and the baby's latching poorly or shallowly because the
breasts are still full. Yeah. And you know everyone thinks that your breasts are full of just milk. I
remember being like I'm gonna pump and get 10 ounces. And it's like an ounce comes out. Your
breasts are still full. Yeah and so I think that's the biggest change that we're seeing just in that
early week. Well even with that the idea of that setting rules. Yeah. Feed your baby every two
hours or things like that. And so maybe they do want to eat every two hours on day two or three.
And then milk supply increases and this kid's knocking back an ounce. Yeah. And they're so full
and they may go three maybe even three and a half and the parents are freaked out. He's supposed to
eat every two hours. Yes. So I think that watching the clock thing doesn't work in breastfeeding. Or
anything. Sometimes. I hate when people tell me I have to eat lunch at noon. I know. Right.
Yeah so that's in the early stage. What happens around two months old that changes. The different
signs that parents were going by in the beginning in that newborn stage of like their babies putting
their hands in their mouths their fingers sticking out their tongue. The development change of oh
look these are mine. I can put them in my mouth. What do they taste like. You know I want to explore
them. It's not always feeding me rooting. Yeah. Me rooting as signs that we were going by in those
newborn stages. Yeah. You have parents ask you that all the time. See does it mean that they're
hungry and the kids like happy sucking on their face. We're like no. They're freaking out. They
they're just happy and they love it's their new toy that they brought with them.
How about if they don't fall asleep after feeds anymore. That's. Well they must still be hungry
because in the first week did they wake. They fall asleep. They eat. They wake. They fall asleep.
That's all they really do. Yeah. And as they get older they start staying awake longer. They have
the ability to kind of be a little bit more alert between feeding sessions. And it's so hard because
there's nothing really to do with them. It's hard to play with the baby. They don't do much.
That's when you put them in tummy time. Yeah. That's something fun to do but they don't do a
whole heck of a lot. What about at three months. Have you seen some changes at that point. I know
one that I see often. I just think they become more nosy. I just want to see what's going on
around the world. I always see those kids who like they're happily breastfeeding and they take their
supplemental bottle and at three months they decide not to do one of those. Like adamantly
adamantly like no oh I'm not taking a bottle anymore. I'm sorry. Yeah. What were you thinking
and completely start fighting it. It's crazy. It always seems right at 12 weeks that that happens.
Those must be looking to go back to bottle refusal. Yes. Yes. Yes. Thankfully they're not on our top
five because they're rough. They are. Yeah. And then what about three to six months. What kind
of differences do you see then in a baby. They just they get good at what they do. They're more
efficient. So again another developmental change based on but my baby was feeding for like 15 or
20 minutes before. Now they're done in like seven. There's no way no way that they got everything
that they needed. I keep on pushing and I'm pushing them on the breast and they're pushing
away. I'm like maybe they're done. They're like no mom thank you. I've had my fill for now. That
goes back to watching your baby not the clock. Yeah absolutely. I'll never forget that picture
of that baby who looks like the Michelin man. The mom walked in and said her baby she was worried
her baby's not getting enough and trying not to giggle. And this kid was taking five or six
ounces out of feeding and she was trying to feed him every two to three hours. And he was fighting
her. He hates it. I'm like no no no. Just not hungry. He loves you. Well what about at four months.
There's always the favorite. We'll ask. Louisa's also our sleep holistic sleep coach. So she's
always hears about the four month. The four month sleep regression. Yeah. You know some families
have started to get in a little bit of a groove of a longer stretch between you know overnight
between feeding sessions. And then it all goes to pot because so many developmental things are
happening at four months. And it's just naturally it's very normal for babies to start waking at
night and everyone panics. My baby's not getting enough. That's why he or she is waking at night.
And it really doesn't have anything to do with it. So that can really throw a wrench. It's also you
know we might have gotten back to work and like we really need our sleep because we have to go to
work in the morning and this little one's like hello. And like once and they're not necessarily
happy. Right. Waking up. And it's not like just once. It's like two three four five times a night.
Right. They automatically think it's food related. Yeah. There's not enough food. And I'm like no
there's so many other things happening. Yeah. And that's a big thing in our culture filling the baby
up so they sleep better. Yeah. And they've done a lot of studies and they don't it doesn't. And
they've done studies with formula to breast milk. And you know when our kids were younger you know
20 years ago formula was different than it is today. And I think babies a lot of the proteins
are broken down so it's a little easier for them to digest. So we're not seeing babies who are
formula fed necessarily sleeping longer. Right. For formula fed babies have a four month sleep
regression also. Yeah. We forget that. It's not just for breastfed babies it's for babies in general.
It is a sleep regression period for babies. Yeah. What about that distracted baby at four months?
That gets to be frustrating when you're especially if you have an older child and you know the toddler
is running around or you're out and about and you're you know at the park and the dog walks by.
There's my nipple. A bird flies by the window. They're just and they and any little thing. Right.
And they think there's something wrong. Why why why won't they stay on the breast? Well you wonder
if the sleep regression has something to do with that if they're taking little snacks and they do
have to eat in the middle. Right. It could be. It could be. Absolutely. Yeah because they have to make up for it. If they're just snacking
they sometimes you will see them wanting to breast longer. They'll get their milk anyway they can.
Yeah. They don't need to do it between you know 7a and 7b. Even though it works better for you. Yeah.
It would be lovely wouldn't it? Yeah I mean some sometimes going into a dark room but when you have
toddlers or you need to go out it's so hard to keep them. Did either of you try those necklaces?
Those nursing necklaces? I know. I've seen babies in the office that sometimes can really grab their
attention. Yeah keep them busy. And they become teething necklaces later in life so they're kind of dual
purposed. Yes. But you do see babies you know pulling on mom's shirt or things like that just
it kind of grabs their attention and they enjoy it. It's worth a try. It's worth anything's worth it.
Sometimes it's painful too when they kind of pop off and then pop on and then pop off. Yeah because some of
them really yank. Yeah. Those older babies they're just not that careful. Yeah. The other option is
trying to get them to feed when they're sleepier. Dream feeds can become a thing for the baby who's
distracted during the daytime to try and get them to eat a little bit more. So that's one of my big
go-tos is like it you're going through this as far as like a possible sleep progression and the
distracted baby. So the best time to try and get them to eat is when they're sleeping or sleepier
and a lot of families do agree that is when they find that their baby's doing better. The best feeds are right because you ask them about
the whole day of what's going on all day it's on and off on and off. I'm like how do things look in the evening and
overnight? Oh they're just fine. I'm like because it's dark and there's nothing to look at and it's quiet and
hopefully their brains are shut off just a little bit more than what's going on during the day. Yep.
Yeah maybe try like a sound machine or something like that that's kind of calming. Yeah and I even say try to
distract your baby. Try to have something to distract them like what do you notice has something that
they might focus on and look at at other times? Do you have a fan? Is there a light? Is there
something that they like to look at? Like stand right up against there while you're trying. Yeah a mirror so they can see themselves.
And the other thing I see at the six months old I since I'm the one who teaches the starting solids
class it's like people think that once the baby starts eating some solid foods they don't need
as much milk they're not going to nurse as much but that's not the case. No still their main source of
nutrition. Their main source. They're just learning to eat a different way. They're exploring
exploring it's not even eating like they're just tasting something different. The textures. Yeah
flavors. Yes and I think we see that the babies aren't switching to less milk till closer to nine
months. Right. So an eight month old is not going to nurse differently than a five month old or a six
month old or seven month old. They still need the same amount of milk and I think that's that's an
eye-opener for a lot of families. Yeah. Is their intake isn't really changing all that much. Right.
We just assume they need more and more and more and more because again go back to our bottle feeding
culture is that some formula fed babies they do need more milk at four months or at eight months
than they did at four months because they're growing and they have more needs different needs.
But they tend to take less bottles. Yeah. So we don't. Yeah we don't work that way. So it all
depends on our storage capacity of how frequently our babies are going to feed and so you know if
they need eight feedings a day to get the 24 to 28 ounces they're going to still need eight feedings
a day to get that. There are no two ways about it. Awesome. So I love these. I loved our top five.
Yeah. And maybe next time we can talk. Well I know we're bringing you back Louisa for your holistic
sleep. Yeah. Talking so because that's the big question these days besides breastfeeding. But
we'll have to think of some fabulous breastfeeding scenarios for you guys in the future. So thank you
Louisa. Thanks Jen. Thank you. And I am Collette and thanks for listening to the BRC's Feeding Frenzy.
You can learn more about us at www.breastfeedingresourcecenter.org.
Thanks for listening to the Feeding Frenzy. The BRC is a non-profit organization committed
to providing expert clinical and educational breastfeeding services. Find out more about us
at www.breastfeedingresourcecenter.org.