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B-R-C.

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Welcome to Feeding Frenzy, a podcast brought to you by the

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Breastfeeding Resource Center. The BRC is a nonprofit

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organization in Abingdon, Pennsylvania. We're here to

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provide support on various parenting topics to help you

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get through the roller coaster ride of parenting. I'm your

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host, Collette Acker. Let's take this journey together.

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Welcome to this edition of the BRC's Feeding Frenzy, where we

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talk about breastfeeding, chestfeeding, and all kinds of

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parenting topics. You know, the BRC opened its doors in 2003. And

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the goal was to provide expert lactation care. We've grown

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quite a bit since those early years. And now we typically see

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about 40 families a week. So there's a lot of experience

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within the BRC walls. And today I have with me, Louisa

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Brandenburger, and Jen Sheave, who have been IBCLCs for 14

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years and have worked with me here at the BRC for all of that

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time. Welcome, Jen, and welcome, Louisa.

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Thanks for having us.

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Thanks for having us, Collette.

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Sure. So what I wanted to talk about was the typical reasons

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people come into the BRC. And I feel like when I think about

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that, there's top five that show up in my head, although there

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are plenty more. I want to talk about those.

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Absolutely.

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So I think the most common is sore nipples. Yep. Yep. So what

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kind of what kind of things do you guys see that people run

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into what's causing the pain?

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First and foremost is latching positioning. I really feel that

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some people have an idea in their head for what it is that

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they are supposed to be doing and then the way that they go

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about doing it, they have a hard time actually practicing it. So

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for them to be able to be taught the better way, I always want to

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say correct because it's like some families feel when you use

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correct or incorrect that they're doing something wrong.

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And we always say that it's a learning curve.

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I think a lot of people have this idea that as seen on TV,

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breastfeeding and I think for newborns, it's not as seen on

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TV. And I think they're also used to what they, you know,

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learned in the hospital. And once you're at day five, six,

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seven, things have changed and we have to change along with our

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babies.

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Yeah, and we come from a bottle feeding culture, so we don't see

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it done. And I remember teaching prenatal classes for years. And

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one of the questions I said, well, how many of you have ever

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seen a woman breastfeed? And in the big years and years ago,

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there was hardly any, then there started to be more hands. And I

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say, how many of you have seen five or more women breastfeeding?

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Nobody would raise their hand. So we don't know what it looks

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like is a big problem. So that's primarily, especially in the

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hospital setting, we work on latch and positioning, but we

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always tweak it here too. That's the first thing we want to we

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make sure that's good before we move on to anything else. So

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what are some other reasons they're sore? Well, I think the

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big one that we hear a lot about are some oral anomalies,

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probably. Tongue ties is a big one. There's a lot of families

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who come in asking, my nipples hurt. It does my baby have a

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tongue tie. I think it's just out there so much. Yeah, with

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social media and the internet, people are jumping to that. When

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there can be so many other things in the baby's mouth that

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could be impacting it. We have short tongues, we have big

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we have those high palates and all kinds of different things.

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So it's not always a tongue tie. But yeah, different structures

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in the mouth can impact and sometimes it's just fixing the

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latch and positioning. That right. Yes, it's everything.

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People think, oh, it's a short shallow latch. It's because my

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baby has a tongue tie. And when you tuck that baby in, lo and

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behold, there's no pain. Or that lipstick. That's a big one. You

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have that lipstick shaped nipple after nursing people just

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assume it's a tongue tie. And a lot of times it's just tucking

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that baby in a little closer and getting them on the right angle.

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And even as simple as something of continuing to hold and

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support the breast. Sometimes some families don't realize that

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is a big important thing. They'll hold the breast, support

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the breast, shape the breast, but as soon as baby gets on, they

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let go and then everything changes. Right. Especially when

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they're large. Yes. So we talk about the baby side. What about

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the mom side? Something that most people don't realize is

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nipples do come in different sizes. Oh, yeah, many different

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many different sizes and shapes. And obviously babies come in

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different sizes and shapes too. So sometimes their mouths are

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tiny, and they are not able to fit the nipple all the way in

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or they can fit the nipple in but not enough in order to

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really get that milk moving.

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Yeah, there. And then you have your flat, your short, you're

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really long, the ones you can hang your hat on. You know, the

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various shapes of the nipples can really impact the latch.

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Let me say square peg round hole. You know, you can't they

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just don't fit together yet. And they eventually do. But in those

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early days, sometimes. And that's rare. Yeah, you know,

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right. Most of the time. Yeah. You know, for species survival.

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Yeah. We do match up. Yeah, we do match up. But yeah, and then

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there's also inverted nipples that can make things difficult.

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And you have true inversion where they're really tucked in

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and there's skin holding them in. Yeah. And then you have the

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ones who if you fiddle with them correctly, they'll join us.

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And some of that is just from birth if someone was induced and

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it's been they were filled with all kinds of fluids and their

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nipples become flat and they think oh, I've inverted nipples

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and then I see them I'm like, they're not inverted. Maybe in

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the hospital they were or flat. Yeah, you see that a lot when

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they're pumped with lots of fluid during labor if they've

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had long extended labor and they were in the hospital the entire

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time there when their ankles are completely swollen. So are there

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are areolas and I look at angles all the time in a concert. I'm

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like, so I wonder what the breasts are going to look like

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if that's what your ankles looks like you're wearing flip flops

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in December. Yeah, your poor feet. And then there's some

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other issues first with sore nipples, which could be some

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type of infection. So what do we see there? Sometimes we see

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we see yeast, but you know, fresh, we don't see a lot of

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fresh, you know, maybe in the summer months a little bit more

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often. Yeah, August. Yeah, a wet bathing suit. I just think

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yeast likes to thrive in warm, dark environments. Yes, that's

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what I meant. Yeah, so we see that in August and sometimes in

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the winter months if people are all bundled up in a lot of

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clothes. Yeah, but it's not as I don't see it as often as we

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used to for some reason. Yeah, I could count on probably both

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hands. How many times I've seen it in the last year, maybe

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probiotics. Yeah, more people are using maybe. Yeah, who knows?

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Although it's very quick to be diagnosed as Yeah, yes,

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absolutely. Yeah. So with the yeast, it's typically bilateral.

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And the baby may have symptoms. They're super duper itchy. Yeah,

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they hurt. Yeah. All the time. It's non intermittent pain.

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And latch on pain is crazy bad. Yeah. Where the other the

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bacterial infection can be similar. Sure mastitis can be

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I mean, on the nipples. Absolutely. Yeah. Just had some

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last week. They were a little. Yeah, it's really hard to tell

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the difference between the yeast and bacterial infection but

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with they're both extreme extremely painful. And I, I

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don't think we see either of those but that something that

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goes into the category of sore nipples and the other reason

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people are sore is all the pumping, right? Yeah. Too hard.

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Like their vacuum is up too hard. They think they have to

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turn it up higher to make it work more effectively when in

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fact that is not the case at all. I tell them it doesn't have

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to be on hot. You're not a better woman if it's up to high

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you just, you know, pump for comfort. So we're just we just

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want it so bad. Yeah, they just turn it really high and it winds

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up biting them in the butt a little bit, especially if they

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don't see much happening when they are pumping they think

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they need to turn it up higher. Yeah. Sometimes they're not

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aware of how long they need to pump for everybody thinks that

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they need to continue pumping as long as the pump is running as

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well. So that's not. Oh yeah, you hear 3045 minutes. Yeah,

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don't stay with a wrong size flange. Really? Yeah. And that

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goes along with the variance in nipple sizes. So it's just

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coming out that we're, you know, having this variety of different

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size shields where we used to have three. Right. Yes. Three or

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four. Four. Four in total. Now we have like 15 to 20. Starting

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at 10 up to 36. 36 and many in between. So I think the

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realization came that nipples come in different sizes, but

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yeah, pumping with the wrong size breast shield is going to

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cause a lot of pain. So I usually say to them, how do I

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know it's the right one? I'm like, it feels good and it gets

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all the milk out. Right. Or feels okay. Putting your nipples

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into a machine that plugs into the wall is not really good.

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Inviting of a thought, but it shouldn't hurt. So yeah, so

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nipples a variety of reasons for that, but that's the biggest

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reason I feel like people come here. What's another one?

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The sore nipples? No. Another reason that they come in. Their

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baby won't latch. Or they can't get their baby to latch or their

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baby's refusing to latch. It's a little bit of both. Yeah,

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that's the hardest. And if it happens early on, you know, and

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they're pumping already, they're already on the crazy roller

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coaster of pumping and bottle feeding. And what happens when

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you start that? The baby gets overfed. And they're like,

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the baby gets overfed. The baby gets used to the fast flow.

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The baby, you know, it's just, that's so hard to turn that

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around sometimes. And they don't, they don't trust

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themselves. They don't trust their baby. Right. And their

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baby's screaming at them. And their baby doesn't like them.

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And it's so hard. They take it personally, because they're

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screaming at their breast. And it's not, it's not that they're

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upset with the breast. I just want to eat and I want it now.

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And I want it the way I want it. Yeah. And I find a lot of the

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times that when you see a baby refusing early on, they weren't

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breastfeeding well before that. Right. They learn pretty

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quickly. When I go here, and I don't get what I need, I'm gonna

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start fighting it. I don't want to do it. So we have that early

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on breast refusal. What are some other reasons that they are

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refusing besides not getting enough milk?

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How they are latching there. So it's just like what they're not

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like you were talking about. So like the the bad latch, they're

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not getting a whole lot at the breast. And just like how

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they're being held at the breast. Sometimes that makes an

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effect on babies too, just if they're not feeling supported

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and comfortable. And that's a lot of the things that I go over

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with with the families as well, too. I see sometimes how moms

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are holding their babies and their legs are kind of like out

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and dangling and little details that are not realized of the

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completely supporting a baby bringing their them in so their

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feet can touch something affects what it is that they're doing at

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the breast too. So they can have a bad latch and then their

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intake at the breast is low. So they get frustrated.

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I remember someone at a conference saying, you know, to

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tuck in the legs and support the whole body. She goes, could you

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imagine hanging from a balcony and someone's putting a

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sandwich in your mouth? Yes, not going to enjoy that meal very

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much. Yes, we have too many bottles. The baby's not

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positioned well. They're getting mad. They're uncomfortable.

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They're not able to get the milk. Or if it's actually a supply

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problem where there is not enough milk available and they

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get angry. And you see those babies come off the breast,

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they'll come back on try again, they'll yank their heads off.

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They're like, what the heck? Where's the milk? So and then

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sometimes what about those early babies? Yeah, we see babies

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born, you know, 37 weeks, 36 weeks, they're just not prepared

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or capable of breastfeeding. They're really sleepy babies,

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not not all but some. They're really sleepy. They're hard to

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keep engaged. And so we're parents are spending, you know,

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20, 30 minutes of just keeping the baby awake to get them to

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stay engaged, which can be really frustrating. More for the

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parent, the baby at that point sometimes is perfectly fine

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taking in half an ounce and falling asleep. And life is fine.

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And we know as you know, lactation consultants and parents

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that our babies need more than that. And so that can be really

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really frustrating for a parent like I have milk and he won't

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take it. Yeah, and it's not because they don't want to

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they're just they always showed they should still be like

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swimming around inside the belly, you know, still be inside

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they shouldn't have to be out here doing this. They shouldn't

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have to suck, swallow and breathe and they shouldn't have

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to you know, hey, mom, dad, feed me. They don't know how to do

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that stuff. Yeah, too young. Yep. It's like asking a seven

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year old to drive a car. Right. Right. They might try. Yeah.

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I can't see you over the drive. The steering wheel. Yeah, so

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sore nipples, baby won't latch. What you know, what are some

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tips that you use to get babies to latch? Increase that supply.

229
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Yeah, make sure there's milk available. So when they get

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there, they're rewarded. Yeah. Yeah. So if it's a low supply

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issue, like the ultimate goal is to get the baby onto the

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breast for most families. And when we're putting a baby to the

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breast where the supply is low, they're going to get

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frustrated. So ultimately, first step in the process is to make

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sure you work on getting that supply up. Because in turn, you

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will have a baby willing and happy to go to the breast

237
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because there's more milk coming out when they're there.

238
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Absolutely. Nobody wants to do work without getting reward.

239
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Yeah. And sometimes it's just fixing the latch and the

240
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positioning that they're on well and they get milk. And what

241
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about nipple shields? They're appropriate for some babies. Not

242
00:16:02,440 --> 00:16:05,480
all. You know, sometimes they're especially sometimes

243
00:16:05,480 --> 00:16:07,480
those early babies, the ones we were just talking about that

244
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are sleepy and tired and aren't engaged. Sometimes we can pop

245
00:16:11,480 --> 00:16:14,840
a shield on and it really engages that baby. It kind of

246
00:16:14,840 --> 00:16:17,160
gets them to stay active longer at the breast, which is

247
00:16:17,160 --> 00:16:19,320
ultimately the goal. Like Gemma was saying, sometimes just

248
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sneaking a little milk in that shield can also be helpful. And

249
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I can't tell you last time I had a family who was using a

250
00:16:26,680 --> 00:16:30,440
shield at three, four, five, six, seven months. It's not all

251
00:16:30,440 --> 00:16:33,640
that typical, at least in my experience. Usually in the

252
00:16:33,640 --> 00:16:35,800
early days, sometimes they're really helpful. They get a bad

253
00:16:35,800 --> 00:16:38,440
name. Yeah. And they have a bad rap and people think they're

254
00:16:38,440 --> 00:16:40,760
horrible. And listen, at the beginning when it starts

255
00:16:40,760 --> 00:16:43,400
working, you're like, this is amazing. And then a couple of

256
00:16:43,400 --> 00:16:45,720
weeks into you're like, I hate this thing. Yeah. And there

257
00:16:45,720 --> 00:16:47,960
usually comes a time where we can kind of pull away the

258
00:16:47,960 --> 00:16:52,040
shield and it's just it's a short term help for some babies.

259
00:16:52,040 --> 00:16:55,480
And that's the key. I think we need to tell parents about

260
00:16:55,480 --> 00:17:00,520
short term. And I think in the outpatient setting, I waste

261
00:17:00,520 --> 00:17:05,560
more than I actually use. I'm like, let's try a shield. Nope.

262
00:17:05,560 --> 00:17:10,840
That didn't work. Never mind. Yes. But yeah, so which always

263
00:17:10,840 --> 00:17:13,800
makes me think in the hospital setting where it's harder to

264
00:17:13,800 --> 00:17:19,160
tell if the baby's latched well and able to get milk, you know,

265
00:17:19,160 --> 00:17:21,720
how many times are we giving it to the parent and it's not a

266
00:17:21,720 --> 00:17:24,040
good match. Right. Yeah. Especially in the hospital

267
00:17:24,040 --> 00:17:27,160
setting because the colostrum and there's not milk

268
00:17:27,160 --> 00:17:31,080
necessarily flowing easily compared to once the milk is

269
00:17:31,080 --> 00:17:34,040
really increased. Sometimes there's a half an inch between

270
00:17:34,040 --> 00:17:37,480
the mom's tip of the nipple and the shield. How does the milk

271
00:17:37,480 --> 00:17:42,280
jump through it? Right. Exactly. Yeah. I want to make

272
00:17:42,280 --> 00:17:46,280
different nipple shields to accommodate different, right.

273
00:17:46,280 --> 00:17:50,120
Different nipples. Yes. Next. Next on the agenda. Mark it on

274
00:17:50,120 --> 00:17:57,400
my calendar. And so we have sore nipples, breast refusal,

275
00:17:57,400 --> 00:18:02,840
production and removal problems. So that's kind of a

276
00:18:02,840 --> 00:18:05,880
mouthful. What do we mean by that? It's kind of a little, it

277
00:18:05,880 --> 00:18:11,400
could be supply is low or the baby can't get the available

278
00:18:11,400 --> 00:18:16,120
milk out. So it kind of goes either way and they're handled

279
00:18:16,120 --> 00:18:18,520
a little differently. We look at them in a different way. If

280
00:18:18,520 --> 00:18:21,640
supply is low, what are we, you know, we're looking at the, it

281
00:18:21,640 --> 00:18:24,440
all goes back to latch and positioning and getting

282
00:18:24,440 --> 00:18:28,360
stimulation. And if supply is low and we have a baby who's

283
00:18:28,360 --> 00:18:31,560
really frustrated at the breast, we still keep them at the

284
00:18:31,560 --> 00:18:34,440
breast, but we often will kind of pop in some pumping to kind

285
00:18:34,440 --> 00:18:39,640
of get some sustained good stimulation for mom. Yeah. I

286
00:18:39,640 --> 00:18:44,200
think the key thing is, is like if we have a baby who's not

287
00:18:44,200 --> 00:18:47,880
gaining weight, it's not always a low milk supply problem.

288
00:18:47,880 --> 00:18:51,000
No, not at all. It could be that the baby can't get the milk,

289
00:18:51,000 --> 00:18:55,800
but milk is available. Right. Or it's there isn't enough milk

290
00:18:55,800 --> 00:18:59,400
available and we have to work on the parent side to get the

291
00:18:59,400 --> 00:19:05,320
milk supply going. So I didn't want to put in the category of

292
00:19:05,320 --> 00:19:09,320
baby not gaining. This was sort of, is it a production

293
00:19:09,320 --> 00:19:13,640
problem or a milk removal problem? Right. Yeah. But you

294
00:19:13,640 --> 00:19:20,360
see both sides. So what do you guys do for low milk supply?

295
00:19:21,080 --> 00:19:24,760
I try to keep the baby at the breast as often as I can, just

296
00:19:24,760 --> 00:19:28,600
for confidence for mom, time at the breast for the baby.

297
00:19:28,600 --> 00:19:30,840
We always go back to the, you know, number one rule is feed

298
00:19:30,840 --> 00:19:33,560
your baby. Number two is preserve your supply. And

299
00:19:33,560 --> 00:19:35,880
they're just like some basics. So we're getting that baby to

300
00:19:35,880 --> 00:19:37,960
the breast, I think is important to keep them acclimated

301
00:19:37,960 --> 00:19:40,680
to the breast. If they're getting milk or not, we still

302
00:19:40,680 --> 00:19:43,080
want to keep the baby at the breast. And then I think we

303
00:19:43,080 --> 00:19:47,320
start putting in a little bit of pumping some skin to skin,

304
00:19:47,320 --> 00:19:51,160
things like that can be really, really helpful to build supply.

305
00:19:52,760 --> 00:19:56,280
Yeah. What about supplementing directly at the breast? Because

306
00:19:56,280 --> 00:19:59,880
in the other method, we are talking about breastfeeding,

307
00:19:59,880 --> 00:20:03,080
supplementing, and then pumping. So it's that triple

308
00:20:03,080 --> 00:20:07,000
feeding thing that everybody knows isn't sustainable long

309
00:20:07,000 --> 00:20:12,040
term. So like how soon would you bring one of those families

310
00:20:12,040 --> 00:20:15,320
back to check in on things? Oh, pretty quick. Within a few days.

311
00:20:15,320 --> 00:20:18,120
Within a couple days. Before a week. Yeah. Yeah.

312
00:20:18,120 --> 00:20:20,920
Just it's not that forever plan. Those words come out of my

313
00:20:20,920 --> 00:20:23,720
mouth. This is not the forever plan. Yeah. But we're going to

314
00:20:23,720 --> 00:20:26,760
see if we can boost up supply. As supply goes up, it gets

315
00:20:26,760 --> 00:20:29,320
easier and easier to get the baby back on the breast or put

316
00:20:29,320 --> 00:20:32,440
the baby on the breast with an SNS, which kind of pulls out

317
00:20:33,320 --> 00:20:36,360
the pumping part. Yeah. The supplemental nursing system

318
00:20:37,240 --> 00:20:39,880
allows you to supplement directly at the breast and the

319
00:20:39,880 --> 00:20:47,640
baby stimulates the breast, gets extra milk, so remains more

320
00:20:47,640 --> 00:20:51,720
active and does the job of the pump. In hopes of mom being

321
00:20:51,720 --> 00:20:55,000
able to cut out pumping. Yeah. So she doesn't have to do that

322
00:20:55,000 --> 00:20:58,280
triple feeding. It has to be a great breast feeder. And so

323
00:20:58,280 --> 00:21:01,320
when you're in a situation of a baby who doesn't feed well, one

324
00:21:01,320 --> 00:21:05,480
of those supplementers don't always work. What do you say

325
00:21:05,480 --> 00:21:09,640
about people just breastfeed more? That'll do it. We have to

326
00:21:09,640 --> 00:21:13,240
evaluate what baby's capability is. If the baby is capable.

327
00:21:13,240 --> 00:21:17,160
And mom's supply. Yeah. Both of them. If it's really low. If

328
00:21:17,160 --> 00:21:21,160
it's really low, then that's not sustainable because yes, mom

329
00:21:21,720 --> 00:21:25,400
and baby can keep breastfeeding, absolutely, but what's

330
00:21:25,400 --> 00:21:29,080
happening? What's baby taking in? The baby's going to be

331
00:21:29,080 --> 00:21:32,200
connected to the breast 24 seven, if that's the case, and

332
00:21:32,200 --> 00:21:33,720
that's not sustainable either. And maybe not getting all the

333
00:21:33,720 --> 00:21:36,440
milk. Yeah. See, the baby on there all the time who's not

334
00:21:36,440 --> 00:21:40,040
getting all the milk. So that's where our scale comes into

335
00:21:40,040 --> 00:21:44,760
play. And I have, you know, heard of some people like, we

336
00:21:44,760 --> 00:21:48,600
don't need a scale because, you know, you have all these other

337
00:21:48,600 --> 00:21:51,880
things that you should be able to look at. And I'm like, it is

338
00:21:51,880 --> 00:21:54,600
a piece of the puzzle, but it is an awesome piece of the

339
00:21:54,600 --> 00:21:59,880
puzzle. And it might be, you know, it allows us to create a

340
00:21:59,880 --> 00:22:03,480
plan that's appropriate for them. Absolutely. Have you had

341
00:22:03,480 --> 00:22:06,360
babies who are gulping up a storm? You hear them across the

342
00:22:06,360 --> 00:22:09,480
room and you pop them on the scale and they take like point

343
00:22:09,480 --> 00:22:15,000
two. Yes. What happened? Yeah. So those babies are the really

344
00:22:15,000 --> 00:22:17,640
quiet baby. And you're like, I don't think this kid got milk.

345
00:22:17,640 --> 00:22:19,800
And then you put them on the scale and they took 1.4 and

346
00:22:19,800 --> 00:22:26,200
you're like, you're really good. Stealthy. Yeah. So babies can

347
00:22:26,200 --> 00:22:30,360
fool us. I've been fooled. And so I love to do the pre and

348
00:22:30,360 --> 00:22:35,320
post weight checks to add that piece of the puzzle to help make

349
00:22:35,320 --> 00:22:38,600
a plan that's good for this particular family. I think that's a lot of

350
00:22:38,600 --> 00:22:41,880
families whose babies going back to, you know, not gaining and

351
00:22:41,880 --> 00:22:44,760
things like that. The question is, well, how much do I

352
00:22:44,760 --> 00:22:48,760
supplement? And I think that also makes it, it just gives us an

353
00:22:48,760 --> 00:22:52,680
idea. You have a baby who's getting, you know, 0.1 at the breast or a

354
00:22:52,680 --> 00:22:55,000
baby who's getting 0.8 at the breast. It doesn't seem like that

355
00:22:55,000 --> 00:22:57,800
much, but that comes into play when you're supplementing.

356
00:22:57,800 --> 00:23:01,560
Absolutely. And to give them a rough idea of how much the baby

357
00:23:01,560 --> 00:23:08,440
will need. I always think of a family who has like a five or six

358
00:23:08,440 --> 00:23:11,880
day old and they've gone to the pediatrician and there's weight

359
00:23:11,880 --> 00:23:15,320
loss and they say, give two ounces after every feeding. And

360
00:23:15,320 --> 00:23:18,920
they are so upset because the baby won't take it. And they

361
00:23:18,920 --> 00:23:21,640
think they're doing something wrong or not feeding the baby

362
00:23:21,640 --> 00:23:26,120
appropriately when it's just not, you know, that wasn't a good amount.

363
00:23:26,120 --> 00:23:29,880
They need a half an ounce. Right. Yes. And they're fine.

364
00:23:29,880 --> 00:23:34,360
And I do that talk, how, when and how much to supplement where

365
00:23:34,360 --> 00:23:37,880
to health care professionals just for that reason.

366
00:23:37,880 --> 00:23:40,360
You're giving a number and you don't even know how much this

367
00:23:40,360 --> 00:23:44,360
kid is taking. So are you giving a number that's an entire

368
00:23:44,360 --> 00:23:49,000
feeds worth or are you giving a supplement? You know, that'll

369
00:23:49,000 --> 00:23:52,360
give them until they keep going. Doesn't necessarily apply to

370
00:23:52,360 --> 00:23:57,960
every baby. And I had a family who was finger feeding and they

371
00:23:57,960 --> 00:24:01,800
were told to keep going until the baby pierces her lips, not

372
00:24:01,800 --> 00:24:07,320
even a certain amount. So, until they throw up, just keep feeding

373
00:24:07,320 --> 00:24:12,200
them. So we've heard that too, essentially for 15 minutes,

374
00:24:12,200 --> 00:24:14,440
however much they can take in 15 minutes. I'm like, do you know

375
00:24:14,440 --> 00:24:18,440
how much I can eat in 15 minutes? That's one of my favorites, the 15 minute one.

376
00:24:18,440 --> 00:24:25,400
15 and 15. I hope he's not listening to the podcast.

377
00:24:25,400 --> 00:24:32,600
Yeah. So the supplementation plan when there's low milk production

378
00:24:32,600 --> 00:24:37,960
is, you know, it's vital to understand what the baby's capable of doing.

379
00:24:37,960 --> 00:24:41,880
And what about those babies who can't get milk? What do we do with them?

380
00:24:41,880 --> 00:24:48,040
What are we looking for? How can we help them?

381
00:24:48,040 --> 00:24:51,960
Looking in their mouth. Yeah. Just looking at their mouth, looking at

382
00:24:51,960 --> 00:24:56,680
the whole picture. Yeah. So we do it with every baby, but

383
00:24:56,680 --> 00:25:00,680
oral assessment. Is there anything going on that

384
00:25:00,680 --> 00:25:04,200
makes, like if the mother's milk supply is good and this baby can't get milk,

385
00:25:04,200 --> 00:25:07,000
what the heck is going on with the transfer?

386
00:25:07,000 --> 00:25:10,760
And so part of here at the BRC, besides us,

387
00:25:10,760 --> 00:25:14,040
we have an occupational therapist here who's,

388
00:25:14,040 --> 00:25:20,120
and we have other resources in our area. One of our upcoming podcasts is with a

389
00:25:20,120 --> 00:25:23,640
physical therapist who works with babies who are struggling to get milk.

390
00:25:23,640 --> 00:25:27,000
So sometimes we can't fix everything. We even

391
00:25:27,000 --> 00:25:29,800
refer on to somebody else, but we'll save all that

392
00:25:29,800 --> 00:25:35,880
fun info for the next one. So we have sore nipples, breast refusal,

393
00:25:35,880 --> 00:25:40,040
production or removal problems. What about the fussy baby?

394
00:25:40,040 --> 00:25:44,280
See a lot of those. I saw one of those today. And what do parents blame?

395
00:25:44,280 --> 00:25:47,960
Themselves. And breastfeeding. And breastfeeding and their milk supply.

396
00:25:47,960 --> 00:25:51,160
And what they're eating. Are they eating something?

397
00:25:51,160 --> 00:25:54,600
It's always something that they're doing wrong.

398
00:25:54,600 --> 00:25:57,560
Yeah. Which is really sad. Because it's not,

399
00:25:57,560 --> 00:26:01,640
sometimes it's nobody's fault. It's just the situation or like you still go back.

400
00:26:01,640 --> 00:26:06,440
Latching positioning. A mom who has like, a parent who has way too much milk and

401
00:26:06,440 --> 00:26:09,240
this baby is goburi, goburi, goburi and like spitting up.

402
00:26:09,240 --> 00:26:12,280
Like some simple positioning changes can make it

403
00:26:12,280 --> 00:26:15,880
that much more pleasant of a feeding session. And we now have this

404
00:26:15,880 --> 00:26:22,200
not so fussy baby or not an overly gaining baby or you know, lots of

405
00:26:22,200 --> 00:26:27,080
it's just management. The oversupply is you know, sort of an easy one in most

406
00:26:27,080 --> 00:26:30,200
cases where we can reduce the milk production

407
00:26:30,200 --> 00:26:34,520
and help this baby manage it a little better. And sometimes it's a natural

408
00:26:34,520 --> 00:26:37,640
overproduction and sometimes it's induced. Yes.

409
00:26:37,640 --> 00:26:42,600
We are so hyped about pumping these days. Everyone gets a pump.

410
00:26:42,600 --> 00:26:46,440
Instagram. Yeah. And when can I start pumping? When can I?

411
00:26:46,440 --> 00:26:49,640
Little do they know. No one says I love pumping.

412
00:26:49,640 --> 00:26:55,480
So I think sometimes we're terrified. We have horrible maternity leave.

413
00:26:55,480 --> 00:26:59,800
We're stockpiling our freezer full of milk. Because what if?

414
00:26:59,800 --> 00:27:03,080
What if? What if? I don't know what if. What if? That's what I'm saying.

415
00:27:03,080 --> 00:27:06,360
All of the what ifs. So I think oversupply is a big one.

416
00:27:06,360 --> 00:27:12,440
Whether it's natural or self-induced. And then of course there's the opposite.

417
00:27:12,440 --> 00:27:15,960
They're like I don't know the baby's not burping. Something's wrong.

418
00:27:15,960 --> 00:27:21,880
You know, baby's colicky. And then you pop the kid on the scale and you're like

419
00:27:21,880 --> 00:27:26,440
maybe it's not enough milk. Yeah. They look very similar sometimes.

420
00:27:26,440 --> 00:27:30,440
The oversupply and undersupply. They're fussy and miserable.

421
00:27:30,440 --> 00:27:33,800
Feeding frequently. You know, there's so many

422
00:27:33,800 --> 00:27:38,120
similarities between the two. And we again, that internet, we just had a mom and

423
00:27:38,120 --> 00:27:40,920
support group. It was like well I think it was oversupply. So I started block

424
00:27:40,920 --> 00:27:47,080
feeding and I was like. But was the baby really gaining? But the baby wasn't gaining well.

425
00:27:47,080 --> 00:27:50,840
That's the main difference between is baby's weight gain.

426
00:27:50,840 --> 00:27:56,120
Yeah. Look at the numbers on the scale. If it's double the norm, yes. We will work on

427
00:27:56,120 --> 00:28:00,360
your oversupply. If it is normal weight gain, it is not oversupply.

428
00:28:00,360 --> 00:28:08,200
Yeah. Something else is going on. Yeah. What about food intolerances and allergies?

429
00:28:08,200 --> 00:28:12,040
You hear about diet. I stopped eating this. I stopped eating that.

430
00:28:12,040 --> 00:28:16,120
I think things have just, we've learned a lot since I know when I had my children

431
00:28:16,120 --> 00:28:19,800
and what I could, could and could not eat.

432
00:28:19,800 --> 00:28:24,440
Everybody comes in and oh my baby's fussy so I stopped dairy. My mom said,

433
00:28:24,440 --> 00:28:28,360
family had today, is like I stopped dairy because and I'm like but why?

434
00:28:28,360 --> 00:28:33,400
Because her baby was fussy. This baby, but you know, it's, I don't think it's that.

435
00:28:33,400 --> 00:28:36,520
And it's usually not. It's. Well and we're hearing less and less

436
00:28:36,520 --> 00:28:39,720
about stopping to eat broccoli. Right. Yes. You know. Thankfully.

437
00:28:39,720 --> 00:28:42,760
Thankfully. Yeah. So. Because there's no chunks of broccoli coming up.

438
00:28:42,760 --> 00:28:46,760
That's what I say. You know. There's big giant pieces of fiber coming through your breast

439
00:28:46,760 --> 00:28:53,000
now that's making your baby gassy. Yes. So I mean that those diet things seem

440
00:28:53,000 --> 00:28:59,480
to have almost gone away. Yes. But yeah, people know about the dairy intolerance.

441
00:28:59,480 --> 00:29:04,760
But they're going to that first. Yeah. I feel like. I like dairy way too much to do that.

442
00:29:04,760 --> 00:29:12,520
Yeah. Ice cream, cheese. It's delicious. Yeah. So if you don't need to do that.

443
00:29:13,400 --> 00:29:18,120
That would be great. But sometimes I've even seen other food allergies. I have a picture of this

444
00:29:18,120 --> 00:29:22,280
baby. He just looks miserable. He's got a rash all over his body. He wasn't gaining weight.

445
00:29:22,840 --> 00:29:29,000
And he had several food intolerances and allergies. So it was dairy and wheat

446
00:29:29,000 --> 00:29:35,160
was causing the problem. And it can really impact them negatively even with weight gain.

447
00:29:35,160 --> 00:29:38,840
They're not just gassy and fussy. I think we see with moms too. There's a lot of

448
00:29:39,720 --> 00:29:44,200
people who have to go on that you don't have wheat and they have celiacs and they're vegetarian.

449
00:29:44,200 --> 00:29:48,680
And then you say to them, so we have all these things that we can't eat anyway. And then we add

450
00:29:48,680 --> 00:29:54,280
on don't eat dairy. And for some people that is all their protein sources. Exactly. Is from dairy.

451
00:29:54,280 --> 00:29:59,240
Is from dairy. So that's why I always say don't want to. Because I think people are limiting

452
00:29:59,240 --> 00:30:07,000
their diets more and more because I think we know more now. And it's hard enough because most moms

453
00:30:08,120 --> 00:30:13,880
were making sure that they are eating because they're so focused on their baby that sometimes

454
00:30:13,880 --> 00:30:20,840
they're not. So to take away. That quick, easy cheese stick. Exactly. Yeah. Or yogurt. If they

455
00:30:20,840 --> 00:30:27,160
don't have to do it. Yeah. Right. And then there's the other thing. The problem with

456
00:30:28,760 --> 00:30:34,360
problems associated with reflux or if they're diagnosed with GERD. We see those babies like

457
00:30:34,360 --> 00:30:40,440
they're miserable. They really are. And they start biting at the breast. So that may be. And we

458
00:30:40,440 --> 00:30:45,560
ought to add that to the breast refusal is usually like at seven or eight weeks if they've been

459
00:30:45,560 --> 00:30:51,880
suffering from it. They start backing off. It's like I want to eat. No I don't. Yes I do. It hurts.

460
00:30:53,480 --> 00:30:59,160
I want to. It'll make me feel better. No I can't. They're just back and backing on and off the

461
00:30:59,160 --> 00:31:05,080
breast. Uncomfortable. Yeah. They want to eat. They just can't tolerate it. Or they eat and they're

462
00:31:05,080 --> 00:31:10,920
just screaming afterwards. They're in so much pain. Yeah. So but you look at you know oversupply,

463
00:31:10,920 --> 00:31:17,960
undersupply GERD. They're crying during feedings after feedings. You know so trying to figure out

464
00:31:17,960 --> 00:31:23,640
which one that is. And if you go to the dairy first it may not resolve any of those other things.

465
00:31:24,440 --> 00:31:30,840
And that again it's a quick measure of the intake. Use that scale. Determine is it oversupply,

466
00:31:30,840 --> 00:31:37,560
undersupply or is this kid self-limiting because he's in pain. So the fussy baby there's all kinds

467
00:31:37,560 --> 00:31:42,440
of things. Or and parents you say oh my baby has colic. That doesn't happen that much anymore.

468
00:31:42,440 --> 00:31:48,440
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

469
00:31:48,440 --> 00:31:54,840
of something. But every parent knows it's a GI distress. This kid is like pulling up the legs

470
00:31:54,840 --> 00:32:01,000
screaming. It happens after feeding. So I think this oversupply, undersupply, food intolerance and

471
00:32:01,000 --> 00:32:10,680
GERD is a huge part of the of the colic issue. So what's the final one? And I think Jen you came up

472
00:32:10,680 --> 00:32:16,200
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

473
00:32:16,200 --> 00:32:21,160
normal development changes and their impact on breastfeeding. So we look through the different

474
00:32:21,160 --> 00:32:29,480
stages that babies go through from the start and the expectations of how things are going to proceed

475
00:32:29,480 --> 00:32:36,040
as they start to get older. So what they start with as they grow it's developmental changes.

476
00:32:36,040 --> 00:32:42,200
Forever changing. Forever changing. So what is said in the hospital when it's done in the hospital

477
00:32:42,200 --> 00:32:52,920
is not going to be done even at like two weeks. Even at a week. So expect changes. Expect things to

478
00:32:52,920 --> 00:32:59,400
to just kind of keep developing as the baby's developing. So yeah I think that's why I like

479
00:32:59,400 --> 00:33:05,640
people to keep coming back because even what we told them two or three weeks ago is going to be

480
00:33:05,640 --> 00:33:12,760
different now. And I feel like people don't trust themselves to just follow their baby. Yeah and so

481
00:33:12,760 --> 00:33:19,640
like checking in and seeing what the changes are. I love. Well and it's so interesting that you talk

482
00:33:19,640 --> 00:33:27,480
about the hospital versus a week out. So we also do hospital work and we've always said it's two

483
00:33:27,480 --> 00:33:35,080
different jobs. Yes. Hospital LC, outpatient LC, two entirely different jobs. And what we say in the

484
00:33:35,080 --> 00:33:43,080
hospital may not be applicable. Be applicable on day four or five. Yeah. So that quick. Yeah it

485
00:33:43,080 --> 00:33:48,200
changes a lot. So that's the one thing in the newborn stage. What else in the newborn stage are

486
00:33:48,200 --> 00:33:58,840
we seeing that like changes and freaks people out? Well that onset of copious milk is it's very

487
00:33:58,840 --> 00:34:04,360
different on day one of life to once you've had that onset of milk day three four five whenever

488
00:34:04,360 --> 00:34:09,000
it is. You're like oh breastfeeding was going swimmingly it was great baby latched all was

489
00:34:09,000 --> 00:34:14,920
good. And then you have these full breasts and the baby's latching poorly or shallowly because the

490
00:34:14,920 --> 00:34:20,920
breasts are still full. Yeah. And you know everyone thinks that your breasts are full of just milk. I

491
00:34:20,920 --> 00:34:25,880
remember being like I'm gonna pump and get 10 ounces. And it's like an ounce comes out. Your

492
00:34:25,880 --> 00:34:30,360
breasts are still full. Yeah and so I think that's the biggest change that we're seeing just in that

493
00:34:30,360 --> 00:34:38,520
early week. Well even with that the idea of that setting rules. Yeah. Feed your baby every two

494
00:34:38,520 --> 00:34:45,320
hours or things like that. And so maybe they do want to eat every two hours on day two or three.

495
00:34:45,320 --> 00:34:51,240
And then milk supply increases and this kid's knocking back an ounce. Yeah. And they're so full

496
00:34:51,240 --> 00:34:56,120
and they may go three maybe even three and a half and the parents are freaked out. He's supposed to

497
00:34:56,120 --> 00:35:04,120
eat every two hours. Yes. So I think that watching the clock thing doesn't work in breastfeeding. Or

498
00:35:04,120 --> 00:35:10,680
anything. Sometimes. I hate when people tell me I have to eat lunch at noon. I know. Right.

499
00:35:12,840 --> 00:35:20,120
Yeah so that's in the early stage. What happens around two months old that changes. The different

500
00:35:20,120 --> 00:35:28,520
signs that parents were going by in the beginning in that newborn stage of like their babies putting

501
00:35:28,520 --> 00:35:35,960
their hands in their mouths their fingers sticking out their tongue. The development change of oh

502
00:35:35,960 --> 00:35:42,200
look these are mine. I can put them in my mouth. What do they taste like. You know I want to explore

503
00:35:42,200 --> 00:35:48,680
them. It's not always feeding me rooting. Yeah. Me rooting as signs that we were going by in those

504
00:35:48,680 --> 00:35:52,440
newborn stages. Yeah. You have parents ask you that all the time. See does it mean that they're

505
00:35:52,440 --> 00:35:59,400
hungry and the kids like happy sucking on their face. We're like no. They're freaking out. They

506
00:36:00,280 --> 00:36:03,080
they're just happy and they love it's their new toy that they brought with them.

507
00:36:03,960 --> 00:36:09,240
How about if they don't fall asleep after feeds anymore. That's. Well they must still be hungry

508
00:36:09,240 --> 00:36:15,880
because in the first week did they wake. They fall asleep. They eat. They wake. They fall asleep.

509
00:36:15,880 --> 00:36:20,840
That's all they really do. Yeah. And as they get older they start staying awake longer. They have

510
00:36:20,840 --> 00:36:25,560
the ability to kind of be a little bit more alert between feeding sessions. And it's so hard because

511
00:36:25,560 --> 00:36:30,840
there's nothing really to do with them. It's hard to play with the baby. They don't do much.

512
00:36:30,840 --> 00:36:36,040
That's when you put them in tummy time. Yeah. That's something fun to do but they don't do a

513
00:36:36,040 --> 00:36:41,080
whole heck of a lot. What about at three months. Have you seen some changes at that point. I know

514
00:36:41,080 --> 00:36:48,360
one that I see often. I just think they become more nosy. I just want to see what's going on

515
00:36:48,360 --> 00:36:53,960
around the world. I always see those kids who like they're happily breastfeeding and they take their

516
00:36:53,960 --> 00:36:59,320
supplemental bottle and at three months they decide not to do one of those. Like adamantly

517
00:36:59,320 --> 00:37:04,120
adamantly like no oh I'm not taking a bottle anymore. I'm sorry. Yeah. What were you thinking

518
00:37:05,000 --> 00:37:11,080
and completely start fighting it. It's crazy. It always seems right at 12 weeks that that happens.

519
00:37:11,080 --> 00:37:17,160
Those must be looking to go back to bottle refusal. Yes. Yes. Yes. Thankfully they're not on our top

520
00:37:17,160 --> 00:37:26,600
five because they're rough. They are. Yeah. And then what about three to six months. What kind

521
00:37:26,600 --> 00:37:35,240
of differences do you see then in a baby. They just they get good at what they do. They're more

522
00:37:35,240 --> 00:37:43,240
efficient. So again another developmental change based on but my baby was feeding for like 15 or

523
00:37:43,240 --> 00:37:48,600
20 minutes before. Now they're done in like seven. There's no way no way that they got everything

524
00:37:48,600 --> 00:37:54,200
that they needed. I keep on pushing and I'm pushing them on the breast and they're pushing

525
00:37:54,200 --> 00:38:01,640
away. I'm like maybe they're done. They're like no mom thank you. I've had my fill for now. That

526
00:38:01,640 --> 00:38:07,240
goes back to watching your baby not the clock. Yeah absolutely. I'll never forget that picture

527
00:38:07,240 --> 00:38:11,960
of that baby who looks like the Michelin man. The mom walked in and said her baby she was worried

528
00:38:11,960 --> 00:38:17,960
her baby's not getting enough and trying not to giggle. And this kid was taking five or six

529
00:38:17,960 --> 00:38:23,320
ounces out of feeding and she was trying to feed him every two to three hours. And he was fighting

530
00:38:23,320 --> 00:38:32,280
her. He hates it. I'm like no no no. Just not hungry. He loves you. Well what about at four months.

531
00:38:33,160 --> 00:38:39,800
There's always the favorite. We'll ask. Louisa's also our sleep holistic sleep coach. So she's

532
00:38:39,800 --> 00:38:45,880
always hears about the four month. The four month sleep regression. Yeah. You know some families

533
00:38:45,880 --> 00:38:52,200
have started to get in a little bit of a groove of a longer stretch between you know overnight

534
00:38:52,760 --> 00:38:57,720
between feeding sessions. And then it all goes to pot because so many developmental things are

535
00:38:57,720 --> 00:39:04,440
happening at four months. And it's just naturally it's very normal for babies to start waking at

536
00:39:04,440 --> 00:39:10,120
night and everyone panics. My baby's not getting enough. That's why he or she is waking at night.

537
00:39:10,120 --> 00:39:16,680
And it really doesn't have anything to do with it. So that can really throw a wrench. It's also you

538
00:39:16,680 --> 00:39:21,480
know we might have gotten back to work and like we really need our sleep because we have to go to

539
00:39:21,480 --> 00:39:26,040
work in the morning and this little one's like hello. And like once and they're not necessarily

540
00:39:26,040 --> 00:39:32,360
happy. Right. Waking up. And it's not like just once. It's like two three four five times a night.

541
00:39:32,360 --> 00:39:37,640
Right. They automatically think it's food related. Yeah. There's not enough food. And I'm like no

542
00:39:37,640 --> 00:39:43,640
there's so many other things happening. Yeah. And that's a big thing in our culture filling the baby

543
00:39:43,640 --> 00:39:49,400
up so they sleep better. Yeah. And they've done a lot of studies and they don't it doesn't. And

544
00:39:49,400 --> 00:39:55,480
they've done studies with formula to breast milk. And you know when our kids were younger you know

545
00:39:55,480 --> 00:40:00,520
20 years ago formula was different than it is today. And I think babies a lot of the proteins

546
00:40:00,520 --> 00:40:05,000
are broken down so it's a little easier for them to digest. So we're not seeing babies who are

547
00:40:05,000 --> 00:40:12,200
formula fed necessarily sleeping longer. Right. For formula fed babies have a four month sleep

548
00:40:12,200 --> 00:40:18,360
regression also. Yeah. We forget that. It's not just for breastfed babies it's for babies in general.

549
00:40:18,360 --> 00:40:25,560
It is a sleep regression period for babies. Yeah. What about that distracted baby at four months?

550
00:40:25,560 --> 00:40:31,400
That gets to be frustrating when you're especially if you have an older child and you know the toddler

551
00:40:31,400 --> 00:40:37,160
is running around or you're out and about and you're you know at the park and the dog walks by.

552
00:40:37,160 --> 00:40:43,400
There's my nipple. A bird flies by the window. They're just and they and any little thing. Right.

553
00:40:43,400 --> 00:40:47,800
And they think there's something wrong. Why why why won't they stay on the breast? Well you wonder

554
00:40:47,800 --> 00:40:52,360
if the sleep regression has something to do with that if they're taking little snacks and they do

555
00:40:52,360 --> 00:40:59,000
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

556
00:40:59,560 --> 00:41:04,760
they sometimes you will see them wanting to breast longer. They'll get their milk anyway they can.

557
00:41:04,760 --> 00:41:09,720
Yeah. They don't need to do it between you know 7a and 7b. Even though it works better for you. Yeah.

558
00:41:10,920 --> 00:41:17,240
It would be lovely wouldn't it? Yeah I mean some sometimes going into a dark room but when you have

559
00:41:17,240 --> 00:41:26,360
toddlers or you need to go out it's so hard to keep them. Did either of you try those necklaces?

560
00:41:26,360 --> 00:41:34,600
Those nursing necklaces? I know. I've seen babies in the office that sometimes can really grab their

561
00:41:34,600 --> 00:41:40,040
attention. Yeah keep them busy. And they become teething necklaces later in life so they're kind of dual

562
00:41:40,040 --> 00:41:45,080
purposed. Yes. But you do see babies you know pulling on mom's shirt or things like that just

563
00:41:45,080 --> 00:41:50,200
it kind of grabs their attention and they enjoy it. It's worth a try. It's worth anything's worth it.

564
00:41:50,200 --> 00:41:54,760
Sometimes it's painful too when they kind of pop off and then pop on and then pop off. Yeah because some of

565
00:41:54,760 --> 00:42:01,560
them really yank. Yeah. Those older babies they're just not that careful. Yeah. The other option is

566
00:42:02,680 --> 00:42:09,880
trying to get them to feed when they're sleepier. Dream feeds can become a thing for the baby who's

567
00:42:09,880 --> 00:42:16,120
distracted during the daytime to try and get them to eat a little bit more. So that's one of my big

568
00:42:16,120 --> 00:42:22,920
go-tos is like it you're going through this as far as like a possible sleep progression and the

569
00:42:22,920 --> 00:42:30,920
distracted baby. So the best time to try and get them to eat is when they're sleeping or sleepier

570
00:42:30,920 --> 00:42:35,800
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

571
00:42:35,800 --> 00:42:40,360
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

572
00:42:40,360 --> 00:42:46,200
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

573
00:42:46,200 --> 00:42:50,920
hopefully their brains are shut off just a little bit more than what's going on during the day. Yep.

574
00:42:50,920 --> 00:42:57,240
Yeah maybe try like a sound machine or something like that that's kind of calming. Yeah and I even say try to

575
00:42:57,240 --> 00:43:02,200
distract your baby. Try to have something to distract them like what do you notice has something that

576
00:43:02,200 --> 00:43:07,240
they might focus on and look at at other times? Do you have a fan? Is there a light? Is there

577
00:43:07,240 --> 00:43:13,720
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.

578
00:43:15,320 --> 00:43:20,680
And the other thing I see at the six months old I since I'm the one who teaches the starting solids

579
00:43:20,680 --> 00:43:27,400
class it's like people think that once the baby starts eating some solid foods they don't need

580
00:43:27,400 --> 00:43:33,320
as much milk they're not going to nurse as much but that's not the case. No still their main source of

581
00:43:33,320 --> 00:43:39,400
nutrition. Their main source. They're just learning to eat a different way. They're exploring

582
00:43:39,400 --> 00:43:46,840
exploring it's not even eating like they're just tasting something different. The textures. Yeah

583
00:43:46,840 --> 00:43:52,600
flavors. Yes and I think we see that the babies aren't switching to less milk till closer to nine

584
00:43:52,600 --> 00:43:57,560
months. Right. So an eight month old is not going to nurse differently than a five month old or a six

585
00:43:57,560 --> 00:44:01,400
month old or seven month old. They still need the same amount of milk and I think that's that's an

586
00:44:01,400 --> 00:44:07,000
eye-opener for a lot of families. Yeah. Is their intake isn't really changing all that much. Right.

587
00:44:07,000 --> 00:44:11,960
We just assume they need more and more and more and more because again go back to our bottle feeding

588
00:44:11,960 --> 00:44:17,240
culture is that some formula fed babies they do need more milk at four months or at eight months

589
00:44:17,240 --> 00:44:21,160
than they did at four months because they're growing and they have more needs different needs.

590
00:44:21,160 --> 00:44:28,760
But they tend to take less bottles. Yeah. So we don't. Yeah we don't work that way. So it all

591
00:44:28,760 --> 00:44:34,680
depends on our storage capacity of how frequently our babies are going to feed and so you know if

592
00:44:34,680 --> 00:44:40,600
they need eight feedings a day to get the 24 to 28 ounces they're going to still need eight feedings

593
00:44:40,600 --> 00:44:47,240
a day to get that. There are no two ways about it. Awesome. So I love these. I loved our top five.

594
00:44:47,240 --> 00:44:54,920
Yeah. And maybe next time we can talk. Well I know we're bringing you back Louisa for your holistic

595
00:44:54,920 --> 00:45:01,000
sleep. Yeah. Talking so because that's the big question these days besides breastfeeding. But

596
00:45:01,000 --> 00:45:07,960
we'll have to think of some fabulous breastfeeding scenarios for you guys in the future. So thank you

597
00:45:07,960 --> 00:45:14,920
Louisa. Thanks Jen. Thank you. And I am Collette and thanks for listening to the BRC's Feeding Frenzy.

598
00:45:14,920 --> 00:45:20,680
You can learn more about us at www.breastfeedingresourcecenter.org.

599
00:45:25,400 --> 00:45:30,600
Thanks for listening to the Feeding Frenzy. The BRC is a non-profit organization committed

600
00:45:30,600 --> 00:45:36,840
to providing expert clinical and educational breastfeeding services. Find out more about us

601
00:45:36,840 --> 00:45:46,120
at www.breastfeedingresourcecenter.org.