Motherhood Blooms Lactation™

Letdown Reflex: why do I feel tingling when my baby nurses?

Updated August 12th 2023

Have you ever felt a tingling sensation in your breast while your baby is feeding or you are pumping? This sensation begins a few seconds after your nipples are stimulated and you feel it within the breast. You might wonder what’s going on, why you’re feeling it and why it’s happening at every single feeding.

This “pins and needles” feeling is your letdown reflex. The letdown reflex happens when your milk starts flowing. Many describe it as a tingling sensation, feeling similar to “pins and needles” like when your arm falls asleep or feeling a warmth in your breast. It is triggered by the hormone oxytocin. Oxytocin is also called the “love hormone”. This hormones is not only responsible for your letdown but also fosters bonding and reduces the size of your uterus after birth.

photo of a beautiful mother breastfeeding her baby — Photo by MART PRODUCTION on Pexels.com

Oxytocin is released when your baby suckles at breast or when your pump turns on and the suction starts. It’s also triggered when you hear your baby cry or look at pictures of your baby (the reason you can let-down without your baby being on your breast!). It’s also released during orgasm so not uncommon to spray some milk then too.

Oxytocin causes the muscles around the milk sacs inside the breast to squeeze (contract) which effectively pushes out (ejects) the milk from the nipple. This can create a tingling sensation. Your letdown reflex is also known as the Milk Ejection Reflex.

When this happens, your baby isn’t actually sucking the milk out but rather working with your body and your let-down to remove the milk. They do this by creating a vacuum inside their mouth to effectively remove the milk as your body is helping by pushing it out. When there are challenges with latching, this can affect their ability to create a vacuum and effectively empty the breast. If you’re not sure if your baby’s latch is optimal, check out this post I wrote about 4 Signs Your Baby’s Latch Might Not Be Ideal.

Some have described feeling a warming sensation when letdown happens and some have described never feeling it and for some it’s painful or uncomfortable. Some women feel only one letdown during a feeding while often more than one happens.

What if you don’t feel your letdown?

This is completely normal as not everyone feels it. Your milk is still likely flowing and the best way to determine this if your baby is nursing is to watch them while they feed. Watch your baby for swallowing.

To watch your baby for swallowing, you want to be looking at their jawline from their chin up to their ears. When your baby swallows milk, you will see their chin drop down (lower than when they are sucking) and pause for a brief moment. This pause is a swallow. Depending how old your baby is, you may also be able to hear your baby swallowing. Hearing them swallow sounds like a soft “kah” sound.

What if my let-down hurts?

If you’re feeling pain with a let-down you first want to rule out any underlying issues with a lactation consultant (IBCLC).

Things that can block oxytocin can impact let-down

There are several factors that can interfere with oxytocin and therefore your milk letdown. This may translate into challenges with pumping or nursing. Pain, anxiety, fear, stress and fatigue can block and interfere with oxytocin. This is why it’s important to feel comfortable, relaxed and pain free while nursing or pumping.

Do you need to find a different room to nurse or pump in to feel more comfortable? Are you experiencing pain with latching or pumping? Are you worried about how much milk you’re producing? All of these can impact your body’s ability to let the milk flow.

How you can support having a letdown

If you’re pumping and you don’t start to see the milk flowing or you’re nursing your baby and you’re noticing they are frustrated or not swallowing, connect with a lactation consultant to help you rule out something else that might be going on.

If it’s related to your milk not letting down due to anxiety, pain or stress blocking oxytocin, you can try a few of the following techniques:

Find the root cause of the pain and address it with a lactation consultant
Hand express or massage your breasts before baby latches to encourage a let down
Back rubs stimulate nerves that serve the breasts (central part of the spine), these too can help so ask your partner for some support on this one or find a Registered Massage Therapist trained to support those who are lactating
Increase skin to skin holding time with your baby and relax together for at least 30 minutes everyday
Take a warm bath/feed in the bathtub (if you have one) or pump after having a relaxing bath
I also like suggesting a version of the box breathing technique to my clients. Breathe in for 4 seconds, hold for 4 and exhale for 6. You can do this anytime during the day where you’re feeling overwhelmed
Laugh – watch a funny show or listen to a funny podcast. Laughter will help the oxytocin flow

mother using phone while breastfeeding her child — Photo by William Fortunato on Pexels.com

Intense negative feelings with let-down

There are people who experience a wave of intense negative emotions when their milk begins to flow. This is known as dysphoric milk ejection reflex or D-MER. The feelings can range from sadness, despair, homesick, anger, irritability, anxiousness or a hollow feeling in the stomach. These feelings are often experienced in the 30-90 seconds before the milk begins to flow.

D-MER can be experienced at breast feedings or when pumping. Those with D-MER feel fine prior to let-down and fine after the let-down.

To learn more about D-MER and how to manage it (as well as find helpful resources) visit https://d-mer.org/understanding-d-mer

Your let-down reflex can also change overtime. It may start off feeling more intense on those early newborn weeks and become much less noticeable as the months go on. Everyone’s experience is different.

If you’re feeling like you need some support around feeding your baby, you can click here to view my services and work with me.

Explore My Services

References:

(2023). Understanding Dysphoric Milk Ejection Reflex. D-Mer.org. Retrieved August 12, 2023, from https://d-mer.org/understanding-d-mer

Understanding Breast Changes During Pregnancy: What’s Normal and What to Expect

July 2nd 2023

Pregnancy is an exciting journey that brings about many changes in your body. If you’ve noticed changes in your breasts and are wondering if they’re normal, you’re in the right place. Breast changes are a common occurrence during pregnancy and are often one of the first signs of this incredible journey. Let’s explore what’s normal and what to expect when it comes to changes in your breasts during pregnancy.

Tenderness and Sensitivity: Experiencing the Hormonal Shifts

One of the initial changes you may experience in your breasts is tenderness and sensitivity. This sensitivity, especially on your nipples, can become quite noticeable early on in your pregnancy. These changes are primarily influenced by the hormones estrogen and progesterone, which start to increase in your body as you grow your baby and placenta.

You may find that this tenderness and sensitivity persists throughout your pregnancy, although it may fluctuate in intensity. Sometimes you’ll feel the sensitivity when you’re getting dressed and for others, it shows up more as you get into and out of the shower due to the temperature changes and pressure of the water. Rest assured, these sensations are entirely normal and expected!

Size and Shape: Preparing for Motherhood

Another common change you’ll notice is a physical increase in the size and shape of your breasts. It’s completely normal for your breasts to become larger during pregnancy. This change occurs as your body prepares to nourish and feed your baby. The average change in size is going up 1 cup size though many people experience a much more significant change in size.

Around 16-18 weeks is when the network of milk ducts grows and your body begins to produce your baby’s first milk, called colostrum. This rapid growth of milk making tissue can also lead to some of the sensitivity you’re experiencing.

If you don’t notice much of an increase in breast size throughout your pregnancy, this isn’t something to necessarily worry about right away especially if you’re experiencing some of these other changes. For some, the growth happens much later in pregnancy. If you do have any concerns, do bring them up with your Midwife/OB/Lactation Consultant.

Areola Changes: Guiding Your Newborn

Alongside the increase in size, you’ll notice changes in your areola—the darker-colored skin surrounding your nipple. The areola becomes much darker in color during pregnancy, serving a purpose: helping your newborn locate the breast. Since newborns have limited eyesight and can only see a short distance, your body prepares for feeding by darkening the areola. This color change helps your baby find the breast, ensuring they can access their nourishment easily.

Montgomery Glands: Nature’s Lubrication System

One potentially surprising change during pregnancy is the appearance of small bumps on the areola. While these bumps may not have been noticeable before, they might become more prominent or even appear for the first time during pregnancy. These bumps are known as Montgomery glands and serve a crucial purpose. They secrete a substance that lubricates your nipple once your baby is born. The secretion has a scent similar to amniotic fluid, further aiding your baby in finding nourishment. While these glands may undergo further changes after your baby’s birth, their appearance or enlargement during pregnancy is totally normal.

Visible Veins: Increased Blood Volume

As your pregnancy progresses, you may observe more visible veins across your chest and breasts. This increased visibility is a result of your expanding blood volume. When you’re pregnant, your body experiences a significant increase in blood volume, rising by almost half to support your growing baby and changing body. While the sight of these veins may be new and surprising, they are positive signs that your body is preparing to nourish your baby.

Leaking Colostrum: Your Baby’s First Milk

Around 16 to 18 weeks into your pregnancy, you may notice your breasts leaking a substance known as colostrum. This thick and sticky fluid is your baby’s first milk. While the leakage may seem unusual, it’s perfectly normal and indicates that your body is producing this essential milk well ahead of your baby’s arrival.

Colostrum is produced in small amounts since newborns require only a small volume of milk in their first 24 hours. Some individuals may notice dried crusts of colostrum on their nipples or in their bras, which is nothing to be concerned about. However, if you don’t experience leakage, that’s also perfectly normal and doesn’t indicate any issues with milk production.

After your baby and placenta are born, your body gets the hormonal signal to ‘turn on’ an increase in milk production and the volume will slowly begin to increase over the next few days following your baby’s birth provided they are nursing often.

Signs Requiring Attention: Possible Red Flags

While most breast changes during pregnancy are expected there are some other signs to watch out for and then get in touch with your primary care provider (OB or Midwife) as well as a lactation consultant if you see them happening.

If you’re feeling any new lumps or bumps it’s something to bring up with your care provider. If your breasts are feeling very tender or swollen or tight that is also something to bring up with your care provider and may also be helpful to also see a lactation consultant. If you see any changes in the texture or colour of your skin (any changes in the color other than the areola) these would all be scenarios to bring up with your primary care provider and then bring on the support of an International Board Certified Lactation Consultant.

Also, if you’re not really noticing any of much of the above signs, it may be helpful to see an International Board Certified Lactation Consultant while you’re still pregnant. We can talk about your health history and any previous experiences that may impact your body’s ability to produce milk such as breast or chest surgeries. We can also go over your plans and goals for feeding your baby. If you’d like to book a prenatal consultation or learn more about working with me during pregnancy, please fill out the form below.

Prenatal Consultation

Alex Wachelka is an International Board Certified Lactation Consultant, mother of two, educator, writer and podcast host. She works with families locally and across the globe to help them feed their babies.

Advice for Transitioning from 1 to 2 kids

person covering infant with swaddling blanket

May 29th 2023

I always knew I’d have kids someday. It wasn’t a burning desire but I knew I wanted to have a family and I knew it meant one than more child.

I have two younger sisters so maybe that’s why I wanted more than one. My sisters and I are all quite close in age with just about two years between each of us. I felt I wanted the same for my family.

When the time came to think about a second child, and to have that child be as close in age as my sister, it meant conceiving when my first was about one year old.

That thought alone was entirely overwhelming. Here I was with an infant who literally just became a toddler. Wearing a diaper just learning how to walk and I was supposed to go through another pregnancy while parenting this little child?

Needles to say, we did not plan our second baby at that time but rather waited an entire year and conceived him just before our first turned two years old. This was perfect timing for our family but I was facing a huge transition, moving from caring for and parenting one child to two.

I’m not sure anyone is really prepared for children. Yes you can plan ahead and learn about labour and birth and breastfeeding and everything to expect in that first year but it’s entirely different when you’re living it.

I knew what to expect after having one child but what I didn’t know was what to expect with two. Would my first child be jealous of my second? Would he be upset at the fact that my newborn would need me 24/7and his time with mama was now split?

I also wondered how I would be able to give myself to two children. What would this mean for my relationship with my husband? Life was already so busy with one baby, how would we have time for each other with two? Needless to say, I had a lot of internal questions.

The physical preparation

As my pregnancy progressed and once I had a noticeable belly, we told our toddler he was going to be a big brother. At age two I don’t think he quite understood but as that year progresses he understood mama had a baby in her belly and that baby was going to be a part of our family.

We talked about how’s mamas body would make milk for the baby and how mama would spend a lot of time feeding the baby. We told him how new baby’s eat often and mostly do a lot of sleeping and pooping.

We had him be as involved as possible when it’s came to setting things up for the baby. This meant transitioning him to a single bed and moving the crib into mama’s room for the baby. He did really well with all of it. I was more emotional than he was.

The day our toddler met the baby

When the day came and our second baby boy was born, our toddler wasn’t actually part of the birth. I chose a home birth but made the decision after labour started to have my toddler be with family.

He came home just a few hours after our birth team left and came into the bedroom to meet me and our littlest addition. I highly recommend filming your older child’s reaction. It was precious. He instantly loved his baby brother.

Navigating life with two children

Everyday we would have our toddler be a part of the new baby’s life whether he joined me in the bedroom for a diaper change or watched his baby brother have his first bath. I spent a lot of time talking to him, asking him how he was feeling and having him talk to his brother.

We quickly discovered he liked to sing to his brother as well as talk to him and tell him that he was his older brother. He never demonstrated any jealousy towards the baby and I’d like to think us helping to prepare him had some influence on that.

As I write this they are now just over 3 years old and almost 11 months old and it’s heart bursting to watch the two of them together. Little brother loves watching his big brother and when his big brother jumps up and down, he gets the cutest giggles. The baby can also cruise around and take a few steps so they love chasing and playing with one another.

There have been a lot of ups and downs these past 11 months. Whenever someone would ask me “so how’s it with two?” my response was honest and usually something like “it’s crazy some days but it’s been easier than I thought. The transition from 1-2 was easier for me than 0-1”. Going from zero children to having my first, rocked my world more than adding a second and I believe it’s because I had been through it once before.

So after having two children for the past 11 months, here’s a few pieces of advice I can share if you’re planning or already pregnant with your second.

Give yourself some grace. You will feel like you’re failing your oldest at times. When they ask you to play and you’re nursing the baby or they ask you to come to help put them to bed but you’re nursing the baby it will hurt your heart but you are the best mom for these children and will figure out a balance.
Lower your expectations of what you can accomplish. And then maybe lower them once more. Seriously. At least for the first few months.
Meal prep ahead of time (in the 3rd trimester) including foods your toddler/older child will eat. If you have a husband or partner that’s not kitchen savvy, write the cooking directions on the freezer packages.
Arrange for help wherever possible especially if your child isn’t in daycare and if you have a dog that needs walking or another house pet that needs care.
Don’t worry too much if your older child’s screen time goes up. You’re not a bad mom. You can create a special play basket of toys/games/activities your toddler gets when the baby is nursing.
Spend time with your oldest before your baby arrives. Day trips with both parents or 1:1 time with each parent, or just you if you’re a single parent.
Talk about the baby and tell your older child what to expect in terms of feeding and sleeping and the baby’s needs
Sometimes dinner will be take out and that’s ok
Don’t shy away from feeding your baby in front of your toddler. My son knows the baby drinks milk from mama and that sometimes I have to pump the milk for baby. He knows breastmilk is for babies and boobies feed babies.
If you breastfed your first or wanted to but had a struggling time, plan ahead for baby number two. Taking a prenatal breastfeeding course will not only remind you of what newborns eating and sleeping patterns are like but it will help you feel more confident and prepared. I have a free 5 day mini e-course you can sign up for here that will be sent straight to your inbox and help set you up for more breastfeeding ease.

Overall, it’s been a wonderfully amazing, joyful, messy, exhausting, overwhelming, love filled adventure adding a second child to our family.

Overtime, you’ll find your groove and before you know it, you’ll have a hard time remembering what life was like before your newest addition joined the family.

Breastmilk: how many ounces should my baby drink

and how do I know if it’s enough?

Updated March 7th 2023

Are you constantly wondering if your baby is drinking enough breastmilk? Do you find yourself on Google trying to figure out how much they should be eating? If you are, you’re not alone! I am frequently asked about this subject especially from first time breastfeeding moms. I know you just want to make sure your baby is getting enough so let’s take a closer look.

This a common worry among those nursing because you can’t see the milk going into your baby. So there are things you want to be looking for and paying attention to when your baby is nursing. They include how your baby is feeding and whether or not they are swallowing milk, what their demeanour is after feeding, how many diapers they are producing in 24 hours and their weight gain. Taking notes of these things will help you determine if your baby is getting enough milk.

1. Looking and listening for swallowing

When a baby is taking in milk, they have to swallow it. 4-5 swallows per feeding of colostrum is what we’re looking for. When milk transitions, and the volume goes up, we’re looking for a 1:1 ratio of suck:swallow after let-down (the flow of milk) has started.

But what are you actually looking for? When a baby swallows milk, you will see their jaw drop slightly lower and pause momentarily. You can also have a look at your baby’s ears or the side of their face as you may notice the bottom of the ears move when the jaw drops down. This is a swallow. You can also listen for a swallow. A baby’s swallow sounds like a soft “kah” sound.

2. Generally content after feeding

Your baby should be alert prior to feeding and generally more sleepy and content after a feeding. Every baby is different and not all babies experience a milk coma right after feeding which is why we pay attention to their behaviour. If they are no longer showing those early hunger cues and seem relaxed, you can take it as a sign that they are content after the feeding. Many babies will also have their hands in fists prior to feeding and then relax to a more open hand afterwards. Sometimes their arms get really floppy after feedings too. This is just another sign they are full and relaxed after a feeding.

3. Diaper output is age appropriate

Newborns produce a lot of wet and dirty diapers. During the first week, we look for 1 wet and 1 dirty diaper for each day of life. On day 1, or within the first 24 hours we are looking for 1 wet diaper and 1 dirty diaper. Baby’s first poop is called meconium and is very dark, sticky and tarry. After this, on day 2, we are looking for 2 wet diapers and 2 dirty diapers. The poop will still be dark but may resemble a darker green than brown. As the days progress, by day 5 your baby’s poop should have transitioned to a mustard yellow in colour and you should be seeing 5+ wet diapers and 3-4 yellow dirty diapers. If there’s so many that you’ve lost track, chances are your baby’s diaper output is appropriate.

It’s always important to track during that first week because it’s a question all lactation consultants will have for you. The first couple of poops your baby has should be about the size of a toonie (if you’re Canadian) or larger.

4. Your baby is gaining weight

This is a clear sign that milk intake is enough. What is most important though is that your baby is sticking to their own growth curve. The growth percentiles are not report cards. A baby in the 50th percentile is not doing poorly nor is a baby in the 95th doing better than others. This is just simply comparing their size and weight to other babies of that age. Humans are different sizes. It’s normal! We’re not all supposed to be the same size so the same goes for babies.

Your doctor/pediatrician should be using the World Health Organization (WHO) growth velocity charts and not the CDC charts. These charts take into account infant growth and development from all over the world and use the growth of a breastfed baby as the norm.

If you can see or hear your baby swallowing for a few minutes each feed, they seem content afterwards and are producing lots of wet and dirty diapers while gaining weight, your baby is getting enough milk.

But how many ounces should they drink?

If you’re doing any pumping at all (even if you’re not) you may still have this question. This is something that’s going to be different for each and every baby, though there are averages. After 1 month, breastfed babies consume an average of 24-32 oz in 24 hours. Some babies needs less than this, some need a little more and many fall right within this range. Prior to one month, they are eating less.

For a baby eating 8-10x per day this averages to about 3-4 oz (90-120mL) per feeding. Now, some feeds they may only take 2.5oz (70ML) and some feeds could be up to 5 oz (150mL).

This volume doesn’t change in the first 6 months! Whatever you produce after the first month (assuming you’re exclusively breastfeeding and not experiencing low supply or over supply) will be what you continue to produce*

The reason for this is quite cool (but I’m an IBCLC so think human lactation is really interesting). Your body changes your milk to meet your baby’s needs! This is how a 2 month old and 5 month old still only need about the same amount of milk in a 24 hour period.

Yes, even if you exclusively pump your body will still be changing the antibodies and make other adjustments to your milk because you and your baby are sharing the same environment.

So what about after 6 months?

I said that the volume of milk a breastfed baby will consume in 24 hours stays the same for the first 6 months. This is because around 6 months, solid foods are introduced. These foods are complimenting what your baby is getting in milk so the volume of milk stays about the same and their increase nutritional needs are being met by the small volume of solids.

Your baby’s milk intake will remain fairly constant for a few months before it gradually starts to decline as they consume more solids. When solid foods are introduced, breastmilk remains their primary source of nutrition. It’s not until they’re about 12 months old that solids will make up most of their daily intake of calories and nutrients. Many toddlers (12+months) may still consume 12-19oz of breastmilk daily in addition to their solid foods (meals and snacks) as well as water.

Learn more about starting solids here

*If you are having challenges and are not producing enough (supplementing with donor milk or formula) you may be able to increase your supply depending on the underlying cause. An IBCLC can help you with this.

Motherhood has its challenges and breastfeeding can bring more of its own challenges.

But breastfeeding isn’t all or nothing. No ones breastfeeding journey is exactly the same as another but all mothers share in their love of their babies. You don’t have to navigate this journey alone. We are in this together.

The Bumps + Breastfeeding Academy is your new mom breastfeeding survival guide. You will get the answers to your burning questions and help you need to breastfeed with ease from a lactation expert.

LEARN MORE HERE

If any of this has you worrying about your milk supply, connect with an IBCLC for a full assessment. You deserve expert lactation support. You can learn more about working with me here.

References:

Bonyata, K. (2018 January 15). Hunger cues: when do I feed my baby? Kellymom.com. https://kellymom.com/bf/normal/hunger-cues/

Hetzel Campbell, S., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core curriculum for interdisciplinary lactation care. Jones & Bartlett Learning

Newman, J., & Pitman, T. (2014). Dr. Jack Newman’s guide to breastfeeding. Harper Collins Publishers Ltd.

Wilson-Clay, B., & Hoover, K. (2017). The breastfeeding atlas (6th ed.). Manchaca, Tex.: LactNews Press.

What is an IBCLC?

And how does it differ from other lactation consultants?

Updated March 1st 2023

The first Wednesday in March is IBCLC day. A day dedicated to all the support IBCLCs provide to families so what better day to share about what an IBCLC is than today.

When you’re expecting a baby, you might have people tell you about lactation consultants and how they are people who can help you breastfeed. Or, you might not discover this kind of support until after you give birth if you didn’t plan for feeding ahead of time.

Some people assume the nurses in the hospital are lactation consultants. Some people assume La Leche League leaders are lactation consultants. Both of those assumptions could be correct given the fact that anyone can use the term Lactation Consultant. It’s not a protected title. It’s not one that requires a specific skill set or education. Essentially, anyone after completing a short course or breastfeeding their own babies could call themselves a “lactation consultant” which can be a dangerous thing. Most people who use that term to describe what they do however, have some kind of education or experience in lactation.

Clinically difficult circumstances call for the support of an IBCLC. For example, weighing a baby before and after feeding to determine how much milk was transferred is out of scope for someone other than an IBCLC. If someone sees you for an in home visit and has a scale with them for weighted feeds, they need to be an IBCLC.

What is an IBCLC?

An IBCLC is an International Board Certified Lactation Consultant. They are a healthcare professional that specializes in human lactation and human milk feeding which includes breastfeeding/chestfeeding/body feeding/bottle feeding and infant supplementation with human milk or formula milk. They hold the highest credential possible in lactation care. It is the gold standard because it is a globally recognized certification. IBCLCs have met a set of very specific requirements and passed an internationally administered board exam (more on this below).

IBCLCs can work in hospitals, clinics/medical offices and some go into business for themselves and open a private practice. Some IBCLCs are also nurses or doctors but it’s not a requirement to become an IBCLC.

How do you become an IBCLC?

Becoming an IBCLC requires years of work. It’s requires 14 specific health and science courses, a minimum of 95 hours of specific lactation education, Basic Life Support Certification and hundreds if not thousands of clinical hours (hands on experience) working with and supporting breastfeeding and human milk feeding families before you’re even eligible to apply for the board exam (you can learn more about this below). So while it’s a certification, there is still a globally administered board exam that needs to be passed and it’s issued by the International Board of Lactation Consultant Examiners (IBLCE).

This board also holds everyone who is certified to practice within a Scope of Practice and act according to Code of Professional Conduct.

After someone is certified, they have to re-certify every 5 years proving they’ve continued supporting families as well as continued learning by earning a minimum of 75 continuing education credits. We also have to keep our Basic Life Support up to date.

Thinking about becoming an IBCLC? Download my free series: 5 questions to ask yourself before becoming an IBCLC

DOWNLOAD HERE

What does an IBCLC do?

An IBCLC goes far beyond just helping you get a good latch. In addition to helping you and your baby get a comfortable latch, myself and other IBCLCs can also:

Teach you how to increase your pump output
Teach you what to look for to know your baby is getting enough milk
Help you with bottle feeding
Help you through a nursing strike
Teach you how to support your teething baby
Help you heal nipple damage (or prevent it from happening in the first place)
Help you suppress your lactation if you don’t want to lactate
Help you induce lactation if you want to co-nurse, nurse an adopted or surrogate baby
Help you end your feeding relationship and wean
Help you navigate medications and breastfeeding
Help you nurse your multiples
Teach you how to assemble your pumps
Teach you about proper pump cleaning and sanitizing
Teach you individually about safe formula preparation
Teach you how to introduce solids to your little one
And more!

IBCLCs are certified infant feeding experts who promote, protect and support breastfeeding. We can also be your sounding board, a trusted member of your healthcare team, your advocate and help you advocate for yourself and support you every step of the way to reach your goals for feeding your baby.

What about other certifications?

The only globally recognized certification is an IBCLC. There are many other forms of lactation certifications out there. Several types of certified educators and counsellors, each with their own scope of practice. The widest scope of practice, supporting you with the most challenging situations is the IBCLC.

Some people complete these other certifications as a stepping stone to becoming an IBCLC. The lactation education that happens within these certifications helps to fulfill the lactation education hours required to write the IBLCE board exam.

Used with permission from Victoria Munro, RMT, IBCLC

In summary, an IBCLC is a specialized healthcare professional dedicated to promoting, protecting and supporting breastfeeding and helping you reach your infant feeding goals.

You can have a closer look at the resource below which is IBLCE.org, the best place to begin if you’d like to learn more about becoming an IBCLC yourself.

If you’re curious about working with an IBCLC you can search this database to find one globally as well as this database to find one in Canada. You can also click the “work with me” tab and book a consultation with me.

To learn more about the specific steps and necessary requirements, check out IBCLE.org website below:

Start Your IBCLC Journey

Alex Wachelka is a member of the Canadian Lactation Consultants Association.

Listen to the Lactation Land Podcast

Is my baby getting enough? – Lactation Land Podcast

This is one of the top questions I get from new parents. There are ways you can tell if your baby is getting enough and in today's episode, I'll teach you what to look for. Covered in today's show: How to tell if your baby is drinking Milk drunk/milk comas Wet and dirty diapers Weight gain and growth curves Pregnant and ready to learn more about feeding your baby? Check out the Breastfeeding Before Baby Program here. Already nursing and feeling like breastfeeding isn't going how you imagined? Join me inside the Bumps + Breastfeeding Academy – a safe space to create the breastfeeding relationship you desire click here to learn more. Enjoyed this episode? Screenshot the episode and share on social media: @motherhoodbloomslactation Join my free weekly email list with even more tips and support for breastfeeding HERE. Learn how you can work with me: www.motherhoodbloomslactation.com

Advice for Expecting Moms

50 Pieces of advice for expecting moms from real, first time moms

Updated January 15th 2023

I asked my Instagram audience a while back to share with me advice that they would give either a first time mom or themselves when they were pregnant and an amazing thing happened.

Answers came in multiples! 5+ people would say the same thing about a particular topic. It’s amazing because it reassures you that you’re not alone when it comes to the experiences of pregnancy and postpartum.

I sorted through them to bring you 50 of the best, most helpful responses. You’ll notice a theme as you’re reading through. Share with me in the comments if you pick up on it.

50 Pieces of advice for expecting moms from real, first time moms

Plan ahead – learn about vaginal delivery as well as c-section and recovery
Trusts your instincts
Get yourself gift cards before you deliver for guilt free spoiling
Breastfeeding is not as easy as it looks! The road is exhausting but try to enjoy your LO
Lower your expectations and understand biologically what baby’s sleep looks like
Take a course, prepare food for months
Please read more on breastfeeding
Give yourself time. Be easy on yourself. It takes time
Learn a lot before delivery!!! I regret that I knew nothing. I was clueless
Just go with the flow
Work with a lactation consultant before baby is born
Search for a breastfeeding consultant and take it 1 day at a time.
Please don’t give up on breastfeeding. It will get better and easier
Go to therapy. Seek help if you need it.
Invest in classes with a lactation consultant
Education is key to breastfeeding success.
Doulas are amazing.
Be patient and take time for your body to heal.
Prepare baby’s room during the second trimester
Talk to someone and get on top of your mental health
Be gentle on yourself and give it time
This too shall pass
Accept all the help
Keep a list handy of what you need from others
Prepare meals and freeze them
It does get better and easier but ask for all the help you can along the way
Take all the classes! My biggest mistake was not thinking I knew what I was in for
Research a good IBCLC beforehand and get an appointment right after delivery (IBCLC stands for International Board Certified Lactation Consultant)
Discuss your expectations of support with your partner
Reach out for support.
You are not alone
Trust your instincts and if that doesn’t work don’t be scared to seek help
Make sure you have someone to talk to who will listen and only give the advice if you ask for it
Go day by day. Nothing is as planned.
Expect the unexpected
The hormones are unreal
Trust your gut and take all other suggestions and opinions with a grain of salt
Go to therapy. Really important.
Take a prenatal breastfeeding class
Reach out for help. Don’t wait and suffer alone
Take it one day at a time
Organize meals
Have a good support system.
Invest in a lactation consultant and a doula instead of a fancy bassinet
Take help when it is offered
Use any support systems you have
Learn about breastfeeding and babies before you give birth
Set up a station with diapers and everything else you need in a few different rooms
Make sure you and your partner are on the same page
Prepare for breastfeeding and learn about normal infant eating patterns and behaviours with the Breastfeeding Before Baby Program!

These are really excellent pieces of advice covering your physical recovery and health as well as your emotional and mental health and relationship with your partner. And, over a fifth of these are about preparing for breastfeeding! Ok, so I added number 50 but the moms who shared advice here as well as the ones I talk to daily would encourage you to prepare ahead of time.

Breastfeeding might not come naturally and winging it isn’t a great idea

Especially because hospital staff won’t likely have the time you deserve to help you. Most hospital based IBCLCs are quite busy (often times there’s just one lactation consultant per shift) and only get a few minutes with each new mom and baby after birth. It’s barely enough time to observe a feeding and support you with latching techniques.

You can feel confident about your body’s ability to breastfeed, and introduce yourself to the key foundations of having a successful breastfeeding experience ahead of time. Planning in advance also allows your partner time to learn about the experience and what normal infant feeding and sleeping patterns look like. It will also help you partner learn about ways they can bond with the baby and there are tons that are not feeding related!

If you want to learn a little more about breastfeeding and what to expect postpartum before jumping into a class, download my FREE 5 Day Mini Course for Prenatal Breastfeeding

This mini course will provide you with essential knowledge and skills to help get breastfeeding off to a good start

DOWNLOAD HERE

Alex Wachelka is an International Board Certified Lactation Consultant, mother of two and her practice Motherhood Blooms Lactation support parents and birth professionals both online and in person.

How to Donate or Receive Breastmilk

And how to safely store breastmilk if you’re donating or accepting donor milk

December 12th 2022

Did you know you could donate or receive breast milk to support feeding your baby? Not many parents outside of those with medically fragile babies in the NICU even know that human milk sharing is available to them! In the NICU, breast milk is sourced from formal Milk Banks which I’ll talk more about below.

Many families outside the NICU are quick to resort to formula instead of human milk because chances are, they didn’t even know they could access it. In 2019 when my first baby was born, it was suggested I use formula to supplement my baby with. I immediately asked if donor milk was an option and was told no because he was a healthy term baby born outside of the hospital. I didn’t know I could informally source milk from another local mom so we supplemented with formula.

This post will cover how to find a donor or recipient, milk bank donation, questions you should ask a donor as well as safe storage guidelines if you are donating or receiving.

How to find milk to donate or receive

There’s two ways to go about breastmilk sharing, informal or formal. Informal is mom to mom/parent to parent. There’s no one monitoring or regulating anything. You could donate to family, neighbours or even strangers. You’re taking this person for their word about what the have or have not been consuming/their health status if you’re accepting their milk.

It’s a donation basis and you can meet up with them locally to pick up or alternatively ship the milk to them. You need to find this person on your own and it’s completely up to you to ask them about their lifestyle habits. You can find a donor by joining a local mom Facebook group or your local Human Milk 4 Human Babies Facebook group. Another is Eats on Feets. You can search “human milk for human babies + [your city name]” to see what comes up for you. You may need to join a local region rather than a specific city one depending on where you live. Once you’re accepted into these groups you can post that you either have or are looking for breast milk.

Formal is going through a milk bank (such as the Human Milk Banking Association of North America) which has very strict guidelines. Only milk from those people who pass these strict screening guidelines are accepted. It requires a blood test in addition to other screenings (including a phone screening) to be able to donate. They will send you a box to donate (once you’ve passed all the tests) and typically require a large volume of 100-150oz. Once this milk is received at the donation centre, it’s all pooled and undergoes pasteurization. This pasteurization is to remove any harmful bacteria and pathogens like viruses. lt’s is often reserved for infants in the NICU and you need a prescription to access it.

Informal donation: What to ask your donor

So you’ve found a donor inside a Facebook group! Before you accept their milk, you should ask them questions about their habits, lifestyle and how they collect milk and care for their pump parts to ensure you feel good about receiving their milk.

Questions you should ask include:

What supplements and/or medications they take
If they consume caffeine and or alcohol
Do they smoke
If they have any recent recreational drug use
Many moms want to know Covid vaccine status which you can also ask about
Ask about how they collect and store the milk to ensure they have proper cleaning, handling and storage techniques (example: how do they wash their pump parts, how often are they washed, how long is the milk in the fridge before it’s frozen)

Never pay for breastmilk unless it’s from a milk bank. This is because it can easily be altered with water (which is dangerous for your baby) and/or people can make claims like “high fat milk” – something they cannot prove. You can offer a donor of a very large donation or a long term donor the option of replacing pumping bags for them. It’s not essential but is a nice gesture.

My Story

I shared at the start of this post that I asked about donor milk when my first was born but had no idea I could access it from another mom so we used formula. My first breastfeeding experience changed my life in more ways than one but one thing it did do, was make me think about donating the next time I had a baby.

As I write this, I have been able to donate over 80oz of milk (over 2300mL). The first 50oz (about 1478 mL) went to one baby in need and the next 30oz (887mL) or so went to a second. I thought a lot about donating milk during my pregnancy because I know first hand how hard breastfeeding can be but I wasn’t sure if I really wanted to pump to be able to create an oversupply to donate. In order to donate milk and have my baby be exclusively breastfed, I needed to make more than what he needed so pumping and removing milk outside of 8-12+ nursings a day would be needed.

After my baby was born I used lots of hand expression and some pumping to help ensure my production remained high enough so that we didn’t have to supplement through his feeding difficulties. I would collect 1 oz maybe 2oz (30-60mL) every other day or so and I would just freeze it because my son was exclusively nursing. As his sleep patterns changed and he began sleeping 3-4 hours overnight, my body would wake me up before him so I would just hand express until I was comfortable and save that milk.

That adds up pretty quickly and before I knew it I had over 50oz in my freezer and my son was exclusively nursing. So I joined my local Human Milk for Human Babies group on Facebook and shared that I had milk available for donation. I ended up reaching out to a mom who posted she was in need because no one had responded to my post (it’s a big group and posts are easily missed!) She had a few extra questions for me around how I collected and stored the milk. From there, we made an arrangement for her to come pick it up from me. The second donation followed a very similar process.

These will likely be the only two families I help as I am no longer collecting milk. As someone who struggled with her first breastfeeding journey and through that experience realized my call to become an IBCLC, it feels so wonderful to be able to support other moms and babies in need beyond my everyday role.

Safe Storage Guidelines

Knowing how to safely store milk is important whether you’re storing milk to donate or accepting donor milk to feed to your baby. Freshly expressed milk should be frozen within 4 days. Always label the milk bag with the date it was expressed and how much is in the bag. Freeze the milk in small amounts of 2 to 4 ounces to avoid wasting any. Breastfed babies consume an average of 2-4 oz per feeding of milk from 1-6 months old – depending on how often they feed in 24 hours. After 6 months it actually doesn’t change much either this is just when solids are introduced to help meet their nutritional needs.

Ideally, store milk in the back of the freezer (or refrigerator before it’s frozen) and not in the door. This is because the temperature is most consistent at the back. When freezing, leave an inch of space at the top of the container; breast milk expands as it freezes. Lay the bags down flat to freeze them as a “brick”. This makes for easier storage later.

Frozen milk can be stored in an insulated cooler bag with frozen ice packs for up to 24 hours when you are traveling to collect milk from a donor or dropping it off to a recipient.

Thawing: Always thaw the oldest milk first. Thaw milk under lukewarm running water, in a container of lukewarm water, or overnight in the refrigerator. Never thaw or heat milk in a microwave. Microwaving creates hot spots which can burn a baby’s mouth. Use milk within 24 hours of thawing in the refrigerator (from the time it is completely thawed, not from the time when you took it out of the freezer). Use thawed milk within 2 hours of bringing to room temperature or warming.

Never refreeze thawed milk. If you lose power to your freezer, and the milk begins to thaw, as long as there are ice crystals in the milk it can safely be re-frozen.

Feeding: Milk can be served cold, room temperature, or warm. All babies have different preferences. To heat milk, place the sealed container into a bowl of warm water or hold under warm running water. Do not heat milk directly on the stove or in the microwave. Alternatively, you can use a bottle warmer if you have one but you can make do without one. Test the temperature before feeding it to your baby by putting a few drops on your wrist. It should feel warm, not hot.

If you have any questions or concerns, reach out to me.

A few final thoughts

Only you know if sourcing donor milk or wanting to donate feels right for you and your baby. It can be an amazing gift to provide for a mother and baby in need. It also feels great on the receiving end to be able to provide your baby with the powers of breastmilk.

If you do informally source donor milk, be sure to ask the donor questions. If they’re not willing to answer all your questions, they’re not the donor for you.

Interested in learning more about breastfeeding including tips and tricks to help things feel easier for both you and your baby?

Breast, pump or bottle, my free weekly email is filled with support and insights to help you on your journey

Holiday Booby Traps: Avoiding Mastitis and other issues

happy diverse family with baby near christmas tree

How to manage a baby and breastfeeding during the holidays

Updated November 15th 2022

The holidays are here and with it can come a lot of stress and worries or concerns over your family and your new baby. I’m going to start with a little story. I had a 4 week old at Christmas back in 2019. I was a first time mom, newly postpartum and I was having a very difficult time breastfeeding. I was exhausted and stressed. That Christmas should have just been my husband and I and our new baby, but that’s not how it went.

I reluctantly agreed to have some family over for Christmas. Because we lived far away from family at that time, they were also ALL staying in my home. Making the decision to have multiple people staying in my home for Christmas added to the stress I was experiencing. It didn’t help that I asked half of them to book a hotel and they flat out refused.

There is SO MUCH going on when you have a brand new baby and the holidays can bring added stress and challenges. I’m going to provide you some tips for making your life easier and still focusing on yourself and your baby during this time.

Holiday Booby Trap Number One: missing feeding cues

It’s important to know babies can become overstimulated. Newborns and young babies can easily become overwhelmed. They will express this overwhelm by crying, fussing and becoming irritable. Bringing them to a quiet, dark space will help. This helps to shut out the distractions and will be very helpful when nursing them. You may also find they want to nurse more. This is because the act of suckling helps regulate their nervous system.

Watch them for feeding cues as well. Catching those early hunger cues which include stirring, their mouth opening, turning their head side-to-side and rooting around can be missed if your baby is with another family member. When a baby escalates those hunger cues to stretching, bringing their hands to mouth and moving around more, a family member may try to shush them in the hopes of soothing them or pop a pacifier into their mouth. This will then start to spread out feedings which can put you at an increased risk of breast inflammation leading to blocked ducts and possibly mastitis (see below for more on this).

When these early cues and escalations are missed, babies start to cry, turn red and get very agitated. This may be the point that Aunt Rita says “let’s get you to mommy” for a feeding but at this point, your baby is going to need to be calmed by you before they will feed.

When a baby is crying because they are hungry, this is more of a distress signal than a true hunger cue so rocking, bouncing, singing, cuddling – any number of these things may need to happen before your baby is in a calm enough space to latch on and feed.

>> For more tips around breastfeeding a newborn in the first two weeks, check out my post ’14 tips for breastfeeding in the first 14 days’

Holiday Booby Trap Number Two: Christmastitis; how to avoid getting mastitis around the holidays

Mastitis is an inflammatory condition of the breast. It’s on a spectrum along with engorgement, plugged ducts and a few other issues. If you notice a red, shiny streak on your breast paired with a fever, chills or body aches, these are signs of mastitis.

This can happen:

If you miss a feeding or a pumping session (easy to happen when you’re at holiday parties or with lots of family)
If you space out the time between feedings (whether intentionally or unintentionally)
If your baby isn’t effectively removing milk at the breast. This could be due to their latch or poor positioning at the breast
If you are using the wrong flange size when pumping
If you have an abundant milk supply (oversupply)
If there’s lots of pressure against your breast such as with a tight fitting bra (because you’re in your holiday clothes). Find a comfortable and supportive bra designed for nursing or pumping

The Academy of Breastfeeding Medicine recently released a brand new protocol for managing mastitis. The focus is on reducing the inflammation. Breastfeed and remove milk as usual. The newest guidelines suggest there’s no need to try and “empty” the breast like outdated guidelines recommend. Excess pumping can increase inflammation further making matters worse and potentially leading to an overproduction which is an entirely new challenge to manage.

USE GENTLE MASSAGE AND COLD

Gentle breast massage to move the excess fluid towards the armpits to the lymphatic system can help. Your breasts are not muscle tissue and should not be treated as such. Hard, vigorous massage can physically damage delicate milk making tissue and your breasts and further increase inflammation. Think of it like a sprained ankle, treat it gently and with care. Use cold after milk removals (nursing or pumping) whether it’s a cold pack, a fancy ice pack for breasts specifically or a bag of frozen peas.

A great video about gentle breast massage is below. This technique helps elongate and gently stretch the milk ducts. It’s called breast gymnastics and was developed by IBCLC Maya Bolman.

https://www.mayabolman.com/videos/v/breastgymnastics

REDUCE INFLAMMATION

Reducing inflammation can include anti inflammatory foods as well as over the counter medications like Advil and Tylenol. These are compatible with breastfeeding. This is a great resource to check for medications.

Holiday Booby Trap Number Three: getting stressed out

The holidays bring their own special kind of stress. Stress hormones can interfere with oxytocin and your let-down. They can also impact your overall production (noticing a dip in your supply).This can make breastfeeding feel more stressful. Supporting milk production by reducing stress is about reducing your stress hormones and increasing oxytocin.

Taking time away in a quiet dark room with your baby can help. Watching videos or looking at pictures of your baby while you’re pumping can help support your let-down. Smelling something of your baby’s can also help.

It’s about finding ways to calm and relax yourself. When your stress hormones are low, your body can optimize oxytocin and prolactin. Maybe this means listening to music you enjoy while feeding your baby. Or maybe it’s using an essential oil you love while in the shower. Maybe you can find 5 minutes to sit still and deep breathe. All of these activities can naturally reduce stress hormones in your body and help to increase your milk production.

If it’s feeling like it’s too much, tell your company you need to feed the baby and take a time out. Go into the bedroom or nursery and spend 30-45 minutes alone with your baby skin to skin. Skin to skin releases oxytocin which is a feel-good hormone that relaxes both of you. Your baby should be in just a diaper and you undressed from the waist up. Your baby can breastfeed during this time if they want to but they can also just rest or sleep. This will help calm the both of you and give you much needed time alone.

>> if you’re wondering what else might be affecting your supply, grab my free video here

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Holiday Booby Trap Number Four: feeling family pressure

You are in charge of who is allowed to come over and for how long. You’re also in charge of your decisions to visit family in their homes or go to parties. It can be very difficult as a new parent to tell family you don’t want them over for an extended period of time but if the people visiting are close enough to be spending time with your new baby, you should be able to set some rules with them.

Set boundaries and stick to them and say NO whenever you need to. They don’t have to hold your baby. You do not have to justify your decisions, whatever they may be. You are the expert of your own baby.

When you’re navigating questions from family like “why don’t you use a bottle?” or “why are you giving him a pacifier?” or unsolicited advice like “just let her cry” or “you’re going to spoil him” you can simply respond with “because this is what works for us” and by the way, babies can’t be spoiled.

Holiday Booby Trap Number Five: worried about what you’re eating

When you are lactating your energy needs are higher than when you were pregnant. Make sure you’re eating enough. Don’t worry so much about what you’re eating but that you’re eating. It’s so busy being a new mom and if you have company over, even moreso.

The holidays are filled with foods that will support your postpartum recovery and milk supply. Protein is very important when it comes to your body healing and your energy levels. It also has a role in milk production because it helps balance your blood sugar. Turkey and ham are great holiday sources of protein. So is roast beef which is also a great source of iron, a mineral needed for milk production. Nuts are also a great snack filled with protein, fat and fibre to support you postpartum.

Other holiday themed foods that can support milk production include oats, dates, molasses, apricots, fennel, sweet potato, almonds and dark leafy greens to name a few.

>> You can learn more about foods that support milk supply and other ways to help your body maximize your milk production inside the Milk Supply Masterclass.

TL;DR

Follow your baby’s cues and feed them when they’re hungry. This will help ensure you’re not at risk for blocked ducts and mastitis. If you exclusively pump, keep to your schedule as best you can
Create some quiet time with your baby
Use gentle massage and cold on your breasts if you feel mastitis coming on
It’s ok to say no
Eat and enjoy yourself

Have questions? Join my private support group on Facebook and connect with other new moms.

Save yourself hours spent on google and connect directly with me and my community. I’d love to have you join us!

CLICK HERE TO JOIN

Was this helpful?

References:

Bonyata, K. (2018 January 15). Hunger cues: when do I feed my baby? Kellymom.com. https://kellymom.com/bf/normal/hunger-cues/

Hetzel Campbell, S., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core curriculum for interdisciplinary lactation care. Jones & Bartlett Learning

Katrina B. Mitchell, Helen M. Johnson, Juan Miguel Rodríguez, Anne Eglash, Charlotte Scherzinger, Kyle Widmer, Pamela Berens, Brooke Miller, and the Academy of Breastfeeding Medicine. (May 2022). Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022.Breastfeeding Medicine.360-376.http://doi.org/10.1089/bfm.2022.29207.kbm

Newman, J., & Pitman, T. (2014). Dr. Jack Newman’s guide to breastfeeding. Harper Collins Publishers Ltd.

Wilson-Clay, B., & Hoover, K. (2017). The breastfeeding atlas (6th ed.). Manchaca, Tex.: LactNews Press.

Breastfeeding, Fertility and Birth Control

Updated June 6th 2022

You’ve likely had someone tell you that you can’t get pregnant while breastfeeding only to have someone else tell you they got pregnant 3 months after having a baby

What’s the right answer? Should you be able to rely on breastfeeding as a method of birth control?

You can get pregnant while breastfeeding. Breastfeeding doesn’t fully prevent pregnancy however, breastfeeding within the first 6 months may be used as a method of birth control when specific conditions are being met. Even then, it’s not a method that works for everyone so always talk with your partner and your primary care provider to discuss your options.

Lactation Amenorrhea Method (LAM for short) is considered a non-hormonal method of preventing pregnancy. This method uses 3 measures of fertility:

1. Return of your menstrual period

2. Your breastfeeding patterns

3. The age of your baby

How does LAM work?

Breastfeeding naturally suppress fertility (ovulation) but only when it’s the exclusive method of feeding your baby (more on this below).

Bleeding in the first 56 days after birth is not your period. This is called Lochia and happens when the placenta detaches from the uterus. So if you haven’t had any bleeding after those first 56 days and your cycle has not returned, you’ve met the first criteria for LAM.

How often you breastfeed also affects how LAM works. To be able to use LAM as birth control, a second criteria needs to be met: you have to be exclusively breastfeeding.

This means all feedings are happening at the breast and you’re not using pacifiers or pumping. As soon as pacifiers or pumping is introduced, the effectiveness of this method decreases. You baby also cannot be receiving any other liquids or foods. If solids are introduced prior to 6 months, again, the effectiveness of this method significantly decreases. You also cannot be going longer than 6 hours between feedings which means your baby needs to be feeding at breast during the night. Basically, all boob all the time.

Finally, if you’ve met the above 2 criteria and are nursing a baby under 6 months old, the studies show that the chance of becoming pregnant is about 2%. This means when all 3 criteria are met, LAM can be 98% effective as a method of birth control. Again, this isn’t always the case for everyone.

woman holding child and breastfeeding — Photo by Helena Jankovičová Kováčová on Pexels.com

What are the advantages of LAM?

It can work for up to 6 months after birth which is quite a while. It’s also effective right away (there’s no delay or waiting period) and very convenient. Using this method means there are no added hormones that can affect your breastmilk production. Some birth control methods especially those that age estrogen based can reduce your milk supply. Finally, breastfeeding provides many other health benefits for both you and your baby.

Your baby has a reduced risk of allergies and asthma, reduced risk of future obesity and diabetes and your risks of breast and ovarian cancer are decreased. You also have a reduced risk of future cardiovascular disease when you breastfeed.

What are the disadvantages?

The reality is that it may be difficult for some to fully or nearly-fully breastfeed. It’s common to face challenges as breastfeeding is a learned skill for both you and your baby.

Situations such as your baby not latching, oral ties or separation may require you to pump and supplement that milk to your baby in another way. Some circumstances require supplementation with formula. Any of these situations would affect the effectiveness of LAM because the frequency your baby is at the breast would be reduced.

It’s also only effective for up to 6 months after you have your baby after that, you and your partner need to have a plan.

When is LAM no longer effective?

If any of the 3 criteria/conditions are not met, the effectiveness of LAM is reduced and you can no longer rely on this method.

Anything that would reduce prolactin levels (the milk making hormone) can lead to your period returning sooner because it increases the chances of ovulation happening.

This would include:

Pacifiers
Pumping
Bottles
Scheduled feedings
Sleep training
Not feeding during the night

All of these space out feedings and reduce the frequency of prolactin being stimulated because baby is not at breast.

Prolactin, the milk making hormone, inhibits two hormones needed for ovulation: FSH & LH. When feedings at breast are spaced out (as mentioned above) there is more opportunity for the ovulation hormones to rise because prolactin levels aren’t remaining as high.

Night time feeds have a big impact on how quickly ovulation returns as well because prolactin levels actually rise overnight.

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What happens when your cycle returns?

Everyone’s body and feeding journey is different so there is quite a range for when your period may return. It may happen as early as 6 weeks after birth and for others, they have no period for 2+ years while breastfeeding.

When your cycle does return, you might experience a temporary dip in milk production. This can lead to your baby displaying fussy behaviour and suddenly clinging to you and feeding around the clock. This dip is often temporary and it’s is normal and very common if it happens.

For some, after a few cycles they don’t notice a dip anymore and for others, every months they notice a dip in their supply.

You will still continue to make enough milk for your baby. Continue to feed your baby when they display hunger cues and work with a lactation consultant if you’re finding it difficult.

You can also check out this blog I wrote about 4 ways to tell if your baby is getting enough milk.

Can you take hormonal birth control while breastfeeding?

Hormonal birth control has the potential to impact your milk supply⁣ especially when taken within the first 2 months of giving birth.⁣

⁣Many doctors will suggest a progestin-only form of birth control as it’s less likely to have a negative impact on milk production⁣. Progesterone (a hormone) inhibits prolactin (the milk making hormone)⁣. Higher levels of progesterone can cause a reduced milk production for some people⁣.

⁣Even though these hormonal birth control methods are considered to be low risk for your baby – they may not be low risk when it comes to your feeding goals. Keep in mind everyone’s body is different⁣. Some see no impact on their production while others do

⁣If you had a previous breast reduction, have thyroid issues or any challenges with infertility you are at an increased risk for lower supply and hormonal birth control could further reduce your supply so always review your options with your care provider and work with a lactation consultant to support your feeding goals.

References:

Bonyata, Kelly. (2018, March 17).Breastfeeding and fertility. Kellymom.com. https://kellymom.com/ages/older-infant/fertility/#:~:text=The%20Exclusive%20Breastfeeding%20method%20of,not%20menstruating%20due%20to%20breastfeeding.

Coly, Shirley. (n.d). LAM – The Lactation Amenorrhea Method. World Alliance for Breastfeeding Action. https://waba.org.my/resources/lam/index.htm

My Health Alberta, (2018, November 2). Lactation Amenorrhea Method. MyHealth.Alberta.ca.https://myhealth.alberta.ca/sexual-reproductive-health/birth-control/natural-methods/lactation-amenorrhea

Vekemans M. (1997). Postpartum contraception: the lactational amenorrhea method. The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2(2), 105–111. https://doi.org/10.3109/13625189709167463

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Is Breast Always Best?

Lactation Lessons From An Expert

Updated April 22nd 2022

What does “breast is best” really mean? And is it true? I recently sat down to be interviewed by Megan Pearson at The Fertile at 40 Podcast to talk all things lactation.

Megan and I quickly discovered that we shared many similarities in our breastfeeding journeys. We were both experiencing painful feedings, we both had a gut feeling that something else was going on and we both lacked the support we really needed.

We sat down to discuss:

What I think about the saying “breast is best“⁠
How new parents can set themselves up for breastfeeding success⁠
How older women can support themselves in the breastfeeding journey⁠
What foods can help with milk supply⁠

toddler taking a photo of her parents — Photo by Jonathan Borba on Pexels.com

We talked about how pain isn’t normal

A big misconception around breastfeeding is that it’s supposed to be painful. Breastfeeding should be enjoyable and comfortable, not painful; no matter what your mother-in-law says. A painful latch means we can improve something.

In the first few days/week your nipples might be tender. Mild soreness or tenderness can be normal provided pain goes away after a few seconds of your baby being latched, the pain doesn’t last the entire feeding, doesn’t show up after the feeding has ended and there are no concerns over milk supply or weight gain.

If you’re dreading feeding or pumping due to pain or if you’re holding your breath while your baby latches, there’s a reason for your pain and you deserve to get skilled support. If someone tells you pain is normal or dismisses your concerns, that’s a red flag to find someone else knowledgeable in lactation.

We talked about milk supply

Removing milk could be by your baby at a feeding or by a pump or by hand expression. What’s most important to consider is that the milk removal is effective. If milk is removed ineffectively, milk will be left behind in the breast. When milk is left behind, the body adapts and slows down milk production. When your baby is effectively removing milk because they have a good latch and you’re still concerned about your supply, you may start considering galactagogues.

There are foods and supplements (and medications) that can increase milk supply. These are called galactagogues. While there’s many products out there claiming to boost milk supply, it’s important to know galactagogues are not a “quick-fix”. Galactagogues will not stimulate a let down nor will they help empty the breasts. They need to be combined with an effective latch and frequent milk removal.

Grab my free video guide to what might be hindering your supply here.

We talked about skin to skin

Enjoying time skin-to-skin with your baby releases oxytocin which is the hormone that helps your milk let-down. In addition, this provides comfort and a safe space for your little one. Skin to skin helps regulate your baby’s body temperature and reduces stress in both your baby and you. A lower level of stress helps support milk production. Your baby is biologically wired to want to be close to you.

You do skin to skin immediately following birth during the “golden hour” and can also do skin to skin in a warm bath after you’re home. This is another great environment to breastfeed your baby. Allow any attempt or opportunity your baby takes to breastfeed during skin to skin. The more often they are at the breast, the more opportunity to increase your supply.

We talked about support

This can make all the difference when it comes to reaching your breastfeeding goals. You need to be informed and supported. You deserve to work with someone skilled in lactation. The average pediatrician or nurse is not. You deserve the time and attention it takes to find the root of why you’re struggling.

You can listen to the full episode HERE

If you have questions when it comes to feeding your baby, join Breastfeeding Mavens. My free community where you can connect with other moms who are feeling just like you.

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References:

Campbell, S.H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core Curriculum for interdisciplinary lactation care. Jones & Bartlett Learning.

Newman, J. & Pitman, T. (2014). Dr. Jack Newman’s Guide to Breastfeeding. HarperCollins Publishers Ltd.

Wilson-Clay, B., & Hoover, K. (2017). The breastfeeding atlas (6th ed.). Manchaca, Tex.: LactNews Press.