April 1, 2021 • 29 mins
This week the doctor is in the house! Dr. Matthew Saidel is here to tell us all the things we should be asking about breastfeeding well before the baby comes.
Most moms forget to talk to their OB’s about breastfeeding and it’s not that surprising if you think about it. Being pregnant takes up a lot of mental space and it’s hard to get focused on anything that comes after labor and delivery. But here at Nest Collaborative, we are huge advocates of prenatal planning for breastfeeding because once the baby is born, a new momma who has already done her breastfeeding homework is much more likely to have a positive experience.
So what should you be asking your OB now during your pre-natal checks? What planning and prep can you do to get on the right track for the best possible breastfeeding journey? Let’s find out.
This episode features Dr. Matthew Saidel, Chief Medical Officer for Women’s Health USA, the country’s leading physician practice management company dedicated to women’s health. A special thanks to IBCLC's Christine Bracken and Lou-Ellen Saidel for their invaluable expertise that was utilized during this episode.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Unknown (00:02):
Laura who's Laurie?
Dr. Matthew Saidel (00:02):
Laurie?
Beeson? Oh, is this Laurie? No.
Amanda Gorman (00:06):
Oh, yeah. Laura is large issue into and then
who's?
Who's the last one?
Unknown (00:12):
Not just
Amanda Gorman (00:14):
Hey, Matt.
Oh, hi. Sorry.
Dr. Matthew Saidel (00:20):
Hello, Eddie.
Amanda Gorman (00:23):
Hi, Craig.
How are ya?
Dr. Matthew Saidel (00:30):
I'm peachy, are you?
Amanda Gorman (00:32):
I'm good. I always like these days because I
get to leave my house.
Dr. Matthew Saidel (00:36):
Oh, that's one.
Amanda Gorman (00:39):
Um, so thank you very much for coming in and
doing this. I think this isgonna be really helpful. Oh,
you're welcome.
Unknown (00:45):
Um,
Dr. Matthew Saidel (00:46):
see if I have anything to add.
Unknown (00:48):
I have something.
Amanda Gorman (00:51):
Chelsea's here with me. She is what like three
weeks postpartum. And it'salready more on point in her
daily postpartum life than Ihave ever been.
Hey, Doc, how are ya?
Dr. Matthew Saidel (01:06):
I'm swell.
Thank you very much.
Cool. I'm not sitting next toAmanda, but you just can't see
me. She's over here. Hello. Iguess a couple of things that
we've already Can you hear me?
Okay.
Amanda Gorman (01:21):
She has a mask on?
Dr. Matthew Saidel (01:22):
Let me move my mic closer. Can you hear me
better now? Oh, that's okay,super. So first of all, thank
you so, so, so much for takingtime out of your busy schedule,
we are going to try to make thisas fast and painless as humanly
possible, we usually run about30 minutes or so. Just like we
talked about on the phone acouple of weeks ago, the whole
idea of this is just to have areally great casual
conversation. This podcast isfor women who are afraid to ask
(01:45):
their ob questions or afraid ormaybe they feel like they're too
far in their journey they'vealready failed. They're kind of
starting to look for adviceelsewhere. So you know, even
from our chair had such anawesome vibe from you. So I'm
really excited about today. Weare recorded not live. So
anything that you say cannot orwill not be used against you.
(02:08):
Effectively when we you know ifthere's anything that you're not
comfortable with or whateverhappens, we can always take it
in Edit, so don't worry. Midwaythrough Amanda will talk about
taking a short break, say staytuned. And it'll sound like it's
going to be a commercial, we'rejust going to break for like two
or three seconds. And thenshe'll just jump into the next
part. We're gonna edit that backin. Yep. And other than that,
(02:31):
like I said, it's just a reallykind of cool casual chat. If
we're running over on time, wemay just cut some questions. Or
if there's anything that you saythat Amanda wants to dive deeper
into, she'll just ask a followup. We'll have fun. This is just
supposed to be something that'sthat's informative, but makes
women kind of feel reallycomfortable. So
again, want to check my audiowith this. I have a couple of
(02:53):
mic settings. I don't know ifyou can hear me now. If I turn
my head or whatever. Does thatgo out? No.
Amanda Gorman (03:00):
It's pretty good.
Dr. Matthew Saidel (03:02):
Is this better here? Does it matter? I
think I'll stick. But you'regonna hear okay. Yeah, I can't.
I can't I have to talk to youabout something else afterwards.
Okay. And I'll just talk to you.
Amanda Gorman (03:15):
But yes, okay.
Got it. Check. I'll see.
I have like a weird moustacheshadow on my face. Or is that
just me? I mean, nothing againstmustaches.
Dr. Matthew Saidel (03:27):
Oh my god.
Can you see it? Oh, yeah. Toraise the computer, is that what
it is? If you move it around?
No.
Unknown (03:42):
It's it's like a zoom feature. Do I?
Dr. Matthew Saidel (03:44):
I've never I've never seen it before.
Amanda Gorman (03:47):
But you see it?
Yeah. It's like Pedro.
Dr. Matthew Saidel (03:51):
Yeah, it does.
I don't know. Is it Do I have,you don't have it on the side?
When you turn this way, youdon't have it. Now you
Amanda Gorman (04:06):
alright, whatever. You want
Dr. Matthew Saidel (04:07):
to move your mic and put it from the mic.
It's a shadow from something. Idon't know what it's from.
Amanda Gorman (04:13):
Well, thank you to you both for not like you
know, acting like you didn't,yes. Well, let's say
Dr. Matthew Saidel (04:25):
I feel like it's someone playing a trick on
me in zoom. All right, whatever.
You know what, what? I've hadworse or moments. What if we
just move you a little bit?
You need a light a differentlight or something?
Amanda Gorman (04:37):
Does does this dim down?
Dr. Matthew Saidel (04:42):
Really just that because it's an audio
studio?
Amanda Gorman (04:49):
The whole time.
Now, I have a good tea overhere.
Dr. Matthew Saidel (04:56):
Yeah.
Amanda Gorman (04:56):
All right.
Oh down here it goes away
Dr. Matthew Saidel (05:03):
yep
Amanda Gorman (05:06):
used to be I know Do you want to get him a
little hit will that help sorryman
Dr. Matthew Saidel (05:14):
okay these things are you know i mean
it looks it's all it's it's Ijust what the heck I have I have
a special zoom light here
Amanda Gorman (05:32):
well I'm actually complexion looks fantastic
Dr. Matthew Saidel (05:35):
I'm completely clean shaven actually
but I don't know what zoom does
Amanda Gorman (05:42):
know it is it's it's not
Dr. Matthew Saidel (05:46):
it's it's if you just get a little little bit
from the side it's
Amanda Gorman (05:51):
oh look
Dr. Matthew Saidel (05:53):
well you can't now it goes away now it's
now it's gone now it's gone wellyou're in the shadow of the mic
now it's it's it's wow what isso weird What?
Amanda Gorman (06:10):
He's filming from here that's where some it's the
camera angle is. I'm sorry.
Dr. Matthew Saidel (06:22):
Is that Is this too vain? But I mean it is.
No no no, no no I said thatdoesn't look at all like you. I
mean we know each other prettywell
Amanda Gorman (06:30):
so well I just I'm thinking of my poor parents
every time they so I have astash
Dr. Matthew Saidel (06:39):
to try to move the lights. If I come down
here. Yeah, if I come down hereat sea go away.
Yeah, there it just popped upthere and opsin is gone. There.
Okay, gone. There. And that'sweird. It doesn't fade out it it
(07:01):
pops out
Amanda Gorman (07:03):
it's zoom playing zoom.
All right, he has some magic.
Anyway, my poor parents anytimethey want to FaceTime with my
child, she puts filters on them.
Oh yeah. Yeah, they don't get itbecause they don't really know
what it is. And they're like,why am I my cat top half or
Dr. Matthew Saidel (07:25):
something?
You know, I could understand.
Amanda Gorman (07:29):
Alright, with a new device. Now I'm getting
light.
Still, they're still there.
Dr. Matthew Saidel (07:40):
Now we look like dark Canyon.
Amanda Gorman (07:43):
Bamako t
Dr. Matthew Saidel (07:46):
Dar tonyan see if there's any effects on
your zoom or something like thatit looked better with it before
it's really weird.
Amanda Gorman (08:01):
You know, you shouldn't mess
Dr. Matthew Saidel (08:02):
with pre menopausal women. Women weren't
close.
Okay, strictly accessibility blabla bla
light made it worse as the nextyear of skin wider. That's so
weird. And the thing is when itpops off it pops off in a
(08:26):
certain pixel you know it's it'sthere but when you go down it it
it complete now it's only at thebottom of the screen. gone
there. Oh, there I saw thatthere was a shadow that shadow
(08:47):
What is that? That is somethingthat's that. That's the zoom
effect.
Amanda Gorman (08:52):
Oh, it is a zoom.
Where we hacked
Dr. Matthew Saidel (08:55):
I don't know. But that's that's the zoom
effect. You could see itfloating over your face. A
little mustache? Do I
Amanda Gorman (09:02):
have like a friend of me?
Dr. Matthew Saidel (09:04):
Look look if you go see it now it's up over
your nose. Yes, it's over yournose. It's trying to be yes it's
totally a zoom effect. I don'teven realize it zoom. I had
those. I should log out log backin or something or
Amanda Gorman (09:21):
Oh my god, this is I'm
Dr. Matthew Saidel (09:26):
Chelsea This is view my quick video tab,
log back out log back in maybemaybe it's something it's
something whose it is totallyzoom effect settings. It
says click your profile settingprofile picture or
Amanda Gorman (09:49):
a view or something?
Dr. Matthew Saidel (09:52):
More that's your profile picture.
Okay.
Amanda Gorman (10:02):
setting, filters, no
Unknown (10:05):
video filters
Dr. Matthew Saidel (10:10):
and then there's the studio
effect. Now that's a filter.
Amanda Gorman (10:18):
Oh, my God, how long has that been on?
Dr. Matthew Saidel (10:26):
It worked pretty well. It's amazing.
Amanda Gorman (10:28):
retiled It's gotta be the Oh, thank goodness.
Dr. Matthew Saidel (10:33):
Good to see you.
Amanda Gorman (10:35):
Oh my god.
To look at the previously doneone since it was it.
Dr. Matthew Saidel (10:42):
Was it on your phone?
No.
I mean, where was the filter onin your profile in my profile?
Oh god, that's
Amanda Gorman (10:53):
got to trick someone.
Someone has it out for me.
Dr. Matthew Saidel (10:57):
I mean, it was a perfect goatee and
mustache is
Amanda Gorman (11:04):
going I'm glad it's not going that poorly.
Alright, I'm sorry. Here we go.
All right, we're recording.
You're muted. Here we go. Hi,everybody.
Hey there mamas and mamas to beand welcome to another week here
on Breastfeeding Unplugged.
Today we are super excitedbecause the doctor is in the
house. And he's here to tell usall the things we should be
(11:26):
asking about breastfeeding wellbefore baby comes.
Most moms forget to talk totheir OBs about breastfeeding.
And it's not that surprising ifyou think about it. Being
pregnant takes up a whole lot ofmental space and it's hard to
get focused on anything thatcomes after labor and delivery.
(11:47):
But here at Nest Collaborative,we are huge advocates of
prenatal planning forbreastfeeding because once the
baby's born, a new mama who hasalready done her breastfeeding
homework is much more likely tohave a positive experience. So
what should you be asking yourOB now during your prenatal
checks? What planning and prepcan you do to get on the right
(12:09):
track for the best possiblebreastfeeding journey?
Let's find out. Today we arejoined by Dr. Matthew Saidel.
Chief Medical Officer at Women'sHealth USA, the country's
leading physician practicemanagement company dedicated to
women's health. After obtaininghis undergraduate degree from
Cornell University and medicaldegree from the Chicago Medical
(12:30):
School, Dr. Saidel completed hisobstetric and gynecology
internship and residencytraining at Hartford Hospital.
He practiced for 39 years withspecial interests in family
centered obstetrics, familyplanning, vaginal surgery, and
most recently, menopausemanagement. He's a regular on
the Hartford and Connecticut topdoctors lists and a valued
(12:54):
resource to our community hereat Nest Collaborative. Welcome,
Dr. Saidel, it's really great tohave you here with us.
Dr. Matthew Saidel (13:00):
I'm tired after all that stuff I
apparently did. So it's nice tosee you. Always good to talk to
you, Amanda.
Amanda Gorman (13:07):
Yes, likewise. So it's really important for us to
get an OB's perspective on theshow. And as I mentioned in my
intro, I think a lot ofmoms-to-be kind of forget about
having breastfeedingconversations with their
prenatal care providers. Wereally advocate for prenatal
prep with our network of IBCLCs,because we see the success rates
(13:29):
that moms have when they'rereally prepared. So what do you
think about this?
Dr. Matthew Saidel (13:34):
Well, I think, you know, the thing that
we see is that everybody's veryconcentrated on the pregnancy
and a little bit maybeapprehensive about the birth.
And then, you know, you you seemoms who are sleep deprived and,
and recovering from the birthprocess. And all of a sudden,
(13:58):
there's this baby, and theirmilk hasn't come in yet. And
it's frustrating. And they havelots of questions, and they say,
gee, I wish I had thought aboutthis earlier. So it is obvious
that I think it's very importantto, to start thinking about it
earlier and with your OBprovider, whether that's your
(14:21):
obstetrician, midwife, APRNwhatever, that's the perfect
place to start.
Amanda Gorman (14:27):
Absolutely. I want to address some
breastfeeding 101 questions thatwe get all the time. But before
we do that, the big question oneveryone's mind is the COVID-19
vaccine. What are your thoughtsfor breastfeeding moms
specifically, as well as womenwho might be pregnant?
Dr. Matthew Saidel (14:45):
So that's a obviously a very, very hot
topic. Everybody's worried aboutit and and most places across
the country, we're beginning tosee availability for the vaccine
in the age group of pregnancy.
So, you know, spoiler alert, I'mgoing to say yes, absolutely get
the vaccine, eitherbreastfeeding or during
(15:08):
pregnancy. I'll just say a wordabout it. The vaccines that we
have, both the mRNA vaccine,which are the Pfizer and Moderna
and also the J&J vaccine, dotheir work by fooling the body
into making copies of the spikeprotein from the Coronavirus.
(15:29):
But they don't make the wholevirus. It's kind of like I
always say if the Coronavirus isthe black knight, then what the
body makes is the helmet bywhich we recognize this black
knight. And so our body makes alot of copies of that helmet
(15:51):
when instructed to do so by theour immune system. And but the
knight isn't there. So thevaccine has absolutely no
capability to cause replicationof the virus. The other thing
that people worry about is thatdoes the vaccine somehow change
our own DNA. The vaccines,especially Moderna and Pfizer
are what are called mRNA, ormessenger RNA vaccines. They do
(16:15):
not go into the center of thecell, which is called the
nucleus, there's the bigoutside, and then the center
part where your DNA and geneticmaterial live. They just go out
into the outside of the cellwhere these little factories
called ribosomes are makingproteins. And they take over the
factory and tell it to makespike proteins and then your
(16:36):
body causes the immune system tomake these smart bombs against
the spike protein. And thevaccine disappears almost as
quickly as it goes into yourbody. It's it doesn't last for
very long. Therefore it can'teven cross the placenta. And so
we have no evidence that thevaccine will cross the placenta,
(16:59):
but the vaccine does cause theproduction of antibodies, which
will cross the placenta intoyour baby give immunity against
the vaccine to a large degree.
And the same thing happens withbreast milk. The virus doesn't
go into the breast milk, but theantibodies do, so that when
you're breastfeeding, and you'vebeen vaccinated, you're in
(17:21):
essentially what we callpassively immunizing your baby.
You're not causing your baby tomake antibodies, but you're
giving the baby antibodies,which you do in a lot of other
things, too. I mean, if you'reimmune to other diseases and got
a flu vaccine, or you knowyou're you're immune to measles
or mumps, you're giving those uhyou're giving those antibodies
(17:41):
to your baby through the breastmilk and across the placenta.
And so in a sense, you'reimmunizing your baby as well. So
the reason that you hear fromcertain authorities that we
haven't done testing in pregnantwomen, yes, that's true testing
is underway. But with all thewomen who've been vaccinated, so
(18:01):
there have been over 30,000pregnant women that we know
about been vaccinated already.
We have very, very significantdata on 1800 of them. There are
no differences in miscarriage,no differences in birth defects,
no difference in pregnancyoutcomes. And so and the babies
that have been born who frommoms have been vaccinated, they
look wonderful. So we give lotsof vaccines in pregnancy all the
(18:26):
time during pregnancy, and wegive the flu vaccine, we give
the Tdap vaccine for tetanus,diphtheria, and whooping cough.
And so we have essentially noreservations about this. And we
think you should get whatevervaccine you can, as soon as you
can get it at whatever timebecause we know, for a fact,
COVID is bad for pregnant moms.
(18:48):
You know, when you're pregnant,your immune system is not the
same as when you're notpregnant, it's got to tolerate
this little creature insidethat's from you, but not of you.
And it's sort of a foreigner, ifyou will. And so your immune
system is dialed down totolerate this little stranger
inside you. And that makes youmore vulnerable to respiratory
(19:10):
viruses. So people who get theflu can get extremely ill and
even die from the flu duringpregnancy. And people who get
COVID are much more likely toget more severe disease and end
up in an intensive care unitthan women who are not. So our
biggest concern here is we don'twant you to get COVID.
Amanda Gorman (19:27):
Hmm. Well, that was wonderful and really
comprehensive and really spokenin a way that I think our
listeners will will reallyunderstand. So thank you for
that. Let's dive into somequestions that that we get every
day at Nest Collaborative. Thefirst one being, when should I
bring up the topic ofbreastfeeding during my prenatal
(19:49):
care?
Dr. Matthew Saidel (19:51):
Well, you know, that's the answer is
really anytime. I mean, youknow, you're gonna have a lot of
questions and a lot of timesyour OB is gonna say, well, it's
not quite time for that, you canask it later. But, you know, one
of the things that people getembarrassed about is bringing
lists into the OB, you know,because the worst thing is to
come in and say, ach I knewthere was something I wanted to
ask, I can't remember what itwas. We like lists because they
(20:15):
have a beginning and an end. Soit's not just our what are we
forgetting here. And so it'sokay to bring those in, in the
OB may say to you, you know,that's something for a little
bit later. But we do think thatbreastfeeding is an important
discussion. And it's adiscussion that you want to
start to have, towards the endof your second trimester, maybe
the beginning of your thirdtrimester. So we're talking 26
(20:38):
to 32 weeks, that kind oftimeframe. Because you want to
start thinking about it, youwant to be able to check to see,
you know, what's the benefit forbreast pump, and what is your
insurance cover and so forth.
And, you know, we love the NestCollaborative model because we,
it causes a connection to bemade with you, and your
lactation consultant at 27, 28,31, 33 weeks, so that you've
(21:04):
already established thatrelationship. And it's not an
unknown. So much of childbirtheducation, whether it's about
the childbirth process itself,you know, whether it's about
huffing and puffing, or whetherit's about breastfeeding is
about fear of the unknown. So ifyou know, I've heard of this
term, I've, I've gotten an ideaof what's going to happen. I
(21:27):
know which number to call atthree o'clock in the morning or
whatever. That's part- that'shalf the battle because it gets
rid of fear of the unknown. Sothe short answer is, you know,
late second trimester, earlythird trimester.
Amanda Gorman (21:41):
Awesome, thank you. Are there any specific
health conditions that mightprevent a mom from being able to
Dr. Matthew Saidel (21:47):
Well, the short answer is not a whole
breastfeed?
bunch. I mean, there are certainthings like you know, if a mom
has active HIV, that would notbe the best time to breastfeed.
Some kinds of hepatitis, if youhave cracked nipples, and
(22:08):
there's a possibility oftransmitting blood to the baby,
it would be a contraindicated.
There are some medications thatthat are cause breastfeeding to
be contraindicated, but not toomany. And there are great
resources for you to look andsee there's, there's a website
called LactMed which Amanda I'msure you're familiar with
(22:30):
LactMed. LactMed.com, I think itis. And you can go on there and
just look up your medication andthey'll give you the- they'll
give you the lowdown on whetherit's safe to take, and when's
the best time to take it inrelationship to feeding and so
forth. So, you know, most of thetime there, I mean, there are
some women who, for example,have had breast reduction
(22:54):
surgery, you know, that's youwant to connect with a lactation
consultant early to see what youcan do to maximize it. There are
some very rare conditioningwhere women have inadequate
breast tissue, but that's prettyunlikely. So the short answer
is, yes, most of the time, youcan but in those conditions I
(23:17):
mentioned you probablyshouldn't.
Amanda Gorman (23:21):
Yeah, and I just want to clarify, it's the
hepatitis in combination withcracked bloody nipples, not
cracked bloody nipples beingcontraindicated?
Dr. Matthew Saidel (23:30):
No, because crack bloody nipples obviously
do come up. It's only incombination with hepatitis. So I
guess the way to turn thataround and say there's lots of
times where with hepatitis, youcertainly still can't
breastfeed. If everything'sokay, and the latch is right,
and all those things that Amandacan talk about.
Amanda Gorman (23:47):
Yes, and we encourage women to, to really go
onto LactMed and checkthemselves. On- a lot of times,
we have women coming to us,unfortunately misinformed about
medications they're on eventemporarily. I think it's easy
for people to often just say,oh, just pump and dump to be
safe. But you don't always haveto do that. So we really
(24:08):
encourage moms to use LactMedthemselves or to reach out to
their OB if they really want toan answer.
Dr. Matthew Saidel (24:14):
And I would I would add to that, that you're
going to hear this phrase pumpand dump a lot. Because if you
ask for example, if you'rehaving surgery, you're asking an
anesthesiologist or whateverthey're going to tell you to
pump and dump. And they're goingto be conservative about that.
And most of the time, it's notright.
Amanda Gorman (24:29):
Right, exactly.
Dr. Matthew Saidel (24:31):
Check with somebody who knows, like a
lactation consultant.
Amanda Gorman (24:34):
Absolutely. Um, so is there a breast exam that
can actually be done to see ifthere are any issues that you
spoke of before? Obviously, wetalk about surgeries but
inadequate breast tissue, whichwhich you mentioned is quite
rare, but is there anything thatcan be done ahead of time?
Dr. Matthew Saidel (24:52):
Well, if, for example, you know, if you
have either flat or invertednipples, that's something you
can talk to a lactationconsultant ahead of time about
that, because there are certainways to prepare and certain
techniques to breastfeed thatit's important to, to have an
expert talk to you about that.
So that that would be anotherreason for our prenatal care.
(25:14):
Consult with a with a lactationconsultant. But those are the
main issues that that you shouldlook at ahead of time.
Amanda Gorman (25:29):
Awesome. So what do you suggest moms should do to
best prepare for breastfeeding?
Dr. Matthew Saidel (25:37):
Well, I think first of all, the most
important thing is to understandthat it's the right thing to do.
You know, we spend a lot of timetrying to make moms not feel
guilty for not breastfeeding.
But by the same token, it'sreally important that people
understand that breastfeed-understand that breastfeeding is
(25:58):
better for both mom and forbaby. And we'll go into that I
think a little bit later on aswell. But I think first of all,
you want to make up your mindearly and realize that that's a
part of this whole discussion inhow I'm going to, you know,
what, what's my birth plan?
Well, it's not just your birthplan. It's your birth and
(26:19):
postpartum. And, you know, I,it's part of what I call, having
the baby is hard, but having thebaby is even harder. So, you
know, those, those plans need togo on for the next 20 years, but
you can really give your baby agreat head start. So you want to
start to think about this early.
And nowadays, it used to be theold Lamaze class and you went to
(26:40):
childbirth education classesonce a week for six weeks, or
whatever. Now they're availableonline, and they're available
virtually, and they're availablethrough Zoom, and all those
kinds of things. But um, it's agood idea to educate yourself a
little bit about aboutbreastfeeding before it happens.
Because it's going to be thelast thing that you want to look
(27:01):
up when, when the necessityoccurs. So a prenatal class that
includes breastfeedingeducation, I think is very
important. As we mentionedbefore, connecting with a
lactation consultant early is areal bonus. The other thing is I
mentioned before you want tocheck and see, does- most
(27:22):
insurance plans will will payfor a breast pump. And you want
to make sure that you A knowwhat is covered and B that
that's ordered for you by yourobstetrician's office- most of
them it's part of theirworkflow. But they need to be
reminded sometimes that theyneed to order that for you so
(27:44):
that you'll have it when youwhen you go to the hospital. But
knowing your resources,educating yourself about the
process, maybe connecting withsomeone. That's the best way to
prepare for breastfeeding.
Amanda Gorman (28:03):
Yes, absolutely.
And I think you're right, Idon't think women realize too,
that their insurance will coverprenatal breastfeeding
education, in addition to thepump. And like you said, you
know, we all know that breastmilk is best. But I think what a
lot of women don't know is thatthere are a lot of pathways to
getting breast milk into yourbabies. And I think that a lot
of what we do prenatally iseducate moms on what
(28:26):
breastfeeding can look like forthem. Because it doesn't look
like the same pathway orjourney. And so there's a lot of
ways that you you can get breastmilk to your baby. And even if
it's just for a window of time,any breast milk is better than
no breast milk. So we love towork with moms and figure out
what what works best for them.
Dr. Matthew Saidel (28:49):
And you know, when we talk about doing
this early in the second tri-,you know, end of the second
trimester, we all hope thatwe're not going to deliver
prematurely. But the sad fact isthat premature birth is is is
out there, and it's notuncommon. And a lot of people
think if I deliver prematurelythat breastfeeding is off the
table. And in fact, that'snothing could be farther from
(29:11):
the truth. You may have to pumpand feed your baby in some
alternative method. Butbreastfeeding is always good.
And so preparing a little bitearlier could also make sure
that you're prepared in casesomething happens and causes an
early birth.
Amanda Gorman (29:28):
Absolutely. And those babies need it most. So
this is awesome info. And Ithink it's really giving
moms-to-be and even second andthird time moms a lot to think
about. Breastfeeding really canbe tough and it does take work,
but there are also so manyresources out there that can
help. We're going to take aquick break but we'll be right
(29:48):
back with Dr. Saidel after aword from our sponsor, so stay
with us.
Thanks for tuning in mamas andmamas to be. Today, we are
chatting with Connecticut basedOBGYN, Dr. Matt Saidel who is
giving us the 411 on whatquestions moms should ask their
OBs to get the breastfeedingball rolling before baby comes.
(30:10):
Dr. Saidel, I just have a fewmore questions to ask you if
that's okay.
Dr. Matthew Saidel (30:15):
Sure.
Amanda Gorman (30:16):
So many studies have shown that both mom's and
baby's health benefit frombreastfeeding. Can we talk a
little bit about that, because Ithink we're so often getting the
memo on what it does for baby'shealth. But I don't know that
moms get the memo on what itdoes for their own.
Dr. Matthew Saidel (30:32):
Well, you know, we talked already in our
discussion about COVID, abouthow antibodies that are present
in the mom's body go through tothe baby. And so right away,
you're getting an immediatebenefit to the baby, even before
the milk seems to have come in,in the first few days. The
(30:53):
colostrum, the fluid that comesout before the milk really comes
screaming in, is antibody richand is really good for babies
starting out. But there's a lotof evidence about things that
that are prevented in, in babiesby breastfeeding. First of all,
(31:16):
breastfeeding babies don't tendto overeat, they tend to eat
more frequently in the amountthat they want. And so there is
a there is a decreased risk ofchildhood obesity, which
translates into a decreased riskof adult obesity. We also see
(31:42):
less asthma and allergies. Andit seems to help with baby's GI
function, constipation, and soforth. And there are, it really
helps them establish the rightcolonies of flora, bacteria and
(32:06):
so forth in their gut, thathelps their GI tract to work
better going forward. There'sless diabetes in- and I think
that goes along with less andless obesity in in these babies.
So real, real benefits. Um,moms. I'm going to take a break
(32:33):
here for just a second because Ihave some notes on this and, and
I and I somehow list 'em.
Oh there, onthe other side. I had a whole
Amanda Gorman (32:39):
That's okay.
ist, I don't want to miss thoseOh, I know where it is. s cond m
Unknown (33:03):
Talking about mom's health.
Amanda Gorman (33:06):
Yeah. Is that does that work for you? If I
start with and what about mom'shealth?
Dr. Matthew Saidel (33:12):
Yeah, yeah, yeah, just give me a second
here. Yep,absolutely. Ready Dr. site? Oh,
sorry. I'm just jumping in.
You're here when you're ready tohave to sit. I'll just tell
Amanda. So we'll cut this out.
And then she'll say what aboutmom's health? And then you can
jump in?
Yep. And I can I can find me butI'll get it. Hang on a second.
Unknown (33:45):
When I was gonna show you
Dr. Matthew Saidel (33:51):
and I noticed you skipped What? What
moms expect right afterdelivery. I don't know if you
meant to do that.
Amanda Gorman (33:58):
No, I don't know that. I did. Hold on.
Dr. Matthew Saidel (33:59):
That's number six. That's just because
of time. Did you?
Amanda Gorman (34:04):
Did you tell me it's sometimes she'll flash me
cue cards over here that okay,gotcha. What to do. Oh, and I
Dr. Matthew Saidel (34:12):
Okay, I got it.
Amanda Gorman (34:19):
All right. Don't rush. Um, okay.
And what about mom's health?
Dr. Matthew Saidel (34:30):
So there are lots of benefits for mom too.
First of all, when baby isbreastfeeding, a hormone is
released which helps to squeezedown on the uterus and helps it
return to normal more quickly,actually cuts down on on the
rate of, of bleeding. And wehave pretty good evidence that
(34:52):
women who have breast fed havelower rates of breast cancer,
ovarian cancer, osteoporosis,hypertension and diabetes, it
helps return to pregnant- aweight loss more quickly. So I
think, you know, there arereally tangible benefits. You
(35:13):
know, it's, so I always say, youknow, puppies get dog's milk and
kitties get cat's milk and, andcows get cow's milk, but so
humans should get human milk, itjust, it makes sense. The other
thing to remember, it saves alot of money for the mom,
(35:33):
because you don't have to spend1000 bucks a year on formula.
It's also better for theenvironment, because, you know,
less bottles and cans andwhatever. So and we think it's a
win win win.
Amanda Gorman (35:46):
Yeah, absolutely.
And I think sometimes moms don'trealize the time that it
actually saves, oncebreastfeeding is established.
Dr. Matthew Saidel (35:54):
You don't have to heat up your breast milk
at three o'clock in the morningwhen you-
Amanda Gorman (35:57):
No, or wash any bottles.
Dr. Matthew Saidel (35:58):
Only slept for an hour and a half, right?
Amanda Gorman (36:01):
Um, so I do think women feel a lot of pressure to
breastfeed, though andespecially, you know, from their
own mothers, or not to dependingon what generation you are. And
in their social circles is somedegree of pressure yay, or nay?
How do you think breastfeedinghas changed over the last
(36:21):
decade?
Dr. Matthew Saidel (36:23):
Well, you know, we, I think there's been a
much more of a permeation intosociety that breastfeeding is a
normal and okay thing to do. Imean, you know, when you just
walk through a- an airport, andyou see these little shelters
where people can breastfeed orwhen you see people
breastfeeding in public and notgetting arrested, and those
kinds of things, there reallyhas been a profound change in in
(36:47):
our attitudes towardsbreastfeeding. There's been a
lot of work done in the last 10years. And, you know, there have
been not only initiatives fromprivate companies, but also from
the government agencies like theCenter for Disease Control, and
(37:08):
the Department of Health andHuman Services. And, and in some
states, patients and physiciansare rewarded for promoting
breastfeeding, because we knowit's kind of a good thing. And
so the- now we're seeing theprivate insurers are covering
education, for breastfeeding.
And we are absolutely pushingfor that to- in many states to
(37:32):
transfer over to the Medicaidpopulation. There's so many
online support systems and theability to virtually meet with a
certified lactation consultant,online or by telehealth or by
Zoom or by however. So the ratesof breastfeeding have definitely
(37:59):
gone up some places more thanothers. But we see a much more
acceptance of this. And we seetechnological improvements,
which allow women to pump whilethey're working, or teaching, or
doing whatever what nobodyknows. So there have been
(38:20):
advances that make it easier todo this even in a world where so
many families have to haveeveryone working. So we think
it's really gone off over thelast 10 years. And we hope that
continues.
Amanda Gorman (38:39):
As do we. Um, so if a mom feels like she's not
getting enough information orsupport from her OB with regards
to breastfeeding, what otherresources are there for her?
Dr. Matthew Saidel (38:50):
So we would love for people to contact a
lactation consultant before theyare giving birth. Because that's
a great- that is a greatresource. There are also a lot
of online resources, the CDCCenter for Disease Control has a
(39:15):
website cdc.gov/breastfeeding isa great resource. Organizations
like La Leche have onlineinformation that's also
searchable online just Google LaLeche League. It's l- lll, at
whatever state .org. And thereis a women's health governmental
(39:41):
office atwww.womenshealth.gov/breastfeeding
and there's a telephone helplineand so forth. But your OB should
have a list of resources. 211 inmany states has a list of
resources. And remember that alactation consultant is
(40:04):
available to you virtually, atpretty much no additional cost.
These visits are covered. Theymay contribute to your
deductible. But remember if thisis the year that you're going to
have a baby, we're going to gothrough your deductible of your
insurance anyway. So why nottake advantage of those services
(40:26):
that are covered for you? Andthat are- that have already been
paid for and you can availyourself of those resources?
Amanda Gorman (40:34):
Absolutely. Well, thank you that that was a great
list. And I know for sure thattoo many moms feel like they're
alone on this journey. But therereally are other people and
places to reach out to for helpboth locally and now virtually
that we live in this virtualworld- worlds, they really
should be taking advantage ofthem. Dr. Saidel you've been
(40:55):
such a great resource for NestCollaborative in general, but
certainly with us today. Sothank you very much.
Dr. Matthew Saidel (41:01):
It's my pleasure anytime.
Amanda Gorman (41:03):
We really loved having you as our guest today.
And I do hope that you will beback again to chat with us about
another topic soon.
Dr. Matthew Saidel (41:11):
Count on it.
Amanda Gorman (41:12):
Awesome. Well, that is our show for today
mamas. I hope you found thisinformation as titillating as I
did. Now, don't forget if youhave a question or a show topic
suggestion, we'd love to hearit. Message us on Instagram or
Facebook @breastfeedingunpluggedor visit us at our website at
breastfeedingunplugged.com, togive us your feedback. While
(41:33):
you're at it, if you've beendigging the show, please leave
us some stars or whateverpodcast platform you're
listening on. Your love is muchappreciated. Until next week,
it's me Amanda sending you allthe good vibes on your journey
through motherhood. Boo bye.
Dr. Matthew Saidel (41:52):
Please don't hesitate to send in a comment
about Amanda's wonderfulmustache and goatee. Because
Amanda Gorman (42:00):
I mean,
Unknown (42:02):
well, you know, it's
Amanda Gorman (42:03):
funny because when we do this, you
know the only other person thathas my zoom password Chelsea
Dr. Matthew Saidel (42:11):
Are you kidding me? I'm so tight Bay and
oh my god. Thank you so much forcoming out and hanging with us.
It was
Unknown (42:21):
so good. Thanks. My pleasure.
No, no. And
Amanda Gorman (42:27):
did you need me to for something else?
Dr. Matthew Saidel (42:28):
I just are the money guy from you know,
women's health USA Greg koskiwould like to chat with you
about some stuff. So I'm gonnasend you both an email introduce
each other. And because we'vewe've sort of filled him in
about you. I mean, it's it's notso much about them, you know
(42:50):
about money as women's healthUSA wanting to provide every
kind of service that envelopsthe mother around the old
episode.
Amanda Gorman (42:58):
Yeah, no, that's great. And absolutely, just just
send us
Dr. Matthew Saidel (43:03):
both. I've been meaning to do that. But I
wanted to tell you who we was.
No, no,
Amanda Gorman (43:06):
thank you. And, um, we had our first board
meeting yesterday. And they, youknow, they did want to bring up
that that that I don't thinkthey have a full understanding
of why we can do a revenue shareversus why we can't do a revenue
share with the DMV. And so justknow that they're going to be
asking us questions, in whichcase we'll probably be pulling
(43:27):
you in for support on
Dr. Matthew Saidel (43:29):
that's fine.
You know, we get it. I mean,it's, you know, that's it,
that's not necessarily a make orbreak, you know, we would get
that. And I was very remiss innot thanking to the lactation
consultants that I bugged tomake sure that I wasn't leaving
anything out. One is as youknow, as my sister who it you
(43:52):
know, I should have thanked herpublicly on this because she,
you know, the problem with heris that if I'd asked her to
answer these questions, I wouldhave received a war in peace,
length treaties.
Amanda Gorman (44:08):
They love their craft, so
Dr. Matthew Saidel (44:10):
Oh, yeah, absolutely. I mean, she was just
so bad. She did help out. Andalso Christine Brackett who is
if you've met those,yeah, can you send Can you email
me the names with the rightspellings, and I can actually
put it in the show notes.
Yeah, well do. Oh,yeah. That'd be fun. And then at
least they'll get some credits.
Yep. Oh, yeah. I bet your sisterwas excited that you were going
(44:30):
to be doing this.
No, she said, You better get awriter. I'll beat you. You know,
basically is that's the way itgoes. relationships,
Unknown (44:38):
sibling love.
Um, all right. Cool.
Amanda Gorman (44:41):
Well, thank you very much. I really I really
appreciate it. I know you'rebusy. So thank you very much.
Dr. Matthew Saidel (44:46):
Okay. See you guys.
Unknown (44:48):
Later.
You
Laura who's Laurie?
Dr. Matthew Saidel (00:02):
Laurie?
Beeson? Oh, is this Laurie? No.
Amanda Gorman (00:06):
Oh, yeah. Laura is large issue into and then
who's?
Who's the last one?
Unknown (00:12):
Not just
Amanda Gorman (00:14):
Hey, Matt.
Oh, hi. Sorry.
Dr. Matthew Saidel (00:20):
Hello, Eddie.
Amanda Gorman (00:23):
Hi, Craig.
How are ya?
Dr. Matthew Saidel (00:30):
I'm peachy, are you?
Amanda Gorman (00:32):
I'm good. I always like these days because I
get to leave my house.
Dr. Matthew Saidel (00:36):
Oh, that's one.
Amanda Gorman (00:39):
Um, so thank you very much for coming in and
doing this. I think this isgonna be really helpful. Oh,
you're welcome.
Unknown (00:45):
Um,
Dr. Matthew Saidel (00:46):
see if I have anything to add.
Unknown (00:48):
I have something.
Amanda Gorman (00:51):
Chelsea's here with me. She is what like three
weeks postpartum. And it'salready more on point in her
daily postpartum life than Ihave ever been.
Hey, Doc, how are ya?
Dr. Matthew Saidel (01:06):
I'm swell.
Thank you very much.
Cool. I'm not sitting next toAmanda, but you just can't see
me. She's over here. Hello. Iguess a couple of things that
we've already Can you hear me?
Okay.
Amanda Gorman (01:21):
She has a mask on?
Dr. Matthew Saidel (01:22):
Let me move my mic closer. Can you hear me
better now? Oh, that's okay,super. So first of all, thank
you so, so, so much for takingtime out of your busy schedule,
we are going to try to make thisas fast and painless as humanly
possible, we usually run about30 minutes or so. Just like we
talked about on the phone acouple of weeks ago, the whole
idea of this is just to have areally great casual
conversation. This podcast isfor women who are afraid to ask
(01:45):
their ob questions or afraid ormaybe they feel like they're too
far in their journey they'vealready failed. They're kind of
starting to look for adviceelsewhere. So you know, even
from our chair had such anawesome vibe from you. So I'm
really excited about today. Weare recorded not live. So
anything that you say cannot orwill not be used against you.
(02:08):
Effectively when we you know ifthere's anything that you're not
comfortable with or whateverhappens, we can always take it
in Edit, so don't worry. Midwaythrough Amanda will talk about
taking a short break, say staytuned. And it'll sound like it's
going to be a commercial, we'rejust going to break for like two
or three seconds. And thenshe'll just jump into the next
part. We're gonna edit that backin. Yep. And other than that,
(02:31):
like I said, it's just a reallykind of cool casual chat. If
we're running over on time, wemay just cut some questions. Or
if there's anything that you saythat Amanda wants to dive deeper
into, she'll just ask a followup. We'll have fun. This is just
supposed to be something that'sthat's informative, but makes
women kind of feel reallycomfortable. So
again, want to check my audiowith this. I have a couple of
(02:53):
mic settings. I don't know ifyou can hear me now. If I turn
my head or whatever. Does thatgo out? No.
Amanda Gorman (03:00):
It's pretty good.
Dr. Matthew Saidel (03:02):
Is this better here? Does it matter? I
think I'll stick. But you'regonna hear okay. Yeah, I can't.
I can't I have to talk to youabout something else afterwards.
Okay. And I'll just talk to you.
Amanda Gorman (03:15):
But yes, okay.
Got it. Check. I'll see.
I have like a weird moustacheshadow on my face. Or is that
just me? I mean, nothing againstmustaches.
Dr. Matthew Saidel (03:27):
Oh my god.
Can you see it? Oh, yeah. Toraise the computer, is that what
it is? If you move it around?
No.
Unknown (03:42):
It's it's like a zoom feature. Do I?
Dr. Matthew Saidel (03:44):
I've never I've never seen it before.
Amanda Gorman (03:47):
But you see it?
Yeah. It's like Pedro.
Dr. Matthew Saidel (03:51):
Yeah, it does.
I don't know. Is it Do I have,you don't have it on the side?
When you turn this way, youdon't have it. Now you
Amanda Gorman (04:06):
alright, whatever. You want
Dr. Matthew Saidel (04:07):
to move your mic and put it from the mic.
It's a shadow from something. Idon't know what it's from.
Amanda Gorman (04:13):
Well, thank you to you both for not like you
know, acting like you didn't,yes. Well, let's say
Dr. Matthew Saidel (04:25):
I feel like it's someone playing a trick on
me in zoom. All right, whatever.
You know what, what? I've hadworse or moments. What if we
just move you a little bit?
You need a light a differentlight or something?
Amanda Gorman (04:37):
Does does this dim down?
Dr. Matthew Saidel (04:42):
Really just that because it's an audio
studio?
Amanda Gorman (04:49):
The whole time.
Now, I have a good tea overhere.
Dr. Matthew Saidel (04:56):
Yeah.
Amanda Gorman (04:56):
All right.
Oh down here it goes away
Dr. Matthew Saidel (05:03):
yep
Amanda Gorman (05:06):
used to be I know Do you want to get him a
little hit will that help sorryman
Dr. Matthew Saidel (05:14):
okay these things are you know i mean
it looks it's all it's it's Ijust what the heck I have I have
a special zoom light here
Amanda Gorman (05:32):
well I'm actually complexion looks fantastic
Dr. Matthew Saidel (05:35):
I'm completely clean shaven actually
but I don't know what zoom does
Amanda Gorman (05:42):
know it is it's it's not
Dr. Matthew Saidel (05:46):
it's it's if you just get a little little bit
from the side it's
Amanda Gorman (05:51):
oh look
Dr. Matthew Saidel (05:53):
well you can't now it goes away now it's
now it's gone now it's gone wellyou're in the shadow of the mic
now it's it's it's wow what isso weird What?
Amanda Gorman (06:10):
He's filming from here that's where some it's the
camera angle is. I'm sorry.
Dr. Matthew Saidel (06:22):
Is that Is this too vain? But I mean it is.
No no no, no no I said thatdoesn't look at all like you. I
mean we know each other prettywell
Amanda Gorman (06:30):
so well I just I'm thinking of my poor parents
every time they so I have astash
Dr. Matthew Saidel (06:39):
to try to move the lights. If I come down
here. Yeah, if I come down hereat sea go away.
Yeah, there it just popped upthere and opsin is gone. There.
Okay, gone. There. And that'sweird. It doesn't fade out it it
(07:01):
pops out
Amanda Gorman (07:03):
it's zoom playing zoom.
All right, he has some magic.
Anyway, my poor parents anytimethey want to FaceTime with my
child, she puts filters on them.
Oh yeah. Yeah, they don't get itbecause they don't really know
what it is. And they're like,why am I my cat top half or
Dr. Matthew Saidel (07:25):
something?
You know, I could understand.
Amanda Gorman (07:29):
Alright, with a new device. Now I'm getting
light.
Still, they're still there.
Dr. Matthew Saidel (07:40):
Now we look like dark Canyon.
Amanda Gorman (07:43):
Bamako t
Dr. Matthew Saidel (07:46):
Dar tonyan see if there's any effects on
your zoom or something like thatit looked better with it before
it's really weird.
Amanda Gorman (08:01):
You know, you shouldn't mess
Dr. Matthew Saidel (08:02):
with pre menopausal women. Women weren't
close.
Okay, strictly accessibility blabla bla
light made it worse as the nextyear of skin wider. That's so
weird. And the thing is when itpops off it pops off in a
(08:26):
certain pixel you know it's it'sthere but when you go down it it
it complete now it's only at thebottom of the screen. gone
there. Oh, there I saw thatthere was a shadow that shadow
(08:47):
What is that? That is somethingthat's that. That's the zoom
effect.
Amanda Gorman (08:52):
Oh, it is a zoom.
Where we hacked
Dr. Matthew Saidel (08:55):
I don't know. But that's that's the zoom
effect. You could see itfloating over your face. A
little mustache? Do I
Amanda Gorman (09:02):
have like a friend of me?
Dr. Matthew Saidel (09:04):
Look look if you go see it now it's up over
your nose. Yes, it's over yournose. It's trying to be yes it's
totally a zoom effect. I don'teven realize it zoom. I had
those. I should log out log backin or something or
Amanda Gorman (09:21):
Oh my god, this is I'm
Dr. Matthew Saidel (09:26):
Chelsea This is view my quick video tab,
log back out log back in maybemaybe it's something it's
something whose it is totallyzoom effect settings. It
says click your profile settingprofile picture or
Amanda Gorman (09:49):
a view or something?
Dr. Matthew Saidel (09:52):
More that's your profile picture.
Okay.
Amanda Gorman (10:02):
setting, filters, no
Unknown (10:05):
video filters
Dr. Matthew Saidel (10:10):
and then there's the studio
effect. Now that's a filter.
Amanda Gorman (10:18):
Oh, my God, how long has that been on?
Dr. Matthew Saidel (10:26):
It worked pretty well. It's amazing.
Amanda Gorman (10:28):
retiled It's gotta be the Oh, thank goodness.
Dr. Matthew Saidel (10:33):
Good to see you.
Amanda Gorman (10:35):
Oh my god.
To look at the previously doneone since it was it.
Dr. Matthew Saidel (10:42):
Was it on your phone?
No.
I mean, where was the filter onin your profile in my profile?
Oh god, that's
Amanda Gorman (10:53):
got to trick someone.
Someone has it out for me.
Dr. Matthew Saidel (10:57):
I mean, it was a perfect goatee and
mustache is
Amanda Gorman (11:04):
going I'm glad it's not going that poorly.
Alright, I'm sorry. Here we go.
All right, we're recording.
You're muted. Here we go. Hi,everybody.
Hey there mamas and mamas to beand welcome to another week here
on Breastfeeding Unplugged.
Today we are super excitedbecause the doctor is in the
house. And he's here to tell usall the things we should be
(11:26):
asking about breastfeeding wellbefore baby comes.
Most moms forget to talk totheir OBs about breastfeeding.
And it's not that surprising ifyou think about it. Being
pregnant takes up a whole lot ofmental space and it's hard to
get focused on anything thatcomes after labor and delivery.
(11:47):
But here at Nest Collaborative,we are huge advocates of
prenatal planning forbreastfeeding because once the
baby's born, a new mama who hasalready done her breastfeeding
homework is much more likely tohave a positive experience. So
what should you be asking yourOB now during your prenatal
checks? What planning and prepcan you do to get on the right
(12:09):
track for the best possiblebreastfeeding journey?
Let's find out. Today we arejoined by Dr. Matthew Saidel.
Chief Medical Officer at Women'sHealth USA, the country's
leading physician practicemanagement company dedicated to
women's health. After obtaininghis undergraduate degree from
Cornell University and medicaldegree from the Chicago Medical
(12:30):
School, Dr. Saidel completed hisobstetric and gynecology
internship and residencytraining at Hartford Hospital.
He practiced for 39 years withspecial interests in family
centered obstetrics, familyplanning, vaginal surgery, and
most recently, menopausemanagement. He's a regular on
the Hartford and Connecticut topdoctors lists and a valued
(12:54):
resource to our community hereat Nest Collaborative. Welcome,
Dr. Saidel, it's really great tohave you here with us.
Dr. Matthew Saidel (13:00):
I'm tired after all that stuff I
apparently did. So it's nice tosee you. Always good to talk to
you, Amanda.
Amanda Gorman (13:07):
Yes, likewise. So it's really important for us to
get an OB's perspective on theshow. And as I mentioned in my
intro, I think a lot ofmoms-to-be kind of forget about
having breastfeedingconversations with their
prenatal care providers. Wereally advocate for prenatal
prep with our network of IBCLCs,because we see the success rates
(13:29):
that moms have when they'rereally prepared. So what do you
think about this?
Dr. Matthew Saidel (13:34):
Well, I think, you know, the thing that
we see is that everybody's veryconcentrated on the pregnancy
and a little bit maybeapprehensive about the birth.
And then, you know, you you seemoms who are sleep deprived and,
and recovering from the birthprocess. And all of a sudden,
(13:58):
there's this baby, and theirmilk hasn't come in yet. And
it's frustrating. And they havelots of questions, and they say,
gee, I wish I had thought aboutthis earlier. So it is obvious
that I think it's very importantto, to start thinking about it
earlier and with your OBprovider, whether that's your
(14:21):
obstetrician, midwife, APRNwhatever, that's the perfect
place to start.
Amanda Gorman (14:27):
Absolutely. I want to address some
breastfeeding 101 questions thatwe get all the time. But before
we do that, the big question oneveryone's mind is the COVID-19
vaccine. What are your thoughtsfor breastfeeding moms
specifically, as well as womenwho might be pregnant?
Dr. Matthew Saidel (14:45):
So that's a obviously a very, very hot
topic. Everybody's worried aboutit and and most places across
the country, we're beginning tosee availability for the vaccine
in the age group of pregnancy.
So, you know, spoiler alert, I'mgoing to say yes, absolutely get
the vaccine, eitherbreastfeeding or during
(15:08):
pregnancy. I'll just say a wordabout it. The vaccines that we
have, both the mRNA vaccine,which are the Pfizer and Moderna
and also the J&J vaccine, dotheir work by fooling the body
into making copies of the spikeprotein from the Coronavirus.
(15:29):
But they don't make the wholevirus. It's kind of like I
always say if the Coronavirus isthe black knight, then what the
body makes is the helmet bywhich we recognize this black
knight. And so our body makes alot of copies of that helmet
(15:51):
when instructed to do so by theour immune system. And but the
knight isn't there. So thevaccine has absolutely no
capability to cause replicationof the virus. The other thing
that people worry about is thatdoes the vaccine somehow change
our own DNA. The vaccines,especially Moderna and Pfizer
are what are called mRNA, ormessenger RNA vaccines. They do
(16:15):
not go into the center of thecell, which is called the
nucleus, there's the bigoutside, and then the center
part where your DNA and geneticmaterial live. They just go out
into the outside of the cellwhere these little factories
called ribosomes are makingproteins. And they take over the
factory and tell it to makespike proteins and then your
(16:36):
body causes the immune system tomake these smart bombs against
the spike protein. And thevaccine disappears almost as
quickly as it goes into yourbody. It's it doesn't last for
very long. Therefore it can'teven cross the placenta. And so
we have no evidence that thevaccine will cross the placenta,
(16:59):
but the vaccine does cause theproduction of antibodies, which
will cross the placenta intoyour baby give immunity against
the vaccine to a large degree.
And the same thing happens withbreast milk. The virus doesn't
go into the breast milk, but theantibodies do, so that when
you're breastfeeding, and you'vebeen vaccinated, you're in
(17:21):
essentially what we callpassively immunizing your baby.
You're not causing your baby tomake antibodies, but you're
giving the baby antibodies,which you do in a lot of other
things, too. I mean, if you'reimmune to other diseases and got
a flu vaccine, or you knowyou're you're immune to measles
or mumps, you're giving those uhyou're giving those antibodies
(17:41):
to your baby through the breastmilk and across the placenta.
And so in a sense, you'reimmunizing your baby as well. So
the reason that you hear fromcertain authorities that we
haven't done testing in pregnantwomen, yes, that's true testing
is underway. But with all thewomen who've been vaccinated, so
(18:01):
there have been over 30,000pregnant women that we know
about been vaccinated already.
We have very, very significantdata on 1800 of them. There are
no differences in miscarriage,no differences in birth defects,
no difference in pregnancyoutcomes. And so and the babies
that have been born who frommoms have been vaccinated, they
look wonderful. So we give lotsof vaccines in pregnancy all the
(18:26):
time during pregnancy, and wegive the flu vaccine, we give
the Tdap vaccine for tetanus,diphtheria, and whooping cough.
And so we have essentially noreservations about this. And we
think you should get whatevervaccine you can, as soon as you
can get it at whatever timebecause we know, for a fact,
COVID is bad for pregnant moms.
(18:48):
You know, when you're pregnant,your immune system is not the
same as when you're notpregnant, it's got to tolerate
this little creature insidethat's from you, but not of you.
And it's sort of a foreigner, ifyou will. And so your immune
system is dialed down totolerate this little stranger
inside you. And that makes youmore vulnerable to respiratory
(19:10):
viruses. So people who get theflu can get extremely ill and
even die from the flu duringpregnancy. And people who get
COVID are much more likely toget more severe disease and end
up in an intensive care unitthan women who are not. So our
biggest concern here is we don'twant you to get COVID.
Amanda Gorman (19:27):
Hmm. Well, that was wonderful and really
comprehensive and really spokenin a way that I think our
listeners will will reallyunderstand. So thank you for
that. Let's dive into somequestions that that we get every
day at Nest Collaborative. Thefirst one being, when should I
bring up the topic ofbreastfeeding during my prenatal
(19:49):
care?
Dr. Matthew Saidel (19:51):
Well, you know, that's the answer is
really anytime. I mean, youknow, you're gonna have a lot of
questions and a lot of timesyour OB is gonna say, well, it's
not quite time for that, you canask it later. But, you know, one
of the things that people getembarrassed about is bringing
lists into the OB, you know,because the worst thing is to
come in and say, ach I knewthere was something I wanted to
ask, I can't remember what itwas. We like lists because they
(20:15):
have a beginning and an end. Soit's not just our what are we
forgetting here. And so it'sokay to bring those in, in the
OB may say to you, you know,that's something for a little
bit later. But we do think thatbreastfeeding is an important
discussion. And it's adiscussion that you want to
start to have, towards the endof your second trimester, maybe
the beginning of your thirdtrimester. So we're talking 26
(20:38):
to 32 weeks, that kind oftimeframe. Because you want to
start thinking about it, youwant to be able to check to see,
you know, what's the benefit forbreast pump, and what is your
insurance cover and so forth.
And, you know, we love the NestCollaborative model because we,
it causes a connection to bemade with you, and your
lactation consultant at 27, 28,31, 33 weeks, so that you've
(21:04):
already established thatrelationship. And it's not an
unknown. So much of childbirtheducation, whether it's about
the childbirth process itself,you know, whether it's about
huffing and puffing, or whetherit's about breastfeeding is
about fear of the unknown. So ifyou know, I've heard of this
term, I've, I've gotten an ideaof what's going to happen. I
(21:27):
know which number to call atthree o'clock in the morning or
whatever. That's part- that'shalf the battle because it gets
rid of fear of the unknown. Sothe short answer is, you know,
late second trimester, earlythird trimester.
Amanda Gorman (21:41):
Awesome, thank you. Are there any specific
health conditions that mightprevent a mom from being able to
Dr. Matthew Saidel (21:47):
Well, the short answer is not a whole
breastfeed?
bunch. I mean, there are certainthings like you know, if a mom
has active HIV, that would notbe the best time to breastfeed.
Some kinds of hepatitis, if youhave cracked nipples, and
(22:08):
there's a possibility oftransmitting blood to the baby,
it would be a contraindicated.
There are some medications thatthat are cause breastfeeding to
be contraindicated, but not toomany. And there are great
resources for you to look andsee there's, there's a website
called LactMed which Amanda I'msure you're familiar with
(22:30):
LactMed. LactMed.com, I think itis. And you can go on there and
just look up your medication andthey'll give you the- they'll
give you the lowdown on whetherit's safe to take, and when's
the best time to take it inrelationship to feeding and so
forth. So, you know, most of thetime there, I mean, there are
some women who, for example,have had breast reduction
(22:54):
surgery, you know, that's youwant to connect with a lactation
consultant early to see what youcan do to maximize it. There are
some very rare conditioningwhere women have inadequate
breast tissue, but that's prettyunlikely. So the short answer
is, yes, most of the time, youcan but in those conditions I
(23:17):
mentioned you probablyshouldn't.
Amanda Gorman (23:21):
Yeah, and I just want to clarify, it's the
hepatitis in combination withcracked bloody nipples, not
cracked bloody nipples beingcontraindicated?
Dr. Matthew Saidel (23:30):
No, because crack bloody nipples obviously
do come up. It's only incombination with hepatitis. So I
guess the way to turn thataround and say there's lots of
times where with hepatitis, youcertainly still can't
breastfeed. If everything'sokay, and the latch is right,
and all those things that Amandacan talk about.
Amanda Gorman (23:47):
Yes, and we encourage women to, to really go
onto LactMed and checkthemselves. On- a lot of times,
we have women coming to us,unfortunately misinformed about
medications they're on eventemporarily. I think it's easy
for people to often just say,oh, just pump and dump to be
safe. But you don't always haveto do that. So we really
(24:08):
encourage moms to use LactMedthemselves or to reach out to
their OB if they really want toan answer.
Dr. Matthew Saidel (24:14):
And I would I would add to that, that you're
going to hear this phrase pumpand dump a lot. Because if you
ask for example, if you'rehaving surgery, you're asking an
anesthesiologist or whateverthey're going to tell you to
pump and dump. And they're goingto be conservative about that.
And most of the time, it's notright.
Amanda Gorman (24:29):
Right, exactly.
Dr. Matthew Saidel (24:31):
Check with somebody who knows, like a
lactation consultant.
Amanda Gorman (24:34):
Absolutely. Um, so is there a breast exam that
can actually be done to see ifthere are any issues that you
spoke of before? Obviously, wetalk about surgeries but
inadequate breast tissue, whichwhich you mentioned is quite
rare, but is there anything thatcan be done ahead of time?
Dr. Matthew Saidel (24:52):
Well, if, for example, you know, if you
have either flat or invertednipples, that's something you
can talk to a lactationconsultant ahead of time about
that, because there are certainways to prepare and certain
techniques to breastfeed thatit's important to, to have an
expert talk to you about that.
So that that would be anotherreason for our prenatal care.
(25:14):
Consult with a with a lactationconsultant. But those are the
main issues that that you shouldlook at ahead of time.
Amanda Gorman (25:29):
Awesome. So what do you suggest moms should do to
best prepare for breastfeeding?
Dr. Matthew Saidel (25:37):
Well, I think first of all, the most
important thing is to understandthat it's the right thing to do.
You know, we spend a lot of timetrying to make moms not feel
guilty for not breastfeeding.
But by the same token, it'sreally important that people
understand that breastfeed-understand that breastfeeding is
(25:58):
better for both mom and forbaby. And we'll go into that I
think a little bit later on aswell. But I think first of all,
you want to make up your mindearly and realize that that's a
part of this whole discussion inhow I'm going to, you know,
what, what's my birth plan?
Well, it's not just your birthplan. It's your birth and
(26:19):
postpartum. And, you know, I,it's part of what I call, having
the baby is hard, but having thebaby is even harder. So, you
know, those, those plans need togo on for the next 20 years, but
you can really give your baby agreat head start. So you want to
start to think about this early.
And nowadays, it used to be theold Lamaze class and you went to
(26:40):
childbirth education classesonce a week for six weeks, or
whatever. Now they're availableonline, and they're available
virtually, and they're availablethrough Zoom, and all those
kinds of things. But um, it's agood idea to educate yourself a
little bit about aboutbreastfeeding before it happens.
Because it's going to be thelast thing that you want to look
(27:01):
up when, when the necessityoccurs. So a prenatal class that
includes breastfeedingeducation, I think is very
important. As we mentionedbefore, connecting with a
lactation consultant early is areal bonus. The other thing is I
mentioned before you want tocheck and see, does- most
(27:22):
insurance plans will will payfor a breast pump. And you want
to make sure that you A knowwhat is covered and B that
that's ordered for you by yourobstetrician's office- most of
them it's part of theirworkflow. But they need to be
reminded sometimes that theyneed to order that for you so
(27:44):
that you'll have it when youwhen you go to the hospital. But
knowing your resources,educating yourself about the
process, maybe connecting withsomeone. That's the best way to
prepare for breastfeeding.
Amanda Gorman (28:03):
Yes, absolutely.
And I think you're right, Idon't think women realize too,
that their insurance will coverprenatal breastfeeding
education, in addition to thepump. And like you said, you
know, we all know that breastmilk is best. But I think what a
lot of women don't know is thatthere are a lot of pathways to
getting breast milk into yourbabies. And I think that a lot
of what we do prenatally iseducate moms on what
(28:26):
breastfeeding can look like forthem. Because it doesn't look
like the same pathway orjourney. And so there's a lot of
ways that you you can get breastmilk to your baby. And even if
it's just for a window of time,any breast milk is better than
no breast milk. So we love towork with moms and figure out
what what works best for them.
Dr. Matthew Saidel (28:49):
And you know, when we talk about doing
this early in the second tri-,you know, end of the second
trimester, we all hope thatwe're not going to deliver
prematurely. But the sad fact isthat premature birth is is is
out there, and it's notuncommon. And a lot of people
think if I deliver prematurelythat breastfeeding is off the
table. And in fact, that'snothing could be farther from
(29:11):
the truth. You may have to pumpand feed your baby in some
alternative method. Butbreastfeeding is always good.
And so preparing a little bitearlier could also make sure
that you're prepared in casesomething happens and causes an
early birth.
Amanda Gorman (29:28):
Absolutely. And those babies need it most. So
this is awesome info. And Ithink it's really giving
moms-to-be and even second andthird time moms a lot to think
about. Breastfeeding really canbe tough and it does take work,
but there are also so manyresources out there that can
help. We're going to take aquick break but we'll be right
(29:48):
back with Dr. Saidel after aword from our sponsor, so stay
with us.
Thanks for tuning in mamas andmamas to be. Today, we are
chatting with Connecticut basedOBGYN, Dr. Matt Saidel who is
giving us the 411 on whatquestions moms should ask their
OBs to get the breastfeedingball rolling before baby comes.
(30:10):
Dr. Saidel, I just have a fewmore questions to ask you if
that's okay.
Dr. Matthew Saidel (30:15):
Sure.
Amanda Gorman (30:16):
So many studies have shown that both mom's and
baby's health benefit frombreastfeeding. Can we talk a
little bit about that, because Ithink we're so often getting the
memo on what it does for baby'shealth. But I don't know that
moms get the memo on what itdoes for their own.
Dr. Matthew Saidel (30:32):
Well, you know, we talked already in our
discussion about COVID, abouthow antibodies that are present
in the mom's body go through tothe baby. And so right away,
you're getting an immediatebenefit to the baby, even before
the milk seems to have come in,in the first few days. The
(30:53):
colostrum, the fluid that comesout before the milk really comes
screaming in, is antibody richand is really good for babies
starting out. But there's a lotof evidence about things that
that are prevented in, in babiesby breastfeeding. First of all,
(31:16):
breastfeeding babies don't tendto overeat, they tend to eat
more frequently in the amountthat they want. And so there is
a there is a decreased risk ofchildhood obesity, which
translates into a decreased riskof adult obesity. We also see
(31:42):
less asthma and allergies. Andit seems to help with baby's GI
function, constipation, and soforth. And there are, it really
helps them establish the rightcolonies of flora, bacteria and
(32:06):
so forth in their gut, thathelps their GI tract to work
better going forward. There'sless diabetes in- and I think
that goes along with less andless obesity in in these babies.
So real, real benefits. Um,moms. I'm going to take a break
(32:33):
here for just a second because Ihave some notes on this and, and
I and I somehow list 'em.
Oh there, onthe other side. I had a whole
Amanda Gorman (32:39):
That's okay.
ist, I don't want to miss thoseOh, I know where it is. s cond m
Unknown (33:03):
Talking about mom's health.
Amanda Gorman (33:06):
Yeah. Is that does that work for you? If I
start with and what about mom'shealth?
Dr. Matthew Saidel (33:12):
Yeah, yeah, yeah, just give me a second
here. Yep,absolutely. Ready Dr. site? Oh,
sorry. I'm just jumping in.
You're here when you're ready tohave to sit. I'll just tell
Amanda. So we'll cut this out.
And then she'll say what aboutmom's health? And then you can
jump in?
Yep. And I can I can find me butI'll get it. Hang on a second.
Unknown (33:45):
When I was gonna show you
Dr. Matthew Saidel (33:51):
and I noticed you skipped What? What
moms expect right afterdelivery. I don't know if you
meant to do that.
Amanda Gorman (33:58):
No, I don't know that. I did. Hold on.
Dr. Matthew Saidel (33:59):
That's number six. That's just because
of time. Did you?
Amanda Gorman (34:04):
Did you tell me it's sometimes she'll flash me
cue cards over here that okay,gotcha. What to do. Oh, and I
Dr. Matthew Saidel (34:12):
Okay, I got it.
Amanda Gorman (34:19):
All right. Don't rush. Um, okay.
And what about mom's health?
Dr. Matthew Saidel (34:30):
So there are lots of benefits for mom too.
First of all, when baby isbreastfeeding, a hormone is
released which helps to squeezedown on the uterus and helps it
return to normal more quickly,actually cuts down on on the
rate of, of bleeding. And wehave pretty good evidence that
(34:52):
women who have breast fed havelower rates of breast cancer,
ovarian cancer, osteoporosis,hypertension and diabetes, it
helps return to pregnant- aweight loss more quickly. So I
think, you know, there arereally tangible benefits. You
(35:13):
know, it's, so I always say, youknow, puppies get dog's milk and
kitties get cat's milk and, andcows get cow's milk, but so
humans should get human milk, itjust, it makes sense. The other
thing to remember, it saves alot of money for the mom,
(35:33):
because you don't have to spend1000 bucks a year on formula.
It's also better for theenvironment, because, you know,
less bottles and cans andwhatever. So and we think it's a
win win win.
Amanda Gorman (35:46):
Yeah, absolutely.
And I think sometimes moms don'trealize the time that it
actually saves, oncebreastfeeding is established.
Dr. Matthew Saidel (35:54):
You don't have to heat up your breast milk
at three o'clock in the morningwhen you-
Amanda Gorman (35:57):
No, or wash any bottles.
Dr. Matthew Saidel (35:58):
Only slept for an hour and a half, right?
Amanda Gorman (36:01):
Um, so I do think women feel a lot of pressure to
breastfeed, though andespecially, you know, from their
own mothers, or not to dependingon what generation you are. And
in their social circles is somedegree of pressure yay, or nay?
How do you think breastfeedinghas changed over the last
(36:21):
decade?
Dr. Matthew Saidel (36:23):
Well, you know, we, I think there's been a
much more of a permeation intosociety that breastfeeding is a
normal and okay thing to do. Imean, you know, when you just
walk through a- an airport, andyou see these little shelters
where people can breastfeed orwhen you see people
breastfeeding in public and notgetting arrested, and those
kinds of things, there reallyhas been a profound change in in
(36:47):
our attitudes towardsbreastfeeding. There's been a
lot of work done in the last 10years. And, you know, there have
been not only initiatives fromprivate companies, but also from
the government agencies like theCenter for Disease Control, and
(37:08):
the Department of Health andHuman Services. And, and in some
states, patients and physiciansare rewarded for promoting
breastfeeding, because we knowit's kind of a good thing. And
so the- now we're seeing theprivate insurers are covering
education, for breastfeeding.
And we are absolutely pushingfor that to- in many states to
(37:32):
transfer over to the Medicaidpopulation. There's so many
online support systems and theability to virtually meet with a
certified lactation consultant,online or by telehealth or by
Zoom or by however. So the ratesof breastfeeding have definitely
(37:59):
gone up some places more thanothers. But we see a much more
acceptance of this. And we seetechnological improvements,
which allow women to pump whilethey're working, or teaching, or
doing whatever what nobodyknows. So there have been
(38:20):
advances that make it easier todo this even in a world where so
many families have to haveeveryone working. So we think
it's really gone off over thelast 10 years. And we hope that
continues.
Amanda Gorman (38:39):
As do we. Um, so if a mom feels like she's not
getting enough information orsupport from her OB with regards
to breastfeeding, what otherresources are there for her?
Dr. Matthew Saidel (38:50):
So we would love for people to contact a
lactation consultant before theyare giving birth. Because that's
a great- that is a greatresource. There are also a lot
of online resources, the CDCCenter for Disease Control has a
(39:15):
website cdc.gov/breastfeeding isa great resource. Organizations
like La Leche have onlineinformation that's also
searchable online just Google LaLeche League. It's l- lll, at
whatever state .org. And thereis a women's health governmental
(39:41):
office atwww.womenshealth.gov/breastfeeding
and there's a telephone helplineand so forth. But your OB should
have a list of resources. 211 inmany states has a list of
resources. And remember that alactation consultant is
(40:04):
available to you virtually, atpretty much no additional cost.
These visits are covered. Theymay contribute to your
deductible. But remember if thisis the year that you're going to
have a baby, we're going to gothrough your deductible of your
insurance anyway. So why nottake advantage of those services
(40:26):
that are covered for you? Andthat are- that have already been
paid for and you can availyourself of those resources?
Amanda Gorman (40:34):
Absolutely. Well, thank you that that was a great
list. And I know for sure thattoo many moms feel like they're
alone on this journey. But therereally are other people and
places to reach out to for helpboth locally and now virtually
that we live in this virtualworld- worlds, they really
should be taking advantage ofthem. Dr. Saidel you've been
(40:55):
such a great resource for NestCollaborative in general, but
certainly with us today. Sothank you very much.
Dr. Matthew Saidel (41:01):
It's my pleasure anytime.
Amanda Gorman (41:03):
We really loved having you as our guest today.
And I do hope that you will beback again to chat with us about
another topic soon.
Dr. Matthew Saidel (41:11):
Count on it.
Amanda Gorman (41:12):
Awesome. Well, that is our show for today
mamas. I hope you found thisinformation as titillating as I
did. Now, don't forget if youhave a question or a show topic
suggestion, we'd love to hearit. Message us on Instagram or
Facebook @breastfeedingunpluggedor visit us at our website at
breastfeedingunplugged.com, togive us your feedback. While
(41:33):
you're at it, if you've beendigging the show, please leave
us some stars or whateverpodcast platform you're
listening on. Your love is muchappreciated. Until next week,
it's me Amanda sending you allthe good vibes on your journey
through motherhood. Boo bye.
Dr. Matthew Saidel (41:52):
Please don't hesitate to send in a comment
about Amanda's wonderfulmustache and goatee. Because
Amanda Gorman (42:00):
I mean,
Unknown (42:02):
well, you know, it's
Amanda Gorman (42:03):
funny because when we do this, you
know the only other person thathas my zoom password Chelsea
Dr. Matthew Saidel (42:11):
Are you kidding me? I'm so tight Bay and
oh my god. Thank you so much forcoming out and hanging with us.
It was
Unknown (42:21):
so good. Thanks. My pleasure.
No, no. And
Amanda Gorman (42:27):
did you need me to for something else?
Dr. Matthew Saidel (42:28):
I just are the money guy from you know,
women's health USA Greg koskiwould like to chat with you
about some stuff. So I'm gonnasend you both an email introduce
each other. And because we'vewe've sort of filled him in
about you. I mean, it's it's notso much about them, you know
(42:50):
about money as women's healthUSA wanting to provide every
kind of service that envelopsthe mother around the old
episode.
Amanda Gorman (42:58):
Yeah, no, that's great. And absolutely, just just
send us
Dr. Matthew Saidel (43:03):
both. I've been meaning to do that. But I
wanted to tell you who we was.
No, no,
Amanda Gorman (43:06):
thank you. And, um, we had our first board
meeting yesterday. And they, youknow, they did want to bring up
that that that I don't thinkthey have a full understanding
of why we can do a revenue shareversus why we can't do a revenue
share with the DMV. And so justknow that they're going to be
asking us questions, in whichcase we'll probably be pulling
(43:27):
you in for support on
Dr. Matthew Saidel (43:29):
that's fine.
You know, we get it. I mean,it's, you know, that's it,
that's not necessarily a make orbreak, you know, we would get
that. And I was very remiss innot thanking to the lactation
consultants that I bugged tomake sure that I wasn't leaving
anything out. One is as youknow, as my sister who it you
(43:52):
know, I should have thanked herpublicly on this because she,
you know, the problem with heris that if I'd asked her to
answer these questions, I wouldhave received a war in peace,
length treaties.
Amanda Gorman (44:08):
They love their craft, so
Dr. Matthew Saidel (44:10):
Oh, yeah, absolutely. I mean, she was just
so bad. She did help out. Andalso Christine Brackett who is
if you've met those,yeah, can you send Can you email
me the names with the rightspellings, and I can actually
put it in the show notes.
Yeah, well do. Oh,yeah. That'd be fun. And then at
least they'll get some credits.
Yep. Oh, yeah. I bet your sisterwas excited that you were going
(44:30):
to be doing this.
No, she said, You better get awriter. I'll beat you. You know,
basically is that's the way itgoes. relationships,
Unknown (44:38):
sibling love.
Um, all right. Cool.
Amanda Gorman (44:41):
Well, thank you very much. I really I really
appreciate it. I know you'rebusy. So thank you very much.
Dr. Matthew Saidel (44:46):
Okay. See you guys.
Unknown (44:48):
Later.
You
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