December 9, 2025 • 39 mins
Want the glow without risking your flow? We dive into the beauty and body questions breastfeeding parents ask most and bring receipts from the InfantRisk Center so you can make confident, evidence-based choices. From cosmetic fillers and microneedling to topical retinoids and modern weight loss strategies, we separate local skin treatments from systemic exposures, explain what actually reaches milk, and call out the real-world factors that matter more than hype.
Some of the Topics Covered:
• why dermal fillers stay local and don’t reach milk when injected properly
• microneedling prep, numbing creams, and safe post-care serums
• topical retinoids hierarchy from cosmetic retinol to prescriptions
• oral retinoids to avoid due to systemic exposure
• calorie needs that include the cost of making milk
• hydration truths vs sports drink myths
• gentle return to exercise and pelvic floor priorities
• why GLP-1 weight loss drugs raise supply and nutrition concerns
• realistic timelines for fat loss while protecting infant growth
Links to InfantRisk Center articles and calculators:
https://www.infantrisk.com/content/cosmetic-fillers-and-breastfeeding-what-you-need-know
https://www.infantrisk.com/content/microneedling-while-breastfeeding-what-you-need-know
https://www.infantrisk.com/content/retinoid-skincare-and-nursing-what-new-moms-should-know
https://www.infantrisk.com/content/we
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Grab your copy at milkdbook.com!
This podcast is provided for informational purposes only and does not constitute providing medical advice.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:02):
Hey there guys.
Welcome to the Boob BusinessPodcast with me, the original
MilkDiva.
I am a former labor and deliverynurse and a board-certified
lactation consultant in Austin,Texas.
I'm the owner of MilkDivaLactation.
And I'm also the author ofbest-selling book called Milk:
Finding Your Flow and the FirstFew Weeks of Breastfeeding.
This podcast is all aboutpulling back the curtain of all
(00:24):
the things in breastfeeding inbirth land.
And so we're just going to talkabout insider things people
don't usually talk about in anunscripted fashion.
So let's just jump right in,okay?
Hey, hey, hey.
Today we're going to be talkingabout things to keep us
beautiful and if they're safefor breastfeeding.
So I am going to put this outthere that this is not my own
information.
(00:44):
I'm getting from my own brain.
I'm going to share with you theresources.
I'm getting this informationfrom.
I'm going to put the resourcesin the show link so that you can
discuss them with your doctor.
Please understand you should notbe getting medical advice from a
podcast.
You should discuss it with amedical professional, your
medical professional.
But I am going to give youinformation so that you can
start the deep dive on whatkinds of things you can and, you
(01:07):
know, maybe should or should notbe considering while you are
breastfeeding, right?
So I'm going to talk about,let's see, cosmetic fillers with
breastfeeding, microneedlingwith breastfeeding, retinoid
skin care with breastfeeding,and weight loss and lactation
section with breastfeeding.
(01:27):
So let's start with cosmeticfillers.
I am going to tell you I'mactually getting this
information from the Infant RiskCenter.
So I'm going to read a littlebit about what this is, and of
course, there's going to beresearch and citation for each
of the things I'm going to talkabout.
But the Infant Risk Center wasfounded in 2011 by Dr.
Thomas Hale.
He's a renowned expert inbreastfeeding and maternal
(01:50):
medications.
The Infant Risk Center ofExcellence, Excellence, excuse
me, abbreviated as IRC, is anestablished international leader
in lactation pharmacology.
Dr.
Hale's groundbreaking work,which began in the late 1980s,
focused on the transfer ofmedications into breast milk and
has laid the foundation forsafety protocols that highlight
(02:12):
the life-saving benefits ofmother's milk even in the
presence of maternal medication.
Located at the Texas TechUniversity Health Science Center
School of Medicine in Amarillo,Texas, the IRC serves as a
globally recognized resourcededicated to supporting
healthcare professionals andmothers worldwide.
(02:32):
So the infant center, the infantrisk center's mission is to
support the health of moms andbabies through the creation and
translation of breastfeedingmedicine research.
Through its commitment, theycontinue to advance the
understanding of lactationpharmacology and its
implications for maternal andinfant health.
They have a call center that youcan call healthcare providers,
(02:54):
physicians, nurses, andlactation consultants can call,
and they can get expert guidanceon medication safety.
Each consultation typicallyaddresses multiple medications,
averaging about three to fourdrugs per call, with the primary
goal of access of assessing therisk of infant exposure while
promoting and encouraging safebreastfeeding.
(03:15):
The reason I put that out thereis because if any of you are
healthcare professionals andyou're not sure if a drug is
safe for your breastfeedingclient, please don't just give
them random information and tellthem to pump and dump.
Instead, call the infant riskcenter.
So I want to put that out there.
And this is where I'm going tobe getting a lot of the
information today.
And you can just Google theInfant Risk Center and their
information and their phonenumber will come up.
(03:36):
So let's start off with talkingabout cosmetic fillers.
If you're not sure what a filleris, that's the injections that
will smooth out wrinkles andfine lines.
And of course, the milk divawould be talking about that.
I don't get fillers, but like Iam a diva, and I am gonna like
probably get, you know, as I getolder, probably some, I don't
(03:58):
know, like I do, let me see.
Right now I use a neurotoxin forin between my lines, uh in
between my eyes right here.
I'm pointing, um, and I'm gonnatell you a true life story.
So during COVID uh 2020, when wewere, you know, doing COVID, I
worked in the hospital.
I'm gonna put this, I'm gonnaput this thing up.
Working in the hospital.
And here, just imagine all youcan see is this on my face.
(04:22):
Like I'm wearing a mask, and allyou see is this.
Not the milk diva.
Let's turn this around.
You just see my eyes.
You just for I'm in the mic, soI should talk to the mic.
All you can see is my eyes.
You can't see anything below it.
And so my facial expressions, Ijust always had RBF.
Um, because my face would likecontort like this all the time.
Like my eyebrows and the linesbetween my people would just say
(04:43):
stuff and I would just lookcrazy and mean.
And so I was like, I need to getmyself some Botox for the lines
between my eyes because I justlook mean all the time.
You most of y'all probably havebeautiful, pleasant, happy
faces, but I was not always sopleasant looking, working 12 and
13 hour shifts in COVID, youknow, covered in plastic, trying
to deliver a baby or startsomeone's IV because they were
(05:04):
COVID positive and I can't seeand we can't hear.
And, you know, you have all thestuff on your head and your face
and your and my ears hurt somuch that I just always had a
cranky little look.
And so, yeah, I started gettingneurotoxin right here.
Not I was not breastfeeding,just saying we should just talk
about it.
And here we go.
But that is currently the onlything that I have done.
(05:25):
But I, if I was a breastfeedingmom, I have a lot of clients who
ask me all sorts of questions.
I've been asked if they canstart spray tanning, if they can
do um weight loss, theinjections, um, let's see, um,
collagen, um, d'sderma typefillers, Botox, ask lots of
questions about weird vitaminsand creatinine and things like
(05:48):
that.
So today we're gonna chat aboutsome of the things that y'all
just asked me, so I'm just gonnatell you.
So cosmetic fillers restorevolume in areas like the cheeks
or under the eyes.
They can plump lips.
A lot of people, you know, gettheir lips like more full with
filler.
Um, it's injected just under theskin so it can stay in place to
create a smoother, more youthfullook.
(06:08):
Um, and so just kind ofdepending on what filler you
select, certain fillers are usedfor different parts of your your
face.
They're not they're not one sizefits all.
So each type of filler has adistinct property and uses and
safety considerations, just sothat you know.
Um, the question here is arefillers safe while
breastfeeding?
(06:29):
So this is what the infant riskcenter says.
Us and quotes, okay?
This is not my words, this istheir words.
They get all the credit.
Infant Risk Center, and I'mputting their link in the show
notes of this article.
A substance must first enter thebloodstream for it to enter
breast milk.
Dermal fillers are injectedlocally and stay in the tissue
where they are placed.
(06:49):
When administered properly,fillers are not absorbed into
the bloodstream, so they do nottransfer into the breast milk.
Um, parentheses Alamma 2021.
Um, the short story (07:06):
you don't need to delay breastfeeding
after getting fillers.
You can continue nursing asusual right after your
appointment.
For more information on fillers,keep reading.
So that's their words, not mine.
Um, most common fillers and whatwe know about them are
hyaluronic acid brands likeJuvederm, Restilin, Bellotera,
(07:26):
Evelise.
Um, hyaluronic acids arenaturally occurring sugars or a
polysaccharide and they attractand retain moisture.
And so these hyaluronic fillersstay in the ejection site and
slowly are broken down byenzymes, and they're cleared
through a natural process.
They do not enter the breast,uh, the bloodstream or the
(07:49):
breast milk.
And that citation is from Becker2009.
There is a product calledEvolice or Evolise, and it does
contain a small amount oflidocaine to help with pain and
bruising and swelling.
However, the amount of lidocaineis not enough to warrant
specific wait times afterinjections.
So that's something that youshould know.
Sounds like hyaluronic acidfillers, like the brands
(08:13):
mentioned above, are safe whileyou're breastfeeding.
There's another kind of uh uhfiller I probably cannot
pronounce.
It looks like calciumhydrolapatite, and it's um one
of the brands is REDES radi Idon't know, R-A-D-I-E-S-S-E.
And it's used for deeperwrinkles and volume loss in
(08:34):
cheeks and the and the jawline.
It's made from a syntheticversion of a mineral found in
bone and suspended in gel.
So breastfeeding safety, it sayshere, um, where it stays where
it's injected and it slowlybreaks down into calcium and
false and phosphate ions,minerals your body knows how to
handle uh in the breast milk,and it's um that citation of
(08:58):
pavic pavic in 2013.
So side effects are similar tothe hyaluronic acid fillers
mentioned above.
Um there's another kind offiller, PLLA filler, something
called like sculptra.
Once again, they're saying thatthat is naturally metabolized.
It does not circulate into thebloodstream, so it cannot
(09:18):
transfer into the milk.
Citation Herman 2018.
Um, so yeah, just I'm gonna putthe link to this particular um
article in the show notes if youwant to learn more and you know
side effects and what do youwant to do if you want to
dissolve the filler and youknow, what about getting filler
into the bloodstream and andthings like that?
(09:39):
There's more information, butchoosing the right provider
matters.
You want to make sure thatyou're you're uh getting an
experienced person and they'renot accidentally putting this
product in a place where it cantouch your your bloodstream.
But hyaluronic acid fillers areconsidered the safest and the
most studied option.
And so there you go.
(09:59):
That's the information onfiller.
Let's jump over to um talkingmore about uh microneedling
while breastfeeding.
I know a lot of people askquestions about microneedling,
so I'll also link this article.
Um, and so microneedling, ifyou're not sure, it's like these
tiny little needles thatsometimes have serum to help um
(10:25):
bring nutrients and you knowboost collagen into your skin.
So the idea is if you createthese tiny fine little um not
incisions, but tiny little umtraumas to the skin, then your
body sends more collagen to fixthat area and it gets plumper
and nicer and more youthfullooking with more elasticity and
(10:50):
helps to um reduce, you know, ithelps us make the skin look
firmer and more useful.
You know what?
I did do microneedling once.
So I can't say that's the onlything I haven't done all these,
I haven't done all the things,but I did microneedling.
So people use it for acne scars,for enlarged pores, for fine
(11:10):
lines and wrinkles, for melasma,from uneven, for uneven skin and
texture, uneven skin tone andtexture.
So you also have to use they usenumbing cream on your skin for
this.
So just just know that that's athing.
Um you know the question is, youknow, is it safe for
breastfeeding?
(11:30):
That's what most people, youknow, want to know.
So let's let's kind of talkabout.
Um it says here micro needling,you know, is pretty popular, you
know, and they want to discusswhat the current safety during
lactation says aboutmicroneedling.
Um as very little downtime,generally speaking, just so that
(13:05):
you know.
Um, so when it comes to the skinprep, they usually just clean
your face with somenon-irritating gentle cleanser
followed by an antisepticsolution like chlorohexidine or
alcohol to disinfect the areabefore they start doing the
treatment area.
And this is what we use when wedo C-sections on you.
We we prep the skin so that it'sum free from bacteria.
And so these part, this part issafe.
(13:28):
The prepping of the skin is safefor breastfeeding mothers.
The things that they put ontoyour skin don't go into your
bloodstream.
Um, and it says they should not,these cleaning agents should not
be applied directly to thenipple or areola, as this may
pose a risk to infant ingestionand potential irritation.
But putting this alcohol or thischlorohexidine on your skin is
(13:50):
not going to cause a problem forbreastfeeding.
The numbing cream is alidocaine-based numbing cream,
and it says that is compatiblewith breastfeeding, but it's
important to avoid applying itover the nipple or the areola,
and that makes sense.
Um, and so these nipple creams,or excuse me, these numbing
creams are both safe andeffective for breastfeeding
(14:12):
mothers undergoingmicroneedling.
The citation there is CUBA 2016.
The procedure itself, like onceyour face is numbed up, takes
about 20 to 40 minutes.
Um, and they might use sometopical treatments afterwards to
help uh heal and reduceinflammation.
(14:36):
Um, things like vitamin C serumsare often used to brighten the
skin, to reducehyperpigmentation and support
collagen production.
And it is considered safe duringbreastfeeding and has a very low
systemic absorption when appliedto the skin, resulting in
minimal to no transfer into thebreast milk.
(14:56):
So this makes it a low-riskoption for lactating mothers.
And the citation there is Butler2014.
It also has here here listedtransnemic acid serum.
And it says this is a serum thatmight be applied to your skin or
might be given to you to go homeafter this procedure.
(15:16):
Um, and it says that less than1% of maternal plasma
concentrations when they usethis on the skin, it said
pharmacokinetic studies ofintravenous form of this serum
showed that breast milk levelsare less than 1% of maternal
plasma concentrations,indicating minimal infant
(15:37):
exposure.
Topical use, because remember,this study was done on IV use,
topical use is expected toresult in even lower absorption,
making it safe, safer forlactation, for lactating
mothers.
Um and so vitamin C serums andtransagnemic acid serums are
products that could be usedafter their procedure.
(15:59):
You don't have to use them, butif they're recommended or they
put them on your skin, you wantto know what they're putting on
their skin so you know thesafety levels of those things.
There's also other creams,creams that might be
recommended, like hydroquinolonecreams.
Um, you know, you just kind ofwant to do your research.
Read this article to learn alittle bit more about that.
(16:19):
But due to lack of data, youknow, there's not an ideal
choice.
That's probably not the idealchoice for you to use because we
don't really know ifhydroquinone absorbs or passes
into the breast milk at thistime.
So maybe limited use or one-timeuse would be okay, but we
probably are not going to beusing that on a regular basis.
And that's the recommendationfrom the infant risk center.
(16:41):
Um, after the procedure, theskin's probably gonna look a
little sunburned for a coupledays.
Um, you cannot use makeup for atleast 24 hours, and you'll get
all this information from youresthetician if you decide to do
this.
Um, but most people are doingthis procedure on your face or
not doing it on your breastarea.
Um and we we just, you know,probably want to get some extra
(17:03):
opinions and talk with differentdoctors if you are getting
microneedling done to the breastarea.
Um, but we would want to preventmaternal skin infection if
you're getting microneedlingdone on your breast area.
And we want to make sure we arenot having any microneedling
done on the nipple or areola.
So it's a little bit aboutmicroneedling.
(17:24):
We um I would probably startwith a smaller area, not doing
like your whole back or yourwhole abdomen or your whole
trunk.
Maybe, you know, people usuallydo it on their face.
Um side effects are mostly likeon the skin, redness, swelling,
uh, skin dryness or flake orflaking.
Um, but microneedling offers,you know, it says here it offers
(17:45):
a great low risk option forpostpartum skin and hair
concerns, even whenbreastfeeding.
And the procedure works locallyon the skin with minimal
systemic absorption and littleto no impact on breast milk.
So, with the right precautions,microneedling can be safe and
confident boosting treatment fornew moms.
So that's just something toknow.
I do want to put this littleside note out here.
If you're spending money onthese things, I hope to God you
(18:07):
have spent the resources ongetting a good lactation
consultant to make sure that youcan meet your long-term
breastfeeding goals.
So um I just want to put alittle plug out there that save
your money for your lactationconsultant and your skin and
your beauty will come next year.
You probably don't need any ofthese things if you're young and
beautiful, just the way that youare.
(18:29):
But I know I get thesequestions, so I just wanted to
put that out there.
Um, the next topic we're gonnajump to is retinoids.
So if you've heard like aretinoid cream, retin A cream,
you can get these things overthe counter.
They have, you know, thesesynthetic versions and they have
naturally occurring versions ofretinal products.
So let's kind of read about thatand see if that might be a match
(18:49):
for you.
Um, retinoids are sometimes usedfor acne, for skin rejuvenation,
for photoaging, like if you havefive line, fine lines or issues
with your skin texture orpigmentation.
Sometimes um psoriasis also canhelp reduce scaling of plaque
formation.
So it's actually vitamin A.
That's where it's derived from.
And so we want to be carefulthat a mom doesn't take
(19:11):
excessive doses of vitamin Abecause they're gonna be too
much vitamin A in her systemalready.
And then if there's too muchvitamin A in the milk, too much
vitamin A and retinol are kindof synonymous, one's synthetic,
one's not, but we want to makesure that you're not getting,
you're not taking too muchvitamin A from another
(19:31):
supplement because vitamin A isfat soluble.
That means it stays in yoursystem and it can become toxic
if you're taking too muchvitamin A.
And so, and the breastfedinfant, some of the symptoms of
too much vitamin A or oftoxicity is a bulging
fontenelle.
So that soft spot that's in thetop of their head would be
bulging instead of being flat,irritability, vomiting, and poor
(19:55):
weight gain.
It's very, very rare, um, but Ijust want you to know that it's
a thing and that you should knowabout that.
Um, it says here, however, thisis rare, even when a mom is
taking high doses of vitamin Aand would be unlikely in a
breastfed infant of a motherusing topical retinoid.
Um, Bosera 2022.
(20:16):
So let's talk about like thedifference between cosmetic
versus over-the-counter versusprescription retinoids and
what's the difference.
Um, lower dose retinoids such asretinol and its precursors are
as effective as higher doses ofprescription trentinoin.
Trentinoin is a higher doseprescription strength of
(20:36):
retinol.
Like retinol is lower dose, youcan get it over-the-counter,
right?
Trentinoin is like the strongerversion that you need from your
doctor or from a dermatologist.
And so you can start off withthe over-the-counter one and you
can achieve similar anti-wrinklebenefits with over-the-counter
retinoid products whileminimizing redness and peeling,
(20:58):
commonly seen with strongerprescriptions.
Retinoids vary in strength, itsays and formulation and how
they work in the body.
So here's a breakdown of themost common kinds.
So in the beauty aisle, thecosmetic retinoids that you can
get, like, you know, in thecosmetic section in the grocery
store or in the Target orwhatever, um, is a naturally
occurring form of vitamin A.
It's less potent, but generallywell tolerated, a good choice
(21:20):
for beginners.
And there's retinal dehyde.
I don't think I'm saying thatright.
It's a little bit stronger andit converts more easily into the
active vitamin A into the skinand may work faster, but it's
still gentle and good forsensitive skin.
Now remember, I am not acosmetologist.
I don't actually know anythingabout these things.
(21:41):
I'm just reading from the infantrisk center.
So if some of you do this for aliving and are just like, oh my
gosh, she's butchering this, Iam, this is not my specialty.
I'm reading you what the data isshowing here.
Um, there's no studies to showon how cosmetic retinols
influence uh milk retinollevels.
However, unlike oral vitamin A,um repeated topical application
(22:07):
of retinol-containing products,even at higher doses, don't
change the blood level ofretinoils uh in females of
childbearing age.
So the it looks like themolecules here can only enter
the milk if it's first in theblood.
And it says here, we feelconfident that these products
won't negatively impactbreastfed infant, um, because
(22:30):
the breastfed infant becausethey're not getting into the
bloodstream.
So that's for the retinoids thatyou can get in the beauty aisle.
Over-the-counter retinoids, soOTC, something called adaptyline
0.1 gel, which is also the thelike the trade name is differin
gel, is that is a syntheticretinoid available
over-the-counter without aprescription.
So it's synthetic, it's not anaturally derived vitamin A.
(22:53):
It's um FDA approved to treatacne, and it works more
directly.
It works more directly and ismore stable than cosmetic
retinoles, uh, retinol.
It's well tolerated and it'skind of just used for spot
treatment of acne.
And so there's no studies ontopical retinoids in human milk.
Like cosmetic retinol, topicalretinoids do not change the
(23:17):
blood concentration of retinols.
This means it will not changethe milk levels of retinols.
The drug itself has lowabsorption, so adilapoline, I
can't say that drug, butdifferin gel is unlikely to be
in the milk.
So the first two categories, theones that are in the beauty
aisle, and then this one productcalled different gel seem to not
(23:40):
be um in the in the bloodstream,and that it says it should not
is unlikely to be in the milk,both of them.
Um in the pharmacy, soprescription only, you get a
higher strength of thisadaplene, so 0.3% is a higher
concentration.
Um, trentinoin is a con is aprescription.
Another one I probably can'tpronounce uh tazeroatin.
(24:05):
It looks like keratin, but tazerI don't know how to say it.
T-A-Z-A-R-O-T-E-N-E is used foracne and psoriasis.
It's highly effective, but a bitmore irritating.
There's no studies on, onceagain, topical retinoids in
human milk, but it says heretopical retinoids do not change
the blood concentration ofretinol, so this means it will
(24:27):
not change the level of themilk.
It says exactly what it sayshere is this means it will not
change the milk levels ofretinol.
These topical, topically applieddrugs have low absorption into
the maternal blood, so the drugsthemselves are unlikely to be in
the milk.
And there's two citations, uhBez Bezera 2022 and Mentor 2000.
(24:49):
So it says here over-the-counteroptions such as retinol and
adilapine and uh are consideredthe lowest risk.
Uh adalapine 0.1, considered thelowest risk while prescription
strengths products such astretinoin and the higher doses
of 0.3% of adilapine are stillconsidered acceptable.
(25:10):
Um, but they should be used whencaution when you're getting into
stronger medications.
Um and so the over-the-counteruh retinols, um, very safe.
I would definitely read thisarticle if you're going to be
getting uh prescription types ofretinols, and then you and your
doctor discuss if the benefitoutweighs the risk.
Um so yeah, a little bit ofinformation for you.
(25:31):
It says here final thoughts.
Retinoids are powerful andeffective treatments for many
skin conditions, but theirsafety during breastfeeding
depends on the type used.
Topical retinoids are generallysafe when properly used, while
oral retinoids should be avoidedto the risk of the harm to the
breastfed infants.
And so when we're talking aboutoral retinoids, this oral
vitamin A.
(25:52):
So I hope that was helpful foryou.
I hope this is not too nerdy,but these are questions that we
we get from y'all.
I want to talk next about weightloss.
So let me take, let me catch mybreath real quick.
Um, and I want to talk about,like I said, um weight loss and
some of the options that arethere.
(26:12):
So hang tight and I'll be rightback and we'll jump into that.
Okay, y'all, I'm back and I'mready to talk about weight loss
stuff.
And this is gonna be a littleless nerdy.
I know the other stuff was supertechnical, but I have to speak
really technical on it becausethere's liability here, right?
These are actual drugs we'retalking about.
Um, so I want to be very clearand I want to say exactly what
the website and the researchshows and not add my own color
(26:33):
to it because you know I'll beadding my own color.
Um, I am gonna also link thisarticle from the Infant Risk
Center and it talks about weightloss and lactation.
You're definitely gonna want tovisit this link because they
have created their owncalculator to um to estimate
what your basal metabolic rateis and based on how many ounces
(26:56):
of milk you produce per day,like if you know what that is.
There's a section here, like ifyou're pumping versus not like
common when feeding at thebreast.
No.
So how much is your it'll askyou how much your infant weighs
and what your how your baby, ithas it's really, really good.
You have to look at it.
So there's one if you know howmuch milk you make per day, and
there's one if you don't knowhow much milk you weigh.
(27:19):
And then when you don't know howmuch milk you make per day, it
asks you some other questions,and then and then it spits out
for you how many total caloriesper day you should be eating to
maintain your current weight,total calories per day to lose
one pound per week, totalcalories per day to lose one
(27:41):
pound per month.
And so and then there's anotherlink on here that talks about
like how to figure out whichthis website can help you
determine your individual dailyvitamin needs.
So I love this.
Okay, so let's talk about weightloss.
What what they're recommendingum is is really important while
(28:04):
you're lactating is to increasewhole foods, diets you know,
rich in foods and vegetables,lean proteins, plant proteins,
whole grains, right?
So I'm not there's plenty ofnutrition out there, nutrition
information.
I'm not the person I'm not anutritionist for adults.
I I am not in that space.
There's plenty of informationout there, but hydration is
(28:24):
really important.
If you've ever like been like,oh, if I drink this particular
brand of Gatorade or body armoror whatever, this color, like it
makes me have more milk, thatstuff is actually not true.
But we just want you to stayhydrated, which also helps to
aid with weight loss.
And we're wanting you to replacehigh-calorie drinks like soda
juices or sweetened teas orsweetened coffee with um with
(28:47):
actual liquid, like with water.
Um, and so that's reallyimportant.
I don't want you drinkinggallons of water.
We just want to drink enoughwater that your urine is always
pale yellow.
So if you're ever getting pee inthe toilet that you're like,
that's pretty yellow, that's thewrong answer.
We really it should be pale,pale yellow.
Um so they also recommended youwanting to make it's important
(29:10):
for you to consume enoughcalories to maintain your milk
supply.
So that's why it's you gotta be,it's a little bit tricky.
You don't want to just go on adiet and start doing all these
things and losing weight toorapidly because your energy
levels can go down, your milksupply can go down.
Um and it says here that you'reif you're breastfeeding on
average, you're gonna need anadditional 250 to 500 extra
(29:31):
calories added to your basalmetabolic rate when determining
your calorie goal.
So that's just something toknow.
And there's a calculator in hereto help you determine that.
Um, they're also gonna ask youyour activity level.
So based on how active you are,and they're really good about
telling you like moderate meansthis and low activity means
(29:53):
this.
So I really like that part.
Um, and yeah, they they madetheir own calculator because
they couldn't find a calculatorthat help you calculate your
calorie needs, like becausethere's apps like My FitnessPal
and all that stuff that helpsyou figure out your calories,
but not for lactating women.
So they made their own, which isa really good calculator.
(30:13):
Um so I would highly recommendyou taking a look at the
infantriskcenter.com and um theweight loss and lactation
article.
There, the calculators there,and I'm gonna link it in the
article.
Um so yeah, just just know thatthey're also recommending
frequent and smaller meals.
So probably intermittent fastingis probably not something you
(30:34):
want to do at this point in yourlife.
Fiber-rich foods, um, and youknow, your insurance a lot of
times will cover a um dietitian,like a like a consultation with
a nutritionist or a dietitian,especially if you're one of your
one of those moms that arehaving to remove foods from her
diet because of infant foodallergies and you're
breastfeeding.
If you have removed more thantwo foods from your diet, you
(30:55):
need to seek the counsel of aregistered dietitian.
Exercising.
So you're gonna want to startslow.
Um, you don't want to just startoff doing, I don't know,
something like CrossFit orsomething.
Just remember you have hormonesin your body that make the
joints and things a little moreflexible than before you were
(31:15):
pregnant.
And so we don't want you tosustain any additional sprains
or injuries or you know, pelvicinjuries because we're doing
crazy things because we're justtrying to be back the way we
were.
It's gonna take you a year or soto, you know, if you're
breastfeeding, you have thesehormones in your body.
It's gonna be like a year or soafter finished breastfeeding for
your hormones to, you know, toto not have so much wiggly parts
(31:39):
of your bones and your pelvisand and ligaments and things
like that.
So take it easy.
They are recommending walking atleast 10,000 steps per day.
And you might do that in yourhouse, going back and forth
chasing around after your kids,or um, you just be surprised.
So that's something to consider.
And you want to check with yourOBGYN or your midwife before you
start doing these activities.
(31:59):
You want to make sure you'redoing pelvic floor exercises and
strengthening that pelvic floorbefore you start doing a bunch
of you know, plyos and jumpingjacks and things like that.
Um, so weight loss medicationsand breastfeeding, I'm gonna
read this verbatim.
It's very important that youhear me say this, okay?
So currently there is noresearch on this.
So it says oral weight lossmedications are generally not
(32:20):
compatible with breastfeedingdue to the likelihood that some
will enter milk and causeappetite suppression in infants,
along with other possible sideeffects depending on the
medication.
There's a lot of hype right nowabout injectable GLP1 drugs for
weight loss, such as Wagovi,Ozempic, and Mongero, et cetera,
(32:43):
that are gaining attention andbreast in the breastfeeding
population.
The Infant Risk Center iscurrently studying these
medications and breast milk todetermine their safety.
And while they do not believethat these medications will
enter the breast milk, we do,we, meaning the infant risk
center, uh we do have concernsabout their use in lactation.
These medications work bydecreasing appetite and slowing
(33:05):
down the digestion process.
Patients that use thesemedications typically experience
nausea, vomiting, and diarrhea,which could lead to dehydration
and decreased milk supply inlactating women.
Due to the decreased appetite, acaloric deficit, which could
lead to dehydration anddecreased milk supply and
lactating women, period.
(33:27):
Like so it could lead todehydration and a decrease in
milk supply and lactating women.
Due to the decreased appetiteand caloric um appetite, a
caloric deficit is achieved,resulting in weight loss.
So if a mother is exclusivelybreastfeeding, there is a
concern that the breast milkproduced while taking these
medications could be lessnutrient dense, which could
(33:48):
negatively impact infant growth.
This is infant growth.
So this is problematic in thefirst year postpartum while
breastfeeding.
After one year of age andassuming your baby's getting
enough nutrition from othersources, which I have a whole
course on, um, the risk islower.
If you're using one of thesemedications, we highly recommend
(34:08):
that you take a high qualityprenatal vitamin.
There's a link here that tellsyou like which, you know, it can
help you determine yourindividual daily vitamin needs.
So it gives you some reallygreat resources resources.
Um it says, you know, wedefinitely want to encourage you
to embrace self-compassionduring the postpartum period and
prioritize the health of bothyou and your baby.
Um I I have a client of mine whois a client for two babies.
(34:33):
Um, when I first first started,so probably like eight years
ago, and she is a nutritionistand she just she had a second
baby, and she had this reallywonderful post that I loved, and
it showed her weight lossjourney over the last two years.
And she just made this post thatwas like, okay, I'm two years
postpartum, and now I'm back tomy pre-pregnancy weight.
And this was her way of showingas a new, I think she's a
(34:54):
dietitian, a registereddietitian.
As a registered dietitian, likeit's we this is how we need to
do it slow and steady, andthat's the safest for our body.
And especially if you're one ofthese people who are trying to
pump and have milk in the firstsix months for a whole year of
life.
If you haven't listened to thatepisode, it's like two episodes
back.
You're definitely gonna want tolisten to that episode.
(35:15):
And what that can do is yourbones and your nutrition in your
body.
So if you're that person who'spumping a ton because you want
to be done in the first sixmonths, and then you're trying
to diet and lose weight, girl,let's be compassionate to your
poor little body.
It's not a machine, it's not aprogram, it's not ChatGPT.
It has feelings.
Let's be nice to it.
And it's gonna, you know, itgets tired.
And so let's just slow andsteady wins the race.
(35:37):
We're not, we're not trying to,we're not trying to look like
the people on Instagram quiteyet.
So don't believe the hype.
So yeah, um, it has some mealideas here for a 2,000 calorie
person.
Oh, you know what?
Let me do the calculation foryou so you can see like what it
says here.
Let me see.
If I am telling it okay, so it'sI let's pretend like I'm younger
(36:00):
than I am.
Let's pretend I'm 30, let's sayI'm 35.
And let's pretend I weigh 170pounds and I'm five feet four
inches, I'm 35 pounds, I'm 35years old, my activity level is
between 5,000 and 7,500 stepsper day.
So that says, Is that true?
Do moms be working?
(36:21):
I don't know.
I'm gonna put it yeah, I'm gonnaleave it as slightly active.
5,000 to 7,500 steps per day.
Let's pretend I take my baby ona stroller ride every day.
Um it's telling me my is thatand my milk.
Let's pretend I make 25 ouncesof milk per day.
(36:43):
So it's gonna tell me thiscalculator is gonna tell me,
don't send me hate mail if youdon't like it, okay?
My basal metabolic rate.
So this means the amount ofcalories I need for my heart to
beat, for me to be able tobreathe, and like my organs to
function, is 1451 calories.
(37:05):
And it's telling me my activitycalories are 544.
And it's telling me that I need580 calories to make my milk.
So my total calories to maintainmy weight per day.
This is why some of my moms whomake a lot of milk are hungry
all the time.
So, with those numbers, weighing170, being 35 years old, being
(37:26):
slightly active, and making 25ounces of milk per day, I need
2,575 calories per day to keepmy weight as it is.
If I want to lose one pound perweek, then it says I should be
at 2,075 calories per week.
And if I want to lose one poundper month, then it's just, you
(37:49):
know, 2,536 calories per day.
So one pound per week, I mean,listen, there's all these
schools of thoughts aboutcalories versus nutrient
density.
I know, I'm just saying this iswhat the data that I have right
now for you.
So it also says, you know, theydon't guarantee weight loss or
(38:09):
anything like that, but theirwhole goal is to help preserve
you, preserve your body to helpmake milk.
So they don't want you andanyone going on any kind of like
restrictive diet, intermittentfasting, you know, keto and
things like that.
You really want to work with adietitian when it comes to
things like that.
Um, so yeah, that is kind ofwhat I wanted to share with you.
Hot topics that people areusually asking me about, um,
(38:31):
weight loss medications andfillers and all those other
kinds of things.
So just know that theinformation's out there.
I'll put these resources in thelink for you.
I hope this episode was helpfulto you.
And please don't hesitate to DMme and let me know what other
topics you want me to um chatwith you guys about.
Okay, have a great night.
Bye.
(38:51):
Thanks for listening.
To learn more about newbornfeeding and get your free swipe
file, visit milkdeva.com forwardslash newborn feeding.
And if you've ever said, wow, Iwish I would have known that
while you're listening to thispodcast, then help a friend out
and share this podcast withthem.
Um, you can also help us byleaving us a rating so more
(39:14):
people can benefit from findingthis podcast.
Medical disclaimer please knowthat all opinions expressed on
this podcast are solely my ownand not intended to substitute
the advice of a medicalprovider.
I am not a medical doctor, andall information shared is
intended for your generalknowledge and is geared towards
full term, healthy singletoninfants and healthy, low risk
(39:35):
pregnant or postpartum women.
Hey there guys.
Welcome to the Boob BusinessPodcast with me, the original
MilkDiva.
I am a former labor and deliverynurse and a board-certified
lactation consultant in Austin,Texas.
I'm the owner of MilkDivaLactation.
And I'm also the author ofbest-selling book called Milk:
Finding Your Flow and the FirstFew Weeks of Breastfeeding.
This podcast is all aboutpulling back the curtain of all
(00:24):
the things in breastfeeding inbirth land.
And so we're just going to talkabout insider things people
don't usually talk about in anunscripted fashion.
So let's just jump right in,okay?
Hey, hey, hey.
Today we're going to be talkingabout things to keep us
beautiful and if they're safefor breastfeeding.
So I am going to put this outthere that this is not my own
information.
(00:44):
I'm getting from my own brain.
I'm going to share with you theresources.
I'm getting this informationfrom.
I'm going to put the resourcesin the show link so that you can
discuss them with your doctor.
Please understand you should notbe getting medical advice from a
podcast.
You should discuss it with amedical professional, your
medical professional.
But I am going to give youinformation so that you can
start the deep dive on whatkinds of things you can and, you
(01:07):
know, maybe should or should notbe considering while you are
breastfeeding, right?
So I'm going to talk about,let's see, cosmetic fillers with
breastfeeding, microneedlingwith breastfeeding, retinoid
skin care with breastfeeding,and weight loss and lactation
section with breastfeeding.
(01:27):
So let's start with cosmeticfillers.
I am going to tell you I'mactually getting this
information from the Infant RiskCenter.
So I'm going to read a littlebit about what this is, and of
course, there's going to beresearch and citation for each
of the things I'm going to talkabout.
But the Infant Risk Center wasfounded in 2011 by Dr.
Thomas Hale.
He's a renowned expert inbreastfeeding and maternal
(01:50):
medications.
The Infant Risk Center ofExcellence, Excellence, excuse
me, abbreviated as IRC, is anestablished international leader
in lactation pharmacology.
Dr.
Hale's groundbreaking work,which began in the late 1980s,
focused on the transfer ofmedications into breast milk and
has laid the foundation forsafety protocols that highlight
(02:12):
the life-saving benefits ofmother's milk even in the
presence of maternal medication.
Located at the Texas TechUniversity Health Science Center
School of Medicine in Amarillo,Texas, the IRC serves as a
globally recognized resourcededicated to supporting
healthcare professionals andmothers worldwide.
(02:32):
So the infant center, the infantrisk center's mission is to
support the health of moms andbabies through the creation and
translation of breastfeedingmedicine research.
Through its commitment, theycontinue to advance the
understanding of lactationpharmacology and its
implications for maternal andinfant health.
They have a call center that youcan call healthcare providers,
(02:54):
physicians, nurses, andlactation consultants can call,
and they can get expert guidanceon medication safety.
Each consultation typicallyaddresses multiple medications,
averaging about three to fourdrugs per call, with the primary
goal of access of assessing therisk of infant exposure while
promoting and encouraging safebreastfeeding.
(03:15):
The reason I put that out thereis because if any of you are
healthcare professionals andyou're not sure if a drug is
safe for your breastfeedingclient, please don't just give
them random information and tellthem to pump and dump.
Instead, call the infant riskcenter.
So I want to put that out there.
And this is where I'm going tobe getting a lot of the
information today.
And you can just Google theInfant Risk Center and their
information and their phonenumber will come up.
(03:36):
So let's start off with talkingabout cosmetic fillers.
If you're not sure what a filleris, that's the injections that
will smooth out wrinkles andfine lines.
And of course, the milk divawould be talking about that.
I don't get fillers, but like Iam a diva, and I am gonna like
probably get, you know, as I getolder, probably some, I don't
(03:58):
know, like I do, let me see.
Right now I use a neurotoxin forin between my lines, uh in
between my eyes right here.
I'm pointing, um, and I'm gonnatell you a true life story.
So during COVID uh 2020, when wewere, you know, doing COVID, I
worked in the hospital.
I'm gonna put this, I'm gonnaput this thing up.
Working in the hospital.
And here, just imagine all youcan see is this on my face.
(04:22):
Like I'm wearing a mask, and allyou see is this.
Not the milk diva.
Let's turn this around.
You just see my eyes.
You just for I'm in the mic, soI should talk to the mic.
All you can see is my eyes.
You can't see anything below it.
And so my facial expressions, Ijust always had RBF.
Um, because my face would likecontort like this all the time.
Like my eyebrows and the linesbetween my people would just say
(04:43):
stuff and I would just lookcrazy and mean.
And so I was like, I need to getmyself some Botox for the lines
between my eyes because I justlook mean all the time.
You most of y'all probably havebeautiful, pleasant, happy
faces, but I was not always sopleasant looking, working 12 and
13 hour shifts in COVID, youknow, covered in plastic, trying
to deliver a baby or startsomeone's IV because they were
(05:04):
COVID positive and I can't seeand we can't hear.
And, you know, you have all thestuff on your head and your face
and your and my ears hurt somuch that I just always had a
cranky little look.
And so, yeah, I started gettingneurotoxin right here.
Not I was not breastfeeding,just saying we should just talk
about it.
And here we go.
But that is currently the onlything that I have done.
(05:25):
But I, if I was a breastfeedingmom, I have a lot of clients who
ask me all sorts of questions.
I've been asked if they canstart spray tanning, if they can
do um weight loss, theinjections, um, let's see, um,
collagen, um, d'sderma typefillers, Botox, ask lots of
questions about weird vitaminsand creatinine and things like
(05:48):
that.
So today we're gonna chat aboutsome of the things that y'all
just asked me, so I'm just gonnatell you.
So cosmetic fillers restorevolume in areas like the cheeks
or under the eyes.
They can plump lips.
A lot of people, you know, gettheir lips like more full with
filler.
Um, it's injected just under theskin so it can stay in place to
create a smoother, more youthfullook.
(06:08):
Um, and so just kind ofdepending on what filler you
select, certain fillers are usedfor different parts of your your
face.
They're not they're not one sizefits all.
So each type of filler has adistinct property and uses and
safety considerations, just sothat you know.
Um, the question here is arefillers safe while
breastfeeding?
(06:29):
So this is what the infant riskcenter says.
Us and quotes, okay?
This is not my words, this istheir words.
They get all the credit.
Infant Risk Center, and I'mputting their link in the show
notes of this article.
A substance must first enter thebloodstream for it to enter
breast milk.
Dermal fillers are injectedlocally and stay in the tissue
where they are placed.
(06:49):
When administered properly,fillers are not absorbed into
the bloodstream, so they do nottransfer into the breast milk.
Um, parentheses Alamma 2021.
Um, the short story (07:06):
you don't need to delay breastfeeding
after getting fillers.
You can continue nursing asusual right after your
appointment.
For more information on fillers,keep reading.
So that's their words, not mine.
Um, most common fillers and whatwe know about them are
hyaluronic acid brands likeJuvederm, Restilin, Bellotera,
(07:26):
Evelise.
Um, hyaluronic acids arenaturally occurring sugars or a
polysaccharide and they attractand retain moisture.
And so these hyaluronic fillersstay in the ejection site and
slowly are broken down byenzymes, and they're cleared
through a natural process.
They do not enter the breast,uh, the bloodstream or the
(07:49):
breast milk.
And that citation is from Becker2009.
There is a product calledEvolice or Evolise, and it does
contain a small amount oflidocaine to help with pain and
bruising and swelling.
However, the amount of lidocaineis not enough to warrant
specific wait times afterinjections.
So that's something that youshould know.
Sounds like hyaluronic acidfillers, like the brands
(08:13):
mentioned above, are safe whileyou're breastfeeding.
There's another kind of uh uhfiller I probably cannot
pronounce.
It looks like calciumhydrolapatite, and it's um one
of the brands is REDES radi Idon't know, R-A-D-I-E-S-S-E.
And it's used for deeperwrinkles and volume loss in
(08:34):
cheeks and the and the jawline.
It's made from a syntheticversion of a mineral found in
bone and suspended in gel.
So breastfeeding safety, it sayshere, um, where it stays where
it's injected and it slowlybreaks down into calcium and
false and phosphate ions,minerals your body knows how to
handle uh in the breast milk,and it's um that citation of
(08:58):
pavic pavic in 2013.
So side effects are similar tothe hyaluronic acid fillers
mentioned above.
Um there's another kind offiller, PLLA filler, something
called like sculptra.
Once again, they're saying thatthat is naturally metabolized.
It does not circulate into thebloodstream, so it cannot
(09:18):
transfer into the milk.
Citation Herman 2018.
Um, so yeah, just I'm gonna putthe link to this particular um
article in the show notes if youwant to learn more and you know
side effects and what do youwant to do if you want to
dissolve the filler and youknow, what about getting filler
into the bloodstream and andthings like that?
(09:39):
There's more information, butchoosing the right provider
matters.
You want to make sure thatyou're you're uh getting an
experienced person and they'renot accidentally putting this
product in a place where it cantouch your your bloodstream.
But hyaluronic acid fillers areconsidered the safest and the
most studied option.
And so there you go.
(09:59):
That's the information onfiller.
Let's jump over to um talkingmore about uh microneedling
while breastfeeding.
I know a lot of people askquestions about microneedling,
so I'll also link this article.
Um, and so microneedling, ifyou're not sure, it's like these
tiny little needles thatsometimes have serum to help um
(10:25):
bring nutrients and you knowboost collagen into your skin.
So the idea is if you createthese tiny fine little um not
incisions, but tiny little umtraumas to the skin, then your
body sends more collagen to fixthat area and it gets plumper
and nicer and more youthfullooking with more elasticity and
(10:50):
helps to um reduce, you know, ithelps us make the skin look
firmer and more useful.
You know what?
I did do microneedling once.
So I can't say that's the onlything I haven't done all these,
I haven't done all the things,but I did microneedling.
So people use it for acne scars,for enlarged pores, for fine
(11:10):
lines and wrinkles, for melasma,from uneven, for uneven skin and
texture, uneven skin tone andtexture.
So you also have to use they usenumbing cream on your skin for
this.
So just just know that that's athing.
Um you know the question is, youknow, is it safe for
breastfeeding?
(11:30):
That's what most people, youknow, want to know.
So let's let's kind of talkabout.
Um it says here micro needling,you know, is pretty popular, you
know, and they want to discusswhat the current safety during
lactation says aboutmicroneedling.
Um as very little downtime,generally speaking, just so that
(13:05):
you know.
Um, so when it comes to the skinprep, they usually just clean
your face with somenon-irritating gentle cleanser
followed by an antisepticsolution like chlorohexidine or
alcohol to disinfect the areabefore they start doing the
treatment area.
And this is what we use when wedo C-sections on you.
We we prep the skin so that it'sum free from bacteria.
And so these part, this part issafe.
(13:28):
The prepping of the skin is safefor breastfeeding mothers.
The things that they put ontoyour skin don't go into your
bloodstream.
Um, and it says they should not,these cleaning agents should not
be applied directly to thenipple or areola, as this may
pose a risk to infant ingestionand potential irritation.
But putting this alcohol or thischlorohexidine on your skin is
(13:50):
not going to cause a problem forbreastfeeding.
The numbing cream is alidocaine-based numbing cream,
and it says that is compatiblewith breastfeeding, but it's
important to avoid applying itover the nipple or the areola,
and that makes sense.
Um, and so these nipple creams,or excuse me, these numbing
creams are both safe andeffective for breastfeeding
(14:12):
mothers undergoingmicroneedling.
The citation there is CUBA 2016.
The procedure itself, like onceyour face is numbed up, takes
about 20 to 40 minutes.
Um, and they might use sometopical treatments afterwards to
help uh heal and reduceinflammation.
(14:36):
Um, things like vitamin C serumsare often used to brighten the
skin, to reducehyperpigmentation and support
collagen production.
And it is considered safe duringbreastfeeding and has a very low
systemic absorption when appliedto the skin, resulting in
minimal to no transfer into thebreast milk.
(14:56):
So this makes it a low-riskoption for lactating mothers.
And the citation there is Butler2014.
It also has here here listedtransnemic acid serum.
And it says this is a serum thatmight be applied to your skin or
might be given to you to go homeafter this procedure.
(15:16):
Um, and it says that less than1% of maternal plasma
concentrations when they usethis on the skin, it said
pharmacokinetic studies ofintravenous form of this serum
showed that breast milk levelsare less than 1% of maternal
plasma concentrations,indicating minimal infant
(15:37):
exposure.
Topical use, because remember,this study was done on IV use,
topical use is expected toresult in even lower absorption,
making it safe, safer forlactation, for lactating
mothers.
Um and so vitamin C serums andtransagnemic acid serums are
products that could be usedafter their procedure.
(15:59):
You don't have to use them, butif they're recommended or they
put them on your skin, you wantto know what they're putting on
their skin so you know thesafety levels of those things.
There's also other creams,creams that might be
recommended, like hydroquinolonecreams.
Um, you know, you just kind ofwant to do your research.
Read this article to learn alittle bit more about that.
(16:19):
But due to lack of data, youknow, there's not an ideal
choice.
That's probably not the idealchoice for you to use because we
don't really know ifhydroquinone absorbs or passes
into the breast milk at thistime.
So maybe limited use or one-timeuse would be okay, but we
probably are not going to beusing that on a regular basis.
And that's the recommendationfrom the infant risk center.
(16:41):
Um, after the procedure, theskin's probably gonna look a
little sunburned for a coupledays.
Um, you cannot use makeup for atleast 24 hours, and you'll get
all this information from youresthetician if you decide to do
this.
Um, but most people are doingthis procedure on your face or
not doing it on your breastarea.
Um and we we just, you know,probably want to get some extra
(17:03):
opinions and talk with differentdoctors if you are getting
microneedling done to the breastarea.
Um, but we would want to preventmaternal skin infection if
you're getting microneedlingdone on your breast area.
And we want to make sure we arenot having any microneedling
done on the nipple or areola.
So it's a little bit aboutmicroneedling.
(17:24):
We um I would probably startwith a smaller area, not doing
like your whole back or yourwhole abdomen or your whole
trunk.
Maybe, you know, people usuallydo it on their face.
Um side effects are mostly likeon the skin, redness, swelling,
uh, skin dryness or flake orflaking.
Um, but microneedling offers,you know, it says here it offers
(17:45):
a great low risk option forpostpartum skin and hair
concerns, even whenbreastfeeding.
And the procedure works locallyon the skin with minimal
systemic absorption and littleto no impact on breast milk.
So, with the right precautions,microneedling can be safe and
confident boosting treatment fornew moms.
So that's just something toknow.
I do want to put this littleside note out here.
If you're spending money onthese things, I hope to God you
(18:07):
have spent the resources ongetting a good lactation
consultant to make sure that youcan meet your long-term
breastfeeding goals.
So um I just want to put alittle plug out there that save
your money for your lactationconsultant and your skin and
your beauty will come next year.
You probably don't need any ofthese things if you're young and
beautiful, just the way that youare.
(18:29):
But I know I get thesequestions, so I just wanted to
put that out there.
Um, the next topic we're gonnajump to is retinoids.
So if you've heard like aretinoid cream, retin A cream,
you can get these things overthe counter.
They have, you know, thesesynthetic versions and they have
naturally occurring versions ofretinal products.
So let's kind of read about thatand see if that might be a match
(18:49):
for you.
Um, retinoids are sometimes usedfor acne, for skin rejuvenation,
for photoaging, like if you havefive line, fine lines or issues
with your skin texture orpigmentation.
Sometimes um psoriasis also canhelp reduce scaling of plaque
formation.
So it's actually vitamin A.
That's where it's derived from.
And so we want to be carefulthat a mom doesn't take
(19:11):
excessive doses of vitamin Abecause they're gonna be too
much vitamin A in her systemalready.
And then if there's too muchvitamin A in the milk, too much
vitamin A and retinol are kindof synonymous, one's synthetic,
one's not, but we want to makesure that you're not getting,
you're not taking too muchvitamin A from another
(19:31):
supplement because vitamin A isfat soluble.
That means it stays in yoursystem and it can become toxic
if you're taking too muchvitamin A.
And so, and the breastfedinfant, some of the symptoms of
too much vitamin A or oftoxicity is a bulging
fontenelle.
So that soft spot that's in thetop of their head would be
bulging instead of being flat,irritability, vomiting, and poor
(19:55):
weight gain.
It's very, very rare, um, but Ijust want you to know that it's
a thing and that you should knowabout that.
Um, it says here, however, thisis rare, even when a mom is
taking high doses of vitamin Aand would be unlikely in a
breastfed infant of a motherusing topical retinoid.
Um, Bosera 2022.
(20:16):
So let's talk about like thedifference between cosmetic
versus over-the-counter versusprescription retinoids and
what's the difference.
Um, lower dose retinoids such asretinol and its precursors are
as effective as higher doses ofprescription trentinoin.
Trentinoin is a higher doseprescription strength of
(20:36):
retinol.
Like retinol is lower dose, youcan get it over-the-counter,
right?
Trentinoin is like the strongerversion that you need from your
doctor or from a dermatologist.
And so you can start off withthe over-the-counter one and you
can achieve similar anti-wrinklebenefits with over-the-counter
retinoid products whileminimizing redness and peeling,
(20:58):
commonly seen with strongerprescriptions.
Retinoids vary in strength, itsays and formulation and how
they work in the body.
So here's a breakdown of themost common kinds.
So in the beauty aisle, thecosmetic retinoids that you can
get, like, you know, in thecosmetic section in the grocery
store or in the Target orwhatever, um, is a naturally
occurring form of vitamin A.
It's less potent, but generallywell tolerated, a good choice
(21:20):
for beginners.
And there's retinal dehyde.
I don't think I'm saying thatright.
It's a little bit stronger andit converts more easily into the
active vitamin A into the skinand may work faster, but it's
still gentle and good forsensitive skin.
Now remember, I am not acosmetologist.
I don't actually know anythingabout these things.
(21:41):
I'm just reading from the infantrisk center.
So if some of you do this for aliving and are just like, oh my
gosh, she's butchering this, Iam, this is not my specialty.
I'm reading you what the data isshowing here.
Um, there's no studies to showon how cosmetic retinols
influence uh milk retinollevels.
However, unlike oral vitamin A,um repeated topical application
(22:07):
of retinol-containing products,even at higher doses, don't
change the blood level ofretinoils uh in females of
childbearing age.
So the it looks like themolecules here can only enter
the milk if it's first in theblood.
And it says here, we feelconfident that these products
won't negatively impactbreastfed infant, um, because
(22:30):
the breastfed infant becausethey're not getting into the
bloodstream.
So that's for the retinoids thatyou can get in the beauty aisle.
Over-the-counter retinoids, soOTC, something called adaptyline
0.1 gel, which is also the thelike the trade name is differin
gel, is that is a syntheticretinoid available
over-the-counter without aprescription.
So it's synthetic, it's not anaturally derived vitamin A.
(22:53):
It's um FDA approved to treatacne, and it works more
directly.
It works more directly and ismore stable than cosmetic
retinoles, uh, retinol.
It's well tolerated and it'skind of just used for spot
treatment of acne.
And so there's no studies ontopical retinoids in human milk.
Like cosmetic retinol, topicalretinoids do not change the
(23:17):
blood concentration of retinols.
This means it will not changethe milk levels of retinols.
The drug itself has lowabsorption, so adilapoline, I
can't say that drug, butdifferin gel is unlikely to be
in the milk.
So the first two categories, theones that are in the beauty
aisle, and then this one productcalled different gel seem to not
(23:40):
be um in the in the bloodstream,and that it says it should not
is unlikely to be in the milk,both of them.
Um in the pharmacy, soprescription only, you get a
higher strength of thisadaplene, so 0.3% is a higher
concentration.
Um, trentinoin is a con is aprescription.
Another one I probably can'tpronounce uh tazeroatin.
(24:05):
It looks like keratin, but tazerI don't know how to say it.
T-A-Z-A-R-O-T-E-N-E is used foracne and psoriasis.
It's highly effective, but a bitmore irritating.
There's no studies on, onceagain, topical retinoids in
human milk, but it says heretopical retinoids do not change
the blood concentration ofretinol, so this means it will
(24:27):
not change the level of themilk.
It says exactly what it sayshere is this means it will not
change the milk levels ofretinol.
These topical, topically applieddrugs have low absorption into
the maternal blood, so the drugsthemselves are unlikely to be in
the milk.
And there's two citations, uhBez Bezera 2022 and Mentor 2000.
(24:49):
So it says here over-the-counteroptions such as retinol and
adilapine and uh are consideredthe lowest risk.
Uh adalapine 0.1, considered thelowest risk while prescription
strengths products such astretinoin and the higher doses
of 0.3% of adilapine are stillconsidered acceptable.
(25:10):
Um, but they should be used whencaution when you're getting into
stronger medications.
Um and so the over-the-counteruh retinols, um, very safe.
I would definitely read thisarticle if you're going to be
getting uh prescription types ofretinols, and then you and your
doctor discuss if the benefitoutweighs the risk.
Um so yeah, a little bit ofinformation for you.
(25:31):
It says here final thoughts.
Retinoids are powerful andeffective treatments for many
skin conditions, but theirsafety during breastfeeding
depends on the type used.
Topical retinoids are generallysafe when properly used, while
oral retinoids should be avoidedto the risk of the harm to the
breastfed infants.
And so when we're talking aboutoral retinoids, this oral
vitamin A.
(25:52):
So I hope that was helpful foryou.
I hope this is not too nerdy,but these are questions that we
we get from y'all.
I want to talk next about weightloss.
So let me take, let me catch mybreath real quick.
Um, and I want to talk about,like I said, um weight loss and
some of the options that arethere.
(26:12):
So hang tight and I'll be rightback and we'll jump into that.
Okay, y'all, I'm back and I'mready to talk about weight loss
stuff.
And this is gonna be a littleless nerdy.
I know the other stuff was supertechnical, but I have to speak
really technical on it becausethere's liability here, right?
These are actual drugs we'retalking about.
Um, so I want to be very clearand I want to say exactly what
the website and the researchshows and not add my own color
(26:33):
to it because you know I'll beadding my own color.
Um, I am gonna also link thisarticle from the Infant Risk
Center and it talks about weightloss and lactation.
You're definitely gonna want tovisit this link because they
have created their owncalculator to um to estimate
what your basal metabolic rateis and based on how many ounces
(26:56):
of milk you produce per day,like if you know what that is.
There's a section here, like ifyou're pumping versus not like
common when feeding at thebreast.
No.
So how much is your it'll askyou how much your infant weighs
and what your how your baby, ithas it's really, really good.
You have to look at it.
So there's one if you know howmuch milk you make per day, and
there's one if you don't knowhow much milk you weigh.
(27:19):
And then when you don't know howmuch milk you make per day, it
asks you some other questions,and then and then it spits out
for you how many total caloriesper day you should be eating to
maintain your current weight,total calories per day to lose
one pound per week, totalcalories per day to lose one
(27:41):
pound per month.
And so and then there's anotherlink on here that talks about
like how to figure out whichthis website can help you
determine your individual dailyvitamin needs.
So I love this.
Okay, so let's talk about weightloss.
What what they're recommendingum is is really important while
(28:04):
you're lactating is to increasewhole foods, diets you know,
rich in foods and vegetables,lean proteins, plant proteins,
whole grains, right?
So I'm not there's plenty ofnutrition out there, nutrition
information.
I'm not the person I'm not anutritionist for adults.
I I am not in that space.
There's plenty of informationout there, but hydration is
(28:24):
really important.
If you've ever like been like,oh, if I drink this particular
brand of Gatorade or body armoror whatever, this color, like it
makes me have more milk, thatstuff is actually not true.
But we just want you to stayhydrated, which also helps to
aid with weight loss.
And we're wanting you to replacehigh-calorie drinks like soda
juices or sweetened teas orsweetened coffee with um with
(28:47):
actual liquid, like with water.
Um, and so that's reallyimportant.
I don't want you drinkinggallons of water.
We just want to drink enoughwater that your urine is always
pale yellow.
So if you're ever getting pee inthe toilet that you're like,
that's pretty yellow, that's thewrong answer.
We really it should be pale,pale yellow.
Um so they also recommended youwanting to make it's important
(29:10):
for you to consume enoughcalories to maintain your milk
supply.
So that's why it's you gotta be,it's a little bit tricky.
You don't want to just go on adiet and start doing all these
things and losing weight toorapidly because your energy
levels can go down, your milksupply can go down.
Um and it says here that you'reif you're breastfeeding on
average, you're gonna need anadditional 250 to 500 extra
(29:31):
calories added to your basalmetabolic rate when determining
your calorie goal.
So that's just something toknow.
And there's a calculator in hereto help you determine that.
Um, they're also gonna ask youyour activity level.
So based on how active you are,and they're really good about
telling you like moderate meansthis and low activity means
(29:53):
this.
So I really like that part.
Um, and yeah, they they madetheir own calculator because
they couldn't find a calculatorthat help you calculate your
calorie needs, like becausethere's apps like My FitnessPal
and all that stuff that helpsyou figure out your calories,
but not for lactating women.
So they made their own, which isa really good calculator.
(30:13):
Um so I would highly recommendyou taking a look at the
infantriskcenter.com and um theweight loss and lactation
article.
There, the calculators there,and I'm gonna link it in the
article.
Um so yeah, just just know thatthey're also recommending
frequent and smaller meals.
So probably intermittent fastingis probably not something you
(30:34):
want to do at this point in yourlife.
Fiber-rich foods, um, and youknow, your insurance a lot of
times will cover a um dietitian,like a like a consultation with
a nutritionist or a dietitian,especially if you're one of your
one of those moms that arehaving to remove foods from her
diet because of infant foodallergies and you're
breastfeeding.
If you have removed more thantwo foods from your diet, you
(30:55):
need to seek the counsel of aregistered dietitian.
Exercising.
So you're gonna want to startslow.
Um, you don't want to just startoff doing, I don't know,
something like CrossFit orsomething.
Just remember you have hormonesin your body that make the
joints and things a little moreflexible than before you were
(31:15):
pregnant.
And so we don't want you tosustain any additional sprains
or injuries or you know, pelvicinjuries because we're doing
crazy things because we're justtrying to be back the way we
were.
It's gonna take you a year or soto, you know, if you're
breastfeeding, you have thesehormones in your body.
It's gonna be like a year or soafter finished breastfeeding for
your hormones to, you know, toto not have so much wiggly parts
(31:39):
of your bones and your pelvisand and ligaments and things
like that.
So take it easy.
They are recommending walking atleast 10,000 steps per day.
And you might do that in yourhouse, going back and forth
chasing around after your kids,or um, you just be surprised.
So that's something to consider.
And you want to check with yourOBGYN or your midwife before you
start doing these activities.
(31:59):
You want to make sure you'redoing pelvic floor exercises and
strengthening that pelvic floorbefore you start doing a bunch
of you know, plyos and jumpingjacks and things like that.
Um, so weight loss medicationsand breastfeeding, I'm gonna
read this verbatim.
It's very important that youhear me say this, okay?
So currently there is noresearch on this.
So it says oral weight lossmedications are generally not
(32:20):
compatible with breastfeedingdue to the likelihood that some
will enter milk and causeappetite suppression in infants,
along with other possible sideeffects depending on the
medication.
There's a lot of hype right nowabout injectable GLP1 drugs for
weight loss, such as Wagovi,Ozempic, and Mongero, et cetera,
(32:43):
that are gaining attention andbreast in the breastfeeding
population.
The Infant Risk Center iscurrently studying these
medications and breast milk todetermine their safety.
And while they do not believethat these medications will
enter the breast milk, we do,we, meaning the infant risk
center, uh we do have concernsabout their use in lactation.
These medications work bydecreasing appetite and slowing
(33:05):
down the digestion process.
Patients that use thesemedications typically experience
nausea, vomiting, and diarrhea,which could lead to dehydration
and decreased milk supply inlactating women.
Due to the decreased appetite, acaloric deficit, which could
lead to dehydration anddecreased milk supply and
lactating women, period.
(33:27):
Like so it could lead todehydration and a decrease in
milk supply and lactating women.
Due to the decreased appetiteand caloric um appetite, a
caloric deficit is achieved,resulting in weight loss.
So if a mother is exclusivelybreastfeeding, there is a
concern that the breast milkproduced while taking these
medications could be lessnutrient dense, which could
(33:48):
negatively impact infant growth.
This is infant growth.
So this is problematic in thefirst year postpartum while
breastfeeding.
After one year of age andassuming your baby's getting
enough nutrition from othersources, which I have a whole
course on, um, the risk islower.
If you're using one of thesemedications, we highly recommend
(34:08):
that you take a high qualityprenatal vitamin.
There's a link here that tellsyou like which, you know, it can
help you determine yourindividual daily vitamin needs.
So it gives you some reallygreat resources resources.
Um it says, you know, wedefinitely want to encourage you
to embrace self-compassionduring the postpartum period and
prioritize the health of bothyou and your baby.
Um I I have a client of mine whois a client for two babies.
(34:33):
Um, when I first first started,so probably like eight years
ago, and she is a nutritionistand she just she had a second
baby, and she had this reallywonderful post that I loved, and
it showed her weight lossjourney over the last two years.
And she just made this post thatwas like, okay, I'm two years
postpartum, and now I'm back tomy pre-pregnancy weight.
And this was her way of showingas a new, I think she's a
(34:54):
dietitian, a registereddietitian.
As a registered dietitian, likeit's we this is how we need to
do it slow and steady, andthat's the safest for our body.
And especially if you're one ofthese people who are trying to
pump and have milk in the firstsix months for a whole year of
life.
If you haven't listened to thatepisode, it's like two episodes
back.
You're definitely gonna want tolisten to that episode.
(35:15):
And what that can do is yourbones and your nutrition in your
body.
So if you're that person who'spumping a ton because you want
to be done in the first sixmonths, and then you're trying
to diet and lose weight, girl,let's be compassionate to your
poor little body.
It's not a machine, it's not aprogram, it's not ChatGPT.
It has feelings.
Let's be nice to it.
And it's gonna, you know, itgets tired.
And so let's just slow andsteady wins the race.
(35:37):
We're not, we're not trying to,we're not trying to look like
the people on Instagram quiteyet.
So don't believe the hype.
So yeah, um, it has some mealideas here for a 2,000 calorie
person.
Oh, you know what?
Let me do the calculation foryou so you can see like what it
says here.
Let me see.
If I am telling it okay, so it'sI let's pretend like I'm younger
(36:00):
than I am.
Let's pretend I'm 30, let's sayI'm 35.
And let's pretend I weigh 170pounds and I'm five feet four
inches, I'm 35 pounds, I'm 35years old, my activity level is
between 5,000 and 7,500 stepsper day.
So that says, Is that true?
Do moms be working?
(36:21):
I don't know.
I'm gonna put it yeah, I'm gonnaleave it as slightly active.
5,000 to 7,500 steps per day.
Let's pretend I take my baby ona stroller ride every day.
Um it's telling me my is thatand my milk.
Let's pretend I make 25 ouncesof milk per day.
(36:43):
So it's gonna tell me thiscalculator is gonna tell me,
don't send me hate mail if youdon't like it, okay?
My basal metabolic rate.
So this means the amount ofcalories I need for my heart to
beat, for me to be able tobreathe, and like my organs to
function, is 1451 calories.
(37:05):
And it's telling me my activitycalories are 544.
And it's telling me that I need580 calories to make my milk.
So my total calories to maintainmy weight per day.
This is why some of my moms whomake a lot of milk are hungry
all the time.
So, with those numbers, weighing170, being 35 years old, being
(37:26):
slightly active, and making 25ounces of milk per day, I need
2,575 calories per day to keepmy weight as it is.
If I want to lose one pound perweek, then it says I should be
at 2,075 calories per week.
And if I want to lose one poundper month, then it's just, you
(37:49):
know, 2,536 calories per day.
So one pound per week, I mean,listen, there's all these
schools of thoughts aboutcalories versus nutrient
density.
I know, I'm just saying this iswhat the data that I have right
now for you.
So it also says, you know, theydon't guarantee weight loss or
(38:09):
anything like that, but theirwhole goal is to help preserve
you, preserve your body to helpmake milk.
So they don't want you andanyone going on any kind of like
restrictive diet, intermittentfasting, you know, keto and
things like that.
You really want to work with adietitian when it comes to
things like that.
Um, so yeah, that is kind ofwhat I wanted to share with you.
Hot topics that people areusually asking me about, um,
(38:31):
weight loss medications andfillers and all those other
kinds of things.
So just know that theinformation's out there.
I'll put these resources in thelink for you.
I hope this episode was helpfulto you.
And please don't hesitate to DMme and let me know what other
topics you want me to um chatwith you guys about.
Okay, have a great night.
Bye.
(38:51):
Thanks for listening.
To learn more about newbornfeeding and get your free swipe
file, visit milkdeva.com forwardslash newborn feeding.
And if you've ever said, wow, Iwish I would have known that
while you're listening to thispodcast, then help a friend out
and share this podcast withthem.
Um, you can also help us byleaving us a rating so more
(39:14):
people can benefit from findingthis podcast.
Medical disclaimer please knowthat all opinions expressed on
this podcast are solely my ownand not intended to substitute
the advice of a medicalprovider.
I am not a medical doctor, andall information shared is
intended for your generalknowledge and is geared towards
full term, healthy singletoninfants and healthy, low risk
(39:35):
pregnant or postpartum women.
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