April 17, 2025 • 45 mins
Planning for a birth that makes breastfeeding easier?
Check out my FREE guide on setting yourself up for breastfeeding success:
https://bit.ly/los-birthpractice-workbook
--------------------------------
In this deeply insightful episode of "Lo’s Lactation Lab," host Lo resumes the podcast with a telehealth consultation featuring Catherine, a new mother facing significant breastfeeding and milk supply challenges.
Despite trying various strategies and consulting multiple lactation experts, Catherine struggles with low milk transfer, nipple discomfort, and the overwhelming task of finding the right pump flange size. Join their conversation as they explore these issues in detail, providing a real-time glimpse into the complexities of feeding a newborn.
Key Topics:
Episode Highlights and Timestamps:
[00:00:00] - Introduction and backstory of Catherine’s breastfeeding challenges
[00:02:32] - Start of the telehealth consultation; immediate issues with feeding
[00:04:10] - Discussion about latching struggles
[00:10:45] - Techniques and suggestions for improving milk extraction and comfort
[00:15:32] - Comprehensive review of Catherine's previous consultations and their outcomes
[00:21:43] - Delving into the specifics of pump settings and their effects on Catherine's experience
[00:30:10] - Exploration of different pumping techniques and equipment
[00:41:15] - Final advice and next steps for Catherine to try before the next session
Follow the Host on:
#breastfeeding #breastfeedingjourney #breastfeedingstruggles #breastfeedingsupport #postpartum #postpartumsupport #ibclc
Become a supporter of this podcast: https://www.spreaker.com/podcast/lo-s-lactation-lab--5834691/support.
Follow Lo Nigrosh:
#lactationjourney #breastfeedingmoms #maternalhealth #postpartumtruths #supportmoms #newborn #ne
Check out my FREE guide on setting yourself up for breastfeeding success:
https://bit.ly/los-birthpractice-workbook
--------------------------------
In this deeply insightful episode of "Lo’s Lactation Lab," host Lo resumes the podcast with a telehealth consultation featuring Catherine, a new mother facing significant breastfeeding and milk supply challenges.
Despite trying various strategies and consulting multiple lactation experts, Catherine struggles with low milk transfer, nipple discomfort, and the overwhelming task of finding the right pump flange size. Join their conversation as they explore these issues in detail, providing a real-time glimpse into the complexities of feeding a newborn.
Key Topics:
- Challenges of breastfeeding and pumping
- Finding the correct flange size for effective pumping
- Strategies to increase milk supply
- The emotional impact of breastfeeding difficulties
- Practical tips for new mothers struggling with similar issues
Episode Highlights and Timestamps:
[00:00:00] - Introduction and backstory of Catherine’s breastfeeding challenges
[00:02:32] - Start of the telehealth consultation; immediate issues with feeding
[00:04:10] - Discussion about latching struggles
[00:10:45] - Techniques and suggestions for improving milk extraction and comfort
[00:15:32] - Comprehensive review of Catherine's previous consultations and their outcomes
[00:21:43] - Delving into the specifics of pump settings and their effects on Catherine's experience
[00:30:10] - Exploration of different pumping techniques and equipment
[00:41:15] - Final advice and next steps for Catherine to try before the next session
Follow the Host on:
- LinkedIn: https://www.linkedin.com/in/lo-nigrosh-16371495/0
- Website: https://www.quabbinbirthservices.com/
- Facebook: https://www.facebook.com/lo.dandy
- Spotify: https://open.spotify.com/show/2F54fe1szmemB9n7YUJgWv?si=2eea7f1cfba64867
- Apple Podcasts: https://podcasts.apple.com/us/podcast/los-lactation-lab/id1614255223
- YouTube: https://www.youtube.com/@loslactationlab3967
#breastfeeding #breastfeedingjourney #breastfeedingstruggles #breastfeedingsupport #postpartum #postpartumsupport #ibclc
Become a supporter of this podcast: https://www.spreaker.com/podcast/lo-s-lactation-lab--5834691/support.
Follow Lo Nigrosh:
- LinkedIn: https://www.linkedin.com/in/lo-nigrosh-16371495/
- Website: https://www.quabbinbirthservices.com/
- Facebook: https://www.facebook.com/quabbinbirthservices/
- Spotify: https://open.spotify.com/show/2F54fe1szmemB9n7YUJgWv
- Apple Podcasts: https://podcasts.apple.com/us/podcast/los-lactation-lab/id1614255223
- YouTube: https://www.youtube.com/@loslactationlab3967
#lactationjourney #breastfeedingmoms #maternalhealth #postpartumtruths #supportmoms #newborn #ne
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Sometimes when I'm pumping a lot, if I've pumped a
lot over the course of a day, or just like randomly,
I will get like almost like a burning or like
a like a tingling feeling on my nipples. But I
just just didn't, like I have really sensitive skin. I
just just do and like they're kind of red, and
I just assume that it's that I've tried like every
flange size under the sun. I was fitted at a fifteen,
(00:23):
and that's mostly what I've been using. But I do
get like a decent amount of areola that like gets
pulled in with that, so I under the thirteen.
Speaker 2 (00:34):
It's Low.
Speaker 3 (00:35):
I'm so glad to be recording again. Welcome to my podcast,
Low's Lactation Lab.
Speaker 2 (00:41):
It has been.
Speaker 3 (00:42):
Nearly a year since I put out an episode, but
I am back and ready to explore the highs and
lows of feeding our babies in such a way that
helps you, the listener, feel as if you can make
the right choices for your baby and for your body
given your u situation.
Speaker 2 (01:01):
There is no better.
Speaker 3 (01:02):
Way to come back to the podcast than with a
recording of a telehealth consultation in which I helped Catherine
explore the underlying root causes of what was making breastfeeding
her baby so challenging. Catherine had a seven week old.
Speaker 2 (01:20):
She had seen several other.
Speaker 3 (01:22):
Lactatian consultants and was trying to figure out why was
her baby.
Speaker 2 (01:26):
Not transferring very much milk.
Speaker 3 (01:28):
And what were the causes of her low milk supply.
Speaker 2 (01:33):
Even when pumping, you.
Speaker 3 (01:34):
Will hear that we just dive right in to the consultation.
She had a crying baby right when we got started,
and so I just hit record and she started latching
her baby. That's sometimes what it's like when we have
a telehealth consultation and we're dealing with itty bitty babies
who just need to get going on their feeding right away.
(01:56):
So enjoy this episode and all the ones that are
to pump as we tackle the challenges and the joys
of feeding our babies. So let's go ahead, and you
can just latch her how you normally would.
Speaker 4 (02:12):
Okay, okay, okay, okay, okay, okay, okay, hold.
Speaker 1 (02:24):
Wokay can you sing? Yeah?
Speaker 3 (02:30):
And this is the side that feels better.
Speaker 1 (02:35):
This side I feel like pumps more readily when I pump,
never had as much like nipple damage. When she was
originally using the nipple shield, and I currently think I
have a clog duct on the other side. So yeah,
this was just my go to. But for what it's worth,
(03:00):
I just revisited our lactation consultant at Cooley who where
that's where I delivered yesterday, and she basically we did
a weighted feed and she just doesn't transfer milk. Basically.
It seems like she like, I think that she did
(03:20):
this for.
Speaker 2 (03:22):
I don't know.
Speaker 1 (03:23):
It always doesn't feel that long when we're taller, I'm
talking with someone, you know what I mean. I don't
feel like she did it for more than ten minutes.
But then she said she got my gosh, I've got
I've done this so many times that I can't remember.
I think she said was like a third of an ounce.
I think that's what you said, A third of an.
Speaker 3 (03:44):
Ounce, zero point three ounces.
Speaker 1 (03:48):
No, I don't know, like a like a third of
an ounce, so like point three to three.
Speaker 3 (03:53):
Right, Yeah, that's what I just said, zero point three yeah, yeah, okay, okay.
Did she word it like a of an ounce or
that's how your brain translated it?
Speaker 1 (04:03):
She told me MILLI leaders and then I okay, and
then got it. I obviously didn't know, so I think
she then translated okay, maybe okay.
Speaker 2 (04:12):
Yeah.
Speaker 3 (04:12):
I was like, that's a weird way to like say
what the transfer was.
Speaker 2 (04:16):
Okay, now I get it, okay.
Speaker 1 (04:19):
But like she what she had commented on, which I
don't know if you can see. She well, first of all,
she typically when she last years like she feels very
like chompy, but we had done something that made it better.
I think it was really just pulling her chin down,
which again, like I never know how I would be
doing that when I'm when I'm holding her and holding
(04:40):
my breast and like you know what I mean, but
to try to get her latch deeper, although it looks
like now I can see it because I have a
camera in front of you, but it looks like I
think her lips and I don't know. Well, first of all,
she always like she's asleep right now. She always like
kind of falls asleep really quickly. She suggested that she
he has like no ties or anything, but oral dysfunction, essentially,
(05:06):
like she didn't like she doesn't utilized like the the
latch is able to be fine, and she said the
tongue movement is fine, but like the suck is not basically,
I don't know. I think that was there was so
much inf like I've gotten so much, I've gotten so
much information.
Speaker 2 (05:28):
Was she able to name what the cause?
Speaker 3 (05:32):
Like there's always an oral dysfunction is a symptom, right,
so is she able to say what she thinks the
cause of the oral dysfunction is?
Speaker 1 (05:41):
Okay, So here's what I walked away from that. I know, honey,
from that that meeting with that, there was like the
dual situation, I know. And so she like she gets aggravated,
I think honestly because there's not a lot of milk coming.
Speaker 3 (05:58):
Out now if you were to compress.
Speaker 1 (06:02):
Sometimes I can never tell. Oh, that's the other thing
is I don't know if you can tell. But she
does a lot of like sucking without swallowing.
Speaker 3 (06:11):
Right, I was trying to watch. We may need to
be silent for a second so I can listen as well.
Speaker 5 (06:21):
That was a swallow. That was a swallow. That was
(06:43):
a swallow.
Speaker 1 (06:44):
And so that's the thing, is like she'll swallow like that.
But then and then this woman said she was like
I weighed her because I just thought, well, maybe she's
taking really big gulps or something. Not a ton of swallows,
but bigger gulps. But then the way the weighted feeds
never show anything other than like a really small amount.
(07:06):
So I walked out of that meeting with a couple
of things. She wants me to pump more, which I
guess to like get up my supply, which just feels
daunting in and of itself. That way pumped me times
a day, and I've never been able to raise my
supply from the average of like one after and I've
(07:29):
been doing this for however many weeks at this point,
and she so that was on my end, and then
on her she wants me to do some like oral
exercises with her where I like stuck my finger and
like touched her like palette and then did the same
thing sort of with the pacifier. I can't I can't
remember honestly what the goal of was the pacifier was,
(07:51):
but just training her to collect, I guess. And then
this was the weird part that I was like, I
was so excited that I was talking to you today,
but I like, I don't, I don't understand this part.
But her major takeaway was that we should be feeding
Annie like with bought when when we feed because we
only feed her bottles at this point. We don't do
(08:12):
this because if she's not getting anything, what's the point she.
Speaker 2 (08:17):
I know, I know, and you.
Speaker 1 (08:18):
Can't see her like legs, but she like kicks around
like she's like unsettled. So we only feed her bottles,
and so we feed her three ounces every I mean
basically on demand. But like during the day it's usually
like two to three hours, unless she's been sleeping and
it's a little bit longer. And during the night it's
(08:39):
like if she wakes up, we feed her, but otherwise,
like well we'll cap her out at like five to
six hours because that's just what our pediatrician told us
to do. But so that's what she takes in and
I know, tell me when you want me to stop her.
(08:59):
And that was the other thing is the PDF, I mean,
the Latian Consulate yesterday asked, I know, asked, like when
does she like show you that she's had enough? Like
how does she does she like pop off?
Speaker 5 (09:09):
What does she do?
Speaker 1 (09:10):
But she's literally never done that. She doesn't like, she
doesn't like pop off the breast unless she's really angry.
She just kind of stays on it. But anyway, so
The major takeaway she.
Speaker 2 (09:21):
Had was she, I know.
Speaker 1 (09:27):
This is where I like always presume that she's just
not getting milk.
Speaker 4 (09:35):
Uh, I, what.
Speaker 3 (09:50):
Is there a place in your breast that you feel
the most amount of milk, like a quadrant, Like if
you are pumping and you're and you compress, is there
a place where like, oh you see a little bit more?
Speaker 1 (10:06):
It varies, It's never it's it's really on the inside here.
It's usually more on the outside, unless I sometimes like
have like sometimes I do get clogs here for some reason.
I don't know if that's I mean, my understanding is
that that's not related to milk, but I don't know. Okay, okay, okay, okay, wine.
Speaker 6 (10:37):
Yeah, yeah, and if you compress on the outside.
Speaker 3 (10:50):
And then yeah, if she's upset after you try to
compress a little bit on the outside, you can let
me see me.
Speaker 4 (10:57):
Seem okay, okay.
Speaker 1 (11:16):
Yeah, it just doesn't seem like.
Speaker 3 (11:17):
Yeah, yeah, do you want to get her off to
dad so she can have a bottle? Okay?
Speaker 1 (11:23):
So yeah, So just what just to kind of briefly
wrap up what I was saying about the Yeah, so
she her major thing that answers your question about like
what she said the cause of the world this function
was was that she she feels as though Annie's almost
(11:44):
seven weeks, she feels as though she should be taking
in four ounces at a feed instead of this three
that we give her, and that we should go up
a nipple size and the bottle, because she watched me
feed her from the bottle, and she said like she
(12:05):
was I forget if she was getting sleepy when she
was feeding from the bottle or oh no, I'm sorry
she was not taking a lot in at once. But
we had always fed her that way purposefully because that's
what I had thought, like paste feeding was all about
in terms of like mimicking the breast. Now, granted, obviously
I wasn't breastfeeding, or I haven't been breastfeeding, so I
don't know what I've been doing that for. But we
(12:26):
also she's just like super refluxy all the time, so
we just thought that that was best. But so her
take was that to get her the milk faster and
to not tire her out so much and to give
her more food was going to make her stronger so
that she could I'm not sure. Like That's where then
I started to get confused, because then I was just like,
(12:49):
I don't really know how that's related. It feels like
you're actually teaching her like to work less hard with
the faster nipple flow. So we did it as soon
as we got home from the appointment, and then I
did it all day today, my husband and I because
my husband feed her overnight, but and by middle of
(13:09):
the day to day like she had spit up so
much over the course of like like multiple tablespoons over
like four to five times after her feed that I
was like, I'm just done with this. But this just
feels like too much. But it is tricky because after
we feed her three ounces, she seems like she's still
(13:29):
she's just a fussy, colicky baby, I think. And so
she sees she doesn't seem content, Like she seems like
she's either still hungry or just angry. I'm not sure,
but she doesn't seem super content. And so she took
the four once and haway. She seemed more content after
(13:50):
the four maybe, I guess. I don't know. I think
I would have to do it for longer, but she
was spinning up so much more that I was just
like we had with three. We had gotten to a
point where she did not typically spit up a large
amount after the feed, and this and I don't know
if it's because of the pacing, the faster pacing, or
(14:12):
the more liquid, but this felt it. She was just
generally like lots of split up today, very like just
seemed uncomfortable, like lots a lot more gassy than normal.
And just with the fact that I couldn't understand why
that guidance would make any sense for improving her like
(14:32):
function of her mouth, I just was like, we'll just
not do that for now. Yeah, I mean, I ask
the pediatrician because I said, because I all, I never
want to be like starving her. I'm like, of course,
if if someone thinks that she should take four ounces
at this point, then great, I'll happily give her that,
But I just the spitting up and like, I don't know,
(14:53):
she's she's been small, like her her weight has been
the whole sort of thing that started all of the
So there is like a real fixation that's been happening
on her weight, which is not frustrating because obviously, like
you just you, that's how they correlate health. At this point,
I feel like with babies, but.
Speaker 3 (15:12):
Our whole lives really, right, like they focus so much
on especially as women.
Speaker 1 (15:17):
Yeah right, right, So so yeah, so that's the summary
of what I've been dealing with over the last you know,
like thirty six hours, which has just sort of added
an extra layer of like confusion. I mean, it was
nice to hear that she didn't think she had ties,
because at this point now two ibclc's have said that
(15:37):
they don't think she has ties, so I'm assuming that
must be true.
Speaker 3 (15:42):
But yeah, yeah, yeah, So you mentioned in your intake
form that you feel like she has a lot of
symptoms of ties, So it sounds like you've done a
little bit of research about that. Tell me some of
the things that have made you wonder and ask seek
(16:05):
out advice from professionals about I've heard a few. I've
you know, I red flags are going off in my mind,
even though other people have said, no, that can't be.
But even with the oral dysfunction thing, there's always a
reason for oral dysfunction. So saying that there's oral dysfunction,
(16:26):
it's kind of like, yeah, of course there's a oral dysfunction.
She can't feed at the breast, she can't transfer milk
like she's struggling to gain weight and that's literally a
baby's only job. So like, yes, there's oral dysfunction, but
why And if somebody can't say why, then I'm like, eh, yeah,
we need to And I'm hearing that she's saying, yeah,
(16:47):
her tongue needs to improve, But what is making.
Speaker 2 (16:51):
It so that that can't happen.
Speaker 1 (16:53):
Well, that's why I get confused, because if it seems
like she can latch, which it does at this point,
and if it seems like she can, granted she's a
little chompy, but she also hasn't had a lot of
practice at this point, right, like she had the first
two weeks where she was actually breast fading. She was
using the nipple shield, and so she's a little chompy,
(17:17):
but like when I adjust her, it's you know, it
doesn't necessarily feel like the sucking that people say it
should feel like. It does feel a little bit more
like this, And I notice, like my nipples a little
flat when it comes out. But she can latch, and
she's on there and we can hear swallows, right, So
I always go back to like, is it not just
(17:37):
I get that it's all sort of cyclical, but is
it not just more related to my milk supply. Like
that's what I assume if she doesn't have ties, which
to answer your question, like all of the things that
I was thinking of with the ties, I mean, it's
all the stuff that you had said, right, it's like
the low milk transfer. It's it's like the low output
(17:58):
that I have because of that. If it's because of that,
it's the like the chompiness at at the breast, the
flattening of the nipple, the she doesn't like open her
mouth really wide. And what was the other thing, Oh,
(18:19):
just in general, like I had read that it was
like reflux fussiness, that sort of thing can annow, I mean,
that can be just because or it can be attributed
to ties, I thought. But there's a lot going on.
I mean, we feed her, we feed her formula, so
(18:39):
I don't know if there is a level of it
just doesn't sit well with her stomach. Like we've never
I've never been able to produce enough to give her
all breast milk for a day to know, So it's
that's tricky. And yeah, but I fundamentally, if she doesn't
(18:59):
have ties, and if like her latch is okay and
she's sucking and swallowing and all of that. I fall
back on. It has to be something with what's going
on with me, just because even when I pump, like,
I don't think that I have like a normal output
(19:19):
or like pattern of pumping. Like I get't let down.
I don't think it's just like kind of drops. Sometimes
I'll get like a stream or like a spray. It's
hit or miss. Some pumps. I get some pumps I don't.
Sometimes it comes on after compression. Sometimes it just happens
(19:40):
on its own. Only I only pump in the I
think it's the stimulation mode master mode, because that's what
I've found like gets me more or like really anything,
And I do it at like the highest sunction my
(20:01):
that my pump has.
Speaker 2 (20:04):
Are you in any pain when you're pumping?
Speaker 1 (20:07):
No, okay, no, I mean sometimes like afterwards, I don't
know it's it's intermittent. But sometimes when I'm pumping a lot,
if I've pumped a lot over the course of a
day or just like randomly, I will get like almost
like a burning or like a like a tingling feeling
(20:29):
on my nipples. But I just just didn't, like I
have really sensitive skin. I just just do and like
they're kind of red, and I just assume that it's
that I've tried like every flange size under the sun.
I was fitted at a fifteen and that's mostly what
I've been using. But I do get like a decent
(20:51):
amount of areola that like gets pulled in with that thirteen.
I I don't know. I showed I showed that yesterday,
well the thirteen verses of fifteen, because I had just
gotten the thirteen in and the thirteen she said looked better,
she thought, which I agree, it looks more. It looks
closer to like just nipple being in the tunnel. But
(21:16):
it seemed like I wasn't getting a lot of output
with the thirteen, although then like last night, it was
the reverse and the thirteen was getting more than the fifteen.
Speaker 2 (21:27):
Like, I don't know.
Speaker 1 (21:28):
It just is all so like there's no rhyme or
reason to it, which is the hardest part for me,
because like if I just knew what I could do
to improve the situation, then I would just do it.
But that's the general pumping.
Speaker 3 (21:43):
Okay, So there's a couple of things you're trying to
sparse out here, like what's going on with milk supply,
because even if baby can't transfer milk efficiently, you're pumping
sufficiently to be able to have more supply. I'm interested
in this idea of the fifteen between the fifteen and
(22:03):
the thirteen, but I want to get a little bit
more information. You said you pump about eight times per day,
and you're getting about one to one and a half
ounces per pump.
Speaker 5 (22:16):
Is that right?
Speaker 2 (22:17):
Yeah?
Speaker 1 (22:17):
Sometimes sometimes it's less than one, sometimes it's two. It's
never really more than that. I mean part of me
too though this is so sorry, this is like sidetracking.
But if I am getting two ounces, let's say, or
I'm sorry, one ounce one and a half ounces, shouldn't
she at least be able to transfer that? Like that's
(22:39):
where I get confused about is it a her thing?
Speaker 4 (22:41):
Then?
Speaker 5 (22:42):
Not necessarily?
Speaker 3 (22:43):
Right, Like we expect babies with good oral motor function
to be able to transfer better than a pump.
Speaker 1 (22:50):
Right, That's what That's what I read. So that's why
I was okay, if I'm at least getting right, you know,
to get more.
Speaker 3 (22:56):
That's why I do think this is a dual issue,
which was your instinct right, that it's both something going
on with her and something going on with your supply,
and what it takes is kind of working on one
like creating building blocks to like, Okay, let's figure out supply,
let's figure out the oral dysfunction, and let's try to
(23:19):
build one upon the other. Now you expressed kind of earlier,
you kind of said offhanded, based on going back to work,
that is it even worth putting a lot.
Speaker 2 (23:28):
Of effort in.
Speaker 3 (23:30):
And I do think that we can at least get
to the bottom of root causes, and then once we
know root causes, it is possible to improve the situation.
I've seen that happen.
Speaker 2 (23:44):
It's not too late. I've seen that happen many times.
Speaker 3 (23:47):
But sometimes it takes more work than what it feels worth.
Speaker 2 (23:51):
It to you to do.
Speaker 3 (23:53):
And I can't answer that for you.
Speaker 2 (23:55):
Nobody can.
Speaker 3 (23:56):
You know, it has to be you that says, okay,
based on what we've discovered, do I want to keep
going or is it time for me to make a
different decision? And I am so happy to like help
you along the way to figure out you know, the
next right step at any given point. But I do
think we need to figure out this oral dysfunction thing,
(24:18):
and the milk supply thing. So I'm gonna stick with
the pumping for just a second. How long does your
typical pumping session last.
Speaker 1 (24:26):
I usually so I have two things going on. I
will use my Spectra my wall pump when my husband's
not working basically, and so when I do that, I
do a single sided pump because I find that when
I do it double sided, the section is like so poor,
(24:49):
Like no, I shouldn't say so poor, but it's it's
notably less than if I just have one plugged in
with the Spectra.
Speaker 3 (24:57):
Yeah, that should not be the case.
Speaker 5 (25:00):
Okay.
Speaker 1 (25:00):
I was like googling it and the Spectrum website, well
the Australia Spectrum website, but the Spectral website said that
like when you have both plugged in the port, the
section is going to be like split, so you're going
to get less than you know what I'm saying. That's
what their site said. I don't know because I was.
I finally was like, this can't be right, Like do
I have to call that it was a new machine,
(25:21):
you know, but it I feel like I get better Spectrum,
but I only have one plugged in, so I mean,
I'd love to be able to do the same time.
But I typically have been having one plugged in and
I'll do it for like twenty minutes, and then if
I'm in the middle of like because I don't get
those like streams a lot, if I do have one,
(25:43):
I'll keep going for a couple more minutes than that,
and then I go to the other side, which is
like that's just super taxing because it's a super long
pomp session. And then my wearables is that's what I
use during the day, which I know we're always as
good here they like sometimes they'll have better sessions with
(26:05):
those were as good, like they basically give me the
same amount of milk, and those ones I just do
for thirty minutes because it's like the auto shut.
Speaker 2 (26:17):
So that's kind of why I've went on.
Speaker 3 (26:18):
Now, I and are you using fifteen milimeter inserts.
Speaker 1 (26:24):
With the wearables, I'm actually using seventeen just because that's
the smallest that came with them, and they're like silicons.
Is it the Zomi No, it's the mom Cozy S
nine something per S nine per.
Speaker 3 (26:39):
Okay, So I would love to see, uh where it
says that on the Australian Spectra website.
Speaker 1 (26:46):
Yeah, do you want me to find it?
Speaker 3 (26:47):
Yeah, yeah, yeah, I worked for Vital Milk breast pump distriber.
Speaker 2 (26:52):
I still work for her on Mondays.
Speaker 3 (26:55):
Uh breast pump, an insurance covered breast pump distributor, and
uh for like it's been like six years now.
Speaker 5 (27:02):
And I've never heard this before.
Speaker 3 (27:05):
And all of the evidence shows that double pumping produces
more milk than single pumping. So I'm wondering if there's
like something going on with your pump.
Speaker 1 (27:15):
Yeah, that's what because like everyone's like, yeah, like double
stimulations better obviously.
Speaker 3 (27:21):
And yeah, having to pump forty plus minutes eight times
a day, that's like a lot, a lot. I could
imagine that if you are using super high section and
you are.
Speaker 1 (27:33):
Well, that's my problem is because I'm I because I
just use stimulation mode. I do it at the five,
so that's when I single pump, but that's the highest
It lets you go for the stimulation mode for the spectra.
So then when I with them, when I double pump
that I can't go any higher than that.
Speaker 3 (27:55):
And are you noticing, like do you notice an actual
reduction in milk out put?
Speaker 1 (28:01):
Yeah? Well yes, and no, I haven't double pumped in
so long, so I double pumped yesterday. But I also was, like,
I wore Annie the day before, so I had like
a bunch of what I think were like irritated dusts.
So I assumed that was why I like did not
produce a lot of milk yesterday at all. I actually
was like kind of freaking out. But I think it's
(28:24):
gotten back to normal, but so I couldn't tell I
guess is Okay.
Speaker 3 (28:30):
Now, there's a few things with pumping.
Speaker 2 (28:35):
That I'm curious about.
Speaker 6 (28:38):
Uh.
Speaker 3 (28:40):
One is the fact that you do feel kind of
a sensation afterwards, like you know, you described it as
like a burning or a just like a discomfort, And
I do think that that is telling us that something
could be improved with pumping, because, uh you really, even
(29:02):
for people who have sensitive nipples and digits and skin
in general, ideally you would not be experiencing any lingering discomfort.
Speaker 1 (29:14):
Yeah, and so I haven't tried the thirteens for very long,
like literally I got them in the mail yesterday.
Speaker 3 (29:21):
So and are they hard for land or are they
silicon insert?
Speaker 5 (29:27):
They are hard, okay, all right?
Speaker 1 (29:29):
Yeah, the only difference about them is that they're still
from like the they're like the main mom My fifteen
is a hard just regular one. This one is still hard,
but it's like it's they're like the crater. I don't remember, No,
it's the panel, okay, yeah, yeah, what's larger? Because in
(29:50):
my mind too, I was like, because I can't get
my nipple anywhere close to the insert, like of the tunnel,
I assume just because I have like a lot of
rest tissue. So what I thought these ones, I was like, well,
maybe if it's like opens up more, I can like
get myself in there more, which I think is valid.
Like I don't that has happened, so yeah.
Speaker 2 (30:12):
That could make a big difference. We see that different.
Speaker 3 (30:16):
You know, there's the crater, there's the piano, there's the traditional,
there's the silicone inserts, And we do see that some
people's bodies respond better to various shapes and configurations and
materials than others. The sucky part about that is insurance
only covers two total sets, and so then you have
(30:38):
to be able to put the money into it to
try the various stuff unless you're working with an LC
who has a bunch of parts for you to try.
And even then, like I carry around a bunch of parts,
but I don't have like every shape for every size
I need to it's just you know, it's hard to
get it all built up. So I'm interested in seeing
what would happen do that the thirteen's that pano shape for.
Speaker 2 (31:05):
A little bit.
Speaker 3 (31:06):
I think your instincts, you know, of trying to improve
the situation have been good. I do think going back
to the double pumping just for a little bit to
see can you get the same amount of milk in
half the time by just going back to double pumping. Yeah,
(31:28):
Also if the wearables seem to produce just as much
milk as the wall pump. For most people that's not
the case, but I do encounter people where it is.
And sometimes it has to do with stress, because anytime
you're feeling stressed, that inhibits the release of oxytocin, which
(31:52):
is what allows for that release, that milk release to happen.
So a lot of times if people super stressed while pumping,
which is a vicious cycle because pumping becomes stressful when
it's not going well, and then it goes back and forth.
But people will feel milk in their breasts and it
won't be coming out because they've got so much cortisol
(32:14):
flowing that they can't have the release of oxytocin. Do
you feel like you experienced that at all?
Speaker 1 (32:20):
Well, the only thing that would like make me think
that is so for it is tough to because pump
outputs can vary so much, it's tough to say definitively.
Like then I was getting in my head and I'd
be like, well, the wearable got me this much, but
how do I know, Like maybe on nap pump my
wall would have gotten me more, do you know what
(32:40):
I'm saying? So but regardless, for a while, I was like,
the wearables they're giving me just as much whatever. So
then I thought there's like a way to kind of
hook up those as the collection cups to the spectra.
So I maybe it's the material, right, Like, maybe it's
the silicon. So I bought this adapter and tried that
(33:04):
to see if my breast just responded better to the
silicone material but still having the wall pump section, and
that didn't really get me anything so or not anything
like noticeable or good. So I basically, yeah, I mean
maybe it's the idea of like with the wearables, I
can feel a little bit more like I'm just somebody
(33:25):
who really likes to be like productive, especially at time
right in our lives where it's like everything is just
so crazy. That variables, I can like pop those on
and be like I'm putting the dishes away, and like
that is really stress relieving to me. And then I'm
also working what's happening. I know people say like, don't
(33:45):
watch the pump when you're doing it. I actually find
with the wall pump at least the least amount of
stress when I am watching it because I'll like do
compressions or watch it and then like if I see
a stream coming out, then I'm like, nice, this is
better look at it.
Speaker 3 (34:06):
Yeah, than yeah, that makes sense. Yeah, whatever is making
you feel the least amount of stress is what you
should do, which is why you know, do I think
you should conduct a little experiment. I think you should
go like three days and do you know, choose what
you want to do first, but one day of just
(34:27):
the wearables and track your twenty four hour total, another
day of like three days in a row, right, because
sometimes we need to let our body catch up to
what we're doing. Another day with double pumping with the thirteens,
(34:47):
and another day with single pumping with the thirteens. So
three sets of three three days, so like, go for
like a week and a half. Now, let's say you
get to the second day of one and you're noticing
really reduced output, then.
Speaker 2 (35:01):
You can stop that experiment, right.
Speaker 1 (35:03):
I think I'm just going to ask, like, I guess
my fear is I'm like, okay, what if I did
that with the wearables for example, But it's really not
good at emptying me, and then I'm like risking my supply.
Speaker 3 (35:13):
Yeah, So if you get to a point where you're like, ah,
this is scaring me, then just go back to what
you normally do.
Speaker 2 (35:18):
Right.
Speaker 3 (35:18):
But if you're if you're noticing, oh, you know, it
does seem like it's pretty similar, then collect more data.
Speaker 2 (35:25):
Right.
Speaker 3 (35:27):
So that's a step that we can take to see
is there anything that can be improved with just the pumping.
The other thing I will say is if you are
using a seventeen insert on the wearable, but you're measuring
like like the thirteen feels really comfortable, then you probably
want to get a thirteen insert for the wearable and
(35:49):
you may see significant increase.
Speaker 1 (35:51):
I will say the wearables, I don't know if it's
because it's but that wouldn't really makes sense. I was
gonna say, I don't know, I it's because it's less suction,
but it's a different type of section or it feels
different at least they are that's my most comfortable like
experience the seventeens. So I never know like why that
(36:12):
would be the case.
Speaker 3 (36:14):
It could be because it's lower section. Like it may
be that you're pumping it up and even though it's
like fine, it may be that you want to back
it down a little okay, So experiment with that too, right,
like you know what is the even just like closing
your eyes and moving it down, not looking at the number,
(36:37):
and like really trying to tune into your body to
see what feels the best, because discomfort again inhibits the
release of oxytocin.
Speaker 2 (36:46):
Yep.
Speaker 3 (36:47):
So if that's your most comfortable pump, you may see
if you can get the right size. You know, those
are going to be like I don't know, nine bucks
on Amazon, or go on a mom group and say,
does anybody have thirteen millimeters inserts? Because people buy those
kits that.
Speaker 1 (37:06):
I bought a kit and I don't think it went
as small as thirteen. It definitely didn't because this is
the first time I've had thirteen's. But even with the fifteen,
I put that in the wearable but it only weirdly
the kit. I don't know, like what the point of
the kit is if you're gonna they only give you
one of each size, so like I only had one.
(37:29):
It's weird, right, Yeah, But so I did test out
both just to see if, like I would get like
drastically different I will put on the side the head
the fifteen. But again, like there's just so many variables
that like, so I didn't get drastically different output. I got,
you know, the same, more less than what I would
normally think I would get. But I'm like, but that
(37:50):
could just be like that breast that day wasn't, which.
Speaker 3 (37:53):
Is why it's better to do, you know, do something
a little more systematic, a little more consistent. And sometimes
people think, Okay, if I just go smaller, my supply
will be better if I need a smaller size. But
sometimes going smaller if it's not small enough, can actually
(38:14):
have the opposite effect. Oh interesting, yeah, yeah, because it
you know, it can kind of pinch the memory glands
as they're coming into the tunnel in just a different
way ye, because if any areola is getting into the tunnel,
it's going to create It's like squeezing a hose, you know,
it's going to make it to where the milk can't
(38:35):
get out.
Speaker 1 (38:36):
The goal is to have I mean, yesterday she this
woman saw the thirteen and said she thought that looked
better as well. But the goal is to have basically
not any areola in the tunnel right in the most parts.
Speaker 2 (38:52):
So here's the deal.
Speaker 3 (38:54):
Fland sizing is part science, part are So the goal
is to find the size that produces the most amount
of milk in the least amount of time with no discomfort,
which really sucks because it means trying multiple sizes. Now,
(39:20):
we have found that for most people, when there is
no areola coming into the tunnel and you use a
little lubricant to allow the nipple to really slide in
and out, that that is the size that produces the
most amount of milk and the least amount of time
with the most amount of comfort. But when I do
faland sizings, if I measure you at a fourteen, I'm
(39:42):
going to try you in a twelve, a thirteen, or
fourteen of fifteen to sixteen and a seventeen, and we're
and I might even leave you with three sizes because
you need to figure out sometimes that we see it
in that one session right away. Other times, especially if
your nipples are inflamed for any reason, we what we
(40:04):
see needs to happen is you might size at a twelve,
but if you've been using a seventeen, then we need
to get you into a sixteen, and then into a
fifteen and then into a fourteen slowly because we have
to the tissues.
Speaker 2 (40:22):
Are inflamed internally.
Speaker 3 (40:24):
And so we have to let your body adapt to
the correct size.
Speaker 1 (40:29):
I mean, I will say, like when I line myself up,
like ready to pump, the thirteen, looks like my whole
nipple is in the tunnel and like maybe a little
bit of space but not really. But then once they
start pumping, I mean it does, it does like fill
and like rub up against the side. But I like always,
(40:53):
I mean, like my nipple always gets like far larger
when I'm pumping.
Speaker 3 (40:57):
Which is why you probably need to go smaller in
the flint size, right, okay, because it's going to fill
that space. It's going to fill the space that's available.
Speaker 1 (41:09):
Book was when I take my wearables off, My nipples
are like bigger than when I'm doing the wall pumping,
which I have a size smaller or.
Speaker 3 (41:18):
Right, and it can it can stay inflamed, like the
capillaries inside.
Speaker 5 (41:25):
The areola and the nipple.
Speaker 3 (41:26):
They they get damaged with it with lots of pumping
and incorrect sizes. And so that's why sometimes even if
I measure somebody at a thirteen, like they can't go
straight to a thirteen, or I might measure them out
of fifteen, but once they get into the fifteen, now
they're going to measure out of thirteen because there's that
(41:48):
inflammation is healing, but it's not going to heal overnight
or in one pumping session.
Speaker 1 (41:53):
You know what, It's really interesting because I think that
the like tingling that I was talking about was happening
most frequently, Like it wouldn't happen right away after, but
it would be like an hour after I would pump
was happening most frequently, like when I was using my
wearables quite a bit. So I do that's just the
(42:15):
size is too big.
Speaker 3 (42:16):
Yeah, yeah, I would definitely see if you can get
a I can send you a link to one that
has doubles for all the sizes, if that's helpful.
Speaker 1 (42:25):
Yeah, well, I thought, like, I don't know, I just
picked I don't know.
Speaker 3 (42:29):
Some random I know, there's so many to choose from whom.
Speaker 2 (42:32):
There would have been to that's annoying. Yeah.
Speaker 3 (42:35):
Yeah, so I am interested in this now. The other
thing I want to talk about when we talk about
milk supply is I want to talk through your blood
work that you had.
Speaker 2 (42:47):
Yeah.
Speaker 1 (42:48):
I had blood work done because well, one I was
just like I was just like grasping at anything to
try to figure out what was going on. And with
this thyroid stuff, I had read like thyroid can be
something that can affect milk supply, and I had like
a questionable thyroid screen in my first trimester. It was
(43:13):
like a little my TSH was a little high and
it ended up being I think we checked it again
later in the first trimester and then again my second
trimester and it ended up being fine. But with like
the wonkiness of it, I was just like, we might
as well check it. So I wanted that to be checked.
And then I also wanted I had a postpartum hemorrhage,
(43:36):
like immediately after birth, and so I wanted to check
like my iron levels, I guess, just to make sure
because that was the other thing I had read could
be affecting supply.
Speaker 3 (43:47):
Yeah, so what did you find out?
Speaker 1 (43:50):
I mean, everything looked normal.
Speaker 3 (43:51):
So tell me what normal was on the labs.
Speaker 1 (43:55):
So for my TSH, My, it's funny, it's it's actually
lower than I've ever had. I've had SIROI tested like
quite a few times. My mom's side has thyroid problems,
so I've always just sort of advocated and asked for
it every now and then. But it's lower than it
had ever been. It was one point sixty six, which
(44:17):
mine are usually not that mine's not usually that low.
Speaker 3 (44:20):
As you can hear, Catherine has a lot going on.
She encountered so many difficulties and was trying really really
hard both to increase her milk supply and to get
her baby latching so that she could body feed more regularly.
Speaker 2 (44:36):
So come back next week and you are going.
Speaker 3 (44:39):
To hear part two, where I offer solutions to her difficulties.
In this first part, I do a lot of listening,
information gathering, making sure that I understand the full picture,
because as a clinical lactation consultant in IBCLC, I have
(45:00):
to really understand the individual difficulties and try to uncover
the root causes, and so offering solutions right away does
not always lead to understanding what might be at the
heart of the difficulty being experienced. So, with that being said,
come back next week and listen to part two of
(45:22):
Catherine's story
Sometimes when I'm pumping a lot, if I've pumped a
lot over the course of a day, or just like randomly,
I will get like almost like a burning or like
a like a tingling feeling on my nipples. But I
just just didn't, like I have really sensitive skin. I
just just do and like they're kind of red, and
I just assume that it's that I've tried like every
flange size under the sun. I was fitted at a fifteen,
(00:23):
and that's mostly what I've been using. But I do
get like a decent amount of areola that like gets
pulled in with that, so I under the thirteen.
Speaker 2 (00:34):
It's Low.
Speaker 3 (00:35):
I'm so glad to be recording again. Welcome to my podcast,
Low's Lactation Lab.
Speaker 2 (00:41):
It has been.
Speaker 3 (00:42):
Nearly a year since I put out an episode, but
I am back and ready to explore the highs and
lows of feeding our babies in such a way that
helps you, the listener, feel as if you can make
the right choices for your baby and for your body
given your u situation.
Speaker 2 (01:01):
There is no better.
Speaker 3 (01:02):
Way to come back to the podcast than with a
recording of a telehealth consultation in which I helped Catherine
explore the underlying root causes of what was making breastfeeding
her baby so challenging. Catherine had a seven week old.
Speaker 2 (01:20):
She had seen several other.
Speaker 3 (01:22):
Lactatian consultants and was trying to figure out why was
her baby.
Speaker 2 (01:26):
Not transferring very much milk.
Speaker 3 (01:28):
And what were the causes of her low milk supply.
Speaker 2 (01:33):
Even when pumping, you.
Speaker 3 (01:34):
Will hear that we just dive right in to the consultation.
She had a crying baby right when we got started,
and so I just hit record and she started latching
her baby. That's sometimes what it's like when we have
a telehealth consultation and we're dealing with itty bitty babies
who just need to get going on their feeding right away.
(01:56):
So enjoy this episode and all the ones that are
to pump as we tackle the challenges and the joys
of feeding our babies. So let's go ahead, and you
can just latch her how you normally would.
Speaker 4 (02:12):
Okay, okay, okay, okay, okay, okay, okay, hold.
Speaker 1 (02:24):
Wokay can you sing? Yeah?
Speaker 3 (02:30):
And this is the side that feels better.
Speaker 1 (02:35):
This side I feel like pumps more readily when I pump,
never had as much like nipple damage. When she was
originally using the nipple shield, and I currently think I
have a clog duct on the other side. So yeah,
this was just my go to. But for what it's worth,
(03:00):
I just revisited our lactation consultant at Cooley who where
that's where I delivered yesterday, and she basically we did
a weighted feed and she just doesn't transfer milk. Basically.
It seems like she like, I think that she did
(03:20):
this for.
Speaker 2 (03:22):
I don't know.
Speaker 1 (03:23):
It always doesn't feel that long when we're taller, I'm
talking with someone, you know what I mean. I don't
feel like she did it for more than ten minutes.
But then she said she got my gosh, I've got
I've done this so many times that I can't remember.
I think she said was like a third of an ounce.
I think that's what you said, A third of an.
Speaker 3 (03:44):
Ounce, zero point three ounces.
Speaker 1 (03:48):
No, I don't know, like a like a third of
an ounce, so like point three to three.
Speaker 3 (03:53):
Right, Yeah, that's what I just said, zero point three yeah, yeah, okay, okay.
Did she word it like a of an ounce or
that's how your brain translated it?
Speaker 1 (04:03):
She told me MILLI leaders and then I okay, and
then got it. I obviously didn't know, so I think
she then translated okay, maybe okay.
Speaker 2 (04:12):
Yeah.
Speaker 3 (04:12):
I was like, that's a weird way to like say
what the transfer was.
Speaker 2 (04:16):
Okay, now I get it, okay.
Speaker 1 (04:19):
But like she what she had commented on, which I
don't know if you can see. She well, first of all,
she typically when she last years like she feels very
like chompy, but we had done something that made it better.
I think it was really just pulling her chin down,
which again, like I never know how I would be
doing that when I'm when I'm holding her and holding
(04:40):
my breast and like you know what I mean, but
to try to get her latch deeper, although it looks
like now I can see it because I have a
camera in front of you, but it looks like I
think her lips and I don't know. Well, first of all,
she always like she's asleep right now. She always like
kind of falls asleep really quickly. She suggested that she
he has like no ties or anything, but oral dysfunction, essentially,
(05:06):
like she didn't like she doesn't utilized like the the
latch is able to be fine, and she said the
tongue movement is fine, but like the suck is not basically,
I don't know. I think that was there was so
much inf like I've gotten so much, I've gotten so
much information.
Speaker 2 (05:28):
Was she able to name what the cause?
Speaker 3 (05:32):
Like there's always an oral dysfunction is a symptom, right,
so is she able to say what she thinks the
cause of the oral dysfunction is?
Speaker 1 (05:41):
Okay, So here's what I walked away from that. I know, honey,
from that that meeting with that, there was like the
dual situation, I know. And so she like she gets aggravated,
I think honestly because there's not a lot of milk coming.
Speaker 3 (05:58):
Out now if you were to compress.
Speaker 1 (06:02):
Sometimes I can never tell. Oh, that's the other thing
is I don't know if you can tell. But she
does a lot of like sucking without swallowing.
Speaker 3 (06:11):
Right, I was trying to watch. We may need to
be silent for a second so I can listen as well.
Speaker 5 (06:21):
That was a swallow. That was a swallow. That was
(06:43):
a swallow.
Speaker 1 (06:44):
And so that's the thing, is like she'll swallow like that.
But then and then this woman said she was like
I weighed her because I just thought, well, maybe she's
taking really big gulps or something. Not a ton of swallows,
but bigger gulps. But then the way the weighted feeds
never show anything other than like a really small amount.
(07:06):
So I walked out of that meeting with a couple
of things. She wants me to pump more, which I
guess to like get up my supply, which just feels
daunting in and of itself. That way pumped me times
a day, and I've never been able to raise my
supply from the average of like one after and I've
(07:29):
been doing this for however many weeks at this point,
and she so that was on my end, and then
on her she wants me to do some like oral
exercises with her where I like stuck my finger and
like touched her like palette and then did the same
thing sort of with the pacifier. I can't I can't
remember honestly what the goal of was the pacifier was,
(07:51):
but just training her to collect, I guess. And then
this was the weird part that I was like, I
was so excited that I was talking to you today,
but I like, I don't, I don't understand this part.
But her major takeaway was that we should be feeding
Annie like with bought when when we feed because we
only feed her bottles at this point. We don't do
(08:12):
this because if she's not getting anything, what's the point she.
Speaker 2 (08:17):
I know, I know, and you.
Speaker 1 (08:18):
Can't see her like legs, but she like kicks around
like she's like unsettled. So we only feed her bottles,
and so we feed her three ounces every I mean
basically on demand. But like during the day it's usually
like two to three hours, unless she's been sleeping and
it's a little bit longer. And during the night it's
(08:39):
like if she wakes up, we feed her, but otherwise,
like well we'll cap her out at like five to
six hours because that's just what our pediatrician told us
to do. But so that's what she takes in and
I know, tell me when you want me to stop her.
(08:59):
And that was the other thing is the PDF, I mean,
the Latian Consulate yesterday asked, I know, asked, like when
does she like show you that she's had enough? Like
how does she does she like pop off?
Speaker 5 (09:09):
What does she do?
Speaker 1 (09:10):
But she's literally never done that. She doesn't like, she
doesn't like pop off the breast unless she's really angry.
She just kind of stays on it. But anyway, so
The major takeaway she.
Speaker 2 (09:21):
Had was she, I know.
Speaker 1 (09:27):
This is where I like always presume that she's just
not getting milk.
Speaker 4 (09:35):
Uh, I, what.
Speaker 3 (09:50):
Is there a place in your breast that you feel
the most amount of milk, like a quadrant, Like if
you are pumping and you're and you compress, is there
a place where like, oh you see a little bit more?
Speaker 1 (10:06):
It varies, It's never it's it's really on the inside here.
It's usually more on the outside, unless I sometimes like
have like sometimes I do get clogs here for some reason.
I don't know if that's I mean, my understanding is
that that's not related to milk, but I don't know. Okay, okay, okay, okay, wine.
Speaker 6 (10:37):
Yeah, yeah, and if you compress on the outside.
Speaker 3 (10:50):
And then yeah, if she's upset after you try to
compress a little bit on the outside, you can let
me see me.
Speaker 4 (10:57):
Seem okay, okay.
Speaker 1 (11:16):
Yeah, it just doesn't seem like.
Speaker 3 (11:17):
Yeah, yeah, do you want to get her off to
dad so she can have a bottle? Okay?
Speaker 1 (11:23):
So yeah, So just what just to kind of briefly
wrap up what I was saying about the Yeah, so
she her major thing that answers your question about like
what she said the cause of the world this function
was was that she she feels as though Annie's almost
(11:44):
seven weeks, she feels as though she should be taking
in four ounces at a feed instead of this three
that we give her, and that we should go up
a nipple size and the bottle, because she watched me
feed her from the bottle, and she said like she
(12:05):
was I forget if she was getting sleepy when she
was feeding from the bottle or oh no, I'm sorry
she was not taking a lot in at once. But
we had always fed her that way purposefully because that's
what I had thought, like paste feeding was all about
in terms of like mimicking the breast. Now, granted, obviously
I wasn't breastfeeding, or I haven't been breastfeeding, so I
don't know what I've been doing that for. But we
(12:26):
also she's just like super refluxy all the time, so
we just thought that that was best. But so her
take was that to get her the milk faster and
to not tire her out so much and to give
her more food was going to make her stronger so
that she could I'm not sure. Like That's where then
I started to get confused, because then I was just like,
(12:49):
I don't really know how that's related. It feels like
you're actually teaching her like to work less hard with
the faster nipple flow. So we did it as soon
as we got home from the appointment, and then I
did it all day today, my husband and I because
my husband feed her overnight, but and by middle of
(13:09):
the day to day like she had spit up so
much over the course of like like multiple tablespoons over
like four to five times after her feed that I
was like, I'm just done with this. But this just
feels like too much. But it is tricky because after
we feed her three ounces, she seems like she's still
(13:29):
she's just a fussy, colicky baby, I think. And so
she sees she doesn't seem content, Like she seems like
she's either still hungry or just angry. I'm not sure,
but she doesn't seem super content. And so she took
the four once and haway. She seemed more content after
(13:50):
the four maybe, I guess. I don't know. I think
I would have to do it for longer, but she
was spinning up so much more that I was just
like we had with three. We had gotten to a
point where she did not typically spit up a large
amount after the feed, and this and I don't know
if it's because of the pacing, the faster pacing, or
(14:12):
the more liquid, but this felt it. She was just
generally like lots of split up today, very like just
seemed uncomfortable, like lots a lot more gassy than normal.
And just with the fact that I couldn't understand why
that guidance would make any sense for improving her like
(14:32):
function of her mouth, I just was like, we'll just
not do that for now. Yeah, I mean, I ask
the pediatrician because I said, because I all, I never
want to be like starving her. I'm like, of course,
if if someone thinks that she should take four ounces
at this point, then great, I'll happily give her that,
But I just the spitting up and like, I don't know,
(14:53):
she's she's been small, like her her weight has been
the whole sort of thing that started all of the
So there is like a real fixation that's been happening
on her weight, which is not frustrating because obviously, like
you just you, that's how they correlate health. At this point,
I feel like with babies, but.
Speaker 3 (15:12):
Our whole lives really, right, like they focus so much
on especially as women.
Speaker 1 (15:17):
Yeah right, right, So so yeah, so that's the summary
of what I've been dealing with over the last you know,
like thirty six hours, which has just sort of added
an extra layer of like confusion. I mean, it was
nice to hear that she didn't think she had ties,
because at this point now two ibclc's have said that
(15:37):
they don't think she has ties, so I'm assuming that
must be true.
Speaker 3 (15:42):
But yeah, yeah, yeah, So you mentioned in your intake
form that you feel like she has a lot of
symptoms of ties, So it sounds like you've done a
little bit of research about that. Tell me some of
the things that have made you wonder and ask seek
(16:05):
out advice from professionals about I've heard a few. I've
you know, I red flags are going off in my mind,
even though other people have said, no, that can't be.
But even with the oral dysfunction thing, there's always a
reason for oral dysfunction. So saying that there's oral dysfunction,
(16:26):
it's kind of like, yeah, of course there's a oral dysfunction.
She can't feed at the breast, she can't transfer milk
like she's struggling to gain weight and that's literally a
baby's only job. So like, yes, there's oral dysfunction, but
why And if somebody can't say why, then I'm like, eh, yeah,
we need to And I'm hearing that she's saying, yeah,
(16:47):
her tongue needs to improve, But what is making.
Speaker 2 (16:51):
It so that that can't happen.
Speaker 1 (16:53):
Well, that's why I get confused, because if it seems
like she can latch, which it does at this point,
and if it seems like she can, granted she's a
little chompy, but she also hasn't had a lot of
practice at this point, right, like she had the first
two weeks where she was actually breast fading. She was
using the nipple shield, and so she's a little chompy,
(17:17):
but like when I adjust her, it's you know, it
doesn't necessarily feel like the sucking that people say it
should feel like. It does feel a little bit more
like this, And I notice, like my nipples a little
flat when it comes out. But she can latch, and
she's on there and we can hear swallows, right, So
I always go back to like, is it not just
(17:37):
I get that it's all sort of cyclical, but is
it not just more related to my milk supply. Like
that's what I assume if she doesn't have ties, which
to answer your question, like all of the things that
I was thinking of with the ties, I mean, it's
all the stuff that you had said, right, it's like
the low milk transfer. It's it's like the low output
(17:58):
that I have because of that. If it's because of that,
it's the like the chompiness at at the breast, the
flattening of the nipple, the she doesn't like open her
mouth really wide. And what was the other thing, Oh,
(18:19):
just in general, like I had read that it was
like reflux fussiness, that sort of thing can annow, I mean,
that can be just because or it can be attributed
to ties, I thought. But there's a lot going on.
I mean, we feed her, we feed her formula, so
(18:39):
I don't know if there is a level of it
just doesn't sit well with her stomach. Like we've never
I've never been able to produce enough to give her
all breast milk for a day to know, So it's
that's tricky. And yeah, but I fundamentally, if she doesn't
(18:59):
have ties, and if like her latch is okay and
she's sucking and swallowing and all of that. I fall
back on. It has to be something with what's going
on with me, just because even when I pump, like,
I don't think that I have like a normal output
(19:19):
or like pattern of pumping. Like I get't let down.
I don't think it's just like kind of drops. Sometimes
I'll get like a stream or like a spray. It's
hit or miss. Some pumps. I get some pumps I don't.
Sometimes it comes on after compression. Sometimes it just happens
(19:40):
on its own. Only I only pump in the I
think it's the stimulation mode master mode, because that's what
I've found like gets me more or like really anything,
And I do it at like the highest sunction my
(20:01):
that my pump has.
Speaker 2 (20:04):
Are you in any pain when you're pumping?
Speaker 1 (20:07):
No, okay, no, I mean sometimes like afterwards, I don't
know it's it's intermittent. But sometimes when I'm pumping a lot,
if I've pumped a lot over the course of a
day or just like randomly, I will get like almost
like a burning or like a like a tingling feeling
(20:29):
on my nipples. But I just just didn't, like I
have really sensitive skin. I just just do and like
they're kind of red, and I just assume that it's
that I've tried like every flange size under the sun.
I was fitted at a fifteen and that's mostly what
I've been using. But I do get like a decent
(20:51):
amount of areola that like gets pulled in with that thirteen.
I I don't know. I showed I showed that yesterday,
well the thirteen verses of fifteen, because I had just
gotten the thirteen in and the thirteen she said looked better,
she thought, which I agree, it looks more. It looks
closer to like just nipple being in the tunnel. But
(21:16):
it seemed like I wasn't getting a lot of output
with the thirteen, although then like last night, it was
the reverse and the thirteen was getting more than the fifteen.
Speaker 2 (21:27):
Like, I don't know.
Speaker 1 (21:28):
It just is all so like there's no rhyme or
reason to it, which is the hardest part for me,
because like if I just knew what I could do
to improve the situation, then I would just do it.
But that's the general pumping.
Speaker 3 (21:43):
Okay, So there's a couple of things you're trying to
sparse out here, like what's going on with milk supply,
because even if baby can't transfer milk efficiently, you're pumping
sufficiently to be able to have more supply. I'm interested
in this idea of the fifteen between the fifteen and
(22:03):
the thirteen, but I want to get a little bit
more information. You said you pump about eight times per day,
and you're getting about one to one and a half
ounces per pump.
Speaker 5 (22:16):
Is that right?
Speaker 2 (22:17):
Yeah?
Speaker 1 (22:17):
Sometimes sometimes it's less than one, sometimes it's two. It's
never really more than that. I mean part of me
too though this is so sorry, this is like sidetracking.
But if I am getting two ounces, let's say, or
I'm sorry, one ounce one and a half ounces, shouldn't
she at least be able to transfer that? Like that's
(22:39):
where I get confused about is it a her thing?
Speaker 4 (22:41):
Then?
Speaker 5 (22:42):
Not necessarily?
Speaker 3 (22:43):
Right, Like we expect babies with good oral motor function
to be able to transfer better than a pump.
Speaker 1 (22:50):
Right, That's what That's what I read. So that's why
I was okay, if I'm at least getting right, you know,
to get more.
Speaker 3 (22:56):
That's why I do think this is a dual issue,
which was your instinct right, that it's both something going
on with her and something going on with your supply,
and what it takes is kind of working on one
like creating building blocks to like, Okay, let's figure out supply,
let's figure out the oral dysfunction, and let's try to
(23:19):
build one upon the other. Now you expressed kind of earlier,
you kind of said offhanded, based on going back to work,
that is it even worth putting a lot.
Speaker 2 (23:28):
Of effort in.
Speaker 3 (23:30):
And I do think that we can at least get
to the bottom of root causes, and then once we
know root causes, it is possible to improve the situation.
I've seen that happen.
Speaker 2 (23:44):
It's not too late. I've seen that happen many times.
Speaker 3 (23:47):
But sometimes it takes more work than what it feels worth.
Speaker 2 (23:51):
It to you to do.
Speaker 3 (23:53):
And I can't answer that for you.
Speaker 2 (23:55):
Nobody can.
Speaker 3 (23:56):
You know, it has to be you that says, okay,
based on what we've discovered, do I want to keep
going or is it time for me to make a
different decision? And I am so happy to like help
you along the way to figure out you know, the
next right step at any given point. But I do
think we need to figure out this oral dysfunction thing,
(24:18):
and the milk supply thing. So I'm gonna stick with
the pumping for just a second. How long does your
typical pumping session last.
Speaker 1 (24:26):
I usually so I have two things going on. I
will use my Spectra my wall pump when my husband's
not working basically, and so when I do that, I
do a single sided pump because I find that when
I do it double sided, the section is like so poor,
(24:49):
Like no, I shouldn't say so poor, but it's it's
notably less than if I just have one plugged in
with the Spectra.
Speaker 3 (24:57):
Yeah, that should not be the case.
Speaker 5 (25:00):
Okay.
Speaker 1 (25:00):
I was like googling it and the Spectrum website, well
the Australia Spectrum website, but the Spectral website said that
like when you have both plugged in the port, the
section is going to be like split, so you're going
to get less than you know what I'm saying. That's
what their site said. I don't know because I was.
I finally was like, this can't be right, Like do
I have to call that it was a new machine,
(25:21):
you know, but it I feel like I get better Spectrum,
but I only have one plugged in, so I mean,
I'd love to be able to do the same time.
But I typically have been having one plugged in and
I'll do it for like twenty minutes, and then if
I'm in the middle of like because I don't get
those like streams a lot, if I do have one,
(25:43):
I'll keep going for a couple more minutes than that,
and then I go to the other side, which is
like that's just super taxing because it's a super long
pomp session. And then my wearables is that's what I
use during the day, which I know we're always as
good here they like sometimes they'll have better sessions with
(26:05):
those were as good, like they basically give me the
same amount of milk, and those ones I just do
for thirty minutes because it's like the auto shut.
Speaker 2 (26:17):
So that's kind of why I've went on.
Speaker 3 (26:18):
Now, I and are you using fifteen milimeter inserts.
Speaker 1 (26:24):
With the wearables, I'm actually using seventeen just because that's
the smallest that came with them, and they're like silicons.
Is it the Zomi No, it's the mom Cozy S
nine something per S nine per.
Speaker 3 (26:39):
Okay, So I would love to see, uh where it
says that on the Australian Spectra website.
Speaker 1 (26:46):
Yeah, do you want me to find it?
Speaker 3 (26:47):
Yeah, yeah, yeah, I worked for Vital Milk breast pump distriber.
Speaker 2 (26:52):
I still work for her on Mondays.
Speaker 3 (26:55):
Uh breast pump, an insurance covered breast pump distributor, and
uh for like it's been like six years now.
Speaker 5 (27:02):
And I've never heard this before.
Speaker 3 (27:05):
And all of the evidence shows that double pumping produces
more milk than single pumping. So I'm wondering if there's
like something going on with your pump.
Speaker 1 (27:15):
Yeah, that's what because like everyone's like, yeah, like double
stimulations better obviously.
Speaker 3 (27:21):
And yeah, having to pump forty plus minutes eight times
a day, that's like a lot, a lot. I could
imagine that if you are using super high section and
you are.
Speaker 1 (27:33):
Well, that's my problem is because I'm I because I
just use stimulation mode. I do it at the five,
so that's when I single pump, but that's the highest
It lets you go for the stimulation mode for the spectra.
So then when I with them, when I double pump
that I can't go any higher than that.
Speaker 3 (27:55):
And are you noticing, like do you notice an actual
reduction in milk out put?
Speaker 1 (28:01):
Yeah? Well yes, and no, I haven't double pumped in
so long, so I double pumped yesterday. But I also was, like,
I wore Annie the day before, so I had like
a bunch of what I think were like irritated dusts.
So I assumed that was why I like did not
produce a lot of milk yesterday at all. I actually
was like kind of freaking out. But I think it's
(28:24):
gotten back to normal, but so I couldn't tell I
guess is Okay.
Speaker 3 (28:30):
Now, there's a few things with pumping.
Speaker 2 (28:35):
That I'm curious about.
Speaker 6 (28:38):
Uh.
Speaker 3 (28:40):
One is the fact that you do feel kind of
a sensation afterwards, like you know, you described it as
like a burning or a just like a discomfort, And
I do think that that is telling us that something
could be improved with pumping, because, uh you really, even
(29:02):
for people who have sensitive nipples and digits and skin
in general, ideally you would not be experiencing any lingering discomfort.
Speaker 1 (29:14):
Yeah, and so I haven't tried the thirteens for very long,
like literally I got them in the mail yesterday.
Speaker 3 (29:21):
So and are they hard for land or are they
silicon insert?
Speaker 5 (29:27):
They are hard, okay, all right?
Speaker 1 (29:29):
Yeah, the only difference about them is that they're still
from like the they're like the main mom My fifteen
is a hard just regular one. This one is still hard,
but it's like it's they're like the crater. I don't remember, No,
it's the panel, okay, yeah, yeah, what's larger? Because in
(29:50):
my mind too, I was like, because I can't get
my nipple anywhere close to the insert, like of the tunnel,
I assume just because I have like a lot of
rest tissue. So what I thought these ones, I was like, well,
maybe if it's like opens up more, I can like
get myself in there more, which I think is valid.
Like I don't that has happened, so yeah.
Speaker 2 (30:12):
That could make a big difference. We see that different.
Speaker 3 (30:16):
You know, there's the crater, there's the piano, there's the traditional,
there's the silicone inserts, And we do see that some
people's bodies respond better to various shapes and configurations and
materials than others. The sucky part about that is insurance
only covers two total sets, and so then you have
(30:38):
to be able to put the money into it to
try the various stuff unless you're working with an LC
who has a bunch of parts for you to try.
And even then, like I carry around a bunch of parts,
but I don't have like every shape for every size
I need to it's just you know, it's hard to
get it all built up. So I'm interested in seeing
what would happen do that the thirteen's that pano shape for.
Speaker 2 (31:05):
A little bit.
Speaker 3 (31:06):
I think your instincts, you know, of trying to improve
the situation have been good. I do think going back
to the double pumping just for a little bit to
see can you get the same amount of milk in
half the time by just going back to double pumping. Yeah,
(31:28):
Also if the wearables seem to produce just as much
milk as the wall pump. For most people that's not
the case, but I do encounter people where it is.
And sometimes it has to do with stress, because anytime
you're feeling stressed, that inhibits the release of oxytocin, which
(31:52):
is what allows for that release, that milk release to happen.
So a lot of times if people super stressed while pumping,
which is a vicious cycle because pumping becomes stressful when
it's not going well, and then it goes back and forth.
But people will feel milk in their breasts and it
won't be coming out because they've got so much cortisol
(32:14):
flowing that they can't have the release of oxytocin. Do
you feel like you experienced that at all?
Speaker 1 (32:20):
Well, the only thing that would like make me think
that is so for it is tough to because pump
outputs can vary so much, it's tough to say definitively.
Like then I was getting in my head and I'd
be like, well, the wearable got me this much, but
how do I know, Like maybe on nap pump my
wall would have gotten me more, do you know what
(32:40):
I'm saying? So but regardless, for a while, I was like,
the wearables they're giving me just as much whatever. So
then I thought there's like a way to kind of
hook up those as the collection cups to the spectra.
So I maybe it's the material, right, Like, maybe it's
the silicon. So I bought this adapter and tried that
(33:04):
to see if my breast just responded better to the
silicone material but still having the wall pump section, and
that didn't really get me anything so or not anything
like noticeable or good. So I basically, yeah, I mean
maybe it's the idea of like with the wearables, I
can feel a little bit more like I'm just somebody
(33:25):
who really likes to be like productive, especially at time
right in our lives where it's like everything is just
so crazy. That variables, I can like pop those on
and be like I'm putting the dishes away, and like
that is really stress relieving to me. And then I'm
also working what's happening. I know people say like, don't
(33:45):
watch the pump when you're doing it. I actually find
with the wall pump at least the least amount of
stress when I am watching it because I'll like do
compressions or watch it and then like if I see
a stream coming out, then I'm like, nice, this is
better look at it.
Speaker 3 (34:06):
Yeah, than yeah, that makes sense. Yeah, whatever is making
you feel the least amount of stress is what you
should do, which is why you know, do I think
you should conduct a little experiment. I think you should
go like three days and do you know, choose what
you want to do first, but one day of just
(34:27):
the wearables and track your twenty four hour total, another
day of like three days in a row, right, because
sometimes we need to let our body catch up to
what we're doing. Another day with double pumping with the thirteens,
(34:47):
and another day with single pumping with the thirteens. So
three sets of three three days, so like, go for
like a week and a half. Now, let's say you
get to the second day of one and you're noticing
really reduced output, then.
Speaker 2 (35:01):
You can stop that experiment, right.
Speaker 1 (35:03):
I think I'm just going to ask, like, I guess
my fear is I'm like, okay, what if I did
that with the wearables for example, But it's really not
good at emptying me, and then I'm like risking my supply.
Speaker 3 (35:13):
Yeah, So if you get to a point where you're like, ah,
this is scaring me, then just go back to what
you normally do.
Speaker 2 (35:18):
Right.
Speaker 3 (35:18):
But if you're if you're noticing, oh, you know, it
does seem like it's pretty similar, then collect more data.
Speaker 2 (35:25):
Right.
Speaker 3 (35:27):
So that's a step that we can take to see
is there anything that can be improved with just the pumping.
The other thing I will say is if you are
using a seventeen insert on the wearable, but you're measuring
like like the thirteen feels really comfortable, then you probably
want to get a thirteen insert for the wearable and
(35:49):
you may see significant increase.
Speaker 1 (35:51):
I will say the wearables, I don't know if it's
because it's but that wouldn't really makes sense. I was
gonna say, I don't know, I it's because it's less suction,
but it's a different type of section or it feels
different at least they are that's my most comfortable like
experience the seventeens. So I never know like why that
(36:12):
would be the case.
Speaker 3 (36:14):
It could be because it's lower section. Like it may
be that you're pumping it up and even though it's
like fine, it may be that you want to back
it down a little okay, So experiment with that too, right,
like you know what is the even just like closing
your eyes and moving it down, not looking at the number,
(36:37):
and like really trying to tune into your body to
see what feels the best, because discomfort again inhibits the
release of oxytocin.
Speaker 2 (36:46):
Yep.
Speaker 3 (36:47):
So if that's your most comfortable pump, you may see
if you can get the right size. You know, those
are going to be like I don't know, nine bucks
on Amazon, or go on a mom group and say,
does anybody have thirteen millimeters inserts? Because people buy those
kits that.
Speaker 1 (37:06):
I bought a kit and I don't think it went
as small as thirteen. It definitely didn't because this is
the first time I've had thirteen's. But even with the fifteen,
I put that in the wearable but it only weirdly
the kit. I don't know, like what the point of
the kit is if you're gonna they only give you
one of each size, so like I only had one.
(37:29):
It's weird, right, Yeah, But so I did test out
both just to see if, like I would get like
drastically different I will put on the side the head
the fifteen. But again, like there's just so many variables
that like, so I didn't get drastically different output. I got,
you know, the same, more less than what I would
normally think I would get. But I'm like, but that
(37:50):
could just be like that breast that day wasn't, which.
Speaker 3 (37:53):
Is why it's better to do, you know, do something
a little more systematic, a little more consistent. And sometimes
people think, Okay, if I just go smaller, my supply
will be better if I need a smaller size. But
sometimes going smaller if it's not small enough, can actually
(38:14):
have the opposite effect. Oh interesting, yeah, yeah, because it
you know, it can kind of pinch the memory glands
as they're coming into the tunnel in just a different
way ye, because if any areola is getting into the tunnel,
it's going to create It's like squeezing a hose, you know,
it's going to make it to where the milk can't
(38:35):
get out.
Speaker 1 (38:36):
The goal is to have I mean, yesterday she this
woman saw the thirteen and said she thought that looked
better as well. But the goal is to have basically
not any areola in the tunnel right in the most parts.
Speaker 2 (38:52):
So here's the deal.
Speaker 3 (38:54):
Fland sizing is part science, part are So the goal
is to find the size that produces the most amount
of milk in the least amount of time with no discomfort,
which really sucks because it means trying multiple sizes. Now,
(39:20):
we have found that for most people, when there is
no areola coming into the tunnel and you use a
little lubricant to allow the nipple to really slide in
and out, that that is the size that produces the
most amount of milk and the least amount of time
with the most amount of comfort. But when I do
faland sizings, if I measure you at a fourteen, I'm
(39:42):
going to try you in a twelve, a thirteen, or
fourteen of fifteen to sixteen and a seventeen, and we're
and I might even leave you with three sizes because
you need to figure out sometimes that we see it
in that one session right away. Other times, especially if
your nipples are inflamed for any reason, we what we
(40:04):
see needs to happen is you might size at a twelve,
but if you've been using a seventeen, then we need
to get you into a sixteen, and then into a
fifteen and then into a fourteen slowly because we have
to the tissues.
Speaker 2 (40:22):
Are inflamed internally.
Speaker 3 (40:24):
And so we have to let your body adapt to
the correct size.
Speaker 1 (40:29):
I mean, I will say, like when I line myself up,
like ready to pump, the thirteen, looks like my whole
nipple is in the tunnel and like maybe a little
bit of space but not really. But then once they
start pumping, I mean it does, it does like fill
and like rub up against the side. But I like always,
(40:53):
I mean, like my nipple always gets like far larger
when I'm pumping.
Speaker 3 (40:57):
Which is why you probably need to go smaller in
the flint size, right, okay, because it's going to fill
that space. It's going to fill the space that's available.
Speaker 1 (41:09):
Book was when I take my wearables off, My nipples
are like bigger than when I'm doing the wall pumping,
which I have a size smaller or.
Speaker 3 (41:18):
Right, and it can it can stay inflamed, like the
capillaries inside.
Speaker 5 (41:25):
The areola and the nipple.
Speaker 3 (41:26):
They they get damaged with it with lots of pumping
and incorrect sizes. And so that's why sometimes even if
I measure somebody at a thirteen, like they can't go
straight to a thirteen, or I might measure them out
of fifteen, but once they get into the fifteen, now
they're going to measure out of thirteen because there's that
(41:48):
inflammation is healing, but it's not going to heal overnight
or in one pumping session.
Speaker 1 (41:53):
You know what, It's really interesting because I think that
the like tingling that I was talking about was happening
most frequently, Like it wouldn't happen right away after, but
it would be like an hour after I would pump
was happening most frequently, like when I was using my
wearables quite a bit. So I do that's just the
(42:15):
size is too big.
Speaker 3 (42:16):
Yeah, yeah, I would definitely see if you can get
a I can send you a link to one that
has doubles for all the sizes, if that's helpful.
Speaker 1 (42:25):
Yeah, well, I thought, like, I don't know, I just
picked I don't know.
Speaker 3 (42:29):
Some random I know, there's so many to choose from whom.
Speaker 2 (42:32):
There would have been to that's annoying. Yeah.
Speaker 3 (42:35):
Yeah, so I am interested in this now. The other
thing I want to talk about when we talk about
milk supply is I want to talk through your blood
work that you had.
Speaker 2 (42:47):
Yeah.
Speaker 1 (42:48):
I had blood work done because well, one I was
just like I was just like grasping at anything to
try to figure out what was going on. And with
this thyroid stuff, I had read like thyroid can be
something that can affect milk supply, and I had like
a questionable thyroid screen in my first trimester. It was
(43:13):
like a little my TSH was a little high and
it ended up being I think we checked it again
later in the first trimester and then again my second
trimester and it ended up being fine. But with like
the wonkiness of it, I was just like, we might
as well check it. So I wanted that to be checked.
And then I also wanted I had a postpartum hemorrhage,
(43:36):
like immediately after birth, and so I wanted to check
like my iron levels, I guess, just to make sure
because that was the other thing I had read could
be affecting supply.
Speaker 3 (43:47):
Yeah, so what did you find out?
Speaker 1 (43:50):
I mean, everything looked normal.
Speaker 3 (43:51):
So tell me what normal was on the labs.
Speaker 1 (43:55):
So for my TSH, My, it's funny, it's it's actually
lower than I've ever had. I've had SIROI tested like
quite a few times. My mom's side has thyroid problems,
so I've always just sort of advocated and asked for
it every now and then. But it's lower than it
had ever been. It was one point sixty six, which
(44:17):
mine are usually not that mine's not usually that low.
Speaker 3 (44:20):
As you can hear, Catherine has a lot going on.
She encountered so many difficulties and was trying really really
hard both to increase her milk supply and to get
her baby latching so that she could body feed more regularly.
Speaker 2 (44:36):
So come back next week and you are going.
Speaker 3 (44:39):
To hear part two, where I offer solutions to her difficulties.
In this first part, I do a lot of listening,
information gathering, making sure that I understand the full picture,
because as a clinical lactation consultant in IBCLC, I have
(45:00):
to really understand the individual difficulties and try to uncover
the root causes, and so offering solutions right away does
not always lead to understanding what might be at the
heart of the difficulty being experienced. So, with that being said,
come back next week and listen to part two of
(45:22):
Catherine's story
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