April 24, 2025 • 48 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 continuation of Catherine's lactation journey on "Lo’s Lactation Lab," host Lo sheds light on the complexities of low milk supply, breastfeeding difficulties, and potential underlying causes.
After reviewing Catherine's initial consultation and discussing her struggles with milk transfer and supply, Lo suggests further testing and interventions to get to the root of her challenges.
From potential thyroid imbalances to insulin resistance and tethered oral ties, Lo offers a comprehensive approach to managing these common yet often overlooked issues. Catherine shares her experiences and hesitations, making this episode a valuable resource for anyone facing similar struggles.
Key Topics:
Episode Highlights and Timestamps:
[00:00:00] - Recap of Catherine's breastfeeding journey and struggles
[00:01:40] - Discussion about Catherine's lab results and missed tests
[00:07:47] - The potential role of thyroid dysfunction and insulin resistance in low milk supply
[00:15:41] - The pros and cons of different supplements for improving milk supply
[00:21:22] - Discussion about oral motor dysfunction
[00:25:43] - Practical advice for new mothers dealing with breastfeeding difficulties
[00:33:40] - Lo’s recommendation on early intervention and IBCLC
[00:40:49] - Next steps for Catherine: Testing, supplements, and consultations
Follow the Host on:
Listening Links:
#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:
Check out my FREE guide on setting yourself up for breastfeeding success:
https://bit.ly/los-birthpractice-workbook
--------------------------------
In this continuation of Catherine's lactation journey on "Lo’s Lactation Lab," host Lo sheds light on the complexities of low milk supply, breastfeeding difficulties, and potential underlying causes.
After reviewing Catherine's initial consultation and discussing her struggles with milk transfer and supply, Lo suggests further testing and interventions to get to the root of her challenges.
From potential thyroid imbalances to insulin resistance and tethered oral ties, Lo offers a comprehensive approach to managing these common yet often overlooked issues. Catherine shares her experiences and hesitations, making this episode a valuable resource for anyone facing similar struggles.
Key Topics:
- The role of thyroid function and insulin resistance in milk supply
- How postpartum bloodwork can reveal hidden issues affecting lactation
- The impact of tethered oral ties on milk transfer and breastfeeding
- Exploring supplements that could help improve milk supply
- Navigating the healthcare system for additional support and diagnosis
Episode Highlights and Timestamps:
[00:00:00] - Recap of Catherine's breastfeeding journey and struggles
[00:01:40] - Discussion about Catherine's lab results and missed tests
[00:07:47] - The potential role of thyroid dysfunction and insulin resistance in low milk supply
[00:15:41] - The pros and cons of different supplements for improving milk supply
[00:21:22] - Discussion about oral motor dysfunction
[00:25:43] - Practical advice for new mothers dealing with breastfeeding difficulties
[00:33:40] - Lo’s recommendation on early intervention and IBCLC
[00:40:49] - Next steps for Catherine: Testing, supplements, and consultations
Follow the Host on:
- LinkedIn: https://www.linkedin.com/in/lo-nigrosh-16371495/
- Website: https://www.quabbinbirthservices.com/
- Facebook: https://www.facebook.com/lo.dandy
Listening Links:
- 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
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
When I did get pregnant, finally, I like really doubled
down on trying to like regulate my blood sugar. I
didn't have any indication that it was dysregulated, but I
just was, like, the thing that I really focused on
was increasing my protein intake, particularly in the morning, because
I really like good for blood sugar regulation. Is there
(00:21):
a relation to what you're talking about with that or
is that not the same?
Speaker 2 (00:24):
Before we begin, I want to share something special with
all of you expecting parents out there. As an internationally
board certified lactation consultant, I've seen firsthand how a little
planning can go a long way to helping you achieve
your baby feeding goals. That's why I'm offering you my
free ebook. It's called Birth Practices to Support Breastfeeding and
(00:48):
it's a workbook, So check out the link in the
description below. Hi, welcome back to Low's Lactation Lab. Last
week you heard the beginning of a telehealth consultation with
a patient named Catherine. In this consultation, we discover that
her baby has been having a lot of difficulty transferring
(01:10):
milk at the body, and Catherine has been relying on
exclusive pumping to feed her baby with bottles. She also
had the added complication of experiencing low milk supply despite
pumping regularly and using correct Flande sizes while pumping. So
(01:32):
now you are going to hear the part of the
consultation where I dive into offering individualized solutions for her
particular difficulties. And that is my job as your IBCLC.
What I do is take a lot of time to
uncover what is making things difficult for you and for
(01:53):
your baby. So listen in to hear the solutions I offered,
and then you're going to come back to a lay
episode as she updates us on what has happened in
the intervening months since we recorded the interview. Did you
also test free T three and free T four as
a part of that thyroid test, because those are the
(02:14):
indicators that really help us to understand if it's impacting
low milk supply.
Speaker 1 (02:20):
This she had only ordered the TSH, like and all
of my other thyroid screens, I've always wad a full panel,
or at least in pregnancy. I got the full panel, but.
Speaker 3 (02:30):
This was not that okay?
Speaker 2 (02:32):
Did it include Ferreton B twelve Sarah Myron.
Speaker 1 (02:37):
No okay, okay, it was just a CEC okay, okay,
all right, okay, So and it was one point.
Speaker 2 (02:47):
One point six six okay. Now tell me what your
other labs were again.
Speaker 1 (02:53):
For the CBC. I mean, like, I don't know what
what do you?
Speaker 3 (02:58):
Okay? It was it was the thyroid.
Speaker 2 (03:00):
You did the thyroid blood test and then anything.
Speaker 1 (03:03):
Else just just like a general CBC.
Speaker 3 (03:06):
Okay, and any anything come up in the CBC.
Speaker 1 (03:10):
Now, the red blood cell count was like moderately low,
hemoglobin was low, but the hematocrit was normal, on the
low side of normal.
Speaker 3 (03:23):
But and how much did you hemorrhage?
Speaker 1 (03:28):
Twelve hundred millions, mostly like lost through my tear, So
like as soon as she could stitch that up was
essentially okay.
Speaker 2 (03:36):
How and then tell me, are there other symptoms that
you have had that have made you think to get
your thyroid checked? No? Nope, all right, and.
Speaker 3 (03:52):
I would love to know.
Speaker 2 (03:55):
So I'm just gonna go through some uh, some other
symptoms that could be related to low milk supply. Do
you ever feel like some of these are kind of
hard when you're in the postpartum period, because it's like, yes,
I feel all of these and isn't that normal? So
(04:18):
I recognize that, but also it does sort of help
me to kind of sparse out.
Speaker 3 (04:24):
What would be the next thing you would want.
Speaker 2 (04:25):
To check to see if there is an underlying root cause. Okay, okay,
so so would you.
Speaker 3 (04:36):
First of all?
Speaker 2 (04:37):
Did you pass your one hour glucose test during pregnancy?
Speaker 3 (04:40):
Yes?
Speaker 1 (04:41):
Like very easily.
Speaker 3 (04:42):
Okay, very good.
Speaker 2 (04:44):
Do you feel sleepy like particularly after meals?
Speaker 1 (04:51):
No?
Speaker 3 (04:51):
Okay. Do you ever.
Speaker 2 (04:53):
Feel irritable or angry or shaky if you haven't eaten? U?
Speaker 1 (05:00):
No? Am I answering this like particularly in like this
postpartum time?
Speaker 2 (05:04):
Yes?
Speaker 1 (05:05):
Yes, yes, no, actually, like it's very weird. I don't
really have an appetite at all. Like I honestly don't
eat a ton. I know that's like that. That's one
of my biggest problems, is I like keep telling myself
like I'm gonna better today about hydration and eating. It's
just like hard when I'm taking care of her along
(05:25):
because I'll look up and it'll be one o'clock and
I'll be like, well, I've eaten like barely anything.
Speaker 3 (05:31):
Have you lost weight like more than you would expect?
Speaker 1 (05:38):
I don't think so, I mean, I don't know, I
don't know. I had gained about forty pounds in pregnancy,
and I pretty quickly lost like twenty of those pounds,
which I just assume was waterweight. But now my weight
has stayed consistent.
Speaker 2 (05:54):
Okay, okay, I like that twenty pound Yeah, so I'm
not like, yeah.
Speaker 3 (05:58):
Okay, okay, but you do have a decreased appetite, you
would say, okay, And do you think.
Speaker 2 (06:06):
It's a decreased appetite or just like eating is just
too hard?
Speaker 1 (06:11):
No, it's a decreased appetite because I don't like normally
I would be like, oh, I'm so hungry, and I
never feel hungry, like I eat meals because like I
should have it's dinner time. I guess I could have dinner,
but I almost never feel hungry.
Speaker 3 (06:23):
Okay.
Speaker 2 (06:24):
Any cold intolerance No.
Speaker 1 (06:28):
Like some days I had been walking around being like,
is it cold in here? It feels cold in here,
and my husband or my mom or I would be
around would say no, but that could just be really
normal too, like it would happen like not every.
Speaker 2 (06:42):
Day, you know. And then any constipation no, okay. Any
really dry skin or hair.
Speaker 1 (06:53):
Yeah, my skin got super dry, like immediately, I would
say like in like the two around maybe the two
week mark, hard, like my face was really dry. It
was just very weird, like I couldn't tell if I
was having an allergic reaction to something. It was just
like so sand papery, and so my skin is dry.
But it's also like it's winter and when now we
(07:16):
have the heat on high for her. And then the
only other thing is like my hands. I have like
like eggzema on my hand, which I've never had in
my life, but I think it's from washing bottles so frequently.
Speaker 2 (07:31):
So yeah, okay. Any hair loss no, okay. Any muscle
aches or stiffness, no joint pain, nope, okay. Slowed heart
rate not to my knowledge, okay. And forgetfulness or difficulty concentrating.
Speaker 1 (07:50):
Not anything that I think is outside the realm of
like normal for this current time.
Speaker 3 (07:57):
Okay, Yeah, I know, I don'd you. It's like a
little hard to sparse it out.
Speaker 2 (08:01):
And fatigue or weakness do you feel like that's no?
Speaker 3 (08:05):
Okay?
Speaker 2 (08:06):
And uh okay. So one of the things I would
be interested in hearing about or asking your doctor about.
Speaker 3 (08:15):
And I can send this to you. I have a
form that I create.
Speaker 2 (08:18):
But in order to understand thyroid function as it relates
to milk supply. We really do need to understand. We
need to get a full panel so T S H
T PO T three T four ft three ft four
reverse T three as well as cortisol, selenia, magnesium, ferritin,
(08:39):
and iron and because all of these can impact low
milk supply. If a person is removing milk regularly and
their milk supply does not increase, there has to be
a reason why. And we've you know, it seems like
you have sufficient glandular tissue. You've had no surgeries, no
(09:05):
trauma to the brasts, Your periods have been regular always
in your life or.
Speaker 1 (09:12):
No, they were pretty irregular for a long time, Like, uh, yeah,
I would say they were pretty irregular up until I
went on birth control. And then I was on birth
control for like now like twelve years maybe, and then
I was able to and I got off of birth
control and like go out myself pretty regular, Yeah, basically
(09:35):
until I got pregnant. Oh, I guess I should also
say I have I like maybe have endometriosis. They don't
really know. I definitively have it in my Like it's
really weird. It's in my belly button, Like, they took
a biopsy of it and they confirmed that it's there,
but there's there was no reason to like try to
(09:57):
see if it was anywhere else, just because there was
no way to do that without surgery.
Speaker 2 (10:02):
So yeah, okay, that's good to know. Do you have
any dark skin patches like on your neck, groin, or
under your breasts in particular?
Speaker 1 (10:15):
No?
Speaker 2 (10:15):
Okay, And have you ever been diagnosed with peacos.
Speaker 3 (10:22):
No, or wondered if you had it?
Speaker 1 (10:24):
No? I never really thought I did. I don't know why.
Speaker 3 (10:27):
Okay.
Speaker 2 (10:29):
Do you have any skin tags anywhere? Yeah?
Speaker 1 (10:34):
A couple.
Speaker 2 (10:34):
Okay, did you have any trouble getting pregnant? I know
you mentioned on being being on birth control for a while.
Speaker 1 (10:41):
I didn't have trouble. I don't think, I mean, like so,
I basically, but it's it's tricky because I got my
I got a biopsy of the weird thing in my
belly button in June. Then I got diagnosed with it
(11:01):
being endometriosis, which twofold like caused a lot of stress.
And then also they like you know, snipped off a
piece of this hormonal thing, right, So I don't know
what it was, but then my body definitely, like my
periods became a little bit more regular in those maybe
(11:23):
like June, July, August months, and so it took me
a while to have regular periods again. But I did
get pregnant in that January, so I basically was like
trying for six months. But I really at that point
had probably only had maybe like four cycles. But yeah,
(11:44):
I mean that that doesn't feel like too hard of a.
Speaker 3 (11:48):
Time, okay.
Speaker 2 (11:49):
And any losses no, Okay? Do you feel like you
ever have mood swings or have you been depressed or.
Speaker 3 (11:58):
Have you thought you might have depressure or anxiety?
Speaker 1 (12:02):
No? I mean I generally run quite high with anxiety, okay,
but like never enough in a way that's a diagnosed,
or like in a way that feels like it impacts
my quality of life.
Speaker 3 (12:16):
Okay.
Speaker 2 (12:18):
And any acne that seems like it's coming out of
nowhere or have you always struggled with acne?
Speaker 1 (12:26):
My skin has never been great, but in pregnancy it
got really bad. It could just be because I couldn't
use a lot of the products that I wasn't use,
but it definitely got pretty bad in pregnancy.
Speaker 2 (12:41):
Okay, Okay, So the thing that I if you wanted
to pursue seeing is there something that is impacting milk supply,
I do think it would be worth doing a full
panel for TSH and then doing some testing to see
if it could be peacoasts. Now I am not a
(13:04):
diagnostic provider, but I am a low milk supply specialist,
and pea coasts. You have enough symptoms that I would
suggest you bring it up with your provider. And insulin
resistance may be likely with peacoasts, and it's common to
have insulin resistance in the.
Speaker 3 (13:26):
Postpartum period.
Speaker 2 (13:29):
Starting them. So there is like a diagnostic hormonal profile,
and you can do some blood testing including a one
C fasting glucose fasting insulin and a metabolic panel and
a lipid panel. So before I go on, when I
say that that there could be some other things that
you could test for just to rule out any other
(13:52):
underlying causes. Does that feel more stressful.
Speaker 3 (13:55):
Or less stressful?
Speaker 1 (13:57):
It doesn't feel stressful. My immediate like this is this
is a problem that I have as a person. My
immediate go to is I'm like, oh, I don't want
to ask my provider and have them think that I'm
like a huge pain in the butt and like they
just sh like I don't want to be this like
psycho person that's asking for all these things. That's like
where my mind not a yeah I.
Speaker 3 (14:16):
Know I get that. Yeah yeah yeah.
Speaker 2 (14:19):
Now. One thing I could do is to help alleviate that,
if it would be helpful, is to create a write
up that says, I'm working with such and such patient,
this is what she's doing to improve supply. My clinical
observation is that supply should have improved significantly and she's
still producing less than half of what she needs for baby.
(14:42):
And based on my experience as a low supply specialist
and the symptoms such and such symptoms that she is experiencing,
I suggest that you test for these things. Please reach
out if you have any questions or concerns, or if
you would like to talk about this over the phone,
because I would be happy to be the one that says, look,
(15:05):
here's the research.
Speaker 3 (15:06):
This is what we know I mean.
Speaker 1 (15:08):
And I will say like, so my provider is like
seven sisters the birth center. So they're like, you're not
like they're not weird at all of them. Okay, Like
there we're totally she like Jenny would be like yeah
for sure, But like I am just like this weird
person that's like, I don't want to like cause problems.
Speaker 2 (15:26):
Do you know what, You're not weird because we've been
socialized to make things easy for everybody else, right, Yeah, yeah,
it's not weird at all.
Speaker 3 (15:35):
I hear a lot of people who say.
Speaker 2 (15:37):
My provider is so supportive, and like, I really hate
asking for this other thing, and especially when it's an
amazing provider like seven Sisters, they'll like flip over backwards
for you, and so you never know, like how are
you asking too much based on the services they've provided?
But you know I can also I'll write it up.
I'll write my recommendations up for you. Anyway, I was
(15:58):
already going to do that, and so I can send
them to you and you can either pass them along
if you decide you want to do them, or you
can ask me to send something and I.
Speaker 3 (16:06):
Would be happy to do that as well.
Speaker 2 (16:08):
Okay, thank you, because you have enough symptoms that like,
and some of them overlap and some of them are
just like a normal part of being a mom with
a young baby. However, there's enough things being ticked that
I'm like, eh, if we could get to an underlying
root cause that could be contributing to the slow milk supply.
(16:30):
Your situation could be improved significantly.
Speaker 3 (16:33):
Yeah.
Speaker 2 (16:34):
Now the other thing that we could do is there
is a supplement.
Speaker 3 (16:40):
Are you opposed to supplements it all?
Speaker 1 (16:44):
No? I take well, I mean like I take a
lot of light, Like I take like magnesium as a supplement,
and Omego's as a supplement in choline and all like.
Speaker 2 (16:52):
So no, I'm not okay. There is a supplement that
is sold by the Lactate Hub.
Speaker 3 (17:00):
They are ib clcs.
Speaker 2 (17:04):
They are the people who do like the low milk
supply specialty course for other ib clcs. They work very
closely with breastfeeding medicine doctors and they have a supplement
called Milkworks I R Plus. It has maringa in it
and myo insanol and d cairo inocetol. It's mayoinoscetol and
(17:27):
de chiro inocetol embedded glue cans blend and it. We
have found that if somebody has an underlying cause of
insulin resistance, even if it's just kind of like minor,
like maybe the A and C is a little bit elevated,
but it's not like crazy elevated that just this blend
(17:49):
of herbs and supplements helps with that insulin resistance, which
can then help improve milk supply.
Speaker 1 (17:59):
Well, can I ask in terms of the like insulin
resistance because I don't know a ton about it, but
what is the relation to So, Like, when I did
get pregnant, finally, I like really doubled down on trying
to like regulate my blood sugar. I didn't have any
indication that it was dysregulated, but I just was, like
the thing that I really focused on was increasing my
(18:20):
protein intake, particularly in the morning, because I like good
for blood sugar regulation. Is there a relation to what
you're talking about with that or is that not the same?
Speaker 2 (18:32):
Yes, But sometimes your diet can be be perfect. You
can be doing everything right and insulin resistance still creeps.
Speaker 1 (18:42):
Up and it's not perfect right now, like certainly, Like
I mean, I like barely eat healthy foods at this time.
Speaker 2 (18:52):
I know, I mean, you have a new baby, right
You're just trying to get any calories in your mouth.
But it can Insulin resistance can disrupt the balance of
hormones of both prolactin and oxytocin, which are both critical
for milk production.
Speaker 3 (19:09):
So and it can also.
Speaker 2 (19:11):
Affect the functioning of mammary gland cells, and those are
responsible for both producing and secreting milk, so they just
become less responsive to the signals necessary for milk synthesis
when there is any amount of insulin resistance. So sometimes
(19:33):
getting that under control so that your body is not
having because what happens is when you have any amount
of insulin resistance, your body just starts making more and
more and more insulin, and making more and more and
more insulin then reduces it messes with the signal for
the production of milk. And so this is a supplement
(19:58):
that's safe to take regardless, but it could help with that.
Under like, it's a supplement to increase milk supply, but
that's the mechanism by which it helps increase milk supply.
It decreases inflammation, It helps the body to regulate insulin
a little bit better so that if there is any
of that insulin resistance that's disrupting the hormonal balance, it
(20:18):
could help. So if you wanted to try something like
that without doing any blood work or anything and seeing
if you notice an impact, I'm not saying you're gonna
go from eight ounces to twenty four overnight, but it
could you may see a noticeable difference.
Speaker 1 (20:34):
And there's no like you know, like I see all
these people with supplements where they'll say, oh, take this
herbal supplement and like like I don't know how you
say it, like fenu Greek or whatever, where right would
help where it could hurt? Right, in this case, it's
not gonna.
Speaker 2 (20:50):
Hurt, right, Yeah, there's nothing in it that would would
decrease milk supply.
Speaker 3 (20:56):
Yeah, that's a good question.
Speaker 2 (20:59):
Yeah, Finu grain if you have thyroid disorders, will actually
have the opposite effect. So yeah, maringa is the primary
herb uh and maringa has no impact, no negative impact
on milk supply, and it has been shown to have
a positive impact in addition to these other insulin balancing supplements.
Speaker 1 (21:24):
So and if my is like normal or whatever it is,
If if that is normal, this also won't hurt.
Speaker 3 (21:30):
That, right exactly, right, right yeah yeah.
Speaker 2 (21:35):
Yeah, So I'll send you a link to that and
you can decide is it something you want to try
or not?
Speaker 1 (21:41):
Right, Like I don't I try every supplement like under
the SunNet.
Speaker 2 (21:45):
Right yeah, yeah, Yeah, So that's the milk supply stuff.
Speaker 3 (21:50):
Now, are you okay?
Speaker 2 (21:51):
I know we're a little over time. Are you okay
to go for just a bit longer? But yeah, okay, Yeah,
So I just want to talk a little bit about
the oral motor dysfunction part, and then if you decide
you want to do a follow up, we can take
care of that offline. So this is a document I
provide when I do in person oral motor assessments and
when I talk about now, there are other things that
(22:16):
can impact oral motor function before I talk about tethered
oral ties, things like.
Speaker 4 (22:25):
A really high palette or a bubble palette or low
tone in a baby.
Speaker 2 (22:35):
But usually you'll kind of notice those things first.
Speaker 3 (22:41):
Uh oh, this is the.
Speaker 1 (22:42):
Thing that I had. You had asked me what made
me think of like certain things with the tie? I like,
I like follow all these people on Instagram that like
talk about things like this even before having a baby.
So this was like something I was like hyper aware
of when she started doing it. But she but she
like breathes with her mouth open.
Speaker 3 (23:02):
A lot, exactly.
Speaker 2 (23:04):
That's one of the questions I always ask when I'm
doing a tetherdoral tie evaluation. Now, IBCLCs We are not
diagnostic providers, so we do not diagnose for tongue ties.
Speaker 3 (23:16):
But here's what we do. I always tell people.
Speaker 2 (23:18):
When I'm doing an oral motor assessment, I.
Speaker 3 (23:22):
Cannot diagnose, but tongue tie and.
Speaker 2 (23:28):
Buckle ties and lip ties. It is a symptomatic diagnosis.
It is not possible just to look in a baby's
mouth and say how much tight tissue could be impacting
the baby, because yes, we get a visual, but if
(23:49):
there's any amount of tightness, it could super impact that
baby or it could barely have any impact. And so
it is very individual. So what we have to do is, yes,
get that visual and sometimes people say you have a slight.
Speaker 3 (24:06):
Posterior tie, but it's not slight.
Speaker 2 (24:10):
If you are doing everything right and baby still can't
transfer milk, that means that amount of tightness is super
impacting that baby. And so when I look at what
are the symptoms, we track symptoms in the infant, symptoms,
(24:31):
in the feeding parent, and feeding symptoms. So you can
see on this list like if you have, you know,
more than five or six total symptoms, then I'm thinking, yeah,
we got to get you into an evaluation to get
it diagnosed by a pediatric dentist.
Speaker 1 (24:48):
Yeah, I mean like with the like these are the
reasons that I had just asked this woman yesterday to
look at this because like for the feeding symptoms, she's
even like she clicks on the bot, we'll do that.
The fighting or chomping. I told you she doesn't really
slip on and off the breast, but yeah, she the
falling asleep while nursing one hundred percent.
Speaker 2 (25:09):
Like immediately right, Like it's one thing if you fed
for ten minutes, you're full and you fall asleep, but
it's that like within a few minutes, I'm asleep.
Speaker 1 (25:17):
Yeah, and then yeah, I mean nurses for when I
was feeding her, nurses for a long time, but then
like immediately kind of wanted to feed again. It was
hard because I was like, is this cluster feeding or
is this what you know? So it socks fewer swallows.
Speaker 2 (25:33):
And then you definitely you said you have misshapen nipples
after she feeds. You've mentioned clog ducks a couple of
times here, that you have a clog duck on the
left side. Now I know you've mostly been pumping.
Speaker 1 (25:46):
So yeah, I mean the clog ducks, I think is
I don't know why I get them, but I don't.
I wouldn't attribute that to her just because I mean,
I don't I didn't nurse her long enough to really know.
Oh I don't. I don't ever use her just because
it would not give her enough food. But I never
(26:06):
use her in place of a pump, So so I
wouldn't attribute that to her.
Speaker 2 (26:11):
But now we do know, and and it's unclear.
Speaker 3 (26:14):
There's just not enough research. We do not know whether.
Speaker 2 (26:17):
Or not it is a correlation or a causation. But
babies have tethered url tie they're feeding parent I usually
has super high supply or super low supply, one or
the other, and you're on that pretty low supply side.
Speaker 3 (26:36):
You know, we know we've.
Speaker 2 (26:39):
Had slow weight gain, colic and unsettled behaviors. You said
she has lots of reflex reflex, I mean, does she
have a blister on her upper lip?
Speaker 1 (26:50):
No, not currently, but she had she had before, Like
I can't remember, I don't remember if it was. I
feel like it was when she was breastfeeding, like in
the first couple of weeks, because I do remember looking
at that and being like, oh, that's weird, and then
it But now.
Speaker 2 (27:09):
She doesn't white coating on the back of the tongue,
like on the tongue right and the yeah, because I
actually asked the pediatrician if it was thrush because I
wanted to make sure it wasn't. Do people have have
you always thought she was super strong, like she's able
to hold that head up, and from the very beginning
you were like, oh my gosh, she's so strong.
Speaker 1 (27:32):
Yeah. I actually I took her to the chiropractor for
two sessions because well, I don't know if it was
really because of that, even though I knew that that
was a thing where you were like, that's not a
great it's not great if like you're immediately able to
hold their head up, you know. But she had like
(27:52):
always I felt like, favored turning her head to one side,
Like every picture of her I had where she was
laying down, like she was always trying her head to
one side. So I did take a catafractor twice, but
and he said she had tension. But like again, it's
(28:13):
one of those sort of like unfortunately, it's just like
models of care where like you just have to keep
going back and it's not you know, like fun, they're
not you know, limitless. So it's where did you go?
Speaker 3 (28:30):
I saw?
Speaker 1 (28:32):
I don't even know if less doctor Dan like Amy
Madger's husband and Drankton.
Speaker 2 (28:39):
I know what you're talking about. I don't know them
very well, but I've seen them, like, yeah, I've gone
on their website before.
Speaker 1 (28:47):
Yeah, everybody like swhears by him. There wasn't a whole
lot that was going on like in the appointment. I mean,
obviously as there shouldn't be. Like I was very much
to like, please don't do anything aggressive obviously right, like
she's just a couple of weeks old. But it was
just a lot of like touching of her head. And
then when I kind of would ask for like the
(29:09):
description of what was happened or like I wanted to know,
Like I was like, do you feel tension? I wanted
to know, like where what was there something I could
be doing to improve it? And he was just like, yeah,
there's some tension, you know. Come back in two days,
come back in a week. And I was like okay,
I mean yeah, yeah, yeah.
Speaker 3 (29:30):
Where do you live again?
Speaker 2 (29:31):
Montague Wilbraham, No, we live oham Yeah, okay. If you
look at this list, it's screaming Tyler dol.
Speaker 1 (29:42):
Yes, yeah, no, I know. That's why I was surprised
yesterday when you know, the woman looked at and said
that she didn't think that or and why I've had
I've had two I've had two people say.
Speaker 2 (29:56):
That, and you know, I don't know the lady at
Koley what's her name, Lisa, Lisa. Yeah, I've emailed with
her a bit. I know Lex speech very well.
Speaker 3 (30:05):
I love her. I think she's amazing.
Speaker 1 (30:07):
Well, the thing is like I find I think I
forget if I told you this, But I finally was like,
what do I do? Because like Lex is at a loss,
like Lex great, Like everybody says like Lex, Lex do
look and she's it's kind of like my last visit
with Lex was sort of just like, yeah, I'm always
(30:28):
here reach out because like I honestly think she doesn't
know what else to do.
Speaker 2 (30:31):
I yeah, and you know what that happens to all
of us, where we're like, oh my gosh. But I
am puzzled by her assessment that it's not ties because.
Speaker 1 (30:45):
She had her her mouth and she said she felt
really good, really normal. She's she's watched her feed now
a ton of times. She's I think she's even watch
her feet from a bottle. I can't remember, but I
think she has.
Speaker 2 (31:04):
Yeah, she probably recommended those bottles to you, the pigeon
and that.
Speaker 1 (31:07):
Even Yeah, yeah, then I think I explicitly asked her
to check for times.
Speaker 2 (31:13):
Yes, I know she's usually really good at identifying ties. However,
if she's not looking at it symptomatically like this, if
she's just doing an oral and feeling a suck. Every
baby moves their body just a little bit differently, right,
and so you know, sometimes I'm feeling a baby and
I'm like, you know, it feels good, but you have
(31:35):
all of these symptoms. And it's the symptoms that really matter,
because if you're having all of these difficulties and no
one can say why, there has to be a reason why, right,
And so if no one else can say this is
the reason why she's transferring zero point three ounces but
chugging three to four ounces from a bottle no problem,
(31:58):
then there.
Speaker 3 (31:58):
Has to be a reason why we can't get the
milk out.
Speaker 2 (32:01):
Now.
Speaker 3 (32:01):
Yeah, low milk supply.
Speaker 1 (32:04):
Can't impact that, but listen, I'm like, if I just
had more milk, would she not just be able to right?
Speaker 2 (32:13):
But if you're able to pump one and a half ounces.
Why can't she transfer one and a half ounces? Like
it would be a different thing if we were like, okay,
she's able to transfer whatever I'm able to make, I
just can't make enough. Well, then that's a totally different conversation.
But if at every weighted feed you're seeing like hardly
anything transferred, then and she, you know, she looked good,
(32:37):
her latch looked okay, right, And when I was counting,
I was like, okay, it seems like there's a swallow
every three to four sucks, which is, you know, it's
a little outside what we consider normal. But you know,
we consider two to three sucks per swallow from the
breast normal, but four isn't that much beyond that.
Speaker 3 (33:00):
When I'm seeing a baby.
Speaker 2 (33:01):
That really can't transfer, well, it's usually like seven eight
sucks per swallow. So what is it that she's swallowing
If it's not milk, is she swallowing her saliva? You know,
is she generating enough saliva that she's swallowing that because
she is swallowing.
Speaker 3 (33:15):
But what is it?
Speaker 2 (33:17):
And could that extra swallowing of saliva, based on you know,
how she's latching be contributing to the acid reflux for instance,
Like we so if it were me, I would go
see the pediatric dentist and I would get a diagnosis
yay or nay.
Speaker 1 (33:37):
Okay. Yeah, I had actually already reached out to I'm sure,
you know, like doctor she. But but and when I
had done that, I was unclear on what their policy
was because I sort of had heard that they like
they prefer that you have a diagnosis from a lactation
(33:58):
consultant to like send you there because they basically want
to like they want you there, and then in that
moment they basically want to say, like, yes it is,
let's do it now.
Speaker 2 (34:08):
So here's here's kind of where it's weird, right because
IBCLCs we are not diagnostic providers. We cannot diagnose. We
can provide assessments. It's it's a weird scope, right because
we're clinical providers, but other providers get weird when we
start diagnosing. So we provide a clinical assessment. So he
(34:31):
provides the official diagnosis, or whichever provider you go to,
they are the ones that actually give you the diagnosis.
But he wants you working with an IBCLC and a
body worker, either a chiropractor or criminal sacrel therapist before
and after, because the outcomes post release are way better
(34:53):
if you have done everything you can to improve milk
supply and to improve the baby's latch as it is,
so if you're going so, it's not that he wants
to diagnosis. He wants to see notes from an IBCLC
that says we've done everything. It is very clear that
this baby is struggling, and it's there's nothing else we
(35:16):
can adapt at the breast or with pumping. Yeah, and
so doctor Shamy, he's an amazing provider.
Speaker 3 (35:23):
I love him. He's expensive.
Speaker 2 (35:25):
So if fun you know you insurance does cover. I
don't know how much United Healthcare covers. There is another
provider that I have really started to work with a
lot recently. Her name's doctor Andrea Fallon. She's in Springfield.
She's very good, very great bedside manner, and even if
(35:46):
your insurance doesn't cover it, the out of pocket cost
is so much lower than even the copey at Doctor
Shamie's okay, and she's done really good work on a
good handful of my patients in the last year. And
she is a mom herself. Her babyhead tether doryal ties,
which is what had made her switch the type ofstry
she was focusing on.
Speaker 1 (36:08):
You know, she does just she laser as well.
Speaker 3 (36:11):
She does use a laser.
Speaker 2 (36:13):
Yeah, yeah, yeah, she's a pediatric dentist as well.
Speaker 3 (36:16):
She has a really good laser.
Speaker 2 (36:19):
You know, typically if you go in she is willing
to do it that same day, but it's also no pressure.
She wants you to feel comfortable making the decision that
feels right for you. So same with doctor Shamey. He's amazing.
I love him too, But you know, when you're throwing
so much money into trying to get to the bottom
of all of your root causes, if you can save
some money here and there.
Speaker 3 (36:40):
I have totally been there, and I get it.
Speaker 2 (36:44):
The other thing I might suggest is doing either some
bodywork like massage or ot which is usually will be
covered by insurance, or cranial sacrel therapy, which is not
covered by insurance but can do amazing work. So you
can kind of look at those three scopes, I'll a'll
(37:05):
send to a recommendation and you can decide, like, which
feels the right for us.
Speaker 3 (37:09):
Have you thought.
Speaker 2 (37:10):
About early intervention at all? No, So early intervention it's
a program that's run by the state and they contract
providers out all across the state. It's cut fully covered
by insurance, and I believe it's free even if your
insurance doesn't cover it. They try to build insurance that
they can, but if not, they provide no cost services.
(37:31):
And what they do is they send out a team
for an evaluation. An SLP, a speech language pathologist which
they deal with infant feeding, OT occupational therapists they deal
with infant feeding. So it's weird. Their scopes overlap and
it depends on like what they have specialized in. But
sometimes it's like a swallowing issue, so the SLP does that.
(37:54):
Sometimes it's an oral motor function issue, which could be
both SLP or OT. Sometimes it's a whole body tension issue,
so the OT is good for that. So they'll come
several practitioners will come to the house. They'll do an
evaluation and if you if they're like, oh, yeah, we're
seeing reduced oral motor function, We're seeing a lot of
(38:14):
bodily tension that is making baby have reflux, be uncomfortable,
be collicky, have difficulty feeding, then they'll provide in home
services to you and they'll they'll outline a plan so
you can ask for that, or I can submit a
referral for you as a professional and they'll call you
(38:36):
and set up a time to do an evaluation. And
that's a way to get some body work and to
get an evaluation of all the oral motor functioning, because
there's some oral motor function that's outside of our scope.
That would be more the scope of an SLP. So
if there was something else going on that wasn't a
tethered oral tie, that could help you to understand why
can she not do this thing that mammals have evolved
(38:59):
to do?
Speaker 1 (39:00):
Right? Right?
Speaker 3 (39:01):
Yeah?
Speaker 2 (39:02):
What do you feel when I give that recommendation?
Speaker 3 (39:06):
How does that make you? What does that? How does
that sit with you?
Speaker 1 (39:09):
I mean, I guess it, Like I guess I just
am curious what you think is the Like it sounds
like there's a couple of things that I could do,
and I guess I'm just curious what you think is
the best path? Like do I do I try to
see the pediatric dentist, Like I also have this fear
that we see them and they're gonna be like, yeah,
(39:33):
like she has a tie, let's let's deal with it.
And either she really maybe didn't need to have that
surgery or she or procedure or maybe like you know,
she she has a tie, and we do that, but
that's not actually like the thing that's inhibiting the feeding.
Speaker 2 (39:53):
I don't know, but I get that worry, and I
guess I have that worry as a practitioner, right that
I recommend that you do this thing to your baby
and then you see no noticeable difference. So I'm right
there with you. None of us want anything to happen
to a baby that is going to cause some pain
that you know is going to alter their oral tissues
(40:15):
or any part of them if it's not necessary. The
thing I always bring it back to is then what
if it's not that, then what is it?
Speaker 1 (40:27):
Right?
Speaker 2 (40:28):
And I think the most frustrating thing about having breastfeeding
difficulties is the fact that so many people have them
and nobody can tell them why. You're like, we're mammals,
like our babies should be able to transfer milk from
(40:48):
our bodies, so why isn't my baby. Now there's a
bigger issue of why are so many babies struggling to
do this thing that until the twentieth century, really there
was not difficulty but that's an anthropological issue, not a
like clinical it's going to help you in this moment.
(41:11):
So if and so that's a that's kind of a
long winded way of me saying if if I were
to outline a path for you, which I just want
you to know, I have no I have skin in
your game because I want.
Speaker 1 (41:26):
You to.
Speaker 2 (41:28):
Get resolution. But whatever you choose to do, I'm gonna
be your big cheerleader behind you saying all right, great, like,
if that's what feels right.
Speaker 3 (41:37):
Then do that.
Speaker 2 (41:39):
But if it were me, I would go ahead and
do the the evaluation from earlier intervention just to rule
anything out that would.
Speaker 3 (41:50):
Not be tethered oral tissues.
Speaker 2 (41:53):
And go to the pediatric dentist because you've done literally
everything else.
Speaker 1 (42:01):
Yeah. And would you say I should do that? I mean,
because I know, like we kind of like split to
now talking about this side for my daughter. But would
you say I should do that simultaneously or before or
after I try to increase my milk supply simultaneously?
Speaker 2 (42:19):
Yeah, because you definitely do want to increase your supply.
Having more milk is going to help your daughter to
be able to transfer milk and her being able to
transfer milk is going to help you to create more milk.
So I do think we need to work on the
Philange sizing stuff. Get that figured out, figure out why
(42:43):
the spectra is worse with one side instead of two,
do that experimenting, and I'll outline those in my notes
that I send to you. We need to either get
to the root cause of the low milk supply by
doing a little bit more digging into the blood work,
or just say, you know what, We're gonna try that
supplement first thing and just see if I notice an impact.
Speaker 3 (43:07):
So you kind of have a choice there. So I'll
have that.
Speaker 2 (43:09):
Outlined, and then let's figure out why she's getting zero
point three to three ounce transfers at the brast when
you're able to pump one ounce to two ounces, right,
Does that feel like it's doable to do like together?
Speaker 3 (43:27):
Yeah?
Speaker 1 (43:27):
Yeah, I mean it's yeah, it's close to what I
sort of was like thinking I should do. I guess
I just like, I don't know, you need somebody to
say like, yeah, this sounds like the right thing to do,
or you know what I mean?
Speaker 3 (43:37):
I know, and you know what we all.
Speaker 2 (43:40):
I think Lisa and Lex do great work. I won't
put keep this in the podcast. I think they do
great work and we all have those moments where we
miss the mark. Every person does right, and it sounds
like they've helped you get to where you are and
that has been really great and supportive. And I just
(44:01):
keep going back to if it's not a tethered uryal tie,
then what is it?
Speaker 1 (44:05):
Yeah, that's truly Like when I showed up in her
office yesterday, I was so convinced, and even when I
got home my husband was like, I guess that's like good,
but it's kind of frustrating because like we wanted to
just hear yes, that she had it, because that what
we had convinced ourselves it had, you know.
Speaker 2 (44:22):
And when I I always send if you go whichever
uh pediatric dentist you go to, if you decide to
do that, I'll send my notes. But I can also
have a conversation with them and say, look, she's she's
been through the wringer, she's seen so many IBCLCs. It's
like visually it's on the fence about whether or not
it's there, because there's pretty good mobility and rural motor function. However,
(44:49):
she's doing everything right and cannot increase molk supply and
cannot get a transferred the breast, and she has all
of the symptoms that are pointing to tether douryl tie.
Speaker 3 (44:59):
Yeah, so that would be.
Speaker 2 (45:02):
My recommendation, okay, And I'm glad that it feels kind
of in line with what you were thinking already.
Speaker 3 (45:10):
Yeah.
Speaker 1 (45:11):
No, it definitely does. It definitely does.
Speaker 2 (45:13):
Okay, awesome, So I will type up I'll send you
extensive notes over the portal. If I said I would
send something and I forget, just send me a chat.
I've been taking notes as we've talked, but sometimes you know,
I don't get it. So I'll send out some decision
trees for you, my low milk supply recommendations, my oral
(45:36):
motor function recommendations. Would you like me to submit a
referral to early intervention or would you like me to
send you the link so you can look at it
and decide.
Speaker 1 (45:44):
I'll look at the link because I've literally never heard.
Speaker 2 (45:47):
Of this book, okay, but yeah, okay, So I'm just
going to make a note of that. So I'll get
you those notes here in the next couple of days,
and i'll send you over the client portal. Doctor Inuria
Fallons info just in case you want to like reach
out to her before I get my notes cleaned up
(46:07):
and the low milk supply supplement as well, and then
that'll get you going initially, and then if you have
any questions at all, just chat me on the portal.
Speaker 1 (46:17):
Okay, great, awesome, thank you so much. I really appreciate this.
This was very helpful.
Speaker 3 (46:21):
Oh good. I'm so so glad.
Speaker 2 (46:23):
And it's gonna be a while before this episode comes out,
honestly because I have a backup and I had to
stop recording for a while. But I'll let you know
when it does and I'll make sure to send you
a link.
Speaker 3 (46:35):
Awesome.
Speaker 2 (46:36):
Okay, yeah, great, great, thank you so much for being
willing to record. I think it will really help other
people who are struggling with similar issues because this happens
too frequently.
Speaker 1 (46:46):
Yeah, yeah, I hope. I mean that's that's why I
was like, yeah, sure, go yeah, it's been a lot,
so it's it would be nice to help anybody that
also is dealing with that exactly.
Speaker 2 (46:56):
All right, hang in there, go give that baby a hug.
She sounds like she needs her mom.
Speaker 1 (47:01):
She was, Yeah, all right, thank you.
Speaker 2 (47:03):
So all right, bye, bye, okay, low again here. So
you just finished listening to the part of my telehealth
consultation with Catherine where I offer solutions to all the
difficulties that she described in her first episode. As you
can see, working with an IBCLC should feel collaborative.
Speaker 3 (47:24):
It should feel like you are both on.
Speaker 2 (47:26):
The same team looking for solutions that are doable for
you and for your baby, and that they are new
solutions that you haven't tried before. If you remember, Catherine
saw two other IBCLCs before she came to me for
this telehealth consultation, and that is just a good reminder
(47:46):
that if you aren't getting to the bottom of your
lactation difficulties, it's okay to try to find somebody else
who is able to help you more specifically with your
problem and get to the solution that is going to
work best for you. Catherine later wrote me and told
me that it turns out her daughter does have tethered
(48:10):
oral ties, as I had suspected based on the symptoms
that she described to me. So you're going to be
hearing from her again in the future to uncover what
her feeding journey looks like now and what has changed
and what has remained the same. Thank you so much
for tuning in, See you next week.
When I did get pregnant, finally, I like really doubled
down on trying to like regulate my blood sugar. I
didn't have any indication that it was dysregulated, but I
just was, like, the thing that I really focused on
was increasing my protein intake, particularly in the morning, because
I really like good for blood sugar regulation. Is there
(00:21):
a relation to what you're talking about with that or
is that not the same?
Speaker 2 (00:24):
Before we begin, I want to share something special with
all of you expecting parents out there. As an internationally
board certified lactation consultant, I've seen firsthand how a little
planning can go a long way to helping you achieve
your baby feeding goals. That's why I'm offering you my
free ebook. It's called Birth Practices to Support Breastfeeding and
(00:48):
it's a workbook, So check out the link in the
description below. Hi, welcome back to Low's Lactation Lab. Last
week you heard the beginning of a telehealth consultation with
a patient named Catherine. In this consultation, we discover that
her baby has been having a lot of difficulty transferring
(01:10):
milk at the body, and Catherine has been relying on
exclusive pumping to feed her baby with bottles. She also
had the added complication of experiencing low milk supply despite
pumping regularly and using correct Flande sizes while pumping. So
(01:32):
now you are going to hear the part of the
consultation where I dive into offering individualized solutions for her
particular difficulties. And that is my job as your IBCLC.
What I do is take a lot of time to
uncover what is making things difficult for you and for
(01:53):
your baby. So listen in to hear the solutions I offered,
and then you're going to come back to a lay
episode as she updates us on what has happened in
the intervening months since we recorded the interview. Did you
also test free T three and free T four as
a part of that thyroid test, because those are the
(02:14):
indicators that really help us to understand if it's impacting
low milk supply.
Speaker 1 (02:20):
This she had only ordered the TSH, like and all
of my other thyroid screens, I've always wad a full panel,
or at least in pregnancy. I got the full panel, but.
Speaker 3 (02:30):
This was not that okay?
Speaker 2 (02:32):
Did it include Ferreton B twelve Sarah Myron.
Speaker 1 (02:37):
No okay, okay, it was just a CEC okay, okay,
all right, okay, So and it was one point.
Speaker 2 (02:47):
One point six six okay. Now tell me what your
other labs were again.
Speaker 1 (02:53):
For the CBC. I mean, like, I don't know what
what do you?
Speaker 3 (02:58):
Okay? It was it was the thyroid.
Speaker 2 (03:00):
You did the thyroid blood test and then anything.
Speaker 1 (03:03):
Else just just like a general CBC.
Speaker 3 (03:06):
Okay, and any anything come up in the CBC.
Speaker 1 (03:10):
Now, the red blood cell count was like moderately low,
hemoglobin was low, but the hematocrit was normal, on the
low side of normal.
Speaker 3 (03:23):
But and how much did you hemorrhage?
Speaker 1 (03:28):
Twelve hundred millions, mostly like lost through my tear, So
like as soon as she could stitch that up was
essentially okay.
Speaker 2 (03:36):
How and then tell me, are there other symptoms that
you have had that have made you think to get
your thyroid checked? No? Nope, all right, and.
Speaker 3 (03:52):
I would love to know.
Speaker 2 (03:55):
So I'm just gonna go through some uh, some other
symptoms that could be related to low milk supply. Do
you ever feel like some of these are kind of
hard when you're in the postpartum period, because it's like, yes,
I feel all of these and isn't that normal? So
(04:18):
I recognize that, but also it does sort of help
me to kind of sparse out.
Speaker 3 (04:24):
What would be the next thing you would want.
Speaker 2 (04:25):
To check to see if there is an underlying root cause. Okay, okay,
so so would you.
Speaker 3 (04:36):
First of all?
Speaker 2 (04:37):
Did you pass your one hour glucose test during pregnancy?
Speaker 3 (04:40):
Yes?
Speaker 1 (04:41):
Like very easily.
Speaker 3 (04:42):
Okay, very good.
Speaker 2 (04:44):
Do you feel sleepy like particularly after meals?
Speaker 1 (04:51):
No?
Speaker 3 (04:51):
Okay. Do you ever.
Speaker 2 (04:53):
Feel irritable or angry or shaky if you haven't eaten? U?
Speaker 1 (05:00):
No? Am I answering this like particularly in like this
postpartum time?
Speaker 2 (05:04):
Yes?
Speaker 1 (05:05):
Yes, yes, no, actually, like it's very weird. I don't
really have an appetite at all. Like I honestly don't
eat a ton. I know that's like that. That's one
of my biggest problems, is I like keep telling myself
like I'm gonna better today about hydration and eating. It's
just like hard when I'm taking care of her along
(05:25):
because I'll look up and it'll be one o'clock and
I'll be like, well, I've eaten like barely anything.
Speaker 3 (05:31):
Have you lost weight like more than you would expect?
Speaker 1 (05:38):
I don't think so, I mean, I don't know, I
don't know. I had gained about forty pounds in pregnancy,
and I pretty quickly lost like twenty of those pounds,
which I just assume was waterweight. But now my weight
has stayed consistent.
Speaker 2 (05:54):
Okay, okay, I like that twenty pound Yeah, so I'm
not like, yeah.
Speaker 3 (05:58):
Okay, okay, but you do have a decreased appetite, you
would say, okay, And do you think.
Speaker 2 (06:06):
It's a decreased appetite or just like eating is just
too hard?
Speaker 1 (06:11):
No, it's a decreased appetite because I don't like normally
I would be like, oh, I'm so hungry, and I
never feel hungry, like I eat meals because like I
should have it's dinner time. I guess I could have dinner,
but I almost never feel hungry.
Speaker 3 (06:23):
Okay.
Speaker 2 (06:24):
Any cold intolerance No.
Speaker 1 (06:28):
Like some days I had been walking around being like,
is it cold in here? It feels cold in here,
and my husband or my mom or I would be
around would say no, but that could just be really
normal too, like it would happen like not every.
Speaker 2 (06:42):
Day, you know. And then any constipation no, okay. Any
really dry skin or hair.
Speaker 1 (06:53):
Yeah, my skin got super dry, like immediately, I would
say like in like the two around maybe the two
week mark, hard, like my face was really dry. It
was just very weird, like I couldn't tell if I
was having an allergic reaction to something. It was just
like so sand papery, and so my skin is dry.
But it's also like it's winter and when now we
(07:16):
have the heat on high for her. And then the
only other thing is like my hands. I have like
like eggzema on my hand, which I've never had in
my life, but I think it's from washing bottles so frequently.
Speaker 2 (07:31):
So yeah, okay. Any hair loss no, okay. Any muscle
aches or stiffness, no joint pain, nope, okay. Slowed heart
rate not to my knowledge, okay. And forgetfulness or difficulty concentrating.
Speaker 1 (07:50):
Not anything that I think is outside the realm of
like normal for this current time.
Speaker 3 (07:57):
Okay, Yeah, I know, I don'd you. It's like a
little hard to sparse it out.
Speaker 2 (08:01):
And fatigue or weakness do you feel like that's no?
Speaker 3 (08:05):
Okay?
Speaker 2 (08:06):
And uh okay. So one of the things I would
be interested in hearing about or asking your doctor about.
Speaker 3 (08:15):
And I can send this to you. I have a
form that I create.
Speaker 2 (08:18):
But in order to understand thyroid function as it relates
to milk supply. We really do need to understand. We
need to get a full panel so T S H
T PO T three T four ft three ft four
reverse T three as well as cortisol, selenia, magnesium, ferritin,
(08:39):
and iron and because all of these can impact low
milk supply. If a person is removing milk regularly and
their milk supply does not increase, there has to be
a reason why. And we've you know, it seems like
you have sufficient glandular tissue. You've had no surgeries, no
(09:05):
trauma to the brasts, Your periods have been regular always
in your life or.
Speaker 1 (09:12):
No, they were pretty irregular for a long time, Like, uh, yeah,
I would say they were pretty irregular up until I
went on birth control. And then I was on birth
control for like now like twelve years maybe, and then
I was able to and I got off of birth
control and like go out myself pretty regular, Yeah, basically
(09:35):
until I got pregnant. Oh, I guess I should also
say I have I like maybe have endometriosis. They don't
really know. I definitively have it in my Like it's
really weird. It's in my belly button, Like, they took
a biopsy of it and they confirmed that it's there,
but there's there was no reason to like try to
(09:57):
see if it was anywhere else, just because there was
no way to do that without surgery.
Speaker 2 (10:02):
So yeah, okay, that's good to know. Do you have
any dark skin patches like on your neck, groin, or
under your breasts in particular?
Speaker 1 (10:15):
No?
Speaker 2 (10:15):
Okay, And have you ever been diagnosed with peacos.
Speaker 3 (10:22):
No, or wondered if you had it?
Speaker 1 (10:24):
No? I never really thought I did. I don't know why.
Speaker 3 (10:27):
Okay.
Speaker 2 (10:29):
Do you have any skin tags anywhere? Yeah?
Speaker 1 (10:34):
A couple.
Speaker 2 (10:34):
Okay, did you have any trouble getting pregnant? I know
you mentioned on being being on birth control for a while.
Speaker 1 (10:41):
I didn't have trouble. I don't think, I mean, like so,
I basically, but it's it's tricky because I got my
I got a biopsy of the weird thing in my
belly button in June. Then I got diagnosed with it
(11:01):
being endometriosis, which twofold like caused a lot of stress.
And then also they like you know, snipped off a
piece of this hormonal thing, right, So I don't know
what it was, but then my body definitely, like my
periods became a little bit more regular in those maybe
(11:23):
like June, July, August months, and so it took me
a while to have regular periods again. But I did
get pregnant in that January, so I basically was like
trying for six months. But I really at that point
had probably only had maybe like four cycles. But yeah,
(11:44):
I mean that that doesn't feel like too hard of a.
Speaker 3 (11:48):
Time, okay.
Speaker 2 (11:49):
And any losses no, Okay? Do you feel like you
ever have mood swings or have you been depressed or.
Speaker 3 (11:58):
Have you thought you might have depressure or anxiety?
Speaker 1 (12:02):
No? I mean I generally run quite high with anxiety, okay,
but like never enough in a way that's a diagnosed,
or like in a way that feels like it impacts
my quality of life.
Speaker 3 (12:16):
Okay.
Speaker 2 (12:18):
And any acne that seems like it's coming out of
nowhere or have you always struggled with acne?
Speaker 1 (12:26):
My skin has never been great, but in pregnancy it
got really bad. It could just be because I couldn't
use a lot of the products that I wasn't use,
but it definitely got pretty bad in pregnancy.
Speaker 2 (12:41):
Okay, Okay, So the thing that I if you wanted
to pursue seeing is there something that is impacting milk supply,
I do think it would be worth doing a full
panel for TSH and then doing some testing to see
if it could be peacoasts. Now I am not a
(13:04):
diagnostic provider, but I am a low milk supply specialist,
and pea coasts. You have enough symptoms that I would
suggest you bring it up with your provider. And insulin
resistance may be likely with peacoasts, and it's common to
have insulin resistance in the.
Speaker 3 (13:26):
Postpartum period.
Speaker 2 (13:29):
Starting them. So there is like a diagnostic hormonal profile,
and you can do some blood testing including a one
C fasting glucose fasting insulin and a metabolic panel and
a lipid panel. So before I go on, when I
say that that there could be some other things that
you could test for just to rule out any other
(13:52):
underlying causes. Does that feel more stressful.
Speaker 3 (13:55):
Or less stressful?
Speaker 1 (13:57):
It doesn't feel stressful. My immediate like this is this
is a problem that I have as a person. My
immediate go to is I'm like, oh, I don't want
to ask my provider and have them think that I'm
like a huge pain in the butt and like they
just sh like I don't want to be this like
psycho person that's asking for all these things. That's like
where my mind not a yeah I.
Speaker 3 (14:16):
Know I get that. Yeah yeah yeah.
Speaker 2 (14:19):
Now. One thing I could do is to help alleviate that,
if it would be helpful, is to create a write
up that says, I'm working with such and such patient,
this is what she's doing to improve supply. My clinical
observation is that supply should have improved significantly and she's
still producing less than half of what she needs for baby.
(14:42):
And based on my experience as a low supply specialist
and the symptoms such and such symptoms that she is experiencing,
I suggest that you test for these things. Please reach
out if you have any questions or concerns, or if
you would like to talk about this over the phone,
because I would be happy to be the one that says, look,
(15:05):
here's the research.
Speaker 3 (15:06):
This is what we know I mean.
Speaker 1 (15:08):
And I will say like, so my provider is like
seven sisters the birth center. So they're like, you're not
like they're not weird at all of them. Okay, Like
there we're totally she like Jenny would be like yeah
for sure, But like I am just like this weird
person that's like, I don't want to like cause problems.
Speaker 2 (15:26):
Do you know what, You're not weird because we've been
socialized to make things easy for everybody else, right, Yeah, yeah,
it's not weird at all.
Speaker 3 (15:35):
I hear a lot of people who say.
Speaker 2 (15:37):
My provider is so supportive, and like, I really hate
asking for this other thing, and especially when it's an
amazing provider like seven Sisters, they'll like flip over backwards
for you, and so you never know, like how are
you asking too much based on the services they've provided?
But you know I can also I'll write it up.
I'll write my recommendations up for you. Anyway, I was
(15:58):
already going to do that, and so I can send
them to you and you can either pass them along
if you decide you want to do them, or you
can ask me to send something and I.
Speaker 3 (16:06):
Would be happy to do that as well.
Speaker 2 (16:08):
Okay, thank you, because you have enough symptoms that like,
and some of them overlap and some of them are
just like a normal part of being a mom with
a young baby. However, there's enough things being ticked that
I'm like, eh, if we could get to an underlying
root cause that could be contributing to the slow milk supply.
(16:30):
Your situation could be improved significantly.
Speaker 3 (16:33):
Yeah.
Speaker 2 (16:34):
Now the other thing that we could do is there
is a supplement.
Speaker 3 (16:40):
Are you opposed to supplements it all?
Speaker 1 (16:44):
No? I take well, I mean like I take a
lot of light, Like I take like magnesium as a supplement,
and Omego's as a supplement in choline and all like.
Speaker 2 (16:52):
So no, I'm not okay. There is a supplement that
is sold by the Lactate Hub.
Speaker 3 (17:00):
They are ib clcs.
Speaker 2 (17:04):
They are the people who do like the low milk
supply specialty course for other ib clcs. They work very
closely with breastfeeding medicine doctors and they have a supplement
called Milkworks I R Plus. It has maringa in it
and myo insanol and d cairo inocetol. It's mayoinoscetol and
(17:27):
de chiro inocetol embedded glue cans blend and it. We
have found that if somebody has an underlying cause of
insulin resistance, even if it's just kind of like minor,
like maybe the A and C is a little bit elevated,
but it's not like crazy elevated that just this blend
(17:49):
of herbs and supplements helps with that insulin resistance, which
can then help improve milk supply.
Speaker 1 (17:59):
Well, can I ask in terms of the like insulin
resistance because I don't know a ton about it, but
what is the relation to So, Like, when I did
get pregnant, finally, I like really doubled down on trying
to like regulate my blood sugar. I didn't have any
indication that it was dysregulated, but I just was, like
the thing that I really focused on was increasing my
(18:20):
protein intake, particularly in the morning, because I like good
for blood sugar regulation. Is there a relation to what
you're talking about with that or is that not the same?
Speaker 2 (18:32):
Yes, But sometimes your diet can be be perfect. You
can be doing everything right and insulin resistance still creeps.
Speaker 1 (18:42):
Up and it's not perfect right now, like certainly, Like
I mean, I like barely eat healthy foods at this time.
Speaker 2 (18:52):
I know, I mean, you have a new baby, right
You're just trying to get any calories in your mouth.
But it can Insulin resistance can disrupt the balance of
hormones of both prolactin and oxytocin, which are both critical
for milk production.
Speaker 3 (19:09):
So and it can also.
Speaker 2 (19:11):
Affect the functioning of mammary gland cells, and those are
responsible for both producing and secreting milk, so they just
become less responsive to the signals necessary for milk synthesis
when there is any amount of insulin resistance. So sometimes
(19:33):
getting that under control so that your body is not
having because what happens is when you have any amount
of insulin resistance, your body just starts making more and
more and more insulin, and making more and more and
more insulin then reduces it messes with the signal for
the production of milk. And so this is a supplement
(19:58):
that's safe to take regardless, but it could help with that.
Under like, it's a supplement to increase milk supply, but
that's the mechanism by which it helps increase milk supply.
It decreases inflammation, It helps the body to regulate insulin
a little bit better so that if there is any
of that insulin resistance that's disrupting the hormonal balance, it
(20:18):
could help. So if you wanted to try something like
that without doing any blood work or anything and seeing
if you notice an impact, I'm not saying you're gonna
go from eight ounces to twenty four overnight, but it
could you may see a noticeable difference.
Speaker 1 (20:34):
And there's no like you know, like I see all
these people with supplements where they'll say, oh, take this
herbal supplement and like like I don't know how you
say it, like fenu Greek or whatever, where right would
help where it could hurt? Right, in this case, it's
not gonna.
Speaker 2 (20:50):
Hurt, right, Yeah, there's nothing in it that would would
decrease milk supply.
Speaker 3 (20:56):
Yeah, that's a good question.
Speaker 2 (20:59):
Yeah, Finu grain if you have thyroid disorders, will actually
have the opposite effect. So yeah, maringa is the primary
herb uh and maringa has no impact, no negative impact
on milk supply, and it has been shown to have
a positive impact in addition to these other insulin balancing supplements.
Speaker 1 (21:24):
So and if my is like normal or whatever it is,
If if that is normal, this also won't hurt.
Speaker 3 (21:30):
That, right exactly, right, right yeah yeah.
Speaker 2 (21:35):
Yeah, So I'll send you a link to that and
you can decide is it something you want to try
or not?
Speaker 1 (21:41):
Right, Like I don't I try every supplement like under
the SunNet.
Speaker 2 (21:45):
Right yeah, yeah, Yeah, So that's the milk supply stuff.
Speaker 3 (21:50):
Now, are you okay?
Speaker 2 (21:51):
I know we're a little over time. Are you okay
to go for just a bit longer? But yeah, okay, Yeah,
So I just want to talk a little bit about
the oral motor dysfunction part, and then if you decide
you want to do a follow up, we can take
care of that offline. So this is a document I
provide when I do in person oral motor assessments and
when I talk about now, there are other things that
(22:16):
can impact oral motor function before I talk about tethered
oral ties, things like.
Speaker 4 (22:25):
A really high palette or a bubble palette or low
tone in a baby.
Speaker 2 (22:35):
But usually you'll kind of notice those things first.
Speaker 3 (22:41):
Uh oh, this is the.
Speaker 1 (22:42):
Thing that I had. You had asked me what made
me think of like certain things with the tie? I like,
I like follow all these people on Instagram that like
talk about things like this even before having a baby.
So this was like something I was like hyper aware
of when she started doing it. But she but she
like breathes with her mouth open.
Speaker 3 (23:02):
A lot, exactly.
Speaker 2 (23:04):
That's one of the questions I always ask when I'm
doing a tetherdoral tie evaluation. Now, IBCLCs We are not
diagnostic providers, so we do not diagnose for tongue ties.
Speaker 3 (23:16):
But here's what we do. I always tell people.
Speaker 2 (23:18):
When I'm doing an oral motor assessment, I.
Speaker 3 (23:22):
Cannot diagnose, but tongue tie and.
Speaker 2 (23:28):
Buckle ties and lip ties. It is a symptomatic diagnosis.
It is not possible just to look in a baby's
mouth and say how much tight tissue could be impacting
the baby, because yes, we get a visual, but if
(23:49):
there's any amount of tightness, it could super impact that
baby or it could barely have any impact. And so
it is very individual. So what we have to do is, yes,
get that visual and sometimes people say you have a slight.
Speaker 3 (24:06):
Posterior tie, but it's not slight.
Speaker 2 (24:10):
If you are doing everything right and baby still can't
transfer milk, that means that amount of tightness is super
impacting that baby. And so when I look at what
are the symptoms, we track symptoms in the infant, symptoms,
(24:31):
in the feeding parent, and feeding symptoms. So you can
see on this list like if you have, you know,
more than five or six total symptoms, then I'm thinking, yeah,
we got to get you into an evaluation to get
it diagnosed by a pediatric dentist.
Speaker 1 (24:48):
Yeah, I mean like with the like these are the
reasons that I had just asked this woman yesterday to
look at this because like for the feeding symptoms, she's
even like she clicks on the bot, we'll do that.
The fighting or chomping. I told you she doesn't really
slip on and off the breast, but yeah, she the
falling asleep while nursing one hundred percent.
Speaker 2 (25:09):
Like immediately right, Like it's one thing if you fed
for ten minutes, you're full and you fall asleep, but
it's that like within a few minutes, I'm asleep.
Speaker 1 (25:17):
Yeah, and then yeah, I mean nurses for when I
was feeding her, nurses for a long time, but then
like immediately kind of wanted to feed again. It was
hard because I was like, is this cluster feeding or
is this what you know? So it socks fewer swallows.
Speaker 2 (25:33):
And then you definitely you said you have misshapen nipples
after she feeds. You've mentioned clog ducks a couple of
times here, that you have a clog duck on the
left side. Now I know you've mostly been pumping.
Speaker 1 (25:46):
So yeah, I mean the clog ducks, I think is
I don't know why I get them, but I don't.
I wouldn't attribute that to her just because I mean,
I don't I didn't nurse her long enough to really know.
Oh I don't. I don't ever use her just because
it would not give her enough food. But I never
(26:06):
use her in place of a pump, So so I
wouldn't attribute that to her.
Speaker 2 (26:11):
But now we do know, and and it's unclear.
Speaker 3 (26:14):
There's just not enough research. We do not know whether.
Speaker 2 (26:17):
Or not it is a correlation or a causation. But
babies have tethered url tie they're feeding parent I usually
has super high supply or super low supply, one or
the other, and you're on that pretty low supply side.
Speaker 3 (26:36):
You know, we know we've.
Speaker 2 (26:39):
Had slow weight gain, colic and unsettled behaviors. You said
she has lots of reflex reflex, I mean, does she
have a blister on her upper lip?
Speaker 1 (26:50):
No, not currently, but she had she had before, Like
I can't remember, I don't remember if it was. I
feel like it was when she was breastfeeding, like in
the first couple of weeks, because I do remember looking
at that and being like, oh, that's weird, and then
it But now.
Speaker 2 (27:09):
She doesn't white coating on the back of the tongue,
like on the tongue right and the yeah, because I
actually asked the pediatrician if it was thrush because I
wanted to make sure it wasn't. Do people have have
you always thought she was super strong, like she's able
to hold that head up, and from the very beginning
you were like, oh my gosh, she's so strong.
Speaker 1 (27:32):
Yeah. I actually I took her to the chiropractor for
two sessions because well, I don't know if it was
really because of that, even though I knew that that
was a thing where you were like, that's not a
great it's not great if like you're immediately able to
hold their head up, you know. But she had like
(27:52):
always I felt like, favored turning her head to one side,
Like every picture of her I had where she was
laying down, like she was always trying her head to
one side. So I did take a catafractor twice, but
and he said she had tension. But like again, it's
(28:13):
one of those sort of like unfortunately, it's just like
models of care where like you just have to keep
going back and it's not you know, like fun, they're
not you know, limitless. So it's where did you go?
Speaker 3 (28:30):
I saw?
Speaker 1 (28:32):
I don't even know if less doctor Dan like Amy
Madger's husband and Drankton.
Speaker 2 (28:39):
I know what you're talking about. I don't know them
very well, but I've seen them, like, yeah, I've gone
on their website before.
Speaker 1 (28:47):
Yeah, everybody like swhears by him. There wasn't a whole
lot that was going on like in the appointment. I mean,
obviously as there shouldn't be. Like I was very much
to like, please don't do anything aggressive obviously right, like
she's just a couple of weeks old. But it was
just a lot of like touching of her head. And
then when I kind of would ask for like the
(29:09):
description of what was happened or like I wanted to know,
Like I was like, do you feel tension? I wanted
to know, like where what was there something I could
be doing to improve it? And he was just like, yeah,
there's some tension, you know. Come back in two days,
come back in a week. And I was like okay,
I mean yeah, yeah, yeah.
Speaker 3 (29:30):
Where do you live again?
Speaker 2 (29:31):
Montague Wilbraham, No, we live oham Yeah, okay. If you
look at this list, it's screaming Tyler dol.
Speaker 1 (29:42):
Yes, yeah, no, I know. That's why I was surprised
yesterday when you know, the woman looked at and said
that she didn't think that or and why I've had
I've had two I've had two people say.
Speaker 2 (29:56):
That, and you know, I don't know the lady at
Koley what's her name, Lisa, Lisa. Yeah, I've emailed with
her a bit. I know Lex speech very well.
Speaker 3 (30:05):
I love her. I think she's amazing.
Speaker 1 (30:07):
Well, the thing is like I find I think I
forget if I told you this, But I finally was like,
what do I do? Because like Lex is at a loss,
like Lex great, Like everybody says like Lex, Lex do
look and she's it's kind of like my last visit
with Lex was sort of just like, yeah, I'm always
(30:28):
here reach out because like I honestly think she doesn't
know what else to do.
Speaker 2 (30:31):
I yeah, and you know what that happens to all
of us, where we're like, oh my gosh. But I
am puzzled by her assessment that it's not ties because.
Speaker 1 (30:45):
She had her her mouth and she said she felt
really good, really normal. She's she's watched her feed now
a ton of times. She's I think she's even watch
her feet from a bottle. I can't remember, but I
think she has.
Speaker 2 (31:04):
Yeah, she probably recommended those bottles to you, the pigeon
and that.
Speaker 1 (31:07):
Even Yeah, yeah, then I think I explicitly asked her
to check for times.
Speaker 2 (31:13):
Yes, I know she's usually really good at identifying ties. However,
if she's not looking at it symptomatically like this, if
she's just doing an oral and feeling a suck. Every
baby moves their body just a little bit differently, right,
and so you know, sometimes I'm feeling a baby and
I'm like, you know, it feels good, but you have
(31:35):
all of these symptoms. And it's the symptoms that really matter,
because if you're having all of these difficulties and no
one can say why, there has to be a reason why, right,
And so if no one else can say this is
the reason why she's transferring zero point three ounces but
chugging three to four ounces from a bottle no problem,
(31:58):
then there.
Speaker 3 (31:58):
Has to be a reason why we can't get the
milk out.
Speaker 2 (32:01):
Now.
Speaker 3 (32:01):
Yeah, low milk supply.
Speaker 1 (32:04):
Can't impact that, but listen, I'm like, if I just
had more milk, would she not just be able to right?
Speaker 2 (32:13):
But if you're able to pump one and a half ounces.
Why can't she transfer one and a half ounces? Like
it would be a different thing if we were like, okay,
she's able to transfer whatever I'm able to make, I
just can't make enough. Well, then that's a totally different conversation.
But if at every weighted feed you're seeing like hardly
anything transferred, then and she, you know, she looked good,
(32:37):
her latch looked okay, right, And when I was counting,
I was like, okay, it seems like there's a swallow
every three to four sucks, which is, you know, it's
a little outside what we consider normal. But you know,
we consider two to three sucks per swallow from the
breast normal, but four isn't that much beyond that.
Speaker 3 (33:00):
When I'm seeing a baby.
Speaker 2 (33:01):
That really can't transfer, well, it's usually like seven eight
sucks per swallow. So what is it that she's swallowing
If it's not milk, is she swallowing her saliva? You know,
is she generating enough saliva that she's swallowing that because
she is swallowing.
Speaker 3 (33:15):
But what is it?
Speaker 2 (33:17):
And could that extra swallowing of saliva, based on you know,
how she's latching be contributing to the acid reflux for instance,
Like we so if it were me, I would go
see the pediatric dentist and I would get a diagnosis
yay or nay.
Speaker 1 (33:37):
Okay. Yeah, I had actually already reached out to I'm sure,
you know, like doctor she. But but and when I
had done that, I was unclear on what their policy
was because I sort of had heard that they like
they prefer that you have a diagnosis from a lactation
(33:58):
consultant to like send you there because they basically want
to like they want you there, and then in that
moment they basically want to say, like, yes it is,
let's do it now.
Speaker 2 (34:08):
So here's here's kind of where it's weird, right because
IBCLCs we are not diagnostic providers. We cannot diagnose. We
can provide assessments. It's it's a weird scope, right because
we're clinical providers, but other providers get weird when we
start diagnosing. So we provide a clinical assessment. So he
(34:31):
provides the official diagnosis, or whichever provider you go to,
they are the ones that actually give you the diagnosis.
But he wants you working with an IBCLC and a
body worker, either a chiropractor or criminal sacrel therapist before
and after, because the outcomes post release are way better
(34:53):
if you have done everything you can to improve milk
supply and to improve the baby's latch as it is,
so if you're going so, it's not that he wants
to diagnosis. He wants to see notes from an IBCLC
that says we've done everything. It is very clear that
this baby is struggling, and it's there's nothing else we
(35:16):
can adapt at the breast or with pumping. Yeah, and
so doctor Shamy, he's an amazing provider.
Speaker 3 (35:23):
I love him. He's expensive.
Speaker 2 (35:25):
So if fun you know you insurance does cover. I
don't know how much United Healthcare covers. There is another
provider that I have really started to work with a
lot recently. Her name's doctor Andrea Fallon. She's in Springfield.
She's very good, very great bedside manner, and even if
(35:46):
your insurance doesn't cover it, the out of pocket cost
is so much lower than even the copey at Doctor
Shamie's okay, and she's done really good work on a
good handful of my patients in the last year. And
she is a mom herself. Her babyhead tether doryal ties,
which is what had made her switch the type ofstry
she was focusing on.
Speaker 1 (36:08):
You know, she does just she laser as well.
Speaker 3 (36:11):
She does use a laser.
Speaker 2 (36:13):
Yeah, yeah, yeah, she's a pediatric dentist as well.
Speaker 3 (36:16):
She has a really good laser.
Speaker 2 (36:19):
You know, typically if you go in she is willing
to do it that same day, but it's also no pressure.
She wants you to feel comfortable making the decision that
feels right for you. So same with doctor Shamey. He's amazing.
I love him too, But you know, when you're throwing
so much money into trying to get to the bottom
of all of your root causes, if you can save
some money here and there.
Speaker 3 (36:40):
I have totally been there, and I get it.
Speaker 2 (36:44):
The other thing I might suggest is doing either some
bodywork like massage or ot which is usually will be
covered by insurance, or cranial sacrel therapy, which is not
covered by insurance but can do amazing work. So you
can kind of look at those three scopes, I'll a'll
(37:05):
send to a recommendation and you can decide, like, which
feels the right for us.
Speaker 3 (37:09):
Have you thought.
Speaker 2 (37:10):
About early intervention at all? No, So early intervention it's
a program that's run by the state and they contract
providers out all across the state. It's cut fully covered
by insurance, and I believe it's free even if your
insurance doesn't cover it. They try to build insurance that
they can, but if not, they provide no cost services.
(37:31):
And what they do is they send out a team
for an evaluation. An SLP, a speech language pathologist which
they deal with infant feeding, OT occupational therapists they deal
with infant feeding. So it's weird. Their scopes overlap and
it depends on like what they have specialized in. But
sometimes it's like a swallowing issue, so the SLP does that.
(37:54):
Sometimes it's an oral motor function issue, which could be
both SLP or OT. Sometimes it's a whole body tension issue,
so the OT is good for that. So they'll come
several practitioners will come to the house. They'll do an
evaluation and if you if they're like, oh, yeah, we're
seeing reduced oral motor function, We're seeing a lot of
(38:14):
bodily tension that is making baby have reflux, be uncomfortable,
be collicky, have difficulty feeding, then they'll provide in home
services to you and they'll they'll outline a plan so
you can ask for that, or I can submit a
referral for you as a professional and they'll call you
(38:36):
and set up a time to do an evaluation. And
that's a way to get some body work and to
get an evaluation of all the oral motor functioning, because
there's some oral motor function that's outside of our scope.
That would be more the scope of an SLP. So
if there was something else going on that wasn't a
tethered oral tie, that could help you to understand why
can she not do this thing that mammals have evolved
(38:59):
to do?
Speaker 1 (39:00):
Right? Right?
Speaker 3 (39:01):
Yeah?
Speaker 2 (39:02):
What do you feel when I give that recommendation?
Speaker 3 (39:06):
How does that make you? What does that? How does
that sit with you?
Speaker 1 (39:09):
I mean, I guess it, Like I guess I just
am curious what you think is the Like it sounds
like there's a couple of things that I could do,
and I guess I'm just curious what you think is
the best path? Like do I do I try to
see the pediatric dentist, Like I also have this fear
that we see them and they're gonna be like, yeah,
(39:33):
like she has a tie, let's let's deal with it.
And either she really maybe didn't need to have that
surgery or she or procedure or maybe like you know,
she she has a tie, and we do that, but
that's not actually like the thing that's inhibiting the feeding.
Speaker 2 (39:53):
I don't know, but I get that worry, and I
guess I have that worry as a practitioner, right that
I recommend that you do this thing to your baby
and then you see no noticeable difference. So I'm right
there with you. None of us want anything to happen
to a baby that is going to cause some pain
that you know is going to alter their oral tissues
(40:15):
or any part of them if it's not necessary. The
thing I always bring it back to is then what
if it's not that, then what is it?
Speaker 1 (40:27):
Right?
Speaker 2 (40:28):
And I think the most frustrating thing about having breastfeeding
difficulties is the fact that so many people have them
and nobody can tell them why. You're like, we're mammals,
like our babies should be able to transfer milk from
(40:48):
our bodies, so why isn't my baby. Now there's a
bigger issue of why are so many babies struggling to
do this thing that until the twentieth century, really there
was not difficulty but that's an anthropological issue, not a
like clinical it's going to help you in this moment.
(41:11):
So if and so that's a that's kind of a
long winded way of me saying if if I were
to outline a path for you, which I just want
you to know, I have no I have skin in
your game because I want.
Speaker 1 (41:26):
You to.
Speaker 2 (41:28):
Get resolution. But whatever you choose to do, I'm gonna
be your big cheerleader behind you saying all right, great, like,
if that's what feels right.
Speaker 3 (41:37):
Then do that.
Speaker 2 (41:39):
But if it were me, I would go ahead and
do the the evaluation from earlier intervention just to rule
anything out that would.
Speaker 3 (41:50):
Not be tethered oral tissues.
Speaker 2 (41:53):
And go to the pediatric dentist because you've done literally
everything else.
Speaker 1 (42:01):
Yeah. And would you say I should do that? I mean,
because I know, like we kind of like split to
now talking about this side for my daughter. But would
you say I should do that simultaneously or before or
after I try to increase my milk supply simultaneously?
Speaker 2 (42:19):
Yeah, because you definitely do want to increase your supply.
Having more milk is going to help your daughter to
be able to transfer milk and her being able to
transfer milk is going to help you to create more milk.
So I do think we need to work on the
Philange sizing stuff. Get that figured out, figure out why
(42:43):
the spectra is worse with one side instead of two,
do that experimenting, and I'll outline those in my notes
that I send to you. We need to either get
to the root cause of the low milk supply by
doing a little bit more digging into the blood work,
or just say, you know what, We're gonna try that
supplement first thing and just see if I notice an impact.
Speaker 3 (43:07):
So you kind of have a choice there. So I'll
have that.
Speaker 2 (43:09):
Outlined, and then let's figure out why she's getting zero
point three to three ounce transfers at the brast when
you're able to pump one ounce to two ounces, right,
Does that feel like it's doable to do like together?
Speaker 3 (43:27):
Yeah?
Speaker 1 (43:27):
Yeah, I mean it's yeah, it's close to what I
sort of was like thinking I should do. I guess
I just like, I don't know, you need somebody to
say like, yeah, this sounds like the right thing to do,
or you know what I mean?
Speaker 3 (43:37):
I know, and you know what we all.
Speaker 2 (43:40):
I think Lisa and Lex do great work. I won't
put keep this in the podcast. I think they do
great work and we all have those moments where we
miss the mark. Every person does right, and it sounds
like they've helped you get to where you are and
that has been really great and supportive. And I just
(44:01):
keep going back to if it's not a tethered uryal tie,
then what is it?
Speaker 1 (44:05):
Yeah, that's truly Like when I showed up in her
office yesterday, I was so convinced, and even when I
got home my husband was like, I guess that's like good,
but it's kind of frustrating because like we wanted to
just hear yes, that she had it, because that what
we had convinced ourselves it had, you know.
Speaker 2 (44:22):
And when I I always send if you go whichever
uh pediatric dentist you go to, if you decide to
do that, I'll send my notes. But I can also
have a conversation with them and say, look, she's she's
been through the wringer, she's seen so many IBCLCs. It's
like visually it's on the fence about whether or not
it's there, because there's pretty good mobility and rural motor function. However,
(44:49):
she's doing everything right and cannot increase molk supply and
cannot get a transferred the breast, and she has all
of the symptoms that are pointing to tether douryl tie.
Speaker 3 (44:59):
Yeah, so that would be.
Speaker 2 (45:02):
My recommendation, okay, And I'm glad that it feels kind
of in line with what you were thinking already.
Speaker 3 (45:10):
Yeah.
Speaker 1 (45:11):
No, it definitely does. It definitely does.
Speaker 2 (45:13):
Okay, awesome, So I will type up I'll send you
extensive notes over the portal. If I said I would
send something and I forget, just send me a chat.
I've been taking notes as we've talked, but sometimes you know,
I don't get it. So I'll send out some decision
trees for you, my low milk supply recommendations, my oral
(45:36):
motor function recommendations. Would you like me to submit a
referral to early intervention or would you like me to
send you the link so you can look at it
and decide.
Speaker 1 (45:44):
I'll look at the link because I've literally never heard.
Speaker 2 (45:47):
Of this book, okay, but yeah, okay, So I'm just
going to make a note of that. So I'll get
you those notes here in the next couple of days,
and i'll send you over the client portal. Doctor Inuria
Fallons info just in case you want to like reach
out to her before I get my notes cleaned up
(46:07):
and the low milk supply supplement as well, and then
that'll get you going initially, and then if you have
any questions at all, just chat me on the portal.
Speaker 1 (46:17):
Okay, great, awesome, thank you so much. I really appreciate this.
This was very helpful.
Speaker 3 (46:21):
Oh good. I'm so so glad.
Speaker 2 (46:23):
And it's gonna be a while before this episode comes out,
honestly because I have a backup and I had to
stop recording for a while. But I'll let you know
when it does and I'll make sure to send you
a link.
Speaker 3 (46:35):
Awesome.
Speaker 2 (46:36):
Okay, yeah, great, great, thank you so much for being
willing to record. I think it will really help other
people who are struggling with similar issues because this happens
too frequently.
Speaker 1 (46:46):
Yeah, yeah, I hope. I mean that's that's why I
was like, yeah, sure, go yeah, it's been a lot,
so it's it would be nice to help anybody that
also is dealing with that exactly.
Speaker 2 (46:56):
All right, hang in there, go give that baby a hug.
She sounds like she needs her mom.
Speaker 1 (47:01):
She was, Yeah, all right, thank you.
Speaker 2 (47:03):
So all right, bye, bye, okay, low again here. So
you just finished listening to the part of my telehealth
consultation with Catherine where I offer solutions to all the
difficulties that she described in her first episode. As you
can see, working with an IBCLC should feel collaborative.
Speaker 3 (47:24):
It should feel like you are both on.
Speaker 2 (47:26):
The same team looking for solutions that are doable for
you and for your baby, and that they are new
solutions that you haven't tried before. If you remember, Catherine
saw two other IBCLCs before she came to me for
this telehealth consultation, and that is just a good reminder
(47:46):
that if you aren't getting to the bottom of your
lactation difficulties, it's okay to try to find somebody else
who is able to help you more specifically with your
problem and get to the solution that is going to
work best for you. Catherine later wrote me and told
me that it turns out her daughter does have tethered
(48:10):
oral ties, as I had suspected based on the symptoms
that she described to me. So you're going to be
hearing from her again in the future to uncover what
her feeding journey looks like now and what has changed
and what has remained the same. Thank you so much
for tuning in, See you next week.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.
Two Guys, Five Rings: Matt, Bowen & The Olympics
Two Guys (Bowen Yang and Matt Rogers). Five Rings (you know, from the Olympics logo). One essential podcast for the 2026 Milan-Cortina Winter Olympics. Bowen Yang (SNL, Wicked) and Matt Rogers (Palm Royale, No Good Deed) of Las Culturistas are back for a second season of Two Guys, Five Rings, a collaboration with NBC Sports and iHeartRadio. In this 15-episode event, Bowen and Matt discuss the top storylines, obsess over Italian culture, and find out what really goes on in the Olympic Village.