56. Navigating Breastfeeding Challenges: Boosting Supply and Finding Support

In this episode, Dr. Monica Minjeur discusses the challenges and joys of breastfeeding as we celebrate August as National Breastfeeding Month. Whether you're feeding your newborn, infant, or toddler, breastfeeding offers unique health benefits for both mom and baby. Dr. Minjeur shares practical tips to boost your milk supply, ensure a proper latch, and find valuable support. Tune in to learn how to navigate breastfeeding obstacles, explore different feeding methods, and access helpful resources for your journey.

Transcript

Monica: 0:02

Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles, to improve health, and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you are listening today. On today's episode, we close out this month of August as National Breastfeeding Month. We're going to be talking all about feeding your newborn, infant, or toddler breast milk. Now, there are many ways this can happen, and every woman's journey is different. So, So, I'm going to talk about ways to increase your chances of success with breastfeeding, share some of my favorite breastfeeding resources, and also discuss how it impacts your health and the health of your baby for years to come. So, let's start off with a story about a client of mine who we'll call Tara. Now, Tara's pregnancy had already been a bit of a struggle, but now the baby was finally here and she was starting to feel like she wasn't sick all the time. Tara had been preparing for a beautiful breastfeeding relationship and knew this was how she wanted to feed her daughter. However, from the first couple of days, Tara struggled significantly with toe curling pain during latching, low supply, and to top it all off, her baby refused to take a bottle no matter how many different types they tried. Despite all the struggles, Tara was persistent and got in touch with me to see if there was anything we could do to help improve her symptoms. So the first thing we did was get Tara connected with an amazing lactation consultant who was able to come to her house and evaluate her. The lactation consultant looked at baby as well to make sure there was no latching concerns and they worked together to troubleshoot some of the basics. They worked through some different nursing positions to try as well and also gave Tara some tips to help her relax more during her nursing sessions. Although this was all very helpful and she began to see some improvement, Tara still was having struggles with getting enough supply, and her daughter still didn't want to take a bottle, so even pumping wasn't helpful. The next stop was sending the baby to see a speech and occupational therapist to make sure there were no concerns with tongue mobility, lip flare, and give them some extra exercises to do at home to help baby develop better sucking tone. We worked together through different dietary recommendations, supplements, and even some medications to help with pain, mastitis, and other issues that came up throughout the entirety of Tara's breastfeeding journey with her daughter. Although she still tells me to this day that breastfeeding was one of the most challenging things she has ever done, Tara and her daughter were able to maintain a breastfeeding relationship until about 15 months of age when her daughter weaned. Now, not every story looks like this, and hopefully this is not your experience. However, breastfeeding can sometimes be a lot of work and overcoming different challenges to achieve that end goal. Tara describes herself as very stubborn, which is why she continued forward despite all the things working against her. But she also knew the significant health benefits for both her and her baby, which helped her to persist. Now, I'm not saying that breastfeeding is the only way to feed your child, but there are many common challenges that I want to discuss a bit more today in case you are needing some encouragement to carry on. Now breastfeeding can look very different depending upon your situation, how soon you're returning to work, if you have other kids in the house, and so there are a combination of different methods that people can utilize in order to get breast milk to their baby if that is their intention. So obviously there can be direct latching, pumping, or a combination of latching and pumping depending upon what works best for your schedule. Other things that may include breastfeeding can include tandem nursing. So you may be already still nursing an older child as you have a newborn. And the other piece that you can think about is donor milk. There are women out there who are willing to give donor breast milk so that you can feed your baby breast milk if you are needing to. And just a quick word on how long you should feed your baby. First of all, I always tell women the recommendation is that whenever you want to continue breastfeeding that you should do so as long as you and your baby are doing well with it. In fact, the World Health Organization recommends up through age two years old as long as you are also using supporting food for nutrition starting no sooner than six months of age. So for all people who think, oh, I just need to make it to six months and then I must stop, or I like my friend said I was supposed to wean when baby was a year old, Please know that you should be supported on this breastfeeding journey, whatever that looks like for you. So one of the most common questions that I get is how do I increase my supply? I feel like baby is not getting enough or I pump and I only get out one ounce per side. So first of all, my question is always do you truly have low supply? So from the first couple of days after birth, even up until four or five days afterwards, baby really only needs a few teaspoons of that liquid gold colostrum in order to feel full. So especially the first few days, please don't get discouraged. It is normal for babies to lose a bit of weight, especially right after they are born, and they will be getting enough of that. going forward. So the number one way to increase supply is to just pump or nurse more. So anytime the baby fusses, Ideally, we recommend not using a pacifier, not using a bottle in those first few days unless you absolutely need to, and working on latching whenever possible. Your body is amazing and the hormones that fire out, especially the prolactin or the oxytocin, when those levels increase, your body will produce enough breast milk to feed your baby. In fact, in those first few days after delivery, your body doesn't know if you're feeding one baby or two or three. And so you can adjust to get enough milk supply depending upon how many babies you are feeding. And so this is where it becomes important to say, just do it. pump or nurse as often as the baby wants to or needs to. Oftentimes this is called nursing on demand. And so there are some schools of thought out there that say, Oh, baby must feed this many ounces, this many hours. And really that's more intended for babies who are formula fed. When you are nursing a breastfeeding baby, the recommendation is to feed on demand whenever baby is hungry for as long as it takes. So, again, number one tip that I have for increasing supply, nurse pump as often as you can. You can try and pump in between sessions if you're feeling like you're just not getting enough. But really we need to be cautious here that we don't want to create an oversupply situation. So, for example, if you try and nurse your baby and baby feeds until they are full. full and then you go and pump directly afterwards or even an hour afterwards and then go back and nurse baby again, you can actually set yourself up for oversupply, which can lead to mastitis. So really just saying, Hey, this is important to know that you don't have to have a certain amount of ounces in order to think that you have low supply. The other big tips that we pay attention to, especially in those first few weeks after delivery, is making sure that you are getting rest. We know that women that don't get enough sleep don't produce enough breast milk, and they have troubles with keeping up with their supply. Ideally we need to make sure that you're getting at least 120 to 140 ounces per day of water. Now some people will say, well I'm getting other fluids in, that's fine, that's helpful, but water really is the best thing in order to make sure that you're boosting that supply. Coffee does not count here, especially if you're drinking caffeinated coffee, that can actually act as a diuretic when you have too much of it, and so making sure that that fluid you're getting is water. Now, interestingly, there are certain foods that can help with your supply and just as in general, you need to have an average of extra 500 calories per day to keep up with your demand. And so many women will notice, I am incredibly hungry while I'm breastfeeding. So yes, we want to make sure that you're getting an increased amount of calories, but this does not mean an extra 2000 calories per day. It's about an extra 500 calories per day to keep up with a nursing baby. Obviously, more calories if you are returning to some more regular exercise or becoming more active. So, a few different foods to pay attention to that can increase your supply. Um, definitely making sure always that you're getting a good variety of fruits, veggies, and protein. But specifically, a couple things you can do include an increase in your omega 3s. flaxseed and brewer's yeast. Now there's lots of different companies out there that make lactation cookies and most of them will have some combination of these things in them. There are also lots of recipes online where you can make your own cookies or better yet, Ask a friend if they will bake for you. If you are utilizing brewer's yeast, this can also be found in some dark stout beers. Now, we always want to make sure that after you have an alcoholic beverage, you're waiting about two hours before pumping or breastfeeding again. But depending upon what your timing looks like, that's actually really doable for a lot of women. There are different supplements and prescriptions that are available in order to increase your supply, but these are going to be only at the recommendation of a healthcare professional. Again, I want you working with somebody who understands that we're not trying to create an oversupply issue, it's a fine balance. There are also some supplements that are not safe to take during different times, so some that shouldn't be taken in those first six weeks after delivery, There are prescription medications also, depending upon what your issue is, whether it's a supply issue, whether it's a latching issue, whether it's a pain issue. Just know that there are prescription options available if that's what your healthcare professional deems as necessary. A final note as far as increasing your supply, especially if you are pumping. You want to make sure that your machine has good suction. So if you are using a pump that is a hand me down or that's from a past pregnancy, sometimes you can have troubles with getting adequate suction on those machines. Most of the time you can get your insurance to cover a pump every delivery that you have. So ask your OB provider if they're able to write you a prescription to go and get a pump covered. We also want to make sure that with that pump that you have appropriate sized flanges. Most of the time they come with just a standard size and many, many, many times I find that women need a different size flange to be sure that you're getting the appropriate amount of breast milk expressed. So for some women, that means they need to use an insert to have a smaller size flange. For some women, they need a bigger size flange. This depends, It's extremely much on your anatomy and sometimes you're not able to tell what size you need until you're actually in the midst of breastfeeding. So make sure that you're having a healthcare professional or a certified lactation consultant evaluate and make sure that your sized phalanges are appropriate. So, let's talk a little bit about ways to get a better latch, um, and sometimes this is a baby issue, and so as we talked about in Tara's case, we want to make sure that baby is evaluated by either a healthcare professional, a speech and language occupational therapist, a pediatrician, to make sure that there's not any latching concerns. One of the big things that we hear out there a lot is, oh, my baby has a tongue tie, it needs to get clipped, or a lip tie. Every single baby in the world is born with that flap of skin underneath their tongue, that's called your frenulum. And a frenulum is a normal thing, in fact you have one yourself. You know, so just because we see that flap of skin there does not mean that it's an abnormal thing. You need to work with somebody who is trained to understand is that abnormal. Frenulum too tight is there enough that needs to be taken care of or are we just seeing that it's there and Trying to create a problem that it's not actually existent So there are things that can be done even if there is a tight frenulum or a lip tie or there's not great flaring There are different stretching Activities that can happen. There are different manual therapies that you can do to help with that. So not every tongue or lip tie requires excision or treatment or getting cut. So I am seeing that a lot more often and I just want to reaffirm that that is not always going to be the fix. I think a lot of times moms are desperate when they are having troubles with breastfeeding and they look at that and they see that and then it gets done or it gets clipped and they're like, it's not any better. Now what? Right? So I just want to I encourage you to look for other options that don't always require that SNP right away. The other thing that can be really helpful is different positions. So a lot of women see other women that are breastfeeding and they think this is the only way to do it, right? Just holding my baby across my chest. And there are really a lot of different positions that you can use to try and see if baby latch is better. So there's the cross body latch, there's a football hold where baby's head is on your breast and you're actually holding baby's body underneath your arm. There's also side lying and side lying works really well, um, especially if you have a significant output, um, if there's a big gush that happens at the beginning and baby's just having a hard time keeping up or we find baby's dribbling or choking on baby's body. breast milk. If you lie down and then have baby lie down next to you, um, side lying position can be really helpful. So lots of different positions. This is obviously not an extensive list, but just know that sometimes all it takes for a better latch is just trying a different position. Interestingly enough, What works on one side for your breastfeeding may not work on your other side. So for example, I know with one of my children we did cross body nursing on my left side and football hold on the right side and that's just how it worked out. Just depending upon baby's positioning and and what worked best, depending upon my anatomy as well. Other things that can really help, especially if you're dealing with pain, would be trying to do something to relax prior to a nursing session. So whether that's a warm shower, warm compresses, just getting yourself in a state of mind where you're ready to breastfeed, that can be really beneficial. For some people, if baby is sleepy or you're sleepy, if you're not having, you know, that active face to face bonding time, finding some way that you can kind of zone out. So, you know, whether that's reading a good book or listening to a book or watching a show, um, ideally just finding some way that you're able to really relax and, and get into that moment. And finally, one of the most important things to get a better latch is to make sure that you're addressing any pain. So if you as mom are having any skin discoloration with your nursing sessions, any nipple discharge, mastitis, pain specifically with pumping, you know, it's really important to make sure that that pain is being addressed and treated appropriately. There are different medical conditions that can cause significant problems with breastfeeding that may not have shown up in other times. Um, things like Raynaud's. things like vasospasm, yeast infections, mastitis, or breast infections, and it's really important to make sure those things are addressed and treated appropriately with a health care professional that understands those nuances. So if you are having any pain, please, please, please continue to seek professional evaluation to make sure that you get the pain addressed because if you are in pain, it's really challenging to relax and have that good latch. So let's talk a little bit as far as some health benefits of breastfeeding. And some of these are really well known and some of them I think just are not talked about enough. So one of the biggest health benefits that we see for both mom and baby is this increase in bonding. So when oxytocin or prolactin is produced with breastfeeding, that's supplied to baby, supplied to mom. Um, a decreases stress and anxiety levels. So that is probably one of the most important things that we see, especially in those early days is that bonding that happens, decreasing stress levels for both mom and baby after what has just been potentially an incredibly stressful time with delivery for baby. What we see as health benefits of getting breast milk, we see a reduced risk of asthma, obesity, Type 1 diabetes and sudden infant death syndrome. Other infections that are reduced include lower respiratory symptoms, ear infections, and GI infections. And so these health benefits are part of the reason that so many moms choose to breastfeed. We also know that when baby is getting breast milk, they are developing healthy gut bacteria. And the breast milk that mom is producing supplies an almost instant amount of antibody protection. So for example, if mom is exposed to a cold or influenza, she will start to produce antibodies herself. Those antibodies are passed through her breast milk And given to her baby, so then baby is also having those great antibodies. So we know that overall babies that are breastfed have much, much, much lower risk of any type of infection across the board because they're getting a lot of that additional antibody protection through mom. That breast milk composition changes hour to hour, day to day, as mom is exposed to new things, eats new foods. We know that even the foods that mom eats, small amounts of that are passed to baby, and so they get small tastes of that. So that way when it comes to eating and food, they are able to have some benefit as far as having those tastes already. For women who breastfeed, we know that there is a significant decrease in weight after pregnancy, and so really being able to nurse helps to increase that speed of how that baby weight falls off postpartum. Some of the other amazing health benefits that we know for breastfeeding moms are that we see long term a decreased risk of breast cancer and ovarian cancer. And what we know is that as we are lowering that long term estrogen exposure, we are able to decrease those risks. So moms who are breastfeeding are able to effectively decrease those risks of cancer just from breastfeeding, which is amazing. Now, before we close out this episode, I do want to share just a couple other quick resources. And one of the things that I think is really important is that I want you to know that if you live in the United States, it is a federal law that you are allowed to take time away from work to pump. And there is no limit as far as what time that needs to be, how long you get. The law states that you need to be provided a reasonable break time. Which is not dictated by your employer and you also need to be provided a private space That is not a bathroom for up to one year after baby is born So, please please please know that if you are a woman who is returning to work and you are concerned about the pumping situation In the United States at least you are protected by federal law That you will be able to pump and express breast milk in a way that works for you in a setting that it works for You that is comfortable In some states, there are even more protections that are beyond the federal laws. So make sure that you check your state laws, but please know from a federal law standpoint, you are protected. There are lots of resources out there depending upon which work industry you're in that you can provide to your employer. They should be able to look that up themselves as well. Um, just as far as knowing, hey, if I'm, if I work in the restaurant industry, what are some ways that I can help work with my employer. to make this happen. However, please know that you are protected by federal law. The other is that in some states you can be exempt from jury duty upon request and basically just delay your time served for jury duty. So just know that those resources are on your side to help protect you in steamrolled. Finally, a couple of my favorite resources, um, when it comes to if you're needing additional hands on. Um, activities or tips in order to find good information. My number one go to is always going to be a certified lactation consultant. Now there are lots of different certifications, so certified lactation consultant, um, international breastfeeding consultants, all sorts of things like that, but make sure you're working with somebody who does have certification because they go through a certain amount of hours training and education as well as testing to make sure that they are certified. Other great resources can include a doula, a midwife, and other interested healthcare professionals. Now I would love to say that every doctor out there that I know knows enough about breastfeeding, but that's just not the case. However, you can find some amazing doctors out there who are very skilled at breastfeeding and are able to help you, including pediatricians, Obstetricians, family medicine doctors, internal medicine doctors, and I'm sure many others. So just make sure that you're working with somebody who has a good understanding of breastfeeding, especially if you are working on troubleshooting. One of my favorite books that I always refer women to is called the Womanly Art of Breastfeeding and this is put out by the La Leche League. This is a great resource. I had this next to my bed during all of my breastfeeding relationships with my kiddos so when I had any issues that came up I was able to just pick up that book and kind of find what what my issue was. And then the final resource is going to be specific for your particular area. So there are oftentimes many community meetups for breastfeeding support. So moms groups that get together and nurse together. There's lots of social media groups. If you're one of my listeners that's in the Cedar Rapids area, one of my very favorite groups is an online Facebook group and it's called Cedar Rapids Leaky Mamas. And this group saved me so many times. You know, it's. It's a collection of moms as well as lactation consultants that are able to kind of give that, you know, real quick advice if you have just a quick question or if you're like, hey, does anybody have some advice about this situation? can be really, really helpful. Now it is not a substitute for medical advice. So obviously if you're having a medical problem, we always want you to seek out a certified healthcare professional for that. Imagine if breastfeeding was more common and you had someone to talk with you each step along your journey to help troubleshoot the challenges as they came up. Now you have more information about how to increase your chances of success to improve both your health and the health of your baby for years to come. If you're ready to work with our elite team of healthcare professionals, go to our website, radiantclinic. com, to schedule a free discovery call with me and learn more about our package based pricing for comprehensive care. We are currently able to see people for in person appointments in the Cedar Rapids, Iowa area, or can arrange for a telehealth visit if you live in the state of Iowa, Illinois, or Minnesota. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of Cycle Wisdom.