#389 | October Breastfeeding Q&A: Colic, Getting Pregnant & Breastfeeding “Rules”

I'm Cynthia Overgard, birth educator, advocate for informed consent, and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Show. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello and welcome, and Trisha, you're in the hot seat.

Back at it.

My favorite place for you is in the hot seat.

Why is that?

For the breastfeeding communities? I guess it's nice. I get to kick back and learn and, you know, chime in with my opinions. But you take on all these sophisticated breastfeeding questions. So it's nice for me to learn from you each time.

Well, I could talk about this all day. We know that, so I am very happy to do this. And as always, we have a lot of questions that come in about breastfeeding. We have a lot of quickies that we'll get to at the end, but we also have an opener that should be a little bit fun to talk about. I was trying to think about how should we kick off this episode today, and the question that came to mind, because social media is such a force of good and bad influence in our lives, and when it comes to breastfeeding, I think it is more harmful than helpful. So I wanted to ask our community what it is that they have seen on social media, like a rule or recommendation or advice that they took that they wish they never did, something that they wish they could just unsee, that they never knew.

Great one.

Yeah. So let's see what we get.

All right.

Okay, here we go. So, what are some things that you wish that you could unsee that you've seen on social media?

I mean, I hope they know you're talking about breastfeeding, and they're not going to start going down some other path.

No, the actual question is, "What's one breastfeeding rule or advice you'd erase from social media, and you wish you had never heard?" That's the specific wording.

Perfect.

Nonstop comments about fixing ties on every single post. Right. I mean, every baby has a frenulum. You could call every single baby tongue-tied just because of the presence of a frenulum. It's about function, so not all need to be released. "Don't let them fall asleep while nursing." Oh my gosh! Whoever says that should not be allowed to speak on social media.

I always did. If you do that, and I felt guilty for doing it every time because I heard...

It's like the worst piece of advice. If you want to ruin breastfeeding, never let your babies fall asleep breastfeeding. The actual thing that makes a baby very attached to breastfeeding, especially if you're having difficulty breastfeeding, is letting them get satiated at the breast, letting them sleep while nursing, letting them go to that place of hunger to fullness with you.

Interesting. It's actually beneficial.

It's actually beneficial. Now that's different than a sleepy baby not effectively breastfeeding. That's a different thing. So this is where it becomes so specific, and general advice is not good. "You have to stop when your child turns one." What? Based on nothing. Completely ridiculous. Based on nothing, except one is a very nice round number.

I mean, so many things in life are based on nice round numbers, right? Even the 10,000 steps a day. Someone recently said, like, no, that was just made up.

Right. Well, it's such a nice round number, right? It's an easy thing to hold on to.

If you think God was behind this, He was like, "I shall make 10,000 steps."

If anyone is behind that, it's cows. It's cows. It's the dairy industry.

Okay.

That you ever have to pump or give a bottle. Of course you don't. They can drink from the tap forever and never need to drink from a bottle. Eventually they'll drink from a cup. Eventually they'll drink water. Eventually they'll drink other things. But you never have to put milk in a bottle if you don't want to. That you need nursing clothes. The loose stuff works fine completely, and I feel the same way about maternity clothes. There are so many clothes that work, other than a pair of jeans, like a maternity pair of jeans. I think you can't really get away with jeans unless they have an elastic band.

Yeah, I feel like I needed maternity clothes. I feel like I did buy, like, a size larger sweater one day, like wintertime when I was getting big, but when I moved my arms, it still lifted up. I had such, like, a big belly in front of my body. I don't know. I feel like I needed that. But nursing clothes, that's so true. Even my nursing bras. You know how they have the little clasp? I didn't even bother with that. I would just, like, lift the bra. What am I doing? I'm not even using the technology of this nursing bra. Totally agree with that.

They're convenient, you know. The cute little shirts that have zippers, they are definitely convenient. But you absolutely don't need them if it feels like something you don't want to investigate and spend money on.

Don't you need, like, baggy clothes, really?

Right. That's it.

Button-down shirt. Like the shirt I'm wearing would be great. You just pull it down a little bit, or lift it up. Baggy clothes. It works.

True. Yeah.

That they need to feed both sides every feed. Absolutely. It is controlled by the baby. One side sometimes, both sides sometimes. The only thing is that in the very beginning, first baby, building your milk supply, I do encourage both sides to help build milk supply, but it is by no means a rule. There are no rules in breastfeeding in general. Like, it's rule-free.

Okay, what about the one where they say if the baby nurses on the left side and then takes a nap and comes back to nurse later, you should start on the other side. Is that a good one or not?

Depends on how much time they spent on the left side. You kind of go by how your breasts feel. Like, if your one breast feels more full, then you should feed on the fuller side.

Even if that builds up an imbalanced demand on the one side, right?

Oh, you mean like never going to the other side? Well, try to balance it.

Yeah. Okay. Yeah, you do want to try to balance that.

Yep. A lot of people do. Sometimes many women experience three-quarters of milk production on one side, a quarter on the other. What you don't really want is like 90% on one side and 10% on the other, because then you're quite lopsided, and that just feels uncomfortable. And your baby gets frustrated on the lesser side because there's no flow. So you do want it to be kind of similar, but almost nobody is equal, even-Steven. It's just not like that because our breasts aren't equal. We all have different breasts, different amounts of breast tissue on each side.

But I think for most people, they wouldn't know that or see that.

No, you wouldn't.

But when you're breastfeeding, you sure can.

Yes.

Okay.

"Give a bottle before bed." People think if you give a bottle before bed, the baby's going to sleep longer because they're going to get more milk or a fuller bottle, or especially if they think formula is going to satiate the baby longer. It's not true. I mean, it might work in some cases. It might feel like it works because you see, like, I give the baby a bottle and they sleep longer. Or if you're giving your baby, say, a six-ounce bottle, and normally when they breastfeed they're only getting three ounces, that might work. But it also just disrupts things, the rhythm. It can be disruptive, and nursing to sleep is what helps a baby get calm and relaxed. So if you want to give your baby a bottle before bed and it works for you, fine. But that's not a rule, absolutely not a rule. "Collect colostrum before birth." Waste of time and money. There are some specific circumstances where it does prove to be helpful, but I absolutely don't think every woman needs to collect colostrum before birth in order to avoid that scenario where it might have been really helpful. "The eat, play, sleep rule. It contributed to diminished milk supply with my first." That is absolutely true.

Never heard of it.

Yeah, we've talked about it.

Oh, sorry. I did. I have heard of it. I just don't remember, like, a single thing about it. Okay, pretend I never heard about it.

It's kind of like the wake-window concept, that your baby should eat, and then they should play and be awake. They should have a wake window of a certain period of time, and then they should put themselves to sleep rather than going back to the breast to go back to sleep. If they want the breast to go back to sleep, if they just naturally fall asleep, you're holding them, rocking them, walking them, and they go to sleep, fine. But it is not a rule. If your baby wants to nurse to go to sleep, you're having a hard time putting your baby to sleep, put them back on the breast. You don't need to teach them eat, play, sleep.

All I hear when you say that is postpartum anxiety.

Right, and diminished milk supply because you might be cutting your baby shy of four to six feeds a day by forcing them to sleep without eating.

Right. That's terrible. In the best-case scenario, though, you've got a woman trying to turn the art of having a baby and caring for a baby into a science. And good luck with that. It's not going to happen. Perfect way to fail and to feel anxious every hour of the day.

Right, because you want it to be predictable. Bottle feeding is predictable. You have to understand this difference. Bottle feeding and breastfeeding are just not the same. You can get a bottle-fed baby on a schedule. You can get them very precisely on a schedule. They drink the same amount every time. You put the same amount in the bottle every time. Occasionally, they're going to go off course and they're going to have a growth spurt and they're going to want more. But breastfeeding just does not work like that. It's got to find its own rhythm, and the only way to find that is to listen to the baby, not the clock, not a schedule, not social media pressure. All right, just a couple more because we got to get into the episode. "That you need to build a freezer supply." Not only do you not need to build a freezer supply, but you may have a lot of challenges if you do build a freezer supply. I'm always talking about how oversupply can be really difficult and harmful to the breastfeeding relationship, but there is always the exception to the rule. I spoke with a mom very recently who was breastfeeding, and in addition to that, she was pumping 72 ounces of milk a day. She was breastfeeding four times a day and pumping over 70 ounces a day of milk, and her baby was breastfeeding just fine.

How do you know oversupply symptoms?

Oh, that was what I was going to ask. Oversupply symptoms are like there's too much milk rushing out and the baby can't swallow it all? Like, is it actually when the baby latches on? That's evidence of oversupply?

Yeah, but like they're drinking from a fire hose when you have oversupply because there's so much milk in the breasts and the pressure at which it comes out can be too strong, or they maybe are getting too much foremilk and not enough fatty milk. The proportion, the ratio of the milk is altered because you're producing all this extra milk. If you're producing a lot of extra milk that your baby isn't actually consuming, and you're feeding a freezer, you have an oversupply.

Right. But she didn't.

No, she did. She just didn't have symptoms in the baby of it.

Oh, okay.

Which was unusual.

Okay.

Okay. Let me just scan to see if there's any last one that we have to do. There's lots still in here, so we can save some for another time.

You always say that, but you don't save them.

Because I forget to go back.

We're always like, "Oh my God, we can't find it. We're recording. We have to get them right now." We probably...

But there's thousands.

There's always new stuff, you know. So you might as well just take what's fresh.

It is enticing.

Lots of freezer-stash ones. "I wish 99% of women didn't go around saying they didn't produce enough, so they didn't breastfeed." Yes, I agree, and that is, it's not because women can't produce enough. Most all women can produce enough milk if they get the right input. It's just that they're not getting off to the right start, and their supply is not getting up to speed in a timely way. So rarely is it the case that a woman actually can't produce enough. It's just how things went in the first few days, in the first couple of weeks.

All right, can you not resist, or shall we put a pin in it?

Let's put a pin in it for now. There's still lots of good ones in here, so I will mark my words. We will come back to this.

Pick one more.

Okay. "Promptly shoving the breast in the baby's mouth when the baby's mouth is open." Well, first of all, it never works well to put the breast in the baby's mouth. You always want to bring the baby to the breast. That is a much better latch, and you do want to try to capture the moment where the baby instinctually is opening their mouth and looking to latch on, rather than trying to force it. Especially if a baby is crying, a lot of times when a baby is crying or yawning, moms will be eager to put them on because they finally have the big, wide-open mouth. That is not a great time to try to put your baby on. We want to get them in that instinct, follow their lead. Yes, you can use some pressure to put them on, but it's never a shove either. Never a shove. The interesting thing is that when a baby is crying, once breastfeeding is well established and a baby's a little bit older, when a baby is crying, putting them to the breast is exactly what stops the crying. But when a baby is trying to learn how to latch, it doesn't work. You know, they're reliant on their instincts in the beginning to get on the breast. Eventually, they learn. It's a different mechanism. It's a different part of the brain, and if they're crying, they're out of their instinct and they can't learn. So I think that's why it confuses women, because ultimately down the road they see babies who are crying, and we use the breast as a way to stop the crying.

Yeah, they almost seek the breast because they do. Soothing the baby, they want it. They'll snuggle up and, you know, lick their wounds while they're curled up nursing. You know, that's a touching and powerful memory I have. Yeah, it does change. I mean, it's a wild experience. You go from nursing a newborn to, like, eventually an older child who's much more conscious. So the relationship of breastfeeding keeps changing all along the way too.

It's constantly evolving.

Constantly evolving, which is also why rules, to go back to the original question, rules do not work in breastfeeding because it's always changing. I guess the one rule is that you should just feed the baby on demand. That is kind of a rule, but it's still loose. No strict rules.

All right, let's start our questions.

Hi, my name is Elizabeth, and I had a question about getting pregnant. I am going to be 14 months postpartum this month, and would love to get pregnant soon, but I have not had my period at all. I'm still breastfeeding at night. We're co-sleeping, and it seems like my daughter will just roll over multiple times a night and just want to suck to fall back to sleep. And I just don't know if I'm ready to cut that off yet. And then I've been trying to wean throughout the day, so really just giving her milk in the morning and in the evening, and I would love to get pregnant in the next few months. But it just seems like if I don't really cut off weaning cold turkey, that I won't probably get it for still a while. So just wanted to know if you have any suggestions. Anything I should really change if I want to get my period back, or if there's any sort of supplements or things that I could start taking that would help to encourage my body to get my period back? Any suggestions would be amazing. Thanks so much. Bye.

Well, first of all, you can get pregnant before you get your first period. You typically do ovulate before that first period. So it could happen next month. It could happen in two months. Just because she's 14 months and that hasn't happened doesn't mean it's going to be another six months or a year. Every month, it's probably very, very close to happening. So relaxing about the time pressure, that need to have babies, really feeling like we need to have babies really close together puts a lot of pressure on us. If you kind of just relax about that, you're probably more likely to spontaneously ovulate and get your period back. Second thing is, it sounds like she might actually be nursing quite a lot during the night. If the baby's just casually kind of rolling over and latching on at 14 months, she might not realize that the baby's latching four to six times a night. Four to six times of latching overnight might be enough to prevent ovulation. But if she doesn't want to change that, you don't have to change that. Dropping some feeds during the day, which is what she was starting to do, might be enough. You don't have to completely cut it off, though. Every time you drop a feed, your prolactin levels drop a little bit more, and you never know when you just might get your hormones back in sync enough to get that first ovulation. The one herb that is kind of helpful is Vitex. That does help with the LH, which is the hormone that causes the ovulatory surge, so you can do a little bit of Vitex. You can just try to take the pressure off. You can drop a little bit of feeding, but you absolutely, absolutely do not need to go full-on weaning unless you want to. And then, if she takes some steps to reduce feeding and it's still not happening, or she's starting to really feel like she needs to do the next thing, you can always get blood work done. There are various hormone markers, thyroid function, things that you can look at that might need a little bit of support to help her body get back into cycling.

All right, let's go to the next one.

Hi, my name is Becky, and I'm from Washington State. Thank you so much for everything you do. You have helped so many women, including me. I was able to have the water birth I always envisioned because of you with my second birth. I have a question about colic. My three-month-old son is mostly a happy baby, but now most of the time that I nurse him, I have to be standing up and moving to get him to stay latched. He has a high-pitched cry and will throw his head back, then relatch and repeat until he gets tired enough that I can finally sit down. Then he gets a good feed. He has been an extremely gassy baby since birth and was always really grumpy with high-pitched cries, but only recently has struggled with nursing. I am exclusively breastfeeding. My pediatrician recommended that I cut out dairy, chocolate, and coffee from my diet. Do you think that is necessary and would help? I'm struggling to find enough snack options that don't have any dairy. Let me know what you guys think. I look forward to hearing from you. Thank you so much. Bye.

First of all, I empathize so much with women who have to cut dairy out of their diets when they're breastfeeding, or are told that they should cut dairy out of their diets when they're breastfeeding, because they need so many calories and they need so much food and they need a lot of protein. And I just cannot imagine, you know, how hard it is to find those foods when you can't eat any butter or you can't have a Greek yogurt or you can't have any cheese.

Well, I also just want to say the pleasure. Like, I know from working with postpartum women so much, it is a period of life, like it or not, where you do gravitate toward a little bit more pleasurable foods because you need it.

Well, you need it and you want it. Like, you want that little vibe in your day. So, like, to say no chocolate, no coffee, dairy. Even if you're not big on dairy, like I'm not big. I don't consume dairy like it's any kind of health food. But I certainly consume it because it's tasty and it's a dessert-like thing that I enjoy. And, you know, it's a drag. Those are very pleasurable foods. And if the doctors are saying it in a knee-jerk manner because they've heard so many other experts say it, I think that's what's happening. They're kind of throwing darts, and it's such an extreme thing as well that the woman is likely to fail at the advice. So later, if she doesn't achieve success, it doesn't look like the doctor gave poor advice. It looks like she didn't follow the advice fully enough. Anyway, what do you have to say about that? Because I'm sure there's something to it. It is a very common thing that women are told to give up those foods. What do you say?

Yeah, I think it's become the go-to, especially for pediatricians, because they really don't know very much about breastfeeding and they don't know the complexity of the picture, like what this baby's going through. So they just say, "Hey, cut dairy." But the thing is, if you cut dairy and you do try it, because babies do have sensitivity to milk proteins, if you cut it and it doesn't improve, you must put it back in. You don't leave it out forever just because, whatever. You have to have a plan. You cut it for a certain period of time. Usually one to two weeks is enough. But you also have to look at the whole big picture of what the baby's going through. Is it just gas and fussiness and high-pitched cry? Does the baby have any rashes, eczema? Look at their birth history. Were they born by C-section? Did they have IV antibiotics? You have to look at all these things to figure out what's really going on. You can't just blanket say, "Cut dairy," especially if things don't improve after you do that. Please put it back in. Now, this baby needs a full oral workup because this is a three-month-old baby, and everything she's describing has to do with either how the baby is swallowing, which could be related to tongue-tie, high palate, oral tension, all that kind of stuff, airway stuff, or there's a milk supply, milk flow issue. Usually, when a baby is frustrated by feeding, and you have to bounce and walk and do all that kind of stuff, it's because they're frustrated with flow. It might be too fast, it might be too much, or it might be too little. So she needs a lot more than just, "Cut dairy out of your diet." She needs an IBCLC who understands oral function to evaluate the whole picture. Colic is not just a thing. There's a reason behind it. It's not just, "Oh, your baby has colic. They'll outgrow it by 12 weeks." There is a reason beneath it.

And colic is still defined in the same old traditional way, like crying for three hours of time at least. What is it? Three days a week, at least three weeks or something like that.

What a weird definition!

It's so nebulous.

I know. It's so weird. We're just imagining how long a baby is crying. I mean, they go through periods of being totally inconsolable anyway. It's so weird to put a label on things like that. You draw a line in the sand and go, okay, after this point, that's how I feel about macrosomia. It's like, ooh, baby is over eight pounds, 13 ounces. Macrosomic. None of it makes sense to me.

Right. So how do you define colic?

Are you struggling with your baby? Does your baby seem unusually unhappy and having feeding difficulty? Then maybe that's some degree. I don't even use the term. I don't use it.

Right. Yeah. We don't agree with colic. We don't use it.

I don't use it.

Yeah. All these years, we don't use it. It's very true, but are feeding difficulties a component of it from your perspective?

Absolutely.

Okay.

Absolutely.

I always just heard it was like some metric related to crying. It's like, what?

No, it has to do with your baby's digestive system. It has to do with their nervous system. It has to do with their feeding. It has to do with their oral function. Colic is just the catch-all term, and it doesn't mean anything.

Right. Well, they used to call women hysterical, right?

Because they got their periods.

I don't know, but, like, it's just the same thing. I mean, this is how society has always operated. When they didn't understand something, they slapped a label on it and took absolutely dreadful actions in pursuit of mitigating the symptoms of whatever said thing is. So we're still doing it. Okay.

Hey, ladies, this is Audrey from Minnesota, longtime listener. Love you both. Thank you so much for everything you do. I know this question has been asked before, but I think it's always been with younger babies in question. I am going on a week-long girls' trip, and I don't want to wean my son yet. He's going to be 16 months old while I'm gone, and I'm just worried that when I get home, he's not going to want to nurse anymore, and I would like to nurse him till he's closer to two. Right now, for nursing, we do it at nap time, bedtime, and maybe one more time early, early morning. Do you have any suggestions or anything at all that might help him not wean that week I'm gone? I tried breast milk in a cup. He doesn't take it. He's been breastfed his entire life. He's had maybe one bottle when he was two months old, and that's it. I do plan to pump twice a day when I'm gone, just to keep my supply up. But anything to help keep him interested while I'm gone, so that I don't come home to a weaned baby. Thank you so much. Love you both. Bye.

I mean, I can't say how this is going to go, but I think she has a good chance of coming back home and her son wanting to dive back on her body and latch onto her breasts and breastfeed. He's going to miss it, and it's not that long that he will forget. If she were gone for a month, probably be the end, but he's older, so he'll remember. I don't think trying to give him breast milk in a sippy cup or anything is going to do anything to help preserve the breastfeeding. So forget about that. You're going on this trip. There's no guarantee, but if you keep your supply up while you're gone, which is important, so the pumping while she's away will help. I suspect when you come back, the first thing he's going to want to do is breastfeed.

Yeah, I'm going to guess the same thing. I mean, the whole pursuit of, like, putting the milk in the cup, she is associating the taste of the breast milk to her baby's pleasure and enjoyment with breastfeeding. But the truth is, it's his comfort. It's his source of love, a source of endorphins he can't get from the cup. So when he sees her, he's probably going to instinctually associate breastfeeding with his mom again. So that's probably what will happen. So to that listener, we would love a follow-up. Just let us know what happened because now we'll all be curious. So leave us another voice message and tell us what happens when you're reunited with your son.

And have a great time on your girls' trip.

Yes, absolutely. All right, quickie time.

All right, today's quickies. I'm just going to read the first ones I see. "Should you wake up your newborn to feed every three hours?" Yes. In the beginning, I do believe in the first two weeks you should wake your baby to feed every three hours because if you don't, they're not going to feed at least eight times in 24 hours. And if they don't feed at least eight times in 24 hours, they are not likely to get enough milk. Now, once breastfeeding is well established, baby's gaining weight well, your milk supply is in a good place, you can start to let your baby go longer. Typically, they won't go much more than four hours in the beginning, and then that eventually extends to five, even six, and that kind of just all hopefully happens sort of naturally. But yes, they do need to feed a certain number of times, so that's a partial rule. "Why do babies have a favorite boob, and how do you fix this?" Well, it has to do with different things. You know, each breast makes a different amount of milk. They have different flow. Sometimes it's more comfortable for the baby on one side than the other side because of their own head, neck, shoulder tension or oral tension in their mouth. Sometimes the nipple just fits better. The shape of the nipple fits their mouth better. Women can have totally discrepant nipple sizes. Sometimes one nipple has, like, three pores where the milk comes out, and the other one has seven. So they like the slower side. They like the faster side.

I did not know any of those things you just said. Nipples can look different from one breast to the next, and there are that few pores, and they can have a different number of pores? I did not know any of that.

Yeah.

So one can actually have a stronger or lesser flow, not based on milk production and milk supply and milk storage, but based on the number of pores. I can't believe that.

It's a factor in it. Yep. Yep.

My God.

So you don't need to identify the reason that your baby has a preference from one side or the other side, but if it has anything to do with the baby's latch, you can actually get them to latch more comfortably on the opposite side using football hold on one side and cross-cradle position on the other. So if your baby likes to latch on your left breast, no, sorry, your right breast in a cross-cradle position, they'll actually prefer to latch in the football hold on your left breast, and then vice versa.

Now, just so everyone knows what you're saying, if you normally do the cross-cradle position on that breast, the baby has its, like, left cheek against your body, and if you do the football now, it's the baby's right side, right cheek, so you're not creating an imbalance in the spine, if that's a concern.

It's more that the way the baby's mouth is attaching to the breast is more similar. So in the cross-cradle position on your right breast, their left cheek is down, and...

And then the football, their right cheek is.

Yeah. Yes, I think that's right. Yes, yes. Okay. Anyway, it's a quickie.

That's right. We're in quickies.

Oh my gosh! Thank you for reminding me.

You're welcome.

Quick, quick, quick, quick. Okay. "When does supply stop increasing?" Well, it generally is supposed to settle between two and three weeks. That's kind of when supply and demand are supposed to be in sync. "Hospital lactation consultants, three thumbs down."

Is that a question?

I think that it...

Doesn't sound like one. Someone's got a voice and opinion.

Yeah. Well.

Yeah. I'm not surprised that some women will feel that way. There's plenty of inadequate, quote, breastfeeding support in hospitals.

Yes, and this is not because the lactation consultants are inadequate. This is because they have limited scope of what they see. They're generally just focused on what's happening in the first few days, when a lot of breastfeeding issues come up way down the road, and what you do in the first few days impacts those. But also they unfortunately have a lot of time constraints, and they don't always see enough variety, I would say. So not that they're bad people. Some hospitals have great lactation consultants, but...

Well, it's not about bad people, but if I am to criticize, I'm going to criticize it like this because this is how I've witnessed it. But not just this industry, with any industry, it's when people get overconfident. You know, you have to have a ton of humility in work like this, and if you have your first credential in breastfeeding, surely you know that there are people with much higher-level credentials who have thousands of hours on you. So it's fair to say, "I don't know for sure." But if they're overconfident and say, "Oh, this is weird. The nipple shield usually works. I don't know why it's not working for you," you know, that's someone who should say, "You know, I'm not the most skilled breastfeeding person. I gave it my best shot. Please, please try the next person now." If you really care about that woman, you're going to say, like, "Please try the next person. Don't give up here. There are people who know more than I. People who have more experience than I." That's a respectable, admirable thing to say, and I think it would be very simple if more doctors said that or LCs said that. Anyone in any field. For years as a childbirth educator, I so often sat comfortably in front of a big group and said, "You know, I don't know, but I'm going to call one of my mentors and find out, and I'm curious. I'm going to come back and answer it next week for everyone." Like, what choice do you have? You can't just bluff your way through it all, and you have breastfeeding on the line for some of these women and babies. So I would just say if they're overconfident, that's a risk.

That's definitely a risk, and you always should be learning and growing and expanding your knowledge base. But if I was going to criticize hospital-based lactation consultants, the first thing I would say is the fact that they give every woman whose baby isn't latching a nipple shield.

That's...

Just like a Band-Aid that just derails breastfeeding really quick.

Right.

Okay. "What age do you think is a good weaning age, if there is one?"

There isn't one.

No, of course not.

"Broken letdown reflex." Not a question. Not sure what she means.

Right. What is that?

She means her letdown reflex isn't... She assumes, she means her letdown reflex isn't working very well.

She might not have strong letdowns.

Well, first of all, she might not know when she's having letdowns. You don't always. You don't have to feel them. You don't always know. But if your baby is getting milk and breastfeeding, you're having letdowns. The milk is transferring. However, what she might mean is that she has a hard time letting her milk down, say when she's pumping. Like, you can then notice when you're pumping. You'll see when you're having a letdown. Now, what is the biggest inhibitor of a letdown? Stress.

Stress.

So, if you're worried that you have a broken letdown and you're saying you have a broken letdown, first of all, never say that again. Never again. Don't ever say that about your letdown. You have to find ways to relax while you're breastfeeding or pumping. You have to find ways to release oxytocin and not cortisol. So cover your eyes, listen to good music, take deep breaths. Don't focus on this idea that you don't have a good letdown. Massage your breasts beforehand. Put your feet in a warm bath. Put a warm blanket over your, or like one of those rice-pack things, like a warm thing over your shoulders. Anything to make you feel warm, cozy, safe, happy, calm, and you'll have a letdown. There's nothing broken. "Tips for avoiding mastitis and clogged ducts." Same tips. Don't have an oversupply, and have a good latch. "Can weaning cause night sweats?" Well, hormones shifting can cause night sweats. Lactating in general causes night sweats. Low estrogen causes night sweats. There are lots of different times in our lives as women where we have low levels of certain hormones that cause night sweats. So, can weaning cause night sweats? Sure. Hormones shifting. "Did either of you collect colostrum during pregnancy?" Absolutely not. Nobody talked about it. It wasn't even a thing.

Thank God it wasn't a thing. It would have been the perfect thing to stress me on. Thank God it wasn't a thing. I would have been all over, like, "Should I do this? What do I do?" I mean, I wasn't prepared to manage anything with my breasts anyway until I gave birth. But yeah, I feel for women. There's just more stuff all the time to be anxious about. And if we had had those baby monitors with video, I wouldn't have gotten anything done ever.

I would never have had... I didn't even have a baby monitor, period. I didn't use one.

No, I never would. I'm not a big advocate for collecting colostrum. I mean, Trisha, you know that there are reasons to do so. You're in the position to know that, but I'm always thinking it's just the perfect thing to create anxiety in a woman, and if she doesn't collect a lot of colostrum in pregnancy, now she's going to form beliefs that she's going to have trouble breastfeeding, and, like, that is such my concern. So I always err on the side of saying, like, no, rather than just in case. If you give birth and you need it, you have colostrum right then and there.

That's right. You can collect it after the fact. The only thing I say is that if you are interested in it and curious about it, it is good to practice hand expression. So if you want to practice some hand expression in the shower, you don't need to collect and save the colostrum. You can just get good at getting it out of your breast. And if you try it and nothing happens, don't worry about it. Maybe try again next week. If nothing happens, don't worry about it. It'll come after your baby's born. But hand expressing is a skill, and it isn't something that women are supernaturally good at. Because why would you be? So if you practice it a little bit in late pregnancy, you get better at it. "Do I need to fix my six-week-old's latch if I have no pain? She nurses fine and is gaining weight."

What? Fix what?

Fix what? There's nothing to fix. Somebody told her the baby's latch doesn't look good, I guess.

There you go.

Stop analyzing the latch all the time. You know, we don't have to look and see that the baby has a perfect latch. We have to feel good. It has to not hurt. It has to feel comfortable, and the baby has to get full and satisfied and transfer milk efficiently and effectively. And that is a good latch.

You want to know one of the things that I think helped me throughout all my years with breastfeeding babies, pregnancy, infants, all of it? I asked myself one question: What would Caroline Ingalls do?

She would do the laundry and breastfeed her baby, and she wouldn't be aware of...

She wouldn't be aware of a due date.

No.

When my doctor told me to top off after breastfeeding, which thank God was advice I turned down, as everyone knows, it was a little question: What would she do? She wouldn't have been able to top off. She would have just been like, you know, "Why am I here with you again, doctor? The baby is fine. Why are we even sitting in this office together right now?" Yeah, they told me to get baby on a schedule. Caroline Ingalls would have been like, "What? We don't know a clock. I don't do that." I really, like, I don't know. We've been in modern civilization for a blip, a blip of the millions of years we've been around, and look at the havoc it has wrought. So that actually was my default question. It was kind of unconscious, but she always came to mind, and it helped.

Well, you know what I have always said about breastfeeding. Breastfeeding works best when we get out of our left brain and into our right brain. It is very, very, very, very, very, very, very much a right-brained activity. It requires trust. It requires intuition. It requires watching and learning from your baby and your own body. So if you are constantly looking outside of yourself and outside of your baby into some social media post or TikTok reel about what is right and what is wrong with breastfeeding, you are not going to be able to trust yourself and your baby. You're going to be in your left brain. If you're listening to the advice of your mother-in-law or grandmother or whatever who bottle-fed a baby, you are not going to be able to trust the instincts and the natural rhythm of breastfeeding. That is how it works best.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.