Guest Blog: The Little Milky Way Talks About Breastfeeding Facts and Myths
A few years ago I wrote this little “quickie” blog “Lactation and Your Pelvic Floor.” I will probably go back and revamp that one, but feel free to check it out. MY lactation journey started after a 38 hour labor and rough delivery with my daughter. Society made me feel that because I needed an unplanned c-section, I was not able to deliver her “naturally.” As a 25 year old, not having any of the skills, knowledge, or life experience I do now, I felt “less than.” I resolved to make breastfeeding work and to feed my baby the way “nature intended.” My breastfeeding journey was not one of rainbows, sunshine, or magic. It was hard, frustrating (for myself, our baby and her father), and it needed outside support.
My lactation consultant at the hospital made sure I knew I could come back for outpatient visits and even virtual support, and I am forever grateful. We needed all of that and more. It took FIVE weeks to get to the point where a latch was even marginally easy, and another FIVE to regulate my supply and manage my baby’s reflux to the point where she didn’t cry constantly. We worked through it, and although it was a struggle, I am thankful for the time I got to feed my baby breastmilk. I can totally see another pathway where I had used alternate methods to feed my baby, and I probably would have been just as happy that way too, because in the end, FED is best.
As a therapist who works with many people postpartum, with a good percentage of them choosing to breast/chest-feed, I have always been a huge supporter of finding a lactation consultant BEFORE birthing the baby. As a provider who also works with babies, I also help manage latch issues from an oral motor, postural, and positioning aspect, as well as helping with infantile constipation, gas, and reflux. I have been begging the universe for an accessible lactation consultant for YEARS, since the ones I know and love are overwhelmed with their caseloads, or have since transitioned into different careers. I recently found out a family friend just finished her training and is accepting clients. I am happy to pull her into our Practically Perfect practitioner referral list! She wrote this blog to introduce herself, her services, and some common facts and myths about feeding babies human milk.
She writes:
Hi, my name is Alexa DuVilla. I am a Certified Breastfeeding Specialist. I received my certification through Lactation Education Resource, where I received 97+ hours of lactation-specific education and training. I found the lactation community after I gave birth to my first child in 2020. He was born in January, so it was when COVID hit. I was 2/3 months postpartum, and my milk supply began to regulate, which is when most lactating parents begin to experience some obstacles. Because of the physical limitations that COVID had placed on in-person gatherings, I didn’t have a way to find support. Honestly, I didn’t even know the world of lactation professionals even existed. I began to do lots of research on breastfeeding online. I landed on an online breastfeeding parent support group run by lactation professionals, and my passion for breastfeeding was ignited. When I had my second child in 2021, I felt prepared, educated, and empowered to ask for help. Shortly thereafter, I decided to pursue a career in lactation.
You might be wondering what a Certified Breastfeeding Specialist is. A CBS is a lactation professional dedicated to help guide and support families through their lactation journey. A CBS can provide one-on-one support through parent/infant feeding assessments, latch and positioning assistance, supplementation guidance, proper human milk storage, return to work plans, and bottle feeding support. A CBS can also guide parents through education in a classroom or group setting, as well as supporting families through weaning.
The second you announce that you’re pregnant or expecting, everyone asks, “Are you planning on breastfeeding?” These same people will share breastfeeding horror stories with you, claiming that giving you the “truth” about breastfeeding will prepare you. These unsolicited “truths” are oftentimes an experience that lacked the proper support from a lactation professional or a myth found and shared. Let’s dispel some common misconceptions of breastfeeding/chestfeeding that you may or may not have heard.
One of the most common breastfeeding/chestfeeding myths is that breastfeeding/chestfeeding hurts, and you need to “rough up your nipples” in preparation for the baby. Please, do not ever “rough up your nipples” (whatever that means). The skin on your breasts/chest is very sensitive. If breastfeeding/chestfeeding is painful, and/or if your nipples are chapped, cracked, or bleeding, you need to have your baby assessed for proper latch or potential oral restrictions. Pain during breastfeeding/chestfeeding is not normal.
Another common misconception about breastfeeding is that after six months or twelve months, there is no nutritional value to human milk. The most amazing thing about human milk is that it is always changing and adapting to the nutritional needs of your baby. Making the decision to breastfeed/chestfeed your baby sets them up for a reduced risk of infectious diseases, contributes to immune maturation, supports organ development, and reduces risk for obesity, diabetes, and cardiovascular disease. There is an Enteromammary Pathway or “feedback loop” where the infant’s saliva provides information when it comes in contact with the lactating parent’s breast/chest. The information provided can alter the composition of human milk as the lactating parent begins to produce antibodies, fat content, micronutrients, or antibacterial properties. Human milk continues to adapt to your baby’s needs, even into childhood.
Additionally, you may have heard that you cannot support your infant’s nutritional needs on human milk alone. However, the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding/chestfeeding to six months with the introduction of complementary food, and breastfeeding/chestfeeding until two years or beyond. The CDC recommends exclusive breastfeeding/chestfeeding to six months with the introduction of complementary food, and breastfeeding/chestfeeding until 12 months. As a lactating parent, you CAN meet your child’s nutritional needs with human milk. The size of your infant’s stomach changes drastically throughout the first few weeks of life. At one day of life, your newborn needs only 1 tablespoon at each feeding. At three days of life, your newborn needs only 0.5-1 oz. At around day ten, your newborn needs 1.5-2 oz. At one month old, your infant needs 2.5-5 oz.
Along the same vein of meeting your child’s nutritional needs with human milk, there are signs to look for to ensure your infant is having adequate human milk intake. A good indicator that your child has adequate milk intake is to look at their diapers. By day five, your infant should be eliminating six wet diapers and three stools. You should be able to hear audible suck and swallows during a feeding. Your baby should unlatch themselves after a feeding, instead of being removed by the lactating parent. When the feeding is over, your baby should be relaxed, with open hands, and content. Your breast/chest should be softer or lighter after feeding. Of course, the most obvious indicator that your baby is getting adequate human milk is by maintaining their growth curve.
If you or your baby is experiencing any of the following symptoms, you would want to immediately contact a lactation professional and get in touch with your primary healthcare provider: your infant is not eliminating enough waste (less than six wet diapers and two stools) and/or your baby is not maintaining their growth curve. Other reasons to reach out to a lactation professional would include painful latch, cracked or bleeding nipples, clicking or popping sounds during a feeding, baby seeming unsatisfied after feeding, very short (only a few minutes) or very long (forty-five minutes or longer) feedings. You should reach out if your baby is extremely sleepy or hard to wake to feed, or if they are experiencing jaundice. As always, if you are ever unsure if you are experiencing these symptoms, reach out to a lactation professional who will help you work through any questions or concerns you may have.
Another common breastfeeding/chestfeeding myth is that a lactating parent has to avoid certain foods, that they have to eat specific foods, or that certain foods will make your baby gassy. The only food that a lactating parent needs to avoid is any food that they personally may be allergic to. A well-balanced diet is always recommended, however human milk is not made directly from the food that is consumed by the lactating parent. Human milk is made in the breast/chest from the lactating parent’s blood. There are no specific foods a lactating parent needs to consume in order to keep their milk supply. There are, however, foods referred to as galactogogues (ie: oats, brewers yeast, fenugreek, etc) which may or may not help to increase or decrease a milk supply, but evidence and research is limited on their use. If a food makes a lactating parent gassy, it does not cause their infant to become gassy. As stated earlier, milk is made from the lactating parent’s bloodstream. Gas does not get trapped in the parent’s bloodstream to be passed to the infant. Some foods however, may cause fussiness in a baby if they are sensitive to a particular protein that is derived from a food that was consumed by the lactating parent.
You may have also heard that if you have small breasts/chest that you cannot make a lot of milk, or if you have large breasts/chest that you will have an oversupply. This is yet another myth that is frequently shared. Breast/chest size does not determine or indicate the lactating parent’s milk supply. Lactating parents with small breasts/chest have successfully fed their children without issue, and lactating parents with large breasts/chest have experienced difficulties with feeding. The size of your breasts/chest does not determine your milk supply. Milk supply is established and maintained mostly from “supply and demand.” The more milk removals that occur throughout a 24 hour period, the more milk you will likely make. Of course, there are no absolute truths- so if you feel like you are having frequent milk removals and your baby is not meeting their feeding goals, then you would want to reach out to a lactation professional to be evaluated.
Another breastfeeding/chestfeeding myth is that you cannot breastfeed/chestfeed if you have a cesarean section. While a c-section may affect the ability to breastfeed/chestfeed in the first few hours through the first few days, a lactating parent that delivers vaginally and via c-section may both be able to feed successfully. If a c-section is necessary to deliver a baby, some common things you may experience are: delayed onset of colostrum or milk production, a sleepy newborn, and delayed first feeding. Some of these may be a cause of the birthing parent’s recovery situation, or medications used during the surgery. If you had a c-section and are experiencing difficulties, a lactation professional can help you troubleshoot a comfortable position to breastfeed/chestfeed in, and monitor your milk supply.
As a lactating parent myself, I have had people say to me, “Don’t let them use you as a pacifier.” The misconception that your baby will use your breast/chest as a pacifier or that you will spoil them if you comfort feed always frustrated me. Infants experience something called “non-nutritive sucking.” Non-nutritive sucking (NNS) is when a baby is sucking without receiving nutrition. NNS helps babies coordinate their suck swallow skills to help soothe, to stimulate the stomach to digest, and to reduce oral aversions. As a parent, the choice is yours. If you want to offer a pacifier to your baby, NNS with a pacifier may be beneficial. If you notice that it is affecting your milk supply or your baby’s ability to feed, limit the use of the pacifier. If you do not want to offer a pacifier to your baby, the breast/chest will be beneficial for NNS. Remember, as the parent, you get to make the decisions that fit your family’s needs.
I hope that as you read through these common misconceptions, you have a renewed sense of confidence and an understanding about lactation and infant feeding. As always, if you feel as though you or your baby may be experiencing breastfeeding/chestfeeding difficulties please reach out to a lactation professional.
Alexa is hosting a workshop called “Breastfeeding Basics” at Practically Perfect Physical Therapy on Tuesday March 7th at 5 pm. This class is a $45 investment for about 90 minutes of time spent reviewing all the things you need to know to successfully feed your baby human milk. Sign up here!
Perfectly Yours,
Dr. Mo
