Latest / Root Cause Conversations / When Breastfeeding Suddenly Gets Hard: Milk Supply, Tongue Ties & the 3-Month Shift with Tabitha Baker, RN, BSN, IBCLC

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When Breastfeeding Suddenly Gets Hard: Milk Supply, Tongue Ties & the 3-Month Shift with Tabitha Baker, RN, BSN, IBCLC · Root Cause Conversations

• 0:04
  SPEAKER_00: Hey guys, I'm Amanda Mavrokis, your host here on Root Cause Conversations, where we look beyond the symptoms, ask better questions, and connect the dots between whole person health and wellness.
• 0:18
  SPEAKER_00: I'm a speech language pathologist, myofunctional therapist, and the owner behind Salt and Light Speech and Language Resources right here in Alabama.
• 0:28
  SPEAKER_00: A quick heads up: this podcast is for educational purposes only.
• 0:32
  SPEAKER_00: It's not individualized medical advice, and it's not meant to diagnose or treat anything.
• 0:39
  SPEAKER_00: So always loop in your own provider for anything specific to you or your child.
• 0:46
  SPEAKER_00: Thanks for pulling up a seat at the table, and let's get into today's conversation.
• 0:56
  SPEAKER_00: Hey guys, today on the podcast, we're talking about breastfeeding.
• 1:01
  SPEAKER_00: It's supposed to feel natural, but for a lot of people, it's anything but easy.
• 1:06
  SPEAKER_00: And nobody can really prepare you for that.
• 1:08
  SPEAKER_00: So today we're talking with Tabitha Baker, a pediatric nurse and a lactation consultant with Birmingham Breastfeeding.
• 1:16
  SPEAKER_00: We're going to be talking about root causes behind common breastfeeding struggles, why tongue ties matter more than a lot of parents realize, and how to feel confident and supported no matter where you are in your breastfeeding journey.
• 1:30
  SPEAKER_00: Hey, Tabitha, thank you for coming on the podcast today.
• 1:34
  SPEAKER_01: Hey, Amanda, thank you so much for having me.
• 1:37
  SPEAKER_01: I'm so excited to talk and about all the things today.
• 1:40
  SPEAKER_00: Gosh, girl, me too.
• 1:41
  SPEAKER_00: I know zero about breastfeeding.
• 1:43
  SPEAKER_00: So this is going to be great.
• 1:44
  SPEAKER_00: And I have a lot of moms come into my clinic every week and they might be bringing their four-year-old, but they also have a three or four month old.
• 1:53
  SPEAKER_00: And sometimes they have questions about things.
• 1:55
  SPEAKER_00: And I'm like, ooh, I can't help you with that.
• 1:58
  SPEAKER_00: And so that's why I'm so excited to have you on here today.
• 2:01
  SPEAKER_00: So you can give us some answers to some newbie questions and things that moms really need to know.
• 2:07
  SPEAKER_01: I'm so honored to be here.
• 2:08
  SPEAKER_01: So thank you so much for asking me.
• 2:10
  SPEAKER_00: All right.
• 2:11
  SPEAKER_00: So we're just going to dive into it.
• 2:13
  SPEAKER_00: When a new mom is reaching out to you and they're researching and they may be worrying about what kind of challenges they may experience in regards to breastfeeding even before the baby arrives.
• 2:25
  SPEAKER_00: So, what are some of the biggest things that you're seeing moms researching and worrying about?
• 2:31
  SPEAKER_01: Yeah, very valid.
• 2:33
  SPEAKER_01: And especially first-time moms.
• 2:35
  SPEAKER_01: And even with other babies too, I feel like a lot of moms end up questioning like, is my milk supply going to be good?
• 2:42
  SPEAKER_01: Is my milk even going to come in?
• 2:45
  SPEAKER_01: Is my baby getting enough from me?
• 2:46
  SPEAKER_01: How do I know if they're getting enough?
• 2:48
  SPEAKER_01: And those are all very valid questions.
• 2:50
  SPEAKER_01: And that's why I have a job, which is the best thing ever.
• 2:54
  SPEAKER_01: But I think that, you know, as part of our visits, we can help answer a lot of these questions, especially is your baby getting enough?
• 3:02
  SPEAKER_01: Kind of what we do whenever we go in with visits is we can do or perform something called a weighed feed.
• 3:08
  SPEAKER_01: And so we can actually weigh the baby and then let mom nurse and then weigh the baby again.
• 3:13
  SPEAKER_01: And it can kind of give us a picture about how much they transferred.
• 3:17
  SPEAKER_01: And even that gives moms like a lot of assurance, hopefully, that their baby is getting enough.
• 3:24
  SPEAKER_01: And so that kind of helps them feel more confident.
• 3:27
  SPEAKER_01: But before, you know, mom even has a baby, I feel like a lot of moms question, is my supply even going to be good?
• 3:33
  SPEAKER_00: And before we hopped on the podcast, we were just kind of talking about some things because I really don't know a lot about breastfeeding.
• 3:41
  SPEAKER_00: And I know there are a lot of new or expectant moms out there who are probably worried about that exact same thing.
• 3:47
  SPEAKER_00: And here on the podcast, we like to talk a lot about root cause issues.
• 3:52
  SPEAKER_00: And so can you talk to us a little bit about some root cause issues that may be associated with low supply?
• 4:00
  SPEAKER_01: So when it comes to low supply, if a mom is coming to me and she's like, hey, my milk never came in, or I feel like it didn't come in enough, or when I'm pump, I only get, you know, this amount, and that's not enough for my baby.
• 4:13
  SPEAKER_01: Our brain starts to spin into three different categories as to what could be the reason for low supply.
• 4:21
  SPEAKER_01: So the first reason would be actually what's called a preglandular reason.
• 4:25
  SPEAKER_01: So glandular means like the glands that are inside the breast, is what we're referring to.
• 4:31
  SPEAKER_01: So preglandular would actually refer to like hormonal issues.
• 4:37
  SPEAKER_01: So if a mom has potentially hypothyroidism that she did not know about, or she previously has been diagnosed with PMOS, that can also contribute to low supply things such as uncontrolled diabetes.
• 4:50
  SPEAKER_01: So if a mom had gestational diabetes, she has had previous type 1 or type 2 diabetes, breasts feed off of insulin.
• 4:59
  SPEAKER_01: And so that can affect hormones and it can end up affecting milk supply as well.
• 5:04
  SPEAKER_01: Okay.
• 5:05
  SPEAKER_01: Yeah.
• 5:06
  SPEAKER_00: And so, you know, there's you tell us you'd use the acronym PMOS.
• 5:13
  SPEAKER_00: I don't know what that is.
• 5:14
  SPEAKER_00: Can you help me?
• 5:15
  SPEAKER_01: So it used to be PCOS, which stands for polycystic ovarian syndrome.
• 5:22
  SPEAKER_01: And within the last month or two, they actually changed it to PMOS.
• 5:26
  SPEAKER_01: And I hope I'm not saying this wrong, but I think it stands for like pre-metabolic ovarian syndrome.
• 5:32
  SPEAKER_01: Okay.
• 5:33
  SPEAKER_01: So yeah, and that pretty much just means it's so metabolic and there's so many different layers to it that that just kind of encompasses the definition a little bit better than the polycystic ovarian syndrome.
• 5:46
  SPEAKER_01: Correct.
• 5:47
  SPEAKER_01: And then things like if moms get put on a birth control really early, that can contribute to low supply or something called retained placenta.
• 5:56
  SPEAKER_01: So if a mom, you know, when she gives birth, after she gives birth, the placenta comes out with it.
• 6:02
  SPEAKER_01: And if any piece of that placenta got left inside, it can cause excessive bleeding and it can also trigger the body to not produce as much milk because as soon as that placenta is delivered, your body is triggered.
• 6:16
  SPEAKER_01: Like, hey, let's make milk, let's make milk.
• 6:19
  SPEAKER_01: Well, if a little piece got left in there, then your body may not be triggered as well.
• 6:24
  SPEAKER_01: Yeah.
• 6:24
  SPEAKER_01: So all that being said, so that's the first thing I'm going to think about.
• 6:28
  SPEAKER_01: So if a mom starts to tell me, yeah, I have low supply, I start going into her own medical history first.
• 6:34
  SPEAKER_01: Have you ever been diagnosed with thyroid concerns?
• 6:38
  SPEAKER_01: If they do have a previous thyroid issue, then if they're on synthroid or a medication to help with that, then their mux supply should be okay.
• 6:47
  SPEAKER_00: Okay.
• 6:47
  SPEAKER_01: So it's fixable for sure.
• 6:49
  SPEAKER_00: Okay.
• 6:50
  SPEAKER_01: Yeah.
• 6:51
  SPEAKER_00: Now, can I ask you a quick question about the retained placenta?
• 6:55
  SPEAKER_00: Yeah.
• 6:56
  SPEAKER_00: How often does that happen, Tabitha?
• 6:58
  SPEAKER_00: Like one in five people?
• 7:00
  SPEAKER_00: Is that frequently occurring?
• 7:03
  SPEAKER_01: I would not say that it happens that often.
• 7:06
  SPEAKER_01: I've probably seen it like once or twice in the five and a half years that I've been a lactation consultant.
• 7:12
  SPEAKER_01: So definitely not very often.
• 7:14
  SPEAKER_01: I feel like most OBs are pretty good about making sure that every piece comes out with it.
• 7:18
  SPEAKER_00: Okay.
• 7:19
  SPEAKER_00: All right.
• 7:19
  SPEAKER_01: The next category would be glandular.
• 7:21
  SPEAKER_01: So those would be more like anatomical variations within the breast.
• 7:26
  SPEAKER_01: So if a mom has had a previous breast surgery, so if she's had implants andor a reduction, we're starting to question where was the incision at, how much damage was done potentially to the breast, and how much time has it been since the procedure.
• 7:44
  SPEAKER_01: Time is actually valuable in this situation because the more time it has been since implants were put in and/or a reduction, your body has had more time to recover and potentially make more milk making ducts.
• 7:58
  SPEAKER_01: If a mom tells me, like, oh, I had a reduction last year, I'm starting to think and question, okay, we don't know exactly how many milk ducts were severed during that process.
• 8:09
  SPEAKER_01: And so if that happens, then that's when we are talking about what it may look like for that mom to potentially have a load supply the whole time.
• 8:20
  SPEAKER_01: And then the last thing in that category would be something called insufficient glandular tissue.
• 8:26
  SPEAKER_01: And that is really hard to explain to a mom.
• 8:29
  SPEAKER_01: Essentially, it has to do with how breasts developed during puberty.
• 8:34
  SPEAKER_01: And if their breast did not grow the correct way and did not fill out the correct way, then there's a potential that they will also have low milk supply with that.
• 8:45
  SPEAKER_01: And with IgT is the short name for insufficient glandular tissue, that typically can a lot of times go hand in hand actually with PMOS.
• 8:57
  SPEAKER_01: Okay.
• 8:58
  SPEAKER_01: There's some correlation there between preglandular and glandular.
• 9:02
  SPEAKER_01: I would love to talk about prenatals in just a little bit, but in a prenatal assessment that we do with a mom, we are doing a whole breast assessment on her.
• 9:11
  SPEAKER_01: And while, of course, we don't have like special goggles to be able to look inside the breast and see what everything looks like, we can do an assessment from the outside and kind of get an idea if they're missing any quadrants or breast tissue just at first glance.
• 9:25
  SPEAKER_01: That's kind of part of our training is being able to do an assessment on a mom and look at her and just say, hey, you may have potential here for missing something.
• 9:34
  SPEAKER_01: And there are things that can kind of help with that as well.
• 9:38
  SPEAKER_01: So those are the two of the reasons why a mom may go into a low milk supply.
• 9:42
  SPEAKER_01: So the last reason would be post-glandular.
• 9:46
  SPEAKER_01: So this is, you know, preglandular could be things that were before the baby was even here that's going to contribute to low supply.
• 9:53
  SPEAKER_01: Glandular could be, you know, anatomical things.
• 9:56
  SPEAKER_01: And then postglandular is typically afterbirth.
• 9:59
  SPEAKER_01: So the biggest reason would be mom's just not stimulating enough.
• 10:03
  SPEAKER_01: She tells me that she is only, you know, putting her baby to the breast four times a day.
• 10:09
  SPEAKER_01: And then she's giving bottles of formula the rest of the time, which is totally okay.
• 10:13
  SPEAKER_01: Like if a mom chooses to go that route, absolutely.
• 10:16
  SPEAKER_01: But if a mom is choosing to want to fully breastfeed her baby, you have to stimulate your breast eight to 12 times a day in those early days to help bring in your milk supply.
• 10:28
  SPEAKER_00: That's a lot.
• 10:30
  SPEAKER_01: Yeah, it's it feels like a lot.
• 10:32
  SPEAKER_01: But what I tell moms is I'm like, even if you were just deciding to like bottle feed with formula, you still have to feed your baby at least eight times a day in those early days to help with their weight.
• 10:43
  SPEAKER_01: So I'm like, either way, you're gonna be feeding a baby every three hours at least.
• 10:48
  SPEAKER_01: Okay.
• 10:48
  SPEAKER_01: So really it's, you know, it's kind of the same thing.
• 10:51
  SPEAKER_01: But it does sound definitely very daunting to a new mom.
• 10:54
  SPEAKER_01: They're like, wait, I have to stimulate my breast eight to twelve times a day.
• 10:59
  SPEAKER_01: But that is, you know, the science behind it.
• 11:02
  SPEAKER_01: That's what they say, you know, this is what's gonna help your milk supply.
• 11:05
  SPEAKER_01: This is what's gonna help it come in.
• 11:07
  SPEAKER_01: But in the early days, it's so important to feed your baby eight to twelve times a day.
• 11:12
  SPEAKER_01: So a mom may not have enough milk supply just from that.
• 11:16
  SPEAKER_01: Like they haven't stimulated the breast enough.
• 11:18
  SPEAKER_01: The other thing would be how is the milk being removed?
• 11:22
  SPEAKER_01: So if they're not using the right type of pump, they're not using the right settings on that pump, they're not using the right flange size, all those things can affect how the milk is being removed by a pump.
• 11:33
  SPEAKER_01: And the last thing would be the baby's function.
• 11:37
  SPEAKER_01: So let's say a mom has been feeding, you know, 12 times a day and she is like, we are doing everything right.
• 11:44
  SPEAKER_01: I thought my milk supply was good, but now it seems like it's not good, and the baby isn't gaining weight.
• 11:51
  SPEAKER_01: Then my mind starts to trigger what is a baby's function like?
• 11:55
  SPEAKER_01: You know, does it can it suck?
• 11:57
  SPEAKER_01: So part of our assessment is that we do a suck assessment to a gloved finger, and we're looking at how they can cup their tongue to our finger and remain that cupping.
• 12:09
  SPEAKER_01: So a lot of babies, you know, they can cup their tongue at first, but then like as they start to suckle, they lose that suction very easily.
• 12:17
  SPEAKER_00: So just to kind of recap to everybody, the three categories are pre-glandular, glandular, and then postglandular.
• 12:24
  SPEAKER_00: And so we're looking at before the baby got there, glandular, any sort of anatomical things or maybe even any surgeries to the breast tissue.
• 12:32
  SPEAKER_00: And then the postglandular is mostly afterbirth, and it could be that mom's not stimulating enough, or there could be some anatomical issues with the baby.
• 12:42
  SPEAKER_00: Correct.
• 12:43
  SPEAKER_00: So can we talk a little bit about what those anatomical issues might be?
• 12:48
  SPEAKER_00: Like if the baby is struggling to latch or feed efficiently or gain weight.
• 12:53
  SPEAKER_00: Like, what are you looking for is the underlying issues there?
• 12:57
  SPEAKER_01: So if I've already going back to the gaining weight, if I've already like figured out that mom has a great milk supply and baby still is not gaining weight, then I'm looking to see if they have any oral restrictions.
• 13:09
  SPEAKER_01: Some people, you know, refer to oral restrictions as like tongue ties, lip ties, things of that nature, which, you know, in our community, a lot of people have different opinions about.
• 13:18
  SPEAKER_01: But at the end of the day, tongue ties and oral restrictions do affect breastfeeding.
• 13:23
  SPEAKER_01: Yes.
• 13:23
  SPEAKER_01: Because you have to be able to use your tongue to get milk out from the breast.
• 13:28
  SPEAKER_01: But in order to effectively get milk out from the breast, your tongue has to be able to cup, lift, move side to side, do all those things efficiently in order to get milk out from the breast.
• 13:40
  SPEAKER_01: So I'm looking to see if I can see anything visible there.
• 13:43
  SPEAKER_01: I'm technically not allowed to diagnose, but I can look at the function and say, like, there's a possibility that this may be going on.
• 13:52
  SPEAKER_01: Let's refer you out to someone to get an official diagnosis on this.
• 13:57
  SPEAKER_01: And so that's kind of what we can help do in that area.
• 14:02
  SPEAKER_01: And, you know, let's say a baby, I think that they may have a potential oral restriction.
• 14:07
  SPEAKER_01: I tell moms, I'm like, in my personal experience, not every single one needs intervention.
• 14:14
  SPEAKER_01: If we can work on the oral function, then and we can work on gaining function within that tongue the right way, and we can work on oral strengthening, then that is going to be so key to knowing if we need intervention or not.
• 14:29
  SPEAKER_00: I'm so glad that you made that point because sometimes it could be a low tone issue.
• 14:34
  SPEAKER_00: There's it could be three things at play here, right?
• 14:37
  SPEAKER_00: I mean, you could have a tongue tie, but there could be other things going on as well.
• 14:41
  SPEAKER_01: We refer out all the time to, you know, PT, OT for babies, because a lot of times people think it's just the mouse that is affecting things.
• 14:51
  SPEAKER_01: And like if this baby has a strong tortois or I can see like other tension within the body, the baby's really stiff, that can also affect feeding.
• 15:02
  SPEAKER_01: And a lot of people don't think about that, but it really can.
• 15:05
  SPEAKER_01: And a lot of times, if you can relieve relieve tension other places in the body, that's just gonna help feeding overall.
• 15:12
  SPEAKER_01: And we may not ever even need an intervention, which would be best case scenario.
• 15:17
  SPEAKER_00: I mean, like we're one person, it's all connected.
• 15:21
  SPEAKER_00: And when you have tightness throughout your body, it's gonna show up in other places.
• 15:26
  SPEAKER_00: And so I'm also glad that you made that correlation to our audience as well, because sometimes it's not just the tongue tie.
• 15:34
  SPEAKER_00: Don't get me wrong, it absolutely could be, but there's three or four other things we need to look at too, because we're a whole person.
• 15:40
  SPEAKER_00: And so we have to look at the whole child.
• 15:43
  SPEAKER_01: So if a baby has been feeding at the breast and they haven't been able to get the milk out adequately, so they've been latching on and they've been sucking, but if it hasn't been efficient over time, that can slowly decrease a mom's milk supply.
• 15:59
  SPEAKER_00: So they're not emptying, and so it's telling the body, oh, well, we're not even empty, we don't need to make anymore.
• 16:05
  SPEAKER_01: And actually, what we see a lot is, you know, mom's milk supply.
• 16:09
  SPEAKER_01: So for the first three months, mom's milk supply is driven a ton by hormones.
• 16:16
  SPEAKER_01: So those hormones that right after you give birth, you have a ton of hormones along with stimulation at the breast that is helping tell your body, this is we got to keep making milk, keep making milk.
• 16:27
  SPEAKER_01: Around three months is when it kind of switches over to just supply and demand.
• 16:34
  SPEAKER_01: So less hormones, more supply and demand.
• 16:37
  SPEAKER_01: So whatever the baby is demanding from the mom at that point is what the mom supply is going to be.
• 16:46
  SPEAKER_01: What can happen is the first three months, baby has a great natural suck reflex.
• 16:52
  SPEAKER_01: That reflex starts to integrate closer to three months.
• 16:56
  SPEAKER_01: Mom supply has been amazing this whole time.
• 16:59
  SPEAKER_01: And baby has just been kind of getting by because mom has such a good milk supply because she had so many hormones that were helping drive that milk supply.
• 17:07
  SPEAKER_01: At four months, they go in and our pediatrician says, Oh man, your the weight looks like it's dropped.
• 17:14
  SPEAKER_01: It's the baby's falling off the curve, off their curve.
• 17:18
  SPEAKER_01: But what happens there is there's that switch.
• 17:21
  SPEAKER_01: There's that switch where mom's it switches over to just supply and demand.
• 17:27
  SPEAKER_01: And then on top of that, the baby suck reflex starts to integrate some.
• 17:31
  SPEAKER_01: And so when that happens, if the oral function was never there to begin with, then at three months, that's when you're going to start to see that big weight dip.
• 17:41
  SPEAKER_00: Up until the three-month point, things have been going great with mom, and we may not have really noticed that the baby didn't have the best latch or wasn't emptying well.
• 17:51
  SPEAKER_00: But when those hormones decrease and it's just a supply and demand issue, then we start noticing.
• 17:58
  SPEAKER_00: Well, and then I think probably moms are questioning themselves first, you know, what's happening in their body, but function with the baby the whole time.
• 18:06
  SPEAKER_00: And we just we're just now noticing it at month four.
• 18:09
  SPEAKER_00: Correct.
• 18:10
  SPEAKER_00: Learning new things to happen.
• 18:12
  SPEAKER_00: Yeah.
• 18:13
  SPEAKER_00: So what about I I don't know if this happens frequently.
• 18:17
  SPEAKER_00: So I'm just gonna ask, what if a mom is really struggling with breastfeeding?
• 18:24
  SPEAKER_00: I don't know if all breastfeeding moms go see a lactation consultant.
• 18:27
  SPEAKER_00: I don't know if that's something that everybody does.
• 18:30
  SPEAKER_00: But what if they're really not getting clear answers and people are just saying, just give it time, give it time.
• 18:38
  SPEAKER_00: What's like one or two red flags and you're like, no, let's not give it time.
• 18:42
  SPEAKER_00: Let's move forward with X, Y, and Z.
• 18:44
  SPEAKER_01: If a mom has come to me and she has said that her baby has been gaining weight and then all of a sudden it is not, I especially at four months, I really want to be really quick to figure out what is going on at that point because my mind typically does go to this baby's oral function is not right or isn't working the way that it should.
• 19:05
  SPEAKER_01: But I think weight is a huge thing for me to be like, hey, that's a red flag, especially if the baby has been gaining so well.
• 19:15
  SPEAKER_01: It is just very rare that just out of nowhere, this baby should just stop gaining weight the way that it was.
• 19:24
  SPEAKER_01: And so that is typically a pretty big red flag to me to be like, we need to look into this further and we possibly need to do something about this quicker.
• 19:32
  SPEAKER_00: Okay.
• 19:33
  SPEAKER_00: Yes.
• 19:33
  SPEAKER_00: Now we've talked about the oral function with the baby.
• 19:36
  SPEAKER_00: What about things related to positioning and technique?
• 19:41
  SPEAKER_00: Does sometimes those things play into that?
• 19:43
  SPEAKER_00: Can you do a little deep dive on like positioning and technique?
• 19:47
  SPEAKER_01: So a lot of people, when they think about breastfeeding, they will have the baby.
• 19:52
  SPEAKER_01: If you think about a baby laying in mom's lap where the chest is facing up towards the sky, when you think about drinking a cup of water, you're not drinking it with your head turned to the side and the cup up.
• 20:05
  SPEAKER_01: You are all in one midline.
• 20:07
  SPEAKER_01: So you're you're holding a cup of water and you're drinking it just right in front of you.
• 20:11
  SPEAKER_01: So when you think about a baby latching to the breast, you actually want baby to be turned with their belly facing your belly.
• 20:19
  SPEAKER_01: Okay.
• 20:19
  SPEAKER_01: So where they're feeding at the breast, you want them all in one midline.
• 20:23
  SPEAKER_01: So their ear, shoulder, and hips are all in one straight line.
• 20:27
  SPEAKER_01: And so a lot of times when I'm coming in, that's one of the first things I'm looking at.
• 20:31
  SPEAKER_01: How is this mom positioning this baby?
• 20:33
  SPEAKER_01: Is she turning baby towards her so that this baby's all in one straight midline?
• 20:39
  SPEAKER_01: Because if she is not, and she is just turning baby's head and not its whole body, babies can't latch super long like that.
• 20:47
  SPEAKER_01: And they typically end up being pretty shallow as well.
• 20:50
  SPEAKER_00: Because they're they're in a more recumbent position.
• 20:54
  SPEAKER_00: And so I would think that would just impact their ability to be able to hold that latch because their body's in such a strained position, they can't actually use the rest of their body like to support them through the latch.
• 21:05
  SPEAKER_01: And some babies, you know, especially a fresh newborn baby, they're so tiny at first.
• 21:10
  SPEAKER_01: And, you know, I think the Lord 100% made mom's bodies to be able to provide breast milk for their babies.
• 21:18
  SPEAKER_01: But, you know, you and your baby have never learned to latch.
• 21:21
  SPEAKER_01: And that's something that y'all are learning and figuring out together.
• 21:23
  SPEAKER_01: And y'all have to learn how to latch effectively together.
• 21:26
  SPEAKER_01: And so sometimes with a fresh newborn baby, sometimes that mom just needs better support with positioning in order to help her baby latch and stay latched longer.
• 21:36
  SPEAKER_01: And it's just a simple fix like that, which those are my favorite ones to do because I'm like, this is just and once you show a mom, she's like, Oh my gosh, this makes so much more sense.
• 21:45
  SPEAKER_00: Like, I feel so much better now.
• 21:47
  SPEAKER_00: It kind of makes you and mom feel great because you're like, Wow, this is a simple fix.
• 21:52
  SPEAKER_00: Like, this took five minutes.
• 21:53
  SPEAKER_00: Why did I not know this to begin?
• 21:55
  SPEAKER_01: But at the same time, like, how would they know, you know, unless like they've Had a friend or they have a sister or someone, like so much of first time parenting, especially comes with like learning the little things like that.
• 22:08
  SPEAKER_01: And so I just want to validate like that is so normal if a mom is feeling like, I'm so lost, I'm so confused.
• 22:14
  SPEAKER_01: Why does this seem so hard for me?
• 22:17
  SPEAKER_00: Well, and you've never done it before, you know?
• 22:20
  SPEAKER_00: Yeah.
• 22:20
  SPEAKER_00: There's a learning curve to everything.
• 22:22
  SPEAKER_00: Yeah.
• 22:23
  SPEAKER_00: I'm sure that one has a pretty wide one.
• 22:26
  SPEAKER_00: I mean, like you think it should be simple and straightforward, but you do have to put things in place and do all the techniques and things correctly to have a good latch and a good flow and keep your supply up to where it needs to be to meet baby's needs.
• 22:40
  SPEAKER_01: Yeah, 100%.
• 22:42
  SPEAKER_01: I agree.
• 22:43
  SPEAKER_00: Now, earlier when we were discussing the three categories when we were talking about low supply, you said you wanted to talk about prenatals.
• 22:51
  SPEAKER_00: Let's dive into that.
• 22:53
  SPEAKER_01: So if anyone asks me, what is the one thing that a mom should do before she has a baby to set herself up for success with breastfeeding?
• 23:02
  SPEAKER_01: It is to do a prenatal.
• 23:04
  SPEAKER_01: Birmingham breastfeeding actually offers prenatal classes every couple of months, but she offers classes and you can learn almost everything you need to know in order to set yourself up for success for breastfeeding right after.
• 23:17
  SPEAKER_01: So many moms prepare for the birth, they prepare for the nursery, they prepare for everything they need for the baby, but they don't think about feeding.
• 23:25
  SPEAKER_01: And so, really, that's like the number one advice that I could give moms is do a prenatal.
• 23:30
  SPEAKER_01: And if you cannot make one of our classes, then we also do individual prenatals with moms.
• 23:35
  SPEAKER_01: So if it's a mom who's kind of sitting there and she's like, hey, I don't have any of those pregandular reasons or grandular reason, then the breastfeeding class would be perfect for you because you're just learning the basics, you're learning the positioning, you're learning everything you need to know about feeding a baby right after birth.
• 23:56
  SPEAKER_01: If a mom is listening to this and she's kind of like, oh man, we had some fertility issues.
• 24:02
  SPEAKER_01: I have been diagnosed with PMOS.
• 24:05
  SPEAKER_01: I do have history of hypothyroidism.
• 24:08
  SPEAKER_01: Wait, I have had a breast reduction.
• 24:10
  SPEAKER_01: That would be worth it to have an individual prenatal with one of us where we can talk about everything individualized to you on how to set your breastfeeding journey up for success.
• 24:22
  SPEAKER_00: You have a class, you have like individual one-on-one sessions at Birmingham breastfeeding, just to kind of meet these mamas where they're at, depending upon their current and past medical history.
• 24:33
  SPEAKER_00: That's awesome, Tabitha.
• 24:34
  SPEAKER_01: Yeah, it's really great.
• 24:36
  SPEAKER_01: And I hands down am like that is the number one thing that a mom should do when they're pregnant.
• 24:41
  SPEAKER_00: Right after that.
• 24:42
  SPEAKER_01: If he's wanting to breastfeed.
• 24:43
  SPEAKER_00: And it's 90 minutes long.
• 24:45
  SPEAKER_00: That's amazing.
• 24:46
  SPEAKER_00: That's a really long appointment.
• 24:47
  SPEAKER_00: So I'm sure they're getting a lot of meat and potatoes out of that one.
• 24:50
  SPEAKER_00: We can go over pumps, measure you for your flange size, all the things.
• 24:54
  SPEAKER_00: Okay.
• 24:55
  SPEAKER_00: Can you tell us maybe like three things that you guys cover like in your prenatal classes?
• 25:00
  SPEAKER_01: So we talk about the benefits of breast milk for both baby and mom.
• 25:05
  SPEAKER_01: And then we also talk about positioning and we also talk about hunger cues and how to know when they're full, which is a lot of questions we get from moms.
• 25:16
  SPEAKER_01: Like, how do I know when the baby's hungry?
• 25:19
  SPEAKER_01: And how do I know when they're full?
• 25:20
  SPEAKER_01: Like, how many minutes should I be feeding for every time I feed?
• 25:23
  SPEAKER_01: And how do I know when they're full?
• 25:25
  SPEAKER_01: So those are questions that we can answer in a prenatal.
• 25:29
  SPEAKER_00: Okay.
• 25:30
  SPEAKER_00: Now I follow you guys on social media and I noticed that Jordan has been posting a lot about your breast pump may be completely covered by insurance.
• 25:40
  SPEAKER_00: Okay.
• 25:41
  SPEAKER_00: I mean, are we getting the insurance company to pay for some things to have with them?
• 25:44
  SPEAKER_00: Yes.
• 25:45
  SPEAKER_01: So technically, through the Affordable Care Act, every mom should be able to get a breast pump covered through insurance.
• 25:53
  SPEAKER_01: Now there's different ways that you can go about that.
• 25:55
  SPEAKER_01: You can call your insurance company directly.
• 25:58
  SPEAKER_01: There's different companies out there where you can like kind of input your insurance information and they'll kind of tell you, hey, these are the breast pumps that your insurance will cover.
• 26:07
  SPEAKER_01: But thankfully, through Birmingham Breastfeeding Now, you can upload a form and we can tell you which breast pumps are covered by your insurance.
• 26:16
  SPEAKER_01: And then we can also help guide you on which breast pump may be best suited for you and your situation.
• 26:23
  SPEAKER_01: If you're a doctor who works in the OR all day, every day, and you don't really get a lot of time to just step away and go to a pump room and pump, then we could talk about maybe the best wearable pump option for you.
• 26:35
  SPEAKER_01: And Jordan is the one who does all that and she's amazing at that.
• 26:39
  SPEAKER_01: So yeah, we're really thankful that we're able to do that now.
• 26:42
  SPEAKER_00: Guys, if you need a breast pump, reach out to Birmingham Breastfeeding.
• 26:44
  SPEAKER_00: They'll can hook you up over there and at least let you know whether it's something that your insurance insurance company will cover or not, which is, I'm sure, a huge blessing to people because I mean, like Tabitha, how much is a breast pump?
• 26:58
  SPEAKER_01: I mean, they can, it depends on which breast pump you're getting, but the best ones out there are typically at least two to two$250.
• 27:06
  SPEAKER_01: You can get cheaper options out there, but that also goes down to like, is this breast pump going to empty you effectively?
• 27:13
  SPEAKER_01: But typically insurance covers at least one good breast pump.
• 27:18
  SPEAKER_01: And what is hard for moms is let's say they'd reach out to their insurance and their insurance is like, we'll cover X, Y, Z.
• 27:24
  SPEAKER_01: Well, then that mom is like, oh man, well, I don't know which one should I pick.
• 27:28
  SPEAKER_01: You know?
• 27:28
  SPEAKER_01: How do I know which one is good and not good?
• 27:31
  SPEAKER_01: And I think that's what's helpful about going through Birmingham breastfeeding is that Jordan can help guide you on which one is the best one based off our experience from moms using them.
• 27:40
  SPEAKER_00: Okay.
• 27:40
  SPEAKER_00: And then also just your own personal situation.
• 27:44
  SPEAKER_00: I'm sure the people who come to Birmingham breastfeeding really appreciate that you get that like one-to-one support, but also like legitimate feedback from people who have already used these pumps and can give you a solid yay or nay on those.
• 27:58
  SPEAKER_00: Cause, you know, if you're spending money on it, even if your insurance is covering it, I'm sure you may have a copay.
• 28:03
  SPEAKER_00: So you want to make sure you're getting the best bang for your buck there.
• 28:06
  SPEAKER_01: You know, some of us, a lot of us, a good bit of us, actually have multiple young kids ourselves.
• 28:12
  SPEAKER_01: I actually have an almost 14-month-old that I'm still breastfeeding.
• 28:15
  SPEAKER_01: And so we've actually personally use some of these pumps as well.
• 28:18
  SPEAKER_01: What's tricky though is that, you know, a pump that works really well for me may not work really well for my friend or for my patient.
• 28:27
  SPEAKER_01: And typically, you know, they're pretty standard across the board, but there are some pumps, like I can even remember like Jordan loved this one breast pump.
• 28:36
  SPEAKER_01: And then I got it, and I didn't like love it as much as she did.
• 28:39
  SPEAKER_01: But at the end of the day, most breast pumps that we're recommending are pretty standard, and most moms have had good reviews across the line for them.
• 28:48
  SPEAKER_00: Thanks for giving us all that information.
• 28:50
  SPEAKER_00: And for everybody out there, go to Birmingham Breastfeeding, use their website, use their services so that they can help you guys on this journey.
• 28:58
  SPEAKER_00: You know, we've talked a lot on the podcast today, and we've talked about hormones and we've talked about prenatals and we've talked about tongue ties and babies' function.
• 29:08
  SPEAKER_00: And you specifically emphasized, you know, if they have availability to come to one of your prenatal classes, that's a great place to start.
• 29:16
  SPEAKER_00: But if they have some underlying issues, they might benefit from more of a one-on-one prenatal session.
• 29:23
  SPEAKER_00: So taking all those things into account, and, you know, what's one thing that you wish every mom knew before her baby arrives so that she can set herself up for success?
• 29:36
  SPEAKER_00: Like, what is that one one or two things, Tabitha?
• 29:40
  SPEAKER_01: It is such a learning journey.
• 29:44
  SPEAKER_01: And even if a mom, I say this too, if she chooses to not breastfeed, that first month, you are figuring out a brand new human.
• 29:53
  SPEAKER_01: And it does take a little bit of time.
• 29:56
  SPEAKER_01: I typically tell moms, I'm like, if you can give it the first 30 days, things typically feel easier.
• 30:02
  SPEAKER_01: And I know 30 days sounds like a long time, especially when you're living the long, exhausting newborn days.
• 30:08
  SPEAKER_01: But if you can give yourself 30 days, things typically do become easier for sure.
• 30:13
  SPEAKER_01: And so I think that's typically advice that I give to a mom if I'm meeting with her before.
• 30:18
  SPEAKER_01: And then setting her up for success too.
• 30:20
  SPEAKER_01: I know we've talked about prenatals, but also just having a lactation consultant come out to your house after birth, even if you feel like things are going well, just to like give you reassurance and make sure things are going well.
• 30:33
  SPEAKER_01: And that can kind of help as well.
• 30:35
  SPEAKER_00: Also, so let's just say things are going well, Tabitha.
• 30:39
  SPEAKER_00: I have a one month old, things are looking great.
• 30:42
  SPEAKER_00: And then that four month hits that we talked about.
• 30:46
  SPEAKER_00: Yeah.
• 30:47
  SPEAKER_00: Would you guys come back out and do another follow-up visit?
• 30:50
  SPEAKER_01: Yes, a hundred percent.
• 30:52
  SPEAKER_00: Okay.
• 30:52
  SPEAKER_01: Yeah, we would definitely want to do that.
• 30:54
  SPEAKER_00: So you would help mom kind of problem solve about all those other things that we had discussed to help her figure out the next best step for her and her child on this journey.
• 31:03
  SPEAKER_01: And we meet with moms anytime within the first year.
• 31:05
  SPEAKER_01: Okay.
• 31:06
  SPEAKER_01: I have some moms who reach out to me, like things are going great.
• 31:09
  SPEAKER_01: They want to do a back-to-work consult.
• 31:11
  SPEAKER_01: So they want to talk about like what do things look like when I go back to work to maintain my milk supply.
• 31:16
  SPEAKER_01: Some moms want to talk with us at six months.
• 31:18
  SPEAKER_01: How do things look to maintain my milk supply when I'm starting to introduce baby foods?
• 31:22
  SPEAKER_01: And then we do a good bit of weaning consults also, like a mom asking us, you know, what's the best way to wean without me getting mastitis?
• 31:31
  SPEAKER_00: And how do I start to introduce whole milk?
• 31:33
  SPEAKER_00: So if somebody's six months in and there's still concern, they can absolutely reach out to you guys.
• 31:38
  SPEAKER_00: Yeah.
• 31:39
  SPEAKER_00: So, Tabitha, before we sign off today, is there anything else that you want to share with our audience that we haven't talked about?
• 31:47
  SPEAKER_01: I think the best thing that I would say is just that breastfeeding can be the most rewarding and best thing ever.
• 31:55
  SPEAKER_01: But it is also okay for it to be hard in the beginning.
• 31:58
  SPEAKER_01: And so just to give herself patience and grace for the hard days because they're long, but they truly do go by so fast.
• 32:08
  SPEAKER_01: And with every single one of my babies, even when I'm in the thick of it and I'm like, man, this is tough.
• 32:13
  SPEAKER_01: Even for me, like as a lactation consultant with all my babies, I still had hard days in the beginning.
• 32:19
  SPEAKER_01: And it does get better and it gets easier.
• 32:22
  SPEAKER_01: And the best thing I can say to a mom is that the Lord specifically picked her to be that baby's mom.
• 32:28
  SPEAKER_01: And so, yeah, just to give her the confidence in that.
• 32:32
  SPEAKER_00: Amen to that, Tabitha.
• 32:34
  SPEAKER_00: And thank you for those words of encouragement.
• 32:36
  SPEAKER_00: That was so sweet.
• 32:37
  SPEAKER_00: Thank you for sharing that with our audience today.
• 32:39
  SPEAKER_00: Yeah, for sure.
• 32:40
  SPEAKER_00: Thank you so much for having me on here.
• 32:42
  SPEAKER_00: Absolutely, Tabitha.
• 32:43
  SPEAKER_00: Thank you again.
• 32:44
  SPEAKER_00: And guys, what I'm gonna do is I'll link in the show notes a way to reach out to Birmingham Breastfeeding.
• 32:51
  SPEAKER_00: I'll put their website and their Instagram down below.
• 32:54
  SPEAKER_00: Can contact you guys and maybe get on the list for one of your prenatal classes.
• 33:00
  SPEAKER_00: Thank you for your time and sharing all of this wonderful information with us today.
• 33:04
  SPEAKER_00: It's really been meaningful and thank you for being on the podcast.
• 33:08
  SPEAKER_00: Yeah, for sure.
• 33:09
  SPEAKER_00: Thank you so much for having me.
• 33:11
  SPEAKER_00: We'll catch you guys next time.
• 33:17
  SPEAKER_00: Thanks for pulling up a seat with us today.
• 33:19
  SPEAKER_00: If this conversation gave you something to think about, make sure you're following the podcast so you don't miss what's coming next.
• 33:27
  SPEAKER_00: And while you're there, take just a second to hit those five stars.
• 33:32
  SPEAKER_00: It really does help more of the right people find these conversations.
• 33:37
  SPEAKER_00: If you're ready to start connecting some of those dots for yourself or your family, I've created a free parent guide called Could These Signs Be Connected?
• 33:47
  SPEAKER_00: It walks you through what to look for when it comes to mouth breathing, sleep, speech, and oral habits.
• 33:55
  SPEAKER_00: It gives you a starting place for knowing what questions to ask.
• 33:59
  SPEAKER_00: You'll find it linked right below in the show notes.
• 34:02
  SPEAKER_00: Until next time, keep asking questions and keep connecting those dots.
• 34:07
  SPEAKER_00: And I'll see you guys soon.