Transcript: Breastfeeding for Moms 40 and Older

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The Boob Group
Breastfeeding for Moms 40 and Older

[00:00:00]

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

LEILANI WILDE: Are you 40- years old or older, pregnant and wondering whether or not you can successfully breastfeed. What questions should you ask to prepare your breastfeeding journey? What risk factors should you be aware of? Today we’re learning how breastfeeding differs for women 40 and older. This is The Boob Group.

[Intro/Theme Music]

LEILANI WILDE: Welcome to The Boob Group, broadcasting from the Birth Education Center of Santiago. The Boob Group is your weekly, online, on-the-go support group for all things related to breastfeeding. I am your host Leilani Wilde, I am also an IBCLC and owner of Leilani’s Lactation and Doula Services. If you listen to our show, week after week, why not subscribe via iTunes, so new episodes are automatically downloaded to your mobile device for you. You can also listen to our show on the go through our free apps in the Android, iTunes and Windows Marketplace. Here is Sunny to tell us more about how you can get involved with our show.

SUNNY GAULT: Okay. Hi everybody. So, we love to hear from our listeners. We want to get feedback from you guys. What do you think of the episodes that we have done and how it has helped you in the past or maybe helped you accomplish some of your breastfeeding and pumping goals? We love that kind of feedback. So, feel free to email us through our website and we’ll include some of those comments on an upcoming episode for The Boob Group. And we have a bunch of different segments you guys can submit for as well, if you go to www.NewMommyMedia.com, click on The Boob Group and click on segments, and you’llsee all of the different segment, but I’ll highlight a couple here. So, we have one that we call our “Boob Oops” where we share our funny breastfeeding and pumping stories. So, you can submit for that. One called “Mamma Hacks”, where you can tell us about your interesting hacks that you have discovered while pumping or breastfeeding your child, and if you want to help other mamas by sharing your hacks that’s a great way to do it and we’d love to hear about other breastfeeding, pumping apps that have helped you. We like to review apps and talk about them on the show, as Leilani said The Boob Group. We have our own apps we have a network app where you can listen to all new Mommy Media shows. So we’re a big fan of apps. So if you want to submit for any of those, go ahead, over to our website www.NewMommyMedia.com. You can click on the contact link and send us an email, or if you actually want to tell your story yourself you can leave a message in our voice mail and that number is 619-866-477

LEILANI WILDE: So, we have a lot of moms on the phone that are on our panel toady. Let’s introduce them each. Go ahead Christine, introduce yourself, and tell us a little about who you are and how you many babies you have.

CHRISTINE GALLO: My name is Christine Gallo and I’m from New Jersey. I have one son. He is 14- he just turned 14 months yesterday. I’m 43 years old and he is my first child and we’re going to be trying for a second any day now.

LEILANI WILDE: Oh! Nice! Good job. Okay and Patty?

PATTY DREW: Hi, I am Patty. I’m 43. I am a stay at home mom. I have two kids. Three year old boy, and almost 9 months old girl. She’ll be nine months old tomorrow.

LEILANI WILDE: Wonderful and Suzanne?

SUZANNA MAKIELSKI: I’m Suzanne Makielski and I am a physician. So, I work full time. I have nine- eight months old tomorrow- little girl Katerina. She’s actually with me tonight. And it’s my first child.

Eight months- she’ll be eight months old tomorrow, this is my first baby. I am 46

LEILANI WILDE: 46? Wonderful! Thank you, guys.

[Theme Music]

SUNNY GAULT: Okay, so, before we get started with today’s show, we have a brand new segment that I’m real excited to tell you guys about. It’s where we do a breastfeeding quiz. Okay, so you got to put on your thinking cap, all of our listeners, how well do you understand breastfeeding? I love this. I saw, I’m actually stealing this from a blogger online. But she says, she was doing a breastfeeding quiz and she said, “Are you newbie to the boobie or are you the breast in class?” And I thought it was really funny, so.

LEILANI WILDE: Nice

SUNNY GAULT: Are you breast in class? Let’s see if we can figure this out. Okay, so what, what I am going to do is, I am, there are three questions. Two of them are true or false and the other one is a multiple choice and kind of answer these in your head and we’ll see do you do at the end. Okay, so, question number one.
1. If baby has vomiting or diarrhea you should stop breastfeeding for a while. Is that true or false? Okay number two.
2. Bigger boobs produce more milk, true or false? And number three,
3. On average, breastfeeding moms get- This is your multiple-choice question.
a. Less sleep- since they are the ones doing all the feeding.
b. The same amount of sleep as formula feeding moms.
Or
c. More sleep, since the feedings are quicker.

Okay, so, very quickly, let’s see how, we all did on this. Okay, so back to number one. If baby has vomiting or diarrhea you should stop breastfeeding for a while. Leilani is that true or false?

LEILANI WILDE: False.

SUNNY GAULT: Why, why is it false?

LEILANI WILDE: Well, because when our babies are sick, we actually need to continue breastfeeding them because the antibodies have already started working as the baby has passed the saliva through the breast milk via the nipple, starts making antibodies before you even know the baby is sick. So, if you stop breastfeeding before or as soon as your baby is sick, then you’re already, actually contributing to them becoming more sick, so it actually protects them. So, the longer you breastfeed even through their illnesses, even your own illnesses will help protect that baby.

SUNNY GAULT: Wow! And it helps with milk supply too, if you don’t want to stop all the sudden or whatever, so.

LEILANI WILDE: That’s right.

SUNNY GAULT: Okay, so number two- bigger boobs produce more milk, it makes sense, right? More place to put the milk.

LEILANI WILDE: Larger capacity?

SUNNY GAULT: Alright.

LEILANI WILDE: No, false.

SUNNY GAULT: No, it’s false.

LEILANI WILDE: Right. So, it has- the size of your breast- does not determine the amount of milk. So, keep on breastfeeding, whether you are small or large, it doesn’t matter. Just as, it’s all about how much you demand or how much is demanded from your breast. That’s how supply is built.

SUNNY GAULT: Okay. And last one:- On average, breastfeeding moms get, is it,
a. Less sleep- since they are the ones doing all the feedings.
b. The same amount of sleep as formula feeding moms.
Or
c. More sleep, since the feedings are quicker.

LEILANI WILDE: I guess, it depends on who you are asking. But technically they are supposed to get more sleep because if you are in tune with your baby. You are picking them up as soon as they are stirring, you put them to the breast, you feed them and off to sleep you both get to go.

SUNNY GAULT: Sounds good to me.

LEILANI WILDE: You don’t have to get up and make a bottle, you don’t have to wake up dad, and wake them up, and wake them up, and wake them up.

SUNNY GAULT: Yeah.

LEILANI WILDE: To get up and do it for you, so. So, actually you get to sleep a little more.

SUNNY GAULT: Alright. Well thanks for taking our little quiz guys. And for those of you who are active on our Facebook page, I’ll post it there as well and you can check it out and see if you are breast in class. So, we’ll post this online.

[Theme Music]

LEILANI WILDE: Today on The Boob Group, we’re discussing breastfeeding for moms who are 40 and or older. Our expert Jeanette Mesite Frem is an IBCLC with a private practice, in Massachusetts. Thank you for joining us Jeanette.

JEANETTE MESITE FREM: Thank you, for having me.

LEILANI WILDE: And welcome to the show. Jeanette, can women 40 and older have a successful breastfeeding relationship?

JEANETTE MESITE FREM: I think so. I think it really vary woman to woman and having- being an older mom, does not always mean, you’re going to necessarily have more problems that someone who is younger.

LEILANI WILDE: Okay. There’s a lot of reason to that and we’ll get to that as they go along. Will they struggle to have a full milk supply?
J
EANETTE MESITE FREM: Again, not necessarily. I think some women who are over 40, had preexisting reasons, why they didn’t- ready to get pregnant as easier- as easily as someone younger. So, if they did have fertility issues then that can be a red flag that there may be some hormonal issues or other medical conditions that could be an indicator that there could be a little milk supply. But of course, you just have to wait and see and address those problems when they happen.

LEILANI WILDE: So, it’s not an automatic assumption. Well, I guess some women would think that, automatic assumption, that you have to have a baby by a certain age, because you might have more difficulties, either a) Getting pregnant or b) Producing enough milk, or you know, the quality of milk or whatever. So there are a lot of myths out there.

JEANETTE MESITE FREM: I would agree with that.

LEILANI WILDE: Yeah. So, we want to really help these, parents or new parents or parents-to-be, understand that just because you are an older mom doesn’t necessarily mean, you are going to have problems. So, the type of moms that might have some problems, what would that look like?

JEANETTE MESITE FREM: Again, when you have some fertility issues, where they just could not get pregnant, hormonal issues, so if, someone have PCOS, so, Polycystic Ovary Syndrome, those with the, sort of the too big ones. Sometimes, lot of women in our country have had breast reduction or breast augmentation, sometimes that can get in the way, other times, it wouldn’t. I think a lot of the myths, lot of it is just confidence. People think, “Oh, I am high risk, because I’m older, a lot of the [inaudible] high risk, and then they have a lot of problems, so, the increased risk of C section in the older moms, and so if that happens, or if an induction that happens, at times it delays the milk coming in and so then, there could be some manifestations of breastfeeding problems. But again, those can happen to younger moms too, so. I think, when it comes down to it, having the confidence is the- I hear some older moms say “Oh, well, I have to go back to work and I need my independence and this is not going to work for me”, and others who are like, “Hey. I have been working all these years. I am confident and independent and I’m going to ask for the help when I need it and ask not to worry because I know what they want. So, I think part of that is the experience often lends itself to them getting the help factor.

LEILANI WILDE: And, I think too, maybe, the moms that have waited, till they were older, that they probably have a strong desire to be that best mom. I’m not that we all don’t want to be the best mom, but they maybe worked and waited and so, now they’re like they’ve put all the time into their careers and now they want to put all their time into breastfeeding or you know, having their relationship with their new baby. Do you, do you believe that might be some truth behind that?

JEANETTE MESITE FREM: Absolutely! I have to say some of them have lot more patience which is hard to say that, not that younger moms don’t always have that patience. I don’t want to make it a blank statement, they start off with a way of being where they are like “you know what I had to work for a lot of things in my life, we’ll eventually figure this out. I’m going to work harder and I’m going to get some help and keep being persistent and me and my baby will figure it out. And that’s ne nice think to see too.

LEILANI WILDE: And, I’m going to ask some of the panelist today. Like Christine, did you wonder could you have a full milk supply?

CHRISTINE GALLO: I did, yes. I did wonder.

LEILANI WILDE: And, did you start researching ahead of time? Or how, how did you deal with that?

CHRISTINE GALLO: I got into it by meeting the right people. Meeting Jeanette, it really helped. I got introduced to you in breastfeeding. I was more looking along the lines of the natural birth. A midwife, and a doula and then the breast milk and breastfeeding kind of fell into that line of thinking and from there it kind of just unfolded. You know when I got pregnant, it wasn’t, you know I did want to breastfeed, but it was just going to be, you know, a little bit in the beginning, maybe three months, and that was about it, you know. So, that was, for me that would be great and plenty. I never, never, never expected to be breastfeeding at 14 months and then planning to do it for another year, two years or whatever after.

LEILANI WILDE: That’s great. It empowers you once you realize you can do this.

CHRISTINE GALLO: Absolutely, yeah.

LEILANI WILDE: Yeah.

CHRISTINE GALLO: Totally.

LEILANI WILDE: How about you Patty? Did you wonder if you could have a full milk supply?

PATTY DREW: When I was pregnant with my first son I actually thought I was going to have no problem whatsoever, I was like Oh milk comes in, I’ll be able to breastfeed, it’ll be easy as the most natural thing ever and then he was actually five weeks early, had to spend two weeks in special care in the hospital. So, I didn’t pump like I should and I didn’t get the nurse right away. So I did have a little supply and then I had to supplement, worked really hard with Jeanette to do the breastfeeding as long as I could. He nursed for 15 months. So, when I became pregnant with my daughter, I was worried, I was like, “I am going to have a little supply, because I had them with my son and the exact opposite happened. It was, my daughter was born maybe a week early, or so, we nursed right away and we’ve been breastfeeding for almost nine months. No supplementing, so, it’s a lot easier the second time around which has been wonderful.

LEILANI WILDE: That’s great and how about Suzanna?

SUZANNA MAKIELSKI: Yes, hi, so, I think I just expected that I, I would nurse and I didn’t have any other- I didn’t even think about any other options. I was pregnant at 45, going to give birth at 46. Everything was going well, with this clinic invention that’s been breached. Scared about having this C section was quite warning off, so a natural birth. And my milk did take a while to come in. I was -fortunately I had a friend who- and actually going through one of the questions, she had a little boob but a lot of milk. And, I was able to get some donor milk which really helped to supplement in the beginning. And however I have been exclusively breastfeeding now doing some baby [inaudible]. But, principally breastfeeding and the baby is eight months tomorrow, so took a little to get there, but we got there.

LEILANI WILDE: That’s great. Jeanette, what are the first steps a woman should take prenatally, to help prepare herself?

JEANETTE MESITE FREM: So, I teach prenatal breastfeeding classes, I’m definitely getting a lots of education so that, especially with the partner, it’s super important for them to come to class or anybody that’s going to be around you, when the baby is, you know, first couple of weeks, so that you can find out what is normal, that’s not in the list of all those counselor may have told you- information, as well as, when to call, when do you ask for help. But, also I am a big fan of prenatal colostrum expression, and I talk a lot about that in my classes and with anybody that I meet when they’re pregnant, so that, we can go through, like how do you do that, what happens, if you don’t get anything? Atleast you’re getting experience putting the hands on your breasts and trying to get some colostrum out. But I have seen many people, now, when they practice to enable to bring colostrum with them to the hospital or at leastbe there confidence, once they get there and they know how to get some out.
And that’s been very helpful with the number of women, for whatever reason, end up having their milk take a while to come in or lot of intervention or baby is away from them for some reason because of medical issues. It’s invaluable to know, how to hand express. It makes- when you to walk in feeling confident because you know you have colostrum in there and you can get it out.

LEILANI WILDE: And do you recommend a certain time frame when to start that? I know the moms need to be aware that they could stimulate contraction, so you want to make sure you are doing it a safe time. Do you, would you recommend a specific time to start doing that?

JEANETTE MESITE FREM: Sure. I would say, like if you were told not to have intercourse, because you are so sensitive and high risk of a term labor, not a good idea to do before you are 37 or 38 weeks. But for most people the research, that I think, says around 34 weeks and I’d say if it causes contraction don’t do it, but right after a shower, doing a little squeeze here, getting partners involved, makes you more comfortable squeezing breastand exploring and it’s so hard to do it.
It’s not to hurt you, but how confident they are with the squeezing they can be. But definitely it’s not the thing you want to be getting into a pre-term labor situation with.

LEILANI WILDE: And that is true, because you want to protect the baby as well, so you will recommend if they are not having any preterm labor that they can start as early as again you said 34 weeks?

JEANETTE MESITE FREM: I do, and I find not everybody does anything, but, if they get a little bit then they usually handed a syringe so they can try to have a goal of having a needle or two to bring with them and talk about how to bring it with them to the hospital if they are having a hospital birth, but honestly I think it is just a practice of figuring out, how do I do this what’s my technique? And a lot of women haven’t touched their breasts and it’s a really great opportunity to do that for the first time. It’s like, “Okay, how am I going to do this? There’s actually something really valuable inside these and let’s see if I can get some out.”

LEILANI WILDE: That’s great. Christine, did you actually do that? Did you hand express early on?

CHRISTINE GALLO: No, no I didn’t. No, just in the hospital. Once he was born he got the colostrum.

LEILANI WILDE: Okay. Good and, how about you Patty?

PATTY DREW: No, before my son was born, I hadn’t imagined that yet. So, I wasn’t aware of all this great practice that you should be doing. So I imagine- my son was in special care, so I did try a little bit with my daughter. But I didn’t really get anything, but had some fun time.

LEILANI WILDE: And, how about you Suzanna?

SUZANNA MAKIELSKI: Yes, I expressed a little bit, but I didn’t end up taking it to the hospital. Itwas a little bit of colostrum inside the syringe, so I didn’tend up keeping that and the other one it kind of got, it looked too dunky after a while, I kept it in the refrigerator but it was a number of weeks old so.

JEANETTE MESITE FREM: You might have hurled it.

SUZANNA MAKIELSKI: That’s what I did.

LEILANI WILDE: Jennet, you would recommend what? If they saw blood in their colostrum collection what would you tell them?

JEANETTE MESITE FREM: They could feed it to their baby.

LEILANI WILDE: Right. And why is that?

JEANETTE MESITE FREM: Pretty much it comes out of you nipple, you can feed it to your baby. It’s a general.

LEILANI WILDE: I mean, what we, we hear about the components of breast milk, and it’s you know, white blood cells mostly and you know blood is just red blood cells, so it’s still all the same in basic components, it’s safe to give it to the baby. It does not harm the baby. It won’t make them sick.

JEANETTE MESITE FREM: It is so true. But I think there’s really this gut feeling that so many of us have just as humans that like, that just feels so off, you know. Just because I have breastfed before, I can imagine that feeling a little bit nerve racking.

LEILANI WILDE: Right. It would make most moms a little nervous about it. But that’s what we’re here to educate these moms, is to help them understand, you know, what is considered, okay, safe, or normal, right?

LEILANI WILDE: Yeah! Suzanna, was going to say something to us.

SUZANNA MAKIELSKI: I actually, I think it was office, you know, despite too actually, that this was like liquid gold, I kind of took it for granted thinking I’d have more. So, I dint think anything about tossing it out of the car. So, early in and I though, I can get rid of this, there’ll be more to come. It was one of those early expressions; it was just kind of a trial goal. But, I think that is an aspect of, I didn’t just know how to handle such a small amount of colostrum to keep that especially, it was red tinged. I mean it was like tiny milliliter and then I had only one other- I just didn’t know, so I just tossed it and the other syringe gave me other opportunity. So again it’s one of those things knowing for sure it was like liquid gold.

LEILANI WILDE: Jennet how would you recommend storing the colostrum that they collect even if it is one milliliter and especially if they are doing it a month in advance?

JEANETTE MESITE FREM: I try to just have an estimation. I actually don’t know that I have ever seen anybody really writedown exactly, like whether they have tested what the limitations are, so, I generally say express it, put it in the fridge for a day or two, if you want to put in a little extra on top of it, refrigerate them and then combine them and then freeze them upto a couple of days, may be not quite as long as you would keep breast milk in the fridge. It could be that you could keep colostrum in the fridge longer than that, but, given that it could be given to a very, very small baby, around the side of being more cautious, but. I would say, I think, in Suzanna’s case, she would have right down the street for me. So, I would have worked a call to say, “Hey can I have those syringes”. But not a real access to all of that so, I think even just a spoon, if people have a spoon, you could just squeeze a little bit on the spoon and stick that in the freezer and ain plus bag and collect the bunch of spoons with little drop in them, and it’s wonderful, coz even a drop or two could be amazing for a baby who’ll really need a little bit energy boost, you know in the first couple of days.

LEILANI WILDE: Right, and it all adds up. So, you know a drop or two will increase eventually with time and especially, you never know when that baby is going to come, so, every little bit is liquid gold. So, I am glad, I am glad to hear that you are educating these moms out here. When we come back, we will discuss what risk factors to be aware of and when you should reach out for professional help. We’ll be right back.

[Theme Music]

LEILANI WILDE: Welcome back to the show. We are here with Jeanette an IBCLC with private practice in Massachusetts. Jeanette what are the most common risk factors for the older moms.

JEANETTE MESITE FREM: The most common risk factors. Well, there’s a risk of having a being induced, because often in the community there’s a belief and some research that women older till 35 as well as going over 40 with the pregnancy can be a risk. So, a lot of moms, they will willingly go in for an induction and induction itself is a risk factor for at that age milk supply or milk coming in on time. So that’s an issue, then induction increase directly with cesarean and so C section can be an issue. Suzanna, she’s with us today, she was able to do breastfeeding right there in the operating room and skin on skin for a very long time and that’s super helpful and not hospitals are encouraging that that activity in the operating room. I think somehow we could do that. I think people who had a hard time getting pregnant and maybe don’t know why but eventually find out there is may be some particular syndrome or virus problem or even nutritional panels. There are some women, who have gone off and really worked on their nutrition and gotten in shape and been able to get pregnant when they couldn’t get pregnant through fertility measures. Like so many factors that go on with their health as well. You know, we get used to our diet, and we have pretty much the same diet. If you are in the area of 40 and have same diet in years, that could be a negative, without having any diversity in your diet and that could impact milk supply as well.

LEILANI WILDE: Will it prevent them from having a full supply?

JEANETTE MESITE FREM: It sometimes can. I don’t know if anybody can predict that, when it comes down to it. Sometimes you just got to breastfeed, you skin on skin, make sure baby doesn’t have a tongue tie, make sure you are expressing milk out other times, doing skin on skin again and wait and see. You know pumping maybe a part of extra wait too.

LEILANI WILDE: So, Christine can you tell us, if you faced any of these risk factors that Jeanette mentioned?

CHRISTINE GALLO: I did get induced because my water broke and I did not have contractions for several hours. They waited and I never had contractions. So, they ended up giving me- they induced me. I had an extended- a long period of- time of pushing. So then I was given Pitocin another drug to induce contractions. And as far as my supply goes, I always had a great supply and now that we are doing extended breastfeeding, the only time I notice a slight dip is, if I do have my periods. Other than that my supply is great. I have never had an issue with the supply. That was about it, for me as far as my age being a factor.

LEILANI WILDE: And what about you Patty?

PATTY DREW: I did get in some, Pitocin with my son. My water broke early at 35 weeks, was not having any contractions, so when I went to the hospital they did give me a Pitocin and I did many, many, many years ago get told that I had PCOS Haven’t really had any issues with it in the past decade or so. So, I don’t know if that have any factor with my first one. But my supply has been great with my second. So, you know, no issues, no issues with my second.

LEILANI WILDE: And, what about you Suzanna?

SUZANNA MAKIELSKI: I had the C section because my baby would breach and I actually had a really tough time in the beginning. So, the first four weeks, I finger fed my baby and probed a lot and waited and trusted that it will take time, to turn to skin on skin. Gave her every opportunity to practice, she wasn’t getting much luck in the beginning with milk transfer. But, I figured that, you know with a lot of help from Jeanette and lot of encouragement and also just allowing her to explore and she learned. You know, one of the great examples that I heard, it’s just like learning how to play and instrument or learning how to play a sport. It takes hours to practice so much to master and I though she going to need hours, as opposed to some babies who could learn right way and same this with my milk supply, it just came along, again a lot of pumping early on, as well as a lot of skin to skin. And after four weeks she became a master.

LEILANI WILDE: Awesome.

SUZANNA MAKIELSKI: And we do it now.

LEILANI WILDE: Where there any other anatomical reasons why your baby isn’t transferring, that you are aware of?

SUZANNA MAKIELSKI: No, we had both- The lactation consultant in the hospital, looked and didn’t see any over tongue tie at the time, and the pediatrician who worked closely with Jeanette didn’t see any over tongue tie. So there wasn’t anything at that point, but, no anatomical reasons. I think it was hormonal and stress-related in the beginning that really held me back.

JEANETTE MESITE FREM: We also had some craniosacral. It, some of it, it could have been just the result of the C section and the pressure, let’s say, you know mutual side effects of pulling a baby out that when you have that craniosacral work some of that may have also helped.

SUZANNA MAKIELSKI: That might have also helped, absolutely.

LEILANI WILDE: Yeah. There are a lot of different components that are involved in birth process. Carrying the baby, then the actual process of birth and the impact that it can have on the skeletal of the baby and you are right, it can affect the type of ability that they are able to do at the breast with their sucking skills or any impeachment that might happen. Sometime I explain to moms that if you woke up, sleeping on your pillow, the wrong way, you have like a kink in your neck and it’s very uncomfortable to turn your head that particular way. It’s going to make it really uncomfortable for doing certain things and sometimes when babies are out of alignment due to a birth experience or just being carried, may be they are sitting in the womb for a long time in a certain position can impact breastfeeding. So craniosacral therapy is a good way to help babies with latch or transfer problems.

SUZANNA MAKIELSKI: And, I think what happened to me was probably because [inaudible] there was a panic, you know, 24 hours after the birth that she had lost a lot of weight. So, that kind of made me feeling chilled out there, because a lot of it was simply water weight, you know fluid weight, but as a result, there was a panic in the hospital and I remember that second day for 45 minutes trying to get the baby to latch and I was in tears the baby was in tears, it was really a traumatic experience that I think also inhibited some of the subsequent attempts at latching and that bonding and then the following day just working on building trust and getting the baby back to trust being at the breast after that, experience. So, I think that, knowing that the baby can lose a lot weight in that first 24 hours and that’s normal, especially after a C section, I wish I had told you people to just leave me alone and let the baby and me figure it out . I remember that because I think that did push us back.

LEILANI WILDE: Jeanette, can you tell us a little bit about what she’s saying in regards to the weight loss due to a cesarean birth?

JEANETTE MESITE FREM: Sure. It can also happen with a long labor with I V fluid especially with Pitocin, but definitely with IV fluid. So, when someone has an I V, then the fluid gloat up and the breast responds by also filling up but, the brain thinks that there’s milk in there, that’s basically the way, it’s explained I think. The brain says, “Oh, the baby was born, but hey there also milk in those breasts. So, we don’t have to make milk.”So, there is a delay in the milk coming in but also when the ...

LEILANI WILDE: The baby also has excess fluid

JEANETTE MESITE FREM: Alright the baby. So, after the baby is born, it’s really normal even in an unindicted birth the baby is to be born with extra fluid onboard just for survival. So, it’s normal that the baby would weigh a little bit more they were at the 23rd hour. It’s becoming a little bit more standard in a lot of countries now, based on a lot of research, to weigh baby at hour 24 and if he is that as the reference weight, well you are looking at weight loss, over the first few days and weeks. We want babies to be back up to their birth weight by two weeks ideally. But if you are looking at a baby who was born after a long IV process, through an induction, or an epidural or with C section, they are going to have a much more elevated weight and so at hour 24, and 48, they are going to look like they lost way too much weight.

LEILANI WILDE: Right.

JEANETTE MESITE FREM: So, we just weigh them at hour 24. Suzanne was aware of that, we talked about that prenatally. So, she was able to kind of relax a little bit and have a conversation at the hospital about that issue and not be so freaked out about it, where, some of the people don’t’ know about it, they are like “Oh, no, my baby is losing weight” and they get tears and they say, “Okay, I guess you have to give some formula”. And sometimes the baby does need it, even that is an issue, but really just like, “wait a second, what was the hour 24 weight and then what is then percent formula”. If they say only nine to ten percent, it’s probably going to be okay. Let’s work on getting her to have some colostrum that comes and get on-get working on that, so we can feed the baby.

LEILANI WILDE: And, overall, it’s most important to understand and recognize, what proper transfer looks like. So, lot of babies will go to the breast and moms might assume that baby is breastfeeding. And sometimes even the hospital staff, maybe a Lactation Consultant, looks at from a distance and go, “Oh, yeah, baby is on, everything looks fine from here”. But, what should a mom recognize, because it’s not being 40 and older that you are having weight loss, it’s, it can happen to any age mom, in results to extra fluids onboard. So, helping moms understand what that transfer looks like from the baby’s point of view?

JEANETTE MESITE FREM: There should be plenty of dirty diapers and lots of urine. And if that’s not happening, I would say, yellow by day five, I didn’t mix that up. But obviously concerned, most people are out of the hospital by day five and every not pediatric or family practice recognizes that, poops should really be yellow, and multiple times a day, by day five, so if that is not happening that is a reason, like that you need to talk to the- a Lactation consultant.

LEILANI WILDE: And, when else should a mom reach out for help? When should she- What should she do? What should she be looking for?

JEANETTE MESITE FREM: So, many people spend the time, but it’s normal for nipples to hurt. Really for everyone what that means is different, ultimately, I always joke.I’m guessing most people would not have had someone suck on their nipple through that many hours a day ever before. So maybe there would a little bit of like, “Oh, this is kind of weird”, but there should be no cracking, there should be no bleeding and there should be no bleeding the next feeding. If that, if you like are so nervous you’re going to just wake up, because your boobs are killing you and your nipples hurt, that means there is a problem with the latch and it could be just a positional thing it could be approach, the breast you are taking as you are putting it into the mouth, itcould be the angle, it could be that baby has a tight jaw, it could be that baby has a tongue-tie or a lip tie or, but if there’s any issues with that watch and I hear so many who say, “Oh, you know, somebody at the hospital told me that the watch looked good.”
So, someone can’t tell you that from the outside, it could look good from the outside. But if you nipples hurt or if your baby is losing weight, and continue to lose weight and not gaining weight, that’s another reason that the baby is not transferring enough milk. Baby is not pooping, baby is not pooping at least once a day- there’s a lot of people on the medical world that say, that it is normal for breastfed babies to not poop every day. And that just been proven to be not true. So, it is really a great thing to monitor how much they are peeing, but it’s more important to see how much they are pooping by some of the means.

LEILANI WILDE: Okay. Thank you so much Jeanette and Christine, Patty and Suzanna, for helping us all better understand what we should consider when planning on breastfeeding as a mom who is forty years and older. And for our Boob Group Club members, our conversation will continue after the end of this show, as Jeanette will talk about how to prepare yourself mentally, and physically from being a career woman to becoming a new parent. For more information about our Boob Group club, please visit our website at www.NewMommyMedia.com

[Theme Music]

SUNNY GAULT: Alright, hey, everybody, it’s time for our fun segment we have on The Boob Group called “Boob Oops” and it’s where we share our funny breastfeeding stories and I love this one. This comes from Becky and Becky writes:

“The funniest breastfeeding experience I ever had was when my daughter was only three days old and technically it wasn’t me. She was pretty much nursing constantly. This particular morning I had to go to the bathroom before she was done. I thrust her at my husband and I asked him to take over. So, he happily laid her belly to belly on his chest while I relieved myself.” Ah, such a good husband.
“As I was coming back into the room Emily began rooding around on his chest. To his surprise, she very quickly found what she was looking for. I came into the room to his screaming, he was lifting her up in the air and screaming. Every lift that she took into the air, her head went down and his chest expanded simultaneously.

Seemed my little girl didn’t carewho’s nipple she had in her newborn mouth. Of course, I hadn’t bothered to explain to him how to unlatch a nursing baby and I never thought he would need it. I just stood there laughing until he finally pulled her hard enough to force her to let go. I told him next time, it would hurt less, if he broke suction with his finger first.”
I love this Becky. Thanks so much for sending it in. And if you guys have a funny Boob Oops,please share with us and we will share with the audience. You can reach onto us via our website, and just go to the contact link, or you can tell your story yourself at our voicemail at 619-866-4775.

[Theme Music]

LEILANI WILDE: That wraps up our show for today. We appreciate you listening to The Boob Group.
Don’t forget to check out our sister show:
• Preggie Pals for expecting parents
• Newbies for newly postpartum moms through babies first year and
• Parent Savers for moms and dads with infants and toddlers and not to forget
• Twin Talks, for parents with multiples.
Thanks for listening to The Boob Group: “Your judgment-free breastfeeding resource.”

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though such information in which areas are related to be accurate, it is not intended to replace or substitute for professional, medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: New Mommy Media is expanding our lineup of shows for new and expecting parents.If you have an idea for a new series or if you’re a business or an organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com.

[00:37:31]
[End of Audio]

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Episode Transcript

The Boob Group
Breastfeeding for Moms 40 and Older

[00:00:00]

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

LEILANI WILDE: Are you 40- years old or older, pregnant and wondering whether or not you can successfully breastfeed. What questions should you ask to prepare your breastfeeding journey? What risk factors should you be aware of? Today we’re learning how breastfeeding differs for women 40 and older. This is The Boob Group.

[Intro/Theme Music]

LEILANI WILDE: Welcome to The Boob Group, broadcasting from the Birth Education Center of Santiago. The Boob Group is your weekly, online, on-the-go support group for all things related to breastfeeding. I am your host Leilani Wilde, I am also an IBCLC and owner of Leilani’s Lactation and Doula Services. If you listen to our show, week after week, why not subscribe via iTunes, so new episodes are automatically downloaded to your mobile device for you. You can also listen to our show on the go through our free apps in the Android, iTunes and Windows Marketplace. Here is Sunny to tell us more about how you can get involved with our show.

SUNNY GAULT: Okay. Hi everybody. So, we love to hear from our listeners. We want to get feedback from you guys. What do you think of the episodes that we have done and how it has helped you in the past or maybe helped you accomplish some of your breastfeeding and pumping goals? We love that kind of feedback. So, feel free to email us through our website and we’ll include some of those comments on an upcoming episode for The Boob Group. And we have a bunch of different segments you guys can submit for as well, if you go to www.NewMommyMedia.com, click on The Boob Group and click on segments, and you’llsee all of the different segment, but I’ll highlight a couple here. So, we have one that we call our “Boob Oops” where we share our funny breastfeeding and pumping stories. So, you can submit for that. One called “Mamma Hacks”, where you can tell us about your interesting hacks that you have discovered while pumping or breastfeeding your child, and if you want to help other mamas by sharing your hacks that’s a great way to do it and we’d love to hear about other breastfeeding, pumping apps that have helped you. We like to review apps and talk about them on the show, as Leilani said The Boob Group. We have our own apps we have a network app where you can listen to all new Mommy Media shows. So we’re a big fan of apps. So if you want to submit for any of those, go ahead, over to our website www.NewMommyMedia.com. You can click on the contact link and send us an email, or if you actually want to tell your story yourself you can leave a message in our voice mail and that number is 619-866-477

LEILANI WILDE: So, we have a lot of moms on the phone that are on our panel toady. Let’s introduce them each. Go ahead Christine, introduce yourself, and tell us a little about who you are and how you many babies you have.

CHRISTINE GALLO: My name is Christine Gallo and I’m from New Jersey. I have one son. He is 14- he just turned 14 months yesterday. I’m 43 years old and he is my first child and we’re going to be trying for a second any day now.

LEILANI WILDE: Oh! Nice! Good job. Okay and Patty?

PATTY DREW: Hi, I am Patty. I’m 43. I am a stay at home mom. I have two kids. Three year old boy, and almost 9 months old girl. She’ll be nine months old tomorrow.

LEILANI WILDE: Wonderful and Suzanne?

SUZANNA MAKIELSKI: I’m Suzanne Makielski and I am a physician. So, I work full time. I have nine- eight months old tomorrow- little girl Katerina. She’s actually with me tonight. And it’s my first child.

Eight months- she’ll be eight months old tomorrow, this is my first baby. I am 46

LEILANI WILDE: 46? Wonderful! Thank you, guys.

[Theme Music]

SUNNY GAULT: Okay, so, before we get started with today’s show, we have a brand new segment that I’m real excited to tell you guys about. It’s where we do a breastfeeding quiz. Okay, so you got to put on your thinking cap, all of our listeners, how well do you understand breastfeeding? I love this. I saw, I’m actually stealing this from a blogger online. But she says, she was doing a breastfeeding quiz and she said, “Are you newbie to the boobie or are you the breast in class?” And I thought it was really funny, so.

LEILANI WILDE: Nice

SUNNY GAULT: Are you breast in class? Let’s see if we can figure this out. Okay, so what, what I am going to do is, I am, there are three questions. Two of them are true or false and the other one is a multiple choice and kind of answer these in your head and we’ll see do you do at the end. Okay, so, question number one.
1. If baby has vomiting or diarrhea you should stop breastfeeding for a while. Is that true or false? Okay number two.
2. Bigger boobs produce more milk, true or false? And number three,
3. On average, breastfeeding moms get- This is your multiple-choice question.
a. Less sleep- since they are the ones doing all the feeding.
b. The same amount of sleep as formula feeding moms.
Or
c. More sleep, since the feedings are quicker.

Okay, so, very quickly, let’s see how, we all did on this. Okay, so back to number one. If baby has vomiting or diarrhea you should stop breastfeeding for a while. Leilani is that true or false?

LEILANI WILDE: False.

SUNNY GAULT: Why, why is it false?

LEILANI WILDE: Well, because when our babies are sick, we actually need to continue breastfeeding them because the antibodies have already started working as the baby has passed the saliva through the breast milk via the nipple, starts making antibodies before you even know the baby is sick. So, if you stop breastfeeding before or as soon as your baby is sick, then you’re already, actually contributing to them becoming more sick, so it actually protects them. So, the longer you breastfeed even through their illnesses, even your own illnesses will help protect that baby.

SUNNY GAULT: Wow! And it helps with milk supply too, if you don’t want to stop all the sudden or whatever, so.

LEILANI WILDE: That’s right.

SUNNY GAULT: Okay, so number two- bigger boobs produce more milk, it makes sense, right? More place to put the milk.

LEILANI WILDE: Larger capacity?

SUNNY GAULT: Alright.

LEILANI WILDE: No, false.

SUNNY GAULT: No, it’s false.

LEILANI WILDE: Right. So, it has- the size of your breast- does not determine the amount of milk. So, keep on breastfeeding, whether you are small or large, it doesn’t matter. Just as, it’s all about how much you demand or how much is demanded from your breast. That’s how supply is built.

SUNNY GAULT: Okay. And last one:- On average, breastfeeding moms get, is it,
a. Less sleep- since they are the ones doing all the feedings.
b. The same amount of sleep as formula feeding moms.
Or
c. More sleep, since the feedings are quicker.

LEILANI WILDE: I guess, it depends on who you are asking. But technically they are supposed to get more sleep because if you are in tune with your baby. You are picking them up as soon as they are stirring, you put them to the breast, you feed them and off to sleep you both get to go.

SUNNY GAULT: Sounds good to me.

LEILANI WILDE: You don’t have to get up and make a bottle, you don’t have to wake up dad, and wake them up, and wake them up, and wake them up.

SUNNY GAULT: Yeah.

LEILANI WILDE: To get up and do it for you, so. So, actually you get to sleep a little more.

SUNNY GAULT: Alright. Well thanks for taking our little quiz guys. And for those of you who are active on our Facebook page, I’ll post it there as well and you can check it out and see if you are breast in class. So, we’ll post this online.

[Theme Music]

LEILANI WILDE: Today on The Boob Group, we’re discussing breastfeeding for moms who are 40 and or older. Our expert Jeanette Mesite Frem is an IBCLC with a private practice, in Massachusetts. Thank you for joining us Jeanette.

JEANETTE MESITE FREM: Thank you, for having me.

LEILANI WILDE: And welcome to the show. Jeanette, can women 40 and older have a successful breastfeeding relationship?

JEANETTE MESITE FREM: I think so. I think it really vary woman to woman and having- being an older mom, does not always mean, you’re going to necessarily have more problems that someone who is younger.

LEILANI WILDE: Okay. There’s a lot of reason to that and we’ll get to that as they go along. Will they struggle to have a full milk supply?
J
EANETTE MESITE FREM: Again, not necessarily. I think some women who are over 40, had preexisting reasons, why they didn’t- ready to get pregnant as easier- as easily as someone younger. So, if they did have fertility issues then that can be a red flag that there may be some hormonal issues or other medical conditions that could be an indicator that there could be a little milk supply. But of course, you just have to wait and see and address those problems when they happen.

LEILANI WILDE: So, it’s not an automatic assumption. Well, I guess some women would think that, automatic assumption, that you have to have a baby by a certain age, because you might have more difficulties, either a) Getting pregnant or b) Producing enough milk, or you know, the quality of milk or whatever. So there are a lot of myths out there.

JEANETTE MESITE FREM: I would agree with that.

LEILANI WILDE: Yeah. So, we want to really help these, parents or new parents or parents-to-be, understand that just because you are an older mom doesn’t necessarily mean, you are going to have problems. So, the type of moms that might have some problems, what would that look like?

JEANETTE MESITE FREM: Again, when you have some fertility issues, where they just could not get pregnant, hormonal issues, so if, someone have PCOS, so, Polycystic Ovary Syndrome, those with the, sort of the too big ones. Sometimes, lot of women in our country have had breast reduction or breast augmentation, sometimes that can get in the way, other times, it wouldn’t. I think a lot of the myths, lot of it is just confidence. People think, “Oh, I am high risk, because I’m older, a lot of the [inaudible] high risk, and then they have a lot of problems, so, the increased risk of C section in the older moms, and so if that happens, or if an induction that happens, at times it delays the milk coming in and so then, there could be some manifestations of breastfeeding problems. But again, those can happen to younger moms too, so. I think, when it comes down to it, having the confidence is the- I hear some older moms say “Oh, well, I have to go back to work and I need my independence and this is not going to work for me”, and others who are like, “Hey. I have been working all these years. I am confident and independent and I’m going to ask for the help when I need it and ask not to worry because I know what they want. So, I think part of that is the experience often lends itself to them getting the help factor.

LEILANI WILDE: And, I think too, maybe, the moms that have waited, till they were older, that they probably have a strong desire to be that best mom. I’m not that we all don’t want to be the best mom, but they maybe worked and waited and so, now they’re like they’ve put all the time into their careers and now they want to put all their time into breastfeeding or you know, having their relationship with their new baby. Do you, do you believe that might be some truth behind that?

JEANETTE MESITE FREM: Absolutely! I have to say some of them have lot more patience which is hard to say that, not that younger moms don’t always have that patience. I don’t want to make it a blank statement, they start off with a way of being where they are like “you know what I had to work for a lot of things in my life, we’ll eventually figure this out. I’m going to work harder and I’m going to get some help and keep being persistent and me and my baby will figure it out. And that’s ne nice think to see too.

LEILANI WILDE: And, I’m going to ask some of the panelist today. Like Christine, did you wonder could you have a full milk supply?

CHRISTINE GALLO: I did, yes. I did wonder.

LEILANI WILDE: And, did you start researching ahead of time? Or how, how did you deal with that?

CHRISTINE GALLO: I got into it by meeting the right people. Meeting Jeanette, it really helped. I got introduced to you in breastfeeding. I was more looking along the lines of the natural birth. A midwife, and a doula and then the breast milk and breastfeeding kind of fell into that line of thinking and from there it kind of just unfolded. You know when I got pregnant, it wasn’t, you know I did want to breastfeed, but it was just going to be, you know, a little bit in the beginning, maybe three months, and that was about it, you know. So, that was, for me that would be great and plenty. I never, never, never expected to be breastfeeding at 14 months and then planning to do it for another year, two years or whatever after.

LEILANI WILDE: That’s great. It empowers you once you realize you can do this.

CHRISTINE GALLO: Absolutely, yeah.

LEILANI WILDE: Yeah.

CHRISTINE GALLO: Totally.

LEILANI WILDE: How about you Patty? Did you wonder if you could have a full milk supply?

PATTY DREW: When I was pregnant with my first son I actually thought I was going to have no problem whatsoever, I was like Oh milk comes in, I’ll be able to breastfeed, it’ll be easy as the most natural thing ever and then he was actually five weeks early, had to spend two weeks in special care in the hospital. So, I didn’t pump like I should and I didn’t get the nurse right away. So I did have a little supply and then I had to supplement, worked really hard with Jeanette to do the breastfeeding as long as I could. He nursed for 15 months. So, when I became pregnant with my daughter, I was worried, I was like, “I am going to have a little supply, because I had them with my son and the exact opposite happened. It was, my daughter was born maybe a week early, or so, we nursed right away and we’ve been breastfeeding for almost nine months. No supplementing, so, it’s a lot easier the second time around which has been wonderful.

LEILANI WILDE: That’s great and how about Suzanna?

SUZANNA MAKIELSKI: Yes, hi, so, I think I just expected that I, I would nurse and I didn’t have any other- I didn’t even think about any other options. I was pregnant at 45, going to give birth at 46. Everything was going well, with this clinic invention that’s been breached. Scared about having this C section was quite warning off, so a natural birth. And my milk did take a while to come in. I was -fortunately I had a friend who- and actually going through one of the questions, she had a little boob but a lot of milk. And, I was able to get some donor milk which really helped to supplement in the beginning. And however I have been exclusively breastfeeding now doing some baby [inaudible]. But, principally breastfeeding and the baby is eight months tomorrow, so took a little to get there, but we got there.

LEILANI WILDE: That’s great. Jeanette, what are the first steps a woman should take prenatally, to help prepare herself?

JEANETTE MESITE FREM: So, I teach prenatal breastfeeding classes, I’m definitely getting a lots of education so that, especially with the partner, it’s super important for them to come to class or anybody that’s going to be around you, when the baby is, you know, first couple of weeks, so that you can find out what is normal, that’s not in the list of all those counselor may have told you- information, as well as, when to call, when do you ask for help. But, also I am a big fan of prenatal colostrum expression, and I talk a lot about that in my classes and with anybody that I meet when they’re pregnant, so that, we can go through, like how do you do that, what happens, if you don’t get anything? Atleast you’re getting experience putting the hands on your breasts and trying to get some colostrum out. But I have seen many people, now, when they practice to enable to bring colostrum with them to the hospital or at leastbe there confidence, once they get there and they know how to get some out.
And that’s been very helpful with the number of women, for whatever reason, end up having their milk take a while to come in or lot of intervention or baby is away from them for some reason because of medical issues. It’s invaluable to know, how to hand express. It makes- when you to walk in feeling confident because you know you have colostrum in there and you can get it out.

LEILANI WILDE: And do you recommend a certain time frame when to start that? I know the moms need to be aware that they could stimulate contraction, so you want to make sure you are doing it a safe time. Do you, would you recommend a specific time to start doing that?

JEANETTE MESITE FREM: Sure. I would say, like if you were told not to have intercourse, because you are so sensitive and high risk of a term labor, not a good idea to do before you are 37 or 38 weeks. But for most people the research, that I think, says around 34 weeks and I’d say if it causes contraction don’t do it, but right after a shower, doing a little squeeze here, getting partners involved, makes you more comfortable squeezing breastand exploring and it’s so hard to do it.
It’s not to hurt you, but how confident they are with the squeezing they can be. But definitely it’s not the thing you want to be getting into a pre-term labor situation with.

LEILANI WILDE: And that is true, because you want to protect the baby as well, so you will recommend if they are not having any preterm labor that they can start as early as again you said 34 weeks?

JEANETTE MESITE FREM: I do, and I find not everybody does anything, but, if they get a little bit then they usually handed a syringe so they can try to have a goal of having a needle or two to bring with them and talk about how to bring it with them to the hospital if they are having a hospital birth, but honestly I think it is just a practice of figuring out, how do I do this what’s my technique? And a lot of women haven’t touched their breasts and it’s a really great opportunity to do that for the first time. It’s like, “Okay, how am I going to do this? There’s actually something really valuable inside these and let’s see if I can get some out.”

LEILANI WILDE: That’s great. Christine, did you actually do that? Did you hand express early on?

CHRISTINE GALLO: No, no I didn’t. No, just in the hospital. Once he was born he got the colostrum.

LEILANI WILDE: Okay. Good and, how about you Patty?

PATTY DREW: No, before my son was born, I hadn’t imagined that yet. So, I wasn’t aware of all this great practice that you should be doing. So I imagine- my son was in special care, so I did try a little bit with my daughter. But I didn’t really get anything, but had some fun time.

LEILANI WILDE: And, how about you Suzanna?

SUZANNA MAKIELSKI: Yes, I expressed a little bit, but I didn’t end up taking it to the hospital. Itwas a little bit of colostrum inside the syringe, so I didn’tend up keeping that and the other one it kind of got, it looked too dunky after a while, I kept it in the refrigerator but it was a number of weeks old so.

JEANETTE MESITE FREM: You might have hurled it.

SUZANNA MAKIELSKI: That’s what I did.

LEILANI WILDE: Jennet, you would recommend what? If they saw blood in their colostrum collection what would you tell them?

JEANETTE MESITE FREM: They could feed it to their baby.

LEILANI WILDE: Right. And why is that?

JEANETTE MESITE FREM: Pretty much it comes out of you nipple, you can feed it to your baby. It’s a general.

LEILANI WILDE: I mean, what we, we hear about the components of breast milk, and it’s you know, white blood cells mostly and you know blood is just red blood cells, so it’s still all the same in basic components, it’s safe to give it to the baby. It does not harm the baby. It won’t make them sick.

JEANETTE MESITE FREM: It is so true. But I think there’s really this gut feeling that so many of us have just as humans that like, that just feels so off, you know. Just because I have breastfed before, I can imagine that feeling a little bit nerve racking.

LEILANI WILDE: Right. It would make most moms a little nervous about it. But that’s what we’re here to educate these moms, is to help them understand, you know, what is considered, okay, safe, or normal, right?

LEILANI WILDE: Yeah! Suzanna, was going to say something to us.

SUZANNA MAKIELSKI: I actually, I think it was office, you know, despite too actually, that this was like liquid gold, I kind of took it for granted thinking I’d have more. So, I dint think anything about tossing it out of the car. So, early in and I though, I can get rid of this, there’ll be more to come. It was one of those early expressions; it was just kind of a trial goal. But, I think that is an aspect of, I didn’t just know how to handle such a small amount of colostrum to keep that especially, it was red tinged. I mean it was like tiny milliliter and then I had only one other- I just didn’t know, so I just tossed it and the other syringe gave me other opportunity. So again it’s one of those things knowing for sure it was like liquid gold.

LEILANI WILDE: Jennet how would you recommend storing the colostrum that they collect even if it is one milliliter and especially if they are doing it a month in advance?

JEANETTE MESITE FREM: I try to just have an estimation. I actually don’t know that I have ever seen anybody really writedown exactly, like whether they have tested what the limitations are, so, I generally say express it, put it in the fridge for a day or two, if you want to put in a little extra on top of it, refrigerate them and then combine them and then freeze them upto a couple of days, may be not quite as long as you would keep breast milk in the fridge. It could be that you could keep colostrum in the fridge longer than that, but, given that it could be given to a very, very small baby, around the side of being more cautious, but. I would say, I think, in Suzanna’s case, she would have right down the street for me. So, I would have worked a call to say, “Hey can I have those syringes”. But not a real access to all of that so, I think even just a spoon, if people have a spoon, you could just squeeze a little bit on the spoon and stick that in the freezer and ain plus bag and collect the bunch of spoons with little drop in them, and it’s wonderful, coz even a drop or two could be amazing for a baby who’ll really need a little bit energy boost, you know in the first couple of days.

LEILANI WILDE: Right, and it all adds up. So, you know a drop or two will increase eventually with time and especially, you never know when that baby is going to come, so, every little bit is liquid gold. So, I am glad, I am glad to hear that you are educating these moms out here. When we come back, we will discuss what risk factors to be aware of and when you should reach out for professional help. We’ll be right back.

[Theme Music]

LEILANI WILDE: Welcome back to the show. We are here with Jeanette an IBCLC with private practice in Massachusetts. Jeanette what are the most common risk factors for the older moms.

JEANETTE MESITE FREM: The most common risk factors. Well, there’s a risk of having a being induced, because often in the community there’s a belief and some research that women older till 35 as well as going over 40 with the pregnancy can be a risk. So, a lot of moms, they will willingly go in for an induction and induction itself is a risk factor for at that age milk supply or milk coming in on time. So that’s an issue, then induction increase directly with cesarean and so C section can be an issue. Suzanna, she’s with us today, she was able to do breastfeeding right there in the operating room and skin on skin for a very long time and that’s super helpful and not hospitals are encouraging that that activity in the operating room. I think somehow we could do that. I think people who had a hard time getting pregnant and maybe don’t know why but eventually find out there is may be some particular syndrome or virus problem or even nutritional panels. There are some women, who have gone off and really worked on their nutrition and gotten in shape and been able to get pregnant when they couldn’t get pregnant through fertility measures. Like so many factors that go on with their health as well. You know, we get used to our diet, and we have pretty much the same diet. If you are in the area of 40 and have same diet in years, that could be a negative, without having any diversity in your diet and that could impact milk supply as well.

LEILANI WILDE: Will it prevent them from having a full supply?

JEANETTE MESITE FREM: It sometimes can. I don’t know if anybody can predict that, when it comes down to it. Sometimes you just got to breastfeed, you skin on skin, make sure baby doesn’t have a tongue tie, make sure you are expressing milk out other times, doing skin on skin again and wait and see. You know pumping maybe a part of extra wait too.

LEILANI WILDE: So, Christine can you tell us, if you faced any of these risk factors that Jeanette mentioned?

CHRISTINE GALLO: I did get induced because my water broke and I did not have contractions for several hours. They waited and I never had contractions. So, they ended up giving me- they induced me. I had an extended- a long period of- time of pushing. So then I was given Pitocin another drug to induce contractions. And as far as my supply goes, I always had a great supply and now that we are doing extended breastfeeding, the only time I notice a slight dip is, if I do have my periods. Other than that my supply is great. I have never had an issue with the supply. That was about it, for me as far as my age being a factor.

LEILANI WILDE: And what about you Patty?

PATTY DREW: I did get in some, Pitocin with my son. My water broke early at 35 weeks, was not having any contractions, so when I went to the hospital they did give me a Pitocin and I did many, many, many years ago get told that I had PCOS Haven’t really had any issues with it in the past decade or so. So, I don’t know if that have any factor with my first one. But my supply has been great with my second. So, you know, no issues, no issues with my second.

LEILANI WILDE: And, what about you Suzanna?

SUZANNA MAKIELSKI: I had the C section because my baby would breach and I actually had a really tough time in the beginning. So, the first four weeks, I finger fed my baby and probed a lot and waited and trusted that it will take time, to turn to skin on skin. Gave her every opportunity to practice, she wasn’t getting much luck in the beginning with milk transfer. But, I figured that, you know with a lot of help from Jeanette and lot of encouragement and also just allowing her to explore and she learned. You know, one of the great examples that I heard, it’s just like learning how to play and instrument or learning how to play a sport. It takes hours to practice so much to master and I though she going to need hours, as opposed to some babies who could learn right way and same this with my milk supply, it just came along, again a lot of pumping early on, as well as a lot of skin to skin. And after four weeks she became a master.

LEILANI WILDE: Awesome.

SUZANNA MAKIELSKI: And we do it now.

LEILANI WILDE: Where there any other anatomical reasons why your baby isn’t transferring, that you are aware of?

SUZANNA MAKIELSKI: No, we had both- The lactation consultant in the hospital, looked and didn’t see any over tongue tie at the time, and the pediatrician who worked closely with Jeanette didn’t see any over tongue tie. So there wasn’t anything at that point, but, no anatomical reasons. I think it was hormonal and stress-related in the beginning that really held me back.

JEANETTE MESITE FREM: We also had some craniosacral. It, some of it, it could have been just the result of the C section and the pressure, let’s say, you know mutual side effects of pulling a baby out that when you have that craniosacral work some of that may have also helped.

SUZANNA MAKIELSKI: That might have also helped, absolutely.

LEILANI WILDE: Yeah. There are a lot of different components that are involved in birth process. Carrying the baby, then the actual process of birth and the impact that it can have on the skeletal of the baby and you are right, it can affect the type of ability that they are able to do at the breast with their sucking skills or any impeachment that might happen. Sometime I explain to moms that if you woke up, sleeping on your pillow, the wrong way, you have like a kink in your neck and it’s very uncomfortable to turn your head that particular way. It’s going to make it really uncomfortable for doing certain things and sometimes when babies are out of alignment due to a birth experience or just being carried, may be they are sitting in the womb for a long time in a certain position can impact breastfeeding. So craniosacral therapy is a good way to help babies with latch or transfer problems.

SUZANNA MAKIELSKI: And, I think what happened to me was probably because [inaudible] there was a panic, you know, 24 hours after the birth that she had lost a lot of weight. So, that kind of made me feeling chilled out there, because a lot of it was simply water weight, you know fluid weight, but as a result, there was a panic in the hospital and I remember that second day for 45 minutes trying to get the baby to latch and I was in tears the baby was in tears, it was really a traumatic experience that I think also inhibited some of the subsequent attempts at latching and that bonding and then the following day just working on building trust and getting the baby back to trust being at the breast after that, experience. So, I think that, knowing that the baby can lose a lot weight in that first 24 hours and that’s normal, especially after a C section, I wish I had told you people to just leave me alone and let the baby and me figure it out . I remember that because I think that did push us back.

LEILANI WILDE: Jeanette, can you tell us a little bit about what she’s saying in regards to the weight loss due to a cesarean birth?

JEANETTE MESITE FREM: Sure. It can also happen with a long labor with I V fluid especially with Pitocin, but definitely with IV fluid. So, when someone has an I V, then the fluid gloat up and the breast responds by also filling up but, the brain thinks that there’s milk in there, that’s basically the way, it’s explained I think. The brain says, “Oh, the baby was born, but hey there also milk in those breasts. So, we don’t have to make milk.”So, there is a delay in the milk coming in but also when the ...

LEILANI WILDE: The baby also has excess fluid

JEANETTE MESITE FREM: Alright the baby. So, after the baby is born, it’s really normal even in an unindicted birth the baby is to be born with extra fluid onboard just for survival. So, it’s normal that the baby would weigh a little bit more they were at the 23rd hour. It’s becoming a little bit more standard in a lot of countries now, based on a lot of research, to weigh baby at hour 24 and if he is that as the reference weight, well you are looking at weight loss, over the first few days and weeks. We want babies to be back up to their birth weight by two weeks ideally. But if you are looking at a baby who was born after a long IV process, through an induction, or an epidural or with C section, they are going to have a much more elevated weight and so at hour 24, and 48, they are going to look like they lost way too much weight.

LEILANI WILDE: Right.

JEANETTE MESITE FREM: So, we just weigh them at hour 24. Suzanne was aware of that, we talked about that prenatally. So, she was able to kind of relax a little bit and have a conversation at the hospital about that issue and not be so freaked out about it, where, some of the people don’t’ know about it, they are like “Oh, no, my baby is losing weight” and they get tears and they say, “Okay, I guess you have to give some formula”. And sometimes the baby does need it, even that is an issue, but really just like, “wait a second, what was the hour 24 weight and then what is then percent formula”. If they say only nine to ten percent, it’s probably going to be okay. Let’s work on getting her to have some colostrum that comes and get on-get working on that, so we can feed the baby.

LEILANI WILDE: And, overall, it’s most important to understand and recognize, what proper transfer looks like. So, lot of babies will go to the breast and moms might assume that baby is breastfeeding. And sometimes even the hospital staff, maybe a Lactation Consultant, looks at from a distance and go, “Oh, yeah, baby is on, everything looks fine from here”. But, what should a mom recognize, because it’s not being 40 and older that you are having weight loss, it’s, it can happen to any age mom, in results to extra fluids onboard. So, helping moms understand what that transfer looks like from the baby’s point of view?

JEANETTE MESITE FREM: There should be plenty of dirty diapers and lots of urine. And if that’s not happening, I would say, yellow by day five, I didn’t mix that up. But obviously concerned, most people are out of the hospital by day five and every not pediatric or family practice recognizes that, poops should really be yellow, and multiple times a day, by day five, so if that is not happening that is a reason, like that you need to talk to the- a Lactation consultant.

LEILANI WILDE: And, when else should a mom reach out for help? When should she- What should she do? What should she be looking for?

JEANETTE MESITE FREM: So, many people spend the time, but it’s normal for nipples to hurt. Really for everyone what that means is different, ultimately, I always joke.I’m guessing most people would not have had someone suck on their nipple through that many hours a day ever before. So maybe there would a little bit of like, “Oh, this is kind of weird”, but there should be no cracking, there should be no bleeding and there should be no bleeding the next feeding. If that, if you like are so nervous you’re going to just wake up, because your boobs are killing you and your nipples hurt, that means there is a problem with the latch and it could be just a positional thing it could be approach, the breast you are taking as you are putting it into the mouth, itcould be the angle, it could be that baby has a tight jaw, it could be that baby has a tongue-tie or a lip tie or, but if there’s any issues with that watch and I hear so many who say, “Oh, you know, somebody at the hospital told me that the watch looked good.”
So, someone can’t tell you that from the outside, it could look good from the outside. But if you nipples hurt or if your baby is losing weight, and continue to lose weight and not gaining weight, that’s another reason that the baby is not transferring enough milk. Baby is not pooping, baby is not pooping at least once a day- there’s a lot of people on the medical world that say, that it is normal for breastfed babies to not poop every day. And that just been proven to be not true. So, it is really a great thing to monitor how much they are peeing, but it’s more important to see how much they are pooping by some of the means.

LEILANI WILDE: Okay. Thank you so much Jeanette and Christine, Patty and Suzanna, for helping us all better understand what we should consider when planning on breastfeeding as a mom who is forty years and older. And for our Boob Group Club members, our conversation will continue after the end of this show, as Jeanette will talk about how to prepare yourself mentally, and physically from being a career woman to becoming a new parent. For more information about our Boob Group club, please visit our website at www.NewMommyMedia.com

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SUNNY GAULT: Alright, hey, everybody, it’s time for our fun segment we have on The Boob Group called “Boob Oops” and it’s where we share our funny breastfeeding stories and I love this one. This comes from Becky and Becky writes:

“The funniest breastfeeding experience I ever had was when my daughter was only three days old and technically it wasn’t me. She was pretty much nursing constantly. This particular morning I had to go to the bathroom before she was done. I thrust her at my husband and I asked him to take over. So, he happily laid her belly to belly on his chest while I relieved myself.” Ah, such a good husband.
“As I was coming back into the room Emily began rooding around on his chest. To his surprise, she very quickly found what she was looking for. I came into the room to his screaming, he was lifting her up in the air and screaming. Every lift that she took into the air, her head went down and his chest expanded simultaneously.

Seemed my little girl didn’t carewho’s nipple she had in her newborn mouth. Of course, I hadn’t bothered to explain to him how to unlatch a nursing baby and I never thought he would need it. I just stood there laughing until he finally pulled her hard enough to force her to let go. I told him next time, it would hurt less, if he broke suction with his finger first.”
I love this Becky. Thanks so much for sending it in. And if you guys have a funny Boob Oops,please share with us and we will share with the audience. You can reach onto us via our website, and just go to the contact link, or you can tell your story yourself at our voicemail at 619-866-4775.

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LEILANI WILDE: That wraps up our show for today. We appreciate you listening to The Boob Group.
Don’t forget to check out our sister show:
• Preggie Pals for expecting parents
• Newbies for newly postpartum moms through babies first year and
• Parent Savers for moms and dads with infants and toddlers and not to forget
• Twin Talks, for parents with multiples.
Thanks for listening to The Boob Group: “Your judgment-free breastfeeding resource.”

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though such information in which areas are related to be accurate, it is not intended to replace or substitute for professional, medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: New Mommy Media is expanding our lineup of shows for new and expecting parents.If you have an idea for a new series or if you’re a business or an organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com.

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