Transcript: Top Questions Moms Ask Lactation Consultants

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The Boob Group
Top Questions Moms Ask Lactation Consultants

SUNNY GAULT: The concept seems easy. Baby is hungry, put him to the breast and feed him, right? But we all know breastfeeding isn’t always that simple. And that’s when turn to the professionals. Lactation educators, councilors and consultants who can help overcome issues that come our way. So what are some of the most common questions we ask these professionals and what are the answers to those questions? We are The Boob Group.

[Intro/Theme Music]

SUNNY GAULT: Welcome to The Boob Group! We're here to support all moms wanting to provide breast milk for their babies. I'm Sunny Gault. Thanks so much for being of our show today, it is great having you with us. We have more than a hundred and fifty episodes covering all sorts of breastfeeding and pumping topics and all of this is available of course for free. You can see a complete list of all of our episodes on the episode guide of our website at www.newmommymedia.com Just click on over the shows, go down to The Boob Group and then that will bring up The Boob Group portion of our website and you can see all of the episodes there. While you are on our website, please subscribe to The Boob Group newsletter. You can get emails each time we release a brand new episode and that’s always helpful. So what topics would you like us to talk about on the show? I ask that a lot and sometimes we get some emails, but I would love to have more, more connection with you, guys. So what are the topics, after you look at our episode guide, right, what are some of the topics that you really want to have more information about.

We’ve covered a lot, we haven’t covered everything for sure, and even if we have addressed the topic, we may not have talked about everything that you are interested in as part of that topic. So again: take a look at the guide, let us know what topics interest you and we will definitely consider them as a possible topic for the future. So let’s go ahead and meet the mammas that are joining our conversation today. Ladies, tell us a little bit about yourself and your family, and since we are talking about lactation consultants today and the questions we ask them, give us a heads-up and let us know if you have seen a lactation professional in the past. So Graeme, let’s start with you

GRAEME SEABROOK: Hi! I am Graeme. I have two kids. One is almost three, our son Andrew, and Lori, or Eleanor, is five months old. And I saw a lactation consultant with Andrew and this time around with Lori I have a lactation consultant, a postpartum duola and a lactation counselor through the hospital, I have a full team.

SUNNY GAULT: You do! I love that! And things are going better for you this time around as a result, right?

GRAEME SEABROOK: Oh my Gosh! So, so good! So good!

SUNNY GAULT: Yes, I love it, I love it! Okay, Alicia tell us a little bit about yourself.

ALICIA: Hi! My name is Alicia. I have four children, ages: ten, eight, six and three, and my experience with the lactation consultant didn’t occur until my last baby when he was five months old and was having some health issues and after that whole situation was over and I was moving forward I have since regretted not having seeked out-resources trough lactation professionals in the first three, so I definitely am a solid promoter of anyone who is trying to breastfeed, looking for that information.

SUNNY GAULT: Alright! And our expert today is Melanie Silverman, but I know, Melanie, we are going to learn a little bit more about you professionally later-on in the show, but tell us more about your experience being a mom.

MELANIE SILVERMAN: Well, I would love to! So I have an eight-year old named Sidney and a ten-year old named Lucas and funny enough I actually had to see a lactation consultant, being a lactation consultant with my first one and I forever love this woman who took care of me, because even though I knew a lot, I still really needed the help and she was instrumental and getting me going with Lucas.

SUNNY GAULT: Yeah! So even lactation consultants need lactation consultants to support each other.

MELANIE SILVERMAN: Yes! We do! We do!

SUNNY GAULT: I love it! And I am Sunny. You guys probably know me, but real quickly - I have four kids and my oldest is five, a boy, a three-year old boy as well, and then I have twin girls who are about two and a half and I did not use a lactation consultant until I had my twins. Actually, it’s not kind of a fair question to ask me, because I was producing The Boob Group while, you know, I was young, and so I didn’t actually have a lactation consultant and in doing these shows, I am sure, I am sure after a show I was asking lactation consultants questions. So it’s kind of an unfair question because I produced the show, but I will say, for my twins, they were a thirty-five week, so they came out a little early and then when they were first born they couldn't latch properly, they were not quite yet at that stage yet, because they were premies. So didn’t need the NICU, but we did need a little bit of lactation help and my body is pretty awesome when it comes to making milk, so I never had a problem with that with my twins, but it least up to their due date so from about thirty-five weeks when they were born up to about forty/forty-one weeks I saw a lactation consultant again trough the hospital that I delivered at.

And it was outpatient and I went in about once a week and we would sit there and she would help me latch the babies, we would get out a huge double breastfeeding pillow and she taught me how to roll up the wash-clause and stuff to get my breast in the right position and squish them and push them up and I am like “Hey, I like how they look now!” So she really did help me with that and that was instrumental in the transition because I was exclusively pumping at the time like I would see her to help me with breastfeeding and I would try to do that at home, but again, they were so tiny. So it definitely helped in the transition to get them to be tender breastfeeders and to get me to the transition from explosively pumping for those first month/month and a half/two months to exclusively breastfeeding them. So she was definitely instrumental in that! So I have a little bit of experience with lactation consultants in that regard. So anyway, thanks, ladies for being a part of our show! We will take a quick break. We will be right back!

[Theme music]

SUNNY GAULT: Alright, so before we kick off our episode today talking about different questions moms ask lactation consultants we are going to talk about an app that I think we can all agree on as part of the conversation we are really excited to learn more about this app because I think it can help a lot of moms out there. And so Melanie, our expert, is actually tied to this app as well, it’s called “Pacify” and Melanie, I want you to tell us more about it and then we can go kind of back and forward on the questions here, but what is your pitch as far as what is Pacify and what does it do?

MELANIE SILVERMAN: Well, “Pacify” is a pretty amazing app! Moms can go to their Google app store or to the app store through Apple and download “Pacify” to their phone for instant video access to lactation consultants, pediatric nutritionists and nurses 24hours a day, 7days a week and it is very, very exciting because usually getting lactation help can be very difficult, What Pacify allows a mom is to get help the minute that she needs it. And then another thing about Pacify is that you can actually gift it. And so it could be like Sunny and I, we would go to our friend Julia’s baby shower and we would bring her a three-month subscription to Pacify, so we are gifting her expert help. So I always say, you know, baby warmers and white warmers, those are very important for new moms to take care for their babies, but this kind of gift is really, really special and that you are giving moms this breastfeeding help that they often can’t get and as we all know, the breastfeeding help needs to happen immediately and it is best to happen right on the spot and Pacify allows it to happen. So I am very excited to be tied to Pacify and help all these moms get all that help that they need immediately.

SUNNY GAULT: So I had the chance to test this a little bit and honestly I am really excited about this possibility. I am actually so bummed out that you will probably hear this from various moms Melanie, that I did not know about this in the beginning. When I had my twins, when I brought my twins home because I had a lot of questions and as you can imagine it was a lot of effort to get out of the house with twins and again with someone watching my other boys to go to a lactation consultant. And not that this is a complete way to not see a lactation consultant in person, but you are right, like we have those questions like in the middle of the night, those middle of the night feedings or we just can’t get out of the house or whatever the case may be, and it would be so nice to have somebody at my fingertips. So the app is actually really easy to use and once you go and download it, it asks you some quick questions and then basically you sign in and it gives you some quick options as to well who do you want to contact, you know, do you want to contact a lactation professional, do you want to contact a nurse or you know… What is the third one, Melanie? There was a third one.

MELANIE SILVERMAN: There is, yeah, it’s a pediatric nutritionist. You know what’s neat about it Sunny, is that it really covers from birth when the moms are breastfeeding all the way really up to the age of when they have picky eaters and beyond, because when you introduce that solid food, that’s when the pediatric nutritionist comes in and can really help moms in all aspects of feeding and that is just what is so exciting about it.

SUNNY GAULT: So, it is great! So we have those three options on the home page - nurse, pediatric nutritionist and lactation consultant so whatever issues you are dealing with, you click this button, it dials somebody up and you are able to talk to them and you can do it with or without video. I think the nurse option right now is just audio.

MELANIE SILVERMAN: That is correct, but that is the neat thing too. It is that so often in historically with lactation help I can’t tell you how many of these amazing lactation consultants over the years have helped moms over the phone. And so much can be done over the phone, Sunny. But what is neat about this is the video aspect for lactation consulting because just for someone to just take a quick look can make all the difference in the world for moms.

SUNNY GAULT: Alright mammas, so tell us what do you think about this, so Melanie and I chatting back and forth here, telling you a little bit about it. I know you haven't had the chance to check it out for yourself, but Alicia, what do you think about an app like this?

ALICIA: I think it's great. I think anything that puts so close, in a palm of a mom’s hand to get direct contact with nurses and educators and consultants is so wonderful. Kudos to whoever thought of this!
SUNNY GAULT: I know, genius idea, right? Well now we are kicking ourselves now for not thinking of it ourselves. At least I am, I don't know. Graeme, what do you think?

GRAEME SEABROOK: I can't talk to you right now, because I am signing up. I am so excited. I have so much support, but I do have questions and I also have a baby and a toddler and there are times when I just can't get to my breastfeeding group or I can’t get to… Leaving the house is just a pain sometimes with both kids, so just being able to just pull out my phone that I am always on anyway, and get answers-this is amazing! I am seriously on it right now!

MELANIE SILVERMAN: And the call, Sunny, can last as long as they can, which is kind of nice, so nobody is feeling rushed on either end, so as long as the mom needs that help, she can have it. It is $15 a month for unlimited access to these providers.

SUNNY GAULT: So we are going to post a link on our website for Pacify so you can download it directly on you know, whatever phone that you have, iPhone or Google play, Android and we will be able to link it there and share more. We are also going to offer to our listeners, thanks to Pacify and Melanie, a discount. So if you are interested in this, you want to learn more about it, you head on to the deal section on www.newmommymedia.com and all the information will be listed there. So Melanie, this is truly exciting, I know we are going to talk more about the app and the different questions you get through the app and through our main conversation today, but I am just super excited about this and I think it can help a lot of breastfeeding mammas out there, so thank you! Thank you for doing this!

MELANIE SILVERMAN: We are all trilled to be doing this! We a very, very excited about it! It's a very, very, very special group to work with.

[Theme music]

SUNNY GAULT: Sometimes the breastfeeding and pumping moms need some expert advice as they pursuit their personal goals to provide breast milk to their baby. What are the most common questions they are asking? Melanie Silverman is our expert today for our conversation and she is also an IBCLC and as you heard earlier she is also associated with the Pacify app so she is getting a lot of questions.
Melanie, I know that you actually answer some of the questions that are coming up through the app, so you are talking to moms directly, so you definitely understand what moms need. Thanks for being a part of our show today!

MELANIE SILVERMAN: My pleasure!

SUNNY GAULT: So let’s dive in to some of these questions and for the purposes of our conversation we are going to assume that the people that are asking these questions trough the Pacify app, these are the questions they would probably ask lactation consultants in person, right? So we are not really making the distinction between you know are they only asking this question because is trough an app, no, we think that these are question that overall moms in general have for lactation professionals. So we kind of want to go through some of the top ones that we see popping up again and again and so let's go through some of these. So the first one is, I like this one: My baby has diarrhea. The poop is yellow, seedy and runny. What do you say to that, Melanie?

MELANIE SILVERMAN: I say that is normal, but a lot of people think it's not and let me tell you why. Because, especially, and maybe the moms can say to that, you know, as first time moms if they weren't able to take a lactation course and let's be honest, they have only been looking at their own poop for many years before that and they did not know what's going on. So when you see that, it can be very shocking. And so we actually have to say sometimes "this is normal, don't worry”.
SUNNY GAULT: Mammas did you have any concerns seeing yellow, seedy, runny poop at the beginning?

GRAEME SEABROOK: I actually did take a class before my son was born and still totally freaked out about that. I had no idea! I mean okay, after all of the black scary poop that happens first that I was like “Okay, it’s finally getting normal! Oh, where did these things come from?” and I was like “There are stuff in his poop!” and I was a mess! I asked everybody all the questions.

SUNNY GAULT: But can we just get real here for a second? I actually don't mind the smell of that poop. It actually kind of smells more like breast milk, because you know, they haven’t had obviously all the external foods that we have in our diet that make it smells not so pleasant and I know this is going to sound so strange, but when I went through that with my kids I was kind of like, it was kind of a pack on the back for me that it was because of what my body was able to do that they are able to do this.

ALICIA: Oh my Gosh, Sunny, you have to be the person that has ever though that. I don’t know, but I’ve never heard that. My mom had a daycare in her house for over ten years when I was growing up and I thought I was fully prepared for what was going to come out of that child and I was still shocked all the time. And how it changed all the time and how it founds its way to the car seat all the other places and oh my Gosh, this baby poop is a like a living, breathing thing.

SUNNY GAULT: But it does stain. That stage of the poop does stain and that's the part I didn’t like about it. I felt like it gets easier to get off, but it gets just that yellow, seedy, mustardy kind of look that is the downside of it. At our sister show “Newbies”. We have actually done a whole episode on poop. So if you are wondering about your babies poop and the color of it, and the consistence, trust me, again, 30 minutes talking about poop on that show, so go check it out.

ALICIA: It’s funny that you can probably do four more 30/40 minutes shows.

SUNNY GAULT: We probably could. Moms like to talk about poop, I swear. Ok, so let’s move on with the next question: So my baby is three weeks old, he is eating every two to three hours for thirty to forty minutes. Is that normal? Melanie, what do you say to that?

MELANIE SILVERMAN: I say it is normal, but here is the thing. A lot of moms think that’s not normal and they start to question their bodies and their milk supply and it makes me so sad when they feel like that. And that is pretty intense. That breastfeeding regiment of two to three hours for about thirty to forty minutes, that is usually within about the first month and what I do say to these moms when they are crying and they are sad, I say "I know this is difficult, I am here to help you, but I promise you, this is the hardest it’s going to be" because what happens over time is that the baby becomes more efficient, they get bigger and they can suck better and they are not sitting there for thirty to forty minutes. And the hour’s stretch-out a little bit longer. But that is normal in the first month, those three weeks.

SUNNY GAULT: Were you guys concerned about this? I mean every two to three hours, that’s a lot of time. That pretty much takes up your entire day.

ALICIA: Look guys, it was shocking to me with my first baby when we were nursing and you know, they tell you it’s every three hours and you think it’s ten minutes and ten minutes on each side and to find out that it’s not, that it’s every three hours is start of one and the finish of another works. And then when I had my second one, my first one wasn’t even two years old and so trying to keep her occupied while I was trying to feed all the time, oh my Gosh! That’s one thing I always try to bring up to new moms either when there are pregnant and preparing for that or after they’ve just started, I always try to bring that up because I want them to know that it’s normal that you are going to feel like you nursing 24hours.

GRAEME SEABROOK: Yeah because it is the way that you guys do the hours and way the moms do the hours are not the same thing. When they say every two to three hours I thought that meant that when she was done I had two to three hours before she was going to start again.

MELANIE SILVERMAN: Not exactly . . .

GRAEME SEABROOK: I feel like there is a bait-and-switch going on there. You guys are trying to trick us.

MELANIE SILVERMAN: Well, we are trying to be supportive people. We are trying to be supportive lactation consultants, but it’s definitely intense. It’s a very intense thing and I really think moms are blindsided even when they are prepared, even when they have taken these courses and talked to their friends and have older sisters, I think that is, it’s a tough one. But I think with support and saying this is normal I think it has helped with many of the moms I have worked with.

SUNNY GAULT: So speaking of what’s normal: How many poops and pees per day is normal in breastfed babies?

MELANIE SILVERMAN: Well, I am happy to talk about poop again.

SUNNY GAULT: I knew it will come up again.

MELANIE SILVERMAN: Yeah because in reality it’s so significant, so this is a great marker. Some people say “How do I know my baby is getting enough?” and I say “You got to look at the diaper.” and they go “Oh, I didn’t realize that!”. But usually when we are talking to moms a real easy rule from birth is day one - one poop, one pee, the second day - two poops, two pees, but by day four the poop should be transitioned to that yellow, seedy stuff that Sunny loves and we should be in that realm maybe five to six diapers a day and I will be honest - anywhere between two to ten poop per day, and I have seen that, but usually three to four. There is a wide range and that’s where a lot of questions come in, because some moms call me and they say “My baby only poops twice a day” but what you should look at is what’s going on with weight gain? What’s going on with how the baby is acting? So there is a wide range and I am sure there is a wide range with these moms too as to what they have seen with their breastfeeding babies and its normal.

SUNNY GAULT: Yeah, so mammas, what did you experience when it came to poops and pees?

GRAEME SEABROOK: I think it changes too when you are talking about like are we talking about the first couple of weeks, are talking about month three and four, are we talking about older, like it really changes, a lot.

MELANIE SILVERMAN: For sure.

GRAEME SEABROOK: So that is where my question came in because I was like alright, so this is what is normal for the first week, but now I am home and it’s the second, the third and the forth week and the poop started slowing down, but she was still gaining weight and she was still peeing regularly, but I was calling the doctor going “She is only pooping once a day! Oh my Gosh, something horrible has happened!” and they were asking me all these questions going “Nope, you are fine.” after I have just been freaking out for hours deciding whether I should call the doctor. So yeah, hearing that things are normal, that really helps!

SUNNY GAULT: Now it’s like the one time in life you really want to be normal. Being like you know oh yeah, being normal it’s good for parenting when it comes to, you know, the development of you baby and hearing the 50% marker is actually a good thing. I remember that was one time in my life I was like “Oh, we are normal, good! We are just going with the flow, I like that!”
So next question; some women may say something to the effect of “It's really hot today, should I give my baby a few drops of water?”

MELANIE SILVERMAN: So the answer is no! And it’s a quick no! And that’s because breast milk is actually formulated to be perfect for hydration and so we really don’t want to give the baby any water and just rely on breast milk during those hot days.

SUNNY GAULT: Did you ladies have any questions when it came to water or did you know from the get-go no, you know, there is enough water in the breast milk to sustain my baby.

ALICIA: Yeah, you know, I never really questioned giving the baby water. We lived somewhere it was really hot and I had all my babies in the summer, so it would be a hundred and five degrees and I don’t know why, I think I just always felt that way, you know, breast milk had whatever they needed.

GRAEME SEABROOK: Yeah, I was always told for me to keep drinking water, you know, when it was super hot, because I am in South Carolina and it gets. You know, it’s soupy out there, and so I was always making sure I was drinking a lot of water and that has been giving us through and I don’t want to think about the summer coming up.

SUNNY GAULT: Now, that’s true. Melanie, how much water should moms should be drinking? I mean, is it more than the average eight cups a day or eight ounces . . . ?

MELANIE SILVERMAN: Yeah, that’s actually a great question! So you know in the literature, for a long time, and also you know hands down across the United States, I would see things like you have to drink eight glasses of water a day to make enough milk. And the reality is that is not really true. To make milk you need to empty the breast and so what I say to moms when they ask me these questions about hydration, is really drink to thirst and that is really what the recommendation is now these days. Drink to thirst, yes.

SUNNY GAULT: Ok, and probably water is better than some of the other options out there, you know, if you can drink water over lemonade, iced tea, all that kind of stuff. I mean, I know all that has a lot of water in it, but it’s still different, right?

MELANIE SILVERMAN: Well, actually it’s a hydrations sorts, but now I am putting my dietitian cap on and so what I say is you know, liquid calories don’t fill you up, so if they do add calories and so… I am not saying ever have lemonade or anything like that, but really water is probably best. Empty calories are not such a fun experience.

SUNNY GAULT: So when we come back we are going to share more of these common questions that moms are asking lactation professionals. We will be right back.

[Theme music]

SUNNY GAULT: Welcome back! We are continuing our list of common questions moms ask lactation consultants and Melanie Silverman is our expert. So Melanie, another thing that mom maybe posting:
I read that I need to stay away from broccoli and other gassy foods when I am breastfeeding, is that true?

MELANIE SILVERMAN: Oh, these kinds of questions make me sad, Sunny! And I am going to tell you why.

SUNNY GAULT: From a dietitian point of view?

MELANIE SILVERMAN: No, no, but that’s funny that you say that. Actually, from a lactation consultant's point of view and I will tell you why. And all of the lactation professionals that are on Pacify, I know that we feel the same way. We don’t want to make breastfeeding difficult. We want to make it as simple as possible. When parents come to us and call us and ask us these questions, you know “I'm staying away from the broccoli and I stopped drinking the milk and don’t eat the nuts and I do all these stuff…” and they are just doing it for prevention and they are not just eating a normal diet, it really sets them up sometimes to be restricting their diets when they don’t need to. And so what I say to moms when they come to see me pre-baby and they really want to kind of understand what breastfeeding is don't change your diet. Just eat a wide area of different foods; enjoy your food, you know, eat when you are hungry, stop when you are full; drink when you are thirsty. And you probably don’t want to have broccoli every single day of the week, but kind of paying attention to “I ate some broccoli this day, so I’m going to take it easy on the cruciferous vegetables the next day is a real wise move.

But I wouldn't necessarily tell a mom to preemptively stay away from broccoli to stay away from broccoli or other gassy foods while they are breastfeeding. I would kind of do a wait-and-see. That said, that said, there are moms that I have treated that their baby has an issue with some of the things the feed on or eat themselves, the moms. So you kind of have to be careful and monitor the child - if there is one kind of gassy episode from broccoli, you probably can kind of wait, but if you have two, or three, or five episodes of it, maybe you want to pull away from some of those vegetables. But I really think it's a trial area.

SUNNY GAULT: Asparagus was one of those things for me and I think that was more about does that change what the breast milk tastes like a little bit, I know all our food kind of does, but that seems to be one that once I had asparagus and then I breastfed, you know, I don't know the amount of time afterwards, but my kids were kind of looking at me a little strange.

MELANIE SILVERMAN: Yes! No, I mean there is definitely I mean breast milk changes for sure, and so I think that was something you investigated and I really rely on the moms to be the experts on their own care, but I don’t want moms to just start to restrict their diets for no reason. I really want them to it open as long as they can until they see a problem.

GRAEME SEABROOK: Well, babies will let you know or am I wrong about this? I feel like about my daughter there are very specific things and broccoli was one of them, cabbage was another, but she let me know. There were all kinds of gas and fussiness and it was quite obvious once I started looking at okay, this is the third day of fussiness in a row, what have I been eating? Well, let me try and cut that out for the next couple of days and it went away-alright, no more cabbage. But it wasn’t a think anybody ever told me to not eat it at the very beginning, from the top, you know.

MELANIE SILVERMAN: Right. I think people want to make breastfeeding that we need to do this, and this, and this, and what I found and what I think moms may agree with me on, is that it just varies from mom to mom, it's such a personal experience.

ALICIA: I would say that in addition to varying mom to mom, it varies child to child. And I know with my first I did all of those rules, it was like don't eat broccoli, don’t do this, don’t do that, and so I had the second I threw all of it out of the window, because it was just too much stress. And then my forth had health issues due to diet and so then I got a whole new acknowledgment on what to eat and what not to eat. But at least for the second and third I let myself just go with the flow.

SUNNY GAULT: So another question may be: If the cradle position (you know, one of the breastfeeding positions) is working for me while breastfeeding, is there any reason I need to change it?
So what do you think about that, Melanie?

MELANIE SILVERMAN: Well, look, it’s kind of my whole philosophy with the eating-don't change it if you don't have to, and I feel the same way about the positioning. If you are doing great, the baby is happy, you are happy, the baby is gaining weight and everybody is kind of in their positions and enjoying it, stay the course. But, Sunny, if there is a situation where a mom is complaining of initial pain or sort nipples is really kind of genius to switch positions and go for pro-hold or trial-sideline because that changes the way the baby is attached to the breast and could provide some relief.

SUNNY GAULT: Well, it could be something really small too that we think we are doing the right position, but there is just something a little off with it, right, so that the baby isn’t positioned in the right way, so that is maybe why we are experiencing some problems or whatever. And I think that’s one of the, we are going back to your app, that’s one of the cool things about the video portion of the app. We mentioned earlier that sometimes it’s a real quick question that we may have and I could see the video portion of this being huge foe hey, is this latch okay; or this position that I am holding my baby in isn’t just working for me, am I doing something wrong with this, cause you know, I have looked at the videos online and I’ve done my research and it is still not working out.

MELANIE SILVERMAN: Right, that is very, very true. And you know, for like premature babies what I often use is the foothold. And so there are different things that people start with, different things that maybe a lactation consultant helps them in the hospital with, and they kind of stay that course, but if it’s working, I say stay the course.

SUNNY GAULT: So our last question that seems to be the most popular is: Breastfeeding has been easy for me until now. My baby girl/boy, (you know, fill in the blank), is about four months old and used to feed every four to five hours; over the past week, the baby is feeding every two hours and I feel like she/he is regressing; what’s going on?

MELANIE SILVERMAN: Well, this happened to me and it was shocking when it happened with my second one and I kind of had to flip through my books and figure out what was going on, but it’s called cluster feeding and what is happening here is, and again this is what is so valuable about Pacify, I think, getting that immediate help like what am I doing wrong, it is actually a signal that your baby needs more milk and it’s growing. So what the baby is trying to do, is trying to empty your breast as much as possible, so that it sends a signal to your brain to make more milk; and so this a temporary situation. It is a very difficult situations for moms, I really feel sorry them when this happens. Usually about four or five months is when we start to see this; and it usually rounds anywhere between about one to two weeks and it really calls on a mom to step back. I really try to say we have to go back to self-care because by then you know, you kind of have the swing of things-you understand how to breastfeed the baby, baby is happy, mommy is happy and all of sudden you can’t just go out with your friends for lunch anymore because the baby is really being demanding, but it is a temporary situation and actually good news.

SUNNY GAULT: Cluster feeding-it’s so much fun! It actually helps with supply. I will give it that. If you are low on supply, and your baby is the more than your breast, it’s the whole supply and demand thing, right. So that’s the good thing I have to say.

ALICIA: The only good thing, the only one, that’s it!

MELANIE SILVERMAN: I know, it’s tough, it’s really tough.

SUNNY GAULT: I know, it’s crazy. We actually did a whole episode on The Boob Group about cluster feeding because we were saying those term and you guys are like I don’t even know what that is.

GRAEME SEABROOK: It means they never stop eating ever, ever, ever, ever, that’s what it means!

ALICIA: Melanie, your answer was wonderful! I never knew. I just knew that was the time of breastfeeding that I would just cry because it was so overwhelming.

GRAEME SEABROOK: Yes, Alicia, yes! Because especially like the forth month comes right around the sleep-progression that both of my kids got, so you are not sleeping and they are eating all the time.

MELANIE SILVERMAN: You know what I say to moms a lot and I would love to use that phrase for so many years as a lactation consultant , I kind of say that you have to surrender to this. This will get better, but I am just asking you-don’t think that this is going to last for the next three months, it won’t, but I just need to take this day to day and with Pacify you can call and just check in even if you just need, even if you just need a pep-talk. These people are good in giving pep-talks too, because a lot of that, you know, helping breastfeeding, is cheerleading, and this is especially a time the mom needs it, she needs to understand what’s happening physiologically in her body and then get some support.

SUNNY GAULT: Great advice! Alright, I think we touched on a lot of stuff today, but there are some good nuggets of information in there and hopefully we helped some mammas out there today. So thanks so much to everyone for being part of our show today. This was a lot of fun. If you remember of The Boob Group club, then please check out the bonus content for this episode, we are going to discuss when it’s time to see a lactation professional in person as oppose to doing some of these newer things like talking to them trough an app, or doing a Skype session, or hangouts, or something like that. So for more information about our club, visit our website at www.newmammymedia.com.

[Theme music]

SUNNY GAULT: Alright, so before we wrap up our show today, we have our segment of the show and it’s a segment we call “What's your breastfeeding IQ?” and so we like to test ourselves a little bit and ask ourselves some questions, remind ourselves why we are continuing to breastfeed and pump for our babies, because we know it’s so good for them; and we like to do this in a form of questions, right. So I am going to ask you guys some questions and if you are listening play along with us and hopefully we can learn a little something as well. So question number one: Is it normal for breastfeeding to hurt? True or false, ladies? Melanie, don’t say anything yet, because I know you are going to give us the answer here, but ladies, what do you think, is it normal for breastfeeding to hurt?

GRAEME SEABROOK: False.

ALICIA: False. I think I will say false too.

GRAEME SEABROOK: I was going to say true, but I'd say common is true.

SUNNY GAULT: Yeah, so okay, common is one thing, but is it supposed to hurt? And Melanie, what do you say about that?

MELANIE SILVERMAN: I would say no, I mean I would say false. It shouldn’t hurt. I mean, I always say this to people, it’s like going to the gym, when you start breastfeeding it’s something you’ve never used before just like using a new muscle in your body, and so, but breastfeeding should not hurt usually.

SUNNY GAULT: So that’s false. Next question:
Moms who breastfeed have lower risk of: (and we have some choices here)
a. breast-cancer
b. osteoporoses
c. uterine and ovarian cancer
d. all of the above

ALICIA: D.

GRAEME SEABROOK: You know, I am going to say “D” because I want it to be true.

SUNNY GAULT: Alright Melanie, hook us up, what is the answer?

MELANIE SILVERMAN: All of the above.

SUNNY GAULT: And probably more stuff that is not on the list too, that didn’t fit our multiple-choice question, but obviously lots of benefits to breastfeeding. Alright, next question:
Breastfeeding prevents you from getting pregnant:
a. sort of, but not really
b. false
c. true
And silence, no one wants to answer that question. Alright, Melanie, what do you say to that?

MELANIE SILVERMAN: Well, I think it’s sort of, and I think we have to be very, very careful about this. There is a specific guideline that you need to kind of understand that your body is going through to claim that it will keep you from getting pregnant. And so it’s exclusive breastfeeding, no supplementation, no additional foods, breastfeeding around the clock. It’s a real hormonally intricate cascade, so if you are following those, then breastfeeding can support some birth-control, but if you are not, there maybe a surprise.

SUNNY GAULT: Yeah, and if you don’t want to get pregnant, don’t just rely, and don’t be like “I am breastfeeding!”.

MELANIE SILVERMAN: That’s correct; you have to be very, very careful about it. I say sort of.

SUNNY GAULT: I agree with that. You ladies agree with that sort of, but maybe don’t rely on it extensively?

MELANIE SILVERMAN: I think it’s really important to talk to your OBGYN about that, that’s what I would say with that, to really get a clear understanding of how that works.

SUNNY GAULT: Our last question here;
How many extra calories do breastfeeding moms burn each day?
Now, we kind of have to do this a disclaimer, right, everybody is different and these numbers aren’t exact, but:
a. up to 500 calories;
b. over 2000 calories
c. hardly any more than usual.
Ladies, what do you think?

GRAEME SEABROOK: I want to say over 200 calories, but that would be fabulous, but my scale says almost nothing.

ALICIA: I think it’s negative 500!

SUNNY GAULT: You think it puts more weight than it take off?

ALICIA: Yeah!

SUNNY GAULT: That wasn’t an option, ladies. Okay, Melanie, what do you say to this?

MELANIE SILVERMAN: I think it does vary and I think there is some literature that said, it was never 2000, and ladies, I am so sorry, I am so sorry! Because I understand, I understand. It was never 2000. I hate to break that news. But there seems to be for some women that it does seem to have some calories burn, so I would probably guess on this question up to 500, but again, some people do not experience any of this calories burn.

ALICIA: Melanie, I always thought that up to 500 is just a way to get moms breastfeeding!

MELANIE SILVERMAN: Not a bad idea! Whatever happens! I mean, can you imagine the 2000? You know that maybe helps with some postpartum weight loss and I really think it various from woman to woman, I mean I think that it just does.

SUNNY GAULT: It does. I have heard too that after women quit breastfeeding, that’s when their weight starts to come-of and again, I don’t want to say that so woman stop breastfeeding, that is not what I am trying to say here, but like that could be a factor too. Again, all of our bodies are different, and at least with these last few pounds that you are trying to lose, that you body actually smart enough to say hey I may need this, I may need this so I am not letting go of this quite yet.

ALICIA: Sunny, I have a positive spin on this, because my weight loss was always after I stopped nursing, but what it did for me was take the stress of trying to loose weight while I’m nursing, because I knew that once it was done, that was going to be my time to address that.

GRAEME SEABROOK: Okay, great, then I am just not going to worry about it for a while!

MELANIE SILVERMAN: You have a little baby to take care for, never worry about that!

SUNNY GAULT: Seriously! You got enough going on, Graeme! Ah ladies, thank you for being part of our little IQ test here. So that’s wrap-up our show for today, Thanks so much for listening to the Boob Group! 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
• Parent Savers for moms and dads with infants and toddlers and
• 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. The 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. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or 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 line-up of shows for new and expecting parents. If you have an idea for a new series, or if you’re a business, or organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com.

[00:39:06]
[End of Audio]

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Episode Transcript

The Boob Group
Top Questions Moms Ask Lactation Consultants

SUNNY GAULT: The concept seems easy. Baby is hungry, put him to the breast and feed him, right? But we all know breastfeeding isn’t always that simple. And that’s when turn to the professionals. Lactation educators, councilors and consultants who can help overcome issues that come our way. So what are some of the most common questions we ask these professionals and what are the answers to those questions? We are The Boob Group.

[Intro/Theme Music]

SUNNY GAULT: Welcome to The Boob Group! We're here to support all moms wanting to provide breast milk for their babies. I'm Sunny Gault. Thanks so much for being of our show today, it is great having you with us. We have more than a hundred and fifty episodes covering all sorts of breastfeeding and pumping topics and all of this is available of course for free. You can see a complete list of all of our episodes on the episode guide of our website at www.newmommymedia.com Just click on over the shows, go down to The Boob Group and then that will bring up The Boob Group portion of our website and you can see all of the episodes there. While you are on our website, please subscribe to The Boob Group newsletter. You can get emails each time we release a brand new episode and that’s always helpful. So what topics would you like us to talk about on the show? I ask that a lot and sometimes we get some emails, but I would love to have more, more connection with you, guys. So what are the topics, after you look at our episode guide, right, what are some of the topics that you really want to have more information about.

We’ve covered a lot, we haven’t covered everything for sure, and even if we have addressed the topic, we may not have talked about everything that you are interested in as part of that topic. So again: take a look at the guide, let us know what topics interest you and we will definitely consider them as a possible topic for the future. So let’s go ahead and meet the mammas that are joining our conversation today. Ladies, tell us a little bit about yourself and your family, and since we are talking about lactation consultants today and the questions we ask them, give us a heads-up and let us know if you have seen a lactation professional in the past. So Graeme, let’s start with you

GRAEME SEABROOK: Hi! I am Graeme. I have two kids. One is almost three, our son Andrew, and Lori, or Eleanor, is five months old. And I saw a lactation consultant with Andrew and this time around with Lori I have a lactation consultant, a postpartum duola and a lactation counselor through the hospital, I have a full team.

SUNNY GAULT: You do! I love that! And things are going better for you this time around as a result, right?

GRAEME SEABROOK: Oh my Gosh! So, so good! So good!

SUNNY GAULT: Yes, I love it, I love it! Okay, Alicia tell us a little bit about yourself.

ALICIA: Hi! My name is Alicia. I have four children, ages: ten, eight, six and three, and my experience with the lactation consultant didn’t occur until my last baby when he was five months old and was having some health issues and after that whole situation was over and I was moving forward I have since regretted not having seeked out-resources trough lactation professionals in the first three, so I definitely am a solid promoter of anyone who is trying to breastfeed, looking for that information.

SUNNY GAULT: Alright! And our expert today is Melanie Silverman, but I know, Melanie, we are going to learn a little bit more about you professionally later-on in the show, but tell us more about your experience being a mom.

MELANIE SILVERMAN: Well, I would love to! So I have an eight-year old named Sidney and a ten-year old named Lucas and funny enough I actually had to see a lactation consultant, being a lactation consultant with my first one and I forever love this woman who took care of me, because even though I knew a lot, I still really needed the help and she was instrumental and getting me going with Lucas.

SUNNY GAULT: Yeah! So even lactation consultants need lactation consultants to support each other.

MELANIE SILVERMAN: Yes! We do! We do!

SUNNY GAULT: I love it! And I am Sunny. You guys probably know me, but real quickly - I have four kids and my oldest is five, a boy, a three-year old boy as well, and then I have twin girls who are about two and a half and I did not use a lactation consultant until I had my twins. Actually, it’s not kind of a fair question to ask me, because I was producing The Boob Group while, you know, I was young, and so I didn’t actually have a lactation consultant and in doing these shows, I am sure, I am sure after a show I was asking lactation consultants questions. So it’s kind of an unfair question because I produced the show, but I will say, for my twins, they were a thirty-five week, so they came out a little early and then when they were first born they couldn't latch properly, they were not quite yet at that stage yet, because they were premies. So didn’t need the NICU, but we did need a little bit of lactation help and my body is pretty awesome when it comes to making milk, so I never had a problem with that with my twins, but it least up to their due date so from about thirty-five weeks when they were born up to about forty/forty-one weeks I saw a lactation consultant again trough the hospital that I delivered at.

And it was outpatient and I went in about once a week and we would sit there and she would help me latch the babies, we would get out a huge double breastfeeding pillow and she taught me how to roll up the wash-clause and stuff to get my breast in the right position and squish them and push them up and I am like “Hey, I like how they look now!” So she really did help me with that and that was instrumental in the transition because I was exclusively pumping at the time like I would see her to help me with breastfeeding and I would try to do that at home, but again, they were so tiny. So it definitely helped in the transition to get them to be tender breastfeeders and to get me to the transition from explosively pumping for those first month/month and a half/two months to exclusively breastfeeding them. So she was definitely instrumental in that! So I have a little bit of experience with lactation consultants in that regard. So anyway, thanks, ladies for being a part of our show! We will take a quick break. We will be right back!

[Theme music]

SUNNY GAULT: Alright, so before we kick off our episode today talking about different questions moms ask lactation consultants we are going to talk about an app that I think we can all agree on as part of the conversation we are really excited to learn more about this app because I think it can help a lot of moms out there. And so Melanie, our expert, is actually tied to this app as well, it’s called “Pacify” and Melanie, I want you to tell us more about it and then we can go kind of back and forward on the questions here, but what is your pitch as far as what is Pacify and what does it do?

MELANIE SILVERMAN: Well, “Pacify” is a pretty amazing app! Moms can go to their Google app store or to the app store through Apple and download “Pacify” to their phone for instant video access to lactation consultants, pediatric nutritionists and nurses 24hours a day, 7days a week and it is very, very exciting because usually getting lactation help can be very difficult, What Pacify allows a mom is to get help the minute that she needs it. And then another thing about Pacify is that you can actually gift it. And so it could be like Sunny and I, we would go to our friend Julia’s baby shower and we would bring her a three-month subscription to Pacify, so we are gifting her expert help. So I always say, you know, baby warmers and white warmers, those are very important for new moms to take care for their babies, but this kind of gift is really, really special and that you are giving moms this breastfeeding help that they often can’t get and as we all know, the breastfeeding help needs to happen immediately and it is best to happen right on the spot and Pacify allows it to happen. So I am very excited to be tied to Pacify and help all these moms get all that help that they need immediately.

SUNNY GAULT: So I had the chance to test this a little bit and honestly I am really excited about this possibility. I am actually so bummed out that you will probably hear this from various moms Melanie, that I did not know about this in the beginning. When I had my twins, when I brought my twins home because I had a lot of questions and as you can imagine it was a lot of effort to get out of the house with twins and again with someone watching my other boys to go to a lactation consultant. And not that this is a complete way to not see a lactation consultant in person, but you are right, like we have those questions like in the middle of the night, those middle of the night feedings or we just can’t get out of the house or whatever the case may be, and it would be so nice to have somebody at my fingertips. So the app is actually really easy to use and once you go and download it, it asks you some quick questions and then basically you sign in and it gives you some quick options as to well who do you want to contact, you know, do you want to contact a lactation professional, do you want to contact a nurse or you know… What is the third one, Melanie? There was a third one.

MELANIE SILVERMAN: There is, yeah, it’s a pediatric nutritionist. You know what’s neat about it Sunny, is that it really covers from birth when the moms are breastfeeding all the way really up to the age of when they have picky eaters and beyond, because when you introduce that solid food, that’s when the pediatric nutritionist comes in and can really help moms in all aspects of feeding and that is just what is so exciting about it.

SUNNY GAULT: So, it is great! So we have those three options on the home page - nurse, pediatric nutritionist and lactation consultant so whatever issues you are dealing with, you click this button, it dials somebody up and you are able to talk to them and you can do it with or without video. I think the nurse option right now is just audio.

MELANIE SILVERMAN: That is correct, but that is the neat thing too. It is that so often in historically with lactation help I can’t tell you how many of these amazing lactation consultants over the years have helped moms over the phone. And so much can be done over the phone, Sunny. But what is neat about this is the video aspect for lactation consulting because just for someone to just take a quick look can make all the difference in the world for moms.

SUNNY GAULT: Alright mammas, so tell us what do you think about this, so Melanie and I chatting back and forth here, telling you a little bit about it. I know you haven't had the chance to check it out for yourself, but Alicia, what do you think about an app like this?

ALICIA: I think it's great. I think anything that puts so close, in a palm of a mom’s hand to get direct contact with nurses and educators and consultants is so wonderful. Kudos to whoever thought of this!
SUNNY GAULT: I know, genius idea, right? Well now we are kicking ourselves now for not thinking of it ourselves. At least I am, I don't know. Graeme, what do you think?

GRAEME SEABROOK: I can't talk to you right now, because I am signing up. I am so excited. I have so much support, but I do have questions and I also have a baby and a toddler and there are times when I just can't get to my breastfeeding group or I can’t get to… Leaving the house is just a pain sometimes with both kids, so just being able to just pull out my phone that I am always on anyway, and get answers-this is amazing! I am seriously on it right now!

MELANIE SILVERMAN: And the call, Sunny, can last as long as they can, which is kind of nice, so nobody is feeling rushed on either end, so as long as the mom needs that help, she can have it. It is $15 a month for unlimited access to these providers.

SUNNY GAULT: So we are going to post a link on our website for Pacify so you can download it directly on you know, whatever phone that you have, iPhone or Google play, Android and we will be able to link it there and share more. We are also going to offer to our listeners, thanks to Pacify and Melanie, a discount. So if you are interested in this, you want to learn more about it, you head on to the deal section on www.newmommymedia.com and all the information will be listed there. So Melanie, this is truly exciting, I know we are going to talk more about the app and the different questions you get through the app and through our main conversation today, but I am just super excited about this and I think it can help a lot of breastfeeding mammas out there, so thank you! Thank you for doing this!

MELANIE SILVERMAN: We are all trilled to be doing this! We a very, very excited about it! It's a very, very, very special group to work with.

[Theme music]

SUNNY GAULT: Sometimes the breastfeeding and pumping moms need some expert advice as they pursuit their personal goals to provide breast milk to their baby. What are the most common questions they are asking? Melanie Silverman is our expert today for our conversation and she is also an IBCLC and as you heard earlier she is also associated with the Pacify app so she is getting a lot of questions.
Melanie, I know that you actually answer some of the questions that are coming up through the app, so you are talking to moms directly, so you definitely understand what moms need. Thanks for being a part of our show today!

MELANIE SILVERMAN: My pleasure!

SUNNY GAULT: So let’s dive in to some of these questions and for the purposes of our conversation we are going to assume that the people that are asking these questions trough the Pacify app, these are the questions they would probably ask lactation consultants in person, right? So we are not really making the distinction between you know are they only asking this question because is trough an app, no, we think that these are question that overall moms in general have for lactation professionals. So we kind of want to go through some of the top ones that we see popping up again and again and so let's go through some of these. So the first one is, I like this one: My baby has diarrhea. The poop is yellow, seedy and runny. What do you say to that, Melanie?

MELANIE SILVERMAN: I say that is normal, but a lot of people think it's not and let me tell you why. Because, especially, and maybe the moms can say to that, you know, as first time moms if they weren't able to take a lactation course and let's be honest, they have only been looking at their own poop for many years before that and they did not know what's going on. So when you see that, it can be very shocking. And so we actually have to say sometimes "this is normal, don't worry”.
SUNNY GAULT: Mammas did you have any concerns seeing yellow, seedy, runny poop at the beginning?

GRAEME SEABROOK: I actually did take a class before my son was born and still totally freaked out about that. I had no idea! I mean okay, after all of the black scary poop that happens first that I was like “Okay, it’s finally getting normal! Oh, where did these things come from?” and I was like “There are stuff in his poop!” and I was a mess! I asked everybody all the questions.

SUNNY GAULT: But can we just get real here for a second? I actually don't mind the smell of that poop. It actually kind of smells more like breast milk, because you know, they haven’t had obviously all the external foods that we have in our diet that make it smells not so pleasant and I know this is going to sound so strange, but when I went through that with my kids I was kind of like, it was kind of a pack on the back for me that it was because of what my body was able to do that they are able to do this.

ALICIA: Oh my Gosh, Sunny, you have to be the person that has ever though that. I don’t know, but I’ve never heard that. My mom had a daycare in her house for over ten years when I was growing up and I thought I was fully prepared for what was going to come out of that child and I was still shocked all the time. And how it changed all the time and how it founds its way to the car seat all the other places and oh my Gosh, this baby poop is a like a living, breathing thing.

SUNNY GAULT: But it does stain. That stage of the poop does stain and that's the part I didn’t like about it. I felt like it gets easier to get off, but it gets just that yellow, seedy, mustardy kind of look that is the downside of it. At our sister show “Newbies”. We have actually done a whole episode on poop. So if you are wondering about your babies poop and the color of it, and the consistence, trust me, again, 30 minutes talking about poop on that show, so go check it out.

ALICIA: It’s funny that you can probably do four more 30/40 minutes shows.

SUNNY GAULT: We probably could. Moms like to talk about poop, I swear. Ok, so let’s move on with the next question: So my baby is three weeks old, he is eating every two to three hours for thirty to forty minutes. Is that normal? Melanie, what do you say to that?

MELANIE SILVERMAN: I say it is normal, but here is the thing. A lot of moms think that’s not normal and they start to question their bodies and their milk supply and it makes me so sad when they feel like that. And that is pretty intense. That breastfeeding regiment of two to three hours for about thirty to forty minutes, that is usually within about the first month and what I do say to these moms when they are crying and they are sad, I say "I know this is difficult, I am here to help you, but I promise you, this is the hardest it’s going to be" because what happens over time is that the baby becomes more efficient, they get bigger and they can suck better and they are not sitting there for thirty to forty minutes. And the hour’s stretch-out a little bit longer. But that is normal in the first month, those three weeks.

SUNNY GAULT: Were you guys concerned about this? I mean every two to three hours, that’s a lot of time. That pretty much takes up your entire day.

ALICIA: Look guys, it was shocking to me with my first baby when we were nursing and you know, they tell you it’s every three hours and you think it’s ten minutes and ten minutes on each side and to find out that it’s not, that it’s every three hours is start of one and the finish of another works. And then when I had my second one, my first one wasn’t even two years old and so trying to keep her occupied while I was trying to feed all the time, oh my Gosh! That’s one thing I always try to bring up to new moms either when there are pregnant and preparing for that or after they’ve just started, I always try to bring that up because I want them to know that it’s normal that you are going to feel like you nursing 24hours.

GRAEME SEABROOK: Yeah because it is the way that you guys do the hours and way the moms do the hours are not the same thing. When they say every two to three hours I thought that meant that when she was done I had two to three hours before she was going to start again.

MELANIE SILVERMAN: Not exactly . . .

GRAEME SEABROOK: I feel like there is a bait-and-switch going on there. You guys are trying to trick us.

MELANIE SILVERMAN: Well, we are trying to be supportive people. We are trying to be supportive lactation consultants, but it’s definitely intense. It’s a very intense thing and I really think moms are blindsided even when they are prepared, even when they have taken these courses and talked to their friends and have older sisters, I think that is, it’s a tough one. But I think with support and saying this is normal I think it has helped with many of the moms I have worked with.

SUNNY GAULT: So speaking of what’s normal: How many poops and pees per day is normal in breastfed babies?

MELANIE SILVERMAN: Well, I am happy to talk about poop again.

SUNNY GAULT: I knew it will come up again.

MELANIE SILVERMAN: Yeah because in reality it’s so significant, so this is a great marker. Some people say “How do I know my baby is getting enough?” and I say “You got to look at the diaper.” and they go “Oh, I didn’t realize that!”. But usually when we are talking to moms a real easy rule from birth is day one - one poop, one pee, the second day - two poops, two pees, but by day four the poop should be transitioned to that yellow, seedy stuff that Sunny loves and we should be in that realm maybe five to six diapers a day and I will be honest - anywhere between two to ten poop per day, and I have seen that, but usually three to four. There is a wide range and that’s where a lot of questions come in, because some moms call me and they say “My baby only poops twice a day” but what you should look at is what’s going on with weight gain? What’s going on with how the baby is acting? So there is a wide range and I am sure there is a wide range with these moms too as to what they have seen with their breastfeeding babies and its normal.

SUNNY GAULT: Yeah, so mammas, what did you experience when it came to poops and pees?

GRAEME SEABROOK: I think it changes too when you are talking about like are we talking about the first couple of weeks, are talking about month three and four, are we talking about older, like it really changes, a lot.

MELANIE SILVERMAN: For sure.

GRAEME SEABROOK: So that is where my question came in because I was like alright, so this is what is normal for the first week, but now I am home and it’s the second, the third and the forth week and the poop started slowing down, but she was still gaining weight and she was still peeing regularly, but I was calling the doctor going “She is only pooping once a day! Oh my Gosh, something horrible has happened!” and they were asking me all these questions going “Nope, you are fine.” after I have just been freaking out for hours deciding whether I should call the doctor. So yeah, hearing that things are normal, that really helps!

SUNNY GAULT: Now it’s like the one time in life you really want to be normal. Being like you know oh yeah, being normal it’s good for parenting when it comes to, you know, the development of you baby and hearing the 50% marker is actually a good thing. I remember that was one time in my life I was like “Oh, we are normal, good! We are just going with the flow, I like that!”
So next question; some women may say something to the effect of “It's really hot today, should I give my baby a few drops of water?”

MELANIE SILVERMAN: So the answer is no! And it’s a quick no! And that’s because breast milk is actually formulated to be perfect for hydration and so we really don’t want to give the baby any water and just rely on breast milk during those hot days.

SUNNY GAULT: Did you ladies have any questions when it came to water or did you know from the get-go no, you know, there is enough water in the breast milk to sustain my baby.

ALICIA: Yeah, you know, I never really questioned giving the baby water. We lived somewhere it was really hot and I had all my babies in the summer, so it would be a hundred and five degrees and I don’t know why, I think I just always felt that way, you know, breast milk had whatever they needed.

GRAEME SEABROOK: Yeah, I was always told for me to keep drinking water, you know, when it was super hot, because I am in South Carolina and it gets. You know, it’s soupy out there, and so I was always making sure I was drinking a lot of water and that has been giving us through and I don’t want to think about the summer coming up.

SUNNY GAULT: Now, that’s true. Melanie, how much water should moms should be drinking? I mean, is it more than the average eight cups a day or eight ounces . . . ?

MELANIE SILVERMAN: Yeah, that’s actually a great question! So you know in the literature, for a long time, and also you know hands down across the United States, I would see things like you have to drink eight glasses of water a day to make enough milk. And the reality is that is not really true. To make milk you need to empty the breast and so what I say to moms when they ask me these questions about hydration, is really drink to thirst and that is really what the recommendation is now these days. Drink to thirst, yes.

SUNNY GAULT: Ok, and probably water is better than some of the other options out there, you know, if you can drink water over lemonade, iced tea, all that kind of stuff. I mean, I know all that has a lot of water in it, but it’s still different, right?

MELANIE SILVERMAN: Well, actually it’s a hydrations sorts, but now I am putting my dietitian cap on and so what I say is you know, liquid calories don’t fill you up, so if they do add calories and so… I am not saying ever have lemonade or anything like that, but really water is probably best. Empty calories are not such a fun experience.

SUNNY GAULT: So when we come back we are going to share more of these common questions that moms are asking lactation professionals. We will be right back.

[Theme music]

SUNNY GAULT: Welcome back! We are continuing our list of common questions moms ask lactation consultants and Melanie Silverman is our expert. So Melanie, another thing that mom maybe posting:
I read that I need to stay away from broccoli and other gassy foods when I am breastfeeding, is that true?

MELANIE SILVERMAN: Oh, these kinds of questions make me sad, Sunny! And I am going to tell you why.

SUNNY GAULT: From a dietitian point of view?

MELANIE SILVERMAN: No, no, but that’s funny that you say that. Actually, from a lactation consultant's point of view and I will tell you why. And all of the lactation professionals that are on Pacify, I know that we feel the same way. We don’t want to make breastfeeding difficult. We want to make it as simple as possible. When parents come to us and call us and ask us these questions, you know “I'm staying away from the broccoli and I stopped drinking the milk and don’t eat the nuts and I do all these stuff…” and they are just doing it for prevention and they are not just eating a normal diet, it really sets them up sometimes to be restricting their diets when they don’t need to. And so what I say to moms when they come to see me pre-baby and they really want to kind of understand what breastfeeding is don't change your diet. Just eat a wide area of different foods; enjoy your food, you know, eat when you are hungry, stop when you are full; drink when you are thirsty. And you probably don’t want to have broccoli every single day of the week, but kind of paying attention to “I ate some broccoli this day, so I’m going to take it easy on the cruciferous vegetables the next day is a real wise move.

But I wouldn't necessarily tell a mom to preemptively stay away from broccoli to stay away from broccoli or other gassy foods while they are breastfeeding. I would kind of do a wait-and-see. That said, that said, there are moms that I have treated that their baby has an issue with some of the things the feed on or eat themselves, the moms. So you kind of have to be careful and monitor the child - if there is one kind of gassy episode from broccoli, you probably can kind of wait, but if you have two, or three, or five episodes of it, maybe you want to pull away from some of those vegetables. But I really think it's a trial area.

SUNNY GAULT: Asparagus was one of those things for me and I think that was more about does that change what the breast milk tastes like a little bit, I know all our food kind of does, but that seems to be one that once I had asparagus and then I breastfed, you know, I don't know the amount of time afterwards, but my kids were kind of looking at me a little strange.

MELANIE SILVERMAN: Yes! No, I mean there is definitely I mean breast milk changes for sure, and so I think that was something you investigated and I really rely on the moms to be the experts on their own care, but I don’t want moms to just start to restrict their diets for no reason. I really want them to it open as long as they can until they see a problem.

GRAEME SEABROOK: Well, babies will let you know or am I wrong about this? I feel like about my daughter there are very specific things and broccoli was one of them, cabbage was another, but she let me know. There were all kinds of gas and fussiness and it was quite obvious once I started looking at okay, this is the third day of fussiness in a row, what have I been eating? Well, let me try and cut that out for the next couple of days and it went away-alright, no more cabbage. But it wasn’t a think anybody ever told me to not eat it at the very beginning, from the top, you know.

MELANIE SILVERMAN: Right. I think people want to make breastfeeding that we need to do this, and this, and this, and what I found and what I think moms may agree with me on, is that it just varies from mom to mom, it's such a personal experience.

ALICIA: I would say that in addition to varying mom to mom, it varies child to child. And I know with my first I did all of those rules, it was like don't eat broccoli, don’t do this, don’t do that, and so I had the second I threw all of it out of the window, because it was just too much stress. And then my forth had health issues due to diet and so then I got a whole new acknowledgment on what to eat and what not to eat. But at least for the second and third I let myself just go with the flow.

SUNNY GAULT: So another question may be: If the cradle position (you know, one of the breastfeeding positions) is working for me while breastfeeding, is there any reason I need to change it?
So what do you think about that, Melanie?

MELANIE SILVERMAN: Well, look, it’s kind of my whole philosophy with the eating-don't change it if you don't have to, and I feel the same way about the positioning. If you are doing great, the baby is happy, you are happy, the baby is gaining weight and everybody is kind of in their positions and enjoying it, stay the course. But, Sunny, if there is a situation where a mom is complaining of initial pain or sort nipples is really kind of genius to switch positions and go for pro-hold or trial-sideline because that changes the way the baby is attached to the breast and could provide some relief.

SUNNY GAULT: Well, it could be something really small too that we think we are doing the right position, but there is just something a little off with it, right, so that the baby isn’t positioned in the right way, so that is maybe why we are experiencing some problems or whatever. And I think that’s one of the, we are going back to your app, that’s one of the cool things about the video portion of the app. We mentioned earlier that sometimes it’s a real quick question that we may have and I could see the video portion of this being huge foe hey, is this latch okay; or this position that I am holding my baby in isn’t just working for me, am I doing something wrong with this, cause you know, I have looked at the videos online and I’ve done my research and it is still not working out.

MELANIE SILVERMAN: Right, that is very, very true. And you know, for like premature babies what I often use is the foothold. And so there are different things that people start with, different things that maybe a lactation consultant helps them in the hospital with, and they kind of stay that course, but if it’s working, I say stay the course.

SUNNY GAULT: So our last question that seems to be the most popular is: Breastfeeding has been easy for me until now. My baby girl/boy, (you know, fill in the blank), is about four months old and used to feed every four to five hours; over the past week, the baby is feeding every two hours and I feel like she/he is regressing; what’s going on?

MELANIE SILVERMAN: Well, this happened to me and it was shocking when it happened with my second one and I kind of had to flip through my books and figure out what was going on, but it’s called cluster feeding and what is happening here is, and again this is what is so valuable about Pacify, I think, getting that immediate help like what am I doing wrong, it is actually a signal that your baby needs more milk and it’s growing. So what the baby is trying to do, is trying to empty your breast as much as possible, so that it sends a signal to your brain to make more milk; and so this a temporary situation. It is a very difficult situations for moms, I really feel sorry them when this happens. Usually about four or five months is when we start to see this; and it usually rounds anywhere between about one to two weeks and it really calls on a mom to step back. I really try to say we have to go back to self-care because by then you know, you kind of have the swing of things-you understand how to breastfeed the baby, baby is happy, mommy is happy and all of sudden you can’t just go out with your friends for lunch anymore because the baby is really being demanding, but it is a temporary situation and actually good news.

SUNNY GAULT: Cluster feeding-it’s so much fun! It actually helps with supply. I will give it that. If you are low on supply, and your baby is the more than your breast, it’s the whole supply and demand thing, right. So that’s the good thing I have to say.

ALICIA: The only good thing, the only one, that’s it!

MELANIE SILVERMAN: I know, it’s tough, it’s really tough.

SUNNY GAULT: I know, it’s crazy. We actually did a whole episode on The Boob Group about cluster feeding because we were saying those term and you guys are like I don’t even know what that is.

GRAEME SEABROOK: It means they never stop eating ever, ever, ever, ever, that’s what it means!

ALICIA: Melanie, your answer was wonderful! I never knew. I just knew that was the time of breastfeeding that I would just cry because it was so overwhelming.

GRAEME SEABROOK: Yes, Alicia, yes! Because especially like the forth month comes right around the sleep-progression that both of my kids got, so you are not sleeping and they are eating all the time.

MELANIE SILVERMAN: You know what I say to moms a lot and I would love to use that phrase for so many years as a lactation consultant , I kind of say that you have to surrender to this. This will get better, but I am just asking you-don’t think that this is going to last for the next three months, it won’t, but I just need to take this day to day and with Pacify you can call and just check in even if you just need, even if you just need a pep-talk. These people are good in giving pep-talks too, because a lot of that, you know, helping breastfeeding, is cheerleading, and this is especially a time the mom needs it, she needs to understand what’s happening physiologically in her body and then get some support.

SUNNY GAULT: Great advice! Alright, I think we touched on a lot of stuff today, but there are some good nuggets of information in there and hopefully we helped some mammas out there today. So thanks so much to everyone for being part of our show today. This was a lot of fun. If you remember of The Boob Group club, then please check out the bonus content for this episode, we are going to discuss when it’s time to see a lactation professional in person as oppose to doing some of these newer things like talking to them trough an app, or doing a Skype session, or hangouts, or something like that. So for more information about our club, visit our website at www.newmammymedia.com.

[Theme music]

SUNNY GAULT: Alright, so before we wrap up our show today, we have our segment of the show and it’s a segment we call “What's your breastfeeding IQ?” and so we like to test ourselves a little bit and ask ourselves some questions, remind ourselves why we are continuing to breastfeed and pump for our babies, because we know it’s so good for them; and we like to do this in a form of questions, right. So I am going to ask you guys some questions and if you are listening play along with us and hopefully we can learn a little something as well. So question number one: Is it normal for breastfeeding to hurt? True or false, ladies? Melanie, don’t say anything yet, because I know you are going to give us the answer here, but ladies, what do you think, is it normal for breastfeeding to hurt?

GRAEME SEABROOK: False.

ALICIA: False. I think I will say false too.

GRAEME SEABROOK: I was going to say true, but I'd say common is true.

SUNNY GAULT: Yeah, so okay, common is one thing, but is it supposed to hurt? And Melanie, what do you say about that?

MELANIE SILVERMAN: I would say no, I mean I would say false. It shouldn’t hurt. I mean, I always say this to people, it’s like going to the gym, when you start breastfeeding it’s something you’ve never used before just like using a new muscle in your body, and so, but breastfeeding should not hurt usually.

SUNNY GAULT: So that’s false. Next question:
Moms who breastfeed have lower risk of: (and we have some choices here)
a. breast-cancer
b. osteoporoses
c. uterine and ovarian cancer
d. all of the above

ALICIA: D.

GRAEME SEABROOK: You know, I am going to say “D” because I want it to be true.

SUNNY GAULT: Alright Melanie, hook us up, what is the answer?

MELANIE SILVERMAN: All of the above.

SUNNY GAULT: And probably more stuff that is not on the list too, that didn’t fit our multiple-choice question, but obviously lots of benefits to breastfeeding. Alright, next question:
Breastfeeding prevents you from getting pregnant:
a. sort of, but not really
b. false
c. true
And silence, no one wants to answer that question. Alright, Melanie, what do you say to that?

MELANIE SILVERMAN: Well, I think it’s sort of, and I think we have to be very, very careful about this. There is a specific guideline that you need to kind of understand that your body is going through to claim that it will keep you from getting pregnant. And so it’s exclusive breastfeeding, no supplementation, no additional foods, breastfeeding around the clock. It’s a real hormonally intricate cascade, so if you are following those, then breastfeeding can support some birth-control, but if you are not, there maybe a surprise.

SUNNY GAULT: Yeah, and if you don’t want to get pregnant, don’t just rely, and don’t be like “I am breastfeeding!”.

MELANIE SILVERMAN: That’s correct; you have to be very, very careful about it. I say sort of.

SUNNY GAULT: I agree with that. You ladies agree with that sort of, but maybe don’t rely on it extensively?

MELANIE SILVERMAN: I think it’s really important to talk to your OBGYN about that, that’s what I would say with that, to really get a clear understanding of how that works.

SUNNY GAULT: Our last question here;
How many extra calories do breastfeeding moms burn each day?
Now, we kind of have to do this a disclaimer, right, everybody is different and these numbers aren’t exact, but:
a. up to 500 calories;
b. over 2000 calories
c. hardly any more than usual.
Ladies, what do you think?

GRAEME SEABROOK: I want to say over 200 calories, but that would be fabulous, but my scale says almost nothing.

ALICIA: I think it’s negative 500!

SUNNY GAULT: You think it puts more weight than it take off?

ALICIA: Yeah!

SUNNY GAULT: That wasn’t an option, ladies. Okay, Melanie, what do you say to this?

MELANIE SILVERMAN: I think it does vary and I think there is some literature that said, it was never 2000, and ladies, I am so sorry, I am so sorry! Because I understand, I understand. It was never 2000. I hate to break that news. But there seems to be for some women that it does seem to have some calories burn, so I would probably guess on this question up to 500, but again, some people do not experience any of this calories burn.

ALICIA: Melanie, I always thought that up to 500 is just a way to get moms breastfeeding!

MELANIE SILVERMAN: Not a bad idea! Whatever happens! I mean, can you imagine the 2000? You know that maybe helps with some postpartum weight loss and I really think it various from woman to woman, I mean I think that it just does.

SUNNY GAULT: It does. I have heard too that after women quit breastfeeding, that’s when their weight starts to come-of and again, I don’t want to say that so woman stop breastfeeding, that is not what I am trying to say here, but like that could be a factor too. Again, all of our bodies are different, and at least with these last few pounds that you are trying to lose, that you body actually smart enough to say hey I may need this, I may need this so I am not letting go of this quite yet.

ALICIA: Sunny, I have a positive spin on this, because my weight loss was always after I stopped nursing, but what it did for me was take the stress of trying to loose weight while I’m nursing, because I knew that once it was done, that was going to be my time to address that.

GRAEME SEABROOK: Okay, great, then I am just not going to worry about it for a while!

MELANIE SILVERMAN: You have a little baby to take care for, never worry about that!

SUNNY GAULT: Seriously! You got enough going on, Graeme! Ah ladies, thank you for being part of our little IQ test here. So that’s wrap-up our show for today, Thanks so much for listening to the Boob Group! 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
• Parent Savers for moms and dads with infants and toddlers and
• 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. The 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. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or 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 line-up of shows for new and expecting parents. If you have an idea for a new series, or if you’re a business, or organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com.

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