You have successfully birthed your baby. Now you are being asked whether you are breastfeeding, formula feeding, nursing, or pumping. Feeding your infant can be hard, and finding what works for both you and your baby can be even harder. Today, we are diving deep into why feeding your infant is more complex than parents are told.

Thanks for joining us. This is Newbies.

Welcome to Newbies. My name is Kaely Garcia, and I'll be your host today. If you haven't already, be sure to visit our website at newmommymedia.com and subscribe to our weekly newsletter, which keeps you updated on all the episodes we release each week. Another great way to stay updated is to hit that subscribe button in your podcast app.

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Jessie Zak. Dr. Zak is an American Board of Pediatric certified MD based in LA with a special focus on pediatric emergency medicine and advocacy for moms, dads, and babies. We love having you guys on our show because I feel like we always get right into the thick of great questions. Anyway, before I steal the show with jumping into questions, I want to hear more about who's part of your family and where you guys are located.

Yeah. Like you mentioned, we live in LA. I recently had an 11-month-old baby girl. So- Oh, yay ... she-- I know, she's about two weeks away from her first birthday, so we're gearing up with that and everything that entails. But it's been just so fun and just, a wild ride on top of everything else.

But but yeah, so me and my husband have our 11-month-old. We have two mini Australian shepherds that also keep us very busy. And then I work at a private practice, Westside Pediatrics, and we have two different offices in LA, in Brentwood and in Manhattan Beach, so in the South Bay. And then there, I see babies from birth until 18.

I worked at CHLA in the ER, so that's our big children's hospital here in LA, for a couple of years, which is why I have some ER experience. But really missed kind of watching babies grow up and also working with parents and, getting to know families and really being a part of their lives.

So I switched from the ER to general pediatrics and private practice about 10 years ago almost now. So it's been great.

Amazing. I think, 'cause I have two, I have a three-year-old and a seven-month-old, and I love when we had the first year of life, right? When you're new- ... parents. You're always, you're coming into the office with questions.

You're like, you have it on your phone, or like we went to the- Yeah ... ER a few times 'cause we're new parents, right? And- Of course ... it is what it is. Anyway, and then once you're a second-time mom, it's s- like my pediatrician or my daughter's pediatrician was like, "I can tell that this is your second child."

Yes. 'Cause they'd be like, "Do you have any questions?" And we're like, "Nope, we're good." Anyway, the, this episode is for the moms, the first-time moms. Great. I'm here with you. I was you. I'm excited- Same ... to dive into those feeding questions specifically. We'll take a quick break and then jump right into it.

Welcome back. Today we're discussing infant feeding. So I wanna hear a little bit about your experience, and I love that your daughter is not one yet. ... Tell us about your experience with feeding her, especially with the knowledge that you have. I mean- Every mom has a wealth of knowledge that's different, right?

Some moms- Yes ... are doctors like you. Some moms are podcasters talking to moms, are talking to lactation consultants. Other moms are teachers, right? And so I love this. So I wanna hear a little bit about your experience with n- maybe working with new moms and dads, and also navigating your first year feeding your daughter.

Yeah. As it's a whole different experience, too, once you have your own and trying to figure it out. I kinda went into it, and I feel really lucky having just the experience I have with new parents and seeing hundreds of people's breastfeeding, bottle-feeding, formula, whatever they chose, journey.

So I went into everything just, I'm gonna try breastfeeding, see how it goes, hopefully it works, and then, was very optimistic. I was in the camp of I had a pretty good supply, but my daughter never really latched. So- ... we went through everything. We did lactation consultants, and we work with one in our practice who I absolutely adore.

Tried having her latch, did the triple feeding experience probably for a week or so- ... which is a whole nother beast in and of itself. Oh, yeah. But then in the end, I just felt, what was best for me and best for my mental health and really our daughter and just keeping her healthy was I just exclusively pumped for about five to six months, and then around six months old, started kinda working in some formula.

I was back to work. I had a decent stock in our freezer, but not enough to kinda sustain us for the first year. And then started to bring in some formula around six months, and now when she started eating solid foods as well, and now she is exclusively formula-fed. And about to switch over to cow's milk and just food, which is also just a whole nother crazy step in the process that we'll have to figure out as it comes up.

But but yeah, it was a wild ride for sure. And then I think experiences like you mentioned with new moms and dads, everybody has, I think, their own expectations, their own goals, which is really important as your pediatrician to sit down with families, and each visit really evaluate where they're at, both mentally, physically.

How is baby doing? What are their expectations? And kind of meeting parents where they're at and helping to guide them, and both keep them happy and healthy, and obviously keep their baby safe as well.

You answered that question amazingly. I love that you have been on both sides of the spectrum- Yeah

even with breastfeeding, and then totally switching over. I love that so much. So talk about some typical questions you get with new parents, and let, I'll even scope it down. So let's say- ... that first week checkup, right? Or I know it's sometimes it's 24 hours, 48 hours, and then it's two weeks or whatever.

Anyway, that really short timeframe, the early, first two weeks with your newborn. What are some typical feeding questions you get? Is it typically mostly breastfeeding complaints? Or I only breastfed both my babies, I don't know. Or early on having formula questions, like maybe the formula they chose isn't really, compatible with their baby.

I wanna know about some typical questions that parents come to you for.

Yeah. You covered the gambit, too. You have moms coming in that are wanting to breastfeed and obviously the whole first month, especially that first two weeks of breastfeeding, is completely different than what your breastfeeding journey's gonna look like three months- six months, nine months out. Definitely. And I think that's so important to stress with moms. I think the biggest thing that new moms don't necessarily know ahead of time is that your boobs are like their own baby. They're like this entity that you all of a sudden have to take care of and pay attention to- on top of healing from birth and on top of taking care of your baby. So I think it's really checking in with moms and seeing how that's going, whether it's the latch is painful baby's potentially not transferring, baby's still figuring it out, wherever they're at. And that's really important to really just help support them through and see what their concerns are.

And I think most importantly, too, just help to instill some confidence and some patience, and most importantly, some grace in that you're new at this your nipples are new at this, your baby is new at this. They've never had to eat before, and so everybody's just figuring out, it out together.

And then, I have dads in there that are trying to support new moms also that are attempting to breastfeed, helping to guide them in how they can support their partner. I should say, moms or dads in how they can support their partner. And then I do have some parents that tried breastfeeding or were never really interested in it or couldn't do it for whatever reason or didn't even want to do it, which is also fine.

And then it's us figuring out the different formula that they want and what they're looking for, and obviously what their baby likes and what agrees with their baby's body. What is available in the hospital isn't necessarily, representing all of the different formulas out there, so it's just figuring out what's important to parents and and going from there.

Question about breastfed babies. What's really big right now, which I'm sure you're getting questions about, is going dairy-free. Yeah. They suspect that their baby has a dairy, intolerance or something like that. So I guess how would someone... What are some red flags that you might see that, if someone listening to be like I don't see that in my baby," or, "Yes, I see that in my baby."

What would be something you would recommend if a mom comes to you and says, "I think, I'm breastfeeding. I think my baby has, a dairy intolerance. Should I go dairy-free?"

Yeah. So most importantly, I think people are very quick to take food away from moms and say that- Absolutely.

Yes.

Right?

Which was, is always so sad to me. Number one, I love food, and then number two- Yes ... when you're breastfeeding, the amount of like calories and nutrition you need to sustain both you and your baby is so high and this whole different level than what you've ever experienced before. So I always tell moms, most importantly, if you- your baby has a one-off fussy day, do not necessarily jump to the food that you're eating.

I think if it is repeatedly you notice, "I've eaten black beans, and the last five times I've done that, my baby's really gassy," then sure, take a look at it. I think always take a step back and know just babies have off days like we do. For the dairy intolerance stuff, it's, it tends to be when babies are a little older.

So the first two, two weeks to one month, and even the first couple months, babies are getting new gut bacteria. They're still, again, trying to figure out how to eat, so they're a little bit gassier than normal. Their digestive system is really trying to kick in. So a- again, dairy, soy, eggs, the other allergens we're a little more hesitant to immediately just jump to that and take that out of mom's diets.

The other reason why you don't wanna just jump to it as well is because if there is... if you completely restrict that food from mom's diet, babies aren't getting that little bit of exposure, and it's something that we could potentially put them at risk for allergies or other things later on if you take it away from mom's diet, and then also, carry that into solid foods and restricting that from babies.

So that's something that we wanna keep in mind to chat with your pediatrician about. But really, the big thing that you see with dairy intolerance and more so what we call a milk protein intolerance, is those babies are incredibly unhappy, right? The dairy that mom is eating is bothering baby.

They're fussy more than they're happy, which I think is a big red flag. They're not gaining good weight, so that's a big reason that we look at if babies aren't necessarily meeting their curves or the weight goals that they should be. And then the other thing that you look for is either microscopic blood in their poop, which you can test in the office, or if there's like obvious blood that parents can see where there's little specks of it in baby's diaper.

So if any of those things are happening, I'd always suggest to just bring it up with your pediatrician. And it... when in doubt, I think even for lesser concerns, come in, see your pediatrician. That's what we're there for, is to make you answer your questions, and hopefully have you go home feeling confident in what you're doing and confident in how your baby's doing.

Absolutely. I loved my daughter's first pediatrician my oldest. I would come in there with, I kid you not, like 20 questions on my phone. Okay. And she knew it after the third or fourth wellness checks. It's so many in the first year. She's like- Yeah ... "All right, Kaile, let me see those questions."

And I would just go through them. And so don't feel ashamed. Definitely come with the questions, 'cause that's what they're there for.

Yes. And I would- It's really helpful, actually. Yes. 'Cause I want you to leave feeling like you're walking out of the door with almost that second time parent swagger.

You're like- Yeah. ... "I got this. I know what to expect in the next month. We can do this. Let's go."

And it's so reassuring too, 'cause like you said, some babies just have, And first-time moms, you don't know this, like your baby- ... is great for two weeks, and now they're so fussy for like- Yeah

six hours, and you're like- Yes ... "What is going on?" Babies grow, right? It's probably very uncomfortable to grow and to - Oh, for sure ... to learn, and so it's okay to have a bad day. I love that you said that so much, 'cause when you bring that up to your pediatrician, they tell you that, and you're like, "Oh, I got this.

Yeah, it was just a bad day." We're fine." Yeah,

exactly. Oh, how fun. Clock it, moving on. Restart the next day.

Exactly. Exactly. Oh, it's so great. So I guess rolling into one of the last questions in this first section is we're talking, you talked a lot about feeding and, types of poopy diapers, right?

But h- why is it so important, especially let's say in that first three months to be keeping ki- or maybe the first month. I'm not sure. You tell me. But to, be keeping track- Yeah ... of baby's wet diapers, whether you're formula feeding or breastfeeding. I guess more so breastfeeding. And I guess more so if you're not pumping, right?

'Cause I- Yeah ... I never know how much my daughters are getting, 'cause I don't pump. Yeah. But why is it so important to keep track of wet diapers for new parents?

The most important window for me is that first kind of first week for sure, and then maybe the second week with the wet diapers.

And wet diapers mean two different things, too, right? So as a pediatrician, we look at pee diapers most importantly, and then poop diapers is a secondary thing. So our pee diapers for babies, that first week you want them to pee the number of wet diapers per days old that your baby is. So if they're one day old, you want one in the first 24 hours of life, two wet diapers in the second 24 hours of life, and so forth.

That to us tells us that baby's getting enough milk or formula, breast milk, whatever, to stay hydrated. And especially as mom's milk is coming in, if you're breastfeeding, those first three to seven days, which is sometimes how long it can take, if they're not necessarily taking as much to stay fully full, but they're staying hydrated, then we know your baby is safe.

And it's a way for us to use as a secondary measure to their weight on how they're doing in that regard. Pooping for us is, again, a lesser important, but still something we want to keep track of. Pooping for sure, you want your baby to poop in the first 24 hours. That just shows us in general their gut's moving, getting rid of that meconium, all of that.

And then once the meconium starts to pass, which is that green sticky tar that you get the first handful of days, it's a good measurement. Most kids clear that on day three through five. So that's a sign to us, like, all right, they're eating enough or they're pooping enough, so their weight gain and how mom's milk supply is probably in a good place.

And then from there That whole second week where we're giving them time to catch up to their birth weight because you want babies to be back at birth weight by about two weeks old. If they're pooping at least after most most feeds in between every feed, then you know that they're also probably taking enough where you're like, "Oh, they're eating enough," or they're gaining good weight in between that time where you see your pediatrician at their first newborn visit, the first like three to five days of life, and then your next visit about two weeks later.

And what I tell parents is if you're not seeing the pee diapers and if you're not seeing the poop diapers, maybe it's worthwhile to schedule a visit and come in and see me sooner than what our normal scheduled visits are.

That is such great advice, honestly. I remember I struggled with breastfeeding- and what they did at the lactation consultant with my first, they did weighted feeds, and that was so cool. Yeah. Yes. So cool to see. Yeah, for especially for the breastfeeding moms. Anyway, we talked a lot about breastfeeding. I do have a lot of questions about bottle feeding coming up- Yeah ... after our break.

Welcome back. We're continuing our conversation with Jesse. So let's chat about the importance of bottle flow. Does the flow make a difference? And really I'll throw most of them at you. When should a parent be, looking at the bottle flow? I know there's the zero month and then there's the one month.

What does all that mean, and when should parents be moving up, moving down? What is, what does that mean for those who are confused?

Yeah, it's a great question. And it's not very clear, I think, on most of the bottles- Yeah, I know ... especially as somebody that bottle fed their daughter the whole first year.

Luckily I felt really lucky in that I had some experience with it as a physician, but, I obviously had to teach the people that were helping take care of my daughter around me. So the flow is really important. It's basically how fast the milk that you're giving your baby is coming out of the nipple itself.

Now, in the US, there is no standardized rate. So what is a level one or a two or a three in one brand does not necessarily mean it carries over to the next brand. There's also- Oh, interesting. I know, which is really hard because some parents and some families use different bottles, right? Depending on where you're going.

Most bottles start with a preemie flow or what we call a slow flow. Then there's a standard. That's like what we call like just like the regular newborn rate, and then it goes up from there. And however many flow rates depends on the bottle brand that you use. Most babies transition out of the like standard flow around two to three months old, and then the next flow is around like four to six months old.

But again, I'd always double check on the bottle and the nipple that you're using. And making sure that you're following kind of their recommendations. My daughter loved to eat, and she transitioned out of nipples pretty quickly, ... much faster than I expected, which was funny to see as a pediatrician.

I was like, "Oh that's a good learning point for us." And really what y- they can show is if your baby is on too slow of a flow, the feeds are taking longer, baby's getting frustrated. You're like, "Why are they pulling off the bottle? I don't understand what changed." And a lot of parents jump to "Is th- there something wrong with the milk?

Is there something wrong with their belly?" When really, all your baby's doing is just trying to drink a milkshake out of too skinny of a straw, and you just gotta bump up the flow. And then on the flip side of that, if your baby's nipple rate is too fast, which a lot of times we see in the little babies in the first couple weeks, then it's oh, they actually need a slower flow to help pace themself and not swallow too much air or feel like they're almost drinking out of a fire hose when they really just need a nice, slower flow.

That is so helpful, and you explained it so well. I remember with my first, we tried bottle feeding. But then I was gonna go back to work, and we were only bottle feeding at night. And I was like, "No, I wanna nurse at night 'cause I'm gonna go back to work anyway." And then the whole bottle refusal thing came up.

Yeah. And so can you navigate, I guess this is specifically for a mom switching from pumping exclusively- ... to maybe nursing exclusively or vice versa, right? A mom nursing exclusively but then going back to work at, three, four, five, whatever months. Yeah ... what would be your advice for those who have to navigate between bottle refusal?

Yeah. It's honestly, it's really hard on, on families just because, it... let's say if babies won't take bottles, moms are always needing to be close by, and that-

... That

is a lot to put on somebody, right? And it also, I think, there's other partners involved that wanna feed their baby, too, and have that experience as well.

Biggest thing that I recommend with families, so if you're exclusively breastfeeding from the beginning, I think it's really im- important, if you want to have a bottle feeding just in general that whole first year, that you introduce a bottle around one month old and that you keep that bottle in the routine constantly.

So the biggest mistake I'll see is people will introduce a bottle around one month. They're like, "Baby's great at it," and then they back off, whether it's breastfeeding gets easier, they enjoy it, whatever comes up, right? And then they try to reintroduce the bottle around three, four, five months old when, usually when moms are going back to work, and babies won't take it anymore.

So as long as you keep it in the routine, it's something that babies know "Okay, this is an expected way that I'm gonna be feeding." And then again, I think paying attention, like you mentioned, with the different flows and whatnot that you're incorporating in with it. There's a ton of different tricks w- if babies are refusing the bottles, which sometimes can just be with different growth spurts or regressions.

It's, using the nipple as a pacifier, putting some milk on it in the beginning of the feed, right? So babies recognize oh, there's food in here. I think a lot of times what happens, too, is moms, if they're breastfeeding and baby's refusing the bottle as they're a little bit older, really a lot of times moms have to completely remove themselves from the equation.

So not being in the room, and I've even some- seen some babies where moms can't even be in the house 'cause they can just hear them. And it's really making it where babies are like, "Okay, the boob is not an option. I gotta feed out of the bottle." It's a lot

though. I think that is so true. So true.

That was my daughter. She... and that you described what we did with her first. Yeah, we tried bottle feeding around one month, and it worked, and then I was like, "Okay, great." And I didn't try again until three months. She just would not take a bottle, and it was very stressful. So yes.

Totally,

and I get it too. We had to give in. And using the bottle, y- means if you wanted to exclusively only give your baby breast milk, it's another thing that mom has to do, right? It's they're having to pump to stock up- Yes ... on breast milk to then use for the bottle. So I- it's a...

I'm not trying to undermine the undertaking, 'cause it is a lot to put on families,

definitely. Yay. We got a little bit more questions coming up, but first, let's take one of our last breaks. Welcome back to Newbies. We are continuing our topic. So Jesse, this has been such a fun episode. But we have more fun things to talk about. Tell us about Infant, I-N-F-A-N-T. I love it. What products do you offer? What is it? Just give us the lowdown.

Yeah, so a little backstory. I actually heard about Infant from a patient of mine who's become a friend. We're from the same hometown. He had asked me about it because he heard about it and was curious about getting involved with it, and as soon as I heard about these products, I was like, "Oh my gosh, this is gonna be a game changer.

How do I personally get involved as a pediatrician? Because I think this is gonna be something my patients are just gonna lose their minds over." What Infant is it's basically a full connected feeding system, and we have two products. They can be used together. They can be used separately. So we have our Infant Thrive Breast, and when I heard about this especially is what made me be like, "I need to get involved."

It's a wearable breastfeeding device that moms can put on. It's- It's small. It does not get in the way of feeding. It's basically a U-shaped device that moms wear on their breast. The sensor is about the size of a quarter, and it lays flat on their chest. It uses the same technology as what we use to measure body fat, and it actually tracks the amount and measures the amount of breast milk that is being transferred from mom until baby-- or to baby.

So like you mentioned, the biggest unknown with breastfeeding is I don't know how much they're getting. Is milk flowing? When is my letdown? How is baby doing? And Infant Thrive Breast can answer all of those questions. So you can actually see on the app when you're using it, you can see your letdown happening, and then again, it gives you this feedback of looking at your baby, look at how feeding's going, and you can see, the milk being transferred in our data, obviously represented in our data, and then look at how baby transferred milk and how much they took

That is absolutely amazing.

I would've loved that first time around, second time around, honestly. We didn't check. We didn't track anything. However, I still think it would be so cool to know when my letdown is happening.

Yes. How much is she actually guzzling down? And so anyway, do you ship across the country? Yeah. Talk a little bit about that.

Yeah. So we ship across the country. We're available on Amazon. We're also available- Lovely ... through our website. The other thing I actually didn't mention too is we also have a smart bottle, so this is like the whole Thrive Feeding system.

So we have infant breast, which is the, breastfeeding device to help moms see how much they're breastfeeding, and then we also have both our smart bottles actually and our smart bottles. So the bottle, if you're having any issues, again, with babies taking a bottle, seeing if they're gassy, unsure of the flow rate, all of that, it's as baby sucks, there's a little kind of stick that hits in the nipple, and each suck pattern is tracked almost like this waveform that you can watch on the app.

So you can look and see how the feeding is going in real time with your baby. I think it's really cool because especially, preemie babies that are having issues going from the breast to the bottle. Maybe if you're out of the house, you're going back to work, and you wanna see how feeding is going with different caretakers.

You can actually watch the feeding happen. You can change the flow of the nipples in real time and really adjust feeding positions, see, oh, look, my baby isn't feeding as efficiently. They should actually be burping three minutes in, five minutes in, all different little pieces of data that can help parents get the reassurance and the confidence that they need throughout these feeds.

And then the bottles that we also have separately that are not, technology associated, and again, the same with the smart bottle, those flows that we have on those nipples are actually the only... I shouldn't say the only, but are data backed that they are consistent flow rates. So they're all laser cut.

Every flow, slow flow, every standard flow, every advanced flow is gonna be the exact same flow with those nipples, and it's a really, I think, consistent and high quality product for parents that are also bottle feeding their baby as well. But yeah, like you said- That's amazing ... we ship across the country.

We also have our feeding app that we use, so you can connect those devices and work with that to track your breastfeeding, time your breastfeeding, also track how much baby's bottle feeding. They can be used just like any of the other, peeing, pooping, feeding, full on baby tracking devices as well.

And that's all with the Thrive Tracker app?

Yep, all with the Thrive Tracker app, and then parents can use it. Different caregivers can use it. You can all kind of share accounts and be connected in your baby and see how they're feeding no matter where you are.

That is so amazing. I love that.

I was definitely a big app girl with my first. Yes. So I know with you, with our listeners- ... I'm sure they all have the apps. There's so many out there, but this one seems so cool. I love that it's real time updates and that you can change the fl- amazing, honestly. Anyway, and so my last question before we head off of this episode is what advice do you have for new parents who are in the trenches with infant feeding struggles?

And I can give a quick answer. Maybe, look at Infant and their products- Yeah ... and tell them of the Thrive a- app. But anyway, what are some advice you have for the new parents who are struggling right now with feeding?

Yeah, I think honestly, take it an hour at a time, take it a feed at a time, take it a day at a time, right?

What your baby does today is not necessarily what they're gonna do tomorrow or even a week from now. And same with breastfeeding, right? What your boobs are doing today, especially in the beginning as they're engorged and painful, and you're working through all that, I promise it all settles out, right?

And again, it's you and your baby learning together, and everybody's just figuring it out, so give yourself some grace. And I think if you want the support and you want a connected feeding system to figure out what's going on and to really help you, learn some confidence, gain some confidence in what you're doing and some reassurance that- that's what Infan is there for.

And I think as a pediatrician in general, I think really don't hesitate to come to your pediatrician. No question is ever too silly, is ever something that we're ever gonna, look at weirdly or think differently of you. We wanna be there for you to really help be a resource and to help you through the trenches, 'cause we all need a support system, and I wouldn't have gotten through it without the people around me.

And again, as y- as a physician, I wanna be that person for my patients. Your doctor's there for you if you need us.

Oh, that's so beautiful. And I'll throw in a really silly question I asked- Yeah ... my little pediatrician. But I remember it was like, I don't know, the three-month checkup or four-month checkup, and I was like, "So my daughter, she always cries when she pees.

Is Is that like a concern? Is that like a UT?" And she was like no. I just think she doesn't like wet diapers." So seriously, no question is so silly. Like- ... I have probably asked them all. Anyway- Oh my gosh, for sure ... thank you. Yeah, thank you so much for coming on. This is a great episode. I love Infan and the products.

I think it is so cool and so useful for all moms really, especially moms going back to work or moms who work from home and have a caretaker, looking over their kids or even their husband or partner taking care of their kids while they're at work or whatever it may be. So awesome. We'll have all of that in our show notes, but thank you again for joining us.

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