Episode 386.

I have some really excellent interviews with fabulous guests that I have already recorded, edited and are just waiting for me to press that release button. But I have had another one of those weeks, so I’m putting those interviews aside this week and going to do one of my “Just Lori” shows where you will hear me get down and dirty.

Yes, I will be ranting and raving. My regular listeners know that this is not all that I do and the rants and raves are far and few between, but every once in a while, like out of almost 400 shows, perhaps 20 have me where I am ranting and raving. If you are new to this show, I would hate for you to think this is all I do, so I encourage you to subscribe to the show and scroll through the hundreds of shows in which you will find some fabulous topics to learn about and some really interesting guests who will educate and entertain you on many subjects related to breastfeeding.

So, yes, ranting and raving today. I have just been so annoyed this week as I have witnessed several mothers work their tushies off, trying to correct the wrongs they were told. Working their tushies off trying to get breastfeeding working for them. Did they start off on the right track? Oh yes they did… and then they had a few kinks on the way and some friend, family or HCP told them some cockamamie way to deal with their issue,,, which set them on a path that was far worse then when they started. So, yeah, it really, really, really pisses me off. Because what am I all about? Helping moms with breastfeeding and in doing so, sharing good, consistent information that will help them settle into a good breastfeeding journey.

Many of these so called helpers, say they have your best interest at heart and yet, IMHO, while I do believe that they do have your best interest at heart, they lack the information they need to do so and therefore, I don’t feel they just don’t take your dreams and goals seriously.

In 2 of this weeks cases, it was their HCP that I take issue with. Many of you listening to the show today who are pregnant, assume that the HCP that you are currently turning to and will be turning to for help with breastfeeding, well your assumption is that they know what they are talking about. There are plenty who do. I don’t need to worry about them. However, there are also plenty who just don’t AND if you are with one of these providers, then you are the one I am worried about. You put your faith and trust that you can count on this person or people to give you the most accurate, consistent breastfeeding information and many are falling short of providing this for you.

It is not good enough for you to be told that they believe breastfeeding is best for you and your baby and that they have a lot of moms in their practice who are breastfeeding. That is a great start, but it is not nearly enough. It is not good enough for them to be your cheerleader, your support person. They need to know so much more if this is someone you are going to rely on to help prepare you for breastfeeding and to help you navigate some choppy waters that you may encounter, particularly in the early days of breastfeeding.

What exactly is it that you need from them? Well, I will get to that as we go along in today’s show.
I first want to acknowledge that for the moms who are listening to this show today who are currently pregnant, new mothers or moms who are struggling with breastfeeding, it may be hard for you to hear that your OB or ND or midwife or Family Dr or baby’s pediatrician that you chose, may not be able to provide for you what you need to know to prepare for breastfeeding and may not be able to provide help for you with the basics of breastfeeding in the early days or as the months go on. I get that.

Which is why you won’t hear too many people say these things that I am talking about today. Of course, I want the best for you just like everyone else in your life does. A happy and healthy pregnancy, a safe birth, a healthy mom and baby. We all want you to begin your early days of breastfeeding with as little challenges as possible and for you to go on to meet all your breastfeeding goals. Of course, I want all of this for you.

Which is exactly why I work hard in my daily practice helping moms with breastfeeding. Which is exactly why I spend a lot of my free time finding great guests, mothers who will share their breastfeeding stories with you, experts on many topics related to breastfeeding, my own “Just Lori” educational shows and yes, some of the rants and raves… given to you, actually with much love and admiration for all of you. It also is why I spent over a year developing the All About Breastfeeding Online class for you – All because I want you to have immediate, easy access to excellent, accurate and consistent breastfeeding information. Check out aabreastfeeding.com/breastfeedingclass so you can get all the details about my class.

I never, ever, even remotely ever try and talk someone into breastfeeding. That is just not my thing. But I will tell you what my thing is….. Any mother who comes to me for help with breastfeeding, I will do all that I possibly can to help you get off to a great breastfeeding start, to help build your confidence, to make sure you have a well fed baby and to help solve any breastfeeding challenges you are having.

Let’s get to 2 mothers that I saw this week and why I am a bit of a raving lunatic. One I am confident will be able to turn things around and right the wrongs she was given. The second mom,, well, it remains to be seen. She is feeling so lost, so lonely, so scared and is over the top exhausted. She only has 1 person who can help her during the daytime hours and they can only stay for a few hours each day and this new mommy needs more than that. So, we shall see…

…I am going to give you the cliff notes, so to speak for each mom and her situation.

The first mom, Claire – well, if her HCP during her pregnancy would have been better educated about lactation, he could have really, really helped to prevent some early breastfeeding challenges.

The first big no-no in my book – he never brought up breastfeeding at all during all of her 16 prenatal visits. She said she brought it up twice and the first time was told – ahhhhh babies know what to do. It can be very tiring in the early days, but if your husband will be home for a few weeks to help you out, you will be fine!

The next thing he did was not connect the dots with some very important health information which had a big impact on the first few days of her breastfeeding. This mom had a risk factor for premature birth and all she was told is that she was giving birth at a very fine hospital with an excellent NICU team and if this should happen, they are well equipped to take care of it.

Want to know what I think the problem is here? What should this provider have said:

First thing is: they should be bringing up various aspects of breastfeeding at every single visit. There truly is so much to talk about. Instead, this provider left it up to her to bring it up and then he basically shot her down, made her feel stupid for even asking. What else should he have one – given her a resource sheet that listed places that she could find breastfeeding support and education in her local area. Encouraged her to actually connect with some breastfeeding moms, attend a local support group and to do this earlier in the pregnancy rather than later. Pregnancy can actually go pretty quick and along with taking care of some of the practical things related to having a new baby in the home, it sure is nice to make some connections in your local community.

Her provider should have considered her desire to breastfeed and taken this into consideration as he examined her and thought about her health history. She had 2 breast biopsies that created some scar tissue, one was very close to her nipple. How this could impact breastfeeding would have been very important for her to know. Knowing also that she had a risk factor for giving birth early, is a major reason she should have been strongly encouraged to meet with an IBCLC before giving birth. You see, most moms don’t know this, but having an excellent NICU who would be taking the absolute best care of her baby, does not necessarily mean that she would have excellent lactation care available to her when she needed it. Breastfeeding can get quite complicated when you have a premature baby and one that, when managed well, will very likely increase your chances of going on to have a wonderful breastfeeding experience. Without proper help, moms are left on their own to figure it out or scrounge around looking for good help. So, yeah… I am really pissed off at her provider for definitely not doing their job.

She will be okay though. I spent quite a bit of time with her and helped move her from exclusive pumping and bottle feeding with half her babies intake coming from formula and half her babies intake coming from her own milk, to where she is now, which is beginning every single feeding at the breast and now 5 days later, any milk needing to be supplemented is all her milk. Her wishes were to exclusively breastfeed until her return to work at 3 months and given another week or so, she will likely meet those goals. Unfortunately, we didn’t meet until her baby was 7 weeks old, so she struggled for a long time, has suffered quite a bit of anxiety over it all. Thankfully, she is very, very motivated and is willing to put in the hard work to make it happen. Of all things, she was referred to me by her veterinarian, who I worked with about 2 years ago. Us IBCLCs, we never know where our referrals will be coming from, but we are always grateful. And shame, shame, shame, on her provider.

The second mom, Bethany, well, I am very sad for her and her baby. Sad because both she and her baby will likely miss out on all of the benefits that breastfeeding would have given them. Both health wise and emotionally. Her baby is only 3 weeks old, however, when I met her, she was so exhausted and emotionally broken down. I am very pissed off because of the advice she was given when her baby was not gaining well. Bethany was very upset that her pediatrician wanted her to supplement with formula in a bottle after every breastfeeding. She assumed that since I was an IBCLC, that I would be angry at that also. She said to me: I know, I know,,, I never should have given him that first bottle, but I just didn’t know what else to do and my pediatrician made me feel so awful and when I said I would rather not give my baby formula, she came down hard on me and said the words: failure to thrive. my baby was failing to thrive. So, I felt awful and followed her advice.

Here is what I told her and you might be surprised at what I initially said – just like Bethany was surprised. In fact, based on her body language, I thought she might have quickly ended the consult, so I got to the punchline quickly.

I agreed that her baby had lost too much weight. I agreed that her baby did need to be supplemented. However, at that point, this is where I parted ways with her pediatrician.

She was never asked about how breastfeeding was going? Did it hurt? Was her baby staying awake and actively sucking during feedings? She was never asked – have you tried pumping? Perhaps you have enough to give your baby all of your milk? Worse yet – she was never given any information about the fact that there are breastfeeding experts, called IBCLCs who can help you with this. Nope, just the absolute worst information which was:

You must wake your baby up every 2 hours and you need to make sure your baby drinks at least 2 oz every feeding. Along with these strict instructions, she was told to make an appointment for the very next day for a weight check.

Well, this happened when her baby was 8 days old. My goodness gracious, what do you think Bethany did? She did what every good mother would do. She fed her baby 2 oz of formula, every 2 hours, round the clock until that next visit. Come the next day, she did not even see the same pediatrician in the practice, she was another pediatrician who praised her for a job well done. Bethany was told to stay on this plan until her next appointment which was made for the very next day…. just to be sure her baby was gaining.

Well, her baby gained fabulous – 4 oz in 24 hours and 3 more ounces the next day. 7 ounces in 2 days. Very impressive and while the Drs were happy and so was Bethany and her husband, she went home with all kinds of emotional feelings… feeling like a failure, upset her baby was getting formula, not knowing what else to do to get her baby breastfeeding. Ohhh, and in addition to that, her breasts were killing her. Turns out that Bethany had a lot of milk for her baby.

When I asked her what instructions she was given about pumping, she was told NONE. What? No information on pumping? She said that they hurt so much that she pumped twice that first day and the same thing the next day. Her thinking was understandable for a mom who has not breastfed before. She wanted to keep trying to breastfeed and wanted the milk there for her baby. I totally understand this logical thinking. However, if you know anything about lactation, how the breast makes milk, you would know that you need to pump on a regular basis.

So, what would I have liked for her to been told?

Well, for starters – Supplement, absolutely, even with a bottle, that is fine. However, what about her milk? What about getting her pumping? What about discussing donor milk since she was adamant about not giving her baby formula? What about not waking her baby up every 2 hours and force feeding 2 oz? And what about: Here is the number of a trusted IBCLC who will help you with all of this because I don’t know the blankety blank I am talking about?

You hear me mention my online breastfeeding class. Every single person who takes this class will be an expert of breastfeeding compared to this and many other Doctors. You will know how to prevent these issues from happening, recognize them if they do, and how to help yourself work through them. If there is any confusion as to what to do, you have me in your toolbox as every person who takes my class can contact me in our private student group and meet with me virtually once a week.

It is unlikely Bethany will be able to follow the care plan I suggested. It requires her to begin pumping regularly and she flat out told me she just is so war torn, her supply has dwindled down to possibly less than a third of what her baby needs and she said she just does not have it in her. She is quite depressed and spends much of her days alone until her husband comes home about 7 pm. She is wracked with guilt and so tired. All of the suggestions I made for her to get some help at home, for her to get some well needed sleep and for her to see a therapist who works with pp moms was pretty much shut down. I know she paid me for a consult and one might ask why she did this if she was not willing to work at it.

Bethany is like some moms that I meet. They are hoping that the problems they have are fairly quick and easy to fix. If I bring in an expert, they will tell me what to do and I will do it. Well, I am a breastfeeding expert, and I did come to her home 2 days after she contacted me and I do know what she needs to do to fix it. And yet, I can’t make her do what needs to be one. I suggested a modified care plan, which may mean that

she won’t make enough milk for her baby, but will keep her breastfeeding and one never knows what can happen over the next few weeks. Some more consistent sleep, a few good nights rest, a breather a few times a day, a few decent meals and a break for even just an hour a day, might literally turn things around. However, she said to me that she just realized in that moment, that she was done trying.

So, yeah, I am pissed at her pediatrician. It is unrealistic for moms to wake babies up every 2 hours and in my class you will learn why this is such bad advice. It is too bad that her pediatrician did not discuss donor milk because if she could have put breastmilk in a bottle, that would have made Bethany so much happier. Too bad this pediatrician did not tell her to start pumping on a regular basis as she would have kept up her milk supply and this would have been one less thing I would have been asking her to do.

If you have never pumped, and you are looking at all these cool breast pumps on the market and thinking that it will be easy, it is not. It is not easy, it is not fun. It does become easy as time goes on and you get use to it, but is certainly is not convenient and it takes a lot of time and actually for some moms, it hurts. And when you are postpartum, it is just one more thing to add to your workload.

Now, I have worked with some moms who are exclusively pumping. A minority will say they don’t mind it at all. They have found their groove and they are happy to do so. However, this is not what most moms who started off wanting to breastfeed will tell you. They will say that they would rather breastfeed, but they have circumstances beyond their control that require pumping. If this is what they need to do so they can give their milk to their babies, they are more than willing to do so. Just not what they had planned on.

Honestly, these scenarios with these 2 moms are something I see in my practice on a regular basis. Most times I just go about my business and every few months it just builds up and then I got to get it out of my system. Plus, I know that this might happen to you so I come here to help you out. To help you avoid this from happening to you.

In my online class, I have a whole section on how do you know that you have found the right provider who practices in a way that goes well beyond just being your cheerleader, but truly understands lactation and breastfeeding.

Here is just a snippet of information that you can test the waters with:

Does your provider know:

What HAMLET cells are?
What IGT is?
about donor milk and human milk banks and how to connect you with one.
If the hospital or birthing center you are going to has IBCLCs
If so, what are their names, their working hours
Proper guidance when your baby is not gaining well?
100,000 more living cells in human milk and why you want your baby to have this?
PPd is not just in the first few weeks but can show up anytime the first year?
That Dads can become depressed postpartum too.

You will often hear me say: Breastfeeding is usually hard in the beginning.
It takes time, practice, patience and commitment.
I would love to be there for you and you can make this happen.

The above topics that I just mentioned,,, all of this is covered in detail in my online breastfeeding class.

I will give you the answer to one of my most favorite subjects that I mentioned.
HAMLET CELLS – This stands for:
Human Alph-lactalbumin Made LEthal to tumor cells

What are HAMLET CELLS?

A substance found in breast milk can kill cancer cells, reveal studies carried out by researchers at Lund University and the University of Gothenburg, Sweden. Why am I so excited about Hamlet Cells and Why should your doctors know about Hamlet Cells? Because HAMLET kills 40 different types of cancer. Research is ongoing about its effect on all kinds of cancer and tumors. Scientists have learned that HAMLET kills only cancer cells and does not affect healthy cells

.So, if your doctor does not know about Hamlet cells and does not know that there are well over 100,000 living cells in every tsp of your milk, .well I would say that it seems that they have not taken even a basics of breastfeeding class, which means they know very little about breastfeeding. Is this the person you want helping and supporting you when it comes to breastfeeding?

I have given you just a sample of the questions I have listed in my class that you should be asking your providers, especially the ones who will be taking care of your baby after they are born. The answers are all in my class.

These are just basic questions.. I have a lot more that you should be asking them. In any event, if they don’t know the answers to every single one of all of these questions, think twice about relying on them for breastfeeding help and advise.

I strongly encourage anyone who is listening to this show – if you are pregnant or breastfeeding – you really need this class. It just checks off all the boxes that I want for moms to have:

The best breastfeeding education ever.
Really and truly prepares you for breastfeeding.
This is very, very, very far from a basics of breastfeeding class
Easy and anytime access. The class is yours forever.
Access to me, your breastfeeding expert.
Support from other moms in the group.
Just go to: aabreastfeeding.com/breastfeedingclass

I created this class for you. I truly want you to have the proper education and support during your breastfeeding journey. Please consider joining us and become part of a wonderful group of moms who will be there to help support you.

I am definitely keeping in touch with both moms and while I know Bethany just does not feel like she can do this right now, I also know that she just might change her mind. In my family, when we are hoping for something good to happen, we don’t just say: keep your fingers crossed. We say: keep your fingers, tits and toes crossed. I don’t even know where that saying came from as I heard it from the time I was a little girl. Considering the fact that I grew up to be a lactation consultant, I kinda like to use it when the situation calls for it. So, please join me in crossing your fingers tits and toes that things will change for Bethany.