Alyssa Goss, IBCLC
Milk Maven has been helping babies and parents learn how to breastfeed for 3 whole years! To thank my community, I am offering an amazing deal! My original pricing, from when I first opened shop for initial consults! $100 flat fee, and have all your burning questions answered (pun intended)!
This offer will only be offered in the month of October, so ACT FAST and book an appointment today!
It is my birthday month, and yes, I do celebrate all month long! This year, for my 35th birthday, I would like to give a gift to all of your June babies. For the entire month of June, I am offering $50 off my usual prices to make sure all my fellow Gemini/Cancer babies get the best start in life!
Give me a call and set up your home consultation today!
Congratulations! You have a baby! Babies come with sweet smells, lovely eyes, and soft skin. What they do not come with is an instruction manual. Luckily, lactation consultants are here to help! Now, I must admit, the idea of a stranger coming in to my home and manipulating my breasts and holding my baby would have made me incredibly nervous as a new mom. I want to write this blog to make that step of reaching out a little easier and help you make the most out of your appointment.
1. Fill out your paperwork ahead of time. Good news! All of my paperwork is online, needs no printer, and I will send it to you as soon as you book an appointment! Giving a full history for both yourself and your baby can help your Lactation Consultant know exactly what tools to bring, what information and handouts to prepare. It can also give them an idea of what they are walking into. Either way, a full medical history will need to be taken. If you fill out all your paperwork ahead of time, your consultation to begin immediately, and your baby won’t have to wait to eat.
2. Go into the consult with a hungry, but not frantic baby. As part of my consult, I will need to see your baby eat normally. I like to do a pre and post feed weigh to see how much milk your baby is getting. If we are working with a baby who is asleep for half your scheduled time, you won’t get as much bang for your buck. My suggestion is to try to feed your baby about an hour before our scheduled appointment for best results.
3. Put your animals away. I am an animal lover! Cats, dogs, reptiles, tarantulas, it makes no difference to me, I love them all! That said, some beloved pets, no matter how loving and calm normally, can turn into a fur-ocious guard when a new baby arrives on the scene. So please, have them outside, in crates or in another room when I arrive.
4. DO NOT CLEAN YOUR HOUSE You just had a baby. As a home visit only Lactation Consultant, I am very aware of what a newly post-partum house looks like, and it does not look like a page from Living Magazine. As long as I have a place for my scale to sit, and a place for my butt to sit (the floor works!) I can do my job. I would rather see a mother who is resting and a baby who is feeding, than a scrubbed kitchen.
5. Don’t be embarrassed, I’ve seen it all. I have seen all manners of family structures, living arrangements, housing types, and income levels. I have visited moms who were in full make-up and heels and I have seen moms who are on bed rest and haven’t showered in days. I do not care what your hair looks like, your breath smells like, or whether your kids/partner/mother are in the room. One of my favorite things is visiting people in their actual, real life environments, and I can’t wait to meet you in yours.
This is my daughter Henley. She is six years old. She loves Barbies, her pink scooter, and dresses with leggings. She was also born with a class 1 tongue tie, which means her tongue was heart shaped. It couldn’t move past her gum line, or lift at all from the bottom of her mouth. She clicked constantly when she was breastfeeding. We had it scissor clipped by an ENT when she was three days old. She was then able to nurse, but couldn’t handle my milk flow, never comfort nursed, and was addicted to pacifiers. She weaned at 21 months. She has always had trouble with balance (didn’t walk until 16 months), swallowing solids without choking, saying certain consonant sounds, and had recently developed a stutter. I knew her tongue was tied, and that it needed to be revised before it caused lasting orthodontia issues or speech pathology. We decided to take her to a pediatric dentist to have her tongue released via laser this time. Here is the interview I conducted with her after the procedure.
Me: So, tell me about your tongue.
Her: My tongue was tied, which meant I couldn’t touch my teeth with my tongue. The string under my tongue was too tight and it hurt when I chewed or talked a lot. [It should be said she said nothing about pain to me until she was in the parking lot of the dentist’s office and I told her what to expect. She said, “Mommy, will this help the string on my tongue not hurt so bad?”]
Me: So what happened at the dentist’s office?
Her: They let me watch Rio 2, and put special lipstick [chapstick] on my mouth so it wouldn’t dry out, and I wore cool shades.
Me: Did it hurt?
Her: It wasn’t ouchy because they gave me stuff to breathe that made me feel funny, then poked my tongue and it went to sleep.
Me: Did you see what they cut your tongue with?
Her: The laser looked like a TINY pen with a light on the end. Like a flashlight for a mouse.
Me: Were you scared?
Her: No. The dentist was nice, and covered me with a comfy blanky, and you were there the whole time watching.
Me: What was your recovery like?
Her: My tongue was weird all day, and then that night it hurt. Then, I got ice cream to lick and Popsicles, and grape medicine [Children’s Advil] that made it go away.
Me: You know, I work with babies who are too little to take medicine for the pain, what would you say to them about your tongue and the procedure you had done?
Her: To not be afraid, and to stay close to your mommy all day so she can give you milk to make you feel better. Oh, and don’t ask to watch Frozen because it doesn’t work on their TV.
By the next day, her stutter was gone. She is still lazy about saying some of her letter sounds, but I have no doubt that will remedy itself with time and as her tongue heals. She likes to show everyone all the things she can now do without her tongue tie. She can stick it out, move it from side to side, and say Ls!
Sleep. She is a wicked mistress.
A few days ago, I received a panicked call from a very worried mama. She was concerned her milk supply was dropping, her baby was losing weight, was upset at the breast, and wouldn’t latch. The mother was getting plugged ducts and worried about mastitis. After the course of the call, we tried to pinpoint what it was that went wrong. Decongestants were used once, not long enough to make a huge difference, her pump broke while she was away from the baby, but that should have been remedied the moment she got back with her baby. The baby was teething, so that could make a bit of a difference in the latch, causing the ducts to clog, sure. Then she dropped the bomb. She admitted she had seen a sleep consultant a month ago (when her baby was 5 months old) to help the child sleep 12 hours at night. She was told by this trainer to spread out feedings to only 4-5 times a day, and never to feed at night.
So, a little background on how milk supply works. When you drop your feedings in half overnight (no pun intended) your milk supply will drop by (anyone, anyone? Bueller?) half. It is a supply and demand relationship. The baby or pump demands, your breasts supply. If you stop demanding, they stop supplying.
Let’s do the math shall we? An average baby 5 months old, needs 24oz-32oz of milk a day to continue growing and being healthy. They get 100% of their calories and hydration from this milk. So, when a mother is told to bar on demand access to the breast, the baby is still only going to take in about 3oz per feed because their tummies are still the same size, but only four or five times a day. Now, what if you took everything you ate normally and cut the portions in half? What if you also drank half the water you should? What do you think would happen to your body? Science tells us malnutrition and dehydration would set in, and you would become very weak, and really sleepy…huh. Yes, it turns out that a baby getting half their nutrition become quiet, sleep a lot, and become very “good” babies. As opposed to those awful “bad” babies with their punk music and their bar room shenanigans.
Many of these sleep trainers, in fact ALL the trainers I found in my area, take babies as young as a couple months old. We know from research in this area that babies must nurse on demand to establish milk supply, and grow correctly. We also know that babies are not made to sleep through the night at this age, and in fact it can be extremely dangerous for babies to sleep too deeply.
Nobody likes to miss sleep. In fact, sleep deprivation can be used as a form of torture!However, starving your baby is not the solution. If you value breastfeeding, and would like to figure out how to continue and get some sleep, hire an IBCLC with years of education on child development, infant nutrition, and breastfeeding management. There could be several reasons your baby is having trouble settling, is nursing more often than is normal, and keeping you up at night. An IBCLC will look at sleep arrangements, schedules, anatomy to check for ties, check weights to check for intake at the breast, work with your other health providers, follow up with you and your little one over the next couple of weeks, help you get reimbursed by your insurance for her visit, and will charge about a QUARTER of what these trainers are charging. The thing is, the person who referred this mother to me once things went south, WAS the sleep trainer.
It is absolutely normal and healthy for your baby to wake up at night. Don’t you? Sometimes you need some water, sometimes you need to pee, sometimes you have a bad dream, and need a snuggle. Would you deprive your husband of these things? Your dog? Yourself? I am 33 years old and I don’t remember the last time I slept through the night. It just stopped being my mother’s problem at some point.
I remember seeing a book on my parents’ shelf when I was young, called Parenthood is Not For Cowards. I assumed this meant that it meant that in order to be a good parent, you had to listen to nightmares, and not be afraid of them. Then I became a parent. I realized that parenting meant being scared to death, every single day, and doing the right thing by your kiddo anyway. It means doing the hard thing, making the hard choices, it means never giving up, and never surrendering.
During pregnancy, we read all the books, we make all the plans, we do all the research. We attend classes, and force our partners to go with us, we pick out the perfect layette, and apply to receive the perfect breast pump. We interview 15 different pediatricians, we find the numbers for lactation consultants, parenting support groups, and visit every daycare center in the tri-state area. But things go wrong. Labors stall, emergencies happen, daycares fill. And when they do DON’T PANIC! There are far more than 42 things that could go wrong, but let them be hurdles, not walls.
Of course, as soon as you think you have breastfeeding down, something is going to change. Your milk comes in, the baby grows, you go back to work, the baby is teething, or baby goes on a nursing/sleep/solids strike. When this happens DON’T PANIC. All of these things are normal, and part of breastfeeding and in no way means that you are insufficient, or doing something wrong, or a bad mom. Here is the thing about bad parents, they never wonder if they are being a bad parent. Just by you being scared to death that you have somehow inadvertently broken your baby, you are being a good parent.
No one expects you to have all the answers. Historically, we never were expected to have all the answers. We used to raise our babies in tribes. Where all the aunties, grannies, mothers, sisters and friends were all around us, informing, encouraging, and supporting us. We used to see breastfeeding everywhere we went. We saw women latching, unlatching, babies sucking and swallowing, and crying and sleeping all the time. Many of my clients have never seen a baby fed at the breast. We no longer have access to this education. We no longer have this tribe. We try our best to fill in the gaps with social media and blogs, lactation consultants, nurses and doctors, and books and books and books.
We must be discerning between good and bad advice, we must be savvy about science v placebo affects, we must trial and error every choice we make and we must do it all while Instagraming our bliss, for beware if someone catches on that we are struggling to stay above water.
Here’s the thing people. You are doing a good job. DON’T PANIC if something goes wrong. DON’T PANIC if you don’t have the answers and you need help. DON’T PANIC if your idea of what parenthood should look like doesn’t exactly match with your life. Let go of your expectations and the expectations of others, and just do the best you can.
Oh, and always carry a towel.
You get home with your baby, everything is going really well. Your baby is latching, and nursing, and happy. And then it happens.
You look like the star of Buxom Beauties 4. Where exactly are the triplets you are supposed to be feeding!? Milk is everywhere. Your baby is sputtering and choking if they are able to latch at all. It is possible that your nipples may sort of disappear into the mass that is your breast tissues, and for the baby, this is a bit like trying to fit a bowling ball into their mouth.
What I am describing is called “engorgement” and though it is common in the early days of lactation. Usually starting the day you get home or the day after. You know, when all your hospital help disappears. Latching a baby on an engorged breast can be difficult, painful, and complicated, so it is a good idea to soften that breast with hand expression or pumping first.
It may be It is possible that you may not even be able to pump to relieve some of that pressure because of all the fluid compressing your milk ducts. If this happens, contact your IBCLC for help, the milk must be removed from the breast to avoid clogged ducts, mastitis and drying up.
For most women, this feeling of being constantly over full is over in a few days/weeks. However, sometimes supply doesn’t really ever regulate downwards. In this case, you may have an oversupply.
The most common reason women start supplementing is a fear their supply is low. This perceived issue and incorrect diagnosis can start a real issue with supply if allowed to continue. Supplementation can start babies and moms on a downward spiral of overfeeding, under emptying of the breasts, and ultimately, a perceived problem becomes a real one. So, how do you know whether your baby is getting enough from the breast? Our breasts don’t have ounce markers on them, so how do we tell whether our supplies are enough?
Is your baby gaining well? If your baby has regained their birth weight by 2 weeks and are they gaining about an ounce a day after that, there is not an issue with supply.
Is your baby pooping and peeing normally? Babies should have one wet diaper on day one, two on day two, and so on. By day five, babies should be having 5-6 wet diapers minimum a day, with 2-3 quarter sized poops. Sometimes poops do space out a bit, and that can be normal, but those wet diapers must remain. If you are changing diapers frequently, there is no supply issue. After all, if there isn’t anything going in, there can’t be anything going out. A trick I tell moms to do if they are worried, is to put a stack of six diapers on the changing table, if they run through them in 24 hours, they don’t need to worry.
The following things are NOT a sign of low supply.
If you truly do feel that you have a low supply, due to hormonal issues, early mismanagement of breastfeeding, or over supplementation, talk to an IBCLC about how to get back on the right track. The nice thing about supply is that it is almost always fixable.
I was asked to write a guest blog by one of my favorite people and pregnancy/birth/breastfeeding/boudoir photographers, Sabrena Rexing. I wanted to touch on family, parenting, breastfeeding struggle, and memory making. This is what came out.
This is my mother.
She fancies herself an amateur photographer. At every event, there she is with her camera, clicking away. No, not just at the happy big events, like Christmas and birthdays, but EVERY event. Hospitalizations, funerals, rehab facilities, shopping trips, and family dinners. I even have a picture of me with 90% of my body covered in poison ivy when I was 10. It has become somewhat of a family joke. I asked her once, why did she feel it necessary to document our entire lives without exception?
Turns out that she had read once, that when bad things happen, people stop taking pictures. Taking pictures was her way of saying, “this isn’t bad enough, we will get through this.”
This mindset, true or not, has become ingrained in me. I am one of those weird people who love seeing selfies on Facebook. I drool over everyone’s beautiful food pictures. I coo over babies (and not just because that is my job). When I was turning 29, I had just had my third and final baby, I was in school and overextended. I wasn’t feeling like the hottest tamale, and my sex drive was at the absolute lowest point of my life. So what did I do? I posed for a boudoir session.
When my kids are being monsters and I am frustrated with my day, I start taking pictures of them being them. I catch them climbing the furniture, singing inane songs repetitively, or putting my make-up on the dog. In this way, I take back the feelings of irritation, and replace it with making memories.
I think it is so important to document the good, as well as the bad. When it comes to parenting, eventually you will want to remember all of it. I highly encourage my clients, especially those who struggle greatly, to photograph their nursing babies. Facebook policies and modesty be damned! Take pictures of this time, for it is fleeting. You don’t have to look at them right away, if they might be painful. You deserve to remember the struggle, to acknowledge it, and then proudly say, “I am strong, I got through this!”
I have lovely professional photographs of my pregnancies, growing family, and even some of my labor and birth. I was about to wean my final baby this summer when I realized, I had none of my children nursing. I, the IBCLC, the person who made breastfeeding her career, have zero professional and frameable photos commemorating the nearly 8 years I spent nursing. I will always regret not making that a priority, but thankfully Sabrena took some lovely ones during her Breastfeeding in Public sessions this summer. She captured perfectly one of our last nursing sessions.
If you look at my mother’s photo albums, they are filled with the minutia of our lives. It is utterly biographical, unashamed, and unblinking. They aren’t all posed, or even flattering (a point that I tease her about) but they are all us. I can hear my Aunt’s voice as she comforts my two-year old about her “boo boo”. I can smell the hospital room, and hear my grandmother’s cackle laugh. Thanks mom, for encouraging me to live my life out loud, and for leaving me a legacy of memory making.
Lots of moms seem to go through the same stages of breastfeeding in the early days following their baby’s birth. These range slightly from situation to situation, but mostly follow the same patterns.
Stage One: Prenatal Bliss
You are pregnant, in the home stretch, maybe only one to two months to go. You have read a few books, gone to that breastfeeding class your hospital or birth center offered, and every woman with a snot nosed toddler and a sassy five year old in tow has told you their horror story. Still, you figure, that won’t be me, breastfeeding is NATURAL. Besides, they don’t want it as much as I do. At this point, you also probably have a lot of feelings about babies sleeping alone, toys staying out of your personal space, and still going on date nights once a week.
Stage Two: Post-partum (The Hospital)
Congratulations! You have a healthy baby! (or you don’t) and they latch right on after birth! (or they don’t) In the next 24 hours, your baby is bathed, washing away the scent of you, and making it hard for them to find you again. Then they are vaccinated, poked for a blood draw. This is followed by prodding, weighing, measuring, photographing, wrapping, and eye goo smearing. Finally, after all that, handed back to you…1-3 hours later. This is if everything goes right and you don’t opt for unnecessary surgeries!
Stage Three: Bliss Bubble
You are floating in a bliss bubble, and so is everyone else you know. They are all crowded around, asking to hold the baby. If the baby latches, you may not even notice it is bad, or that it hurts (my first born literally gave me hickies on 80% of my breast) until the nurses start bothering you. Everything is measured: weight, blood sugar levels, jaundice levels, body temperature, how often/how much you are nursing, and poop and pee output. By the way, their answer for all of this, is supplementation.
Meanwhile, it is really hard to nurse on demand when everyone you have ever known is in your postpartum room, holding your new baby. That is when the nurses and doctors aren’t doing their rounds.
This is about half of my IMMEDIATE family. I know what I am talking about.
Stage Four: Hospital Help
At this point you may see the hospital’s Lactation Consultant. Or, you may see a nurse who once sat through a two hour course online, who calls herself the Lactation Consultant. If you are lucky, she will help you with latch and she will give you great tips on how to better position the baby. If you are extremely lucky, and the hospital is empty, she will look at the baby’s oral anatomy as well as yours and make sure everything is working properly. If you catch her on a good day, she will treat you like a human. Often, none of this actually happens.
Stage Five: Things Change
You arrive home, finally. Perhaps you are already are supplementing or using a nipple shield just to get out of the hospital. Maybe this was for good reason, or maybe this was a band-aid that was put on a problem that was ignored. You are tired. You are grateful to be home. You are ready to start enjoying your baby. His latch is great! Everything is going so well!
And then, The Milk Fairy arrives! Suddenly, your breasts have swollen to the size of bowling balls and the baby won’t latch. Or, your milk isn’t coming in and the baby cries all day. Your nipples may be sore, cracked, even bleeding. You are worried the baby isn’t latching correctly, or that you just don’t know how to do this. You saw a Lactation Consultant in the hospital, do you really need a home visit from one now?! You call the hospital. You realize you can not talk to the kind and wonderful LC you talked to when you were there anymore. That is against the rules.
Stage Six: Home Help
You find the number for a International Board Certified Lactation Consultant (IBCLC) in private practice. You make an appointment. She will come to your home, spend as long as it takes with you and your baby making sure everything is working properly, and give you a care plan. She will communicate to your healthcare providers. She will empower you to make good decisions based on your goals and your baby’s needs. Best yet, your insurance is required to reimburse you for her services, just like they covered that shiny new pump you received a few weeks ago.
Stage Seven: Healing and Learning
Lactation Consultants can’t make everything all better with just one visit. They can, however, empower you to do so. The first weeks out of the hospital are difficult. You don’t have to go it alone. There is still going to be a learning process and a period of really getting to know your baby, their likes and dislikes and quirks. There is also a getting to know yourself as a mother period, so be kind to your body, to your soul, this all takes time, this is not a skill you just know how to do. And you are NOT alone.
Stage Eight: Breastfeeding Boss
You are pain free! You can now cook while you tuck Junior under one arm, latched the whole time. You no longer fear public places, or feeding time, or returning to work. You are a pro! Your baby is growing, and thriving, and starting to smile at you while he nurses. You might even be thinking, you could do this all over again in a few years…
