The Boob Group
Moms Who Can’t Breastfeed: When Do You Stop Trying?

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

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SUNNY GAULT: If you are listening to a podcast such as The Boob Group, you probably want to breastfeed you baby! But what happens when life throws you a curveball and you’re unable to breastfeed? What? Is that even possible? Weren’t our bodies designed to nourish our babies? Is you are mom struggling with not being able to breastfeed your baby, you are not alone! And sometimes you just need to let go. We are The Boob Group.

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SUNNY GAULT: Welcome to the Boob Group! We are here to support all moms wanting to provide breast milk for their babies! I am Sunny Gault. If this is your first time listening thanks so much for giving us a try! If you’re a regular listener, then please join us on a feature episode. And it’s now easier than ever to be part of our podcast because you can join our conversations straight from your home computer, which is awesome, because you don’t have to get a babysitter!

Maybe someone just kind of watch your kids while you are recording. Visit www.newmommymedia.com more information. And we are also looking for episode ideas! We’ve done a bunch of episodes for The Boob Group, I think we are at over 160 episodes for The Boob Group now. So we always want to hear what ideas you have when it comes to topics for our show. So let us know! You can e-mail us, you can post something to our Facebook page, you can send us a voicemail through our website. Whatever is easiest for you!

So let’s meet the moms and ladies I guess I should say joining our conversation today. So Lesley, let’s start with you. Tell us a little bit about yourself and your experience with today’s topic.

LESLEY: Hello, I am Lesley, I am from Hoboken, New Jersey, and I have two daughters. One is 5, and one is one and a half. And my breastfeeding experiences were valiant efforts. With my first daughter I breastfed for 12 days that included contact nipple-shields and a pump, and supplementation and postpartum depression… We can get to all of that a little bit later. So that was my 12 day journey.

With my second daughter I was determined to make it last longer, but her lip-tied, tongue-tied and apparently flat nipples led to disaster there too. So we pumped for about a month and by the end of the first month of her life we had to had help for a little while and she left, and suddenly there was just me pumping and feeding, and it was not happening. So we stopped about a month after there too.

SUNNY GAULT: Well, thanks you so much for being a part of our show! And Christine is our expert. We’ll introduce her as an expert a little later on, but Christina, tell us a little bit about yourself.

CHRISTINE TOTH: Well, hi Sunny! Thanks for having me! My name is Christine and I’m a lactation consultant down in San Diego. And I actually first became involved with breastfeeding witnessing my own mom’s struggle with my sister Kerry who’s a special-needs baby. And ever since then I’ve passionate about helping moms overcome their breastfeeding challenges and I’ve been working in public health for the past nine years as a lactation consultant and a dietitian.

SUNNY GAULT: Wonderful! Well, ladies thank you for being a part of our show. We are going to take a quick break and we will be right back!

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SUNNY GAULT: So before we kick-off our episode today and our discussion about moms who are unable to breastfeed, we have a news-headline that I want to share with you. And this just kind of warms the heart! I love sharing positive breastfeeding stories. And this is out of Sidney, Australian and it does kind of send around a photo, so I’ll make sure to post that to our Facebook page, so that you guys can check it out.

So there is a restaurant that is in Sidney, Australia. I believe they call it a café, so I think its tea and coffee, and probably some you know light food. But they have a sign that they put out it’s regarding breastfeeding in public and they just want moms to feel a little bit more comfortable with breastfeeding in their store. So there is this sign that they put, I believe it’s in the window of their store, and you know, I will just read it for you guys.

It says: ""Breastfeeding mums…", and it’s “mums” because it’s Australia, right, and they sound really cool when they say that, it says:"…pop-in and have a free cup of tea if you need a pit stop. No need to eat, no need to ask, just relax!” And it has a nice little smiley face, so… Such a positive message especially when so many moms feels uncertain, you know, when they are going out into public, and breastfeeding, as we are going to talk about it today, there’s a lot of issues that can come with breastfeeding, and it can be challenging for a lot of moms.

So just to kind of get this kind of vote of confidence, you know, seeing a sign like this in a window. I know, you know, when I am out and about, if I saw a sign like that, that would make me feel pretty good. Lesley, I know you have a little bit different perspective with this, because you tried breastfeeding and it didn’t you know quite well work out for you, but what do you think about this article and this sign, that this café put out?

LESLEY: I am pro whenever they need to get fed and however they will get fed, so I honestly think this is amazing! And to have that welcoming nurtured feeling for moms anywhere you can, it is great! You know, there’s shame and stigma that come with breastfeeding, as much as it’s recommended by so many people, but people still make you feel bad for doing it in certain places.

SUNNY GAULT: Christine, what do you think?

CHRISTINE TOTH: Oh, yes I absolutely have to agree with Lesley! A mom never needs permission to breastfeed, yet if she knows she is welcomed and encouraged, it just makes it that much easier for her to not have to worry about it and she is in a worry-free zone. And so what a cool idea!

SUNNY GAULT: Yeah… And this isn’t the first article that I’ve seen on this. I think there have been some places in the United States that, you know, have done this as well. And I don’t know, if you guys are out there listening and you have a store or something like that, or if you know of places that welcome breastfeeding and pumping moms with open arms, it might be a really cool idea to just say: hey, have you ever thought about putting a little sign out there. Because yeah, I don’t know, the moms may not know if they are just passing by, you know, and they don’t already know this store is committed to something like this. They may never know, right? So such a great idea! Again, we’ll post in on our Facebook page if you guys want to check it out.

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SUNNY GAULT: So today we are talking about a topic that I believe is somewhat controversial. We are talking about moms who are unable to breastfeed their babies and do you just stop trying. You know, when do you just kind of put it aside despite, you know, you valiant efforts and despite your passion for breastfeeding, when do you just say: enough is enough? So our expert is Christine Toth. She is a registered dietitian and an international board certified lactation consultant. Christine, welcome to The Boob Group!

CHRISTINE TOTH: Hi, Sunny! Thanks for having me! Happy to be here!

SUNNY GAULT: Hi! Well, we are happy to have you! And you know, like I said, you know, when I was kind of introducing the topic, I do feel like this is a little bit taboo mainly because we are admitting that sometimes it is in a mom’s best interest to stop trying to breastfeed. Do you think this is a controversial topic, Christine?

CHRISTINE TOTH: Well, yes! It certainly brings up a good point, I would say yes and no. Well, it can be controversial nearly every breastfeeding journey really does need support. And if breastfeeding isn’t working, sometimes the mom just needs help giving her self-permission not to breastfeed, to let go. And especially in cases if breastfeeding is ever doing more hard, than good, there’s actually an important part to understanding the process of letting go. So there are always two sides to the story.

SUNNY GAULT: Of course, so let’s talk about letting go, you know. Why is it important for moms to let go of these goals? Honestly, I’ve talked to women that have pictured themselves breastfeeding their whole lives! You know, and they have little babies, baby dolls breastfeed kind of a thing! You know, and we have in our head before we go into childbirth and everything, we’ve got this picture usually of how we expect things to turn out. And it doesn’t always turn out this way. So why is it sometimes good to just let go of that when things don’t turn out as planned?

CHRISTINE TOTH: Sure, sure, it’s such an important topic and letting go, when a mom is able to let go, it really enables her to focus on this new baby that she has. The side of is that it helps her to heal and helps her to move on and focus on what she can do for her baby. If a mom is holding on to these disappointing feelings of what she can’t achieve, what’s not working, sometimes it can lead to even bigger problems like postpartum depression. So letting go is absolutely key sometimes and understanding when the time is right is part of the process.

SUNNY GAULT: Alright, so Lesley, we learned in the intro, that you have tried this a couple of times and it didn’t work out the way that you hoped. So can share a little bit about you experience?

LESLEY: Absolutely! So with my first daughter, she was born in an emergency induction situation after I had a complication in the end of my pregnancy. And everything went smoothly, except during my epidural they punctured dura, they call it, and I had a spinal headache for the next five days resulting in excruciating pain if I sat up which as you may imagine you need to do when attempting to breastfeed.

So really right from the start every time I would sat up to breastfeed I would associate that with excruciating pain. Not even in my breasts, which happened as well. And it just kind of spiral down from there. In addition to that, despite looking like there should be an all you can eat buffet on my chest, there was not. My supply was impacted I think by the negative associations that I had, although I don’t know how much of that is medically proven or just in my own head.

But I had flat nipples which along with my daughter’s shoddy latch caused us to have a bit of, you know, we just had problems right from the start. So I tried the contact nipple-shield to try make it better, but that was just one more thing to wash along with bottles I was using to supplement, because I wasn’t making enough. And the time she was eight pounds eight when she was born. So she was a big girl that needed more that I could give her. And even if it had been the most perfect journey I’m still not sure that I would have been producing enough for her.

So I was supplementing right from the start. And all of these things contributed I think to my spiral into what turned to severe postpartum depression, which was also a little bit of anxiety as well which I think a lot of moms suffer from than even realize. So my postpartum anxiety once there was the parts of the pump, and the nipple-shield, and all of these things to wash and do it just became too much of an overwhelming process, especially when I was already supplementing to begin with. It was just easier.

It got to the point where it was, like Christine said, negatively impacting me. I would have loved to continue, but once there were too many obstacles to jump through, I stopped. And I remember whipping, which was probably the depression, and calling my husband and saying: I think I’m going to stop today, is that ok? Like I needed him to say it was ok. And I don’t know why, but I just felt like it had been my plan to try and breastfeed and I was just in such a state that you know… And he said to me: is that what you want? And I was crying, because it’s a bitter sweet moment to decide that you are going to stop, it is.

You want to be able to do this thing for your baby. It’s one of the first things you can do. And those moments when it was sort of working when she was latched on, we had lovely bonding moments, you know. And I did want that to happen. And we decided to end there. And I never looked back. It was literally… I cried that last feeding and then stopped, and then it felt like a ton had been lifted off my shoulders, a huge weight. So that was my first breastfeeding journey.

Then when my second daughter was born, again-valiant effort. I got a pump, and this time it was an exciting free benefit from my new [inaudible]which was great. And I think that is such a huge perk for women and it makes it so much easier to jump into breastfeeding if you are able to. So I had my pump ready, and I had all of my supplies. And again, I thought it was going great. And the lactation consultant showed up and looked at me and said: oh my goodness, stop right now! She is like: I’ve never even seen nipples look like that! She said: I don't know what’s happening and she looked at my daughter.

And meanwhile, yes, it did hurt, but people told me it hurt, so I thought we were doing ok despite wincing every time she latched. And literally she looked in her mouth and she has lip-tie, and I can have operation, you know, where they can have it snipped and then maybe she will be able to breastfeed, but with your nipples, I’m not even sure that it would work, so that was the end of our breastfeeding right there. She was just a few days old when I stopped doing that. But I committed to pumping, because I had somewhat of a supply. And I pumped like I said until my help that I had on hand, because of the depression and the anxiety. So I have her month of… It was pretty much half and half breast milk and formula. And again: never looked back. It was just the right decision for us to be best that we could be.

SUNNY GAULT: I’m curious, Lesley, with both of your experiences, did you get to a point where people were offering you advice? Like: Well, before you quit, you know, did you try this? Did you try that? And I know you sought the help of a lactation consultant with your second, but did you get anyone else offering you that “free advice”?

LESLEY: Absolutely! Everybody! I mean, I have so many friends that breastfed successfully and everyone else was just like: oh, just flip her around, or hold her this was, or make a sandwich with your breasts… I don't even know what they were telling me to do, but it was not working out. But yes, I know everyone wanted to help and I wanted the help to a point. And what I wanted was the out. And the second time I didn't even look for that. The second time I told myself and my husband. I just knew that it was time to stop, that it was doing again more harm, than good. And in the end of the day she needed me to be at my best and if getting frustrated by the pump and not having the time, and it giving me anxiety of: oh, I have pump her and still feed her a bottle, it just adds a whole layer on to it.

SUNNY GAULT: Christine, I know moms mean well. We are trying to help other moms. And especially if breastfeeding had been a little bit easier to us, you know, we try…we just try to help. But why up to a point, like Lesley said, she wanted the help. And then it got to a point where any words after those were really doing more harm than good. So is that what you find as well, you know, as far as moms trying to help other people? And when does it turn bad?

CHRISTINE TOTH: Okay, that’s a great question! And Lesley highlighted it so well that, through both of her stories, she made every possible effort! You know, she went to the point of pumping, and her birth stories, especially with her first child, her body had been through so much at that point. She was absolutely exhausted. And often times when a mom is starting to come to the point where she is realizing that she might have feelings of resentment for the baby, and she feels like she is not a good mom, she is exhausted at that point.

To have one more person recommend mother's milk tea, and drinking more water, it’s only going to exhausted her that much more. So at a certain point it’s best to just kind of turn that off, just like Lesley did. If you are the support person, one of the things I always try to do is try asking open-ended questions, instead of making recommendations or just giving advice where it’s not asked for. Things like: oh, what measured have you tried, what have you explored already, in that way… sometimes there is an underlining issue or a story behind breastfeeding’s not working and often times mom has tried pretty much everything and then some to get breastfeeding to work. And so yeah, there is that kind of a critical point where mom herself can choose to turn off, you know, social media, choose to turn off maybe relatives that are pressuring her, and focus of what’s best for her baby.

SUNNY GAULT: Alright, well when we come back we are going to break down the most common reasons moms are unable to breastfeed. So we'll be right back.

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SUNNY GAULT: Welcome back! We are talking about moms who are unable to breastfeed and Christine Toth, she is a registered dietitian and IBCLC, she is our expert. So let’s go through, Christine, some of the common reasons moms might not been able to breastfeed. And I realize, these aren’t all isolated incidents, right? It could be that mom is experiencing several of these situations perhaps that are kind of leading up to this. So let’s just go through some of them and learn a little bit more about them. So the first one we have on our list here is milk production, right? So not having enough milk, high enough milk supply?

CHRISTINE TOTH: Right, exactly! And this can be for multiple reasons. It’s actually a simple term for complex issues if you will. This could be pre-glandular issues which are more hormonal. Things like hypo or hypothyroidism. Thyroiditis as well which is an inflammation of the thyroid gland. Also things like a routine placenta after the birth. Lesley herself mentioned a traumatic birth. Any history of insolent-resistance, PCOS, infertility issues in the past, prolonged pushing stage, and multiple medications.

Anything that’s going to interfere with her breastfeeding hormones, as well as glandular issues. Things like hyperplasia which is an insufficient glandular tissue maybe she didn’t develop during puberty, maybe she didn’t experienced any breast changes during the pregnancy. Other glandular issues might also be things like breast surgery, or breast augmentation or reduction. And anything that interferes with the glandular tissue can also interfere with the mom’s production.

SUNNY GAULT: Lesley, how would you rate your milk-supply with both of your babies? If you had to rate it like on a scale from 1 to 10, what would you give it?

LESLEY: I’d give it a 3, maybe 4. I really just never had… You know, I would hear stories of people and milk was just coming out all over the place and they're spraying their babies in the face, and I was like: I don’t understand what you are even saying, like that just… I just never had these experiences. And I would get so excited, I would pump for literally 20minutes on sides and put it together and have like two and a half ounces and I was like: yes, that’s almost enough for half of a feeding next time! You know, it was so… Again, negatively associates the entire action for me. If I had pumping and I had a supply that was enough, or enough to freeze, which I even don’t understand people getting spare freezers for their extra breast milk, it was nothing I needed to get into. But if that had been the case, I would have forged through I think. But it just beats you down even further I think.

SUNNY GAULT: You know, even I thought I had a lack of supply, a low milk supply with my first two kids. So I have four kids all together. And my first two… I now don’t think it was a supply issue, but if you would ask me why I stopped breastfed, I stopped breastfeeding them at about 6months. And I wanted to breastfeed longer than that, but I would have chocked it up as a supply issue. But what’s interesting is my next two babies are twins and I never had a problem with them.

So now I’m kind of looking back going: I don’t think that was a supply issue. And I think this one of those issues where absolutely there are, you know, for the reasons that Christine mentioned, they are plenty of women out there that struggle with supply issues. But I also feel like sometimes this is kind of misdiagnosed, Christine? You know, a lot of people, they thing they have a low milk supply and it maybe some other reasons, you know, that they are not able to breastfeed. But do you feel like this is kind of the go to that a lot of people, you know, kind of point to as the reason?

CHRISTINE TOTH: Absolutely, yes, absolutely! And a lot of times what ends up happening is moms will doubt their supply or it might be other influences, maybe it’s a family member as well, they’ll interfere with nature and rather than being a primary insufficient milk supply issue, it kind of transitions into a secondary causes that also interfere with her full production. And so one of the things that a lot of moms don’t quite realize in those first few days of life, is that’s when her body is getting set-up to achieve its peak milk supply and she should achieve her peak supply about around the first 3 to 4 weeks of life. And so anything we do to interfere with that process, whether it’s in the first few hours, or the first few weeks, sometimes that can affect her overall supply later on down the road.

SUNNY GAULT: So we talked about milk supply. Let’s talk a little bit about what we are calling transfer. So this could be couple things we talked about before-poor latch, we talked about the status of our nipples, we have inverted nipples, flat nipples, tongue-tie, things of that sort.

CHRISTINE TOTH: Sure, sure! So after the birth, you know, coming into the pregnancy, and then coming into the birth, breast milk is produced based on hormonal issues. It’s controlled by the endocrine system. And then shortly after the birth, within hours after the birth, it switches over to a local control of supply and demand. And so if the breastfeeding is not working, and the baby is not transferring the milk, maybe it’s a latch issue, like Lesley mentioned, flat or inverted nipples, anything that interferes with the poor latch. That can then affect the supply and demand, and also interrupt the mom achieving her full potential for milk supply.

SUNNY GAULT: You know, Lesley, you were talking about the status of your nipples and it reminded me… I love how open we are on thins show! It reminded me of when right after I had my first baby I was delivered in a hospital and I never really thought about my nipples that much honestly. And the nurse… I am not so sure if it was a nurse or a lactation consultant. But you know, she was checking out my latch and stuff. And my baby really, you know, my son really wasn’t latching very well and she was like: oh my… She took one look at my nipples and she is like: I’ll be right back!

And she comes back with a nipple shield! And I’m like: what is this? It’s one those things… And I kind of, while I was happy to have something to help my son in the beginning, no one ever told that nipple shield is only supposed to be temporary, so I used it throughout my, you know, whatever, 4months of exclusively breastfeeding him.

He would not nurse without it! And then when I tried to transition off it, it was kind of a nightmare. And that’s when we ended up supplementing and supplementing turned into just feeding in bottles of formula. So… But I understand the whole nipple thing! And I know that was a struggle for you. And I know you talked a little bit about tongue-tie. So sounds like this whole transfer thing was definitely an issue for you too, Lesley, right?

LESLEY: 100%! If I look back and look in my daughter’s mouth, my older daughter, I think she also has tongue-tie a bit. Which is something that is easily fixed. I have a best friend who just literally two weeks ago had her son’s tongue-tie clipped and now there are happily breastfeeding and doing great. For me, and the lactation consultant recommended that the second time, to have my younger daughter's tongue and lip, her upper lip is also shortened…

CHRISTINE TOTH: It's a shortened labial frenum.

LESLEY: There you go, exactly! But to me, I knew that it wasn't that important to make her go through a procedure to make breastfeeding work. Now, for my best friend it was! She knew everything else was working. For them to say to me: look, we can do this procedure on your daughter, but we are still not sure if you are going to be successful, then there was no reason to go through that! I didn't think so. And we didn’t.

SUNNY GAULT: The next thing on our list here is what we are calling utilization issues, which basically is when infants, when the babies aren’t able to tolerate mom's milk. And honestly, Christine, does this kind of… Is it a common thing? It's not something that we hear about too much.

CHRISTINE TOTH: No, it's actually pretty rare. There are very rare cases of congenital lactose intolerances. This is actually a genetic trade that the baby would inherit from their parents. Galactosemia is less than 1 in 100.000 births. But it's break down of liver enzymes so that the baby literally can’t digest mom’s milk. And they're of course special needs kids. These are the downs babies. I mentioned Cleft Lip, Cleft Palate some of those, some of those special needs babies with intervention breastfeeding can sometimes be improved.

But with something like galactosemia the baby's system literally can’t tolerate mom's milk. And it is very rare. It’s not the common issues that transfer into production issue that we tend to see more often. But in those cases too that mom still might struggle, as Sunny mentioned, with her early desire to breastfeed and having to figure out how to let go of not being able to breastfeed, so…

LESLEY: Christine, I just have a quick question. I have a lot of friends who have cut out dairy from their diets and more than, and it's more than 1 in 100.000, I don't know… A bunch of people who has stopped eating dairy because they thought it was irritating their child. I’m just wondering if that’s really true?

CHRISTINE TOTH: Sunny, that’s a good idea for another topic someday! But when a mom’s diet affects the baby’s tolerance to her breast milk, typically it's recommended not to change the diet. If it’s not broken, don’t fix it. If the baby is tolerating everything in mom's diet, there is really no need for her to cut out certain foods. However rarely and sometimes it’s if the mom actually has any reason for an immune compromised system, if she has like any kind of like leaky gut syndrome, what actually happens is certain foods, certain gassy foods, dairies are another ones, soy is another one, there are tiny perforations within her intestine and if these foods leak through and enter her breast milk, sometimes it can cost the baby certain amounts of, I wouldn't say intolerance, but possibly extra-gassiness.

I know moms say that their babies have running a stools, or the babies are uncomfortable, like a bloated tummy would be another sign. And so my recommendation I always kinds go through and explain the elimination diet. And if it’s helping her-absolutely! If it’s helping the baby and she notices, you know, an instant improvement, then absolutely! And it might not be that those moms need to cut out dairy forever, but maybe they need to cut out dairy for a few extra months until things start to improve and she sees that the baby can tolerate the breast milk at that point.

SUNNY GAULT: Yeah, I’m glad that you guys brought that up. We actually have done a couple of episodes on this. So did one on dairy intolerances, we’ve talked about nutrition in general, and some stuff like this. So you guys, can go to www.newmommymedia.com and type in some key words or whatever you are looking for in particular and those episodes will pop-up for you.

So one thing that I know is common, is family pressure, lack of support, whether that comes from your partner or you know, other moms, or your friends, your family, things of that sort affect. We just released an episode about what do you do when your partner doesn’t support you and your breastfeeding goals. So let’s talk a little bit about that Christine, and how that can impact everything.

CHRISTINE TOTH: Sure, sure! So, it kind of goes both ways. Sometimes the family can pressure the mom into giving a bottle, so that they can participate in feeding. Other times even before the birth, maybe it’s the spouse, or mother-in-law, or the mom felt pressured into breastfeeding and it was something she was unsure about from the get-go. And that’s an interesting case as well because it’s like she never really felt comfortable with breastfeeding in the first place and she was doing it almost to please everyone around her.

So in those cases as well, sometimes mom just needs the permission to really do what she wants to do and what she feels is best for herself and for her baby. I mentioned, you know, avoiding things like depression and preventing her from resenting her baby every time her baby is hungry and ready to eat. So yes, lack of support is another, you know, another important key thing when moms are faced with this question of when to give up on breastfeeding as well.

SUNNY GAULT: Lesley, I thought it was interesting when you said that you asked your husband: is it ok? Can I just no do this anymore? So obviously that support is important to you as well.

LESLEY: 100%! And he responded in the exact right way! He said, you know: if you are sure that’s what you want, then of course! He said but think about it! So just knowing that he would be ok with me stopping… It was something that I was doing for our baby, so for whatever reason, I needed his ok to stop doing it. I don’t know, yeah, I just did. Didn’t occur to me to just stop and do what’s best for me without consulting him and knowing that I had his blessing to do that. And the second time I didn’t need it. The second time I knew it was whatever will get us through.

SUNNY GAULT: Christine, the next on our list is history of sexual assault. Which a lot of people may not think about necessarily unless this is something you’ve personally experienced. Again, we did an episode on this too, so I know a little bit more about it, but how can that impact breastfeeding and pumping goals?

CHRISTINE TOTH: Yeah, sure! So sometimes, you know, obviously if the woman has had any history of sexual assault or abuse growing up, it can be a really hard thing for her to bring herself to breastfeed after that trauma. Sometimes actually breastfeeding can help her with the healing process, but other times are just too hard for her to breastfeed. And, you know, some of those mom are able to pump ok, but putting baby to breast just isn’t comfortable for them. But if they do have history, they shouldn’t be pressured into having to breastfeed. You know, they need to also give themselves permission if it’s just not going to work for them and for their baby.

SUNNY GAULT: And depression is next on our list here. Lesley, I know this is something that you talk about and something that you personally went through as well.

LESLEY: Absolutely! So I think of a chicken and egg question. Postpartum depression or any real maternal mental health issue and breastfeeding. Some people will you that because they were depressed they couldn’t breastfeed and some will says they couldn’t breastfeed and that made them depressed. There are also people… Postpartum anxiety and OCD are things that are lesser known. But it was definitely a factor for me that when she was breastfeeding I didn't know how much milk she was getting.

So if my daughter was fuzzy 20minutes later, but has fed for, I don’t know, half an hour, I had no idea how many ounces she had drink and I needed to know those numbers for my own sanity. For whatever reason that’s what I come to, is knowing how much milk she had drink. And with formula I could poor it in, mix it up and I knew exactly… I would write it down. I think I still have the notebook where I wrote down every single bottle she drank for the first I would not even tell you how long of her life. But I needed to know that.

So people that are struggling with anxiety and OCD not knowing what the reason could be for fuzziness and thinking: wasn’t latched correctly, maybe she didn’t enough, is she hungry and then trying to feed more and then that leads to cloud things or cracked things, I don’t know, I never got to that point. But I think that depression, anxiety, OCD and breastfeeding, it’s a complicated balance.

SUNNY GAULT: Absolutely! Christine, I feel this is one of the things a lot of times this depression isn’t diagnosed, right? It's something that we experience and we just think it’s a part of motherhood, and we kind of just push it to the side. And it could be sabotaging our, you know, breastfeeding goals.

CHRISTINE TOTH: Yeah, absolutely! It sometimes gets glazed over, kind of misdiagnosed as baby blues or it’s just the hormones after the pregnancy. But as Lesley mentioned, postpartum depression and breastfeeding do go hand in hand. And there are a lot of hormones going on after the delivery. So it's absolutely understandable that one can influence the other. And especially if she had her mind set on something and it didn't work out the way she wanted it to, it can lead to depression. And of course with depression and with the added stress and anxiety that Lesley mentioned, that can inhibit the mom’s milk injection reflex and her let down. And so that can cause more problems with milk production. So really truly the two kinds of feeds off of each other.

SUNNY GAULT: Alright, so last one on our list is medication and illness. And Christine, what specifically are we talking about when it comes to medication?

CHRISTINE TOTH: Definitely! So certain medications can actually suppress milk supply. Sometimes moms don’t realize it, but receiving the epidural, a prolonged epidural during the delivery can sometimes delay the lactogenesis process or the milk production process after the birth. As well as certain medications, as Lesley mentioned, after the birth. Most medications won’t, are not contradicting with breastfeeding, but some medications can cause her to be sleepy and not breastfeed as regularly or as frequently as she should be. And so medications can definitely interfere not only with the supply and demand, but also with her mood and her success with breastfeeding and production.

SUNNY GAULT: Lesley, you mentioned you were on some medication as well, right?

LESLEY: For the spinal headache I was taking Tylenol with caffeine. That wasn’t exciting! So caffeine is what can help heal you spinal headache. Caffeine, much like you take Excedrin, it has caffeine in it to make your headache go away. So there was I chugging mountain dew literally, cans of mountain dew, and then trying to breastfeed my baby who wouldn't had gone to sleep and had colic, and reflex, and all of these things and none of us put it together that here I was, feeding her caffeinated breast milk.

SUNNY GAULT: So yeah, what does caffeine does to the breast milk? Or does it do? Is it just matter of keeping the babies more active, Christine? Or what does it do?

CHRISTINE TOTH: So caffeine would more play a role for the mom in reducing the headache, but it does transfer into the breast milk. And so if a mom, I always recommend if a mom can wait to reintroduce caffeine after the delivery, wait as long as, you know, at least a few weeks until she feels like breastfeeding becomes established. Because just as Lesley mentioned, if the baby is getting caffeine in the breast milk, it can interrupt the baby's process of sleeping, and waking to feed, and kind of that normal sleep-eat-sleep pattern that the babies tend to do. I missed poop in there too, and babies they poop.

SUNNY GAULT: Oh, they do!

CHRISTINE TOTH: But if the baby is over stimulated as well, than it can also interfere. So what I usually recommend for caffeine, and poop Lesley didn't know this, like she said she figured it out after the fact, but if the mom really does want a cup of coffee, it's always important to try to nurse the baby first, have the cup of coffee after she nurses and then wait to breastfeed again, so that the baby is not over stimulated.

SUNNY GAULT: Yeah, and we talk about this as I’m literally finishing up a cup of coffee. And I did breastfeed my girls earlier, but they are older. They are older, they are awake no matter what I do! Ok, so we have gone through our list here and obviously there are other things that could affect breastfeeding. We are just trying to kind of give you guys some idea of the common ones that we see. So Christine, what should moms do once they realize they can’t breastfeed? Obviously that may come as a shock, they may not want to admit to it, they, you know, may want keep pushing on, right, but what are some of their options if they are still committed to providing breast milk for their babies?

CHRISTINE TOTH: So, as we mentioned, some of the issues, the production and the transfer issues, with early intervention a lot of those issues can be improved. And especially if it's any kind of hormonal issue, a referral to endocrinologist can certainly help with supply issues. And seeking help from a good lactation consultant early on will definitely help with any kind of transfer issues.

But if breastfeeding is not working and the mom is starting to come to the realization, there are still options for her. And it’s important to know about donor milk as an option. A good lactation consultant can put her in touch with a milk bank in her area and discuss ways to help the mom achieve the bond that she desired from the get-go. And sometimes that’s the part of breastfeeding that the mom so desires.

Certain things like skin-to-skin with the baby or using a supplementing nursing system, even if it’s with donor milk, that mom still deserves credit-she is breastfeeding. And starting to begin the healing process-maybe going to a support group, maybe seeking help from a non-judgmental friend or family member or good lactation consultant like I mentioned. There are options for her so that at the end of the day, no matter how that mom feeds her baby, she needs to know she’s an amazing mom.

SUNNY GAULT: If breastfeeding is something that a mom wants to do and it’s just not working out, like we said earlier, it’s about giving ourselves permission to just say: we tried, we tried, we tried to do what we wanted to do and it didn’t work out. I mean, honestly, I associate a lot of this, cause we have our sister show, Preggie Pals, which is all about pregnancy and delivering your baby, and I hear it all the time on that show: listen, I went in it with this birth plan and I came out with a totally different experience. And there is really nothing you can do sometimes, you know, you tried, you gave it your all! And so many times I think as moms we just have to give ourselves a break! It’s just a break!

LESLEY: That is advice… So I am a period advocate essentially for moms who have maternal mental health issues and I will speak to pregnant women all the time and just tell them that you have no control. You have no control! Birth plans, I think, are like taboo-they should not be even aloud! You can't say what you want, you don't know what's going to happen! You’re absolutely no in control of that. And it's the same kind of thing, you know. You can take as many steps as you can, but if it's not meant in the cards, it's not in the cards. And I think women need the permission to be ok with that.

SUNNY GAULT: Absolutely! Ladies, great conversation! Thanks so much for being part of our show today! If you are a member of The Boob Group Club, then be sure to check out the bonus content for this episode where we'll discuss ways friends and family can help moms through this time, if they are having a rough time excepting that they can't breastfeed their babies. So for more information about our club, you can visit our website at www.newmommymedia.com.

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SUNNY GAULT: So before we wrap up our show today we have a “mamma hack”! I love this segment, because it was actually an idea from a listener. A listener kept sending us different ideas of what worked for her in breastfeeding and pumping, and I thought: hey, we got to make a segment out of this. So hence mamma hacks! And this one actually comes from Amanda. And this is in partnership with the SmartMom app.

So if you haven’t checked out SmartMom yet, it’s a free download, I encourage you to do so! It’s a great forum for moms to be able to help and support other moms. And it’s not just about breastfeeding. There are breastfeeding topics up there, but it could be anything related to pregnancy, you know, you’ve got a toddler, or a baby, anything within those first couple of years of life I think this app is really great for!

There are opportunities to win prizes at depending on how much you participate. So if you like help other moms and you want to, you know, maybe take a break from Facebook for a while, this app is really cool one to check out! So Amanda posted this on the SmartMom app and this is what she said about her mama hack. She says:

“I exclusively pump and my app has been a life saver!” So the app she’s referring to isn’t the SmartMom app. It is the app that she uses to track her breast milk, and her pumping storage, and stuff like that. She continues, she says:

“It help me keep track not only when I pump, but when my little one gets a bottle, when I change her diaper, and it even has features that show volume pumped by day versus the volume that I fed my baby”.

So just a little quick tip there from Amanda. And I know, I used a couple of different apps in the beginning when I was breastfeeding. They are really helpful, I find, in the beginning when you are really tracking all the poops, and the pees, and all that kind of stuff and you are trying to get breastfeeding off to a good start. And like to talk about apps a lot on this show, so… We actually have a section on our website where you can go and see some of our app reviews. So if guys are thinking about downloading an app to helps you track some stuff, I encourage you guys to check that out.

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SUNNY GAULT: So that wraps up our show for today. Thanks for listening to The Boob Group.

Don’t forget to check out our sister shows:
∞ Preggie Pals for expecting parents
∞ Newbies for newly postpartum moms
∞ Parent Savers for moms and dads with toddlers and
∞ Twin Talks for parents with multiples.

Thanks for listening to The Boob Group where moms know breast!

[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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