The Boob Group
Talking with Your Pediatrician about Breastfeeding

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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.

[Theme Music]

ROBIN KAPLAN: Sometimes the breastfeeding information you received from friends and find on the internet can clash with what your paediatrician recommends. How can you discuss these discrepancies with your paediatrician and get on the same page?

Today, I’m thrilled to welcome a new expert to the show. Dr. Jenny Thomas is a paediatrician and breastfeeding medicine specialist at Lakeshore Medical Clinic in Franklin, Wisconsin and is a Clinical Assistant Professor of Community and Family Medicine; and Paediatrics at the Medical College of Wisconsin. She is also an International Board Certified Lactation Consultant.

Today, we’re discussing: “Talking with your paediatrician about breastfeeding.” This is The Boob Group Episode 103.

[Theme Music/Intro]

ROBIN KAPLAN: Welcome to The Boob Group broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I’m your host Robin Kaplan. I’m also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.

Have you checked out our Facebook Page recently? If not, head on over and join in on the conversation that happens there daily. Feel free to post questions on our wall and we will try to answer them on an upcoming episode. Best of all, help a share all of our great content by sharing your favourite episodes with your friends.

So, today we have three lovely panellists on the studio. Ladies, will you please introduce yourselves?

SAMANTHA EKLUND: So, I’m Samantha. I’m 22. I’m a barista and I happen to be a producer on our sister show – Preggie Pals. I have one 18 month old daughter Olivia that I’m still nursing and she’s quite a pistol.

MELISSA LANG LITLE: Hi. I’m Melissa Lang Little. I’m 43 years old. I am a birth doula and birth worker advocate. I have three children. I have Milo with me and he’s 9 – 10 weeks and unhappy at the second. I have Benjamin age 5 and Joseph age 3 ½.

ROBIN KAPLAN: All right.

SHANNON BENECCHI: I’m Shannon Benecchi. I’m 32. I’m a kindergarten teacher. I have one daughter, Vivian. She is 10 months old and we are still nursing.

ROBIN KAPLAN: Awesome. All right and Mj is our producer. So, Mj you want to talk really briefly about our Virtual Pannelists Program?

MJ FISHER: Yes, definitely. The VP Program is really come along way. It’s a really cool way for you out there to join a conversation and be a part of the show. If you can’t be in the studio with us because we post a same questions that are in-studio pannelists are answering. So, you can share your experience, your opinions or tips and just engaging and supporting other moms. It’s nice to know that you are not alone.

It’s a sneak preview of our show before it releases and we post tips and info as we record. You’re really just supporting each other. So, check out www.TheBoobGroup.com under the community tab for more info on the VP Program and possible perks for participation.

ROBIN KAPLAN: All right, thanks Mj.

MJ FISHER: You’re welcome.

[Theme Music]

ROBIN KAPLAN: So, here’s a question from one of our listeners. This is from Sarah and she posted this on Facebook.

The majority of moms I know either formula-feed or supplement with formula because they say they don’t produce enough. Is this really true or are they most likely mistaken? I thought milk just keeps forming when the baby is on the boob? -Sarah

VERONICA TINGZON: Hi Boob Group listeners. This is Veronica Tingzon, International Board Certified Lactation Consultant, owner of the Original Comfort Food in San Diego, California. Sarah, I love this question from you because it is such a loaded question. So, here’s kind of my dial-down version of an answer.

A lot of moms do supplement unnecessarily and it’s not so much because they’re not producing enough. There’s a perception as not producing enough because they don’t know how to read their babies cues – or they don’t trust in the ability of their breasts to make the milk.

The funny thing is and it’s really not funny. But, I guess the ironic thing is that: “Eventually that extra supplementation will actually lead to the demise of their milk supply.” So, it will diminish and diminish the more interruptions that there are for the supplementation and not simulating at the same time.

So, instead of using formula trying to pump and breastfeed and do things like that to help make that to supply go up a little bit more. So, I’ve kind of find it funny that you should ask this because there is just a study that came out pretty recently and I was just reading it the other day about: “The low milk supply – our supply is epidemic in the United States.”

Mothers in other countries who have better support and better knowledge of breastfeeding don’t have this perception. Over here in the United States, this perception is still hot because even our medical staffs or paediatrician’s or OBGYN really aren’t well-equipped to answer the question.

So, it’s kind of a “blame game” on if the baby is lost too much weight. You don’t have enough milk. If the baby is too Jaundice, it’s because you don’t have enough milk. So, they had find a flame and moms take it from there because of their insecurity and their desperation from wanting to be the provider and wanting their baby to be okay.

If their baby is not “okay” then they take it upon themselves to do something to make them better. It’s really not the mom’s fault but it’s all of those little pieces in that health care provision. I guess you could say between the doctors, the nurses and everybody in the hospital and post-discharge who sees the baby and kind of to find blame to the mother breaking down her confidence in her own body.

I really truly suggest that mom see a lactation consultant very soon after birth. Once the milk is in, you can do pre and post feed test weight. Then, you can truly as routines whether or not your baby’s not taking enough milk. There are higher cases nowadays of lower milk supply but it’s still not huge.

I mean you maybe 5% of women and because of our toxins we have in our environment, the chemicals that we have the pesticides, the plastics and all of that. It is changing the structure of our hormones and changing the structure of our breasts development in our early development phase as pre-teens and teenagers.

So, there’s a small percentage of women who truly do not have the supporting hormones or mammary tissues to produce milk and I do see it often. But, I would say: “Good 50 to 60% of women who have a “low milk supply” it’s just a perception of a low supply and nothing more.” But, unfortunately, that extra supplementation of formula will lead to the true diminishment of that milk supply.

So, great question Sarah, I love this question and I hope moms as they’re pregnant hear this and do something to have that backup plan with the lactation consultant once they have delivered soon thereafter; so that they can have that follow-up. If they feel that something may not be going the way that they wanted too. Thank you.

[Theme Music]

ROBIN KAPLAN: So, today we’re talking about: “How to talk to your paediatrician about breastfeeding.” Our expert Dr. Jenny Thomas is a paediatrician and breastfeeding medicine specialist at Lakeshore Medical Clinic in Franklin, Wisconsin and is a Clinical Assistant Professor of Community and Family Medicine and Paediatrics at the Medical College of Wisconsin.

She is also one of only a few paediatricians internationally to be recognized as a fellow of the Academy of Breastfeeding Medicine for her expertise on breastfeeding and she’s also the author of Dr. Jen’s Guide to Breastfeeding. So, welcome to the show Dr. Jen. It’s great to have you.

DR. JEN THOMAS: It’s great to be here. Thanks for the invitation.

ROBIN KAPLAN: Sure. So, Dr. Jen, what is the average amount of training that a paediatrician gets on the topic of breastfeeding and what inspired you to take it so much further?

DR. JEN THOMAS: The average amount I think really is dependent on when you actually trained. So, when I was in my residency about 20 years ago, there wasn’t a whole lot of breastfeeding information that was out there.

The more recent graduates are getting the benefit of more-and-more teaching in their paediatric or family medicine residency which is I think for working much harder at helping this generation of doctors coming out to know more about breastfeeding.

But, when I decided to go into general practice, I had wanted to be an ICU Doc my whole career and tried to skip some ropes to paediatric selective as I could. I ended up to a twist of faith in time being a general paediatrician. I went to go and get some education on general paediatric topics and one of them offered was a wonderful series of lectures on breastfeeding by Dr. Nancy White.

As I sat in the audience, I thought to myself for: “Why does she know this and I don’t?” So, I went back to my home hospital after that trip and talk to the lactation consultant that work there and the rest as they say is: “It’s history.”

ROBIN KAPLAN: That’s fantastic. That’s so funny because Nancy White is here in San Diego with us.

DR. JEN THOMAS: That is exactly I thought: “Yes, very nice location and timing.”

ROBIN KAPLAN: Absolutely. Well, what tips do you have for talking with the paediatrician about the desire to supplement with donor milk rather than formula?

DR. JEN THOMAS: It’s less intuitive supposing that the decision to supplement is already been aid.

ROBIN KAPLAN: Yes.

DR. JEN THOMAS: Because there are still so many reasons that we supplement that don’t really need this to be a reason to supplement. So, if we’re talking about supplementing with donor milk in the NICU, that’s one of the things that we sort of hope that already occurring.

If we’re discussing about using donor milk for any other reason, there’s a wide variety of places that you can bring that up. One of it is saying: “That Dr. Stu is we could have stuck into an algorithm or a regular way of doing things.” One of the best things that I can tell moms to do is: “Just to ask the question, to sort of help us out of what we think is how our regular way of approaching problems – and to sit down and seriously consider alternative avenues of proceeding.”

We get very used to saying: “Okay, this child comes in and these things for the ear infection or these things that dehydration or these things that something and we know what we’re supposed to do.” But I find it very compelling when my patients make me slow down and sort of thinking have to answer your question. That’s different that what I expected to be asked.

Just being able to engage in that conversation, I think is wonderful. Hopefully, most of the moms have found a provider that they can have that discussion with and if you haven’t found a provider that you can have that discussion with and maybe you should find somebody who’s a better fit.

ROBIN KAPLAN: That’s a really good point and that also kind of leads into my next question too. If we see a lot of moms had long labour, lots of fluids; it can often inflate a baby’s birth weight. So, how can a parent negotiate the need for supplementation if baby’s weight drops rapidly in those few days due to possible due to the shedding of all that fluid during that labour?

DR. JEN THOMAS: Yes, I think there are enough studies up there right now to prove that that is indeed the case, that IV fluids are independent risk factor for weight loss. I have often asked if – I ask you to lose 10% of your weight in the next three days, how would you do it?

Would you put on a treadmill for three days? We’ll just hope that you had a really bad gastroenteritis. Would you poop and puke on the treadmill. I mean how would you lose 10% of your weight so to amputate something? It’s physiologically possible unless we’re dealing with something like Diuresis.

So, if we can point out the provider that the first day was 8% and then now, day two and day three afterwards – now, you really that whole progression of weight loss slowed down a lot. That maybe we could talk to that provider about Diuresis or just saying: “I think that the first 24 hours really was a lot of fluid loss and now it’s not so much.” See, he’s pooping. He’s doing great. I’m not having any problems with the latch.

ROBIN KAPLAN: That’s a great bit of advice. One last question before we open this up to our panellists as well. Sometimes when a family is supplementing due to maybe baby not-gaining weight as quickly back up to their birth weight and things like that.

Sometimes the recommendation is just to give the baby as much in a bottle as he/she will take because of the belief that sometimes babies won’t over eat. What are your thoughts on this?

DR. JEN THOMAS: Well, sure I think they will over eat that’s what they have so many kids barfing in the hospital when they need to keep supplemented for things like artificially inflated birth weight and a lot fluid loss afterwards. I don’t think that they self- regulate early. They are at the mercy sort of its flow of the bottle.

We didn’t actually start burping hours until we fed a bottle-feed because they don’t have control over the flow. So, just sipping a random number out of the areas to but to supplement the baby with is not the best idea.

ROBIN KAPLAN: Okay. Ladies, did you have to discuss supplementation with your paediatrician at all? When you had your kids? Shannon, you’re nodding your head.

SHANNON BENECCHI: I did. My daughter had a little bit of jaundice when she was born, not too much but just enough that her paediatrician recommended doing formula because he thought that it would get it out of her system quicker. We ended up not doing formula. We kept nursing. We found out that he was not the right fit for our family.

ROBIN KAPLAN: Okay, so how do you get the jaundice out then?

SHANNON BENECCHI: She just nursed and after a few days, she was looking beautiful again.

ROBIN KAPLAN: The yellowness tended to go away.

SHANNON BENECCHI: Yes.

DR. JEN THOMAS: I find Jaundice another very interesting topic because it is a physiologic adaptation to being born. It’s the jaundice itself has an anti-oxidants and it’s supposed to – every baby is suppose to turn yellow just a little bit after delivery.

We turned it into a disease in the 1950’s and ever since, they’ve been sort of fighting our way back to see as his normal physiology. So, when I hear that my baby had jaundice or quite jaundice, there was jaundice I’m like: “Right because they are human”

ROBIN KAPLAN: That’s a good point. I think the main thing too is that you were keeping on track of how things were going as well. So, it didn’t turn to the one where we’d end up becoming a medical issue I guess.

DR. JEN THOMAS: Right.

ROBIN KAPLAN: Yes, Dr. Jen there’s been a trend lately in San Diego where our practitioners have been recommending solid starting at four months. Can you explain why the American Academy of Paediatrics Guidelines for exclusive breastfeeding until six months has now been kind of modified to starting solids at four months and why are so many doctor’s so keen on rice cereal?

DR. JEN THOMAS: I don’t think of any providers really switched to the six months recommendation. I think that that’s been a battle for quite some time. Even within the American Academy of Paediatrics, there was some discussion between the community and the nutrition and the section of breastfeeding about whether 4 to 6 months is going to be agreed upon.

It is the AAP’s position that it’s exclusive breastfeeding for 6 months. But, because there’s been a lot of confusion on there; I’m not sure that the average paediatrician knew what to do. I think what has been driving infant’s feeding practices in the United States has been the infant food companies and they are still the marketing too parent to start at four months.

We know that kids who are feasibly breastfed for six months are less ill, have much less infection than kids who are exclusively breastfed for four months within the introduction of supplementary foods at four months. So, the exclusivity is really important for infectious disease. The idea for rice cereals is just a tradition.

It’s really one that needs to go away. Given by the – again by the baby food companies. A lot of really powerful mythology that somehow is starch can make your babies sleep better. We are working hard to have kids exclusively breastfeed for six months and then start-off with really powerful good food instead of the rice cereal.

I’m a big advocate for baby lead weaning, baby lead solids and I just think that that’s definitely a good hope.

ROBIN KAPLAN: What are your favourite top foods to start with?

DR. JEN THOMAS: I like avocados, sweet potatoes, bananas. I like things that you can smoosh and give to the kids and left them work on their fine motor skills and experience texture. At the same time sort of learn to feed themselves.

ROBIN KAPLAN: Awesome. How can a parent respond when her practitioner doesn’t believe that breast milk has nutritional value after one year and that she should start to wean and offer that cow dairy instead?

DR. JEN THOMAS: Well, you’re talking to somebody sitting in Wisconsin. I’ll be pulled out of the state by my ear. But, I was always amazed that there’s a feeling that your breast milk turns into water and that how’s the mammal out there that needs better milk for human than a human does. But, I think I respond by giving t-shirts at a year. If somebody makes it for an entire year of breastfeeding, we have a small little party that ends with me giving a t-shirt to the baby.

I find it to be a great transition to talk about how important it is to continue nursing after a year. But, I do think that a simple negotiation with your primary doctor that you want me sense to give human milk to your human baby I think makes a lot of sense.

ROBIN KAPLAN: I think when you stated in that way as well, it makes – it kinds of hits it home in a nice way too: “Human milk for human babies.”

DR. JEN THOMAS: Human milk for human babies.

ROBIN KAPLAN: Exactly.

DR. JEN THOMAS: Not that you’re going to pick out a cow that looks like it’s going to be able to make better milk for you.

ROBIN KAPLAN: All right, ladies in the studio; have you discussed with your paediatrician his or her recommendation for how long you should breastfeed and what was his or her response? How about you Melissa?

MELISSA LANG LITLE: I think it’s really important to decide on your breastfeeding goals before you ever see your paediatrician, somewhere in your pregnancy perhaps and I have the luxury of utilizing a midwife. So, I think we talked about some of those goals before I even saw a paediatrician.

So, is a paediatrician we’re trying to sway me. I already have my goal set and I’m working on that goal before I really even hear what it is that they say or respond with.

ROBIN KAPLAN: Okay.

MELISSA LANG LITLE: So, that helped me.

ROBIN KAPLAN: That’s absolutely helpful. How about you Samantha?

SAMANTHA EKLUND: I really love your answer for that actually. That’s a really great way of looking at it. Luckily, my paediatrician has been really great. We actually haven’t really had a discussion to be perfectly honest. I nurse Olivia during every appointment at one time or another. She’s getting her vaccinations or we’re just sitting there.

So, she knows that I’m still breastfeeding obviously. I’m going to take her not saying anything as support. She hasn’t said: “Well, are you keep doing that or do you know that it’s not giving her X Y and Z.” So, I’m going to take as support.

ROBIN KAPLAN: All right, that sounds good. How about you Shannon?

SHANNON BENECCHI: I also haven’t had that conversation with my paediatrician. He was advocating starting solids at four months. So, I just kind of taken nursing on as my own thing; I sort of feel like it’s not something I need to discuss with him kind of at this point.

ROBIN KAPLAN: Okay and Mj we have a virtual panellists who wants to chime in?

MJ FISHER: Yes, Ashley Williamson says that: “Her paediatrician told her – I will never tell you not to breastfeed. I will never tell you to wean.” She says: “That was the best thing ever.” She also said that: “Her paediatrician said for her to put breast milk in her daughter’s eye to cure an infection.” So, there are some supportive ones out there.

ROBIN KAPLAN: That’s fantastic. All right, well, when we come back Dr. Jen will discuss: “Dealing with sleep recommendations that may not support breastfeeding as well as what to do if you’re paediatrician doesn’t agree that tongue-ties affect breastfeeding.” So, we will be right back.

[Theme Music]

ROBIN KAPLAN: Well, welcome back to the show. We are chatting with Dr. Jen Thomas about: “How to talk with your paediatrician about different breastfeeding topics.” So, Dr. Jen, how can a parent respond to the comment that: “A baby shouldn’t be nursing throughout the night once he/she hits a few months old?”

DR. JEN THOMAS: Well, I think that there’s a couple of different ways to approach that. I think the pretty logical way to approach with is to say: “Why.”

ROBIN KAPLAN: Yes.

DR. JEN THOMAS: To find out what the motivation is to say that the baby is shouldn’t be nursing through the night because we know that that physiologically normal. But, we have a lot of ideas 21st century ideas that we’re putting on babies that don’t know and didn’t consent to 21st century ideas. So, it’s important that we understand where the provider is coming from and then you are able to express ourselves in terms of what your goals are.

ROBIN KAPLAN: I think it kind of leads to my next question. Sometimes doctors will say that: “A mom shouldn’t nurse her baby to sleep or throughout the night because it can cause bad sleep habits.” So, this is a baby who is going to want to nurse until they go to college or need to be rocked until they go to college. Actually, I still rock my 7 year old.

DR. JEN THOMAS: I have a colleague one say that: “It’s the only way that she could get some others in her practice to stop breastfeeding their babies at night was to say that – there was going to be a four year old that was in their bed that night.” So, that’s not so bad. I sort of like having my four year old in my bed.

If I didn’t like having my four year old in my bed, that four year old was talking. I could say: “Go back to bed.” I find all those things to be very frustrating pieces of advice.

ROBIN KAPLAN: I think our parents find them frustrating as well. Ladies, have you been giving any sleep advice from practitioners or something that maybe you didn’t necessarily agree with that you questioned and how did you handle it? Shannon, how about you?

SHANNON BENECCHI: For me, my daughter’s 10 months old so I am being told that she no longer needs that night nursing session. I disagree, I think she does. I needed too. I like the closeness I am working out at the house five days a week. I treasure those moments at night with her.

It’s just wonderful just have that bonding time with her; just the two of us snuggled up close together. I love it. She loves it. It’s working for us. So, I’m not changing anytime soon.

ROBIN KAPLAN: I think the point that you brought up too that it’s working for you I think is a key component as well because obviously, people look for changes when it’s not working for them and seek it out. But, if it’s working, you want to just keep doing what you’re doing. So, how about you Melissa?

MELISSA LANG LITLE: I’d nursed all two of my boys and now the third until three. So, one of the things I learned by my breastfeeding relationship was: “What works for both of us but also that breastfeeding at night wasn’t just for nutrition. Sometimes if they were teething or uncomfortable or not feeling good and I always like that I had an answer that always seem to work.” That made me really happy. So, it didn’t bother me.

I have the advantage of being able to have my boys in my bed with me. I think sometimes that makes it easier than having to get up out of bed and go somewhere else. So, I always say that as a caveat; that it was pretty easy for me to breastfeed my boys at night.

ROBIN KAPLAN: Okay, cool. How about you Samantha? Go ahead Dr. Jen.

DR. JEN THOMAS: I think a bit the pieces advice where you’re told that you shouldn’t be nursing at night anymore really is in conflict with a lot of mother’s experiences. I think what you’re saying there is very important that you have something that was always going to work.

When someone is asked to change their way of parenting simply because of unknown outcome in the future, I don’t think it makes much sense. I think it make sense to do the thing that works best for your family. I think that’s a very good point.

ROBIN KAPLAN: Absolutely. Samantha, what were you going to add?

SAMANTHA EKLUND: So, I had a certified nurse practitioner at our paediatrician asked when she was probably 10 months old asking: “Where she slept?” I said: “She sleeps with us.” She asked: “Well, she’s sleeping through the night?” I said: “No, she’s still nursing.” She was like: “You better get that in check.”

For the time it was working for us, I have no problems. Now, at 17 months where she still waking up 4-5 times a night; now I think I’m in the position where it’s not coming from anybody else, it’s coming for myself. That now is the time where maybe we need to transition out of that. I’m okay with that decision because it came for me and not the paediatrician.

ROBIN KAPLAN: I think another thing that my kids were a little bit older and so, they sleep in their own rooms and stuff like that. But, I think Melissa you brought up a good point like one of them had a stomach bug like a couple of weeks ago.

So, I didn’t want them sleeping in his own room for me to have to get up every couple of hours and rush in there and freak out. I’d rather him in bed with me and plus I haven’t think: “I’m almost 38 years old and when I don’t feel well – I call my mom to have her come and take care of them.”

So, it’s going along with all that with what feels right to you until it’s not working. Then, it makes feel so much better when it’s kind of like: “Well, we need to make this change because I want too.”

SAMANTHA EKLUND: But exactly.

ROBIN KAPLAN: Mj, do we have our virtual panellists as well?

MJ FISHER: We do and also I wanted to add too with my paediatrician, I wasn’t going in and saying: “I can’t get enough sleep.” That’s the thing is: “We’re not asking for it.” They’re just giving it to us. So, it’s kind of odd that way. But, that’s sweet like Leslie Thomas Sander. She said:

I just nodded my head, smiled and went about my business. -Leslie

Then, another one was Emma Wade. She says:

He’s recommended crying it out at 9 months and she ignored him. -Emma

ROBIN KAPLAN: All right, Dr. Jen, what if a pediatrician doesn’t believe that tongue ties or lip ties negatively impact breastfeeding or even exist for that matter?

DR. JEN THOMAS: We’re far from consensus on this. There are clearly some tongue ties that make a huge difference and then there are a lot of debates surrounding the whole idea of tongue tie and lip tie. So, we are in a really exciting time of research and understanding and trying to figure out what is the best way to approach a child with a tongue tie.

There’s no way that a practitioner can say that: “It doesn’t make any difference because it certainly does make a difference to that mom who’s in pain and that baby back hence sustains a good latch.”

One of the things that is important to know is that: “You can seek out an opinion from an ENT or other qualified practitioner as long as you have a referral from somebody who is appropriate.” So, if you have a lactation consultant that says: “I think that your baby needs to go see a [inaudible] doctor. A lot of the times he can bypass your primary as they don’t think that’s an issue.”

ROBIN KAPLAN: Okay and we’ve had a couple unfortunately not just in San Diego but I heard it from other moms as well in other places that a pediatrician just said: “You can get the procedure done but there’s a 50% chance that it will help and I don’t know where they get these numbers from.”

DR. JEN THOMAS: Yes, right. Exactly, we’re in a time of a very interesting debate and research. It’s really numbers like that don’t exist.

ROBIN KAPLAN: We don’t have any of those numbers, absolutely. So, do you have a recommendation for if a mom is actually seeking out a maybe go to an ENT but she’s also feeling kind of nervous because her pediatrician is someone that she trusts? This is a person who is saying: “Well, there’s a good chance, it’s not going to help anyway.” Anyways to get the mom to feel more confident to maybe get a second opinion?

DR. JEN THOMAS: You are still the customer, the client; you are of course the one paying us for the services. So, if you have a question about the services that you’re paying for – then absolutely. Go advocate for your child. Go ask for a second opinion.

This is not the 1950’s where we get to dictate what happen. This is a time of relationship and empowerment for our families. So, I would do what was necessary to make sure that I was doing the right thing for my child.

ROBIN KAPLAN: Okay and then the million-dollar question of the day: “Is it normal for a babies to poop only once a week, Dr Jen?”

DR. JEN THOMAS: It depends on how old that baby is. It’s an emergency if they’re only pooping once a week in their first couple of weeks of life and they’re not transferring any milk. But, if they get to being 2-3 months old and they still once a week that is consistent with the recipe of breast milk – the main nondigestible component of breast milk is oligosaccharides which are very prevalent in the recipe for breast milk in the first several weeks. But it goes down.

There’s a different rate for every women. It sounds like: “From the research” and as those oligosaccharides leave the recipe – the stool obviously can decrease because oligosaccharides drive the stool out in the initial days of breastfeeding.

ROBIN KAPLAN: Okay, all right well fantastic. Well, thank you so much Dr. Jen for our incredible panelists for discussing this very important topic.

For our Boob Group Club Members, our conversation will continue after the end of the show as Dr. Jen will discuss: “Her recommendations for iron supplementation for the exclusively breastfed baby.” For more information about our boob group club, please visit our website at www.newmommymedia.com .

[Theme Music]

Wendy: Hi Boob Group listeners. I’m Wendy Wright, an Internationally Board Certified Lactation Consultant and owner of Lactation Navigation in Palo Alto California. I’m here to answer some of your most common questions about returning to work as a breastfeeding mother.

One of the questions we routinely receive is: “What will I need for my employer so I can return to work while breastfeeding?” This is a great question and very, very important to discuss with your employer if it all possible before leaving for maternity leave. There are three items that your employer can provide that would be extremely helpful for your breastfeeding career.

The first is: “A private space.” This is preferably a room with good lighting, an electrical outlet and a comfortable chair. This could be an office, a conference room or even a large supply closet. The only provision that is mentioned in the law is: “This is not a bathroom.” So, any other room within your building that you would feel safe and secure, clean, well-lit will be great for breastfeeding and pumping while at work.

The other item that your employer should provide is flexible break time to use for pumping. The first few months back at work, you will need to pump approximately every three hours. That looks like two breaks – one in the morning and one in the afternoon plus, pumping on your lunch hour. This is a great way to maintain your breast milk supply to make yourself feel comfortable during the day and to provide enough milk for your infant for the following day before your infant start solids.

The last item that your employer can provide so that you can return to work easily while breastfeeding isn’t supported of company policy; often times, this is overlooked. However, it’s not simply enough to have an agreement between the HR individuals and the employee who is pumping at work.

It’s an excellent idea to have a company policy so that other employees are entitled to the same rights; so that managers and supervisors and peers all know what to expect. So, that your rights are protected. Sample policies can be found on my website at www.lactationnav.com. Thanks so much for listening today.

This is the website for more information about my business Lactation Navigation and be sure to listen to The Boob Group for fantastic conversations about breastfeeding and breastfeeding support.

[Theme Music]

ROBIN KAPLAN: This wraps up our show for today. We appreciate you listening to The Boob Group.

Don’t forget to check out our sister shows:

• Preggie Pals for expecting parents
• Parent Savers for moms and dads with newborns, infants and toddlers
• Our brand new show – Twin Talks for parents of multiples.

Thanks for listening to The Boob Group, your judgment-free breastfeeding resource.

[Disclaimer]
This has been a New Mommy Media production. 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. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor 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 co-branded podcasts, visit NewMommyMedia.com.

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