Picking Bottle Nipples for the Breastfed Baby

With Amy Peterson, IBCLC

This post made possible by the support of EvenFlo Feeding

Brand-Ad_29APR16________________________

Lots of breastfed babies will also use a bottle. Most of us have heard that introducing a bottle can potentially have a negative impact on the breastfeeding relationship. But thankfully, we can control these risks.

Lower risks

Latch:  The way your baby latches on the breast needs to be similar to the bottle. Look at your baby while s/he is feeding at your breast.  Notice how the bottom lip flares, and the top lip rests in a neutral position. Observe how the corners of the mouth seal on the breast, and how milk doesn’t leak from the lips while baby feeds. Pull down baby’s lip slightly and see the baby’s tongue cup or curves around your nipple. We look for these same characteristics when baby sucks on a bottle nipple.

gradual wide leaking bad

Not a good latch: Averted gaze (no eye contact), top lip rolled in, leaking at corners, latched more toward the tip.

wide abrupt good no leak

Decent Latch: Eye contact, flared lips, deep latch near collar of bottle, relaxed posture, no leaking at corners.

 

Flow preference: You want your baby to prefer the flow of your breast over the flow of a bottle. There is no standard flow rate for bottle nipples, so you might have to try more than one bottle to find a similar swallow pattern. Most babies will use a slow flow nipple, but slow flow isn’t best for every baby–match your own flow. For detailed information, Balancing Breast and Bottle lists bottle flow rates in Appendix C.

Milk supply:  Anytime the baby takes 2 ounces from the bottle, ideally you will be able to pump this amount so your body knows how much your baby is taking and can maintain your supply. But don’t worry if you don’t pump exactly what your baby eats every time, baby is likely more effective at removing milk from your breast than a pump will be. Adding a pumping session may be necessary to ensure you’re producing the amount needed for your child’s bottle feed.

 

breastfeeding and bottle feeding

Good latch: Eye contact, flared top and bottom lips, no leaking, medium depth latch, relaxed posture.

 

Reduce risks by picking a nipple shape

One way to reduce bottle risks is in choosing the nipple shape we use to bottle-feed our baby.

Nipples have three general shapes: narrow, wide-abrupt, and wide-gradual.  

bottle nipple - narrowbottle nipple - wide abruptFullSizeRender

Narrow neck nipples fit narrow neck bottles, and most have a gradual transition from nipple length to base where the baby’s lips can slide easily to latch deeply.

Wide neck nipples fit wide neck bottles.  Wide, abrupt shapes have an abrupt transition (like a 90 degree angle) between the nipple length and nipple base. Make sure your baby is able to rest their lips opened widely on the nipple base, not suck on the nipple length like a straw. Also, make sure your baby is able to fully seal the lips without gaps in the corners of the mouth.

Wide, gradual shapes gradually blend from the nipple length to the base. This shape may help the baby’s lips to rest on a portion of the base, and help the lips to form a complete seal. Make sure your baby is able to keep the nipple inserted deeply during feeding, rather than sliding down to the tip of the nipple.

 

Best does not exist

Different bottle nipple shapes work for different babies. One bottle will not be best for all babies, but you can find which bottle is best for your baby.  Therefore, beware of marketing and packaging claims. You’ve probably noticed many bottles claim to be best for breastfed babies, or to look just like the breast. But neither of these statements matters. How your baby latches onto the bottle nipple matters, not the packaging claims. You have found the right nipple when the nipple tip reaches deeply into the baby’s mouth; tongue cups the nipple; lips open widely and rest on a portion of the base; lips form a complete seal.

Additionally, now that you know that one bottle will not be best for every baby, don’t be swayed when you hear which bottle is “best” from other moms; what’s best for their baby might be terrible for your baby. You will need to look at your baby’s latch and then decide.

Picking bottle nipples - evenflo cobranded

Buying bottles

If you are having trouble finding a bottle your baby accepts, make sure you have tried all three types: narrow, wide-abrupt, and wide-gradual.  A lot of moms tend to buy various bottles marketed for breastfed babies, and then end up with a bunch of wide-abrupt shapes. Make sure you try the other shapes.

Chances are you will own more than one type of bottle, either bottles you have experimented with, or baby shower gifts that your baby can’t achieve a good latch with. Don’t despair.  As your baby grows, the mouth grows as well.  Nipples that do not work for young babies often work well when the baby’s mouth is bigger, say 4 months or so. Feel free to try the other nipples you have when your baby is older, and check the latch again.

________________________

Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.
Share

Nipple Pain in Breastfeeding

By Jessica Martin-Weber

This post is generously made possible by Bamboobies

bamboobies banner - 2016

All kinds of advice and myths abound when it comes to breastfeeding and preparing nipples for the experience or what to do when there is pain. Dire warnings and emphasis on getting a “good latch” can make it seem as though it is tricky, inevitably painful, and consuming. (Do you need to worry about your baby’s latch? See here for more on what to look for in a good latch and what to do if it is causing problems.)

But there’s good news! While some do experience nipple pain, many do not and for those that have pain, there is usually an answer and steps that can help resolve the underlying cause. Breastfeeding shouldn’t hurt but that doesn’t mean it won’t and it doesn’t mean that if it does it is your fault or that you did something wrong. Seeing a professional breastfeeding helper such as an IBCLC (International Board Certified Lactation Consultant) may help identify the cause of the pain and find a resolution that will help you reach your breastfeeding goals.

Here are a few points on nipple pain in breastfeeding and tips for how to handle such pain. It is our hope that nobody goes through pain in feeding their babies but if you do, most of the time it doesn’t have to stay that way.

bamboobies nipple pain

Is it serious? Figure out if this is the type of pain that indicates an issue or is within the range of normal sensitivity with initial latch. If it lasts for 30 seconds or so and doesn’t bother you when you’re not breastfeeding or pumping then it is possible it isn’t serious and just an adjustment period while your nipples are a little sensitive. If it is toe-curling, swear-worthy pain that makes you hold your breath and try not to scream obscenities or toss your baby far, far away from you, then it is serious and you need to be seen by an expert professional breastfeeding helper. Any tissue damage, cracking, bleeding, scabbing, inflammation, bloody expressed milk, etc., will require proactive treatment and you need to see a health care provider. Keep in mind that if your pain tolerance is high, you may push through pain that is a warning sign that something is wrong, don’t wait too long to get help from a breastfeeding helper such as an IBCLC.

What is the cause? It could be a number of causes from baby’s physiology such as a high palate or tongue-tie (frenulum restriction) to your anatomy such as flat or inverted nipples, bifurcated nipples, or Raynaud’s syndrome (vasospasms), or from a pathology such as a bacterial infection or yeast overgrowth, to a damaging latch. Unfortunately sometimes the case is baby just needs to grow more and it will take time but there may be ways to improve things until that time comes and a breastfeeding helper should be able to help you with that.

What’s the treatment? Working with an experienced breastfeeding helper, once the cause is determined, the first step is to address the underlying cause. This may mean changing positioning and learning latch techniques (such as this “Flipple” technique for latching), a prescription to treat thrush or a bacterial infection, using a device to pull flat or inverted nipples out, a procedure to correct frenulum restriction, therapeutic suck training, and a number of other possibilities. We should start with the easiest to implement first, such as positioning and latch but an early diagnosis can mean resolving the underlying cause for the nipple pain quickly and getting back to reaching those breastfeeding goals.

How to heal? Pain, particularly pain that was ongoing for a while, usually means some tissue damage that’s going to need to heal and until it does, the pain will continue. Treating the underlying cause of the pain is essential for complete healing but there are ways to encourage healing even as the cause is addressed.

bamboobies nipple pain 2

Air drying is important for healing, as much as possible, allow your nipples to air dry before closing up your bra. Air is healing and having the area dry prevents bacteria and yeast from growing in a dark, damp environment. Additionally, rinsing them several times a day (not after each feeding but frequently) can also reduce possible irritation from baby’s saliva.

A good nipple cream, one that is plant based, breathable, and safe enough to leave on during breastfeeding can not only help with healing but can prevent chapping in the early days of breastfeeding as a preventative measure. Wiping off an ointment from sensitive and damaged tissue is painful and can cause further injury so picking one that is safe for baby to ingest in tiny amounts is ideal. Apply after every feeding after allowing the area to dry and pick nursing pads that won’t stick to damaged tissue and your nipple cream.

Your own breastmilk may help your nipples heal. Breastmilk is full of good things that can expedite healing, including stem cells! Be careful though, the sugars in breastmilk will feed a yeast overgrowth, making thrush worse.

Air and sunlight may help nipples healing from thrush as yeast thrives best in dark, damp areas. Make the environment hostile for yeast by exposing your nipples to sunlight and taking a probiotic and cutting out refined sugar.

Heat or cold packs can provide comforting relief, it’s personal, some will love these and others will find them uncomfortable for addressing nipple pain. For those with Raynaud’s Syndrome there is no cure or way to permanently resolve the problem but a heat pack like this one may help minimize the symptoms, apply immediately after feeding.

Cold shredded carrots in the bra (will stain!) promotes healing and is soothing. After breastfeeding or pumping, put shredded carrots stored in the refrigerator in your bra (if you don’t mind your nursing pad turning orange, they can help hold the carrots in place).

Protect the nipples with a nipple shield may be necessary. Nipple shields should be used with caution and hopefully with the guidance of an experienced breastfeeding helper such as an IBCLC because there is a risk of lowering milk supply with using a breast shield (not everyone experiences this, just a factor to be aware is a possibility), but they can be a good option for some to help with tissue healing for a short time.

Take a break if you need to. Sometimes damaged tissue just can’t heal until it has the chance to rest. Regularly empty your breast to protect your supply and have breastmilk for your baby, be sure that you’re using the proper flange size so as not to potentially cause more damage.

________________________

What are your tips for preventing and healing nipple pain and tissue damage?

Share with us in the comments, together we can support each other in reaching our baby feeding goals.

________________________

JMW headshot

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.
Share

How Lubrication Can Improve Breastmilk Pumping

by Kristine Phillips Keller

This post made possible by the support of Ameda

Ameda banner

________________________

I learned the answer to this question the hard way with my oldest son. I was not much of a reader but breastfed because both of my sisters did the breastfeeding thing. If they could do it, so could I. However, in hindsight, I pretty much did everything wrong that I could have done. I wanted a nursery (I needed sleep, right?), I wanted pacifiers (he can’t just suck on me or I won’t get any sleep) and I wanted bottles (dads need to help too, right?). I thought, surely I can make all of this work. Boy was I wrong!

Not only did I go into it uneducated, I also have flat nipples. I honestly thought they were broken as they never became fully erect prior to years of nursing/pumping. I also have really naturally dry skin. Early on, I had damage but didn’t realize how bad it was until it was visible, right at Stage III damage (which means skin is literally gone). I was in such pain that I would cry when my boys would cry because I knew what was coming. I would fear nursing them because of the toe curling pain that it took to get them latched on. For the most part, after a minute or two it became bearable. Other times, the entire feeding was excruciatingly painful for me.

At six weeks with my first, I gave into pumping full time. I asked for help from family repeatedly to try and figure out what I was doing wrong and what I could do to correct the latch. No one seemed to be able to offer me the advice that I needed to make direct breastfeeding work and I just didn’t have it in me to bear that kind of pain any more. However, I still wanted to give them my milk…so I continued on with pumping & still continued to have cracked, bloody nipples until a good 10-11 months of pumping.

Around that same time, I was talking with my sister about all of the bloody milk that I was dumping because, even though I was no longer nursing, I still had pretty bad damage on both of my nipples. I just thought that’s how it was going to be for me. She then asked me if I was lubricating before I pumped. My response to her was, “Isn’t that what you do when you have sex?” She laughed & then said yes but that the pump shields were dry. Babies have moisture in their mouth for lubrication but there is no moisture on the pump shield prior to pumping.

I mean, would you ever expect to drive a car with NO lubrication and have things go well? ABSOLUTELY NOT! There must be lubrication to prevent friction… and to prevent damage. After all, isn’t that what our healthcare is supposed to be about these days, preventative care? Well, let me tell you…the difference was night and day. I went from having constantly damaged, bloody nipples to pain free/damage free nipples overnight. It was such a relief to know that there was something I could do to prevent this pain and discomfort.

IMG_1735

I started working for WIC 2.5 years ago as a peer counselor and have since applied theory to moms that come to me with damaged or sore nipples. If you lubricate before you latch, you lessen the probability of damage happening from the initial suck (regardless of whether it’s baby or the pump). That lubrication gives both something to slide against instead of that reverse pressure working against dry skin.

I’ve asked numerous breastfeeding professionals and no one seemed to know of any literature that puts emphasis on “lubricating BEFORE nursing or BEFORE pumping”. The only reference that I’ve seen is to use breast milk on sore nipples AFTER nursing. If it works after, why not try it before?

Lubricant suggestions: (you may need to try a few different ones to decide which is most comfortable for you.)

  • Your breastmilk
  • Nipple cream/ointment (suggest vegan and edible, rather than animal based)
  • Coconut oil
  • Olive oil
  • Almond oil
  • Infant massage oil
  • Avoid synthetics such as traditional baby oil

Some moms have found that regularly lubricating their breasts and pump horns before pumping greatly reduces the amount of discomfort they experience which in turn helps them let down easier and respond better to the pump.  There’s no need for pumping to be a painful or uncomfortable experience, experiment with different lubricant options to find what works best for you.  I hope this simple tip helps you in your breastfeeding and pumping journey as it has helped me.  How about we pass along this little known tip and prevent the damage in the first place?

________________________

What pumping tips do you have to share to help other moms?

________________________

Kristine Thanks to her sister, Kristine breastfed/exclusively pumped for her two boys now 3.5 and 8 years old, she pretty much did everything wrong when it came to breastfeeding but managed to get the pumping thing right (after a while).  After experiencing discrimination she contacted WIC about becoming a breastfeeding peer counselor and begin training to become an IBCLC. She sits for the IBCLC exam this summer and looks forward to continuing to help mothers reach their breastfeeding goals.
Share

Weaning Off Formula back to Exclusively Breastfeeding

by Shari Criso MSN, RC, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

Brand-Ad_29APR16

________________________

________________________

“Supplementation with formula does not have to be the end of breastfeeding and it may be very possible to transition to exclusively breastfeeding if that is your goal.”

First of all Amy, great job at making it to the 8 week mark! It is a big deal and something to be very proud of. From your questions it is clear that you’re just about exclusively breastfeeding but now we need to help you over that last hump.

What I tell all my clients is that if all you’re supplementing is 1-2 feedings per day of formula and breastfeeding the rest of the time, then in most cases you probably don’t need to do any at all! It is obvious that your body is quite capable of producing adequate amounts of breastmilk, however the continued supplementation will not give your body the opportunity to catch up. What you need to do is feed a little more frequently so that your body can kick inn and start to make more.

If all you’re doing is one or two supplemented feedings a days and your baby is gaining weight adequately, I would immediately start cutting out formula supplementation and begin to encourage your body to make more milk. Those few ounces that you have been supplementing can usually be made of with more frequent feeding or were not really necessary anyway, as many supplemented babies are over fed and encouraged to gain weight faster than they need to.

Typically, it is when I see moms that have been supplementing for weeks and weeks with very little breastfeeding that I am more concerned about the status of their milk supply and the need to build that up slowly by cutting back formula supplement slowly over time with careful evaluation throughout.

However, for you Amy, what I would recommend is to stop the supplementation, increase the frequency of your feedings, allow your baby to stay on the breast longer, drain the breast completely by switching sides multiple times during a feeding (feed both sides and then return to the first side again), do lots of skin to skin and wear your baby as much as you can, and basically let the baby guide you right now.

As for how hungry he is, treat it as a growth spurt. In my online breastfeeding program “Simply Breastfeeding,” I have an entire chapter on growth spurts and what to do when your breastfed baby is going through one. These are times during the breastfeeding journey when you actually are not making enough and it is very NORMAL! These are times when you baby is growing and your body is attempting to catch up with your baby’s needs for more milk. The only way that it can do that is to respond to your baby’s signal of hunger, which is what happens when they start feeding very frequently. During these times, allowing your baby to nurse as long as they want and as often as they want for a few days is the answer. With frequent and “on demand” feedings, your body will kick in very quickly and start to get the message, “Oh…MAKE MORE MILK!”

transitioningbacktobreastfeeding_ig_12dec16

Regardless of the reason in the beginning or whether the initial supplementation may or may not have been necessary, it does not mean that you need to continue doing it indefinitely. For most mothers it is a lack of understanding about how much their baby’s need to be eating, how much and how fast they need to be gaining, and how the body responds and makes more milk that causes them to continue to supplement unnecessarily and eventually add more formula which further decreases their breast milk supply. What may start off as a true need under certain circumstances is then replaced with an issue that has been unknowingly created and unnecessarily continued.

Another important thing to understand is that babies should not be weighed weekly. This is huge! When moms and dads ask me, “How much should a baby be gaining every week?” The answer I give is somewhere between 4-8 ounces per week on average. The key point here being, ON AVERAGE. That means, under normal circumstances you are not bringing your baby in every single week to weighed. This is because one week you may only have a weight gain of 2 ounces and you are going to think something is wrong. Then the next week your baby is going to gain 10 ounces cause they had a growth spurt. This is why weighing your baby every week and monitoring so closely can cause you to think your baby is not growing appropriately and cause unnecessary supplementation.

The best way to monitor that your baby is doing well is to keep watching for those wet and poopy diapers, looking out for all the signs that I talk about in my DVD program on how to make sure your baby is getting enough milk, and weighing your baby monthly.

So after a month’s time you’ll go back to weigh the baby, you divide that gain by four weeks, and now you can say to yourself, “Okay, did they gain somewhere between 4-8 ounces a week on average?” If the answer is yes then you’re pretty much in the right spot. Babies grow at their own pace and we cannot be too rigid with this. Breastmilk is just too important to sacrifice that quickly. Just as a baby that truly needs to be supplemented must be addressed and few for their well being, your breastmilk supply and breastfeeding relationship is critical to their short and long term health and must also be protected and supported appropriately.

I recommend that you go back and watch my program and pay particular attention to the chapter on growth spurts. Work with your pediatrician and treat this time just like you would a normal growth spurt. With the right support, patience and understanding of what is normal, I believe you will be on your way to exclusively breastfeeding your little one in no time!

________________________

Find more from Shari supporting your parenting journey including infant feeding on Facebook, or her classes at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

____________________

Shari Criso 2016

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
Share

Seven Points To Know About Breastmilk Supply Issues

By Jessica Martin-Weber

This post is generously made possible by Bamboobies

bamboobies banner - 2016

For the most part, if you decide to breastfeed, the experience will be: have boobs, feed baby. A process that has worked long enough to get us to this point in civilization, as mammals, generally speaking we will produce enough milk for our young. If everything is working normally, our breasts are going to make the milk our babies need. Lactating after giving birth is, for our species, normal, like breathing.

Which is well and good. But for as normal as it all may be sometimes there are issues with breathing and sometimes there are issues with lactation. Sometimes those issues are related to milk supply.

Before you worry about it or before you tell someone else to worry about it or not to worry about it, there are a few things that may be helpful to know. This is all just the tip of the iceberg, we’ll have more on this topic in the future but for now this is just a quick overview of breastmilk supply issues and not intended to be health care or replace medical care. If you are experiencing any problems with your supply, please see your healthcare provider and an experienced, professional skilled breastfeeding helper.

bamboobies-milk-supply-image-11-2016

1. Supply issues are real. Though biologically speaking it is normal to produce milk for our young, the fact is some will experience issues with supply. While they aren’t as common as it may seem, supply issues aren’t made up, they really do happen. Dismissing the concerns about supply can actually cause more supply problems as it may lead to feelings of isolation, failure, pain, grief, anger, and depression. If someone is concerned about their breastmilk supply, getting help is the right thing to do. They may discover that there is no evidence of supply issues and they can let go of their worry or they may find there is in fact a problem and take steps to address it to adequately care for their child(ren).

2. There is more than one type of supply issue. Often when talking about supply issues people assume it is low supply or not producing enough milk. Low supply is indeed a very concerning issue but it isn’t the only supply issue that may be experienced. Pumping supply, oversupply, and temporary supply issues (ovulation/period, illness, pregnancy, separation, etc.) are other supply issues that may present challenges for breastfeeding families. From poor weight gain to recurring mastitis to not reaching breastfeeding goals, the effects of supply issues cover a wide range and all of them matter.

3. Don’t borrow supply issue trouble. Yes, supply issues are real but before stressing about or trying to fix a supply issue, it is important to know if there is one (see related: Help, My Milk Supply Is Low, Or Is It?). This can be difficult to do if we don’t understand normal human lactation or normal baby behavior. For example, if you heard that I was pumping up to 24 ounce every pumping session at one point and you pumped 1-4 ounces in a session, you may think you have low supply (tip: this wouldn’t mean you have low supply- this means I had oversupply, one I manufactured to pump enough to skim the fat off to feed my very sick baby with two holes in her heart). Or if you found that your baby was extremely fussy and wanting to breastfeed every 30 minutes suddenly and you didn’t know what cluster feeding was and that it was common for babies to increase their feeding sessions during times of rapid growth, you may fear that your breasts suddenly weren’t making enough milk. Understanding the range of normal in human lactation is crucial!

4. There are multiple reasons for supply issues. Physiologically speaking, most breasts should have everything necessary to make plenty of milk (statistically less than 2% of breasts are equipped for adequate milk production) though there are some theories that this number is increasing. But a lack of milk making tissue isn’t the only cause of low supply. Other reasons for low supply include, but are not limited to, fluids in labor, tongue tie (frenulum restriction), high palate, hormone imbalance, diabetes, gut health, scheduled feedings, retained placenta, excessive pumping, ineffective sucking, health issues, some medication, early sleeping through the night, and the list goes on.

bamboobies-milk-supply-cobranded-11-2016

5. Supply issues can create other issues. Yes, even perceived supply issues can create other issues. Confirmed supply issues even more so. Postpartum depression, anxiety, mastitis, gas, poor weight gain, breast tissue damage, unwanted and unnecessary supplementing, early weaning from the breast, etc. Those encountering issues with supply need more support and care on both a social level and from health care professionals.

6. Supply issues aren’t all doom and gloom. For starters, it doesn’t have to be all or nothing when it comes to feeding our babies. There are ways to address supply issues including methods to boost supply, supplement at the breast, train baby to suck more effectively, and reducing oversupply. Identifying the type of supply issue, the cause, and then the most effective methods for improving the supply issue (i.e. skin-to-skin helps low supply, decreasing pumping duration and frequency helps oversupply, hands-on-breast compressions and proper flange sizes can help pumping low supply, and magnesium can help temporary low supply caused by fertility cycles) along with supplementing techniques to encourage breastfeeding (i.e. paced feeding and at the breast supplementing) may all work together to turn things around.

7. There is support for supply issues. I often hear from breastfeeders with supply issues that they feel broken and alone. Supply issues can directly impact a parent’s confidence, causing them to question their competency in parenting when the most elemental aspect of parenting, feeding the child, is so difficult and overwhelming for them. While it can feel lonely when you’re dealing with supply issues, we don’t have to be alone. From social media groups to in person breastfeeding support groups to specialized breastfeeding helpers in the healthcare field, there is support for those experiencing supply issues. Working with a breastfeeding helper such as an IBCLC may help resolve the issue more quickly.

________________________

Jessica Martin-Weber

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.

Share

Everything You Need To Know About Postpartum Bleeding And Periods After Childbirth

by Dr. Kymberlee Lake

lunapads-logo

 

Most women know that there may be some bleeding after giving birth but often women are surprised by how much and how long and they aren’t aware of the difference between postpartum bleeding and discharge and menstruation. The first bleeding after you give birth is called lochia.

What exactly is lochia? 

Lochia is the discharge consists of blood from the area on the uterine wall to which the placenta was attached during pregnancy, the sloughed off endometrium (uterine lining which makes a bed for the fetus) which gets considerably thickened during pregnancy, blood and mucus from the healing cervix,  and dead (necrotic) tissue. Your blood volume increases by approximately 50% in pregnancy, all that extra blood also has to go somewhere after birth. Most women will experience blood and lochia discharge for 3- 6 weeks though that time span can very from pregnancy to pregnancy and can be directly influenced by a healing mother’s activity level.

Why do we have lochia and where does it come from?

The blood in the lochia comes mainly from the large raw area left in the uterine wall after the placenta detaches from it. While bleeding from this area is controlled by contraction of the uterine muscles immediately after delivery, it takes on the average about two weeks for this area to heal. It is important to remember that this is a wound and it is possible to do too much before it has healed and reopen the wound, causing fresh bleeding. You will experience this bleeding for around four to six weeks postpartum.
Stages of lochia postpartum bleeding lunapads reusable menstrual pads
For the first few days it will be a heavy flow (kind of like a heavy period) and will be  colored dark red, with some clotting.  About the end of the first week the flow should start to taper off, becoming lighter in saturation and color; as time passes, it will fade to a brown, yellowish or even almost-white discharge. 

One thing to remember is that the placental area as well as the sites of sloughing endometrium are raw and open during this time and bacteria can easily spread from the vagina. So, the use of tampons should be avoided – sanitary pads are the best options to be used during this time. 

What is normal and when should I be concerned?

You might notice a ‘gush’ of blood with clotting when you stand up – this is very normal. Also, if you’re breastfeeding, you might notice that you lose more blood after feeding baby; this is caused by your hormones doing their work to help shrink your uterus back to it’s pre pregnancy size. The lochia is sterile for the first 2-3 days but then becomes colonised by bacteria giving off a typical distinct lochial smell which is normal and should not be confused with the bad odor from lochia in postpartum infection.

If the discharge smells foul, you’re still noticing a lot of blood loss after the first four weeks, or the blood is bright red, these are signs of infection and you should speak to your health care provider as soon as you can. This is especially true if you also have a fever (no matter how slight)  or are generally feel ill. Likewise, if your blood loss is so heavy that you’re going through more than a pad an hour, you should get medical help immediately – this can be a sign of a hemorrhage. If in question and something feels “off” it is worth a call to your health care provider for advice.

Types of Lochia

Depending on the color and consistency, lochia can be of three types:

  • Lochia Rubra: Lochia rubra occurs in the first 3-4 days after delivery. It is reddish in color – hence the term ‘rubra’. It is made up of mainly blood, bits of fetal membranes, decidua, meconium, and cervical discharge.
  • Lochia Serosa: The lochia rubra gradually changes color to brown and then yellow over a period of about a week. It is called lochia serosa at this stage. The lochia serosa contains less red blood cells but more white blood cells, wound discharge from the placental and other sites, and mucus from the cervix.
  • Lochia Alba: The lochia alba is a whitish, turbid fluid which drains from the vagina for about another 1 – 2 weeks. It mainly consists of decidual cells, mucus, white blood cells, and epithelial cells.

Do women who give birth by c-section still have lochia?

Many women believe that the flow of lochia is less after a cesarean section since the uterine cavity is cleaned out after the birth of the baby. This is not true. The flow of lochia is not dependent on the type of delivery –  The amount and duration is the same in both cases.

Return of Menses

There’s no hard rule as to when your period will return post-baby – it can vary from woman to woman, and pregnancy to pregnancy. Here are some general guidelines:

  • Women who bottle-feed can see their menstrual cycle return within six weeks of birth – and most will have menses back by ten to twelve weeks.
  • Women who exclusively breastfeed may not get their period back for some time. When you breastfeed, you body releases the milk-producing hormone prolactin, which, in turn, keeps our levels of progesterone and estrogen low. Progesterone and estrogen are the hormones responsible for signaling ovulation and menstruation. Night nursing directly effects these levels, a decrease in breastfeeding at night may lead to a return of menses.

Cloth pad for postpartum bleeding
Once your period returns, it can take even longer for it to get into a regular cycle. If you are bottle feeding it can take around six months, while exclusively breastfeeding your baby can take 12-18 months. But keep in mind that this does vary from mom to mom and pregnancy to pregnancy. Even with exclusive breastfeeding on demand and no artificial nipples, there are women who see a return of their menses as early as 6 weeks while others may not breastfeed and still experience a considerable delay. Each woman is different. Some women experience lighter flows and/or less cramping with their menses after having a baby, others experience the same, and still others may experience an increase. The range of normal variations is considerable but very heavy bleeding, soaking a full size pad in 1-2 hours, may indicate a problem and should be addressed with your health care provider. There are a variety of factors that contribute to possible changes with the return of your period but keep in mind that diet, physical activity, and your menstrual products can all contribute to cramps and duration.

____________________

Please be aware that your first egg (ovulation) will be released two weeks before your period starts, so if you have unprotected sex without realizing that you are ovulating, you could get pregnant before you have even began menses again. It’s a good idea to speak to your healthcare provider about contraception even before you start thinking about sex again, so you can be confident in your choice ahead of time.

____________________

cloth pads for periods and postpartum bleeding
Kymberlee Lake- headshot

Kymberlee is a Physician/midwife, Therapeutic foster/adoptive parent with 6 kids ranging in age from 31 to 3 and three grandchildren. She is living life to the full with MS in the Pacific NorthWET.  As an international travel enthusiast and fan of teleportation you can find her under the name “Dr_Kymberlee” live streaming and on social media, or on her often neglected blog, TheMamaMidwife.com
Share

Pumping Breastmilk and What You Need To Know

By Amy Peterson, IBCLC

This article made possible by the generous support of Earth Mama Angel Baby.

earth-mama-angel-baby-2016

Not every mom needs to pump. When baby is with mom for feedings and transferring milk effectively, there is no need to pump. But there are times when pumping breastmilk is important:

  •      Baby needs more milk (a supplement for one or more feeds)
  •      Mom wants to increase her supply
  •      Mom and baby are apart for feedings, such as when mom is at work or school
  •      Mom wants to have someone else participate in feedings
  •      Anytime mom will miss a feeding

In these circumstances, using a breast pump helps maintain or increase the milk supply for future feedings, and the pumped milk offers the perfect food for baby. This article touches on choosing between the different types of breast pumps, general pumping guidelines, and tips for increasing milk supply if necessary.

When possible, choose a pump that meets your unique situation. If you’ll only miss a feed or two each week, a manual pump or single electric is plenty. If you need to pump for several feedings a day, a high quality, double electric pump is a better choice.  If your baby is hospitalized or you need to dedicate time to increasing your supply, a hospital grade/rental pump is the best choice.

You can get a breast pump from many different places: box stores (Babies ‘R Us, Target, WalMart, etc.), online, a friend, thrift store, or possibly through your insurance company. Buying a used breast pump or borrowing a pump is usually not recommended. Most brands are considered single user items. These pumps do not control for the transfer of bacteria or germs between the pump motor and the milk, putting the baby’s health at risk. If you know the pump brand has a closed system, you could consider purchasing a new collection kit with tubing. Even so, you may not know if the pump is working less effectively than when purchased new, potentially putting your supply at risk.

earth-mama-angel-baby-2016-2

It is also important to note that not all women respond well to pumps and not all pumps work equally well for every lactating individual. This is why we have options. There are various contributing aspects that may impact how well a pump performs such as flange size, suction strength, type of suction, etc. If a pump is not working well for you it is possible that another would. Some breasts prefer one pump over another and some breasts prefer manual expression.

Most breast pumps have two settings. One button controls the vacuum, and the other button controls how fast the pump cycles (sucks). These settings let you fine tune the pump to mimic your baby’s suction and rhythm. For maximum milk production, use the highest comfortable suction. Use a fast cycling rate until your milk flows, then adjust to your comfort level; this mimics how your baby sucks before and after a let-down. A few brands of breast pumps have a built in feature that begins with fast cycling and adjusts slower. Some moms find they have better milk flow when they reset the button and continue with fast cycling.

Here are some general pumping guidelines to get you started:

  •      Pump for any feeding you will miss. Your milk supply is based on supply and demand, and pumping for each missed feeding tells your body to keep producing milk during that time.
  •      Pump the amount of milk your baby needs.  For example, if your baby takes 3 ounces of milk, pump 3 ounces total (1 ½ ounces from each breast).  If you pump what you need in 4 minutes—you can stop pumping.
  •      Pump between feedings to build a bottle. You can combine the milk from several pumping sessions to make a larger bottle of milk.
  •      Pump at night or in the early morning hours when your supply is highest.
  •      A gentle breast massage routine, called hands-on pumping, has been proven effective in increasing the amount of milk a mom can pump. Check it out here.

For moms who are not able to pump enough milk and who want to increase their supply, there are additional pumping tips:

  •      Pump until your milk stops flowing, and then pump two more minutes. This limited extra pumping is enough to tell your breasts to make more.
  •      Pump more often. Leave your pump set up (where your toddler can’t reach it!). Pump for 5-10 minutes once or twice an hour.
  •      Use the hands-on pumping technique listed here and above.
  •      Know that pumping alone may not increase your milk supply. Work with a breastfeeding helper who is knowledgeable about other targeted methods to boost supply.
  •      While you work on increasing your milk supply, feed your baby. You can combine your breastmilk with donor milk or formula to be sure your baby is getting enough. Some moms choose to feed breastmilk separate from formula to avoid wasting any breastmilk if baby doesn’t finish the bottle. As long as your guestimate is cautious, it is safe to mix; the milks will mix in baby’s belly anyway.

While pumping is an important aspect for many families in reaching their breastfeeding goals, how much is pumped is not a reliable sign of milk production. As with most areas of parenting, take your cues from your baby. When baby is growing well and reaching milestones within range then how much you pump doesn’t need to be a concern. If you see signs of dehydration or poor weight gain, speak with your child’s healthcare provider.

________________________

earth-mama-angel-baby-nov-2016

Happy pumping mamas! You’ve totally got this and we’ve teamed up with Earth Mama Angel Baby to support you in your pumping journey with a giveaway of Earth Mama Angel Baby’s Milk-to-Go kit for Leakies in the USA. A $40 retail value, this kit includes:

One pair of Booby Tubes® (one pair) for cold or warm therapeutic use, 1 box of Organic Milkmaid Tea (16 tea bags) a fragrant comforting blend that supports healthy breast milk production, safe Natural Nipple Butter (1 fl. oz.), Happy Mama Body Wash (1.67 fl. oz.), one Eco-friendly Reusable Insulated Bag, and a tasty recipe for Organic Milkmaid French Vanilla Chai.

Use the widget below to be entered!

________________________

a Rafflecopter giveaway

Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.

 

 

Share

Clicking Sound While Nursing

by Shari Criso MSN, RC, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

Brand-Ad_29APR16

________________________

________________________

clicking-sounds-ask-the-expert-cobranded

 

Question:

From time to time while my baby is nursing, I hear a clicking sound. I try to take her off and re-latch her, but she gets really mad and doesn’t like to be interrupted… what could be causing this?

Answer:

I can’t blame your baby for being mad- who likes to be interrupted when they are eating?

As for the clicking issue… here is my definition of the perfect latch when breastfeeding: the one that doesn’t hurt and the baby gets milk. That’s the perfect latch. So, if your baby is clicking but the baby is not hurting you and seems satisfied, and your nipple come out looking normal and there’s no damage being done, I’d say to either try holding the baby a little closer while nursing, or don’t worry about it. Sometimes, that clicking sound comes from an oversupply, when you have a lot of milk. The baby keeps unlatching because it’s hard to latch when the nipple is so wet. So that’s probably what you’re listening to. But if you’re not in pain, and the baby’s latching, don’t disturb the baby – let her eat!

 

clicking-sounds-2-ask-the-expert-cobranded

____________________

Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

____________________

Shari Criso 2016

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
Share

Ask The IBCLC- Migraines, Blebs, and Teething

by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

Brand-Ad_29APR16

________________________

 

migraines-ask-the-expert-cobranded

 

Dear Shari,

Help! I’m 8 weeks postpartum with my third child. It was also my third C-section and the third time I’m breastfeeding exclusively. I’ve been having dizzying migraines that sometimes blur my vision, make my ears ring, and make my head feel like it’s in a fog. My OB recommended an excedrin migraine or a little caffeine. That doesn’t often help and I don’t want to take an excedrin or two daily. I’ve gotten the depo shot two weeks ago, and the migraines are still unrelenting. Is it hormones like everyone says? Is there something I can do to help control them or relieve them?

Dizzy Mama

 

Hi Dizzy Mama,

I am sorry to hear that you are suffering so much at a time when your full focus should be on caring for and enjoying your new little one!  As someone who has migraines myself and cared for many women who have also experienced this debilitating condition, I truly feel your pain.  It is not an uncommon occurrence affecting up to 17% of women of childbearing age.  Migraines tend to get better during pregnancy, due to the high estrogen levels.  Although this is not always the case.  Non-pharmacological treatments should be the first choice when treating anything whether you are pregnant or breastfeeding and can be quite effective. Keeping a “headache diary” can help to identify triggers and make lifestyle changes that will work. Unfortunately, some of the things that do trigger migraines are the norm for any new mom such as not eating regular meals or getting good sleep, however knowing this you can make an effort to take care of yourself as well as your baby.  Something that we as moms can forget quickly!  Caffeine can make a big difference in the effectiveness of migraine treatments and is generally safe to use in moderation and as long as it is not affecting the baby.  Excedrin is actually NOT a drug that I would recommend since it contains Aspirin which is transferred into breastmilk.  The baby receives about 4-8% of the mother’s dose.  Breastfeeding women are advised not to use aspirin because of the risk of Reye’s Syndrome in their babies.  As for what prescription medication to take, Imitrex is generally considered safe for breastfeeding as the infant will only receive about 1% of the maternal dose and it is cleared quickly out of the milk.  No short-term problems or long-term developmental issues have been documented in breastfeeding infants exposed to these drugs.  Of course you will need to consult your doctor about this or any other medication, as well as to obtain the prescription.  If your OB is uncomfortable due to lack of experience or knowledge, maybe it is worth seeking a second opinion.  I hope this helps and that you have some relief quickly!

________________________

 

Dear Shari,

My daughter is 16 months old now. Lately my nipples feel so sensitive and sore and I’m not sure why. I think she may be teething, cutting her molars now, could that be causing this pain? What can I do about it? My plan was to let her self-wean but right now I wish we were done. I don’t want to give up on my goal yet though, how can I get through this and how long will it last?

Feeding a teething baby

 

Dear Feeding,

Congratulations on your great success breastfeeding!  Yes, it is possible that her teething is causing her to clamp down while nursing and causing your nipples to feel sore. If that is what is happening, it is important to pay attention to when she is done “eating” and to remove her off your breast before she has a chance to bite down or rub against your nipple trying to soothe herself.  You can also offer her a cold or frozen washcloth or teething ring to chew on so that she is not using you!  The other thing that I was thinking as I read your question…is to take a pregnancy test   This is actually the very first sign for most pregnant moms!  Nipple pain and soreness all of a sudden after many months of pain free breastfeeding (in the absence of any infection or damage to the nipple) can be the first sign that you are expecting again and it is worth ruling that out first with a pregnancy test.  If the soreness is due to pregnancy, there is not that much that can be done about it since this is hormonal vs. mechanical or technique.  For many nursing moms who become pregnant this is the main reason that they decide to wean their older child, but for others it is not a problem and they can safely continue throughout their pregnancy and beyond to tandem nurse their children. Keep me posted!! xoxo

________________________

 

Dear Shari,

I have a sort of white dot on the tip of my nipple and it is extremely painful when my baby is latched on that breast. It’s been there for a couple of weeks now, it looks sort of like a pimple. I tried squeezing it but that just hurt more and didn’t do anything. My baby is just 7 weeks old and the idea of this pain lasting until we’re done breastfeeding is so discouraging. Help!

Owie Nipple

 

Hello Owie Nipple,

I am glad you wrote in to ask this question because it is a fairly common issue that moms will encounter.  It is called a “milk bleb” or a blockage of milk inside one of the nipple pores where the milk comes out of the nipple.  That is why it is white.  A milk bleb is not serious condition, but can cause serious pain in the nipple especially when trying to nurse or pump.

The best way to approach this is to first not wait to do something about it. Left untreated it can cause your breast to become engorged which can lead to a decrease in your milk production as well as mastitis.  The first thing you can try is to soak your entire breast in a bowl of hot water.  Fill the bowl with water and then lean over it and just soak for 5-10 minutes or longer.  Immediately try to nurse your baby or pump after that.  The water will often soften and loosen the plug and it will be sucked out by the baby!  It is perfectly fine for them to swallow.  You may notice after nursing that it is starting to come out.  If you can you can pull it out, but I would not squeeze your nipple to try and “pop” it.  It is not a pimple and squeezing your nipple can cause more inflammation.  If the soaking and suction does not work you may need medical help from your doctor or midwife who can use a sterile needle to remove it.  This is not something that I would do at home (although I know women who have) due to the risk of injury or infection.  Good luck!

 

milk-blebs-ask-the-expert-cobranded


________________________

Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

________________________

Shari Criso 2016

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
Share

A Heartfelt Latch – What You Need To Know

by Jessica Martin-Weber

This post is generously made possible by Bamboobies

bamboobies banner - 2016
That moment when they’re finally in your arms and you can count fingers and toes and sniff their head and stroke the softest cheek you’ve ever felt in your life, that moment is, whether you can feel it right then or not, when you heart is captured forever. Suddenly everything this little person needs from you, you are ready to do with all your heart. Comfort them, change them, bathe them, sing to them, and feed them, simple yet profound tasks of care are heartfelt acts of love.

No matter how your feeding journey unfolds, there is no doubt that every moment is fueled by love. Even if it is stressful at times. But it does help to know some of what you can expect, how things may unfold, and what you should know going into it. Love may be all you need but love with information and support is just so much more… well, lovely.

There’s a lot of information so we’re just latching onto one little tidbit for now here: the latch.

If you’re breastfeeding or planning to, you’ve probably heard a lot about the importance of a “good latch.” For some, that can create some anxiety about getting that good latch and a sense that doing so can be elusive so we wanted to help break it down a bit with 3 need-to-know tips about a breastfeeding baby’s latch.

heartfelt-latch-bamboobies-2

  1. If it ain’t broke, don’t fix it.

Many of us want manuals for everything, how-to guides so we avoid making mistakes and pursue the elusive perfection. You’ll find all kinds of diagrams, pictures, and descriptions of what constitutes a “good” latch. Step 1, step 2, step 3 and if you follow them exactly, voila! The thing is, that’s very rarely how it works with human beings, not even textbook babies.

It is really very simple: if it’s comfortable and it’s working, it’s a good latch.

If it isn’t comfortable and it isn’t working well, then it may not be a good latch.

Baby has plenty of wet diapers? Gaining weight? Good signs!

Baby has low wet diaper count? Difficulty gaining weight? Hmmm, not so good signs.

Mommy can feel her breasts soften a little with baby at the breast? Nipples doing well? Good signs!

Mommy has pain beyond initial latch through the feed? Nipple damage? Not so good signs.

There is a real possibility that your baby’s latch won’t look like the textbook “good latch”, there may even be clicking (though I’d get that checked out just in case anyway), but if it is working for you both then it’s not a good latch, it’s a great one!

A good latch is one that works for mom and baby!

  1. It’s a team effort.

Mom and baby make a dyad, a new team, and they have to work together. Which can be tricky since you barely know each other. But you also know each other better than anyone else. Working together can seem really complicated but don’t borrow trouble and remember that you’re both equipped to do this.

Given that one of the team hasn’t been around too long, that can get tricky sometimes, especially if there are other obstacles in the way such as jaundice.

What team work looks like in achieving that latch of your dreams:

Mom is in a comfortable position and has brought the baby to her level to her instead of leaning down to the baby.

Baby has wide open mouth.

Baby’s body is facing yours.

Chin will touch the breast, nose will be unobstructed, lips will be flared like a flange around the nipple taking in as much of the areola as possible.

Hold baby securely, a snug, close hold will help.

Pull baby in quickly when mouth is open wide.

If you can relax, try leaning back on some pillow, work together, and remember that first rule, it may all just surprise you.

If your baby is not able to do their part of the teamwork, it is time to seek out the support of a health care professional. Speaking with an IBCLC and your child’s pediatrician to identify the cause and options early can go a long way in getting on track to reach your breastfeeding goals.

heartfelt-latch-bamboobies

  1. If you’re hurting or even just worried, ask for help.

Once upon a time women feeding their babies was visible in our communities and while we’re shifting that way now thanks to the global village of the internet, we still don’t really see it regularly and not all that up close and personal. This has led to us entering our baby care days without much of an idea of what’s normal and even when to ask for help. In fact, it can be easy to start thinking we shouldn’t ever ask for help.

Can you imagine telling your child some day that their nipples may be in agony but they shouldn’t ask for help? Of course not! That would be cruel.

Thankfully, between the internet, hopefully some in-real-life friends, and health care providers, more and more we have resources to help us find our way. Ask in forums, watch videos (this “flipple technique” is helpful for correcting some common latch problems), and read resources (like this one and this other one).

If you’re experiencing anything more than an initial twinge of pain with breastfeeding your baby it may be a sign that something is wrong. Not that you’re doing something wrong or have somehow failed, but rather pain can be a common sign of a problem that with support may be able to be corrected. (There are some conditions that will lead to regular pain in breastfeeding such as Raynaud’s phenomenon.)  It is possible that a painful latch, a baby with too few wet or soiled diapers, low weight gain for baby, stabbing or burning feeling in the breast, or a fussy baby at the breast in combination with any of these issues could be an indicator that there is some problem to address. From tongue and/or lip tie to high palate to jaundice to any number of reasons that a mom and baby dyad would be experiencing difficulty, seeing an IBCLC (International Board Certified Lactation Consultant) can help bring things together and set you and your team mate well on your way to reaching your breastfeeding goals.

And then you can get back to doing what you do best, holding them close to your heart and loving them completely.

_____________

What helped you get a good latch?

Leave a comment below! We’d love to hear how you figured out what was best for you and your baby.

_____________

Jessica Martin-Weber

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.
Share