All Things Breastfeeding Podcast

So sorry for the delays in podcasts! COVID has done a real number on me and I have been struggling to get tasks done that are not critical. Jessica and I are committed to recording and releasing more often! Thank you for your patience. Barbara

Back in May 2022 I got this email: “I don’t expect you to remember, but 2 years ago we corresponded about writing a clinical perspective essay for Clinical Lactation about Exclusive Pumping and lessons I gained as an IBCLC from being an exclusive pumper. I really appreciate you reaching out when you did to acknowledge how important my experience was, and for encouraging me to write something more formal. It meant a lot to have my experience and my voice valued in that way…I have finally had time to revisit the idea of writing this article. I’ve been working on this article with a writing group, and I think that it is finally ready to go.”

I was so excited! I had reached out to Miriam about exclusive pumping back when I was tasked with writing clinical articles for the journal Clinical Lactation Although I was not responsible for this anymore, I felt that this was information people needed to have. I put Miriam in touch with the right people at the journal and extended the idea of us doing a podcast about her story, experience, and the wisdom I knew she had for us.

Miriam talks about her own breastfeeding journey which, as is true for many of us, did not go as planned. She then talks about the lessons learned that she has applied to her own work in the field of lactation. I think one of her biggest take home messages is that although many people do choose to exclusively pump from the beginning, most exclusive pumpers really wanted to breastfeeding/chestfeed but didn’t end up being able to reach that goal for many, many reasons.

Please listen and enjoy!

The post All Things Breastfeeding 71: Miriam’s Story- Exclusively Pumping appeared first on The Breastfeeding Center of Ann Arbor.

Yes! Sometimes you feel like breastfeeding one baby is almost impossible but then you have TWO babies! Anna shares her story about how she is successfully breastfeeding her twins. It was not easy but also achievable with the right help and support. When you have babies who are early, even a little bit, it can make the process harder. Although Anna’s babies were born “term” for twins, 37 weeks, that is still early! These babies often need some supplementation while they transition to the breast.

Anna had taken a prenatal breastfeeding class with us so she would be prepared. After the birth, she spent lots of time with the babies skin to skin, and got her milk moving right away! She did a combination of hand expressing (she started within the hour after birth) and then pumping, at least eight time per 24 hours. This allowed the babies to get her milk AND protected Anna’s breastmilk supply so when the babies were ready to fully breastfeed, she had plenty of milk for them.

Anna and her husband Dirk had no idea how much work twins are. I don’t think anyone can be totally prepared for this. It is not just twice as much work. It seems like ten times the amount of work! Fortunately, Anna’s parents were here to help and, boy did they! It seems like everyone had a baby in arms all the time! This extra help meant Dirk and Anna could focus on caring for the babies and here and there for themselves. The meals, cleaning, all those other tasks were taken care of by the grandparents. Anna says the first months were a blur!

This is an art, helping babies move from bottle feeding to breastfeeding. Making sure good Paced Bottle Feeding is happening is critical. Also, having a good IBCLC in your corner can do nothing but help. We met on Zoom primarily, the babies were born during the height of COVID, about once a week to assess where the process was and what to do next. Of course, so typical, one of the babies was ready to be exclusively breastfeed before the other. This happens most of the time! Karen Gromada has a great book about this, called Mothering Multiples. Getting help for this transition is critical so don’t be afraid to reach out!

Enjoy Anna’s story!

The post All Things Breastfeeding 70: Anna’s Breastfeeding Story- Breastfeeding Twins! appeared first on The Breastfeeding Center of Ann Arbor.

Many people are surprised to find out that to becoming an IBCLC (International Board Certified Lactation Consultant) is hard. You need 8 college courses, 6 continuing education courses, 300-1000 clinical hours working with breastfeeding families, a 90 hour professional lactation course, and THEN you can qualify to take a four hour exam. It is a true profession! If you want to learn more email [email protected] to learn more! We have monthly Zoom meetings to review the process and help answer questions.

Jessica and I first met when she had her first baby five years ago. She was having breastfeeding trouble. We had a consultation and then she was a regular attendee at our weekly Breastfeeding Cafe. Jessica was very lucky that she did not have to return to work until the baby was six months old.  I did help Jessica return to work and meet her breastfeeding goals.

Jessica contacted me again in the spring, 2018. She had been thinking about a career change. Jessica has a Master’s degree in adult education that she was utilizing in her current job developing trainings for her work and as a employee trainer. She wanted to do something that she felt could make more of a difference.

I have many people who want to work with me to get their clinical hours on their path to becoming an IBCLC so this was not a new request. I have developed a way that helps me get to know my possible future intern and allows them to really see my style to determine if we will be a good fit. Basically, I have people I think might be a good fit come to my Breastfeeding Cafe. I want to see how the candidate interacts with parents, and if they have been a parent themselves, how they shift from the role of being helped to being the helper. I am looking for great communication skills, someone who can listen well, and help families feel cared for during this, often, challenging time. Needless to say, Jessica did a great job!

Once Jessica and I established we wanted to work together she needed to apply for Pathway 3 with IBLCE. They needed to approve Jessica as a Pathway 3 IBCLC candidate and approve me as one of her mentors. This happened in the fall of 2018. Jessica also needed to take my 90 hour lactation course. I do require my interns take this course with me so they have the knowledge base needed (from my point of view) to actually work with clients. I do suggest that any aspiring IBCLC take a 90 hour course near the beginning of their training so they have this foundation of knowledge. Jessica took Part 1 of my course is spring of 2019 but then had her second baby! She delayed Part 2 until the fall of 2019. All the while she was collecting clinical hours working hard with me.

Jessica applied for the IBCLC exam to be taken in the spring of 2020. We all know what happened there! Because of COVID Jessica had to wait until the fall of 2020 to take the exam. Of course she passed! Jessica got her exam results in December of 2020!

Jessica now has left her old job and works full time as a mother and part time with The Breastfeeding Center of Ann Arbor! Jessica is seeing clients, helping me with business tasks, and maybe most importantly, she helps me develop curriculum and she teaches for me!

The post All Things Breastfeeding 69: Becoming an IBCLC- Jessica’s Story appeared first on The Breastfeeding Center of Ann Arbor.

Great question! Basically it means getting breastmilk out of a lactation breast without a baby or a breast pump. At The Breastfeeding Center of Ann Arbor, hand expression is a typical tool we review with most of our families because you never know when you might get caught with no baby, no pump, and a full breast! Literally a life saver. Practice does make perfect with hand expression.

We have a brand new podcast about this! Enjoy here!

Here are just a few reasons you might want to hand express. Listen to our podcast to here many more!  The first is the day or two after the baby is born. If the baby is having trouble with latching, the hospital staff are concerned about the baby for a medical reason and want to supplement, or not the baby is not draining your breasts well, doing hand expression in the first hour after birth, right into a clean teaspoon, is a great way to help keep your baby fed and protect your breastmilk supply.

Another reason is to help entice the baby to latch. A little hand expressing before latching gets the breastmilk right there, at the end of your nipple for your baby to taste. Some hand expressing after pumping to help finish draining the breast when increasing or protecting your milk supply is also a great use. Having a preterm or a baby in the NICU is a great time to get going immediately with hand expression while the hospital staff gets you set up with a breast pump.

There are so many different ways to hand express. One of our very favorites was created by Maya Bolman, IBCLC from her experiences in Russia where hand expression is very common. Here is a link to her video. It is also great for engorgement or any time you have a really full breast. Don’t worry if this method is not for you. There are others listed below to try. Whatever method you use hand expression should not hurt! Be gentle with your body!

1. Have a clean container ready to catch the milk and wash your hands. If you are in a bind and don’t have a container, a sink will do in a pinch. A shame to waste the milk but better to protect your body!

2. Preparing the breast. Consider doing some gentle massaging before hand expressing. Research shows this and/or warmth before trying to hand express or pump for that matter increases the effectiveness of hand expression. Maya demonstrates a “tapping” on the breast which seems to be important. Spend a few minutes getting your breasts ready to be expressed. If your skin feels tight or fragile, consider using a bit of olive or coconut oil on your hands for comfort.

3. Maya has families place their hands close to the nipple. Think about where a baby latches on. Not way back in the breast. We like to think of lining up the finger tips with the nipple. Finger tip, nipple, finger tip. See the photo.

4. Push the fingertips together gently. Release. Bring together. Release. It may take 10-30 of these gentle squeezes before milk appears. Don’t get discouraged! If milk is not coming yet. Just go back to step one. Breathe deeply and try to relax. This will help as well. If the milk is still not coming try going a little closer to the nipple or a bit further away from the nipple. Put your fingers in a different spot.

5. Alternative hand expressing with tapping and massaging until your breasts feel comfortable.

Another popular hand expression technique is from Jane Morton. Here is a link to her video.

1. Again, Jane encourages some gentle massaging before beginning to hand express.

2. Having a bigger handful of breast might be helpful, still having the nipple centered.

3. Having families, gently push back in their breast, bring their fingers together, and release, Jane’s method can be effective. We encourage you to give 10-30 of these gentle squeezes before getting frustrated.

4. If the milk is not flowing yet, do some more massaging, shift your hands a bit, and try again.

Here are some other examples of hand expression. Everyone does it a bit differently!

Great one! Global Health Media

A modified version of Jane Morton’s technique

Another version of Jane Morton’s technique

Another example

The post All Things Breastfeeding 68: The Beauty of Hand Expression! appeared first on The Breastfeeding Center of Ann Arbor.

What on earth do I mean by breastfeeding book groups?

Let me explain a few things here. First of all, I am a voracious reader. Have been my whole life. I read 1-4 books per week. However, what I almost exclusively read is fiction. I read Pulitzer prize winner to the worse chick lit. I don’t read a lot of non-fiction.

Secondly, I love book groups. I spent the first 31 years of my life reading alone. I had no one to talk to about what I was reading or had read. In 1995 I boldly asked to join a book group with someone I liked very much but didn’t know very well. 26 years later I am still part of this group and have read some of the most challenging books of my life. About 5 years ago I did start a book group that started out reading fiction but quickly moved into books about self transformation which are non-fiction. Because of my commitment to the group, I almost always would read the book.

Back to fall of 2019. I knew I wanted to read this new amazing book very closely so I could best help my clients. But when I thought, we should read this (my interns and I) as a book group it occurred to me that many others might like to join us as well. I even proposed the idea to one of the authors, Lisa Marasco who is a good friend of mine in November of 2019. She thought the idea was interesting. I tucked this thought aside and moved on with my life.

My husband was an early predictor of the tragedy COVID would bring to us all. Toward the end of January he predicted we were all in for some serious trouble and would be needing to isolate for a long period of time. I was thinking of until June.

Ha! But this meant my consultations and teaching would be greatly impacted so it was time to get into gear. Necessity is the mother of invention! I reached out to Lisa again and she was in for the book group. Diana West was struggling with some health issues and other commitments so she gave her blessing but was not able to participate.

I was already doing a hybrid model for my 90 hour professional course and we had just moved our courses to a new online education system, Learning at The Breastfeeding Center of Ann Arbor on Thinkific. I knew Zoom was going to become everyone’s new best friend ASAP so I imagined a book group that could be for professionals BUT also for parents. Making More Milk, 2nd Edition is written for families but it is also the best resources on increasing breastmilk supply for professionals.

Just FYI, I could not have done this without the support and guidance of my then intern, now colleague, Jessica Beemsterboer. She did research, help trouble shoot, and gave me the confidence that I could do this!

I created a 7 week course using my hybrid model. We would read assigned chapters, I created chapter summaries for each of the chapters. We also had supporting materials, and then once a week we would meet on Zoom with Lisa Marasco. She was able to attend 5 out of 7 of our meetings.

Lisa and I would discuss each chapter, clarify points and emphasizing what we felt was important, and then we would take Q and A. We meet for 1.5 hours, recorded the meeting, and then posted it on Learning at the Breastfeeding Center of Ann Arbor on Thinkfic so if someone could not attend our live session they could listen to the recording later.

This was a hit! We had over 70 people join us!

It became clear in May that COVID was here to stay so I reached out to another good friend, Cathy Watson Genna about doing a 10 week book group with her book, Supporting Sucking Skills, another critical professional breastfeeding book. I did that book in fall, 2020 and had over 100 attendees!

The Breastfeeding Center of Ann Arbor is now rocking it out with Nancy Mohrbacher and her new Edition of Breastfeeding Answers, 2nd Edition. We have 130 attendees for this group!

Now we are offering both Making More Milk and Supporting Sucking Skills as self study groups. You will have access to all the supporting materials and then recordings of our Zoom meetings. Obviously not the same as attending live but we sure dive in deep!

Listen to this podcast to get a taste of what we did for Making More Milk. This was recorded last July when we were sure what direction we were going but it is interesting how a bit of creativity and will power get something really cool finished.

The post All Things Breastfeeding 67: Breastfeeding Book Groups! appeared first on The Breastfeeding Center of Ann Arbor.

OMG. It has been too long! Karen and I recorded this back in June but due to Covid I haven’t been able to get this to move to the top of my list to publish. Thank Jessica for pushing me (in the nicest way) to keep after this and get it done!

We love breastfeeding stories. Karen’s is very interesting because she is actually part of the health care system herself. She did great with breastfeeding but actually in spite of the “help” she got.

What happens before and after the birth can make or break breastfeeding. Fortunately, Karen had educated herself about what to expect with breastfeeding and kept on her path even though she had a few nay sayers, especially in the hospital where she gave birth.

Returning to work was another challenge but again, Karen had prepared herself and knew what to do!

She did a great job. Enjoy her story!

The post Episode 66: Karen’s Breastfeeding Story appeared first on The Breastfeeding Center of Ann Arbor.

Do you want to unlock the secrets of Breastfeeding Answers, 2nd Edition? Barbara D. Robertson will be joined by Nancy Mohrbacher, the author of the book, to discuss their upcoming venture and break this down for you. Having a structured format of a book group tends to move things from the “oh I should do that” to DONE!

Barbara and Nancy will talk about how this group will be using Zoom Meeting. and Thinkific, an online learning platform. December 17, 2020 (Or if you register after this date a day or two later) you will get an invitation to join us on Thinkific, an easy to use, online learning program. You will see the required reading listed for each of our ten sessions and meetings.

You will need to get your own copy of Breastfeeding Answers, 2nd Edition, either a hard copy or an ebook edition. There are many different ebook options, Kindle, ePub, and a PDF versions. The 1st edition (or earlier!) will not do! So much has changed in these past years. You will read the assigned chapters, attend our live Zoom meetings or listen to our recording meeting discussion with Q and A, review any supplemental materials, and then, if you registered for our 36 CERPs version, take the quiz at the end of each session. 

36 L-CERPs Early bird price $299  (Ends December 17, 2020) Regular price $350

A book group is where a group of like minded people get together after having read the same materials. Usually, they get together (often with a glass of wine!) but during COVID groups are meeting virtually. This group can then have an informed discussion about those materials. Usually, the author of the book does not attend the meetings. The power of a book group is the collective knowledge, experience, and perspectives from its members. Each person’s voice needs to be heard to form questions for discussion and to be able to analysis the materials. We are honored to have the author Nancy Mohrbacher join us for 10 out of our 10 sessions!

When will this be?

The dates for this book group are:

Each session consists of a 2 hour Zoom meeting where we will discuss the materials and answer questions. Before each session you will read the assigned chapters (most sessions only have one chapter but four sessions so have two) and any supporting materials, and after our Zoom meeting you will take a quiz at the end of each session in you have registered for CERPs.

The Zoom meetings will be recorded so you have the flexibility of missing a session if needed and then listening to the recorded Zoom meeting at your leisure on Thinkific.

You will have access to all the materials until 4-15-21.

The post Episode 65: Interview with Nancy Mohrbacher- New book group! appeared first on The Breastfeeding Center of Ann Arbor.

Too much breastmilk? Is that really a problem? The answer is, YES, oversupply is a big problem for people who are struggling with this.

Milk everywhere, choking babies, are there answers? For sure! Listen to this podcast to get more information.

Baby choking

First, figure out what is really going on. Some families can actually just have a strong milk ejection reflex and actually not have too much milk, a true oversupply, but it can be confusing. Sometimes it can look like too much milk is the issue but actually it is the baby not being able to handle flow period. Babies are fussy for lots of reasons. Fast flow is just one of them! Getting help from an IBCLC can help sort out these questions for sure and make a strong plan to move forward.

Many people turn to google when they think they have an oversupply. It’s what we do! Sadly, there is a lot of information on google that will come up first and actually potentially make breastfeeding worse. Many of the suggestions (such as blocked feedings, pumping after feeds to fully empty, and taking medications or eating certain foods to reduce your supply) can shift an oversupply into an under supply with the family being unaware that this is happening. Personally, we don’t use these methods very often (but never say never). Instead we help identify the cause of the trouble and then create a concrete plan as to how to address the issue.

It is common for families to start out in the first weeks with what feels like an oversupply but then milk supply naturally calms down as the milk supply shifts from being driven by hormones to supply and demand.

Please don’t sit with these issues yourself! Get help. Oversupplies are something that is fairly straightforward to resolve. It does take time and a good plan to make sure all is going well.

The post All Things Breastfeeding 64: Oversupply! appeared first on The Breastfeeding Center of Ann Arbor.

This one is particularly dear to Barbara’s heart. Melissa came to see Barbara after the birth of her first baby and was struggling with her rate of breastmilk production. Although Melissa was able to increase her supply a bit, she still needed to supplement her baby.

When Melissa was pregnant with her second baby she called Barbara to set up a prenatal breastfeeding consultation. Barbara was surprised because she remembered Melissa as being a very successful breastfeeder. Melissa was, she nursed for over two years! She also struggled with low milk supply. Indeed when Barbara looked up Melissa’s records she found that this was true and they worked on setting up Melissa for as much success as possible.

Barbara met with Melissa shortly after the birth of her third child. Again, the goal was to optimize Melissa’s milk supply. Melissa used formula to supplement her first baby but then she delved into the world of milk sharing. She wanted human milk for her human babies. She carefully screened her donors, asking about their health history, any medications, their babies, and pumping practices. She also choose to use flash pasteurization to make the donor milk even safer.

Melissa has (and still is) been a successful breastfeeding mother who struggles with her rate of breastmilk production. Many times families don’t realize that you can be successful with breastfeeding and it doesn’t have to look the same each time. Families go back to work, struggle with milk production, have babies how can’t latch well, all kinds of issues that make it hard to have the tradition model of having the baby exclusively breastfeed directly from the breast. Remember, breastfeeding isn’t all about food, it is about the relationship as well. Babies suck on pacifiers all the time and don’t get milk! Why not use the breast as a place of comfort, peace, calm. And any milk that baby gets is so, so good for it!

Melissa attributes a lot of the success to her story to paced bottle feeding. By slowing the bottle feeds down and making them more work she helped her babies know that feeding is work and takes time, like breastfeeding!

The post All Things Breastfeeding 63: Melissa’s Breastfeeding Story appeared first on The Breastfeeding Center of Ann Arbor.

Barbara accidently published the unedited version of this podcast! Here is the edited version. Sorry!

Jessica is at home with her two your children trying not to miss a beat while being a full time parent and having her and her partner continue to work full time. This sadly, is a common theme. Although this is very challenging, Jessica is very aware of the privilege that she has, being able to continue to work from home, that she hasn’t lost her job, or been deemed as an essential worker.  Many of our families are not able to work from home. Where do the babies go? Most child care is closed during this time.

Jessica is also continuing to help run the Breastfeeding Center of Ann Arbor.

Barbara, on the other hand, because her babies (24 and 21 years of age!) are older, has been moved into a very creative and productive time. She does struggle with depression, so it hasn’t all been smooth sailing (there have been several days of despair) but since she has been sheltering at home she has had enough time to get several new projects going and updated some old ones. Working in pajamas, sitting at the dining room table, Barbara has created the Making More Milk Book Group and lined up to two future book groups, Supporting Sucking Skills with Cathy Watson Genna and the new 2nd edition of Breastfeeding Answers  with Nancy Mohrbacher! Look for info about these soon.

Barbara is also moving all of her online training to Thinkific. The CCLS (Clinical and Communication Lactation Specialist) 90 hour professional course hybrid is just about ready to go for the fall session. She will also be launching her totally online version of this course starting in September, 2020! Due to not be able to meet in person Barbara is now offering virtual breastfeeding consultations. Rebecca, one of Barbara’s interns, is offering a virtual Breastfeeding Cafe on Zoom! Email [email protected] to join us!

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