Everything you need to know about feeding your newborn (with The Baby Feeding Experts)

23:06Like our bodies change so much postpartum and your nipple is no different. Right. TMI, I went down six millimeters in like four weeks postpartum because you get swollen when you're pregnant. And so I had to go down six numbers. Okay. So keep measuring. If things get worse, if something's different, check that. Yeah. You can probably feel that too. Yes. It was more uncomfortable. A pumping session should never, you know, we can get to this of like, does breastfeeding hurt? But when you're controlling a baby's latch, you don't have much control. So if it hurts, you got a lot of things you got to work on.

23:36A pump should never hurt. It's a mechanical thing. You should be able to get a size and a material and a shape of flange if you need to get that detailed that you're comfortable. And if you're not comfortable, something's up. Okay. Okay. I think that's, that's, I have never heard that. So I'm very excited about that. Okay. If a mom wants to breastfeed, so let's start there. Let's start in that camp. How can moms prepare for breastfeeding before birth? I mean, we just kind of touched on it. I'll say like with Tate, I never made colostrum before having her. So when we went into the hospital, I was like, I don't know if I'm going to produce milk.

24:06And then I did right now I'm making like a little claustrum. So I'm like, okay, that's, that's good. But I know a lot of people before they're first don't necessarily have any signs that they're going to be able to make milk, et cetera. So how can a mom prepare for breastfeeding? So the prenatal colostrum is actually a little bit of a misconception and a little bit of the myth in the breastfeeding world. So the amount of colostrum you produce or are able to extract or harvest before baby is here has no barrier or bearing on how much milk you will make postpartum. But does it tell you you'll be able to?

24:34No. Oh. Okay. No. And she'll go through like the science. There's phases of milk production. So another misnomer that I still use because it's in my brain is when your milk comes in. We don't love that because there's milk there. And she'll tell – you know, she's going to go through like the placenta thing of like how that milk comes in. But really the science of milk making happens when the placenta leaves your body. Okay. Not while you're pregnant. Okay. Okay. And there are absolutely outliers. There is a very small subset of women who are physiologically not able to produce milk. like certain hormonal issues, certain anatomical issues, those types of things absolutely happen.

25:06We're talking about the vast majority of women here. So when we are pregnant, your body goes through anatomical changes to get ready for that production of milk. But the magic starts happening when the placenta leaves your body. So regardless of how baby evacuates, when the placenta leaves your body, your brain opens up prolactin receptor sites. And this is the time to tell your body, I want to make breast milk for this child. So you have about two hours before those windows start to close. And so the goal is we want to start telling our body, I want to make milk by getting it out. So that often looks like I'm going to latch baby.

25:38I'm going to let him suckle. We're going to hang out here for that two hours or as long as they'll participate. If you are a person that's like, I don't want to latch. I just want to be an exclusive pumper from the beginning, but I want a full milk supply. You're going to hand express. You're going to use your hand pump. You're going to start stimulating to get some of that colostrum out. We're talking teeny, teeny tiny volumes at this phase the more frequently that we are doing that in the first two days scientifically connects to the more satisfied parents are with their milk supply two weeks later so when the placenta leaves the body you have there's a two-hour window where you tell your body i would like to make milk to feed this child and it's not perfectly black and white that is gold standard traumatic births happen there are reasons why that doesn't happen and that should not make a listener say guess can't breastfeed right the the idea of someone just not making any milk at all.

26:26I mean, we've never met anyone that doesn't make anything. We've met a few moms that make significantly less than what their baby needs based on their anatomy. Vast majority will make either all or close to all. But the best chances of having the milk supply that you want are milk removal in the first two hours. If that doesn't happen, that's where that timely intervention. Again, hospital staff, they're not breastfeeding experts. Even the lactation consultants to them. Great. They have the role. The ones that come into your room are more focused on like, how do I get this family home? What do they need today?

26:59They're not necessarily your best go-to for long outcomes and long-term goals. So we've even talked about a way to prepare for breastfeeding is to remove all barriers to appointments with professionals. Make that appointment before the baby's even here. You can cancel it if you want to. They don't care. But like maybe six days, seven days postpartum, you're having somebody come to your house and you're ready for that or you're having a virtual consult planned, you have their phone number, getting ready to have that professional intervention when your birth didn't go the way that you thought it would.

27:25It's also on that note, if we're going down that route, it's important to almost like interview your providers because there is really little consistency in lactation education for professionals, even among IBCLCs, which is considered the gold standard of lactation education. Finding somebody whose skills and values align with your goals so that you have their number, You have your appointment set up with them so that you're not scrambling. We had a mom that we worked with recently who worked with – We were number 10. We were the 10th lactation consultant that she worked with and the first one who she made progress with.

27:57Okay. Wow. Yeah, and I do think that's probably a big thing if their values don't align with the way that you want to feed or – I think it's a huge – because it's such a personal – breastfeeding is such a personal experience, but you do need help on it. Yeah. So it's – I mean that's – Very rarely do we have moms that like it just clicked. And I feel like before you have babies, you think it's like, oh, it's going to click or it's not going to click. We say a lot that we're the second time moms type of professional because our culture says this is a natural thing. You're supposed to just like do it.

28:27It just worked. Right. And just like we can't predict the barriers you're going to face, we can't predict who is going to be that person that it just works for. Yeah. Correct. So we'll meet first time moms at like vendor booths and stuff that like bless their heart. I mean they'll be like, oh, yeah, I'll reach out if something happens. but that preparation, like you've talked about, is so important that a second-time mom runs up to our vendor booth and was like, what you said, what Harrison said about Alex's mental health last time, I mean, even it's the husband walking her over being like, not doing this again.

28:54Right. You need to be ready. Correct. So we see a lot of second-time, third-time moms. Yeah. Yeah. I believe that. I'm more excited about it the second time around because if you told me that I needed to measure, you know, the nipple size last time, I think it's too overwhelming. I don't know what we're talking about. I'll figure it out when he gets it. I'm like, I can do that. You can be right. Yeah. And then I can understand too, within the first two hours, like at least hand express a little or I'll obviously try to breastfeed the baby, but you never know if maybe the baby has to go somewhere right after.

29:22Like you never know. Absolutely. Her first breastfeeding journey went, I mean, within days. And she, one of her big factors is that when birth went haywire, when baby need a little bit extra support, no one was standing next to her going, Hey, if you want to do this, you need to get milk out. I, especially with our prenatals, I, this is the part where I like to educate partners because if you don't get the birth that you want, I think the best thing, the kindest thing we can do for a mom is to give them the feeding journey that they want. And so my first, personally, my birth did not go to plan and my feeding journey didn't go to plan either.

29:59So my second, it was so critical for me as a person that I got one of the two. And so that was where, personally, I'm teaching my husband, here's how you hand express me if I'm unconscious. Right. It is so critical that we get milk out of my body within two hours if we can. I need you to take this role. And so if we meet a mom who's also had a traumatic experience or who it is so critical, that education for the partner can be helpful. And we don't care why it's critical. I mean, it could be critical that they formula feed, you know? Absolutely. And if I'm advocating, I know we'll get to this, but like if I'm advocating for a family that is dead set on exclusive formula feeding, I'm going to say things like, hey, the minute your support partner gets in the hospital, have them pull a nurse aside and say, put in that chart that we don't want a lactation visit.

30:43I don't want my wife to have to tell someone to leave the room. Absolutely. So supporting whatever you're passionate about, if you're passionate about it, your support partner can be prepped to say the right things and push you in the ways that you want to be pushed or let you go in the ways you want to be let go. So you're so part of this, you know, preparing a mom for breastfeeding before birth, or let's call it preparing a mom for her feeding journey before birth for the sake of this, how the partner comes in like he knew the first time with Tate, I said, I want to try to exclusively breastfeed, but he knows this time I want to go 80 20 in some capacity, like, and hopefully I make more.

31:19And that's a lot. It's a lot of like, We'll see how it falls. But what do you suggest for a first time or a second time mom when it comes to them telling their partner? What are the tips that you say? And for the partner. Yeah. You need to decide how hard I want to be pushed. A lot of times this comes up for the moms who are shooting for an unmedicated delivery. They say, no matter what, I want you to tell me that I can do this. I want you to give me these affirmations. I want you to use these tools. Or if I hit X point, this is my safe word. This is when we're going to give in and you're going to stop pushing me.

31:53So having that conversation of like how critical is this? How hard do you want me to push you? And continuing to check in with each other because what your goal is before you have that baby can be so different from your reality afterwards. And acknowledging that like it's okay if your goal changes as long as you are okay with that. We only care when you fell into a feeding method that you didn't want. And form choice is all we care. And in that, some moms don't even know that they didn't have an informed decision. That comes up frequently, especially in hospital states. It's like I'm dogging on hospital staff and I'm not.

32:27But they just have a different role and different mindset. They're coming from a different background. But, you know, a nurse might not understand why you have a certain goal. And so they might not present three options. They might present one. So if you went in with Tate and you were like, I'm exclusively breastfeeding, if you would have supplemented with formula in the hospital, that might have bummed you out. That might have set you up for, you know, a certain type of way of feeling. But if the nurse said, hey, she needs a little bit extra milk. Here are three things we can try. Let's latch her again.

32:53Let's hand express or let's formula. What do you want to do? And that's how we operate with our – we text a lot with our clients. That's part of the package is they get to text. And I always tell parents if someone is pushing something on you that doesn't feel comfortable, say, I need five minutes. Nothing is emergent when it comes to baby feeding unless it is. And if it is, they're not messing around. They're grabbing that baby. They're doing the thing they need to do. They're going to keep that baby safe. Right. So it's probably not urgent. Give them five minutes and talk to someone that you trust.

33:19Talk to your partner. Talk to a professional and get options because there's almost always options. One option that we were presented was donor milk. Yeah. And we were like, I don't know what that is. It's somebody else. And so we Googled it and we were like, wow, we really like this option. And so we opted for donor milk over doing formula in the hospital. And I looked back on that and I was glad we did it because I was still trying to figure it out. But she was small and needed more milk. Yeah. Yeah. Donor book is a great option, especially for families, even if you choose to combo feed down the road.

33:50If like the gut health benefits. There's some research that if one – so you know, you might want to breastfeed for a different lot of reasons. One of her main breastfeeding reasons the second time was financial. You know, she wanted to – they are a very – they're a budget family. They are so good at spreadsheets. They're so financially wise. And so she was like, this is how much we spend on formula. Watch what I'm going to do with this money when I don't have to buy formula. Right. Totally. And so that was one of her motivators. And so she, if your motivator is, let's say gut health, if you're like, I have read that gut health is better with breastfeeding, the gut of a breastfed baby looks different than that of a combo feeding baby.

34:28And that doesn't mean you have to do it. But those are information, those are pieces of information we want families to know. If that's your why and you need some supplementation in the hospital, you may opt for donor milk over formula. Yeah. Got it. Totally. And I think that was our gut. Yeah. No pun intended. Was to try and do that with the little that we knew, you know, about it. But absolutely. OK. OK. So I never answered the original thing, which was how should you combo feed from the beginning? Well, that's it. But I'm going to go to combo feeding next. OK. So what are the most common breastfeeding issues in the first weeks that people see?

35:04Nipple pain. This is kind of controversial. I just saw Danny Austin made a reel. I don't know if you saw that that was like, I want to strangle anybody that says breastfeeding doesn't hurt. And I was like, I feel that. Because before I had my lactation training, I told people, wait about 11 days, it'll get better. There is some pain with breastfeeding, it'll get better. And then the more that I learned, I stopped saying that because there's going to be a subset of people where it hurts forever. Because the root cause of that pain is something that needs to be fixed. There's a subset where that pain comes from your learning and baby's learning.

35:32Even if you've latched another baby, you've never latched this baby. So a perfect latch that is doing what it's supposed to do is not painful. But most things with parenting aren't perfect the first time, and that's why we still see pain. So pain is common. There are preventative measures that we can do. That's what we teach in our prenatal consults to increase the likelihood that you don't have pain or it's short-lived. But that's a big one. Perceived low milk supply. That's a thing. And it's actually more common than real low milk supply too. This is kind of fueled by like On Instagram especially, we see like the deep freezers full of milk or people will be like, I need more freezer space.

36:06I have to keep pumping. You don't need a freezer full of milk. It's great to have a bag or two in the freezer for like when you're at work or you're going out of town or something like that. But when you think that you aren't making enough milk but baby is growing adequately, we're having plenty of wet and dirty diapers, we are producing what they're eating in a day, you make plenty of milk. Or you're happy with your combo feeding balance, you're making plenty of milk. Right. Right. So it's – okay. So it's a perceived – And the anxiety because with a boob, you can't see what's going in. And so the anxiety behind is my baby getting enough is a thing that we address in the first couple weeks quite often.

36:42Is my baby getting enough? Watching that growth, watching that diaper output, nipple pain. And then we – this is another term we use is lactastrophe. We see lactastrophes when there's a tiny little bump in the road like, you know, baby's jaundice or baby has a little blood sugar. something happens and the interventions that went into trying to fix that kind of snowball into bigger deals and things that last longer so that's another one we see often that's probably a big one yeah so okay so how can a mom build milk supply from the beginning that immediate window post birth is a great thing to have in mind so in an ideal world if we can get milk out of our body within two hours of baby being born that is the first step in your foundation from there we want to make sure that removing milk consistently and frequently and effectively.

37:33The biggest, I would say, the biggest determining factor in how much milk you're going to make is the duration between milk removal, especially in the first two to four days. So one thing you hear often is feed every three hours. What we tell people is feed every time baby wiggles a little bit. Feed on demand. Feed when that, especially when you're in the hospital and you're sitting there and baby's on you. Keep baby close and feed often. And when in doubt, whip it out. basically. That is a really good foundation. Like she said, those first two hours, get milk out. That's foundation number one.

38:04Shorten the durations between feeds. A general time guideline that will work for most people that want to exclusively breastfeed, I would say two to two and a half hours between feeds during the day. And that way you can go up to four overnight. The first couple of days, science says, if either baby eats 10 to 12 times or you pump 10 to 12 times and milk is being efficiently removed, you are really, really likely to have a full supply. Okay. We often lean towards like a tally mark system and then the four-hour window overnight if you are on track to meet that 10 to 12 goal for your 24 hours. That's a good support partner thing that we – in the hospital, the nurses will often ask, how long did she nurse?

38:40You know, how long was she on that left side or that right side? You don't actually get a lot of data by how long they're on the breast because we've seen babies transfer nothing in 45 minutes or six ounces in three minutes. And so you just don't know what they're doing on the inside. That's not one of the data points we use to say how much they're getting. But one data point we do is how many times they eat. So until you're feeling cozy, until your milk volume has increased, until life is going well, the 10 to 12 tally marks a day, I started a feed 10 to 12 times, is a great way to say you're probably on track.

39:06So even dad just opening a phone note and, oh, she fed again. Let me mark that. And then if it's nighttime and you're like, hey, you've already fed 10 times, let's send the baby to the nursery for four hours. Totally. So 10 to 12 times in the first 24 hours? And then 10 to 12 in the next 24 hours as well. Yeah. The little things that we don't know. But that's cool. And it's easier than the apps that are like seven minutes on the left. That might work for some people's brains. We also have interventions with mom where like maybe the app's the problem. Like we really need that data. Where they're so obsessed with the data.

39:37Yes. Watch the baby. Not the app. Not the clock. Watch the baby. Right. We had an app. And it can be great. It just depends. But once our night nurse left, I didn't really use the app so much. yeah i almost think just like i want to put together like a little checklist of things so right for like right after the baby comes it's like okay the two hour reminder and then you have like the little tally well listen you just have like a piece of paper but you just kind of design it quickly one thing i would love from you is like a room like just a reminder and those two hours just like hey remember you're gonna want if you i know you're not gonna want to say you're gonna want but heads up you're in the two-hour window yeah yeah and then like even just writing like the the date of the time of the birth the weight and like all these other details and then you can just kind of keep it like as a as a keepsake yeah you know what that reminds me of too this is like kind of a little known fact um one thing that can influence your feeding journey birth story always matters we never work with a mom without asking the birth story and especially for inductions in your case.

40:42You get a lot of fluids when you're induced. And they have found breastfeeding medicine doctors or pediatricians that are breastfeeding specialists have found that sometimes baby's weights are actually inflated when they come out because they also are full of a lot of fluids. If that baby pees and poops six times in the first hour, their birth weight was maybe higher than their actual body weight. And that data point is how we track weight loss in newborns. You expect weight loss in newborns. That's an indicator of how things are going, especially breastfeeding wise if baby's weight is inflated because of a lot of fluids you might do better and this is another thing you can write down Harrison is their 24-hour weight breastfeeding specialists look at that 24-hour weight as their starting point for baby weight gain and baby weight loss instead of that first one because it's probably a better indicator of how they actually how much yeah a doctor friend of ours because she had that the 36-hour labor and so um they're the doctors at the hospital were like called out tate's first 24-hour weight loss and a doctor friend of ours is like well she was overinflated with liquids so like that isn't the relevant metric right and so like what they're looking for in terms of weight gaining back like it's unrealistic and off so like she did hit it but he was like you're kind of they're putting you in a hard spot and you're likely going to need to stay in the hospital longer than I think you should.

42:05That's the start of a really common snowball to where you end up perceiving that you have a low supply and then you can quickly get into a situation that you didn't plan on because you were trying to meet an unrealistic goal. You were set up for failure without the full information. You're not making enough or, oh, my milk's not like the fatty cunt, like something's going on. But yeah, lo and behold, it's just like they had an inflated birth weight. People are very quick to blame mom's supply for baby weight gain where we see a lot of babies that that's not actually a problem. There's something on baby's end or maybe mom was told to feed every three hours by the clock and that's the problem.

42:40It's not always just how much milk you make. Totally. Totally. Okay. So how do you know if a milk supply is actually low? So the way that the milk is going into the baby matters a little bit. So if baby is taking a bottle and we can really clearly see how much is coming out of your body and how much is going into the baby, if they match and baby is having good output, so our diapers are consistent, we're having plenty of wets and dirties for their age, awesome, great, we have no worries. Okay. If we are feeding from the body, it becomes a little bit more complicated. And so I think of different stages.

43:13So while we are feeding, we use clues like is baby an active participant? If they're over four days, are we hearing consistent swallows? We want to shoot for swallows every like one to three socks for most of the feeding. So are we hearing consistent swallows? You can't fake a swallow. It sounds like a little pop of air. They're taking milk in and transferring, right? Does mom feel softer after they have fed? And then outside of the feeding, are they satisfied? Are they giving you like a little period of happy, alert, content time at some point in the day? That should slowly increase as they age with development.

43:45And then even farther outside of that, we're looking at those diapers. So we're looking for clues to give us the confidence of this baby is eating. A couple really common misconceptions in is my baby getting enough on both ends of the spectrum, sometimes there are babies who are really good babies who just sleep all of the time. Newborns are really sleepy. They're supposed to be sleepy, but they should have some kind of alertness. They should start telling us when they're hungry some of the times within the first few days. And so if a baby is never telling us that they're hungry, they're really calm and sleepy all of the time, they may be underfed and conserving some of that energy.

44:17sheet we may need to get a little bit more in it. On the opposite side it's also really hard to tell between my belly hurts and I'm hungry and so we can get in an overfeeding cycle and this is really common with our families that are using formula. There's a really cool stat that like the vast majority. 41 % of formula fed babies are overfed three times their first day of life. That's a lot of numbers. It is our perception as humans and how much milk a newborn needs is higher than the actual amount. Colostrum is beads. And so when we're trying to mimic that with formula, we're talking very small amounts.

44:50And that can support a combo feeding family. If you are doing a little bit of formula the first couple of days, we want those volumes small because that's going to preserve your milk supply. If we overfeed with formula and baby doesn't want to nurse, your body's not going to make as much because it's all about supply and demand. So the first four days, I wouldn't think that baby needs a bottle even up to an ounce, smaller than an ounce. The first couple feeds, if you're exclusively formula feeding might be 10 milliliters or 15 milliliters. More of like picturing a syringe even. Isn't their belly the size of a peanut when they're born?

45:22People argue about that. But yes, that is a thing that we all say is like cherry sized, then walnut sized. It's not a lot. It's not well researched. But the theory is presumed that yes, it starts really teeny tiny size of a marble and then is supposed to increase in those first few days of life, matching colostrum volume that like anatomically we are making tiny, tiny beads. and then it slowly increases over the course of four days or so. What's a good visual to know? Because you do get paranoid. You're like, they need a bottle. And it's like, no, they don't. They need drops. Those ready-to-feed bottles in the hospital are confusing as well because they're two ounces.

45:53And feeding a two-ounce bottle on a first day of life could have really long-term negative impacts on their metabolism, obesity rates, things like that. Keeping your volume small and frequent, that's how we are made as humans. So they've done a really cool thing where they look at human milk versus other animals. and fat content versus water content. We have very watery milk as humans. And the thought is that we are made to feed frequently because that will go through their system faster. So for example, an possum has similar milk to us because a possum carries their babies on their back. Their babies are right there.

46:27Their babies can feed anytime they want. And while that's not realistic for everyone's lifestyles or parenting styles, you might be someone that's more scheduled. You will have the best shot at a massive milk supply if you're latching constantly. My other one is elephants. elephants have watery milk they think that the more time a baby spends under an elephant the more protected from the sun that they are and so we want that watery milk so they're under their mom's nursing frequently and the contrast is like a deer that will feed a fawn and then leave them for hours and hours and hours and hours baby's totally fine they come back and nurse again and then they leave and they have fattier content milk okay okay your Missouri is showing yeah So, okay, that makes a lot of sense.

47:15So is there anything else on a low milk supply potential? I don't want moms to – we are talking so much about how most moms can make enough milk. That doesn't discredit the fact that some can't. Right. And some of it is anatomical. Some of it might be a thyroid issue, blood sugar issue. There's some medical conditions that might result in low milk supply. So I want to validate those moms and say that low milk supply is real. Totally. And those moms might not have a choice as far as combo feeding or they might be doing donor milk from the beginning and maybe informal donor milk as they go on and getting it from friends or something like that.

47:48But it exists. It's real. But a lot of it, that's what we call primary low supply. That is, it was going to be like that. Secondary low supply is something happened that wasn't perfect in those first couple days, whether that was a NICU stay or mom had a hard labor or mom was not educated correctly by the staff around her in what was needed to build a milk supply. Secondary milk supply is very common and a lot of those moms have this shame that my body didn't do what it was supposed to do. And so those are my favorite moms because I want to meet them and be like, probably wasn't you. You probably did exactly what you thought you needed to do in that time and it was kind of out of your control.

48:22So getting the support and the education around it. Absolutely. Low supply also occurs a lot when mom goes back to work or when we start changing behaviors or maybe dad goes back to work and we've got other kids at home. And there's a behavioral change that part of our job is to help investigate what happened. If you were once making a larger volume of milk and it reduced, there's a lot we can do to get your supply back out. People think that your supply just goes down one day. The only time it naturally really just goes down as the course of what it should is if the solids intake has increased so much that the demand for milk is lower.

48:54Other than that, there's a reason. Something happened and we can help. We should get it back. So it doesn't just go down in three months. You don't just dry up. You don't just dip. Something happened. Even if you're not eating as much or hydrating as much or eating as much protein, that's not really a factor. So I have a theory with, you know, have you seen like Dr. Pepper and Oreos? Those are like some things that people are saying recently help with milk supply. If you were really undernourished and you pounded a whole thing of Oreos, those calories might have helped. But that doesn't mean you couldn't have eaten real food instead.

49:25It wasn't anything about the Oreos. But they do – on the flip side of that, we don't want moms to stress too much about their diet because they've done some studies on like refugees who were very malnutrition themselves. Your body is going to prioritize your baby. If your diet is suffering, if you're lacking protein, I'm more worried about your body than baby. Bobby wants to get – body wants to get baby fed. Your body is, yeah. Maybe at your expense. Okay. So we're going to prioritize milk. There's some cultures where nutrition is unstable that parents will extend breastfeeding for a lot more years than our culture does because it is a stable, consistent source of nutrition.

50:02And it's a way to help ensure or protect the health of their family. So we'll see nursing multiple children at once, nursing for a really, really long time, even if nutrition for mom isn't the most stable thing. Okay. So this whole – it's kind of a myth of like you need to eat more protein. A little bit. I don't want to discount it entirely because if you feel better, you're going to be more likely to feed more often. If you are run down, you might be like, I can't do it again. Give him a bottle. You know what I mean? Totally. So if your goal is exclusive, you need to feel good. You need to be healthy to be a good mom and to meet your feeding goals.

50:33So you don't want to discount it entirely. But a lot of times I'll see a post online that's like, I have tried everything and I cannot get my milk supply up. And the things they list aren't science-based. I've tried the supplements. I've tried eating more. As far as hydration goes, if you are dehydrated, you'll probably make less milk, but you can't drink your weight into more. If you're adequately hydrated, that's as good as it's going to get. You can't drink a gallon to make more. Right. That's how it works. Okay. That's good to know. Yeah. You can hit your number, but you're not going to make more by eating more protein.

51:03Okay. That was one thing that I think I thought. But it's valuable that your body feels good. So if you feel better when you eat more protein, you need to eat more protein. Totally. Totally. Yeah. And that's what I would do. And I thought it made a difference. But OK, so now let's go to if a mom wants to combo feed. So what makes somebody a good candidate for combo feeding? So my favorite candidate for combo feeding is someone exactly in your position who is informed and empowered. So they, either from previous experience or they know themselves, the idea of having a little bit of the weight lifted off feels really good for them.

51:39And combo feeding can offer you more solutions in the hospital to obstacles or solutions when you get home. We've talked about, you know, if something comes up like jaundice or blood sugar, if you know you're going to combo feed and you have the ability to give that baby 10 mLs of formula after you fed and you're like, I don't have to worry about being the sole source of this, that can feel really good for a subset of moms. The other subset is moms that say, my baby will get more breast milk overall if I incorporate formula earlier because it is more sustainable for me to have some of that pressure off.

52:10I might breastfeed for eight months because it's not as hard. And if I put the pressure onto exclusive and I'm never going to put formula in, I might burn out at four months. I do think that might be more my journey is maybe if I combo earlier, I can do it longer because I won't be so just mad at the pump or mad at the breastfeeding. You know, like I think that 80-20 could, I don't know. So I think it always changes when the baby comes out of you. You feel, I don't, so I don't know how I'm going to feel. Maybe it's not even 80-20. Maybe it's not, right? So I do think that's probably a big one of I can go longer because I won't burn out so soon.

52:45Absolutely. Take a day at a time. If today is 100 and tomorrow is 80, you know. And we would recommend, well, and I guess just to digress on like, I want to go back to who's a good candidate for combo feeding. There's also two other sets of combo feeding parents. Okay. 75 % of babies will have formula before their six months. So you're in good company if you're combo feeding. That is such a lovely statistic. Yeah. Combo feeding feels like such a hidden closeted thing. And culturally, I think there's a lot of shame and guilt associated with it. But almost everybody does it. Love that. So 75 % of people, of babies will get formula.

53:22And there's three camps. There's empowered and informed. This is what I wanted to do. There is, I literally couldn't make enough milk. Either primary, low milk supply, or something happened. The third is they were unfortunately bullied into it or the choice was taken from them. And that subset of people reminds me of how we always say we don't say fed is best because that might be the mom that I was going to exclusively breastfeed. This was really important to me. I show up to my six-week OB appointment. I'm crying. I'm like, this isn't working. I need help. And the doctor's like, hey, fed's best, mama.

53:51Throw some formula in. But that's not what she wanted, you know? She was crying for support and instead. Formula was a Band-Aid solution to like, can someone just teach me what I'm supposed to be doing? Right. Right. Right. Right. Correct. Okay. Okay. So those are the, that person's not necessarily a good candidate. No, that's like the thing and I'm so sorry. And I don't want you to feel like it's, I don't want you to feel like there's anything wrong with giving your baby formula, but I also want to validate your feelings if that's not what you wanted to do. Correct. It could be your choice. But there's the flip side of that where I just, maybe there's a mom that's like, I just wanted a formula fed and my mother-in-law was like, you need to do breast milk.

54:21Oh, yes. There's two sides to every coin. Absolutely. Okay. So what are the biggest mistakes that parents can make when starting combo feeding? Going too fast, I think, is really – it's important to understand how the choices that we're making today are going to impact what our supply and that balance, that 80-20, looks like in two weeks and two months from now. So we want to talk about why do I need this change now? Why am I ready for this? And what do I want feeding to look like a little bit down the road? Making a change too fast often ends up in a shorter combo feeding journey and we end up fully formula feeding faster than we wanted.

54:59I think just having – there's a concept sometimes that combo feeding can fully be having your cake and eat it too. And there are restrictions to how to make combo feeding work. So we meet families that are like, I'm going to nurse during the day and I'm going to formula feed overnight. If you're not – you don't have to pump at night if you're nursing. But either pumping or nursing at night in those first eight weeks is for most moms going to be important to make any sort of milk supply at all. So if you go straight to 80-20 in the hospital or 50-50 in the hospital and you're skipping feeds, I'm going to nurse at 7, at 8.30 they're getting formula and I'm not nursing again until 2, really quickly you're going to be lower on that percentage than you thought you were going to be.

55:40So if that's okay, that's okay. If you're like, I'm going to give them breast milk until I don't have breast milk anymore. Know that if you're going long chunks of time without nursing or pumping, you are putting in a lower milk order for the days to come. You're not necessarily going to maintain where you're at for most people. And we always talk about we give the gold standard. And so we try really hard not to be scary on the internet because a lot of what we teach is like what a lot of moms will need to be successful. You have unicorns. You have people that from the beginning pump five times in 24 hours and they're fine.

56:10They make enough milk. They don't get mastitis. They don't get clogs. Those people exist. But we try to give the gold standard so that you can make an informed decision and you can know that if something didn't work out, it's because you chose. You know, you chose that. And you wanted to pivot your goal. When it comes to combo feeding, is there any difference between a 100 % formula bottle versus a half breast milk, half formula cocktail? There's a million ways to combo feed and whatever you want to do is totally fine. It's what works for your life and what is sustainable. Okay. So if it works where I want to put a little bit of breast milk in every single bottle and top it off with formula, that's great, cool.

56:46The only nuance here is how we're mixing the formula. We want to always make sure that we are, if we're using like a powdered formula, we reconstitute it the way that the instructions say. So you're mixing it with the water and then we're adding the breast milk into that. We're not mixing formula powder into the breast milk. Got it. Okay. So do your, because I had a lot of friends, if they were first time moms, they'd be like, what'd you do? And I'm like, I don't know. We did both. We would add breast milk into the bottle. Sometimes you wouldn't. I didn't know if there was a difference between the two.

57:13There's not a difference as far as how the baby gets it. As far as your body goes. So you have some options. Let's say you're mostly pumping and you are like, I'm at a point where I want about 80 % of the milk that goes into baby's body to be breast milk and I want about 20 % to be formula. A couple different ways you could look at this. So we gave, Harrison, we gave you those metrics on time for the first at least four days. I would say even first week, 10 to 12 times of milk removal from mom's body is great. But you get home and you're like, I'm kind of ready to not do that anymore. What does that look like?

57:44So if you spread your windows a little bit and you say during the day I'm going to do three hours and at night I'm going to do five hours, that might reduce your milk supply a little bit, but it's not going to tank it. It might get you more to that 80. And so slow changes in the duration between feedings is helpful. If you're mostly pumping, that's kind of straightforward because whatever milk comes out, you put in the fridge or you give to the baby and whatever you need beyond that, you do formula. So I think of even like if you're using a night nurse, you could decide I'm going to go in my room and I'm going to sleep for five hours and then I'm going to pump and I'm going to put that milk.

58:18I'm going to give that milk to the nurse. And then in that five hour period, if baby's waking up and wanting to cluster feed or wants a snack, all of that can be formula. You put that bottle that you pumped out and you contribute to what baby's taking in, but you don't have to cluster feed then. Right. You can also make a different choice every day or even every bottle. So if it's like, yeah, I pumped early. I've got a little milk in the fridge. Go ahead and put that in and then top off with formula or vice versa. It doesn't have to be the same every time. It's really hard to mess up. Yeah. Right.

58:46Right. OK. And I think that's the beauty of it is that there is no true formula here. I do want to ask you this, and this is going backwards a little bit for the listener on we're kind of this is a breastfeeding question. Do you guys view it different pumping versus breastfeeding? I like to think if baby's getting breast milk, then they are breastfeeding. Correct. And I actually tried to find – I had a mom. It was like a court case, very complicated. She wanted evidence that nursing was significantly better for a baby. And I didn't find that much. I mean there are things. And it might be a preference for mom and maybe that bonding feels better for them because like you said, some people hate the pump.

59:23And that feels mechanical. So it's maybe a mom benefit to nursing. But there's not that much. One thing that I will say for me personally, all three of my kiddos were breastfed. I'm still breastfeeding my toddler right now. I struggled with my last baby. The first couple weeks, she was jaundiced. She was on the belly bed. Her latch was not great. I knew what I was talking about and it didn't matter. It was still hard. I used Courtney as a lactation consultant. I went into our clinic and I was like, fix me. She had lungral malaysia. She refluxed. She had a lot going on. And so there was a point where both my mother-in-law and my husband said, how do you pump?

1:00:01And for me, I was like, okay, let me think about it. The reason that I need to nurse is I use it as a parenting tool, especially as they get older. I breastfeed my toddler because it's easier for me. And that's not going to be everybody. Some people are going to be like, you're breastfeeding a toddler. That sounds like it would ruin my life. And I totally respect that. For me, it's everything. She falls, boob. I didn't pack a snack, boob. I don't feel like making lunch. Well, I mean she had kind of a crappy lunch but I breastfed her afterwards. Like, you know, she still breastfeeds to sleep sometimes when it's convenient or when she's sick.

1:00:32It's a tool for me outside of hunger. And so I maintain nursing as my choice because I parented three times and I know that it's how I parent best. That being said, the actual benefit for baby, pumping is really good. I mean you're doing a good thing and the magic of the antibodies. Babies still get antibodies from pumped milk. You guys are in the same environment. that baby is, you know, I don't know if you've seen this, but they think the reason babies stick their fingers in your mouth when they're older is to try to get those antibodies and give them your, they give you their germs, you give them their germs.

1:01:06Breast milk is dynamic. It still changes as baby age. It doesn't matter how it comes out. So still breastfeeding. Okay. So I view it the same way. If they're getting breast milk, I think it's considered breastfeeding, but I do know some people get like nuanced because of the bond or the latch or whatever. So, okay. I just wanted to see what you guys thought. Okay. So we're going to move on to formula fed. But one thing that I haven't asked about is the nipple biting. And I had it in the first few weeks. But for me, I noticed it when she had her teeth is when it hurt a lot more. So what do you suggest to somebody that's experiencing nipple biting?

1:01:44The stage of when it's happening definitely matters. So figuring out, well, why is this happening? If it's really, really early on, it may just be like a poor latch mechanics. And so like a little bit of a tweak when we're actually going to latch may help with that a lot where babies operate on reflexes when they're eating. So if something touches their gum line, they're going to clamp to protect their airway. They think they're choking. So that can feel like a bite. If something touches their tongue, they're going to suckle. That's why when we latch, we want the tongue to be touched first. So if they're tiny, that may be what's happening.

1:02:15When teeth are coming in, the theory is that like something feels different. I'm seeking that sensory input, so I'm going to clamp. We also, in infancy, are changing our suck patterns to prepare for big kid eating. Eventually, if you wean a baby from a bottle and you give it back to them, they're going to be like, I don't know what to do with this. Or some parents will talk about, I've weaned my baby from nursing, and then eventually they ask again and they don't know what to do. That reflex, that automatic muscle pattern, motor pattern has gone away and now they're operating on a more mature motor pattern.

1:02:48And so it could be that they're learning and they're growing, which is great. We want them to do that. But our reaction can either make it continue to happen behaviorally or help it go away faster. And every baby in temperament is a little bit different. A common thing is just try not to scream and give them a big reaction because they might think it's funny. That's your kids. And that depends on kids. So either, two types of babies. If they're old enough to understand this, so like seven, eight months and they start biting as a behavior, as a fun little thing to do. So it's not something to do with their latch.

1:03:16They think it's funny. Half the kids, you scream your head off. And sweet little angel is like, I'm never doing that to my mama again. I have three in a row where they bit, I screamed, and they laughed their heads off. And it was the funniest thing that happened in the world. And so it was a behavior. It was a phase. It was short-lived. I had to breathe through it a couple more times. They lost that reaction. They lost that reinforcement. They didn't do it again. Another thing I tell parents is to look at when it's happening within the feed. If a baby has a deep latch and they're actively eating, like she said, the tongue is beyond the gum line.

1:03:45And it's really hard to bite. So we see biting either the beginning when they're trying to get your milk flowing or they see it at the end when they're kind of full and they're kind of bored. So do we start cutting the feed by two minutes at the end so that we can have fewer reinforcing events? Or do we try to get our letdown with a pump or with our hand before we put baby on so, oh, there's milk. I got to focus. There's definitely a place to – Analyze the wife. For some women who have like a really fast flow or a really heavy letdown, a baby will clamp because they're – it's like drinking from a fire hose.

1:04:15for some babies and some moms. And so they'll clamp in like a protection reaction if I need to hang on here. And so there's some strategies that we can do with like positioning and supply management and things like that to make it better too. So knowing why it's happening. Okay, okay. So that, what were you gonna say? I recall that the later stage of biting, like several months in, you would talk about it happening at the beginning of the feed. Yeah, I would. And I would be like, and I would react. You'd put it on. I feel like you'd put her on and then she'd do it and there'd be the discomfort.

1:04:44and well and you had deemer too didn't you yes oh man oh my gosh i can't believe i didn't think about asking you guys about deemer so will you explain deemer to the listener yeah the way that we get milk flowing so we call it our letdown you have milk in there but there has to be a mechanical release of the milk and that happens a few different ways you'll see on movies like a baby cries and a mom starts leaking that's that concept um so the chemicals involved with that some brains don't love that. And so we have a negative reaction. We have our happiness just depleted really quickly. The really the only things, there's no supplement that's been well studied.

1:05:22The best thing that we've seen is some breathing exercises. For me, I had, it's so much worse postpartum. Did yours get better gradually? Yes. Did it stay terrible? It got better, yeah. Good. Mine's worse at the beginning. And it's really hard when you also have a toddler because it was really hard for me to effectively parent during those moments because, oh my gosh, I mean, you're terrible how do you tolerate a toddler poking you in the head so there was a period of time where i would have to go into another room to nurse because i didn't want to accidentally snap and yell at my kid when i didn't mean to you know or not or not be kind and patient with my toddler because i didn't feel good but for me it's distract myself until it's gone and remember that it's going to be gone it's interesting i don't know if you noticed this but it doesn't matter how many times it happens those feelings of home hopelessness or homesick that they feel so real that you have to remind yourself that it's happening again like initially i'm like why is everything terrible oh that's okay and it's gone yeah and it goes away some people i think were was longer than mine mine back one or two minutes but the moment i i would tell him i'd be like i get these just like little bouts when my milk is dropping of sadness and my sadness for some people it's anger and then we googled it and just knowing just if i can say this is going to go away just power through i would breathe through it sometimes i would want to scream sometimes i would want to cry and just understanding like this is real this does happen to people then i was able to get through it i think that may have been another internet learning yeah i could i think you may have talked about it on a video and then your comments lit up but i don't recall exactly yeah um question yeah uh and i also don't recall this your deemer i remember it was very very prevalent when it really slowed and went away was that when you started combo feeding or was that just gradually over time oh that's a good question i think it went away around four or five months which was also when i felt my postpartum depression like lift a little like i do think it was all tied together i don't think it went away when i started combo but i don't i don't know for sure it's amazing what a blur all this stuff is well i didn't think about the deemer I'm not going to be nervous.

1:07:30Maybe you won't. Knowing what it is, if it happens, I think can help a lot, especially with your second and third. I would be in the room and she would get a letdown and she would very like out loud, take a deep breath and she goes, this is not real. It's going to pass. This is not real. This is going to pass. And I did a lot of this. And then she would open her eyes and be fine. And so you would, if you know what it is, you can talk yourself through it. Just like a lot of our mental health strategies. If you know what it is, you can talk yourself through this. Isn't it real? It's a thing. It's not you.

1:07:57It's a trick on me. You are not sad. the sadness is in there yeah yeah totally and i i did this with my husband a lot like he would start talking and i would get it and i go right okay like hold on and just them understanding that was huge and now he like knows the term deemer and we had a friend who she had three kids and remember she came over and she was like do you deemer and i said yeah and she said i've never had it before but i have it with my third so what i have no idea i'll tell you after but But like you do – some people – so maybe I won't have it with the second. I don't think that – Not necessarily.

1:08:28And it was very different for me. Mine lasted the longest with my third for some reason. And I also noticed it when my supply was higher. Like I did a little experiment where I let my supply – once you're nursing a toddler, the other benefit of that is you don't have to care about your supply. She's a great eater. It's extra. So I don't pump. I don't care. I had to pump because I'm away from her. But I did an experiment to see if I could get my supply up using our strategies. And when my supply went back up, my deemer came back. which it's associated with your letdown like the hormonal reaction of a letdown so the more milk you're making the more letdowns you're having the more episodes of that dysphoric milk rejection you're having yes that's a big yeah that that i did experience and that's a lovely reason to combo feed too you know if you're yes i am reducing my exposure to this horrible feeling and i feel good about this solution it's a great reason i it's so funny like i read these questions I was like, there's nothing.

1:09:21I forgot I had Deemer. Yeah. I hope I didn't burst your bubble. No, no, no. But you're warned now. Yeah, I'm warned now. And I think, I don't know, we convince ourselves of these things. But with Tate, I had pre-partum depression. Then I had postpartum depression. And I had Deemer. Man. I don't have pre-partum depression with this one. Great. So somebody told me that most of the time is a window into how postpartum will look. So maybe I've gaslighted myself into thinking it's going to be good. And then hopefully maybe with Deemer too. I also think that there's a lot of differences here from like an external forces perspective on baby one versus baby two, just like around general life uncertainty.

1:09:59Like baby one surrounded by a new relationship, new city, new career. Like there were so many question marks. And you're a mom for the first time. So it's scary. Plus total new chapter of life, the biggest, most important thing. And now you flash forward two years and pretty much all of those uncertain questions have been answered and very fortunately answered in the best way possible. And so I think that that was hopefully been a driver why this pregnancy from a psychological perspective has been so much better or more enjoyable for you. And that's where hopefully the postpartum experience is the same.

1:10:42Right. but with Deemer is the same as in correct but Deemer is not Deemer is just the way it was explained to me is like there's four of us in this room there's five of us in this room if we all were breastfeeding like some people just get it like you just have it not me yeah not you but like do you know is that accurate yeah it's just a percentage of people it can present differently too I get nauseous during mine so if I was taking a bite of food and it happened I'd get it away from me so I had to purposely not eat while I nursed for a while. Some people get really thirsty. And maybe that's all it is.

1:11:16We've had people that are like, I must be so dehydrated because I am so thirsty when I breastfeed. But they literally mean when I breastfeed, like the second I start. And that feels evolutionary. You know, they want you to stay hydrated. So your body is like, ugh. So it shows up in different ways. Yeah, and you can't predict who's going to be. Yeah, it just kind of like happens. Okay, that's how they were explaining like gestational diabetes too. Like some people just get it. Yeah. Okay. So if somebody wants to exclusively formula feed, what should moms think about before deciding to exclusively formula feed?

1:11:47I love that. I am very passionate about our exclusive formula feeders. I think that this group doesn't get enough attention for the choices that they still get to have. I think once you make that choice to formula feed, I want you to feel empowered and I want you to like stick to that if that is your choice. I don't want you to like let the world make you feel guilty or talk you out of it or have any feels about it. Totally. I love that choice for you. If we are before that point and we aren't certain that it's for us, the thing that you can do that preserves your most options is to establish a milk supply.

1:12:20Establishing a milk supply when baby is born, if you don't know how you want to feed them, gives you all of your options longer. Once we choose to not make milk, you take an option away. And then that choice is made for you. And we're all about informed decision making. So if you don't know, establish a milk supply and give some formula. Great. Cool. Let's see how we feel in a week. And that decision can evolve and it can change over time. And on the flip side, if the decision has been made, one little partner support trick is let the staff know that you don't want a lactation visit and that you don't want any qualms because your full answer is no.

1:12:56We saw a really cool thing online once where it was a cancer survivor who had a double mastectomy. They made her a really cute banner above her bed. It was like not breastfeeding. I love that. It was really cool. Yeah. So making the decision and knowing that no is a full sentence, knowing that because something has a benefit doesn't mean you have to give it to your baby because it doesn't mean it benefits your family. And I think acknowledging that subset of people that didn't get to make the choice. Like we talk about, well, how are you going to feed your baby as if everybody gets to choose? Correct.

1:13:26And there are so definitely a subset of people that for whatever reason it is not a choice and you will formula feed. And I am so thankful that we live in a time where science has given us so many great choices. Correct. And I think that we can feel really good about, even if you put no ounce of research into it and you sent your partner to Walgreens and you grabbed something off of the shelf, that it is a complete form of nutrition. And that baby is going to be fine. Totally. They always say if you line up everybody, nobody knows if you were formula fed or breastfed. I love that. I say that all the time, especially when I was grieving formula feeding my first.

1:14:00That was a thing that made me feel so much better about it. When he goes to kindergarten, I can't tell you which kids were breastfed. No idea. Yeah. Us in this room, like I still haven't asked. Absolutely. Like I don't know. And it was less achievable when we were little. For positive and negative reasons, pumping has been – pumping is so important in America because we don't have maternity leave. Correct. So I have Canadian followers who are blown away about how much pumping content I do. And I don't know if you know anybody that you can support that, but they'll be like, I have to remind myself to not pump like an American because I don't have to.

1:14:34and this is what I want to do I want a nurse and so they don't get pumps through their insurance and we do one thing yay um but it's because we don't have that you know we don't have that care so when our when I was a baby for example my mom worked full-time she went back at six weeks she didn't have an electric pump the pumps were like glass and you like pulled them out like a pulley nobody's doing that full-time no so most of us were you know breastfeeding rates in the 90s were not high um most of us were probably not exclusively breastfed some of us are but it was The numbers were low. Right.

1:15:04And formulas come such a long way. Like we really are living in such an amazing time. We interviewed the founder of Bobby and like just talking to her about the way that she was like, you know, people used to want to slow boat it over from Europe. Now we're making here in America the same formulas. And it was like we just felt this like massive weight lifted off of us understanding the back end of how they think about things. And I was just like, thank you. I like to say that, especially just like building your confidence and your choice to formula feed, that formula is magic. You know, we say that breast milk is magic and it's magic in a different way.

1:15:38No one is pretending like formula has everything that breast milk has. Breast milk is dynamic and it changes and your breast milk is different than my breast milk. But formula is magic because it's kind of the last time that you have the opportunity to give something formulated by scientists to have the nutrients that your baby needs, the vitamins, the minerals. You know, by the time they're two, you can offer them that food and they're going to pick what they're going to eat. You know, we work with picky eaters. There are strategies. But at the end of the day, it might be chicken nuggets. When they're a baby, you have this opportunity where scientists developed a thing that said your baby's going to grow.

1:16:08It wasn't on the shelf. They weren't going to grow. And you have this opportunity to give something that is so complete. And that's different than 100 years ago. I mean, I got really into my ancestry for a minute. And I have two great aunts who passed away before their first birthday due to malnutrition. It's like they were rule. I mean, that's dark. But like they were rule. What do you think lactation support and formula was like in the middle of nowhere in Missouri? A hundred years ago. And that wasn't that long ago. Right. You know, that's we are so formula has saved lives. Totally. Absolutely.

1:16:37No question. So has that. So has, you know, education around feeding, I feel like. And so one thing that somebody, you know, listening and you said you love your exclusively formula fed mother. So you guys are lactation consultants, but still somebody that exclusively formula feeds would use you. Absolutely. And that's where a lot of our SLP and our feeding expert background comes into play. Because even if we're not working with lactation or a mom's body, we are still looking at the mechanics of how baby is extracting from a bottle, how they are managing that milk flow, how they are swallowing.

1:17:09We can be working on managing the symptoms of like reflux. How are they, what's their comfort level? How much are we feeding them? How often are we feeding them? How can we make this a sustainable system? There are a million things that we can do to help make life easier for a family who is exclusively formula feeding. Okay. So if you're exclusively formula feeding, don't hesitate to get support. And that's because we're feeding therapists too. Not every lactation consultant is going to be an expert on every little thing. We have a thing where we get really upset if we're not an expert on something.

1:17:39So we obsess until we are. Our thing this year was formula ingredients. We made a formula guide. It's 80 pages. It's how to choose a formula, how to give a formula, how to troubleshoot. And the troubleshooting doesn't get enough tension because if you're formula feeding and you have a problem, there's not a formula consultant. And a lot of our followers say that. Like, I didn't know that you existed. And formula gets this reputation as the mental health choice. The best postpartum mental health scores come from mom fed the way she wanted to feed. She wanted to breastfeed and it didn't work. Those are your lowest scores.

1:18:09If she wanted to breastfeed, she wanted to formula feeding and it worked. Those are your best. So it's not that formula feeding moms have it easy. Feeding a baby is hard. No matter how you do it, it's going to be hard. So give them some credit that they might need a little bit of help too. And some things aren't common sense even with bottle feeding. I don't want to be someone that's like, sorry. No, you're okay. I don't want to be someone that's like, everything needs to be hard. Everything needs a tutorial. Everything needs a guide. Obviously not. If it's working, it's working. Use any bottle you want.

1:18:31Use whatever. But there are also gold standards like bottles that we prefer or feeding positions that we prefer, feeding schedules that we prefer. There are things when there's an issue that we can troubleshoot. Especially when we are formula feeding or bottle feeding. There are so many variables that can be in our control. And when we are postpartum, our brains are not nice to us. And we will change something every other day. And 24 hours can feel like we always do X. And it does this, even though that may be correlated but not causing the thing. And so then we jump to, I need to change my formula.

1:19:04I need to change my bottle. I need to do this. And then you just get in your head and end up doing 75 things and not really knowing what's working. We often work with families who are changing formulas constantly, trying to find something that is a fit for their baby. Well over 80 % of babies tolerate a standard or a regular formula well. So we're talking about things that do not have gentle, do not have sensitive, hypoallergenic. Most babies don't need those. Yes, tiny percent need those. Parents don't know that there's other solutions. So changing a formula feels like the thing you have to do.

1:19:39So over half of babies will change formula in the first six months, whereas maybe 5 % to 10 % of those babies truly couldn't tolerate anything on the shelf. Okay. So that's an interesting stat. And the other one is when it comes to formula-fed babies, 41 % are overfed? In the first day, three times. That was a fun fact. But most formula-fed babies are going to be overfed at some point. And overfeeding has its own issues. I've solved – I don't know if you guys – do you guys know anything about tongue and lip ties? Does that come up for you guys? No, but do talk about that because I know it comes up for a lot of people.

1:20:11It's spicy on the internet right now. It's a spicy topic. And there was a Wall Street Journal article that said the business of tongue ties. And it said it's all a scam. And there's other people that think every baby in the world needs to have a laser surgery release before they're a month old. We are very comfortably in the middle. We're evidence-based people. We follow protocols and recommendations. And we're in the middle. So tongue ties, basically, you have this little string of tissue under your tongue. Everybody has it under there. You have one right here that connects your lip to your gum.

1:20:39That is anatomically normal. But some babies, their tongue frenulum right there is either too tight, too short, or too thick for baby to have the range of motion to eat the way that they want to. So breastfeeding, it matters a little bit more than bottle feeding. But if you're having feeding problems that you can't solve, sometimes it's related to that piece of tissue. It's a basically birth defect sounds intense, but it's something different about anatomy. When a baby is forming, the tongue starts. It's completely formed, attached to the floor of the mouth. And then as they continue to develop, that frenum kind of backs up and the tongue develops to separate from it.

1:21:13And so it's just a deviation of normal. In our practice and what literature, scientific journals support is that when we have a tongue function issue, really good intervention with a feeding therapist like what we do, 80 % of the time we can meet your goals. 20 % of the time it is a structural issue. those are the babies that would benefit from a release a laser if you're concerned that your baby if you're concerned that your baby might have a tongue tie or lip tie especially because when you start googling things like reflux gas sleep trouble that is one of the things that pops up now and that's why we bring it up because it's going to show up and we want your information to be evidence-based and so the thing you do is you start with someone that is a feeding specialist you go to them first because the american academy of pediatrics says this we agree start with either either an SLP or an OT, an occupational therapist who's a feeding specialist or a lactation consultant who knows a lot about ties, they will do your first steps.

1:22:08And if you get to a point where you need that release, that therapy that you did beforehand will get you the most bang for your buck for the release and get you the best results. But the reason, another reason I brought that up is I remember a baby who was all set to do the surgery. It's almost always out of pocket. It was going to be$900 for her. And it's not a huge deal, but it's a deal. You know, you're putting a wound in your baby. It's a thing. It's another appointment postpartum. You want to go to appointments. Totally. So she came in. She was scheduled for that. Her issues were that baby was spinning up like crazy.

1:22:40The first week of life, just vomiting everywhere every single time. Someone glanced at her mouth and was like, oh yeah, it's probably a lip tie without enough evaluation, right? So that person is scheduled to do this thing. Mom couldn't afford it. She came to us first. We changed the flow rate of her bottle and we changed the way she held the baby when she took the bottle and the problem was gone. So for one consult fee, no other intervention. In everything in health, shoot for the thing that's least burden on the family. Absolutely. Totally. So yeah. So does that, in that case though, did the baby still have the tongue tie or the lip tie?

1:23:16Diagnostics is tough because it's more subjective than it should be. At that age, because they're so young, it's hard to tell. Some people think everything's a tie. And everybody has one. 93%, percent of newborns, lip tie specifically, 93 percent of newborns will look like they have a lip tie when you flip their lip. Because of the placement and the presentation of that front. Okay. The visual presentation of that is not directly correlated with outcomes. Okay. The way it looks doesn't tell you how the baby's going to eat. So we say it's a tie if it's preventing the goal. It's a lip tie if that lip tie prevents them from doing a thing.

1:23:52We are very intervene on the tongue tie or the lip tie if it's causing a current problem, not because we're worried about the future. Dentists agree that you can wait for the future. If, for example, a lip tie can cause a gap if it stays in between your teeth, basically. But you can't predict what that piece of tissue will look like when the baby has adult teeth. So you wait, you see how it goes, you don't do an unnecessary surgery on the baby. And same thing with the tongue. If the tongue function can't be improved with non-invasive measures and we are still having a functional impact, a parent can opt for that procedure.

1:24:25But if we have met our goals and they still have that frenum that presents as short or tight or restrictive, we would wait until there is a functional impact that we can't resolve. Okay. That's our stance. And that's – you're going to get – you could invite 10 people on this podcast and you'll get different opinions, but we've worked really hard. Before we became obsessed with formula ingredients, we were obsessed with tongue ties. And we try to be the expert on anything we don't feel knowledgeable enough on. So we've spent a lot of time on it. That's where we've landed. So if you're someone who's heard 19 opinions, I'm biased.

1:24:56But I think ours is pretty science-based. Okay. That's really cool, though. Because while we didn't deal with it, I know a ton of people that did. Yeah. So it's obviously very relevant and prevalent. Okay. So, you guys, this was a wonderful episode. We learned a ton. We've got our homework. We're going to go home and measure my nipple size. And in the first two hours after my placenta comes out, you're going to remind me. I've got a checklist. You've got a checklist started. You're going to take tally marks. Can you guys tell people where they can find you? Yeah. Online, Instagram, et cetera. Plug yourselves.

1:25:28Instagram's our main presence. We haven't gotten brave enough to venture into TikTok yet. I feel like I don't know. You'd love it. I'm not hip. I want to be. I want to be. I love TikTok as a consumer. So we are Instagram girls. It's at babyfeedingexperts. obviously our link in bio has really quick links to everything you need. Our main service menu is basically we developed something we call the bestie plan because we learned that you can't educate yourself. And you already said something to this. You can't educate so hard and so intensely before baby gets here and expect that to be enough because you don't know.

1:26:00And so we focus on the education being a really tiny piece. And we're like, you need to know the foundations. You need need to know the basics. And then from there, you need timely intervention if you have a hiccup. You might have zero hiccups. You might have jaundice. You might have a painful lash. You don't know which one. So we include unlimited texting in that plan so that almost all of our moms tell us within or they have their partner tell us within a couple minutes of the baby being born. And we're like, reminder, here's what you care about. And then they text us when something goes wrong.

1:26:27So that plan has videos online if that's how you learn. You get a 30-minute prenatal session with us where we prep the things that we think you need to know versus a full breastfeeding course. And then you have access to us. You also get discounted lactation virtual appointments when you're on that package. You can also do an individual, just a prenatal. You just want to chat with us for 30 minutes and see if we meet your vibe. That's also an option. How do we meet your plan A? We'll get you that run down. And then we do a couple courses, a couple guides, and then we do troubleshooting sessions.

1:26:56So if you want to chat with us live, then you would go to that bio link and schedule. You can self-schedule on there for about 45 minutes, chat with one of us. That includes seven days of follow-up as well. So usually when you're postpartum, you walk out of a doctor's appointment and you're like, what was I supposed to know? So we'll send you a summary of what you were supposed to know and then we will probably bug you most days after that. How's it going? What do we need to change? What advice did you end up hating because it didn't work for you? How do we pivot? Yeah. Absolutely. Amazing. Well, it's very valuable.

1:27:26Thank you. And so you guys go check it out. I know a lot of our listeners have so many feeding questions. I get tons of feeding questions. I'm like, I don't know. This is just what I did. So thank you ladies very much for coming and providing us with so much good insight. We appreciate it. So good to meet you guys. Thank you for having us. Nice to meet you too. Thank you. Thanks for listening to another episode of Two Parents in a Podcast powered by Just Media House. If you enjoyed the show, don't forget to like, subscribe, comment, rate, and review. Stay connected on Instagram, TikTok, YouTube, and Facebook at Two Parents and a Pod.

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