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​Most lactation consultants, including those working in outpatient hospital clinics, have switched exclusively to virtual modes (video and phone) as a way of protecting everyone during the COVID-19 outbreak. You may be wondering if it’s possible to get good lactation support without sitting in the same room as a lactation consultant, and the answer is definitely YES! During a video consult, I can still:

• Offer reassurance, empathy, and emotional support (always important, now more than ever)
• Take a complete history
• Visually assess breasts and nipples
• Visually assess baby’s mouth and latch
• Help with positioning
• Help with pumping
• Help with bottle-feeding
• Advise on breast and nipple care
• Answer questions about feeding and general newborn behavior
• Talk with partner/support person about how they can help
• Provide a written care plan to keep baby well-fed and maximize milk supply

My support doesn’t end after we hang up! Following all consults, I still:

• Send an email summary about our session, including useful videos and information
• Share my clinical notes with your family’s health care providers (pediatrician, midwife, and/or obstetrician)
• Provide two weeks of unlimited follow-up communication by email and text

To make the most of our virtual lactation consult:

• Hold off feeding your baby for 60-90+ minutes beforehand.
• Set up yourself and your baby in a place with adequate lighting.
• If possible, have a support person available to hold your electronic device and point the camera.
• If you need help with pumping, have your pump set up nearby.
• Don’t worry about cleaning your house or looking “camera ready”!

Weight checks

I bring my sensitive pediatric scale to all home visits, and weight checks and measurements of milk intake at the breast are helpful for assessing your baby’s well-being and feeding skills. If we meet virtually, I can’t weigh your baby, but I will ask you lots of questions to guide my assessment. Please keep track of:

• Your baby’s last recorded weight, including the date
• The number of times your baby feeds each day by breast and bottle
• The general length of feedings
• Diaper changes, including color and consistency of stools

 
If you have concerns about weight and milk intake, regular visits and weight checks with your baby’s pediatrician are recommended. Another option is to rent or purchase a baby scale, and I can guide you through checking your baby’s weight and milk intake during our session.
 
Some of my clients have bought this $55 scale on Amazon and found that it is accurate enough for daily weight checks, but no necessarily milk transfer during breastfeeding. The Hatch changing pad and baby scale is also popular among my clients and is $150. I have done side-by-side weight comparisons with my pediatric scale and found it to be adequate for weight checks.
 
Payment and insurance

I am offering my virtual services at a discount since I do not spend any time driving or paying for gas or parking. As of this writing, I understand that telehealth services are being covered by most insurance carriers. I am billing Aetna and Meritain for my services as usual. If you have another insurance carrier, you may prepay for your session when you book an appointment, and I will provide you with a SuperBill to submit to insurance for any reimbursement you qualify for.

Do I really need to take a breastfeeding class? Can’t I just watch YouTube videos about latching instead?

My clients often say that breastfeeding is more difficult than giving birth. They wish someone had told them this when they were pregnant. The difficulty is not necessarily pain-related (although breastfeeding can be quite painful for some at the start), but rather the day-in and day-out intensity of nursing a baby again and again and again. And each session goes a bit differently, ranging from beautiful aha moments to tears of frustration for everyone involved.

A lot of new parents tell me that they had no idea that feeding their babies would be such an all-consuming task. During pregnancy, they were hyper-focused on the birth and made sure to take classes and do their reading. Given all of the information expectant parents receive about birth, it’s no wonder that what happens afterwards might feel like a footnote. Perhaps it’s because there’s so much emphasis on childbirth as this marathon-like experience. And as someone who’s had two babies, I don’t dispute that! However, it might be more apt to say that giving birth is a sprint (even if labor was long), and breastfeeding is the real marathon.

All that being said, I absolutely think that there is value in taking classes and reading about breastfeeding prenatally. Non-birth parents need this education, too! Yes, there are some great YouTube videos to demonstrate positioning and latch, but these videos aren’t nearly as useful without a fundamental understanding of why and how breastfeeding works. Pregnancy, Childbirth, and the Newborn by Penny Simpkin is a book that encompasses all of this information, with an extension section on breastfeeding. I also recommend The Womanly Art of Breastfeeding from La Leche League International as a wonderful guide to the first-time parents.


What should I do to prepare to my breasts and nipples for breastfeeding?

Good news: pregnancy is the best preparation for breastfeeding! Your breasts are building milk-making tissue throughout pregnancy, and you start making colostrum (early milk) by the time you’re 10-14 weeks along. Some expectant parents see this colostrum leaking out or can express it with their hands, and others don’t. Whether you leak or not is a sign of how your nipple plumbing works, not a predictor of your supply.

Some people recommend toughening up the nipples by rubbing them with a rough towel during pregnancy, and fortunately, this is not necessary. Nipple skin doesn’t develop calluses like the skin on our hands and feet. Postpartum nipple pain is often due to the tissue and muscles in our nipples being repeatedly stretched, much the same way we feel soreness when we start a new fitness routine. Cracked and bleeding nipples are the result of compression during breastfeeding, not dry skin. Adjustments to positioning usually make a big difference, as does softening engorged breasts to facilitate a deeper latch. As these issues resolve, so does the pain.


What do I need to buy to get ready for breastfeeding?

You really don’t need much! Here are my recommendations:

Rice. You read that correctly. Put two cups of uncooked rice into a large sock, tie off the end, and microwave for a minute or two. You now have a heat pack to soften your breasts before nursing.

Ice. During the early engorgement phase, about three days after giving birth, many parents find that it feels good to ice their breasts after nursing.

Olive oil, nipple cream, or lanolin, to soothe damaged nipples. I don’t have a favorite brand of nipple cream and encourage people to use whatever they have on hand. Lanolin can cause itching for some people since it is a wool byproduct. I recommend applying oils or creams when there is damage to the nipple skin, keeping in mind that addressing the cause of the damaged skin is crucial. Nine times out of ten, the nipples heal once the breasts soften and positioning is adjusted. If nipples do not heal despite these improvements, there is a possibility of an infection, and a medicated ointment may be necessary.

Nursing bras or tanks. To start, buy two or three bras/tanks that are not underwire (which can cause plugged ducts) and have some stretch to them. You won’t know what size you’ll be postpartum, and your size may change a few weeks later, anyway.

Breast pads. Not everyone leaks, but it’s nice to have a few cloth or disposable breast pads to tuck into your bra in case you do. I don’t recommend buying a huge case of breast pads before giving birth, as you may not need them. Some moms can have an allergic reaction on their skin to the disposable pads.

A firm nursing pillow, such as My Brest Friend or the Blessed Nest. Firm bed pillows and sofa throw pillows work well, too. A softer nursing pillow such as the Boppy can be problematic when the baby sinks too low to stay at the breast. You may also find that you prefer a more reclined hold and don’t need one of these pillows, so it’s fine to hold off on buying one.

A new, high-quality breast pump, which you get through your insurance. My top pick is the Spectra S1/S2, followed by the Medela Pump in Style. You may have a friend or relative giving you their previously used pump, but keep in mind that pumps wear out, and some pumps are meant for a single user due to contamination concerns.

A lot of people want to know if they should pay out of pocket for a wireless pump like the Willow or Elvie. I always recommend getting a regular pump from insurance first, as the cost is covered 100% and they are typically more effective and easier to use. You can decide later, based on your situation, if a wireless pump would be useful.

If your baby arrives before you get your pump from insurance, you can rent a pump from the hospital. Your OB or midwife may be able to write you a prescription for the pump to cover the rental cost by your insurance.

A pumping bra. Pumping is much more effective when you use your hands to massage and compress your breasts, and a pumping bra makes this more manageable. Combination nursing/pumping bras are an especially convenient option. Alternately, you can repurpose an old sports bra by cutting holes where the flanges can sit.

Finally, remember that you can send someone out to Target or click through Amazon Prime for anything else you might need. Or perhaps you have several boxes or bags of hand-me-down bottles and other supplies. It’s okay to politely accept these and then put them aside as you figure out what you really need.


My mom/sister/aunt didn’t make enough milk. Will I have the same issue?

Not necessarily. The factors that influence milk production are complex and multifarious, like a spider web. Certainly there could be genetic components at play, such as endocrine dysfunction, but so many cases of low milk supply can be traced back to simple and preventable causes. Many routine hospital practices, especially a generation or two ago, were not conducive to getting breastfeeding off to the best start. We now know that holding our babies skin-to-skin early and often is a powerful way to set up a good milk supply and get the hang of positioning. Frequent breast stimulation and milk removal (breastfeeding, pumping, hand expression) are important, too. When babies were regularly sent to hospital nurseries and only brought to their mothers every four hours for breastfeeding (and perhaps given bottles of formula at night while mom slept), it’s no wonder that there were milk supply problems. Making More Milk by Lisa Morasco and Diana West is a fabulous resource and may be very helpful to peruse while you’re pregnant.


When will my milk “come in”?

You now know that you start making milk during the first trimester of pregnancy, so it’s already there when you give birth. After three or four days, though, you start making more milk. This is a very important point! When I hear people talking about their milk “coming in,” they are usually referring to the early postpartum engorgement phase. It’s normal for breasts to get larger and feel heavy and tender during this time. Some people even have lumpy or firm areas on their breasts. This phase can be quite intense for some and barely register with others.

Engorgement is partly an increase in milk and partly inflammation. That’s why it can feel good to ice breasts after nursing. I also encourage people to continue taking anti-inflammatory medications (usually ibuprofen) as recommended by their health care providers to manage their postpartum pain as well as engorgement.


What can I do to prevent problems like cracked nipples, plugged ducts, and mastitis?

Nipple pain and damage is often the first breastfeeding challenge that many new parents encounter. If you received a lot of IV fluids during your baby’s birth, your breasts may be very full and firm, making it more difficult for your baby to latch deeply. Getting hands-on help as soon as possible has saved many a nipple from an otherwise unpleasant fate! A lactation consultant, postpartum nurse, or doula can help you with good positioning to bring your baby onto the breast as deeply as possible. They can also suggest measures to soften your breasts, such as heat, massage, or reverse pressure softening.

A deep latch is also the key to thoroughly draining your breasts, which goes a long way in keeping plugged ducts and mastitis at bay. If your breasts still feel very full after nursing your baby, you can try hand expression or pumping to get more milk out. Some people discourage new mothers from pumping in the very early days postpartum, claiming that this will lead to a milk oversupply. In my experience, it is better to get the milk out when someone is uncomfortably full, and the risk of oversupply is minimal provided someone is pumping as needed (once or twice a day) for relief.

Mastitis is a breast infection that can occur two ways: milk sits in the breasts for several hours, or bacteria enters the breast through damaged nipple skin. Therefore, if you have nipple damage, it’s best to wash your nipples at least once a day with soap and water and apply oil, nipple cream, or lanolin after each feeding. It’s also important to breastfeed or pump at least 8 times per 24 hours, especially in the first month postpartum while you are establishing your milk supply. Some new parents find that they can go one 4-5 hour stretch without breastfeeding or pumping, which often occurs around the time their babies are able to sleep a little longer at night. Others wake up very full after 3 hours and need to do something about it. I always recommend listening to your body and getting the milk out sooner rather than later. It’s good for keeping the ducts clear, and it’s good for supply!


People are sending me recipes for lactation cookies and telling me to drink lactation tea. Do those really work?

Oats, flax seeds, and brewer’s yeast are all known to have lactogenic properties. They’re also highly nutritious, so you have nothing to lose by eating those foods regardless of whether they boost your milk supply.

The effectiveness of lactation teas is a real question mark because they contain a blend of herbs and vary from brand to brand. You can brew them to different strengths, and no one seems to agree how many cups it takes to make a difference.

Frankly, I think the cookies and teas are nothing more than a marketing scheme that preys on the anxiety of new parents. If a client is trying to increase supply, I always start with a plan that emphasizes consistent and thorough breast stimulation and milk removal. If that is not enough, I share information about galactagogues in capsule or tincture form, which parents can discuss with their health care providers and consider taking if medically appropriate.


I want to start building a freezer stash of milk as soon as possible. How do I do this?

Returning to work looms largely in the minds of parents even before their babies arrive, and it’s understandable that they want to be as prepared as possible for that transition. I encourage people to spend the first month of their babies’ lives focusing on establishing breastfeeding. It takes this much time to figure out how to breastfeed comfortably and set up the milk supply, and adding in pumping sessions can be disruptive to breastfeeding and/or create more work during an already busy time.

After the first month, or whenever breastfeeding and milk supply are well in hand, a lot of parents pump first thing in the morning after nursing. Supply is often highest at this time, yielding a nice pumping output. Parents can freeze this milk in storage bags for up to 6 months or save it in the fridge for bottle-feeding within 6 days. It’s okay to freeze milk that has been in the refrigerator for a few days.

Silicone hand pumps, such as the Haakaa, make it easy to add milk to a freezer stash as well. You can combine milk from different sessions by leaving it at room temperature, or keep a container in the refrigerator and add to it. Chill fresh milk before adding it to a container with cold milk. When freezing combined milk, label with the date of the oldest milk.

Finally, it’s important to note that an Armageddon-level stockpile of breast milk is not necessary for going back to work. Most babies need 1-1.5 oz. (30-45 mL) of milk for every hour that they’re being bottle-fed, so for example, if you work an 8-hour day and have a 1-hour commute each way, you’ll leave about 10-15 oz. of milk for your baby. You really just need to be one day ahead of your baby’s milk intake, and you’ll continue pumping at work in order to replenish the supply. Many parents aim to have about 3-days’ worth of frozen milk to provide a generous cushion.

A month or two before returning to work, you may find it helpful to take a pumping and working class through your hospital, or schedule a session with a lactation consultant. This will give you general information about how to prepare yourself and your family for the transition of returning to paid employment and allow you to ask questions and strategize about your unique needs and circumstances. Most parents tell me that they find these classes and sessions very reassuring and empowering!


How can my people support me with breastfeeding?

A lot of people think that the best way to help a breastfeeding parent is to bottle-feed the baby, but that can actually create more work and cause disruptions for some families. As already stated regarding milk supply and plugged ducts, frequent milk removal is really important in the early days and weeks. Nature synced babies and their nursing parents together so nicely, with baby feeling hungry right about the time the parent needs to get the milk out. So sure, a nighttime bottle is an option, but it may require the breastfeeding parent to get up and pump while someone else feeds the baby, which often defeats the goal of giving anyone a break.
Fortunately, a family with a newborn has many other needs that friends and family can attend to. A few ideas:

• Helping position baby at the breast
• Supporting a parent’s arms with pillows for more comfortable breastfeeding
• Providing drinks and snacks that the breastfeeding parent can eat one-handed
• Laundry
• Dishes
• Diapers
• Meal preparation
• Grocery shopping
• Errands
• Caring for pets
• Helping parents take baby to and from pediatric appointments
• Holding baby while a parent gets a nap, eats a meal, or takes a shower
• Providing words of encouragement

I could go on, but you get the picture. If you are getting offers of help, share these ideas with your people and let them know that by doing these things, they are making it possible for you to focus on your most important job: breastfeeding.

Some family members are eager to bottle-feed as an opportunity to bond with the baby, and again, there are so many ways to do this!

• Hold, rock, and snuggle baby
• Read to baby (It’s never too early.)
• Give baby a massage
• Give baby a bath, or take a bath with baby (get in the tub first and have a helper hand baby to you, and vice versa when the bath is over)
• Talk and sing to baby
• Walk around the house with baby

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Expectant parents, what other questions do you have about breastfeeding? Experienced parents, what do you wish you’d thought to ask while pregnant?

“So, how does the latch look?”

I get this question a lot. Many new moms tell me that the hospital nurse or lactation consultant talked with them about what to look for when baby is latching: baby’s wide-open mouth and smooth cheeks (no dimpling), upper and lower lips flanged out, a generous amount of the areola in baby’s mouth, no clicking noises or loss of suction, a round and elongated nipple after breastfeeding, and no pain. Often, moms are tripped up by the last item on the list. If the latch looks good, why is it still painful?

Because in breastfeeding, looks aren't everything.

Pain is a signal that something needs adjustment, whether it’s the baby’s position or the breastfeeding pair’s emotional state or the way the baby is sucking. Sometimes the adjustment is as simple as manually flipping a baby’s bottom lip out, which can be hard to see when that little chin is deeply buried in the breast. Flipping out the upper lip may help, too, but there is evidence that this is not as critical for a deep, comfortable latch as was once believed.

If a baby’s mouth is not wide open when latched, I find that pushing down on a baby’s chin typically doesn’t help. Instead, I recommend moving the whole baby! Often I see babies being brought to breast with their chins tucked into their chests, so pushing on the chin is futile if baby is curled up in this way. The snuggle and slide move is very useful in these cases.

When breastfeeding has been stressful, I find that moms and babies are often holding tension in their bodies as they attempt positioning and latching. Relaxed babies tend to open wider, and relaxed mothers tend to feel less pain. I like to look for ways to help the pair relax together, particularly the mom since her baby will take cues from her. Often a few deep breaths and some measures to soothe the baby, such as skin-to-skin holding, make for a much better experience initiating breastfeeding.

I also encourage moms to take a few moments to let baby relax into a latch. If baby came to the breast very hungry or fussy, her mouth is likely to be tighter, and she may need a minute or two to settle in. Rather than unlatching baby immediately to get a “correct” latch, I ask mom to see what happens if she waits a short time. Does baby open wider? How does the latch feel now? Often, the improvement comes quickly, and without the frustration of baby going on and off the breast several times until she gets it “right” (which can lead to more soreness for some moms).

It’s also possible that have a baby who is latching well and to have some lingering nipple soreness, especially if there were wounds in the early days. As those wounds heal, it’s normal to continue feeling some discomfort, particularly in the first 30-60 seconds of the latch. If the pain subsides, that is an encouraging sign that baby is not continuing to latch in a way that is causing further damage.

If, despite these adjustments, pain continues and breastfeeding feels unsustainable, there may be other factors at play. A full assessment with a lactation consult, who may loop in mom and baby’s doctors, can be useful to determine the cause of the pain and possible treatments. 

​Positioning a newborn for breastfeeding can be an awkward affair. Their little bodies are wiggly and floppy. They love to put their hands by their faces and sometimes bat at the breast, sabotaging their own efforts to latch. After a few minutes of getting baby into the right spot and (presto!) achieving that latch, they come off the breast after a few sucks. And so the process starts again.

Once baby is finally sustaining the latch, a lot of moms still have a “pinchy” sensation. They usually consider two choices: A) unlatch the baby and start over, or B) grin and bear it. Neither option is particularly appealing, particularly if it took a lot of effort to get the baby on the breast in the first place. Let me offer choice C) snuggle and slide.
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This simple maneuver works in any breastfeeding position. All mom needs to do is put her hand on baby’s back (not the head, which can lead to arching and fussing), and slide her baby’s body in the direction the feet are pointing. Sometimes, baby just needs to move an inch or two in order for that pinching sensation to subside.

Why does this work? Bringing baby in closer to mom’s body often deepens the latch, and sliding creates a bit of space between baby’s chin and chest to allow baby to open wider. This move also gives baby a better airway and swallowing ability, both of which are essential for good drinking.
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Breastfeeding is a dynamic activity, an interaction between two live bodies, so it makes sense to continually adjust throughout the feeding. I encourage my clients to experiment with moving their babies’ bodies across or slightly up or down and course correct if that pinchy feeling returns. It’s an empowering and effective strategy that gets moms to drop into their own bodies and find their own ways to breastfeed comfortably. And lest you think that I coined the adorable term “snuggle and slide,” it actually comes from one of my favorite papers by Dr. Pamela Douglas and Renee Keogh in the Journal of Human Lactation.

Need in-person help with positioning? Book an appointment with me!

I’m excited to share a brand new resource that I’ve contributed to, More to Mother, which launched today! Check out my article, Fourth Trimester: Lactation Consultant, which explains why you might want to hire a lactation consultant, what to expect, and more.

More to Mother was created by two San Francisco-based women who saw a need for more resources on their journey to becoming parents. The site provides evidence-based guidance from preconception through the postpartum period.

Please follow along with @moretomother on Instagram, and sign up to get updates when they launch their City Guides (list of trusted practitioners and resources in various cities).

Do you live in San Francisco, Marin, or San Mateo county, CA? I'm your local breastfeeding resource! Book an appointment with me.

Looking to increase your milk supply? Want to pump more, and in less time? Breast massage and compression are your best tools. Invest in a pumping bra, or make one yourself by cutting holes in an old sports bra. The idea of going “hands-free” is very appealing so that you can text or unlock the next level of Candy Crush, but using your hands may make all the difference! Experiment with where and how you massage your breasts and see how your body responds. Some people need only a light touch to get the milk flowing, while others find that placing a fist on either side of one breast and pressing is most effective.

Depending on your anatomy and the fit of your flanges and pumping bra, it may be easier or more challenging to massage while pumping. I’ve had some clients who couldn’t massage without causing a break in suction while they pumped. They had good results massaging before pumping and then tucking heat packs into the pumping bra (such as these, or using a sock filled with dry rice).
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Wireless pumps such as the Willow and Elvie make it much more difficult to massage and compress while pumping. It can be done but again depends on the individual. Anyone who relies heavily on using their hands while pumping for a good breast draining may want to refrain from dropping a lot of money on one of these pumps. I encourage people to use the pump they can get through insurance and use these massage techniques instead.

​Need help with pumping? Book an appointment with me!

“I need to drink more water to increase my supply!” I hear this and similar statements from the moms I support all the time. Or, their obstetrician or their baby’s pediatrician told them that hydration is the key to milk production. I know a doctor who prescribes a gallon of water a day to new moms! So the moms chug, chug, chug, hoping that all of this water will transform into milk. Or they blame their low milk supply on their lack of commitment to staying hydrated.

But is dehydration really the cause of low milk production?

No. At least, not the kind of severe hydration that any of us are likely to encounter. If a mother has access to water, she’ll drink when she needs to, and she’ll drink enough to make milk.

According to The Breastfeeding Mother’s Guide to Making More Milk (West & Morasco, 2009), the factors that matter most to milk supply are:

• “Sufficient glandular tissue
• Intact nerve pathways and ducts
• Adequate hormones and hormone receptors
• Adequate frequent, effective milk removal and stimulation” (p. 13)

I do occasionally see moms whose milk production is affected by one or more of the first three items on this list. For example, breast reduction surgery removes glandular tissue and may cut across nerve pathways and ducts, and moms who have had this surgery often make less milk as a result (but they do make some milk!).

I see a larger number of moms who need to increase milk removal and breast stimulation. The earlier they are able to do this, the better the results. To establish milk supply, most moms need at least 8 breast drainings (breastfeeding and/or pumping) per 24 hours. If they can do more than that, they’ll usually see more milk more quickly.

Mother-baby contact is also really important for milk supply. If a separation is medically necessary in the early days, such as a NICU stay, many moms find that their supply goes up once they are able to snuggle and breastfeed their babies more often. A lot of babies ask to be held frequently, but some are mellower and may be fine hanging out in a bassinet or bouncy seat much of the time. If I am supporting a family whose baby has this personality and the mom is trying to make more milk, I suggest that she wear her baby some of the time in a soft wrap or sling. This physical closeness sends the body a powerful signal that says, “Baby’s here! Let’s make some milk!”

So let’s get back to hydration for a moment. It’s true that many breastfeeding moms tell me they’re thirsty much of the time. And yes, that could very well be because they’re making milk and need to replace those fluids in their body. But even if they were a bit dehydrated, they’ll still make enough milk for their babies. Moms whose production is below their babies’ needs may not be quite as thirsty because they’re making less milk, for one of the aforementioned reasons. See how that might cause some confusion?

I always encourage moms to simply drink to thirst. More water just makes more urine! And any breastfeeding mom will tell you that she already spends enough time waiting for her baby to finish nursing so she can finally go to the bathroom. Ah, the glamour of motherhood!

​Need help with breastfeeding? Book an appointment with me!

I see a lot of families in the early days and weeks of their babies' lives. Most new parents are contacting me because they need support feeding their babies, both at breast and by other means (mostly bottle and syringe). Common worries revolve about baby's weight gain, milk supply, feeding cues, and the stress and discomfort of figuring out breastfeeding.

Often when I arrive for a home lactation consultation, the family is already using a feeding plan recommended by a hospital lactation consultant or pediatrician. The plan involves some combination of breastfeeding for a set amount of time (usually 15-30 minutes), pumping, and supplementing with pumped milk and/or formula, i.e. triple feeding. This is a huge improvement over the old advice to "just give formula, and good luck!"

These types of feeding plans are important for many families in order to keep baby well-fed and protect the milk supply. I reassure parents that if they continue feeding their babies any way they can and keep mom's milk flowing, breastfeeding will usually follow. It may take days or even weeks, but they'll get there.

This is a stressful time for the family. They're working so hard, and they don't know things are going to get easier. Numbers rule their lives: timing feedings and pumping sessions, counting diapers, measuring ounces and milliliters, weight checks for baby. Those numbers are important for ensuring that their babies get enough to eat and continue gaining.

For a time, the numbers may crowd out something that new parents crave: simple, sweet, uninterrupted time with their babies. But does it have to be that way? Is there space for snuggling and lingering at the breast with all of these other boxes to check off?

I believe there is. I call it recreational breastfeeding, and I write it into the feeding plan. The goal of recreational breastfeeding is just as the name suggests: fun and enjoyable. It is not about transferring a certain amount of milk into the baby (who may not yet be capable of getting a full feeding at breast). In fact, it isn't really about feeding at all. It's soul nourishment for a family that is working very hard and deserves a brief respite from triple feeding.

The concept of recreational breastfeeding is also a way to plant the seed for what is to come. So often, I see families who triple fed in the past and have graduated to exclusive breastfeeding. They celebrate this milestone, and yet they remain attached to the numbers. It makes sense. What could be more anxiety-provoking than parenting a newborn who is having feeding difficulties? The numbers represent a morsel of control in a situation that may largely felt beyond the control of the parents. So I talk with the parents about starting to do some recreational breastfeeding as a way of gently letting go of the numbers, just a little bit, and trusting that they are at a different stage.

It is a beautiful moment when I see this idea click for a family that has gone through so much. I see them settle in and really soak up the sweetness of their babies. This is what I wish for all breastfeeding families.

​Want to learn more about recreational breastfeeding? Book an appointment with me!

When I was pregnant with my first baby, I assumed that there was no need for me to take a breastfeeding class because my mother is a lactation consultant. After all, she’d teach me everything I needed to know, right? I was surprised when she suggested that my husband and I sign up for a class at the hospital where we planned to deliver, but I decided it certainly couldn’t hurt.
The class was held on a weekday evening and was about 3 hours long. Honestly, I don’t remember a lot about what was covered, but I was pleased to see how many partners attended. In many ways, the class was structured to educate partners so that they knew how to support the new moms and babies in their lives. Nobody would argue with the value of that.
I have been teaching hospital breastfeeding classes for the better part of a year, and I expect I’ll continue until I finally break into the modeling industry. And yes, I think that all expectant parents should take a breastfeeding class. It would probably be helpful for the grandparents, too, along with anyone else who is going to be supporting the new family.
Last week, I was at the hospital where I teach, and a dad-to-be asked me, “Do we really need to take the breastfeeding class? I mean, won’t it be enough to get help from the lactation consultants at the hospital?” How interesting that this thinking persists: lactation consultants are a shortcut to understanding breastfeeding and solving your problems! Well, sometimes…
Of course I told the dad that he and his partner should take the class because:

1. Hospital lactation consultants are busy! There are no guarantees that an LC will be available when you most need help, and you may not get as much of her time as you’d like.
2. Breastfeeding is a skill that takes time for mom and baby to learn, so even a nice, long visit from a hospital LC is unlikely to address all of the questions and concerns that arise over the next few weeks.
3. It is so much easier to help parents with breastfeeding when they already have a basic understanding about how it works. LCs can then focus on the specific needs of the family rather than teach a crash course of Breastfeeding 101. The chaos and sleep deprivation of the newborn period makes it difficult to retain a lot of new information, anyway.
4. With early feeding problems, it’s critical to know when to reach out for help and who to call. Breastfeeding classes cover how often newborns should be fed and how to tell if they’re eating well. The sooner any problems are addressed, the better.

While I may be slightly biased, I think you should take a breastfeeding class!

Want a private, in-home breastfeeding class? Book one with me!

 ​Ten years ago, I was teaching writing classes at the University of San Francisco and doing the final copyedits on my first novel. The written word was my world, and I was getting paid for my art. I was an artist. It was pretty awesome.

I continued my writing endeavors after my first baby arrived, but I found that I was spending at least as much time reading about breastfeeding and parenting. When my novel hit the shelves in 2009, I was working on a second manuscript and had also applied to become a La Leche League Leader. I eventually ditched the manuscript to make more head space for learning about breastfeeding, and I welcomed a second baby. At that point, I told myself that I could go back to writing novels whenever I felt called to do so. I expected I would also return to teaching writing.

The families that I have supported through La Leche League have been some of my greatest teachers, and they have changed me in ways I never could have imagined. I learned the art of listening (REALLY listening) and keeping the conversation focused on the family’s situation rather than sharing something personal. No one needed to tell me that word choice matters, and I learned language for the art of reflective communication. I learned the art of praising new parents without being overly flowery or giving false hope. Most of all, I learned the art of holding space for people in times of need.

What really came as a surprise was that I was also learning A LOT of science. I had never considered myself a “science person.” Math was always fun for me, but science just wasn’t. I did okay in the science classes I took in high school and college and paid a bit more attention when learning about human sexuality. Ultimately, though, science was not my jam. Not yet, anyway.