Ep. 72: Your Breastfeeding Questions Answered! Interview with Jessica Claire, IBCLC

November 18, 2019

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Laura interviews lactation consultant Jessica Claire, IBCLC, who answers listener questions about everything from sore nipples to the Haakaa manual breast pump. Also, in the weekly check-ins, Shanna discusses her baby’s unusual new skill, and Laura reports on a receiving an unexpected result at her baby’s nine-month checkup. Finally, they reveal their BFPs and BFNs for the week. Shanna’s baby is ten months and one week old, and Laura’s baby is nine months and one week old.

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Episode Transcript

[Music]

Shanna Micko: Hi. Welcome to Big Fat Positive with Shanna and Laura. On this week’s episode, we’ve got our weekly check-ins. We have a very special segment, an interview with lactation consultant, Jessica Claire, answering listener questions. It’s such a great segment and we wrap it up with our weekly BFPs and BFNs. Let’s get to it.

[Music]

Shanna Micko: Hey. Welcome to the show. Hey, Laura.

Laura Birek: Hey, Shanna.

Shanna Micko: How are you guys doing? How old’s your baby?

Laura Birek: My baby is nine months and a week. We’re actually at 40 weeks, which feel special because it’s a due date on the outside. We kind of had a week. So I mentioned I had back pain last week and I thought it was because I had taken away the Brest Friend nursing pillow and thought I could just set my baby on my lap now and I am happy to report that I went back to the Brest Friend and I am feeling better.

Shanna Micko: That’s good.

Laura Birek: So that helps. I’m just trying to be a little more conscious of my ergonomics and I think that’s helping and this week we went to my baby’s nine month appointment. One of the positives was that I thought he was going to get some shots, but it turns out he didn’t need to get any shots because he had already gotten both of his flu shots and he isn’t due for more of his immunizations until next time. That was nice.

Shanna Micko: Yay.

Laura Birek: That was a benefit. However, he did have to get his little toe pricked for the hemoglobin test to see if his iron was doing okay.

Shanna Micko: Oh, yeah.

Laura Birek: Turns out it’s not.

Shanna Micko: Wait, what?

Laura Birek: Yeah, okay.

Shanna Micko: Oh, no.

Laura Birek: I went with my mom, which was my first mistake, because she just talked the whole time over the doctor.

Shanna Micko: And remind everyone your mom is a doctor too.

Laura Birek: She is a doctor. So I barely got a word in edgewise, but when they came in and they did a little pinprick on his toe, which he actually didn’t mind that much. They squeeze a little drop of blood out onto a little test strip or whatever and then they came back and they were like, “We need to do that again.” My mom was like, “I bet it’s low. It looked really pale to me,” and I was like, “Okay.” She was like, “I’ve seen so much baby blood in my life. I know one. I can see it.” I know, right?

Shanna Micko: Not many people could say that phrase.

Laura Birek: Thank, God. It’s not something to be proud of I guess. But she was like, “I could tell. It looked kind of pale.” So the first little test came back as nine and a half and then the second one came back as 10 and 11 is normal. I guess it’s not so low that they have to worry. My mom said when it’s at six they want to admit you and when it’s at eight they want to really start supplementing. These numbers are kind of off the top of my head. But the idea is that he was just under what’s normal.

Shanna Micko: Wait, did you say what this test is for?

Laura Birek: Yeah, it’s hemoglobin. It’s to test to see if he has enough iron in his system, because I guess babies have a big iron store in their system from in utero and then it starts getting depleted and that’s why it’s really important to start solid foods around six months at least, because you need to start getting that iron back in. But apparently, we haven’t been doing a good enough job.

Shanna Micko: Oh, no.

Laura Birek: I guess there’s a benefit to having a formula fed baby because there’s a lot of iron in formula. So it’s fortified really well. I was worried because I realized I’ve been continuing taking my prenatal vitamins this whole time thinking I’ve been like a good girl and then I realized I was taking the Gummies and the Gummies don’t have iron in them.

Shanna Micko: That’s right.

Laura Birek: But then I googled it and discovered it doesn’t actually matter much. The maternal diet doesn’t really seem to affect breast milk iron levels. So I didn’t have to feel guilty about it for very long.

Shanna Micko: That’s good.

Laura Birek: But anyway, so there was another little thing at the doctor’s appointment where they give you a little questionnaire asking three questions. It was like, “Do you live in a house that was built before 1950? Does your child go to daycare or childcare at a place that was built before 1950? Or are you currently renovating a house that was built before 1970 or something.” 

I don’t remember the exact dates, but our house was built in 1922. So I was like, “Yep.” That at least in my doctor’s office means that we have to automatically get a blood test for lead.

Shanna Micko: Right.

Laura Birek: So because we have to get a blood test for lead as well, my doctor said, “You’ll get your iron and your lead tested at the same time, but why don’t you wait a month and just try to get him as many iron rich foods into his diet as possible and then retest?” That’s now our plan. We are going to be eating like meat and spinach and beans and tofu and just trying to get him iron rich foods all the time and hopefully that’ll solve it so we don’t have to supplement. Not that it matters. Supplementing is not that hard, but it does cause constipation and I really don’t want to have to deal with that on top of everything else. But it’s interesting, because my mom was like, “He doesn’t act anemic.”

Shanna Micko: I was going to say, are there any side effects or what’s the signs of having this low iron in a baby?

Laura Birek: I think being anemic just makes you really lethargic.

Shanna Micko: I would imagine.

Laura Birek: My baby is not lethargic. Lethargy is not a problem.

Shanna Micko: No, not that I’ve noticed.

Laura Birek: He’s full of energy. I’m sure there’s other health problems if it’s really, really low. But I think energy is a big one. We’ll see. We’re just going to wait a month and then get his blood drawn. I don’t want to get his little blood drawn though. It’s not a little toe prick. It’s like an actual venous blood draw.

Shanna Micko: Poor buddy.

Laura Birek: I know. I’m excited to put that off. When she was like, “You can wait a month.” I was like, great. I would like to do that.

Shanna Micko: Good.

Laura Birek: That was the result of his nine month checkup. He’s also in the 45th percentile of weight now. If you recall when he was a newborn and all the way through I think four months, he was in the eighth, ninth percentile in weight. I’m not sure. Did I talk about that?

Shanna Micko: Yeah, I think you talked about that.

Laura Birek: He was a small fry and now he’s definitely bulking up. That’s very cute. He’s got the baby rolls on his arms, forearms and his legs.

Shanna Micko: Yes.

Laura Birek: That’s fun. It’s always fun to go to the doctor and find out how much they’ve grown, because you can’t really do it at home.

Shanna Micko: No, you’re just like all of a sudden thinking, God, that baby looks big in that car seat.

Laura Birek: Right. I know.

Shanna Micko: To me that’s how I feel. I’m like, you’re not a newborn anymore, because you take up the whole seat.

Laura Birek: Corey kept joking. The whole week up to the appointment he was like, “This guy’s heavy. 20 pounder for sure.” Then he ended up being 19 pounds, two ounces.

Shanna Micko: Okay.

Laura Birek: Not quite, but soon. But the other thing that happened this week that is also medical and not fun is I got awful horrible terrible food poisoning.

Shanna Micko: How do you even deal with parenting while you’re going through that?

Laura Birek: Corey stayed home. I did not do any parenting. I couldn’t do anything. Thank God Corey could stay home. I got it on Friday and then it got better by the end of the weekend thankfully. But on Friday, I couldn’t walk into the other room without feeling dizzy and weak and couldn’t eat anything. It was so unpleasant and then I was just out of it for like three days.

Shanna Micko: Were you still nursing?

Laura Birek: Yeah, I was a little afraid it was like a virus. I wasn’t sure if it was food poisoning or a stomach bug and so I wanted to keep on nursing the baby just in case it provided some kind of antiviral benefit to the baby: antibodies in the breast milk and whatnot. But also it seemed way easier to nurse than to pump.

Shanna Micko: That’s true.

Laura Birek: The thought of sitting and pumping while I was sick just seemed awful. I could have Corey come on in and my baby nurses for like five minutes now. He’s really efficient. He brings him in, nurses and it gave him a little time with me, because he was really mommy starved. Poor little guy.

Shanna Micko: He was probably so confused.

Laura Birek: I know. I just felt so bad. But being sick as a parent is just awful. Especially as a mom, you just can’t ever just totally turn off. I got really close though. 

Corey really, really took care of the baby and just managed everything and was trying to help take care of me and I didn’t really need much taking care of. I just needed to be left alone.

Shanna Micko: I dread the day that happens with me with two kids, because obviously I’ve been there with one and it does suck. Now I’m just like, oh my God, what are we going to do? I feel like I always just push through. I don’t think, knock on wood, I’ve been to the point where you were this time, thank God, where you feel like you couldn’t do anything. I’m always just like, I feel terrible, but I’m going to push through. What else are you going to do?

Laura Birek: I’m a classic push through. This time getting up to walk to the bathroom or walk to the kitchen to get a glass of more Gatorade, honestly, I was drinking a lot of Gatorade, was making me almost faint. I was dizzy. There’s two options of things it could have been. It could have been breakfast sausage that I ate that no one else ate. Or I was eating samples of apples at the farmer’s market and I don’t know if they really washed those things when they cut them up.

Shanna Micko: I always see kids running up to those sample things with their grubby little hands and sticking them in there. So maybe it was a virus that you picked up from some grubby little kid. I don’t know why I’m picking on kids.

Laura Birek: Thankfully, knock on wood, no one else has gotten it.

Shanna Micko: Good.

Laura Birek: It’s one thing to be sick as a mom. It’s another thing for the entire family to get like norovirus.

Shanna Micko: We’ve been through that. That’s definitely not fun. Anyway, you know how I just love that topic.

Laura Birek: I know. We’re not going to get into details. But anyway, my week was not great: kind of shitty. But that’s life and it’s not too funny. Shanna, why don’t you tell us about your week and bring us out of this sick cloud?

Shanna Micko: Yes, my baby’s 10 months and one week. Luckily, I have nothing on the sick front to report. Yay, knock on wood. But we also went to a checkup. We do 10 month. We do every two months. So we’re a little bit off schedule of you guys.

Laura Birek: We’re different. I think that’s really kind of interesting. Our office does right after newborn I think then two weeks, four weeks. I don’t remember at the beginning. Go back to listen to those episodes if you really want to know. But then it’s I think 2 months, 4 months, 6 months, 9 months, 12 months.

Shanna Micko: Okay. We go every two months and it sounds pretty much like exactly what you did. So I don’t have too much else to add except that she did pass her iron test, yay.

Laura Birek: That’s good.

Shanna Micko: The thing of note with that is funny that you said they took it out of his toe. They took the blood out of CeCe’s finger in the lab at the doctor’s office, which was fine. She was all right with it and then they wrap it in a Band-Aid and then they said, “You are not allowed to leave this doctor’s office for 15 to 20 minutes, because we need to take the Band-Aid off and see that it’s off before you leave, because they can sit in the backseat and chew on it and choke on it. So if you don’t have another person with you…”

Laura Birek: They said the same thing to us.

Shanna Micko: Really?

Laura Birek: But you were alone. They just said like, “We have to take this off.” They came and took it off for us, but they said the same thing: it’s a choking hazard.

Shanna Micko: I guess if I’d had someone with me, they would’ve allowed us to leave, because someone could sit next to her in the back seat and make sure, but I was alone with her and so we just sat and hung out and of course the second that Band-Aid was on, she was just chewing on it, putting it all in her mouth. So I was like, this is a really good idea. I’m glad you guys are doing this because I would not have thought of that. Even though I have lived through this before with my first child, now I remember that we did it with Elle. But I forgot about that and so I’m really glad that someone else in my life is vigilant about my baby’s safety. The other thing to note is that she’s now 80th percentile for weight and 55th for height.

Laura Birek: Dang, girl.

Shanna Micko: Those fun little stats. Very chunky legs.

Laura Birek: Delicious tiny feet chunky legs.

Shanna Micko: So funny. That’s that. The other big news is that she took four steps all by herself.

Laura Birek: Wow. Consecutive steps. That’s cool.

Shanna Micko: I’m like, I think she’s walking.

Laura Birek: What do you call it, because that sounds like walking to me?

Shanna Micko: She’s not walking across the house, but she’s making attempts on her own and taking multiple steps. I don’t know where we’re going to go from here, but obviously I think it’s climbing mountains or something, because this kid is on the move.

Laura Birek: Definitely. I think you should go straight to the climbing gym.

Shanna Micko: She does go to My Gym.

Laura Birek: That’s true.

Shanna Micko: But yeah, rock climbing might be the next thing.

Laura Birek: Can she get onto her standing from the ground or does she need to pull up on something first?

Shanna Micko: She has done that once. I saw her do that one time and she concentrated really, really hard and she was working on it and she stood up and balanced and looked at me like, what did I just do? I’m like, what did you just do? But I haven’t seen that happen since.

Laura Birek: It’s hard for me to do. It’s a lot to get up from the ground onto your feet.

Shanna Micko: It truly is. It’s only getting harder for me. But she has to use at least a little something like my knee or something like that and then the other thing she’s been doing lately is whistling.

Laura Birek: What? She says backpack. She whistles.

Shanna Micko: She’s such a conundrum. I love her so much. What the heck? All of a sudden I just hear her whistle. I was like, what? Where did that come from? I’m looking around, huh, that’s weird. I think that was her, but I don’t know, because I didn’t see it at the moment. 

Then an hour later I listen to the little baby whistle. My three and a half year old has been trying for years to whistle and cannot do it. If I whistle for the dogs, that’s like a dog whistle. Here’s my three and a half year old’s attempt at whistling, “Woo. Woo.” I am just flown next by the fact that my 10 month old has figured this out. I’m sure it’s just accidental. She’s just experimenting with wind going out of her lips and whistle.

Laura Birek: That’s amazing.

Shanna Micko: It really is. I totally thought it was a fluke and I messaged Steve. I was like, “Oh my God, she’s whistling,” and he’s like, “What?” Sure enough, it’s been a thing. It wasn’t a one off.

Laura Birek: Have you gotten it on video?

Shanna Micko: I haven’t. I really need to try.

Laura Birek: You should try. It’s hard. I know how it is because every time my baby does something cute I’m like, got to get the phone out. Got to get it on video and then he stops.

Shanna Micko: Yes, instantly. They know that camera’s on them. It’s too funny. So those are my updates this week. Nothing major.

Laura Birek: You had a much fun week than I did.

Shanna Micko: Just to take the good weeks as they come.

Laura Birek: No, that’s great.

Shanna Micko: Why don’t we take a break and come back for our special segment, which I’m very excited about, because you interviewed a lactation consultant with listener questions.

Laura Birek: I did.

Shanna Micko: Let’s do it.

[Music]

Shanna Micko: Welcome back. We have a special segment for you today. Laura went out in the field without me. Laura, how dare you? I kid. She went out in the field and recorded an interview with a lactation consultant at the… Where was it?

Laura Birek: It was actually at the place I go to Mommy & Me class. They have an in-house lactation consultant named Jessica Claire and so after my Mommy & Me class, I just popped over to her office with my baby, as you will hear, and got to ask her all of the listener questions we had about nursing.

Shanna Micko: Awesome. It’s so great. You guys sent in so many wonderful questions and we really did this, because Laura and I read those questions and we’re like, we have opinions but we have no actual knowledge. We are not qualified in this.

Laura Birek: Way above our pay grade.

Shanna Micko: We wanted to get good information for you guys. So I hope you find this helpful. I loved it. Even though I’m done nursing, I’m all formula now, but I wish I had a lot of this info back in the day. So let’s hear your interview.

Laura Birek: I’m here with Jessica Claire, who is an IBLBC. Is that how…

Jessica Claire: It’s an IBCLC.

Laura Birek: I said that wrong.

Jessica Claire: You want to know what it stands for?

Laura Birek: Yes, please.

Jessica Claire: It’s International Board Certified Lactation Consultants. It’s kind of a mouthful.

Laura Birek: Okay.

Jessica Claire: That’s what’s it is.

Laura Birek: But you’re a board certified lactation consultant and I was able to get in touch with you, because we’re at the Family Room, which is a fantastic resource in San Marino, California, which is right next to Pasadena where I live. You will hear that my baby is breastfeeding at this very moment.

Jessica Claire: Yay.

Laura Birek: Jessica has graciously agreed to answer your listener questions, so shall we dive right into it?

Jessica Claire: Please.

Laura Birek: All right. We will just start at the beginning.

Listener 1: I am a very soon to be first time mom who hopes to breastfeed and I guess one of my burning questions is how to properly introduce and use a Haakaa breast pump. I don’t want to mess up my milk supply, but I also want to start saving some milk as soon as I can and I really like the idea of it. I just don’t know how to use it properly. So any advice you have for me would be amazing.

Jessica Claire: Great question. I wouldn’t classify it as a breast pump. It’s basically a breast suction cup that collects extra milk that drips out on the side that you’re not breastfeeding on and so it is best used when the baby’s on one side and you’re suctioning the Haakaa onto the other side. You’re right. You’re really smart to think about not overusing it in the beginning, because if your baby is breastfeeding really well in the first four weeks or so, you don’t want to be taking tons of extra milk out typically. Even if you’re going back to work a few months out, you would prepare for that closer to the time of going back to work, not when your baby’s a newborn. I do see it really be helpful in the beginning first week when mom is maybe having a lot of engorgement and she’s wanting to just take the edge off of that really full feeling on the other side when the baby’s nursing. So you could use it a little bit then. Then when you get close to wanting to introduce a bottle, which typically I recommend four to six weeks is when we might try using a bottle for the first time if our baby has been nursing great up until then, then you could use the Haakaa little bit here and there. Maybe once a day, twice a day to collect little bits of extra milk to practice with. So that’s how I would recommend most people use it. But again, it depends on your situation and you’d want to find either a local lactation consultant to work with if you were having problems with milk supply or anything like that early on. But yeah, you can overuse it in the beginning, because you do get a lot of milk in the beginning and I would say, use it judiciously because if you are taking out tons of extra milk and breastfeeding your baby, you can get yourself into an oversupply situation which can be uncomfortable.

Laura Birek: Because it’s like a supply and demand situation.

Jessica Claire: Yeah, but I will say, I have a lot of moms who use it in that first week just to kind of soften the breast a little bit, because things are so overactive. But you shouldn’t be putting ounces and ounces and ounces in the freezer in most circumstances. Now, some people may have a special need to go back to work early or something like that and then we might have a different discussion.

Laura Birek: How would someone find a lactation consultant in their area?

Jessica Claire: You can go to ilca.org, the International Lactation Consultants Association. They would have a directory there of board certified lactation consultants. Usually, the hospital that you give birth at or the birth center or if you have a midwife at home, they would have good contacts for good lactation consultants in your area. Those are some resources.

Laura Birek: Great. Let’s do this one from Courtney.

Courtney: Hi, Big Fat Positive. This is Courtney from Austin, Texas and I have a breastfeeding question. My nine month old weaned at six months old after struggling since her birth to get my supply up. We were breastfeeding as much as possible. We did the skin to skin, everything everybody suggested, all the supplements and pretty much just anything anybody suggested, we tried it and we were triple feeding for about four of these six months. It was insane. We went through several lactation consultants only to find out at the very last appointment we had that I have something called insufficient glandular tissue or IGT. So my question is, in future pregnancies, is there anything I can do to help my supply or am I just kind of stuck with this? Thanks, guys. Love the podcast as always.

Jessica Claire: Great. Wow. Thank you so much for your question. It sounds like you were doing Herculean effort with the breastfeeding with your first baby and I’m so sorry it took many, many healthcare professionals to actually give you a reason why you were struggling so much that. That’s amazing what you did for your baby. I would say a couple things. Keep in mind that if you have more children, every time you get pregnant, your breasts grow more milk-making tissue than they had at the last pregnancy. So I have worked with numerous moms who are in the same boat as you, meaning having not quite sufficient glandular tissue to make enough milk for their baby with baby number one, but then with subsequent babies, they make a lot more. Sometimes 100% of their babies need. So that will be helpful if you have a subsequent pregnancy. Now you’d really want to be working with a healthcare professional, but there are some herbs that one could take at the very end of pregnancy that can help proliferate the milk-making tissue. But you really would want someone looking at your complete health history before making a decision to take something like that during pregnancy. A really good resource for you to have if you don’t own it already is a book called Making More Milk by West and Morasco. They just are coming out with a second edition and it’s totally tailored for women who are in your situation. It would be great for you to read the portions about IGT, insufficient glandular tissue, in that book while you were pregnant with your second baby if you do have another child. But yes, there are things to do, but I don’t want to give any specific recommendations because I don’t know what your health history is.

Laura Birek: That makes sense. We’ll make sure to put a link to that book on our website: bigfatpositivepodcast.com. That sounds like a great book. Let’s just dive into the next question. We have a question from Maria.

Maria: Hi, Shanna and Laura. This is Maria from Austin, Texas with my two weeks old Juniper. My question is, when did your nipples stop hurting, because mine have just been getting more and more sore. I’m really hoping there’s a light at the end of the tunnel. Thanks, guys.

Jessica Claire: Hi. I so love your baby’s name. Such a cute name. I am so sorry that you are having sore nipples still. The way I describe normal is a little bit of tenderness in the first week. Meaning, they feel a little worked. I feel like I want to put a little bit of lubrication on them after I breastfeed my baby, because I don’t know about you. But nobody was sucking on my nipples 10 times a day before I had my first kid. So they felt a little worked if everything is normal. Some women feel no pain whatsoever from the beginning, but they might be a little tender. Anything beyond that and especially if it’s getting worse as time goes on, needs someone looking at the whole situation, because the most common reason you’re going to have nipple pain of course is latch and positioning. I’ll bet you have YouTubed, asked your friends, the consultants at the hospital, everybody’s tried to help you with latch and positioning. If that isn’t really making a difference, you need a full workup in terms of having someone really skilled look at your baby’s anatomy and function for breastfeeding, which includes their whole body and usually that’s a very skilled IBCLC who has extra special training in structure and function and tongue tie, those kinds of things. That would be one thing to check out. Also, there might be underlying health issues that are causing this nipple pain to continue as well. If I were meeting with you in person, I’d have a million other questions for you, because pain can present in different ways and that can sometimes help us figure out why it’s there. But you deserve to have pain-free breastfeeding. You really do and if there is pain like what you’re describing, there’s a reason for it and sometimes it takes specialized help to really suss out the why. So I don’t have anything super specific, but it sounds like what you’re experiencing isn’t normal and I hope you can find someone in your area to help you.

Laura Birek: I feel like a lot of women just assume that breastfeeding is supposed to be painful.

Jessica Claire: Totally.

Laura Birek: Like you said, tenderness is one thing. Pain is another.

Jessica Claire: I would say if you are having excruciating pain: you don’t want t put the baby to the breast, you’re crying, there’s visible cracking and bleeding, that I would get help as soon as possible like in the first few days. If someone tells you the latch looks good but it’s really painful, that’s not acceptable. You need to find someone who can help you get to the bottom of it. If after the first week it’s getting better and better and just a little tender, that tenderness can stretch on past a week, but typically it should be gone by then. That’s kind of where I would go with it.

Laura Birek: Very good to know. Okay. We have one more question here from Joy.

Joy: Hi. This is Joy in Atlanta, Georgia. I wanted to ask, how did you guys get your babies on a feeding schedule? I have a six week old who’s sort of on a schedule, but it’s kind of a challenge. Thanks.

Laura Birek: I wanted to ask you this because she’s asking Shanna and I, how did we get our babies on the schedule? My answer is I didn’t really.

Jessica Claire: That’s true.

Laura Birek: I’m still basically feeding on the man and I guess my question is like, is that a thing?

Jessica Claire: Yeah, now I’m not sure if she’s breastfeeding or bottle feeding.

Laura Birek: That’s a good question. I’m actually not sure. She didn’t specify.

Jessica Claire: But even so, I’m maybe not the best person to ask, because I’m not a big fan of strict baby schedules. I’ll tell you why. I always encourage my families to think about this as a marathon, not a race, not a sprint. This is a long-term project. What do I want for my kid? I want my kid to eat when he’s hungry, finish when he’s full. I’m going to trust that my baby full-term, healthy baby knows when they’re hungry and I’m going to look for those cues, which I’m sure you’ve been going off of, whether you’re breastfeeding or bottle-feeding. So even at six weeks, which is still pretty young and even beyond into babyhood, it actually sets up a much healthier relationship between your baby’s brain and their stomach and their satiety and learning not to overeat and not to starve themselves in between if you go on cue-based feeding.

Laura Birek: Okay.

Jessica Claire: If that doesn’t work for you, most of the scheduling programs and books and such are somewhere on a three hour kind of rotation. But that’s not going to work for every single baby or mom, because some babies are going to want to sleep longer, earlier. So it’s hard to say. I’m not the best person to ask about how to get babies onto a schedule.

Laura Birek: It sounds like the question could also be like, do I need to get my baby on a schedule? Your answer would be no.

Jessica Claire: I would be no. There are extreme cases where mom isn’t getting any sleep and we try to get baby onto a more reasonable rhythm that’s going to work better for her mental health, that kind of thing. Certainly not opposed to that, but babies aren’t robots. I don’t know about you, but I wouldn’t want someone telling me exactly when I could eat lunch every day.

Laura Birek: Of course.

Jessica Claire: So I think some part of it is trusting that your baby will space out their feedings at some point, that they’re not going to need the breast or the bottle constantly all the time. But the first six to eight weeks, there is no discernible for most babies’ super clear rhythm. But by 6, 7, 8 weeks, a lot of babies will get themselves into a more predictable rhythm of eating and sleeping and certainly, I’m not going to recommend a book or anything, because there’s a million out there telling you how to get your baby to be the perfect baby. 

I would say, think of it as a rhythm and think of it as a communication between you and your baby and continuing to feed on demand is actually a very healthy way to go for most moms and babies.

Laura Birek: Okay. Sounds like my baby wants to communicate something.

Jessica Claire: Yes, he does. He’s trying to talk.

Laura Birek: We’ll see if we can get one more question. I’m not 100% sure. So I’m going to ask. This is actually not an audio question. I’m just going to read it. We’re not sure who asked this. Someone sent it on Instagram. The question is, “Is it respectful to my baby to keep trying to breastfeed even though she prefers her bottle? A little background, my baby is 12 weeks old and I’ve been exclusively pumping since about two weeks. I try and breastfeed every day, but she always starts crying and fusing as soon as I put boob even close to her face. I really want to nurse, but I don’t know if I should keep trying or not if she really hates it as much as she seems to.”

Jessica Claire: Thank you for writing in. Sounds like a really hard situation and I’ve seen it many, many, many times before. The way I usually think about this is it’s not that your baby doesn’t want to breastfeed, she’s just having a really hard time doing it. I don’t know why. I’m not watching you guys, but there’s a reason for it. I would say if we’re trying to get baby interested in breastfeeding, you don’t want to let her scream at the breast. You’re just reinforcing this is hard for me and mom is trying to do this thing. I don’t know if I’d use the word disrespectful. 

Maybe just that if you are trying to get baby to be interested in latching onto the breast, you might try when she’s half asleep, when you’re in the bath together, when you’re using a baby carrier and she’s moving when she’s not hungry. So thinking of the breast as almost like a soothing tool to begin with and so after a bottle, offering the breasts and see if she’ll do a little bit of non-nutritive sucking, that’s where I’d back up and start if we were trying to get baby interested in breast.

Laura Birek: So associating the boob with something else.

Jessica Claire: It’s Disneyland here at the breast and let’s try to keep it a happy place. If she’s really arching and fussing, she’s trying to communicate with you and it’s not that she doesn’t like breastfeeding, it’s just she’s never felt successful at it. Again, a bit of a broken record, you probably should be seen by a really good lactation consultant who can really look at the whole situation. But that’s where I’d start: really trying to just back off rather than trying to, she’s really hungry. I know she’ll latch on. Give her the bottle that she’s used to and has an easier time with and then try some comfort nursing and see where you get with that.

Laura Birek: That’s great.

Jessica Claire: You have so much to say.

Laura Birek: You’ll handle one more question. Okay. This is actually the last one.

Listener 6: I’d really love to hear your thoughts on nipple confusion. I’m wanting my partner to feed the baby maybe once a day or something just to help me out. But I’m really unsure as to when to introduce a bottle. I don’t want to do it too early or too late and I’m afraid of the dreaded nipple confusion. So any advice you have for me would be amazing.

Jessica Claire: Great. Yes, the dreaded nipple confusion. I actually don’t think of it that way. I think of it as nipple or flow preference. So some babies, not all, who are introduced to a fast flow bottle early on are going to prefer that. I don’t know how far along you are in your breastfeeding journey, but typically if I have a family who wants to or needs to use bottles, I do recommend introducing the idea of it around four to six weeks when the suck reflex is still there so the baby is very unlikely to reject it. But breastfeeding has been well established, because it’s a different skill. Some families do fall into a pattern like you’re describing where the partner will feed the baby one time a day and the breastfeeding parent might have a little bit of a break. But remember, if you’re going to want to keep your milk supply up, you’re going to have to pump to replace that bottle. So there is work involved.

Laura Birek: The idea is you should pump for every missed feeding.

Jessica Claire: Ideally, yeah. By and large. Some moms will use that Haakaa again to collect little bits throughout the day and then have enough for a feeding when partner gets home or whatever. That’s another way some people structure it. But I would say if the baby’s nursing well by 4, 5, 6 weeks, you usually find to introduce a bottle without fear of the baby preferring bottle. Then if you’re going back to work and you’re not going to go back to work for a few months, you might just sprinkle in a little bit of bottle feeding practice if you’re not doing it every day just a couple times a week and it could be like a little quarter ounce just to practice the skill so that baby when he’s three or four months old doesn’t decide that he doesn’t want to bottle feed even though he did it fine at five weeks.

Laura Birek: Interesting. You’ve been so generous with your time.

Jessica Claire: Absolutely.

Laura Birek: It’s been really great talking to you and you have so much experience in this much more than I do in my breastfeeding unicorn situation. We’re really happy you agreed to talk to us and answer our questions. So Jessica Claire, IBCLC.

Jessica Claire: That’s right.

Laura Birek: You practice in Los Angeles. How can people find you if they’re in the area?

Jessica Claire: Let’s see. On Instagram I’m Jessica Claire, IBCLC: jessica.claire.ibclc. Then my website is lactationconsultantla.com.

Laura Birek: We’ll be sure to put those on our website as well: bigfatpositivepodcast.com. Thank you so much for talking to us. I’m sure everyone’s going to love hearing this.

Jessica Claire: Good. Excellent. Thank you.

Laura Birek: Oh my God, that interview was really fun. I’m so glad we did it.

Shanna Micko: Yeah, wonderful. How nice of her to give her time for that. That was amazing.

Laura Birek: Yes, thank you so much, Jessica. We will be coming back to you if we have more questions about nursing and everything related to it and thanks for sending in your questions, everyone.

Shanna Micko: Now it’s time for us to take a break and come back with our weekly BFPs and BFNs.

Laura Birek: Let’s do it.

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Shanna Micko: We’re back with our weekly BFPs and BFNs. Laura, what do you have for us this week?

Laura Birek: I have a BFP.

Shanna Micko: Ooh, tell me.

Laura Birek: Okay. These are products that I found on of all places Amazon. You know how you had that thing a couple weeks ago where you were like, “I don’t know if this is a BFP or a BFN because I feel bad,” when you were talking about the pouches?

Shanna Micko: Yes.

Laura Birek: I feel similarly about these, but I think they’re a BFP, because they are saving my life and they are the Neat Solutions Table Topper Disposable Stick-on Placemats.

Shanna Micko: English.

Laura Birek: They are basically just adhesive backed plastic single use place mats that you can stick to tables, especially when you’re out at a restaurant and the baby can eat.

Shanna Micko: I’ve seen you use these.

Laura Birek: They have cute little designs on them and the baby can just eat right off of it and you don’t have to worry about staining the table at the restaurant you’re at. Or whatever germs are on the table, you don’t have to worry about. The BFN part of it is that they’re single use plastic and they are truly single use, because they have that adhesive on the back. You can’t reuse them, but I find they’re really useful for eating out and also for cleaning up after eating out, because you can wipe up all the food that the baby’s dropped on the floor and stick it in that and kind of create a neat little bundle of trash to throw out. So this is one of those things where I’m just finding other ways to be good for the environment and for now I’m using this until the baby can reliably use a bowl, not pick it up and throw it on the ground. I think this is my life for now, because we love going out to lunch and he loves feeding himself. He won’t almost let us feed him anymore. He has to be the one to pick it up and put it in his mouth and for that it needs to be on the table, because I’ve tried doing little bowls and they’re bowls that stick to the table supposedly like suction cup. I’ve never gotten them to actually work suction cup to the table.

Shanna Micko: Interesting. Because I was going to say I just put a couple of those in my Amazon cart, because I was thinking about getting them per home. But you’re finding them not useful.

Laura Birek: You use a high chair with a tray at home, right?

Shanna Micko: Uh-huh.

Laura Birek: See, that will work for when you’re out and about and eating at restaurants. If they have a glass table, it’ll work. If they have a cool rustic wood table with grain and whatever, the suction cup just doesn’t stick.

Shanna Micko: True.

Laura Birek: I know this, because I have a section cup toy that I use for him all the time and it works maybe 10% of the time at restaurants.

Shanna Micko: Isn’t that the way suction cups always are? If you buy something for your shower to put shampoo in and then just falls in the middle of the night, you’re like, what the fuck was that: suction cup?

Laura Birek: Suction cups are imperfect technology, but they are the technology we have. The one I have, you can get a pack of 60 for just under $13 on Amazon.

Shanna Micko: Still enough to last till he’s ready for bowls.

Laura Birek: It’s certainly lasting a long time. They’re also very, very thin. So they’re really easy to stick in the diaper bag and have a couple just ready to go. They really don’t add bulk, which is nice, because those silicone table topper things, they’re thick. They roll up, but they’re bulky. This is what I’ve been using.

Shanna Micko: I remember trying to use those silicone ones for Elle. Even at home I was just like, gosh, the table always gets so messy and maybe if I set this down, I’ll wash that in the sink and it just sucked. It did not work. It shifted all over the place and those really aren’t great either. So I think you found a good solution. I’m down with it.

Laura Birek: They are cute and a lot of people comment on how cool they are. What we do with them is I’ve learned that instead of just like putting the matte flush on the table where the backside ends or I guess the front side depending on how you’re looking at ends at the edge of the table, I’ve discovered that if you wrap them around the edge of the table so that the front edge is stuck to the bottom of the table, that really helps with cleanliness and also with babies who to put their mouths on the table like mine.

Shanna Micko: My baby.

Laura Birek: Exactly.

Shanna Micko: I was going to say your other solution, you could be like me and just never go anywhere.

Laura Birek: I can’t do it. I’m so house stir crazy. By 11:00 a.m., I’m like, okay, we’re going. We’re going to do something and usually eating is a thing we can do.

Shanna Micko: Yes.

Laura Birek: Anyway, that’s my BFP for the week. Do you have a BFP or a BFN for us, Shanna?

Shanna Micko: I have a BFP as well.

Laura Birek: Awesome.

Shanna Micko: It is also food-related.

Laura Birek: Cool.

Shanna Micko: It is frozen peas.

Laura Birek: Okay.

Shanna Micko: I discovered when Elle was a baby that frozen peas are an amazing baby snack. She loves them and the reason I discovered this is because I dropped some frozen peas on the floor one day and the dogs were scrambling to get them and I was like, “No, no, no, no.” I’m just trying to pick them up. She crawled over and picked it up and put it in her mouth and chewed it and was like, “Mmh.” I was like, you could eat that? Isn’t it kind of too hard?

Laura Birek: I would think it was like a pebble or something.

Shanna Micko: Yeah, you would think so. But I think they’re so small that they kind of warm up in their mouth just enough and they’re really not that pebble-like, because I tried it too and I was like, it does kind of just like mush in your mouth a little bit, but it’s cold so they like it on their gums and it’s perfect bite size. It’s not a choking hazard and so I was like, maybe I’ll try giving her some frozen peas. I did and she loved it and they became her favorite snack.

Laura Birek: Wow. I’m going to have to try this.

Shanna Micko: Once CeCe got old enough to eat more things like this, I was like, I got to try it with her too and she loves it. So for me, I love snacks that are easy and healthy. So I just will put her in her high chair and throw a handful of frozen peas and it keeps her occupied. She loves them, she gets a veggie and it’s easy for me. I love it.

Laura Birek: I bet it feels great on their teeth when they’re teething too.

Shanna Micko: It totally does.

Laura Birek: I’m running out today to go buy some frozen peas.

Shanna Micko: I’m dying to know if he likes them and I had never heard this before. It’s not like a thing I had ever read anywhere, just kind of stumbled upon it and I shared it in one of my Facebook moms groups and now it’s like a thing that people recommend to each other all the time. They’re like, “Frozen peas: a great snack.”

Laura Birek: You started a trend.

Shanna Micko: I think I did. We all know I’m just the world’s best trendsetter. But another frozen thing that I like to do. I’ll tack this on here. I will also break a frozen waffle in half and just hand it to her and she gnaws on that and that’s cold on her gums and she just kind of takes little bites and that occupies her in her high chair too while I’m doing dishes or whatever.

Laura Birek: That’s smart.

Shanna Micko: I utilize those frozen foods.

Laura Birek: I still do the frozen breast milk in one of those teething pacifier. You know what I’m talking about?

Shanna Micko: Yes.

Laura Birek: We talked about ways back. You can either get a mesh bag version or the silicone ones. That’s what I have and I put a frozen ice cube of breast milk inside of them and he loves that when he’s teething, which seems to be all the time now.

Shanna Micko: I have so many teeth popping in. You know what I just thought of speaking of frozen stuff, because we use that too? I got one when you recommended it. I bet if you put like a few frozen blueberries or a frozen strawberry or something in there too, that would be great. They would probably love that too.

Laura Birek: He probably would. I always think of you when I eat frozen grapes, because I didn’t know that was a thing until you introduced. If anyone out there doesn’t know about frozen grapes, Shanna, will you tell people about the joy? Will you give them the gift you gave me?

Shanna Micko: I don’t even remember giving you this gift, so I’m so glad that I did because I love it. It’s one of my favorite snacks. First of all, grapes are just probably one of my top two favorite fruits. You just pop them in the freezer and then when they’re frozen you eat them and they’re frozen little sweet popsicles. They’re so delicious.

Laura Birek: You would think you’d break your teeth, but they’re so full of sugar. They don’t freeze solid. They’re just like little slushies. They’re so good.

Shanna Micko: They’re not like ice cubes. It’s not like biting into something super hard. I wonder if it’s similar thing with the peas. They don’t freeze super hard like ice. It’s just got some sugar and stuff.

Laura Birek: I should say, don’t give your baby a frozen grape.

Shanna Micko: No, please don’t.

Laura Birek: It’s a massive choking hazard. But for you and your partners and your other adults in the house, frozen grapes. Delicious.

Shanna Micko: Yummy. So that’s what I have this week utilizing that freezer.

Laura Birek: We’ll make sure to put a link to my place mats, like I discovered them. 

I did not create these place mats. They have like a thousand reviews on Amazon, but we’ll put them on bigfatpositivepodcast.com.

Shanna Micko: If you have any suggestions for high iron foods that Laura can feed to her baby or anything else you want to share with us, you know we love hearing from you. Laura, where can everyone reach us?

Laura Birek: We are on all the social media’s Twitter, Instagram, Facebook at BFP Podcast. We also have a Facebook community group. Just search Big Fat Positive community. It’s a closed group so you have to ask to join, but I will add you and you can join in the great discussions we’re having there. As mentioned, we have a website, bigfatpositivepodcast.com. You can also send us questions or comments at [email protected].

Shanna Micko: If you love our show, please spread the word. If you know a pregnant person or a new parent, let them know about BFP Podcast. Big Fat Positive is produced by Laura Birek, Shanna Micko and Steve Yager.

Laura Birek: Thanks for listening, everyone. We will see you later.

Shanna Micko: Bye.

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