Episode 270 Crystal Nightingale Returns + Postpartum & Lactation Tips

Crystal Nightingale from The Mama Coach joined us a few months ago and is back again today diving deeper into postpartum and breastfeeding than we’ve ever gone before!Did you know that new research is showing that cold compresses are more effective in helping clogged ducts than warm compresses or showers?Crystal shares her valuable insight gained as a registered nurse and IBCLC of over 10 years. Meagan and Crystal discuss everything from appropriate newborn weight loss to all types of infant feeding to how to have a successful breastfeeding journey starting even before birth. As we kick off 2024, we promise to bring new topics, deeper discussions, and exciting changes that will empower you even more to continue to have better birth AND postpartum experiences.  Additional LinksCrystal’s WebsiteThe Mama CoachThe Lactation NetworkHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello you guys. It’s 2024. I cannot believe that 2023 went so stinking fast and we’re already here. I think the new year is super fun because I think about all of the exciting things that we want to do for the year and we have this extra motivation. Today, we’re actually going to be talking about something that we don’t talk about a lot on the podcast. This is going to be postpartum. I’m excited to talk about postpartum because, with The VBAC Link, we are all Women of Strength. You are all preparing for birth. You’re all preparing for pregnancy sometimes. We’re so focused on the birth, but we forget about what comes after the birth. So we have our friend, our dear, dear friend, Crystal. Hello, Crystal. Crystal: Hello, good morning. Happy New Year. Meagan: Good morning. I am so excited to have you on today. Crystal: I’m excited. Thank you. Meagan: Yes. You are a registered nurse, an international board-certified lactation consultant which is an IBCLC and for everyone who has never seen an IBCLC, you guys, I have three babies and I breastfed with all three of them. I’ve seen an IBCLC with each baby because I’ve found that each baby is so different. Crystal: Yes. Meagan: If you haven’t seen an IBCLC before, I would highly suggest it. They can help so much. But Crystal is from The Mama Coach and she is going to be talking with us today about postpartum and mood stuff and breastfeeding and so many powerful things. So hold on tight. We’re going to do a review and dive right in. Review of the WeekThis review is from– I don’t even know how to say it– miralamb04 on Apple Podcasts and it says, “A Must Resource During Pregnancy.” It says, “The VBAC Link was most helpful and encouraging during my TOLAC (trial of labor after Cesarean) preparation. I used all of the episodes to everyone’s different expectations and outcomes to help me prepare for my VBAC. Finding out I was pregnant six months postpartum after a planned C-section due to a breech baby was frightening at first.”We have talked a lot about this close duration. It says, “I knew immediately I wanted to VBAC and started doing my research. The VBAC Link was constant during my stroller walks with my baby and helped me mentally prepare for my second pregnancy. I used the resources provided to help open up conversation during my prenatal appointments and ultimately advocate for myself and my baby for a planned, hospital TOLAC. I successfully had my second baby via VBAC a few days ago and I’m so happy that I did. Everything I could have wanted and so much more. Thank you, Julie and Meagan.” I love that so much. You guys, this is what this platform is for. It’s for you to have the education, the information, and the empowerment to go on and make the best decision for you no matter how that is and what your birth outcome looks like. I love how she said, “To advocate for me and my baby.” Right? Crystal: Yes. Love it. Meagan: I love it. That is so cool.Crystal: Very, very. Meagan: Thank you so much for that review. They touch me from the bottom of my heart and if you haven’t, please drop us a comment. Drop us a review. Let us know what you think about The VBAC Link. Crystal Nightingale Meagan: Okay, cute Crystal. Welcome, welcome. Crystal: Hi. Thank you for having me. Meagan: Absolutely. I’m so honored that you are here and taking the time out of your very busy day to talk more about that topic that we just don’t talk about. It’s not even that we don’t talk about it. I think it’s just that we don’t think about it. Crystal: Yeah, yeah. Meagan: It’s so far over there because we have such an event to get through. Birth is an event. Crystal: Yeah, it’s huge. Meagan: It’s such an event to get through that we can’t think about what we’re doing here or over here because we are right here in this moment preparing for this event. Crystal: Yeah. Yeah. Meagan: I mean, I have ridden tons of bike rides, races, long distances, and ran half marathons. I’m telling you that at mile 10, the only thing I was thinking about was where that finish line was, not where the next starting line was or that next experience. So I’m excited that you are here with us to talk more about this next journey because it is a whole other journey that leads us down a path through life in general and it can impact us for our next birth. Right? Crystal: Yes. Right. Meagan: It’s a circle. It all goes together. Let’s talk about it a little more. Let’s talk about your professional background. What got you into this? What got you into your passion for postpartum and serving moms and babies through postpartum and through breastfeeding? Crystal: Yeah, so I always knew that I wanted to work as a nurse or in the nursing field. I was just fascinated with labor and delivery and women’s health. Of course, being a woman and all of the amazing things that we can do. I had my oldest children younger so I was very naive. After I became a nurse, I really got into postpartum and mother and baby and just seeing new babies come into the world and helping the parents, the whole family, with breastfeeding and helping them take care of their newborn baby and just all of that fascinates me. It’s just incredible to me. I’ve been working with mothers and children as a nurse for a little over 10 years now and you know, just through my time in the hospital and the clinic, I have seen a trend. A lot of parents have the best intentions. They want to breastfeed and they want to do this, but then there is not a lot of support. The WHO, World Health Organization, and CDC all recommend breastfeeding for at least six months, but what? Then parents go back to work at six to eight weeks maybe? Some even sooner. I’ve seen some moms who have to go back to work within two or three weeks. So just seeing that lack of support postpartum for families just triggered, “Okay.” It’s very frustrating to be in a hospital or a large health organization setting and not be able to do as much as I want to because of all of the policies and regulations and things like that. So I teamed up with The Mama Coach to start my own private practice and being part of The Mama Coach has been awesome. We are a group of registered nurses and some nurse practitioners all around the world helping parents to make parenting easier through education, evidence-informed solutions, support, assessment, individualized plans, and all of the stuff to help support parents from the prenatal period to postpartum to feeding and starting solids, all the way up to five years of age with sleep and CPR and things like that. So yeah. That’s a little bit of my background. I have four kids and I did not get to breastfeed my older two because again, I was young and naive. I didn’t know anything. I “tried” to breastfeed not knowing that cluster feeding was normal. I just thought, “Oh no. I need to give formula because they sent me home with formula.” Then all of a sudden, my milk dried up and I was like, “Oh well. I guess I’ll just formula feed.” That wasn’t what I wanted to do. I just didn’t know how to continue the breastfeeding journey. Meagan: Yeah. This isn’t like anything that we talked about, but I kind of am wondering if you know the answer to this. We are talking about how all of these organizations– big organizations– encourage breastfeeding. We talk about how we don’t necessarily have the support but not only do we not have the support, but we have the alternatives given to us so easily which I think is great. I’m not saying it’s a bad thing, but it makes it easier or if we don’t know. Like with cluster feeding, you think you’re baby is starving. You think, “I’m not giving my baby enough. They are always hungry, always hungry and I have to supplement with formula,” when that’s not necessarily the case. Why do you think these companies are providing so much formula right out of the gate?Crystal: You know, I’m not sure. I can say it probably is because they are not thinking of the long-term effects of starting formula. If it’s needed, how I always was taught especially working in the hospital is that really, formula should be used and treated as a medication. Use if absolutely needed. But, when some staff or doctors or whatever see that a mother is struggling maybe, they don’t automatically think, “Let’s support her and see how we can help her reach her goal. Let’s just feed the baby and deal with it later,” not knowing that that can negatively impact the breastfeeding relationship down the road. You know, like you said, that is there for a reason, and if a baby really needs it, of course, use it. I think the organizations are getting better, but they can still be better. Meagan: Yeah. Do you know what I would like to see more? I know that this can be tricky because of all of the things that are put into our bodies and in this world, but I would love to see milk bank donations more. Crystal: Yes. Meagan: There are certain countries that are literally like Winder Dairy and they bring breastmilk to your porch for people who are struggling. It’s so awesome and there are parents out there. There are moms out there who have an insane overproduction, but their baby isn’t necessarily using it and it could go to a preemie baby or to a mom that may have a little bit of a rough start or have had a Cesarean under general anesthesia and isn’t able to really even be present in that moment. I would love to see that happen more. I don’t even know. There are all of the things out there. There are all of the apples off of the tree that I would like to grab and make happen. Crystal: That would be so amazing. Meagan: But they are out there too. So if you are struggling in your breastfeeding journey, it doesn’t hurt to ask, “Hey, is there a breastmilk donation in our area or in this hospital?” because there are situations where some hospitals– it’s not talked about and it’s not big enough yet, but there are banks where people who donate. And because of the craziness in this world, they are really, really strict on who can donate. My cousin did one and you have to check a million boxes to be able to donate. So anyway. Crystal: It makes sense. Meagan: It could be weird to people like, “Someone else’s milk, what?” Crystal: I’ve definitely encountered that before. Everyone has their feelings, beliefs, and opinions, so it’s like, “Well, it’s there.” I am seeing more hospitals in my area up in northern California have donor breastmilk available in the hospital, but the problem with that is they give the donor milk in the hospital, but when they go home, there is still not that support or continuation of care because now, mom’s milk maybe is not quite sufficient yet and how do we help them when they go home? Meagan: Right. Crystal: That’s another thing that we’re seeing too. Meagan: Okay. So that is a question right there even. We can go home, but I’m going to go back and talk about breastfeeding with that. What do we need to not forget about the postpartum journey during the birth preparation? What are some things that people who are pregnant, preparing for birth, and preparing for their birth– they are so excited. They are figuring out if birth is right for them. What do we need to focus on and not forget about during that pregnancy journey? Crystal: Yeah, so of course, like we were saying earlier, getting ready for birth and preparing for birth is a huge event. We prepare for that and all of that, but then we don’t think about like we were saying, the postpartum. Think that postpartum can last a year or two years, sometimes even longer depending on how long you breastfeed if you plan to breastfeed. It takes 9-10 months for your hormones to increase and grow this baby and things like that, then of course, it can take– to me, this is my thinking– at least nine months for it to go back down to somewhat normal levels. If you’re breastfeeding, you’ve still got all kinds of hormones going on. So think about that. Babies have to be fed, so how are we going to feed them? Are you going to breastfeed? Do you know what to expect? Do you know what kind of bottles and what kind of formula to use? Do we know what to expect with just newborns in general and newborn care and diapers? Because babies’ poops look funky. They are different from ours, so it’s like, okay. All of these things, I feel like if parents are a little bit more prepared, then they will have less anxiousness for one because it’s a whole new thing whether you are a first-time parent or even if it’s your third or fourth baby– even with me for my fourth baby, I was like, “Wait. Is this normal?” I’m a nurse and I work in the field, but it’s so different when you’re on the other side. So just to be prepared for that so that way you have the expectations and you know, “Okay, what’s normal? What’s not normal?” Have somewhat of an idea of how to manage some things and know that there is support out there when you need the support. Meagan: Absolutely. Something that I– with my first baby, I ended up going back to work at 12 weeks postpartum. I already wasn’t prepared for a Cesarean, so then I was recovering from that, but when it came to feeding my baby and even my emotional status, I really wasn’t prepared for all that was happening in such a short period of time and then to shift. As soon as I started feeling like I was kind of getting the hang of it and things were in control or I had a routine, it was like my feet got swooshed underneath me and it was changing again. I was all of a sudden in a back storage room pumping every three hours. I was storing my milk in a fridge where everyone stored their lunch and then trying to figure out that and trying to get enough production for my baby while they were with the babysitter. It was so much. Crystal: It’s a lot, yeah. Definitely, going back to work after having a baby, no matter how soon whether it’s six weeks or six months is definitely a big change as well. That’s something that a lot of parents aren’t really thinking about or prepared for which is totally fine. There is so much more going on at the moment, but knowing that, “Okay. I need to prepare and be ready before I go back to work so I know what to expect.” And like I said, getting some support on how to manage that. Get a plan together. Get a schedule together. Meagan: Yeah. So as a doula, I work a lot with my clients right before pregnancy and sometimes they are a little caught off guard when I’m like, “What’s your postpartum plan?” They’re like, “Huh? Aren’t you a birth doula?” I’m like, “Yeah. I am a birth doula, but I know a lot about postpartum and I didn’t plan for it either. Let’s talk about it. How are you going to eat so you can feed your baby? How are you going to get sleep?” because just like you were talking about before, a lot of moms have to go back 12 or so weeks after. Some of them two weeks after. We also have an issue with our paternity leave– Crystal: Paternity leave for the fathers or the partners. Meagan: Yeah. We have one week. Especially if you have multiple kids, we have one week a lot of the time and then they’re gone and we’re like, “What are we going to do?” Get your meal trains. Get your support. Rally up together. Have your birth team. Have your postpartum team. Have a plan. We know plans change no matter what– birth, postpartum, everyday life. I sometimes plan to go to Costco and then I don’t go to Costco that day because something happened. Plans change, but if we can have a baseline of an idea, I will be like, “Okay.” I have a friend who gets mastitis with every baby. Crystal: Oh gosh. Meagan: With her third baby, she was like, “I’m going to do everything.” She had her IBCLC to go to the hospital on day one to get a good, established latch. She met with her as soon as she left the hospital. By day four, she was meeting with her again to make sure. You guys, she was on sunflower lecithin. I don’t know how you feel about that, but that helped her personally to not be so sticky. She was like, “I have got to get this under control. I have two other kids. I cannot be sick with mastitis.” Then she would end up getting thrush after that so she took a probiotic. Crystal: Oh my gosh. Meagan: There are things we can do and it’s really hard to focus on that in the pregnancy stage. Crystal: Yeah, yeah. Meagan: But there are things. We can get on those probiotics. We can contact those IBCLCs. We can have a plan in place so we are not just thrown into the fire. Especially in my case, where I did have a Cesarean and a repeat Cesarean, those were just things that were unexpected so prepare the best you can. I love that. I love your advice. This is so important and get that support. Crystal: Yeah, for sure. I just thought of something because I talked a lot about breastfeeding and feeding your baby, but you brought up a good point. As mothers, we for sure neglect ourselves all of the time so like you were talking about with eating, make sure you eat and hydrate. Moms are recovering too from birth so whether it’s vaginal or a Cesarean, planned or an emergency Cesarean, your body is doing a lot postpartum. It’s just crazy. Meagan: We’re amazing. We are amazing human beings. We are incredible.Crystal: Yes. We are. We are. We so are, but then we have to remember to take care of ourselves as much as possible. That’s where the support and village come in because you can’t do it all yourself. I guess you could. I’m sure some women have, but you shouldn’t have to do it by yourself. Meagan: No, and I think like you are saying, we shouldn’t have to but for some reason, we do. Crystal: Yeah. I know. I know. Meagan: We don’t ask for help. We struggle asking for support. We struggle spending money on ourselves. We struggle getting postpartum doulas or going to an IBCLC because it costs so much and insurance doesn’t cover it. You guys, you are worth it. You are worth it. You are amazing. You grew a human. You birthed a human. You are now taking care of a human. You are feeding a human. There is so much to it. It’s okay to get that support and give back to yourself. Crystal: Totally, totally. I 1000% agree. Meagan: Yes and sometimes, that is finding a coach and just getting some advice or talking to someone and just being heard. Maybe you don’t physically need anything, you just need to be heard. Crystal: Yeah, yeah. Meagan: Yes. Okay, so now we’ve had our baby and everything. What can we look for in the first few weeks to know that maybe we need to ask for more help or get more resources or take care of ourselves? What are some things that we can look for in those first few weeks with nursing and postpartum just in general? Crystal: Yeah, yeah. So for moms, I have spoken to a lot of moms who weren’t aware that there would still be bleeding afterward so there is that. Meagan: That is a thing. Crystal: Yes, that is a thing. You are still bleeding. That is normal, but obviously, from a nursing standpoint, if there is excessive blood or you are filling a pad every hour, then for sure, you want to reach out. A lot of women tend to swell postpartum. Some are like, “No, I didn’t have any swelling during the pregnancy,” then all of a sudden postpartum, you just blow up. Your feet are swollen and things like that. That could be due to some IV fluids or other stuff going on, but for sure, you want to reach out to your provider with that. Contractions and cramping afterward are still a thing, especially with breastfeeding. Some women are just like, “Oh my gosh. I did not know about this.” Some women feel great after delivering. They are like, “Yeah. I don’t need to take my meds. I’m feeling okay,” but once they start breastfeeding and they start feeling these contractions, it’s like, “I’m in labor again.” That is normal. I know it’s uncomfortable, but that is definitely normal. If you still feel that when you’re not breastfeeding or it’s not relieved with pain meds, then for sure, I would highly recommend reaching out to the provider. Meagan: That can also get worse with each baby, right? Crystal: Yes. Yes, it can get stronger. Meagan: It can last a little longer and be a little bit more intense, yeah. Crystal: I know which is like, “Why? We already went through this. Why do we have to make it worse?” Meagan: Our uteruses have to shrink down. Crystal: I know. It’s a good thing. The cramping is a good thing. It’s a normal thing. We want that. It controls bleeding. It gets the uterus back down to the normal size and all of that. Engorgement. Even if a mom is not breastfeeding, the body’s natural, physiological response is to bring in milk. With the delivery of the placenta, your hormones drop and that triggers, “Oh, okay. Baby has been born. Let’s make milk.” Meagan: We have to feed it. Crystal: Yes. So whether you breastfeed or not, if you don’t breastfeed, you may not get as much engorgement, but there is still stuff going on there. If you are breastfeeding, you will almost 100% get engorged in the first few days anywhere from day three to five. Sometimes it is a little bit longer, but around there, your breasts will feel really full. Some women say their breast sizes double or triple. Meagan: Mhmm. Crystal: They can get really rock hard. That’s pretty normal because your milk is coming in. Getting support with latching well so the baby can empty it or if you need to, maybe you have to pump a little bit, but like I said, of course. Reach out for lactation support because depending on the situation or what’s going on, the lactation consultant can further guide you on how to manage that. But lumps, you may feel little lumps in the breast. That is pretty normal. Those are just basically milk ducts that are swollen or filling with milk because of the postpartum period with increased swelling and things like that. After engorgement, I’m thinking of the progression of things, a lot of parents see clogged ducts, but now we know that it’s called ductile narrowing instead of clogged ducts. Meagan: Oh. Crystal: Yes. Before, we thought that the milk was getting clogged. Meagan: Getting sticky. Crystal: Yes, then we had to somehow remove this milk plug, but the new research by the Academy of Breastfeeding Medicine is saying that it’s not that. It’s inflammation and swelling of the milk duct itself that causes the narrowing of the channel or the passageway that milk goes through and that makes it back up. It backs up the milk. Management for that beforehand was warm compresses and massage, massage, massage, dangle feeding or something like that. Now, they are saying that we should be using cold compresses. Meagan: Oh, okay to reduce inflammation. Crystal: Exactly, to reduce inflammation. I always tell parents that if we have a swollen ankle and the breasts are swollen, we wouldn’t put a hot or a warm compress on it. Meagan: No. Okay, I’m noting it. Crystal: You would do the ice or the cold compress to reduce the inflammation and when we reduce the inflammation in those milk ducts, now that passageway opens up, everything can calm down, and milk can flow a little bit easier. Meagan: Mind blown!! Crystal: I know. Meagan: That is amazing. That would have been nice to know a long time ago. Crystal: I know. When I see moms say, “Oh my gosh, I have this lump and my breasts don’t feel empty even with breastfeeding or pumping. I’ve been doing hot showers and massaging it.” I’m like, “No. Try cold.” Almost always, it helps. Meagan: I am totally adding this to my doula toolbox. Crystal: Yes. Yes. Meagan: This is really good information. Crystal: It is. It’s so amazing when parents come back and they are like, “Oh my gosh. It worked. I can’t believe it.” Also, breast tissue is very delicate. It’s soft tissue. Some moms are just aggressively massaging their breasts like, “Oh my god. I have to get this out.” You don’t want to do that because you can further damage and cause trauma to the breast tissues. Meagan: More inflammation. Crystal: Yes, more inflammation, exactly. Light massage. If you need to, cold compresses for that. For moms, I’m going on and on right now. This episode is going to be forever. It’s going to be hours long. That’s kind of the basics of the immediate thing that we need to look for in mom physically. Emotionally and mentally, parents are sleep-deprived so we definitely want to make sure, like you said, have those meal trains. I even suggest adding this to the baby registry when you are pregnant like meal cards, Door Dash cards, a postpartum doula even. It’s like, “Whoa. Instead of giving me all of this, this is what I’m going to need help with in the first couple of weeks.” I know for me, I guess I’m thinking of myself and my baby, but I’m also thinking of everything else in the house that I need to do like, “Oh my gosh, I need to do the laundry. Oh my gosh. The other kids need to get rides to school,” or what have you. If there is anything, you know how friends and family are always saying, “Let me know if I can do anything to help,” please ask for help because moms and parents need sleep definitely. That helps because, for one, sleep is just a human need. Two, for sanity, and three, because the more rest that we can get as mothers, as a breastfeeding and lactating parent, the better our milk supply will be too. Meagan: Yeah, 100%. Like we were talking about, we are not thinking of drinking and that helps our breast supply. That helps our healing physically and keeps us in our minds. On that topic, Be Her Village– I’m sure you’ve heard us talk about it. Check out Be Her Village. You guys can create a registry just like Crystal is describing where you can go and register for a doula or childbirth education or money for an IBCLC or pelvic floor health or mental health. All of these things, if this is your registry– Crystal: Pelvic floor health, oh my gosh, is another thing. We don’t know about that. Most mothers are just– not that we don’t care, we just don’t know. There are just so many things going on down there that for sure you need some kind of pelvic floor rehabilitation afterwards even if you have a C-section. Meagan: 100%. It’s aggravating. I’m not going to spiral off on this tangent. It’s aggravating to me that so many insurance companies do not cover this as a standard part of postpartum. But they’re not covering postpartum pelvic floor issues. They’re not covering this. Crystal: Yeah. Meagan: I went and it was $250 per visit and as a new mom, especially if we invested in a doula and an IBCLC and a photographer or whatever. Crystal: All of those things, yeah. Meagan: It’s like, “Oh, whatever,” and now we have a newborn that has to have diapers at $50/box. It’s really hard. Crystal: Right and that’s where we neglect ourselves again. Not that we want to, but I don’t even know who to blame. Healthcare or insurance or whatever is preventing us from getting the proper care or support. I did the same thing. I just wanted to touch on that. I did the same thing. I was having issues holding my bladder and I asked for a referral from my doctor for pelvic floor health because doing our own research, we’re like, “Okay. I think I need to see a pelvic floor therapist.” They did not. They were like, “Well, normally we don’t do that.” I’m like, “Why?”I did the same thing. I tried to look into it myself to pay out of pocket and it was expensive and I just kind of gave up and was just like, “Okay. I’ll just do my own research and find out some exercises on my own and just do it on my own,” which is sad. We shouldn’t have to do that. Meagan: I agree. I agree. Crystal: But okay, so on to what to expect because there are still a couple of other things. There is so much, but I just want to touch on the emotional and the mood disorders because that is very, very important and huge. I always recommend that when moms take classes prenatally they have a partner or a birth partner or something that is along for the ride with them who comes to the classes and things like that. I really recommend that postpartum too. Any time of postpartum class, newborn class, or breastfeeding class, the partner or caregiver should definitely be involved as well as the birthing parent because as moms, we don’t initially see that there is something more going on with us for postpartum anxiety, postpartum depression, and things like that. It’s usually a close family member who notices things going on first. Definitely, I feel like the whole family should be involved in that and if parents are just struggling with coping and with new life as a parent breastfeeding and all of the things, then definitely reach out for support because that can definitely happen with all of the hormones going on and the stress. Meagan: Lack of support. Crystal: Lack of support. Meagan: Lack of sleep. Crystal: Lack of sleep, yes. That’s definitely something big. Meagan: I want to talk just slightly about this. It’s really hard as a new mom to and I hope this isn’t triggering, pass your baby to someone so you can take care of yourself. We had a client years ago that was really struggling. She had a series of things and was really struggling. One of the things that we ended up coming up with was for her to go to her mom’s for the night. We came up with a good plan and had help with dad and the kids for baby. She ended up pumping and coming up with a supply and for one night– she did wake up engorged– she slept all night. All night. She went to bed at 8:30. She pumped before and went to bed. She woke up. I think she said it was at 6:30 which is still early, but 8:30 to 6:30 is a good stretch. She was probably so engorged that she had to wake up, but you guys, she was a new person. She said that. She was like, “Whoa. It’s like my funk was just sucked out of me just by getting that sleep.” That was really hard for her to do that. Crystal: Of course, I’m sure. Meagan: It was really hard for her to be like, “I’m giving up my baby who is four days old overnight.” It’s not ideal. It wasn’t ideal, but she spiraled quickly and she got to a place where that’s ultimately what she thought was going to be best. Anyway, it was amazing. She still had trials to get through because the next night, she had lack of sleep but she was able to build up that foundation a little bit more by getting a good night’s rest. Crystal: Of course. Exactly. Meagan: Her mom seriously had all of these broths and all of this high-protein food and all of these amazing things to fill her being with all of the good things. Crystal: Yeah, because as mom, we are filling everybody else’s cup usually, but we aren’t filling up our cup. Meagan: Yeah. You don’t have to leave your baby with anyone overnight, but going back to that, have someone fill your cup. Have someone fill your cup. Food, all of those things. Crystal: Everything. I’ve heard of some parents when they finally get three or four hours of sleep straight, they’re like, “Oh my gosh. That was amazing.” Same thing. “I feel like a new person.” Just because sleep is a human need, so we need that and if we’re just constantly days upon days upon days of getting only 1-2 hours at a time of sleep, that’s definitely not sustainable and not enough. Meagan: Yeah. Yeah. She started resenting her baby. Crystal: Yeah. Yeah. I’ve heard of that too. Meagan: She started having anxiety at nighttime. Crystal: Yeah. Yeah. I could definitely see how that can come about for sure especially if you’re breastfeeding, especially with that. We all know that of course, breast is best. Breastmilk is best, but we also have to think of the whole picture. I always tell this to all of my clients and patients that I work with. Mental and sleep health is very important. Very. I know breastmilk is too, but you do the best that you can. Meagan: It’s like when we’re on the airplane and they talk about if we’re in an emergency and the masks fall down, prepare your mask on you first before you help someone else. Crystal: Yes. Meagan: It’s a similar concept to me where if we cannot fuel ourselves with the oxygen and the sleep and these things, we cannot 100% take care of this baby. Crystal: Right, yeah. Meagan: We can’t make milk. Crystal: Right. Meagan: Because our body is going to protect us and sometimes we will see a milk dip with stresses and things like that. I have clients who are nursing really, really well and then a stressful event happens in their life and they’re like, “I’m losing my milk. I’m losing my milk. Is my baby not eating enough?” It’s crazy how just mentally our body can do that. It can stop making as much milk. Have you seen that?Crystal: Yeah. I have. I have actually. A stressful event or if mom starts a new medication, especially birth control. They don’t know. They just don’t know. When I talk to my doula consultation, I say, “Any new medications?” They say, “Well, I just started taking birth control but my doctor said it should be fine and won’t affect my milk supply.” I’m like, anything new can. It can. Meagan: Hormones. Crystal: It’s not to say that we can’t get the milk supply back up, but at least being aware of it. Okay, this is why. It’s not because of something else or whatever. So yeah. I’ve seen that. Meagan: Yeah. Crystal: Periods, too. Moms starting their period again, it can–Meagan: Throw it off. Crystal: Every month during your cycle, yeah. It throws it off. Lots of different things that could happen and will happen, so just something to have in the back of your mind like, “Okay. This is what I remember Crystal, The Mama Coach, saying or whoever saying that this can happen, but there are ways to work around it.” Meagan: This next question is a did-you-know. I feel like this is something actually that a lot of people do not know and that is that babies lose weight in the first few days. They can lose even more than the recommended loss if there was an induction, or a lot of fluids, or a surgery. Can we talk about that? Crystal: Yes. Yes. Correct. Meagan: Can we talk about what is normal? Because I feel like again, mentally, there is so much stress on feeding the baby, getting enough, cluster feeding, and all of these things, then we have this baby that weighed in at 7lb, 12 oz and is now weighing in at 6lb, 15oz, and we are like, “Whoa. This is a big loss.” We’ve got providers freaking out about it, suggesting supplements, and things like that. What’s normal? What is the average loss just without induction and things like that? Can we talk a little bit about that so we can offer some comfort to these mamas who might have a baby that’s losing weight? Crystal: Yeah, yeah. So babies can lose up to 10% of their birth weight within the first three to four days or so. Normal weight loss is about 2-3% per day. So with that being said, when babies are in the womb, they are swallowing amniotic fluid. They are swallowing, swallowing, swallowing, so technically, they are born full and their first stool is that sticky, black, tarry meconium that is just getting rid of all of that amniotic fluid that they were swallowing while they were in the womb. So that’s some weight loss because they are probably pooping five or six times within the first one or two days and it’s super sticky. Then, like you said, if mom was inducted or induced or got a lot of IV fluids, antibiotics, and a Cesarean, then they got extra fluids. Anything that mom gets during labor, baby gets some of it too. Really, some providers are saying that a newborn’s true weight can be seen 24 hours after birth versus one or two hours right after birth. That weight loss takes into account that. Fluids, getting rid of the meconium, and things like that, and then anything more than 10%, then we get kind of concerned. Like you said, some providers are like, “Oh my gosh. Let’s do all of this.” Me, as the lactation consultant, I am less freaked out because I know that especially if a mom is breastfeeding, babies’– we’re getting to probably one of our next questions– bellies are really small, so in the first couple of days, they are only taking 2-10 milliliters per feeding which is less than half of a teaspoon up to two teaspoons per feeding. That is the colostrum that they are receiving from mom, that yellow, thick, first milk that is expressed from mom’s breast and although it’s smaller in volume, it’s really packed with a lot of nutrients and antibodies and things like that. It is nutritionally–Meagan: I say dense. Crystal: Dense, yeah. Nutritionally dense. So baby is getting what they need, it’s just a smaller volume because it makes up for the fact that it takes a couple of days for mom’s milk to increase and increase in volume and things like that. Babies are losing all of this excess fluids, pooping out all of this meconium, and then they’re just getting smaller, frequent amounts of colostrum. All of that are factors in weight loss. And then when mom’s milk starts to increase around day three to seven, they start taking in more volume and then we start to see some weight gain there. Now of course, as a lactation consultant, we look at the whole picture. What happened with the mom’s labor and delivery experience? Is this baby number one or two or multiple for them? Do they have any medical background that might be a factor in milk increasing or milk coming in? All things like that and when I look at that, I’m like, “Okay. Maybe we need to supplement just a little bit if we need to.”And then I will tell moms, “Let’s maybe have you pump or hand express. Any extra colostrum or transitional milk that you can express, give that to baby first and we will see how that goes,” especially if they are not wanting to start formula. Every baby and family is different so I look at the whole picture, look at their goals, and see how best I can help them. But obviously, if a baby loses a significant amount of weight like 13-15%, then we are like, “Yes. We probably need to supplement.” So like I said in the beginning, formula is used when we need it if we need it, not just automatically, “Oh my gosh. Baby is at 9 or 10% weight loss. We need to give formula.” I definitely disagree with that. And it’s all the parent’s choice as well. I give them the options and they decide what they want to do and then I support them in whatever they decide. Meagan: Right. So as we are kind of working on getting our milk to come in and recovering and things like that, we talked about sleep, mental health, food, water, and things like that. That’s all going to help our breastmilk. But are there other things that we could be doing or should be doing to help our milk to come in quicker or once it comes in, to help it be more– savory comes to my mind, but really rich for the baby? You just talked about how some babies do lose up to 13% and then I guess a side question is, do we know why some babies lose a little bit more? Is there a reason or is there something that we as parents could do or should we just be like, supply and demand? Nurse your baby. Your milk will come in. Your milk is great. Just because your baby is not gaining as much weight doesn’t mean you should shame yourself or your milk is not good enough, because there is a lot of that too. Is there anything you would give us tip-wise to help milk come in? There are a lot of questions within this one question so I’m just going to turn the time over. Crystal: Okay. So yes. The best thing we can do is early hand expression. Typically, after birth, during the first 24 hours, babies are super sleepy. Super sleepy that it’s hard to get them to latch or want to nurse frequently. Thinking about how breastmilk supply works, the more you demand on the breast or remove milk, the more milk you will make. So if the baby is sleeping the first 24 hours, the baby is not expressing as much milk and that is where hand expression is important. Frequently, newborns tend to eat at least 8-12 times in a 24-hour period, so if we break it down by hours, it is just so much easier. Every 2-3 hours or so, attempt to put baby to the breast. Do what you can. If the baby is too sleepy or not latching well, then hand express. Hand expression and get out that colostrum. You can spoon-feed that to baby or cup-feed or syringe-feed that to baby, and then you’re still stimulating your supply. Sometimes, I hear parents say, “Oh my gosh, the first day or two, my baby was just so good and slept for four hours.” I’m like, “Did you hand express or pump at that time?” We just don’t know. They were like, “No, I didn’t. I slept too.” I’m like, “I’m glad you got sleep,” but to help your milk supply increase for baby, it is very, very important to express milk every few hours whether it’s hand-expressed, latching, or pumping. I’m trying to think what was the other question you had. Oh, how we can make it more savory. I always recommend doing breast massage prior to any breastfeeding or pumping or expressing session. That’s just because especially in the first couple of days, colostrum is very thick, so by massaging– and light massage. Not too hard, not too aggressively. You’re basically unsticking or loosening up that milk so that way it can be expressed and you can collect that good, sticky, fatty, colostrum or milk. That’s for even at any time. You might have heard of a foremilk and a hindmilk type of thing. That’s basically when you express, you see a little fat layer in the bottle or in the milk and to increase that, some researchers say that you can’t do anything to increase that, but we can help it to come out a little bit more. That’s by hand-expressing or doing what we call a breastmilk shake. I’ve done this myself with my last baby is just doing the breast massage before breastfeeding or nursing. I have seen a thicker fat layer on the milk, so you can do that. Meagan: That’s really good to know. With my son, he was kind of small to begin with, but when I would pump, I was like, “Oh my gosh. There is this much fat in this milk.” All of it separated and I had someone kind of suggest that, but it was a warm compress, not a cold compress. It was a warm compress, slight massage, and then nurse or even hand-express for just a second, and then nurse. Crystal: Yeah, yeah. Yeah. You can do that too. You can breastfeed or even hand-express a little bit too just to help that milk supply especially if baby didn’t have a good feeding or wasn’t quite latched very well just to ensure we stimulate the breast properly to give that signal of, “Okay, make the milk. Bring the milk in,” and things like that. I just wanted to say as a side note, all breastmilk is beneficial for baby whether you have a thin fat layer or not. Meagan: Good to know. Crystal: Your body still tailors and makes the breastmilk to your baby’s needs. Meagan: Awesome. So hand-expressing during pregnancy, we were talking about postpartum, but is it suggested to do a little bit during pregnancy? Crystal: You can, but you have to be considered at least term which is about 37-38 weeks or so, and of course, check with the OB provider because it depends on what risk factors you have. Meagan: Yeah, because it can stimulate. Crystal: It can stimulate because it does with the hand expression, the same hormone is released when you are having a contraction which is oxytocin so it can cause some cramping or contractions so you definitely want to get cleared by the OB first before just starting the hand expression, but yes. Once you get cleared, you can start antenatal hand expression and start collecting. It may be nothing or you might get drops. I’ve actually tried it on myself before and I didn’t get anything. I was kind of discouraged, but I was like, “No, knowing what I know, it’s fine,” but it’s good practice, too for hand expression postpartum. So practice, collect drops, and then you can freeze it and then bring it to the hospital if for some reason baby needs to be supplemented if they have low blood sugar or jaundice or whatever, so yeah. Meagan: So good to know. Okay, and then last but not least, we have different types of feeding. Bottles, paced bottle feeding, we talked a lot about breastfeeding. Can we talk about all of the different types of feeding?Crystal: Yeah, yeah. So of course, you can do exclusive breastfeeding and that’s just feeding baby at the breast, or you can do breastfeeding and pumping so feeding breastmilk in some type of vessel whether it’s a bottle or syringe. I typically see bottle and syringe usually especially when the milk volume increases or you could do combo feeding which is breastfeeding, pumping, and formula feeding so you can do a combination of all three. Some moms do exclusively pumping. They don’t put baby to the breast at all for whatever reason. It could be their own preference or they were just struggling with latch and it just was not working out for them, or sometimes it takes a long time to breastfeed, 30-45 minutes, so some moms feel like that works better for them to just pump for 15-20 minutes and bottlefeed. Or some, whether it’s their own personal preference or medical reasons, exclusively formula feed. With that, when you do any type of feeding other than breastfeeding and you bottlefeed, you want to pace bottlefeed. We do that for several reasons. For one, sometimes, newborns don’t really know how to pace themselves and they will just take that whole bottle. Meagan: Chow it down. Crystal: Chow it down in one minute flat and we don’t want that because I always tell parents to think about how we eat. We don’t just shove food in our mouths. Meagan: Chew your food. Crystal: Yes, chew your food and things like that. One, it can help baby learn how to slow down their feeding and then learn their own hunger cues like signs of fullness which in turn can help in the longer term as they get older knowing their hunger cues and knowing when they’re full and not overeat. Then three, it can help with digestive issues. Gulping too much too fast or drinking too fast, they can take in more air which means they will be more gassy and more fussy and then we are like, “What’s going on? Why is my baby so fussy?” It’s because they are gassy most of the time. A lot of the time, babies are just not very comfortable when they have gas and they definitely express it and communicate that they are uncomfortable, so we want to prevent that. By pace bottle-feeding, we help to remedy that. Meagan: That makes total sense. Sometimes, I feel like when they are gasping all of that air, then they spit up a lot. This is not really one of the questions we talked about, but when a baby spits up, a lot of the time we see it, and it looks like a lot and we are like, “I can’t believe I just fed my baby and it’s right here on this blanket or all over myself.” Is there a rule of thumb to be like, “Okay, really, that is true. Every little ounce of that just came out?” Or is it like, “Okay, your baby still got quite a bit.” Crystal: That’s kind of hard to say because like you said, it does visually look more than it is which is why pace bottle-feeding is important because we want to take frequent breaks, little, quick breaks of a couple of minutes or so to burp, let that move down their belly, and get that excess air out, and then continue feeding. I always recommend that if your baby spits up and it looks like a lot, see how they’re doing and go by their cues. If it seems like they are looking for food again, try and give a little but maybe a smaller amount just to see how it goes. Meagan: Mhmm. That’s a good rule of thumb. Crystal: Keeping babies upright after feeding, if you can,  will help to lessen the chance of spit-up, but then again, sometimes babies spit up out of nowhere an hour after feeding. Parents are like, “I don’t know what’s going on. He spit up.” If that happens and you are burping your baby and keeping them upright after feedings, I would definitely talk to a provider because sometimes it can be the formula if they are drinking formula or something to that effect. Meagan: Mhmm. Yeah. Awesome. We’ve gone over so much. Crystal: I know. Meagan: I want to just end on The Mama Coach. How can people find you? What do you guys offer? How does The Mama Coach? I mean, I know how. It’s in amazing ways and who is a good, qualifier to go and find a Mama Coach?Crystal: Yeah, like I mentioned earlier, The Mama Coach is a group of registered nurses all over the world. I am the owner here in Vacaville, California which is in Northern California. Our goal is just to help make parenting easier. Like I mentioned, we do have prenatal services. We have postpartum services and newborn services, helping with any type of feeding even if you are not breastfeeding. Meagan: Sleep?Crystal: Sleep, yes. We have sleep. We help with newborn sleep, toddler sleep, potty training, CPR and choking classes, starting solids as well as one-on-one services here. For me, locally, I do home visits and home lactation visits. I can do any of the workshops one-on-one in home or virtually. My niche is breastfeeding– prenatal breastfeeding education and consultations as well as postpartum of course, newborn care, and sleep because those are all important things. Meagan: Very, very important things. Crystal: Very important. Meagan: You guys make it really, so easy. You just go to themamacoach.com. There is a “Find a Mama Coach”. You can search what you are looking for or you can type in your zip code and you can pull up all of the Mama Coaches near you and go over all of their services. I don’t think there is a single one that only does one thing. Crystal: No, we all pretty much do a lot. Yes, correct. Yep. For sure. If you are a new or expecting parent or even a parent of a three-year-old– any parent that is struggling and your baby is five years old or under, we can help you. I am on Instagram. My Instagram is crystal.night.themamacoach. We also have a website like you were saying. The main website is themamacoach.com. We each have our own individual sites as well and I’m sure we’ll post that information somewhere, but yeah. Reach out to any one of us and myself if you are in Northern California in the Vacaville area. We, like I said, almost all do virtual and then also locally in person too. I do ongoing workshops and that’s always posted on my website in the classes or on my Instagram. Meagan: So amazing. You guys are doing so much. You even have a blog where you can look specifically at pregnancy, newborn, sleep schedules, and parenting in general. I mean, these guys have amazing things so make sure to go follow. We’ll make sure to tag you today on our Instagram and our Facebook so you can go and find it. We’re going to have the website in the show notes. We’ll have all of the things we have talked about and seriously, thank you so much for helping our community because like I said, we don’t talk about postpartum as much. We don’t focus on it as much. We don’t focus on feeding and all of the things, so thank you so much for kicking off the 2024 season with a new type of topic. Crystal: Yes. Yes. Awesome. I was so happy to be on here. Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands