Breastfeeding in the Early Postpartum: Overcoming Challenges with Dr. Morgan MacDermott

[00:00:00] Gina: Welcome to the MamasteFit Podcast. If you’re wondering how you can approach breastfeeding in the early weeks postpartum to help support long term breast supply in addition to handle any sort of issues that you may encounter such as clogged ducts, engorgement, or even mastitis, this is the episode that you want to listen to.

[00:00:17] Gina: We’re interviewing our friend, Dr. Morgan MacDermott, who’s a naturopathic doctor all about what you can do in the early weeks postpartum to help support your breastfeeding journey.

[00:01:17] Gina: Welcome to the MamasteFit Podcast. In this episode, we have Dr. Morgan MacDermott here, who is going to be talking all about breastfeeding in the early days, how we can enhance that, some common myths,

in addition to what happens if we’re coming across any sort of issues with breastfeeding, like nipple pain or mastitis, and some ways that we can remedy that. So thank you so much for being here, Morgan.

[00:01:38] Morgan: Thanks for having me, ladies. This is so fun to see you again.

[00:01:42] Gina: I know! We met Morgan last year at the Needed retreat and we have been in love with her ever since. So we’re really excited to have you with us. Can you just introduce yourself to our listeners?

[00:01:53] Morgan: Yeah. Awesome. I am Dr. Morgan MacDermott. You can just call me Dr. Morgan or Morgan. I am a naturopathic medical doctor. That’s what we’re considered here in Idaho, but you may hear the term naturopathic doctor more frequently. I graduated at Bastyr San Diego in 2018, and I have been in the women’s health and perinatal health specialty ever since with also some pediatrics.

[00:02:14] Morgan: I have a particular interest and passion with pregnancy, birth prep, breastfeeding postpartum, and then just motherhood in general. I think that this time period is so magical. It’s so amazing. It’s been my favorite thing. It’s been where I’ve been very steeped with having my own four children for the last, almost 10 years.

[00:02:33] Morgan: But then also I find it to be something where it seems that if with just a little bit more support or education, people can have either a very good experience or a very bad experience, and I am somebody who had a very bad experience with my first postpartum, and it was due to breastfeeding problems, which is why I have a particular passion with breastfeeding. And it would maybe not have been that way had I just been a little bit more prepared and known some things. And so I was led a stray and, I, it just, it brought me down a path of postpartum anxiety and chronic pain for a very long time and recurrent mastitis and all this stuff that I just don’t ever want people to have to experience if they can know about some of the warning signs ahead of time and just have heard about some of these topics.

[00:03:16] Morgan: Because, in 2015 I felt like I was pretty prepared. I had planned this home birth and the home birth went great and the pregnancy was great. I felt awesome, but I didn’t do as much preparation about breastfeeding because I thought, well, this is the natural, normal next step after a baby is born. And it’s just, yes, while that is true, you still have to learn how to breastfeed and your baby still has to learn how to breastfeed. And so there’s some hiccups along the way that can come. And so I’m just very passionate about educating

around this time and also normalizing that it’s hard, and helping point women in the direction of resources that can help them.

[00:03:52] Gina: My first baby, my breastfeeding experience was much more challenging than the next two, where I just had more experience and just knew more about like how to prepare, what to expect. So I had all my gadgets like ready for my second and third baby. And I’ll have all those things ready for my fourth.

[00:04:09] Gina: But feeding our babies is like a very, it can be a very stressful thing.

[00:04:13] Roxanne: Oh, it’s so stressful.

[00:04:14] Gina: Especially if you’re wanting to breastfeed and you’re wanting that experience. Cause there’s a lot of pressure on us. We give birth and then now we have to nourish this baby and be its only lifeline for six months, at least.

[00:04:27] Gina: So let’s start with what are the kind of like some of the myths that are surrounding breastfeeding in the early days? Some folks are like, “Oh, if I’m leaking milk during pregnancy, Oh my God, like I’m not going to have any milk for my baby,” or, “My milk doesn’t come in for three to four days, like what feeds my baby then?” Like, “My baby is starving, like I should supplement with formula.”

[00:04:48] Roxanne: “My baby’s losing weight.”

[00:04:49] Gina: What are some of those early breastfeeding myths?

[00:04:53] Morgan: I think that the problem with breastfeeding, unfortunately, or fortunately, I guess, depending on the way you look at it, is that so much of the success of breastfeeding lies on that first couple of early weeks. If we don’t get the hormonal loops and patterns set and the supply established early on, it is not something that we can just choose to do when the baby is four months old, or something.

[00:05:16] Morgan: You really need to, the body is primed and set physiologically to have these, this big change once the baby is born. The placenta is gone, all of the hormones change. This triggers one of the initial onset of the way the prolactin now is going to become the big heavy hitter hormone. And estrogen, progesterone, and testosterone will be in a more sort of a suppressed state, and now this is the hormonal picture of a breastfeeding woman instead of a pregnant woman.

[00:05:42] Morgan: And in the very, very beginning, there’s a lot of these little things that can get tripped up, and so let’s, talk about it, because like you just said, there’s a lot there.

[00:05:50] Morgan: So if you are leaking in your pregnancy, you are still going to continue to make breast milk. So let’s just back it up really quick. What is milk? What is breast milk? Breast milk is a blood product. And so your blood is constantly circulating through your body. And if you are in that state of the, towards the late of pregnancy or while you’re continuing to breastfeed, you are constantly making new milk supplies, and it is not something that just builds up and stays stagnant.

[00:06:17] Morgan: Yes, there’s periods of time where we do have more of a capacity for holding larger ounces of milk, but it’s something that’s continually refreshed. This comes into play or is eludicated in the situation of women who are drinking alcohol and they’re trying to figure out, can I still feed my baby? And the idea is that if you had, three drinks at 2 PM at 8 PM, your milk is going to be, well, it may have a little tiny bit of alcohol in it, who knows, don’t hold steady onto these time periods, but my point is that it doesn’t hold the alcohol in there and just never breaks down and it has to be removed from your breasts. That’s not the way that it works. If it’s out of your blood, it’s out of your breast milk. And so, anyway, it’s a blood product. You’re continually making it. So if you leak during your pregnancy, it does not mean that you’re not going to have enough for when your baby comes by any means.

[00:07:04] Morgan: That leakage during pregnancy is called colostrum. Colostrum is a form of milk, so this is another one of those myths that people think, “Well, colostrum is not milk. My baby doesn’t have milk yet. I don’t have milk yet. What’s my baby going to be drinking?” It’s like colostrum is just an early form of milk, and it is in a much smaller, concentrated form. It’s slightly yellowish. Sometimes it’s very yellowish. It is thicker, stickier. It’s higher in immunoglobulins and less in fat and less in proteins.

[00:07:31] Morgan: And so it’s this like serum, you could think about it. It’s like a really amazing potent immune boost for your newborn baby because they are vulnerable to things. So it’s nature’s beautiful way, intelligent system, to help protect them and keep them well. It also helps to coat their gut lining and start that whole process of gut colonization. Lots of beautiful things.

[00:07:52] Morgan: If you leak in your pregnancy, you’re still going to have lots of milk when your baby, or colostrum, when your baby is born. If you don’t leak in your pregnancy, that does not mean that you don’t have colostrum in your breasts. It does not mean that you are going to be somebody that can’t make enough. Some people are just not leaky and it has to do, the leakiness in

general, has to do with the little teeny tiny smooth muscle fibers that are around the nipple pores on our nipple tip. There’s, this is another thing a lot of people don’t know is that milk does not just come out of one mainstream hole, this is a weird example, but the way that like urine comes out of your urethra, it’s not like that. It’s not like one tube and then there’s milk in there. It sprays and there’s multiple little pores and holes there. And around each of them at a molecular level, there are little teeny, tiny muscles all around there, and if they don’t clamp shut or they don’t have that kind of a tone, you may leak milk when there’s pressure backed up behind there. You can have pressure from colostrum. Or maybe you go on like a hike, or you’re jumping around. One time, I really only leaked with my first pregnancy, I don’t know why, I didn’t leak with my other ones. But I went to a concert and I was like 36 weeks pregnant and I was wearing a light gray tank top.

[00:09:01] Roxanne: Oh, no!

[00:09:03] Gina: I already see where this is going!

[00:09:05] Morgan: Yeah, not good. And I didn’t know until the end. We were walking out. It was like all dark. It was inside of a building in San Diego. And as we were walking out, my husband looks at me and he’s like- he calls me Moses, that’s just like his nickname for me- he’s like, “Moses! Your shirt!” And I look down, and it was just like two perfect dark gray, quarter sized, dime sized, whatever, spots, right on my nipples. And it was like hardened because it was colostrum. So it didn’t evaporate and go away the way that milk can. Colostrum’s a little bit different. So it was so obvious and so awful. But anyway, that’s an aside.

[00:09:37] Morgan: But not being leaky, or being leaky does not indicate necessarily a good milk supply or a not good milk supply. So there’s a couple of things there that like, even before your baby is born to just understand about what’s happening in your body. And some people want to choose to, or maybe are advised to, for various reasons, to harvest their colostrum. And you don’t need to do this. I’ve never done this, but you can if you want to. And it’s pretty easy. You’re just going to be doing like a hand expression towards the end of your pregnancy. You do want to get clearance though, from your provider, whether it’s your midwife or your OB, because if you’re having any kind of pre labor symptoms, maybe you have a bit of an early dilation happening, or short cervix, or something like that where we don’t want to trigger labor from happening, there is going to be some oxytocin half floating through your system when you are doing any kind of a hand expression at the breast or pumping or anything like that. So you definitely would want to get some clearance. But where that might be helpful for people is in the situation of gestational diabetes, and perhaps the baby would be born with some low blood sugar. It would be

nice if Mom maybe had a little bit of colostrum stored up that they can administer to the baby.

[00:10:45] Morgan: And yes, baby would get it from nursing, but sometimes babies come out and they have extremely low blood sugar, depending on what was going on with Mom during the pregnancy, and they need a little boost. And what they would maybe do in a situation where that wasn’t available is just get some formula and it’s okay, if we need to do that, we need to do that. But you can have your colostrum saved. Or, you can save those, freeze them, in 1cc little syringes or the company Haakaa, like H-A-A-K-A-A, it’s that New Zealand company that makes the silicone breast pump, they make these little silicone, colostrum kind of harvester things and they’re easy to freeze as well. And then you can use those with your baby maybe later on when they become sick, or in their eyes for conjunctivitis, or on their skin, or different things like that.

[00:11:29] Morgan: So colostrum, this has been a 10 minute conversation about colostrum! But I think that it’s important to understand because people, you know, your baby may be born and your milk doesn’t transition into real breast milk for that first three to five days, let’s say. Some babies, or some women, their milk may come in on day two, some, it might take seven, eight days, depending on the way the birth went, or their hormone loops, birth trauma is something that can play into this, or even a Cesarean section, just because of sometimes the way that the hormone loops have been changed a bit, and it can be a bit delayed. And that’s okay. We need to understand that a newborn baby’s stomach is primed and ready for colostrum. They are not expecting to be able to come out and have full on milk.

[00:12:10] Morgan: And so, I think that it’s obviously due to the goodness of our heart and our concern for our infants that we’re like, “Wait a minute, are they eating enough? Are they eating enough?” But it’s yes, it’s okay. And the more that you can feed, the more often you can get them on, and they’re having a good suck swallow pattern, they are gonna be getting colostrum. If for some reason they’re not, or you’re unable to nurse them at the breast, or if you are planning to formula feed, then you obviously would be giving them formula from the get go, if that was the plan. But if you are planning to breastfeed, you can hand express some of that colostrum, feed it on a spoon, in a little tiny open cup, with a syringe, there’s other ways to get the baby to get the colostrum if we need to.

[00:12:47] Morgan: But your milk may not actually start to transition for that first three to five days on average. And what that looks like is suddenly one day, usually you’ll start to notice that maybe on their mouth or if you are leaky that the colostrum is starting to change into more of a yellowish milky substance, or you may even see white coloring come in. Or, you are also starting to become

engorged. And engorgement is where your breasts are becoming very full, very quickly. There’s also just mostly a lot of swelling. That’s what a lot of that firmness is. And for somebody like me, who has really small breasts, I wake up one morning and it’s like, “Whoa! This is crazy!”

[00:13:29] Gina: What is this?

[00:13:30] Roxanne: It’s like you grow in like cup size.

[00:13:32] Gina: I know it’s three cups size, almost like overnight. I’m like, “Oh my GOD!”

[00:13:37] Roxanne: And they’re like veiny. But it’s so uncomfortable. It’s so uncomfortable.

[00:13:42] Morgan: It’s so uncomfortable. And it’s like implants overnight. They are rock hard. The shape is all funky. Yeah. Like the veins are out.

[00:13:50] Roxanne: It’s like lumpy.

[00:13:52] Morgan: Yeah, they’re lumpy. You can’t even put your arms down. Yes.

[00:13:55] Roxanne: Oh, yeah, because it’s, that’s the one thing that people don’t tell you is your milk duct is not just your breast. It’s in your armpits. So I would get like lumps in my armpits. And I’m like, what is happening? I was engorged in my armpits and I was like, this is so gnarly.

[00:14:17] Gina: Oh, man.

[00:14:18] Roxanne: So the woman’s body is amazing, but also why?

[00:14:23] Morgan: Yeah, it is amazing. And if you look at a breast diagram, on like Google Images or something, it’s called the Tail of Spence. And it’s literally like the breast tissue goes all the way up into the armpit in this like little kind of, odd tail that kind of goes up and it’s like, why? Why there? That’s so uncomfortable.

[00:14:39] Gina: Of all the places to go. Like, why did you have to go there?

[00:14:42] Roxanne: Monthly breast exams that we should be doing on ourselves, they tell you to go all up into your armpit.

[00:14:47] Gina: Which makes sense.

[00:14:48] Roxanne: That’s also a part of your breast. But I felt like I was like this some of the days because I couldn’t put my arms down.

[00:14:55] Gina: Yeah. Some of the things that I did during my postpartum phases, whenever I was super engorged, was one, I made sure I was wearing, really loose fitting bras. So, Bodily has these really nice, Every… it’s Every Day? Everything?

[00:15:09] Roxanne: Everything Bra.

[00:15:10] Gina: Everything Bras that’s super loose fitting, and so I would wear those. Cause, any sort of compression, especially along, the sides, always make things like way more uncomfortable and worse.

[00:15:21] Gina: And I would also do a little bit of pumping just to relieve some of the pressure and then like just nurse baby as much as I could. Cause sometimes like they couldn’t latch cause it was like two rocks like of my chest.

[00:15:34] Gina: Do you have any other tips for folks when they are engorged and like super uncomfortable or trying to figure out what can they take or what to do at this point?

[00:15:44] Morgan: Yeah, absolutely. So we should just have the expectation set that at some point you will experience engorgement and it’s usually 24 to 72 hours, it shouldn’t be very many more days than that. And if your baby is having a hard time latching at the breast because it is like a balloon and it’s so hard to, for them and their little mouth and they’re, just newborn babies and they’re trying, they’re doing their best, but like they are still learning.

[00:16:07] Roxanne: They’ve never done this before.

[00:16:09] Morgan: Yeah! You, can do something that’s called reverse pressure softening. And there are tons of YouTube videos. Basically, you’re just going to take both hands, your index and pointer finger, or sorry, your index and middle finger. Yeah, because index and pointer finger are the same finger! So you’re going to take your two fingers and you’re going to go on either side of your areola and around your nipple and you’re just going to press gently straight in towards your chest wall. And then you’re going to rotate 90 degrees so you’re making like a square. And basically you’re going to just be pressing in and making a divot of space amongst all of that inflammatory fluid.

[00:16:44] Morgan: So what’s happening inside the breast is it’s not that you’re that full of milk. I think that’s another common misconception. People think, “Oh my gosh, I have so much milk right now!” But it’s actually a mostly a fluid. It’s interstitial fluid, so it’s swelling and it’s inflammation from this sort of like fast, hot and heavy process as “milk comes in,” air quotes, because again, colostrum is milk, so don’t let anybody fool you that colostrum is not milk.

[00:17:07] Morgan: And I do see this unfortunately in like a hospital setting where, maybe it’s day four and the baby is crying in the room and the nurses, while they might mean well, they may come in and be like, “Your baby is really hungry, you should give him a bottle of formula or something.” And it’s well, we have to think about what’s physiologically at play here. It’s not physiologically necessary yet for a baby that is four days old to be getting a full on milk. That is okay. They also may be crying and want to latch again. And yes, at four days you may have felt like all you have done is nurse. But there is a system to this that is really intense in the beginning, and it’s temporary, and it will become easier and faster as time goes on. But when you allow the baby to just have open access to the breast nursing as much as possible, they’re gonna pull the milk in faster, it’s this beautiful stimulation loop of stimulation at the breast plus sucking and the removal of milk cause more milk to be made. And so if we can just get around that.

[00:18:04] Morgan: But back to engorgement. One of the very best things that you can do, in my opinion, is something called lymphatic massage. And so lymphatic massage is going to follow along with the chains of lymph tissue, as the name would suggest. And I think a lot of us, when we think about massaging breasts, massaging breastfeeding breasts, you would almost want to go down towards the nipple because you feel like we need to get something out. But in this case, we are not doing that. We are starting at the nipple and starting to use the sort of pressure on your skin that you would be rubbing in like a thick lotion, okay? So it’s not super light where nothing’s happening, but you’re also not pressing by any means like very hard. You’re going to start at the nipple and you’re going to work your way up.

[00:18:47] Morgan: I know that, there’s a video here and so those who can’t see the video, you’re just going to basically be going up towards your armpit because that’s where all of the chains of the lymphatics dump into. This is where we also have lymph nodes and this is also, again, just back to like our breast cancer conversation, or like breast screening conversation, always checking your armpit, because there is a lot of lymph nodes there. This is a main center for the way that our torso and our thoracic, our chest dumps lymph.

[00:19:14] Morgan: So, anyway, we’re gonna, everything’s gonna be up towards your armpit. Even when you’re at the bottom of your breast, you’re still

gonna be like pulling it up. You’re gonna be doing this light touch massage, you would, I think it’s easier to use like a coconut oil or some sort of a lotion or you can do it in the shower. And you may even notice, leaking from your nipples, of milk, when you’ve done this a little bit. Because when we can relieve the pressure and the swelling, the milk can flow easier. Also, your baby can latch easier.

[00:19:43] Morgan: Another common misconception about engorgement specifically is that we want to be using cold and not heat on this situation because we have to think about it. Inflammation, we’re trying to reduce inflammation to make ourselves not only comfortable, we’re comfortable, but also so that the baby can get a good latch and help to relieve some of this pressure. We need to be using cold for a short period of time. You don’t want to be using like full on ice packs for hours and hours at a time. It could be 20 minutes here and there a couple times just to get you through this like accute period, again.

[00:20:14] Morgan: So some warning signs really quick is you should feel softer, or the way that… Let’s, talk about green flags, okay? This is what we want to see. You should feel softer, ever so slightly, or sometimes dramatically softer, after your baby has had a feed. If you don’t, if your baby has been sucking on there, and you feel like, oh my gosh, 35 minutes has gone by and my breast does not feel any different, there’s a really good chance that they’re not getting anything out of you, and that could be that there’s something going on with their latch and it would behoove us to then look into working with an IBCLC. That stands for International Board Certified Lactation Consultants. IBCLCs are more trained. They have a lot higher training than a regular lactation counselor or consultant and lactation consultants can be really awesome. But if we have any sort of a pathology happening, if there is anything beyond normal lactation, it’s usually better to get in with somebody who has more experience with that. So we might want to be, that’s one of our signs that something, this baby’s latch is not good, they are not able to get milk. Now this doesn’t only affect the baby, and they’re not going to be getting milk, they’re going to be hungry and upset all the time, they won’t be gaining their birth weight, or they won’t be regaining their birth weight, but also, it can affect you, because now, here you are with these breasts, that the milk is not coming out, and it’s going to continue to be stimulated with them latching at your nipple, and your body is like bringing this in hot and heavy, and now we’re at risk for things like clogged ducts and mastitis.

[00:21:41] Morgan: Which, unfortunately, I have a lot of experience with. Do either of you?

[00:21:44] Gina: In my first pregnancy, I had more issues with clogged ducts and mastitis because my daughter’s latch wasn’t great at the beginning. So I also had a lot of nipple damage. We also had a much more difficult birth, the two of us, so I was not surprised that her, like in retrospect, I’m not surprised that her latch was like kind of problematic. And so I had way more like clogged duct issues. I never developed mastitis though, which I was thankful for, but I did all of the opposite things you’re supposed to do. Like I always used heat. And now it’s, “Actually, you’re supposed to use cold!” And I’m like…

[00:22:16] Roxanne: But at the time, that was the recommendation.

[00:22:18] Gina: That was the recommendation.

[00:22:19] Roxanne: In 2015 it was like, “Oh, yeah, you like need like massage and heat. And that’s going to help with the engorgement.”

[00:22:24] Gina: “And be aggressive! Rub them!” But for my next two, they really, it was a really easy breastfeeding journey with them, which I always feel guilty about saying, “I’m sorry, guys, I didn’t suffer through that.”

[00:22:36] Roxanne: Because Roxanne suffered. Roxanne had a lot of suffering. Because all of my kids have tongue ties, so they all compensated pretty well at the beginning. But like it’s tons of nipple damage, tons of clogged ducts. I never got mastitis where I needed like antibiotics, but I’ve definitely had them where I would, like I had a clogged duct, it started to be painful, started having a fever and chills, but then 24 hours later, I was good. I still had the remnants of the soreness from the clogged duct, but my fever was gone and I was feeling a lot better.

[00:23:13] Roxanne: But I would notice that like they would nurse on that side for a lot longer, probably because like my milk supply was a lot less after having that clogged duct, so then they would need to rebuild the supply, for a lack of a better word.

[00:23:28] Roxanne: But I, I haven’t had one in a while. I think I got one like maybe a couple weeks ago because the bra that I was wearing wasn’t the best. And so it was like right where the bra was like lining I got one.

[00:23:40] Gina: Yeah.

[00:23:40] Roxanne: And that sucked, but Joan took care of it pretty well. But those first like three months with all of my kids were all pretty rough.

[00:23:48] Roxanne: Lily was the worst. The just like nipple damage.

[00:23:52] Gina: She’s just the worst.

[00:23:54] Roxanne: Like, the experience was the worst out of the three. It was long. I freaking, my nipples didn’t heal for four months of just pain every time she nursed and trying to find someone who would give her a tongue tie release.

[00:24:11] Roxanne: And then Colin nursed great. No pain. I didn’t really have much nipple damage, but he was like, no weight gain, which obviously is alarming. He like dropped from 50th percentile to like 15th percentile and then just just hung out around the 15th percentile for… he’s still 15th percentile. Oh, no, just kidding, he’s 30th percentile now, so like he’s, up now.

[00:24:37] Roxanne: But Joan has been the easiest, but she still had a tongue tie, and I still needed to get it adjusted. I still had some nipple damage in the hospital until we got all the body work and all that, but. Yeah, mastitis and clogged ducts. I know them well, probably not as well as you, because I never really got it bad mastitis wise with Lily, but I would pump, so I had an insane oversupply with Lily, where I leak. My smooth muscle things are very weak. They let the milk out very easily, soaked through an entire towel overnight. Like bath towel, large bath towel, soaked by the morning from just milk.

[00:25:24] Morgan: Just coming out.

[00:25:25] Morgan: I’d burst into tears cause I’m like, “This is milk my baby could have drank!”

[00:25:28] Gina: Squeeze it out into a bottle.

[00:25:31] Roxanne: So then I started using like a Haakaa at night to collect it, or else it would just go everywhere, and put it in the little mini fridge that I had on my bedside. So I had so much milk with Lily because I was just like leaking it out everywhere. And then just like perpetuating this oversupply by doing all this, which made me have more clogged ducts. Endless cycle.

[00:25:54] Gina: Let’s take a break from this week’s episode to talk about our podcast sponsor, Needed. Needed is a nutrition company that focuses on optimizing nourishment for the perinatal time frame and is a brand that Roxanne and I both use during our pregnancies, postpartums, and beyond. And Needed has a lactation bundle to help support you in your breastfeeding journey.

[00:26:12] Roxanne: And this is something that I grabbed in preparation for my postpartum and we will grab for Gina’s postpartum. And inside the bundle it has, one, hydration support. So it’s really important to be hydrated during postpartum in general, but especially for a milk supply. So Morgan was saying how our milk is basically a blood product and one of the biggest things for our blood volume is hydration. So we need to be not just drinking in water though we also need to be drinking those electrolytes and those trace minerals so that we have an optimal hydration level.

[00:26:44] Roxanne: Needed’s hydration support has the electrolytes in those optimal dosages, but also trace minerals, which others don’t really have.

[00:26:50] Gina: The lactation bundle also includes Needed’s collagen, which is a protein source to help nourish you in the postpartum, in addition to their stress support, because how we feel can impact our milk supply, and so the stress support is a wonderful supplement to take on. So the combination of the collagen and the stress support can help to support your milk supply.

[00:27:08] Roxanne: And if you want to grab the lactation support bundle, in addition to maybe even the choline to help if you have mastitis, you can check them out at thisisneeded.com and use our code MAMASTEPOD to get 20 percent off your first order.

[00:27:19] Gina: So, can you talk about what if someone has a clogged duct, which I feel like it’s probably similar to engorgement, but there’s probably some different strategies, what could they do to help resolve that?

[00:27:29] Gina: I did things like massaging below where the clog was because I was told like “Well, it’s not the clog, that’s not the issue. Like that’s a collection of milk below it, is where like the stickiness is that’s blocking it.” I know there’s some supplements that you can take to help thin out your milk to help it come out. Like what tips do you have for clogged ducts? And then we can dive into: what is mastitis? Because it might be the first time that somebody’s ever heard that word.

[00:27:57] Gina: It wasn’t something that I was familiar with during my pregnancy. What do you mean you get sick from breastfeeding?

[00:28:03] Roxanne: I think, and there’s also the misconception of mastitis where if you get it, you need antibiotics immediately. It’s like this infection within your milk and the only way to get rid of it is with antibiotics. Because that’s what I was taught, is that if you get mastitis, you need to go to the hospital

and get put on the antibiotics because you could develop into a freaking abscess within your boob and like you would need it to get drained and all that.

[00:28:26] Roxanne: I was like, “Whoa, my gosh, this spirals quickly!” But that’s not the case for everybody.

[00:28:33] Morgan: Yeah, no, this is, there’s a lot here. This is awesome. So really quick just to back up on that point because I don’t want to miss it, there are two main ways, or two main forms of a breastfeeding mastitis. So yes, there is the bacterial form of mastitis, which is more common in a situation where there is really active obvious nipple damage and one of the bacteria that’s normal on the skin, but is abnormal in a cut, is something called Staph Aureus. And Staph Aureus can get in there and it’s probably Hawaii to them or something. It’s like a warm, dark, milky, sugary fluid and they can proliferate and cause an actual bacterial infection. But that is, there’s also some signs and symptoms that’s what’s happening. A much higher fever, like a 103 or above fever would be more in line with a bacterial infection. Something that’s like around 101, maybe even 102, could be the other form, which is called inflammatory mastitis.

[00:29:31] Morgan: So inflammatory mastitis is this kind that we get in those typical situations where baby slept too long and we didn’t even know it and we wake up in a panic and yeah, maybe you’re like in a puddle of milk but now you have this really firm red spot, it hurts, it aches, you have the fever, the chills, the whole symptoms, all the symptoms. And inflammatory mastitis is much more common in women who have an oversupply. So oversupply, if anybody doesn’t know what that means, it just means that you make more milk than what your baby drinks on a daily basis. So you’re always rocking like a little too much. You’re always a little too full. Your baby feeds to their filling, but you’re not synced in terms of their need. And so you don’t have that kind of even ground of flowing just being able to like only make what your baby needs and not tons more. So maybe this is the situation where people are, yeah, they’re pumping often, or they are often using things to catch milk, but there’s like a slight suction on those things that catch milk, and that does in turn, cause more of a supply to be encouraged. So there’s a double edged sword there. It’s like we think, “Oh, well, too much milk is great. Like, why wouldn’t we want too much milk? It’s better than having not enough milk.” And it’s well, they’re both unfortunate in different ways.

[00:30:44] Morgan: But inflammatory mastitis is… So I have four children. I have had bacterial mastitis one time. Truly, it was the very first time I ever got mastitis. I was four days postpartum. The worst. The worst. Four days, you guys. Can you even imagine? And all of a sudden, I have this 103, 104 degree

fever. And at first we thought it was maybe my uterus, which would make sense because we’re like, crap, what’s going on here?

[00:31:09] Morgan: Yeah, but my nipple damage was so bad because, like you, Roxanne, all four of my children are tongue and lip tied. But with him being my first, I didn’t know that yet. So he was just ripping my nipples to shreds and I was just like, young little new mom trying to do my best. Really wanted to breastfeed my baby and I just wasn’t getting the support that I needed at that time.

[00:31:29] Morgan: So anyway, one time of true bacterial mastitis got on antibiotics. It was definitely needed in that time period. The other 11 times that I have had mastitis have all been inflammatory mastitis. Yeah, 11! 12 total. It’s so, it’s just, I don’t know. I, have smaller breasts and I do make a lot of milk, so I’m always battling that oversupply edge as well.

[00:31:51] Morgan: So, but anyways, what happens in that situation is we have these little grape like structures that are holding the milk inside of our breasts, and they become filled up over time. And if you don’t have a pressure relief, they can start to leak that milk into the, it’s called the interstitial space, it’s basically the space in between the cells, where your body now recognizes this milk as being something foreign. It’s what is that? What, is all this? There’s tons of immunological components to breast milk and all these different proteins. And so it’s smart of our body to want to try to attack it. They, it’s like we see it as a foreign substance because it’s in a place of our body where it’s not supposed to be. And so then we have this big inflammatory response. When we have a big inflammatory response, this is where we get pain, swelling, redness, fever. So it’s weird that you would get a fever if there’s no infection, right? But no, it’s not. And actually, when we speak with anyone with autoimmune disease, they know that very well. Inflammation can cause a fever, whether or not it’s from a microbe. So this is a very common misconception. I think in places like urgent cares, even OBGYN offices where people are going, they have these symptoms, they’re immediately going to be prescribed antibiotics, and it’s unfortunate because it’s probably not even going to help.

[00:33:03] Morgan: Or, potentially what could be happening is that several antibiotics do have an inherent anti inflammatory action as well. So they may feel, “Oh, once I started taking that medication, I started feeling better.” Well, it’s probably because of the anti inflammatory aspect.

[00:33:18] Morgan: But now, this is another thing that people are not told, is that now we are at risk for you and the infant developing thrush. Thrush is something, it’s called candida albicans or thrush commonly, and it’s like that white coating on the baby’s tongue. Or it could be the shiny red painful nipples

and the shooting pains throughout the breast that are different from mastitis. But thrush is a very difficult breastfeeding issue to resolve as well, so we need to be given informed consent if we’re going to be taking antibiotics while we are breastfeeding. We need to also be very good and diligent with our probiotics at the same time.

[00:33:51] Morgan: Speaking of that, and Gina, back to your question about what can we do about this, so, if you are somebody who’s prone to clogged ducts and mastitis, there are things that you can do that will be of your benefit. There’s a lot of different aspects to look at here, so I’ll talk about several different things, but there are probiotics that are breast specific. So, BioGaia makes one, Klaire Labs makes one, we can put these in the show notes. And they are some breastfeeding strains, or sorry, some probiotic strains that we find in good, normal breast milk that are beneficial there and they are going to keep the peace. And the microbes don’t just attack or keep other microbes out, they make certain metabolites, they keep a certain pH, etc. There’s a lot of benefit there. And what we know now is that clogged ducts are actually a biofilm. So it’s not just that the milk may be curdled or something like that and is physically blocking and it’s just milk. It’s not just milk. It’s milk mixed with these extracellular proteins, with layers of bacteria, with debris, skin, all sorts of different things, yes, and maybe some thicker fat globules, different things like that, and it almost makes like a plaque. When we think about atherosclerosis or something, where your heart arteries are blocked. And what even is a plaque? You could think about it like that, that a clogged duct is this thing that is building up in one of these very, thin little ducts, and these ducts are so, so, so small, these little tubes, and they cross each other, they’re not just like direct lines out from the areas where the milk is made to the nipple. They cross and they are like little hairs and they’re all jumbled all over the place because really the breast is considered a gland. It’s not just this like certain tissue. It’s a glandular tissue and so that’s why the old advice of pressing super hard and doing a deep massage doesn’t really make sense because we think in our mind, all the pictures you see, “Oh, well, I’m going to press along this duct, this like tube highway towards the nipple, and I’m going to push that thing out,” and it’s no, the duct might be going like, wee oo, it’s like a stream goes like under the bridge. Like you’re not pushing on any one highway, you’re just causing more damage and more inflammation and swelling, and now we really can’t get the milk flowing.

[00:36:07] Morgan: So what the advice is, is to reduce the inflammation at all costs and to feed normally. So let me break those two parts apart. Reducing the inflammation would look like rest, ice, and maybe even NSAIDs, so non steroidal anti inflammatories, so like ibuprofen. Tylenol is good for pain. Tylenol is not an anti inflammatory and Tylenol will not do anything for inflammation. So if we’re going to choose something, we would want to choose

something like ibuprofen if that’s okay for you and your particular body. This is not medical advice. This is just like from the Academy of Breastfeeding Medicine. It’s one of the things that they say. If you don’t want to take a pharmaceutical, you could maybe look into the leafy tincture that is a high dose ginger and turmeric, and it also has some anti inflammatory effects. But one of my very favorite ways to reduce inflammation is in that sort of way, besides the therapeutic or the lymphatic massage like we spoke about with engorgement, you can totally do that, but also using contrast hydrotherapy.

[00:37:05] Morgan: So, contrast meaning there’s two different things happening, right? So we’re using hot and cold water in a way that is going to help reduce swelling. So you guys know this, you’re athletes. If we use cold water, we reduce the inflammation, but you can sometimes go back and forth and what you’re doing when you go back and forth using hot, cold, hot, cold is you’re flushing and pumping. You’re causing your interstitial fluid and your vasculature to pump away all of this excess swelling and fluid. And so what you would do with that is take two washcloths, one in a bowl of ice water, one in a hot bowl of water, or like what I like to do is just get it wet, wring it out, and then be putting it in the microwave because it’s gonna get a lot hotter.

[00:37:45] Morgan: Obviously, don’t burn yourself, be careful, but you want it pretty hot. You’re gonna do three minutes, hot. One minute cold, three minutes hot, one minute cold, and go back and forth. Maybe do you do it ten times? That’s one round. You need to do that a couple of times a day if we’re dealing with some sort of a really gnarly clog or an active mastitis that’s an inflammatory mastitis. It could be a bacterial mastitis. This will still help.

[00:38:08] Morgan: But also if you’re prone to mastitis and clogged ducts, you can take something called sunflower lecithin, which is a form of a choline that will go in and it emulsifies the fat globules so that they aren’t as sticky. Some women have much fattier milk than others, and it does seem like the women who have the, that really thick, fatty milkshake milk, that they are more prone to clogged ducts this way. Because it would make sense that if it’s just not broken up that it could potentially get stuck and then there causes this backup behind there.

[00:38:45] Morgan: So anyway, there’s, that’s just a couple of the ideas. The second thing I wanted to say is the “feed normally.”

[00:38:51] Morgan: So, again, back in the day, there used to be this tenet or idea that was, “Well, when you have a mastitis or something, you need to be emptying the breast, empty the breast, get all the milk out of the breast.”

[00:39:02] Morgan: And it doesn’t, as we know, it doesn’t really work like that. You can never really get all of the milk out of the breast because it’s continually being made. Because every time your heart pumps, and milk, or sorry, and blood runs by these structures, you are making milk from it. It’s so smart, so beautiful, so cool.

[00:39:16] Morgan: But also, when we do that, if we’re maybe going to feed our babies and then we pump on top of that to “drain the breast” because we are experiencing mastitis, what are we doing? We’re really just making more milk.

[00:39:28] Roxanne: You’re just making more milk.

[00:39:30] Morgan: We’re calling more milk in and it’s that’s not what we want to be doing right now.

[00:39:33] Morgan: We really want to feed normally. And just let the system pacify. It’s think about it like a, volcano that’s really active and it’s like everyone in the town below is just trying to wait till it stops. Like just chill out. Like we just got to wait till it goes away or a pimple or something.

[00:39:48] Morgan: Like the more you push and prod and work on it and stuff, you’re just going to make it worse. Let’s just give it a couple of days, do the best things we can, keep a hot compress on it, or whatever it is for the pimple analogy. But does that make sense in terms of the way it works with breastfeeding too?

[00:40:04] Roxanne: It’s so hard to leave like a clogged duct alone, like you wanna get it out.

[00:40:09] Morgan: Yeah, absolutely. And you’ll see videos of people being like, “Look at this crazy clogged duct that I got out!” And there is, it’s not that you can’t do that, you can, it’s just maybe not going to be as successful, or there will be women who have the opposite happen, where they are really in the shower, and they’re just going to town, pressing super hard, working towards the nipple, and it makes everything worse, or it just doesn’t help at all.

[00:40:30] Morgan: What we’ve found is that there’s more success if we are doing some kind of like a lymphatic massage, a contrast hydrotherapy, using ice and anti inflammatories, and then resting your body and feeding your baby normally.

[00:40:42] Roxanne: And I think they just came out with the whole new guidelines, too.

[00:40:46] Morgan: Yes.

[00:40:46] Roxanne: Because there used to be the old guidelines of using the heat and all of that. But now there’s like the new guidelines for dealing with clogged ducts, and they explain that like an inflammatory mastitis or clogged ducts is not necessarily like an actual clog in your ducts. It’s from that inflammation that’s happening that is potentially even just like making the ducts smaller because the inflammation is like pushing down on it.

[00:41:09] Roxanne: And then doing the ice is helpful, the NSAIDs, so the anti inflammatory medications, doing the lymphatic massage, but it’s like a gentle massage because the deep tissue massage on the breast is just causing more damage. And then the things like the sunflower lectin, they say even just like choline by itself, if you can’t get the sunflower lectin, could be really helpful.

[00:41:33] Roxanne: Just like taking more choline in, like eating eggs if you don’t have a supplement of a choline, could be really helpful, and then hydrating. Also just feeding your baby. But the biggest thing with it is if your baby doesn’t have a good latch, like that is like number one. Assess the latch because that is how you’re like long term going to be able to continue feeding.

[00:41:57] Roxanne: And if youyour lactation consultant is like, “no, the Latch is fine, this is all, these are other things that are happening,” but you’re still continuing to have clogged ducts, you maybe need to have another lactation consultant assess what’s going on with baby, because maybe there is some sort of oral restriction, maybe there’s some sort of tongue tie that the first one missed, and that’s why you’re still having all these clogged ducts. Because they don’t just happen out of nowhere. Maybe one time, you could have one out of nowhere.

[00:42:30] Gina: Like you wore your bra that was too tight.

[00:42:31] Gina: But even with the latch issues, because I think about your first postpartum, with Lily, there was a lot of fear to do a tongue tie revision. I don’t want to, do surgery on my baby.

[00:42:47] Gina: And so there’s other options for folks, too, if they’re trying to help improve their baby’s latch. And so, I haven’t had any revisions for my children for tongue ties. They, I don’t know if they have them or not. They never, I’ve never had issues with it. Maybe Adeline does, I don’t know.

[00:43:04] Gina: But we did, cranial sacral therapy with them, a few days after birth. We’ve done chiropractic care. So, a lot of body work to help. Birth is a

process for both of us. It’s a physical process for our babies as well. And so, sometimes if they just have, too much tension in their body, it can make it hard for them to get into a good position to then latch. And so there are options that we could explore before, like the revision, if that is something that is like making somebody nervous too.

[00:43:32] Roxanne: But that’s one of the things with an IBCLC, they have to take all these like additional continuing education and they have to like, they’re required to like, learn all of these things other than just like lactation, like latching babies well. Like a lot of them will have continued education on body work that can be really beneficial, or like their like tongue tie specific IBCLCs that are really great at identifying those tongue ties or other oral restrictions, and they’re able to give you sometimes a lot more help to identify these things, especially if you’re having like more than two, I would say clogged up episodes or even mastitis, that is a reason that something needs to be addressed.

[00:44:14] Roxanne: And like you said, if someone has mastitis and then they’re given an antibiotic and now they have this like fungal infection of the thrush that now breastfeeding is painful, as well as this baby doesn’t want to eat, because like thrush hurts when you’re drinking! Like it hurts to drink for the babies, and so then now it’s just snowballing.

[00:44:37] Gina: Oh, God!

[00:44:37] Roxanne: It’s just when you drop a little snowball at the top of a hill, it just gets bigger and it becomes this bigger problem if we can just address the root cause.

[00:44:48] Morgan: Exactly, you can see why women are so overwhelmed and then they feel like they can’t keep going and it’s like, “What is this experience? This has been hell from the very beginning. It hurts, and I’m so stressed about my baby’s well being, and now this happened, and now this happened, I just want to enjoy my baby! I feel like I haven’t done anything besides troubleshoot breastfeeding problems.”

[00:45:08] Roxanne: Yeah.

[00:45:08] Morgan: And it’s not like this for everybody. It’s really not. There are people who birth a baby and they put their baby on the breast and their latch is amazing and they have no pain and their supply is great and everything’s awesome.

[00:45:18] Gina: Well, that’s my last two babies. I’ve been just like, no problems. I’ve had all the things prepped and I haven’t used any of them. Cause I’m like…

[00:45:27] Roxanne: I used them.

[00:45:28] Gina: Oh, I’ll just put these aside for my next baby, but the first one was challenging.

[00:45:34] Gina: But what can someone do to prepare for breastfeeding? Let’s say they’re still pregnant, I think a lot of folks that listen to our podcast are pregnant. What could they do to help, prepare so that if they do come across these issues, they already have a plan enacted. So, things that I have personally done is I always had my silverettes on standby for, nipple soreness.

[00:45:58] Roxanne: Oh, yeah.

[00:45:58] Morgan: Oh, yeah.

[00:45:58] Gina: To help with healing. I always have some sort of pads available because there’s nothing worse than having the leaking and then your nipple sticking into your bra as you’re pulling it off for baby.

[00:46:13] Roxanne: Especially when you have the nipple damage.

[00:46:14] Gina: So tons of pads available. I always had like happy ducts tincture and like the sunflower, I can never say the second word, the sunflower lecithin,

[00:46:27] Roxanne: That’s Gina’s tongue tie coming out.

[00:46:29] Gina: I have a tongue tie. So I always have a bunch of breastfeeding stuff like ready and then I don’t actually have to use any of it, which I’m thankful for.

[00:46:39] Gina: But what would you like recommend for somebody who’s pregnant and like preparing for breastfeeding to maybe avoid getting clogged ducts or mastitis? Or if they do get it….

[00:46:49] Roxanne: Or if it’s 2am, they have it…

[00:46:51] Gina: They already got the stuff ready.

[00:46:53] Gina: Because that’s what was happening to me with my first. It’d be like 2am and I’m like crying because my nipples hurt so much. And I’m just like, “I have to Amazon? And it’s not going to be here for two days? Two days is a long time!”

[00:47:04] Roxanne: One day now. It’s one day. Amazon one day.

[00:47:07] Morgan: Yeah, absolutely. No, these are great questions. So like you said, silverettes, which are those little silver nipple covers, they can feel pricey. People are like, “What? Why? What? What’s going on there with those?” But they are absolutely amazing. And if you are, planning on having more children too, it’s something that you’re going to use again and again, and you can actually gift them on to friends when you’re done with them because they’re easy to sterilize, and they’re silver. What they do is silver is inherently antimicrobial and also anti inflammatory, but also you can express a little bit of milk in the cups and then you put them gently under a very loose soft bra, like you said, and it can help keep your milk up against your tissue, which then is going to help you heal.

[00:47:50] Morgan: Or just, and I know that this isn’t really for prep, but just as an aside, they do make all kinds of nipple butters and balms and different things, but I have found time and time again the very best thing that heals nipples is milk. Expressing some milk onto the surface of the nipple tip and allowing it to air dry, doing that multiple times a day, and then if you do have to put your clothes back on to put your little silverettes on top of them to keep them away from touching anything.

[00:48:17] Morgan: That’s how bad it gets, sometimes. Even just gently brushing up against a t shirt is like unbearable, it’s not happening. So a pregnant woman who’s listening to this and is like, “Wow, that all sounds awful!”

[00:48:29] Gina: Oh, God, what have I… What am I in for?

[00:48:32] Roxanne: Just get silverettes.

[00:48:34] Morgan: Yeah, exactly.

[00:48:34] Morgan: First of all, I don’t want to freak anyone out, but I do want people to go, “Oh, there’s a lot here. And it would be in my best interest to potentially become more educated about these things.” And just know that there’s areas where there’s pitfalls and there’s things that we can do to pivot from that place and get back on to center, so that you can have the wonderful long, however long, breastfeeding journey that you want.

[00:49:03] Morgan: And I really also just really want to say that it is not like this forever. It is usually an acute period of time, and then it gets better. If your baby is lip and tongue tied, which Roxanne, you and me, we both know this- Gina, you are, I bow down to you, I’m so happy for you that’s been your experience- but if they are lip and tongue tied, that’s a whole other trajectory and path.

[00:49:23] Morgan: But I just wanted to share some of my favorite resources or things to do for people who are pregnant still. So I think that one of the very best things is to find your IBCLC in your town. So find it. Find the person. Find like the office. And maybe you’re going on to Facebook groups of like natural parenting Facebook groups or new mom, there’s always like a birth month and year Facebook group so that moms can connect and, maybe they meet up or whatever while they’re pregnant. Or asking your OBGYN, asking your friend, your midwife, your doula, your anyone around you, and what you’re going to start to hear is the same names repeated again and again, and whoever is usually the one that’s most highly recommended is the one I would go ahead and choose. I would even go so far as to call the office, even if it’s just with the front desk person, and say, “Hey, can you tell, Jane Doe, so-and-so lactation consultant, I’m 36 weeks pregnant. I want to be using you guys if I need any help and I just wanted to get my name on your radar,” or whatever. Also now you have the number, the address, you have everything already figured out so that when you’re a couple of days postpartum or a week postpartum or whatever, and you’re having to struggle you’re not trying to do all of those steps in the midst of extreme stress.

[00:50:41] Morgan: Because it sounds little. But as you guys know, postpartum is banana pants and there’s a million things going on with a newborn. And if you can just take one extra step off your plate, then that’s a huge deal. So I think that’s a big deal.

[00:50:55] Morgan: Similarly to that, if there is lactation support groups in your local area of where women physically go and they meet up, it doesn’t have to be with this one that I’m talking about. You can hire one lactation consultant who’s going to come to your house and they’re an IBCLC and they can help you get established with the basics of breastfeeding and maybe even troubleshoot some of the issues you’re having; but you may also go to a different. support group with, that’s run by a different lactation group. That’s okay. There’s no like “allegiance.” It’s not like you’re cheating on someone. You can go and do that. And also, I’ve met some of my like best friends in those kinds of situations and it’s been so helpful to follow along with the same women on their same path, and everybody usually gets a chance to talk about what’s been happening with them.

[00:51:38] Morgan: You can also do something called a weighted feed, where you weigh your baby before you feed them, then you feed them, then you weigh them again, and you see how much they’re intaking. And it can be really reassuring, especially if you’ve ever had the situation, like Roxanne, you were talking about with Collin, that’s how it was with my first baby too. Where the weight gain was such a problem and it was so stressful and it, when I started to get to see consistently that, okay, he is getting enough milk from me, we’re finally over that hump. It was really encouraging and it just made me keep chugging along through some of our difficulties until it wasn’t difficult anymore.

[00:52:12] Morgan: So finding your local IBCLC, find a breastfeeding support group. And then there’s a couple of resources that I think are really good to start to delve into while you’re pregnant and begin to learn about. So one of them is the Jack Newman website. We can put all this stuff in the show notes. Jack Newman is a Canadian OBGYN and he has this website that’s awesome. It has all these videos of like newborns with good latches and bad latches and a video of a baby that is just suckling to pacify.

[00:52:41] Morgan: It’s called a non nutritive suckle. Or a baby who is like chugging milk with a nutritive suckle. And there’s a difference there. This one particular thing for me as a new mom was the one thing I think, if I had to boil it down, if I had known what to look for, I would have, this is where I would have been like, red lights flashing in my mind, something is wrong, because I did not know there was a difference.

[00:53:07] Morgan: I thought, “Oh, he’s latched. He’s latched for 45 minutes and now he fell asleep. Of course, he’s milk drunk and happy and fine, everything’s fine.” No, his tongue tie was so bad that he was latching, trying to get milk out, not getting anything out, getting completely exhausted and then falling asleep. And if I had known to look for what a nutritive versus a non nutritive suck was, I don’t think that would have happened. So the Jack Newman website is a mecca of videos to just watch.

[00:53:35] Morgan: And the reason why I think this is important too, just another note, is that we have to remember where we came from. We came from situations back way, way, long ago where we were, as little girls grew up, inextricably linked and built into the system of watching our mothers or sisters, or aunties, or cousins nursing babies. Birthing babies and nursing babies. Like the Red Tent kind of situation. We used to be around it so much more often, it was more normalized. We got to see it. We got to watch a woman, in various settings in our life, unlatch a baby when their latch was bad, and then try to latch him again. Or watch a woman struggling a little bit and then fixing it. Or watch a toddler who is standing up on her mom’s shoulder and still nursing. Or

whatever it is! But you know what I’m saying? Like, when we don’t have that, and a woman has never seen a baby latch to the breast until it’s their own baby in their arms right after birth, and now we’re trying to do this thing that’s like super important that we, really want to do, and it’s like, what do we think is gonna happen? You know what I mean? It’s banana pants.

[00:54:38] Morgan: So actually you can go to breastfeeding support groups while you’re still pregnant too. And yeah, it might seem like it’s a really extensive next step or something. It’s really not that big of a deal. It happens all the time. Pregnant women come in and they just sit and listen and watch and it’s really just being proactive if you have the time and you can do that. So that’s another thing to know to do.

[00:54:58] Morgan: I also really love two books. Ina May Gaskin’s Guide to Breastfeeding. Also, The Womanly Art of Breastfeeding by the La Leche League. And then also a website which is called kellymom.com. Kellymom, I don’t know anything about Kelly or anything, I don’t know why that’s the name of the website, but kellymom.com is like Wikipedia for breastfeeding. It has every kind of article ever. It’s amazing.

[00:55:23] Morgan: So I would say that those are my top like six things. There’s a couple of resources, so Womanly Art of Breastfeeding book, Ina May Gaskin’s Guide to Breastfeeding book, Jack Newman’s website, Kellymom’s website, and then the idea of finding a local IBCLC and support group that you already have figured out when they meet or how to contact them so that when you’re in the midst of that, like you said, at 2am or whatever, that you know some things that you can do.

[00:55:50] Morgan: In terms of supplies, I think the Silverettes or some kind of a thing like that, a cheaper version that is also really helpful is the Lansinoh Soothies. They’re like a hydrogel.

[00:56:02] Gina: Oh, I used those for my first. They were really nice.

[00:56:06] Morgan: Yeah, they were really nice.

[00:56:07] Gina: It’s very refreshing for sore or painful nipples.

[00:56:11] Morgan: Yep, they’re like a Medipatch kind of a gel, silicone kind of feel and you can put them on, it’ll help protect your skin from touching the inside of your t shirt, but it also can help heal the skin.

[00:56:23] Morgan: But I also think, although I don’t suggest them to be used unless we really need to, there is a time and a place for a nipple shield. We want to try to find a nipple shield that’s very thin and soft. I like the Medela one because it’s just really thin. Just to have. So for that, again, that, 2 a. m. in the middle of the night, you can’t do anything, you can’t really contact anybody, but you’re in so much pain that you’re like, “I literally cannot imagine , getting this baby on” or the baby really feels like they can’t latch or something like that. You can throw a nipple shield on and give yourself a little relief for a minute.

[00:56:56] Morgan: Or watching some videos, too, of hand expression. And knowing how to get your milk out so that you could feed it to the baby in a different way while you’re healing, while your tissue is healing, and you’re both learning.

[00:57:08] Morgan: My very favorite quote ever about motherhood in general, because I feel like it’s the microcosm to the macrocosm of this entire thing of parenting, is that “Women learn to breastfeed by breastfeeding. Babies learn to breastfeed by breastfeeding.” Like, it’s something we’re in together. We’re learning, nobody’s perfect at it yet. There’s maybe gonna be some hiccups along the way, but the more we do it the more we do it, right? Practice makes perfect. We just need to get through it and it won’t be like however it feels in those really intense moments forever. It just won’t be. And it can be such an amazing, long lasting, beautiful relationship, but I completely understand why these beginning weeks can feel really hectic and heartbreaking and painful, and it’s just, I wish it didn’t need to be that way for everybody, right?

[00:57:55] Morgan: So this is like my message, is, know that there’s some things that can go awry, and also know where you can get your support so that you can right the ship. Who can help you and what resources are the most powerful to right that ship?

[00:58:08] Morgan: In addition, last one, last thing I’ll say is that I do have a mastitis ebook because I have had mastitis so many times.

[00:58:14] Roxanne: You are the subject matter expert of mastitis.

[00:58:18] Morgan: Yeah, it’s like, did I pick this life to be the mastitis expert? No. But here we are.

[00:58:24] Roxanne: It chose you.

[00:58:25] Morgan: Yeah, this life, the mastitis life, chose me. So I, do have an ebook that we can again put in the show notes, on my website that is, it’s been a

labor of love to create and it has all of the different information. It has also, it goes into some very deep ideas about the energetics of breastfeeding and mastitis from like a depletion standpoint or a feeling unmothered standpoint, the emotional side of mastitis. And then, of course, as a naturopathic doctor, it has all of my integrative medical ways of approaching this. In addition to the big main tenets that we spoke about with like rest and ice and feeding the baby normally, all of that, there’s also a lot of homeopathic remedies we can take and herbs and different things that we can do to avoid antibiotics, where they’re not necessary, but then also in the guide I talk about how to know when we maybe do need antibiotics. And there are times and places where we need that because abscess, breast abscess, is a big deal and it can happen. And so there’s some signs and symptoms we talk about to know about that, et cetera, et cetera.

[00:59:25] Morgan: So anyway, that would be like the way I would, if I could give every pregnant woman like a big chunk of info download, be like, “Please learn this while you’re pregnant and I hope that it would help so that you can enjoy those sweet moments with your baby.”

[00:59:39] Gina: Absolutely. Well, thank you so much, Morgan, for coming on the podcast and sharing this wealth of information about breastfeeding in the early weeks because it can be such a stressful time, and a painful time, and you just want it so bad, but knowing like what to do to help support this journey is so, so, so important.

[00:59:58] Gina: And you also have a podcast that folks could listen to. And I did a consult with Morgan before I got pregnant with my current pregnancy to do a bunch of blood work, and she reviewed my labs and helped me figure out some things to help support preparing for pregnancy. So there’s lots of options there as well to work with Morgan.

[01:00:17] Gina: And so, yeah, thank you again for coming on the podcast and sharing all this information with our listeners.

[01:00:24] Morgan: Thank you so much for having me.

[01:00:28] Carly: Hi there. My name is Carly. I’m a huge fan of MamasteFit. I’ve taken a handful of their courses. I would highly recommend their Childbirth Education Course to anyone who is expecting, along with any support people that will be there with you during your pregnancy and labor and delivery.

[01:00:43] Carly: My husband and I took the course together, and not only did we learn the science of birth, the biomechanics of the pelvis, different labor positions and comfort measures and techniques, we were presented with

unbiased information so that we can make evidence based decisions that were the best for us during our pregnancy and labor and delivery.

[01:01:02] Carly: We had to completely pivot from our original birth plan, and I believe that I still had such an empowering incredible experience in part due to the wonderful information that was provided in the childbirth education course. Thanks Gina and Roxanne.

[01:01:21] Gina: Thank you so much for listening to this podcast episode. Hopefully you learned a lot about what you can do to prepare for your breastfeeding journey, in addition to how to navigate it if you are having any sort of issues. If you have the opportunity to work with a lactation professional after birth, it can be really helpful for your breastfeeding journey, but hopefully this podcast episode has given you enough tools to start to figure out a lot of it on your own as well.

[01:01:44] Gina: If you want more support throughout your pregnancy, be sure to check out our online prenatal fitness programs and online childbirth education course, so that you can move confidently throughout your pregnancy and throughout your labor. And you can use code STORY10 to get 10 percent off our prenatal fitness program, or childbirth education course, or really any of our online offerings, or you can bundle them together to save an additional 15 percent off.

[01:02:05] Roxanne: And if you’re in the postpartum, we offer postpartum support with our postpartum return to fitness programs. We have both return to running, just general fitness, and we even have Olympic weightlifting. And then we also have a postpartum prep course of what to expect in the postpartum for both you and baby, where we discuss a little bit about breastfeeding, but also what to expect with baby with things that they might have on their skin. So different rashes that are normal and when to maybe seek help for both you and your baby.

[01:02:32] Gina: You can check out all of our online courses on our website and mamastefit.com, and again, you can use code STORY10 to get 10 percent off any of our online offerings.

[01:02:39] Roxanne: And this podcast is sponsored by Needed, a nutrition company focused on the perinatal timeframe that both Gina and I have used and even our husbands use it. And you can check them out at thisisneeded.com and use code MAMASTEPOD percent off your order.