IBCLC, CLC, CLE…so many letters! What’s the difference?
Let’s see if we can break it down to make it a little easier to understand.
A couple other articles which may be helpful:
Blog post – IBCLC vs CLC – which is better? Why are we asking?
Many medications are totally fine to take during lactation. Many meds won’t affect milk production and they won’t harm your baby!
Medications, prescription and over the counter, are processed through several steps which determine how much makes it into your milk and determines if it will affect your baby or the milk production process.
Let’s take a look at this process!
As you can see oral medications need to be digested, metabolized through the liver, processed through the target organs, before they can make it into the mammary tissue of the breast and into the milk.
If they make it that far the remaining molecules still have to be small enough and attracted to water, fat, or both to make it into the milk.
If it makes it into the milk it still needs to be digested and processed through baby’s liver before it will possibly affect baby!
Most medications are diluted to 0.5-10% of the parent’s dose before they even make it to baby! That’s very small!
There’s a lot that goes into determining if a medication is safe for you and baby during lactation. You can discuss the medications, supplements, and herbal remedies you are considering with your IBCLC who will provide you with resources to talk with your doctor.
Often there are alternatives if the medication you want to take is not compatible.
Since it’s cold and flu season you can check here for information about common medications you may be thinking of taking if you get symptoms.
The flu vaccine is safe to take while breastfeeding and gives your baby extra protection!
Choline is an essential nutrient during pregnancy and lactation but only 15% of us are getting the recommended daily amount.
So what is it and why do we need it?
Choline is one of the many B Vitamins we need. B4, to be exact.
Choline is a key nutrient for fetal brain development and protection. Choline supports brain development, memory, and learning —and protects us from infections. When we think about brain development during fetal growth we often think about folate (which is also very important!) but choline plays an important role in neural tube development.
During pregnancy choline protects us from serious complications.
Choline is required for maintaining normal levels of homocysteine:
Elevated homocysteine levels during pregnancy have been associated with complications like: preeclampsia, miscarriage, placental abruption, intrauterine growth restrictions (IUGR) , venous thrombosis, and cardiovascular related complications.
Adequate choline during pregnancy can also protect us from cholestasis which is a common complicating during pregnancy and postpartum.
Choline can also be used to reduce risks and prevent mastitis. It is one of the components of lecithin.
Choline RDA During pregnancy 450 mg/day During lactation 550 mg/day
Choline is a naturally occurring amino acid found in egg yolks, liver, animal meat, beans, milk, some vegetables, as well as in human breast milk.
Amount of Choline Per Serving of Food:
If you are considering supplementing your diet with choline look for products containing phosphatidylcholine.
❤ Megan
“The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for about the first six months. We support continued breastfeeding after solid foods are introduced as long as you and your baby desire, for 2 years or beyond.”
The new recommendations bring the AAP in line with the World Health Organization, UNICEF, The American Academy of Family Physicians, and so many more health organizations!
This article from Healthy Children explains the recommendations and highlights the need for skilled lactation support. It also addresses the structural barriers to meeting these feeding goals.
You can read the official statement titled “Breastfeeding and the Use of Human Milk” here.
❤ Megan
The Basics of Inducing Lactation — Breastfeeding Without Birthing (Alyssa Schnell, IBCLC)
Milk Junkies — Breastfeeding and parenting from a transgender perspective (Trevor MacDonald)
Using an At-Chest Supplement Device
Trans Breastfeeding FAQ – Diana West
Find an LGBTQ Care Provider — Breastfeeding Network (Jaye Simpson, IBCLC)
Professional Organizations on LGBT Parenting — Human Rights Council
Two Women and a Baby: LGBTQ and Breastfeeding
❤ Megan
Lots of parents are surprised to find out their baby has ankyloglossia (tongue tie) and that such a tiny piece of tight tissue under the tongue is causing so many feeding problems!
Luckily, it a simple procedure to release the tongue and get on our way to easier feeding!
In my experience providing care for babies with tongue tie, doing just “the snip” isn’t enough to get full results. If we think about how baby has never had full range of motion with the tongue it makes sense that they will need time and help to get to normal movement.
Of course, working with a tongue tie-saavy Lactation Consultant and your provider is key but there are also things you can do at home!
Top 5 At-Home Tongue Tie Care
The biggest thing, is to have patience and keep working with your experienced tongue tie-saavy Lactation Consultant for continued help.
❤ Megan Dunn, IBCLC
New parents are given lots of advice about how to feed their baby. Where to feed, when to feed, how to hold baby, how long to feed, and so much more!
You may have been told to feed your baby at least 8 times a day or every 3 hours but feeding on a schedule doesn’t really meet baby’s needs.
Baby has a high need for frequent feeds to keep them alert and build their brains! Research shows that with responsive feeding there is a high variability in how many times a day baby will feed but it’s much closer to 12 times per 24hours than 8.
Reasons you should feed your baby on cue:
Readiness – Feeding your baby when they cue means you are offering a meal when they feel hunger and are alert enough to communicate that to you. Imagine being offered your favorite meals when you are super tired…would you feel ready to eat? Or would you have just enough before falling into a deep sleep?
Meeting all baby’s needs – Baby wants to feed and be close to you for lots of reasons! You are their home. You smell like home, you sound like home, you taste like home. Feeding our baby promotes bonding, reduction of stress hormones, brain development, and so much more than just calories and nutrients!
Milk supply – Your baby doesn’t feed on a regular schedule and your body doesn’t make the same kind of milk every 3 hours on the dot. AM milk is different from PM milk. Milk composition changes, too. At different times of the day it will have higher fat or sleep hormones to help set your baby’s clock and meet their nutritional needs. If we schedule all the feeds we miss the opportunity to give baby the perfect custom meal each time!
Feeding when baby asks also supports a robust milk supply! Frequent feeding communicates a need to your body to keep making lots of milk!
Capacity – Different breasts/chests hold different amounts of milk (no, this isn’t related to size). Some people have smaller capacity and can make all the milk baby needs but they need to feed more often. Scheduled feeds or expectation of only 8 feeds in the day can make parents feel like their milk supply is low – when it’s totally normal!
Responsiveness = communication, trust, and independence – What do all these words have in common? They are what happens when we are responsive feeders. When we respond to baby’s needs and pay attention to their body language (rooting, sucking, wiggling, lip smacking) we tell them they are heard. When we respond to our babies they build trust and know their communication will be heard and they will get their needs met. And that’s how we get independence! Studies show that responding to our children and meeting their needs results in more independence in toddlerhood and beyond.
❤ Megan
This is also a good time to explore what “enough” is. Some bottles are really huge! And other parents on social media share huge pumping session successes which may not reflect what is average or achievable.
On average, exclusively pumping parents can express 3-4oz (90-120mL) with each session. Whereas, parents pumping after feeding baby will express about 1.5oz (45mL).
This is a reflection of what baby’s stomach can hold. Around 4-6 weeks most babies reach their maximum intake and can hold up to 5oz at a time. This doesn’t mean they need all 5oz (I don’t want to feel Thanksgiving dinner full after every meal!).
Over the course of a day, baby will take 27-30oz and this does not increase with age for breastfeeding babies!
So….how are you doing? Are you expressing 3-4oz when you exclusively pump?
If not, try some of the tips above and if that doesn’t work, check in with your IBCLC for a full evaluation and support!
❤ Megan
Linn Benton Lincoln Breastfeeding Coalition 