Podcasts about breastfeeding medicine

In this episode Katie Oshita and Karen Garcia discuss how bodywork and lactation work together.  As a practitioner of Osteopathic Manual Manipulation (OMM) and lactation, Dr Garcia is in a unique place to combine the two fields to help the dyad thrive.  From breast manipulation for mastitis to helping with body tension on tongue tied babies, Dr Garcia works with the whole dyad to achieve wellness.  Listen here for more details.Podcast Guest: Dr. García is Board Certified in Pediatrics through the American Board of Pediatrics and American Osteopathic Board of Pediatrics. She is also one of the first physicians Board-Certified by the North American Board of Breastfeeding and Lactation Medicine. She maintains her Board-Certification as a Lactation Consultant by the International Board of Lactation Consultant Examiners. She is an ongoing member of the American Academy of Pediatrics, American Osteopathic Association and Academy of Breastfeeding Medicine. She opened García Consulting and Lactation Services in 2023 to provide specialized care for more complex lactation related issues. Dr. García has been practicing pediatrics and newborn care in the Kalamazoo and Calhoun counties since 2012. Dr. García is hoping to support all of our communities that struggle with breastfeeding, and those communities with limited access to breastfeeding resources. Dr. García is collaborating with Milk Like Mine/Bellies Like Mine through our local Baby Café to further reach our Black, Brown and LBGTIA+ communities in Calhoun County. Podcast Host: Katie Oshita, RN, BSN, IBCLC has over 25 years of experience working in Maternal-Infant Medicine.  While Katie sees clients locally in western WA, Katie is also a telehealth lactation consultant believing that clients anywhere in the world deserve the best care possible for their needs.  Being an expert on TOTs, Katie helps families everywhere navigate breastfeeding struggles, especially when related to tongue tie or low supply.  Katie is also passionate about finding the root cause of symptoms, using Functional Medicine practices to help client not just survive, but truly thrive. Email katie@cuddlesandmilk.com or www.cuddlesandmilk.com 

Submit your question and we'll answer it in a future episode!We never seem to get enough sleep – and we never seem to get enough episodes on sleep.This is a presentation from the Academy of Breastfeeding Medicine on bedsharing.  Listen up and learn what the medical professionals have to say.If you are a new listener, we would love to hear from you.  Please consider leaving us a review on itunes or sending us an email with your suggestions and comments to badassbreastfeedingpodcast@gmail.com.  You can also add your email to our list and have episodes sent right to your inbox! Things we talked about:Where this presentation came from [3:56]Message from the UK [6:34]Why human babies want to be close and feed often [8:57]We don't understand infant sleep [13:37]Does evolutionary biology change? [16:10]What sleeping like a baby really means [18:40]Poor sleep = breastfeeding cessation [23:30]Options given to parents [25:00]Babies in another room [27:40]Are you really someone who promotes breastfeeding if you discourage bedsharing? [30:30]“Never bedshare” messages prevent conversation about the issue [33:598]ABM protocol #6 on Bedsharing [39:44] Today's episode is brought to you by Silverette! Silverette silver nursing cups are your one-stop solution to soothe and protect your nursing nipples! Use code BADASS at www.silveretteusa.com for 15% off!Today's episode is brought to you by The Breastfeeding Shop! The Breastfeeding Shop supplies breast pumps, accessories & more through insurance. Visit www.thebreasfeedingshop.com. Links to information we discussed or episodes you should check out!https://www.bfmed.org/assets/Ball%20Helen.pdfhttps://badassbreastfeedingpodcast.com/episode/082-nighttime-breastfeeding-with-tracy-cassels-phd-evolutionary-parenting/https://www.basisonline.org.uk/about-us/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/     Check out Dianne's blog here~https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast~https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby~Abby Theuring  https://www.thebadassbreastfeeder.comDianne Cassidy http://www.diannecassidyconsulting.com Music we use~Music: "Levels of Greatness" from "We Used to Paint Stars in the Sky (2012)" courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes

In this episode, learn how Dr. Kimarie Bugg's lifelong dedication to lactation and health equity is transforming lives nationwide. Dr. Bugg is President of Reaching Our Sisters Everywhere (ROSE) and the first African American International Board Certified Lactation Consultant (IBCLC). Dr. Bugg shares her journey into the field of lactation, sparked by personal challenges breastfeeding her first set of twins in the late 1970s. She recounts the evolution of breastfeeding support, her groundbreaking work at Grady Hospital in Atlanta, and the founding of ROSE, a nonprofit addressing breastfeeding inequities in the African American community. Dr. Bugg discusses the systemic barriers to breastfeeding, including workplace challenges, access to lactation support, and the lack of consistent education for healthcare providers. She emphasizes the importance of policy change, workforce development, and healing generational trauma through initiatives like ROSE's "Breast Friend" and the Reaching Our Brothers Everywhere (ROBE) programs. Tune in for a conversation about the critical role of breastfeeding equity, the unique challenges faced by African American families, and the power of community-driven solutions.   (09:34) Empowering Black Nurses in Breastfeeding Support (8:08) Supporting Breastfeeding in African American Community (27:08) "Breast Friend Program: Reducing Breastfeeding Disparities" (28:22) Empowering Communities for Inclusive Breastfeeding Support (32:46) Reframing Breastfeeding Narratives in African American Community (34:54) Enhancing Breastfeeding Equity Beyond Hospital Stay (41:39) Community Transformers: Empowering Maternal Health Support   Explore ROSE's programs, including Breast Friends, Community Transformers, and more here. Learn about Boston Medical Center's Community and Hospitals Advancing Maternity Practices (CHAMPS), a Baby-Friendly hospital initiative, here. Learn more about the Academy of Breastfeeding Medicine here. For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Send us a textHappy 2025! Sarah sits down with two incredible physicians in this episode--Dr. Laura Ward, MD, IBCLC, FAAP & Dr. Sheela Geraghty, MD, MS, IBCLC, FAAP, FABM. Both Dr. Ward & Dr. Geraghty are pediatricians who did additional training to become International Board Certified Lactation Consultants (IBCLCs) and practice breastfeeding medicine. They have insightful stories to share on why breastfeeding matters so much and how to help parents and babies reach their breastfeeding goals. Sarah can guarantee you'll learn something new in this episode--just like she did! Dr. Sheela Geraghty: sheela.geraghty@cchmc.orgDr. Laura Ward: laura.ward@cchmc.org

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional "drop" that occurs in some women just before milk release and continues for not more than a few minutes. Although research is still evolving, one study Published in 2019 (Breastfeeding Medicine) states that up to 9% of breastfeeding women may experience dysphoric milk ejection, although the true incidence is still unknown. The brief negative feelings range in severity from wistfulness to self-loathing. In Arch Gynecol Obstet, in July 2024, authors published, “Dysphoric milk ejection reflex – a call for future trials”. This is gaining interest in the published literature. The etiology of this is unclear but a new (soon-to-be-released) publication in the AJOG provides some interesting insights into this. This was just accepted for publication on September 18, 2024 and the official release is pending. Haven't heard about D-MER? Due to a lack of awareness, this phenomenon is easily misdiagnosed as postpartum depression and aversion by many healthcare professionals. A July 2024 Harvard Review in Psychiatry publication called D-MER, “A Novel Neuroendocrine Condition with Psychiatric Manifestations”. This condition is a physiologic tale of oxytocin, milk- let down, dopamine and prolactin, and the fight and flight response. Listen in for details.

Link to “Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants >35 Weeks” from ABM published in Pediatricshttps://doi.org/10.1542/peds.2018-3696Link to Academy of Breastfeeding Medicine protocolshttps://www.bfmed.org/protocolsNo content or comments made in any TIPQC Healthy Mom Healthy Baby Podcast is intended to be comprehensive or medical advice. Neither healthcare providers nor patients should rely on TIPQC's Podcasts in determining the best practices for any particular patient. Additionally, standards and practices in medicine change as new information and data become available and the individual medical professional should consult a variety of sources in making clinical decisions for individual patients. TIPQC undertakes no duty to update or revise any particular Podcast. It is the responsibility of the treating physician or health care professional, relying on independent experience and knowledge of the patient, to determine appropriate treatment.

Submit your question and we'll answer it in a future episode!Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcast Listen in today as Abby talks with Lyndsey Hookway about Breastfeeding the Brave.  You don't want to miss this important and eye opening episode If you are a new listener, we would love to hear from you.  Please consider leaving us a review on iTunes or sending us an email with your suggestions and comments to badassbreastfeedingpodcast@gmail.com.  You can also add your email to our list and have episodes sent right to your inbox!Things we talked about:Who is Lyndsey Hookway? [5:00]Limited research for breastfeeding in the pediatric setting [14:22]The goal of the research [19:32]Staying involved in the care of babies [25:00]Negative vs positive breastfeeding experiences [33:35]Professionals who are nurturing and supportive [43:32]The Academy of Breastfeeding Medicine [46:20]Being met with hostility [49:33]How has working with the families affected work as a lactation consultant [50:55]How does breastfeeding affect older children? [52:49]How many studies focus on breastfeeding children with cancer? [54:50]What would happen if we support children through illness? [1:00:15]The support group [1:02:19]Where to find Lyndsey [1:06:00]Website https://lyndseyhookway.com/Instagram https://www.instagram.com/lyndsey_hookway/Facebook https://www.facebook.com/LyndseyHookwayBreastfeeding the Bravehttps://lyndseyhookway.com/product/breastfeeding-the-brave/SPONSORToday's episode is brought to you by CoBoo's Organic, 100% Natural Breast Pumping Spray! Just one quick spray on each flange perfectly lubricates your breast so they can slide smoothly in the flange. Use Code BADASS for 15% off your total order on their website CoBooMom.com. Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/why-dont-babies-sleep-through-the-night/https://badassbreastfeedingpodcast.com/episode/benefits-of-breastfeeding-for-parents-and-babies/  Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/      Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc,  http://www.diannecassidyconsulting.com  Music we use:Music: "Levels of Great

At some point in our lives we've probably all felt like we've settled into a groove where everything is comfortable enough and there's nothing standing in the way of life going on like this for a while. But what if you know deep down that you want to change something about your life? It can be EXTREMELY hard to make that decision to make a change when you know that you might be straying away from comfort and stepping into the" unknown". But you also know that if you don't make a change, you might have regrets or feel unfulfilled.This is called miserable discomfort, and it's what we're going to be talking about this week on the Ending Physician Overwhelm Podcast. As you listen, I encourage you all to dream big and consider what is possible beyond your current circumstances. I'll share stories of incredible physicians breaking free from the traditional mold of medicine to embrace their passion and find professional freedom. We'll reflect on areas of our lives that might be holding us back, and discuss ways in which we can side-step them to take the first step forward to a life that aligns more with what we dream of.So enjoy, and to see what other badass Women Physicians are building, follow these folks on IG:Dr Rachel Rubin, Sexual Medicine and Menopause Specialist @drrachelrubin Dr Funke Afolabe-Brown, Sleep Medicine Physician and Coach for families @restfulsleepmd Dr Sadaf Lodhi, Sexual Health and Menopause @drsadafobgynDr Andrea Wadley, Breastfeeding Medicine @breastfeedingmedicinedoc Support the showTo learn more about my coaching practice and group offerings, head over to www.healthierforgood.com. I help Physicians and Allied Health Professional women to let go of toxic perfectionist and people-pleasing habits that leave them frustrated and exhausted. If you are ready to learn skills that help you set boundaries and prioritize yourself, without becoming a cynical a-hole, come work with me.

Co-Hosts: Leyla Warsame, MD and Davina Zamanzadeh, PhD Guest: Dr. Victoria Nichols Johnson, MD, retired Associate Professor and Physician from Southern Illinois University School of Medicine in Obstetrics and Gynecology. She is the founder and past president of the Academy of Breastfeeding Medicine, and past chair of the Ethical, Legal, and Social Issues Work Group of AMIA. Description: This latest installment of the Forgotten No More Series perfectly intersects with the observance of Black History Month and the start of Women's History Month as we focus on Henrietta Lacks. Listen and share this storytelling and historical perspective of the no longer forgotten, Henrietta Lacks.

  Today's episode is featuring Lara Proud, RN, who is joining HeHe to discuss the signs + symptoms of Mastitis, what professionals can help & what options you have for remedying it! We also dive into preventative measures and what to consider when it comes to antibiotic use with Mastitis!    Lara's Bio:  Beyond The Bump was started when Lara Proud went on maternity leave with her son in 2018. As a Registered Nurse, Lara was blown away by the lack of local resources for prenatal classes, postpartum support, and didn't want anyone else to have to struggle like she did with breastfeeding. Beyond The Bump is located on the East Coast of Canada in Fredericton, New Brunswick serving all across Canada virtually and in-person locally. Her biggest goal is to empower parents in their decisions surrounding all things birth and parenting and help them feel prepared and supported along the way!   Connect with Lara on IG   Connect with HeHe on IG   Join HeHe's FREE CLASS that shares How to Avoid a C-Section & Reduce Tearing in Labor here!   Resources: ACOG: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/02/breastfeeding-challenges   Breastfeeding Medicine: https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf Le Leche League: https://lllusa.org/mastitis-updated-la-leche-league-usa-resource-page/

In this episode of the MamasteFit Podcast, hosts Gina and Roxanne invite Dr. Sibyl Knight, a doctor of osteopathic medicine based in Monterey, California, to discuss the nature and benefits of osteopathic medicine. Dr. Knight explains the key differences between osteopathic medicine and traditional medicine, elaborating on the holistic approach osteopaths take toward treatment. She covers various topics including the role of osteopathic manipulations in alleviating pregnancy discomfort, aiding patients' postpartum recovery, and supporting breastfeeding. Dr. Knight also reveals the treatment techniques applicable for babies and their significance.  In This Episode: 00:00 Introduction to the MamasteFit Podcast 00:17 Meet the Hosts: Gina and Roxanne 01:07 Introducing Dr. Sybil Knight 01:35 Understanding Osteopathic Medicine 03:06 Differences between Osteopathy and Chiropractic 04:39 Experiences with Osteopathic Medicine 05:15 Benefits of Osteopathy for Pregnant Women 13:16 Osteopathy for Babies and Children 28:32 Osteopathy and Breastfeeding 34:25 Closing Remarks and Contact Information 35:39 Sponsorship and Additional Resources ----- More about Dr. Knight: Dr. Knight has had an interest in musculoskeletal medicine ever since she did a Yoga Teacher Training prior to medical school. When she went to medical school she immediately fell in love with Osteopathic Manipulation as a way to treat the body with the hands. Throughout her training she has constantly been amazed at the power of this modality to treat everyone from the elderly to newborns. Dr. Knight found osteopathic manipulation particularly helpful during her pregnancy and throughout the growth of her children. Osteopathic Manipulation has really allowed her children to thrive and she hopes to someday have every newborn receive treatment shortly after they are born. She has a special interest in Breastfeeding Medicine and helping infants and toddlers who have latch issues with breastfeeding. Find an osteopathic doctor near you: americanacademyofosteopathy.com Find Sibyl's practice on Instagram here: https://www.instagram.com/theosteopathicway/?hl=en Find Sibyl's website here: TheOsteopathicWay.com ----- This podcast is sponsored by Needed, a nutrition company focused on optimal nourishment for your perinatal journey. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Use code MAMASTEPOD for 20% off your first order or three months of subscription.⁠ ⁠⁠⁠⁠⁠⁠⁠⁠ 

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

Got mastitis? Learn all about the new protocol to help you get through this holiday season while breastfeeding. When you're traveling and you and your baby are eating and sleeping differently, it's easy for mastitis to come along. Have you ever dealt with mastitis or clogged ducts? Did you know that the Academy of Breastfeeding Medicine updated their clinical guidelines on Mastitis treatment this year? Let your favorite cohosts update you on all the big changes in a 2 part series.This first episode focuses on our new understanding of the physiology of mastitis, aka what the heck is happening in there! Join Heather and Maureen as they explore the real cause of mastitis and talk about the latest research into clogged ducts, milk blebs, and more! Then tune in next week for a dive into the updated treatment options, with a focus on first-line, at home treatments! Stay current and let the Milk Minute help you use the latest and greatest clinical guidelines.We're still on a break over here at the Milk Minute, so please enjoy one of our most impactful episodes, especially this time of year. Please consider supporting us by subscribing on Apple Podcasts or on our Patreon at Milk Minute Podcast | Patreon. Work With Us!Book a Lactation Consult with Heather! Click HERE for the deets.Book a Lactation Consult with Maureen! Click HERE to get started.THANK YOU TO THIS EPISODE'S SPONSORSHighland Birth Book a Lactation Consult today! Booking a virtual consult with Maureen is now easier than ever. Click HERE to get started!Click HERE to save 25% off and free shipping on all Liquid IV products with the code MILK_MINUTEAeroflow –  The easiest way to order your breast pump through your insurance. Click HERE to order today!Click HERE to order your Evivo! Use code MILKMINUTE for 15% off your purchase!Listener question: Can you get rid of an oversupply? I have one breast that produces a lot more milk and I want it to be even with the other one.Mentioned in this episode:Ep. 87- Oversupply…What It Means and How to Handle It!Ep. 83- Up-Regulating and Down-Regulating SupplySources:Physician Guide to BreastfeedingAcademy of Breastfeeding Medicine Clinical Protocol #36:The Mastitis Spectrum, Revised 2022Click HERE to read the full transcriptSupport the showCheck out Milk Minute Podcast's website here!Become a VIP Click here to get exclusive access and more!Send us an e-mail! MilkMinutePodcast@gmail.comFacebook | Instagram | TikTok

Event Objectives:Understand why knowledge of breastfeeding medicine is vital to providing care to pediatric patients and their families.Discuss common scenarios in which caregivers are often inappropriately advised to stop breastfeeding/providing breast milk AND true contraindications.Identify breast feeding/breast milk resources available to clinicians.Claim CME Credit Here!

Below is copy and CME link for Episode 7: Let's Talk About Breastfeeding   https://cmetracker.net/UTHSCSA/Publisher?page=pubOpen#/getCertificate/10095061   FACULTY: Alice K. Gong, MD is the William and Rita Head Distinguished Chair in Developmental and Environmental Neonatology, Professor of Pediatrics, Medical Director, PREMIEre Program, at UT Health San Antonio and University Health.   OVERVIEW: Pediatrics Now Host and Executive Producer Holly Wayment brings you this expert talk for free credit by Texas Pediatric Society President, neonatologist and breast feeding expert Alice K. Gong , MDabout breast feeding and the latest advice for your patients.    DISCLOSURES: Alice K. Gong, MD has no financial relationships with ineligible companies to disclose.   The Pediatric Grand Rounds Planning Committee (Deepak Kamat, MD, PhD, Steven Seidner, MD, Daniel Ranch, MD and Elizabeth Hanson, MD) has no financial relationships with ineligible companies to disclose.    The UT Health Science Center San Antonio and Deepak Kamat, MD course director and content reviewer for the activity, have reviewed all financial disclosure information for all speakers, facilitators, and planning committee members; and determined and resolved all conflicts of interests.   CONTINUING MEDICAL EDUCATION STATEMENTS: The UT Health Science Center San Antonio is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.   The UT Health Science Center San Antonio designates this live activity up to a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   CREDITS: AMA PRA Category 1 Credits™ (1.00) Non-Physician Participation Credit (1.00)    

Dr Jack Newman has been working with breastfeeding mothers for over 4 decades! His knowledge of breastfeeding medicine is expansive, and his passion for helping breastfeeding mothers never wavers.  In this episode Katie Oshita and Dr Newman discuss inducting lactation, at breast versus bottle supplementation and much more.  If you want to learn about lactation from one of the leaders in Breastfeeding Medicine ins the world, listen to this episode now.Podcast Guest: Dr. Jack Newman graduated from the University of Toronto medical school in 1970 and completed his residency at Vancouver General Hospital. Following this, he trained in pediatrics in Quebec City and then at the Hospital for Sick Children in Toronto from 1977-1981. In 1981, Dr. Newman became a Fellow of the Royal College of Physicians of Canada, as well as Board Certified by the American Academy of PediatricsDr. Newman was a staff paediatrician at the Hospital for Sick Children emergency department from 1983 to 1992, and acted as Chief of Emergency Services for a short period. During his time at the Hospital for Sick Children, he founded the first hospital-based breastfeeding clinic in Canada in 1984. He has been a consultant for UNICEF for the Baby Friendly Hospital Initiative, where he evaluated the first candidate hospitals in Gabon, the Ivory Coast, and Canada. In 2013, Dr. Newman was awarded the Queen's Jubilee Medal for service to the community.Podcast host: Katie Oshita, RN, BSN, IBCLC has over 22 years of experience working in Maternal-Infant Medicine.  Katie is a telehealth lactation consultant believing that clients anywhere in the world deserve the best care possible for their needs.  Being an expert on TOTs, Katie helps families everywhere navigate breastfeeding struggles, especially when related to tongue tie or low supply.  Katie is also passionate about finding the root cause of symptoms, using Functional Medicine practices to help client not just survive, but truly thrive. Email katie@cuddlesandmilk.com or www.cuddlesandmilk.com

Tongue ties are such a vast, controversial, and often misunderstood topic that we brought in pediatric otolaryngologist (ENT) surgeon Dr. Elise Graham to help us wade through the topic. She is also a mom to two boys with a complex breastfeeding journey of her own, which has brought her to shine a postpartum lens onto her field which she admits can gain from providing more support to patients, especially as information about tongue ties can vary greatly and specialized support can be hard to find. In addition to being a pediatric surgeon, Dr. Graham is also a certified lactation consultant (IBCLC) and earning a fellowship through the Academy of Breastfeeding Medicine, which is why we're very excited to have her guide us through the evidence-based truth about tongue ties. Resources: Academy of Breastfeeding Medicine Protocols: https://www.bfmed.org/protocols JAMA Otolaryngology - Head & Neck Surgery: What Is a Tongue Tie? IG: Dr. Elise Graham @elisegmd Feedback: Please take a moment to fill out this very short anonymous survey (>1 minute). We want to optimize Pregnancy for Professionals to suit your needs, so any feedback is very valuable and much appreciated!

Engorgement, clogged ducts & mastitis are words all breastfeeding moms are familiar with. They can be scary & overwhelming, particularly at the beginning of your breastfeeding journey, but can pop up throughout the duration of time that you are breastfeeding - mainly when significant changes are happening in your life, including night weaning & complete weaning. To further complicate things, there has been a fundamental shift in the way that science and leading lactation organizations and experts understand these conditions - this has resulted in the Academy of Breastfeeding Medicine completely overhauling their Mastitis Proctol.  This means that the approach both lactating people & those who support them take when addressing engorgement, clogged ducts & mastitis has changed, or needs to change. This is relevant to those who are early in their breastfeeding experience, of course, but it's ALSO relevant to those who have been breastfeeding for a year or more.   You are more likely to be supporting friends & family members when they are encountering these things, and you are more likely to be using methods you were told to use when you face them yourself - but those methods are likely based on an outdated understanding of what engorgement, clogged ducts & mastitis are and could be creating MORE issues than they are solving. In this episode I break down: -> The big change -> Each condition in the Mastitis Spectrum of Conditions-> Support for general treatment & prevention -> The role stress plays (and what to do about it)   DISCLAIMER: This podcast is for educational purposes only and is not intended to be medical advice. Resources & Citations: Academy of Breastfeeding Medicine Mastitis Protocol.Quoted study: Segerstrom, S. C., & Miller, G. E. (2006, July). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychological bulletin. Study on EFT Tapping efficacy"Burn Out" Book by Emily & Amelia Nagoski Strains to look for in a probitic: Lactobacillus fermentum and Ligilactobacillus salivarius Want to learn more from me? Watch my free, instant access workshop: Designing Your Pathway to Toddler Breastfeeding Mastery Grab your free guide to say "No" to the feed while still saying "yes" to the need at www.ownyourparentingstory.com/guideLove this episode?! Shoot me a DM over on Instagram @own.your.parenting.story and tell me all about it.

The following resorces were discussed on today's episode:https://www.positivemed.com/2012/10/27/the-breastfed-baby/https://lacted.org/https://www.infantrisk.com/infantrisk-center-resourceshttps://trashthepumpanddump.org/https://www.bfmed.org/protocolshttps://www.cmqcc.org/resources-toolkitshttps://physicianguidetobreastfeeding.org/

This just in! The guidelines around the treatment of mastitis, a common complication of breastfeeding, have largely changed! On today's episode, Drs. Sarah and Alicia provide an overview of the updated clinical protocol from the Academy of Breastfeeding Medicine - and let us (possibly) be the first to tell you that the new guidelines are almost the exact opposite of what was previously recommended. A must listen! For clarification, the probiotics we were referring to are called limosilactobacillus fermentum ligilactobacillus salivarius. Additionally, this Pregnancy for Professionals Podcast episode on Intrusive Thoughts, while intended for providers, is a great deeper dive into postpartum mental health. And last but not least, our friends at Happy Health Eaters have offered our listeners 15% off of their great course on Starting Solids Confidently, using this link and the code SFH15! Super helpful for new parents everywhere!

In this episode, Cara and Missi are joined by Jenna Erickson, CNM, IBCLC for an important clinical update on the 2022 mastitis guidelines from the Institute for Breastfeeding Medicine.  This episode is a must listen to learn to stop the ice, treat the inflammation, feed naturally, and get down to the real causes of mastitis.  Jenna give us her IBCLC take on things to do, not to do, how to care for the breast, and products that we should be recommending to our patients.  https://physicianguidetobreastfeeding.org/ https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdfhttps://www.amazon.com/Improved-Medihoney-Wound-Dressing-Sciences/dp/B007EBRA6Ahttps://www.motherlove.com/?gclid=CjwKCAjw4ZWkBhA4EiwAVJXwqRuMkcQNaaQ42eGxLfXlJjP0x_vNkG7G4QXmh_oOhkcVTe6yoqnF1xoCLBwQAvD_BwE

In this episode, Cara and Missi are joined by Jenna Erickson, CNM, IBCLC for an important clinical update on the 2022 mastitis guidelines from the Institute for Breastfeeding Medicine.  This episode is a must listen to learn to stop the ice, treat the inflammation, feed naturally, and get down to the real causes of mastitis.  Jenna give us her IBCLC take on things to do, not to do, how to care for the breast, and products that we should be recommending to our patients.  https://physicianguidetobreastfeeding.org/ https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdfhttps://www.amazon.com/Improved-Medihoney-Wound-Dressing-Sciences/dp/B007EBRA6Ahttps://www.motherlove.com/?gclid=CjwKCAjw4ZWkBhA4EiwAVJXwqRuMkcQNaaQ42eGxLfXlJjP0x_vNkG7G4QXmh_oOhkcVTe6yoqnF1xoCLBwQAvD_BwE

Have you dealt with jaundice and wondered if the information you were given regarding your baby's care matched the evidence? Today on The Milk Making Minutes IBCLC Lo Nigrosh shares about the different types of jaundice and how breastmilk impacts the baby in those situations. On this episode you will learn: The clinical definition of pathological jaundiceThe clinical definition of physiological jaundice How to distinguish between suboptimal intake jaundice and prolonged jaundice associated with breast milk feedingVarious treatments for jaundiceTo read more about jaundice download the Academy of Breastfeeding Medicine's Clinical Protocol #22: https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/22-jaundice-protocol-english.pdfTo get delicious home cooked meals delivered right to your door go to the Feast and Fettle Website and use the code MILK for $30 off your first week! To book a lactation consultation with me, visit my website: www.quabbinbirthservices.com. In many cases I can bill your insurance, or create a superbill for you to submit for reimbursement. I offer virtual consults for clients outside of my service area! Make your voice heard on The Milk Making Community Group on Facebook!To learn about modern influences that make breastfeeding challenging, purchase The Big Let Down How Medicine, Big Business and Feminism Undermine Breastfeeding from my Milk Making Minutes Bookshop here!To purchase other books about breastfeeding, birth, or parenting that I love and help support the show, go here. Head to Apple Podcasts or Spotify for more Milk Making Minutes episodes!Listen to Episodes of The Milk Making Minutes on Amazon Music too!Follow me on IG https://www.instagram.com/lonigrosh_ibclc_podcast_host/ to laugh about baby feeding (so you don't cry) and to see photos of guests. Follow me on TikTok to answer questions of the day and ponder systemic inequities together: htttps://www.tiktok.com/@lonigroshibclc This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/5834691/advertisement

Living a healthy lifestyle can be challenging, and can be even harder when you are dealing with an eating disorder. This can affect one's physical and emotional state and can impose great health risks. Dr. Rebecca Berens, a board-certified Family Medicine Physician and International Board Certified Lactation Consultant, brings her expertise in eating disorders, focusing on their diagnosis, treatment, and prevention. She discusses the three most common eating disorders which are anorexia, bulimia nervosa, and binge eating. These involve disrupted eating patterns and an intense preoccupation with weight, body shape, and food. Conditions such as PCOS and ADHD can act as triggers for eating disorders, as PCOS can cause hormonal imbalances and weight gain, while ADHD may impact impulse control and emotional regulation, increasing vulnerability to disordered eating. If you or someone you know is struggling with an eating disorder, don't hesitate to seek help. Remember, support and treatment can make a significant difference in your journey towards recovery and health.   Episode Highlights: About Dr. Rebecca Berens The three common eating disorders Why PCOS and ADHD can trigger eating disorders Where should people with eating disorders go for help Making healthy lifestyle changes without triggering their disordered eating behavior About intuitive eating and how people can utilize this tool Relapses for people with eating disorders  Advice for people who are suffering with eating disorders   Connect with Dr. Rebecca Berens: Website | www.vidafamilydpc.com Facebook | www.facebook.com/vidafamilymedicine Instagram | @rebeccaberensmd   About Dr. Rebecca Rebens Dr. Rebecca Berens is a board-certified Family Medicine Physician and International Board Certified Lactation Consultant (IBCLC) with expertise in Women's Health and Breastfeeding Medicine. She serves patients from newborns to the elderly, focusing on both the physical and mental well-being of each family member - perfect for patients looking for a lifetime of care and support. She treats each patient as an individual and tailors prevention and treatment plans to the needs of each patient rather than using a one-size-fits-all approach. Her office is welcoming to all, and her care is trauma-informed and weight-inclusive. Dr. Berens grew up in the Houston area and received her undergraduate degree in Biochemistry and Cell Biology from Rice University. She continued her studies at Baylor College of Medicine where she earned her MD. She completed her residency training at Providence Hospital, affiliated with Georgetown University in Washington, DC. She graduated residency as the program's first obstetrics scholar with additional training in women's health and obstetrics. She went on to serve as Associate Clinical Director at Carl Moore Health Center in Philadelphia, PA before returning home to Houston. She was an Assistant Professor in the Family and Community Medicine department at Baylor College of Medicine where she taught medical students and residents while continuing to practice full-spectrum family medicine before she decided to open her own practice.   Resource: Project HEAL offers Free Clinical assessment, Cash Assistance program, Treatment placement program, and Insurance navigation program  for treatment of Eating Disorders. People can apply for their different programs. If you're interested click the link www.theprojectheal.org !   Resources: FREE! Discover the 5 Reasons Your Weight-Loss Journey Has Gotten Derailed (And How To Get Back On Track!)

The proliferation of tools and devices designed to be used during lactation has occurred without an accompanying body of research to support it. Parents are receiving hundreds to thousands of marketing messages for these products during pregnancy and lactation, a time when they are especially vulnerable to being influenced about making buying decisions that they are told can impact their ability to breastfeed. In fact, any tool or device designed to support lactation can have a negative impact if used improperly or without indication. Much like the "cascade of interventions" terminology used to describe how labor interventions accumulate, parents can also experience a cascade of lactation interventions. Lactation support providers in every setting need to keep up with the use and indications for these products and understand how to recognize when their use is becoming problematic so that they can educate parents prenatally and provide appropriate lactation care and referrals to a higher level of clinical lactation care or medical care as needed.Evolve Lactation with Christine Staricka IBCLC is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.In this session, we'll talk about how we can help simplify lactation for so many by ensuring the basics are always in place. Thank you for listening! I appreciate your support. Here's a link to a handout that goes with this session. When you share my posts, it helps this information reach more people, and that's my goal:) References for this sessionAlibhai, K. M., Murphy, M. S., Dunn, S., Keely, E., O'Meara, P., Anderson, J., & El-Chaâr, D. (2022). Evaluation of a breastmilk hand expression toolkit: the MILK survey study. International Breastfeeding Journal, 17(1), 8.Çınar, N., Karakaya Suzan, Ö., Kaya, Ö., Karataş, H., & Duken, M. E. (2021). Investigation of the Effect of Human Milk Expression Techniques on Milk Content: A Systematic Review. Journal of Tropical Pediatrics, 67(6), fmab108.Johnson, H. M., Eglash, A., Mitchell, K. B., Leeper, K., Smillie, C. M., Moore-Ostby, L., ... & Academy of Breastfeeding Medicine. (2020). ABM Clinical Protocol# 32: management of hyperlactation. Breastfeeding Medicine, 15(3), 129-134.McCue, K. F., & Stulberger, M. L. (2019). Maternal satisfaction with parallel pumping technique. Clinical Lactation, 10(2), 68-73.McGuire, M. K., Seppo, A., Goga, A., Buonsenso, D., Collado, M. C., Donovan, S. M., ... & Van de Perre, P. (2021). Best practices for human milk collection for COVID-19 research. Breastfeeding Medicine, 16(1), 29-38.Mitchell, K. B., Johnson, H. M., Rodríguez, J. M., Eglash, A., Scherzinger, C., Widmer, K., ... & Academy of Breastfeeding Medicine. (2022). Academy of Breastfeeding Medicine Clinical Protocol# 36: The Mastitis Spectrum, Revised 2022. Breastfeeding Medicine, 17(5), 360-376.Moorhead, A. M., Amir, L. H., Forster, D. A., & Crawford, S. B. (2022). ‘Is there any point in me doing this?'Views and experiences of women in the Diabetes and Antenatal Milk Expressing (DAME) trial. Maternal & Child Nutrition, 18(2), e13307.Shehata Ibrahim, S., El-Shabory, M. E. S., El-Hoda, N., Abdel–Fatah Mohamed Shehata, A., Mansour Moustafa Mohamed, S., & Osman, A. R. (2023). Effect of Hand Expression and Lactation Support on Self-Efficacy of Primiparous Mothers and Quality of Breast-feeding. Egyptian Journal of Health Care, 14(1), 34-44.Witt, A. M., Bolman, M., & Kredit, S. (2016). Mothers value and utilize early outpatient education on breast massage and hand expression in their self-management of engorgement. Breastfeeding Medicine, 11(9), 433-439.Witt, A. M., Bolman, M., Kredit, S., & Vanic, A. (2016). Therapeutic breast massage in lactation for the management of engorgement, plugged ducts, and mastitis. Journal of Human Lactation, 32(1), 123-131. Get full access to Evolve Lactation with Christine Staricka IBCLC at ibclcinca.substack.com/subscribe

It's not uncommon for many of us to find passion in a particular niche, but how many of us pursue it? Today I'm speaking with Dr Sadaf Lodhi, OB-GYN, Sexual Health Coach and host of The Muslim Sex Podcast. After experiencing burnout and deciding that she needed a change, Dr Lodhi became a coach, focusing her expertise on helping women have a better understanding of their bodies and intimacy. We talk about factors that have led to so many of us being ignorant of much of Sexual Health and Menopause Health, and how she decided to pursue her interests and build a new pathway for herself.For all my listener-clients with a passion for Breastfeeding Medicine, this episode is for you!Dr Sadaf Lodhi is a board-certified OB-GYN, as well as a Sexual Health Coach and host of The Muslim Sex Podcast. Dr Sadaf has over 22 years of experience in Clinical Medicine, as well as Coaching Certification with Rutgers University and a Sexual Counseling and Education Certificate from the University of Michigan. She practices in New York and is opening her new practice, providing Sexual and Menopause telehealth for patients in New York and Michigan. In addition to this, she also works as a Boards Examiner for the DO oral exams and writes test questions for the written components.To learn more about Dr Lodhi and her work, find her in these places:Website: Drsadaf.com (Online confidential intimacy/sex coaching for women to help with sexual confidence so that they can find more pleasure in their relationships)Instagram: @drsadafobgyn/ TikTok: @drsadafobgyn Facebook: handle: @drsadaf LinkedIn: https://www.linkedin.com/in/sadaf-lodhi-2018 To learn more about my coaching practice and group offerings, head over to www.healthierforgood.com. I help Physicians and Allied Health Professional women to let go of toxic perfectionist and people-pleasing habits that leave them frustrated and exhausted. If you are ready to learn skills that help you set boundaries and prioritize yourself, without becoming a cynical a-hole, come work with me.

In this episode of BS Free MD, Dr. Susan Landers, a retired neonatologist with over 35 years of experience, talks about her career and her book "So Many Babies". May, Tim and Dr. Landers discuss the challenges of burnout and overwhelm faced by women in the workplace, not just physicians. Dr. Landers shares her experience of getting to retirement and the struggle with burnout. She also talks about the rewarding aspects of practicing neonatology, and how she got to know patients and their families very well. After retiring, Dr. Landers wrote a book based on her NICU stories, "So Many Babies". About Susan Landers: Dr. Landers is a retired neonatologist who practiced in the NICU for thirty-four years. When she joined a practice of nine males in 1997 she slowly brought them into the modern medical world by changing schedules to be more family friendly, talking about coping with sick children, and proved the benefits of hiring other women physicians. Dr. Landers volunteered for the AAP and served on the Section on Breastfeeding's executive committee for six years. She took a slight detour in her career and worked as the medical director of the Mother's Milk Bank at Austin and joined the Academy of Breastfeeding Medicine. After she retired she wrote a memoir, “So Many Babies.” Are there any specific questions/talking points you would like to include?: What is a family friendly medical practice? How do women physicians accommodate breastfeeding after return to work? How do women physicians handle the demands of medical practice and burnout differently from men? Links! Https://susanlandersmd.com Https://instagram.com/drsusanlanders Www.linkedin.com/in/susan-landersmd Https://www.facebook.com/SLandersMD Looking for something specific? Here you go! [00:02:07] Rewarding NICU Specialist Career.  [00:04:33] Career moms and parenting struggles.  [00:09:05] Women in male-dominated fields.  [00:16:13] Balancing family and career.  [00:17:30] Working remotely during pandemic.  [00:21:26] Working mothers and burnout.  [00:26:05] Dealing with injuries as athletes.  [00:31:35] Importance of Support System.  [00:38:35] Donor milk sharing online.  [00:39:05] Contaminated donor milk.  [00:44:25] Pumping laws in the US.  [00:49:28] Breastfeeding guilt and shame.  [00:54:51] Breastfeeding controversies.  [00:57:20] Working moms and children's health.  [01:02:05] Tough ethical issues in medicine.  [01:05:40] Electronic Medical Record problems.  [01:10:00] A.I. in medicine. Our Advice! Everything in this podcast is for educational purposes only. It does not constitute the practice of medicine and we are not providing medical advice. No Physician-patient relationship is formed and anything discussed in this podcast does not represent the views of our employers.  The Fine Print! All opinions expressed by the hosts or  guests in this episode are solely their opinion and are not to be used as specific medical advice.  The hosts,  May and Tim Hindmarsh MD, BS Free MD LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest's statements and opinions are subject to change without notice. Thanks for joining us! You are the reason we are here.  If you have questions, reach out to us at doc@bsfreemd.com or find Tim and I on Facebook and IG. Please check out our every growing website as well at  bsfreemd.com (no www) AND sign up for our WEEKLY NEWSLETTER at bsfreemd.com/truthserum ! And don't forget our new weekly DOCTALES livestreaming on Facebook and YouTube where you get to be part of the party! GET SOCIAL WITH US! Website: bsfreemd.com YouTube:https://www.youtube.com/channel/UCiQ5Rm4eBWqbK5hSQ05--mw Rumble: https://rumble.com/search/video?q=bsfreemd Instagram:: https://www.instagram.com/bsfreemd/ Facebook: https://www.facebook.com/bsfree Newsletter: https://www.bsfreemd.com/truthserum

In this episode of Breastfeeding Talk, host Jacqueline Kincer engages in a thought-provoking conversation with guest Dr. Susan Landers, whose impressive background includes working full-time as a neonatologist while serving as a speaker for the Texas Department of State Health Services, Medical Director of the Mothers' Milk Bank at Austin, a Fellow in the Academy of Breastfeeding Medicine, and also contributing to the Section on Breastfeeding for the AAP for six years.Together, Jacqueline & Dr. Landers delve into the critical role of breast milk in the NICU and the challenges faced in advocating for its use. They explore the importance of donor milk, the need for informed consent, and the significance of maternal support in making breastfeeding work.The episode also addresses the struggles of working mothers, the cultural shifts required to create a supportive environment, and the essential role of healthcare providers in empowering breastfeeding mothers. With personal stories and practical advice, this episode sheds light on the journey of breastfeeding mothers, fostering understanding and offering valuable insights for both healthcare professionals and new moms alike.In this episode, you'll hear:NICU changes and advancements in the field of breastfeeding medicine over the last 30 yearsSupport mothers in the NICU need to breastfeed & provide milk to their babiesThe role of fortifiers to promote healthy growth in NICU babiesResistance and challenges faced when advocating for human milk feedings in the NICU, including biases and prejudice against breastfeeding.Addressing the concerns and potential dangers of online donor milk sources.Emphasizing the crucial role of maternal support in making breastfeeding work, with practical tips and advice for new moms during the challenging fourth trimester.Shedding light on the prevalence of postpartum depression and the importance of support systems for new mothersDr. Landers' own breastfeeding experiences 30 years ago and her journey supporting her own daughters in breastfeedingStruggles faced by working mothers in balancing breastfeeding and professional responsibilitiesNeeded cultural shifts required to foster a more supportive environment for breastfeeding and the role of healthcare providers, including lactation consultants, in empowering mothers with the necessary knowledge and resources.Burnout among working mothers and the importance of self-care and taking breaks to maintain mental health and sustain breastfeeding journeys.A glance at this episode:[5:00] Breastmilk in the NICU[13:25] Resistance that Dr. Landers encountered when she started advocating for human milk[19:04] Why donor milk is so important [26:48] Why maternal support is crucial to making breastfeeding successful[38:04] Dr. Landers' advice for other healthcare providers to help support their communities[46:53] The importance of support in breastfeedingRelated Links:Dr. Landers' WebsiteDr. Landers' InstagramDr. Landers' FacebookABM Find a Physician DirectoryAAP Find a Pediatrician toolDr. Landers' Book on Amazon

Our special guest for this episode is Dr Sharon Silberstein - medical doctor, IBCLC and Tongue tie specialist. Known as The Breastfeeding Doctor, Sharon has been working in the field of Breastfeeding Medicine for the last 10 years. She runs the Dr Silberstein Clinic in London, which is dedicated to delivering a holistic approach to Infant Feeding. Sharon is the only doctor who practices breastfeeding medicine full time in the UK and she runs the only UK clinic that offers breastfeeding medicine as its speciality. As she explains in the podcast, she takes a holistic approach to breastfeeding and her clinic offers the services of an Osteopath, Speech and Language Therapist, Child Psychiatrist and Gynaecologist. In this episode Sharon talk to us about induced lactation for same sex and adoptive couples - what exactly it involves and how best to go about it. Sharon works with a variety of same sex couples, couples who choose surrogacy and even transgender couples. She shares the advice she gives her perspective parents about lactation and how best they can physically and mentally prepare for the journey. “Anyone who wants to induce lactation needs to know that this is a process and it's quite time-consuming and laborious. They need to be prepared to do the work as it isn't always very easy.” Our podcast sponsors for this episode are Fraupow.  They are an award-winning breastfeeding brand offering a selection of breast pumps and exclusive midwife support for breastfeeding mothers. Fraupow was founded by Sunita Boyes, a passionate breastfeeding mama, who is on a mission to support all mothers on their breastfeeding and pumping journey. The Fraupow hands-free breast pump gives the wearer a freedom and flexibility that other traditional pumps simply cannot. It's so simple and easy to use, you'll forget you're even wearing it. Their hands-free breast pump won Best Breastfeeding Accessory 2022 and Best Wearable Breast Pump 2022. You can find out more about Fraupow and their support services on fraupow.com. Induced lactation for same sex and adoptive couplesOur podcast Sponsors - Fraupow

Join Dr. Rubin to discuss the essential role of Breastfeeding Medicine. Learn what sets it apart from other lactation support and why it matters. Dr. Rubin is a pediatrician and breastfeeding medicine specialist practicing in the Western Suburbs of Chicago. She did her undergrad at Stanford University, medical school at Georgetown, and pediatrics residency at the University of Chicago. She worked as an outpatient general pediatrician at Loyola University Medical Center for 13 years before opening her new practice, In Touch Pediatrics and Lactation.  In Touch is a Direct Pediatric Care practice offering general pediatrics services and breastfeeding medicine consults. Dr. Rubin is thrilled to be able to provide these services in patients' homes when and where they need them most! She continues to teach medical students as the adviser for her Breastfeeding and Lactation 4th Year Elective. She serves as the Co-Chair for the Committee on Breastfeeding for the Illinois chapter of the AAP and is a board member of the North American Board of Breastfeeding and Lactation Medicine. Contact Dr. Rubin. https://www.facebook.com/InTouchPeds https://www.instagram.com/intouchpeds/ https://www.youtube.com/channel/@intouchpeds www.linkedin.com/in/cindyrubinmd https://twitter.com/drcindyrubin --- Send in a voice message: https://podcasters.spotify.com/pod/show/urcaringdocs/message

At the age of 101, my grandmother, Beverly's, dementia is really starting to show. I'm over at her house one day when her new social worker comes by. I hear him talking to one of her caregivers in the other room. She says to him, “Sometimes Beverly says she wants to go home. Yet, she's in her own home. So when Beverly says that, we just tell her, ‘You ARE home.' But it doesn't really register.” He responds, “Beverly is simply looking for a safe space. So rather than trying to battle with her, all you need to do is remind Beverly that she is 100% safe and everything is fine.” As I listen to this conversation, I find myself smiling and feeling happy that she has someone besides myself advocating for her... and someone helping the caregivers too, offering them a different perspective instead of telling them that they're doing it wrong. My guest today, Dr. Karen Federici, also advocates on behalf of others. She's an award-winning family physician and an expert in breastfeeding. In this episode of the Storytelling School Podcast, you'll hear all about her story on advocating for others and answers to questions like: How is your Talk enhanced when you use story versus when you don't? What role does storytelling play in the work that doctors do, and how can healthcare professionals integrate it into their own work? And what can you do to redirect the story you're hearing from those you serve in your profession to better help them? What you will learn in this episode: How a story not going to plan can set you up for a new (and even better) story How other people's unhelpful advice can hinder your emerging story Why sometimes the real story isn't where the main focus is Who is Dr. Federici? Inspired by her own experience as a new mother, Karen Federici, MD saw a genuine need for doctors who championed breastfeeding. So she became that doctor, leaving her career as an actuary behind. Now, she's an award-winning physician and breastfeeding expert.  Dr. Federici founded Family First, a practice centering around primary care for women and children and breastfeeding medicine, after completing her residency in 2006. Recently, she founded TeleLact which provides expert lactation support through telehealth to expand access to quality care for breastfeeding moms. Last year, she opened the first and only donor human milk dispensary in her region. As part of the Academy of Breastfeeding Medicine and with a certification in family medicine, Dr. Federici volunteers as a clinical preceptor, teaching breastfeeding medicine to students and fellow physicians. Not enough families have access to a doctor with knowledge on breastfeeding. So she likes to direct them to her TEDx Talk to help spread the word so that they can positively impact breastfeeding, advocate for themselves, and encourage their doctors to seek more education on the subject. Links and Resources: TeleLact Family First Dr. Federici's TEDx Talk @dr.karen.federici on Instagram @telelact247 on Facebook Dr. Federici on LinkedIn Storytelling School Website @storytellingschool on Instagram @storytellingSchool on Facebook

New Mastitis protocol? Yes, the Academy of Breastfeeding Medicine has added a new protocol, #36, the Mastitis Protocol. Actually, it is updated but the ideas in it are so revolutionary, it may as well be new! Dr. Katrina Mitchell was a major force behind these changes. She had noticed in her clinic as a Breastfeeding… The post appeared first on The Breastfeeding Center of Ann Arbor.

In this episode, Rich has a conversation with Dr. Susan Landers.Get to know Dr. Susan Landers, an accomplished neonatologist. She holds BS degrees in Biology and Chemistry from Auburn University and an MD degree from the Medical University of South Carolina. Dr. Landers completed her pediatrics residency at the University of Texas Southwestern Medical School hospitals, and her neonatology fellowship at Baylor College of Medicine hospitals. As an academic neonatologist, Dr. Landers conducted clinical research and published twenty-three peer-reviewed papers. On top of that, she also served as a speaker for the Texas Department of State Health Services, Medical Director of the Mothers' Milk Bank at Austin, and on the board of directors of the milk bank. She continued to publish papers and work for the American Academy of Pediatrics (AAP), becoming a Fellow of the Academy of Breastfeeding Medicine in 2002. Dr. Landers also contributed to AAP policy statements and clinical guidelines, serving on the Executive Committee of the Section on Breastfeeding from 2008 until 2014. Her contributions didn't go unnoticed, as she was awarded a national award for "Outstanding Accomplishments in Quality Improvement" in 2008.Thank you to Dr. Susan Landers for the conversation. Here are some links for Dr. Landers:Website:

Dr. Rubin is a general pediatrician and breastfeeding medicine specialist practicing in the Western Suburbs of Chicago. She worked at a large academic center as an outpatient general pediatrician for 13 years before opening her new Direct Pediatric Care practice, In Touch Pediatrics and Lactation. Dr. Rubin loves providing pediatrics, breastfeeding medicine, and 4th-trimester care services in patients' homes, when and where they need them most! She continues to be involved in teaching medical students as the adviser for her Breastfeeding and Lactation 4th Year Elective, and she serves as the Co-Chair for the Committee on Breastfeeding for the Illinois chapter of the AAP and is a board member of the North American Board of Breastfeeding and Lactation Medicine. www.intouchpediatrics.comFind the youtube video interview here!For more from Cappella, follow us on all social media channels:Website | Instagram | Facebook | Linkedin | Twitter | YoutubeTo get in touch with us, send us an email at hello@cappella.io! --- Send in a voice message: https://podcasters.spotify.com/pod/show/cappella/message

Description:   Carrie Bruno, Registered Nurse and IBCLC lactation consultant, made it her life's work to support families as they move through all of parenting's challenges. She is empathetic to parent's journeys with breastfeeding and evidence based so you will be getting the most up to date advice in this interview! Some of this new information may come as a surprise, so Carrie breaks it down and shares advice on how to navigate your breastfeeding journey.  Carrie Shares: New research and guidelines about breastfeeding from the Academy of Breastfeeding Medicine - hint, it's probably not what we've been taught!  New information on plugged ducts and mastitis and how to treat them D-MER, breastfeeding anxiety, and postpartum mental health When to start pumping, how much to feed, and how often  How to avoid oversupply and undersupply - plus, how to know if your supply is “good”  How formula can play in (and how that's okay)  Your experience will look different than what you see others doing, this is your journey! Show Notes:  For more of Carrie, please visit instagram.com/the.mama.coach  on Instagram and themamacoach.com on the Web For more of We Go There Podcast, please visit instagram.com/wegotherepodcast on Instagram and wegotherepodcast.com on the Web *Warning- this podcast is completely unfiltered. If you are around young children, we suggest headphones.*  

In this episode, Arya Pretlow, CNM, IBCLC shares her knowledge and recommendations about lactation. Many moms have questions about breastfeeding, lactation, when to pump, how to increase supply, etc. This episode touches on some of those hot-button topics and offers resources that new moms (and experienced moms) can tap into for guidance, peer support, and lactation resources.Contact Arya:https://www.apwellnessservices.com/Here are some of the resources mentioned in the episode:The Academy of Breastfeeding Medicine bfmed.orgUSLCA find a lactation consultanthttps://uslca.org/resources/find-a-lactation-consultant-map/ILCA find a lactation consultanthttps://ilca.org/why-ibclc-falc/La Leche Leaguehttps://www.llli.org/la-leche-league-online-support-resources/WIC Breastfeeding Supporthttps://wicbreastfeeding.fns.usda.gov/ Coaching offerSupport the showConnect with Kelly Hof at kellyhof.comMedical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

We never seem to get enough sleep – and we never seem to get enough episodes on sleep.This is a presentation from the Academy of Breastfeeding Medicine on bedsharing.  Listen up and learn what the medical professionals have to say.If you are a new listener, we would love to hear from you.  Please consider leaving us a review on itunes or sending us an email with your suggestions and comments to badassbreastfeedingpodcast@gmail.com.  You can also add your email to our list and have episodes sent right to your inbox! Things we talked about:Where this presentation came from [3:56]Message from the UK [6:34]Why human babies want to be close and feed often [8:57]We don't understand infant sleep [13:37]Does evolutionary biology change? [16:10]What sleeping like a baby really means [18:40]Poor sleep = breastfeeding cessation [23:30]Options given to parents [25:00]Babies in another room [27:40]Are you really someone who promotes breastfeeding if you discourage bedsharing? [30:30]“Never bedshare” messages prevent conversation about the issue [33:598]ABM protocol #6 on Bedsharing [39:44] Today's episode is brought to you by Silverette! Silverette silver nursing cups are your one-stop solution to soothe and protect your nursing nipples! Use code BADASS at www.silveretteusa.com for 15% off!Today's episode is brought to you by The Breastfeeding Shop! The Breastfeeding Shop supplies breast pumps, accessories & more through insurance. Visit www.thebreasfeedingshop.com. Links to information we discussed or episodes you should check out!https://www.bfmed.org/assets/Ball%20Helen.pdf https://badassbreastfeedingpodcast.com/episode/082-nighttime-breastfeeding-with-tracy-cassels-phd-evolutionary-parenting/https://www.basisonline.org.uk/about-us/Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/     Check out Dianne's blog here~https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast~https://badassbreastfeedingpodcast.comHere is how you can connect with Dianne and Abby~Abby Theuring  https://www.thebadassbreastfeeder.comDianne Cassidy http://www.diannecassidyconsulting.com Music we use~Music: "Levels of Greatness" from "We Used to Paint Stars in the Sky (2012)" courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes

The latest and most up-to-date protocol for clogged ducts, engorgement, mastitis and abscesses from the Academy of Breastfeeding Medicine. Learn how to take care of your breasts, so they can take care of you (and your baby!)Love the show? Buy Bri an ice creamCheck to see if your insurance will cover 6 consults with Breezy Babies (for free!)Join Bri's crew so we can stay in touch.*This podcast is not "medical advice". Please consult with your Healthcare Provider about your specific situation.This episode appeared first on the Breezy Babies website. Follow along @breezy__babies on Insta for more tips and tricks.Support the showLove the show? Buy Bri an ice creamCheck to see if your insurance will cover 6 consults with Breezy Babies (for free!)Join Bri's crew so we can stay in touch.This podcast is not "medical advice". Please consult with your Healthcare Provider about your specific situ...

Did you hear about all the major changes with mastitis?This year the Academy of Breastfeeding Medicine updated their protocols for the treatment of Mastitis, clogged ducts, and milk blebs! We have made some serious progress in our understanding of why and how these things happen and we now have much better methods to treat them. Tune into the Milk Minute and let your favorite cohosts give you the low down on the updates. Heather and Maureen want you to have the best information available to manage your own health!This information is crucial to both self care  and healthcare provider management of these conditions, so don't miss it!Work With Us!Book a Lactation Consult with Heather! Click HERE for the deets.Book a Lactation Consult with Maureen! Click HERE to get started.Listener Question: Would it be bad to dry up my supply with Sudafed?THANK YOU, PATRONS!Amanda from Waterville, Ohio, Nancy B & Mandy, G from Morgantown, West VirginiaTHANK YOU TO THIS EPISODE'S SPONSORSGet your breastfeeding journey BACK ON TRACK with a Lactation Consult with Heather! Telehealth available and some insurance accepted. Click HERE for the deets. If you have Blue Cross Blue Shield, Anthem, Cigna PPO or Provider Network of America– you can fill out a short form to get pre-approval to get your visits with Heather 100% approved! Click HERE to access the form.Ceres Chill - Click HERE and enter promo code MILKMINUTE15 for 15% off!Click HERE to get HappiTummi and enter code MILKMINUTE10 for 10% off your order!Dairy Fairy - Click HERE and use Promo Code MILKMINUTE for free domestic shipping on any of our itemsMentioned in this episode:Ep. 43 - Cold and Flu Medications while BreastfeedingEp. 84- Let's Talk Nipple Shields!The bathroom bird episode: Getting Baby Back to the Breast: Nursing strikes and breast refusalPrefer to read the transcript? Click Here to read the edited version of this episode! All of the resources cited in this episode are available on our professional transcript.Support the showCheck out Milk Minute Podcast's website here!Become a VIP Click here to get exclusive access and more!Send us an e-mail! MilkMinutePodcast@gmail.comFacebook | Instagram | TikTok...

Have you ever dealt with mastitis or clogged ducts? Did you know that the Academy of Breastfeeding Medicine updated their clinical guidelines on Mastitis treatment this year? Let your favorite cohosts update you on all the big changes!This first episode focuses on our new understanding of the physiology of mastitis, aka what the heck is happening in there! Join Heather and Maureen as they explore the real cause of mastitis and talk about the latest research into clogged ducts, milk blebs, and more! Then tune in next week for a dive into the updated treatment options, with a focus on first-line, at home treatments! Stay current and let the Milk Minute help you use the latest and greatest clinical guidelines.Work With Us!Book a Lactation Consult with Heather! Click HERE for the deets.Book a Lactation Consult with Maureen! Click HERE to get started.THANK YOU, PATRONS!Blair from Indiana, PA and Erin KeyTHANK YOU TO THIS EPISODE'S SPONSORSHighland Birth Book a Lactation Consult today! Booking a virtual consult with Maureen is now easier than ever. Click HERE to get started!Click HERE to save 25% off and free shipping on all Liquid IV products with the code MILK_MINUTEAeroflow –  The easiest way to order your breast pump through your insurance. Click HERE to order today!Click HERE to order your Evivo! Use code MILKMINUTE for $10 off of your purchase!Listener question: Can you get rid of an oversupply? I have one breast that produces a lot more milk and I want it to be even with the other one.Mentioned in this episode:Ep. 87- Oversupply...What It Means and How to Handle It!Ep. 83- Up-Regulating and Down-Regulating SupplyCheck out Milk Minute Podcast's new website here!Become a Milk Minute VIP: Click here to get behind-the-scenes-access and exclusive merch!Contact us: To send us feedback, personal stories, or just to chat you can send us an email at milkminutepodcast@gmail.comGet Community Support: Click Here to Join our Free Facebook Community!Stay up to Date: Find us on INSTAGRAM @milk_minute_podcastStare at us on TikTokPrefer to read the transcript? Click Here to read the edited version of this episode! All of the resources cited in this episode are available on our professional transcript.Support the show

Kiddada Green, the co-founder of Black Breastfeeding Week, is my guest on the podcast this week. Kiddada lives in Detroit, and also the Founding Executive Director of Black Mothers Breastfeeding Association, which was first set up in 2007 to reduce racial inequities in breastfeeding support for black families. As a thought leader and innovator, Kiddada has made huge strides in the area of breastfeeding support, and policy making. She serves on various committees and special projects and has had work published internationally in Breastfeeding Medicine and other noteworthy publications. It's no surprise she has been the recipient of many awards for the work she does and continues to do in support of black maternal and child health. Celebrating 10 years of Black Breastfeeding Week Black Breastfeeding Week has been running since 2012 and is marking its 10th anniversary this year. Looking back on the past ten years, Kiddada explains the reasons why she and her other co-founders Kimberly Seals Allers and Anayah Sangodele-Ayoka first felt the need to set up Black Breastfeeding Week to bring greater awareness to breastfeeding in black and brown communities. Kiddada tells us about the exciting things in store for this year's Black Breastfeeding Week celebration, including an awards ceremony happening in New York City on 30th August. She also lets us know about the fundraising they are doing to support the work of Black Breastfeeding Week - which is run purely by volunteers. Kiddada also explains the poignancy of this year's theme: 'A New Foundation' A New Foundation Kiddada gives us an insight into how she and her co-founders came up with this year's theme 'a new foundation' - how it organically came about and how ultimately they were inspired by Beyonce's new album Renaissance. Speaking about the 2022 theme for Black Breastfeeding Week, Kiddada says: "We feel like Black Breastfeeding Week is at a pivitol point. We want to respect the traditions and history of black women and breastfeeding and at the same time look at what's been done despite the historical trauma and atrocities that have happened. We wanted to keep that in mind whilst looking at this new foundation which has been born through community. We're excited by that and what will come in the next ten years." Podcast sponsors - The Mum Collective Our sponsor of this episode of the boobingit podcast is the maternity and nursing clothing brand The Mum Collective. If you're looking for beautiful and sustainable loungewear that's designed with breastfeeding mamas in mind then look no further! You can shop online at themumcollective.co.uk. The Mum Collective is kindly giving boobingit listeners 10% of their collection. Shop now at themumcollective.co.uk.

National Breastfeeding Month – August 2022Dr. Allison Stiles, Chair of the Shelby County Breastfeeding CoalitionAugust is National Breastfeeding month and on this episode, my guest and I explore the health benefits to both mom and baby as well as the barriers to breastfeeding. Dr. Allison Stiles is a physician and advocate for breastfeeding and an advocate for underserved populations. Join us for this informative conversation. More About Dr. Stiles:Dr. Allison Stiles has been practicing Internal Medicine and Pediatrics, “Med-Peds” in Midtown Memphis since 2003 when she moved back to be closer to family. She had lived in Memphis from the age of 5 through high school at Central High. She attended the University of Missouri-Columbia where she received a BS in Biochemical Engineering in 1985. She worked for Procter and Gamble as an Engineer in Cape Girardeau, Missouri, Cincinnati, Ohio, Italy, and England. In 1995 she retired after 10 years and went to Medical School at the University of Cincinnati. Dr. Stiles did her Med-Peds (Internal Medicine and Pediatrics) residency at the University of Illinois- Chicago. She is double board certified in Pediatrics and Internal Medicine.Practicing in Pediatrics and her experience with her own children led to her interest in Breastfeeding and “Lactivism”. She is Chair of the Shelby County Breastfeeding Coalition and a TN AAP Chapter Breastfeeding Coordinator. She received her certification as a Lactation Consultant in 2016. She has lectured on Breastfeeding for UT Medical students, Family Practice Residents, Pediatric Residents, and Midwives. She was a lecturer for the TN Breastfeeding Symposium 3 times and has taught a class for new Parents every month for over 5 years. She is a contributing author of the article, “Breastfeeding Sisters that are Receiving Support: Community-Based Peer Support Program Created for and by Women of Color, published in the Journal of Breastfeeding Medicine on 2/21.Dr. Stiles has partnered with and supported OutMemphis, Friends for Life, and the Metamorphosis Center. She treats Transgender and Non-binary people to help them with their healthcare needs and to be their Primary Care doctor. She is one of the few Memphis providers of PrEP, to prevent HIV. She has been treating HIV for over 15 years.Dr. Stiles is a fellow of the American Academy of Pediatrics (AAP) and the American College of Physicians (ACP). She is a member of the Academy of Breastfeeding Medicine, the AAP Section on Breastfeeding Medicine, the US Lactation Consultant Association, the International Lactation Consultant Association, the Memphis Pediatric Society, and the Memphis Medical Society. She is a member of the WPATH – the World Professional Association for Transgender Health, and the Academy of Pediatrics –Section on LGBTQ.Her Midtown practice, called “Memphis Internal Medicine and Pediatrics” is nearly 20 years old. She takes care of people of all ages, from newborns to Geriatrics. Dr. Stiles believes in science and compassionate care for all people without boundaries.Resources:www.shelbycountybreastfeeding.orgwww.memphis-medpeds.com

Are you ready for a life-changing podcast? Dr Renee White sat down with Dr Nicole Gale, specialist GP and Lactation Consultant who practices Breastfeeding Medicine and Perinatal care for mothers and babies. Dr Gale discusses why mothers are reverting to more traditional models of care for their babies, the evolutionary mechanisms at play with the newborn breast crawl and explores the physical, mental and emotional symmetry of the mother:baby dyad. Learn more about Dr Renee White and Fill Your Cup Postpartum Doulas:Want to be nurtured and nourished after the birth of your baby, have a peek at our doula offerings.If you want to gobble up of famous Chocolate + Goji lactation cookies, look no further. Oh and our Creamy Coconut dahl mix is to die for, just sayin'.Learn more about Dr Nicole GaleDr Nicole Gale is focused in providing holistic and individualised care to families in a comprehensive model, where she is able to care for both babies AND mothers with continuity of care and support - especially helpful in complex situations, conflicting opinions and families with multiple practitioners involved. She practices in Surrey Hills and Fitzroy, Melbourne.

New "gender inclusive" language guides from the Academy of Breastfeeding Medicine are making their way into US hospitals. Plus, the Biden Administration now says sex and gender ARE the same.Get exclusive content here!: https://thepetekalinershow.com/See omnystudio.com/listener for privacy information.

Article in question: https://www.liebertpub.com/doi/pdf/10.1089/bfm.2021.29188.abm _______________________________________ If you appreciate my work and would like to support it: https://subscribestar.com/the-saad-truth https://patreon.com/GadSaad https://paypal.me/GadSaad _______________________________________ This clip was posted earlier today (July 30, 2022) on my YouTube channel as THE SAAD TRUTH_1432: https://youtu.be/WV5kLQx88h4 _______________________________________ The Parasitic Mind: How Infectious Ideas Are Killing Common Sense (paperback edition) was released on October 5, 2021. Order your copy now. https://www.amazon.com/Parasitic-Mind-Infectious-Killing-Common/dp/162157959X/ref=tmm_hrd_swatch_0?_encoding=UTF8&qid=&sr= https://www.amazon.ca/Parasitic-Mind-Infectious-Killing-Common/dp/162157959X https://www.amazon.co.uk/Parasitic-Mind-Infectious-Killing-Common/dp/162157959X _______________________________________ Please visit my website gadsaad.com, and sign up for alerts. If you appreciate my content, click on the "Support My Work" button. I count on my fans to support my efforts. You can donate via Patreon, PayPal, and/or SubscribeStar. _______________________________________ Dr. Gad Saad is a professor, evolutionary behavioral scientist, and author who pioneered the use of evolutionary psychology in marketing and consumer behavior. In addition to his scientific work, Dr. Saad is a leading public intellectual who often writes and speaks about idea pathogens that are destroying logic, science, reason, and common sense. _______________________________________

Hi Dolls! Thanks so much for coming back for our 33rd episode. We are so happy you are here. Each week I will be joined by different guests to answer your questions as best we can. 

Matt was inspired by Gill Tietz's Sober Powered episode, Staying Sober During the Holidays.  The episode is much less staying sober during the holidays, and more staying sober at events where booze is available.  Practicable advice for those in recovery for anytime.BBQsWork partiesConcertsEctJohn, Matt and Steve talked about their experience being on guard for the unguarded moment.  In this episode we talk about:Keeping your drink in your hand.  If you put it down, get anotherTell a bartender you are not drinking and stick with that person (thanks Gill)Our thoughts on non-alcoholic versions of an alcoholic drinkHow people put booze in food and to watch out.This is great advice for anyone looking at sobriety, new or old.Deep MC'sMental Health, Crazy Stories, Viral Videos, and Big YouTube Guest. What more do you need?Listen on: Apple Podcasts Spotify Katie The Traveling Lactation ConsultantTongue Tie, Breastfeeding Medicine, Breastmilk allergy & more as Katie travels the countryListen on: Apple Podcasts SpotifyWe wanted to alert you that you may hear some ads inserted into the show. We've carefully selected each ad to be sure it's recovery appropriate. We are not looking to make a profit, only looking to get enough help to make this expense neutral. We'd love your feedback. You can email at matt@soberfriendspod.comSupport the show

My name is Ernest Ramirez, I was a single parent who lost my son a few days after he received the shot. My son Ernesto received the shot and following his death, the only explanation that was given to me was an enlarged heart. My son was in good health and regularly played baseball since he was 7 years old. Advertising claimed that the vaccine is safe for adolescents, and this convinced me to book Ernesto Jr. for the jab on April 19th. Five days later, he died. I need to spread my story so that, hopefully, no one else will go through what I'm going through. Ernesto Jr was my world, and I feel I need to fight for him and others that are also suffering It kills me to come home to an empty house. We need to yell, we need to fight, we need to do something. His life was worth much more than what the Government or anybody else thinks, I love the hell out of my country, but I do not trust my Government anymore.” According to his autopsy, Ernesto died of an enlarged heart five days after the jab, which showed his heart was double the normal size. Support Ask The Nurses Podcast1. https://www.patreon.com/AskTheNursesPodcast2. buymeacoffee.com/AFLN              Sandy K Nutrition - Health & Lifestyle QueenYour Aging Better Advocate midlife & beyond through biohacking & alternative wellness.Listen on: Apple Podcasts Spotify Katie The Traveling Lactation ConsultantTongue Tie, Breastfeeding Medicine, Breastmilk allergy & more as Katie travels the countryListen on: Apple Podcasts Spotify The Zen (ish) Mommy Educate Empower Laugh Connect. A place for real information you want to know.Listen on: Apple Podcasts Spotify There is a Method to the MadnessThis is a podcast where I will be discussing all aspects of physical fitness. I am an...Listen on: Apple Podcasts SpotifySupport the show

I am Dr. Bryan Ardis, D.C.In early 2020 I lost my Father-in-law because of ill-advised hospital protocols. Since that time, I have been on a mission to help educate the public about the dangers to Americans, in many of our "institutes of health".I am passionate about exposing corruption of the medical system and the powers that be in this country. My focus is on medical freedom, education, and waking up the world with the truth.I hope to inform, inspire and empower those who are struggling with personal health issues. I promise to deliver real research and applicable information that can free people from emotional despair and fear, created by symptoms of disease and disinformation.Ardis Labs and the Ardis Healing Center have helped thousands of patients from all over the world, including, from countries as far away as the Philippines, Taiwan, Australia, Barbados, Italy, Scotland and many more.I am the CEO of ArdisLabs and Host of The Dr. Ardis Show.I sold the Ardis Healing Center in October of 2018, and now consult the three practitioners who have taken over the practice, which now carries the name, North Texas Healing Center.I co-founded TruLabs LLC and formulate all of the hydration products we make.You can find my podcast, "The Dr. Ardis Show", on vokalnow, rumble and right here on the site.You can find all our healthy and natural Ardis Labs products right here on the site.For more information about our hydration products please visit www.trulabs.comSupport Ask The Nurses Podcast1. https://www.patreon.com/AskTheNursesPodcast2. buymeacoffee.com/AFLN                Sandy K Nutrition - Health & Lifestyle QueenYour Aging Better Advocate midlife & beyond through biohacking & alternative wellness.Listen on: Apple Podcasts Spotify Katie The Traveling Lactation ConsultantTongue Tie, Breastfeeding Medicine, Breastmilk allergy & more as Katie travels the countryListen on: Apple Podcasts Spotify The Zen (ish) Mommy Educate Empower Laugh Connect. A place for real information you want to know.Listen on: Apple Podcasts Spotify There is a Method to the MadnessThis is a podcast where I will be discussing all aspects of physical fitness. I am an...Listen on: Apple Podcasts SpotifySupport the show

Live with Canadian Trucker Chad Metz!Sandy K Nutrition - Health & Lifestyle QueenYour Aging Better Advocate midlife & beyond through biohacking & alternative wellness.Listen on: Apple Podcasts Spotify Katie The Traveling Lactation ConsultantTongue Tie, Breastfeeding Medicine, Breastmilk allergy & more as Katie travels the countryListen on: Apple Podcasts SpotifySupport the show

Live with Canadian Trucker Chad Metz!Sandy K Nutrition - Health & Lifestyle QueenYour Aging Better Advocate midlife & beyond through biohacking & alternative wellness.Listen on: Apple Podcasts Spotify Katie The Traveling Lactation ConsultantTongue Tie, Breastfeeding Medicine, Breastmilk allergy & more as Katie travels the countryListen on: Apple Podcasts SpotifySupport the show

Live with Canadian Trucker Chad Metz!Sandy K Nutrition - Health & Lifestyle QueenYour Aging Better Advocate midlife & beyond through biohacking & alternative wellness.Listen on: Apple Podcasts Spotify Katie The Traveling Lactation ConsultantTongue Tie, Breastfeeding Medicine, Breastmilk allergy & more as Katie travels the countryListen on: Apple Podcasts SpotifySupport the show

Every year a number of Moabites injure themselves doing activities they are passionate about. Paying for medical bills and possibly dealing with trauma can be difficult. But there's a growing number of options for help, from grants for medical bills to therapists dedicated to post-accident trauma. Plus, a nationwide formula shortage is affecting parents and their children across the country, including Southeastern Utah. // Plus, the Weekly News Reel where where we check in with reporters on their latest stories of the Moab area. Doug McMurdo of The Times-Independent talks 20 years for thrift store WabiSabi, Moab Regional's recovery center and former county commissioner Curtis Wells heading the state's Community Impact Board. Alison Harford of the Moab Sun News discusses Moab Bee Inspired Gardens, a local law enforcement officer receiving a national award, and the return of the Moab Arts Festival. // Show Notes // Photo: Hunter Kessler spent nearly three weeks in a Grand Junction hospital after a canyoneering accident. He says he's struggled to return to the sport, but is working on trusting his equipment again. // High Fives Foundation https://highfivesfoundation.org // The White House: Biden Administration Approves Operation Fly Formula Mission https://www.whitehouse.gov/briefing-room/statements-releases/2022/05/19/biden-administration-approves-first-operation-fly-formula-mission/ // HHS: Helping Families Find Formula During the Infant Formula Shortage https://www.hhs.gov/formula/index.html // Academy of Breastfeeding Medicine re: Shortage of Breastmilk Substitutes https://www.bfmed.org/statement-on-shortage-of-breastmilk-substitutes // Weekly News Reel Mentions // The Times-Independent: ‘Much more than a thrift store' https://www.moabtimes.com/articles/much-more-than-a-thrift-store/ // The Times-Independent: MRH substance abuse clinic set to open https://www.moabtimes.com/articles/mrh-substance-abuse-clinic-set-to-open/ // The Times-Independent: Moab's Wells to head Community Impact Board https://www.moabtimes.com/articles/moabs-wells-to-head-community-impact-board/ // The Times-Independent: Commission to lobby DOI on SITLA swap https://www.moabtimes.com/articles/commission-to-lobby-doi-on-sitla-swap/ // Moab Sun News: Bee Inspired Gardens project buzzes to life https://moabsunnews.com/2022/05/19/bee-inspired-gardens-project/ // Moab Sun News: Moab BLM law enforcement officer Cody Marsh receives national award https://moabsunnews.com/2022/05/19/cody-marsh-national-award/ // Moab Sun News: ‘This is going to be a fabulous year' https://moabsunnews.com/2022/05/19/moab-arts-festival-2022/

Tongue ties are such a vast, controversial, and often misunderstood topic that we brought in pediatric otolaryngologist (ENT) surgeon Dr. Elise Graham to help us wade through the topic. She is also a mom to two boys with a complex breastfeeding journey of her own, which has brought her to shine a postpartum lens onto her field that she admits can gain from providing more support to patients, especially as information about tongue ties can vary greatly and specialized support can be hard to find. In addition to being a pediatric surgeon, Dr. Graham is also working towards becoming a certified lactation consultant (IBCLC) and earning a fellowship through the Academy of Breastfeeding Medicine, which is why we're very excited to have her guide us through the evidence-based truth about tongue ties! Academy of Breastfeeding Medicine Protocols: https://www.bfmed.org/protocols  JAMA Otolaryngology - Head & Neck Surgery: What Is a Tongue Tie? IG: Dr. Elise Graham @elisegmd

Happy Friday Friends!My next guest has shared her story in the medical field juggling being a mother. I love her openness and her vulnerability about witnessing some very hard cases being in the Neonatal ICU. Please welcome PREMIERE guest Dr. Susan Landers. Susan has 34 years of experience in the neonatal intensive care unit (NICU). She practiced in academic medicine (on faculty of two medical schools) and in private practice. She found her work in the demanding environment of the NICU rewarding & managed to postpone burnout until the end of her career. She and her physician husband raised three children (now all young adults) while they both practiced medicine full time. She recently wrote a memoir called "So Many Babies: My life Balancing a Busy Medical Career and Motherhood." Susan enjoys recounting some of her best, and worst, experiences of being a working mother, and how she managed to stay resilient. She shares with other working mothers many things she learned along her journey as a busy mother and successful doctor.She attended medical school at the Medical University of South Carolina in Charleston and completed her pediatrics residency at University of Texas Southwestern Medical School and Parkland Hospital in Dallas. She completed her neonatology fellowship at Texas Children's Hospital and Baylor College of Medicine in Houston. She has special expertise in breastfeeding medicine, and human donor breastmilk banking. She previously worked for the American Academy of Pediatrics as a leader in the Section on Breastfeeding Medicine. She currently is retired and lives in Austin, Tx.https://www.linkedin.com/in/susan-landersmd/https://www.instagram.com/drsusanlanders/https://www.facebook.com/drsusanlandershttps://twitter.com/susanlandersmdhttps://susanlandersmd.comSupport for Label Free Podcast is brought to you by ​MANSCAPED™​, who is the best in men's below-the-waist grooming.  ​ @MANSCAPED offers precision-engineered tools for your family jewels. They obsess over their technology developments to provide you the best tools for your grooming experience. MANSCAPED is trusted by over 2 million men worldwide! We have an exclusive offer for my listeners - 20% off + free shipping with the code: LabelFree20 at   https://www.manscaped.com​ As always thank you for the support, to contact me directly follow the link below: https://www.labelfreepodcast.com​ Stay Healthy, Stay Ready- Deanna Marie Kuempel #ad​​ #sponsor​ #publishedauthor #neonatal #ICU

Happy Friday Friends!My next guest has shared her story in the medical field juggling being a mother. I love her openness and her vulnerability about witnessing some very hard cases being in the Neonatal ICU. Please welcome PREMIERE guest Dr. Susan Landers. Susan has 34 years of experience in the neonatal intensive care unit (NICU). She practiced in academic medicine (on faculty of two medical schools) and in private practice. She found her work in the demanding environment of the NICU rewarding & managed to postpone burnout until the end of her career. She and her physician husband raised three children (now all young adults) while they both practiced medicine full time. She recently wrote a memoir called "So Many Babies: My life Balancing a Busy Medical Career and Motherhood." Susan enjoys recounting some of her best, and worst, experiences of being a working mother, and how she managed to stay resilient. She shares with other working mothers many things she learned along her journey as a busy mother and successful doctor.She attended medical school at the Medical University of South Carolina in Charleston and completed her pediatrics residency at University of Texas Southwestern Medical School and Parkland Hospital in Dallas. She completed her neonatology fellowship at Texas Children's Hospital and Baylor College of Medicine in Houston. She has special expertise in breastfeeding medicine, and human donor breastmilk banking. She previously worked for the American Academy of Pediatrics as a leader in the Section on Breastfeeding Medicine. She currently is retired and lives in Austin, Tx.https://www.linkedin.com/in/susan-landersmd/https://www.instagram.com/drsusanlanders/https://www.facebook.com/drsusanlandershttps://twitter.com/susanlandersmdhttps://susanlandersmd.comSupport for Label Free Podcast is brought to you by ​MANSCAPED™​, who is the best in men's below-the-waist grooming.  ​ @MANSCAPED offers precision-engineered tools for your family jewels. They obsess over their technology developments to provide you the best tools for your grooming experience. MANSCAPED is trusted by over 2 million men worldwide! We have an exclusive offer for my listeners - 20% off + free shipping with the code: LabelFree20 at   https://www.manscaped.com​ As always thank you for the support, to contact me directly follow the link below: https://www.labelfreepodcast.com​ Stay Healthy, Stay Ready- Deanna Marie Kuempel #ad​​ #sponsor​ #publishedauthor #neonatal #ICU

Dr Yang is a Breast surgeon and IBCLC candidate.  As a Breastfeeding Medicine doctor she seems clients prenatally for education and support, lactating for assistance and also oncology patients as well.  While she is a traditionally trained surgeon, Dr Yang also understands and uses alternative methods when appropriate, such as recommending probiotics instead of antibiotics for mastitis.  Dr Yang is a part of MarinHealth.Podcast host: Katie Oshita, RN, BSN, IBCLC has over 22 years of experience working in Maternal-Infant Medicine. Katie is a telehealth lactation consultant believing that clients anywhere in the world deserve the best care possible for their needs. Being an expert on TOTs, Katie helps families everywhere navigate breastfeeding struggles, especially tongue tie and gut/allergy related issues. Email katie@cuddlesandmilk.com or www.cuddlesandmilk.com

Dr. Yvonne LeFort is a Canadian-trained Family Physician. Dr. LeFort has a special interest in Breastfeeding Medicine. Her passion for helping mothers and their infants, dates back to when she had her second son and was faced with feeding difficulties, which her medical colleagues were sympathetic of but knew little or nothing about. She decided after this experience to learn more about this neglected are of general practice training and to be there to help other dads who needed such knowledge and skill.She is a Fellow of the Academy of Breastfeeding Medicine – with over 1000 multi-disciplinary doctors from around the globe with a common interest in helping women achieve their breastfeeding goals. She is also an elected board member and an active member of this organisation. She has presented both nationally and internationally on issues related to Breastfeeding and established a RNZCGP Breastfeeding Medicine Peer Review Group with 12 current members from around the country. She runs a private Breastfeeding Clinic in Milford on Auckland's North Shore.In this episode, we discuss her journey into breastfeeding medicine, the differences between lactation consultancy and breastfeeding medicine, her own experiences with post-natal depression and breastfeeding, balancing her work with general practice and starting her own clinic. As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show (https://www.patreon.com/doctornos)

On today's podcast, to celebrate IBCLC Day, we're going to highlight and talk with IBCLC Nichelle Clark about supporting pumping parents in lactation. Nichelle Clark (she/her) is an International Board Certified Lactation Consultant, or IBCLC, wife, and mother of two residing in Chesapeake, Virginia. She is the owner of SonShine & Rainbows Lactation Services. Born and raised in Upper Marlboro, Maryland, Nichelle joined the United States Navy in 2010 and served honorably for 7.5 years. In 2020, she founded Black Breastfeeding 365, an organization that seeks to bridge the gap between Black parents and the lactation professionals who serve them. When she's not spending time with her husband and children, she serves as a United States Lactation Consultant Association, or USLCA, advisory board member, and Clinical Lactation Journal social media editor. In her spare time, she admins multiple online support groups for people of color, providing breastfeeding support and lactation education to her community. As an exclusive pumping mom herself, Nichelle is a champion for breastfeeding parents to write down their own rules and breastfeed their way. We talk about Nichelle's personal experience with being an exclusive pumping parent and the barriers she faced when advocating her choice to exclusively pump and re-lactate. We also talk about debunking pumping myths in lactation and how Nichelle serves parents of color in her community as an IBCLC to encourage making informed choices during one's lactation journey.  Content warning: We mention COVID, trauma, and infant loss. RESOURCES: Learn more about Nichelle Clark here. Follow Nichelle on Facebook and on Instagram.  Listen to EBB 189 here.  Learn more about the Academy of Breastfeeding Medicine here. Learn more about Black Breastfeeding Mamas Circle here. Learn more about Breast Milk Donation for Black Moms here. Learn more about Lactation Education Resources here. Learn more about the United States of Lactation Consultants Association (USLCA) here. Learn about the Black Birth Healer here. For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on Facebook (https://www.facebook.com/EvidenceBasedBirth/), Instagram (https://www.instagram.com/ebbirth/), and Pinterest (https://www.pinterest.com/ebbirth/). Ready to get involved? Check out our Professional membership (including scholarship options) (https://evidencebasedbirth.com/become-pro-member/). Find an EBB Instructor here (https://evidencebasedbirth.com/find-an-instructor-parents/), and click here (https://evidencebasedbirth.com/childbirth-class/) to learn more about the Evidence Based Birth® Childbirth Class.

Join us for a chat about breastfeeding, gathering your support team, what to expect early in postpartum, pumps, and more. Carrie and Sarah do not hold back! And they have their own upcoming podcast, the Boob Half Full Podcast. These ladies are so fun and incredibly informative.My top takeaway: Build your support system early! Find a lactation professional in your area while you're still pregnant so you have someone to call when you're in the thick of it.The Boob Half Full PodcastThe Boob Half Full Podcast is a collaboration between both Carrie and Sarah!bhfpodcast.comFacebook: https://www.facebook.com/boobhalffullInstagram: https://www.instagram.com/boob_half_full/Resources Carrie & Sarah mentionedPostpartum Support International:https://www.postpartum.netLa Leche League: https://www.llli.orgGlobal Health Media Project Videos: https://globalhealthmedia.orgKelly Mom: https://kellymom.comThe Academy of Breastfeeding Medicine: https://www.bfmed.org10% Happier meditation app (what Sarah uses): https://www.tenpercent.comBooks:The Breastfeeding AtlasThe Melanated Mammary Atlas: https://www.mmatlas.com/product- The Womanly Art of BreastfeedingFind Carrie HereMidwifery & Women's Health Care in Anchorage, AK: https://mwhcanchorage.comIn-clinic or virtual visits, you don't have to be a current client to make an appointment.Find Sarah HereJust Call Sarahhttps://www.907justcallsarah.comjustcallsarahak@gmail.com

Continue listening to the second installment of this Black History Month featured podcast, focusing on Black Health and Wellness. Your host is Lisa Akers (https://myunion.edu/member/lisa-akers-phd/), PhD, RDN, IBCLC, RLC, FAND. She is joined by lactation expert Dr. Kimarie Bugg, D.N.P., FNP-BC, M.P.H, IBCLC (https://myunion.edu/member/kimarie-bugg-dnp-fnp-bc-mph-ibclc/). Be sure to listen to the first part of this two-part series as you won't want to miss any of the discussion. Here are references/links to help you find more information: Asiodu, I. V., Bugg, K., & Palmquist, A. E. (2021). Achieving breastfeeding equity and justice in Black communities: past, present, and future. Breastfeeding Medicine, 16(6), 447-451. Bartick, M. C., Schwarz, E. B., Green, B. D., Jegier, B. J., Reinhold, A. G., Colaizy, T. T., ... & Stuebe, A. M. (2017). Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs. Maternal & child nutrition, 13(1), e12366. Merewood, A., Bugg, K., Burnham, L., Krane, K., Nickel, N., Broom, S., ... & Feldman-Winter, L. (2019). Addressing racial inequities in breastfeeding in the southern United States. Pediatrics, 143(2). https://maternalhealthlearning.org/

In this final Black History Month featured podcast, highlighting the 2022 theme of Black Health and Wellness, we will focus on maternal and infant health and the inequities that have plagued Black communities throughout history. Our guest is lactation expert and Union faculty member, Dr. Kimarie Bugg, D.N.P., FNP-BC, M.P.H, IBCLC (https://myunion.edu/member/kimarie-bugg-dnp-fnp-bc-mph-ibclc/). Dr. Bugg is President and CEO of Reaching Our Sisters Everywhere (ROSE), a national nonprofit created in 2011 to address breastfeeding inequities in the African American community, and a career perinatal and neonatal nurse professional. Dr. Bugg has spent nearly four decades working in the Atlanta Metropolitan area and nationally in mostly African American communities promoting perinatal health, breastfeeding, and community-based impact solutions. Dr. Bugg is joined by host Lisa Akers (https://myunion.edu/member/lisa-akers-phd/), PhD, RDN, IBCLC, RLC, FAND. Dr. Akers is currently the Program Chair for the Bachelor of Science in Maternal Child Health: Human Lactation, the Master of Arts in Health and Wellness, the Master of Arts in Human Lactation Studies, and the Master of Arts in Applied Nutrition and Dietetics Programs at Union Institute & University. Join us now for this timely and thought-provoking discussion. This is a two-part series, so be sure to listen to both segments (once available). Dr. Bugg mentions numerous articles and websites during this podcast. Here are references/links to help you find more information: Asiodu, I. V., Bugg, K., & Palmquist, A. E. (2021). Achieving breastfeeding equity and justice in Black communities: past, present, and future. Breastfeeding Medicine, 16(6), 447-451. Bartick, M. C., Schwarz, E. B., Green, B. D., Jegier, B. J., Reinhold, A. G., Colaizy, T. T., ... & Stuebe, A. M. (2017). Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs. Maternal & child nutrition, 13(1), e12366. Merewood, A., Bugg, K., Burnham, L., Krane, K., Nickel, N., Broom, S., ... & Feldman-Winter, L. (2019). Addressing racial inequities in breastfeeding in the southern United States. Pediatrics, 143(2). https://maternalhealthlearning.org/ 

Hoy, jueves 3 de febrero, celebramos el National Women Physicians Day en los EEUU. Es por esto que les quise traer este episodio especial donde les comparto una mirada hacia los retos de lactancia materna en la profesión médica. Muchos de estos retos también aplican a otras madres que trabajan fuera de su hogar. Pero lo cierto es que la presión social para nosotros los médicos es aún mayor, ya que la vida y la salud de otras personas también depende de nosotras. Me gustaría me contaras tu experiencia con alguna de estas barreras. Puedes contactarme por DM en Facebook o Instagram o al correo electrónico del podcast: info@latetada.com. Aquí les dejo mi Guía Rápida para Iniciar la Lactancia Artículos o recursos adicionales para madres lactantes médicos: Breastfeeding in Medicine: Time to Practice What We Preach Dr. Milk FB Group Academy of Breastfeeding Medicine

Insights into how we approach products marketed to assist in lactation and breastfeeding, ethics of discussing products, and a framework for helping parents make decisions about lactation products. Parents are being targeted with marketing of products purported to assist with or support breastfeeding and human milk feeding​ There is a growing need for lactation care providers to consider ethics in relation to lactation-related products and the promotion of chest/breastfeeding and human milk feeding In this episode of The Lactation Training Lab Podcast, we explore What is the relationship between ethics & devices? ​ Provider bias and knowledge of devices​ Inequities in clients' access to devices​ Difference between public teaching and direct care/counseling of an individual This episode makes reference to Protocol #32 from the Academy of Breastfeeding Medicine, which you can access here.  Questions or feedback Email LactationTrainingLabPodcast@gmail.com  or DM me on Instagram @IBCLCinCA

In celebration of National Breastfeeding Month, Dr. Julie Ware, a physician in the Center for Breastfeeding Medicine, joins us to discuss breastfeeding. In this episode, we talk about the highs and lows of a mother's breastfeeding journey, milk sharing, tips for new mothers, breastfeeding disparities, and so much more.   For additional resources and to learn more, please visit the Center for Breastfeeding and Medicine.    Learn more about World Breastfeeding Week, please visit World Alliance for Breastfeeding Action.  If you or someone you know has extra milk to donate, please visit Human Milk Banking Association of North America.  For additional information on All Moms Empowered to Nurse (AMEN), please visit: https://amencincy.org/   For additional breastfeeding resources, visit: US Breastfeeding Committee , American Academy of Pediatrics and Academy of Breastfeeding Medicine.  Ohio Statewide Breastfeeding Hotline: 1-888-588-3423 

Olympian sells silver medal to pay for infant's heart surgery; Judge rules against father who wants his son to be recognized as a boy; French research team overturns Darwin's view of the appendix; Paleontologists realize beetle fossil must have been buried rapidly; Evolutionary geologists try to make diamonds tell time; Another medical organization adopts science-denying language codes . . . and other stories reviewed during this August 23, 2021, broadcast of Answers News. - - - - - - - - - - - They made their hearts diamond-hard lest they should hear the law and the words that the Lord of hosts had sent by his Spirit through the former prophets. Therefore great anger came from the Lord of hosts. - - - - - - - - - - - Zechariah 7:12 Articles: Polish Olympian sold silver medal to raise money for infant's surgery https://nypost.com/2021/08/18/olympian-maria-andrejczyk-sold-medal-to-fund-infants-surgery/ Court awards full custody to James Younger's Mother, but requires permission for puberty blockers, gender surgery https://www.nationalreview.com/news/court-awards-full-custody-to-james-youngers-mother-but-requires-permission-for-puberty-blockers-gender-surgeries/ The appendix is thought to increase life expectancy according to French study https://www.gilmorehealth.com/the-appendix-is-thought-to-increase-life-expectancy-according-to-french-study/ 49 million-year-old beetle looks like it was squashed yesterday https://www.livescience.com/attenborough-beauty-beetle-fossil.html Ugly Diamonds Hold a Billion-Plus Years of Earth History https://www.scientificamerican.com/article/ugly-diamonds-hold-a-billion-plus-years-of-earth-history/ Not satire: The Academy of Breastfeeding Medicine just one-upped the term "birthing person" with "human milk-feeding individual" https://notthebee.com/article/uh-what-the-academy-of-breastfeeding-medicine-goes-woke-with-new-official-terms-like-chestfeeding-lactating-person-and-human-milk-feeding-individuals Rare ancient baby turtle identified inside fossil egg https://www.cbc.ca/news/science/nanhsiungchelyid-fossil-egg-embryo-1.6144051 This person says she doesn't "identify as human" and I have some serious questions https://notthebee.com/article/this-person-says-she-doesnt-identify-as-human-and-i-have-some-serious-questions - - - - - - - - - - - Photo by Evie S. https://unsplash.com/photos/dcniOOqByj0 --- Send in a voice message: https://anchor.fm/answerstv/message Support this podcast: https://anchor.fm/answerstv/support

Time for another round of Scott's Thoughts! I have thoughts about the Afghanistan situation, but we'll save that for the final topic. 1:24 - Starting off, Fox News reports that the Academy of Breastfeeding Medicine has released a statement changing common known terminology to more gender-inclusive words. Think ‘chest feeding' instead of ‘breastfeeding.' Now, as we dive into it we learn that as usual, Fox News is going overboard with their reporting (the Academy was simply stating that they have new gender-inclusive terminology that CAN be used in the correct situation). That being said, the fact that this is even news really makes me weary of where our money toward medicine is going. Is this really where our dollars need to be spent? Did you even know the Academy of Breastfeeding Medicine existed? 14:29 - THE HBCU's (Historically Black College) of the nation are erasing student debt. While it IS important to help the minorities of the nation, I find it a tough pill to swallow that ANY college debt is being ‘forgiven' or erased. It's even tougher when the decision on who receives these benefits is based on ANYTHING other than the education they received or their contributions to society. No matter who you are, if you are given free money, you're gonna take it. Taking it a step further, where is the money coming from? Wait for it…….the Cares Act! The act that is supposed to help us with Coronavirus relief! This is not for hospitals, or science, or businesses that lost money, but for student debt. This is why so many people had problems with the rushed relief bills, there was SO MUCH MORE SPENDING that had nothing to do with the Coronavirus hidden in it! So much has nothing to do with Covid-19! 26:24 - A ton of people have been asking for my opinion on the Afghanistan situation, and it was really hard to sum up in a Facebook post so I wanted that to be the focal point of this podcast. I was in the Army before the war began, and therefore I have a bunch of friends who have first hand experience dealing with the situation. 34:31 - Let's start by checking out Biden's interview with ABC News specifically about the withdrawal, and my thoughts on that. I will say that it's super frustrating but you'll need to watch to hear my thoughts. 46:25 - We play one more clip from Podcaster Megyn Kelly and I share my thoughts on this as well. ------------ New Full Episodes are released every THURSDAY at 10:00am and clips are released frequently throughout the week. ------------- Thank you for checking out the Podcast. We're building our community AS WE SPEAK and would love it if you checked us out in one of our communities: On The Edge Podcast Community & Facebook Group on Facebook: https://www.facebook.com/groups/ontheedgepodcast/ On The Edge Podcast Page on Facebook: https://www.facebook.com/MeetScottGroves On The Edge Podcast on Locals: https://reddotbluestate.locals.com/ ------------ www.OnTheEdgePodcast.com ------------

It's finally Friday and topics tackled today include...The Taliban have gained control of large sections of Afganistan faster than almost anyone expected, meanwhile, the Pentagon is dispatching troops to assist in evacuating staff from American Embassy in Kabul.; San Antonio City Manager Erik Walsh during the city's Covid-19 update said all 39 of the city's available EMS units were in use for 26 minutes due to a surge in 911 calls.; Academy of Breastfeeding Medicine is now affirming its commitment to gender equality and health equity providing guidelines on infant feeding and lactation-related language.; On the JR poll, "Are you superstitious about Friday the 13th?" And its finally Friday and another serving of "The Dish" is hot and fresh served on your TV tray.

Dr. Lauren Macaluso is a board certified pediatrician and lactation consultant with a breastfeeding medicine private practice. She provides specialized medical care for breastfeeding mothers and their children. She is proud to have a medical practice where a mother can get her and her baby's breastfeeding needs met in one place. She attended Cornell University for her undergraduate studies and was an All Ivy field hockey player. She received her medical degree from Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia and completed her pediatric residency at Children's National Medical Center of George Washington University in Washington, D.C. Her special interest in breastfeeding started after nursing her own two children while working part-time with medical students and residents in the newborn nursery. She identified a need for breastfeeding focused care and started her practice in 2006. Dr. Macaluso is a fellow of the Academy of Breastfeeding Medicine, Fellow of the American Academy of Pediatrics, and the American Academy of Pediatrics New York Chapter 2 Co- Breastfeeding Coordinator.  She is a partner in Allied Physicians Group, the largest private medical partnership in the New York Metropolitan area. Join us Thursday nights at 8 PM EST on Instagram live @jowma_org for our latest podcast discussions!!

In the fourth episode of the series. Dr. Beckford interviews Dr. Berens in the Docs Who Care series and shares tips for new moms! You don't want to miss this if you:

What is a lactation consultant and how can they help the UC patient?  Dr Katie Fourie, a GP and Board Certified Lactation Consultant introduces us to this area of medicine and encourages us to consider the services of a lactation consultant for our breastfed and breastfeeding patients.      - Academy of Breastfeeding Medicine: https://www.bfmed.org/  - International Board of Lactation Consultant Examiners: https://iblce.org/  - New Zealand Lactation Consultant's Association directory: https://www.nzlca.org.nz/find-a-lactation-consultant  - La Leche League New Zealand: https://lalecheleague.org.nz/     www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor

If you'd like to support our podcast, you can find us on Patreon at patreon.com/milkminutepodcast.Thank you to our sponsors, Heather and Maureen! We're your hosts and we both run side businesses that focus on breastfeeding.Maureen creates for and runs the Esty shop The Wandering Wombetsy.com/shop/thewanderingwom6Heather owns and operates Breastfeeding for Busy Momsbreastfeedingforbusymoms.comTable of Contents0:40 Bonus episode: discussing the vaccine, for lactating people1:15 We read one (of many!) listener questions1:35 Thank you to our sponsor The Wandering Womb2:20 The listener question3:05 Thank you to our sponsor Breastfeeding for Busy Moms3:55 Vaccine approval: where we're at right now5:05 Previously, approved in UK and Canada5:15 UK and Canada guidelines, if lactating and pregnant6:00 CDC guidelines are similar (and why)6:40 No vaccine data for lactating and pregnant people (and why)7:25 Collecting vaccine data, touching on the topic8:45 Physiology and risks for lactating (vs.) pregnant people10:00 Academy of Breastfeeding Medicine statement (helpful!)11:26 Details about vaccine, you, and baby11:40 This is an MRNA vaccine, not new technology12:15 The vaccine journey in a lactating person14:43 Four barriers to breastfeeding baby: recap15:44 Possible risks, possible benefits17:20 Most other vaccines are approved for lactation17:55 The choice is always yours18:11 Why this vaccine is a big deal19:05 Addressing MRNA technology20:00 Fear of forced vaccination, please don't panic21:15 Places you can do your own research22:27 Baby in utero vs. breastfeeding baby: very different!24:00 Pregnancy and vaccine vs. pregnancy and getting sick: risk considerations25:00 What can we look forward to with this vaccine27:11 A step in the right direction27:47 This is science in real time28:30 Thank you for listening!ResourcesCredits and contactThanks to Cherie Louise Turner for editing and production and to Lindsay Brett Carothers for her musical stylings of our intro and outro.Cherie's podcast about female ultrarunners is Strides Forward: stridesforwardpodcast.comAdditional music credits, thank you Wataboi and Mazzaccaro from Pixabay.Thanks for listening to The Milk Minute. If you haven't already please like, subscribe, and review our podcast wherever you listen.To send us feedback, personal stories, or just to chat you can send us an email at milkminutepodcast@gmail.comSupport the show (https://www.patreon.com/milkminutepodcast)

En este episodio hablamos de la muerte subita del lactante, pero mas que eso hablamos de como disminuir el riesgo en tu bebé dandote las recomendaciones de la campaña "back to Sleep" de la Academia Americana de Pediatria, además te damos las recomendaciones del 2020 de la Academy of Breastfeeding Medicine del Colecho Seguro

Doing Good is a lively and engaging podcast conversation with people who are actively engaged in projects in their communities that are Doing Good. Twice a month, join Josh Smith, local news anchor and Rebecca Powers, MD, pediatrician and owner at Village Pediatrics and Breastfeeding Medicine as we talk with interesting guests who share what sparked them to make positive changes and how they overcame the fear and inertia that keep others from tackling problems they see in their communities. And you won't want to miss the insight into the teen mind provided by their oldest offspring Elijah Smith and Susanna Digby both 16, and their impression of what Doing Good looks like to the next generation of Do Gooders. We look forward to learning and growing with you to make all of our communities safer, healthier and happier! Doing Good is a proud member of the Market Street Media family of podcasts, along with: Better Every Day with Brad Weems I See You, Mama: A Maternal Mental Health Podcast with Kristina Dulaney Marketing That Works with Drew Bedard Johnson City Living with Leighton Hart Measure Once, Cuss Twice with Seth Thomas The Johnson City Small Business Podcast with Ryan McKinney One Conversation at a Time with Kelly Rhea Barber College Success with Craig Charles The Huddle with Spencer Huddleston and Brad Weems Allpointswhole with Krista Wright

Today on Extraordinary Women Radio, I'm excited to bring you this extraordinary woman - Dr. Marianne Neifert aka Dr. Mom, Pediatrician and Nationally Recognized Expert on Breastfeeding. Marianne is another 2020 Inductee to the Colorado Women's Hall of Fame. In this episode, Marianne shares her story of how she developed the US model of comprehensive lactation services and founded the Mothers’ Milk Bank. Marianne has built a lifetime career raising her voice to make an impact with her work and her voice. Marianne Neifert, MD, MTS, FAAP—aka Dr. Mom--is a pediatrician and nationally recognized expert in lactation management, who has long provided breastfeeding education for diverse health professionals nationwide. She is a graduate of the University of Colorado School of Medicine and completed her pediatric residency training at the University of Colorado Medical Center and Affiliated Hospitals. Dr. Neifert is the managing member of Dr. Mom Presentations LLC and is a clinical professor of pediatrics at the University of Colorado Denver School of Medicine. A long-time leader in the field of breastfeeding medicine, Dr. Neifert co-founded in 1985 the first US model of comprehensive lactation services, which today have become a standard component of optimal hospital maternity care. Dr. Neifert is a founding member of the Academy of Breastfeeding Medicine; co-founder of the Denver Mothers’ Milk Bank and Colorado Breastfeeding Coalition; founder and longtime moderator/facilitator of Colorado Lactation Journal Club; and Advisory Committee Member of Colorado’s Baby-Friendly Hospital Collaborative. She has published numerous articles in the medical literature on breastfeeding and lactation management, and addressed audiences in all 50 states and internationally. In addition, Dr. Mom has authored five parenting books (including two on breastfeeding), contributed hundreds of magazine articles on children’s health and behavior, and been a guest expert on countless radio shows and numerous national television programs. “It is important to use our signature strengths and to use them in service to something greater than yourself.” - Dr. Marianne Neifert Discover more about Dr. Marianne's works and passion on her website here: Dr. Mom. You can also follow her on Facebook and connect with her on LinkedIn. Let’s meet Dr. Marianne Neifert! Dr. Marianne Neifert Show Notes *** The Colorado Women’s Hall of Fame mission is to inspire by celebrating and sharing the enduring contributions of Colorado’s distinctive women. To achieve this, the Hall educates the people of Colorado about the stories of the women who shaped our state and the nation’s history with courage, leadership, intelligence, compassion, and creativity. Their talents, skills, struggles, and contributions form a legacy that the Colorado Women’s Hall of Fame is dedicated to protecting. I invite you to join us at the March 18, 2020 Colorado Women’s Hall of Fame 2020 Inductee Gala by purchasing your ticket here. Watch for five additional interviews in the coming months of the 2020 Inductee Hall of Famers: Katherine Archuleta – LISTEN TO HER INTERVIEW Archuleta was appointed as the first Latina to lead the U.S. Office of Personnel Management in in 2013 by President Barack Obama, overseeing a budget of roughly $250 million and managing human resources for the federal government’s 2 million employees. Archuleta also served as chief of staff for U.S. Secretary of Labor Hilda Solis and Secretary of Transportation Federico Peña, where she strived toward justice and equality through her direct influence on policy at the state and national level. Lupe Briseño LISTEN TO HER INTERVIEW Briseño made waves within Colorado’s Labor Movement after organizing the Kitayama Carnation Strike—the women-led social movement in 1969 at the Kitamaya floral plant in Brighton, which centered on demands for worker’s rights, especially in regard to the treatment of female workers.

Zaiba and Uzma review how they fed their babies, what led to those decisions, and the social backlash they received for their choices. What’s normal, what’s real, and what’s the Islamic perspective on our Muslim American boobs and bottles?Links: Find Senators up for re-election in 2020: https://www.270towin.com/2020-senate-election/Breastfeeding duration recommendations: https://www.nichd.nih.gov/health/topics/breastfeeding/conditioninfo/recommendationsLa Leche League on Muslim perspectives on Breastfeeding: https://www.llli.org/islamic-cultural-practices-breastfeeding-2/Academy of Breastfeeding Medicine on Infant Supplementation: https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/3-supplementation-protocol-english.pdfWeb: mommyingwhilemuslim.comEmail: mommyingwhilemuslim@gmail.com FB: Mommying While MuslimsIG: @mommyingwhilemuslimpodcast

Breast-feeding mastitis is a common occurrence and a source of disruption of breast-feeding and negatively affects quality-of-life. In this session, we will review the Academy of Breastfeeding Medicine’s treatment protocol for the condition. When is abscess identification required? What about drainage? We will answer these questions and more in this episode!

Mamas who spend time in the NICU know there is an intense focus on collecting and providing breastmilk for infant patients. On this episode of With You in the NICU, host (and former pumper) Jenna Morton talks with Dr. Rebecca Hoban about why human milk is so important for preemies and other NICU patients, as well as tackling some of the challenges moms face in producing and pumping. Dr. Rebecca Hoban is a neonatologist and Assistant Professor of Paediatrics at the University of Toronto. She is the Director of Breastfeeding Medicine at Toronto's Hospital for Sick Children. With You in the NICU is a podcast for those that care for infants in a neonatal intensive care unit. The discussions are geared toward parents of preemies, but will resonate with anyone spending time beside a NICU isolette. With You in the NICU is a project of the Canadian Premature Babies Foundation, with funding from presenting sponsor Medela and support from AbbVie and Prolacta. The podcast's host and producer is Jenna Morton; technical producer is Tosh Taylor.

Хөхөөр хоолллох нь нярайн авах ёстой шим тэжээлийг бүрэн хангаад зогсохгүй эх үрийн холбоог нягтруулж, бие ба сэтгэхүйн эрүүл мэнд, эдийн засгийн хувьд асар их үр ашигтай нь хэдийнээ тодорхой болсон билээ. Харин эмнэлгийн ажилтнуудад сургалт явуулсанаар хөхөөр хооллолтыг нийтээр нь нэмэгдүүлж чадах уу? Дэлгэрэнгүйг: Balogun, O. O., Dagvadorj, A., Yourkavitch, J., da Silva Lopes, K., Suto, M., Takemoto, Y., ... & Ota, E. (2017). Health Facility Staff Training for Improving Breastfeeding Outcome: A Systematic Review for Step 2 of the Baby-Friendly Hospital Initiative. Breastfeeding Medicine, 12(9), 537-546.

Хөхөөр хоолллох нь нярайн авах ёстой шим тэжээлийг бүрэн хангаад зогсохгүй эх үрийн холбоог нягтруулж, бие ба сэтгэхүйн эрүүл мэнд, эдийн засгийн хувьд асар их үр ашигтай нь хэдийнээ тодорхой болсон билээ. Харин эмнэлгийн ажилтнуудад сургалт явуулсанаар хөхөөр хооллолтыг нийтээр нь нэмэгдүүлж чадах уу? Дэлгэрэнгүйг: Balogun, O. O., Dagvadorj, A., Yourkavitch, J., da Silva Lopes, K., Suto, M., Takemoto, Y., ... & Ota, E. (2017). Health Facility Staff Training for Improving Breastfeeding Outcome: A Systematic Review for Step 2 of the Baby-Friendly Hospital Initiative. Breastfeeding Medicine, 12(9), 537-546.

Session 50 Dr. Kristina Lehman is a Med-Peds doc who specializes in Breastfeeding Medicine, helping new moms and new babies through the struggles of breastfeeding. Check out all our other podcasts on MedEd Media. If you're a med student and you want to be prepared for what's coming, we have a boards podcast coming up for Step 1 and probably Step 2 in the future. Back to today's episode, Breastfeeding Medicine is one of those fields that really gets down into a "super" niche which is pretty awesome. Kristina is a Med-Peds doc who has taken some further specialty training being a breastfeeding physician. While the breastfeeding side of her practice only comprises about 25%, still this is worthwhile to talk about as a stand alone podcast. This will give you the information you need if this is something you're interested in. Out of training now for about ten years, Kristina is practicing in an academic setting. [02:13] Her Initial Interest in Breastfeeding Kristina's interest in breastfeeding sparked when she had her first child. She always knew she would breastfeed and when she had her baby, she thought she had no idea what she was doing. So she began researching until she just grew more passionate about it. But the turning point for her was when she discovered the Dr.MILK group, a breastfeeding group. MILK stands for Mothers Interested in Lactation Knowledge. She realized there were people out there who actually are pediatricians and lactation consultants. Before this, her training focus was in internal medicine and pediatrics. She did a med-peds residency. Coming out of it, she wanted to do primary care and she started in an academic setting. She joined the faculty at where she trained to do Med-Peds Primary Care. [04:00] Lack of Coverage on Breastfeeding During Pediatric Rotations Kristina explains that a lot of times, experiential learning comes down from our attendings. Because doctors don't do a great job at breastfeeding, they're not likely to advise their patients well, too. To add to that, there is a lot of formula marketing in pediatric residency. A lot of the AAP stuff is sponsored by these companies. "We know that doctors don't necessarily do a great job breastfeeding themselves. And that when they don't do a great job, they don't advise their patients very well." That said, AAP now has a curriculum where they recommend breastfeeding but still it's not widespread. Also, there are a lot of issues with breastfeeding in terms of other specialties telling that infectious disease antibiotics are not compatible with breastfeeding. So when a mom has a complication, she has to stop breastfeeding or pump and dump. Kristina thinks doctors should just really go back to medical school. [05:40] Traits that Lead to Being a Good Breastfeeding Medicine Doc Kristina cites the primary things to be a good breastfeeding doc are wanting continuity of care, being a good listener, and wanting to know what's going on. Kristina says the need to integrate and see what's happening to both the baby and the mom. Think about what's going to be best for both of them. "You can sit there and talk about what's really important for the baby but then that can lead mom to the wayside." Kristina adds having good problem solving skills is helpful. More importantly, you have to be interested in women and women's health. You shouldn't be afraid of breasts since the breasts are a big part of the practice. She admits there are people that are actually scared of that a lot of times. Kristina says that are male lactation consultants. It's obviously a female-dominated field. But if you're a guy and you're super interested in helping women then it's like male OB/GYNs. There are a lot of women that see male OB/GYN and they have a good reputation. [07:37] Other Specialties that Caught Her Interest Before going to Med-Peds, Kristina was interested in OB/GYN. She loved prenatal visits and all the outpatient stuff that goes with it. She hated surgery and being up at night. So she realized quickly that it wasn't the right specialty for her. That said, she has always been interested in the women's health aspect of things. Within primary care, she was happy just to do straight up primary care. She loves the variety of seeing both kids and adults. And when she found Breastfeeding Medicine, she was happy she had the opportunity to focus on the academics. She was happy she could get to work on it with medical students and residents. She had the opportunity to work on curriculum development. [08:30] Types of Patients and Taking Calls On a daily basis, she deals with regular breastfeeding stuff. She's able to give more evidence-based information and more support for the day-to-day latch and milk supply. When she has a more specialized referral, she gets varied cases. For example, a baby that hasn't latched since birth. Or it could be a baby that was in the NICU so he/she was formula-fed so they have a hard time getting back to the breasts. Sometimes too, moms are having a hard time with milk supply so she helps them troubleshoot how to make this better. Although there are really moms that have insufficient glandular tissue which never developed from puberty so there isn't enough milk supply. She also deals with other issues like cracked and bleeding nipples or mastitis. "Most of the stuff is just the day-to-day maintenance of breastfeeding that moms just need a lot of support." Kristina doesn't do any of the inpatient stuff such as taking calls. But she wishes sometimes though that there was somebody on call. They recently had a mom that had a wound infection. She was in the hospital and got switched around in antibiotics, specifically Cipro. The doctors on the service talked to the pharmacist and the pharmacist said it wasn't okay to breastfeed with it. They told the mom that she had to pump and dump. And so for ten days, she had to pump and dump. Then the mom came to her a bit later. But they would have been able to take care of that early on. She didn't actually need to pump and dump since there was no indication for that. Moreover, mastitis would be an urgent thing but not necessarily too urgent for you to really drive to the hospital just to see it. [11:10] Erring on the Side of Safety Kristina explains there's a lot of stuff that says benefits outweighs risks. But very few places actually consider a mom's plasma level and what level gets into the breastmilk. Therefore, how much is the baby ingesting and how much of that ingested amount would the baby absorb into their bloodstream? There is the infinite risk center run by a pharmacologist that has gone through all this. But doctors prefer to err on the side of safety. But Kristina points out there is more risk of clogged ducts and mastitis if you're pumping. Throwing milk away is just heartbreaking too. There is also the risk of that formula to the baby if the baby is formula-fed. "Basically, nobody feels comfortable with the information that is out there saying it's okay to breastfeed." [12:37] Work-Life Balance Kristina describes having a good work-life balance. Her husband is also a hospitalist in internal medicine. So financially, they're in a good spot but they're also busy. They have two kids. She started full-time and as they're having kids, she has worked herself down to 50%. Currently, she's working herself back up with some nursery work. Nevertheless, this has allowed her to have some good work-life balance. Similar to primary care, you're not on call and you're not going to the hospital necessarily. It's mostly an office-based work. [13:24] What It Takes to Become an IBCLC Kristina notes that to become an International Board Certified Lactation Consultant (IBCLC), there is an international exam that anyone can take. But there are different pathways depending on your background. The nurse or a doctor has a different pathway than a lay person off the street that wants to get it. It requires some health and science background classes. As a doctor. you have to do 90 hours of lactation coursework. And you have to have a thousand clinical hours. Fortunately, those aren't supervised. So if a OB/GYN wants to become an IBCLC, they can use the time they talked for prenatal and postnatal counseling. Their hospital rounds can count too if they took care of mastitis or if they've worked with support groups. All those hours can add up. Once you have those hours, you take the exam and then you're given this gold standard of certification. You're reputable and the community is having that level of knowledge and experience. Another program is the Healthy Children Project, the certified lactation counselor. And this is how Kristina actually got her start. She did a 40-hour course. You do an exam and then do a little certification. "Technically, anybody can do it. It's just having that evidence-based information. Make sure you're learning the right stuff." There's also the Academy of Breastfeeding Medicine that has the fellowship track where you get an FABM designation. They're also working on a more clinical-based fellowship in the future. Kristina also adds getting knowledge from mentorship and working other people and getting those other certifications.When it comes to billing, Kristina bills not as a lactation consultant but as a physician. [16:20] Working with Primary Care and Other Specialties Again, Kristina recommends making sure that what you know is evidence-based. See if there's somebody in your area that is more specialized. See if they're listed on the Academy of Breastfeeding Medicine's website or there's a doctor in town that's IBCLC. This way, you know who to refer to if you're having issues. Secondly, it's nice to reach out to them and talk about it especially if you have any questions. "Search out that extra bit of training so you can be the best resource for your patients possible." Other specialties she's working with are ENT and Peds in Dentistry. Kristina says it's nice being trained both in internal medicine and pediatrics since she's self-sustaining. She can take care of the mom and the baby. But if you're a pediatrician and doing breastfeeding medicine, you'd probably be working with internal medicine or OB counterpart to help you with some of the mom stuff. Conversely if you're an OB/GYN, you'd have to work closely with pediatricians to take care of the peds stuff. Other special opportunities outside of clinical medicine would be academia and research. They sponsored fourth year medical students to do some pre-residency lactation work. She also worked on the curriculum development for the interns in the pediatric residency. She does nursery rounds so she does teaching there. Research-wise, there are a lot of opportunities in terms of curriculum and teaching development and the biochemical science behind breastfeeding. [18:55] The Most and Least Liked Things About Breastfeeding Medicine Kristina has been so enriched with the experience personally that bringing it on to other moms is helpful. She likes the fourth trimester concept when they help moms realize that those first couple of months of motherhood are really overwhelming and exhausting. So being able to support moms through that is enriching for her. She likes watching those kids grow and develop and the parents become parents and learning the parenting kinds of things. "For me, the biggest things is helping those moms meet their goals and raise cool kids." On the flip side, she finds it frustrating how little other people understand about the field. When people do or say things along with their lack of knowledge can affect how they take care of patients. [20:17] Major Changes in Breastfeeding Medicine Kristina hopes they can get a more dedicated fellowship or clinical track for this niche. We are in the day and time when breastfeeding is becoming more than the norm. So moms are initiating a lot more and are being more successful. Along with that, we see more moms struggling or having issues that need the support. Unfortunately, Kristina admits the lack of infrastructure for them at this point in time. Things have definitely been a lot better. But she hopes to continue to see more changes with that like paternity leave for instance. [21:20] Breastfeeding versus Formula-Feeding Kristina points out that it's important to let moms know that there are going to be challenges and they need that support system. So find that support system and make sure you know what your resources are. She often tells parents to never give up on their worst days. Reach out for help when you need it. "I often tell parents too, never give up on your worst day. You're going to have bad days. You're going to have bad moments." Breastfeeding also has a lot of health benefits for moms that we don't usually look at. It actually reduces the risk of breast cancer, diabetes, heart disease, hypertension, multiple sclerosis, etc. So there are lots of benefits for moms as well. So there should also be a focus not just on the baby but also on moms. [22:35] Final Words of Wisdom If this is something you're interested in, Kristina recommends checking out the Academy of Breastfeeding Medicine. They have a great website with a lot of great protocols there which are evidence-based. If you're a woman and interested in this, look up Dr.MILK group. They have over 10,000 members on Facebook. They welcome even those who are not breastfeeding but just want to learn more about breastfeeding. Lastly, be open to the fact that you may not get a lot of training about this but it's super important and there are opportunities out there to learn more. Do you have any ideas for specialties or if you know any physician whom you think would be great guest on this podcast, shoot me an email at ryan@medicalschoolhq.net. Links: MedEd Media Dr.MILK IBCLC Healthy Children Project Academy of Breastfeeding Medicine

Dr. Sheila Gephart. Photo courtesy of Dr. Sheila Gephart. Episode 8 features Dr. Sheila Gephart, neonatal nurse scientist and assistant professor at the University of Arizona College of Nursing. During this episode, Dr. Gephart provides a comprehensive overview of GutCheckNEC, a first-of-its-kind, 10-item risk assessment that she developed for the early detection of NEC in premature infants. She discusses: * Her transition from bedside nurse in the neonatal intensive care unit to her development of GutCheckNEC—what she calls a “real-time, early warning score for NEC,”* The 10 risk factors that make up GutCheckNEC, their associated symptoms, and how risk is communicated,* The development of NEC Zero, an intervention that has evolved out of the Unit NEC rate component of GutCheckNEC,* The strength of evidence for the use of probiotics in the prevention of NEC, and* The importance of shared decision making in the NICU. Copyright © 2015 The Morgan Leary Vaughan Fund, Inc. This episode was produced in part by the TeacherCast Educational Broadcasting Network. [powerpress] STEPHANIE VAUGHAN, HOST: Welcome to Episode 8 of Speaking of NEC—a free, audio podcast series about Necrotizing Enterocolitis. Produced by The Morgan Leary Vaughan Fund, and funded by The Petit Family Foundation, Speaking of NEC is a series of one-on-one conversations with relevant NEC experts—neonatologists, clinicians and researchers—that highlights current prevention, diagnosis, and treatment strategies for NEC, and the search for a cure. For more information about this podcast series or The Morgan Leary Vaughan Fund, visit our website at morgansfund.org. Hello, my name is Stephanie Vaughan. Welcome to the show. I’m the Co-founder and President of The Morgan Leary Vaughan Fund. Today, my guest will be Dr. Sheila Gephart, neonatal nurse scientist and assistant professor at the University of Arizona College of Nursing, who developed a first-of-its-kind, 10-item risk assessment for the early detection of NEC in premature infants called GutCheckNEC. During our conversation, she will discuss in varying degrees: Her transition from bedside nurse in the neonatal intensive care unit to her development of GutCheckNEC—what she calls a “real-time, early warning score for NEC,” The 10 risk factors that make up the acronym GutCheck and their associated symptoms How risk is communicated, The significance of the Unit NEC rate component in GutCheckNEC, and how that led her to develop the NEC Zero Intervention, The strength of evidence for the use of probiotics in the prevention of NEC, and The importance of shared decision making in the NICU. With that in mind, let me introduce my guest today. Hi, welcome to the show. This is my guest, Dr. Sheila Gephart. She is a neonatal nurse scientist from the University of Arizona College of Nursing. Hi, Sheila, how are you? DR. SHEILA GEPHART, GUEST: Good, thank you, Stephanie! STEPHANIE: Thank you! So, we have had more than one person mention you on our show in previous episodes, so I’m thrilled to have you join me today and would love to let you talk a little bit about your background and how you got involved with Necrotizing Enterocolitis. DR. GEPHART: Well, I am very thankful to be asked to be on the broadcast today, and I will tell you that I started my interest in Necrotizing Enterocolitis risk understanding when I was a bedside nurse. I have been a nurse since 1997, and I worked in the neonatal intensive care unit as a bedside nurse taking care of babies, and many of them were really convalescing. They were doing well, but then we had a subset of babies, or a clump of babies, that all developed this horrible disease within about three weeks. And now I know the clustering of NEC is very common, or not common, but it does happen. STEPHANIE: Right. DR. GEPHART: But then I didn’t really understand a whole lot about the disease, but I was very concerned because I realized that we had been concerned about these babies, as nurses, for hours to days before the actual diagnosis of NEC was made. So what happened at that point was I had the role of getting into the data for our NICU. I collected the data and reported the data for a large registry called the Vermont Oxford Network. And so I was focused on looking at the baby’s case and looking at the research and looking at the data, and I realized that there was a constellation of risk factors that kind of coalesced for these kids, that all of these things seemed to snowball with these babies who developed NEC, and we really had no context for talking to physicians to communicate why we were concerned. We were using terms like something’s not right with this baby, and from there, it really launched me into the next five years of understanding more about NEC risk. STEPHANIE: Okay. And can you talk to me a little bit about the protocol – I think it’s a protocol -- that you’ve developed called GutCheckNEC and how you got from starting to look at the data to compiling and understanding this set of risk factors? DR. GEPHART: Sure, I’m happy to talk about GutCheckNEC. So, being a bedside nurse, sometimes I would work in the middle of the night, and I needed a strategy for putting things together so I could remember them. And when I thought about NEC, I thought about well, we just need to check the gut. So GutCheck was kind of how it organized these risk factors, and I wrote GutCheck in a line straight down, and I remember one day I was at a delivery, and it was about three in the morning and it was taking a while for the baby to be born. And I was trying to understand all of the research that I had been reading about NEC risk and so what I did was I write GutCheck straight down on a napkin and horizontally for each letter I wrote the risk factor that was associated with that letter, and so that helped me organize what I was reading in the literature. But really it started out as just wanting to develop a risk assessment so nurses could really know what the risk factors were, physicians could know what the risk factors were, but then also put the symptoms in the context of what was going on with the baby. So that’s where I started, but then I went into a Ph.D. program, and in science you have to be very systematic. And so my literature review was the systematic beginning. But then what I did was I asked neonatal NEC experts how relevant they thought the different risk factors were to actually developing NEC. So I asked them to rate the relevance, and we went through three rounds of surveys to determine if we had the right list of risk factors, so that was very useful. We got rid of some, we kept most of them and added a few. And then, the next step was I got a very large dataset from a group of neonatal practices here in the US called The Pediatrics Medical Group, and I built, this is research speak, but I will tell you that I threw all of the risk factors into a statistical model to see what fell out as the most important, and the way statistical models work is that they keep the most important things that account for most of the explanation for what you’re looking at, and they get rid of everything that’s not quite so important. STEPHANIE: Okay. DR. GEPHART: So we went from like 33 risk factors down to essentially ten risk factors for GutCheckNEC. And then we tested it to see if it actually discriminated or told the difference between the kids that got NEC and the ones who didn’t, and it showed pretty good discrimination, or separation of groups, for the kids who had the most severe NEC compared to those who didn’t get NEC at all. STEPHANIE: Okay. DR. GEPHART: So that was the work we did, and now we’re taking this ten item tool and we’re trying to combine it with clinical science so that we can really have a real time early warning score for NEC. STEPHANIE: Great. Can you sort of go down the list just for parents that might be listening or family members if they’re seeing any of these risk factors? DR. GEPHART: Sure, I’d be happy to do that. The items that we kept in GutCheckNEC, like I said, there are two versions. There’s the one before the statistical modeling and then there is the one after, and the one that’s before is actually more comprehensive. And if you think about just writing GutCheck down linearly, you think for G, you’ve got growth restricted, so they’re born really small for gestational age, you’ve got gestational age. Those are the main ones that I always thought of with the G. And then with U, the one item that the experts recommended adding was the unit NEC rate, because infants who are in units with high NEC rates are more likely to get NEC, and so I didn’t understand that finding. I’ll talk about that in a minute, about the unit NEC rate. T, if you talk about T, transfusion. There is an association that we see in lots of studies with transfusion and NEC. We don’t see any evidence of causation, but the studies aren’t designed to show us that, so there is a temporal relationship or a time based relationship between transfusion and the most severe NEC. That said, there is a lot of babies who get transfusions and don’t get NEC. So that’s what makes it hard. STEPHANIE: Right. DR. GEPHART: What else goes with T? I’m going to stick to the final version, okay, as we think through the acronym. And then for C, signs of infection, so chorioamnionitis is when mom has a really bad uterine infection prior to the baby being born. Some preterm moms have this because—we don’t know exactly why they have this, but chorioamnionitis, particularly if it’s invasive, if it’s really severe, that is a risk factor. Also cardiac kids are going to be more at risk, so if you think of the C, kids who have had heart disease or heart malformations, particularly those that are low oxygenation kinds of defects… STEPHANIE: Right. DR. GEPHART: ..and there are some more for C but I don’t recall exactly what those were right now, but I’m just going to stick—oh, culture proven infection. That also goes with C. So if babies have had sepsis, particularly more than once, which sometimes these really early babies do get multiple bouts of infection, that is a risk factor. So that stayed in my model long term. Enteral feeding is definitely a risk factor that all babies are hopefully exposed to because we want them to be fed. That I understand a lot more now about the details of enteral feeding, and that particularly if the enteral feeding is formula, that is very important. We know formula is a high risk factor. There is a whole slew of argument about cow’s milk based fortifiers that go with that as well, so there is some argument about how extensive of a risk factor that is, but formula and enteral feedings certainly. And then the H, I skipped the H. That would be hypotension treated with medicines to bring that blood pressure up. So hypotension is low blood pressure. A lot of preemies have episodes of low blood pressure, but we know that the most sick are going to be hemodynamically unstable which means that their ability to regulate their blood pressure and keep their heart rate within a good level is not quite as solid as a kid who doesn’t have those light fluctuations, so that was a risk factor that did stay. Also race. Race stayed. The experts did not think that race was a risk factor, and they were pretty, if you remember the stages that we used to develop GutCheckNEC, we asked experts about how relevant they thought these risk factors were and they really didn’t think race was relevant. But it was so strong in the model, I couldn’t get rid of it. So if a baby is either black or Hispanic, that puts them at higher risk. Now, the reason for that we think, we don’t really know exactly why that stayed in the model, however, we know that black babies are very much less likely to get human milk… STEPHANIE: Okay. DR. GEPHART: ..than white babies, and that is something we can fix. So that’s really important. As I went through these risk factors that are in GutCheckNEC, I started to separate in my mind what’s modifiable, which is what of these can we do something about and what is non-modifiable? And what I saw really was quite a few of these things were modifiable that stayed in GutCheckNEC. You can do a query online for GutCheckNEC and it will pop up the actual, you’ll be able to find GutCheckNEC in the literature. It’s published so anybody can find it. But the thing that was so interesting to me, and I’m probably going to go off a little bit here, is that the NICU NEC rate consumed a huge amount of the variants in this tool which means that if we were to say that these items explained an infant’s risk for NEC. The NICU NEC rate explains three times as much as gestational age, three times as much as transfusion. So it was so important, and what we saw in the sample, we had 284 NICUs in the sample that we used to build GutCheckNEC and to verify it, of those 284 NICUs, we saw huge variance in NEC rates. So that was pretty concerning, and it wasn’t something that I went into the research expecting or looking for really even because I had read 70 papers about NEC risk, and invariably, they would start with Necrotizing Enterocolitis is a disease that we have very few answers for. We don’t really know why it occurs, but we know that premature babies are at risk and that is the most consistent risk factor across studies. So prematurity. STEPHANIE: Right. DR. GEPHART: Everybody blamed it on prematurity and low birth rate, and very few said anything about—oh, and we know, actually we have about six large studies from 20 years ago that show that unit NEC rate is consistently an issue. So that is something that I didn’t expect to find, but I found, and then I was able to go back into the literature and find other studies that verified it. STEPHANIE: Excellent. That’s a phenomenal amount of information, and I think that’s really great for parents going into the NICU to have in their minds. DR. GEPHART: And I think, I apologize to the parents for throwing out all these terms, but I know that you’re smart, and you can handle it. Okay, I’m just going to give you credit, because if you’re NICU parents, you’re super savvy, and you know how to find information. STEPHANIE: Right. DR. GEPHART: But one of the things we were really concerned about with NEC is how we communicate risk to parents and how parents are really the eyes and ears of understanding what’s going on with that baby just like the nurses are. STEPHANIE: Right. DR. GEPHART: And they are really better situated, honestly, to be able to identify the trends in their own kid, because that’s all they’re worried about. STEPHANIE: Right. DR. GEPHART: They’re not worried about the delivery down the hallway or all these other things, they are the expert. So one thing I’ve been working on trying to frame this message for parents as partners on the team looking for signs of any kind of complication and I think if they know to speak up. To keep track and to speak up if things don’t seem right, and I’ve heard many physicians actually say that it’s the parents indication of concern that will make them stop, and think slower, about what’s going on with that baby. So either the nurses concern or the parents concern, because often the physician, as excellent as they are, may not be right at that bedside… STEPHANIE: Right. DR. GEPHART: ..at that moment when something is changing. STEPHANIE: Right. Right And we did have an experience between Morgan’s surgeries where there was a concern in the NICU, and I can’t even remember who had mentioned it at rounds of attempting to give him—I don’t know if it was formula or breast milk—but giving him something that the surgeon had previously not agreed to—and it was a whole day of me trying to get in contact with the surgeon and making sure that nobody did anything until the surgeon had said yes or no. And he called me back from outside of the surgical room and said if anything like this happens, call me, I will call you back. So we definitely found that the doctors are very receptive, and especially when you raise an alarm, and to give people concrete things to look at for their babies I think is a wonderful tool. So thank you for sharing this. DR. GEPHART: Absolutely! And I can say that within the next few weeks, probably by the time this podcast is released, our website will be active, and on that website are parent materials that we’ve created that are designed to help them. Anyone can download these parent materials, they can use them in their NICU, and they are basically pamphlets to talk about things to watch for, what you can do to prevent NEC, and what the signs are, and a little bit about what happens afterwards. Because you know the first-hand experience of how different your life is… STEPHANIE: Right. DR. GEPHART: ..coordinating care for a child who’s had NEC. STEPHANIE: Right. DR. GEPHART: So the long term impacts of dealing with life after NEC, I know Laura Martin was on the broadcast… STEPHANIE: Yes. DR. GEPHART: ..recently… STEPHANIE: Yes. DR. GEPHART: ..and her story has been such an important part of my development as a nurse scientist. Think beyond just the NICU stay, to think about how NEC impacts these kids forever. STEPHANIE: Right, right, and we’ve been very lucky that Morgan has had (knock on wood) minimal residual effects. We see a little bit, but I mean, I looked at Laura’s story and they are doing a phenomenal job with him. He is a miracle. DR. GEPHART: Yeah, Joseph is pretty awesome. I haven’t had the chance to meet him in person yet, but Laura and I collaborated to write up his story, and that paper is going to be coming out in the next couple weeks in Journal of Perinatal and Neonatal Nursing, and it is a testament to his resilience. STEPHANIE: Right. Hers too and her husband’s and the family’s. DR. GEPHART: It’s pretty awesome. STEPHANIE: Definitely send me those links and we can certainly share that with everyone—direct links in the show episode notes. So I’ll ask you, now that GutCheckNEC is I’ll say standardized if that’s a correct term, is there anything that you’re looking towards in your research moving forward from GutCheckNEC? DR. GEPHART: Well, that’s a great question, and GutCheckNEC is a risk assessment, it’s a tool. It fits on one page. We’ve just gone through a process where we’ve added to it a structured communication protocol, so if a NICU wanted to use GutCheckNEC, we would have them complete a request form, and on one side is GutCheckNEC, and on the other side is the structured communication form, which also clues the nurses, the parents for which signs and symptoms to look for and how to communicate it. So that’s easy. So that’s where GutCheckNEC is going. We’re also trying to combine it with clinical science right now, so that’s the analysis I’m working on right now, and I’ve worked with a great collaborator, Sherry Fleiner from the Inner Health to do that work. But beyond that, one of the things with research, you do a project and then you have these findings and then there is something that just kind of nabs at you and it doesn’t fit like you expected it to. And for us, that was the unit NEC rate component of GutCheckNEC that carried so much weight in the score, and it demonstrated across the 284 NICUs how variable NEC rates can be. So what we did next is we asked the question, well, why are they different? Why are the NEC rates different? And what if we did something to try to standardize prevention care? So there are a couple of main things that prevent NEC. One is human milk—very, very important starting with colostrum for oral care. The other thing is standardized feeding protocols, stewarding antibiotics, and I can kind of get into more detail there, and then there is a lot of controversy about transfusions. STEPHANIE: Right. DR. GEPHART: So those components, those four things plus a strategy for early recognition, we’ve put those components into an intervention we call NEC Zero, and the name of it is designed to convey that we’re hoping to get NEC to zero rate. Now, this is an audacious goal. But why set goals if they’re not crazy? This is an audacious goal, but it was not my idea. There was an editor for Journal of Perinatology, his name is Jonathan Swanson, and he wrote a paper the year that I finished my dissertation, so I think that was in 2012, it might have been 2013, and the title of that paper was “Can We Get NEC to Zero”? And if you ask scientists this and clinicians this, you will hear a lot of concern that this is an audacious goal. Like of course, we’re not going to get NEC to zero, we don’t even know what causes it. However, we do know some things that consistently reduce the risk for NEC. So human milk is, like I said, those five components, but human milk is so primary. So now we’re trying to put those interventions together, make them implementable so that people in the NICU in Delaware could implement them with the same consistency and clarity that people in Texas could do. STEPHANIE: Right. DR. GEPHART: So that bundle of practices is NEC Zero. So the process for NEC Zero right now where we’re at in the project is that we’ve gone through kind of an expert process of refining the recommendations. So we’ve gone through that, we need to publish that, but we’ve got them. We had a really great expert group of almost 20 people, and four of those people were parents. Laura Martin was on that group. So we’ve got the recommendations, now we’re trying to break those recommendations into implementable steps, and we’re creating tool kit products to go with the NEC Zero intervention. So pieces of that are— GutCheckNEC is definitely a primary component of that. Frankly, GutCheckNEC has the least strong evidence of any of the components in the tool kit. But it’s something that is actionable, it’s something that we can use to monitor, and we know that monitoring and evaluation is a key component of implementation success for anything. So that’s where we’re at right now is we’re working on NEC Zero. STEPHANIE: Great, that sounds excellent. Do you have a projection of when people might see this? You said you’re looking to get it published, or the first stages of it getting published? DR. GEPHART: Right. We’re working on refining the recommendations really in terms of publishing any sort of a recommendation list or a guideline. They carry much more weight if you have the authority of a professional organization behind them. So our strategy right now is to try to link up with some professional organizations and see if we can get some endorsements for them. So if any of your listeners are prominent members of the American Academy of Pediatrics, the National Association of Neonatal Nursing, The Academy for Breastfeeding Medicine—any of those groups would be excellent proponents. So we have the recommendations, we have some parent products that will be available, like I said, within a few weeks once our website gets done, and the other pieces of it being available, I will say that we’re testing it right now. So with the testing, there are two things we’re doing. We have the recommendations, we’re asking experts to kind of assign relative importance to the different parts of the intervention, and that score, we’re creating a ten point score for the NEC Zero adherence score, and that’s almost done. And then we’re going to look at relationships between adoption of NEC Zero practices and NEC rates, because we really don’t have a great evidence body for understanding why NEC rates differ so much NICU to NICU. STEPHANIE: Right. DR. GEPHART: So this is kind of an effort to add to that body of evidence of understanding why are they different. We don’t know what we’ll find, that’s the beauty of research is you start with a hypothesis, you get your data, you test your hypothesis, and you see how it turns out. STEPHANIE: Excellent. This is great work, Sheila. I mean, it sounds like it’s really sort of simple, but I’m sure it’s not. DR. GEPHART: That’s right! It does kind of sound simple, doesn’t it? STEPHANIE: Or that it maybe should be simple. Hopefully it will be simple, but it sounds like parents in the NICU could really take this information and be able to be confident in their monitoring of their children and really confident in voicing any concerns that they see. DR. GEPHART: Right. STEPHANIE: So I think it’s great. DR. GEPHART: The challenge is that really statistically you’re not going to have a lot of kids get NEC. Even in a high rate NICU, you’re going to have a lot of babies who don’t get it, and a few babies who do. But the outcomes can be so devastating for those few babies. So the simple part is really important, and the other question is do the interventions of NEC Zero affect other outcomes? And really, the answer is yes, because interventions are things like human milk standardized feeding protocols, antibiotic stewardship—those things are good for any baby— STEPHANIE: Right. DR. GEPHART: Any baby! So the good thing is that any NICU clinician can implement those things with relative confidence. Now, the big wildcard here that people don’t agree to consistently is holding feeding during transfusion. So that piece is a little bit controversial, actually it’s a lot controversial right now, but that component—the health system I’m working with has already adopted a practice to do that, so that is part of our bundle, and we’re going to keep it that way, but as we get into the literature about transfusions and NEC, it is somewhat controversial, and the evidence is not really conclusive. STEPHANIE: Right. We actually had an episode with a Dr. Hussain from Connecticut Children’s Medical Center, and in his conversation about transfusion associated NEC, he had mentioned GutCheckNEC. So it does seem to sort of all circle around. DR. GEPHART: It does, and the thing with GutCheckNEC is that transfusions is a risk factor. So in our structured communications protocol, which is coupled with GutCheckNEC, understanding the context of if a baby has been transfused in the last 48 hours, that’s a trigger. STEPHANIE: Right. DR. GEPHART: So those two pieces put together do heighten our awareness of what a baby could be at risk for. STEPHANIE: This was a really great conversation, Sheila. I really appreciate you sharing all of this. A lot of this, even though I have done a lot of research myself is pretty new in this context to me. So I think it really sort of simplifies some really complicated information. So I appreciate you sharing this with us. DR. GEPHART: Well, it’s been my pleasure and honor to try to simplify things. I have to do that for my own brain. I will say that this is an audacious goal. STEPHANIE: Right. DR. GEPHART: People look at me cross eyed when I say NEC Zero. They think what are you talking about? Is that possible? But I will tell you that there are a handful of NICUs across the country who are getting to zero with their NEC rates, and they are models. STEPHANIE: Right. DR. GEPHART: The things they consistently do are they prioritize human milk feeding, it is critical, they use standardized feeding protocols, they start feedings early with trophic feedings, which is just small feedings, and they generally have a fairly specific approach to handling transfusions and feeding. So those things are very important. But the human milk is essential. STEPHANIE: Right. Right. So before we wrap up, is there anything else with regard to NEC or your research moving forward that you would like to share? DR. GEPHART: I appreciate that offer. I would like to just emphasize how we do have evidence. We have pretty good evidence about things that prevent NEC. Now, does that mean that we’re going to prevent every single case of NEC? I don’t know that yet. STEPHANIE: Right DR. GEPHART: But we have pretty good evidence, and one of the things that’s pretty controversial in our country right now is the use of probiotics. I don’t know if any of your experts have gotten into that realm yet, but- STEPHANIE: We’ve touched on it and they’ve sort of said the same thing you did that it is sort of a controversial topic because if I’m saying this correctly, the FDA regulations and the procedures around that, but I know in other countries that they have seen reduced rates of NEC with probiotics. DR. GEPHART: Right, right, and that is one thing that I would say is certainly controversial. There is one of the NICUs that I’m aware of that uses probiotics. They’ve been at zero for like six years. One of the issues we have, I’ve spent a lot of time lately understanding the strength of evidence for all of these components that prevent NEC, we don’t have randomized control trial evidence for most of them. But we have 24 randomized control trials that show a decreased risk for NEC with probiotics—thousands of babies—thousands, and even some people will say the preparations are different in these different studies, there is a recent study that actually pulled the results from just a certain type of probiotic and they still showed benefit. So the issue here we have in the United States is that probiotics are marketed as a food product. And so as a food product, their regulation is different with the FDA than as a medicine. STEPHANIE: Right. DR. GEPHART: However, I think parents should know this, frankly. STEPHANIE: Right. DR. GEPHART: I think this is one of those opportunities for shared decision making in the NICU where a physician, a nurse practitioner could bring up this issue with parents to say hey, look, we have this opportunity to give your baby probiotics and this is what is available, this is the evidence, this is the risk. See, this is shared decision making. STEPHANIE: Right. DR. GEPHART: You go and you have a test, your physician or nurse practitioner would say this is how you have to decide what’s important, but I think NICU parents are very, very smart people, and I think we’re at the point in the United States where it is time to open up the conversation about probiotics to make it a joint decision versus an “oh, we’re just not going to do it”. STEPHANIE: Right. DR. GEPHART: Because we have such strong evidence, it’s just that most of those studies were not done in the US. STEPHANIE: Right. DR. GEPHART: However, there are many things that have been developed in other countries that we can adopt. The other issue is a standard formulation, a safe, standard formulation. There was a case of sepsis a few years ago that was very concerning—that’s severe widespread infection in a premature baby. That is the risk. So that’s what the clinician would say to the parent. But it’s very, very small risk if you look at all of the benefits. STEPHANIE: Right. DR. GEPHART: So I’m not going to pretend we should be using probiotics, but I do think that parents need to start asking for them. They need to start asking why are we not using them… STEPHANIE: Right. DR. GEPHART: ..because we have such strong evidence. So we have actually stronger evidence for probiotics than we do for antenatal steroids or Surfactant. Those are common, important, consistently delivered interventions for NICU babies. But you have risks, and that’s the issue. STEPHANIE: Right. DR. GEPHART: So we’re at a place for decision making. STEPHANIE: Right. And actually ironically, or maybe not ironically, I know that my boys did get probiotics, and that was five years ago that they were born. DR. GEPHART: That is ironic. STEPHANIE: We had an anomaly with Morgan. Nobody can sort of figure out why he got NEC when he did, but we did do all of the sort of standard care practices, probably even advanced practices for five years ago, and we had one that got it and one that didn’t. So…but knowing now what I have learned is they were doing the very best practices at the hospital where my sons were born. So I think we were at the right place at the right time and had the best outcomes that we could hope for. DR. GEPHART: That’s awesome. That’s awesome. Did you feel like with Morgan that they were able to recognize it pretty fast and act? STEPHANIE: I really think they did. I think that is probably the key that saved his life because he developed NEC at four days old and had really only had two trophic feeds, and it was colostrum. DR. GEPHART: Okay. STEPHANIE: Actually after the conversation that I had with Dr. Hussein, I went back and looked and he did not have a blood transfusion within that timeframe, so he sort of, it’s my understanding he’s just sort of an anomaly, but that’s why we’re looking to the researchers to piece together all of these things. That’s sort of what drives me is he doesn’t easily fit into something that could have, should have, would have, maybe been different and that seems to be the riddle that’s NEC. DR. GEPHART: Sure. There’s an analogy for this it’s called, a wicked problem, I don’t know if you’ve heard of that term, but you were at my talk when we were in Connecticut,… STEPHANIE: Right. DR. GEPHART: ..and I talked about the wicked problem and how it’s like a forest fire, it’s not easily solved. There’s a lot of pieces to it,… STEPHANIE: Right. DR. GEPHART: …and I think NEC is really the neonatal wicked problem. STEPHANIE: Right. DR. GEPHART: So I’m so glad that Morgan got care so quickly and got such excellent care. And that’s the thing is that clinicians, physicians, dieticians, lactation consultants, nurses, nurse practitioners, they want to do the absolute best for your baby. STEPHANIE: Right. DR. GEPHART: Nobody has ill will. This is a team effort, but they’re human, and that’s the thing with wicked problems… STEPHANIE: Right. DR. GEPHART: ..is that you have humans operating in these complex systems, and trying to deal with things and what we know with solving wicked problems, like forest fires, it’s a combination of boots on the ground, and standard protocol. STEPHANIE: Right. DR. GEPHART: So it’s the strength and protection of both approaches that really is effective, maybe not taking away completely the wicked problem, but at least confronting it. STEPHANIE: Right. DR. GEPHART: So I’m so glad that Morgan got such great care. STEPHANIE: Thank you. We are too. We are too. And like I said, I think it goes to show that I’ve heard multifactorial used and all kinds of big words with regard to NEC, and just knowing that there are researchers out there like yourself who are trying to distill this information and simplify it for parents and practitioners as well that this is one of the ways that I think we will get to zero NEC. That’s our goal as well. So I really appreciate you talking to me today, and would love to talk to you again, and any of these links when the website is up, would love to share. So thank you! DR. GEPHART: Absolutely. It would be my honor to share those. It’s been fun to be with you. STEPHANIE: Thank you. You too. Direct links to more information about the GutCheckNEC can be found in this episode’s show notes. In closing, I’d like to share a few thoughts about today’s conversation with Dr. Gephart. Simply put, information is power. I believe that a risk assessment like GutCheckNEC can empower parents in the NICU by distilling complex medical information, and presenting it in a simplified, and actionable way. Morgan was diagnosed with NEC at four days old. My husband and I were still in shock, and hadn’t even begun to come to terms with our twin sons’ unexpected and traumatic birth, when Morgan was transferred to another hospital and underwent emergency surgery. In the days and weeks that followed, I diligently called two NICUs every morning after rounds for updates on our two babies. I took copious notes to share with my husband on weight gains, Oxygen levels, and whatever else each nurse made mention of during the phone calls. And during our daily visits, we spoke with each baby’s nurse personally about all of the day’s happenings. Since then, I’ve learned a lot more about prematurity and NEC. And if we were in the same situation today, I would have a lot more questions to ask about all areas of our babies care. In retrospect, I realize we didn’t know what questions to ask. We took our lead from the nurses, and we looked to them to tell us what we needed to know. GutCheckNEC presents parents the opportunity to learn what questions to ask about NEC. Objectively. And, proactively. And, it can help open up the dialogue between parents and caregivers in advance of potential crisis. Show your support for our smallest and most fragile babies, those who have the greatest risk for developing NEC. Show your support for continued research in NEC. And join our effort to raise awareness about, and funds for research in NEC by making a donation to Morgan’s Fund at morgansfund.org/donate. If you’ve had a personal experience with NEC and would like to share your story, or have a question or topic that you’d like to hear addressed on our show, e-mail us at feedback@morgansfund.org. We’d love to hear from you! Additional Information You can make a donation directly to Dr. Gephart’s research in NEC at the University of Arizona College of Nursing by visiting https://www2.uafoundation.org/NetCommunity/SSLPage.aspx?pid=341 You can become a donor to the College of Nursing by visiting http://www.nursing.arizona.edu/giving/leave-your-legacy Copyright © 2015 The Morgan Leary Vaughan Fund, Inc. The opinions expressed in Speaking of NEC: Necrotizing Enterocolitis (the Podcast series) and by The Morgan Leary Vaughan Fund are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis and treatment. Please consult a local physician or other health care professional for your specific health care and/or medical needs or concerns. The Podcast series does not endorse or recommend any commercial products, medical treatments, pharmaceuticals, brand names, processes, or services, or the use of any trade, firm, or corporation name is for the information and education of the viewing public, and the mention of any of the above on the Site does not constitute an endorsement, recommendation, or favoring by The Morgan Leary Vaughan Fund.

Special Guest: Susan Vierczhalek, MD, FAAP, FABM, IBCLC is an Associate Professor of Clinical Pediatrics New York University School of Medicine and is the medical director of the Bellevue newborn nursery, and of the Bellevue Breastfeeding Program and co-director of the high-risk newborn follow-up program.  She serves as the American Academy of Pediatrics New York Chapter 3 Breastfeeding Coordinator, Chair of the New York State Breastfeeding Coalition and Vice-chair of the New York City Breastfeeding Leadership Council.  She is a Fellow of the Academy of Breastfeeding Medicine and an International Board Certified Lactation Consultant. Special Guest: Karen Hylton-McGuire has been a Neonatal Intensive Care (NICU) nurse for over 35 years.  She received her BSN from Carlow University in Pittsburgh and her MS in nursing education from Adelphi University on Long Island.  She is currently pursuing her PhD at Molloy College on Long Island.  Ms. Hylton-McGuire is certified in Neonatal Nursing and is an Internationally Board Certified Lactation Consultant.  She initiated the lactation program at the Brooklyn Hospital Center, and is currently the Lactation Educator at Winthrop University Hospital. Ms. Hylton-McGuire is the recipients of the 2010 Nurse of Excellence Nassau-Suffolk Hospital Council, Healthcare Heroes Nurse Educator. Both women are on the board of the NY State Breast Feeding Coalition.