All Things Breastfeeding Podcast

From Barbara Robertson and Nancy Mohrbacher: Using new research in clinical practice? How do we do this? When is it time to let go of our old ways of doing things and incorporate new information? These are some of the questions Nancy and Barbara discuss in this episode of All Things Breastfeeding. Sometimes, incorporating new research in clinical practice is easy. It can be an “ah-ha” moment. Nancy had this when she learned about Suzanne Colson’s research on releasing babies’ reflexes to stimulate breastfeeding. She knew Suzanne’s description was true and immediately began incorporating Suzanne’s ideas into her practice. Barbara had this type of moment when she read Nancy’s article, “The Magic Number.” On the other hand, we can also suffer from confirmation bias. We may want to believe that we can use human milk for longer than the current recommendations (see article below), so we are happy when a study suggests this might be true. On the other hand, it can take 17 years or longer for research to become clinical practice. When should we wait? When is it time to change? Some clear guidance both Nancy and Barbara use is: “Will it be harmful?” It does not harm anyone to start playing around with latch and positioning, or adding extra milk removals, for someone struggling with milk supply. Take a listen to learn more about Nancy’s and Barbara’s thoughts on this subject. Enjoy! Resources: Colson SD, Meek JH, Hawdon JM. Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Hum Dev. 2008 Jul;84(7):441-9. doi: 10.1016/j.earlhumdev.2007.12.003. Epub 2008 Feb 19. PMID: 18243594.: https://pubmed.ncbi.nlm.nih.gov/18243594/ Anders, L. A., Mesite Frem, J., & McCoy, T. P. (2025). Flange size matters: A comparative pilot study of the Flange FITSTM guide versus traditional sizing methods. Journal of Human Lactation, 41(1), 54-64. https://pubmed.ncbi.nlm.nih.gov/39614713/ Mohrbacher, N. (2011). The Magic Number and Long-Term Milk Production. Clinical Lactation 2(1), 15-18. https://lactalearning.com/wp-content/uploads/2025/07/MohrbacherMagicNumber2011.pdf All Things Breastfeeding Episode 108: Tongue Tie Update: https://lactalearning.com/tongue-tie-update/ Scharff, A. Z., Sedlacek, L., de Oliveira Mekonnen, A., Liolios, I., Ritter, S., Fuchs, F., & Happle, C. (2026). Leftover Infant Milk After Bottle Feeding: Parental Practices and Microbiological Findings. medRxiv, 2026-02. https://www.medrxiv.org/content/10.64898/2026.02.13.26346179v1 The post All Things Breastfeeding Episode 110: Using Research in Clinical Practice appeared first on The Breastfeeding Center of Ann Arbor.

From Barbara Robertson What is 2nd Night Syndrome? 2nd-night syndrome is a common feature of newborn behavior. It typically occurs on the 2nd night after birth, when the baby’s behavior shifts from sleepiness to greater wakefulness, often asking to nurse frequently. Our colleague, Jan Barger, has discussed this. In her description of this she says, “All of a sudden, your little one discovers that he’s no longer back in the warmth and comfort – though a bit crowded – womb where he has spent the last 9 months – and it is SCARY out here!” No wonder babies are upset!” Correct! Infants are upset, but our takeaway message to families is that this is normal and your baby is fine. And, happily, there are things you can do that may help. What does 2nd Night Syndrome look like? The key sign of this is that the baby wants to be held continually and nursed frequently. This is expected behavior. The baby is shifting from being fed through the umbilical cord and held constantly in the womb, to now needing to eat themselves and realizing they are not always being held. People often classify this behavior as “fussy” or “starving”. Suzanne Colson discussed infants needing to transition from the womb to the world. The baby was warm, fed, and cuddled 24/7 in the womb, and in Western society, we tend to try to put the baby down, away from us, to sleep. As the baby becomes more alert, they instinctively know this isn’t where they belong. They are safest in their birthing parent’s arm, right next to their food source for easy access. The baby may appear more wakeful, irritable, and cry more frequently. They want to cluster-feed, nursing for long periods of time and/or in short, frequent bursts, especially in the evening or at night. Again, they seek constant contact and to be held. What are the theories as to why Second Night Syndrome is happening? To begin with, as mentioned, there is a significant environmental adjustment for infants. They go from a warm, cozy, noisy, dark womb to the world where noise, light, and temperature are inconsistent and often unpleasant. This change can be overwhelming for a baby. Babies in the womb are also being fed constantly, so the idea of being hungry is new as well. Their stomachs are tiny and expect frequent, small feeds. Frequent feeds also stimulate the parent’s milk supply, progressing from colostrum to transitional milk to mature milk. A review of research on secretory activation found that frequent milk removals are precisely what is needed at this point. The baby’s intake needs are going to increase over the next few days from about 0.5 oz (15 mLs) per feed to about 2-3 oz per feed in the next week. By frequently removing milk, the baby signals to the parent’s body that it is time for secretory activation, leading to a full milk supply. A fascinating study found that, among exclusive pumpers, the number of milk removals was critical for reaching and maintaining this stage. If the parent did not maintain frequent milk feedings, they would move out of secretory activation. Why does it happen in the evening and at night? One theory is that the surrounding environment is loud and chaotic during the day. If the family remains in the hospital, many staff members are in and out of the room throughout the day. It is usually bright. There are often many visitors, especially if it is the first baby.  All of this can cause the baby to feign sleep, thereby appearing calm. Once the chaos subsides, the lights are dimmed, and the baby “wakes” up, ready for interaction and feeding. What can be done about Second Night Syndrome? In many ways, this increased behavior in the baby is the parent’s first opportunity to set the tone for the relationship. The parent has a choice: give the baby what they need at this moment, or fight it. Note that I used the word “need,” not “want.” The first stage of human development, according to Erik Erikson, is trust vs mistrust. Will the parent be present for the baby, or prioritize their own needs (or societal expectations) over the baby’s needs? What does the baby want? The bottom line is they want to be close to their parent. They want to be held skin-to-skin constantly. Skin-to-skin contact soothes the baby and helps them regulate their body. Make sure the baby doesn’t have mittens on. One of my interns once said that babies “see” with their hands. They also want access to their food source (the breast/chest) as often and as long as they feel they need to access it. After the baby feeds, gently shift so that the parent and the baby are comfortable. If you try to put the baby down somewhere, they will most likely wake again. If the baby is to be moved, the family should wait until the baby is in a deep (REM) sleep. The baby begins in light sleep, and if moved, they will wake. Keep in mind that infants move in and out of REM sleep more quickly than adults, approximately every 30 minutes. We encourage the parent to rest as much as possible during the day. The adage “sleep when the baby sleeps” is no joke in the early weeks. Ensuring the family has as much support as possible greatly helps, so the parents’ only primary job is to meet the baby’s needs. Getting family and friends involved is a great idea. Hiring a doula for the first week or two can be a good solution. Remember, too, during the day, keep things calm, dark, and quiet so the baby doesn’t feel the need to play possum. Using calming techniques can also be effective. Rocking, walking, shushing, and letting the baby suck are great ideas. Again, Second Night Syndrome (SNS) is a normal developmental hurdle, not an illness. The baby isn’t starving, and there is nothing wrong with the baby. The baby intuitively knows that the safest place for them to be is at or near the breast/chest. This intense need is very temporary. The sooner the family learns how to meet their baby’s particular needs, the sooner this tends to pass.  The post All Things Breastfeeding Episode 109: 2nd Night Syndrome? appeared first on The Breastfeeding Center of Ann Arbor.

A tongue tie update? Barbara and Nancy discuss a 2026 research study on tongue ties by Raol et al. and a commentary response in this episode of All Things Breastfeeding. One of the goals of LactaLearning is to provide recent studies that have the potential to impact clinical lactation practices. The debate over whether tongue ties are being over- or under-treated has been ongoing for several years. After reviewing the latest research on tongue ties for the upcoming edition (this edition is still at least a year away from being released), the research conclusion seems to be that there are absolutely cases where a tongue tie release appeared to be critical for an infant to be able to nurse effectively and/or without pain for the parent. On the other hand, it appears that more babies are undergoing this procedure, even though this may not have been the core issue. The Raol study looked at 476 infants and found “Conclusions: Although ankyloglossia may affect breastfeeding experiences, ankyloglossia alone does not appear to affect breastfeeding maintenance or infant weight gain. Improving breastfeeding outcomes should include multidisciplinary management to focus on all potential causes and not only ankyloglossia.” What was so different about this recent study?  “Their study is unique in that none of the infants had a frenotomy or other surgical treatment of their ankyloglossia, and exclusive breastfeeding was assessed at 2–4 weeks, 3 months, and 6 months after delivery. Surprisingly, there were no differences in rates of exclusive breastfeeding at any time point, including at 6 months (82.3% [no ankyloglossia] vs 73.5% [assessed with ankyloglossia]; P?=?.25), and no differences in infant growth velocity at any time point.” Dr. Ann Will and Dr. Lydia Furman reported. What was also unique was that, instead of releasing the tongues, they provided great lactation support and were grounded in a community that valued breastfeeding. Could this be enough for many babies? There are flaws to the study as well. One issue was the way the authors identified tongue ties. It is not clear how many of the babies had more serious ties. Again, this is food for thought. If you work with breastfeeding/chestfeeding families and are passionate about lactation support, or you want to turn your passion for nursing into professional practice, visit LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Raol, N., Silamkoti, B., Syed, S. M., Hosek, K., Theetla, P., & Madireddy, A. (2026). Ankyloglossia, breastfeeding, and infant weight gain: a mixed-methods study. Pediatrics, 157(1), e2024070531.Witt, A., & Furman, L. (2026). Untreated Ankyloglossia: A Broader Perspective. Pediatrics, 157(1), e2025073238.Bristol Tongue Assessment ToolMartinelli Tongue Tie Assessment Lingual Frenulum Protocol for InfantsThomas, K., Kliff, S., & Silver-Greenberg, J. (2023). Inside the booming business of cutting babies’ tongues. New York Times, 18.LeFort, Y., Evans, A., Livingstone, V., Douglas, P., Dahlquist, N., Donnelly, B., Leeper, K., Harley, E., Lappin, S., and Academy of Breastfeeding Medicine. (2021). Academy of breastfeeding medicine position statement on ankyloglossia in breastfeeding dyads. Breastfeeding Medicine, 16(4), 278-281. https://www.nytimes.com/2023/12/18/health/tongue-tie-release-breastfeeding.html Responses to the above article: https://www.liebertpub.com/doi/10.1089/bfm.2024.29263.editorial https://www.thestewartcenterforoptimalhealth.com/2024/03/17/breaking-down-the-nyt-article-inside-the-booming-business-of-cutting-babies-tongues The post All Things Breastfeeding Episode 108: Tongue Tie Update appeared first on The Breastfeeding Center of Ann Arbor.

Why does early breastfeeding position matter? Nancy and Barbara discuss one of their favorite topics with friend and colleague, IBCLC Rene Fisher. Whether you are talking about the starter position, laid back breastfeeding, or biological nurturing from Suzanne Colson, they all mean the same thing. Relax, lean back at a comfortable angle (not flat on your back), and place the baby tummy-to-tummy on the parent’s body. When this is done suddenly, the baby can move their body more easily, and many infant feeding reflexes are triggered, ensuring that at least one person knows what they are doing. Nancy discusses her experience improving breastfeeding practices at a Chicago-area hospital, and Rene shares her experiences with her own grandson, which made her a firm believer. Rene took this simple, time-saving technique back to her hospital on the East Coast, where it was a great success. Nancy’s ideas of adjusting your body, adjusting the baby, and adjusting the breast make it even easier to help families nurse easily and comfortably. As is known, changing hospital practice is not easy. Nancy and Rene share their wins and hurdles. There are three studies discussed in detail, which are listed below. Enjoy! Milinco 2020 (RCT): https://pubmed.ncbi.nlm.nih.gov/32248838/ Yin 2021 (RCT): https://pubmed.ncbi.nlm.nih.gov/33913745/ Wang 2021 (Meta-analysis): https://pubmed.ncbi.nlm.nih.gov/33761882/ The post All Things Breastfeeding Episode 107: Why Early Breastfeeding Positions Matter appeared first on The Breastfeeding Center of Ann Arbor.

Barbara and Nancy discuss their experience at the 2025 ILCA conference. This was the first conference at which LactaLearning participated in the exhibit hall! They were joined by a good friend and fellow IBCLC, Rene Fisher. It was so much fun seeing old friends and making new ones! There was such a great response. When asked, some people had heard of LactaLearning; folks either said, “Yes, I love it!” or “No, but it sounds like a great idea in terms of what we are doing with education.” It was thrilling to get such good feedback. Nancy and Barbara each attended several presentations and discuss what they learned. Because they are both lifelong learners, it is exciting to see what other leaders are doing in the field. In particular, Barbara and Nancy had dinner with Dr. Lisa Anders to continue their discussion of the pump flange fitting. Lisa’s poster presentation presents data suggesting that flange size fitting may not be as important as we thought. Stay tuned for more on that! LactaLearning is the result of a long evolution and journey stemming from Barbara Robertson’s dreams and drive. Barbara started with a strong passion for learning and teaching, and then later fell in love with lactation. As a national and international professional trainer, Barbara realized her business needed to reflect this and created the LactaLearning brand with love and intention. Nancy Mohrbacher came on board to help with course creation and many behind-the-scenes tasks, and we are continuing to imagine new ideas and bring them to life. The post All Things Breastfeeding Episode 106: 2025 ILCA Conference Recap appeared first on The Breastfeeding Center of Ann Arbor.

Working and Breastfeeding Made Simple? Nancy and Barbara discuss this important topic and how their new book group, Working and Breastfeeding Made Simple, can help make you an expert on this topic. Here are just five topics that will be covered in depth during the book group! Yes, it is possible to support working parents in achieving their infant feeding goals. Several critical factors for supporting breastfeeding/chestfeeding among employed parents have been identified in the literature and clinical practice. Despite the dire statistics, families in Barbara’s private practice actually do well. None of them discontinued breastfeeding during the first month of returning to work. Providing accurate information about how breast milk supply works and how to express breast milk, along with social and emotional support, appeared to help clients maintain breastfeeding despite occasional difficulties. Here are five critical factors that help families meet their breastfeeding goals. 1. Breastfeeding Is Going Well Before Returning to Work One critical factor for success is having the parent be good at breastfeeding before they return to work. It is well established that breastfeeding becomes less labor-intensive (and generally easier) for most mothers at approximately 6–7 weeks (Mohrbacher & Kendall-Tackett, 2010). If breastfeeding isn’t going well or a mother goes back to work before 6–7 weeks, she is more likely to be unsuccessful with this transition. If a mother is struggling with pain, has a baby who doesn’t feed well at the breast, or her milk supply is low when she returns to work, she is doubly challenged from the get-go! Providing a plan to address these issues along with hope, accurate information, and support can help mothers continue breastfeeding even as they return to work. 2. Support From an International Board Certified Lactation Consultant The support and information that an International Board Certified Lactation Consultant (IBCLC) can provide are critical for success. Many parents don’t have anyone in their lives who understands or cares about why they are even trying to continue to breastfeed and work. IBCLCs do care. They want them to achieve their breastfeeding/chestfeeding goals. Together, IBCLCs can help improve the low statistics on working and breastfeeding success. 3. Success at Milk Removals Another critical factor for success is how effectively the parent expresses their milk when separated from their baby. Most clients use a standard, personal-use, double-electric breast pump. However, not all pumps are created equal. Some work well, and some don’t work as well. Using a pump with adequate vacuum, different-sized breast shields (as necessary), and variable speeds will increase her chances of success. At the same time, if a pump has all these things and they is still not getting out their milk, IBCLCs have to get creative. Perhaps they need to try a different pump brand, rent a hospital-grade pump, use a hand pump, or hand express. Watching a parent pump is essential. Test the vacuum. Make sure their shields fit well. Many families are unaware that different-sized breast shields even exist. Positive associations to help them “Feel the Love” for their pump. Without an oxytocin release, parents are trying to pull the breast milk out of their bodies. With an oxytocin release, they are working in sync with their body. Their body is pushing the milk out of their breasts. This is much more effective. If the parent is having trouble “feeling the love,” suggest warm compresses, warm breast shields (Kent, Geddes, Hepworth, & Hartmann, 2011), and/or massage before pumping (Bolman & Witt, 2013; Bowles, 2011). They can also use “hands-on” pumping techniques to help get the breast if the milk is flowing (Morton, n.d.). Additionally, hand expression for a minute or two on each breast after pumping can support milk production (Morton et al., 2012). Some mothers find that visualizing their baby or their milk flowing helps. Others find that playing Candy Crush helps! There are some hypno-pumping visualization MP4 products out there. Have them practice pumping while getting a massage, eating chocolate, or watching their favorite comedy. It’s straight classical conditioning. Pair a condition with a response (think Pavlov’s dog). Clients can help train their bodies to have an oxytocin surge in response to their pumps. If a mother is having difficulties with her milk production, encourage her to blame her pump for lack of breast milk, not her body! If breast milk is not being removed effectively while she is separated from her baby, her supply will go down. 4. Supportive Child Care Working and breastfeeding success can also be at risk if the family’s child care provider does not value breast milk or the breastfeeding relationship with the baby. Overfeeding the baby while the parent is away is a common problem. The child care provider needs to understand that not all crying or fussiness is about food. They also need to know how to care for expressed breast/chest milk and how to bottle-feed a baby in a breastfeeding-friendly manner by pacing the bottle feed. It is now recommended that all infants be fed in this manner, not just breastfed infants, even when there is breast milk in the bottle. Pacing the feed helps the baby control his or her intake and prevents overeating, which may help prevent obesity in later life. 5. Avoid Overfeeding at Child Care The final stumbling block concerns overfeeding and subsequent reduced breastfeeding when families are reunited. When a baby has been overfed at child care, not only is it almost impossible to keep providing enough pumped breast milk for the baby, but the baby also doesn’t need to breastfeed as often from mom when they get back together. It is as if the baby is saying, “No thanks; I’m good! I had all my needed calories for day from my caregiver.” This does not hold true for all babies, but it does for many. Additionally, being away from one’s mother can be stressful and tiring. Babies can sometimes sleep longer at night because of this. Between not needing to nurse because of the calorie overload during child care and sleeping longer at night, mothers can end up breastfeeding far less than they were before returning to work. Suggesting that mothers pump before going to bed if their baby is scheduled to sleep at 8:00 p.m. and will not feed much during the night can help. This strategy appears to help improve their breast milk supply. Summary In Barbara’s clinical practice, she has found that these five factors can undermine a parent’s ability to continue breastfeeding/chestfeeding after they return to work. Again, breastfeeding not working well, the lack of information and support, milk removals not working well, lack of paced bottle feeding, and a parent’s daily milk removals reducing over time are the most common culprits that have been found to sabotage a mother’s success in meeting her breastfeeding goals when returning to work. Providing information about these issues may help families anticipate problems before they arise, or at least help them quickly identify when they are moving down a slippery slope, and can significantly increase their odds of having the breastfeeding/chestfeeding relationship they dreamed of before returning to work. The post All Things Breastfeeding Episode 105: Working and Breastfeeding Made Simple appeared first on The Breastfeeding Center of Ann Arbor.

Exclusive pumping? Why would some one do this? Barbara and Nancy discuss the latest research on exclusive pumping. They look at who is exclusive pumping and why. This has shifted in the past 2o years or so. It used to be that the majority of exclusive pumpers were pumping for their preterm babies while they go mature enough to directly nurse. Not true anymore. Some people choose to exclusively pump from the very beginning but the majority of exclusive pumpers end up exclusively pumping because they had problems with breast/chestfeeding that they couldn’t resolve. There is also new research that shows maybe our suggestions in the past aren’t as accurate as we thought they were. Listen to find out what the latest research says! Important references: Eden, C. (2024). Shifting the paradigm for establishing and maintaining milk production in the setting of mother/infant separation. Journal of Human Lactation, 40(4), 535-538. https://pubmed.ncbi.nlm.nih.gov/39313928/ Hoban, R., Pei, Q., Medina Poeliniz, C., Golan Maor, Y., Walker, R. E., Meier, P. P., Monk, A., & Parker, L. A. (2025). Maternal complications of pregnancy and achievement of secretory activation and coming to volume in breast pump-dependent mothers of preterm infants. Breastfeeding Medicine, 20(7), 512-520. https://pubmed.ncbi.nlm.nih.gov/40626629/ Levene, I., Fewtrell, M., Quigley, M. A., & O’Brien, F. (2024). The relationship of milk expression pattern and lactation outcomes after very premature birth: A cohort study. PLoS One, 19(7), e0307522. https://pubmed.ncbi.nlm.nih.gov/39074108/ Mago-Shah, D. D., Athavale, K., Fisher, K., Heyward, E., Tanaka, D., & Cotten, C. M. (2023). Early pumping frequency and coming to volume for mother’s own milk feeding in hospitalized infants. Journal of Perinatology, 43(5), 629-634. https://pubmed.ncbi.nlm.nih.gov/37037987/ Yuan, S., Wang, H., Xu, X., & Li, Q. (2025). A randomized control trial of early breast milk pumping interventions for mothers of moderately pretermi infants. Breastfeeding Medicine. https://pubmed.ncbi.nlm.nih.gov/40768317/ The post All Things Breastfeeding Episode 104: Updates on Exclusive Pumping appeared first on The Breastfeeding Center of Ann Arbor.

Are you looking to become an IBCLC and are having trouble finding clinical hours? Let Nancy and Barbara help! Deciding on which PATHWAY  The 3 exam eligibility pathways are open to individuals from a variety of backgrounds. Each person must decide which pathway will work best for them. For more info, go here: https://ibclc-commission.org/step-1-prepare-for-ibclc-certification/lactation-specific-clinical-experience/ Pathway 1 involves using appropriately supervised clinical experience obtained through paid employment or volunteer service as a health professional or mother support counselor. The kind of supervision that is considered appropriate depends upon the candidate’s professional background and scope of practice. Under Pathway 2 and Pathway 3, the candidate completes clinical practice in lactation care under the direct supervision of experienced IBCLCs. Individuals with no paid or volunteer experience in providing care to breastfeeding families or those who desire a more structured way of learning lactation care clinical skills may choose to follow one of these pathways. Pathway 1 Many candidates use clinical practice they have obtained through paid employment or volunteer service to qualify for the IBCLC certification exam. If you fall into one of the following categories, Pathway 1 is a reasonable choice to make. Your current work or volunteer service includes providing care to breastfeeding families. In the past 5 years, you worked or volunteered in a position in which you provided care to breastfeeding families. Employment or volunteer experience in a position in which you will provide care to breastfeeding families is something you can reasonably expect to obtain. Pathway 1 candidates must complete at least 1000 hours of clinical practice experience in lactation care that were accrued in the 5 years immediately prior to applying for the IBCLC certification exam. Clinical practice may be obtained through paid employment or volunteer service in a variety of settings such as hospitals, clinics, birthing centers, medical practices, public health departments and mother support counselor organizations. Appropriate supervision of your clinical practice in lactation care is required. Providing breastfeeding support to family and friends and/or in a setting without appropriate supervision may not be used to qualify for the IBCLC certification examination. For assistance in determining if you have sufficient clinical practice hours in lactation care to qualify through Pathway 1, use the Lactation Specific Clinical Practice Calculator found on this page. Pathway 2 We don’t have a lot of information on Pathway 2. Pathway 3 Individuals seeking qualification through Pathway 3 must have an approved Pathway 3 Plan on file with IBLCE. This mentorship plan must be developed according to the specifications found in https://ibclc-commission.org/ibclc-information/pathway-3-plan-guide/ and must be approved by IBLCE prior to beginning the mentorship. The first step toward qualification for the  IBCLC certification examination through Pathway 3 is to develop and submit a mentorship plan to IBLCE. Details about Pathway 3 Plan development can be found in https://ibclc-commission.org/ibclc-information/pathway-3-plan-guide/ Pathway 3 requires a minimum of 500 hours of clinical experience in lactation care that were directly supervised by experienced IBCLCs and accrued within the 5 years immediately prior to applying for the IBCLC certification examination. If you are considering Pathway 3, you must locate and contract with one or more IBCLCs. These IBCLCs will serve as your mentors and will provide the direct supervision of your clinical practice in lactation care. Listen to the podcast to find the best places to connect with others to obtain your clinical hours. The post All Things Breastfeeding Episode 103: Finding Lactation Clinical Hours appeared first on The Breastfeeding Center of Ann Arbor.

Barbara takes the time to sit down with her LactaLearning co-founder, Nancy Mohrbacher to discuss her journey in the field of lactation. Nancy Mohrbacher, IBCLC, FILCA fell in love with breastfeeding while nursing her three sons, Carl, Peter, and Ben, who are now grown.  In 1982, before the lactation profession existed, she began working as a volunteer peer-supporter and found her passion: helping families meet their lactation goals. Board-certified as a lactation consultant in 1991, from 1993 to 2003 Nancy started and grew a large private lactation practice in the Chicago area, where she saw thousands of families. Since then, she’s worked for a major breast-pump company and a national corporate lactation program. Currently, Nancy speaks at events around the world and trains aspiring and recertifying lactation consultants online via LactaLearning.com. She also contracts with hospitals to help improve breastfeeding practices. Nancy’s mission is to simplify life for new families, many of whom–without realizing it–make breastfeeding more complicated than it needs to be. To accomplish this mission, Nancy develops innovative lactation education and tools. Her textbooks for lactation specialists, Breastfeeding Answers, Second Edition and its Pocket Guide, are used worldwide.  Her Natural Breastfeeding Professional Package provides digital resources for professionals for staff training and one-on-one work with families. Her books for parents include Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, which she co-authored with Kathleen Kendall-Tackett, Working and Breastfeeding Made Simple, and her tiny troubleshooting guide Breastfeeding Solutions: Quick Tips for the Most Common Nursing Challenges. Its companion Breastfeeding Solutions app is used worldwide and is available on the App Store and Google Play. Her YouTube channel is viewed by millions of families. In 2008 the International Lactation Consultant Association officially recognized Nancy’s contributions to the field of lactation by awarding her the designation FILCA, Fellow of the International Lactation Consultant Association. Nancy was one of the first group of 16 to be recognized for their lifetime achievements in breastfeeding. You can follow Nancy on Facebook, Twitter (@BFReporter), Pinterest, and YouTube. If you work with breast/chestfeeding families and are passionate about lactation support OR you want to turn your passion for nursing into professional practice, check out LactaLearning.com and consider following us on social media! The post All Things Breastfeeding Episode 102: Interview with Nancy Mohrbacher appeared first on The Breastfeeding Center of Ann Arbor.

From Barbara Robertson: Barbara spent some time with Dr. Kathy Kendall-Tackett. She is a health psychologist and International Board Certified Lactation Consultant, and the Owner and Editor-in-Chief of Praeclarus Press, a small press specializing in women’s health. Dr. Kendall-Tackett was the Editor-in-Chief of Clinical Lactation and is still the Editor-In-Chief for  Psychological Trauma. She is Fellow of the American Psychological Association in Health and Trauma Psychology, Past President of the APA Division of Trauma Psychology, and a member of the Board for the Advancement of Psychology in the Public Interest. Dr. Kendall-Tackett specializes in women’s-health research including breastfeeding, depression, trauma, and health psychology. Her research interests include the psychoneuroimmunology of maternal depression and the lifetime health effects of trauma. Dr. Kendall-Tackett is Clinical Professor of Nursing at University of Hawai’i at Manoa. Dr. Kendall-Tackett has won several awards for her work including the 2016 Outstanding Service to the Field of Trauma Psychology Award from the American Psychological Association’s Division of Trauma Psychology, the 2011 Community Faculty Award from the Department of Pediatrics, Texas Tech University School of Medicine, and the 2011 John Kennell and Marshall Klaus Award for Excellence in Research from DONA International (with co-recipient, Thomas Hale). She has authored more than 400 articles or chapters, and is currently completing her 35th book, a social history of The Phantom of the Opera. Her most recent books include: Depression in New Mothers, 3rd Edition (2016, Routledge, in press), Psychology of Trauma 101 (2015), The Science of Mother-Infant Sleep (2014), and The Psychoneuroimmunology of Chronic Disease (2010). She is also co-author of the bestselling book, Breastfeeding Made Simple, 2nd Edition (2010). Her websites are UppityScienceChick.com, BreastfeedingMadeSimple.com, KathleenKendall-Tackett.com, and PraeclarusPress.com. If you work with breast/chestfeeding families and are passionate about lactation support OR you want to turn your passion for breast/chestfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning The post All Things Breastfeeding Episode 101: Interview with Kathy Kendall-Tackett appeared first on The Breastfeeding Center of Ann Arbor.

Nancy and Barbara are celebrating that LactaLearning, Inc is now 3 years old! It is hard to believe that what started out as a dream for Barbara has evolved with Nancy into a thriving business. This podcast shares how Barbara and Nancy became colleagues over forming a book group with Breastfeeding Answers, 2nd Edition in 2020 (now offered as a self-study program), then developed a self-study 95 hour course, brought LactaLearning to life with its first website, and then comprehensive recertification programs. Now three years later, they offer lactation courses that are different than anyone else’s. Really, they have set up LactaLearning to be able to meet anyone’s lactation education needs! They are also celebrating 10 years and 100 episodes of this podcast! Many new podcasts are in the hopper to continue to deliver interesting and informative topics on lactation. Barbara started the podcast in 2015 with the guidance of Barb Demske, then continued with Jessica Beemsterboer, and now Nancy has been added! Busy bees. With a growing social media following, LactaLearning continues to offer posts on Facebook and Instagram that help keep their followers entertained and up to date on lactation happenings. LactaLearning is offering a one day seminar on Low Milk Supply on Saturday, October 25th and in the winter of 2026 a new book group, Working and Breastfeeding Made Simple. Nancy has recently been working on the LactLearning Youtube channel as well to help round things off. Finally, Barbara and Nancy have launched the newly updated LactaLearning website. Check it out! Again, as they celebrate three years in business, founders Barbara Robertson and Nancy Mohrbacher, along with the LactaLearning team, Jessica, Veronica, Heather, Janelle, and Carrie, unveil a new look and introduce easier-than-ever access to all things lactation. With a new glossary of terms, clear class descriptions, and resources designed to empower your lactation journey, we aim to be your go-to resource as you pursue lactation consulting.  We invite you to visit lactalearning.com to browse our many options for lactation education. Barbara and Nancy are always available to answer your questions and to make your lactation goals attainable. The post All Things Breastfeeding Episode 100! LactaLearning is 3! appeared first on The Breastfeeding Center of Ann Arbor.

Kimberly Seals Allers’ words, “I’m a femtech founder, writer, speaker and maternal and infant health strategist with a bold vision to transform the experience of motherhood for all and to eradicate racial disparities in birth and breastfeeding.” Kimberly is someone who sees an issue and works on solutions! She gets things done! Barbara was lucky to be able to catch up with Kimberly on All Things Breastfeeding. From her website: “Veteran journalist and five-time author turned maternal and infant health advocate and femtech founder. A former senior editor at ESSENCE and writer at FORTUNE magazine, I created Irth, as in birth but we dropped the B for bias, as the first-of-its kind, doctor and hospital review & rating platform just for Black and brown women and birthing people. I leveraged decades of media experience and a passion for mothering into a vision and platform to use technology to amplify community voices to address racism and bias in Black maternal and infant care. Irth is a non-profit project of my 501C3, Narrative Nation, which also produces the Birthright podcast, where I share positive Black birthing stories as a direct counter to the doom and gloom narrative too common in mainstream media coverage of Black maternal health.” Kimberly’s new project has been connecting families with a maternal loss at birth with a human milk bank so the baby can receive human milk for the beginning of their life. So powerful. Human Milk Justice for Infants “Powered by HMBANA & Kimberly Seals Allers. The Restoration Project (TRP) is an innovative national response mechanism that addresses the nutritional needs of newborns who have lost their mothers due to pregnancy-related deaths. A partnership between the Human Milk Banking Association of North America (HMBANA) and Kimberly Seals Allers, this initiative builds a nationwide network to collect and distribute donor milk to medically and economically vulnerable populations. Human milk is critical for infant health. TRP ensures that infants impacted by childbirth-related maternal loss receive compassionate care and immediate access to human milk, the best first food for an infant’s health and development.”   The post All Things Breastfeeding Episode 99: Interview with Kimberly Seals Allers appeared first on The Breastfeeding Center of Ann Arbor.

In this episode Nancy and Barbara discuss the latest findings on relacation and induced lactation. According to University of Western Australia’s LactaPedia, an online comprehensive glossary of human lactation terms freely available to professionals and parents (https://lactapedia.com/lactapedia-site/homee), relactation is defined as the re-establishment of lactation after the immediate post-birth period. This restricts relactation only to mothers and other birthing parents who delivered the current baby. This differs from the broader definition used in the 2020 Breastfeeding Answers and other lactation textbooks, which includes anyone who had ever given birth to any baby. Due to the breast-tissue growth during pregnancy, this previous definition assumed those who had ever given birth had an advantage in bringing in milk. Now, establishing milk production by anyone who did not give birth to the current baby is defined as induced lactation. Bringing in full milk production for a baby the parent did not birth is not easy but it can be done. However, thinking of nursing in terms of “all or nothing” is particularly unhelpful. Any nursing can be beneficial for the parent and the baby. Any human milk the baby receives is positive. At the end of this Module, you will find many induced lactation resources. One of the best is Breastfeeding Without Birthing, a book by Alyssa Schnell, an easy read and loaded with information. Here are some possible strategies for inducing lactation. Before the baby arrives One option is an induced lactation protocol using birth control pills and other medications and/or herbs, although these protocols have not been formally studied https://www.asklenore.info/breastfeeding/induced-lactation Another option is taking galactagogues during the month before the baby is due Consider improving gut health to improve milk production Consider beginning a pumping schedule to maximize milk production. For the adopted babies, breastfeeding more than just something nice to do  http://www.internationalbreastfeedingjournal.com/content/pdf/1746-4358-1-5.pdf Once the baby arrives, have the baby’s overall weight checked once a week to ensure proper gain and consider pre and post weights until milk supple is fully established and baby is exclusively nursing. Spend lots of time with the baby skin to skin as soon as possible.  Get comfy in a starter position and enjoy!  It will help remind the babies about breastfeeding and trigger inborn feeding behaviours.  https://vimeo.com/user64721573 Make sure the baby latches deeply. https://drive.google.com/file/d/1GvA-nXVp0esv3Y0TmZ-Q87Amv-4Ylbda/view If the baby is nursing, consider supplementing the babies at the breast using a supplemental nursing system or a Lactaid  https://youtu.be/-mDeRb_iGD4 If using bottles, consider paced bottle feeding.  See Module VII.A.1 for more on this. Until baby is nursing, consider finger feeding. Induced lactation websites and resources: Alyssa Schnell- Best one in our opinion https://alyssaschnellibclc.mykajabi.com/ Podcast (45 min.) hour) with Alyssa Schnell, Getting Off to a Good Start with Inducing Lactation/Relactation: https://podcasts.apple.com/us/podcast/042-getting-started-with-inducing-lactation-relactation/id1078526428?i=1000429588067 Podcast with Alyssa Schnell about her book https://bfcaa.com/all-things-breastfeeding-episode-13-breastfeeding-without-birthing-with-alyssa-schnell/ The biology of the induced lactation in a nutshell https://www.asklenore.info/breastfeeding/induced-lactation/an-introduction-to-induced-lactation/biology-of-induced-lactation https://kellymom.com/ages/adopt-relactate/relactation-resources/ https://www.canadianbreastfeedingfoundation.org/induced/accelerated_protocol.shtml https://breastfeedingusa.org/breastfeeding-your-adopted-baby/ https://www.breastfeeding.asn.au/resources/relactation-and-induced-lactation Nice blog on Re-lactation http://lactationmatters.org/2012/11/29/providing-support-for-mothers-who-wish-to-relactate/ The post All Things Breastfeeding Episode 98: Relactation and Induced Lactation appeared first on The Breastfeeding Center of Ann Arbor.

Barbara first meet Kay Hoover at her favorite conference, Lactation Consultants in Private Practice about 18 years ago. Kay and her dear friend Chris Mulford, created the conference to help private practice folks improve their skills. Kay has been in the field for years, in many different roles, working in private practice, at the hospital, and in public health. From the introduction to The Breastfeeding Atlas, 7th Ediction, Kay…”retired from her hospital job as a lactation consultant at the end of 2019. During the pandemic she provided many on-line presentations to maintain her career-long commitment to educating the next generation of lactation consultants. Kay became an International Board Certified Lactation Consultant in 1985 and was recognized as a Fellow of the International Lactation Consultant Association in 2008. During her career she served as a lactation consultant for four different hospitals. Kay was also employed as a lactation consultant by the Pennsylvania Department of Health for the Breastfeeding Awareness and Support Program, the Philadelphia Department of Public Health in the Division of Maternal, Child and Family Health, and the Center of Childhood Obesity Research at the Pennsylvania State University. In addition, she maintained a private practice for over 20 years. Kay has an international reputation as a lecturer, author, and clinical photographer. Since 1971 she has been a La Leche League Leader and a member of the Pennsylvania Breastfeeding Coalition since its inception in 1992. She served for six years on the Board of Directors of the International Board of Lactation Consultant Examiners. Kay and Charlie, her husband of 55 years, raised their sons, Douglas, Steven, and David, in the Philadelphia area and are the grandparents of Daniel, Eric, and Robert.” Articles Kay referred to: Vazirinejad R, Darakhshan S, Esmaeili A, et al. The effect of maternal breast variations on neonatal weight gain in the first seven days of life. International Breastfeeding Journal Nov 2009 https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-4-13 Claesson IM, Larsson L, Steen L, et al. “You just need to leave the room when you breastfeed” Breastfeeding experiences among obese women in Sweden – A qualitative study. BMC Pregnancy Childbirth 18(1):39, 2018 https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1656-2 The post All Things Breastfeeding Episode 97: Interview with Kay Hoover appeared first on The Breastfeeding Center of Ann Arbor.

Wanting to get to know some of her favorite mentors who are the leaders in the field of lactation, Barbara Robertson is creating a series of podcasts to share with all of you! The first is with Dr. Anne Eglash. Barbara did an interview with Dr. English in 2015 about pain that is published here. Since that time Barbara became an advid fan of IABLE, the Institute for the Advancement of Breastfeeding & Lactation Education that Anne is a huge part of. This organization has a great find lactation support including breastfeeding medicine doctors. It also has one of my favorite brain teasers, Clinical Questions. In this podcast, Barbara and Anne talk about how Anne became interested and involved in the field of lactation, tracing her roots back to medical school. Anne Eglash MD, IBCLC, FABM, is a clinical professor with the University of Wisconsin School of Medicine and Public Health, in the Department of Family and Community Medicine. In addition to practicing family medicine, she has been a board certified lactation consultant since 1994. Dr. Eglash is a cofounder of the Academy of Breastfeeding Medicine, the Medical Director and cofounder of the Mothers’ Milk Bank of the Western Great Lakes, and the Medical Director of the University of Wisconsin Lactation Services. She has published many peer- reviewed articles on breastfeeding medicine, and has special research interests in chronic breast pain, human milk storage, nipple shield use, and outpatient breastfeeding education for health professionals. She sits on the editorial board for Breastfeeding Medicine Journal. She co-hosts and produces a free breastfeeding medicine podcast series, co-sponsored by The Academy of Breastfeeding Medicine, called The Breastfeeding Medicine Podcast, available on i-tunes. Dr. Eglash is founder and president of The Milk Mob, a nonprofit organization dedicated to the creation of breastfeeding-friendly medical systems and communities. The post All Things Breastfeeding Episode 96: Interview with Dr. Anne Eglash appeared first on The Breastfeeding Center of Ann Arbor.

What’s the deal with lipase? There was a recent paper published called Food-Derived Compounds Extend the Shelf Life of Human Milk. Nancy and Barbara found this very interesting and discuss the merits of the findings from this paper, what we actually know about lipase and human milk, and what should we be doing about lipase, if anything. They had many questions about this paper including the fact it was not peer reviewed, not published in a journal, they didn’t actually measure the lipase levels of individuals, and address the question of fresh expressed milk sometimes smelling “lipasey”. Let’s start with what is lipase? We know it is an enzyme that helps break down food. Not everyone agrees about what is true concerning lipase and human milk. Dr. Katrina Mitchell says, “There is no scientific evidence to support the concept of high lipase breastmilk from the freezer.  Milk may smell bad after thawing, but it is from general breakdown of fatty acids rather than an abnormally high content of lipase.  Because the breast is an endocrine organ and sweat gland, breastmilk may smell in the same way our armpits or groins smell. Humans are smelly animals :). In addition, babies may dislike bottle milk because they prefer feeding at mom’s breasts, with her warmth and smell. The Academy of Breastfeeding Medicine Human Milk Storage Protocol reviews the fact there is no evidence to support the concept of “high lipase” and IABLE has an excellent podcast on this topic as well.” So, do we even have a problem? It does seem like some parent’s milk becomes “smelly” after it has been expressed and some babies don’t seem to want to drink it. So what is going on? The fact is we are still not sure. From the new article. “We developed a first-of-its-kind high-throughput screening platform to identify food-derived compounds and combinations of compounds that, when added to human breastmilk, preserve fat content, retain antioxidant capacity, and reduce production of rancid-associated free fatty acids during extended freezer storage. These formulations represent leads for the development of safe and affordable frozen breastmilk shelf-life extenders for easy at-home use to increase the longevity of stored breastmilk.” But do we need this? Nancy and Barbara worry that people will use this compound in their milk preemptively, even when they very well might not have a “lipase” issue.  Are we “solving” a problem that doesn’t need to be solved? In other words, exploiting worried families? The author does note this: “Competing Interest Statement The authors disclose affiliation with and equity in PumpKin Baby Inc., a Princeton University spinout and for-profit public benefit corporation formed over the course of this work. PumpKin Baby Inc. is working to develop and commercialize the technology presented in this report, as the organization&#39s stated purpose is to provide access to scientific research and products that aim to improve access to breastmilk, breastfeeding, and maternal and infant health. Several patents related to the technology described in this manuscript are pending and assigned to Princeton University.” Clearly, he wants to make money off of this, well meaning or not. If you come across colleagues or parents wondering about this, let them know the jury is still out. At this time we cannot say that this is a good solution to the problem. My expressed breastmilk doesn’t smell fresh. What can I do? https://llli.org/breastfeeding-info/smell-human-milk/ The post All Things Breastfeeding Episode 95: Lipase appeared first on The Breastfeeding Center of Ann Arbor.

How to become an IBCLC…. The answer to this is not as simple as we would hope! In this podcast Nancy and Barbara answer some of the most common questions people ask about how to become an IBCLC. Below is a description of the process. You can also join us for our monthly “How to become an IBCLC” Zoom meeting on Monday, August 25 at 7 PM ET. Email [email protected] to join! How to become an IBCLC The International Board of Lactation Consultant Examiners (IBLCE) defines the standards for IBCLC certification. These standards include: Prerequisite education in the health sciences Clinical experience in providing care to breastfeeding families-Deciding on which pathway Education in human lactation and breastfeeding Sign a pledge to adhere to the Professional Code of Conduct Passing a professionally developed certification examination Let’s look at each of these areas.  Prerequisite education in the health sciences The IBLCE Board of Directors has specified 14 subjects in which all candidates for the IBCLC certification exam must complete courses of study. All General Education requirements must be completed prior to applying for the IBCLC certification examination. The General Education requirements include 8 higher education subjects and 6 continuing education At least one course in eight (8) higher education subjects is required. Higher education is defined as education acquired after completion of compulsory education. It is typically provided at academies, universities, colleges, vocational schools, institutes of technology, trade schools and career colleges that award academic degrees or professional credentials. Candidates must have a passing grade in each course. Each course must be at least one academic term in length and completed at an accredited institution of higher learning. Academic term varies from school to school. Semesters, trimesters, quarters and “mini-mesters” are all acceptable academic terms. There is no time limit on this education. It is acceptable if it was completed some time ago. This coursework may be completed as in-person classroom education or through distance learning methods such as on-line courses. These Courses are: Biology Human Anatomy Human Physiology Important note:  Human Biology can fulfill Biology, Human Anatomy, and Human Physiology!!! Infant and Child Growth and Development Nutrition Psychology or Counseling or Communication Skills Introduction to Research Sociology or Cultural Sensitivity or Cultural Anthropology Courses in the additional 6 topics are most typically available as non-credit, continuing education courses of varying length. IBLCE does not specify a certain number of instructional hours for these topics; therefore, courses of varying amounts of instructional time are acceptable. There is no time limit on when these courses must be completed. Courses completed some time ago will be accepted. Courses that combine more than one of the topics are acceptable. There is no time limit on this education. It is acceptable if it was completed some time ago. This coursework may be completed as in-person classroom education or through distance learning methods such as on-line courses. Basic Life Support (e. g. CPR) Medical Documentation Medical Terminology Occupational Safety and Security for Health Professionals Professional Ethics for Health Professionals Universal Safety Precautions and Infection Control When applying for the IBLCE exam, individuals educated in the following health professions will be asked to identify their profession and submit a copy of their license, registration, diploma or transcript. Here is a list from the site. https://ibclc-commission.org/ibclc-information/recognised-health-professions-list/ Dentist Dietitian Midwife Nurse Occupational Therapist Pharmacist Psychologist Physical Therapist or Physiotherapist Physician or Medical Doctor Speech Pathologist or Therapist Individuals who are not educated in one of the above health professions will need to provide transcripts and certificates of completion for the General Education courses. For more information about the General Education requirements, please consult  https://ibclc-commission.org/step-1-prepare-for-ibclc-certification/health-sciences-education-2/ Clinical experience in providing care to breastfeeding families-Deciding on which PATHWAY The 3 exam eligibility pathways are open to individuals from a variety of backgrounds. Each person must decide which pathway will work best for them. For more info, go here: https://ibclc-commission.org/step-1-prepare-for-ibclc-certification/lactation-specific-clinical-experience/ Pathway 1 involves using appropriately supervised clinical experience obtained through paid employment or volunteer service as a health professional or mother support counselor. The kind of supervision that is considered appropriate depends upon the candidate’s professional background and scope of practice. Under Pathway 2 and Pathway 3, the candidate completes clinical practice in lactation care under the direct supervision of experienced IBCLCs. Individuals with no paid or volunteer experience in providing care to breastfeeding families or those who desire a more structured way of learning lactation care clinical skills may choose to follow one of these pathways. Pathway 1 Many candidates use clinical practice they have obtained through paid employment or volunteer service to qualify for the IBCLC certification exam. If you fall into one of the following categories, Pathway 1 is a reasonable choice to make. Your current work or volunteer service includes providing care to breastfeeding families. In the past 5 years, you worked or volunteered in a position in which you provided care to breastfeeding families. Employment or volunteer experience in a position in which you will provide care to breastfeeding families is something you can reasonably expect to obtain. Pathway 1 candidates must complete the following minimum requirements. General Education in the Health Sciences 14 subjects Education in Human Lactation and Breastfeeding 95 hours Clinical Practice Experience in Lactation and Breastfeeding Care 1000 hours   The General Education requirements must be completed prior to applying for the IBCLC certification exam. You must evaluate the higher education that you have already completed and determine whether or not additional coursework is needed. Education in human lactation and breastfeeding is available through various education providers. The required minimum of 90 hours in lactation education must be completed within the 5 years immediately prior to applying for the IBCLC certification examination. Pathway 1 candidates must complete at least 1000 hours of clinical practice experience in lactation care that were accrued in the 5 years immediately prior to applying for the IBCLC certification exam. Clinical practice may be obtained through paid employment or volunteer service in a variety of settings such as hospitals, clinics, birthing centers, medical practices, public health departments and mother support counselor organizations. Appropriate supervision of your clinical practice in lactation care is required. Providing breastfeeding support to family and friends and/or in a setting without appropriate supervision may not be used to qualify for the IBCLC certification examination. Individuals from two types of backgrounds are eligible under Pathway 1. Health Professionals: Nurses, midwives, physicians and dieticians working in maternal-child care are the health professionals who most often seek IBCLC certification through Pathway 1. Unless independent practice is permitted by their scope of practice, health professionals are expected to obtain their clinical experience in the same location in which their supervisor works. Please note that you must possess the legal authority to practice as a health professional in the country, state or province in which your lactation care experience occurred. Mother Support Counselors:  Accredited mother-to-mother breastfeeding support counselors and breastfeeding peer counselors are among the mother support counselors who may use their experience to qualify through Pathway 1. To qualify as a mother support counselor, you must volunteer with or be employed by an organization that requires its counselors to: Complete a structured training program that includes comprehensive education in breastfeeding management. Work within a supervision structure that is appropriate to their training. Adhere to defined ethical standards for conduct. Remain up to date by participating in continuing education. Volunteer mother support group counselors must report to their appointed organizational supervisor and they receive credit for 500 clinical practice hours for each year of active volunteer service. Mother support counselors who are not accredited volunteers must be supervised by an IBCLC or health professional who works in the same location where the mother support counselor works. For assistance in determining if you have sufficient clinical practice hours in lactation care to qualify through Pathway 1, use the Lactation Specific Clinical Practice Calculator found on this page. Pathway 2 Within the 5 years immediately prior to applying for the IBCLC certification examination, individuals seeking qualification through Pathway 2 must graduate from an academic program in human lactation and breastfeeding that meets all of the following requirements established by IBLCE. The program must be offered at an accredited academic institution and the program director must be a recertified IBCLC. Students must complete a curriculum that includes all of the following: Completion of the General Education requirements either prior to enrollment or concurrent with the other academic requirements At least 90 hours of instruction in human lactation and breastfeeding A minimum of 300 hours of clinical practice experience in lactation care that were directly supervised by International Board Certified Lactation Consultants who report to the academic program director Currently, there are 4 academic programs worldwide that meet the above requirements.  Each academic program has unique admission and graduation requirements; no two programs are exactly alike. You may contact the academic institutions for more information about their requirements. This list is provided for the convenience of visitors to the IBLCE website. IBLCE does not recommend or endorse these academic programs. Pathway 3 Individuals seeking qualification through Pathway 3 must have an approved Pathway 3 Plan on file with IBLCE. This mentorship plan must be developed according to the specifications found in https://ibclc-commission.org/ibclc-information/pathway-3-plan-guide/ and must be approved by IBLCE prior to beginning the mentorship. The following table describes the minimum requirements for a Pathway 3 mentorship. Approved Pathway 3 Plan On file with IBLCE General Education in the Health Sciences 14 subjects Education in Human Lactation and Breastfeeding 90 hours Clinical Practice Experience in Lactation and Breastfeeding Care  500 directly supervised hours Pathway 3 was designed for individuals who have little or no opportunity to obtain clinical experience in lactation care through their paid or volunteer employment and/or those who do not have access to an academic program in human lactation and breastfeeding. The first step toward qualification for the  IBCLC certification examination through Pathway 3 is to develop and submit a mentorship plan to IBLCE. Details about Pathway 3 Plan development can be found in https://ibclc-commission.org/ibclc-information/pathway-3-plan-guide/ The General Education requirements must be completed prior to applying for the IBCLC certification exam. Pathway 3 candidates must evaluate the higher education that they have already completed and determine whether or not additional coursework is need. Education in human lactation and breastfeeding is available through a number of education providers. The required minimum of 90 hours in lactation education must be completed within the 5 years immediately prior to applying for the IBCLC certification examination. Pathway 3 requires a minimum of 500 hours of clinical experience in lactation care that were directly supervised by experienced IBCLCs and accrued within the 5 years immediately prior to applying for the IBCLC certification examination. If you are considering Pathway 3, you must locate and contract with one or more IBCLCs who have recertified at least once. These IBCLCs will serve as your mentors and will provide the direct supervision of your clinical practice in lactation care. Education in human lactation and breastfeeding- We offer this online! Check it out! All candidates for the IBCLC certification examination must complete at least 95 hours of education in human lactation and breastfeeding. The required lactation education must be completed within the 5 years immediately prior to applying for the IBCLC certification examination. Lactation education may be completed in a variety of ways, including in-person presentations, online education, distance learning and independent study modules. Our sister site, LactaLearning, offers this educational opportunity! 4. Sign a pledge that you will adhere to the professional code of conduct      5. Passing a professionally developed certification examination You must have your application and materials submitted to IBLCE by these dates.  These dates change and the earlier you apply for the exam, the cheaper it is.  The exam roughly costs $660.00 as of 2024 depending on how early you turn in your materials. The skills in the https://ibclc-commission.org/2018/12/17/revisions-to-ibclc-scope-of-practice-and-clinical-competencies/sections are discussed and are representative of the ways in which IBCLCs apply this knowledge to clinical situations. IBLCE Detailed Content Outline All exam questions have both Discipline and Chronological parameters. This Detailed Content Outline gives you exactly the breadth of information you need to know for the exam.   The post All Things Breastfeeding Episode 94: How to Become an IBCLC – Common Questions appeared first on The Breastfeeding Center of Ann Arbor.

What’s the deal with infant growth spurts? The fact is we aren’t sure. One theory is that the babies are growing faster so needed more calories. The idea is the babies ate more frequently because they needed more food! However, a recent 2024 systematic lit review shows that this is most likely not true. It is true that there are times when babies do nurse intensely for several days. The problem is instead of understanding that this is a common part of infant growth and development, both families and health care providers panic and reach for infant formula which undermines milk supply. Sigh. “In a systematic review of 120 studies, Davanzo and Baldassare found unsatisfied hunger, fussiness, and short intervals between feeding times have been documented as commonly and hastily attributed to inadequate milk supply. In order to provide an easy-to-understand explication for these, unsettled infant behaviors have been connected to the so-called infant growth spurt.” Growth spurts are commonly believed to be short periods of time when a child shows a faster growth rate in height and weight until reaching physical maturity. They are often considered to be at roughly 2–3 weeks, 6 weeks, and 3 and 6 months. This term “infant growth spurt” has been embraced by websites on maternal health and/or breastfeeding, magazines for new parents, and certain public health recommendations on early childhood feeding. “However, there is no evidence that this disproportion (of frequent feeding) might be due to a biological trigger, as suggested by the term “spurt”, but rather simply to physiological variable maternal production, which is expected to be periodically and transiently reduced or frankly inadequate, even in a mother who successfully breastfeeds. Low milk production, insofar as the infant is healthy and properly latches to the breast, can be overcome in most cases by exploiting the mechanism whereby the greater the baby’s request and the longer time spent sucking at the breast, the greater the stimulus to produce breast milk. In fact, the weight growth of a healthy breastfed infant may show, at subsequent checks, a slowdown or arrest of growth followed by phases of true weight recovery (short-term catch-up growth) rather than acceleration (growth spurts) triggered by an endogenous mechanism.” In other words, these “growth spurts” are not associated with increased infant growth. So what are these periods of frequent feeding? They are real! Babies do have days when they seem to eat more intensely. Nancy and Barbara talk about possible theories. Nancy calls them “increased frequency days’ and wonders if either the parent or the baby have gotten a bit complacent with feedings and the baby needs to bump up the supply. Barbara wonders if they are associated with parent hormone drops. The milk ejection reflex is not as strong so the baby needs to pick up their nursing skills a bit. Practice makes perfect! We still don’t know the answer to what is happening but it is a interesting question to think about. The post All Things Breastfeeding Episode 93: What’s the Deal with Infant Growth Spurts? appeared first on The Breastfeeding Center of Ann Arbor.

Nancy and Barbara discuss a new article that came out in 2024. The study was a large study (20,000 women) in Canada and it looked at the length of breastfeeding, overall years/months of breastfeeding and the onset of menopause. Breastfeeding and women are the terms used in the study so we will be using them here and in the podcast to reflect accurately how the authors used these terms. As we age, this becomes more important to us! They looked at different lengths of breastfeeding. We discuss the study and what does the term “menopause” mean. “We analyzed survey data on 19,783 parous women aged 40 to 65 years at enrollment in the Alberta’s Tomorrow Project (2000–2022), a prospective community-based cohort study in Alberta, Canada. Duration of lifetime lactation across all births was categorized as: <1 month (reference group; 19.8% of women), 1–3 months (12.1%), 4–6 months (11.7%), 7–12 months (18.8%), and ??13 months (37.7%). Women were classified as premenopause, natural menopause (age at 1 year after the final menstrual period), surgical menopause (age at bilateral oophorectomy), or indeterminate menopause (age at premenopausal hysterectomy with ovarian preservation).” The results: “In a dose-response manner, longer lactation was associated with reduced risk of natural menopause before age 50 (for ??13 months of lactation, adjusted hazard ratio at age 45: 0.68, 95% CI 0.59–0.78), surgical menopause before age 55 (age 45: 0.56, 0.50–0.63), and indeterminate menopause before age 50 (age 45: 0.75, 0.69–0.82). Longer lactation was associated with lower odds of surgical (adjusted odds ratio 0.54, 95% CI 0.45–0.66) and indeterminate menopause (0.63, 0.55–0.73), compared to natural menopause.” So interesting! Just another reason for us to nurse! The post All Things Breastfeeding Episode 92: Menopause and Nursing appeared first on The Breastfeeding Center of Ann Arbor.

The Breastfeeding Center of Ann Arbor (BFCAA) has been operating for more than 15 years!! To celebrate this milestone Jessica and special guest Barb, the original co-host of the podcast, interviewed Barbara on the journey of starting, building, and growing the Center. From Barbara: “I opened the center in 2008 as a place for all of families’ nursing needs. We had weekly support groups, consults, classes for families, a human milk depot, and some retail. In 2012 I started offering more professional lactation trainings under BFCAA. I was able to combine my two greatest professional loves, education and lactation. I was lucky enough to be joined later on by Jessica Beemsterboer who has a Master’s degree in adult education. The two of us were having such fun! Jessica started as my intern, quickly began teaching with me, and became an IBCLC herself.” The pandemic years changed a lot, but we were able to keep the business running, we moved to a new space during that time, Barbara expanded the professional trainings into a separate business, LactaLearning.com, and we added another IBCLC, Veronica Rapin to the team after she completed her internship with us. Now, both organizations are thriving. With Jessica and Veronica handling operations of running the Breastfeeding Center of Ann Arbor, Barbara is able to focus more of her time on LactaLearning to train lactation supporters, with all three of us continuing to see clients, and planning to continue to grow and support more families. https://traffic.libsyn.com/secure/bfcaa/ATB_Ep_91-_BFCAA15YearUpdate.mp3 The post All Things Breastfeeding Episode 91: 15 Years of BFCAA! appeared first on The Breastfeeding Center of Ann Arbor.

Barbara has been honored to work with many families over the past 20 years but Jamie and Nikki were some of her favorites. Barbara worked with Nikki when she had the family’s first baby a few years ago. The commitment to nursing was powerful! After a few bumps, things went really well. Fast forward and it was Jamie’s turn to carry the new baby for their growing family. There were more hiccups than with the first baby but after a few months, everything settled down as it usually does. Barbara talked with this couple to explore some of the benefits and surprises of nursing babies when you have two moms in the picture. They started out with an idea of how co-nursing might look and watched how it actually evolved. They shared a great resource for queer families looking for some tailored birthing and postpartum support. This is a link to the classes offered currently by Liam Kali. The offerings were a little different four years ago, but we took a childbirth class and did an early parenting weekly support group. https://maiamidwifery.com/pregnancy-parenting/ Enjoy their story! If you work with breast/chestfeeding families and who is passionate about lactation support OR a  and you want to turn your passion for nursing into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning   The post All Things Breastfeeding Episode 90: Parent’s Stories with Jamie and Nikki appeared first on The Breastfeeding Center of Ann Arbor.

Barbara and Nancy discuss the ABM 2022 Mastitis Protocol. Both Nancy and Barbara feel this Protocol is a step in the right direction! However, we don’t agree with everything and you can see others feel the same way. Listen and find out! The ABM (Academy of Breastfeeding Medicine) Mastitis #36 Protoco replaces Protocols #4, #20, and Engorgement Protocol has been retired. From the Protocol: ”…Scientific evidence now demonstrates that mastitis encompasses a spectrum of conditions resulting from ductal inflammation and stromal edema. If ductal narrowing and alveolar congestion are worsened by overstimulation of milk production, then inflammatory mastitis can develop, and acute bacterial mastitis may follow. This can progress to phlegmon or abscess, particularly in the setting of tissue trauma from aggressive breast massage. Galactoceles, which can result from unresolved hyperlactation, can become infected. Subacute mastitis occurs in the setting of chronic mammary dysbiosis, with bacterial biofilms narrowing ductal lumens.” The protocol claims, “Milk stasis has been postulated to be a potential instigating factor for mastitis, although scientific evidence has not proven a causation.” This is one of ideas that really challenges what we have seen in our private practice. A parent misses a feed or a pump, becomes engorged and then seems to have ductal narrowing (what we used to call a plug!) which can lead to mastitis. We will have to wait for more information and research on the subject. Level of research- Not all are in agreement Not everyone agrees with new Protocol. This protocol was heavily influenced by Dr. Katrina Mitchell who is a breast surgeon. We love Dr. Mitchell so don’t get us wrong but she is a breast surgeon so instead of seeing our everyday horses or one off ductal narrowing or mastitis she sees zebras, folks who are in real trouble, all the time! Below are some reactions to the Protocol from others. (Douglas, 2023) https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-023-00588-8 “Clinical Protocol #36 offers some advances in the management of breast inflammation. However, Clinical Protocol #36 also exposes clinicians to two international trends in healthcare which undermine health system sustainability: overdiagnosis, including by over-definition, which increases risk of overtreatment; and antibiotic over-use, which worsens the crisis of global antimicrobial resistance. Clinical Protocol #36 also recommends unnecessary or ineffective interventions which may be accessed by affluent patients within advanced economies but are difficult to access for the global majority. The Academy of Breastfeeding Medicine may benefit from a review of processes for development of Clinical Protocols.” (Baeza et al, 2022) Re: ‘‘Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022’’ by Mitchell et al. “Authors state it is an entity necessitating antibiotics or probiotics to resolve—again, no evidence.” “Changing the term ‘‘mastitis’’ to ‘‘mastitis spectrum’’ seems a step backward, as it implies losing scientific accuracy. It disperses the predisposing factors, the illness itself, and its complications under the term ‘‘spectrum.’’ More solid studies on mastitis are needed, but it is an entity that has a clear clinical definition, which we know how to diagnose and manage. Inserting it within a spectrum adds complicated nuances that are not scientifically justified.” Subacute mastitis “This term is not defined in the literature, much less its cause. The articles cited by the authors (no. 19–22) give different clinical symptoms to define it. Reference no. 22 bases its conclusions once more on the mentioned article on candidosis (no. 5), so we have a circular citation wheel based on opinions and no facts. That subacute mastitis is an entity and that it is caused by biofilms in chronic mammary dysbiosis is supported by no evidence.” Lecithin for blebs- Claim no evidence Therapeutic ultrasound for pain- Claim no evidence Probiotics for mastitis- Claim no evidence Here are the main take homes from the Protocol. I like that they include the strength of evidence. Listen to the podcast to hear Nancy and Barbara discuss each one. All treatments From Protocol #36: “Management of mastitis spectrum disorders includes general strategies that apply to the entire spectrum, as well as condition-specific interventions. Prompt and effective treatment will halt progression in the spectrum. Many of these measures provide not only treatment, but prevention as well.” Treatment suggestions: “Reassure mothers that many mastitis symptoms will resolve with conservative care and psychosocial support.” Level of evidence: 3. Strength of recommendation: C “Assist mothers in identifying ways to decrease stress, increase opportunities to rest, and help resolve early signs of inflammatory mastitis.” “Fourth-trimester care programs represent a holistic approach to postpartum care, including mental health, psychosocial needs, and breastfeeding counseling.” “Educate patients on normal breast anatomy and postpartum physiology in lactation” Level of evidence: 3. Strength of recommendation: C “Many patients experience breast fullness or palpate normal lactational glandular tissue and misinterpret this as ‘‘plugging.’’ They should be reassured that lactating breasts can feel ‘‘lumpy’’ and even painful at times. Although this is uncomfortable, it is not abnormal. Patients should be reassured that infection does not develop in the period of several hours. The pain and redness they may experience in mornings after a long stretch of sleep represents alveolar distention, edema, and inflammation rather than infection.” “Feed the infant on demand, and do not aim to ‘‘empty’’ breasts.” Levels of evidence: 2–3. Strength of recommendation: C “Overfeeding from the affected breast or ‘‘pumping to empty’’ perpetuates a cycle of hyperlactation and is a major risk factor for worsening tissue edema and inflammation.” “In some instances, in which the retroareolar region is so edematous and inflamed that no milk is expressible by infant breastfeeding or hand expression, the mother should not continue to attempt feeding from the affected breast during the acute phase. She can feed from the contralateral breast and return to feeding from the affected breast when edema and inflammation subsides. Edema may resolve more quickly with ice and lymphatic drainage. She should be counseled that a decrease in milk production is expected, but can later be augmented.” “No evidence exists to support ‘‘dangle feeding’’ (i.e., feeding an infant on the floor with the mother hovering above) or other unsafe infant positions.” “Minimize breast pump usage.” Levels of evidence: 2–3. Strength of recommendation: C. “Mechanical breast pumps stimulate breast milk production without physiologically extracting milk as an infant will.” “Avoid the use of nipple shields.” Level of evidence: 3. Strength of recommendation: C “Available evidence does not support the use of nipple shields. Neither safety nor effectiveness has been demonstrated.” “Wear an appropriately fitting supportive bra” Level of evidence: 3. Strength of recommendation: C “Avoid deep massage of the lactating breast.” Levels of evidence: 1–2. Strength of recommendation: B. “The most successful technique approximates manual lymphatic drainage with light sweeping of the skin rather than deep tissue massage.” “It should be noted that gentle compressions during breast pump usage, often termed ‘‘hands on pumping,’’ provide an effect similar to hand expression and is safe if excessive manual force is avoided.” “Avoid saline soaks, castor oil, and other topical products.” Level of evidence: 3. Strength of recommendation: C. “Topical products such as castor oil will not treat this condition and may in fact cause tissue damage particularly if they are combined with massage.” “Avoid routine sterilization of pumps and household items.” Level of evidence: 3. Strength of recommendation: C. “Mastitis is not contagious and does not result from unhygienic practices.” Finally, below are their medical interventions. Medical interventions Decrease inflammation and pain Treat associated blebs and avoid “unroofing” Decrease any hyperlactation Utilize therapeutic ultrasound Consider probiotics Look for mood and anxiety disorders and address if needed If you work with breastfeeding families who is passionate about lactation support OR a  and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning The post All Things Breastfeeding Episode 89: ABM 2022 Mastitis Protocol appeared first on The Breastfeeding Center of Ann Arbor.

Breastfeeding during emergencies used to be a topic about something that was happening somewhere else to someone else. However, now with the rise in tragedies that are happening everywhere in the world, breastfeeding during emergencies affects all of us. We know these emergency situations are increasing and will continue to do so as time goes by. These could be earthquakes, hurricanes, flooding, drought, or war. As Nancy and Barbara were recording this episode, Florida and the surrounding areas were expecting another hurricane. We know that during emergencies, nursing is key to infant health and survival. It provides optimal nutrition and needs no outside resources.  A common myth is that the stress of the emergency or lack of resources for parents will negatively affect families. However, even when malnourished and stressed, nursing parents can produce good quality milk for their babies. New research also shows that during emergencies a mother’s mental health is positively affected by breastfeeding which also promotes more breastfeeding. Good for babies, good for parents. So, what are some of the barriers to promoting and protecting breastfeeding during emergencies? Knowing that providing lactation training to health care workers, relief workers, and families is key for success is at the top of the list. Miss-information is still rampant even among well meaning health care workers and relief workers. Families need accurate medical information and social and emotional support. Exclusive nursing, wet nursing, induced lactation, and relactation should be encouraged in emergencies, as even partial milk production can save babies’ lives. Since 2020 studies show that breastfeeding supportive practices in the hospital during emergencies can increase breastfeeding rates. New research also shows, surprise, surprise, understanding and addressing specific cultural breastfeeding practices and barriers is important. Providing support to a population that already has high breastfeeding rates is very different than working with families that come from an area of low breastfeeding rates. Even the differences between families from urban areas vs. rural areas and their needs can be dramatic. Another recent finding was that facilitating ways to provide breastfeeding privacy is critical to some populations. Being creative is important for this to assess what resources are available and practical. Ideally, families would have a private, safe space to nurse but this isn’t always possible. Aprons, baby carries, and shawls can be helpful here. International rules exist on formula distribution. Making sure these are followed is such an important piece for success. The idea that a milk supply is fragile is a common belief and families worry they don’t have enough milk for their babies (even though they often do!) can be reinforced by having lots of formula available vs. breast/chestfeeding support. We hope you enjoy our podcast! If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning The post All Things Breastfeeding Episode 88: Breastfeeding during Emergencies appeared first on The Breastfeeding Center of Ann Arbor.

In this episode, Barbara Robertson and Nancy Mohrbacher review recommendations and outcomes of parental leave policies around the world.  Paid parental leave varies by country, but the Academy of Breastfeeding Medicine (ABM) has issued a new position statement for maternity leave guidelines, recommending at least 6 months of paid leave. Nancy and Barbara dive into some of the details of when mothers return to work, the economic cost of not breastfeeding babies, as well as the long-term health outcomes for women who breastfeed, such as reduced incidences of heart disease and diabetes.  Nancy also reviews a study looking at the impact of parental leave on mental health issues, which is such an important topic. And keep in mind, it’s not just the length of parental leave that matters – mothers need support for breastfeeding: from their families, their community, their health care providers, and their workplace.  And they need that support through all stages of breastfeeding, however long they choose that to be.  Parental leave policies can help provide the support that families need to be successful in their breastfeeding journey. Resources: ABM Position Statement: Paid Maternity Leave—Importance to Society, Breastfeeding, and Sustainable Development – https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/bettinelli-et-al-2024-abm-position-statement-paid-maternity-leave-importance-to-society-breastfeeding-and-sustainable.pdf U.S. Department of Health & Human Services: Business Case for Breastfeeding – https://www.womenshealth.gov/breastfeeding/breastfeeding-home-work-and-public/breastfeeding-and-going-back-work/business-case Bartick, 2010. The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis – https://publications.aap.org/pediatrics/article-abstract/125/5/e1048/72534/The-Burden-of-Suboptimal-Breastfeeding-in-the?redirectedFrom=fulltext Society for Human Resources Management 2023 Employee Benefits Survey: Executive Summary – https://shrm-res.cloudinary.com/image/upload/v1685728116/Employee%20Benefits/CPR-222434-Employee-Benefits-Executive-Summary-FINAL-for-PUBLICATION.pdf Want more information? If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog If you are a parent and want to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast The post All Things Breastfeeding Episode 87: Parental Leave appeared first on The Breastfeeding Center of Ann Arbor.

In this parent interview episode, we focus on Emily‘s experience with returning to work and breastfeeding, specifically going back to work after maternity leave, pumping and continuing to breastfeed her baby. She worked as a hospital pharmacist in a fast-paced and high-pressure role, the type of job where taking a “break” to pump meant leaving extra work her team needed to cover. This is a challenging factor many working and pumping parents can relate to. Emily shares how she made the situation work, logistics of the (let’s be honest, tedious!) task of pumping every day, and about her emotions around pumping at work for a full year. If you are returning to work and breastfeeding, this is a great story to listen to! Resources: Returning to Work private consultation, we normally recommend these 2-4 weeks before your maternity leave ends, but earlier or later (even after you’re back at work) is fine too Book: Work, Pump, Repeat by Jessica Shortall Book: Working and Breastfeeding Made Simple, by Nancy Mohrbacher If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog   If you are a parent and wanting to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast The post All Things Breastfeeding Episode 86: Emily’s Returning to Work and Breastfeeding Story appeared first on The Breastfeeding Center of Ann Arbor.

We have another parent interview episode! We were thrilled when Alicia reached out to us from across the country to offer to share different parts of her feeding journey with baby Grant, especially factors related to returning to work and breastfeeding. We discussed Grant’s week-long nursing strike soon after Alicia returned to work, the intense emotions involved, and what helped resolve that difficult time. Next, Alicia gives lots of ideas about traveling and pumping, which she learned from her regular multi-day work trips. Her tips will be helpful to anyone traveling without the baby, and/or flying with a pump. And, make sure to listen to the end about what happened after Grant was done weaning! (If you would like to be featured on an episode, send us an email!) Resources: Returning to Work private consultation, we normally recommend these 2-4 weeks before your maternity leave ends, but earlier or later (even after you’re back at work) is fine too. In-person or virtual. We also regularly do virtual or in-person milestone appointments on phases like: making a plan for weaning, on nursing strikes if they come up, what feeding looks like after 6 months or after 1 year, etc. We’re with you from the start of your infant feeding journey to the end, whatever that looks like for you! We are happy to also help with nursing strikes, plans for upcoming travel while lactating, or anything else that comes up for you!   Resource on traveling with milk: https://lllusa.org/traveling-with-frozen-human-milk/ Book: Work, Pump, Repeat by Jessica Shortall Book: Working and Breastfeeding Made Simple, by Nancy Mohrbacher   If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog  If you are a parent and wanting to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast The post All Things Breastfeeding Episode 85: Alicia’s Returning to Work, Travel and Breastfeeding Story appeared first on The Breastfeeding Center of Ann Arbor.

Jaundice and Hypoglycemia Did you know there are new guidelines for diagnosing and treating jaundice and infant hypoglycemia?  In this episode, Barbara Robertson and Nancy Mohrbacher discuss updates to the clinical practice guidelines for safe bilirubin levels and when babies might need intervention. Nancy and Barbara review why bilirubin levels are important and some of the risk factors, like baby’s gestational age.  And there’s the question, is a baby’s stooling is a good indicator of milk input and bilirubin levels? It’s also important to remember that when babies are diagnosed and treated for high bilirubin levels, there can be longer-term effects on breastfeeding and how parents view their baby. Nancy describes a recent study that compares the impact of the new guidelines versus the previous guidelines, and how this may lead to changes in the approach to monitoring and treating jaundice. They discuss the importance of skin-to-skin contact and its impact on bilirubin levels.  Barbara and Nancy also talk about the use of oral dextrose gel to treat infant hypoglycemia, as an alternative to formula. This is one of a series of podcasts that shares new research related to the breast/chestfeeding / lactation / infant feeding world as Barbara Robertson and Nancy Mohrbacher work on the newest edition of Breastfeeding Answers! You can also have access to the newest research and Barbara and Nancy’s reflections on these studies by subscribing to LactaLearning’s newsletter or following LactaLearning on Instagram or Facebook! References for this podcast: Academy of Breastfeeding Medicine protocols #1, #22: https://www.bfmed.org/protocols Kemper, 2022. “Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation” –https://pubmed.ncbi.nlm.nih.gov/35927462/ Sarathy, 2024.  “Bilirubin Measurement and Phototherapy Use After the AAP 2022 Newborn Hyperbilirubinemia Guideline” – https://pubmed.ncbi.nlm.nih.gov/38482582/ If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog If you are a parent and want to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast The post All Things Breastfeeding Episode 84: Jaundice and Infant Hypoglycemia appeared first on The Breastfeeding Center of Ann Arbor.

How important are our communication skills as lactation professionals for our families’ success? This episode is all about the power of words as lactation supporters to boost or undermine our nursing families self efficacy. Barbara and Jessica discuss how the social emotional state of breast/chestfeeding families plays a huge role in the postpartum period and whether or not a family will achieve their infant feeding goals. With all the voices directed at families in the post-partum period, our words as health care providers can be that of empowerment or dis-empowerment. Do we take this seriously enough? We know the social emotional health of our families is important, but have we given it enough weight? Are we considering the weight of how our words are impacting their social emotional state? Give this podcast a listen to dig into this topic more. Barbara shares examples of how this plays out with real life families and introduces new research that emphasizes the importance of how confident families feel and how that correlates to their success at reaching their infant feeding goals. This is one of more podcasts that will be sharing new research related to the breast/chestfeeding / lactation / infant feeding world as Barbara Robertson and Nancy Morbacher work on the newest edition of Breastfeeding Answers! You can also have access to the newest research and Barbara and Nancy’s reflections on these studies by joining LactaLearning’s newsletter or following LactaLearning on Instagram or Facebook!   Research studies referenced in this podcast: Dagli, 2023 “The effect of online hypno-breastfeeding and solution-focused psychoeducation on mothers’ breastfeeding motivation and perception of insufficient milk: Randomize controlled study” – https://pubmed.ncbi.nlm.nih.gov/37917809/ Aderibigbe, 2023 “Psychometric testing of the breastfeeding self-efficacy scale to measure exclusive breastfeeding in African American women: a cross-sectional study” https://pubmed.ncbi.nlm.nih.gov/37822543/ If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog If you are a parent and want to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast The post All Things Breastfeeding Episode 83: The Power of Words and Breastfeeding Success appeared first on The Breastfeeding Center of Ann Arbor.

Lots of families are using formula to feed their babies, either partially or fully, short-term or long-term. But there’s not a lot of info shared with parents on how to feed formula in the healthiest way. In today’s episode, we share some guidelines and ideas on bottle feeding techniques, appropriate amounts based on age and baby’s size, preparing formula bottles, and more. We also discuss the emotions that can come with needing to use formula, especially for families that didn’t plan to or want to. And, we absolutely support families who plan to use formula from the start, or decide to transition to it at any point! There are so many ways feeding journeys can look. We hope this helps answer some questions or gives ideas on how to feed with formula.  Links and resources mentioned: Paced bottle feeding videos on our YouTube channel: https://www.youtube.com/@breastfeedingcenterofannar1863 Amounts: https://kellymom.com/bf/pumpingmoms/pumping/milkcalc/ (Especially see image for baby’s stomach size over first week, and then calculator for after that. Feed sizes apply for both breastmilk and formula. Also: https://kellymom.com/pregnancy/bf-prep/bfcostbenefits/#table2  CDC recommendations on formula preparation: https://www.cdc.gov/cronobacter/pdf/Cronobacter-prevention-infographic-html.pdf and https://www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/infant-formula-preparation-and-storage.html Formula preparation: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/infant-formula/art-20045791 Article on formula marketing: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00118-6/fulltext If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog If you are a parent and want to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast If you want to learn more about formula feeding, check out some of our other posts or podcasts below!: Blog post – Difference between Formula and Breastmilk Blog post – Cost of Formula Feeding Blog Post – Bottle Feeding Help The post All Things Breastfeeding Episode 82: All About Formula Feeding appeared first on The Breastfeeding Center of Ann Arbor.

Breastfeeding/chestfeeding should not be painful! Ongoing and significant breastfeeding pain is a sign that something is wrong. Unfortunately, Julie‘s feeding journey was full of pain for the first few months! She was in a lot of discomfort both while the baby was feeding, later in between feeds and throughout the day as well. It turned out this was from multiple causes. If you are a lactation professional, this is a great episode to learn from a case study around how to navigate a complex case of pain. If you are a parent, this could be a good episode to learn what kinds of things can cause breastfeeding pain and how to recognize the signs of what is not normal to seek out help from an IBCLC. Listen to Julie‘s experience looking for answers and finally getting resolutions and pain-free breastfeeding (yay!). In this episode, you will also hear a bit about Jessica’s clinical experience of the identifying reasons and possible solutions for Julie‘s symptoms as an IBCLC (International Board Certified Lactation Consultant). If you are a breastfeeding parent experiencing pain, we encourage you to reach out for support in your area right away! We also provide virtual consultations that you can schedule at bfcaa.com If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog If you are a parent and wanting to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast Check out more blog posts & podcasts related to ongoing breastfeeding pain and other parent’s stories below: Blog/podcasts on breastfeeding pain Blog post on common causes of breastfeeding pain and information and resources to help  Post on unresolved breastfeeding pain The post All Things Breastfeeding Ep 81: Julie’s story resolving ongoing breastfeeding pain appeared first on The Breastfeeding Center of Ann Arbor.

This is part two of Tara’s breastfeeding story! This one got really long, so we made it into two parts. That’s what happens when Jessica’s best friend is the guest. They just kept going! Tara‘s original vision was to exclusively breastfeed Evie for at least a year. But as she says, even though these were her “best laid plans,” the reality ended up quite different. She struggled with low milk supply, and Evie struggled with feeding at the breast and was mostly bottle fed with pumped milk and formula. Tara eventually made the choice to wean, and finished producing milk around 6 months. So the headline is, “Baby Receives Mom’s Milk for 6 Whole Months! Yay!!” We want to celebrate ALL feeding journeys, whatever the reality looks like for the family. And this story is very representative of a lot of feeding journeys. Despite her low  milk supply and other challenges, Tara did an amazing job providing for Evie, even though it wasn’t as much breastmilk or for as long as she originally pictured. But she is a breastfeeding mom regardless, and we applaud and celebrate everything she’s done, both as a breastfeeder and as a parent! If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog If you are a parent and wanting to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast Check out more blog posts & podcasts related to low milk supply and other parent’s stories below: Episode 63: Melissa’s Breastfeeding Story  Episode 26: Low Milk Supply Blog: Increasing Breastmilk? The post All Things Breastfeeding Episode 80: Tara’s Story Pt 2 appeared first on The Breastfeeding Center of Ann Arbor.

This one got really long, so we made it into two parts! That’s what happens when Jessica’s best friend is the guest. They just kept going! Tara‘s original vision was to exclusively breastfeed Evie for at least a year. But as she says, even though these were her “best laid plans,” the reality ended up quite different. She struggled with low milk supply, and Evie struggled with feeding at the breast and was mostly bottle fed with pumped milk and formula. Tara eventually made the choice to wean, and finished producing milk around 6 months. So the headline is, “Baby Receives Mom’s Milk for 6 Whole Months! Yay!!” We want to celebrate ALL feeding journeys, whatever the reality looks like for the family. And this story is very representative of a lot of feeding journeys. Despite her low milk supply and other challenges, Tara did an amazing job providing for Evie, even though it wasn’t as much breastmilk or for as long as she originally pictured. But she is a breastfeeding mom regardless, and we applaud and celebrate everything she’s done, both as a breastfeeder and as a parent! If you are a parent who is passionate about lactation support OR a professional who works with breastfeeding families and you want to turn your passion for breastfeeding into professional practice, check out LactaLearning.com and consider following us on social media! Instagram @lacta.learning Facebook LactaLearning Blog If you are a parent and wanting to learn more from the Breastfeeding Center of Ann Arbor, you can find us at: BFCAA.com Instagram @breastfeedingcenterannarbor Facebook Blog & Podcast You can find more information about low milk supply through our blog & podcasts related to low milk supply. Check out a few of them at the links below! Episode 63: Melissa’s Breastfeeding Story  Episode 26: Low Milk Supply Blog: Increasing Breastmilk? The post All Things Breastfeeding Episode 79: Tara’s Story Pt 1 appeared first on The Breastfeeding Center of Ann Arbor.

This one is so special! Liz shares her journey of growing her family via a gestational surrogate, and how she induced lactation to bring in her own milk supply! Jessica hosted, and said “beautiful” and “oh my gosh” more times than you can count throughout this amazing story of strength, support, and love for baby Eve and Liz‘s family. (Apologies that Liz‘s microphone was a bit crackly during our Zoom recording!) Some resources on induced lactation: Kellymom.com – https://kellymom.com/ages/adopt-relactate/relactation-resources/  Alyssa Schnell’s Breastfeeding without Birthing – https://www.alyssaschnellibclc.com/book   For parents interested in induced lactation or relactation, we’re able to offer private consults either virtually or in-person. The post All Things Breastfeeding Episode 78: Liz’s Breastfeeding and Induced Lactation Story appeared first on The Breastfeeding Center of Ann Arbor.

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 Medicine Doctor, that parents with recurrent mastitis tended to be massaging their breasts like crazy to “get out plugs”. She believed doing this then led to more plugs! Go to her amazing site, The Physicians Guide to Breastfeeding to learn more. Jessica and Barbara actually had discovered these ideas on their own several years ago with Jessica’s own experience with recurrent plugs. Did she massage like crazy? No! She used cool, Ibuprofen, and gentle touch to help resolve her plugs. What’s going on? Basically, inside the breast/chest, there is not a “piece” of something blocking the way like a literal plug in a bathtub. Rather the area around the milk duct becomes swollen and is pinching off the ability for the milk to flow down and out. Think about a sprained ankle. Would we massage it to death? Or put warmth on it? No, just like mastitis, we want to reduce swelling by cool and maybe some anti-inflammatory medication if it is safe to take. The other idea to consider, is some very gentle massaging (and I mean GENTLE) away from the breast. If you go through the area it can help to help the lymphatic system to help drain away the extra edema (the swelling). If you are struggling with plugged ducts, please consider a consultation! We can help! To learn more about lactation consider one of our amazing Professional Lactation Trainings! We offer two 95 hour courses, several books groups, and many short courses to help with re-certification!   The post All Things Breastfeeding Episode 77: Plugged Ducts and Mastitis New Protocol appeared first on The Breastfeeding Center of Ann Arbor.

Sarah’s breastfeeding story Sometimes it is so nice to just hear a positive breastfeeding story! We tend to hear more about the how things went wrong instead of right. Sarah is lucky enough to have a lot of family support and access to lactation help when she needed it, so guess what? She reached her infant feeding goals! This doesn’t mean that her journey was easy but she was able to keep working on doing what she felt was best for her family. Her journey illustrates what would be possible if our society prioritized making all these resources available to everyone. Good health care, birthing support, lactation support, and family support. Enjoy!     The post All Things Breastfeeding Episode 76: Sarah’s Breastfeeding Story appeared first on The Breastfeeding Center of Ann Arbor.

Barbara is joined by Nancy Mohrbacher to talk about education, particularly about professional lactation education. In the field of education, the traditional method of lecture and Power Point stills dominates the trainings that are available. Research has show over and over again that this is one of the most non-effective ways to help people learn. The purpose of education is suppose to lead to change, in one’s thinking, beliefs, and behavior. In order for this to happen, the brain needs to be engaged, not passively listening to a person talk. In this podcast, Barbara and Nancy talk about what can help make learning more effective, and then how they applied these ideas to the creation of their new 95 hour self study course, the Self Study CCLS. Using a variety of materials, podcasts, videos, webpages, and yes, a few short power points, as opposed to lecture after lecture is crucial. There are reflection questions that help guide the participant to know what is important and what is not. Finally, the participant has to do two assignments that require that they reflect on what they learned, synthesize the information, and then, most importantly, be able to apply it to a common challenge in the field of lactation. Take a listen and see what you think!   The post All Things Breastfeeding 75: Best Education Principles appeared first on The Breastfeeding Center of Ann Arbor.

My work is extremely important to me and is a perfect fit for all of my beliefs and my personality. To me, what we do here at the Breastfeeding Center of Ann Arbor is to help families either become more attached to their babies (hopefully through breastfeeding but sometimes this isn’t possible) and also help professionals learn how to best help families. Jessica, my colleague, has joined me whole heartedly in this work! In this post, we are discussing what we consider our North Stars. The foundational and guiding principles that keep us on the right track for our work. Enjoy! The post All Things Breastfeeding 74: Our North Stars appeared first on The Breastfeeding Center of Ann Arbor.

Used with permission from USBC Yes! Yes! Yes! We say birth and postpartum doulas are the front line defenders of breastfeeding along with nurses and midwives! I believe that the explosion of doulas in Detroit, MI is one of main reasons for this incredibly, too long time in coming change: “According to Michigan Department of Health and Human Services data, Detroit’s infant mortality rate plunged from 16.7 deaths per 1,000 live births in 2018 to 11 per 1,000 live births in 2019, representing a one-third rate reduction.” How amazing! We know that breastfeeding is important for helping save babies lives. Doulas are usually with families for longer periods of time so they can help with multiple feeds. Sure, just like there are breastfeeding issues that are out of an IBCLCs scope, any infection, mental health concerns, physical issues with the baby, and then the IBCLC refers to the proper health care provider. For doulas there are also breastfeeding issues that would need immediate referrals such as pain that is not quickly resolved (I mean like in 24 hours!), low milk supply, and a baby who is not latching. However, there are so many breastfeeding issues a doula CAN help with. And having more training in the field of lactation can help everyone. Here is just a partial list: Explaining how breastfeeding works- basic anatomy and physiology The benefits of breastfeeding and breastmilk Latching and positioning Hand expression Basic engorgement Making sure the baby is eating at least 8 times per 24 hours The signs of a well fed baby How much babies need to eat Paced bottle feeding Pumping Skin to skin Getting ready to return to work SO IMPORTANT- able to refer to a great IBCLC if help is needed! In the field of lactation we have the rules of lactation: Feed the baby Protect the milk supply Solve the problem Knowledge is power and the more folks who work with new families have the knowledge and power of helping with breastfeeding, in my mind, the better. Doulas can absolutely help with steps 1 and 2! It does take a village. To this end we have now created The Breastfeeding Doula Course. Join us this spring! We have been teaching birth and postpartum doulas for almost 20 years. We know what doulas need to help their clients meet their infant feeding goals. Let us help you! This course uses a hybrid-learning model: 20 hours of independent pre-work (reading, videos, podcasts, and assignments) done at your own pace, and then two live Zoom days of discussion, working with families, and practicing skills. Spring 2022 session The pre-work will open March 1, 2022 Live Zoom days: Saturday, May 21 and Sunday, May 22, 2022 from 8:00 AM EDT to 5:30 PM EDT If you are interested in becoming a doula, check out Lifespan Doulas. Patty Brennan has been training doulas forever with DONA and now has created her own streamlined programs and certification.   The post All Things Breastfeeding 73: Doulas and Breastfeeding? appeared first on The Breastfeeding Center of Ann Arbor.

In 2020 Nancy Mohrbacher published her latest book, Breastfeeding Answers, 2nd Edition. We jokingly call this book BA2 and it is one of the most important books in the field of lactation. I was honored that Nancy was willing to co-host a professional book group with me. I had hosted two other book groups before, Making More Milk, 2nd Edition with Lisa Marasco and Supporting Sucking Skills with Catherine Watson Genna, and this format had worked really well to help me (and apparently many others!) to read the other entire book. Having a book group allowed for time discuss the findings and implications of the material, and then hopefully apply the new information into practice. Nancy and I sat down the other day and recorded a podcast about some major shifts that have recently happened in the field of lactation that are included in her new book. One of the great things about BA2 is that Nancy has done all of the research so we don’t have to! This is so convenient for busy lactation professionals! Here are the seven updates to the field of lactation based upon the latest research. To get the full story listen to the podcast below.   1. The research of neonatal jaundice has changed (Hint: it is not all about the poop!) 2. Rethinking tongue tie assessment. Function and symptoms are key. 3. How and when to introduce hyper allergenic foods to babies. 4. The mammary microbiome. 5. Parent obesity and how it plays into breast/chestfeeding success. 6. Prenatal hand expression. Thank you Jane Morton for helping to push this great technique forward! 7. Inclusion of LGBTQ+ folks and their needs. If you want to know more, listen to our podcast below. If you are intrigued by what you might find in Breastfeeding Answers, 2nd Edition, if you want to connect with other lactation professionals in this time of isolation, if you need 36 L-CERPs, then you might want to join our book group with Nancy and I spring of 2022. 36 L-CERPs $299 early bird, $350 regular price Just for fun, no CERPs, $220 early bird, $280 regular price Early bird extended to February 18, 2022! Dates for the group: The dates for this book group are: Session 1: Sunday, March 13, 2022 2:00 PM EDT Session 2: Sunday, March 20, 2022 2:00 PM EDT Session 3: Sunday, March 27, 2022 2:00 PM EDT Session 4: Sunday, April 3, 2022 2:00 PM EDT Session 5: Sunday, April 10, 2022 2:00 PM EDT Session 6: Sunday, April 24, 2022 2:00 PM EDT Session 7: Sunday, June 5, 2022 2:00 PM EDT Session 8: Sunday, June 12, 2022 2:00 PM EDT Session 9: Sunday, July 10, 2022 2:00 PM EDT Session 10: Sunday, July 17, 2022, 2:00 PM EDT Each session consists of a 2 hour Zoom meeting where we will discuss the materials and answer questions. Before each session you will read the assigned chapters (each session has several chapters to read so be ready) and any supporting materials, and after our Zoom meeting you will take a quiz at the end of each session in you have registered for CERPs. You must buy the most recent edition of the book! This is Breastfeeding Answers, 2nd Edition by Nancy Mohrbacher. The Zoom meetings will be recorded so you have the flexibility of missing a session if needed and then listening to the recorded Zoom meeting at your leisure on Thinkific. You will have access to all the materials until September 1, 2022.   The post All Things Breastfeeding 72: 7 Must Know Changes in the Field of Lactation–A Conversation with Nancy Mohrbacher appeared first on The Breastfeeding Center of Ann Arbor.

So sorry for the delays in podcasts! COVID has done a real number on me and I have been struggling to get tasks done that are not critical. Jessica and I are committed to recording and releasing more often! Thank you for your patience. Barbara Back in May 2022 I got this email: “I don’t expect you to remember, but 2 years ago we corresponded about writing a clinical perspective essay for Clinical Lactation about Exclusive Pumping and lessons I gained as an IBCLC from being an exclusive pumper. I really appreciate you reaching out when you did to acknowledge how important my experience was, and for encouraging me to write something more formal. It meant a lot to have my experience and my voice valued in that way…I have finally had time to revisit the idea of writing this article. I’ve been working on this article with a writing group, and I think that it is finally ready to go.” I was so excited! I had reached out to Miriam about exclusive pumping back when I was tasked with writing clinical articles for the journal Clinical Lactation Although I was not responsible for this anymore, I felt that this was information people needed to have. I put Miriam in touch with the right people at the journal and extended the idea of us doing a podcast about her story, experience, and the wisdom I knew she had for us. Miriam talks about her own breastfeeding journey which, as is true for many of us, did not go as planned. She then talks about the lessons learned that she has applied to her own work in the field of lactation. I think one of her biggest take home messages is that although many people do choose to exclusively pump from the beginning, most exclusive pumpers really wanted to breastfeeding/chestfeed but didn’t end up being able to reach that goal for many, many reasons. Please listen and enjoy!   The post All Things Breastfeeding 71: Miriam’s Story- Exclusively Pumping appeared first on The Breastfeeding Center of Ann Arbor.

Breastfeeding twins? Yes! Sometimes you feel like breastfeeding one baby is almost impossible but then you have TWO babies! Anna shares her story about how she is successfully breastfeeding her twins. It was not easy but also achievable with the right help and support. When you have babies who are early, even a little bit, it can make the process harder. Although Anna’s babies were born “term” for twins, 37 weeks, that is still early! These babies often need some supplementation while they transition to the breast. Getting started with breastfeeding twins Anna had taken a prenatal breastfeeding class with us so she would be prepared. After the birth, she spent lots of time with the babies skin to skin, and got her milk moving right away! She did a combination of hand expressing (she started within the hour after birth) and then pumping, at least eight time per 24 hours. This allowed the babies to get her milk AND protected Anna’s breastmilk supply so when the babies were ready to fully breastfeed, she had plenty of milk for them. It does take village! Anna and her husband Dirk had no idea how much work twins are. I don’t think anyone can be totally prepared for this. It is not just twice as much work. It seems like ten times the amount of work! Fortunately, Anna’s parents were here to help and, boy did they! It seems like everyone had a baby in arms all the time! This extra help meant Dirk and Anna could focus on caring for the babies and here and there for themselves. The meals, cleaning, all those other tasks were taken care of by the grandparents. Anna says the first months were a blur! Transitioning to breastfeeding This is an art, helping babies move from bottle feeding to breastfeeding. Making sure good Paced Bottle Feeding is happening is critical. Also, having a good IBCLC in your corner can do nothing but help. We met on Zoom primarily, the babies were born during the height of COVID, about once a week to assess where the process was and what to do next. Of course, so typical, one of the babies was ready to be exclusively breastfeed before the other. This happens most of the time! Karen Gromada has a great book about this, called Mothering Multiples. Getting help for this transition is critical so don’t be afraid to reach out! Enjoy Anna’s story! The post All Things Breastfeeding 70: Anna’s Breastfeeding Story- Breastfeeding Twins! appeared first on The Breastfeeding Center of Ann Arbor.

Becoming an IBCLC is not easy! Many people are surprised to find out that to becoming an IBCLC (International Board Certified Lactation Consultant) is hard. You need 8 college courses, 6 continuing education courses, 300-1000 clinical hours working with breastfeeding families, a 90 hour professional lactation course, and THEN you can qualify to take a four hour exam. It is a true profession! If you want to learn more email [email protected] to learn more! We have monthly Zoom meetings to review the process and help answer questions. Jessica and I first met when she had her first baby five years ago. She was having breastfeeding trouble. We had a consultation and then she was a regular attendee at our weekly Breastfeeding Cafe. Jessica was very lucky that she did not have to return to work until the baby was six months old.  I did help Jessica return to work and meet her breastfeeding goals. The journey to becoming an IBCLC begins… Jessica contacted me again in the spring, 2018. She had been thinking about a career change. Jessica has a Master’s degree in adult education that she was utilizing in her current job developing trainings for her work and as a employee trainer. She wanted to do something that she felt could make more of a difference. I have many people who want to work with me to get their clinical hours on their path to becoming an IBCLC so this was not a new request. I have developed a way that helps me get to know my possible future intern and allows them to really see my style to determine if we will be a good fit. Basically, I have people I think might be a good fit come to my Breastfeeding Cafe. I want to see how the candidate interacts with parents, and if they have been a parent themselves, how they shift from the role of being helped to being the helper. I am looking for great communication skills, someone who can listen well, and help families feel cared for during this, often, challenging time. Needless to say, Jessica did a great job! Next steps… Once Jessica and I established we wanted to work together she needed to apply for Pathway 3 with IBLCE. They needed to approve Jessica as a Pathway 3 IBCLC candidate and approve me as one of her mentors. This happened in the fall of 2018. Jessica also needed to take my 90 hour lactation course. I do require my interns take this course with me so they have the knowledge base needed (from my point of view) to actually work with clients. I do suggest that any aspiring IBCLC take a 90 hour course near the beginning of their training so they have this foundation of knowledge. Jessica took Part 1 of my course is spring of 2019 but then had her second baby! She delayed Part 2 until the fall of 2019. All the while she was collecting clinical hours working hard with me. Ready for the exam… Jessica applied for the IBCLC exam to be taken in the spring of 2020. We all know what happened there! Because of COVID Jessica had to wait until the fall of 2020 to take the exam. Of course she passed! Jessica got her exam results in December of 2020! What next? Jessica now has left her old job and works full time as a mother and part time with The Breastfeeding Center of Ann Arbor! Jessica is seeing clients, helping me with business tasks, and maybe most importantly, she helps me develop curriculum and she teaches for me! Congratulations Jessica!   The post All Things Breastfeeding 69: Becoming an IBCLC- Jessica’s Story appeared first on The Breastfeeding Center of Ann Arbor.

What is hand expression? Great question! Basically it means getting breastmilk out of a lactation breast without a baby or a breast pump. At The Breastfeeding Center of Ann Arbor, hand expression is a typical tool we review with most of our families because you never know when you might get caught with no baby, no pump, and a full breast! Literally a life saver. Practice does make perfect with hand expression. We have a brand new podcast about this! Enjoy here! Reasons to hand express Here are just a few reasons you might want to hand express. Listen to our podcast to here many more!  The first is the day or two after the baby is born. If the baby is having trouble with latching, the hospital staff are concerned about the baby for a medical reason and want to supplement, or not the baby is not draining your breasts well, doing hand expression in the first hour after birth, right into a clean teaspoon, is a great way to help keep your baby fed and protect your breastmilk supply. Another reason is to help entice the baby to latch. A little hand expressing before latching gets the breastmilk right there, at the end of your nipple for your baby to taste. Some hand expressing after pumping to help finish draining the breast when increasing or protecting your milk supply is also a great use. Having a preterm or a baby in the NICU is a great time to get going immediately with hand expression while the hospital staff gets you set up with a breast pump. Ways to hand express There are so many different ways to hand express. One of our very favorites was created by Maya Bolman, IBCLC from her experiences in Russia where hand expression is very common. Here is a link to her video. It is also great for engorgement or any time you have a really full breast. Don’t worry if this method is not for you. There are others listed below to try. Whatever method you use hand expression should not hurt! Be gentle with your body! The steps to Maya Bolman’s technique 1. Have a clean container ready to catch the milk and wash your hands. If you are in a bind and don’t have a container, a sink will do in a pinch. A shame to waste the milk but better to protect your body! 2. Preparing the breast. Consider doing some gentle massaging before hand expressing. Research shows this and/or warmth before trying to hand express or pump for that matter increases the effectiveness of hand expression. Maya demonstrates a “tapping” on the breast which seems to be important. Spend a few minutes getting your breasts ready to be expressed. If your skin feels tight or fragile, consider using a bit of olive or coconut oil on your hands for comfort. 3. Maya has families place their hands close to the nipple. Think about where a baby latches on. Not way back in the breast. We like to think of lining up the finger tips with the nipple. Finger tip, nipple, finger tip. See the photo.             4. Push the fingertips together gently. Release. Bring together. Release. It may take 10-30 of these gentle squeezes before milk appears. Don’t get discouraged! If milk is not coming yet. Just go back to step one. Breathe deeply and try to relax. This will help as well. If the milk is still not coming try going a little closer to the nipple or a bit further away from the nipple. Put your fingers in a different spot. 5. Alternative hand expressing with tapping and massaging until your breasts feel comfortable. Stanford University- Jane Morton’s technique Another popular hand expression technique is from Jane Morton. Here is a link to her video. 1. Again, Jane encourages some gentle massaging before beginning to hand express. 2. Having a bigger handful of breast might be helpful, still having the nipple centered. 3. Having families, gently push back in their breast, bring their fingers together, and release, Jane’s method can be effective. We encourage you to give 10-30 of these gentle squeezes before getting frustrated. 4. If the milk is not flowing yet, do some more massaging, shift your hands a bit, and try again. Other ways to hand express Here are some other examples of hand expression. Everyone does it a bit differently! Great one! Global Health Media A modified version of Jane Morton’s technique Another version of Jane Morton’s technique Another example   The post All Things Breastfeeding 68: The Beauty of Hand Expression! appeared first on The Breastfeeding Center of Ann Arbor.

Breastfeeding book groups? What on earth do I mean by breastfeeding book groups? So, fall of 2019 I had just finished helping Lisa Marasco with some final edits of her and Diana West’ new edition of Making More Milk, 2nd Edition. The holidays were coming and I ordered a copy of the book for each of my interns. I thought to myself, we should read this together as a book group. Let me explain a few things here. First of all, I am a voracious reader. Have been my whole life. I read 1-4 books per week. However, what I almost exclusively read is fiction. I read Pulitzer prize winner to the worse chick lit. I don’t read a lot of non-fiction. Secondly, I love book groups. I spent the first 31 years of my life reading alone. I had no one to talk to about what I was reading or had read. In 1995 I boldly asked to join a book group with someone I liked very much but didn’t know very well. 26 years later I am still part of this group and have read some of the most challenging books of my life. About 5 years ago I did start a book group that started out reading fiction but quickly moved into books about self transformation which are non-fiction. Because of my commitment to the group, I almost always would read the book. Professional Breastfeeding Book Groups Back to fall of 2019. I knew I wanted to read this new amazing book very closely so I could best help my clients. But when I thought, we should read this (my interns and I) as a book group it occurred to me that many others might like to join us as well. I even proposed the idea to one of the authors, Lisa Marasco who is a good friend of mine in November of 2019. She thought the idea was interesting. I tucked this thought aside and moved on with my life. COVID Ruins Everything My husband was an early predictor of the tragedy COVID would bring to us all. Toward the end of January he predicted we were all in for some serious trouble and would be needing to isolate for a long period of time. I was thinking of until June. Ha! But this meant my consultations and teaching would be greatly impacted so it was time to get into gear. Necessity is the mother of invention! I reached out to Lisa again and she was in for the book group. Diana West was struggling with some health issues and other commitments so she gave her blessing but was not able to participate. I was already doing a hybrid model for my 90 hour professional course and we had just moved our courses to a new online education system, Learning at The Breastfeeding Center of Ann Arbor on Thinkific. I knew Zoom was going to become everyone’s new best friend ASAP so I imagined a book group that could be for professionals BUT also for parents. Making More Milk, 2nd Edition is written for families but it is also the best resources on increasing breastmilk supply for professionals. Just FYI, I could not have done this without the support and guidance of my then intern, now colleague, Jessica Beemsterboer. She did research, help trouble shoot, and gave me the confidence that I could do this! Making More Milk Book Group I created a 7 week course using my hybrid model. We would read assigned chapters, I created chapter summaries for each of the chapters. We also had supporting materials, and then once a week we would meet on Zoom with Lisa Marasco. She was able to attend 5 out of 7 of our meetings. Lisa and I would discuss each chapter, clarify points and emphasizing what we felt was important, and then we would take Q and A. We meet for 1.5 hours, recorded the meeting, and then posted it on Learning at the Breastfeeding Center of Ann Arbor on Thinkfic so if someone could not attend our live session they could listen to the recording later. This was a hit! We had over 70 people join us! New Ideas, New Groups It became clear in May that COVID was here to stay so I reached out to another good friend, Cathy Watson Genna about doing a 10 week book group with her book, Supporting Sucking Skills, another critical professional breastfeeding book. I did that book in fall, 2020 and had over 100 attendees! The Breastfeeding Center of Ann Arbor is now rocking it out with Nancy Mohrbacher and her new Edition of Breastfeeding Answers, 2nd Edition. We have 130 attendees for this group! Self Study- On Your Own, At Your Own Speed Now we are offering both Making More Milk and Supporting Sucking Skills as self study groups. You will have access to all the supporting materials and then recordings of our Zoom meetings. Obviously not the same as attending live but we sure dive in deep! Listen to this podcast to get a taste of what we did for Making More Milk. This was recorded last July when we were sure what direction we were going but it is interesting how a bit of creativity and will power get something really cool finished. We hope you might join us for one of these self study groups or one of our live book groups in the future!   The post All Things Breastfeeding 67: Breastfeeding Book Groups! appeared first on The Breastfeeding Center of Ann Arbor.

OMG. It has been too long! Karen and I recorded this back in June but due to Covid I haven’t been able to get this to move to the top of my list to publish. Thank Jessica for pushing me (in the nicest way) to keep after this and get it done! We love breastfeeding stories. Karen’s is very interesting because she is actually part of the health care system herself. She did great with breastfeeding but actually in spite of the “help” she got. What happens before and after the birth can make or break breastfeeding. Fortunately, Karen had educated herself about what to expect with breastfeeding and kept on her path even though she had a few nay sayers, especially in the hospital where she gave birth. Returning to work was another challenge but again, Karen had prepared herself and knew what to do! She did a great job. Enjoy her story!   The post Episode 66: Karen’s Breastfeeding Story appeared first on The Breastfeeding Center of Ann Arbor.

Barbara Robertson chats with Nancy Mohrbacher about her new edition of Breastfeeding Answers, 2nd Edition and their upcoming project. Do you want to unlock the secrets of Breastfeeding Answers, 2nd Edition? Barbara D. Robertson will be joined by Nancy Mohrbacher, the author of the book, to discuss their upcoming venture and break this down for you. Having a structured format of a book group tends to move things from the “oh I should do that” to DONE! Barbara and Nancy will talk about how this group will be using Zoom Meeting. and Thinkific, an online learning platform. December 17, 2020 (Or if you register after this date a day or two later) you will get an invitation to join us on Thinkific, an easy to use, online learning program. You will see the required reading listed for each of our ten sessions and meetings. You will need to get your own copy of Breastfeeding Answers, 2nd Edition, either a hard copy or an ebook edition. There are many different ebook options, Kindle, ePub, and a PDF versions. The 1st edition (or earlier!) will not do! So much has changed in these past years. You will read the assigned chapters, attend our live Zoom meetings or listen to our recording meeting discussion with Q and A, review any supplemental materials, and then, if you registered for our 36 CERPs version, take the quiz at the end of each session.  36 L-CERPs Early bird price $299  (Ends December 17, 2020) Regular price $350 No CERPs Early bird price $220 (Ends December 17, 2020) Regular price $280 What is a book group? A book group is where a group of like minded people get together after having read the same materials. Usually, they get together (often with a glass of wine!) but during COVID groups are meeting virtually. This group can then have an informed discussion about those materials. Usually, the author of the book does not attend the meetings. The power of a book group is the collective knowledge, experience, and perspectives from its members. Each person’s voice needs to be heard to form questions for discussion and to be able to analysis the materials. We are honored to have the author Nancy Mohrbacher join us for 10 out of our 10 sessions! When will this be? The dates for this book group are: Session 1: Sunday, January 17, 2021 6:30 PM EDT Session 2: Sunday, January 24, 2021 6:30 PM EDT Session 3: Sunday, January 31, 2021 6:30 PM EDT Session 4: Sunday, February 14, 2021 6:30 PM EDT Session 5: Sunday, February 21, 2021 6:30 PM EDT Session 6: Sunday, February 28, 2021 6:30 PM EDT Session 7: Sunday, March 7, 2021 6:30 PM EDT Session 8: Sunday, March 14, 2021 6:30 PM EDT Session 9: Sunday, March 28, 2021 6:30 PM EDT Session 10: Sunday, April 4, 2021 6:30 PM EDT Each session consists of a 2 hour Zoom meeting where we will discuss the materials and answer questions. Before each session you will read the assigned chapters (most sessions only have one chapter but four sessions so have two) and any supporting materials, and after our Zoom meeting you will take a quiz at the end of each session in you have registered for CERPs. You must buy the most recent edition of the book! This is Breastfeeding Answers, 2nd Edition by Nancy Mohrbacher. The Zoom meetings will be recorded so you have the flexibility of missing a session if needed and then listening to the recorded Zoom meeting at your leisure on Thinkific. You will have access to all the materials until 4-15-21. The post Episode 65: Interview with Nancy Mohrbacher- New book group! appeared first on The Breastfeeding Center of Ann Arbor.

Oversupply? Too much breastmilk? Is that really a problem? The answer is, YES, oversupply is a big problem for people who are struggling with this. Milk everywhere, choking babies, are there answers? For sure! Listen to this podcast to get more information. Symptoms: Baby choking Baby clucking at the beginning of feed (when the milk is flowing fast) or during let downs Fussy babies Milk everywhere! What to do about an oversupply? First, figure out what is really going on. Some families can actually just have a strong milk ejection reflex and actually not have too much milk, a true oversupply, but it can be confusing. Sometimes it can look like too much milk is the issue but actually it is the baby not being able to handle flow period. Babies are fussy for lots of reasons. Fast flow is just one of them! Getting help from an IBCLC can help sort out these questions for sure and make a strong plan to move forward. Possible solutions for an oversupply Many people turn to google when they think they have an oversupply. It’s what we do! Sadly, there is a lot of information on google that will come up first and actually potentially make breastfeeding worse. Many of the suggestions (such as blocked feedings, pumping after feeds to fully empty, and taking medications or eating certain foods to reduce your supply) can shift an oversupply into an under supply with the family being unaware that this is happening. Personally, we don’t use these methods very often (but never say never). Instead we help identify the cause of the trouble and then create a concrete plan as to how to address the issue. It is common for families to start out in the first weeks with what feels like an oversupply but then milk supply naturally calms down as the milk supply shifts from being driven by hormones to supply and demand. Please don’t sit with these issues yourself! Get help. Oversupplies are something that is fairly straightforward to resolve. It does take time and a good plan to make sure all is going well. The post All Things Breastfeeding 64: Oversupply! appeared first on The Breastfeeding Center of Ann Arbor.

Another breastfeeding story! This one is particularly dear to Barbara’s heart. Melissa came to see Barbara after the birth of her first baby and was struggling with her rate of breastmilk production. Although Melissa was able to increase her supply a bit, she still needed to supplement her baby. Second baby When Melissa was pregnant with her second baby she called Barbara to set up a prenatal breastfeeding consultation. Barbara was surprised because she remembered Melissa as being a very successful breastfeeder. Melissa was, she nursed for over two years! She also struggled with low milk supply. Indeed when Barbara looked up Melissa’s records she found that this was true and they worked on setting up Melissa for as much success as possible. Baby number three Barbara met with Melissa shortly after the birth of her third child. Again, the goal was to optimize Melissa’s milk supply. Melissa used formula to supplement her first baby but then she delved into the world of milk sharing. She wanted human milk for her human babies. She carefully screened her donors, asking about their health history, any medications, their babies, and pumping practices. She also choose to use flash pasteurization to make the donor milk even safer. Your breastfeeding story, it doesn’t have to be all or nothing Melissa has (and still is) been a successful breastfeeding mother who struggles with her rate of breastmilk production. Many times families don’t realize that you can be successful with breastfeeding and it doesn’t have to look the same each time. Families go back to work, struggle with milk production, have babies how can’t latch well, all kinds of issues that make it hard to have the tradition model of having the baby exclusively breastfeed directly from the breast. Remember, breastfeeding isn’t all about food, it is about the relationship as well. Babies suck on pacifiers all the time and don’t get milk! Why not use the breast as a place of comfort, peace, calm. And any milk that baby gets is so, so good for it! The importance of Paced Bottle Feeding Melissa attributes a lot of the success to her story to paced bottle feeding. By slowing the bottle feeds down and making them more work she helped her babies know that feeding is work and takes time, like breastfeeding! We hope you enjoy Melissa’s breastfeeding story as much as we have! The post All Things Breastfeeding 63: Melissa’s Breastfeeding Story appeared first on The Breastfeeding Center of Ann Arbor.

Here are our COVID updates! Barbara accidently published the unedited version of this podcast! Here is the edited version. Sorry! Jessica COVID updates Jessica is at home with her two your children trying not to miss a beat while being a full time parent and having her and her partner continue to work full time. This sadly, is a common theme. Although this is very challenging, Jessica is very aware of the privilege that she has, being able to continue to work from home, that she hasn’t lost her job, or been deemed as an essential worker.  Many of our families are not able to work from home. Where do the babies go? Most child care is closed during this time. Jessica is also continuing to help run the Breastfeeding Center of Ann Arbor. Barbara’s COVID updates Barbara, on the other hand, because her babies (24 and 21 years of age!) are older, has been moved into a very creative and productive time. She does struggle with depression, so it hasn’t all been smooth sailing (there have been several days of despair) but since she has been sheltering at home she has had enough time to get several new projects going and updated some old ones. Working in pajamas, sitting at the dining room table, Barbara has created the Making More Milk Book Group and lined up to two future book groups, Supporting Sucking Skills with Cathy Watson Genna and the new 2nd edition of Breastfeeding Answers  with Nancy Mohrbacher! Look for info about these soon.   Even more COVID updates! Barbara is also moving all of her online training to Thinkific. The CCLS (Clinical and Communication Lactation Specialist) 90 hour professional course hybrid is just about ready to go for the fall session. She will also be launching her totally online version of this course starting in September, 2020! Due to not be able to meet in person Barbara is now offering virtual breastfeeding consultations. Rebecca, one of Barbara’s interns, is offering a virtual Breastfeeding Cafe on Zoom! Email [email protected] to join us!   The post All Things Breastfeeding 62: Updated COVID updates appeared first on The Breastfeeding Center of Ann Arbor.

A conversation with Laurel Wilson IBCLC! Yes, we were lucky enough that Laurel Wilson IBCLC reached out to us to do a podcast. We have been big fans of Laurel for a number of years. I attended a talk to hers in Grand Rapids a number of years ago and was hooked! Don’t know Laurel Wilson IBCLC yet? Laurel has the site Mother Journey. “Tens of thousands of research articles are published each year with potential health implications for new families. Healthcare providers rarely have the time to read, digest, and implement the growing database of research. At Mother Journey, keeping up with the perinatal research is something Laurel is committed to. She watches trends in health care, prepares succinct, insightful presentations, helps YOU provide better care to families.” Yes! Laurel is doing presentations on epigenetics (something that I am blown away by) and the implications for breastfeeding. I am hooked. I have now seen several more of her discussions of the biological implications of not breastfeeding. So important! Laurel Wilson IBCLC Tedx Talk “Breastmilk is an evolutionary food. It has helped humans succeed in inhospitable places, during traumatic times, and in habitats that would not otherwise have been possible. None of us would be here if it weren’t for breastmilk.”? Love this! I also think that we have no idea as to the health implications when we feed our babies milk that is not our own. From the podcast on the power of breastmilk: “Its a very powerful tool that we have as mammals: this ability to literally liquefy ourselves and provide genetic, immune, and nutritional information to our children.” Yes! We hope you enjoy this podcast and learn more about what Laurel has to say.       The post All Things Breastfeeding 61: Conversation with Laurel Wilson IBCLC! appeared first on The Breastfeeding Center of Ann Arbor.