All you ever wanted to know about Breasfeeding

Apr 19, 2023 | Let's Hear From The Experts

Lauren Sams is a Pediatric Registered Dietitian and International Board Certified Lactation Consultant. She received the majority of her training while working in the NICU at a children’s teaching hospital in South Carolina. Lauren struggled to breastfeed her son, who is now 5 years old, and it was through this journey that her passion to support ALL moms and ALL their feeding decisions was born. She started Grow Baby Nutrition & Lactation early 2021 and serves moms locally in Waco, Texas.

In this Episode:

  • Why you need to work with an IBCLC
  • Common breastfeeding issues for first time moms
  • Regulating an oversupply
  • Tips for increasing an under supply
  • Pumping when baby sleeps through feeds
  • When you can expect your period to return while breastfeeding

Connect with Lauren:

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Connect with Lindsey:

Instagram: @‌food.freedom.fertility
Twitter: @lindseylusson
Tiktok: @foodfreedomfertility

Podcast Transcript

Welcome, Lauren.

Lauren Sams  01:25

Thank you!

Lindsey Lusson  01:26

We’re so glad you’re here and love to always like pick the brain of an expert on any topic, in particular, a topic that is near and dear to my heart and near and dear to a lot of moms or future moms or expectant moms lots of questions that we have around this. So as a international board certified lactation consultant or an ibclc. How many hours do you think you’ve spent so far helping women learn how to breastfeed?

Lauren Sams  01:54

Yeah, that’s a great question. So in order to become an IBCLC, there’s three main pathways and each pathway has a different amount of hours that you are required to log. So the one that I did, it was officially 1000 hours, and I’m going to be honest with you once I got those 1000 hours, I have not been logging my hours. I don’t know I don’t know how many hours I spent teaching, teaching and helping moms. But I have been probably like an easier way to answer the question. 

I have been working with moms and babies since 2015. helping mothers feed their babies either via the breast via the bottle. I’ve had a lot of babies feed, using like tube devices, baby’s feeding breast milk, baby’s feeding formula baby’s feeding food. So I’ve been in the game since 2015. I have no idea. At least, I had to log at least 1000 hours in order to be eligible. But wait more than that.

Lindsey Lusson  02:48

Amazing. So tons of hours and almost a decade now have experienced healthy speed babies.

Lauren Sams  02:55

Yeah. I mean, who knows!

Lindsey Lusson  02:58

What made you want to go the ibclc route because it sounds like you started as a pediatric dietitian. You know, we decided through some experience like hey, this is my passion. This is what I want to do. Where do you think that’ll start in?

Lauren Sams  03:10

Yeah, that’s a great question. So, um, in school, you know, we learned from textbooks and as dietitians we go to school for a really long time we learn from textbooks. And then we have our internship and our internship allows us to see really kind of what the real world looks like. And so, when I started working in the NICU, as a pediatric dietitian, I immediately fell in love and made friends with all of our lactation consultants, because a lot of what we do, like lactation is nutrition, there’s so much overlap there. 

So I found myself, you know, just doing my consults with the lactation consultants because they were going to be asking similar questions that I was going to be asking. And so really started to learn from them at that point, as we were treating patients together. And then, you know, I felt like I gained a lot of that kind of sparked my my textbook knowledge of desire for textbook knowledge and lactation. But it wasn’t until I had my son and I was like, holy moly. 

They don’t teach you all of this, the textbooks, this is way harder, you know, going into it thinking I’m a baby dietitian, I have a lot of knowledge about lactation, like, this is going to be a walk in the park for me, and it just wasn’t. So I came back from maternity leave. I was talking to some of my ibclc mentors. And I was like, Hey, I think you know, I want to get some type of certification and lactation, and there’s different levels that you can get. And they’re like, don’t do the baby levels. Just you need to work on IBCLC with your experience with your passion, go towards IBCLC and I was like okay, all right. I’m going to officially start like collecting hours and do the ibclc route.

Lindsey Lusson  04:43

You’re a legacy. They should like shave off some hours for that or something. That is amazing. I always have thought even before becoming a mom, I have always thought breastfeeding is incredibly fascinating, like the science behind it. But then I also remember after breastfeeding my daughter, I was like, oh, I should become an IBCLC.

Lauren Sams  04:43

And it’s actually fun too, because my grandma was one of the first IBCLCs way back when and she has passed since then. So she has not been been able to be a part of my journey, but it’s fun to know that it’s kind of it’s also in my blood a little bit too.

Lindsey Lusson  05:22

I looked into it, and I was like, Whoa, that work. And so I love that too. Because right, there are different certifications, there are people kind of like dietitians and nutritionists. Right, there are gonna be people who might still be helpful, but they’re gonna have less knowledge, less experience and less credentialing, then, like ibclcs, like y’all like our gold standard for breastfeeding experts. So it is a badge of honor. 

One of the common questions that I got from some of my followers who are wanting to know about breastfeeding, and in particular, a couple of people who have breastfed babies before, it has to do with kind of like supply. So my experience with breastfeeding, my three kids have all been very different. And you know, at least two of those experiences, because I hired you to help me with both my daughter and both my third baby and my second baby. And so supply questions. Like if you had an oversupply with baby, number one, are you likely to also have that oversupply with baby? Number two? Is that pretty common for what we experienced with subsequent pregnancies?

Lauren Sams  06:30

Great question. So our breast, each breast and even it can be different between the two breast in our bodies have a specific amount of milk making cells. And so there’s not really anything we can do to increase the amount of cells that we have. Now, there are some cases in which we can make those cells more efficient. And there are some cases in which we can make those cells less efficient, but there’s not really anything we can do to change the amount of cells that we have in our bodies. 

There are some moms who feel like all of their breastfeeding journeys between kids are exactly the same. And so moms who feel like they’re completely different, and there’s not really a rhyme or reason of if it looks exactly this way with first baby, it’s gonna look exactly the same with second baby. There’s a lot of a lot of why, like, Well, why did you experience this in your first pregnancy? is did you experience a low supply in your first pregnancy because you were having issues with latching at first and you weren’t able to pump very quickly. So you weren’t able to activate those milk making cells as efficiently early on. 

That kind of sets you up for having a low supply in the future. And on the flip side of that, did you over activate those milk making those milk making cells was baby born, and they latched beautifully. But then you felt the pressure to pump after every single feed, basically telling your body that you’re feeding for two babies. And maybe that’s what led to your oversupply.  So there’s a lot of will tell me what happened with your first pregnancy that so we can try to figure out maybe what your second pregnancy might look like. But it doesn’t necessarily it’s not always like a foolproof if this damn this sort of situation.

Lindsey Lusson  08:15

Yeah. So if someone listening had an oversupply with their first day, the first question to ask is, why did you have an oversupply? Is it one of the things you mentioned a frequent pumping? On top of that, like, we know that, you know, it’s kind of supply and demand that it can create even more milk even beyond what baby needs? Let’s pretend for a second though, Lauren, somebody wasn’t doing that, right? Because there are yes, some women that just naturally make a ton of milk.

Lauren Sams  08:43

And so in those cases, you know, if you once again, you have that same amount of milk making cells in your breast, and so if with first baby, you had an oversupply, and you weren’t you weren’t over activating or over stimulating those milk making cells, and the second baby then if everything’s going well, you’re not over stimulating or there’s no like overstimulation going on. It’s just a normal baby latching, it is likely that you’re going to see that oversupply again because your body has those cells and then wants to make that milk. 

In those instances, sometimes an oversupply can just be a blessing. And then you have tons of milk in the refrigerator, or the freezers other times oversupply. I mean, I’ve actually had moms stop breastfeeding, because the oversupply is causing so many issues with baby’s digestion with increased risk of clogged ducts and mastitis. And so if that’s the case, where you had an oversupply first pregnancy, and and you know, you didn’t do anything to cause it, and you’re worried about that oversupply in the second pregnancy, I would definitely get with an ibclc to come up with strategies of how to maybe down regulate that supply a little bit in order to make it a little bit more manageable for you and baby.

Lindsey Lusson  09:59

I mean, it’s great to hear that there’s, you know, options either way, and I personally have always been jealous of people that have an oversupply because I tend to be a just another and with my two recent pregnancies, even low supply. And so for somebody who maybe had a low supply with their first, what would be your tips for making sure that if it’s not something genetic, right, because there are women, correct, there are some women that don’t make enough milk?

Lauren Sams  10:25

Yes. And I think that that’s incredibly important to note and to highlight is that there are some women who have certain things in their past medical history, where there’s just, they just won’t make any more milk and pumping all day long, taking all of the supplements, spending all of the money is not going to increase that milk supply. And I think it’s very, very, very important.  It’s another reason why it’s important to work with an ibclc, who can help you identify that so that you’re not chasing your tail, and putting all this extra effort into making more milk when your body is maxed out. And there’s nothing you can do to change that.

But if that’s not your case, and you know, there aren’t any of those what we what we call primary reasons of insufficient milk, then things that we can do our make sure that your breast is going to produce milk more efficiently whenever it is frequently drained, whenever we ask the body for more milk under normal circumstances, than the body is going to make more milk for us, especially if we’re doing that frequently asking for milk frequently removing milk from the breast during those first couple of weeks after birth, that is going to make our breasts much more efficient and continuing to produce an adequate amount of milk as the breastfeeding journey goes on.

Lindsey Lusson  11:43

Yeah, such great points. I mean, I think number one is being educated and kind of understanding that, you know, during those early weeks, it is important to be breastfeeding almost around the clock, if you want to establish a good supply. So like understanding how frequently you should be feeding to establish supply.  But then also the the point that you made initially that I feel like there’s just so much pressure, and a lot of lactation consultants I’ve met with in the hospitals, or even like taking a breastfeeding class, before I even had my first baby, the take home that I got was all women are capable of exclusively breastfeeding their baby. And because that message got hammered home to me, it made me feel like a failure when I couldn’t do it with my son.

And I think I’ve gained some resilience in that with my third pregnancy. Thanks a lot to you.  I just think that it’s important that, you know, women are empowered to know that it’s not necessarily your fault, and that you feeding your baby is enough. It doesn’t have to be 100% breast milk for what, up to two years now is that?

Lauren Sams  12:59

Well, and I just I mean, I could get on a whole entire soapbox on this subject. But yes, exactly. Like, we’re meant to feel like breastfeeding is so natural, and that we should all be able to do it. And like I have a job because it’s not that easy.  Like, it’s not that easy. And I feel like so many times whenever we’re struggling with breastfeeding, we are afraid to ask for help. Because we feel like we’re the ones doing something wrong, and that it’s not supposed to be hard. Then you don’t ask for help. And then you push through and then it just becomes so much more of a burden.

And there are definitely women who are physically on able to meet the needs of their babies with the breast milk that they’re able to produce, like there are women out there.  Then there’s also women out there who don’t want to breastfeed or who wanted to breastfeed, but it took such a like a negative toll on their mental health that they they stopped which honestly, good job, if you were able to recognize like, Hey, this is really taking a negative effect on my mental health, like I’m a dietitian and a lactation.

So like baby nutrition is my jam. And I am here to tell you that breast milk is great. But the moment that that breast milk and getting that breast milk starts to negatively affect your mental health, it is no longer the best thing for baby because the best thing for baby is to have a happy and healthy mom.  There are other ways to feed baby it does not have to be breast milk.

And it also doesn’t have to be exclusively breast milk. I mean, I think that’s another place where we as moms get ourselves into trouble is with this like all or nothing mentality of oh, I’m breastfeeding or I’m formula feeding and like there can’t be any sort of a sort of middle ground between those two but you can you can do it your mom, you are the mother you can do it ever you want to so I think that’s another really thing that I really want moms to know is like it doesn’t have to be all or nothing. 

There are lots of moms who successfully breast bottle formula like all One of the things that a combination and I think that’s one of the beautiful things is that you get to decide what combination works best for you and your family and your mental health and your baby’s needs and all the things.

Lindsey Lusson  15:11

 Big fan of the combination fee, that’s something that you introduced me to. But I was really hesitant or it’s with my son. And I think it’s just really important. I’m thinking about myself here, too, but also a lot of the clients that I work with who tend to be very type A, and I think that there are some real things that go on for somebody whose mind just works that way. I will 100%, breastfeed for at least a year, no matter what.  Lauren, what I hear you saying is your baby is going to be nourished whether it’s breast milk, or formula or some sort of combination, that her mental state matters.

Lauren Sams  15:51


Lindsey Lusson  15:52

It matters even more than whether it’s exclusively breastfeeding, sort of material combat or fully formulated feeding.

Lauren Sams  15:59

Yes, definitely.

Lindsey Lusson  16:00

Yeah, completely agree. And a lot of the people that I work with, you know, I don’t know how much you see this in your practice, Lauren, but because I work with a lot of individuals who have past history of eating disorders and disordered eating is I do see for some people breastfeeding turning into this obsession around caloric expenditure. It’s all about how much milk can I produce?  Because that could for some people, not for all people write loses weight from breastfeeding. turns into this, like obsession around must breastfeed must make as much milk as possible so that I can expend as much calories as possible. Is that something you see it all in your practice? Or am I kind of working with a really tiny subset of the population here?

Lauren Sams  16:49

Yeah, no, that’s a great question. So it is not something that I see frequently, it is definitely, you know, I would say, I definitely have moms asking me, like, Okay, well, how many extra calories do I need each day, whenever I’m breastfeeding, or say, Hey, I’m breastfeeding, I thought I was going to lose a whole bunch of weight from doing this, and I’m not. So I am definitely exposed to those conversations.  I wouldn’t say that I see a frequent like hyper focus on I must do this in order to lose weight.

Oftentimes, you know, if I, if I was in that situation, I would just remind mom that hate when you’re stressing about this, that’s not good for anyone, it’s not good for you know, your, our stress hormone, our cortisol hormone, can negatively affect our oxytocin, which is our hormone that allows our milk to float from our body.

And if we’re stressing over something, no matter what it is, which we stress is new moms.  It’s impossible not to but when we over stress about things, it can actually have a negative effect on our milk supply and baby’s ability to transfer milk at the breast. So I think that that’s kind of where I would direct that conversation in that instance, is, hey, let’s Yes, you know, it takes more calories in order to create this breast milk. But we want to make sure that we’re doing it in as low of the stress environment as possible, because that could have detrimental effects. 

And not only could that I’m not saying that you should breastfeed in order to lose weight, but not only could that derail that goal that you might have for yourself, but that stress could also derail your goal of providing breast milk to your baby too.

Lindsey Lusson  18:30

Yeah, definitely just this, the whole stress around it. And I know that a lot of people stress about supply, especially if you really do have an under supply where you tend to be kind of adjust enough for a common question that I have been getting from people is whether or not it’s necessary when babies sleeping long stretches.  So let’s say you are one of those lucky moms and you’ve been like two, three months old. Is it typically necessary for moms to wake in the middle of the night to get in that middle of the night pomp, if baby sleeping through the night? And maybe let’s answer it like in the early stages, whatever you consider that to be Lauren, and then maybe even in the later stages?

Lauren Sams  19:10

Yeah, great. So, so I’m gonna give a very general answer to this question. But this is another instance in which working with an IBCLC to figure out your specific situation is going to be most beneficial. But what I what I tend to see being true and what we see in the literature is that as a baby gets older, typically, typically, as the baby gets older, they start to have longer sleep stretches overnight, they begin to be a little bit more efficient at the breast and so maybe they’re able to take slightly more volume when breastfeeding and they’re able to go a little bit longer in between feeds overnight. 

Now, typically, this doesn’t just happen overnight. Your baby isn’t like waking every two hours overnight one night, and then the next night they’re going out Hours, like, typically babies will, okay, you know, normally they wake up every two hours. Now they’re waking up every three hours. They’re waking up, waking up every four hours. Now they give us a five hour stretch. Now they give a six hour stretch, and this happens, and incremental periods.  So when that’s happening, and baby is kind of extending those deep stretches on their own, the breast is usually able to follow suit on its own as well, the breast is not going from getting drained every two hours to eight hours stretch, it’s going from getting drained every two hours to every three hours to every four hours and just gradually increasing that time in between milk expression.

I see that being the most successful for most moms, whenever it’s led by baby’s timeline. versus, you know, I see moms getting into a little bit more trouble whenever we try to sleep train, baby, especially if we’re trying to sleep train baby within those first like three months or so.

And we’re encouraging baby to sleep longer stretches, maybe before they’re actually ready to sleep longer stretches, especially for exclusively breastfeeding moms.  Like we have no idea how much baby chick from the breast Baby has no idea how much they take from the breast, they have no idea what time it is, they know, hey, I’m hungry, hey, I’m not hungry anymore. And so with sleep training, or with sleep assistant devices, where we are really encouraging baby to sleep, sometimes it works out fine. Sometimes that can also lead to those sleep stretches getting a little bit longer, a little bit quicker. And then that breast not necessarily being able to keep up with those increases in time between milk removal, and then that may lead to a decrease milk supply. 

So I would say my general answer is if baby is sleeping longer overnight, the breast is usually okay to go longer as well, it will adapt. Now, if you are adjusted number or you can have a low supply, it may still benefit you to wake up in the middle of the night, in order to pump so that you can keep that up. I always recommend my mom’s whenever we make a change, hey, keep an eye on your supply.  Like if you notice a decrease, maybe it’s because we’re going a little bit longer. And maybe we do need to alter your your pumping schedule or add an extra pump or whatever in order to kind of keep it from dipping down too much. Does that answer your question?

Lindsey Lusson  22:26

Yeah, I mean, I think takeaway is first of all is gonna be person dependent, right?

Lauren Sams  22:32

Which is such a frustrating answer. Like, every mom is different. Every mom has a different amount of milk making cells in the breast. And we can’t just like look at a breast and be like, Oh, you have like 9200 Milk being held? We can’t do that we could ultrasound it. But how often are we going to get like ultrasounds of our breasts not often. So every mom has a different milk storage capacity. And every mom is just able to make a different amount of milk. And because there’s so much variation in that it’s hard to get like blanket answers all the time.

Lindsey Lusson  23:04

Yeah, yeah, definitely. I mean, so probably the best answer this, it’s gonna depend on you. And you might want to if you have this question, or if you’re experimenting, and you’re seeing dips in supply, that would be a good time to get get with a professional to kind of figure out your own little schedule. Let’s talk about freezer stashes.  So, you know, a lot of times moms get this very, very short, sometimes paid, sometimes unpaid maternity leave, or going back to work. And so for moms that are wanting to do the best they can with exclusively breastfeeding, it can be helpful to build a little freezer stash. So can you explain what freezer stash is? And you have to help moms build that if they’re willing to go back to work?

Lauren Sams  23:49

Yes, do my number one tip for freezer stash is don’t let social media make you feel like you need a deep freezer full of breast milk. You don’t need a deep freezer full of breast milk.

Breast milk is good in the freezer for up to 12 months. And actually that recommendation was semi recently extended, it used to only be six months. And so it’s good in the freezer for up to 12 months now. So it’s great to have you can definitely use it past baby’s first year of life, but you do not have to have a freezer stash. And once again, when we when we start to stress about something it doesn’t help our milk supply at all. So I think it’s very beneficial to have some backup milk in the freezer. 

My number one tip is do not expect to fill up a deep freezer. Not every mom can do that. And the moms who can do that sometimes they’re struggling with an oversupply that’s causing other issues, that they’re not lasting on social media. So it’s not always the grass is greener on the oversupply side but in order to you know, whenever we’re preparing to go back to work, it is helpful to have a little bit in the razor to have a little bit of backup. I typically tell my moms it’s good to have it least a three day supply of breast milk in the freezer whenever you’re getting ready to go back to work, because let’s say you’re working Monday through Friday eight to five, and you baby’s going to daycare on that first Monday and your little hearts don’t hurt so much. 

And I’d like to say it gets easier, but I don’t know if it does get easier. But anyway, baby goes to daycare on Monday while you go to work. And so you have to send bottles of breast milk with baby to daycare that you have pumped previously. But then while you’re at work on Monday, hopefully your work is going to allow you and it should allow you in Texas, there’s laws and to go and pump. And so then you are going to pump milk on Monday that you could send to school with baby on Tuesday. And then on Tuesday, you’re going to pump milk that you can send on Wednesday. 

So really, you don’t need those three days, like a full three days. But I like to recommend three days in case you miss a pumping session. Or in case heaven forbid someone spills, a bottle of breast milk or baby goes through a growth spurt and all of a sudden they’re wanting more milk. So my number one tip is that you don’t have to have a freezer full. It is helpful to have about three days heading into work. But then you always want to feed your freshest milk first. So I would recommend like you got those three days in the freezer Great. Send what you need to on that first Monday morning.

But on Tuesday sit or on Monday when you pump that milk, have that milk on Tuesday because it’s going to be the freshest.  Don’t put that pump that that milk that you just pumped in the freezer. The fresher it is the better it is for baby now that frozen milk is still good for baby but the fresher it is the better it is for baby and in order to kind of set yourself up for success for those you know three days of storage or however much.

Typically my recommendation is sometime after four weeks postpartum and before are like four weeks before you’re planning to go back to work. start pumping once per day after baby has nursed and our milk making hormones.  Our prolactin is typically higher in the early morning hours, which what that means is that then after some of those early morning feeds, you can let baby nurse you can follow your normal nursing routine baby gets all the all of the milk that they want. But then you follow that up with a pumping session.

And since those milk making hormones are typically higher in the morning, you’re hopefully going to get the most bang for your pumping buck and actually get like an extra hour or maybe an extra two ounces pumping that earlier in the day. Versus if you’re pumping in the in the afternoon or evening. So that’s usually my recommendation for starting that freezer stash is just once a day don’t try to do it after every feed just once a day after baby’s nurse preferably in the morning. Get yourself an extra ounce put it in the freezer for when you need it.

Lindsey Lusson  27:48

I think that’s so helpful to know that you don’t have a freezer stash because I think that that can create a lot of anxiety for our moms with a perfectly fine amount of milk creating this stress around oh my gosh I don’t have the freezer stash what’s wrong with me or I have my well no if your baby’s growing appropriately enough that they don’t have less supply but exactly it’s really helpful and I also love the tip about sending the fresh milk it took me months to get on board with that because I was pumping freezing buying milk in the morning and then yeah my in home daycare with my daughter so yes guys the be smart use Lauren’s tips. 

All right a little a little little switch up topic here. Lauren, what is the deal? I feel like I don’t hear about this very often but like in the early no one you’re like breastfeeding her spine you’re like almost start to like become obsessed with it and you like entertain like every like wrong scenario. What is the deal with this for milk and hind milk imbalance? Can you explain the difference between the two and whether or not the imbalances are real thing number one and a thing that needs to be fixed?

Lauren Sams  29:01

Yeah, I love this topic. And it’s actually kind of a controversial thing in the lactation world right now. And a lot of lactation consultants feel like we should not be having this conversation. There is no such thing as for milk versus high milk. But here my thoughts on the situation is that the human body is so amazing. It is so cool. And so when you’re breastfeeding, your baby is not only getting their quote unquote food from you, but they’re also getting their their fluid from you too.  So they’re getting their hunger needs met and they’re getting their thirst needs met when they’re breastfeeding.

So when a baby first goes to breast and they are like super hungry, super thirsty, the milk that leaves the breast most readily the milk that’s kind of like on tap, it’s just ready it’s going to come when we asked for it tends to be a little bit lower in fat tends to be a little bit higher in our carbohydrates and our protein may be a little bit more watery. And this is what we He would refer to as being the for milk for meaning before or early. 

And so when they first visit breast, they are getting their thirst quenched by a slightly watery, slightly, it’s still great, still perfect nutrition, but slightly, potentially a little bit lower calorie, breast milk, because the fat and you know, we talked about how you have lots of like milk making cells in your breast, and the fat tends to clean to the outside of those milk making cells. So as those milk making cells start to squeeze, they’re squeezing out the carbohydrate and protein rich milk first.

Then as they continue squeezing that fat times, and then more of that comes with them more fat comes and more fat comes. And towards the quote, unquote, end of that feeding, the fat is being pushed out of all of those cells a little bit more efficiently, which fat increases our calories of our breast milk. And now this is what we kind of consider to be our hind milk or our later milk.  That has a little bit more fat calories in there.

So I think where we get in the most trouble for this concept is that there is no point at which your milk switches from for milk to high milk. And so they’re not really more milk as a way to describe milk that has less fat in it. Whereas high milk is a way to describe milk that has more fat in it. But there’s no point at which we say like, oh, it’s been five minutes into the feed. You know, this is no longer for milk this time, though. Like there’s no there’s no switch. 

There’s actually a really great example, if anybody’s not familiar with Kelly Mom, it’s a fabulous resource for all things, lactation related. She has the best example like whenever you go to your kitchen faucet, and you turn on your hot water, your hot water is going to start out cold, right. And then it gradually starts to get warmer and warmer and warmer and warmer. And eventually it’s hot. So it’s your hot water, you turn on your hot water, you’re asking your body for breast milk, but that breast milk just started out with a little bit less fat. Then we get more fat and more fat and more fat and more fat. And so with that water classic example, you know, we turn the water faucet on, it’s cold water, but that cold water starts warming up, warming up, warming up warming up, it’s hot. 

And if we turn that faucet off, and we leave that faucet off, then the next time we turn it back on again, it’s gonna start out cold, and then it’s gonna get warm and warm and hot. Again, if we turn that faucet off and on really quickly, without letting it warm up, it’s potentially going to stay a little bit more cold, right, so baby’s going on the rest of the rest on the rest of the breasts really quickly. Without really spending a lot of time at the breast, there’s potential that they might not be getting as much fat, if I’m the breast. 

If mom has an oversupply and has let’s say mom is able to pump eight ounces from one breast babies don’t really need eight ounces at a time. And so that baby goes to the breast and only takes two ounces from that breasts, which is the other breast only takes two ounces, they are going to be less likely to get that higher fat breast milk.

And so that’s kind of where we get this whole like for milk, high milk imbalance is when baby has a harder time staying at the breast for for a long time to get that fat kind of flowing. Or if baby’s constantly switching back and forth. Or if mom has an oversupply, and baby just simply does not need to pull all of you know, pull a significant amount of milk in the breast.  I am, I believe in formal chemical imbalance.

And typically what I do in these situations, and I actually, I actually see like pretty good success with is doing what we call block feeding. So let’s say mom has an oversupply, if she’s able to make those eight ounces of one out of one breast, well, instead of offering both breasts in that situation, we would keep baby on just one grass for that feeding. And let them take as much as they want to from that one breast.

So that kind of gives them gives the faucet the opportunity to be on for a longer period of time. And to gradually warm up warm up warm up warm up hot. And so do that a lot.  Another thing that I’ll incorporate into my practice is what’s called breast gymnastics, which sounds crazy. And when you do it, you feel kind of crazy, but basically removing the breast tissue around prior to feeding and kind of potentially loosening up some of the fat in those milk making cells warming the breast up for that nipple stimulation to allow that milk to flow a little bit more. And it’s it’s really a silly concept, but it’s actually incredibly effective.

There might be a lot of people out there that disagree with me on this, but I do believe in Formula time milk and balance. You know, I think that we can get ourselves in trouble by thinking that it’s completely different things. It’s not it’s just a way to describe milk as a little bit less fat versus milk that has a little bit more fat.

Lindsey Lusson  34:48

How would you know that you had this imbalance?

Lauren Sams  34:51

Yeah, so what I typically see is with infants who have who are potentially like experiencing this formal kind of imbalance What is really green schools, really green schools and typically a little bit of diaper rash as well.

And the reason why that happened want to nerd out real quick is because with the lack of fats, or with an inadequate amount of fat in that breast milk that breast milk is able to travel through the GI system much more quickly. And when that breast milk is able to travel through the GI system more quickly, it can come out a little bit more green. 

The other thing is that if that milk is going through the GI tract a little bit more quickly, more lactose, which is the sugar in our breast milk, there’s nothing you can do to get rid of that lactose and your breast milk, you are a mammal, lactose is what you’d have in your breast milk. But when that milk is moving through the GI system a little bit more quickly, more lactose gets to the large intestines before it’s able to be digested. In large intestines, we all have bacteria and bacteria love lactose.

So when bacteria eats lactose, they produce they fermented kind of and then they produce gas. And then baby can get a little bit more bloated a little bit more gassy, a little bit more fussy. It’s not because baby has a lactose intolerance. It’s just because that lactose is not getting a chance to get digested. Because moving through the GI tract so quickly.  We can also see a little bit more diaper rash with high milk or milk imbalance too. Because the sugars that lactose can kind of irritate the bottom a little bit as well. So dang fascinating thing. It’s fun. I think I think it’s also like a fun thing about being a dietitian and a lactation consulting this because I’m able to really appreciate the science behind some of these things.

Lindsey Lusson  36:36

I know that a lot of people that I work with work in healthcare, so we’ll probably appreciate that. And I know I did. Well, let’s end it today. Yeah, the question that I get the most, and I save this one for the end, because I know you guys are like on the edge of your seat.  Let’s talk about breastfeeding and when people can expect their periods to return and I know that this can be person dependent. But yeah, it does give us kind of some some background, I guess, like initially, like, how long is it normal if you’re an exclusively breastfeeding mom to not have any sort of cycle or period?

Lauren Sams  37:09

So there are certain hormones that are involved in breastfeeding, that can delay ovulation and delay your period coming back, the data suggests that the average length of time that we can expect your period to to be on pause is about three to six months postpartum. But it is definitely so variable between moms.  And I will say to that I have a lot of moms that reach out to me around that six week postpartum mark saying, Oh, I restarted my period. But actually, it’s not uncommon to have some like postpartum bleeding around that six week mark, again, that can be that we might think is a period, but it’s not actually a period.

So usually around three to six months is kind of the average that we see that period being delayed, it’s definitely seems to be delayed a little bit more effectively, or consistently, and moms that are exclusively feeding from the breast versus moms that are pumping. And my question is to is like, Okay, well, do we see our periods coming back like, is three months, kind of like the earliest because that’s also when we’re going back to work. And that’s when we start pumping a little bit more. You know, I don’t I don’t know, the research, I don’t know, the study well enough to know all of the different like, methods and designs, and if that was taken into consideration or not.

Lindsey Lusson  38:32

I don’t think this is a very well researched topic, because I have I have dug and dug and kind of come up with my own, you know, reasoning, based off the things that I’ve read, and just what I’ve observed in individuals, but so three to six months is kind of what we’re told, what about past that six month mark, like if somebody’s not getting a period, and they’re exclusively breastfeeding? So they’re breastfeeding, you know, five to 10 times a day or seven months postpartum? Are we concerned? Like, is this something that you would be like, ooh, we need to, you know, get some things checked out? Or can that still be normal?

Lauren Sams  39:09

Great question. So from my like, dietitian, lactation consultant understanding that is not something that worries me. Because I have definitely seen it go like I feel like the text, the textbook answer of three to six months is actually kind of on the low end of what I actually see in my practice. So it’s not a red or even a yellow flag to me if I have a mom who hasn’t even gotten that period within that first year.

Lindsey Lusson  39:37

I’ve read two different things as to why periods are or why ovulation is not occurring and why we aren’t getting a period and I’m curious if if you think there’s any merit to this second theory. So the first one is the lactation right or sorry, that prolactin so because prolactin levels are so high that interferes with our body’s ability to ovulate therefore, we’re not going to see a period because we’re not ovulating theory that I’ve heard or is the caloric expenditure so much like when someone loses their period when you’re just extending so many calories through breastfeeding, that they’re in a deficit, whether they’re losing weight or not. And that can be another thing at play. Have you heard that? Is there any truth to that? Or are people are suspecting.

Lauren Sams  40:19

Yeah, I have not heard that. But it makes sense, right? Because our calorie expenditure is directly related to the amount of milk that we’re producing. So the more milk that we produce, the more expenditure we have. And usually, so typically, we gain weight during pregnancy. And some some of the reason behind that weight gain is so that we have extra fat stores to rely upon in that postpartum period when our body needs so much.  So many extra calories for lactation and and for healing.

Yeah, you know, that’s, that’s interesting, because our your body does need extra calories in order to produce this breast milk. So I don’t know. I mean, I’m also not familiar with like, how much of a deficit you need to be at in order to start being Ha, but yeah, I mean, I could think that could be a reasonable a reasonable theory.

Lindsey Lusson  41:14

Yeah. Yeah. I mean, the fact of the matter is, we don’t know. And it can be person dependent, because there’s going to be some women who are exclusively breastfeeding, they see their cycles return for months postpartum. And they’re gonna be women who are exclusively breastfeeding, and it takes them 13 months postpartum, right? Well, I’d be a little bit different. 

You’re saying perhaps the caloric expenditure could be a play? Yeah. You don’t necessarily know hasn’t been your experience or, you know, in what you’ve studied? Is it possible for all women to be able to breastfeed? Let’s say somebody wants to practice extended breastfeeding into your two into your three, nurse, a young toddler? Is it possible for most women? You know, I don’t know if we can say, right, because it’s hard to be 100% sure about anything. Is it possible for most women to be able to nurse and be able to ovulate, get a period and get pregnant? or what have you learned? What has been your experience and what what is typical for most?

Lauren Sams  42:13

So I think it’s definitely typical for most women to still be nursing and ovulate and sometimes ovulate before you actually even have that period, and so not realize that you’ve ovulated and then definitely possible to get pregnant while breastfeeding. And there are a lot of moms who are successful, continuing to breastfeed through that pregnancy.  There are other moms who choose to wean during pregnancy.

And there are other moms who, you know, experienced a decrease in milk supply during pregnancy that either causes the mom to want to wean, or causes the nursling to want to wean, but definitely possible to get pregnant while breastfeeding even period yet, so don’t try to use it as a means of contraceptive it is not. You know, there are people who will use it as a means of contraceptive but it is not. It is not foolproof by any chance.

Lindsey Lusson  43:08

I know that’s gonna be encouraging for a lot of people to hear. What would you also say on the flip side, though, Lauren, to the mom who really wants to conceive, but also really wants to breastfeed, but she’s settled seeing her cycle return, or she’s got her cycle back, and she’s not ovulating. Like how what would be your advice to somebody who can’t get over the mom guilt of needing to wean in order to conceive her next?

Lauren Sams  43:29

Oh, gosh, that’s so hard. I mean, it’s, I have conversations about mom guilt on a daily basis with my clients, because it is such a real thing. And I, you know, I’m never affected and say, just like, oh, just, you know, try not to worry about it. Yeah, exactly. I think, I think you have to just prioritize, and, you know, figure out what your goals are. 

Are your goal is to have another baby sooner rather than later? Or are your goals to, you know, preserve your breastfeeding relationship with your current baby, keeping in mind that that current baby is perfect. They will love no matter what you do, and they’ll probably never know how you fed them or for how long you’ve had them. They even if you do No, even if you do tell them, they’re probably not going to care until they’re an adult. And if they’re a boy, they’re probably never going to care.  And if they’re a girl, they’re probably not going to care until they’re breastfeeding their own kid. I think just keeping that in mind of your baby is perfect. And they’re going to love you no matter how you keep them. And just really, you know, evaluating those priorities and making that decision from there.

Lindsey Lusson  44:40

Oh, I love that. I love that so much. Thank you so much, Lauren for your time and worth all of our questions in depth and yeah, sharing your wisdom with us. If somebody wants to know more about you and what you do, where would be the best place for somebody to like get in touch with you or like Where where are we most active?

Lauren Sams  44:59

I’m most active on Instagram. I’m probably in my DMs more than I should be. So you can, you can follow me and you can reach out to me at grow that baby dot nutrition. On Instagram. I’m also on Facebook, but huge Instagram fan. So that’s

Lindsey Lusson  45:14

Awesome. Well, thanks and I’ll link that in the show notes. And then if somebody happens to be listening and they’re local, I can also learn how to get in touch with Lauren and to work with her. But when you guys can follow along on Instagram, I’ll also link something else that Lauren mentioned Kelly mom in our show notes because I think that’s a really helpful resource for breastfeeding. So thanks again Lauren.

Lauren Sams  45:38

Alright, so wonderful chatting with you.

Lindsey Lusson  45:40

Thank you so much for tuning in and listening if you found this episode to be inspiring or helpful, please share on social media and tag me at Food dot freedom dot fertility. Also don’t forget to leave a rating and a review


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I’m a fertility nutritionist and registered dietitian who specializes in hypothalamic amenorrhea. My passion is helping women trying to conceive find freedom with food and exercise, so they can recover their period, and get pregnant naturally.

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Jan 19, 2022

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