Posts in Breastfeeding
Answers to Your Questions About Postpartum

Most questions we received this week were related to Postpartum OCD (ppOCD), so our brilliant and kind Dr. Michelle expounds on the topic here.  

Postpartum OCD (ppOCD) is an anxiety disorder characterized by intrusive, unwanted, and repetitive thoughts, images, or urges (obsessions), which may or may not be accompanied by compulsive behaviors. While the exact cause of ppOCD is unknown, experts believe that it results from a combination of hormonal, psychological, genetic, biological, psychosocial, and environmental factors. Obsessions and compulsions can take many forms for different people and usually focus on the baby.

Obsessional thoughts might include:

  • I’m terrified my baby will get sick and die.

  • What if my baby stops breathing in the middle of the night?

  • I’m scared someone will steal my baby if we go out in public.

  • What if I accidentally or intentionally act on an urge to stab my baby?

  • Why do I keep having an image of my baby falling off the changing table?

Compulsions can include:

  • Repeatedly checking on the baby’s breathing in the middle of the night

  • Excessive bathing and washing rituals

  • Repeatedly asking others for reassurance that baby is okay

  • Taking great measures to avoid the baby

Obsessions are unwanted, difficult to control, and increase anxiety. In order to neutralize the anxiety associated with these obsessions, one might then engage in overt or mental compulsions or avoidance. For example, a mother might have repetitive images of something terrible happening to her baby while driving in the car. As a means to decrease the anxiety associated with this thought, she may avoid driving anywhere with her baby. Another mother might have unwanted thoughts that she will act on an urge to intentionally harm her own baby.  This mother might then begin to avoid her baby altogether. It is important to understand that in the latter example, this mother does not have these thoughts because she actually wants to hurt her child, but rather she is terrified that she might act on these thoughts. The obsessions are unwanted and conflict with a person's self-image and character.

According to the International OCD Foundation, up to 80% of new mothers report having strange, unwanted thoughts. This means that most new parents have similar experiences with anxiety and intrusive thoughts, but would not be diagnosed with Postpartum OCD. A diagnosis of OCD might be made when preoccupation with the intrusive thoughts is clearly disruptive to a mother’s normal functioning and greatly interferes with her ability to care for herself and her baby. It is no surprise that this can have devastating effects on the parent-child relationship and highlights the immense need for treatment. Due to the fear of stigma and feelings of intense shame, however many women are resistant to seeking help. If you or anyone you know is experiencing these symptoms please know that you are not alone and it is okay (and important) to reach out for help from a qualified and licensed mental health professional.

Others of you wanted to learn a little more about psychological and emotional responses to weaning. Dr. Michelle responds here: 

It is not uncommon for women to feel tearful, depressed, irritable, or anxious when weaning. Not much research exists on this topic, but some hypothesize that a shift in hormones when weaning may be a major cause for these feelings. Other factors might involve feelings of sadness around the loss of this special time with your infant. These mood changes usually go away on their own, but some weaning mothers may experience more severe symptoms that require treatment.

A Laywoman’s Guide to Breastfeeding Pro Tips

By Ellie Bergmann

Mom of 2 boys, social worker & addiction therapist, and wife to a cyclist & ski enthusiast (aka: nut)

Ellie Bergmann

What I’ve learned from opening up and chatting with other moms has been the gold of motherhood. Professionals like lactation consultants and postpartum doulas are angels. But I’ve gotta say: I’d be lost without the street smarts of other moms. So here’s a stream of consciousness account of some of my favorite pro tips learned in the (mother) hood.

With my first babe, breastfeeding and subsequent breast pumping went smoothly. I had enough milk, I didn’t experience pain, I had a few clogged ducts along the way, but all in all, it was manageable and enjoyable. I reached the one year goal I set and had to wean my supply. My son was over it within a day. My milk wasn’t. I talked to a few people and they suggested to take Sudafed for a few days, and it dried my milk right up. It was astonishing. This was after weeks of engorged pain and attempting to slowly pump less and less, all the while sporting a sexy cabbage leaf bra, even at work. None of this worked for me. But pop a few Sudafed? BAM, milk was gone.  That was my first pro tip.

What I’ve learned from opening up and chatting with other moms has been the gold of motherhood.

This time around with baby boy #2, I had a surplus of milk the first few months. Like, had-to-buy-a-deep-freezer-for-the-garage-in-order-to-store-all-the-milk, kind of surplus. Great right? Sure. Until baby started to sleep mostly thru the night (you hate me now and are about to stop reading, but hear me out) and my milk supply dipped. Suddenly at work I was pumping HALF of what he was consuming. I was NOT ready to stop or reduce breastfeeding. Baby was 7 months old. So again, I reached out to people. I talked to lactation consultants, I emailed lactation supplement people, I talked to moms, I talked to a dude at work who remembered his wife’s tips! I was desperate; I wouldn’t shut up. And again, I learned some tools that were revolutionary! And seemed so basic! How could I not have known these little tricks? Where is the universal manual that provided these gold nugget tips?  Am I the only one who doesn’t know how to pump?

One sneaky little tip was to hand express some milk upon finishing pumping. I was skeptical at this one. I just finished pumping? Why would I hand express an empty boob? Time waste…until I tried it and got probably 2 additional oz out. AFTER PUMPING. That was mind blowing. So not only getting more milk (BONUS) but also sending the message to your body to MAKE MORE MILK. So I’ve been doing that regularly and my milk supply is on the up!

Another tip related to that is to hand express about 10 mins AFTER pumping to mimic cluster feeding. I haven’t tried that but man, I now don’t doubt it.

Also, change out the little membranes on the valves of your pump. I hadn’t been doing that. Didn’t realize I needed to. They are the piece that help suction out milk.  Did that and noticed a difference. AMAZING.

Here are some other tips: make an appointment with your baby (AKA your pump) and put it on your calendar. If you have a shared calendar at work, first, my condolences. Second, call it a “hold” and keep the appointment like it’s with Michelle Obama. Space your sessions out about 2.5-3 hours apart, maybe even timing them to your baby’s feeds. As hard as it is to do, really try and shift out of your working day mentality by taking a few deep breaths with your eyes closed, thinking of or looking at photos of your baby, and/or facing away from your computer -- at least until letdown.

Make an appointment with your baby (AKA your pump) and put it on your calendar. Call it a “hold” and keep the appointment like it’s with Michelle Obama.

Speaking of letdown, the stimulation mode can be your best friend. It’s so tempting to skip ahead to the main event, but your baby always stimulates first. And they are the real experts.    

Don’t forget to eat, and drink, drink, drink. Bring a container you love to work, and try to drink 32 ounces or more of straight water. And eat healthy fats (avocados, walnuts, nut butters, Totum Treats [editor’s note, oopsie!] etc.). If you’ve found a lactation tea you like, put it in your insulated thermos with some almond milk and honey.  It’s your little secret stash.  

And then of course, the power pump. I hadn’t even heard that phrase with my first son. Probably because I was smooth sailin’ with a strong milk supply and a good eater. But with babe #2, I was told a few times by the pros to power pump. Here’s the deal with a power pump.  So after you pump a regular session, however long that is, you then take a 10 min break (those nipps need a rest, sis), then return and pump for 10 mins. Then stop for 10 mins. Then pump for 10 mins. And repeat. So you are pumping for 30 mins total over an hour. I initially did that for 3 days but was informed, again when I wouldn’t stop yapping about my reduction in milk supply, that to see a difference, do it for one week. 7 days. It’s brutal, but it’s WORKING .

Shift out of your working day mentality by taking a few deep breaths with your eyes closed, thinking of or looking at photos of your baby, and/or facing away from your computer — at least until letdown.

I’m mid-way thru this power pump jam. Wish me luck. Wish my milk supply luck. Here’s hoping I return to Dairy Queen status.  I am not ready to stop, and judging from baby boy reaching for my shirt, he’s not ready to stop either. And lest we forget how this baby refuses new things and takes MONTHS to come around; See: taking a bottle (went on hunger strike for 1.5 months when I returned to work) and baby food: gross. No way. Pass. The thought of an attempt to introduce formula to this baby seems impossible. Another reason to be diligent in increasing my milk supply. Hopefully some of these suggestions contain some helpful new info for the moms out there.  If so, pass it on.  Get it Bosses.

The Story Behind the First At-Home Breast Milk Test

by Dr. Stephanie Canale

Totum Women Dr. Stephanie Canale

When I was breastfeeding my second child, I had so much milk that my husband and I joked that we’d have to buy an extra freezer!  Supply was never my problem. But when I returned to my medical practice around 5 weeks after my second daughter’s birth, pumping in my office in between seeing patients, something changed. My daughter stopped gaining enough weight, and she even stopped pooping. I was panicked.

I had enough stress juggling my medical practice, being on call, and doing hospital work while also caring for my older child. Now this? And I was perplexed - even though my supply appeared to be sufficient, something must have been off with the quality of my milk. The scientist in me wanted to know exactly what was in my milk and what I could do to help my baby thrive.

Extensive literature searches revealed blanket statements about the overall benefits of breast milk, but no tools or tests existed to find measurable, objective data. I wanted to confirm that I was providing my child with the nutrients she needed, and more, and I wanted to be able to help my patients, too. In my medical practice, many mothers expressed the same concerns about the quality of their breast milk and frustration with the inability to uncover any information about it through lab testing. 

The scientist in me wanted to know exactly what was in my milk and what I could do to help my baby thrive.

Faced with these questions and an obvious need for answers, I decided to use the academic resources available to me, consult with my colleagues and develop a unique, comprehensive set of tests specifically for breast milk. I spent over a year working with top chemists to develop a simple, at-home breast milk test to empower moms with nutritional information such as fat and calories, vitamin and mineral content and even whether their breast milk contained potentially toxic substances such as arsenic or mercury.

I made the test available first to the patients in my practice, with astounding results. I learned that while we’re all conditioned to worry about our breast milk supply, it’s actually quality, not quantity that matters most. And many of the assumptions that we have about breast milk may be wrong - especially, that all breast milk content is the same.

One mom whose baby wasn’t gaining weight took the test and found that her breast milk was extremely low in fat and calories. A simple switch to a fuller fat diet helped her baby start gaining weight.

Another mom took our premium test and found elevated levels of arsenic in her breast milk, originating from regular consumption of rice at dinnertime, which was easily remedied by reducing her rice intake.

One mother was found to have high levels of mercury, and we discovered it was her fish oil supplements. We changed her to a plant-based supplement and the levels decreased within one week. Another mother was found to have high levels of mercury which was directly related to eating sardines and tuna. She stopped eating fish and her levels went undetectable. (For more on which fish to avoid while breastfeeding, check out these FDA guidelines.)

I learned that while we’re all conditioned to worry about our breast milk supply, it’s actually quality, not quantity that matters most.

Several moms found low levels of DHA in their milk, which has been proven to support a healthy nervous system and most important for brain development. Many moms stop taking their prenatal vitamins after their baby is born, some women simply forget, and some are not sure about what they should take. Everyone knows about prenatal vitamins but there are few “postnatal” vitamins available. I am asked almost on a daily basis “well now that I am breastfeeding what should I take”? After re-starting DHA supplements, most moms I treat see noticeable improvement in under two weeks.

Seeing the value of our tests to my patients, I made the tests available commercially earlier this year through Lactation Lab, a company founded by me and my husband Eric.

Totum Women Dr. Stephanie Canale

Back to the story of why my baby wasn’t gaining weight despite adequate supply, I started to supplement my breast milk with formula, despite knowing the benefits of breastfeeding and wanting to continue. My daughter did start to gain weight and the problem resolved best when she started on solid food. I’m happy to say she loves to eat!

That said, I do believe that the quality (and quantity) of many mothers’ milk drops when they go back to work for several reasons. In general, working moms are just plain busy. They have less time to eat well and drink enough water and have more stress overall. Many moms do witness a drop in supply, but it’s important to consider the overall quality of milk as well. It’s critical for working breastfeeding moms to remember to take care of themselves, because that will affect the health of their baby.

Each test that we complete through Lactation Labs is helping us to learn more about how moms can give their babies the best nutrition possible. Short term, it’s very gratifying to see a mother’s frustration transformed into confidence; to know that a simple and accessible test can open up new vitality for a newborn baby. Long term, I’m optimistic that patterns we see through the results of these tests will give way to new discoveries about what makes breast milk so powerful.

It is my hope that the scientific knowledge gained by this research will ensure that mothers everywhere raise the healthiest babies possible.

Moms wishing to try Lactation Lab’s breast milk testing kits can receive 20% off their order by using promo code TOTUM at checkout. (Offer valid through March 31, 2018) 

I Wanted to Prove That I Could Nurse My Child With an Extra Chromosome

Maria Jordan MacKeigan

Edmonton, Canada

Author of mommytor blog and A Princess Wish

When I was twenty weeks pregnant we found out our baby on the way had a heart defect; immediately after, we also found out she would be born with Down syndrome.

My world was literally shattered. I felt that our lives were about to change for the worse. We were told by the doctor who delivered the news to us that our baby wouldn’t be able to feed herself or clothe herself, that she would be a burden to society and more than likely end up in an institution. 

This mama’s heart was broken into a million pieces. We had been longing for a baby for quite some time now, and my daughter was begging for a sister by her side. We had tried to get pregnant but it had taken us more than nine months. Now this doctor was telling us our best choice would be to terminate our pregnancy. 

I didn’t want to read anything in regards to Down syndrome, so I stayed away from Google, but as the word spread that we would have a little one with Trisomy 21, people came out of the woodwork with “knowledge” and advice. 

I wasn’t thrilled to hear all the things my baby wouldn’t be able to do, including nursing. Some of the causes of having Down syndrome are low muscle tone, which would make it difficult to breastfeed according to all the stories I was hearing.

My first daughter nursed until she was a year old. I had every intention of nursing my second child even if it was six years later. 

When our Jordan Grace was born, she latched on pretty well, she was nursing like a pro and I had absolutely no concerns. The nurses on the other hand were doubting me and wanted to make sure the baby was getting enough milk. 

Some of the causes of having Down syndrome are low muscle tone, which would make it difficult to breastfeed according to all the stories I was hearing.

I was told I needed to pump and feed her with a bottle. I didn’t agree, but I felt I had to show them that she was indeed eating well. 

My stress level was beginning to rise as nurse after nurse would come in even after I had breastfed to tell me that I needed to pump and write down the amounts I was feeding her. I had to oblige or else they would not be able to release us. 

Two days later, we were released and sent home with some paperwork that would have to be completed. I needed to prove that the baby was eating. 

To be honest, there was so much stress in my life in those moments from the diagnoses to the feedings, that I hadn’t fully thought about how this was affecting the baby or me. I was successfully able to nurse for a few months, and then my milk supply stopped. I was still wanting to prove the professional world wrong, that I indeed could nurse my child with an extra chromosome. 

After a few days of tears, pain and suffering to feed my own baby naturally, my husband and I decided it was time to turn to formula. I feel the milk supply must have stopped after my body went through so much stress in not only trying prove I could feed her, but all the stress I had endured for weeks and weeks of mourning the child I thought I was having. 

I was still wanting to prove the professional world wrong, that I indeed could nurse my child with an extra chromosome. 

Turns out there are many children with Down syndrome who have successfully nursed. But I also believe that stress cannot help our bodies positively. I’m happy that I was able to feed my baby girl naturally for at least a few months. She got the most important nutrients during the start of her precious little life. 

Three years later, I can say with confidence that the doctor was wrong. Jordan Grace feeds herself, gets dressed, learns just like the others, just in her own time. She brings us incredible joy each day. She’s our dream come true in ways we never expected. 

To Breastfeed or Not, That is The Question

Rachel Zaslansky

Los Angeles, CA

Mother of 2, Connector, Champion of Women, Girl Boss

I always thought I was going to be that mom whose baby latched perfectly from day one. Before my first baby was born, I took all the classes, read all the books, got all the Baby Center email updates and was as prepared as possible to be the best breastfeeding mommy out there. Up until this point, whatever I wanted in my life, I would get -- with the right mix of preparation, confidence and drive. Well as the saying goes, man plans and god laughs. 

The day my little Griffin was born, I immediately put him on my breast just like I was taught. I adjusted him over and over but nothing was happening.  Suddenly I felt a flood of feelings I was not expecting to feel on the day I met my baby: rejection; failure; and stress to name a few.  What was I doing wrong? Since I had a c-section, I was in the hospital for 4 days, and most of the time I was sitting there stressed about why my baby wasn't eating. "What’s wrong with me," I would think. The nurses and lactation specialist came in one by one -- all with a different method or opinion on the matter. We realized my baby wasn’t interested because he wasn’t getting any milk (or very little). How could this be? I am a size DDD and always assumed those suckers were literally made to be sucked!?!

Finally, a nurse came in and told me we had to give him a bottle as a supplement. In all the books I had read that was a big NO NO! As a first time mom it was hard to navigate this unknown territory, while on pain medication, overwhelmed by my changing hormones and with everyone giving me a different opinion on the matter. I agreed to start supplementing with a bottle because god forbid I starve my perfect newborn baby. Next the breast pump got wheeled into my room, and before I knew it, I was hooked up to the machine while my baby was peacefully eating a bottle next to me. 

After leaving the hospital (with the breast pump and cases of Enfamil) I felt confused and defeated. Over the next 3 weeks I tried and tried to produce milk. I drank the teas and listened to my baby nurses’ advice.  I even called a lactation specialist, but nothing was making a difference. I would try to nurse for about 30 minutes on each side and also was pumping every few hours. It got to the point where I was so overwhelmed, stressed and emotional I couldn’t see straight. I wasn’t enjoying anything about it. The thought of having to “try to feed” would make me feel blue and it was starting to take away from that bonding time with my baby. 

With frozen cabbage stuffed in my bra one night, I decided this was it, I’m officially done.

My mother in law who didn’t breast feed kept telling me to stop, but I am not a quitter.  The thought of stopping stressed me out even more. How could I give up on this? Isn’t this what women are meant to do? After a few more days of feeling like a total failure and crying that I was going to let down my husband, all of my friends, anyone who passed me on the street, my newborn and mostly myself, I made the decision to stop. With frozen cabbage stuffed in my bra one night, I decided this was it, I’m officially done.

Totum Women

The next morning, despite the swollen achy boobs, I have never felt better. I was like a new person. I was lighter. I think I had already mourned the idea of not breast feeding for those few weeks when it wasn’t working that once I actually stopped, it was a whole new world. I was happy. I felt more connected to my baby. I realized the expectation that everyone around me would judge me or care or be disappointed was gone. Nobody even thought twice about it. It was no longer the main topic in my head. Once that pressure was off of me, I immediately felt back to my old self. Not one person gave me a dirty look, my husband started feeding the baby and letting me sleep, and all of a sudden I knew in my heart it was the right decision for ME.  It was my first lesson in “happy mommy equals happy baby.”  Nothing rang more true to me in that moment.

When it came time for my second baby, I knew right away that this is not something that works for me and I am OK with that.  I know my body, I know myself and I am confident enough this time around to say “No, I will not be breastfeeding, it doesn’t work for me and I am OK with that -- and so is my baby”.  My second baby is now 9 months old, and her belly is filled with Enfamil.  She is perfect just the way she is, and so am I.   

Totum Women
No Two Babies Nurse the Same

Hayley Simon

Temecula, CA, Mom-boss to Two Crazy Beauties, Jesus/Coffee/Wine Lover

“I am a total failure,” I kept telling myself over and over again after my lactation consultant said “I’m sorry but I have never in my 20 years of work not been able to get a baby to latch. You are a new case for me.”

No one could figure out why my healthy 3-month-old baby girl refused to nurse but would happily take a bottle of breast milk. Every time I put her to my breast, she would scream as if she was in terrible pain. Trust me, we tried every trick in the book.  So reluctantly I went to plan B and exclusively fed her breast milk through a bottle. Holy hell did I underestimate the amount of work and sacrifice that would be. Not only is it time consuming to feed your baby, but I also had to find time to pump while holding, entertaining, and caring for her all while attached to a machine. Needless to say, I was drained, exhausted, and overwhelmed.

After a total breakdown, I heard some eye opening wisdom; “If you aren’t happy, your baby isn’t happy”, and truthfully, I was miserable, so I decided to transition from breast milk to formula. But this entire nursing experience haunted me. I had friends nursing their babies until they were nearly two years old, doctors offices with signs on their walls saying “breast is best”, and mothers giving me dirty looks when I mixed a bottle of formula in public.

This entire nursing experience haunted me.

 It got so bad that when I became pregnant with my second baby, I had nightmares that I couldn’t produce milk, my baby wanted to nurse from other women but not from me (that’s freaking weird, right?!), and several other nursing dilemmas. My first nursing experience really (excuse my language) fucked with my head and my confidence. So you better believe when I gave birth to my second baby, a boy, I had researched and prayed that I would do everything right to make sure this baby nursed happily for longer than just 3 months.

…Irony is amusing, isn’t it? Funny enough my now 4-month-old baby boy refuses a bottle entirely and will not suck on anything other than my nipple. Sure, my prayers have been answered and I finally feel like my baby wants me, but I realized the freedom I gained when my first baby happily took a bottle. Now, if I want to go to a wedding, out to dinner, or God-forbid do anything that takes longer than 2 hours, my baby has to tag along. There’s no such thing as a night off or a weekend away.

So I’ve learned a thing or two about babies and myself.  You can do everything right but no two babies, even your very own, will nurse the same. You better believe that now when a friend or mom comes to me with struggles over breast or bottle, I will never judge, nor tell you that one way is better than the other. What is right is what makes both you and your baby happy because ladies lets face it, we are all doing our best to provide for our babies. 

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