#283 | Breastfeeding Q&A: A 5-month Old Baby Starts to Breastfeed, Low Milk Supply, How Often To Feed in First 24-hours, Plugged Ducts & Pumping

This is why mothers and babies should not be separated at all post birth. I am becoming increasingly adamant about mothers and babies literally being stuck together for you know, days after birth.

It's an understatement to say emotional. It was my desire to exclusively breastfeed, and I tried everything to increase my supply. I've heard it all, I've read it all, I've tried it all. I've been so heartbroken over this that it causes me to reconsider having another baby.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello, welcome to the second breastfeeding Q and A.

Yes, I am excited to be back and answering more of our awesome breastfeeding questions.

So the LA, the reason we do this is that we get so many questions for our monthly Q and A's that we decided to take at least the breastfeeding questions and put them into a separate episode. We might do this in the future with other topics. If we get a lot of topics about like VBAC, if we get a lot of, let's say, questions about relationship stuff, we might put that into a special episode. But we do have a lot of questions coming in, and to all of you women who call in, and by the way, your partners can also call in, they are welcome to that would be really awesome if we had more guys involved in this whole prenatal, postpartum thing. But when you call in, you might wonder, what gets your question selected. So we are good. Trisha, I did. We didn't plan this. I'm being spontaneous as we are. But what we've talked about it. Let's tell everyone what increases the likelihood of their question getting on the air. So you go first pick something.

Concise questions are really helpful. Yeah. On that note. On that note, we have received many questions over the years where the voicemail of the voicemail maxes out at three minutes. That's out of our control. That's a Google Voice thing, and we have women who call back, sometimes up to three times, and it ends up being about an eight or nine minute question. There's just no way we can possibly use that, even if we edit it, it would be just a ton of work just to edit that down so sometimes we can hear women are reading the questions. And actually, that sounds really good. They've thought it out. They wrote it down. They call and they read it. So babies in the background makes it really tough to have good sound quality. Women who speak, women who speak too timidly. Is really tough to get on the air, even sometimes, though we really want to answer those questions. Sometimes women go outside to get out of the noisy homes, and we hear traffic in the background, so we really need good sound quality. Sometimes cell phones are sketchy.

Yes, it helps if you practice it a little bit. It takes a lot of courage to call in a question. We know that not everybody wants to do it, and some of you it's easy for and some it's much harder to do. But your questions are so valuable, and we hate to not be able to use questions that have great content. But you know, just the quality isn't isn't there, so please keep calling in your questions. We love them. Practice them a few times. And and I, and I want to disagree with what you said. It takes no courage at all. It's no big deal. It's just a voicemail. I know you're you're being very nice and empathetic to everyone, but I'm gonna, I'm gonna give everyone a swift kick and say it's no big deal. Pick up the phone and ask a question. You can do this. You're a grown up, you're a mother. You can make a phone call. You can leave a voicemail. In the worst case scenario, if you start talking and you feel like you went off track. Just say, scratch that. Let me start over and say, Hi, Cynthia, over again. You know, don't be afraid that. You know, 100,000 people are going to hear your question, right? It is no big, no big deal. But, uh, Trisha, the millions, so we are in the millions of downloads. Yes, okay, that is true. So with that said, we have some wonderful breastfeeding questions, and we're going to get started Patricia, you had a you said you had a really special client that you worked with who had a very unusual challenge. And you and she celebrated really great success about something. And you. Said You asked her to call in, so can we I did?

Yes, I would love to share her story, because her story is really unique in the sense that her baby did not start breastfeeding until beyond four months of age, and while the baby had latched prior to that time, the baby really didn't breastfeed and had a lot of breast stress, and there were numerous things going on which she'll explain, but it's one of my favorite stories of all time, of all my lactation success stories, because so many women will give up once their baby is a certain age. And in my experience, a lot of babies will not latch for the first time after about three months, they will latch instinctively that that instinct is there, hardwired into their brain well into like 12 weeks of age. But this baby started breastfeeding full on, full time at like four and a half months of age, so it's just a great example of why they got to keep the hope and keep working on it. If that's the goal, it can happen. I first was pressure when Zia was about two months old. I'd seen a few other lactation consultants who advised me to just keep up their milk supply while trying to get via to gain weight through bottle feeding. I said to myself that after seeing Trisha, if she told me the same thing, I'd officially closed the door on breasts. I'd become an exclusive doctor. Trisha observed Zia and validated what I was seeing. I continued to work with Trisha. However, all of the supplemental therapy that we were doing with Zia was tough, and sia developed a feeding and mouse aversion that meant she didn't want to be anywhere near the bottle or breast or anyone examining her mouth. Trish and I had worked really hard to overcome this, and she guided me into making sure that the breast was always a happy place to see. I'd sang to Zia while she was nearby, move without even attempting to feed her. I did lots of skin to skin, and still worked on the side pumping to keep up my supply. Zia was nearing about five months now, and I was planning to go away to visit my parents in England for a month. Trisha had mentioned possibly fortifying the breast milk with formula to give Zia some additional calories. In a last ditch effort, we started to do this, and via actually did begin to gain some strength at about five and a half months, when I was in London and cuddling Zia, all of a sudden, she just went for me. It was wild. There are many points where I was ready to give up, and Trisha and I had very open and honest conversations about what was working, and what was it for me, I had an excellent support system. I hope my story is helpful to anyone else who might be at a point where they're struggling with breastfeeding and just about to give up and just know where your limits are and how you can continue taking care of yourself.

So I said four and a half months, she's I misremembered. She said five and a half months was the first time her baby really took to breastfeeding. And while we had some success with the baby latching in the office prior to that time, we also had lots of days where the baby wouldn't latch. The baby struggled a lot with bottle feeding, feeding, sometimes would take over an hour. There was a lot going on with this baby, and you know, she had been born early, and there was feeding aversion with both breast and bottle. Fortunately, the mother always had a great milk supply, so that really helped make breastfeeding easier. But then there was breast stress involved, and this mother just was so committed and believed so much that she could get her baby to do this, and she would sing The itsy, Bitsy Spider song for, you know, a half an hour straight, just to get the baby to suckle a few times at the breast. But it worked, and it kept the baby interested. And then one day, because the breast had always sort of been this happy place for the baby. She just started breastfeeding, and they went from a few suckles at the breast for, you know, the first five months of life to a marathon of breastfeeding all weekend long, around the clock for several days. And now they just breastfeed and bottle feed to whatever extent. You know she wants. Sometimes she pumps and bottle feeds, sometimes she breastfeeds, and it's always an option now, and it's just to me, it was a remarkable story because of the age of the baby and how long she worked at this and how she managed it. And I just hope that it inspires women who really want to stay the course with breastfeeding that you you know it's not, it's not over until you want it to be over five and a half months. I never thought. I never thought the first time

I've seen it, yeah, and I'm sure there's other lactation consultants out there that have seen it, but And it isn't always the right choice. For a mother to want to can continue. Some mothers mentally just need to switch that part of their brain off and say, you know, I'm this, is it? I'm bottle feeding and doing this. But if you don't want to do that, it is possible. And I just love to see them now, because breastfeeding is such a long journey, you might breastfeed your child until they're 234, years old. So, you know, even five and a half months is a short amount of time when breastfeeding is a three or four year relationship.

Yeah. I mean, from my perspective, the main thing is the the mom has to feel at peace with her decision, and that's why we can never presume what is right for her to do. But she has to feel at peace. And you can't talk a woman like a lot of women who want to continue. I can't imagine how much this woman heard from people around her, like, just stop trying so hard. Give yourself a break. And that's a completely legitimate perspective for the woman who feels like she is just done. But the thing we have to think about is her long term interest, and she needs to feel at peace long term. So if it's time for her to stop, yes, she needs permission to stop trying so hard because it's brutal and exhausting, but if she isn't ready to stop, and she's talked into stopping, she's then left to sit with the guilt and the regret that she'll feel. And I know that because I get those women in my postpartum group, and that's something those women are going to think about their whole lives. So we all have to mind our own business and let women work with their ibclcs and and get to that themselves.

And many women don't even know that it's an option to pick up breastfeeding later. They they, you know, think early on, if they switch to pumping and bottle feeding, that they can never go back to breastfeeding. And it's just not it's not true. You can. So it isn't like if breastfeeding isn't working now and I switch to bottles breastfeeding, I'm throwing in the towel on it. You don't have to do that.

All right. Well, story, great story. Thank you for sharing. And let's get into the questions.

Hi, Cynthia and Trisha. I struggled with low breast milk supply for no apparent reason, and that made my postpartum experience extremely stressful, and it's an understatement to say emotional. It was my desire to exclusively breastfeed, and I tried everything to increase my supply. I've heard it all, I've read it all, I've tried it all, and I sent every single lactation consultant I met with. I've been so heartbroken over this that it causes me to reconsider having another baby. I participated in the milk supply workshop, and I have two follow up questions. First is, what could be the cause for unexplained low supply when all the usual reasons have you know, been ruled out? And the second is, do you know if I'm likely to have the same supply issues with the future baby? I'm sure you can tell in my voice how emotional this has made me and my baby is 15 months old, so it is something that really weighs heavily on my heart. So thank you so much for your time and all that you do for women and family.

Low milk supply is one of the most common reasons that mothers discontinue breastfeeding, and it happens for so many different reasons. So I know she said she explored all the options, and I'm sure that she did explore all the available options, but somewhere there is an explanation for it, and I don't know what it is, because I wasn't her lactation consultant, and I don't know her medical history, and I don't know the story of her baby. But there are, you know, there's, there's half a dozen different common reasons for low milk supply. One of the most misunderstood is the slowly gaining baby who just doesn't up regulate the milk production, the milk making cells early on, and it's very hard to upregulate the milk making cells later in the breastfeeding journey. So if a baby doesn't gain weight well in the first two weeks, that's a very common reason for mothers to have low milk supply. But of course, there's insufficient glandular tissue. That is a real thing. It's more commonly diagnosed than I believe it actually exists, but it is actually a real thing where a woman's breasts are underdeveloped and the milkmaking tissue is just not sufficient enough to easily make a full milk supply. It doesn't mean that they can't, but it takes a lot. It takes recognition early on and a lot of effort early on to get those cells up to speed. And it can be very challenging to get to a full milk supply. And many women don't, you know, thyroid issues that need to be looked at, nutritional issues that need to be looked at, most lactation consultants that women are seeing are not doing blood work and not looking at magnesium levels, vitamin B levels, vitamin D levels, iron, all these different things that can play into milk supply as well, or even blood sugar imbalances. It's a really common reason if a woman is pre diabetic. Or has, you know, poor insulin sensitivity, these things can affect milk supply, so most people aren't digging deep enough.

Just a question. I just want to make sure I'm understanding from listening to what she said. So are you saying you're confident there's always an explanation, and theoretically no one should have low milk supply without a reason for it.

I'm saying there are reasons that may not have been looked into because they are not so commonly investigated in in the lactation world. So there usually is a reason. Yes, okay, it's hard to know always. We don't always get it right. We don't always pinpoint exactly the reason. But so were you saying, like a nutritional supplement can potentially resolve it. If the B levels are off, if the D levels are off, there are you that it can it can help. It can help support milk production. Yes, okay. And then so her follow up question is, will this happen to me again? And of course, that depends on the underlying cause. But the good news is that once the breast cells have made milk once, they are much more receptive and much more efficient to making milk the second time around, so she will have an easier time making milk early on, I have known so many women who had really significant breastfeeding challenges with the first baby and absolutely none with the Next. I've also known women where the reverse was true, that the because it could be anything, could be related to birth, it could be related to something that happened, but so many women can breastfeed the next time around, right? The reason you see that is because it's a learning process, and the first time around, we don't always get it right, and we have a short window of time to get it right, to get the milk supply up to full volume. And it's not that you can't increase a milk supply later. You absolutely can, you can, you can you can induce lactation, so you can increase milk supply later on, but it is much easier early on. And if latch isn't correct in the beginning, or feeding isn't happening enough, it's hard to get to get to a full milk supply, and then most women are playing catch up for a very long time, and eventually that's very exhausting. So breastfeeding ends, or they start supplementing with formula, and, you know, slowly weaning off the breast milk. And that's how the breastfeeding journey ends. But the next time around, it's like, the breasts are prime. The cells are primed. They're like, we've done this before. It's ready to go. Same thing happens in birth. It's the same reason that a woman generally has an easier second birth than a first birth, because those oxytocin receptors are primed. They're like, Oh, we recognize this. Let's do it. Let's, you know, kick right into action. So that is the reason that you see easier breastfeeding the second time around. Plus, moms are more confident in how they hold their baby. They're more confident in how they latch their babies. They have more confidence overall in just being a mother. So it does make it easier. We think breastfeeding is so instinctual, and it's actually really not. It's very much a learned process. The instinct to feed is there, but it's not the most instinctual process to actually do it. It's it's such a strange thing, because every mammal latches on unassisted.

So because the the offspring is hardwired to latch, their brain is hardwired to latch on, they cannot not latch.

So I feel like the biggest issue then, is the interventions, someone else's hands on the baby, someone else moving the baby away from the mom. But if the mother were like literally lying, let's say, on the ground or some field, or or wherever, women have given birth for so many millennia, they would take their babies into their arms instinctually. And the babies are primed to everything fires up and they latch on. So I would guess that so much of what gets in the way is just all of the interventions that we have as humans, including clothing the unfamiliar people, right?

Yes, well, the instinct to latch and feed is there, but the process takes learning to make it work successfully. And that learning comes from the fact that we are didn't grow up seeing it, you know, we've unlearned it, yes, exactly to relearn it, exactly.

Women weren't alone doing this. They were surrounded by women and who women who knew exactly what had to be done. And the truth is that in nature, it doesn't always work. You know, sometimes an offspring doesn't latch Well, or it's it is causing the mother serious damage, and it doesn't work. Unfortunately, in human life, we get support, and we can get help, and we can make it work, and we have alternatives so that, you know, that's unacceptable option, but it is a process of learning too.

Yep. All right, let's go to the next one.

Hi, Cynthia and Trisha. I have a question about breastfeeding and pumping. My lactation consultant told me to pump after each breastfeed, to reduce plug ducts and to also increase. To my milk supply. But won't that potentially increase plug ducts? Unfortunately, I am prone to plug ducts, and typically have like one to two per week. My baby will be three months old on September 16. Unfortunately, I also have a low supply, so I'm currently breastfeeding, pumping and bottle feeding with formula. My goal is to stop supplementing with formula, but unfortunately, my supply just isn't enough. I would like to schedule another appointment with my ibclc, but she charged me 200 bucks, and I feel like I'm almost more confused now than I was before. So I'm coming to you ladies for help. Thank you so much.

Well, she has a she she has a little bit of a conundrum, because the plug ducks may be a result of the pumping, and yet she needs to pump to increase her milk supply, so her best remedy Here is her hands. Her hands are going to be the most helpful tool after breastfeeding in helping to increase her milk supply and helping to reduce the occurrence of plug ducts. Pumping itself can lead to plug ducts because of the way it traumatizes the nipple in some women. So she may be pumping with the wrong flan size, she may be pumping with too much pressure, she may be pumping for too many minutes. So a lot of mothers are told to pump for 30 minutes, and that can absolutely cause plug ducts, because it actually causes trauma to the nipple tissue, which can lead to inflammation in the ducts. So she needs to increase your milk supply, so she needs to remove more milk, but the way she's pumping might be contributing to the plug ducts. Plug ducts and mastitis also are associated with a dysbiosis in the ductal tissue. So there are probiotics that can be helpful for reducing plug ducts, but honestly learning how to remove milk with her hands after breastfeeding is going to be the best tool that she could use to reduce the chances of plug ducts. Happy ducks is a great supplement too that helps with inflammation in the ducts. It's made by wish garden, and it's a tincture that is has an anti inflammatory effect on the milk jugs. So I would recommend that too, if I were seeing her as a lactation client.

And it also seems to me that a pump, it doesn't have the art of breastfeeding that a baby's mouth does, so the baby is so much more efficient. The baby moves the mother, moves the baby into different positions, thereby accessing so many other ducts in there, right? And the pump just is very static. It goes in one location, even if it's a perfect fit, it just always must access the same ducts. That's what I envision. Do you think that that's that's a fair point, or not?

Well, a well, latching baby absolutely is going to remove milk from the breast better than a pump, yes, but there's a reason she has low milk supply, and that may be that her baby is inefficient at the breast, or doesn't latch Well, or has oral restriction, and that so her baby may not be as effective at that now, as far as moving the baby around and accessing different milk ducts, it is commonly said that You know, if you have a plug on one side, get the baby's chin on that side, and that will help get the plug out. But what we understand about plugs now, it doesn't actually make sense to do that, even though some women will swear that that was the trick. The dangling technique, or the chin on the side, you know, is what got the plug out. But it is an inflammatory process, not a blockage. A pump is just suction. A baby's mouth is suction and compression, which is a very different mode of action than just the suction. Plus, we respond so much better to our baby, because we love our baby, and when we're looking at our baby and touching our baby and holding our baby. We have all this oxytocin going through our body. We have all these loving feelings, and that helps get the milk out of your breast. When you're sitting there pumping, you're usually not very excited about it. You're usually not feeling very loving toward your pump, and plus, you're like, looking at the bottles, going, Oh, this is why is this taking so long? This is all I'm getting. There's a lot of performance anxiety pressure, so it's really hard to get the milk out with the pump. The same way in a latching a well, latching baby will get the milk out.

Hi, yes, I have a question about breastfeeding, specifically the first, like one to three days of breastfeeding. So I am a nurse. I actually work in women's and infants and at my hospital, and I'm a new nurse as well, so I'm kind of just learning everything and trying to sort it out. So at my hospital, we teach moms, especially first 10 moms, oh, the first 24 hours after birth, you know, initially, baby will probably have one good feed, and then they're just going to be sleepy. We call it the birthday nap. And then after that, they tend to perk up. And then we have kind of like a cluster feeding that second day or night. And it just, despite us teaching them that baby is going to be sleepy and that that's normal, we at the same time teach them, but you need to wake up the baby every two to three hours to make sure they have a good feed, which is, you know, at least 10 to 15 minutes breastfeeding, or else, you know, they're going to have blood sugar problems. And things like that, and so we have to do that. And then, you know, but then they'll wake up the second day and start cluster feeding. So I'm just wondering, what is physiologically normal? What can we do to help our moms build their supply and make sure babies get what they need? You know, even in a hospital environment, like, what should this really look like? Thanks.

This is a great question, and no wonder moms are confused as heck, because they're getting the totally contradictory advice that it's normal for your baby to sleep constantly in the first 24 hours, and it's really difficult to wake them and difficult to get them to feed, but make sure that they feed enough so that they don't get low blood sugar. So what is a mother to thank and do and know and plus, in the first 24 hours, there's so much going on in the hospital with a new baby that's interrupting the possibility of even getting the baby on the breast for the very few short minutes that they might be awake. This is why mothers and babies should not be separated at all post birth. I'm just, you know, I've always felt that way, but I am becoming increasingly adamant about mothers and babies literally being stuck together for, you know, days after birth, especially the first 24 hours that skin to skin is so important. And that doesn't mean that a mom cannot take her baby off her and go to the bathroom or, you know, take a two hour nap and have her baby off her, but every minute that she is awake, really, that baby should be on her chest and skin to skin with her if she is not showering or eating or taking a nap, and that's not happening. And if that does happen, the opportunities to feed your baby are going to be so much more available, and the opportunities to catch your baby instinctively crawling down to the breast and trying to latch are going to be so much more available. And there's so many things that happen in the hospital that interfere with this process. And yes, it is true, in the first 24 hours, babies are very sleepy, and it can be really hard to feed, and both the mother and baby should have one long stretch of sleep post birth. Babies are very alert in the first two hours after birth. That is why the golden hour got its name, because that is like the optimal time to get your baby latched on the first one to two hours after birth, they are primed to latch in that moment. They're in a quiet alert state. Then they go into a deep state of a deep sleep state after that. So in the first 24 hours a baby will take probably one four to six hour stretch of sleep. Usually it's after that first two hour wakeful period, but not necessarily, but that is the only stretch of sleep that can be that long for the next six to eight weeks. So one four hour, one four to six hour stretch of sleep pretty much for the next six weeks. And other than that, they should be awake and nursing at least every one to three hours at the max. So we know that the incidence of jaundice and babies goes down dramatically if a baby nurses at least, I'm going to forget the numbers, but it's like it was a lot. Yeah, it was a lot. It's six or eight times. And if they feed like eight to 10 times, there's basically a 0% chance of jaundice on day seven.

Well, if they feed three times, they have like a 30 to 40% chance of significant jaundice. And I might be saying these numbers wrong, so I should look it up. But it's something, it's something in that range. It's significant. It makes a difference. And so the advice that a baby really doesn't need to eat in the first 24 hours is completely wrong.

Let's Wow. I always heard that. I always heard, yeah, don't worry. It's the first 24 hours. It's fine. They'll wake up in the feed tomorrow. No such bad advice.

Let's make a commitment to getting the specifics on what you were just trying to recall into the show description. So everyone can just scroll down right now read the show description and get the definitive, accurate numbers that you were just trying to write, where it is in my textbook. Yeah, well, we'll, we'll commit to having them in the description. So actually, it is on our Instagram page as well. It's okay. Well, we'll, we'll get it in the description. Okay, go looking through our Instagram page. Yeah, there's a lot of great content way back eventually, fact it go through our whole page, people, we will have it in the description. All right, great.

So hopefully that answered that nurse's questions. Thank you for answering it. I hope she can implement some change in the hospital. Because. If we can get these babies breastfeeding more in the first 24 hours, women are going to do so much better in the first two weeks with feeding their babies. The first 24 hours influences the first few days. The first few days influences the first two weeks. The first two weeks set the tone for your entire breastfeeding relationship. If you aren't able to get what you need in the first two weeks with breastfeeding, the whole rest of your breastfeeding journey can be like a game of catch up, which is why it's so important to take those two weeks and make sure you have the support at home so that all you have to worry about is resting and feeding your baby. All right. Okay, so we have like 100 breastfeeding quickies. I know that list.

We will keep working through them. People. We will keep working through them there. Well, they're quickies. That's why we get to do fast. Yeah? So let's do we'll just run through them as many as we can. Okay, yeah, no, okay. Will my milk supply drop when I become pregnant again? Most likely, yes, it does, usually get impacted at some point. But some people absolutely can breastfeed all the way through. It just depends on the age of your baby. I'm not going to go into too much, I'm just going to say yes, it may likely drop. How do I fix one side producing more than the other side? Well, first of all, it's not a problem unless it's really bothering you. As long as both breasts are producing enough milk for your baby, that's what you need. But if it's highly imbalanced, then you can favor feeding a little bit on the other side to increase feeding on that side, or pump the other side to increase the supply on that side. Is there anything I can do to prevent thrush, avoid antibiotics and wash reusable nipple pads frequently. If you don't wash them often enough, you can definitely get thrush, developing, yeast developing there. Is there anything I can do to increase my supply while pregnant and still breastfeeding? My 11 month old. Unfortunately, it's really difficult to do. Is it because of pregnancy or the hormones of pregnancy are just going to dominate the hormones of lactation, and your body is going to prioritize growing of the baby over producing milk. It's we don't really want to fight that that much. It's just the natural process. Again, some people breastfeed all the way through pregnancy, and tandem feed babies. And it works. It just depends on how much your baby is feeding and how much your milk supply is impacted. How should I prepare for breastfeeding when pregnant? I'm a first time mom, take a prenatal breastfeeding course. Get some education in advance, it's very helpful. We have a digital course you can do. I do one on one prenatal consultations as well if you have specific questions. So But getting that advice in the beginning really helps you, because again, what I said it's that, you know, the first 24 hours influences the first three days. The first three days influence the first two weeks. The first two weeks determines your breastfeeding journey, and most women aren't getting lactation help until they're past a week or two or they're many weeks out until there's a problem. Yeah, and that's usually many weeks out that you notice the problem we had.

It reminds me of when we had Maggie O'Connor years ago on the podcast talking about when couples go to marriage marital therapy, and she said, usually when their only other option is divorce. And she said, Gosh, if we could get couples in here when they're when they're getting along and when things are functioning, that's a lot better than dragging them in when they're both, you know, trying to get the last bit of life out of this thing. It kind of reminds me of it we don't take proactive care of our health, right? An ounce of prevention is worth a pound of cure. I mean, that applies in so many cases. So will using a nipple shield cause the baby to get less milk and drop off the growth curve? Potentially, yes, not a big fan of nipple shields unless they're used very strategically. Is there a way to prevent engorged breast when milk comes in? I experienced crazy pain with my first and looking to avoid that this time around. I mean, the milk comes in and the way the milk comes in, so the best thing you can do is feed your baby frequently, stay skin to skin. But engorgement is not just about milk. It's also about fluids that enter the breast tissue. So cold compresses are very helpful. It's particularly cabbage. It does actually work. Cabbage actually really works placing the cabbage leaf over your breast. But can you prevent it? You know, again, it's your body is kind of going to do. What your body's going to do. Do you recommend a breast pump brand and how to know if it's the right size you should be if you're flan, if you're unsure about your flange size, it is best to have it looked at by somebody who knows how to size flanges and actually not just measure but to actually look at what's happening to your nipple as it's being sucked into the flange. That's the best way to tell if a flange is fitting properly or not. I really like the baby Buddha pump. It's very reasonably priced, it's very powerful, and it's portable. All right? One more. What are the best snacks to keep on hand while breastfeeding? Chomps. Oh, come on.

Oh God answered everything. Okay? Protein, people, protein.

There are so many other sources of protein than a chomp, I know, processed almonds. Almond. Girl, do almonds? Most people probably agree with you. I'm not. I'm it's just, it's good. We don't have the same opinion on these things. What if it's not animal protein? Yeah, I said almonds. Be an almond girl. Almond not you're saying protein, cheese. Protein, yes, protein, because protein helps you balance your blood sugar. You burn through a lot of the chia pudding. Hemp seed, sure. Yogurt cheese, eggs, nuts and carbs too. But mix always have protein in the mix, chickpeas, hummus, if you like those things. Well, chicken wings, chocolate milk.

It's good not to have a solitary, unitary, united voice on literally everything, I suppose. Well, thank you, Trisha, that was awesome. And thanks to everyone who called in and that's it. We got our regular q&a coming next week.

We sure do so, yeah, looking forward to that one.

All right, see you guys there.

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Paul asked me what I wanted for my birthday dinner this week. What do you think I
said? Steak with a side of chomps, chicken wings. Chicken wings, hot wings.

Oh, my goodness. My goodness. So yes, we had them.