Transcript:
Hey, everybody. Welcome back to the Milk Minute. I wish you all could see Maureen’s hair right now. It looks like she just came out of a wind tunnel. She’s got her headphones on and then the hair just goes at a 180 like perpendicular to the headphones straight like it’s trying to reach the walls, you know.
I think I sprayed a bunch of dry shampoo in this morning because it was looking greasy and it looked, it looked great, but it might be just a little too stiff. Now it’s, now it just won’t, won’t adjust to the new angle, so it is what it is. Your hair doesn’t know what’s going on. Are we dirty? Are we clean?
It’s confused. I’m not telling it. Alright. What’s going on in your life? Oh god. Well, it’s, it’s still very snowy here, and now it’s like starting to melt, so it was fun to have like 10 inches of snow until it became like 10 inches of slush this morning. And even though it, there’s been snow on the road for like a week and a half now, we still, we still have snow on the roads.
I don’t, I don’t know what our county is doing with this plow situation, but it’s clearly not working. County? You mean our whole state? Yeah. Yeah. No, but really like, I think the county I live in gets the most snow in the entire state, like this and Tucker County. So we’re just like. Yeah. Oh, by the way, for our listeners in the North, so like Michigan, North Dakota just so you know what our life is like down here, if we get.
One and a half inches of snow, they will cancel school. Adding to that, we get one and a half inches of snow a lot. Right. It’s not, it’s not like living in Georgia where that is actually a state emergency. They declare a, a state of emergency here, but it happens like every week in the winter. And the emergency is that we don’t have enough money.
Infrastructure, yeah. To pay snowplow people and pay for the salt. So they’re like, this is an emergency. And truly, too, people who live here. People who’ve lived here their whole lives really act like it’s an emergency so much. And I’m like, but didn’t you get more snow when you were a kid? Like, yeah, what is going on?
Like, even when I lived in the most like Southern part of the state here, they would still get big snowstorms. I don’t, I don’t know what’s going on. Everybody would freak out and get milk, eggs, bread, and whiskey and, and cigarettes. And then, It was so crazy and, and my work would get canceled for like a dusting, like my boss would call in and be like, y’all are gonna die if you hit the road, so stay home.
You’re like, I have a Subaru for the love of God. Yeah, exactly. I’m like, so do all of you, like. Yeah, I don’t understand it, but I do know that. Every end of the fall season, holidays come and go, and then the winter sets in. It shocks me every year that my work is interrupted at least two or three times a week.
Yeah. From two hour delays and cancellations. And I’m like, how am I not prepared for this still? We’re both New Yorkers. Right. I learned to drive in New York, and we actually didn’t get more snow in New York than we get here. It’s the same. I mean, I didn’t grow up in like Buffalo or anything, but New York is so much richer than West Virginia that they like pre-treat every road.
Yeah, the first snowflake falls and they’re like, we’re on it. They’re like, salt. We’re just going to salt the earth now and destroy our ecosystem. West Virginians just look to the sky and they’re like, I can’t believe this is happening again every year. It’s just a weird dynamic to live in the South, but also have the like ecosystem of the North.
And not the mindset. Yeah, we don’t, we don’t know what we are. We’re definitely in the middle of everywhere. But, neither here nor there. My children did go to school today. For the first day in like two weeks. Yes. Yes, absolutely. And I was So ready for them to go. I was like, bye. I love you guys. See you later.
I hope you have a great day. They got on the bus and I was like, fuck yeah. I was like, Oh, I turned on a podcast. I was like, I’m getting ready for work. I got the baby ready. And we got out of there. Oh, you know, it’s so funny. So Lyra likes Christmas music, right? So we still listen to it. And in the song, it’s beginning took a lot like Christmas.
There’s that line that mom and dad can hardly wait for school to start again. And my kids are homeschooled, so Griffin looks at me and he goes, Mom, what does that mean? And I was like, what do I say that some people don’t like their kids? I was like, you know, it just means people can’t wait to get back to their regular schedules after the winter.
That’s true too, though. Like if I was homeschooling, I would build in some time for myself. But when you’re, when your life is not built like that, it’ll jack you right up. So, anywho, speaking of getting jacked up the first three days postpartum is what we’re talking about today, and, yeah, this is an episode that is definitely fresh in my mind, postpartum because as we’re recording this, Marty is three months old.
And I want to talk about those very special, but also very difficult first three days. Every day is different, those first three days. And even when you’re doing everything right, it can honestly feel like it’s not working and everything’s going wrong. And so we want to make you feel a little bit better and give you some guidelines and key indicators that you are in fact crushing it, even though you feel like you’re not.
I like, I like the way you phrased that. And just a reminder, if you are struggling in those first 3 days or any other time, Heather and I both offer virtual consultation as well as in person consultation, so if you’re across the country and you still would like some personalized help from us, please don’t be afraid to reach out and schedule, and those links are always in our show notes.
Alright, so before we get into this, let’s thank some patrons, and we have a question. Okay, today I have a big thank you for Elizabeth from New York, Miranda, and Casey, thank you so much for being our new patrons. We deeply appreciate all of your sponsorship, all of your support and if you guys want to join the Cool Kids Club, you can find that at Patreon.com/MilkMinutePodcast.
You can sit at our lunch table. Maybe. That’s only funny because Maureen and I were, Maureen and I were definitely not at the cool kids table in high school. Definitely at our own nerd table. I wish we went to high school together, but. You went to that fancy all girls private school.
I, I did go to that fancy private school. I was a public school heathen in West Virginia, but that’s okay. We’ll have to post, we’ll have to post some pictures on Patreon from high school. I peaked in high school, so, I mean, you’re going to be shocked by my athleticism and The size of my ear, you know, I, I really love looking at pictures from high school because every single year I look like a different person because I was like trying on new stuff because I was like, well, whatever happened freshman year did not work.
So let’s be totally new sophomore year. Okay. That didn’t work. Let’s do something totally different. And I went to a school after my two older sisters. Oh, right. So, like, everybody would constantly call me Jen or Christine, every teacher and I just didn’t have an individualized identity there. Wow. Yeah.
I didn’t go through that. That sounds worse. That was, that was bad. It sounds worse than my goth phase that I went through. My sister still teaches there, by the way. Seriously? Yeah. She teaches there. She’s a STEM teacher. STEAM. I don’t know. She runs like, she does like robotics and calculus and all kinds of shit.
Wow. Okay. She’s great. Yeah. Cool. All right. Well we have a question today and I’m going to let you take this one. Oh, how about you read the question and I’ll answer it. Okay. Alright, here’s our question today. I’m interested in home birth and have enjoyed learning so much about the process from beyond the boob.
I’m wondering why in hospitals baby and mom have to have vitals checked every two to four hours, and whether that is just unnecessary and therefore doesn’t happen with home birth? That was the most disruptive thing for me while in the hospital postpartum. Thanks, Larissa. So actually, it, it still happens at home birth, but there is a difference.
And. So it is evidence based, right? So during labor, we check mom’s vitals every two to four hours. Usually four hours, but if there’s something that’s a little bit off, we’ll check more often. And we’re checking heart tones for baby every 15 to 30 minutes, depending what part of labor we’re in. But postpartum, I’m actually checking like every 15 to 30 minutes for the first two hours.
Which is really often, and then I usually leave. If vitals are not normal, I’ll stay longer. But that’s the difference, right? I’m not there all night long, waking you up to check your vitals. But, I do try to be as minimally disruptive as possible. Right? Like, I don’t require you to stop what you’re doing to check your vitals and listen to Baby I’m Not Gonna Wake You Up if you guys are sleeping.
But it’s just a different timeline because we’re not looking at monitoring you for a full, like, 24 hours postpartum at home. Right? We’re going to just do it for the most vital time, the minimum two hours postpartum. I think the longest I’ve ever been there is like six hours postpartum. And then I’m leaving, and I’m leaving you guys with the tools to check your own vitals if you need to, as well as what the norms are there.
And I come back if I have to. And yeah, as somebody who had a home birth with Maureen and I’ve had hospital births, I can tell you that the vitals were not disruptive to me at all. And I think a lot of that has to do with, I was comfortable in my own environment. I wasn’t like teetering on a sore tailbone in that terrible hospital bed.
I was comfortable on my couch and I was able to shift the way I needed to shift to continue feeding while. Getting my blood pressure checked. And she could take her time. She also didn’t have six other patients to run off to get vitals on. So I could take five minutes to be like, oh, hold on one second.
Like, let me just move really quick and then you can do what you need to do. I never felt rushed and I think that’s kind of the thing that bothers people with vitals at the hospital. It’s like, no matter what you’re doing, whether it’s sleeping or feeding or They’re like, all right, I got to get these now because if I don’t, I’ll be in trouble with the nurses or whatever.
They have a million other things to do, and hierarchical system that punishes them for not being on time, which really sucks. Yeah. Yeah, and, and also like, I’m not walking into the room and flipping on the light and being like, all right, time for vitals, which, you know, not every nurse does, but I’ve definitely seen some nurses do that and they just don’t read the room very well.
You know, I kind of like peek in and I’m like, Hey, is it okay if I come check your vitals? And I have my little headlamp in case the lights are off. And, you know, sometimes I can do it basically without waking you up if you are asleep. Yeah. And really like my goal is different from the goal in the hospital, right?
I’m like, okay, I want to make sure you’re stable for that minimum amount of time. So I’m checking pretty often. My like minimum is I have to stay at least two hours. And if I’m not getting normal vitals, I stay at least two hours from the first normal vital. Yeah. That’s different. Yeah. And I will say like something I feel guilty about that definitely happens.
It’s happening right now at the hospital is that they’ll hook your blood pressure cuff up to your arm and they’ll set it on automatic every 15 minutes. And then they’ll see. Yeah. And then they’ll go chart or do what they need to do because there’s so much to do. And so like. The machine’s not going to ask you if it’s a good time, it’s just going to go off, it’s going to be like bzzz, and you’re like, just got your baby latched, and it like, shakes everybody up, and it’s, it’s very annoying, and you feel like a prisoner, and I regret that I did do that back in the day, and so if you’re And it’s what you’re set up to do, you know.
Right, you’re like, look how convenient this is for everyone, except the patient. Yep. Absolutely. No, what I hate too is that the alarm bells, like, like, I wish those things that are like your blood pressure cuffs not working would just go off at the nurse’s station and not like in the room where you’re like, no, I have to listen to this and no, no one who is going to take care of it hears it.
Exactly. And the nurse is like, don’t touch any of these buttons. And you’re like, Oh my God. Okay. Are you sure I can’t just press the mute button? All right. Well, let’s take a quick break. And when we come back, we’re going to get into day one of postpartum feeding.
Have you guys ever been listening to our show and thought to yourself, man, I really want to work one on one with Maureen. I do every day that I sit here podcasting across from you. Well, lucky for you and everybody at home, I offer both in person and virtual support through my business. And in my business, Highland Birth Support, I’m dedicated to mentoring you guys through your childbearing year.
So that could start with fertility all the way through pregnancy, childbirth, postpartum. I offer home birth midwifery services, doula services, lactation support, herbal support. Anything you guys need. You even do miscarriage support. Absolutely, I do. That’s one of the biggest things that is so hard to find, and I think that your people that are local to you are so incredibly lucky to have this service.
Thank you, and I just feel really happy to serve everybody, and I’m so happy I can expand my services virtually as well. Yeah, telehealth for lactation has been really important through the pandemic, and I think we just about got it perfected at this point. So if you guys want to work with me, head over to HighlandBirthSupport.
com and check out what I can offer you. That’s H I G H L A N D BirthSupport. com Okay, welcome back everybody. So just to intro, like, context for what we’re talking about here we’re gonna try to go through what a Normal postpartum feeding experience should look like does look like just to kind of talk about the baseline This is not gonna be what it looks like for people who have significant infant feeding problems or breast anatomical issues or NICU admissions or All of that kind of stuff.
We’re, we’re, we’re leaving the complications at the door today. Yeah, and we want to do this so if your feeding looks far off from these guidelines we’re talking about, you’ll know that you need to reach out to your lactation consultant immediately. We do want to stress that these first three days postpartum are really important, which is why we’re dedicating a whole episode to this.
So if you are having issues, you do need to call somebody. This isn’t something that’s going to just like work itself out. A lot of lactation and especially milk supply and pain issues can be resolved in these first three days if we get to it in time. And if not, sometimes it’s not as fixable. Not saying it’s not, just like these are important days.
Right. And, and especially if it’s your first breastfeeding experience, everything feels so Alien. It’s really hard to pick out those few things that are like, oh, this is a warning sign for things being abnormal. So that’s, that’s why we’re kind of going to do it this way. Okay. All right. So let’s start with day one.
Your baby has popped out and shot out of you, shot out of you. One way or another. You are now two people sort of and baby is Ideally up on your chest and we have other episodes about that, that we can link in the show notes like skin to skin and, you know, kind of like how to have a breastfeeding friendly birth.
So we’ll link those in the show notes, but often during this time, the baby will be rooting around and want to nurse. And you might have your feet up in the stirrups, you might be Might be getting stitches in your cooter. Right. You might not be in an ideal position to latch that baby right now, so Right.
You might still have a placenta inside you, like, and the latch does not have to happen that moment. Now, I have seen some babies come out, and they’re super vigorous, and they immediately latch, and that’s fine. But that’s not the majority, right? The majority are like, really dazed and confused and acclimating to literally like, breathing air.
Because that’s new. And so they’re just kind of like, opening their eyes and moving around and falling asleep and moving around and like, kind of doing this little Periodic adjustment at the tail end of their transition. Yeah, but that doesn’t mean they’re not going to try to latch. They’re just not going to do a very good job of it.
Totally fine. Yeah, and they babies come out with, you know, a healthy baby comes out with the perfect reflexes that allow them to latch, but they have no integration of those yet. They don’t. They don’t use them all at the same time at the right time yet, so they’re gonna do things like root in the middle of your chest and bob their head around and lick your nipple and maybe bite it or get it in their mouth looking like it’s gonna be a perfect latch and then do nothing.
Yep, like they get it in their mouth and then they stare at you and they’re like, I’m done and you’re like, Oh, no, you haven’t started so, and it doesn’t matter. Can we be honest? It doesn’t matter. That’s all normal. So I want you to take the stress and the pressure of getting a First latch that’s like perfect and baby’s transferring it while your legs are still up.
Just throw that out the window. Let’s wait until the dust settles when the only person left in the room is the nurse. All of the bloody covered plastic crap is out of the room. And you can sit up and put a vertical pillow behind you. So you can actually move your elbow to actually position your baby and your breast appropriately.
And then have a more intentional. first feeding. Yeah. Now, personally, I do like the laid back position for a first latch for some people, but I will say, you know, a lot of you guys have probably like looked at that. If you’ve looked into like the breast crawl and stuff, it’s not easy to do if you have very large breasts or like pendulous breasts that kind of like swing around, whether they’re large or not.
So it’s okay if your first latch is not like that where everybody’s laid back and relaxed and baby’s like in this perfect physiological position. It doesn’t always happen like that, you know, so, and it’s okay if you try it and you’re like, that’s not working great. Sit up straight and do a cradle hold and we’ll figure out the rest later.
Exactly. All right. So now let’s talk about the frequency of feedings because what you’re going to hear most often as the nurse leaves the room is, okay, feed your baby every two to three hours. And you’re like, okay, but let’s talk about what they actually mean. I would love that because that exact phrase confuses so many people.
And we touched on this and we talked about neurodiversity and parenting and how many people take things literally. And especially when maybe you haven’t slept in three days, you know, maybe you were in for a long haul induction and someone says feed your baby every two to three hours, you’re like, okay, I’ll set an alarm for two hours and only feed them then.
That is not what they mean. What they mean is your baby should not go longer. Then two to three hours without feeding. Three at the max. So it means we’re going to feed on demand, meaning anytime the baby looks like they want it, unless they’re asleep and it’s been three hours, then you better wake them up.
So, and that’s All night long, too. So, frequency of feeding on day one, babies are typically pretty sleepy on day one. So this is the sleepy day where they’re recovering. So, they’re actually, a normal physiologic baby is going to have enough brown fat on their body to last 24 hours with no food. Okay.
Right. That doesn’t mean no stimulation. That doesn’t mean they’re not licking the nipple. Right. That doesn’t mean sleep forever. They should be awake, still, you know, be trying to feed. What I usually warn people is that often the first nap after baby is born is longer than the rest. Sometimes it’s like five hours.
Now, whether or not your provider feels comfortable with you letting your baby sleep that long is a great question to ask. But birth is traumatic for everybody, so babies need to rest after that, because essentially every single time you had a contraction, they had physical stimulation that caused, you know, usually their heart rate to go up a little bit, and they got really excited, and so that happened for hours and hours and hours, and they’re tired, man.
Yeah, it takes a while to recover. Yeah, and it also means that they might not have a whole lot of energy for latching. So, you know, we might see in the first 24 hours, baby have like one really successful feed and a whole bunch where you’re like, I don’t know if they got any milk. Yeah. That’s okay. Yeah, that might look like you put them on their they, they were making the early feeding cues, which is they’re awake, number one.
If they’re awake and you see the whites of their eyes, it’s time to feed. Hand to mouth movements rooting, trying to bite the blanket next to them. Any of those that you see, and of course crying is the late sign of hunger. Any of those, and we’re going to be trying to feed baby, but you might put them on and then they immediately fall asleep after three sucks.
That’s okay. You can hand express a little bit into their mouth just to get them kind of go in a little bit and see if you can reactivate them. But we don’t need to, like, take a wet wipe to the baby at this point. Not the first day. Yeah. And really our goal the first day is some feeding and to get one wet diaper.
And one poopy diaper and so typically that will happen even if you just had one real good feed. Okay, so length of feedings in, on day one could be anywhere from two minutes to Anything. 45 to an hour. You just don’t know. It’s really hard that first day to tell, like, when they’re actually feeding, when they’re not, when they’re just hanging on, like.
Yeah, what is time? It’s chaos. It’s, it’s chaos, but also time is standing still and there’s a lot of hormones, a lot of recovery. There’s a lot to do and most of what is being done. is you sitting there, and your body is doing it, you know? So, just take some deep breaths and just keep trying to feed, but don’t stress about the feeding so much.
Just keep trying. Now some things that don’t need to happen on this first day. With a healthy, normal baby, you don’t need to be separated to have a bath. You don’t need to be supplementing with formula or expressed milk. And you don’t need to be pumping unless baby won’t latch at all. Right. So, and if baby won’t latch at all, you know, we’re kind of looking at that curiously, and then they might no longer be considered normal.
Yes. So this is like, your baby’s fine, there’s no medical concerns at all. No low blood sugar. Their term, their, yeah. Yeah. And if there becomes, if there are any issues, all of this can change, even if they’re like, small problems. You know. Right. So if your baby was a 39 week, 7 pound, 5 ounce baby who’s latched four times in the first 24 hours and had one really good feed, we should not be supplementing with bottles of anything.
Yeah, absolutely. Because, you know, as we said, they have enough brown fat to manage the first 24 hours and then day two is going to be a little bit different. Alright, so let’s take a quick break to thank a couple sponsors and when we get back we’re going to talk about day two and three.
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All right. So you had your baby yesterday. You maybe got something that looked like sleep last night and now we’re on to day two. Hopefully you’re in a room that actually has a window. So you know if it’s daytime or nighttime, that can be a struggle. Yeah, so day two. Now, this isn’t exact for every baby.
Sometimes it’s day three for some babies, but day two usually looks a little bit different. Your baby is going to be waking up more and trying to feed more frequently. Mm hmm. Yeah, so this could look, especially as you get closer to that 48 hour mark. Yeah. It’s gonna look a lot more Like, the baby doesn’t ever stop feeding.
You’re like, where does one end and another one begins? Right, this might be your first experience with cluster feeding. Yeah, and so this is where people usually fold and call me and they’re like, Heather, I’m starving my baby. And I’m like, there is a deficit. You’re correct. You’re not crazy. But. As long as your baby is holding steady, we can lean in and let that baby do what they need to do to get your body where it needs to be.
So we have to have this deficit so baby will mechanically remind your body over and over and over and over again how much milk it needs. And this is called second night syndrome. You know, so it’s a real thing. You’re not special. Your baby’s not broken. This is built into nature because our bodies are naturally selfish.
And we want to make really sure that there is another human being out there that needs us to switch into milk making mode, because it’s a lot on our body energetically to make that milk and use those resources. So by the baby repeatedly being like, Hey, Hey, Hey, Hey, Hey, our body’s like. Okay, fine, fine. And every time your baby nurses on day two into day three, they’re building more receptors for prolactin on your glandular tissue.
So the more receptors you have, the more activated your glandular tissue and sensitive your glandular tissue is going to be. And so we have really good research that shows us that the frequency of feeding on day two directly correlates with milk supply at six months. Mm hmm. Now, adding to that, while this is an important process, I am not fully against if using a little bit of supplementation if we have to do that in order to get literally like an hour or two of sleep.
However, we do need to make sure if you’re doing things like that, that you are not fully replacing this process that is going to make you milk, because like Heather said, it’s not just about this one day. The process of building prolactin receptors on your glandular tissue is essential. essential to the entire future of your lactation for this baby, right?
And also if you’re supplementing at all for whatever reason we do not need to use a bottle. The baby’s tummy is so small I’m talking like five to ten milliliters. A syringe, a cup, a spoon, you know and I mention this because I want to make sure we understand like Sleep is essential too. And this, this process is sort of antithetical to sleep sometimes.
So it’s okay to be protecting your health, your mental health, your sleep in this process. But you can do that while balancing the physiologic norm. Yeah. So this is where. So, for example, for me, I chose to use some of my colostrum that I had harvested prenatally. I think I had six milliliters or something like that just to prevent jaundice, number one, and also to give her a little bit more energy because she was still a little bit like, I don’t know, she was my third kid and I was like, she’s a little, you know, sleepy still, and I don’t love it.
So gave her a little bit of that. And then. Did we hand express? I feel like I hand expressed a little bit more, just so I didn’t miss out on that. stimulation, but don’t be surprised if you don’t get anything out. So this is where people, this is where, I see this all the time, people supplement, and then they’re like, okay, and I’m gonna pump, but then nothing comes out when they pump, and they’re like, oh my god, and then they freak out, there’s nothing in there!
The colostrum is super sticky, it’s like maple syrup in there, and that pump sometimes cannot get it out. So you’re fine. Yeah, this is usually the, the day slash night that Heather and I get the most panic calls. Totally fine if you feel that way, quite normal, but let’s, let’s talk about some, some ways to reassure yourself, right?
So day two, we’re looking for two wet diapers and one poopy diaper. Okay? If you’ve already seen that, you’re doing fine. And the poop will sometimes at this point look like that black tarry meconium, but with a green tinge to it. Like, it’ll start getting a little bit thinner, like an army green slime.
Right, and it is normal for your baby to seem always hungry during this point. It’s normal for them to be a one boob or a two boober at this point. I think most babies tend to do both breasts before your milk comes in, you know, and a lot of people are like, when should I switch? Typically, I say if your baby is Not asleep after feeding, definitely offer the other one, and even if they are, you can still wake them up to offer the second, that’s fine.
If they immediately fall asleep at the second breast, they don’t need it. Yep, I always offer the second one, I’ll like, I’ll burp them in the middle, and if they’re passed out, then like, whatever. But if you put them up to your chest after one boob, and they’re, awake or bobbing around at all, then definitely give the other one.
All right, so Heather, what do we not need to do on day two or night two? Okay, so this one I get some pushback from patients on, but you can do whatever you want to do, but we’re going for a normal average. This is our recommendation. Recommendations. Okay, we do not need a million visitors going in and out holding your baby.
Because, like we just said, that baby has a very important full time job to do, getting your body to cross over into milk making mode. And if you have a grandma there who is like, Oh, let me hold the baby, and oh, let me put her to sleep for ya, and she’ll bounce around and put her to sleep, the baby will go to sleep.
But if the baby is on you, the baby’s gonna smell you, and it’s gonna be like, Oh yeah, I have a job to do. You know, we don’t want this baby to be asleep, being held by every family member, and then starving and so angry that they can’t coordinate themselves neurologically to have a feeding. And I’ve had a number of people where that happens, you know, grandma very nicely is like, let me hold baby so you can sleep, ends up holding them for four hours, they come back in and the baby cries literally for two hours straight.
You know, because they’re so dysregulated at that point that they can’t coordinate calming, sucking, swallow, feeding, you know. So, it’s okay if you again need some help to sleep, but say, hey, yeah, great, take the baby for two hours, max, then come back. Yeah, or if the baby’s eyes open at any point in time, that’s an indicator that they need to eat.
And if they’re sleeping, but they’re making those fish lips, those guppy lips where they’re, you know. It’s time to eat. So like, please don’t let me sleep. If you see any of these things, give me the baby. Yes. Also, if you are in a teaching hospital, you do not need to be a lesson for students in there on day two.
I absolutely understand if you want to do that and you want to help because it was amazing for us being students to have parents who were really willing to do that, but this is not the day. This is not the day. That every nursing, or med student, or first year resident, or whatever gets to come in and redo the same exam that was just done.
Yeah, I’d actually prefer those exams to happen on the first day. Because they’re sleepy. You know, they’re sleepy, and they’re recovering, and the baby’s gonna sleep through it most of the time. Day two, they will literally have four or five people come through and examine that baby until the baby is so hungry and dysregulated that you, they can’t get them to latch anymore.
And it is so annoying. So let’s talk about circumcisions, Heather. Let’s. Okay, so, Every hospital has a little bit of a different take on how circumcision should be done. Most of the time, it’s day two before the baby is discharged. Let me just qualify this. If you are outside of the United States, this is probably not standard.
Inside of the United States, circumcision is offered and usually recommended for every male baby. We will not pass judgment or opinion on whether or not you should do it, but we will let you know it is optional. Yeah, and it is becoming less common, I will say that, and insurance companies are not automatically paying for it anymore.
So if you’re still pregnant and you’re having a boy, you might want to check with your insurance company and see if that is something that they are going to cover. Because you might be stuck with like a 600 bill if you choose to get this optional procedure done. Yeah, anyway, it’s often offered on day two, so what’s that looking like and should we do it?
Okay, so what it usually looks like from my experience working in hospitals is it happens all at the same time. So it’s like a good time for the doctors, they say line up all the babies, we’ll just knock all these out so we can get these babies discharged when they’re ready to go. And so they will tell you don’t feed before the circumcision because they’re going to strap them to a board on their back and they don’t want them to vomit and aspirate.
However Babies are born with a reflex to turn their head when they are going to spit up. So they are not like little drunk people that are just going to aspirate breast milk. And also, if you aspirate breast milk, it’s actually kind of fine. Yeah, and really realistically, they’re not going to take baby from your breast.
To immediately circumcise, it’s going to be like a 20 minute wait, a 30 minute wait. Some nurse is going to hold them and then they’re going to have to get some stuff and they’re going to set up the room. And then maybe there’s two babies ahead of them. So just feed them if you want to do that. Or if you’re going to be in the hospital longer.
If you have another day before discharge, just do it tomorrow. Right, exactly. And also, I just say, we’d never interrupt a feeding to do a circumcision. Like, feeding is actually the priority. And don’t feel bad, because there’s usually like six other babies that they could do before you. So, if the nurse comes in and is like, Oh, hey, we’re gonna do the circ in one hour.
Don’t believe them, number one. Because. First of all, you know, it’s not guaranteed, and other things will trump it, so like, an emergency c section is gonna push it back. So, you feed when your baby needs to feed, and when the nurse comes in, and is like, Oh, I’m actually on time, and I told you not to feed an hour ago, you can say, Sorry, baby was hungry.
Come back in 30 minutes and they’ll be like, okay, and then the doctors will go, okay, I’ll just go to lunch and we’ll do it after lunch. It’s fine. And you can always do this as an outpatient procedure a week later, two weeks later, you don’t have to do it before your discharge because it is not medically necessary.
It’s a cosmetic procedure, so it doesn’t have to happen at a certain time. I will also say that it is standard practice for them to give what’s called sweeties or sucrose sugar water to baby during the procedure and you can ask them to use some of your colostrum instead. So if you have some harvested colostrum prenatally, you can have them use that because that way the baby’s blood sugar doesn’t get jacked up and then Completely crash after the procedure, babies typically will sleep for a long time after the circumcision, partly because definitely before.
Yeah, so definitely feed before because you don’t want to miss out on several opportunities for feedings on that very important day too. So what we’re saying is circumcisions can really kind of fuck up day two for you. So just do feeding first. Priority than the circumcision and don’t feel bad about it.
Okay. So day three, this is when for a lot of people, your milk starts to come in and you might wake up being like, holy cow, what the fuck happened to my boobs? They feel different. They look different. Now this day three for some people might be day four and day five. Totally normal. Don’t worry about that.
Yeah, but if it is day four, day five, call somebody, let us help you through it, because at that point you’re going to be short on sleep. So day three, the frequency of feeding is going to look a lot, not more predictable, but you’re going to definitely not be still in that cluster feeding hell of day two.
Especially if you start to see milk dripping, you feel some fullness in your breasts, baby might only eat one breast and actually be full. So you offer the second one and they’re like, oh, no, thank you. And for a lot of people, this is when they actually see their babies finishing a feed on their own.
It might be the first time that your baby finishes the feed and not you initiating that. Because the volume has just changed so much and their little stomachs have not stretched yet to meet the volume that you’re offering. Right. And so you will still see some cluster feeding, perhaps. So, you know, they’re still tired.
Their tummy, like Maureen said, is still stretching, but they want to take in more volume. So what that looks like when you start with a stomach that’s the size of a marble and eventually want to get to like a three or four ounce feeding, you have to push the volume barriers a little bit, but not all at once.
It doesn’t look like a beer bong. You know, we want it. It takes a few days to, to really, yeah, right. And then it will happen again around two weeks. So we’re kind of pushing more towards like the one, one and a half ounce. So your baby might eat, you know, three quarters of an ounce and then fall asleep and take a 10 minute break and then want more to finish that feeding.
So it might look like a pause in between. So that’s also totally normal, and we are looking for three wet diapers on day three, and at this point, after your milk comes in, your poop starts not your poop, god, the baby’s poop Baby’s poop starts to look more green and then yellow. And typically, you know, once baby is drinking mature milk and has processed that into a poop, that’s when we will see it yellow.
So if you see that poop changing colors and we’re at the yellow phase and you feel some fullness in your breasts, your milk is coming in. It’s not mature yet, it’s transitional milk, and you’ll see it if you put it in a series chill milk stash. I love those pictures where it’s like little cubes and you can see the yellow turn to white.
Anyway, things that don’t need to happen on day three, if everything is normal, we do not have greater than 10 percent weight loss, we don’t have blood sugar issues, we don’t have jaundice we do not need to be pumping after feeding, okay? But this happens a lot because you feel full, and it makes sense in your tired brain, you’re like, ugh, I feel full, I should pump and feel better.
That is the road to oversupply. So we’re not doing that. Now, if you have engorgement and you still feel full after baby feeds, you feel full all the time, your breasts are really swollen, maybe so swollen baby’s having trouble eating, we can manage that differently. We’re going to manage it with ice and ibuprofen, hand expression if we need to, just to feel a little bit of relief.
But really, we’re going to do our best not to change that too much so that it helps us regulate our supply. Exactly. And also, still, we do not need to be bottle feeding. Baby’s tummy is still really small, so if we do need some supplement, due to maybe your milk isn’t in yet maybe some medical stuff is going on, you can use an alternative feeding method like syringe, cup, spoon, something like that, and then you would pump to replace any of those supplemental feedings.
Okay, well, everybody, that’s days one through three, briefly. Let us know if that brought up any questions, or if you want any follow up there. We are happy to continue that conversation in another episode. Absolutely. All right let’s take a minute to thank a sponsor, and when we get back, we’re going to go to our favorite segment, the award in the alcove.
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infantis. I have personally seen this probiotic help my baby and the babies of many of my clients. And frankly, if we’re dealing with any of these symptoms, it is the first thing I go to. And the best part is it’s not like any other probiotic that we would take when we’re sick or taking antibiotics where you take it every time you go through antibiotics for the rest of your life.
If you give your baby Evivo in the first hundred days of life, it actually colonizes in their gut and becomes a part of their immune system, which then they can pass to the next generation. And this is how we make change y’all. Evivo is amazing because it’s going to safeguard your baby’s health today and give you peace of mind in the future.
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All right, everybody. Welcome back today. We have an award. Is this for our patron Heather? It is. Yes, this is a patron Mariana and she wrote in to tell us, I have a heart condition and shockingly, both of my male cardiologists were super supportive of me continuing to breastfeed my 22 month old twins past two years old.
That’s badass on so many levels. Also, that told me that you did some advocating. Definitely. Oh, yeah. Oh, yeah. And, I mean, you had twins with a heart condition, so that heart, I’m just imagining what your prenatal care was like, and you know, they’re watching you really closely while you’re growing two other human lives with a heart that’s maybe got a bit of a gimp.
So, Mariana, great job advocating for yourself. What award should we give her, Maureen? Mariana, we’re going to give you the Heart Warrior Award. We are really proud of you for persevering and continuing to breastfeed through what I’m sure has been a lot of doctor’s appointments and medications and all of that.
Yes. And before we go, let’s read a couple of Apple reviews. This one is for the Milk Minute podcast from Emcole 27. They say, I’ve learned so much about breastfeeding through this podcast. Heather and Maureen do a great job of explaining common breastfeeding issues and providing comfort to mamas. The start to my breastfeeding journey was difficult and learning from them helped me get through some tough nights.
Their guidance, encouragement, and general happy demeanor has been a blessing. Thank you. Awesome. Thank you. And this one is for beyond the boob that doesn’t have as many reviews. So if you listen, go leave one on Apple, please. All right. From Niela Bella titled big fan with five stars. I have already been a big fan of the Milk Minute and I even weaned and still listen.
I knew if I got pregnant again, I would subscribe to Beyond the Boob and follow along. Well, the time has come. I am six weeks and I couldn’t be more stoked to subscribe. Oh, Niela Bella. Six weeks. I’m wishing you all the best. Yes, we wish you so much. So, so much happiness and so little nausea. Yeah. Well said, Maureen.
Well, thank you all for listening to another episode of the Milk Minute Podcast. The way we change this big system that is not meant to support us as parents is by educating ourselves, our friends, and sometimes our health care providers. If you found value in what we provided for you today, could you just go tell a friend?
Send this to a friend who’s pregnant, who’s about to pop a kid out so they know what to expect the first three days postpartum. That’s all I’m going to ask you to do today. Just do that. Just send it to someone. Bye, friends. Bye.
