Transcript:
*We apologize for any typos, misspellings or incorrect grammar. Our transcript is auto-generated by software that’s trying its best, just like all of us.*
Hey there. We are back this week. We’re going to talk a little bit about cluster feeding. I feel like no matter how many times we talk about this, I still get more questions about it.
Yeah. So, you know, let’s, let’s revisit it. Yeah. I get a lot of questions in my charting app from patients that are like, I think my baby’s cluster feeding or everything’s falling apart. Not sure. How do I know? What do I do? Maybe both is happening. Yes, and? Hard to know. It’s like a big improv skit, you know, we’re just all in an improv joke training period of time where we think this is what’s going on and it’s always a yes and so before we dive into that, let’s thank a couple of our patrons.
Yeah. So I want to thank two new patrons today. Well, sort of three. We’ve got Sarah and John who joined us a couple. We really appreciate that. And we love when husbands are super supportive of breastfeeding and this show. And then we have Espen. So thank you so much. All two, three of you for supporting the podcast.
Yeah. And I think Espen’s from Norway. I’m guessing because they opted out of gifting like by mail. For our patrons, and then they paid in Norwegian currency, so that’s kind of exciting. I mean, it’s a little bit of a guess, but, I love that, expanding our horizons, yes, we’re in Norway, we’ve made it. Yeah, send us a message, Espen, if we’re correct.
Or if we’re not. Or if we’re really, really wrong, that’s fine too. Oh gosh, and also we have a question today. Okay, so today’s question is from Pam Mallory, and Pam originally sent me an email just to say that she loves the podcast, she’s a lactation professional, she was wishing me well in my pregnancy, and that was it.
And I said, Hey, thank you. So I responded, you know, thank you so much, you know, pregnancy, blah, blah, blah. And she just wrote back the other day and said, does Maureen have any information or references I can go to? I have a mom who’s breastfeeding and wants to take ashwagandha. I’ve searched everywhere.
Thank you. If you have that information, you guys are so super, super good. And I don’t mind paying for that information if she has something. Okay, ashwagandha, so here’s the thing, once again, about herbal safety in pregnancy and breastfeeding. We’re pretty much never going to have a source that we can look at that says, yes, a hundred percent, this is safe.
And, you know, so I tend to look for, Like more traditional recommendations of herbs during pregnancy and postpartum just to kind of see like, do we have a long history of use because that does indicate some level of safety if we’ve had certain cultures using these for thousands of years. So ashwagandha does have a history of use in the postpartum to support breastfeeding in like hormonal states.
And especially, you know, there’s some question about safety, but not, not like a huge one. There’s no like really big red flags that I’m particularly worried about with breastfeeding. So typically the conversation I have with my clients is like, Hey, you know, here, here’s the information that I have. It’s not definitive in any way, but this is a traditional herb used in the postpartum.
So, you know, I feel like then the level of risk is a little bit less. With this specific herb, we do have a LACTMED article so I wanted to bring that up. And you’ll often find that with herbs we have to use the Latin names to find any scientific information. Ashwagandha is not the Latin name. The Latin name is Withinia somnifera.
And for this one we don’t have like, obviously there’s no, no one did a published safety study, blah, blah, blah. However, it’s generally well tolerated in adults. It’s not an herb that we have just like broad warnings about. There’s not a lot of adverse reactions, so that’s good to know. And then we do have a little bit of study that was about like supporting breast milk supply.
And I think it was 40 women. Who complained of insufficient milk supply at five days postpartum were given some like herbal supplements with ashwagandha in them and we did have some amount of improved milk supply in that study. It’s not a lot of great controls or anything, but as far as we know, we didn’t really have.
any adverse effects. And then I, I know, I don’t know, there were some issues with how that study was performed or whatever, but there were no red flags in that study. No one was like, my infant got sick because you gave me this herb. So, there’s that. You know, if we have a preterm baby or a newborn, I might say, you know, what if we waited a couple of weeks to introduce herbs?
There might be something that we have a little more safety data on that we can do in the meantime. But, you know, it’s, it’s really up to your patients to make that choice ultimately. And I typically, you know, do recommend that we start with low doses and then kind of work up from there after doing some observation.
Yeah. I like that. And also day five, I mean, there’s a lot going on anyway. Some people’s milk doesn’t even come in until day five. So I’m sure you did see an increase, but I, I do like that. It’s basically like nothing crazy happened. That’s what I care about with herbs too, where it’s like, Okay, blah, blah, blah.
Maybe it worked. Maybe it didn’t. But did anything bad happen? Okay, great. Yeah, absolutely. And honestly, I love this herb. I think it’s really, really great for helping with some mood issues, some hormonal issues. So I would be very supportive of a client trying that, you know, depending what they’re taking it for, of course.
And, and if there’s something more appropriate, you know, don’t be afraid to refer to an herbalist about that or consult with one directly for sure. Love it. And will you drop your info for people working with you? Oh, yeah. Yeah, you can go to my website, which is HighlandBirthSupport. com. And then right on the front page, you can click book a consult and you can book an herbal consult if you want to, lactation consult, all kinds of different stuff.
And we can just do that online. I go to Maureen for all my herbal questions for sure. And if you’re a lactation professional, you can pay her for her herbal support as well. Yeah, yeah, yeah. We can do professional consultation or like, to patients. So, either way is great. Love it. Love it, love it. Alright, well let’s take a quick break to thank a sponsor, and when we come back, we’re gonna dive into the hellscape of cluster feeding.
Ha ha ha!
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. 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.
All right. Welcome back, everybody. Let’s yeah, let’s just dive right into the torture that is cluster feeding. Just quick reminder recap of what we’re talking about. Cluster feeding is sometimes periods of a few hours to a few days of when your baby literally just is on that titty nonstop.
It just doesn’t want to stop feeding. Yeah. Yeah. And it can happen. I mean, it’s not like it happens with a warning sign beforehand. It’s not like you get a little notice in the mail, like jury duty, like just so you know, cluster feeding is coming up there. There are a couple of times where we see it happen pretty predictably.
So like in the beginning, as your milk supply is regulating and as your baby’s stomach is stretching from the size of a marble to, you know, a size of a tummy that can take three to four ounces at a time, we’re going to see the baby cluster feed in order to stretch that tummy gradually.
So lots of times we will definitely see it at day five. We’ll definitely see it all day to day five and at two weeks where it’s like, wow, do I do anything but feed? And I typically recommend that people are prepared for that if there are big changes in their life. So if you’re traveling, be prepared for that.
If you’re starting a new routine, like daycare, new jobs, something where not only is the environment changing for baby, but also like the way that you interact with baby might be changing because it, it appears that this is kind of a protective mechanism that baby’s brain employs as well, like for neurological development and for getting attention from the caregiver.
And so, yeah, it can be hard to predict, but you know, if you’re like, Oh yeah, we’re moving across the country. I’m like, just like plan for a three day cluster just in case. Illness also. Yes. Illness as well. So regardless of the cause, honestly, like it feels the same. Most of the time, suddenly your baby doesn’t want to stop feeding and then you realize you’ve been sitting in a chair for like five hours crying because your baby won’t stop breastfeeding.
And, you know, that’s typically when I got a lot, a lot of like calls and messages a lot of SOS’s. And, you know, I don’t know if it’s going to just be tonight or if it’s going to be three days. So I typically say, Hey, like prepare for at least 24 hours of this. It might be longer. And really just think of it as like, you need to take a sick day to be with your baby.
If there are things you can cancel that are happening in the next day or two, or reschedule, or have somebody sub in for you, that might be a good idea to start thinking about that, because it is easier to survive cluster feeding if you are not stressing about other things that you need to do. The laundry will be there when baby is done.
The floor will still have dirt on it when baby is done. You can get takeout. You know, you don’t have to do all the household, like, domestic chores. It is okay to take a few days off from that because Being with your baby is going to be more important than those things. Right. And also just let me, let me give a nod to people that are exclusive bottle feeding.
You will still see a cluster feed with bottles. Sure will. So that’s difficult because if you’re exclusively pumping and you’re already trying to stay on the same page with your baby, and then your baby suddenly is fussy. all day long or seems like they’re starving to death after they finish a bottle, don’t automatically assume you’re underfeeding.
Just kind of look at the timeline and be like, all right, Heather said this was going to happen. This kid is two weeks old, probably the tummy is stretching. Maybe they do want a little bit more and it’s okay to take a 10 minute break and reevaluate. You know, so make your baby communicate with you. Just because you’re bottle feeding doesn’t mean you can’t check in with baby’s reflexes.
So I always recommend putting baby up on your chest, chest to chest with you. And if baby bobs up and down and starts rooting and doing the breast crawl, they want more food. You know, if they kind of rub their face back and forth and pass out, they’re just overtired and they just need to go to sleep. And, and it’s really hard to distinguish between that when they’re feeding all the time because their sleep is going to be disturbed.
Right. And so, you know, I usually remind people that it is okay during any point in this time period, if you feel way overstimulated, you feel like you cannot feed for another minute, you feel unsafe as a caregiver. It is okay to put your baby down in a safe place, go to another room, close the door, and, you know, put a timer on for five minutes, right?
And take a second to breathe, to pee, to drink water, to care for your own body, and then return to your baby, even if they cry the entire time. Yes, and also get out your baby carrier. Wrap that baby. If you have been avoiding your baby carrier because it seems overwhelming to you, this is when you pull that thing out.
I promise you, you have got to figure this out. Do not be intimidated by that thing. It is going to help you get through these cluster feeding periods, illness periods, all kinds of stuff. Sometimes your baby just needs to feel close to you. And also you’re going to catch those early feeding cues a lot better where you’re like, oh, you’re bobbing up and down.
I’ll nurse you now instead of waiting until they cry when they’re in their swing. And then you have to calm them down first before you feed them. So the baby carrier is going to be Yeah, and you can do skin to skin in the baby carrier too, and, you know, at least in my experience, often the only naps my kids would take during these cluster feeding times were when I was walking with them, so, you know, putting them in a carrier.
having them secure so I can just walk in circles in the yard or whatever in my own like sleep deprived state was, was much easier. And also allowed me to do the bare minimum of like cooking myself some food, feeding my other child, you know, things that I absolutely could not, you know, just say I wasn’t going to do that day.
And. You know, I really do, like, I think of this as like, this is your sick day, right? Like, your plan to be in bed with that baby for a day or two. Put a giant pile of snacks by your bedside table and two huge bottles of water. It’s a good time to start Grey’s Anatomy if you never watched that. Yeah, and also.
Let me remind you that this doesn’t mean there’s something wrong. It can mean there’s something right. Like your baby is neurologically intact and they know something you don’t know. So just assume that if your baby is normal and healthy, that they know what’s coming and that they’re trying to get your body to do what they need it to do.
So I think a lot of people immediately plunge into that mental fear mode where they’re like, something is wrong. I’m not doing something for my baby. And then they interrupt it with a bottle of formula or. a big bottle of breast milk for an exclusively direct fed baby, and then you will be on different pages.
So what I encourage you to do is look at the things that are objective. So look at the wet diapers. Do we have adequate wet diapers? You know, so like, if your baby is feeding, 15 times in a 24 hour period, which is a lot, so that would be kind of like a cluster feed for, I would classify it as a cluster feed.
And they’re wetting three diapers and the pee is really concentrated. Something’s wrong. Something’s going on. But if they’re peeing normal, they’re pooping normal, and they’re like otherwise fat and sassy, we don’t have a problem. And, you know, I, I’ve definitely had parents describe children in this timeframe to me as inconsolable, but when I ask them about it, it’s not that they’re inconsolable, it’s just that the only thing that consoles them is feeding.
And that is a tough place to be in, but that’s not like, okay, your baby literally is inconsolable and you have to go to the ER because like nothing will stop your baby from crying. And they’re turning purple and it’s been five hours, you know, like, That’s not the same thing. You do have a way to console them, but it’s a challenging way, especially when your body is the only thing that can provide that.
And I want you to think in this time period too about protecting that body that you are in because it’s not just this like infinite resource for your child. It only works if you are feeding yourself and taking care of your own needs. Right? Drinking water and if your nipples are not shredded to bits.
Ha. Yeah. Let’s talk about that. Yeah. Let’s talk about that. Because a baby feeding nonstop for hours and days is definitely something that can lead to nipple injury, particularly if your baby doesn’t have the best latch to begin with. So this is not a time to let a baby hang on with a cruddy latch just cause you want them to stop crying.
This is a time you want to fix the latch whenever possible. And I really encourage lots of side lying feeding during this time in a safe sleep space, just in case you fall asleep because you’re so freaking tired. But that gives you like often a lot of control over the latch. You don’t have to be holding so many things and you can see the latch pretty well usually.
And yeah, so we’re gonna, we’re gonna be really protective about the latch, but let’s, let’s say we’re already in a shit position here. You already have a nipple crack and baby’s cluster feeding and you’re like, I don’t know what to do. Now I’m crying too. We definitely can have some kind of adaptations to make this more survivable for you and your nipples, right?
You can certainly Say you have a one sided injury, just decide you’re going to pump on that side and feed baby from the other as much as possible because pumping is less painful, you can control the suction more, we’re going to use a lubricant in the pump tunnel, but you do want to pump you know, as often as you can to keep up with that cluster feeding.
You can turn the suction rate down. You don’t necessarily have to get a large volume out, but you want to keep that stimulation as consistent as possible side to side. And I actually many times have had baby feeding on one side in the carrier and then my other boob like sticking out the side of the carrier with a pump on it.
I love that. And also, if you don’t have an open nipple wound just yet, but you do have, like, a bruised compression stripe on your nipple, it’s probably because you’ve been sitting in the same position, nursing in the same position, over and over and over and over again, and it’s time to change positions.
So, like Maureen said, side lying, but side lying is the same exact thing. as upright position, which I love. So you’re literally changing the way the baby’s mouth is sitting on the nipple and changing that suction pattern so that compression stripe is different and it’s going to be less likely to open. So if you see a bruise, first of all, call a lactation consultant because it could be a shallow latch.
Make sure that chin is flicked down. Make sure baby’s head is. kind of back and sniffer position a little bit so we can get a straight shot to the back of the throat. But if all of that has been adjusted and oral restrictions have been ruled out, it might just be overuse in one position, usually cradle.
Yeah. And usually you’re not thinking about it too much because it’s 2 a. m. and your baby’s been feeding since 4 p. m. and you’re just like a zombie trying to feed your baby. So like, don’t feel bad about this. Mistakes happen in this process and we’re just going to fix them whenever we realize they’re happening, right?
And, you know, a lot of people will wonder if this is a good time to introduce a nipple shield. I don’t recommend that, if possible, because you might get stuck using one. And it kind of depends how old baby is, too. Like, for an older baby, introducing a nipple shield usually just gives them something. that they want to chew on.
For a younger baby, it might be appropriate, especially for protecting really intense wounds. So I would definitely say like chat with an LC before introducing one and just make sure you’ve got a solid plan and you kind of understand how to appropriately use it and, and like what the possible next steps would be after that.
You know, we’re also going to be looking at using something like silverettes and Medi honey If we’ve got those wounds that we’re trying to manage between feeding and you can absolutely Use a pacifier, right? If you’re like my baby is peeing and pooping fine. They have just fed for three hours straight They are not really that hungry.
It’s okay. You can give them a pacifier You could also have somebody else feed You know, bottles, if you need to, I just recommend doing very small bottles and very slowly paced feeds because typically if we give a baby who’s cluster feeding a big bottle, they’re going to chug it, they’re going to throw it up and they’re going to want another.
Yeah, or they’re going to pass out and you’re going to be like, see, I knew I was starving them. But really, my kind of general guideline is if you are giving a full bottle, you have to do a full pump. Exactly. So that’s kind of why I say like, maybe just do like a bottle with an ounce. In it and have your husband go outside with baby, feed it as slow as possible.
It’s not gonna make a difference if you feed them an ounce and you don’t pump an ounce. Go sleep. Yeah. , I’m talking about a full bottle. If you’re gonna do like a full four ounce bottle, lady, you better pump because it’s gonna be bad later. . Yeah, exactly. And so, you know, it, it, it is a lot of things to think about, but really at the heart of it, It’s pretty simple, right?
We want to keep baby consoled, whether that’s through feeding, giving them another way to suck, holding them close, giving them that stimulation, swaddling them even can work really well. And you want to keep your body safe and healthy.
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Thanks Aeroflow. Thank you so much. Go ahead and check out the link to Aeroflow in our show notes and order your pump through them.
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So, what do we say? To people that ask us why this is happening, you know, like why are they doing this to me? Yeah, so typically I say, you know, there are a couple of reasons There’s not really a great way to say this is what’s happening right now you know, we might be going through a physical or neurological growth period in which case, you know, baby needs that stimulation.
That sucking for them is extremely calming and helps regulate their body processes. And in that same vein, if we have some extra stress because of say environmental or schedule changes or because of an illness, again, the process of sucking and feeding and being close to a parent. is the best way that that infant has to regulate themselves.
Okay, so what do we have to say to the people around us that are watching your baby cluster feed who are continuously telling you that you’re starving your baby? One, you could just tell those people it’s none of their business. You could say something a little bit with some more teeth in it, if that’s what you feel like saying at that time.
Or, you know, if you really, it’s someone you value and you want to have that, like, Exchange of information. You really want them to understand. You could say, Hey, you know, this is a cluster feed. Baby just needs a little bit more care and attention from me right now. And I know they’re eating enough because, you know, they’re pooping and peeing the same amount that they have every other day.
This is just, you know. This is just me needing to spend more time with my baby today. Yeah. And just say it won’t last long. Just watch, you know, tomorrow or the next day we’re going to be back on track and we won’t be if I don’t do this. You know, that’s kind of, this is, you’re looking at the intervention right now.
Like all the milk making cells you have friends are working at capacity. So if your baby cluster feeds, they’re actually helping your body recruit more milk making cells. To make more milk, but that doesn’t happen after one feed. It happens after clear, consistent messaging over time, which is why if, if it’s truly like the, if the baby’s not sick or anything like that, if it’s truly that the baby is trying to level up your milk supply game, it could be days, you know, it could be a couple of days of this.
And then you get rewarded after leaning into the cluster feed with more milk making cells. And suddenly you and baby are back on the same page and all as well. Yeah, and I, I think more than anything, like understanding that this can and will happen and what to expect during it is the key to survival, right?
Having adequate expectations. And having the people who support you in your family life, like, you know, your partner, maybe your mother, maybe your mother in law, having them understand that it’s happening to you and making sure that you communicate your needs clearly. Yeah, because I think whenever they are looking at you, telling you, like, this is crazy, like, It imagines to me, Heather, this is crazy.
You know, look at what this baby’s doing to your nipples or look at what you’re letting this baby do to you. You haven’t slept in so long. It’s like, let’s change that conversation. How can you help me? Like I am doing what I need to do for the baby, but how can you help me get more sleep? Like, how can you, maybe you could feed me.
You know, would you like to bring me a glass of water? Because I’m the only person that can do this particular job. Yeah. And it’s definitely okay to say, you know, yes, what I’m doing is hard. Thank you for pointing that out. I agree. This is hard and it does feel kind of crazy and you know, it would be great.
If you could cook dinner for the kids tonight so I can, so I can do this with baby or, you know, maybe you can take the older kids out to a movie so I have a couple hours to nap if baby falls asleep or something like that, you know, and just really clearly communicate that. That’s what you need. Just ask for it.
And then also you could take a bath with baby. This is another good one. So if you’re tired of laying around in bed and you need something different. Baths are great because they’re very tactile, babies respond to that very well, because it’s different, it kind of shocks their reflexes awake, and they’re like, oh, I forgot why I was upset, like, oh, what’s this new thing going on, but they’re still getting that skin to skin, you can nurse in the bath too if you want, but it might be a way to regroup, change the environment a little bit, and change the perspective.
Yeah, my two like environmental changes I always do with that are bath or going outside. That’s Doesn’t matter what the weather is, right, even if it’s snowing, folks, sometimes that is the best time to go outside with your baby because they’re all bundled up, you know, they’re super warm, their nose is all cold, like the air is very stimulating to them, it’s calming, it’s fresh, they smell new things.
And it just tickles their brain in a new way. And if you have not read the book, there’s no such thing as bad weather. You absolutely should, because it changed my perspective as a mom and I’m not outdoorsy. Maureen can tell you how not outdoorsy I am, but it did change my perspective on. The outdoors and children and that we need clothing that’s appropriate for it, you know, that we shouldn’t be afraid of it, that it’s actually very normal to have little babies and kids out in all kinds of weather.
We just have to be prepared for it. And yeah, culturally, America’s just kind of weird about weather. And, you know, it’s great Lyra used to love feeling rain fall on her head as an infant. Like, like not a hard rain, but like a drizzle. She loved it. It was so calming for her. And I don’t know if it was just like something about that, like gentle touch on her head.
But yeah, I would just stand out there with her in a carrier, her head exposed. She’s fine. She’s not going to get too cold, like, and just let rain fall on both of us. for a few minutes. Aw, that sounds really peaceful. It is. Someday I’ll have a baby and I won’t be pregnant anymore. And we’re going to let rain fall on their head.
Yeah. Okay, so I think that’s going to be enough to get you through cluster feeding. We wanted to keep this one short because if you are going through a cluster feed, you don’t have time for a whole hour episode. And we did just want to remind you that we are going to be settling in for a long winter’s nap and taking a break from the Milk Minute podcast for…
November and December to allow me some time to bond with my new baby that is currently still gestating but will be coming out soon and get through the holidays and prep for our new Milk Minute in 2024 with new interviews, new topics, and a fresh face. And a new baby, but we will still be over on beyond the boob that is still going to be happening weekly.
So you’ll still be getting my pregnancy updates weekly. And then after I have the baby, we’re going to do at least three months of weekly updates on how feeding is going with my new baby. So please don’t miss that. You can catch that on Patreon. com slash milk minute podcast or subscribe on apple. And I just want to take a really quick break and then we’ll get back and do an award in and say goodbye for today.
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Enjoy.
Okay. Welcome back everybody. Maureen, who do we have an award for today? I wanted to give an award to one of our patrons, Marie. So she had reached out to me, I think a couple of weeks ago, navigating that really hard topic of infant tooth decay and breastfeeding and pediatricians versus dentists and all of that.
And… It was really stressful and emotional, you know, having all that mixed information and I just want to really commend her for reaching out to us and really kind of standing up for herself with, with her doctors and making sure she had really clear communication with them. She ended up. Being in a really good place with that pediatric dentist, having a good outcome from all of this, and I know that is really hard and really stressful and really easy to doubt yourself in that situation.
So, amazing job, Marie. Great job, Marie. We will also link our episode to Tooth care for your gummy baby in the show notes if you are interested in hearing all about how to care for your baby’s mouth. All right, Marie. We are going to give you the admirable advocate award. Good job. We really are very proud of you for getting through this.
We know how stressful that is anytime something is happening with your kiddos. So kudos. Kudos to you and the rest of you listening out there who are just doing your best to get through cluster feeding. All right. Well, thank you all for listening to another episode of the Milk Minute Podcast. The way we change this big system that is not set up for lactating parents is by educating ourselves, our loved ones, our friends, and also sometimes our pediatric dentists.
So, you know, Yeah yeah, and just, I don’t know, I’m, I’m done with brain functioning. Thanks everybody. Thanks. And goodbye. We’ll see you on Patreon.
