Ep. 83- Up-Regulating and Down-Regulating Supply

Transcript:

This is Maureen Farrell and Heather ONeal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way. So join us for another episode.

Hello, everybody. Welcome to the Milk Minute Podcast. I’m going to talk about me for a little bit. I mean, what else do we ever talk about, Heather? It’s our show. It’s our show and we’ll do what we want. But first let’s do a listener question. Yeah? Yeah. This is a question from Carolyn and she reached out to us on our Milk Minute Facebook Page.

And if you haven’t gone over there yet, it’s pretty fun. So hop on over there if you haven’t already and give our page a like. Carolyn says question here. Any advice or resources you can recommend on night weaning a 17-month-old? The night feedings are taking a toll and looking for a gentle approach if there is such a thing. Thank you all for what you put out there and I love the podcast.

Well, thank you so much for listening. What I told her was I’m definitely not a sleep expert, but I can tell you what worked for me and I can give you a resource for somebody that does know what they’re talking about. So, first of all, Carolyn, 17-month-olds do know how to play you at this point in time.

So their brains are developed enough to have abstract thoughts that make you do things that they want you to do. Yeah. It’s not like manipulation in the sense that it’s a bad thing, but they understand that like they can do things to influence what you’re going to do. Exactly.

So it’s really important if you have a partner that’s involved that you guys both do this together because your kid knows at this point that if you won’t do something for them, the other partner will. My daughter did the same thing and yours will too. So here’s what you do. You, first of all, want to separate eating and sleeping.

So you’re going to feed this baby in a completely different room than that you were putting them to sleep in. So before you have your nighttime Bubby, you’re going to do some kind of trigger activity, like a bath. You don’t have to use soap every time, but water is a really tactile experience that if they consistently get this tactile stimulation that leads to bedtime, they kind of get in the right mindset and know that it’s coming.

Then you’re going to feed them in a room that’s not their bedroom and have all the lights on. So I know that sounds counterintuitive to probably what you’re normally doing, but this is the best way to separate it in their brains. Then you’re going to have a small buffer activity. I mean, small. It can be like three minutes.

You can go stand outside and listen to the birds or feel the wind or read a small little book. And then you lay baby down awake, but sleepy in their crib or whatever you’re using. And then you leave the room. And so will they cry? Maybe. Are we going to let them cry to the point where they are losing their ever-loving minds? No, we’re not.

So if they get to that point where they’re really revving up, the crying, you both go in, you and your partner, you are allowed to pick them up. You kind of bounce them around. You tell them it’s going to be okay and you put them back down and you leave. And you wait another 15 minutes unless they are wiling out at that point.

So if they, if it’s been eight minutes and they’re already creeping back up to like the highest decibel of crying, we’re going to go back in. But this time, instead of picking them up, you’re just going to pat them and tell them it’s okay. And then you both leave the room and then another 15 minutes you go back in if you have to, but this time you don’t touch them, you just tell them it’s going to be okay with your verbal cues. You’re going to tell them it’s going to be okay. And then you leave the room and you repeat that third one. I know Lyra, right? You repeat that third one over and over again for no more than a 45-minute period.

If it’s taking that long to do this and we’re going to get up, maybe we’ll go to the other room, have another boobie and start all over. Cause we don’t want this to be torturous. We are trying to send a message though that like this is bedtime and this is how we do bedtime. Okay. Now that is the extent of which I can tell you how to separate feeding and sleep.

And it’s not the only way. It’s not the only way. And it’s certainly not a way that I would have felt comfortable with because we cosleep. So, you know, alternately, if you bed share with your baby, you could remove yourself from the situation and just say, Hey, guess what? My partner who doesn’t have lactating tits is doing bedtime and doing night wake-ups and you can ease them into that.

*baby squeaks* Hi, Lyra. You know, there’s a couple of ways to do this, but regardless the transition into it is always kind of rough at first with a baby of that age. So I’m just going to say whichever you choose whatever path you choose, consistency is key and showing your baby that they are safe and loved is key.

Yep. And call a professional. I really like Lauren Garmon at SleepEatGrow.com and she works really, really well with breastfeeding families and she is able to, she’s able to customize a sleep plan for you. So that’s a long answer to a short question, and I hope that helps some of you out there.

Good luck to everybody who is trying to change your baby’s sleep habits. All right, now let’s talk about up-regulating and down-regulating supply. Boom.

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I just wanted to tell you about this hilarious thing. It’s not funny at all. So my husband cuts himself regularly with a knife when he’s cooking. So every couple of weeks he nicks himself and he goes, oh, dagnabbit, or he’ll say, oh, yup, there we go again. And I’m like, all right. And I get out the wound kit and I’m like, all right, let me bandage em up.

And you know, it’s hard to have empathy over a while for something that just feels so avoidable. But we had this Fall Fest planned with our little pod of neighbors that we always hang out with. And we do it outside when we get together with all the food and we potluck it. And we had got pretty aggressive with the planning for this particular event with like lots of food.

I mean, we were ambitious. That’s the word. Ambitious, you know, very yummy recipes that we were going to try. So also I had family in town just saying that’s also a thing. Just pile it on Heather. Just piling it on. Sounds great. It’s all right. We were getting ready to record for this, you know, I was like, oh, by the way, I’m coming early.

Maureen came early, which is always just a blessing. And anyways, so my husband starts cutting onions and as he does, cuts himself. And he goes, oh, got it. And he goes over to the sink and I just like, don’t, my heart rate doesn’t go above 60. You know? And I said, just wrap it in a paper towel. And I go to get the wound kit out as I do.

And I said, come on, meet me in the bathroom. And he. Opens the paper towel over the sink. And I said, you can go ahead and put that back on. There’s nothing here in my wound kid that can help you today. And he was like, what? It’s like, geyser squirting out of there. And he has chopped off basically the whole side tip of his finger.

We have done no cooking at this point, like right. It was his first chop, the first onion. Okay. So I’m like mother of God. And of course it’s like a deer meat situation, which I don’t really handle that much. And it’s just, I was irritated about the whole thing and it’s hunting season y’all, so I just, if you’re a hunting widow out there you know, I’m here for you because I’m going to start, my next support group is going to be for hunting widows.

But anyways, so he goes, I send him right out the door. I wrap it up in gauze, which it’s immediately bleeding through. I tell him to hold his hand up and drive himself to urgent care. Pull over if you get lightheaded. Yeah, pull over if you get lightheaded because apparently I have to make deer meat, chili, and some sauerkraut kielbasa, and also some German potato salad and also set up all the stuff outside.

So bless my neighbors who all came over and they were like, oh my gosh, what can we do? And I was like, lower the bar. That’s what you can do. Just take that bar. Yeah. Throw it out the window. We might be eating pizza tonight. I’m not sure. So my dad steps in and he’s the sous chef for me and my husband is putting on the bravest face you’ve ever seen in your life because he wants to go hunting today.

Oh my gosh. So he was like, he knew, he’s like my finger’s fine. I’m only missing a little piece Heather. I was like, so you’re not going hunting tomorrow, right? Oh, no I’m going. And I was like, really? So was it your plan to hang like 10 tree stands tomorrow? How are you going to do that with one hand? And he’s like, well, it’s my left hand.

So it doesn’t matter. I was like, okay, great. So anyway, I don’t mean to brag, but I made the food with my dad. Was I in a great mood? No, I wasn’t. Was I the most empathetic wife in the world? Also not. Also not, but did the kids have a great time? Yes. Did my husband get to do what he wanted to do? Yes. Was it my favorite finger?

No, thank God. So, you know, I’ll just keep you updated on how that plays out. Wins were had, losses were had, we’re fine. Fun was had by all. So, yeah. Oh, deer season deer. Oh gosh. Yeah. I don’t look forward to hunting season because our, like, where we live is like where everybody goes to hunt and then there’s just, well, I have dogs and they love to escape and go gorge themselves on gut piles that people leave in the side of the road.

And bring home dead deer that have been sitting on the side of the road for like a month. Oh yes. So, oh my Lord. Okay. So what’s going on with you? Sorry, I just had to get that off my chest. I’ve been like hanging on to that one for a while. Oh, okay. That’s okay. Well I just did a little bit of a road trip to recertify my CPR and my NRP.

The Neonatal version of CPR, which was great and Lyra hung it for both and managed. But yeah, it’s nice to have those done with again, because I always forget when things expire. You know, and then I’m sitting there like, oh, that was yesterday. Well, there we go. Right? Yeah. So that was fun. And I did that and Lyra’s learning how to travel better and not just scream in the car, but also I’m using a tablet to do that, which makes me feel like kind of a bad parent, even though I know it doesn’t make you a bad parent, but like, you know, with Griffin, he like, literally didn’t look at a screen until he was 18 months old.

That’s amazing. Which, which was like, I, you know, and now I’m like, so what if we watched Spirit in the car for four hours to my, you know, six-month-old. And she, her little brain is like, great. I’d love to be stimulated. Over and over until I fall asleep from overstimulation. Perfect. You know, but there was a hilarious, it’s not a meme.

It’s just like something that somebody shared on Instagram. Like a TikTok or something? I don’t know. One of those stimulating things, new-fangled thingies, where they were like, yeah, maybe we could parent without screen time, but we could also churn our own butter. Let’s not get crazy. I’ve churned my own butter before.

Of course you have, of course you have. Oh my goodness. What I do have to tell you though. So my husband has been trying, he he’s been like working more often than he usually does cause it’s kind of getting to the end of the time where he can do that just with the weather and whatnot. So I don’t do well, just like having a whole week at home with the kids.

And anyway, it was like one day I was like at the end of my rope and I was trying to get Lyra down for a nap and it hadn’t worked all day. And I was like, I don’t know. I said something to Griffin. Like if you come up here, like you’re just in huge trouble and blah, blah, blah. And you know, like the thing that I don’t like to do and just like snap at my kid and be like, get the fuck downstairs. I thought you were going to say stab him.

I was like, yeah, don’t also want to do that. But anyway, so he, he was like real serious. Mom does not want me to come up there. Okay. So like Lyra is in that point where like for 20 minutes she’s like kind of sleep nursing, but not asleep enough that I can like roll away and escape like a ninja, but like almost there.

So I’m just like, oh, I don’t want to move. And I start hearing things in the kitchen. Oh no. And I’m like, oh, that’s a metal bowl. And oh, I can hear the stool getting dragged across the floor. Never good noise. And ah, I heard the fridge open, you know, so I’m like up there trying to like, not to move and trying to do this, like be like wait it out so I can roll away at the right time.

So the baby’s anyway, I finally like get through all these steps and then Griffin pokes his head in the door and he has a metal bowl on one hip, like a huge metal mixing bowl. And he’s got a whisk in one hand and he’s whisking. Oh no. And he just looks and mouths. He mouths mom, I’m making whipped cream.

And I was like, Okay go away. Because I was like, literally don’t care what you’re doing. If you wake your sister right now, you’re in trouble. And I finally, you know, five minutes later get downstairs when I heard the mixer start going, oh my gosh. And he’s standing there, making whipped cream. He almost had it made, he used an entire pint of heavy cream.

Oh. Added vanilla. We, I have convinced him that that’s the only thing you need for whipped cream. That sugar is not necessary because seriously, like we’re adding it to fucking pie. You don’t need sugar, but it’s his favorite food. Right? So this kid knows how to make whipped cream. So he’s standing there on his stool with the little hand mixer going and he only got one of the whisks in it because it had gotten like bent when it got washed. So the two wouldn’t fit together. So he’s like there with his one little whisk in the mixer and he’s like, I’m almost done mom. And I was like, I see, and it’s like getting thinker. And I was like, okay, sure. You want me to help you get the other one in?

And then you can finish it faster. So I like shove it in, let him finish his whipped cream. I gotta say I’m pretty impressed with the initiative. I know, and I, and I noticed the vanilla and I was like, oh, did you put vanilla? And he was like, yes, I followed your recipe because it’s the best whipped cream ever. And I was like, how much did you put in?

He’s like a capful. I was like, did you measure? And he’s like, no, I estimated, I just, it looks like a cap full it’s like you do it, mom. Oh boy. It was actually good. It was only a little too much, but yeah. And I was like, okay, I’m just going to stay calm. And I, it really wasn’t that big of a mess. Well, that’s amazing.

And he made whipped cream, and it was fine. And then he ate all the whipped cream. And then he didn’t poop for three days. See it does the opposite to me. Oh, well that dairy anyway. Anyway. So now that we’ve caught you up on just, you know, our regular lives, which are equal parts enjoyable and stressful. Both of those experiences. Hourly, really.

I can swing from one to the next, like nothing. I mean that whole thing of watching and hearing him make whipped cream was extremely stressful, but also I was like, I’m very proud of you. Six-year-old child, right? Very complicating. This complicated multi-step process correctly. Yeah. And I’m sorry that I’m still mad about it, but also can I have a spoonful?

Oh yeah. He shared that. Well guys, today, we want to talk about regulating supply, which has nothing to do with eating whipped cream. Does it not? I mean, I don’t know. I guess we’ll find out. Did you regulate your whipped cream intake? No, no, just ate it. So supply. Pretty much one of the, if not the biggest question I get from my clients.

And if you don’t know if you have a supply issue or not, I would encourage you to go back and listen to Episode 14 that we did, where we help you kind of deduce if you actually have a supply issue. Yeah. Absolutely. Reason being is you don’t want to assume that you have a supply issue and then go power pump four times a day and create another issue of an oversupply, because we’re going to give you some tools to manage your supply in whichever direction it needs to go today.

However, it’s not a quick fix. It’s not particularly easy. And, you know, don’t start this process unless you have to. But the whole point of figuring out if you have a supply issue or not for real is because we don’t want your life to be more complicated. Like if you actually have an issue, can we fix it?

Probably. And is it going to be easy? I don’t know. Maybe. Maybe, probably not, but we can definitely get you in the right direction. If you don’t have an issue, why over-complicate your life? Yes. You know, and if you’re trying to shoot for a whole freezer stash supply, ask yourself this question. Why? Because remember, you know, at six months they start solids, there’s no chance in hell your baby can consume 1000 ounces in the first four months of life when they’re also still directly nursing.

You know, if they’re getting everything they need from you, what are you saving it for? The whole neighborhood of children? Are you going to donate it? That’s a whole other thing, but if you’re saving it for just in case, it’s like, you don’t need to have breast milk until middle school.

So we’re going to start with assessing your needs. Yeah. Sorry. I had a lot of coffee today. It’s okay. It’s okay. And you know then we’re going to assess like, what do you need and where are you at now? And how are we going to get there because we don’t want to, whichever way we’re regulating go too far. Yes.

Whether or not we’re up-regulating or down-regulating, it’s kind of a delicate balance. And, you know, it’s, we don’t want to mess with it if it ain’t broke. So if possible it would be great for you at home there to work with a lactation professional, you know, to guide you through this process, but also I get it.

They’re not readily accessible sometimes. So that’s why we’re here. Right. So do you want to start Heather with just a little bit of like anatomy and physiology? Always, yes, but first before we do that, I just want to say the number one reason that people stop breastfeeding is because of a perceived lack of supply. Perceived. Not actual. Perceived.

So before you go and quit, please make it through the rest of this episode and episode 14. Yeah. It’s like possibly 95% of episode 14 is us picking that apart, right? Exactly. Okay. So how do milk cells work? So milk cells are called lactocytes and they have one job and their job is to make the milk and secrete it.

Okay. They’re pretty cool. I like them. They are. I like to imagine very adorable. I think so. Yeah. Okay. So these lactocytes basically using enzymes and different proteins, will pull what it needs to pull out of your bloodstream and makes a recipe that is pretty much the same all the time on a macro nutrient level, but can vary on a micronutrient level, fills it up and drops it down into the ducts. And the way these kind of regulate is with demand.

So when your baby demands it, and that milk is removed from the duct, the cells go, oh, you know what. I got all used up. So I think I need to phone a friend and we tell our, the lactocytes go and tell our brains, you know what? We need more milk. So your brain doesn’t tell that cell to make more milk. That cell is at capacity.

The brain has to recruit more cells. So we have to now build more cells, just like we would build more muscle at the gym when we lift heavy weights. Same thing. So you go to do CrossFit and you do that every day for a year. Your brain is like constantly putting more muscle cells and making them max out. And when you max out, you may make more muscle cells, same thing for the lactocyte cells.

So we are recruiting more cells, but here’s the kicker guys. It takes some time to grow a cell. It’s not a light switch. Like more cells and less cells. No, your body is like, okay, so now we take resources. We send them to the right place. We do cellular division. Like, this is great. We’re doing it all the time, but it takes a couple of days.

Exactly. So when you’re trying to, up-regulate your supply, have some grace with yourself and be consistent with your messaging because it is also a lot of work for your body to do that. And you’re busy doing other things like breathing and existing in your environment and digesting and pooping and working and and doing cellular division like everywhere else in your body all the time.

So your body has to know that this is definitely something that we need to prioritize. So your body will, your body responds better with consistent, clear messaging. And what that looks like in this scenario is emptying your breasts, right? The regulations switch for this is pressure. Remember what we’re saying.

Pressure and lactocytes are the opposite of each other. So the more pressure you have, the less, well, actually let’s, let’s get into that in a little bit. So yes. Pressure is a big deal and we need to talk about that next. Under pressure, so, okay. That’s upregulating. It takes about three days to grow and mature a milk cell to the point where it can secrete milk.

Because you can grow it, but then it has to mature a little bit, you know, like your red blood cells, if you spit out a bunch of immature red blood cells, that’s not a good situation. Your body will do it if it absolutely needs to do it, but they’re not going to be functioning at peak capacity, like a mature one would.

Three days. So if you’re trying to up regulate, you can maybe pump at the same time every day, just once. Power pump, whatever your lactation professional tells you to do, you do it consistently. And you do not even think about judging yourself or your supply until at least 72 hours after you’ve been clear and consistent with that intervention.

Okay. So I hope everybody understands that. And I’m going to say, we’re not going to judge ourselves, we’re going to judge the efficacy of the intervention. Right? You are still enough because your milk supply does not equal your value. Right. And not every intervention is going to work equally for everybody.

So some people could stick a haakaa on there every feeding for three days and suddenly make 10 more ounces a day. Some people might have to power pump three times a day, every day for three days, you know. There’s a spectrum of possible interventions and what’s going to work for you. Right. Exactly. Now some people, and I’ve seen this happen a lot.

Somehow early on in the game, they ended up pumping for some reason and ended up with an oversupply because they had a baby that was eating really well, but they did have to pump and they couldn’t get out of that cycle because it’s uncomfortable when you’re engorged. So they pump and then they accidentally tell their body to make more because they removed that milk.

So when we we’re trying to down-regulate, how do we get rid of these cells? Yeah. Maybe I might lead us off by saying we’re going to lean into discomfort a little bit. We need to lean into discomfort. The arch enemy of a lactocyte is pressure. Under pressure. Yeah, we do not recommend binding your breasts.

No, we don’t want to like squash everything that we have on our chests, but we do want to allow internal pressure to build. Yes. So when you are feeling that feeling of engorgement, what’s actually happening is that pressure is putting pressure against those lactocytes, which have a, basically this is a simple way of explaining a trigger inside of them, that when they reach a certain level of pressure, they apoptosis or kill themselves. Yeah. They explode. They explode. It’s violent. Cell death is what happens. So it’s like putting it in a vice grip. You have one adorable little cell and you squeeze it, squeeze it, squeeze it, it explodes. So we have to have some discomfort in order to eliminate those superfluous cells.

Right. Yeah. So basically when your breast is full, it actually interrupts the machinery and the mechanics of the breast. Over full equals cell death. And it also reduces the prolactin circulation. So every time you empty your milk, prolactin is released that says, oh, we need to make more prolactin. So if your milk isn’t emptying, that little trigger for prolactin isn’t happening.

So we’re not circulating like we should be. And especially in the beginning, when your baby is eating very, very frequently, that prolactin has kind of always peak valley peak valley. Yeah. I think we’ve got some studies that show us that it peaks the most in the first 10 minutes of feeding. So that’s why, especially in the beginning, it’s that frequency that really helps us build supply.

Right? Yup. So that’s why we need to not worry when our babies are not eating on a schedule or eating much more frequently than you think that they would eat. So, especially for first timers. If your baby eats very frequently or just feels like they’re on the boob all the time or for extended periods of time, it does not mean that you have low supply.

No, it means that they are consistently, reducing the pressure in that breast and telling your body, Hey, we need milk. We need lactocytes. Here’s the prolactin let’s do it. Right? So that being said, I think that was a very oversimplified way of telling you how these cells work. We know that pressure is bad and emptying is good.

If we want to build supply, right? If we want to reduce supply, then pressure is good and fully emptying is bad. Exactly. So we always recommend down-regulating slowly. So I told you up-regulating, minimum three days before you see any change. Down-regulating, to do it safely, I always recommend working with, *phone rings*

*Lullaby music* I think we’re going to have to record with a baby. Okay.

All right. So Lyra has joined the recording. She’s six months old. So anyway, good luck to us, but here we go. So. If we are, if you are trying to down-regulate, I highly recommend that you work with the lactation professional to prevent doing it too quickly, to prevent clogs and mastitis, and just generally make it as comfortable as possible for you.

You know, unless there’s some emergency that you have to dry up quickly. We want to slow down the process of down-regulate, *baby burp* Lyra, no. She is your daughter. She is. Anyway, we want to slow down that process of down-regulating as much as we can, because we want to avoid injury, right. We want to avoid mastitis, infection, stuff like that. So I’d be remised to not take a second to hate on bras in the patriarchy.

Oh, yeah, let’s do that. I’m always down for it. Right. So bras are a new thing for human beings. In case you didn’t know that. Cave people did not fashion themselves fashion bras back in the day. As our breasts were developing to be this upright bipedal, you know, homosapien that we are. I mean, we’re, you know, they’re, they’re kind of supposed to hang, they’re supposed to be mobile and move with us.

Right. And it’s all about that, the mechanics that I was telling you about. The mechanics and the emptying and the hormones that happen because of emptying. And the, actually the more that our breast tissue moves to an extent, the better our blood flow is going to be in there. And that has a lot to do with producing milk as well.

Right. Milk is made from blood, all of the cells in our breasts need blood to function. So if we compress them and we take that away and we create pressure and we like prop them up and don’t let them move. I don’t know about you, but this does get like, doesn’t sound like a good recipe for lactation.

It just doesn’t make logical sense. If you’re trying to up your supply, like I said pressure from the inside, but also pressure from the outside. So if you’re really trying to upregulate and you need some more milk, we want to increase the surface area available on your breast for nerve functions. So when baby lays on your bare breast, they’re going to be activating the nerves in your skin and your breasts are going to be able to kind of dangle.

And in a sense realign the natural mechanics of that breast. So at least for the first couple weeks when you’re trying to build supply, or if you’re at a point where you have a supply deficit and you want to build supply, really assess your bra situation. Yeah. Like assess what’s going on. Maybe, if you feel like you’re one of those people who wears a lot of, I just gave her an apple core and she’s about to make a lot of noise with it.

But if you’re one of those people who wears a lot of underwire and you really just feel like you always want structure and support, at least when you’re home, maybe take that off if you’re trying to build supply, right. And let your breasts get the stimulation they get from movement.

Guys. This episode is kind of a train wreck because of my lovely daughter. And I hope you stick with it cause we have some valuable information for you. If you’re trying to downregulate you can wear a bra, but I never recommend underwire. I’m like who? Who? Who the corsets and the bones and like the boning and the wire and the wooding.

I mean, all kinds of things people put on them. Yeah. So just why do people do this to our bodies? I don’t know. Let them be, I don’t know. Let your muscles hold your torso up instead of a corset and let your breasts hold themselves up if they’re not excessively large without a bra, you know?

Right. Exactly. Goodness. Yeah. So we’re also going to want to increase, like I said, the stimulation, so more times that your baby is at the breast, the more nipple stimulation that’s happening. And just every time, their little hand grazes your breast skin, a little spurt of oxytocin flies out of your pituitary gland and just increases the milk let down, which increases the prolactin, that peaks then and tells your body to make more milk.

So, you know what this takes? Time. Yeah. It takes time. You have to take the time to do it. You have to take the time to be naked in bed with your baby for three days and do nothing but nurse. Right. And you know what we’re giving you here by kind of focusing on the mechanics of this is we’re giving you the baseline information to understand this process so that no matter what side of a supply problem you’re on, you can use this information to fix it.

Lyra! Be the apple core. She’s making apple sauce in her mouth right now, like from apple. It’s cute. So yeah, if you are in a place where your supply is low and you want to build supply. Number one thing we recommend go to bed with your baby, take the weekend.

Binge Netflix, let them nurse whenever they want for three days, maybe even let them twiddle a little bit. I don’t know. Maybe that’s crossing a line and drives me bananas, but it does help. Right. And you know, the thing that just hopefully is coming across to you is this consistency. In addition to the mechanics and the emptying and the hormones being reappropriated when you’re consistent about your interventions.

The other thing, like I said, with the neuro stuff, that’s happening when your baby is skin to skin and stimulating your nipples, is that just like in episode 68, where we talk about meditation and your neural pathways, these nerve pathways that you’re using when you’re nursing constantly and removing milk, get pruned and prioritize from its repetitive use.

So repetitive, consistent messaging is what gives your body those clear instructions on what the heck it’s supposed to be doing. Yeah. And so if we’re up-regulating and say we pump or we’re working and we can’t go to bed with baby. Let’s talk about power pumping a little bit and just how to do that specifically.

Let me just do a little that. Yeah. So the way I tell people to power pump is first of all, if your baby is latching and able to nurse, I say, let the baby nurse for breakfast. And baby breakfast is somewhere between 4:00 AM and 7:00 AM. So it’s a window of time. This is when you’re the prolactin is the highest and when you’re probably going to have the most milk at, during this breakfast.

So you’ll find that, you know, when you first wake up in the morning and you’re like, holy geesh, look at these things and they’re just completely full and that’s okay. We just need to empty them. So typically power pumping is 20 minutes of pumping. 10-minute break, 10 minutes of pumping. 10-minute break, 10 minutes of pumping.

I like to use that morning breakfast as the first initial 20 minute. Yeah, because it’s going to cut down on the amount of time and it’s going to be a lot more sustainable for you to do this over the course of three to seven days. And I do just want to point out if you know, this sounds like a lot, it takes about one hour to complete your power pump, you know?

So it might be the case where if you can, if you have a wearable pump, this is kind of the time for that to shine. And if you don’t have a wearable pump, you, you might just want to like leave, you know, unplug the tubing and leave the rest on. Right? Like don’t bother taking it off for the 10 minutes.

You know, and if, if, if you’re at work, if you go to work, you know, and you’re not sure how doable this is, we, we can figure it out. Right. Maybe we can power pump on the way to work and the way from work. And then once at home with baby. Like be, be creative. Don’t just look at your schedule and say, ah, there’s no way it’ll never work.

Even if say when you’re home from work every time after baby nurses, you wait 10 minutes and pump for 10 minutes. That works too. And also if you’re the type of person that has a very demanding job during the week, guess what? Your weekends are for power pumping to kind of reset the mechanism, to get you through that workweek, where you might be missing some pumps here and there, you just kind of have to plan ahead and be realistic with your schedule and no judgment, no pressure, no shame.

You just do what you can, but it does take a little bit of forethought to plan this out because it does take some time and consistency. Yeah, it’s, it’s tricky. I mean, I, I often I have a really inconsistent work schedule, so I have a hard time pumping at work, but I usually have a long commute, so I pretty much power pump every time I drive.

Yeah, but, you know, I don’t like it, but it works. And like I said, like the morning is the best time that I’ve found for my clients. But if you can only do it in the evening, you can only do it in the evening. And that’s when you do it, you should just do it. Doesn’t mean don’t do it. It just means, you know, pick a time of day and whatever that time is, just do that for three days and see what happens.

And if it works for you and you get to where you need to be you don’t have to keep doing that forever. It’s like a bump. You know, you do it when you need to do it. Right. This is a tool we’re going to use when it’s needed. It does not have to be an adaptation that we have to forever continue with. Yeah.

I had a patient one time who said that she had a lactation consultant who told her to pump after the morning feed every time. And she’d been doing that for six months and I was like, okay, so your body basically has enough milk for twins now. Like you just, all right. And she’s like, do I have to keep doing that?

And I was like, no. No, we’re going to downregulate and expect some discomfort in the mornings when you normally do that, because that’s when your body timing wise makes the most milk. Your body’s like, oh, I need 10 ounces in the morning. I will do that for you. So the body is weird like that, you know, as far as giving the milk that you request at the time you request it on the clock, which is why we tell you to do it at the same time.

Yeah. And also, I just wanted to say that the research shows us that in the first six weeks prior to milk regulation, the frequency of breast stimulation and milk removal, yields more milk, which is not a surprise, but it’s a lot more plastic in that first six weeks. But it does not mean that you can’t fix it after that.

So I get a lot of clients that asked me if I’m 12 weeks out, is it too late to upregulate? No, no, it’s not, but it’s going to be different. It’s going to be different. It might take a little bit more effort. It might take a little bit longer, but it’s not, not worth it because you pass that arbitrary six-week mark.

In the first six weeks, we tend to focus on frequency of you know, breast interaction as what will stimulate more production, but with an older baby we tend to focus then on emptying the breasts fully as the mechanism of action then. The frequency isn’t really as much of a deal breaker as is the complete emptying later on.

And also just fun fact that first timers, which we call prime MIPS, they make more milk when they breastfeed more frequently on day three of life. And the baby’s consumed more milk on day four when they breastfed in the first two hours after birth. So that’s why to be baby-friendly now as a facility, we really like to see latching in the first two hours after birth.

And then if it’s day three and your baby is requesting it, requesting, requesting it, do not put a Binky in their mouth, put a boob in their mouth. Okay. Yeah. And this should reassure you that on those days when you’re like, why is my baby feeding nonstop? They’re doing it because that’s how they that’s how they’re supposed to do it right.

Now we can continue. Down-regulating? Yeah. So let’s talk about down-regulating a little bit and how we typically work with our clients to do that safely. Okay. So this would be for people who make too much milk to the point where it’s uncomfortable, pumping is taking over your life. You know, there’s just something about how much milk you’re making that is disrupting your life.

And maybe your baby has developed symptoms because of it. Because they have now frothy green stools and they are really getting a lot of foremilk. Now I’m hesitant to tell you that because everyone’s going to go run out and every time your baby has a green poop, think that you have an oversupply, which is not the case, which is why I tell you to work with the lactation professional.

But it could all come together and make one big picture that points to too much milk. And I will tell you the term to Google for that is not going to be fore and hind milk unbalance. You’re going to look up lactose overload which should lead you down the right rabbit hole. Okay. So you’ve got too much milk.

What do we do about it? Well, we’re going to baseline increase the pressure. Yup. We have to increase the pressure in such a way that isn’t too disruptive to you, but just disruptive enough to the mechanics of the breast that it kills those cells that we don’t need that are a little too extra. And we get your milk supply to where we need it.

So that can look like if you are a pumping person, maybe to start really slow, you decrease the amount of time that you’re pumping by five minutes or 10 minutes. If you were somebody that just has that, you could be a little bit more aggressive with it. You could drop an entire session. So with a really established person, for example, who has a one-year-old and they’re still pumping at work, I tell them just quit pumping during your lunch hour.

You know, you can keep the pump in the morning, keep the pump at four o’clock, but skip the one in the middle of the day. But if we are dealing with an oversupply and we’re not pumping, we can look at block feeding. I like to do full drainage block feeding, which you can look up, but basically what that is we feed on only one breast for a certain block of time.

And depending on how severe the oversupply is, is how long of a block I will do for people. So very severe people I’ll start with four hours. I’ll be like, all right. So for four hours, we’re just feeding on one breast. And the other one, if you are very, very uncomfortable, you can just hand express a little bit off the top or use the haakaa just to take a little milk off the top.

Or if you really have to, you can pump just a little bit off the top, but we do not want to empty that breast. Then at the end of that four-hour block, we switch to the other breast, same thing. And then as your milk regulates, maybe three days later, we will increase the block of time, maybe six hours, maybe seven hours.

And it just kind of depends on your body and where you’re starting and who you’re working with. Yeah. I mean, this is part of the reason we recommend working with someone locally, if you can, because it gets a little bit tricky. And we want your plan to be responsive to your body. So if the plan that you start with isn’t working, it’s okay to change it, to modify how long we’re block feeding or how many minutes we’re cutting off of pumps or how many pumps we’re cutting out of the day.

Because as I mentioned earlier, we do not want to court mastitis. We do not want clogs. Right. We don’t want this physiological problem to morph into a pathological one. No, thank you. So in this process, just like when you are trying to increase your supply, give yourself some grace. Understand that it takes time.

You know, we might be weaning down somebody from an oversupply for a few months, or it might take a week. Just depends on where you’re starting from and what your goals are. That’s the other thing, if you’re working with somebody that never asks you what your goal is then who knows what direction you’re going in.

Yeah. May maybe find somebody else. Have somebody else that’s going to actually listen to what you’re saying and get, make a plan that’s going to get you to where you want. And also, I have to say if your goal is to have a thousand ounces in the freezer, you still need to call us. We need to talk about that.

We need to talk about why. We need to talk about maybe ruling out postpartum OCD, because pumping is one of those repetitive actions that people do to alleviate anxiety. And if that’s what you’re doing, so if you’re an exclusive breastfeeding, and you’re wondering if you have low milk supply, and you run off and pump to see how much you have.

That repeatedly can be a very big problem because first of all, let me tell you that what you pump does not equal what you make. What the pump is able to remove does not equal what the baby is able to remove because the baby is a much better pump than your pump. So that is actually not a good way to see how much milk you have.

I know that pediatricians will often recommend that. Well, why don’t you go pump and see how much you actually have. Heather, this is such a pet peeve of mine. The, for the most part, those same doctors, then that is the end of their guidance. They’re not going to say, Hey, Andy, why don’t you bring your pump in?

And let’s look at your flange size. And let me show you how to use your pump. Cause guess what guys? Pumping is not intuitive. I mean, breastfeeding isn’t intuitive. How on earth would pumping be intuitive if breastfeeding isn’t. Exactly. So if you’re caught in that trap where you, you’re trying to pump to prove to yourself how much volume you have, you need to phone a friend, you need to get to the bottom of that and alleviate some anxiety.

And sometimes with those clients, I will do a full assessment, a full physical assessment of both mom and baby. So I can tell you, hey, you’re normal. Yeah. Look, I just looked at the whole thing. Let me tell you all the stuff you’re doing right. And let’s start trusting you again and trusting your baby. I see this a lot in people that had a rough start.

So babies that had low sugar or jaundice and, or maybe they were hypotonic for some crazy reason. And they just don’t trust their baby anymore to let them know when they’re hungry. So I will tell them, I just looked at your whole baby and they are neurologically intact and we need to start trusting them again to let us know when they’re hungry.

And when they alert us to that, we then need to give them the boob. Yeah. I actually had a conversation with somebody where they had been feeding on a schedule because they were afraid their baby wasn’t giving them hunger cues, but their baby was fine and growing. And I was like, Hey, can you take a weekend and just cover all the clocks in your house?

And they were like, actually, I’m going camping this weekend. And I was like, cool, chuck your phone out the window. Don’t take it with you. Don’t look at the time. Don’t let anybody bring a watch. Do it for two days, you know, healthy. What was it like a six-month-old or something? I mean, it was an, it was an older baby.

I was like look; a healthy, older baby could deal with eating less than an optimal amount for two days. So if it doesn’t work, it’s fine. Right. But it most likely it’s gonna work. Yeah. So this would not be my recommendation with someone who actually has a baby that has weight gain issues or was diagnosed failure to thrive, or is, you know, there’s something going on physiologically that is preventing them from removing the milk or something like that.

This is for normal, healthy babies that just the only thing going on is that we don’t trust them. And we don’t trust our own bodies. And I think that’s really the key is we were kind of taught not to trust ourselves. Yeah. So I guess folks, all of this is to say that if we understand the mechanism of action for making milk in our bodies and what triggers that, you can use it to help regulate your supply.

So think carefully, if you’re wondering, do I have low supply? Oversupply? Think about what that looks like for you. What are your goals? Is your supply issue, functionally a problem for you and your baby? And if it is, you know, where do you want to be? And then we can look at the road to get there. And throw your bra out the window if you’re trying to make more milk. Ah, all right. Let’s do an award before we leave. Huh. Let us.

So it’s a couple of weeks postpartum. You’re breastfeeding baby at home and money is tight. We get it. Our postpartum leave sucks here. Super sucks. And actually it’s adding insult to injury that maybe you even have a bachelor’s degree and you used to work in like this high-powered teaching position and your teaching job doesn’t support your new postpartum experience.

So why not consider teaching through VIP Kid? VIP Kid is making education accessible by bringing together young learners and educators through one-on-one online classes. Maybe you could be a teacher through this online learning platform that matches motivated kids studying English in China with inspiring teachers in the U S and Canada.

VIP Kid is seeking qualified applicants with a bachelor’s degree and ideally more than two years of teaching experience to teach on their global platform. So who knows? What’s the harm in applying? So click the link in our show notes to apply for VIP Kid and see if you’d be a great match for their program.

Okay. Today’s award goes to Sharon Valentine. She says last night, the fire alarm went off, which spooked our 14-month-old, pretty badly. I don’t usually co-sleep or nurse him at night anymore, but he was super distraught. So I made a little bed on the floor with him. He snuggled close and nursed a few times during the night.

My supply managed to keep up and he has been just the happiest baby all day. He loved having me there with him. Oh, that’s sweet. I love that story. And I love that example of a highly regulated nursing relationship that it’ll just be there when you need it. It’s dynamic. It’s changeable.

Our bodies adapt. And I bet you anything. If she did that for two more days, she’d wake up on day four and be like, oh, hello, what are we doing with this extra milk supply that I didn’t think I needed at night anymore? So thank you so much, Sharon. We’re going to give you the rescue boob award because what are boobs good for, if not for rescuing us from these situations that are unknown and scary.

But it’s always nice to have a boob around. Absolutely. Well, everybody, thank you so much for listening to this episode of the Milk Minute Podcast and educating yourself about lactation. The way we change this big system that isn’t set up for lactating parents is by educating ourselves and sharing with our children and our friends.

Now, if you found some value in this episode that we produced, please go to Patreon.com/MilkMinutePodcast and show us your support with a small donation. This will grant you access to cool members only stuff like behind the scenes videos, funny little blurbs about our day-to-day life and also cool merch. What do you have to say about it Lyra? I think we should close out the episode, listening to Lyra munch on this apple. Well, no, she just wants to go. Bye guys.