Thanks for tuning in to this episode of MomTalks with Christa. We are here with another episode with Kristen Sorondo, a lactation consultant from Florida. And last month, we talked all about breastfeeding issues, different things you might see in your breastfeeding journey and how you can look out for them and what you can do to treat them. So, we realize there were so many questions, so many topics to cover. So this is part two of that. So welcome back, Kristen. We are excited to have you.

Kristen: Thank you, Christa. Hi, everybody. I am Kristen Sorondo, I am a lactation consultant out of Orlando, Florida, with Orlando lactation. So super happy to be here with you guys today.

Christa: So we'll kind of go through some of those questions. So, first issues with latching what are some of the signs that you might need a better latch.

Kristen: So, probably one of the biggest ones that just stands out is it's painful. Hands down. Breastfeeding should not be painful. Although you might read if you search or you Google that it is common, it might be common, but it is not normal. Latching with breastfeeding should not be painful. If you are having pain with latching, even if it's within the first couple minutes, still that lets me know that there's something not quite right. It could be to though that may be right after delivery, or in the middle of the night, baby got a bad latch and ultimately, just that one bad latch kind of tore up your nipples a little bit. It will be uncomfortable for a little bit because now that has to heal. But overall, in general, on your breastfeeding journey, breastfeeding should not be painful. So if we're having any issues with pain in general, then baby is usually not getting the best latch.

Christa: All right. Also, when it comes to latching, can that affect milk supply? Or is there anything else we can kind of look at? Like maybe it's not painful but is there something else that can kind of be a factor in a bad latch?

Kristen: The two key components were successfully breastfeeding is getting a good get having great positioning. If the baby's not positioned, well, then they ultimately might not empty the breast the way that they should getting a good position, and then ultimately getting a good latch. When I look at babies when they're breastfeeding, they really do feed like we do. Just in a baby form. I don't even know if that even makes sense but when I'm helping moms, I try to help them understand, okay, if you were sitting there like that, or laying there like that, would you be able to drink something efficiently? If the baby looks uncomfortable, they're probably uncomfortable, and they're not ultimately going to transfer the milk well. So kind of ask yourself those questions. If I was laying there like that, could I drink something from a straw for say, a per and effectively drink what it was in there with a straw if you kind of make that same position yourself and you try to kind of think of what it would be like laying there drinking like that, would you be able to? So for example, sometimes I’ll come into a room especially like in the hospital and the baby's head might be turned towards the breast, but the body is facing up? Well, that would be kind of like us trying to drink like this. So, the face is facing in towards the breast tissue, but my body is facing up, how hard would it be to drink from a bottle of water, say or out of a straw like this, it would be difficult? Because you're not aligned properly to where you could actually suck and swallow. You probably could do it but it wouldn't be as efficiently say if I'm sitting here and I'm drinking or swelling from something in this position. So, those are probably the two biggest components with breastfeeding is making sure that you're getting good position your technique wise and then ultimately Getting a getting a good latch. If you're not positioned, you're not latching well good, you will can have those cracks, and then nipples just from the way that the baby's positioning their head, and ultimately might not transfer the milk the way that they're supposed to. So we'll come off the breast and they'll still be hungry and you'll say I fed the baby, but in 10 minutes, they still seem like they're hungry. Well, they probably just didn't get the milk the way that they should have if they had been positioned just a little bit better.

Christa: Okay, awesome. And so we talk a lot, obviously on this channel, and mommy knows best about milk supply, increasing milk supply. We don't talk a lot about the other end, which is oversupply and pain or issues that can come along with that. So first, what are some signs of oversupply? And then kind of what moms can do to kind of regulate that a little bit?

Kristen: In our breastfeeding talk journeys, we have talked a little bit about colic and spitting up and tongue ties and things like that. A lot of things that are with babies that are abnormalities show very similar symptoms. So it's super hard to kind of toe, kind of key in on what is exactly the right thing. So, Monza have oversupply, babies could be spitting up, babies could be very gassy, irritable, their stools can change, which could be very similar to say, baby who's got reflux, or maybe a lot of gas or tummy issues. So we're like medicating babies with things to help prevent them from spinning up or, colic or there's all these issues, when in general, it was just an oversupply. So you might find that, okay, you're giving your babies gas drops, or the doctor puts the baby on, say an anti-acid type medication to help with spinning up but things don't really get any better. Well, it's because it wasn't the reason to begin with. So it's super hard with babies, because they can't tell you what the issue is. So when we're looking kind of at the big picture, that's kind of what we have to take into place. So sometimes it's just all a matter of, figuring out what was actually the reason that was causing it to begin with and then if it was an oversupply, you're going to see once we help regulate that a little bit, that the baby's not going to be spitting up, the baby's not going to be having those tummy issues when all along you thought it was something different. So things that you would be looking for over supply is say maybe breast fill full before feeding and don't really feel softer afterwards, they still feel full baby does spit up a lot. If they're getting too much for milk, sometimes it just doesn't set well on their tummy. It's kind of like a skim milk. If they're getting a lot, especially if they're getting it super fast. If you have a lot of milk a lot of times, as soon as the baby starts to suck and drink at the breast, it becomes very forceful and comes out super quick. So there's a lot of gulping or maybe choking at the breast, they come off, they're spilling milk out of their mouth. Like I said, spitting up, they have just a lot of gas, whether it be burping or passing out the rectum, their tummy just kind of seems to have issues. Also green stools, green stools is a big one to let me know that the baby is getting too much for milk and not enough high milk. You want to make sure that you're kind of with breastfeeding and breastfeeding issues. We have like little checkboxes and Okay, well we know it's not this, check it off. We know it's not this, check it off until we actually kind of eliminate and fig kind of figure out what is exactly the reason. If we do have a large supply some things that you can do is try to breastfeed just on one breast to where the baby is nursing actually longer just on that one side, to where they do get the four melt as well as the hind milk. Don't be so consumed with well, the baby's got to feed on both sides, and the baby's got to do 10 minutes on one side, and 10 minutes on the other side because if they're doing a little bit on both sides while they just that for milk from both breasts and probably never even made it to the high milk. So, try to nurse just on one side or say manual express and remove some of the milk. There's different things out on the market that you can use to put on the breast to remove some extra milk like a milk collecting device to remove some milk. So say, you're waking the baby up your change and the baby's diaper, put on one of those products to kind of help draw out some of the milk why you're changing the baby, you're getting the baby ready to feed. Sometimes just removing like an ounce off of the breast prior to feeding will help solve a lot of your issues. It'll take that forceful so way, it'll kind of help get a little bit of that for milk so that way when baby feeds, they're actually emptying that that breast and you can, like I said, you can do with a collection device, you can manually express it you can do with a hand pump, you can do with an electric pump. Any of those things to kind of, to kind of help just relieve it. If they still seem like they're hungry, you can put them back on as they breast versus switching to the other side. If they still seem like they're hungry than that after that, then go ahead and put them on the other side. In general, some things just, kind of write down like all the symptoms, the baby's having, removed some excess milk from the breast prior to getting the baby to latch, try to stay on the one side for that full field feeding to make sure the baby's getting both before milk and the hind milk, and then kind of see how things go. If a mom has an excessive amount of milk supply, then we might look into other things as far as helping to decrease supply but we wouldn't necessarily want you guys to start those things. First, we would want you to try to naturally be able to decrease your supply or just remove some of the milk off first, before we kind of get to some of those other things before you kind of go to that extreme. Like when we talk about herbal supplements and things like that to actually increase supply, there are things that we can do to help decrease it but we want to look and do some of the other things first, because we really don't want a mom to do anything, like an herbal supplement or medication to actually decrease supply and so we've checked off some of those other things first, because ultimately, we don't want it to hinder supply long term.

Christa: We do see that a lot and we don't talk about as much like some moms that one more book here, oversupply. They're like, Oh, that sounds great. But there actually are like, cons to both sides of the fence for sure.

Kristen: Well, I hear moms to that. I mean, it's constantly a discomfort. I mean, if your breasts are always full and uncomfortable, I mean, think about, those of you guys who babies are just starting to sleep through the night and how uncomfortable you are when you wake up in the morning with your breasts full and gorge. Think about that, every hour and a half to two hours, the breast just constantly are filling and filling and filling. It's not necessarily one of those things that moms really enjoy happening either because they're constantly having a lot of discomfort. And then, in return, comes the clogged ducts that mastitis all of the other issues that we've talked about on episode number one, because if the milk is not, if they're not emptying the breast and the milk is staying in there, then it's like a domino effect of issues that come from there as well.

Christa: And so another question we see a lot in the group and post is about thrush. So, what is thrush? What are some signs and symptoms? And then how can it be treated?

Kristen: So, when I first started as a lactation consultant, 13 years ago, truth thrush was very uncommon. I mean, it wasn't really something that you saw, and if it was, it was few and far between, I think a lot of times, even now, years later. True. Thrush is probably one of those things that you're not going to see as much, but nothing against providers, but pediatrician and OBS will just say, well, let's just treat you for thrush, based upon symptoms, but sometimes those symptoms could be coming from something else. So again, just to touch base on this is the doctor says you're being you're being treated for thrush, you think you have thrush and they just call you in a medication and without seeing you or whatever and you're taking it and things aren't getting better, it probably wasn't that to begin with. Okay, so thrush is a fungal type of infection can be exacerbated, say, mom's if you're taking steroids or you're taking antibiotics say you were positive GBS and you got antibiotics or say you're right after delivery and you had an infection in your amniotic fluid and he gave you a lot of antibiotics during labor or say you got mastitis and they have you on antibiotics or whatever, steroids, antibiotics if you have a diet high in sugar, you're naturally your blood sugar runs high. You're going to be more at risk of having thrush, especially if you like have thrushes a yeast infection. So, if you naturally are prone to having like vaginal yeast infections as well, you could also get it in the breast. Medication wise, if you were taking anything that would kind of put you at risk in general. If you have cracked nipples Okay, so here is, we're adding on to those cracked nipples of things that could ultimately continue as a domino effect pattern as we go. You have cracked nipples so our nipples are cracked because the baby's not latching Well, we're putting nipple cream on the nipples, and then we're putting breast pads and then we're putting our bras on and our clothes were leaking because our breasts are full. So now we have a cracked area that's warm, it's moist, and you're just going to be at risk for getting infections, okay, so, what we want to be doing is, true thrush, or yeast, nipples can be itchy. They can be scaly or scabby a lot of times, all of a sudden the nipple is like red or pink in color. Sometimes if you have like actually yeast in, say, in the breast tissue itself, a lot of pain in the breast tissue after feeding, like I am done feeding, it's been 30 minutes, I have this stabbing, horrible discomfort actually inside of the breast tissue itself and that could be from the crack nipples and getting an infection and actually getting inside of the breast within your ductal system. Babies can also have it, say baby Lisanna on antibiotics and after delivery for some type of infection. Sometimes babies are on antibiotics for a week or so and they can get it in their mouth, it might not necessarily be pronounced. And then the baby like it's not obvious, and it's in there, and then the baby's nursing, and then it goes into the pores, the nipple and into the breast based upon baby's mouth. So with mom's pain, itchy nipples that can be read, they can be pain within the breast tissue itself. Babies, they can be irritable, crying, because it can be painful. Usually you'll see it like on the pockets of their cheeks and their gum line. A lot of babies if you guys notice, we'll just have a white patch on their tongue. So you guys can look at your baby's tongue and they kind of have natural white patch. That doesn't mean that they have yeast. Sometimes they and this goes back to one of our talks that we had before, if a baby has a high palate, or they have a tongue tie, and they're not able to take their tongue and rub it across the palate of their mouth to clean it after feeding, they'll naturally have a white residue there as well. So, think about when you guys eat in general, we as adults, we usually rub our tongue at the top of our palate to kind of clean our mouth as our foods going down, we kind of push it back, the tongue is constantly rubbing on our palate to kind of clean it. Well, babies have a high power, they have a tongue tie that's restricting them the functionality of it being able to do that, they'll have that white patch as well doesn't mean that it's yeast. Okay, so look for like patches of white and baby's mouth that won't come off. When you rub it, say with a warm washcloth. A lot of times they'll be irritable, uncomfortable, maybe not want to eat because it is painful and then you'll see, some of the issues with you. But again, if you are being treated for it, and you're not seeing it get any better, it might not that might not actually be what it is, it might be something else that's exhibiting similar symptoms that you're having. Treatment wise, if you do physically you guys have yeast you have rash, it is hard to get rid of so it's one of those things like you tell you don't wish on your worst enemy because it's super hard to get rid of. Mom and baby usually are treated. So, if the pediatrician says the baby has it, usually they'll treat both of you also with OB and then we want to make sure both of you are getting treated. Just one of you getting treated usually does not work per if mom has it but babies absolutely not showing any symptoms, then maybe we'll just treat mom but usually both of you guys will be showing symptoms. So, treatment wise really great handwashing, sterilizing everything a clean brawl every day changing out breast pads regularly. Bottle nipples, toys that come in a baby's mouth pacifier, you're wanting to make sure that you're sterilizing, because what will happen is say, okay, things are getting better, well it's on the pacifier, baby puts the pacifier back in their mouth, baby goes back to the breast and we've just reintroduced it again. So, usually it'll take a good couple of weeks for it to actually clear up. So, it is definitely a long process.

Christa: All right. And I think one of the questions too UAC with breastfeeding issues, his lack of support or encouragement. A lot of times moms feel like they're kind of on their own, they might not have support from their partner, or, their parents’ family. So what tips of encouragement do you have for moms that are kind of in that spot where maybe they're not getting a lot of milk? And so they're being told give up or different things like that, what kind of, what would you say to a mom like?

Kristen: So, and we've talked about this on many, many of our talks throughout the last year is find a lactation consultant and find like a support group. We, I mean, we live in a big city here in Orlando, but so it might be different in the area that you live in but ultimately, just Google lactation consultant near me. If you have a good lactation consultant, she's going to definitely help be supportive along the way. But also, maybe help you find groups we have all of our major hospitals here have like a mommy and me group, or a lunch bunch, or whatever to where it is kind of that support for that, like fourth trimester. So after you have the baby, and we've talked about it, no one talks about the fourth trimester all of the changes you're going through, and it's so, so much changes all at once. So find that support group, I was not a support group person until I became a lactation consultant. And now that I actually run one, I just see how these moms flourish, and how it is so great not only mentally for them, but they establish these relationships with other moms. My very first group that I did, they actually call themselves the baby bunch now. My very first mommy group, I had a group of moms that ended up becoming best friends, it's like four or five of them. Now on a regular basis, they get together weekly, they have somebody they can talk to you to kind of go through this journey with and that's the whole key of a Postpartum Support Group, or a mommy and me group, or whatever is to meet other moms in the community that have babies about the same ages you that are going through some of the same journeys to have that additional support and there's nothing against family or spouse or whatever, it's more they don't know how to help. So, the easy solution is just to tell moms it's okay to stop because they don't necessarily know any better. My mom didn't breastfeed. My mother in law didn't breastfeed, my sister didn't breastfeed. So for me, I was kind of on this journey alone as well. And I struggled, which is why I became a lactation consultant, because I wanted to help other moms, because I didn't get that support. So for me, just my journey is has made me into the profession that I have now. So it's super important because I was the one who had the cracks, bleeding nipples, who had the overproduction, who had a baby who went latch, who had a baby that wouldn't take a bottle, all of these things through our journeys that we go through, I had most of those or had those issues. So, it's helped me be able to be more sympathetic and help educate moms, and really help be supportive and most of the times dads are really great. But like I said, they don't necessarily do it to be malicious to say just stop, it's more, they don't know any different, and they don't know what to say. So it's the only thing that they really feel like they can say to help be somewhat supportive. So find somebody in the community, a lactation consultant is a great resource and then search mommy groups, or go on Facebook or Instagram or whatever your social media realm is and find whatever city you live in and search that city and mom or children's or whatever, and try to start looking for some groups or maybe moms that you friends that that have had kids and ask them, did you go somewhere, did you have somebody. Probably one of my biggest things and I try to tell my moms all the time, when you decide that you're going to go on a diet or you're going to exercise, you go to a gym and you're educated on it. When you have a new job, you have to go through training to educate yourself on the job. So, breastfeeding is just like all of those, you have to be educated on it. So, you have to find somebody who can educate you on it. So, a lactation consultant is your best resource and most of the time insurances will pay for it, but if not, I promise you it is worth the money to find somebody that can help you because ultimately it can help make your journey much easier.

Christa: Awesome. I love that. And that was a great metaphor of, when you start a new job or, doing different things in your life, or losing weight or something like that, you're not going to ask people outside of that realm like, oh, how do I do this? So it's great to find that support group that are in the same journey as you and can help you along in that journey instead of listening to the negative voices around you? Or just yeah, not necessarily hearing what you want to hear, because you have to be the one to make the decision, like, Okay, I want to keep going, this is what I see for myself and my baby. So, on the other end of the spectrum, it's surround yourself with those positive encouraging voices as well so.

Kristen: Absolutely.

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