Today we're talking everything breastfeeding. Tips for low supply, tips for oversupply, breastfeeding with a tongue tie, and so much more. This is an awesome episode you guys, I can't wait for you to check it out. Let's just dive right in.

Christa: So now kind of switching over to postpartum, you talk a lot about what your kind of mentioned a little bit earlier is helping parents thrive in that newborn stage. What are some of your main tips for new parents that are kind of just skating by that newborn stage and you're like come on let's you know let's thrive and what do you tell them.

Rue: Build your village! Know your villages ahead of time! Build your village, let people know what you want. I think a lot of times with new parents, you know baby arrives and then everybody else is either telling you when they're coming to visit, what they're gonna do, and grandparents are super excited and dictating it's gonna happen, and I’m like when you are pregnant everybody expects you to be just a little bit extra. Take advantage of that time and lay down the law, and say this is what we're gonna expect your baby's pregnant. this is when we're accepting visitors, and just kind of let people know ahead of time because it's always heartbreaking, especially right now with covid. People are having to quarantine before they visit but sometimes grandparents are like surely not me. Yes, you! Everybody's getting to quarantine, it's our first baby. Oh, it's our baby so everybody wants to be safe and I’m like the more you can kind of let people know ahead of time, what to expect, what you guys want, and what you're going to need. Writing a list of these are our favorite meals. We would love for a meal train or people to help us with this. Don't be afraid to ask for help and you'd be surprised how many people want to help you. They just don't know how and they don't want to offend you. We live in this culture where no one wants to offend anybody. No one wants to seem like oh I know you're not going to know, what you know, what you're doing, what you need help with, so people sometimes don't offer help not because they don't want to help you but because they don't want to offend you. They want to make it seem like oh yeah you know; you don't know what you're doing. So definitely just don't be afraid to ask for help and build your village ahead of time.

Christa: And of course we couldn't not talk about breastfeeding because you are the boob boss so let's talk a little bit about breast shape. I know you talk a lot about the importance of understanding your breast shape and how it matters with breastfeeding, so let's kind of dive into that.

Rue: It's so heartbreaking to me as a lactation consultant when moms come into the clinic they've been pumping every hour, on the hour for two weeks, and they're like “Rue, I just don't get it! I’m taking every supplement under there, I’m stuffing my face with Mommy Knows Best Brownies, they're absolutely delicious but nothing is happening. What is going on?” And then I’m like, okay let's do an exam and let's see what we're working with and I do a breast exam and I’m like: “did anybody ever inform you that you've got tubular breasts?” And they're like what and you know moms will say something like I knew my breast, you know shape was different or that one breast was really much smaller than the other, but I really didn't think how that would affect breastfeeding. For me it's heartbreaking because this is something that we can figure out, find out, and let moms know ahead of time and set expectations. Breast shape, a lot of times people think breast size matters when it comes to how much milk can I produce. Shape matters more. So what do your breasts actually look like? Do they look like two grapefruits? Does it look like a grapefruit and a nectarine? so you've got really asymmetrical breasts. Do they look like zucchini where they're long and tubular with a huge areola? So what do your breast shape look like? How much spacing do you have between your breasts? If I was to try and put my hand between my breasts, all the way full, all the way around. But if your breasts have a huge spacing in between you've just got this huge flat spacing, the clearing in between your breasts then I’m worried about you having what we call insufficient glandular tissue. That means you're missing some of the necessary breast tissue for you to make milk. The thing is I can let you know this before you have the baby. So for our moms who are like I’m going to breastfeed. That is the only thing that I’m going to do. I am determined to do it! And you have severe IGT, the chances of you being able to make a full milk supply are going to be low. So to give you enough time before your baby comes for you to mentally prepare for that, not to say we're not going to try. I’m like listen we're going to get as much milk as we can get out of your breasts. We can optimize whatever output you can give us but to kind of give moms opportunity to mentally prepare themselves, for the fact that my breastfeeding journey may not look the way that I thought it was going to look is I think one of the biggest gifts that we can give moms. It's not that it's going to be any less heartbreaking but it really does give you an opportunity to just wrap your head around that.

Christa: So many moms kind of have this idea of that they want to breastfeed and they kind of wait until after the baby comes and that's when they really start learning it or just kind of dive in, so super helpful moms go to a lactation consultant before. I thought this was awesome you had a video about the hamburger latch or is it the burger latch? I thought that was so helpful so if you could just explain a little bit about what that is I think that's that was so cool.

Rue: The burger latch, yes! I’ve been doing this for about six going on seven years now. So one of the things that I really started noticing a lot of times with moms with breastfeeding, is in the hospital and even as a lactation when I worked with as a labor and delivery nurse. In the hospital anytime you're feeding your baby, we would always tell you hold your breasts back here, right? And then the more and more I did it and it's like get your fingers out the way. That's what we tell moms over and over again but the more I did that the more I realized it did nothing for the actual shape of the nipple. And when you want the baby to breastfeed you're trying to get baby to get as much of the areola right as possible. Not to hang on to just the nipple. If you've got pointy nipples like this boob, if you're holding back here all your baby is going to do is grab on to what's sticking out and that's going to be your nipple. In baby latches, all baby's going to do is hang on to the nipple. So the more I started doing this the more I realized that when you eat a burger you don't eat a burger like this, right? You squish everything because you want to get that bun you want to get the lettuce, the tomato, the burger patty, you all in one bite. So that's the same thing that we need to do for our baby. So when you bring your fingers just a little bit closer and you can see everything just kind of sticks out more, right? So when baby goes on to latch, you're actually creating landmarks for them so they can so you can guide where they go. You point the nipple to baby's nose they will tilt up and drop their jaw and bite the burger. You're trying to feed the burger into baby's mouth, right? So that's where I was like okay we've been teaching moms how to do this wrong for so long because when you're holding again, holding back here it doesn't absolutely nothing to that shape. So think of a burger and always remember babies eat burgers. They don't eat tacos. So when it comes to positioning your fingers, you need to make sure that they're parallel to baby’s lips as well. So when you're coming with that burger latch, you're coming from under here if you're holding baby in that cross cradle hold because their lips are going to be parallel. So now you see when you squish just a little bit closer, point to the nose, baby will drop and get a nice big bite of the burger and I absolutely love having partners in the clinic with me when we do this because I call them by hamburger helpless. A lot of the times babies have like thick hands in their face, mom's like I can't see, so really having that extra set of hands to help you makes such a big difference. And for moms who are like engorged and so your nipple trying to squish everything so baby can get a good bite can be difficult especially when you're forged. You want to use that reverse pressure and hand express so you can soften the areola first. Always remember your baby needs to get as much of the areola in their mouth which is the brown part around your nipple as much of that in their mouth as possible. And once they're on there, we need to free the nipple and literally this is what baby's going to be doing, compressing around the areola and all the nipple is the opening, so we don't want baby to suck on the nipple. That is the equivalent of you sucking on your milkshake with your tongue at the end. If you stick your tongue at the end of the straw, it's not going to come out and it makes babies want to compensate by sucking even harder and flicking and that's when you come up and you show up in the clinic and you've got pieces of your nipple missing because literally baby has just been chewing at that nipple.

Christa: That's such a like helpful visualization to see and I’m sure like once you’re kind of show moms that like to remember the hamburger not the taco, that's gotta be so helpful. I know I saw that on your page and I was like I gotta have her talk about that because I’ve never heard someone say it that way before. You mention what to do for engorgement, what are some other like tips you have for moms with engorgement? I’ve had some you know that reach out that are kind of at that point where they're they think they're like over feeding their baby because they already have like oversupply, they're uncomfortable.

Rue: When it comes to engorgement phase I mean, it makes me so happy when moms pull me into like I’m engorged I’m like good because you got milk, right? This is what we're looking for but you're right it can be super uncomfortable so heat and massage, right? A lot of times I will tell moms like if you're severely engorged and they can be a time especially you know day 3 to day 5 when your milk comes in and you can't even touch your breasts because they hurt so much. I will have you jump into the shower and make the water nice and warm but turn your back to the shower so that the water just flows over your shoulders and you don't have because it'll literally feel like somebody's throwing beaties at your boobs, from the water from the shower because that's how sensitive they are. You just want to make sure using the palm of your hand because a lot of times I see people digging in with their fingers when they're trying to massage, that's never comfortable even when you're getting a massage, right? So you want to make sure that you're using a wide surface and just use nice rolling massage. Let's try and move that flow, let's try and get that milk to start coming out, and with engorgement a lot of times people like okay I’m gonna do it and then it's gone and then I’m good I’m like no it's gonna come right back. Because your body's like this is what we're supposed to be doing and if we're not careful especially the moms were like but Rue said I must pump she talked about pumping and then you start pumping and then you end up with over supply. It's like okay well I’m always engorged, I’m always leaking, my baby is choking, and I’m like yeah because they're drinking out of a fire hose. So how do we back that up? I think helping people understand, a lot of people like yeah breastfeeding and I’m like it actually is a science. So when you start understanding the science behind breastfeeding, demand equal supply. The more we ask your breasts to make the more milk they will make. As long as there's nothing else going on so if you've got like insufficient glandular tissue or you've got medical issues, diabetes, thyroid, some hormonal issues, or you lost a ton of blood, that is when it's going to be a little bit more challenging, the whole demand thing. We can ask but we cannot ask of an empty vessel. So when your body is like super stressed out or there's other underlying causes we may not be able to get milk. But in general, for a healthy mom, if we ask your breasts to make milk, they will make more milk. It's all about demand. The same thing applies if we leave milk in your breasts. If we keep leaving milk in your breasts, your breasts will be like hey what gives? We're making all this milk but this baby must not be that hungry because they keep on leaving milk behind, right? So your body will actually start backing up. Part of getting rid of oversupply is dealing with the discomfort of having your breast just a little bit full for a few days and then waiting for your milk supply to start tapering down. It's going to fulfill a back loop and so tell your body to stop being away from the milk production. But a lot of times as soon as moms feel uncomfortable, they're like I’m gonna pump out I’m like great and we just made it all worse again. So it's important for moms to then realize if you've got over supply, I don't want you pumping using a haakaa, using hand expression, and all you want to do is release enough milk for you to get comfortable, to where you can be like okay I can see, I’m good, I can go ahead and sleep. If you take any more than that you're telling and encouraging your body to make more milk. So cabbage leaves, taking sage tea that will also help with over supply but we need to be really careful because we don't want to shoot and then the next thing we're doing is we're going back to pumping so we can bring your supply back up and we're playing this back and forth again.

Christa: If it is over supply where you know baby is choking or coughing while breastfeeding, would you recommend using the haakaa before breastfeeding so you don't have like you know too much coming out and the babies choking or holding the baby differently?

Rue: If your baby is spluttering and choking, first things first, let baby come off because you don't want them to have continue having this negative experience in the breast with you like this hurts so good. You want to be able to pull baby off, let them catch their breath. A lot of times I’ll actually have you hand express into a breast pad so we can just get that let down to go, get things to slow down. Moms with like really fast let downs or really powerful let downs and over supply, I will have you hawk out for about three to five minutes before you even stop breastfeeding baby, right? And this will let you take out about an ounce and a half and it will slow the flow down and it makes it a little bit easier for baby to breastfeed again. We want to try and balance taking off milk before and then how much baby is going to drink so we don't keep on encouraging the body to keep on making more mouth. Again it is a delicate balance. A lot of these babies will also end up with like hind milk-fore milk imbalance symptoms, so a green frothy poop, really gassy. I did a reel on doing oversupply and doing the milkshake and really just shaking your boobs before you start breastfeeding so that we can mix up the milk. When we say hind milk and fore milk, a lot of people like you've got two different types of milk? I’m like no, you have one type of milk. If you're taking Mommy Knows Best cookies, we're gonna build up that fat content in that milk and the one thing I know about that is it loves to stick. So what ends up happening is that fatty layer and the milk sticks to the alveoli which are the little collection and the little sex where the milk is actually created, so it sticks to the walls of the alveoli. When you first start breastfeeding, just the watery stuff starts coming out. If you take your boobs, literally massage them with some heat, some warmth, and you just shake. You'll mix all that milk up and we'll start moving that fat into the milk so that when baby drinks they have more balanced milk. We're trying to go for that so we can make sure especially you've got oversupply because you might have an insane abundant amount of fore milk and baby gets full on that. But after about an hour, an hour and a half, baby is starving again and you're like I know you just ate, right? But fore milk is mostly sugar water so they burn through it really quickly and they turn super gassy.

Christa: That's such an interesting technique that's really cool so I know we're getting to the end of our time here but can you talk just a little bit more about what kind of things you offer right now? And where everyone can find you? any courses you offer? And all that good stuff.

Rue: I’d love to! So you can find me on Instagram at Rue the Boob Boss, rue_theboobboss and we do the virtual lactation consulting and it's in my bio so feel free to check that out. I have an absolutely awesome Amazon baby list because I’m obsessed with baby products. If you're trying to figure out again with new parents there's so many things be marketed out to you, so a lot of times it's like hard to figure out like what's really worth spending money on. So check out my Amazon baby list, it comes with all the comments on what is the most expensive thing in the market and I’m like great it's expensive. If you've got the money wasted but here's a cheaper alternative that works just as well so it definitely has a few comments and sometimes some things you just can't you know skimp on and you just have to you know pay for them. I absolutely love working on that every month through The Perfect Push, we offer a newborn care and breastfeeding class, it's once a month, and you can register for that too on my bio and you can also find me find us at theperfectpush.com so if you're looking for a lactation, which again if the baby is here I really prefer in person. If you're out of state, if you dm me, I will even try and see if we can find you someone with where you are. I’m super passionate about hands-on care especially with lactation so I don't offer as many virtual offerings for that because it's just not as effective, so if we can get you somebody who you can see better but prenatally, you can book a prenatal lactation consult with me through my bio.

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