Thanks for tuning into this episode of MomTalks with Christa. We are back with our special monthly episode with Kristen Sorondo is a lactation consultant and registered nurse from Florida. And we've just been kind of going through different topics related to breastfeeding from different stages. And this month, we decided we wanted to do exclusive Q&A that you guys had. So I have a few different questions from Instagram that people reached out. And we're going to go through them today. So welcome back, Kristen.

Kristen: Thank you.

Christa: So for anyone that hasn't been tuning in, can you just do that little intro to who you are, and we'll get to the questions.

Kristen: Absolutely. I'm Kristen Sorondo. I'm a lactation consultant out of Orlando, Florida. Our company is Orlando lactation. So if you guys have any questions, feel free to message through the website.

Christa: Alright, so like I said, these are questions that we received from Instagram. If you guys like this, let us know we can definitely do more like this as well. So first question, it says, how to start weaning from the pump? I'm exclusive pumper here and I'm nervous.  

Kristen: So I saw this question. And you know, this is one of those things that there's not necessarily a right or wrong answer. So when we look at, okay, I'm ready to kind of start declining my breastfeeding journey, whether it is physically with breastfeeding or with being a pumper, and bottle feeder, you have to do it kind of in stages, it's not something that you want to stop, because then you're going to be more at risk for getting clogged milk ducts, possibly mastitis, have a lot of discomfort. So we want to try to prevent that. So it really depends upon where you are in your journey. Say, if I have a mom who's pretty quickly right after delivery, and she just finds that this is not for her, she's probably going to have way more milk than say a mom who's nine months in and body is naturally started to decrease production a little bit because babies now taking solids. So it really depends kind of what stages you're in. So for this particular Mom, I would say depending upon how often you're pumping, kind of a good rule of thumb is you want to start if you say if you pump about every three or four hours, and you can just take physically one of the pumping sessions out of your schedule, to where instead of pumping, maybe every four hours, you do it to five, five and a half or six, if you kind of get to that five hour point and you're really feeling uncomfortable, Okay, then let's do it about every five hours for a couple of days, give your body some time to regulate itself again. And then the next you know, after two or three days, once you're feeling better, with a five hours, just stretch it out to six, until over time, you're slowly cutting out another session. Usually probably the two hardest are at night before bed and the first thing in the morning. Because usually by that point babies are sleeping through the night. And that's the longest period that you're usually going without pumping. So those are usually the two last ones that we ended up getting rid of. And then once you kind of get down to say maybe you're just doing it once a day, you're really not feeling uncomfortable when it comes time for that pumping session, then that's probably a great time that you can that you can stop. So you will naturally have maybe some fullness or a little bit of discomfort. But the key is to not stimulate the breast and try not to pump or try not to manually express or get in the shower and manually Express because whatever is taken out is going to get replenished. So even though we've cut it back to that one time of day, if you are still expressing it will just come right back. So once you've gotten down to that once a day, and then that's usually a great point that you can just stop altogether. And then some great things that you can do are buying the breast at that point. So put on a really tight fitting sports bra. And you can even do an ace bandage overtop of it anything to really compress the breast against the chest. To prevent those the milk glands from actually filling up. If you don't have any type of allergy or sensitivity to an antihistamine that's really great because antihistamine anything that kind of dries up your head and your sinuses and also dry up milk. And so we typically tell moms don't take it while you're breastfeeding during your breastfeeding journey. But this would be something great that you could add to your daily routine just to try to help that milk dry up a little bit quicker so you're not having any discomfort. So it really depends upon where you are during your journey. But that's kind of like a good overview.

Christa: Awesome, awesome. great tips there. Alright, so the next one is my one month old sometimes gags on breast milk after nursing, is this normal?

Kristen: I have to talk to her and say like after the baby's like finished nursing, like they're just sitting there, and all of a sudden they're just gagging, or while they're eating, not necessarily uncommon while they're eating, especially if a mom has a very quick letdown. And basically what a letdown is, is the breast has been stimulated. Now as soon as the breast is stimulated, and the milk is actually coming down through the ductal system, and being excreted to baby. Sometimes moms is super fast. And it's pretty much like you opened the door to the to the dam, and then waters, you know, the milk is just flying out. And sometimes that's very overwhelming for baby, think about if you guys were to drink out of a water bottle, and you're not able to pause and be able to control that flow, you have to suck I mean, they're usually like suck gulp, suck gulp. And they, it's almost like a defense mechanism, they actually pull back, or they might even gag just because it's so overwhelming. So if that was the case, then a couple of things that mom can do is she can actually recline back when she's feeding. If we're sitting upright, the flow is going to be working with the baby. So it's going to be more aggressive. And so if you can actually recline back a little bit, or do sideline feeding, the baby actually has to work for the flow to be coming because it's not your body's not doing it for them anymore. So then it kind of helps slow that down a little bit. So trying to do that. Or when it's really really quick and the baby's still struggling, just you can kind of press back on the breast tissue just a little bit to try to you manually kind of control the forcefulness of it and see how those go. Those are probably, you know, the best options. If it's a baby, say like after feeding like they've completely finished feeding and then just like they're gagging, not necessarily sure what that would be. So for the particular mom who asked that question, if she watches, comments, and let me know if it is the opposite to where it's just random after the baby has physically finished at the breast, and maybe we can kind of troubleshoot some things with her to help make that a little bit better.

Christa: All right, awesome. So yeah, definitely, I'm going to send a message to everyone to letting them know that we are answering these questions as well and send her along as well. And we'll get that as well. So I know we also wanted to talk about this in future episodes, this will be a helpful one as well, how to stop reoccurring mastitis and help in baby's mild tongue tie. Because we also kind of covered tongue ties in a previous episode as well. I know and when you put all of that in one sentence, it actually is like a tongue twister. I was like, that was a lot harder to say than I thought.

Kristen: Okay, so if we go back and we think about some of the things that we talked about in our tongue tie video that we did, if a baby has a tongue tie or oral issues, a lot of times they're not able to physically get the milk out of the breast or maybe they're not able to fully empty the breast for mom. So what happens is, the milk stays in there and sometimes it can just continue to get backed up and in return can cause a clogged milk duct and possibly mastitis. Usually mastitis is caused by also some type of nipple breakdown, say mom has cracked nipples or bleeding nipples, or again, like a baby's got a tongue tie, or lip tie. A lot of times they're doing a lot of chopping, and there's nipple trauma. So what ends up happening is bacteria kind of feeds through that trauma of the breast tissue and can cause some type of infection. A couple of things. Usually, like I said, if moms are getting recurrent mastitis, did it ever actually get healed the first time like did the doctors put you on a strong enough antibiotic to where it actually cured it completely that very first time? So that would be one thing to look at. And then two, if we do have a lip or a tongue tie baby, are you seeking treatment for that? And do you have an oversupply? Typically, I'll find that it is any moms that have an oversupply that are that it is reoccurring and because if they have x quantity of milk, but the baby only takes out a small portion of that, that is building up back in there, so some things that she can do. If you're having reoccurring clogged milk ducts, sunflower lecithin in is really good. What that does is it helps decrease the viscosity of the milk to where it makes the milk a little bit thinner so it helps filter through that ductal system. Think about having very very tiny coffee straws within the breast and that's kind of the diameter of your milk ducts. So any little tiny bubble or thickness of milk can prevent the flow of it coming physically out of that little tiny straw and then just continue to back up from there. So if you definitely have reoccurring clogged ducts which tend to lead to mastitis, let the sun is a great option. You want to make sure that are you seeking help for the lip or tongue tie, possibly, you might need to be somebody that we try to decrease your milk supply a little bit. If you're making way over an abundance for your baby, you know, decreasing that a little bit to help prevent that reoccurrence, you can do some pumping afterwards, just to make sure that you're physically emptying the breast tissue. So there's a lot of different things that you can do. But you know, probably the key elements are, was it actually treated properly to where you actually completely healed. That's probably one of the biggest things and then making sure that you are getting assistance with the baby. And then hopefully, clogged ducts are a little bit different. But the recurring mastitis would definitely be something more concerned about because that's actually where you have an inflammation inside of the breast tissue that leads to an infection. So we want to make sure that that infection is completely getting taken care of.

Christa: Awesome. Yeah, awesome advice there. And like we kind of we talked about before recording, we're going to next month, we're going to focus a little bit more on breastfeeding complications, so like clogged ducts, more about mastitis and so many other things. So this should help answer anyone that's listening, that's kind of worried about clogged ducts or anything of that source, we will address that and so on for this last question. It's a little bit longer. A lot of backgrounds that helps the final answer here, I think. But okay, to give you some info, my baby is 11 weeks old, she had a pretty bad tongue and lip tie at birth, I had a good amount of colostrum and did a lot of hand expression. But she lost a lot of weight in the hospital and days after we visited LC and we found she lost over 10% of her body weight. So we needed to start supplementing with formula, her tongue lip tie made her stuff completely wrong and use the wrong muscles. So she would exhaust yourself on the breast and fall asleep. But of course, she wasn't full. So it took forever to get my milk to come in. And when it did, my supply was low and still is. I do have thyroid issues, which is also a part of it. We are still supplementing at this time, is it too late to up my supply? I go back to work soon and we will be pumping the day but still nursing when I can.

Kristen: Okay. So the answer to the last part of the question is, the further that you get out from delivery, the harder it is to regain a milk supply. Okay, so any of you moms that are really struggling with milk production, the earlier the interventions, the better your outcomes are, okay? So if you are getting ready to have a baby, or you just had a baby, and you guys are having complications, definitely reach out to somebody, because the earlier that we can catch some of these issues, the more successful you are going to be long term. So to answer hers is, you know, can you get it, it really depends upon where you are. So say if I have a mom who's making 20 ounces a day and the baby's taking 25, Is it possible to actually increase that quantity? That's so much more doable. If I have a mom who's making an ounce for an entire day, and the baby's taking 25 ounces, the chances of you know getting that quantity to increase at three months out. slim to none. Okay, so it you know, key factors are you know, how far out are you? What is it? What type of quantity are you making? How far off Are you from baby. So for this particular Mom, I definitely would recommend going back and watching our tongue and lip tie video, I think it would be super helpful for you just to know some of the history behind that. So if you have a baby that has a lip or tongue tie or any type of oral issues, yes, they don't stack appropriately. So what in return, what happens is just this little domino effect, you hit one domino and they're just going to keep falling down. So what's going to happen is you don't get the stimulation that you need to properly tell your body to continue that prolactin level being elevated. And then to continue ultimately, to produce adequate enough milk for your baby. So you were actually hindered right from the beginning. So for somebody like you, in the initial stages probably would have had you pumping right away, even though you were manually expressing which is super great. If you're not having a baby who's also doing some of that additional stimulation, the manual expression might not necessarily be enough for you to get that milk to fully come in. And then what will happen is that prolactin just starts to decrease and then it's harder and harder for your body to be able to make milk. That prolactin which is your milk making hormone has to stay elevated in order for your body to continue to produce milk and whatever is taken out is what gets replenished. So if the baby is not taking the full feeding from the breast. In return, they're going to still be hungry, and you're still going to have to supplement. But you also didn't have enough milk removed from the breast in order to get your body to replenish it for the following feeding. Another aspect of this particular question is, mom had thyroid issues, so they can play a part in milk production in some way, shape, or form, if mom's levels are all out of whack, usually, they're pretty great because they've been monitored during pregnancy. So typically, your obstetrician or your endocrinologist is monitoring your thyroid levels, whether it be hyper hypothyroidism. And they're regulating your medication based upon that. However, when you have a baby, your hormones get all out of whack again, because your estrogen and progesterone level decrease because you've just delivered the baby. So it can throw your thyroid off a little bit. So I usually will tell moms that are breastfeeding, if we're having some issues with milk production, when they do your one week follow up or six weeks is usually too long to wait. So if you had a vaginal delivery, your doctor is not seeing you until six weeks, you know, request some postpartum hormone levels to be checked to make sure that delivering the baby didn't throw off your hormone levels. As far as your thyroid goes that. Usually, I would probably trigger this mom's decrease in supply to probably the tongue and the lip ties and just not getting adequate stimulation, definitely the thyroid could have played a part. But most of the time, like I said, they're pretty unsafe, because their doctors have been watching them through pregnancy every once in a while have a mom that it just totally throws him out of whack after delivery, and it's way off. And that really can hinder milk production. And then the last part of the question, can we get that supply to increase? Definitely, there's things that you naturally can do. Like I said, if you're off just a little bit, you know, things like and we've talked about this, you know, with Mommy Knows Best products, you know, the brewer's yeast supplements, the lactation cookies, adding oatmeal to your diet, making sure that you're drinking plenty of fluids, just to kind of maybe boost it up a little bit. But if you're way off, definitely you can try some herbal supplements and see, you know, again, Mommy Knows Best has the goat through and the fenugreek free products and the different ones that you can try to see if that will help. But again, it really determines how far off you're you are from what the baby is taking. So, again, you would be somebody that would be great to comment on the video, or when Christa puts it out there that we've answered these questions, you know, comment or message me and see, you know, so if it is just a little bit, definitely there probably are some things that you can do to kind of help boost that up. But if you're way off, then probably not likely at the end 11 weeks postpartum. All right.

Christa: Awesome. That was that was really great advice. And again, we will message you directly to let you know that we've answered your question, and then you guys can kind of connect to once it's posted as well, because I know a lot of these questions while these breastfeeding questions we get are very personal. And I know we've talked about before, too, breastfeeding is not black and white. There's not necessarily one answer that's going to help everyone. It's a very personal thing. And there's so many different factors.

Kristen: Yeah, absolutely. And Christa, even if these moms want to talk before the video goes live, you know, definitely reach out. But, you know, I think when we start to talk about a lot of the abnormal things and complications, probably the best advice that I can give is to really reach out to a lactation consultant. I think that people are worried, maybe a financial burden, or they feel like overall that things are going well. But if there's anything that you don't feel like is going well, even if you just need some reassurance, it's better to see somebody to have that extra input to kind of put your mind at ease than to hold off and feel like everything is going well, when maybe it's not just because that earlier intervention, the long term, the better your outcomes are going to be.

Christa: Awesome. Yeah, definitely. That's great. Because I think a lot of times we want to, if there is an issue, just kind of like, move through it if we can. And so I think Yeah, dressing as soon as possible. Even if maybe you're just kind of unsure about something. It's always good just to kind of get the extra support and resource. Awesome. Well, this was great. And again, if you guys found this helpful or want us to keep doing these kind of Q&A, you can submit your questions, please let us know in the comments. And we'll keep doing these and like I said as well next month we're planning more of a series on breastfeeding complications covering clogged ducks and mastitis and other kinds of kinds of things as well. So yeah, this was really awesome to have and thanks for awesome interview.

Christa: And I'm sorry I always forget and then can you just for people that this is their first episode, please tell them where they can find you?

Kristen: Absolutely. It is orlandolactation.com My name is Kristen Sorondo. And again, I'm a lactation consultant here out of Orlando, Florida.

Christa: Awesome. Definitely go check her out guys. And we will be tagging guys whose questions they are. We'll message you guys since they were anonymous question. So I'll message you guys. So yeah, awesome. Thank you so much, Kristen. Thanks for coming back on.  

Kristen: All right, you guys. Take care.

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