Ep 69: All About Breastfeeding and Breastmilk with Laurel Wilson

I have such a fascinating episode to share with you today, and it's packed with both practical and interesting advice about breastfeeding and breastmilk. 

Laurel Wilson owns MotherJourney and has a degree in Maternal and Child Health - Lactation Consulting. With over twenty six years of experience, she is also a lactation and perinatal health speaker, sharing her knowledge at professional conferences around the world on subjects ranging from hot topics in breastfeeding to epigenetics and the prenatal environment.

Laurel breaks down some common obstacles parents face when breastfeeding, how you can find support with these issues, and how to work through some of these common questions and concerns. We also cover how you can start to prepare for breastfeeding while you're still pregnant and where you can find some of the resources you'll want to have on hand.

Laurel also talks about how human milk is designed to nourish babies and their microbiomes, and we discuss the importance of skin-to-skin contact well beyond the "golden hour" after birth. We also cover how we can support families' choices about feeding their children, whatever they may be, and she shares some tips for going back to work while you're breastfeeding.

In this Episode, You’ll Learn About:

  • How Laurel's own birth experiences affected her breastfeeding and her interest in this work
  • How a baby's environment - including the milk they drink and the amount of skin-to-skin contact they get - can change the way their genes are expressed
  • Why any breastmilk you can give your baby is great
  • Why you shouldn't feel guilty if you have a hard time breastfeeding and how to make feeding work well for you and your family
  • What to know about milk sharing, where to find more information about it, and how to do it safely
  • What to know about milk sharing, where to find more information about it, and how to do it safely
  • Why developing a supportive community will really help with feeding your baby
  • Great tips for returning to work when you are still breastfeeding

Links Mentioned in the Episode



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Transcript

Speaker 1: Hey there. I am super excited for this episode all about breastfeeding.

Speaker 2: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a practicing board certified OB GYN who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at www.ncrcoaching.com/disclaimer. Now let's get to it.

Speaker 1: Hello, welcome to another episode of the podcast. This is episode number 69, thank you for spending some of your time with me today on today's episode. I have a very fascinating and informative conversation about breastfeeding. I think we're all aware that breastfeeding is best for both moms and babies and I wanted to bring you this episode to help you get off to a great start with breastfeeding. Now I want to be clear that a fed baby is the best baby. So if you decide that breastfeeding is not right for you, then of course I support your choice, but I want you to make whatever choice you decide with all the right information to guide you and there is a ton of useful information in this episode. So I am joined by Laurel Wilson. Laurel is a Ted X and international speaker, a pregnancy and breastfeeding specialist, a consultant educator, an author.

Speaker 1: She has coauthored two books, The Attachment Pregnancy and The Greatest Pregnancy Ever. She is also a contributing author to Round the Circle. Doulas talk about themselves. Laurel's passion is blending today's scientific findings with the mind, body, spirit, wisdom to help professionals and families realize the magnitude and importance of the perinatal period. Spending 17 years as executive director for lactation programs for the Childbirth and Postpartum Professionals Association, helped form the foundation of her inquiry into the science of human milk. Laurel believes that the journey into parenthood is a life changing rite of passage. Amen to that. And it should be deeply honored and celebrated. Laurel and I have, like I said, a really fascinating and interesting conversation about the longterm impact of human milk including how it affects your baby's genetics, something called epigenetics. She shares some very interesting information about the history of human milk feeding.

Speaker 1: You will be surprised actually at how long our ancestors fed their children human milk. We talk about sharing human milk, things women can do to get off to a great start with breastfeeding. What are some common challenges women encounter and how they can overcome them? What are some recommended resources and much, much more. I really, really enjoyed this conversation and learned a lot and I know you will too. Now before we get into the episode, I have a quick question for you. Are you on my email list? My email list is a great way to get reminders about podcast episodes. I send a weekly newsletter that includes a link to the latest podcast, but it also includes a weekly dose of information to help you have that beautiful pregnancy and birth, so there's a helpful tip in there about something related to pregnancy. There's a little bit of inspirational information in there, like an inspirational quote.

Speaker 1: This newsletter is great if you aren't big into social media, so you can still get all of the great information I provide while stepping back a bit from social media. I know I need to step back a bit from social media myself, so you can sign up for the email list at www.ncrcoaching.com/email. Those emails are once a week. No spam. I never sell your info to anybody else. Just jam packed information concisely done so it doesn't waste your time. Folks really enjoy the email list and the email, so go ahead and sign up for that at www.ncrcoaching.com/email. All right, so without further ado, let's get into the episode with Laurel Wilson.

: Nicole: Thank you so much Laurel for agreeing to come on the podcast. I was excited when you reached out. I've been looking to have someone on to talk about breastfeeding and you seem like an absolutely fabulous person to do so.

Speaker 3: Laurel: Well, thank you so much for having me. I'm really happy to be here today.

Speaker 1: Nicole: Yeah. So why don't you start off by telling us a little bit about yourself, your work, and maybe your family if you'd like.

Speaker 3: Laurel: Sure. So, I am a lactation consultant and speaker and also just a perinatal advocate. So I work hard to help families realize their specific goals around becoming pregnant, giving birth and feeding their children. And I got into this business almost 30 years ago with the birth of my two boys. I had very, very difficult birthing experiences with both of them and pretty challenging breastfeeding experiences as well. And that kind of, that led me into the path of advocacy. And that started as being a doula and then I became a childbirth educator, then a lactation educator. And then I started getting very involved in my community and working a lot with professionals. And my two boys now are grown men. And it's really exciting to kind of look back over the years as things have evolved and I've seen so many things changed in the world of birthing and breast and chest feeding that it's just, it makes me very happy to see that we've been able to improve so many things for around birth in the United States. But there's, there's so much work, particularly in the world of equity work, we still have so much to do around that.

Speaker 1: Nicole: Very, very true, for sure. For sure. So you have been at this for a long time, so you have seen a lot. So do you mind just giving us a quick snapshot or scenario of what the difficulties were with your births and breastfeeding experiences?

Speaker 3: Laurel: Sure. So I was born in the early seventies, and my mother was a, what you would describe as a hippie of the time. And so I kind of grew up with that idea of, you know, being close to nature and doing things naturally, as you know. And so when I became pregnant with my first child, we were in the military and we were very quickly stationed in Guam. I think by the time I was three months into my first pregnancy and the Island had just been devastated by a massive typhoon. And over my pregnancy, we experienced multiple typhoons throughout that time. It was a very stressful period. But I was really intent on having a natural childbirth. Initially I had wanted to have a home birth, but I was, I was very quickly told in the military that that would not happen or we would be in a tremendous amount of trouble.

Speaker 3: Laurel: And so we had to proceed with kind of a military experience of giving birth. And my son in the very last month or last weeks of pregnancy, decided that he was most comfortable in a bottom down position. And so we tried all the things, you know, I laid upside down and I had the radio, you know, between my legs and we even did some medical intervention, like trying am, oh, I can't think of a word of it right now. Immersion aversion. Right, which did not succeed. And so they planned a cesarean for me. And the night before the planned cesarean, I woke up and felt my baby turning and my water breaking. And I was just so excited that I was going to have a vaginal birth. But by the time we drove the hour to the Naval facility, they had me that, the surgeon had already been woken up, so I was having a cesarean section like it or not.

Speaker 3: Laurel: And from that point on, things just really kind of degenerated in terms of the experience and really the health care that both my son and I had, it was a long time before I actually had physical contact with my child. We were separated. And you were not allowed in those days in the Navy to get to, to go visit your child unless you could walk to your child. And I had lost so much blood. I kept passing out in the hallway. So it took a long time before I could see my son. And so breastfeeding got off to a difficult start. We really tried, you know, everything to get things started as well as we could. And we did finally establish breastfeeding and I breastfed him for, I think I breastfed my first for 10 or 11 months.

Speaker 3: Laurel: And with my second child I was determined to have a VBAC and I did not want to have another cesarean. And I did succeed in having a VBAC. But it was also a very traumatic experience because my doctor, we were in Hawaii at the time. My doctor had had his first uterine rupture with a VBAC ever in his entire practice the night before I was, I went into, so he entered it with a lot of fear and told me I had to have a, you know, an epidural and it just, it set the stage for a lot of things. That led to a very, very difficult birth experience. And so of course I had postpartum depression with that child and that impacted our breastfeeding experience. But we wound up breastfeeding for a little over a year. And, but we struggled. And being in the military, I felt very isolated and being in areas where there were smaller communities, I also didn't have a lot of group support like we do today. So that was kind of my impetus into jumping into how do we make sure that families do have support, that they do have information that they can advocate for themselves when they are in situations where they feel as though their decision making process is not in their hands. And, so that's how I really dove into this field.

Speaker 1: Nicole: Gotcha, gotcha. Well, I'm sorry you had to go through that experience. I'm sorry for every woman who has that experience because we can and must do better. I guess like bright side, but we have made some progress, but as you said, we have, we still have work to do. And it's also, you know, the other, I hate to say bright side in the sense is that some of the traumatic experiences that we have in our life are often the inspiration for some of our greatest work. I know for me some that's how I kinda got into this space. So I'm glad that you were able to take a difficult experience and turn it into then helping so, so many women, down the line.

Speaker 3: Laurel: Absolutely. And I, I feel grateful actually every day now for the experiences that I had with both of my children because it woke me up and it lit a fire in me to kind of warm the communities that I have been working with for all these years. And I feel a deep gratitude for those experiences now. They were, they were so difficult at the time. But had I not gone through those experiences, I absolutely would not be doing the work that I'm doing today because it was nowhere in my consciousness or field of interest. And now it excites me every single day to learn about lactation, to learn about human milk, to learn about the amazing capacities of the human body, to grow a child and give birth to a child and, and feed a child. So I am grateful for the experiences. I'm sorry that my children did not have optimal experiences, but I hope that they went on to have the best childhood.

: Nicole: And I'm sure they did. So what I'd love to do is talk about some of the things you do in your work and some of your speaking work and then we'll transition into giving folks some practical advice about breastfeeding if that's okay. So let's start off with, you know, I listened to your TEDx talk where you talk, and guys I'll link to that in the show notes is very good and it's not very long. It's, it's brief to the point is, it's very interesting information where you talk about the longterm impacts of human milk. So why don't you tell us a little bit about that, how you got interested in it and what are some of the longterm impacts that you've found in, you know, sort of your research into that? That's sort of a long question.

Speaker 3: Laurel: Okay. So I've been working in the field of lactation for about 20 years and have always known that human milk is so important. We talked for years, for decades really about the benefits of human milk and I understood that, I knew it boosted immune systems for babies. I knew it was the perfect nutrition, like I knew I knew all these things, but the mechanisms behind all that are really only now starting to become clear. And a good friend of mine and colleague of mine, we were in the process of writing one of our books called the greatest pregnancy ever. And it was about how the experience of pregnancy through environmental impact and emotional States, relationships you have with your partner and family and friends and your nutrition all changed the development of your child. And as I was doing a lot of this research, I was also looking at research around stress and the impact on the parent and the baby.

Speaker 3: Laurel: And I started seeing this term of epigenetics pop up and that really seriously, that just, I jumped into a hole from that point on that I've never been able to come out of it because it has fascinated me. And what epigenetics is, is how our environment interacts with our genes. So it doesn't necessarily change our genes, it changes which of our genes activate or inactivate. And there's a whole range of expression on the in between. And as I started, you know, really getting into this, I thought this is it. This is what's going on with human milk. This is why human milk is so important. This is why it has quote benefits. And so then I started looking into nutrigenomics and nutrigenomics is the study of how food changes the expression of our genes. And there are, there's some amazing research being done today about how our first foods really change things for us longterm.

Speaker 3: Laurel: And there are a couple of ways that it that it does this, you know, our first foods as they go into the newborn's gut, one of the things that our first foods do is kind of place all the bacteria in our gut that will live there, kind of set up household there for the rest of our lives. But not only does it help to set up this what we now call a microbiome, these communities of bacteria and viruses and fungi. Fungi are very important actually, but the human milk also continues to feed them. And this microbiome is in constant communication with all aspects of the baby's body and causes genetic changes, causes epigenetic changes for the child. So we know that our human milk confers information to the bacteria to communicate through the vagus nerve to change how we feel to change which hormones are being released throughout our lifetime.

Speaker 3: Laurel: It changes how the gut actually develops, how the protection layers in the human gut function and also which proteins access the human body, which that changes things like how allergic we are and whether we have a topic illness. So it's such a fascinating field because things in so many ways, it's not just one thing, but what we now know it's not that human milk necessarily that it increases the potential for health. It's that human milk is what human babies are designed to have for the health of a human being. And when we receive anything other than human milk, it changes that a bit. And it's so dependent on how long we experience food that's not from our parents or whether it's, you know, from a cow or from a, those things really do shift longterm health so they can increase the risk of illness because they really change our microbiome and they change our genetic expression.

Speaker 1: Nicole: Interesting. So, and I take it that this is based on research studies or I'd love to, I'm a research kind of nerd, so I would love to, if we have some resources that I can share in the show notes, I think that that would be very helpful for people who kind of want to see sort of where this is coming from. Or if you've done it in your book, then we can link to that as well.

Speaker 3: Laurel: Yeah, absolutely. I'll actually send you, there's a very lengthy resource list that I had just for my Ted talk. And so it breaks it down to all the sections I talked about and some specific research articles they can look at. But also they can go to my website, mother, journey.com and click on my epigenetics page, epigenetics and the microbiome. And I have, you know, hundreds of links to research there around how this changes things.

Speaker 1: Nicole: Yeah. So, okay, so now I have lots of questions. One is, how long do women need to breastfeed in order to see some of these benefits?

Speaker 3: Laurel: So there, there's pretty much international agreement that humans are designed to human milk feed for at least six months exclusively. So that would mean not having sugar waters, not rice cereals or anything else, that it's just human milk for six months.

: Laurel: And then, depending on whether you're looking at the American Academy of Pediatrics or the World Health Organization, they say that then you continue, breast or chest feeding for 12 to two years and beyond as is comfortable for the parent and child. And that's really kind of a negotiation between mom and baby almost every day. You know, are we gonna feed them 14 times today, one time today, what does that look like every day? So that's kind of a family negotiation that happens from that point on. But a really interesting study just came out, there's a lot of anthropologic data out there that had suggested that humans kind of ancient humans breastfed for six to seven years.

Speaker 3: Laurel: And yeah. And so we thought, well, you know, like where, where's that data come from? And it comes from when our milk teeth come in, when our levels of lactose start to diminish, which is between ages two and 12. Just just as a, an aside for your listeners, how the jaw changes and also more recently how our microbiome changes. And so we suspected that that was true. And when you look at cultures around the world, we do see that actually the average length of time that children are fed average, okay is four years. So really there's some truth to looking at that culturally. But now I'm a recent anthropologic dig was looking at the teeth of ancient infants and what they actually found when they looked layer by layer of the children's teeth, they found that those children actually did um, human milk feed for six months exclusively and they, they breast and chest fed for about six years. So now we have the data in, in ancient teeth from our human ancestors that that would actually be interesting. Yeah. Yeah.

Speaker 1: Nicole: Wow. So my next question then is we all know the difficulties and challenges with breastfeeding and how some women choose not to breastfeed. I want to be supportive of women's choices yet providing accurate data and information. So my question is, is some better than none? Is any amount better than not doing breastfeeding at all?

Speaker 3: Laurel: Yes. Every drop of milk is a good drop of milk. Every drop of human milk is beneficial for the child. So you know, whether a parent breastfeeds just for one day in hospital or whether they go home and they breastfeed while they're home and they formula feed at work or whether they exclusively feed for six weeks or six months. All of that is beneficial for for their child. And absolutely we want to support families in the choices made. And we also have to be very aware that we have areas of our country where some families are returning to work at two weeks and we don't leave policies in our country. So I definitely do want to embrace that idea that we want to make sure that whatever a family situation and choices, we help them optimize all aspects of their upbringing for their children.

Speaker 1: Nicole: Gotcha, gotcha. Now another thing is in relation to the microbiome, and I did a podcast episode with a gastroenterologist about the microbiome and she also talked about how she went through her own journey of realizing how important breastfeeding was to establishing microbiome for the child when she looked at the data and evidence. But one of the things that came up then, and I'm curious what your thoughts or perspective are about the differences between vaginal birth and cesarean birth and how breastfeeding can help with differences in the microbiome because those babies are going to have different microbiomes. What are your thoughts on that?

Speaker 3: Laurel: Yes, so absolutely whether we're born vaginally or via cesarean section changes a lot because of the, you know, what we're exposed to during the birth process. But the Maria Bello team who's done a lot of research on the microbiome in newborns did find that even for children who were born via cesarean delivery, that if they were breastfed, that their microbiome was closer to vaginal birth in those families who did not breastfeed. And so one of the things that they are seeing is that when human milk does go into the human gut, that it does elevate the levels of lactobacillus and bifido phyllis strains, which are really important strains to our longterm health and to the health of our gut in general. So breastfeeding does help not necessarily completely mitigate the changes between vaginal birth and sincerity, but it does really help normalize things in the gut.

Speaker 1: Nicole: Gotcha, gotcha. So it's another thing that we can do to help. I feel like that's a big deal because a lot of women feel guilt sometimes around cesarean birth if it comes to that. So I think it's great to hear that this is something that, you know, you're not like damaging your child for life or anything like that if you have cesarean birth.

Speaker 3: Laurel: Right. Human milk, you know, that's one of, that's one of the things I do this talk a lot to professionals about how human milk and the act of breast and chest feeding actually can heal a lot of things that that happened during pregnancy and birth and it's the human milk itself, but it's also the act of feeding and it's also the act of skin to skin. So I'm a real proponent of us going beyond that concept of the golden hour. We talk a lot about the golden hour to parents, how important it is to skin, to skin and hopefully to to breastfeed in that first hour. But the reality is is that skin to skin is an important component of developing the child's microbiome beyond just the first hour of post delivery. It's important during the newborn period. So just because parents go home doesn't mean that they then should never practice skin to skin again.

Speaker 3: Laurel: In fact, they should employ that practice as much and as often as they possibly can. You know, if they can in the mornings with their first feed, maybe just, you know, take their little baby's jammies off and just hold them in skin to skin and breastfeed them skin to skin and maybe continue that practice in the evening and throughout the day if they can. I mean for some parents it's not going to be realistic for them to walk around all day long, but, but it is still a really important part because you're also continuing to seed your baby's external microbiome with your family bacteria as well. So there's a whole lot of components of breastfeeding that it's not just about the milk, but the milk is very important.

Speaker 1: Nicole: I love that. I don't think that that's something that we really emphasize. I think we've gotten better at about the golden hour, but I don't think we talk a lot about how skin to skin is continually important even after baby comes home. So that's really great advice.

Speaker 3: Laurel: Well, and even for families who are bottle feeding, you know, it's still a really important component because it helps regulate the baby's temperature. It helps optimize like comfort hormones for the baby and calms the baby's brain down. It helps calm their heart rate, it helps them get into deep sleep. There are so many things that skin to skin can do, whether we are breastfeeding them at the breast, whether we're bottle feeding them human milk, whether we're bottle feeding them formula. Skin to skin is a practice that all families should embrace. And the beauty is is it can be done with, with mama or dad or grandma and grandpa and even the siblings can all do skin to skin with the little one, to really promote family bonding and health.

Speaker 1: Nicole: I love that. That that is really, really awesome. I know sometimes, at least in some cultures and black cultures, it's like don't pick the baby up too much. You're going to spoil the baby. And I always say like that is not possible. You cannot spoil a baby. Pick those babies up, you know?

: Laurel: Yes. Yeah.

: Nicole: And it may be the case in other cultures or family traditions as well. I can't speak for everyone, but I've certainly heard folks say that and it's like, no, pick up your baby. Babies want to be held.

Speaker 3: Laurel: Yes. Babies want to be held and actually they need to be held in there. There is quite a bit of data coming out of the attachment parenting movement there. There's a lot of day you can actually find on birth psychology.org around how responding to children's early needs by picking them up, by responding to crying, by holding them actually does change the brain development and it helps them to actually be more independent children and it helps with their, it just helps optimize all things hormonal development and brain development and their feeling of being safe in the world.

Speaker 1: Nicole: Love it. Love it. Love it. Now before we get into some practical advice you mentioned at the end of your Ted talk kind of briefly about milk sharing. That's probably a whole other episode quickly. Would you mind sharing your thoughts about that?

Speaker 3: Laurel: Yes. So when a parent does not have the capacity or the ability to human make milk, feed their baby there, there are options, right? One is for them to use artificial milk, but a lot of families today have found that they have decided that they want to continue or start feeding their child human milk. And so one option is donor human milk. And if the child is in the hospital or the child is in the NICU, that is a very good option. But once they leave the hospital environment, accessing donor milk through donor milk banks becomes sometimes a challenge for many families, a financial challenge for many of them. And you also have to have a prescription for donor human milk. And so what we have seen in response to that is there are organizations really around the world that have banded together to help families connect with other families that have excesses of human milk.

Speaker 3: Laurel: And there is something called the five pillars of safe milk sharing and you can find that on the website eats on feets and it helps families to identify what the considerations are around if you are receiving shared milk from another family, you know there are a lot of things you can do. You can do self screening. Families are most of the time tested throughout pregnancy. So if you are receiving shared milk, you can always ask to see some of their blood work to feel more comfortable about receiving milk from that family. And you can also ask a series of screen questions. And then you also can do flash pasteurization at home if you want to go one step further at creating a little bit higher level of safety for using shared milk. But the reality is is that shared milk is something that we have seen literally for centuries, whether it was through wet nursing or whether families would simply just share milk.

Speaker 3: Laurel: And in other capacities, and, this is part of how our human culture has survived is through one feeding our babies human milk, but also community sharing when necessary. When a baby couldn't access, he'd be helped from their parent. And so there's no reason for us to fear it as much as we do today. I am absolutely for the safest practice possible and I'm absolutely for families going through that five pillars of a safe milk sharing. If they are considering milk sharing and they do need to go in it with their eyes wide open, you know, they want to minimize any risk to their family, but they also have to realize that a child receiving human milk is one of the best things they can do to optimize their child's longterm health. So yeah, I'm an advocate for families who are interested in it and I definitely support families educating themselves and making a decision that feels the best and safest for them.

Speaker 1: Nicole: Gotcha. Well, you know, I guess I had never even thought about the fact that I know wet nursing has a long history in this country, especially for black women. I mean that was like what they did, you know, way back when in slavery times for so many families. So, you know, so yes, there is this long history, but you're saying that it's appropriate, but do it safely and be responsible about it. Be informed about it,

Speaker 3: Laurel: Be informed about it. Yeah. And some families will use it just for a short period. Like, if they're experiencing a period of illness and their milk supply drops and they don't want to switch to formula, they can reach out to the community and do screening and, and receive milk. But we also see it, um, you know, there's some really beautiful examples of community sharing. For example, there is a story of a mother who went into a coma and her LA Leche league community all donated milk to ensure that that child would receive breast milk during the mothers, you know, hospital stay. And when she awoke from her coma and realized that her child had continued to get human milk, that was one of her ways that she healed emotionally from that experience. And of course, we also see families who are adopting children and wanting to human milk feed will reach out to their community until they can start to create the milk that they need. And sometimes they need extra milk. And sometimes we also see like same sex male couples will reach out to the community so they can have human milk for their adopted children, or the children that they've had through surrogacy as well. So there's a wide variety of options out there for families who need to tap into that sharing community.

Speaker 1: Nicole: Awesome. I love it. You know, again, another whole episode about how our society is so hung up on breast and like the way we treat breast and breastfeeding and looking at breast is not always ideal. So, and that's a lot of where the milk sharing phobia or overreaction comes from. So I appreciate you presenting like a clear, you know, advice and guidelines and, um, or the ways that families can do this and do so and feel good and safe and comfortable about it.

Speaker 3: Laurel: Yes. Yeah, absolutely. But I do also want to say, I mean when we're talking about children who are not well or you know, preterm infants, the gold standard is really to go through a donor donor milk bank that is through the Human Milk Banking Association of North America. So because screened and everything.

Speaker 1: Nicole: Yeah. Yeah. Good. Good, good. All right. So let's give, let's talk about some practical things that women can do. What are like two or three things that women can do either during pregnancy or right in the beginning to get off to a great start with breastfeeding?

Speaker 3: Laurel: Well, the first thing is just to trust their body, to kind of tap into the wisdom of their body and recognize that their body is throughout pregnancy, not only helping to grow and develop this little child, but it's also preparing her body to grow and develop her mammary glands to feed that child. You know, I like to think about conception and growing and having a baby as this, you know, extended period. It's not just about pregnancy, but in fact the body is designed to continue to nourish that child well beyond pregnancy. So to watch how their breasts are changing, to see how they become denser and notice how their aereola is become larger and darker. And the reasons for that is that it helps babies kind of find their target. So there are all these beautiful ways for them to tap into the wisdom that their body is preparing to feed and that can kind of help them in the postpartum period to realize that, yeah, my body is designed to do that.

Speaker 3: Laurel: The other thing is to tap into lactating communities. So there's no reason why you can't go to a league meeting or a local breastfeeding support group or online breastfeeding support groups while you're pregnant. In fact, it is encouraged and that's so that you kind of meet the parents who are already doing it. You start to hear about the challenges they are going through and how they work through that. And you also develop a community kind of beyond your small little family that you can tap into when you might have challenges with breast and chest feeding. So we definitely recommend that. And the third thing I would recommend is going to a preparation class, a breastfeeding preparation class and prenatally. And if there isn't one available in your community, there are some amazing breastfeeding books out there. One of my favorites is Breastfeeding Made Simple.

Speaker 3: Laurel: There are also some really good online classes that you can take. So even if you don't have something locally, there are ways to tap into educating yourself. And most of my favorite breastfeeding books are available in the library as well, so, so you definitely can kind of self-educate if you can't tap into kind of a group class.

: Nicole: Awesome. And do you have links to some of your resources on your website at all?

: Laurel: Yeah, on my, just on my basic resource page, I have a big area of kind of, you know, preparation for parents. So all sorts of things they can look at to kind of help them get ready for the, you know, the big experience.

: Nicole: That's okay. Perfect. Well we will certainly link to that in the show notes. Okay. So once women get started with breastfeeding, I always call breastfeeding kind of like a labor of love. It's not necessarily always straightforward or easy. So what are challenges or three common challenges that women encounter and what can they do to overcome them?

: Laurel: Sure. Well, one challenge that we do actually see for 90% of all postpartum parents is that they may experience some degree of breast or nipple tenderness. And that's relatively normal considering all the hormonal changes that are going on. And the fact that for some people that breasts have never done this role before, so that's normal. And so understanding the difference between normal tenderness and when it goes into pain, which is something that we do not want to anticipate and make sure that we have someone, you know, they get intervention very quickly if there's pain because pain can mean there's some other things going on either with baby's mouth structure or with latch or, or some other things.

Speaker 3: Laurel: So that's one. The other thing that some families kind of bump into is just exhaustion. Exhaustion is very real. You know, the average labor is more than 24 hours for a first time parent. And so that does not set you up for feeling really, you know, full of energy, right? After exhaustion is a real thing. And so connecting with your community to find out how are you going to deal with without exhaustion, postpartum, is it just the mom? Is it from the mom? And her partner is, you know, is there a grandparent that can come into the home? Do they have access to postpartum doulas? Do they have a church or good friends that could come in and help kind of alleviate some of maybe the household work or other things so that the mom or lactating parent can just focus on feeding and sleeping and doing the things they need to recover?

Speaker 3: Laurel: Because exhaustion plays a huge role in that. And then the other challenge is where do they go when they have questions? Because every new parent has so many questions about this period of feeding their baby. And so during pregnancy, a way to alleviate that stress is to tap into your community resources ahead of time. Find out if you're having a hospital birth, where's your hospital recommend you go? Do they have breastfeeding support groups? Do they have lactation consultant? You know, do they have free resources for you? Do they have a hotline or a warm line that you can call and if it's not through your hospital system, say you're having a home birth or your hospital system doesn't have it, what is local in the community? Do you have La Leche League, do you have Breastfeeding USA? Does your public health department offer a warm or a hotline for you to call? So there are resources out there that you should already have set up. And one of the things that we would do in my breastfeeding classes is we would create magnets that were on the fridge so that anyone who's helping to support the parent had all those resources right there in times of need. So you didn't have to go online and start searching or going through all your paperwork. It was all right there on a magnet for them.

Speaker 1: Nicole: Gotcha. Gotcha. Okay. So when do you recommend, you mentioned a lactation consultant, when do you recommend women seek the advice or help? Whether it's free or offered by the hospital or even a paid lactation consultant?

Speaker 3: Laurel: Yeah, so when, when they need help. I mean we have, there's so many different amazing lactation support professionals out there. We have peer support professionals and so you'll find peer support, which means kind of they've been there and done that. So they're going to connect someone with you who is in a similar circumstance. Like that's what La Leche League is all about. It's other mothers who have breastfed before for I think they had to have breastfed for at least a year. And then WIC, peer support, you know, their parents who have used WIC services and have breastfed their children and understand how to support families. You know, there's also NICU peer support groups that they can go to. So that's kind of the first level of when you have questions and you need lactation support, you can go to your peer support providers.

Speaker 3: Laurel: The next level would be if you want education or like more community support, there are levels of professionals like certified lactation educators or lactation specialists that can help and provide some additional information. And then you have clinicians, which are board certified lactation consultants. And they're really there when you're having clinical issues. They can do all the other things too, but they're there to help when you know, support a family through kind of a tongue tie experience or help a family who is experiencing and gorgeous or help a family who may have mastitis, you know, they, they will work with your healthcare provider throughout that experience and also can help identify some, some issues that families may be having to help them get through and meet their, their personal breast and chest feeding goals.

Speaker 1: Nicole: Got it. Now and I hope we're not given the impression like you need to spend 40 hours researching and doing all your resources. It sounds like you can spend, you know, you take a a class which may be, what's the average one or two hours or maybe longer, I'm not sure. And then like another, you know, a couple hours just like calling the hospital and filling out, looking at resources, looking at in your community, this doesn't have to feel like an overwhelming task.

: Laurel: No. And that's the benefit of kind of going to one of those community breastfeeding classes that they've already done that research for you. So they often will give you the handout that you're going to put on your refrigerator that has all the resources. So you don't have to do it. That's just if you don't have those resources in your community, you'll need to do a little extra footwork. But yeah, most breastfeeding classes are one to three hours and you know, the reality is what they're going to focus on is understand, you know, you want to understand the anatomy of how, how your breasts work. You want to understand how to optimize things for yourself in the first few hours, like skin to skin and how to help get in good positions so that your baby can get kit the best latch possible.

: Laurel: And then how to transition home and really have the most supportive environment possible. So you don't have to have a degree to breastfeed, you know, your body is designed to do this. And the reality is babies are equipped with all these fantastic reflexes that have designed them to know how to feed, to find the breast on their own, to latch on their own, to even move milk. Like they have all these reflexes in their hands that are designed like, you know, a lot of people say, well you know, put the baby's hand down the breastfeeding. No babies need their hands, their hands help them feed and their hands also helped release milk from the breast. And so babies are designed to do it, you know, pregnant parents and moms are designed to do it. It's something that is natural, but there is an element of kind of guidance and learning that is also really, really helpful. You know, we, we definitely want to encourage that, but also know that your body and your baby is designed to do this.

Speaker 1: Nicole: Right. Right, right. I would guess probably the other biggest transition is for women who work outside of the home are, you know, or are away from their babies. What kind of resources and recommendations do you have for them?

Speaker 3: Laurel: Yeah. So for parents who work outside the home, the first thing I would say is, is try as much as you possibly can to get breastfeeding firmly established before you start to engage a breast pump. And that's because adding additional technology, if you don't need it, is a little overwhelming. And at least a week before you were returning back to work, 10 days of possible you want to get your pump out, learn how to use it. Or if you're hand expressing, you know, start learning, you know, really get good at that. And once a day on the first day, you know, express with your palm or your hand and you can store that milk or you can feed that to your baby and then the next day add in another pumping session so that by the time that you returned to work, you have added in a few pumping sessions a day so that you're comfortable and familiar.

Speaker 3: Laurel: You have a very small supply, you don't have to have a huge fridge supply of milk. And what I really recommend to parents is if possible that they returned to work a day early than they are supposed to. And it's a day that no one's expecting them to be there. If they have baby going to grandma or a friend or daycare, they've set that up and this is their trial day. So they get up, they do all the things they're going to need to do for work, get their baby ready, feed their baby at home right before they leave so the baby's happy. At drop-off if possible, feed the baby right when you drop them off and then go to work and you're only going to do a half day, but you're going to figure everything out on that day.

Speaker 3: Laurel: People aren't expecting you to be there, so you're not going to have a whole bunch of tasks and, and figure out where are you going to pump, where are you going to store everything so that you have that all on your doubt and then you can pick your baby up. You know, you've only gone for half a day if possible. Pick your baby up, feed them at daycare so you have a happy ride home and when you get home you can go, well all these things were challenges. How am I going to work this out before I returned to work officially? So it's just kind of this trial day so you can work out kind of the things that are going to be the weeds for you before you actually go to work. And that can really ease ease the stress and ease the transition.

Speaker 1: Nicole: Well that is an amazing idea. I don't think I've ever heard that before. That is really, really great advice. The other thing I would say that just kind of popped into my mind is that sometimes you have to go to more than one place for help. Just like you may have a care provider who doesn't necessarily give you the help that you need. I would encourage women, if you encounter a peer or a lactation consultant who you don't click with or you feel like you know it's not really helping you, then please try and find someone else.

Speaker 3: Laurel: I completely agree with you on that. I mean, and the reality is feeding your baby, you know, is it's such an intimate experience and allowing in a support provider into that relationship is very intimate as well. So you want to feel comfortable with that person. You want to feel that that person is listening to you, that they're meeting your needs. And if that doesn't feel good to you, you absolutely have the right to move on to say thank you for your care. I'm going to find some additional care.

: Laurel: And that's actually, that's a really good parenting tool to learn because you are going to have be your advocate and your child's advocate forever. You know, so it's starts in pregnancy and you know, as you're lactating, you're going to learn that as well. If this doesn't feel right, if your intuition and gut is telling you, I need to move on, move on, find someone else. The beauty is that a lot of people who get into this kind of perinatal support world, they are, they're so desirous of supporting families that it's not hugely common that you're going to find someone who's not willing to listen, but sometimes there's just not a direct connect there. So you do want to make sure that you feel, you feel comfortable receiving those services.

Speaker 1: Nicole: Yeah, I agree. I think, to be honest, where I've seen sometimes where there's a disconnect is from more marginalized communities seeking out help. Yeah.

Speaker 3: Laurel: Yeah, I absolutely agree. And you want to make sure that families are tapping into, you know, culturally competent lactation care as well, you know, so that again, that's another reason why in during pregnancy you want to find out who in your community you're going to click with, who in your community can provide the services that are going to be most beneficial to you.

Speaker 1: Nicole: Yeah, yeah. And I'll be more specific. By marginalized, I mean like racial and ethnic groups or income differences, those kinds of things. So whether it's a black woman or a Latino families or, sometimes run into challenges. So as you said, culturally competent and connection is important.

Speaker 3: Laurel: Definitely. And if families are receiving WIC services, WIC programs do have peer support programs to connect families with kind of a one-on-one support provider throughout that, throughout that experience. And that's a free service that they can tap into in addition to the other breastfeeding support services. Some of them even have support groups for partners as well at the WIC program. So it really, it's very regional what's available. But definitely they should tap into that if they qualify for WIC services.

Speaker 1: Nicole: Okay. Okay. And just to end one last question before we ask some final wrap up, cause we're, gosh, we're almost getting to an hour here. You've mentioned that you were doing equity work. What does that mean for you? What is that about?

Speaker 3: Laurel: So equity work for me is making sure that families, all families receive the services that are, that will help them optimize their family experience and the health for their family. And equity work primarily is focused on marginalized communities and communities that lack resources are in food deserts or also in healthcare, healthcare deserts. And primarily we are focused on work for communities of color. So I served on the board with the United States breastfeeding committee for three years and that was, that was our focused work was equity work. And we were really primarily focused on ensuring that that communities of color were being heard and that we were increasing the amount of services and culturally competent care where needed. And that work is ongoing with the United States breastfeeding committee and with health departments all around the country and breastfeeding organizations all around the country. Because we do need to make sure that, that families who are marginalized, that we lift them up so that their voices are heard and we are listening to their needs.

Speaker 3: Nicole: Yeah, absolutely. Absolutely. So just just to finish up, what is the most rewarding part of your work?

: Laurel: You know what, it's, it's just being able to be an observer of that connection between parents and their babies. I mean, there is never a more heart opening time then when, when you see, you know, a baby breastfeeding and the parent relaxing and their partner kind of like, you know, knowing all is okay in the world because we are this little new family traveling into the world. And I just feel very humbled when I have the opportunity to, to view that, to support that. And I'm very, very grateful for the work that I've had an opportunity to do over the past 30 years. And it is my hope and my intention that I can create more opportunities for families to tap into the resources they need.

Speaker 3: Nicole: Yeah, absolutely. Now on the flip side, what's the most frustrating part of your work?

: Laurel: To be really honest and not to be too serious here, but to realize the huge gaps in our healthcare system, it's incredibly frustrating when, when I hear about families who can't access care, particularly in our migrant communities and low income communities and certainly in communities of color, when we, we find that the enormous, both healthcare gaps and just plain resource gaps, it's frustrating and it creates a huge amount of anxiety. I would say that, yeah, I can totally relate to that. We have some issues with our healthcare system and several ways and some differences and things that we need to work on. So yeah, I totally get that. So, so what's your favorite piece of advice to give to people about breastfeeding? My favorite piece of advice is to trust your intuition and to trust your body.

Speaker 3: Laurel: You know, when things don't feel right, find some help. You can do that online. You can do that through your healthcare system. You can do that through your support groups and also trust that your body is prepared to do what it needs to do. You know, the majority of pregnant bodies can fully, you know, only less than 1% have some sort of anatomical issue that would prevent them from doing so. But of course we do have some other things like some hormonal issues which may be temporarily, cause some temporary challenges. So you have the capacity and if things are challenged, you know, reach out, reach out to your community to get to get some support. Don't be afraid to reach out.

Speaker 1: Nicole: Awesome. And speaking of reaching out, where can people find you?

Speaker 3: Laurel: I am at www.motherjourney.com on my website and on Facebook I'm Mother Journey. Laurel Wilson is my handle and Instagram is the same thing. Mother Journey Laurel Wilson. So reach out, share your experiences and let me know if you need some resources to tap into, I'm always happy to help families out.

Speaker 1: Nicole: Awesome. Well thank you so much Laurel for agreeing to come on. This was an absolutely fabulous episode. Tons of great information. I really, really appreciate it.

Speaker 3: Laurel: Thanks Nicole. It was such a pleasure.

Speaker 1: All right. Wasn't that fascinating and very informative? I so enjoyed that conversation and learned a lot. Now, after every episode where I have a guest on, if you've been listening, then you know that I always do something called Nicole's notes where I talk about my top three or four takeaways from the conversation. So here are my Nicole's notes from the episode and the conversation with Laurel.

: Number one, some breast milk is better than no breast milk. So what ever amount you are able to do is great. Even if you do a little bit in the beginning and then stop after that again, every amount is great. Also don't feel guilty if you end up having to supplement. With my first daughter, she was a NICU baby and I had to supplement with formula just in order to help her grow. And then with my second daughter, I just had trouble with breastfeeding and milk production, so I had to supplement with her fairly on as well.

Speaker 1: I know I certainly experienced some guilt about that even though they're both perfectly normal, healthy and happy now. But at the time, you know, it can feel a little bit difficult and a little bit like you're a failure, but just remember that some breast milk is better than none and whatever you're able to do is great, so don't beat yourself up about it in the process.

: Number two, I really appreciated Laurel's discussion or recommendation about skin to skin contact. I talk a lot about it in the context of the golden hour after birth and how it's important, but I don't think we emphasize it enough about how it can be important even after that and for the longterm as your baby is growing up. Remember you can't spoil a baby by holding them too much. It is not possible and that skin to skin contact is just for temperature regulation for connection. It feels nice for both you and for the baby. It's something you can do. Your partner can do. Other children can do something you can do even if you're not breastfeeding. You can do it during bottle-feeding as well, so remember to do that skin to skin contact even after you go home.

: Number three, education and community are really important with breastfeeding. Breastfeeding is not normalized in our society even though actually most women, over 75% of women will at least start breastfeeding. It's still not a normalized part of our society. Some of us have never seen anybody breastfeed. People get all squeamish about seeing breast and breastfeeding, those kinds of things. So it's really important to be educated about it and then have some community surrounding it to support you along that journey. So I'll link to some of those resources in the show notes that Laurel mentioned about online communities and things that you can find in order to find that education and community.

Speaker 1: And the education again doesn't have to be overwhelming, doesn't have to be like hours and hours and hours and hours and hours. A lot of it is ongoing education, but you definitely want to have a basic foundation to get yourself off to a great start.

: And then number four, the final thing that I say is I always tell women that breastfeeding is a labor of love. You do it because you do enjoy it, but you also do it because you want to do what's best for your baby. But it can certainly be work. It's not necessarily something that's easy or straightforward and as you continue to do it, the longer you do it, the truth is a lot of your schedule in life will revolve around breastfeeding because you have to figure out like when's the next time I can pump, where am I going to store the milk? It's all worth it, but don't feel guilty or feel bad if you have some of those. Oh my God, this breastfeeding is a lot because it is a lot. Not all of it is, you know, roses and unicorns. But in the end it is enjoyable and a great thing for your health and for your baby's health.

: All right, so that's it for this episode of the podcast. Do not forget to hop onto my email list so you can get that weekly newsletter with a dose of information to help you have that beautiful pregnancy and birth, helpful information and tips about pregnancy, inspirational quotes, links to the latest podcast episode. You can hop onto the list at www.ncrcoaching.com/email. It'll help you step back from that social media a little bit, something that we all need to do. Also be sure to subscribe to the podcast and Apple podcast, Spotify, Google Play or wherever you listen to this podcast. And of course I would appreciate it if you leave a review particularly in the Apple podcast, that helps other women to find the show, helps the show to grow and I do shout outs of reviews on episodes. So I would be most appreciative if you'd leave me that review and of course subscribe while you are there next week on the podcast, I am talking about a topic that I have gotten so many requests to talk about. That is labor induction. So do come on back next week. Until then, I wish you a beautiful pregnancy and birth.

: Thanks so much for listening to this episode of the all about pregnancy and birth podcast. Head to my website at www.ncrcoaching.com to get even more great info including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class on how to make a birth plan as well as everything you need to know about The Birth Preparation Course. Again, that's www.ncrcoaching.com and I will see you next week.

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