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How Do You Know When You Should Stop Breastfeeding?

For me, I wanted to finish lots of times, but I felt it was my duty to breastfeed as long as I could. Not everyone feels that way, and that’s ok. This is just my story.

I didn’t feel like I could stop breastfeeding any more than I could suddenly decide to stop changing nappies or giving hugs. These things are all a part of parenting for me.

When I wanted to quit I just accepted I was having a hard day, but kept going and found things changed for me soon enough. I got through my bad days and made it to the good days again.

When my son was about 2.5yrs old, I was pregnant and really hating breastfeeding. I was suffering aversions and nipple pain, and hormonal aversions that we’re making me think bad things, so I night weaned him.

Night weaning gave me enough space (and sleep) to enjoy breastfeeding again. I also felt gratitude to my son for giving me that space and this appreciation made it easier for me to feel positive about what was left of our breastfeeding journey together.

Then when my second daughter was born, I needed to put more boundaries in place for my son. These boundaries were steps towards weaning, but to me, I was preserving the breastfeeds we had left. I wanted to approach them with love, not dread.

At the end of the day, everyone will share their personal stories, but I hold the World Health Organisation’s recommendations to breastfeed til at least 2 in very high regard.

Ultimately my son stopped breastfeeding when he was 5.5 years old, and my daughter (who will be 3 in a month is going strong with no end in sight.

But at the end of the day, you know your own story better than anyone else. It’s not up to anyone to give you permission to stop – to be ok with your decision, you need to give YOURSELF permission to stop. I’ll support you whether you decide today is the day, tomorrow, next week or next year. But you need to be the one who makes the decision.

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“Facebook Punished Me For Trying To Help Breastfeeders” – Kerryn’s Story

Breastfeeders in Australia suffered a huge setback this week.  Kerryn Gill-Rich, one of our support group’s most active administrators and prolific commenters received a Facebook ban for sharing links to a Nipple Blanching (Vasospasm) article on the Kellymon website.  After repeatedly pleading for common sense from the Facebook team, her case has been closed.  It would appear Kerryn is now receiving a 1 week ban for each instance she has shared the link.  To see a gallery of the communication between Kerryn and Facebook, please click on this link.
It only takes a quick search on Facebook to find a flood of sexual and graphic content.  We will never understand why Facebook is so selective with the way they police comments and posts, or why they seem to be so bothered by breastfeeding.
With very little opportunity to take this further, Kerryn has written a letter to Facebook for us to publish.
“Dear Facebook,

I’m cross. You and I were onto something. You and I had a great thing going. You and I had helped 30,000 breastfeeding women to find success in nourishing their babies and reach their breastfeeding goals, however long that may have been. We have talked them through sleep deprivation, poonamis, and puke down their backs. We have shared our stories and cried with people that are standing on the edge of their threshold as a parent because things weren’t going to plan. Maybe their expectations weren’t realistic or maybe the well-meaning advice they had received wasn’t working or maybe they had too many nights in a row with no sleep, crying baby and burning nipples or many, many other reasons why those early days of parenting can see us crash and burn and feel like we are alone.

I’m a lactavist. I’m passionate about helping women that WANT to breastfeed. I don’t tie myself to trees or march in the street but I do make myself available to friends and family as well as perfect strangers that reach out for help….. UNTIL THIS WEEK.

Nipple blanching and vasospasm

I posted this article (above)in a response to a mum who was experiencing nipple pain when breastfeeding.  She had reached out in a BREASTFEEDING SUPPORT GROUP. She was about to give up due to the lack of help she was receiving. She didn’t know what was causing her pain and she didn’t know how to fix it. My advice was not unsolicited, it was factual and medically sound. It  directed her to relevant online as well as real world help. The offending article is written by an IBCLC qualified lactation consultant and has medical based information regarding vasospasms. It also contains 2 photos of a blanched nipple for reference.

I received a notification that this was not appropriate content for Facebook and was banned for a week as a result. This happened twice as I’ve shared the article more than once so I suspect there will be more bans in the pipeline. Yet, a quick search and I can find Karma Sutra positions with links to videos, topless beach babes with a poorly placed scribble across her nips, vibrators and many other pages with similar, sexual content. These are all still in place as of this morning. I can join these groups and buy these products and services. I can even link up with a group that do live sex both using Facebook live OR if they get in trouble for that, they advertise ‘plan B’ which is a whats app group… all with Facebook’s blessing. Yet I can’t link an article to help a mother feed her baby.

Breastfeeding is in no way whatsoever sexual. It is simply feeding a baby in the most natural way possible, yet breastfeeding information is not in line with community standards? What is it exactly that’s so offensive about breastfeeding? Given the amount of daily dinner plates that are posted on timelines, it can’t be the FEEDING part that is of concern! But using THAT theory, the amount of breasts in timelines probably beats the pants off the butter chicken or steak and potato plates posted….. so I’m stuck! Is it the baby? Nope, they feature pretty predominantly on timelines too!!


Yours in confusion and utter frustration
Kerryn Gill-Rich”

Many people from our breastfeeding community have expressed shock, confusion and disappointment at Kerryn’s situation.  Here are some direct quotes:

Tyler Enaj – I was also reported and photo deleted

Krystal Jane

The advice and support you give mothers is invaluable and I’m sure many other mothers can attest to that. To ban you for sharing breastfeeding specific information in a breastfeeding group is just absurd

Kristy Benson

This is so infuriating!!!
A man who is a body builder stole pictures of my children & posted them to his 40,000 followers and it DID NOT go against Facebooks community standards! What the heck is wrong with Facebook?!?!
  It’s really hard not to be a ranting feminist when it’s so clear the Facebook is ran by misogynists and the patriarchy is cool with women being naked as long as we are giving sexual satisfaction to men.  Over 200 people reported my issues (pictures of my children, my name and location) but that didn’t even matter.

Facebook claim to support breastfeeding, but actions speak louder than words.  Have you ever had a breastfeeding photo reported or taken down? 



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Can Anabella Live Up To The Hype?

My newsfeed has been flooded today with a video about “Anabella”, a new kind of breast pump.  The video comes from Indiegogo, which is a crowd-funding website that help people raise money to kick start their projects.  In this case, Senia Waldberg from Tel Aviv, Israel, wanted to return to work, but it would appear she couldn’t find a breast pump that worked well for her.

Her pump, Anabella, appears to be a rechargeable, single-breast pump that has a patent-pending design that tries to mimic the perstaltic movement of an infant’s tongue during breastfeeding, rather than creating suction using a diaphragm.

Please let me preface this post by saying I think this is a marvellous idea in theory.  The way breast pumps operate is very different to the way babies breastfeed, and this will always be a barrier for many women to express.  I have a lot of respect for anyone who tries to fund their own product.  I have written before about working with Pumpables, promoting their Milk Genie breast pump.  I have seen what the competition is like among breast pump brands, and I sincerely wish Senia Waldberg the very best when it comes to meeting her goals of mass producing her pump and getting it global.

The pitch video makes some big claims that seems to have excited the breastfeeding community, but I have some concerns.

  • At the start of the video, it is claimed that most breast pumps only remove up to 60% of breastmilk from a breast.  Besides the fact that I have never seen this figure before, I know from personal experience that all pumps operate differently, and that different women respond to different pumps, differently.  I don’t know where that 60% figure came from, but if anyone can send me links to reputable info supporting this, I’d love to see them.
  • The video claims that this problem is entirely down to the shape of the suction cup (or breast shield, or flange, or whatever you know that part to be).  I really struggled with this claim.  There are so many factors that can impact how effectively someone can drain their breast while pumping – personal comfort, mental state, the physical environment around you, whether you have a double or single breast pump are a few – blaming poor drainage solely on the design of a pump oversimplifies a complex issue.
  • My biggest worry is that the pump can supposedly remove 100% or “close to 100%” (depending on where you look) of the milk stored in a breast.  Many breastfeeding experts, including Kellymom, tell us that “milk is being produced at all times, so the breast is never empty”.  The claim that this pump can remove 100% or so of the milk from a breast isn’t in line with my understanding of the way breastmilk production works.
  • The video alludes to the claim that pumping will decrease your supply, because 40% of your breastmilk is left remaining in your breast, making your body think that it’s making more milk than necessary, and therefore telling it to make less milk.  While some breast pumps may contribute to a decrease in milk supply due to an inability to extract breastmilk appropriately, factors such as pumping technique, frequency, duration and what kind of pump you’re using are all important factors. In my own experience, once I knew what I was doing, pumping increased my supply.  Given that many breastfeeders are advised to embark on a pumping routine to increase their supply, it would appear I’m not alone in my experience.
  • Additionally, Senia tugs at our heartstrings when she tells us her daughter was “hungry and mad” because 40% of her mother’s milk was left in her mother’s breasts and Senia felt frustrated because there was nothing she could do.  As a mum who has had to express while working fulltime, I disagree that there was nothing she could do.  Pumping more frequently, breastfeeding more frequently or breastfeeding instead of pumping are three options that can be explored when pump output is low.
  • The idea for Anabella was apparently borne from “hours” of research.  I don’t know if there has been a language barrier, but a few hours of googling doesn’t do the conundrum of how to make the best breast pump anywhere near enough justice.

I don’t want to completely tear down what appears to be an innovative start-up, but all of the hype surrounding the video has made me want to put my hand up and gently suggest that we need to calm down and look at this critically.  If I were to invest my money in the best breast pump ever, I would want to know that the people making it had a lot of experience in other breast pumps, a high degree of knowledge about how breastfeeding and expressing work, and the ability to produce it well enough to deliver on it’s promises.  For now at least, I think I’ll keep my money in my pocket.

Have you seen the hype over Anabella?  What are your thoughts?

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The Choice To Breastfeed

When I was growing up, everyone in our family breastfed.  No one asked the pregnant lady if she planned to breastfeed, because it was taken for granted that she would.  When I was pregnant with my first child, I didn’t really decide that I would breastfeed – there was no decision to be made about it.  Breastfeeding is the normal way for families to feed their kids.  If I couldn’t breastfeed then I’d cross that bridge when I came to it, but I’d seen breastfeeding work lots of times and I had to reason to believe that I wouldn’t be able to do it too.

I never seriously considered choosing to stop breastfeeding either.  I had some epic problems establishing breastfeeding, but I had faith that I would get through it, because I’d seen other people get through the same problems before.

I never felt like breastfeeding was a choice.  That probably sounds bad, like I felt forced to breastfeed, but it wasn’t like that.  I didn’t need a thought process behind a decision, there was no list of pros and cons.  Breastfeeding is the normal way to feed our babies.  I just did what needed to be done.

I look at changing nappies in the same way.  I can’t choose to change nappies or not, it’s a part of parenting.  My kids need their nappies changed, and I would neglecting to meet their most basic of needs if I chose not to do it.  If I was physically unable to change their nappies for some reason, then I’d be forced to find an alternative solution – a costly and inconvenient solution that other people would be shocked I’d have to go through.  They would probably be impressed at the great lengths I’d go through to do something that other people could do easily, and seeing me go through such a rigmarole would make them grateful for their natural ability to change nappies the normal way.

That’s how I look at families who can’t breastfeed.  I am wowed by the struggles that they’ve overcome, and concerned about how are coping mentally with being unable to do what they had hoped.  I’m shocked at how expensive bottles and formula are, and I’m blown away by all the effort they have to go through to get it done (the handwashing, careful measuring of scoops, sterilising, boiling water, washing extra dishes, etc – it’s a big workload!).  And ultimately, seeing a family who can’t breastfeed makes me very grateful for my own ability to do so.

Growing up in a family where breastfeeding was normal, I can’t imagine why anyone would ever choose not to breastfeed, because from where I’m standing it’s much easier than other feeding methods.  I know that most people don’t see it that way because they didn’t grow up the way I did.  But as we continue normalising breastfeeding, and helping the broader community see more happy breastfeeding relationships, one day things might be different.

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Annual Breastfeeding Education For Nurses

Yesterday I had the privilege of attending the local Annual Breastfeeding Education seminar with the Child & Family Health Nursing Services at Maitland Hospital, NSW.  The seminar was presented by the Breastfeeding Interest Group – that’s right, there is a team dedicated to making sure our local Community and Family Health Services Nurses have relevant and up-to-date knowledge about breastfeeding.

3 families came to talk about their own unique experiences, and 2 case studies ere presented.  The main themes throughout the day were making sure tongue ties were referred for assessment as early as possible, maintaining breastfeeding through weight gain issues and the importance taking detailed notes from the very first meeting to assist with identifying mental health issues.

There was also a strong focus on referring families to allied health services, with a speech therapist and pediatric physiotherapist present to weigh in on each of the case studies.  The importance of having a list of experienced professionals who could assess and correct tongue tie issues was also raised more than once.

I was absolutely thrilled with the accuracy of the information presented.  The level of breastfeeding knowledge from everyone who spoke was brilliant.  When the speech therapist talked about how she checks a baby’s attachment and watches a breastfeed before encouraging weaning from nipple shields, and when the pediatric physiotherapist talked about using different breastfeeding positions to assist the treatment of torticollis, I actually wanted to cry happy tears.  One of the nurses presenting a case study talked about how she wanted to watch a mum breastfeed to troubleshoot problems but the chairs weren’t supportive enough and didn’t accommodate the plus-sized mum well enough.

In Breastfeeders in Australia, sometimes breastfeeders share negative experiences with local nurses, and express frustration about a lack of breastfeeding knowledge.  The women at the seminar yesterday were acutely aware of the problems breastfeeders face, and they had excellent tools for managing them.  They were very keen to learn more about how to better serve families too.  It felt really really good to be a part of a movement to improve this gap in our health services.  I’m very keen to see the practices discussed yesterday become commonplace across the board.

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My Stance On Tongue Ties

People often ask me what my thoughts are on tongue ties – specifically whether or not I think they are over-diagnosed, whether I think they are a fad, and what I think of professionals who deny their existence.

Well here it is.

Some people are tied and some people are not.  We should have professionals we can trust to assess and correct ties, and assist and support families through the recovery process so they can feed (and live) normally.

In an ideal world, this would be all I would have to say.  Sadly, there is a lot about the way tie issues are handled that are not ideal.

I’m tired of feeling like tie issues are political. I’m tired of feeling like I need to say which team I’m on. When it comes to breastfeeding support, I think we should all be on the same team.

I’m tired of the issue of ties being so contentious that I have had to alter my language when I’m troubleshooting breastfeeding problems with other families.  I feel like if I say “have you considered ties?” I might start a huge drama, basically where a bunch of people with loud opinions and an inability to listen to others join in the conversation to essentially embarrass themselves.   Instead I find myself saying “Have you considered having your baby’s oral function assessed by a health care professional who is experienced in the way oral structure can affect breastfeeding?  Some babies have physical deformities in their mouth that prevents them from breastfeeding effectively.  Sometimes these deformities require surgical correction”.  It’s convoluted and nonsensical, but I find myself feeling like I need to skirt the issue to avoid world war 3.

If ties are being overdiagnosed, then that’s a huge problem.  And if they are being underdiagnosed, then that is also a huge problem.  But the language people are using around these discussions, and the suggestion that families are irresponsibly seeking surgical treatment that’s unnecessary, is perhaps an even huger problem.

When I read posts about about ties being a fad, or that they are being overdiagnosed, and that online support groups are contributing to the problem, I feel like I am being blamed because my kids had ties, and having them surgically corrected had a positive impact on both of my breastfeeding journeys.  I feel like I am being accused of making this perceived issue worse because I tell other people about my situation, and encourage them to investigate whether they are facing the same problems I faced.  I have felt scorned for talking about my experience, and that is wrong.

Whether a family is being affected by ties, or whether they only think they are being affected by ties, the bottom line is that they have a problem that warrants investigation.

I’ve seen a lot of posts and articles published by medical professionals about ties that really concern me.  The language used ranges from dismissive and patronising (as if accounts from individual families are irrelevant, as if their successes and failures are meaningless and as if they’re so stupid that they don’t even know what did or did not help their breastfeeding journey) to alarmist (implying negligence or abuse for either seeking or failing to seek surgical correction).

If you’ve promoted a strong opinion on whether tongue and lip ties are a fad, whether they are over or under diagnosed or whether mum-to-mum social media interactions are creating mass hysteria, then perhaps you need to think about the consequences of that, and what your ultimate goals are.  Do you want to make parents afraid to talk about their experiences because they don’t match your own?  Do you want to make political statements and criticise your peers?  Or do you want to help families breastfeed.  Every family is unique, and we would do better to focus on the individuals in front of us, instead of making sweeping statements about what is a very broad and diverse group of people.

Our community of breastfeeding advocates is too small to be divided over this issue.

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3 Things To Say To Someone Who Is Worried About Their Milk Supply

It can be hard to know how to support someone who is having concerns about their milk supply. You may be aware that a lack of milk supply is actually very rare, but hearing that when you’re worried you’re not making enough can feel dismissive too.

On the flipside, going on a long-winded explanation about the process of supply and demand can feel overwhelming to the parent who is probably already feeling confused enough, as well as tired and stressed out.

And suggesting an introduction of formula, a full-time switch over, or early solids bring their own set of problems along. Additionally, lots of breastfeeding support groups (like Breastfeeders in Australia) have rules about not suggesting formula use to a parent who is committed to breastfeeding. You can read more about why we have this rule here and here.

Here are 3 things that I like to say:

  • How is nappy output?  When my son was a newborn, I remember ringing my IBCLC/Midwife, distraught that my son hadn’t had enough milk that day because he was crying and looking for more milk.  She asked me to think about how many times I’d changed his nappy that day.  Um, OK, well I wasn’t keeping track, but it felt like about a million, because he was a peeing, pooping machine.  And the penny dropped.  All of those wees and poos weren’t being created out of thin air.  The Australian Breastfeeding Association suggest that if your baby is having “at least 6 very wet cloth nappies or at least 5 very wet disposable nappies in 24 hours” then that is a good sign they are getting enough milk.
  • Have you thought about seeing an IBCLC?  An International Board Certified Lactation Consultant (IBCLC) is a health care professional with a specific focus on breastfeeding.  If you are having supply concerns, an IBCLC is the best person to talk to about whether supplementation is necessary, what the best way to offer it will be, and how to balance offering supplementation without unnecessarily risking your longterm breastfeeding goals.  Just as you would talk to a dietician about planning a healthy diet, or a personal trainer about the best way to improve your fitness and strength, an IBCLC can help you with any aspect of your breastfeeding journey.  The Lactation Consultants of Australia And New Zealand (LCANZ) can help you find someone close to you.
  • Have you thought about ringing the National Breastfeeding Helpline on 1800 686 268?  Here in Australia, we have a a free helpline with trained breastfeeding counsellors available 24 hours a day, 7 days a week to talk to families about feeding issues.  These counsellors have a minimum Certificate IV qualification and have the right skills to not only talk about the technical side of breastfeeding, but to also communicate in a supportive manner.  While their training is not to the same standard as an IBCLC, they are accessible to everyone and they have more breastfeeding experience than the average fellow parent you’d come across in an informal breastfeeding support group.  If you need help, but aren’t sure if your problem warrants a booking with an IBCLC, calling the National Breastfeeding Helpline is a great option.

There are lots of other things that MIGHT help – expressing, offering top-ups via a cup or syringe, breastfeeding more, skin contact, special cookies and other recipes and medication – but they also MIGHT NOT help either.

We’ve all heard at least one horror story of a baby who’s health was placed at extreme risk due to malnutrition because supplementation was not given when it should have been.  But if you join any community of families, you will also find many who’s breastfeeding journey had an untimely end because of unnecessary or inappropriate supplementation.  We can avoid both of these situations by making sure families have access to factual information and qualified people to support them.

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Milk Production – What All Breastfeeders Need To Know by Maureen Minchin

Maureen Minchin BA(Hons), MA (Melb), TSTC is a medical historian and health educator, and author of Milk Matters.  She is all that, AND she is an active contributor in our Breastfeeders in Australia community on Facebook.  Maureen recently sent me this post and asked me to share it far and wide, so I’m uploading it onto our website to facilitate that. 

Maureen is a very educated person, and some of the language used in her post may feel overwhelming.  I can not stress this enough – if you have questions, please ask, as we are all learning, and we are all here to help each other.  You can comment with questions, you can email us at or you can join our Facebook group and post there.

“The basics: hormonal stimulation + emptying of milk from breast
Obviously you need to allow baby to feed as needed.
And feeding must be effective and no obstacles put in the way of milk drainage.

Stimulation creates and maintains a basal level of prolactin, essential to getting increases in supply from birth, and later if supply has dropped . (But by three months a happily breastfeeding mum’s basal prolactin levels are comparable to a non –lactating mum – it is the repeated bouts of sucking-stimulated prolactin level rises that does the job of enabling lactose and so milk production, with prolactin returning to baseline in between if intervals allow).

Initially breasts overproduce, and then supply drops down to the level of milk taken on a daily basis. Lactation is energetically expensive, and thoughout human history women have never been able to afford to waste energy. So volume is regulated by need, and responds rapidly to change in demand. How?

Regulatory controls are within the breast itself. If a feedback chemical (FIL) reaches a certain level in the breast, it signals that milk is not needed and secretion is inhibited, and eventually stops.

The second internal down-regulator is high pressure. If enough pressure flattens the rectangular-ish secreting cells, then they stop work; over time they regress and disappear. That can be a local or a whole breast pressure. So habitual finger pressure that prevents drainage from one area, or an underwire bra that sticks into a particular spot, or surgical scarring, or a tight crop top, can have an effect. As can over-distension because of too long a gap between feeds from a breast. Or from sleeping/lying on one’s stomach, OK for some mums, hopeless for others (check out massage, might be best not to be too long facedown, and much massage can be done seated). If pressure gets high enough, it not only squashes the secretory cells, it can cause milk from the ducts and cells to leak into surrounding tissues and trigger inflammation. (mastitis) (SO feed before massage, time appt for the afternoon preferably; be prepared for some leakage. Towels and large absorbent pads in bed can be useful, save bed changes..)

Milk is made continuously, and is mostly water based, with about 7% cream. (The most variable component of milk, and babies drink less by volume of a high fat milk.) The watery part of the milk flows out of cells rapidly, the fat has to be extruded, sort of squeezed out by the cell into that aqueous fluid. The oxytocin contracts tiny muscles around those cells and pushes milk out into the ducts (the let down). A vacuum in the baby’s mouth is created when the baby’s jaw drops, and baby sucks. The seal needed for vacuum is created by tongue, cheek pads, and upper gum ridge etc. The vacuum – lower pressure area – allows milk to flow out from the breast – higher pressure area with letdown pushing milk out.

The relative amount of cream in milk varies over a feed, between feeds, between breasts, over the day, over time, following the general rule that the emptier the breast and the more letdowns it has been exposed to, the higher the fat levels. So after an interfeed interval, milk from the start of the first breast is ‘waterier’ than the milk at the start of the second breast will be, because the second breast has had oxytocin squeezes while the first is being fed from. And swapping back to the first breast after the second can mean an even richer milk again. Babies can be trusted to know when they are satisfied, and it sometimes takes the extra cream of a ‘third’ breast to do so.

Once lactation is established, the interfeed intervals are heavily influenced by the interaction between breast storage volume, and infant stomach volume. Over a day a baby takes about 750mL. A breast with storage capacity of 800mL could theoretically mean one feed a day, except that a baby’s stomach capacity won’t allow that! SO: a breast with very small storage volume will mean more frequent feeds at shorter intervals. So too does a small tummy. A baby with a big tummy capacity means fewer feeds per day if the mum’s storage capacity allows that tummy to be filled up (it can even get down to 3-4 feeds in 24 hours in some thriving babies under 6 months old.) They say the size of the baby’s stomach is roughly the size of its fist, but it can be distended comfortably. (If over-distended the baby will blurt back the extra – sometimes too much comes up, so yet another feed is indicated to settle things.) Being creamy, sometimes only a few extra mouthfuls are needed to get bub to drop off drunk.

Rates of milk synthesis vary over the day, and are governed by the degree of breast fullness. When the breast is close to its residual baseline (it’s never truly empty), synthesis rates are faster. When breasts are fuller, synthesis rates are slower. The small breast that empties quickly also refills quickly.

During the night sleep, longer intervals and higher-at-night prolactin levels combine to produce a full breast by morning. Take out a single feed then, and refilling will be slow: the 600mL capacity breast might have dropped to 500mL, but there’s still plenty there, so no rush to refill. By the next feed volume might be back to 540mL, and drop down to 450 after that feed. Over the day, by evening you can come close to running on empty, with baby staying at breast and drinking pretty much as you produce it. That milk may move from the stomach on into the small intestine at much the same rate, so baby doesn’t get that satisfactory FULL STOMACH feedback signal and fall off looking drunk, or else will sleep for a short time but wake up and want more. [There’s stuff that could be said here about gastric hormones and signalling, but no need.]

But take out a lot of milk in the am, by feeding on one side and pumping the other breast, then letting baby have the second side for as long as wanted, and milk synthesis rates speed up to replace milk in both breasts. SO this is the ideal time to express milk for storage or as a reserve. (Don’t be persuaded to think about expressing after every feed unless it’s for a medical reason: it creates too much work, keeps breasts cold, and is a pain.) And while you would freeze that extra expressed morning milk, it can be stored in the fridge during the day till it’s clear there’s enough been made to keep baby full that day; if not, you can pour off some and feed it to baby bu spoon, cup, syringe, whatever.

I developed this strategy to deal with what I called six o’colck starvation, when I just could not satisfy baby wioth a full feed. Before I tried this, I had to keep baby at breast for hours, contentedly getting small dribs of milk but refusing to leave or drop off to sleep. Topping baby up in the evening with some of the morning milk meant she went off to sleep, my empty breasts refilled before she woke again a few hours later, and in between I got my other two kids to bed and cleaned up. This was where the Kaneson pump came in handy, as it’s a simple silent no-strain one-handed pump: draw back the outer cylinder a tiny bit to create the slight suction needed to relax the ring of muscle around the nipple and milk pours out of the second breast when oxytocin hits both breasts and triggers letdown). But not until mums are comfortably feeding and can multi-task should they think about trying this. Getting position and attachement right and baby feeding well and breasts producing well is the first priority. When mums can feed and drink a cuppa they can do this no trouble. If they want to get milk to store. Or to give an older child a glass, or make breastmilk ice blocks. Or whatever it’s needed for.

Breasts being peripheries, they are colder than other parts of the body. They need to be warm for blood circulation to bring in nutrients for milk making. Simple things like hotpacks or having a small patch of wool, silk or fleece to tuck into the bra around the breast not in use can make a difference to refilling rates. So can an afternoon nap. I never ran dry on days when I snuggled down with a baby and had a full-body after-lunch rest. I always did if I worked through the day and only sat down for feeds. Some mums can cope with strenuous exercise and still lactate successfully; others can’t. (Babies don’t like the taste in milk of lactic acid created by exercise, but it disappears after about 30 minutes.)

So increasing milk production means increasing sucking stimulus, and frequency, increasing synthesis rates by breast emptying, and decreasing any competing activities. In short, go to bed with baby and sleep and feed feed feed, and (optional) express first thing in the am. After 2 days of more frequent feeding, basal prolactin levels rise – they may have fallen too far – and milk-making increases. A babymoon it’s sometimes called. Not possible for many mums with children and dogs and household tasks. Using drugs to increase prolactin has its risks and in any case will not work if the problem is insufficent breast emptying and natural feedback down-regulation of supply.

Decreasing milk production is equally simple. Increase intervals between feeds, for example by one-breast feeding with only short times on the second breast, back to the emptier first breast for a couple of hours, monitoring the unsuckled breast and expressing only to comfort and to avoid mastitis. Within 24-48 hours of one-breast feeding supply will drop, sometimes catastrophically. It’s disaster to suggest this to new mums with oversupply, as many hospital-based midwives have done. The mums go on for more than 24-48 hours and then wonder why their milk has gone. Lying face down compressing boobs, wearing a tight crop top or bra, creating pressure feedback, and you may achieve the same outcome via mastitis. (In a breast with no skin damage, most mastitis starts with milk leaking into breast tissue where it shouldn’t be, under pressure.)

Mums need to know what an efficient working breast feels like: soft and flexible even when heavy with milk, filling up, softening again after a feed; maybe tight and tense to touch if the interval is too long but immediately relieved by milk removal. Warm but not heated, not reddened skin. Not lumpy, even up in the armpits where there is some glandular tissue in many women. There’s always a reason for any change and thinking though exactly what’s happened can find it, and prevent recurrences.

There is a lot more in Breastfeeding Matters 1998 edition that would be of interest and relevance, in chapters on milk supply, nipple problems and mastitis. Breastfeeding is a skill that has to be learned, and without early practical support and understanding of how supply is regulated, women struggle.”

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My Body Failed Me

When I fell pregnant with my son, I had my sights set on a drug-free, vaginal birth.  A normal birth.  I was a woman, after all.  Billions of women did it before me, and billions would do it after.  Our bodies were made to do this, why should mine be any different?

Well things didn’t happen that way.  It all started to go wrong as I approached my estimated due date and showed no signs of readiness for labour.  After going through several “stretch and sweep” procedures, I was induced.  First with cervidil, then a cervical balloon, and then after both of those failed to put me into labour, my waters were broken and I was put on a syntocin drip.  I didn’t cope with the sudden onslaught of labour, and my son’s posterior position probably didn’t help.  I accepted gas fairly quickly.  The gas made me nauseous and vomit, but it also masked the fact that my body was involuntarily pushing.  I was only 3cm dilated, so I was given an epidural.  Sadly the uncontrollable pushing caused my cervix to swell shut, and 12 hours after my waters were broken, my son was pulled out of my via an emergency csection, 10 days after his due date.

I felt so good about my body during pregnancy that I never considered it might not do what it was supposed to during birth

When I was pregnant with my second baby 2.5 years later, I felt determined to do better.  I did special exercises to try to keep my baby out of a posterior position.  I walked and swam as much as I could to keep myself strong and make sure my stamina was good leading up to birth.  And I rested more.  I eliminated stress from my life.  I made a point of informing myself better, and this time around, when I showed no signs of labour I politely refused the stretch and sweeps.  I stonewalled conversations about induction because I was healthy and my baby was healthy and I didn’t want to submit my body to unnecessary procedures just so I could conform to the hospital’s preferred timeline of events.

Seven days after my due date I woke to contractions – I had gone into spontaneous labour and I could have been happier.  But despite my best intentions, my labour followed the same route as my first – I began pushing involuntarily when I reached around 3cm dilation, resulting in cervix literally closing the door on any chance of a VBAC.  I was eventually taken in for another emergency csection, except this time we had to deal with a torn cervix, bladder adhesions and serious damage to my uterus.  I was told very seriously that if I ever decide to have another baby I will need to have a csection scheduled before 37 weeks, because it would be very dangerous for me to have even one single contraction.  I will never have another chance to get the birth I wanted.

I was trying to look happy for the photo but I feel like my face gave away the other emotions I was feeling too

I am a successful breastfeeder and an advocate for it too.  I don’t pretend to know what it’s like to not be able to breastfeed.  To do so would feel disrespectful to those who have actually lived it and feel hurt over it.  But I do know what it’s like for your body to fail at something that it should have been able to do.  I know what it’s like to prepare for something and then find that it’s just not going to be possible.  I really wanted vaginal births, and I thought I did everything I could to make them happen, but my efforts weren’t good enough.  Is this what it’s like when someone wants to breastfeed but can’t?

When I think about my birth stories, I feel a lot of feelings.  I have grieved for the birth that I wanted but didn’t get.  Even though my daughter turned 2 last March, my grieving process doesn’t appear to be over yet (the tears in my eyes as I type this out are proof of that).  I accept that my kids face some increased health risks because of their delivery and although I strive to learn more about them, I still sometimes feel indignant and defensive when someone else brings them up.  I feel confused about what went wrong – did I do something wrong?  Is my body built wrong?  Did my care providers do something wrong?  I feel frustrated because when I ask questions to piece together exactly what happened it seems everyone is more concerned with reassuring me that everything is OK and that I did my best, and that method of delivery doesn’t even really matter.  They ignore the fact that I want factual, objective and honest information to help me move past this.

I am thankful that I don’t feel guilt or anger.  Guilt and anger are toxic feelings because they revolve around blame, and the idea that something could still be done about my situation, and they can’t.  Nothing can be done because it’s already happened and I can’t change the past.  I think some people use guilt and anger to hide away from their feelings of sadness, without realising that this stops them from moving on and finding their closure.  Talking about my story still makes me feel really sad, but each time I open up about it, I feel myself let it go a little bit more.

My c section births didn’t meet my expectations, but I love my kids more than I ever could have hoped

I guess the reason I’m talking about this today is because when talking to a pregnant friend about their breastfeeding goals, someone else chimed in that I shouldn’t get her hopes up so much because not everyone can breastfeed, and that I have no idea what it’s like to deal with the disappointment of being unable to do something I thought I could.

It may be true that not everyone can breastfeed and not everyone can have vaginal births.  But it doesn’t mean we shouldn’t hope we can.  It doesn’t mean we shouldn’t try.

If you are struggling with your feelings about birth or breastfeeding, please talk to a trusted health care professional, or get in touch with PANDA – Perinatal Anxiety & Depression Australia

Have you ever felt like your body failed you? 

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Member Story – The Boob Job Risk That People Forget About

Elective breast surgery is risky.  Actually, any surgery is risky.  But weighing up the risks versus benefits for an elective surgery is not as straightforward as when the surgery is essential for your survival.  Many women, particularly those who are planning to start or grow their family after the surgery, feel that they negate the risk of  breast surgery by seeking reassurance they will be able to breastfeed when their children are born – by having implants inserted under muscle, with the incision made at the crease of the base of each breast.

As elective breast surgery, including elective breast surgery performed overseas, becomes more common, many seem to have become completely accepting or even dismissive of the other risks involved.  It would appear that many women consider the risk of infection so low that it’s barely worth considering.  Courtney O’Keefe never thought her breast surgery could result in an infection that could prematurely end her breastfeeding journey, let alone her life.

Early in 2011 I lost 35kg after a lap band surgery.  The weight loss affected my breasts, so I decided to get implants and a lift.  The lowest quote I got in Perth was $22,500, but I could get it done for $7,500 in Thailand at Pattaya Hospital, Bangkok.

The plan was to get 350cc implants and I was expecting a small anchor scar (as I was having old breast tissue removed as a part of the lift).  Instead, I woke up with cuts straight across my breasts, plus the incisions under my armpits where the surgeon had inserted 550cc implants, not 350cc as we had agreed.  I felt like I’d been completely butchered.

But the biggest shock was yet to come.  I had been feeling unwell since the surgery, but 2 days later I felt extremely sick and I started hallucinating.  When the surgeon removed my bandages to remove my stitches, my wounds immediately split open.  Please click on this link if you would like to see Courtney’s infected wounds.

I came back to Australia and was admitted straight into a local hospital, fighting for my life.  Whatever was wrong with me was shutting down my liver, kidneys, brain and heart.  The hospital immediately began treating me for golden staph and methicillin-resistant staphylococcus aureus (MRSA), until swab results came back and we learned I had contracted some kind of super bug from Thailand.  The infection resisted treatment and my whole body went into some kind of meltdown.  I had repeated seizures and losses of consciousness.

I spent 4 months in the care of Infections Disease Control, then I was transferred to another hospital to be cared for by Plastics, to treat some of the damage inflicted on my body.  I thought I had recovered but the infection came back in November 2015.  I was rushed back into hospital.  My implants were removed this time, and I was given a partial mastectomy after the implants infected some surrounding tissue and muscle.

Again I recovered and gave birth to a beautiful baby girl early in 2017.  Miraculously I was able to breastfeed her, and I was so happy!

Sadly the infection struck me again when she was only 5 months old and I had to give up breastfeeding while I was being treated.  I was, and am completely devastated.

As Courtney’s treatment made it unsafe for her to breastfeed, or even use the undrinkable breastmilk in a bath, she was forced to pump and dump a huge amount.

Thanks so much Courtney, for bravely sharing your story with us.  It’s unfair that her breastfeeding journey ended prematurely, but I hope she takes comfort in the knowledge that every breastfeed that she was able to give her baby was a win and the benefits her daughter will reap from those feeds will last a lifetime.

If your breastfeeding journey has ended prematurely, the Australian Breastfeeding Association offer debriefing by their trained breastfeeding counsellors.  You can access this free service by calling the National Breastfeeding Helpline on 1800 MUM 2 Mum