Let’s Talk About PMADs!


Let’s talk about PMADs!

What are PMADs? Perinatal Mood and Anxiety Disorders. We commonly know this as “Postpartum Depression” or “Postpartum Anxiety.” So, why the fancy term “PMADs?” Evidence shows that a lot of the cases of postpartum anxiety and depression actually begin during pregnancy. So many mothers are experiencing these issues during pregnancy that we began calling them Perinatal mood disorders (peri means surrounding and natal means birth so Perinatal literally means the time surrounding birth, pregnancy and postpartum). But, not only mothers experience PMADs. Fathers do too. Today, I’m going to focus on mothers.

As mothers, we fight sociatal norms and expectations as we try to raise our small children. Some of us get extremely overwhelmed with the duties we have to our growing family, extended family, and potentially work, church, and the list may go on. New mothers are at a high risk for PMADs in part due to the overwhelm, in part due to changing hormones, and also in part to other factors that I will discuss further. The mother in this picture looks overwhelmed. She looks sad. Shown above is only part of the picture. Here’s the rest.

Young mother working with her baby

This mother may very well not have any mental health concerns. A smiling mother may have postpartum depression or anxiety. It’s hard for others to be able to tell on the surface, in part because our society continues to push that if you have a new baby you need to be happy, or at least look the part. This is why I’m so passionate about this subject. We need to be talking about it. Talking about PMADs needs to be a norm. We need to fight to help mothers help themselves and know that it’s important to recognize and seek out resources and help.

I had the opportunity a year ago to guest post on Mary Morrow of ToMorrows Memories blog. Here is the text from that post (you can see the original here):

I’m grateful I have the opportunity to talk to you today about Perinatal Mood and Anxiety Disorders (PMADs). I prefer to use this term when I am speaking about Postpartum Depression (PPD) and Postpartum Anxiety because statistics say that half of postpartum depression episodes begin during pregnancy (Cynthia Good Mojab, 2016 GOLD Lactation Conference. “The Rug Pulled Out from Underneath Me: Depression During Pregnancy and After Birth.”). Not only can mothers be affected but fathers can as well. More studies are now looking at PMADs in fathers because fathers were ignored for a very long time.

Like diabetes or a broken arm, PMADs are a group of disorders caused by something in your body not working in the way it’s supposed to. It doesn’t mean something is wrong with you as a person, that you’re weak, that you are not faithful, that you’re a bad person, or that you aren’t willing your body and mind enough. Being told to “snap out of it” or “pull yourself together” will not help you overcome these issues just like someone with a broken arm can’t just pull their self together or will their arm to just be better. Your mind is extremely powerful, however, and there are a lot of different things you can do to help you overcome this.
Mary already shared some great information about symptoms of PMADs in her earlier post. I want to focus on risks, screening, and 4 keys that I hope all moms (and dads) remember if they do have PMADs.
Some of the risk factors that I especially want to share include: parents of multiples, parents with babies with special circumstances (including a NICU stay), survivors of sexual abuse, parents who have personal or family history of depression or anxiety, mothers who experienced birth trauma, and mothers who wanted to breastfeed but had challenges or were not able to get it to work. There are certainly other risk factors but I wanted to especially point these out because as an IBCLC, I work with families with these risk factors a lot. When I’m obtaining a history, I have to ask some sensitive questions including asking if you have a history of abuse or if you have experienced depression or anxiety in the past. These directly relate to breastfeeding because they can affect your breastfeeding relationship and put you at a higher risk. This doesn’t mean you WILL experience depression or anxiety but it’s a good idea to watch yourself and have your spouse or partner also watch for red flags. It’s also extremely important if you have breastfeeding challenges to get early and continuous help.
I screen all of my clients for depression and anxiety. I encourage dads to also complete my screening tools. I do not diagnose, instead I notice red flags and refer you back to your physician or to other local resources if there are concerns. I include a handout with my screening tools with common symptoms of depression and anxiety so that you can continue observing one another. Many of the mothers I have worked with that have experienced symptoms have not recognized them in themselves for quite some time, including myself. My own journey with postpartum depression and anxiety has made this topic very important to me.
Because I have also suffered with PMADs, I want to share with you 4 things that I feel are very important to remember if you have depression or anxiety.
1. This is not your fault, and you are not alone. You did not do anything to make this happen. You are an awesome mother (or father). You are an amazing and special person. Many of the best of us have experienced these issues. Here are some statistics about generalized anxiety and depression (link to: https://www.adaa.org/about-adaa/press-room/facts-statistics). 20-26% of women and 8-12% of men will experience depression at some point in their lifetime (link to: http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_depression). There is a stigma around mood disorders and there shouldn’t be. You are not alone. Please share your story! You have no idea who else is suffering in silence that your story may help.
2. There are many treatments that are safe for breastfeeding mothers! There are treatments that range from supplements, therapy, lifestyle changes (including exercise and yoga), to medications. There are natural remedies and there are pharmaceuticals. Even many pharmaceuticals are safe for breastfeeding mothers. If you have questions about the safety ratings of a medication please don’t hesitate to call myself, the Oklahoma Breastfeeding Line, or Infant Risk (please see the resources at the end for contact information). We are all happy to share the data and safety ratings of medications.
3. A healthy mother and father are extremely important to the family. If you have ever had a flat tire in your car, you know that it’s hard to drive. The flat tire slows down the rest of the wheels, your ride is super bumpy, and it can be dangerous. If mom (and/or dad) are not healthy mentally it can be much the same. You are important! Your mental health can also throw off the balance in your home. There have been studies that mothers with untreated mood disorders can impact the brain and emotional development of their child.
4. YOU are worth it. You are worth spending the time and money to get help. If money is an issue, often there are free and low cost resources. You just have to ask. One of the hardest parts of PMADs is often an overwhelming feeling that you aren’t worth it. I’m here to tell you that you are. You are a very important person, even if you don’t feel that way. You are worth getting help. This is a problem worth getting help for.
Ashley Barrett, BA, IBCLC, RLC, Certified Babywearing Educator. Nurturing Bonds, www.nurturingbonds.com, ashley@nurturingbonds.com, 405-261-6274. Serving the Southwest Oklahoma City, Mustang, and Yukon area.
I Am Woman: The Life After Trauma Project: www.facebook.com/IAmWomanTheLifeAfterTrauma. Offering meetings and online encouragement and support for survivors of trauma and PMADs.
More breastfeeding resources are available at: nurturingbonds.wordpress.com/breastfeeding-resources
Oklahoma Breastfeeding Line: 1-877-271-MILK (6455). 24/7 number. If you have an urgent question select to talk to an IBCLC on call.
Infant Risk Center Hotline: Monday – Friday, 8am – 5pm CT (806) 352-2519. www.infantrisk.com. Also available is the Mommy Med app (it’s about $3-you can even scan a medication at the pharmacy or store to check the safety during pregnancy and breastfeeding).
www.postpartumprogress.com: A website with a lot of articles relating to PMADs.
www.kathleenkendall-tackett.com: Kathleen Kendall-Tackett is an IBCLC and PhD who studies PMADs. She has a lot of articles on her website and references to many books she has written or co-authored.
Depression in New Mothers: Causes, Consequences and Treatment Alternatives, 3rd Edition by Kathleen Kendall-Tackett.
The Hidden Feelings of Motherhood: Coping with Mothering Stress, Depression, and Burnout by Kathleen Kendall-Tackett.
This Isn’t What I Expected: Overcoming Postpartum Depression by Karen R. Kleiman and Valerie Davis Raskin.
Transformed by Postpartum Depression: Women’s Stories of Trauma and Growth by Walker Karraa.
Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression and Anxiety by Shoshana S. Bennett and Pec Indman.
Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family by Diane Wiessinger, Diana West, Linda J. Smith, and Teresa Pitman.
Nighttime Parenting: How to Get Your Baby and Child to Sleep by Dr. William Sears.
Traumatic Childbirth by Cheryl Tatano Beck, Jeanne Watson Driscoll, and Sue Watson.
When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women by Penny Simkin and Phillis Klaus.
Rebounding from Childbirth: Toward Emotional Recovery by Lynn Madsen.
It’s OK Not to be OK…Right Now: How to Live Through a Traumatic Experience by Dr. Mark Lerner.

August Updates

It’s been quiet on my side lately because I’ve been planning for World Breastfeeding Week! Here’s an almost August update for upcoming classes and events from Nurturing Bonds.

Babies Are Born to Breastfeed: Second Annual World Breastfeeding Week Event


It’s not too late to pre-register for the Big Latch On and join our fun event celebrating breastfeeding with the rest of the world! Help us beat a Global Big Latch On record this year! The record to beat is the record from 2016: 17,992 breastfeeding children, 17,852 breastfeeding women. The Big Latch On is very inclusive. If you are an exclusively pumping mother, if you use a supplemental nursing system, a nipple shield, or anything else to make breastfeeding work, please join us! If you are expecting and not breastfeeding a child yet, you are also welcome! Please come support us!

  • Pre-register NOW here. Please arrive by 10:15 to settle in and prepare for the latch! If you pre-register, we will have you review your information and sign in. If you don’t, that’s ok! You will fill out our registration form when you arrive and get settled in and ready.
  • Doors will open at 10 AM. The first 50 families that arrive will receive an awesome swag bag that was printed by Lettering Express.
  • There are at least 18 door prizes! Enter to win a Tula baby carrier, Baby Hawk baby carrier, a wrap convert ring sling, a Haakaa silicone pump, a spa basket with a complementary chiropractic exam and adjustment by Hackney Chiropractic, Usborne books, and more! Every adult will receive one ticket when you arrive that you may enter in to a drawing of your choosing.
  • Enjoy lunch with us (and bring a card/cash)! We will be having two incredible food trucks join us: Wicked Hangry and Cook’n It Up! Check out their menus on our Facebook event!
  • We will be having mini classes about breastfeeding and infant massage during the 12 o’clock hour.
  • We will be having two panel discussions. Come and ask your questions about getting breastfeeding off to a good start with midwives, doulas, and lactation. Our second discussion will be about local resources to support breastfeeding. Did you ever wonder how massage, chiropractic care, or speech therapy can assist a breastfeeding mother and baby? Learn about it here!
  • Join our Facebook event here to learn more details and to see the schedule of events! There may even be one more pre-event prize up for grabs that will include 5 extra tickets in to a door prize of your choice!

Upcoming Classes

familybabycarebasicsSaturday, August 19 at
The Edmond Birthing Center
14901 N Kelley Ave Ste 102
Edmond, Oklahoma

Learn all about newborn and infant care. $10 for the whole family. This class is geared toward new parents, new siblings, new grandparents, and new babysitters that will be caring for infants. For more information see the description or register here. You can also register at the door.

BasicsclasswebsiteimageMonday, September 11 at
The Edmond Birthing Center
14901 N Kelley Ave Ste 102
Edmond, Oklahoma

Learn about the basics of breastfeeding and getting off to a good start. This class focuses on the first 4-6 weeks of breastfeeding. I recommend taking both classes. If you have breastfed before, and just need a refresher, the Beyond class may be a better fit for you. For more information see the description or register here.

I also offer this class privately if your baby is due to arrive before this or the time doesn’t work for you. Contact me for more details!


Monday, September 18 at
The Edmond Birthing Center
14901 N Kelley Ave Ste 102
Edmond, Oklahoma

Review the basics of breastfeeding and learn more about pumping, expressing, going out with baby, and common concerns from 4-6 weeks and beyond through weaning. We will also discuss the readiness signs to begin solids. I recommend taking both classes. If you have breastfed before, and just need a refresher, the Beyond class may be a better fit for you. For more information see the description or register here.

I also offer this class privately if your baby is due to arrive before this or the time doesn’t work for you. Contact me for more details!

April Classes and Support Groups

Happy April!  This month I celebrate my oldest son’s 9th birthday.  He’s the whole reason I’m here supporting breastfeeding mother’s today.

In April, classes will be offered privately only.  Check out May and June dates below.  Breastfeeding classes will now be taught every 3 months, unless you would like to register for classes privately.  Registration is available on my website here.  More information about what is taught in the classes here.  Preregistration is required for all breastfeeding classes.


Saturday, May 20, 2017, at 11 AM. I’m pleased to announce that this class will be held at The Edmond Birth Center (14901 N Kelley Ave, Ste 102, Edmond, Oklahoma). Preregistration is strongly encouraged.


Monday, June 5, 2017 at 7:30 PM. I’m pleased to announce that this class will be held at The Edmond Birth Center (14901 N Kelley Ave, Ste 102, Edmond, Oklahoma). Preregistration is required at least 1 week before class.


Monday, June 19, 2017 at 7:30 PM. I’m pleased to announce that this class will be held at The Edmond Birth Center (14901 N Kelley Ave, Ste 102, Edmond, Oklahoma). Preregistration is required at least 1 week prior to class.

TWO FREE mother-to-mother breastfeeding support group meetings this month:

Wednesday, April 5 at 6:30 PM.  This is a meeting for mothers and children not comfortable being away from mom (nursing children are always welcome).  Fathers are also welcome at our evening meetings.  Please bring some toys for your older children to be entertained.


Friday, April 21 at 3:30 PM.  This is a meeting for mothers and children not comfortable being away from mom (nursing children are always welcome).  Please bring some toys for your older children to be entertained.


March Classes and Support Groups

Happy March!  Here are my class dates for March.  Registration is available on my website here.  More information about what is taught in the classes here.  Preregistration is required for all breastfeeding classes.


Tuesday, March 14: 7-9 PM at Cardon Family Chiropractic in Mustang


Tuesday, March 21: 7-9 at Cardon Family Chiropractic in Mustang

and TWO FREE mother-to-mother breastfeeding support group meetings:

Wednesday, March 1 at 6:30 PM.  This is a meeting for mothers and children not comfortable being away from mom (nursing children are always welcome).  Fathers are also welcome at our evening meetings.  Please bring some toys for your older children to be entertained.


Friday, March 17 at 3:30 PM.  This is a meeting for mothers and children not comfortable being away from mom (nursing children are always welcome).  Please bring some toys for your older children to be entertained.


February Classes and Support Groups

Happy Valentine’s Day!  I hope that your 2017 is going well so far!

Here are my class dates for February.  Registration is available on my website here.  More information about what is taught in the classes here.  Preregistration is required for all breastfeeding classes.


Tuesday, February 7: 7-9 PM at Cardon Family Chiropractic in Mustang


Tuesday, February 21: 7-9 at Cardon Family Chiropractic in Mustang

and TWO FREE mother-to-mother breastfeeding support group meetings:

Wednesday, February 1 at 6:30 PM.  This is a meeting for mothers and children not comfortable being away from mom (nursing children are always welcome).  Fathers are also welcome at our evening meetings.  Please bring some toys for your older children to be entertained.


Friday, February 17 at 3:30 PM.  This is a meeting for mothers and children not comfortable being away from mom (nursing children are always welcome).  Please bring some toys for your older children to be entertained.



2017 Goals


It’s almost 2017!  I had originally planned to sit for the IBCLC exam in 2017 and was so excited to find out that I could sit a year earlier than I had planned when they started offering it twice per year.  I want to share with you my business and personal goals for 2017.  There is a lot of power in writing down goals and working to achieve them in bite-sized pieces.


  • I’m a homeschooling mother.  Something I have struggled with in the past is PLANNING.  I have a love/hate relationship with sitting down and planning things out.  If I can plan out for a few months at a time though we are more likely to do ALL the subjects.  Otherwise sometimes music or art fall by the wayside or something else will for a few weeks.  I hope to start out the 2017 part of the school year well planned and with a good idea of what we hope to accomplish for school work.
  • I want to go on more adventures with my kiddos and husband.  I would love to explore new places in Oklahoma and visit other places nearby (including Texas and possibly even Tennessee).  We have a limited vacation budget while we’re working hard to pay off debt and save for a down payment to get in to a house that’s our own so we really want to explore what this area has to offer!
  • Tomorrow I will be celebrating my daughter’s 3rd birthday (and hubby’s 33rd!).  I’ll be celebrating my longest time breastfeeding as well.  In all, I will have breastfed 6 years and 6.5 months and counting.  My daughter has some tummy issues and thank goodness after a VERY difficult first 6 months breastfeeding is smooth now and it helps her so much when she’s sick.
  • I look forward to celebrating my 11 year wedding anniversary with my husband.  I hope to go OUT and possibly overnight somewhere with him.  Some years we have had to celebrate in or have taken a baby with us but this year I look forward on focusing on us now that our babies are all a bit older!
  • I would like to practice my knitting colorwork techniques in my spare time.  I also would like to make myself another sweater or maybe even 2 and make one for each of my kiddos.
  • I hope that I am able to exercise more often and become healthier.  I battle allergic asthma and while it’s gotten quite a bit better here, I still suffer from time to time which makes exercising very difficult.  I hope that I can stay healthy this next year and have a consistent schedule to take care of myself!


  • Blog: Consistently post every 2 weeks.  Last year was hard preparing for the IBCLC exam.  I have been working on a bunch of really great topics and posts for 2017 though and I hope to keep posting (at least) every other Friday through all of 2017.
  • Blog: I want to interview some really remarkable professionals in our area including the OKC Metro Birth Professionals!
  • Blog: I hope to continue to bring you more mother’s stories!  If you have a story you would like to share with my readers please email me!
  • Continue to offer excellent service to my wonderful clients.
  • Community: Grow the Nurturing Bonds Breastfeeding Circle.  Become a great resource for the members of my local community and give back.
  • Share current, evidence-based information to doctors and work with local professionals that work with moms and babies.  It’s so important that all professionals are sharing the same up-to-date information with new mothers.

What are your 2017 goals and resolutions?

Lactation Cookies, Drinks and Galactagogues


There is NO “magic” food or drink that will increase your supply.  Your breasts make milk based on supply and demand-the more milk removed, the more you make.  Most mothers can and should trust breastfeeding and watch for the cues that baby is getting enough (for more information see this post).  That said, there are mothers that struggle from hormonal issues, PCOS, diabetes, Insufficient Glandular Tissue, and some other issues that can cause low milk supply.  If after you have read the post linked and baby is not gaining weight sufficiently and/or isn’t having 6-8 wet diapers and 3 poopy diapers each day (24 hours) in the first 6 weeks (may have less poopy diapers after 6 weeks possibly) this would be a good time to:

  • Call an IBCLC and have a thorough assessment of baby’s anatomy and your breasts.  Issues can be ruled out and pre-feeding and post-feeding weights can be taken to get a glimpse of how much milk your baby is taking at that particular feeding.  This is just a glimpse and shouldn’t be used to determine absolutely how much milk your baby is removing from your breasts over a full day.  An IBCLC can also check on any possible positioning issues that may be going on-I’ve found with many of my clients very tiny changes can make a huge difference!
  • Pick up Breastfeeding Mother’s Guide to Making More Milk before making any decisions about any extra foods/supplements to take.
  • You may also want to contact your doctor to have prolactin levels checked through some blood work.
  • Finding a cause of the issue is more preferable option because if you’re treating the symptoms rather than the cause you’re just putting a bandage on the problem.

A wise lactation consultant (Christy Jo Hendricks at the GOLD 2016 Lactation Conference) shared a story that really stuck in my mind that I will relay to you now.  We all have that one pair of shoes in our closet.  You know the ones I’m talking about-those ADORABLE pumps that you had to have.  They were a little more than we usually pay for shoes but they were just cute and you had to have them.  You got them home and tried them out for a date or an evening out.  OUCH!  Those adorable pumps aren’t as comfy as you thought there were in the store.  You get home that night and find a blister.  They’re so cute though and a little expensive so you put a bandage on and wear them again the next day to work.  You realize they’re a little too small and they really just don’t feel great on.  Every time you wear them you know you need to wear a bandage.

Closeup of a woman's heel with a blister plaster on

Ultimately, the problem is the fit of the shoes.  Instead of tossing them out and getting a different pair you put a bandage on and keep going though.  Galactagogues work much the same often.

Some mothers do find that certain foods or drinks have boosted their supply.  Some of these work because they’re acting on some type of discrepancy or some mechanism in your body that may need a little extra boost or they’re just helping mama limp along a little (like a bandage).  These are all very individual-Breastfeeding Mother’s Guide to Making More Milk AND working with a knowledgeable IBCLC can help you figure out the possible problem together.  Taking the wrong supplement can actually reduce your supply or cause some serious medical issues (remember that herbs are medicines and just like taking the wrong prescription they can cause some major problems or possibly interfere with medications you are already taking).

A few “lactation boosters” that I have seen throw out a lot online:

  • Blue Gatorade (MUST be blue for some reason)-my guess is that this helps if mom is slightly dehydrated or has imbalanced electrolytes.  Oddly enough, I had issues as a child with “fainting spells” and a neurologist said I had issues keeping my electrolytes balanced.  I wonder if this is somewhat common and this is why it may work for some women, especially a new mom that isn’t able to take as good of care of herself as women in other cultures with laying in periods and lots of help from friends and family from their village.  Other options you could try are coconut water or homemade “laborade” drinks that have less sugar and less sodium.

Sports Drink Set Isolated

  • Lactation cookies/bars/smoothies-these often contain oatmeal, flax seed, and can even have some nuts, brewer’s yeast, and fenugreek (from imitation maple syrup).  Some of these ingredients work on the digestive system or just give a calorie boost.  They are often high in sugar though and can really upset a mom’s system with pre-diabetes (many mothers don’t know that they’re pre-diabetic).  Fenugreek also is known to interfere with some medications as well as cause issues with blood sugar.  If you want to eat a cookie-eat a cookie!  It probably isn’t a good idea for many mothers to eat the 3+ cookies each and every day that many cookie makers recommend.  Instead, try eating oatmeal in the morning or try some of the other digestive system aids mentioned in Breastfeeding Mother’s Guide to Making More Milk.

American style oatmeal rising cookies

  • Lactation Teas-often contain some or all of the following: fenugreek, marshmallow root, nettle leaf, alfalfa leaf, fennel seed, red raspberry leaf, milk thistle, anise seed, or others.  Most of these are considered safe for breastfeeding depending on the source (it’s a good idea to use trusted brands if you chose to use herbal supplements or teas) according to Nursing Mother’s Herbal.  Many of these aren’t in sufficient quantities to really make a difference though or some are contraindicated long term (more than a few weeks)

Some of these may give you a little boost to help you get through a growth spurt along with nursing frequently and following baby’s cues.  They may also help if you need a little extra boost on occasion when you’re pumping if you notice a little supply dip.  They aren’t necessary though, and are just an extra expense that most mother’s can avoid.  Ultimately though, the best way to increase milk supply is to remove milk more frequently.  If you want to eat a cookie or drink a smoothie go for it!  It’s probably not a good idea to have some of these every day without finding a cause for low supply though.  If you genuinely have low supply issues, working with an IBCLC is the first and best thing to do.  If you don’t find the answers you’re seeking, just like with a doctor or other professional you can always seek out a second opinion.

What “lactation boosters” have you heard about or tried?


Surviving Growth Spurts


Growth spurts happen a lot with your baby.  I get a lot of questions about growth spurts and what to expect or symptoms that baby is showing that are very common with growth spurts.  Often, breastfeeding professionals and mother-to-mother support group leaders will refer to these times as “frequency days” or sometimes even “fussy days.”

While a growth spurt can occur at any time they typically occur at about 7-10 days, 2-3 weeks, 4 weeks, 6 weeks, 3 months, 4 months, 6 months, 9 months, and really any other time.  They continue to happen about every 2-3 months through toddlerhood and periodically through to teenage years.  Your baby’s only way to communicate is through crying and baby will often communicate that something is wrong.  Growth spurts can be painful for baby (breast milk has pain relieving properties for babies and the oxytocin released when you breastfeed helps calm you both).  They can just be a confusing time or a time that baby’s brain is growing and not necessarily their body as much.  One nice thing about a growth spurt is if baby is having a fussy day and you’d rather stay home and relax together you can always blame a growth spurt!

Quite often mom will recognize something is different about baby but not quite pin point it to being a growth spurt.  Here are some signs that baby may be having a growth spurt:

  • Baby is nursing more frequently than usual (Do note though that it’s common to have a growth spurt at around 4-6 weeks and this is around the time that mothers will notice their breasts feeling much less full.  This is usually not an indicator that you’re not producing enough milk but this is a concern many mothers have).
  • Baby is fussy even after nursing.
  • Baby seems inconsolable.

While all of these can be signs of other issues, if your baby is gaining weight and has plenty of wet and poopy diapers it is very often a growth spurt.  Another possibility is over-stimulation if the crankiness is happening after being around a lot of new people or things, in the evening, or after being outside for a while.  If baby is about 3-4 months or older it could be teething causing these issues.  More on this in a later post.

Please also remember that your breast milk is usually enough.  If you have any doubts about your supply please be sure to check out this post.  Baby will start nursing more frequently on these days because baby is putting in an order for more milk later.  Imagine that it’s a Friday night and you know you want to have a pizza delivered at 6 PM.  Friday nights are really busy at the pizza delivery restaurant.  If you wait until 5:30 to order they might not be able to deliver or even have a pizza ready for you to pick up until 7 or 8!  Since you’ve probably had that experience before you know that you need to call in earlier so your food arrives when you’re ready for it (and hungry!).  When baby starts nursing more frequently they are phoning in their order for more milk later.

So how do you survive when baby can’t seem to get enough?  Here are some ideas to try:

Surviving growth spurt meme.png

A little more about the “nest.”  I help mothers that attend my breastfeeding classes prepare what I call their “nest” before baby arrives so that they can have everything easily at hand whenever baby wants to nurse.  Many mothers find that having everything close at hand (and having a little box or container to carry everything room to room as needed) helps to be able to sit down and nurse comfortably whenever baby shows early cues rather than going through the house to hurry and grab a snack, the remote, water bottle, etc.  By the time all of those items are gathered baby may be crying and harder to get to latch well and begin nursing.

Something else that you may find helpful is to have a good breastfeeding book.  I really love the Womanly Art of Breastfeeding and Breastfeeding Made Simple.  A lot of parents also enjoy The Wonder Weeks because it helps predict when baby may be going through a growth spurt or another developmental leap.  Remember that babies haven’t read the instruction manuals so not every baby follows the books exactly as they’re written but they can be reassuring even still.

One last thing I want to note is on dinner and snacks.  It’s so important to take care of YOU during a growth spurt.  Having easy snacks and maybe an easy meal that you can eat one handed while nursing can be very helpful.  It’s very common for babies to be crankier at night during growth spurts so having dinner taken care of is helpful.  You can always call in a favor to a friend that offered help, have some freezer meals on hand that just need to be heated up or baked, or have some crockpot meals on hand that you just need to throw in the crock pot the day of.  We really enjoyed having a couple of whole chickens in the freezer so we could throw one in our crock pot all day with some baby carrots and some other veggies we had on hand with salt and pepper, garlic powder, onion powder, and whatever other seasonings we had on hand that we like.  It would take me about 5 minutes to throw it all in and I didn’t have to worry about dinner.

I offer breastfeeding and babywearing consultations and classes in Oklahoma City, Yukon, and Mustang.  If you’re interested in learning more, you can visit my website, or contact me.

What do you do to survive growth spurts?

Watch the Baby, Not the Clock


After my last post, you may wonder if it’s better to watch baby or the clock.  A sleeping baby usually only needs to be woken up if there is special circumstances once they have gained back to birth weight.  Breastfeeding is so very intuitive.  We are very procedural and scientific as a society and we are very concerned about numbers.  This is helpful in some ways, especially to make sure that baby is thriving and not having breastfeeding struggles.  In other ways it sometimes gets in the way of what is normal and natural about the ART that is breastfeeding.

Healthy, full-term babies can tell YOU when they’re hungry.

You should expect that baby will continue to want to nurse 8-12 times per day approximately in the first six months.  Unlike with formula, baby will continue to get approximately the same amount of milk at the breast until baby begins eating solid food.

Feedings will eventually become shorter but still work on supply and demand.  Many mechanisms in our bodies work in cycles.  Breastfeeding is no different.  It’s very normal for milk supply to be higher in the morning and lower in the evenings.  It’s very normal for baby to want to nurse more frequently in the evenings and even to be fussy (more on this in a later post).

Scheduled feedings based on a certain time came because someone took the average of 8-12 feedings per day and decided to break that up on a clock.  Because our bodies (baby’s as well as mom’s) don’t work on a strict schedule but more of a routine, this can cause breastfeeding issues when you limit feedings based on certain times.  Certain baby programs meant to train and discipline babies highly discourage feeding more often than a set amount of time (usually more often than every 2 or 4 hours) and also discourage feedings longer than a specified amount of time (usually 15 or 20 minutes).  All babies are different in their efficiency, breasts are different in how often let-downs occur (where baby gets the majority of the milk in a feeding), and some babies have a stronger sucking need than others.  All people are different.  We all have different appetites.  We all expect meals at a certain time to some degree but if we get hungry most people will have a snack when they start to feel hungry.  If you wake up thirsty during the night you will get up and drink some water rather than say “Only 2 more hours until I’m allowed another sip of water.”  Babies are the same in that regard.  Babies will fall in to a routine eventually and following baby’s cues helps keep breastfeeding going in the most optimal way.

Because we don’t have graduations like a bottle on our breasts and can’t see how much milk baby is actually getting in there are some good indicators to help you know that baby is getting enough.  The most important keys to watch for to be sure that baby is nursing frequently enough and getting enough milk are:

  • Watch for early feeding cues: rooting, smacking/sucking noises, bringing hand to mouth, and in the early days just waking up.  Don’t wait for baby to cry-it will be harder for baby  to latch on and baby may become so tired that they may not nurse as effectively.

Early feeding cues include bringing hands to mouth and making smacking noises.  This is my daughter when she was just a couple of weeks old.

  • Diaper counts: by the end of the first week expect to see at least 6-8 wet diapers and 3 poopy diapers.  At about 6 weeks baby may have less stools and this is normal.  Some babies may go less than once a day at about 6 weeks and may go as infrequently as once a week or up to 2 weeks and be healthy.  If you have concerns, talk to your baby’s doctor and see a breastfeeding professional.
  • Weight gain: Baby should gain at least 5-7 oz per week after getting back to birth weight.  Baby should be back to birth weight by 10 days, 2 weeks at the latest.
  • When baby finishes a feeding (baby should usually be allowed to finish the feeding by coming off when he/she is finished) his/her hands and body will be more relaxed.  Babies often have fists at the beginning of the feeding and relax as their stomachs are filled.

If you have supply concerns some helpful ideas are to:

  • Check latch-if it’s painful an assessment by an IBCLC is important.
  • Let baby finish a breast, burp, then offer the other breast.  Following babies cues is important as is getting enough breast stimulation so that you continue having a good supply.
  • Nurse baby on cue as long as baby wishes.
  • Take away pacifiers and extra bottles, if baby needs a supplement consider an at-breast supplementer or work on paced bottle feeding to simulate how your breast delivers milk.  If you have supply concerns, all suckling should be at the breast.
  • Skin-to-skin contact as long and as much as possible during the day.
  • RELAX!  Stress can inhibit your let-down and make you not feel the best.
  • And above all, get professional help and support.  Mother-to-mother support groups and volunteers can be extremely helpful as well.
  • A very helpful book is Breastfeeding Mother’s Guide to Making More Milk.


For further reading see:

What cues does your baby give to let you know that he/she is hungry?

I offer breastfeeding and babywearing classes and consultations in Oklahoma City, Yukon, and Mustang.  If you would like more information please contact me or visit my website.

What to Expect in the Early Days of Breastfeeding


To learn more about getting breastfeeding off to a good start and know what to expect in the first two hours postpartum please see my earlier post in this What to Expect series.  You can also learn more about what to expect that first night home from the hospital (regardless of the timing of that due to a normal vaginal birth, surgical birth, or bringing a preemie home) here.  To learn more about days 2-7 postpartum please see this post.

Now that you’re home from the hospital, your milk has transitioned and is changing to more mature milk, and you’re starting to get to know your baby more you may start to feel a little bit of a groove and your baby may be starting to get more of a routine (or not!).  Your husband or partner may be back to work or may have a little more time off.  You no longer have the call button that you had at the hospital and now is the time to call in those favors that everyone left (“If you need anything let me know.”).  Postpartum is the best time to learn to ask for those favors because taking care of you and your baby are the top priorities, even over dinner. I recommend during pregnancy creating a list of duties, chores, errands, and meal preparation so that when someone is visiting you can encourage them to do a task before getting to see baby.  In many other cultures outside of the United States women have some type of a “laying in” period that other women come and take care of the household chores so mother can feed baby frequently and work on recovering.  A wise midwife, who “caught” my third baby (Lisa Lehrer in Corvallis, Oregon), encouraged me to stay down as much as I was able in the first 2-4 weeks postpartum and promised me that if I did I would feel much better at 6 months postpartum than if I had been running errands, doing chores, etc.  She was absolutely correct.  I felt MUCH better with her at six months postpartum than I did with my first two children.


Check out my FREE printable helping list!

At this point your baby may begin sleeping up to a 4 hour stretch during the day or night (maybe, it’s totally normal not to have a stretch for a while though).  If baby is gaining well and having enough diapers letting baby sleep is usually ok.  You may need to wake up a sleepy baby though if your baby is not up to birth weight by 10 days or has lost more than 10% of their birth weight, is jaundiced, or was premature or has special circumstances.  If you need to wake baby up, and baby is difficult to arouse, here are some ideas to help:

Ideas to help wake baby up

One other note that is important in the first two weeks.  Babies lose weight after birth.  It should be 7% of their birth weight or less.  It can be up to a 10% weight loss.  More than this and it’s very important to get immediate help from an IBCLC and your doctor to figure out if there is an issue with breastfeeding (even if you aren’t having any pain).  If you received IV fluids during labor baby may lose more weight than if no IV fluids were given.  Baby should be back up to birth weight by 10 days, 2 weeks at the latest.  If baby is not back up to birth weight by 2 weeks it’s important to see an IBCLC right away to assess for any breastfeeding issues.

Who was the biggest help to you postpartum?

If you live in the Oklahoma City, Mustang, or Yukon area and need breastfeeding help or would like to attend breastfeeding classes please see my website for more information.  You may also contact me here.