Episode 74: Overcoming The Most Common Struggles in Breastfeeding with Sarah Early, MSN, RN, IBCLC
Show Summary:
Today’s episode is a special conversation between one of our nurse practitioners at CIH, Silvia Hazel, and Sarah Early.
Sarah is a nurse and certified lactation consultant who provides breastfeeding support to families in the community, using a holistic approach and taking into consideration personal needs, physiological challenges and individual
circumstances.
Silvia is a nurse practitioner on our team who enjoys working with her patients on hormonal balancing, fertility, preconception and pediatric concerns.
This is a conversation about how lactation consultations support families and how to navigate the many challenges that can arise along the journey for baby and the family. Please enjoy.
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Full transcript:
Sarah Early:
What happens a lot is, you know, when you talk to people about law speak for me specifically, when I talk to people about what I do. I get stories. You know, I get everybody's story on what it was like I could be on an airplane, and, you know, talking to my seatmate, and they will tell me their story or their you know, somebody's story that they know, breastfeeding in is such a polarizing event in a person's life that they're, if it's going well, then that's how you remember it. And if it's not going well, I can't even begin to tell you the people that I've met along the way that still carry that guilt of feeling like a medic, yes, that they didn't do enough. And it goes from one baby, on one pregnancy to another. And if I can help someone work through that, so that they know that they were enough, and that they did do enough. That to me is is huge. Even if you know Breastfeeding has to stop for that couple, if they can do it on their terms, so that they don't feel like they failed. I feel like that is you know, ultimately, it's just it's ultimately what I want somebody to do, because I don't want them to carry that with them forever.
Dr. Andrew Wong:
Today's episode is a special conversation between one of our amazing nurse practitioners at CH, Silvia Hazel and Sarah Early is a nurse and certified lactation consultant who provides breastfeeding support to families in the community. Using a holistic approach and taking into consideration personal needs, physiologic challenges and individual circumstances. Silvia is a nurse practitioner on our team who enjoys working with their patients on hormonal balance, fertility, preconception and pediatric concerns. This is a conversation about how lactation consultants support families, and how to navigate the many challenges that can arise along the journey for baby and the family. Please enjoy this conversation.
Silvia Hazel:
Welcome Sarah to the Capitol Integrative Health podcast. We're so excited to have you here today and to be able to talk to you about the very important topic and probably not talked about enough topic of lactation. So for all of you out there listening, Sarah is a lactation consultant and she's gonna give us some insight about that. But first of all, Sarah, tell us a little bit about how you got started in lactation.
Sarah Early:
I am so excited to be here. I love Capitol Integrative Health and I love talking all things lactation. Because it's definitely one of those topics that I don't think is discussed. I feel like sometimes people feel it's a little taboo to talk about. But it is so important for families. I became a nurse and I became a lactation consultant when I was working in the hospital still because I wanted to be able to give a better feeding opportunity and more education to the families I was working with. And the more I got into the process, I realized that there was a big gap from when patients delivered in the hospital to when they left and were at home. There weren't a lot of outpatient supports for them. So I took my credential, which is the International Board Certified Lactation Consultant credential and started the company lactation room in 2014. We're now in the DMV. So we're in Maryland, DC and Virginia. And we have a wonderful group of consultants that are able to really support these families in some of the most transitional times and periods of their life. So I am just super excited to be able to have that opportunity and to continue to grow and evolve as a as a health care provider with them.
Silvia Hazel:
Yeah, yeah, that sounds like a really fulfilling space to kind of be in especially for families who are like new parents and trying to figure out how to care for their newborn and whatnot. So how does that look for you? You know, when you're kind of when a family reaches out to you initially, how does that process look?
Sarah Early:
So when a family reaches out, typically they have a goal. And more often than not, the goal is either geared toward improving the breastfeeding parents milk supply, or helping the baby eat better. But what that looks like is they reach out and we discuss what's going on and you know, find out what their goals and their needs are. And we scheduled them an appointment. Most of our clients are utilizing insurance for their benefits. So insurance does cover for most people, the consults for the parent and the baby. But there's also the son may have to have the self pay option but the Affordable Care Act has really opened up the door to allow parents that have had babies and babies to receive this type of care, but they get scheduled and they work one on one with us. Sometimes we may work at home, sometimes they need to come to the office. There are times that we'll see families via telehealth it really just kind of depends on the need. And the visits themselves take anywhere from 45 to maybe 90 minutes, roughly any more than that. And it's everybody's tapped out. There's a lot going on in those visits. And so we want to make sure that we're capitalizing on that, but not overburdening the patient and their families. That's a lot to take in. Yeah. And the babies kind of tap out.
Silvia Hazel:
Yeah, that makes sense, especially newborn.
Sarah Early:
They do. They're kind of done. But yeah, so it's just it's, you know, it's an all encompassing process.
Silvia Hazel:
Yeah. Awesome. So that's really awesome, that families are able to reach out to you and get that type of support. What are some of the challenges that you guys see, you know, when you're dealing with these families?
Sarah Early:
I think that's a good question. challenges, I think some of the challenges is access, they don't realize that there is this type of access to care. So they suffer alone. And they struggle without knowing that they have a way to get some help. When we're together, a lot of it is really based on education, you know, let's give you good evidence based practice. The philosophy or the principle behind lactation is pretty simple. You feed the baby with however that looks, whether it is exclusive breastfeeding, or use a formula on a bottle, and then you protect the chest or breastfeeding parents milk supply, you know, those are the founding principles. And then you kind of build the care plan, if you will around that. And it's as individual as the human or the person, excuse me, that's, that you're working with, you know, I mean, you're working with to individual people that have unique characteristics and unique backgrounds. And that's really what it is. It's a tailored approach to helping them meet their goals. They're not our goals. They're theirs.
Silvia Hazel:
Yeah, yeah, absolutely. So as far as like, what families will reach out to you for typically, I know that, you know, I've personally used you, or that sounds bad, not used you. But I've personally reached out to you for support during, you know, my postpartum periods. And that has been, you know, so helpful. I feel like that's such a vulnerable time for parents and for families. And I know, you know, there are several different reasons why families will reach out to you, what are some of the, I guess, like physiologic aspects or potentially barriers for families to really be able to achieve their goal, whether it's breastfeeding or chest feeding, or, you know, adequate milk supply? What are some of the barriers to those things?
Sarah Early:
I think some of the barriers are health conditions, you know, those are kind of in the forefront. So things that can get in the way of actually being able to make milk, you know, you can have insufficient glandular tissue, you can have a possible hemorrhage, that, you know, definitely can get in the way of milk production, lots of comorbidities. So if the, you know, the parent has background health issues that need to be addressed in order to be able to move forward with production, that that's always a key player. I also find unrealistic expectations. unrealistic expectations are a big one. Social media is good and bad, right? It's a way to connect with the community in whatever phase in life you're in. But it can also really get in the way of what's normal, and it changes some of those variables for people. So seeing that someone can pump 24 ounces in one day and breastfeed their baby. That's not really normal, nor should it be normalized, you know, we really need to understand what what a parent's body can do. And the other piece of that is the baby, there's, you know, they're a match set. So, from a physiologic standpoint, from where the babies are concerned, you're looking at their ability to transfer efficiently. So lots of little ones have a difficulty with that, whether it's because they are, you know, they may have had a bit of a struggle with being born. So we're working through some, maybe torticollis or, you know, side preferences, Angular glossa, or tongue, tongue tie. That's a that's a big one. I know. It's also hotly contested, and there's lots of debate around it. But there are a lot of barriers when it comes to that, and understanding what function looks like. So really assessing for oral function ism pourtant when we're talking about the babies, and making sure that we're not standing in the way of them getting the care so that we're actually seeing them as two independent clients, and seeing how we can make sure that they're both in the best possible scenario, you know, to be able to function effectively together. Yeah,
Silvia Hazel:
that makes sense. Yeah. So so my question is, because this was a rude awakening for me, when I had my first child was, you know, breastfeeding is not so simple as you just put the baby on there, and they eat. So why is or I guess, in your opinion, why is there this, like, lack of understanding that it's actually a very, you know, it can be very difficult and very hard? And, you know, it's understandable to need support? Where's the, like, disconnect there in our culture and society?
Sarah Early:
Oh, that's like a really good question. And I feel like that could be a whole series. What I'm finding, or what I've seen over the years and doing this is there is a lack of understanding within healthcare, of how to really support the breastfeeding couple. There's not a lot of education about it, and any schooling, nursing school, medical school, you know, ABCD, that just there's not a lot of time spent on that. I don't know why there's not because it's a big part of our population. And it's a big part of the caring for people across the lifespan. But a lot of information that's provided comes from personal experience and not vetted or evidence based information. So because, you know, so and so's grandma did it this way, then their daughter did it this way, and now they're passing on that information. That doesn't mean, it's always the best course. Yeah, you know, that that village mentality is definitely needed. But I think what we need to do is make sure that whoever is in that village is able to support the family in a way that they need it at that time.
Silvia Hazel:
Yeah. Yeah. Speaking of kind of, like that village mentality, how do you see that that kind of like impacts families in those first few months? Or, you know, the first year after birth? You know, is that always like, a good thing? Is it always, you know, how does that how does that usually play out?
Sarah Early:
I think it's good. You know, I think it's good. But I think it also depends on the dynamic within that village. Is it healthy from an emotional standpoint? Is there some autonomy? Are the parents given the ability to actually parent can they make decisions for their children without being made to feel like it's a bad decision? And then, you know, setting them up to doubt their future decisions and choices that they're making? Because really, I think one of my most favorite things about being just a tiny part of that village, and the beginning is that we get that special opportunity to support a parent learning how to be a parent. Yeah, that's it. I mean, I didn't know how to do it, I had no idea how to do that. And it's trial and error. And, you know, for me, it's super important to reinforce that you are going to be your child's best advocate. And that that gut instinct you have, there's a reason for it. And it's okay to listen to it, even if it's wrong. You know, that's okay. That's okay. You still keep listening to what you know, needs to be addressed. Because that's that innate connection, I think, that you as the birth parent have with that child, you know, I mean, genetically, you've imprinted and there's, you're not going to lose that. And so, if the village you have is reinforcing your ability to be a good parent and your ability, let me back that up. I don't think there is a bad parent. If your village is reinforcing the ability to follow your instincts as a parent, then I think it's a it's the right fit. Yeah.
Silvia Hazel:
Yeah, that makes sense. It made me think that, you know, I think all of healthcare in general sometimes distances us from our, like instincts and our gut feelings and our intuition about things and definitely being a parent or becoming a parent like reawakens that in you in a way that like you cannot deny. You can't, you know, stuff it back in a box and be like, I'm not gonna listen to you. It's really difficult. Yeah, exactly. Yeah. So that makes sense. That makes a lot of sense. As far as like, you know, supportive measures for these families that are struggling with issues with lactation, or just like struggling in that, you know, initial period after delivery and stuff like that. Do you have any recommendations that you Start with like, what are your foundations for these people?
Sarah Early:
You know? Yeah, I think honestly, the foundation is education early and often right, like, get a prenatal session on board, I recommend everybody have a prenatal session, whether it's for, ideally, for me, I like it four to six weeks before the baby comes. So that the families that we're working with have an opportunity to digest and process what we're teaching them because it's a lot. And then it allows them an opportunity to ask questions if they have questions. And you know, so that prenatal session really sets them up for success. We discuss what's normal, and what to expect. And then we also kind of talk about ways and strategies to support things, if they're not progressing as you would intend, you know, the intention is always to make sure that the baby is protected, and that the milk supply is protected. That so that means that you know, if a parent needs to pivot and give a bottle at two o'clock in the morning, because they're concerned that the baby hasn't had enough wet diapers, absolutely, I want them to feel in control. And in charge of that, it's not going to ruin breastfeeding, what it's going to do is support that baby give you peace of mind for that feeding, and allow you to move on until you can get help. The other component to that is connect with the right type of lactation support within a few days after the baby's come. So that way, you can really see what that looks like. And you know, you know you've had, you've got multiple babies, each one's different, you know, you are the same person, but you've changed as well. And so you know, there's no to breastfeeding, dyads or journeys that are going to be the same even within the family. So I think getting some eyes and support on that. And a different perspective is really helpful. There are multiple ways to get that and you know, you have a peer counselor, which is typically runs through the WIC organization. And they help with general breastfeeding questions, maybe some milk production questions, and just some basic information. There are a lot of folks right now getting the credential to be a certified lactation consultant, which is a little more extensive than the peer support, they are also a good resource to help with, you know, hey, I don't know how to position this, maybe I don't understand why this is happening the way it's happening. Again, really good to be able to triage and support that. And then you've got the credential, which is the International Board Certified Lactation Consultant credential, which is considered the Surgeon General's gold standard to be able to provide care across the spectrum from prenatal to weaning. The credential itself, just to digress a second on that I'm kind of I don't know, that shows like my, my whole geeky side, I guess, as far as like learning, but the credential itself is pretty cool, because it takes 90 hours of didactics and IDR, classroom, 90 classroom hours, excuse me, you need to have 12 to 14 college level courses. And there's either depending on the pathway they take, it's either 500 or 1000, supervised clinical hours, it's a lot of hours. Yeah. And so that's a lot of families that you're going to see. So you're going to see a lot of different situations to care for. So if we have, you know, babies and dyads that are really kind of struggling, then absolutely, I think you know, ibclc is is hands down the way to go. That's not saying there's not a place for others. But given just the background, I think it's really important to know, what your situation is, and who you should kind of be seeking out.
Silvia Hazel:
Yeah, that makes sense. Yeah. Um, as far as like, you know, kind of actually to go back a little bit to what you were saying about, about families and expectations and stuff like that. And this is a little bit of a rabbit hole. But what do you find as far as like relationships to control with families? Like how do you manage expectations with that? How do you, you know, allow them to control the things that they do have control over and then, you know, gently remind people that they might not have control over other things, you know, I'm sure that especially in that postpartum period, when everyone is high emotions, and hormones are fluctuating and stuff like that, that could be a difficult kind of area to, to move through.
Sarah Early:
Oh, it is it is because you have to, you have to remain respectful, you know, that that's their family dynamic. That's their family unit. I speaking for me, I approach it from an education standpoint. You know, again, I go back to evidence based I go back to best practice and who's ever in the room? I talk with everybody about it, and I teach them what that looks like. I asked if if there's questions you know, I honestly I can tell if the families are not fully believing what I'm saying because I you can just you know, you can read them and I'll ask Um, you know, in, in a, in a joking way, like, Oh, you don't look like you think you don't look like you believe what I'm saying, you know, tell me what you think. And so then you know, I engage them in a conversation. But first and foremost, I really just want to understand what the the parent wants, you know, I want to understand what her dynamic is because the family dynamics go much deeper than this one session that I have with them, you know, and so I don't want to be disrespectful in my approach. So I do redirect it back to the patient, and I asked them what they want. And then I can buffer that if they feel safe enough to really, truly open up about, you know, what they're hoping for? Yeah. And then I can be that bridge to communicate that with the family in a way that allows them not to feel like they're hurting anybody or stepping on anybody's toes. And so for me, I find that role pretty powerful. Yeah.
Silvia Hazel:
So you're kind of like the you're almost like the I know that there are postpartum doulas, but like, you're kind of like playing that role of a doula in the postpartum period, too, because you're the advocate for those parents and the advocate for the baby. Yeah. So that's like, that is a really powerful role. And a really special one, I'm sure
Sarah Early:
it is, I think that that is, you know, the babies have a lot of oversight after they're born. I mean, you you've got hospital background as well, you know, the babies are born, there's lots of touch points for them to get care in the hospital. There's lots of touch points for them to get hit care within the first two weeks of life. With that, you know, and then they're they're regularly monitored. The birth parents don't have that. They don't have that, you know, they they go home from the hospital. And if things are going well, they'll get checked at roughly six weeks. And then they're kind of done. Yeah. Right. So who's there to support these parents? And it's, it's us? Yeah, you know, we are that resource for them. We're able to, you know, help them through some periods where they might not have a lot of, of not necessarily medical support, because they can always reach out to their providers, but where they don't have a lot of non bias support, where it's just focused on them. Yeah. Yeah, that
Silvia Hazel:
makes sense. Yeah. So obviously, you and I have worked very closely in different capacities, which has been really awesome and phenomenal. And you know, that I have a big part of my heart is working with families that are kind of preconception to prenatal to postpartum and everywhere kind of in between. So as far as lactation, and breastfeeding go, Where do you think that functional health kind of falls in there? How can that be supportive to these families?
Sarah Early:
Oh, I love this question. I really love this question. So functional health is all about root cause, right? Like, how can we figure out the the foundation of what you need to you know, to be your best self? And for those that are planning pregnancy, then yeah, let's look at that for you. How can we support your body to allow you to grow a human right now and still be healthy, and then take it to that fourth trimester, if you will, and be able to, you know, do all the things that come from that while still functioning to provide you quality of life. I think that getting some support, preconception is huge. And, you know, if there's anything identified and then working, you know, with like you and being able to sort through those, you know, there's different issues that need some some support and some some care to improve. I have learned so much from working with you, uh, you know, I guess I don't know, I've we haven't really talked about it, but I'm in school to be a family nurse practitioner. And I have actually been lucky enough to be able to work with Capitol Integrative Health and with with Sylvia, and then I'm working also with Arlene, but I've learned so much from Sylvia throughout this process. And, you know, it's got the wheels, my wheels spinning like, okay, how can we do this? How can we better support these families? So they're not struggling on the back end? Yeah, ahead of time. Yeah. And then, you know, really looking at what that looks like. Because if you're healthier, going into a pregnancy, you're going to, you know, more often than not, you're going to be healthier coming out of it. If your body is ready to make milk, and you know, it's not having to kind of work through all of the, the challenges upstream, if you will, then, you know, you're gonna likely have a better opportunity to be able to feed your baby, honestly, however you want to, but, you know, hopefully, minimizing some of those barriers ahead of time is helpful.
Silvia Hazel:
Yeah. So it's kind of like that proactive versus reactive. You know, medicine. Yeah, absolutely. I love that. So, as far as like preconception things as a lactation consultant, and also a Future NP, what kind of things would you be interested in for someone who's looking to conceive and thinking about their, you know, potential future, for lactation?
Sarah Early:
So I think what would be really helpful to know is really, let's get their background like, what is your health history been like health history, then like, since you were a child, like, Let's go that far back and kind of see what's happening with that, you know, what type of illnesses or ailments are we seeing? Now, you know, we talked about this a lot, that sickness is just, it's a symptom of something that's much deeper, right. So let's look at what those are, and really start to assess for them and, and work through them. inflammation, chronic inflammation, I can't help but think that that impacts breastfeeding, you know, if your body's working just to stay healthy, and to filter out all of the things that it needs to, you know, the milk production isn't gonna rank up there. And as far as a top priority for your body, you know, your heart health is going to be there, your brain is going to be there, your gut is going to be there. But breast milk isn't necessary for the parent to survive, right. And so, you know, the body's got to kind of give where it can I guess, to be able to keep everything else functioning. So understand what that looks like, what's the liver health look like? Where are we at with that? Let's look at the gut health, you know, where are we at with that? What's your microbiome look like? Because you're going to be seeding the baby's microbiome, right? So how can we make sure that that we're giving them the best start as well? So for me, I think it's really just looking at the whole picture, and making sure that we're giving them the best, the best opportunity to to get a good start.
Silvia Hazel:
That makes sense. So ideally, you know, when we're thinking about things like lactation and stuff like that, we'd be starting way earlier than when we typically start. Yeah, absolutely. Well, that's, I feel like that's important for families to know, I'm sure, you know, because of the lack of education out there about lactation, and just the lack of access to support, I'm sure that patients think or people think that you know, you just kind of wait until you're, you have milk, and then you know, if you need support, then you talk to a lactation consultant, but from speaking to you, it sounds like it's really best to kind of get things rolling, or at least to start thinking about things and what you can do for yourself and your body even before the pregnancy starts.
Sarah Early:
Absolutely, absolutely. You know, I know, there's a lot of families that are a lot of birth parents, excuse me that start taking vitamins or supplements in anticipation of becoming pregnant. Like if we could get those that want to feel strongly that they want to be able to, you know, breastfeed or provide human milk for their babies, thinking about it in the same vein, you know, how can I get this started? In a way that works? Well, for me, I think that, you know, that would be a really good way to help some families prevent some of the stress and anxiety that comes with it all when it's not working well. Right, change that change the narrative. I feel like, what happens a lot is, you know, when you talk to people about law speak for me, specifically, when I talk to people about what I do, I get stories, you know, I get everybody's story on what it was like, I could be on an airplane, and, you know, talking to my seatmate, and they will tell me their story, or their you know, somebody's story that they know, breastfeeding in is such a polarizing event in a person's life that they're, if it's going well, then that's how you remember it. And if it's not going well, I can't even begin to tell you the people that I've met along the way that still carry that guilt of feeling like a medic, yes, that they didn't do enough. And it goes from one baby, one pregnancy to another. And if I can help someone work through that, so that they know that they were enough, and that they did do enough. That to me is is huge. Even if you know Breastfeeding has to stop for that couple, if they can do it on their terms, so that they don't feel like they failed. I feel like that is you know, ultimately, it's just it's ultimately what I want somebody to do, because I don't want them to carry that with them forever.
Silvia Hazel:
Right? Yeah. Well, you know, this is like the perfect segue into one of my favorite topics, which is the nervous system. Where do you feel like that plays in here? You know, where is the nervous system playing a big role? You know, is that a big component of of, you know, life for the first few months for these families? What's going on there?
Sarah Early:
I was huge, and I think that you could even go back further. You know, the nervous system isn't over in overdrive as soon as they want to become pregnant. And then you know, it that changes once they become pregnant, and then it's during the pregnancy and then it's after the delivery. I feel like these families are, you know, so and rightly so focused on wanting to have the best possible outcome and experience that sometimes that fight or flight is just really reven high. And, you know, you're shooting off those hormones that are just going to directly conflict with breastfeeding. Yeah. And it's going to deplete your immune system, which is going to make it even harder, because your body, you know, is then trying to keep you healthy. And so it just becomes this cycle. So I think mental health is an area that really shouldn't be a part of the dialogue, you know, early on and continuing through. You know, as long as the family needs it, the there's a new focus on, I shouldn't say new, maybe it is new, there's a new focus on postpartum depression and postpartum anxiety. And I think that it was underplayed and normalized for a long time, like, oh, you know, this is just how it is you're tired, you're fatigued, you're you know, you're not happy, you don't enjoy what you're doing right now as a new parent. And I think that it's now becoming talked about more like, Hey, these are real, you know, it's, it's okay, that you're feeling this way. But let's get you some resources, so that you can enjoy this time in your life.
Silvia Hazel:
Yeah. Yeah, that makes a lot of sense. It can be I'm sure, very isolating. Especially if, you know, you're feeling that way. And the part your partner is not feeling that way. I'm sure that it can probably feel very isolating and lonely, to have that experience.
Sarah Early:
I agree. I agree. And I think again, that's where having some of these other opportunities to work with providers, gives you an opportunity to have a connection with other people. And you know, those connections in your community are really what's important that you know, that connectivity? Yeah, yeah. helps keep you grounded a little bit. Yeah,
Silvia Hazel:
absolutely. So So what would you say I guess, for a family who is experiencing issues with lactation, whether it's like lower milk supply, or, you know, having trouble with latch? What would you say to a family that feels like they have tried everything, and they're feeling very, you know, alone in that case?
Sarah Early:
I think, for me, it's important to remind them or reinforced to them that they are doing a great job, they might not be getting the outcome they want. But they're still they're still doing a great job. You know, I also would ask them what their goals are. Yeah, you know, because it's not about me and the care plan I can create, I can give you a great care plan. But if you're not wanting to go down that route of that road, then it's it's not necessary, you know, it's not serving them the way we need to. So I think really understanding where they're at in the process. And sometimes you have to understand where they're coming from in. I know, some, it's hard to do, especially if you're just getting to know somebody and you may not have that relationship. But I've had so many people tell me, You gave me permission. You told me it was okay. You know, you they needed that validation
Silvia Hazel:
that have definitely done that for me.
Sarah Early:
You know, you gave me permission to give a bottle. Yeah, I felt like I was gonna ruin my baby. If I gave them a bottle. And you told me it was okay, are you gave me permission to stop pumping you gave me you know, you told me it was gonna be alright. That level of validation is impactful. Yeah, it's really impactful. You know, I, I get it. I'm, there's, I'm super type A. And so you know, you can you can put on blinders right, and just keep moving forward. And sometimes you just need somebody to, you know, kind of gently support you and say it's okay, if you want to stop. Yeah, you know, you've been brilliant. Everything you've done is perfect. And it's okay.
Silvia Hazel:
Yeah. And it's okay to be sad too, in that fact, like, you don't have to pretend like you're not sad because, you know, you didn't get the outcome that you wanted, but, but it's also okay to be sad, and also to let go.
Sarah Early:
Yeah, absolutely. Yeah. Yeah, I know. It's kind of, um, again, it's one of those points in life where nobody talks about it. Everybody thinks, Okay, I'm gonna have this baby and I'm gonna breastfeed him for 12 months and 12 months, I'm gonna magically get them on a cup. And then they're gonna be eating three solid meals a day and everything is just gonna be like the book say, right. But it's not like that. It's not like that at all. And I think, you know, understanding that is really is really important. Yeah, yeah, it's, um, you know, it's like a story cuz sometimes with what you're doing
Silvia Hazel:
so I, as a lactation consultant, what would be kind of like your favorite part of the job? Like, what's, what's the best part about doing what you do?
Sarah Early:
I, for me personally, yeah, I love watching parents grow into their new role. I love, love, love, love watching them know, that they can do it, you know, seeing their confidence raised with, with how they're taking care of their babies, you know that, to me, there's nothing greater than that, you know, you have been able to help somebody feel better about themselves, and know how that they can do it. Right. You know, there's always self doubt with parenting. I mean, I've got three kids, you know, they're all young adults. And I still every day, you know, have doubts on things that I'm doing with them, and they're grown and independent. And that that part never goes away. But I know that the foundation that I'm laying that I've laid for them, you know, they're going to be okay. And that's really what I think is important. When you're getting started as parents knowing that whatever foundation you lay, you trust that it's going to, it's going to be the right one for them. So for me seeing parents learn that I have that, like makes my heart happy. Yeah.
Silvia Hazel:
So So for new parents, if you're talking to new parents, and they asked you, Sarah, what's the most important thing for us to be doing right now? What would your answer be,
Sarah Early:
I would say, your the most important thing you can do right now is make sure you're taking care of you. You know, as cheesy as it sounds like with the air, the air mount, or the oxygen mask analogy and the airplane, straight up, that's it, you need to make sure that in some part of this transition, you're still okay. And that you are having your needs met, because then you are definitely going to be better served to meet your baby's needs. Yeah, like I, I'll go back to what I said, your baby has so much oversight from their medical providers from the people in your life, everybody's going to make sure that that baby's taken care of. And a lot of times the parents are struggling, you know, they're not getting that same kind of support. So support yourself, however, that looks. I know, time and fatigue are a big key piece of that some people you know, if you can meditate, even if it's just five minutes a day, if you can work with your partner to make sure that you're getting fed something as simple as eating, let's get you fed, set up little snack stations and hydration stations around your house. So you don't have to think about it. And it's easy to grab and go. You know, I know we like to reduce waste. But during that period, if you need to use, you know, paper plates, then you use paper plates, cut it where you can so that you're not having to really focus on the minutiae of, of, you know, life. Yeah, and ask for help. Oh my goodness asked for help. Yeah, ask for it. I can guarantee you if you ask for help, you're gonna get flooded.
Silvia Hazel:
Yeah, one of my favorite books, actually to recommend to like pregnant and preconception women is the first 40 days by hanging out I love that book, because it normalizes this idea of, you know, we need to take care of ourselves as parents have to take care of ourselves. You're right, the baby gets so much oversight. And honestly, if you're okay, the baby's okay. Right. Yeah, you know, but I do really love that. And you're right, like that village is they're just waiting to be asked, but like, they don't need to necessarily be watching the baby. They need you to be you know, cuddling and taking care of yourself and watching the baby and they can do dishes and laundry and making meals and stuff like that.
Sarah Early:
I mean, you need to be able to get all those those feel good hormones. Yeah, you know, really, you need that that's what you're gonna get from, from holding, and snuggling and kissing and smelling and the thinking about your baby, you know, that's what you get. And that's what really helps that postpartum period as well. You know, your body is incredible. And I guess I'm a bit of a sciency, geeky, but like, I love the fact that your body responds to your baby's needs. If your baby's cold, you know, and you're doing skin to scanner feeding your chest heats up a degree or two or cools down a degree or two to help regulate so some thermo regulation. The fact that breast milk is living, you know, it's a living organism and it's evolving and your baby's feedback tells your body what it needs to do. So you innately are set up to be able to You care for your baby. But I think you lose sight of that by caring for the baby and all the things that that come with that. So getting help, and making sure that you're taking care of you is huge.
Silvia Hazel:
Yeah. So what I'm hearing is our bodies are magical. And we just have to listen to what they're it's trying to tell us we need.
Sarah Early:
Yeah, it is it is, you know, the foundation is there. That's not to say that there's not going to be barriers. And there's not going to be things that get in the way of that at all. Like, I don't want this, I don't want it to be kind of like glorified like, Oh, our bodies know what to do. But they do it knows what to do. But also realistically, like, if you've got a baby that's got a tongue or lip tie, and you're not they're not able to transfer milk, then, yeah, that needs to be assessed and addressed by you know, people that know how to help you with that. But there are people that can help you with that. And I think that's the walk away. Like you don't have to like toughed it out on your own at all.
Silvia Hazel:
Yeah, that makes sense. So, for families out there that, you know, are hearing about tongue lip tie, that sort of thing. What are some signs and symptoms of that? That you would say, Okay, you should probably be evaluated or have your baby evaluated for this?
Sarah Early:
No, that's a really good question. And honestly, that's about the bulk of our practice with lactation room, it's probably 85 to 90% of the babies that we see. When we're talking symptoms, you've got two patients, two people that you're thinking about. So for the parent, you will have or could have nipple pain, significant net nipple and tissue trauma, low milk supply, frequent clogged ducts, mastitis, feeling like your breasts are never inter empting. You there could be supply issues over or under, you could have from the baby, we could be dealing with low or slow weight gain, you know, all babies lose weight, but it's to what degree and when we need to intervene. And, you know, how is their regain happening? How are they able to do that? Those are going to give us the some red flags on function and the baby's efficiency at the breast? Does the baby you know choke and come off the breast pop on and off often is the baby falling asleep a couple minutes into the feedings where you cannot get them to wake up? Are they just kind of managing and writing your milk wave meaning like, you put the baby to the breast and your body's super cool in that it's like, oh, okay, I know what to do. And it lets down this little, you know, better reserve that you've got in your breasts before, you know, the baby has to suck to be able to continue to make the milk. But they stop because they don't know how or they can't suck efficiently, gassy babies that have lots of colic, explosive diarrhea, mucousy stools, and also babies that leak milk, you know, all of those things tend to be symptoms, that raise flags, that there's some feeding dysfunction. And I do want to say that all of I know, you know, I'm, we're lactation. But I do want to say that that is not only on the breast, that's bottle as well. So those symptoms are not unique just to breast or chest feeding, they can also be present on the bottle. And one thing I do want to caution is just because you see something that looks like a tie, that doesn't mean that it necessarily needs intervention. That's why you need to get connected with an ibclc who can do a good feeding assessment and you know, a functional assessment on the baby and on you to make sure that you know, yes, this is something that we should think you should you know, seek an opinion from, you know, a dentist or EMT or a provider that can give you that insight.
Silvia Hazel:
Okay, yeah, that's really helpful. I think that there's lots of like tongue ties, like a buzzword, you know, and I don't think that people fully understand what that means or what that entails or how it impacts feeding or, or even other things further in life for these kiddos. So that I think that that's really helpful for people to hear. Learn a
Sarah Early:
little bit about it, you know, and it's it's, I think it's the genetic component is there. And again, I think it's one of those things that's been normalized through the generations. Yeah.
Silvia Hazel:
So as far as like, you know, kind of more collective looking at the collective. What do you think that our community and our communities need, in order to help better be supportive to these parents?
Sarah Early:
Oh, that's such a good question. I think to in order to really support these families, we need we need to do better with educating our health care providers, those those points of contact, they're going to be taken care of these families. They they really need to have more education so they can better educate. That I think is important because so many people rely on them, you know, and they really trust them which they should. I think that we need to have More normalization of what breastfeeding looks like. And I think it's okay to also normalize the use of a bottle and formula if necessary. So people don't feel like there's, you know, it's so divisive and two camps. Because ultimately, to support this time and life, everybody needs to be together, you know, it needs to be collective, just because a person is bottle feeding their baby, it doesn't mean that they can't support somebody that's breastfeeding. Right. And so if we can create some collectives and within the community to, to reach everybody, you know, make access to care much more attainable, that that would be really, really important.
Silvia Hazel:
Yeah, yeah. I think that that makes a lot of sense, just kind of making people feel comfortable in the decisions that they're making or the decisions that, you know, kind of have been made for them. Yeah. But that they're, you know, committing to
Sarah Early:
which is important. So, absolutely, absolutely. You know, there's room at the table for everybody. Yeah, absolutely. I think that we just need to make the tables. Yeah.
Silvia Hazel:
Yeah, that's really powerful. Well, Sarah, you know, for anybody who's listening that wants to get in touch with you, or your team or wants to work with you and your team, what would be the best way for them to do that?
Sarah Early:
We have several, okay. So you could send an email to Hello, at lactation room.com, you could go to our website directly, which is lactation room.com, there's booking options online, you can also read about the different services that we provide. Or you could call, you could call us directly and the number I can I guess I can give it 301-529-5433. I have and I say this all the time, I raised three children, that we're all athletes, so I have a lot of sports analogies. But I have a deep bench of we have within within lactation room, like our benches deep with talent. So I have no doubt that whoever you would work with will be able to provide you, you know, 10 out of 10 great care. Yeah,
Silvia Hazel:
I love that. Well, and I can definitely attest to that too, because I've worked with you a lot. But this was so great. I feel like this was a conversation that really needs to be had more, and I'm just so grateful for you. And for you to come on and kind of talk about this with me. So thank you so much for being here.
Sarah Early:
It is my pleasure. Thank you so much for having me. And, you know, thank you for all that you do. I know that we our journey got started together because of lactation. And now I feel like you know you are now able to to help me learn and you know, it's full circle. It's community. Yeah, yeah. Right community. Yeah, absolutely.
Silvia Hazel:
I love that. Thank you. Yeah, this has been great. Thanks.
Dr. Andrew Wong:
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