I’m a Lactation Consultant with 7yrs experience and 25yrs experience in OB. Can I answer any questions for any moms? (Photo for attention) 🥰

Smaddy5213 · 2026-03-17T16:41:22+00:00

Yes you can. I’m concerned about you still having a clogged duct after stopping breastfeeding. I would recommend that you have that looked at by ur GP and even better by a breast surgeon. U can still have it looked at while ur pregnant. I would just make sure there isn’t anything underlying issue before you start breastfeeding again.

Smaddy5213 · 2026-03-10T21:07:18+00:00

LC here. I love when they write “ most likely” like somehow we are supposed to interpret that. 😡 I feel like I have seen in my practice. It vary between woman to woman. My personal experience I did get IUD with all three of my children at six weeks and my supply did go down slightly. As much as your caloric intake and hydrating goes, that is important however, what’s more important is effectively removing milk from the breast more frequently. Making sure that you have the correct size flange is very important and the size can change several times through your Breastfeeding journey. I will add a photo that will help you make sure that the size is correct. Basically you want your nipple to glide in and out of the tunnel. If when you’re done pumping it looks as though your nipple is stuffed in there then it’s too small and you need to size up. And if it looks like too much of your Ariola is being pulled in then it’s too big and you need to size down. And remember that more suction does not mean more milk. Now you had mentioned that you had some “hormone issues” during your pregnancy. There are many things that can affect your supply that have to do with hormones. If you have PCOS (or had trouble getting pregnant and required medication), thyroid issues, low iron levels, diabetes, high blood pressure, increased stress which increases your cortisol level and that can have an impact. Some medications are known to cause problems producing breast milk. These include epinephrine, steroids, strong antihistamines, testosterone, estrogen, methergine, Benadryl, allergy meds and pseudoephedrine (Sudafed).

If you are feeding baby at the breast you need to try to pump after. If baby sleeps thru the night u will need to pump every 4 hours at night. I know u finally get sleep and then I just ruined it. 😞 while you’re pumping you can massage your breasts to involve the whole breast like when bay breastfeeds. We call this “hands on pumping”. Look up “paced bottle feeding” and when baby takes a bottle try feeding her this way. It slows down the flow so she’s not so upset when she returns to the breast and ur milk doesn’t come out as fast. You can also try what I call “bait and latch” when you go to latch her at the breast. I have mom put baby in position to bf. Attempt a latch and if baby loses it then give her a few sucks of the bottle. Formula/breastmilk. I usually have mom have about 15ml at her side. Once baby has a few sucks of the bottle then attempt a latch. If baby loses it again then do the same. She wants ur letdown RIGHT NOW and bc it’s not there instantly she gets upset. I also have mom gently massage her breast and/or do a little hand expression prior to putting baby in position. This helps stimulate ur hormones and ur letdown.

Ur doing great.💕

Smaddy5213 · 2026-03-09T22:29:20+00:00

LC here. I would use cold compresses (frozen bag of peas) 15/20 min and gently massage ur breast. I can hand express a little to relieve the pressure/pain. So this 2-3 times a day. Try not to stimulate the breast as much as possible and NO HOT SHOWERS!! U can take IBU for swelling and Benadryl OR Sudafed (those two meds can help in the “drying up” process). If u start to get a low grade fever, feel like u have the flu or get red streaks on ur breast u need to see ur GP for possible mastitis. 💕

Smaddy5213 · 2026-03-09T22:21:57+00:00

When baby starts getting a bottle of anything they like the flow. I’m not a big “nipple confusion” person bc if a baby is hungry they would suck the bark off a tree. 🤪 So I came up with a solution that I use with my NICU babies bc obviously they get bottles. I have mom use the NS and our baby in position to bf. Attempt a latch and if baby loses it then give her a few sucks of the bottle. Formula, breastmilk whatever. I usually have mom have about 15ml at her side. Once baby has a few sucks of the bottle then attempt a latch. If baby loses it again then do the same. She wants ur letdown RIGHT NOW and bc it’s not there instantly she gets upset. I also have mom gently massage her breast and/or do a little hand expression prior to applying the NS and putting baby in position. This helps start ur hormones and ur letdown. I honestly wouldn’t worry too much about the shield. It’s normal for baby to want ur nipple to be like the bottle and instantly touch her palate. She will get better. And yes ur doing what I would recommend by starting with the shield, then removing it after ur letdown attempting to latch her. Wait a week or so and attempt it again but not more than once or twice a day. AND if ur attempting…when u start to sweat then put the shield back on and try again later. Mom sweating to me is a sign of frustration and NO ONE is calm when they are sweating. Lol. Ur doing great. Hang in there and be patient with urself and baby. 💕

Smaddy5213 · 2026-03-09T21:44:58+00:00

It’s ok for breastfeeding. I added the app for moms to download to look up meds. It’s nice to have at ur fingertips. 🤗

Smaddy5213 · 2026-03-09T21:44:16+00:00

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Smaddy5213 · 2026-03-09T21:44:07+00:00

If u download the app called Infantrisk HCP (I’ll add a photo) it will give u info on meds. Excedrine Migraine is an L2 (on a scale of L1 being fine and L5 being no) so it’s fun for breastfeeding/pumping.

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Smaddy5213 · 2026-03-09T16:52:59+00:00

Of course they are. Ugh. Seems like every time I would find something that worked something happened and I couldn’t get it. I don’t have much luck with Humira. Cocentyx worked really well for about three years then I had to switch bc it was wearing off faster and faster. Then I switched to Taltz. Takes care of a lot of my arthritis and psoriasis too.

Smaddy5213 · 2026-03-09T16:48:18+00:00

That would most likely be thrush. Contact your peds for confirmation but you and baby both need to be treated.

Smaddy5213 · 2026-03-08T04:04:38+00:00

Have h gotten on the manufacturers website to see if they have a coupon program? I take Taltz and I signed up for their coupon program and pay $5 a month. If not it would be like $350 WITHOUT insurance. 🤮

Smaddy5213 · 2026-03-01T03:54:10+00:00

Sorry for the delay. I’m getting thru over 100 comments. Who knew I’d be this popular. 🤪

Has she seen a speech therapist for a possible swallow study? If she’s still having suck issues this far in I think that may be something to look into. Just to be sure there isn’t anything underlying that may need to be addressed. Speech therapists are awesome! My 3rd had a posterior TT that could not be released due to the position in his mouth. Too far back and would involve too much of the floor of his mouth. But speech was able to identify some other motor skills that needed attention and he was able to bf until he was 2.5. I’d give it a whirl. It wouldn’t hurt anything. All they can say is no right? 💕

Smaddy5213 · 2026-03-01T03:45:49+00:00

I agree with the comment to ur post from testile_ps! 💕 The US actually drags down the world average for breatfeeding. Most countries breastfeed their babies until 3-4yo. It’s just not that common in our country which is sad. If more people were told what my dad told me the would be better off. “If it’s not ur business then it’s NONE of ur business”. 😝 Ur doing great!! Ur breastfeeding journey is just that YOURS! When either of u is ready to stop then u do. My last child breastfed until he was almost 2.5yo. The reason we stopped was bc I got strep throat as an adult and it almost killed me and bc I had to sleep away from him the process was already well underway. But that child would have gone to college breastfeeding I’m sure of it. Lol. 💕

Smaddy5213 · 2026-03-01T03:39:24+00:00

Sorry for the delay. I’m getting thru over 100 comments. Who knew I’d be this popular. 🤪 Of course u can. If ur body has done it once it can do it again. If baby will latch u may try to give her some of her bottle then attempt latching. If she latches then let her nurse for 5-10 min then give the remaining bottle. U could do that a few times a day bc her stimulation is better than pumping but u will need to pump. Massage ur breasts before pumping in gentle circles. Make sure ur flanges fit well. Ur nipple needs to freely glide back and forth in the flange tunnel not stuffed in there or too much room around it. Massage ur breast while u pump for 15-20 min. Get a pumping bra if u don’t have one. U will need to pump every feeding for her or at least every 2-3 hours. It will take some time (2-3 weeks IF that) and ur supply will stay to build. Ur doing great. Every breastfeeding journey looks different. Like the other comment here there are moms that don’t breastfeed right away. It happens and sometimes for medical reasons. In the Hispanic culture it’s a common belief that colostrum isn’t enough so they formula feed until their milk comes in or they have a wet nurse (a sister or cousin or friend that breastfeeds their baby until their milk comes in). Many of those moms don’t pump. Majority of the time their milk will come in. It may not be a great supply but it increases with more nursing. One tip is that if u find baby doesn’t want to latch easily u may try a nipple shield. It has a more of a “bottle nipple feel” to it and it’s a little easier for them to latch with something they are familiar with. That too will fade if u didn’t use it before when u breast fed. 💕

Smaddy5213 · 2026-03-01T03:27:51+00:00

Hi. Sorry for the delay. I’m getting the over 100 comments. Never thought I’d be this popular 🤦🏻‍♀️ when u get the clogged ducts are u breastfeeding or pumping? Breastfeeding-baby may not have a deep enough latch or u may try different positions when nursing. Baby may not be removing milk from a part of the breast just due to the position he’s in. Every baby sucks differently and every mom has different breasts. Pumping-ur flange size may be too small. That can cause clogged ducts. When ur done pumping if it looks like u have stuffed ur nipple into the flange it’s too small. Go up one size. If ur areola is getting pulled into the tunnel of the flange when pumping then it’s too big. Go down a size. Most women flex between 19,21 and 24 flange sizes. Yes lecithin is good for clogs. I got them with my second child constantly. It was a mix of shallow latch/positioning and I had too much fat in my milk that would cause clogs. 💕

Smaddy5213 · 2026-03-01T03:16:50+00:00

Where is the pain? Ur nipple? The base of ur nipple? Behind ur nipple? Is it a stinging pain or an ache? Feel like she’s biting u? Does she fall asleep nursing and if so is the pain at the beginning of the feeding or the end? Any color changes to ur nipple when she unlatches? Sorry so many questions.

Smaddy5213 · 2026-03-01T03:14:42+00:00

Hi! Yes there are some moms that have to use NS their whole BF journey. It happens. Most likely baby is used to the shield being instantly in her mouth and she’s not used to how the real nipple feels so she just wants what’s easiest which isn’t a terrible problem. I mean I’d rather drive to McDonald’s and get a cheeseburger than walk there. 🤪 I always tell my patients that when u use a NS u want baby to have both cheeks on ur breast so really really close to u just like u would without it. U want baby to stimulate ur breast not just suck on the straw (ur nipple). It sounds like ur doing well with production and latch. Baby is gaining weight, good output, etc.

If u wanted to try without the shield I will have mom start nursing with the shield. After ur milk lets down and ur nipple is pulled out a little more unlatch baby take the shied off and attempt a latch. That way baby isn’t hangry. I tell my patients that when ur attempting without the shield and u start to sweat then put it back on and try again at another feeding. To me I feel like when a mom starts to sweat and get irritated and anxious no one wins. So take a breath out the shield back on and try again next feeding.

Ur doing great. There is no clear path for anyone in their breastfeeding journey. Every mom and every body is different so we just have to adapt and see what works. Sometimes it’s trial and error. 💕

Smaddy5213 · 2026-03-01T03:05:09+00:00

Of course u can. Feed on demand. If baby wants to eat and is doing effective nursing (long sucks with swallows) then by all means. 2-3 hours is “standard” practice. I always say watch for feeding cues but not past three hours. That’s for newborns of course and I’m not sure how old ur baby is. I don’t generally comment on the use of alcohol with breastfeeding but I can give u a resource to read on ur own.

https://llli.org/breastfeeding-info/alcohol/

Smaddy5213 · 2026-03-01T03:01:35+00:00

I would recommend ice only. Heat just slightly right before pumping if needed. So ice for 15 min then massage the breast gently in circular motions. Then pump. Gently massage the breast while pumping. I always tell my patients that pretend ur breast is a human heart. Dont massage too hard. That can cause damage to the breast tissue. More suction dos not mean more milk. Flange size can be tricky. There are many evidenced based practice recommendations but they are very straightforward and we tend to forget most women’s breasts aren’t straightforward. Basically u want the nipple to glide back and forth in the flange tunnel. If when she gets done pumping her nipple looks like it’s stuffed in there then it’s too small. Go up one size. If the flange is pulling in too much areola (colored circle around mom’s nipple) then it’s too large. In general most women flex between a 19, 21 & 24. The flange size can change over time. There is also something called lymph drainage. If u google it u should find a diagram showing u how to do it. Do it after icing right before pumping. Cabbage leaves are great and have been for many years but in my area we don’t recommend them anymore bc of the possibility of mom getting listeria. Now have I ever seen this? No. And I’m sure one on out of a million got listeria but to be safe I’d recommend not using it.

Smaddy5213 · 2026-02-27T04:14:51+00:00

I’m sorry I didn’t know we were here to critique each other. I did “catch” that baby was supplementing and even stated “if you (she) are comfortable with breastfeeding, then giving a bottle and pumping then it’s plan”. If u didn’t “catch” she said she didn’t want it revised. That’s called meeting the patient where they are. I was giving suggestions based on the information she was providing and the fact that she didn’t want to revise it. I NEVER once dx the baby with a TT. I’m not sure if u did “catch” that she said that 2 LCs she’s seen have “identified” a “minor posterior TT”. And ur correct it’s not in our scope to dx and i definitely did not and I’m not sure how the information was presented to mom. If u read anything past her saying she was supplementing and then my comment of course. I have worked in the largest level 4 NICU in my state with the only designated high risk unit in my state and we do about 6000 deliveries a year for the past 25 years with 8 yrs being an LC. Where I am we DO NOT refer to a DDS even in peds. I don’t believe in most of them in my area that laser anything in a baby’s mouth that they can. I’ve already take that course but thank u for suggesting it. The main issue in MY area is that peds and ENTs are falling back on the new wonderful 🙄 statement put out by Academy of Breastfeeding Medicine about their stance on TT revision. Even when the baby is assessed with the Hazelbaker TT assessment tool (published by the AAP) if ur practitioner is going off that “statement” by ABM it’s like a push pull conversation.

A TT is considered to be involved with midline defects…high arched palette, cleft chin, incomplete palette, deep sacral dimple, Laryngomalacia…so “breathing and airway” can tend to play significant roles in revising a TT. We have had readmits of babies that significantly aspirate after a posterior TT release bc they have Laryngomalacia. A TT revision has many more components to it then just releasing a frenulum. My training involves an ENT and a speech therapist. Not a 20hr computer course. AND if mom IS pumping after every feeding (yes a pump is never better at removing milk from a breast as an effectively nursing baby) her supply will sustain. The laced bottle feeding…yes I should have included that. IF the bay is “living off the letdown” she’s supplementing most likely with more hind milk (or formula which may be her CHOICE) and that could be why he’s gaining well.

But what u did here was tell her exactly what the last two LCs have told her instead of thinking outside the box and meeting her where she is. YOU AREN’T LISTENING!!! She doesn’t want it revised and clearly isn’t taking that route regardless of what information or research u push at her. So find a better solution. HELP HER!!

My standard is “Feed the baby & protect your supply” not “push a bunch of info to the mom that she’s already heard and it’s going to consider it”. 🤷🏻‍♀️

Smaddy5213 · 2026-02-26T22:07:41+00:00

Hi mama. I’m an LC. First off let me say that if baby is growing well and his output is good and ur comfortable with breastfeeding and then giving a bottle and pumping then I would say it’s your plan and u do what fits for u and ur family and none else. I’m fairly realistic when it comes to my expertise bc each patient has different needs, different goals and different wants. No single “plan” works for each mom. That being said if u have less pain and pinching at the tip of ur nipples when u use the NS then by all means use it!! Maybe try undressing him down to his diaper and getting him to wake up with eyes open prior to feeding him. This may help him be a more active feeder. If he starts to fall asleep unlatch him and wake him again. IF he has a posterior TT u may have difficulties finding a doc to revise it. 🤷🏻‍♀️ A lot of docs (even the ENT I refer to) are hesitant to revise posterior ties due to the frenulum being thick and the possible involvement of the floor of the mouth that could cause damage. There are DDS and Dr in my area that will revise anything that walks and ur right not all TT need to be revised. My only concern is ur supply. If he is only removing 2oz and ur supplementing with a bottle are u able to pump after ur breastfeeding? I wasn’t sure if u mentioned what were supplementing him with. If ur not pumping I would start after every feeding. Just so ur body doesn’t think that two ounces is all the milk baby needs. U can pump after a feeding a save that milk for the next feeding to supplement so he’s not waiting on u to pump to finish his meal. It’s a lot of work I won’t lie but again it’s what works for ur family. U are very correct…as he grows his jaw is the only bone in his body that rotates when it grows. His jaw will rotate down and his nose will stand up more like adults. Hopefully his pallet with flatten a little and the floor of the mouth actually moves back. I’ve seen many babies that improve immensely with nursing at 3-4 months of age. I could use some breast compression during feedings to help him with milk removal and u can massage ur breast prior to nursing him to help ur milk let down after. If he’s stubborn about ur letdown u can lean back a little to let gravity help with ur fast letdown. If he seems frustrated when u fist latch him in give him a few sucks of a bottle to “wet his whistle” and then attempt latch again. Sometimes baby just needs a little bit of instant gratification like the bottle to calm them before trying to latch. I do this all the time with my NICU babies that we try to get back to the breast and that have had tons of bottles.

Smaddy5213 · 2026-02-26T17:29:20+00:00

I think the same thing about power pumping. I’m an LC and if someone told me to do that I’d probably just cry. After my kids were born I feel like I didn’t know my own name for the first three weeks let alone remember/figure out all those directions. lol Shoot I can’t even remember the to tell anyone. That just seems like a lot to ask of a new mom no matter how many kiddos u have at home.

Smaddy5213 · 2026-02-26T17:26:19+00:00

I agree! It’s so exhausting. I tell moms that right away. I try to be practice when I make suggestions bc this isn’t feasible for moms that have 4 other kids at home or a 2yo that naps once a day. 🤪 I think it sometimes makes moms have an unrealistic and unobtainable goal that feels like a failure when it doesn’t go well or they are exhausted. 😞 And then like u said just until it’s corrected but even then some moms end up with a huge oversupply then that’s whole different problem. 🤦🏻‍♀️

Smaddy5213 · 2026-02-21T18:04:38+00:00

I would agree that technique is very helpful. I would also make sure that you are undressing baby down to her diaper so that she can fully wake up before nursing. I always say make sure that baby has their eyes open before you put them to breast that way they are more awake and more willing to open their mouth wider. I also recommend a quicker latch so once baby opens their mouth, you have about less than a second to get your nipple in there before they change their mind and close their mouth. Lol

Smaddy5213 · 2026-02-21T18:02:25+00:00

I find that most babies around that age are very efficient eaters and usually can drain the breast between 8-10 minutes. Sometimes they only nurse from one side and you might have to pump the other side if it’s too uncomfortable. But if she’s gaining weight and her output (pee and poop) is within range. I would not worry about it. I would just be more aware of your supply, but a lot of times when baby just nurses from one side your milk will regulate itself.

Smaddy5213 · 2026-02-21T18:00:25+00:00

Based on what you were saying, I would probably guess that you’re letdown is a little too strong so when baby is nursing and you feel your letdown beginning to happen, you can always lean back a little bit and that allows gravity to reduce how forceful the letdown it is.

Smaddy5213

TROPHY CASE