The Fourth Trimester

Today’s episode is a wide ranging discussion about all the things you can expect from the fourth trimester, those first few months with your new baby. 

I’m joined by Lucy Webber IBCLC, a former midwife who went into private practice following the birth of her third child. Her new book, Breastfeeding and the Fourth Trimester, is out now. Lucy shares her wealth of experience and knowledge on hunger cues, recovering from a difficult birth, the early days of breastfeeding, pain and faltering growth, and towards the end of the episode, we bust some breastfeeding myths.

You can find out more about Lucy at www.lmjinfantfeedingsupport.com

My new book, ‘Supporting the Transition from Breastfeeding: a Guide to Weaning for Professionals, Supporters and Parents’, is out now.

You can get 10% off the book at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

Follow me on Twitter @MakesMilk and on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com

Resources mentioned -

Lucy’s book,  Breastfeeding and the Fourth Trimester: A supportive, expert guide to the first three months

English Language Videos - Global Health Media Project https://globalhealthmedia.org/language/english/?_sft_topic=breastfeeding

Breastfeeding Support - Breastfeeding tips, tricks & support https://breastfeeding.support/

Lucy’s Facebook group, Breastfeeding Autistic Children https://www.facebook.com/groups/1528426334368681

This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Transcript

Hi. I'm Emma Pickett, and I'm a lactation consultant from London. When I first started calling myself Makes Milk, that was my superpower at the time, because I was breastfeeding my own two children. And now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end. And I'm big on making sure parents get support at the end to join me for conversations on how breastfeeding is amazing. And also, sometimes really, really hard. We'll look honestly and openly about that process of making milk. And of course, breastfeeding and chest feeding are a lot more than just making milk. 

Emma Pickett  00:47

Lucy is a modest person, so she's probably not going to allow me to gush too much here. But I will say without hesitation that she is one of the gems of lactation support in the UK. You'll find her on Instagram where she's got around 60,000 followers. You can also read her book, which we'll be discussing today. And you can find loads of valuable articles on her website. She qualified as a midwife in 2002 and became an IBCLC 10 years after that. So with her work in the NHS, she was leading her hospital trust working towards UNICEF Baby Friendly accreditation, she also ran a tongue tie division service and a specialist clinic. But after her third baby, she decided not to go back to the NHS and moved into private practice. And today I'm very excited to be talking to Lucy Webber about The Fourth Trimester, because that's the title of her beautiful book, breastfeeding and the fourth trimester. So we're going to be talking particularly about those first three months after birth and getting breastfeeding off to a good start. Now, I know Lucy, on your website, you also mentioned you have a beagle. Is there anything else important I haven't said in the introduction that you think we need to get covered before we get started?

Lucy Webber  01:54

Thank you so much for having me. Yeah, I mean, what is there to know about me? I mean, I have got a beagle. But actually, I'm a crazy cat lady. I have five cats. So you know me and I would quite happily just live me snuggle up with my cats. So I have a beagle, five cats and axolotl, and some stick insects. So I live in a zoo. And I also have three children in my zoo, who are 1715, and seven, and they are all neurodivergent with wonderfully wired brains, autistic and ADHD. And I live with my husband as well. And we live in North Somerset, having moved into our new home just a few weeks ago. So we're still settling in and surrounded by boxes. 

Emma Pickett  02:32

Well, thank you for making the time when you're surrounded by axolotls. I can't even say the word, let alone look after the I've got a gecko that's easier to pronounce. So I read your book a few weeks ago, and absolutely loved it. It's a friendly book, which I think is a word I would really use to describe how you come across generally, in your, in your Instagram lives and in your posts on social media, you say on your website, that you're non judgmental, and that's a word that often gets thrown around. But I think it's really clear that that's something you believe in profoundly in the work that you do with families. What do you mean, when you use the term non judgmental?

Lucy Webber  03:08

I think really, for me, it's about the families I work with. I mean, there really is just just no judgement coming from me, it's as simple as that, really, and that there's no, I'm not placing any good or bad or right or wrong, or any sort of anything, it's just a completely neutral. You know, I will support you in whatever you are doing. As long as you are making an informed choice about what you're doing, and you're happy doing it. Those are the two most important things really, if I know that the families I'm working with have got that going on and I am very happy person because ultimately it doesn't matter what I what I think or feel about anything. It's up to the individual families with very much in a world of the mummy was still and I drives me crackers, you know that everybody's pitted against each other with whether you're, you know, using real nappies or disposable nappies or bottle your breast or using dummies or you're not your co sibling, and you're and it's just exhausting is absolutely exhausting. And it's not needed. Because we do what we do, and it's not up to anybody else. And so if somebody's working with me, or if I'm supporting them in some way, it's nothing to do with me really unnecessary for them regardless.

Emma Pickett  04:17

Yeah, well, I need to do a brilliant job doing that. So let's talk about the fourth trimester. Why did you particularly want to focus on that, and why do you think that's a useful term?

Lucy Webber  04:26

Um, I was approached to write a book and I was humming and hawing about where I was gonna go with it. And I realised that the things I do most are working with these families trying to, I could have called it navigating the fourth trimester honestly, because it feels like families are trying to navigate the sort of massive Venn diagram of all these different things that could possibly be coming up in the fourth trimester and trying to work out what's going on for them. You know, they're trying to figure out latching and reflux and colic and thrash and nipple pain and all these different Things in trying to work out what signs and symptoms are happening for them. And what that means or whether it's just normal. I spent so much time working with families helping them navigate through this, they felt like there was a little bit of a missing window. And I had written this sort of blog post, I guess just about this, you know, trying to navigate these bits where you're being told, or it's thrush, or it's cow's milk allergy, or it's, you know, all these different things. And so many families have read it and kind of gone, oh, my gosh, you're describing my life right now. You know, I've never seen anything more validating I've never seen anything that just, I could have written this. Yeah. Are you watching me through my window, that kind of thing? That I just thought that I feel like there's this needs to be expanded and given some more information. So that's kind of why I chose that topic to write about. And then the reason I think it's a useful term, is because it really I mean, there's obviously there isn't four trimesters try me three, there are three trimesters of pregnancy. But those first few weeks and months after a baby is born, it very much is like you're trying to replicate a sort of very womb like environment, and you're just trying to almost continue pregnancy. But on the outside, you know, there's lots of closeness and warmth and little feeds all the time, and rocking and heartbeat sounds and all this kind of stuff. And I just, I think it's quite a useful term in that respect to try and help people understand that actually just really trying to recreate, you know, pregnancy on the outside.

Emma Pickett  06:26

Yeah, and scale back your expectations. So what you can achieve, you're not going to be talking about Brexit and Gaza in the local coffee shop on day three. I think other cultures get that better than we do possibly in the UK. Okay, so I don't want to steal too much thunder from your book, because I want people to buy it and read it for themselves. But I'd love to pull out just a few quotes because I love the language that you use. So this is a quote from your first page and you talk about the first three months of a baby's life being a whirlwind of a time, magical but messy, terrific, but testing, surprising, Soul affirming, and yes, perhaps a little unsettling at times. It is both wonderful and awful. I mean, that is just bang on. What do you remember about your own fourth trimesters? Just to put you on the spot for a moment there? How were you? Where were your experiences?

Lucy Webber  07:15

I mean, yeah, it was pretty much like that. Really? I think I mean, the first with my first baby, who was 17, nearly 18, which is terrifying. So I don't know where that went. I was a midwife, you know, and I thought I knew what I was doing with breastfeeding. I thought I understood. And I did not, I had no idea. And it really threw me, I don't think anything can really prepare you for that first baby experience that just feeling completely shocked by the whole thing. And just the hormonal. I mean, some people are much more affected by their hormones. And certainly I'm one of those you know, and that hormonal craziness, the sleep deprivation, I thought I knew what tired was, I thought, Oh, I've done night shifts. You know, I've done loads of night shifts, I've had busy shifts, I know what tiredness is, but this was like a whole nother level of tiredness, you know, and, and it threw me because I thought I knew what I would be doing. And I did in general, even though I've been a midwife for however many years, I have no clue. And actually, we had quite an okay time in that first with my first sheep sheep fed. Well, she grew. She was great. She was colicky in an evening, you know, that's what people were referring to it then and a very sort of cry, baby, and then evening. But other than that, things were were as easy as they could possibly be. And yet, I found it terrifying. And that sort of bed dread of the nights coming was was huge. And I didn't know that was a thing. That's a real phenomenon that people experience and I thought it was just me and that I was just being, you know, being really washy or not coping well, or do you know, and so many experiences, so many things that I went through that I thought were me, or that I was doing wrong. That actually turns out were, you know, real, genuine things that were going on, that I knew nothing about. So I had to do a lot of I did a lot of reading a lot of researching and calls 17 years ago, Facebook was very new. We didn't really you know, Facebook wasn't really a thing. Instagram certainly wasn't the thing. I think we had sort of baby centre forums that was about we forums, 

Emma Pickett  09:26

good old forums! Remember, mumsnet, net mums. And if you found your board, so I remember I was a moderator on the breastfeeding board for the wet baby whisperer forum. I was about that. That is not a book I'd be recommending to anyone. So we spent we spent hours on those forums and we we did our sticky posts. 

Lucy Webber  09:45

Yeah. It was the only place really and everybody was very hidden. You know, you you would just you could say anything or do anything or write anything and people did you know and so it's been going on a long time this kind of people giving their thoughts and opinions and and that was the only place I could get any Help, really because there just wasn't any. And it was still fairly new, not new, but fairly new that people were starting to introduce solids a bit later on. And so there was still this kind of Minister, there's now wasn't there, but still very much this kind of pressure of are you going to start solids and some baby rice a bit early and all sorts? So it was it was a lot the first time around. And then the second time around? I thought I've done this before. I know what I'm doing. No, no way. No, no, completely different. You know, every baby is completely different. Every experience is completely different. She was a completely different baby. And little things like and I've talked about this quite publicly that my first baby, once we settled into feeding was a was a one boob per feed child. My second baby, I thought she only needs one boob, that's what you do. One boob per feed. And if she was hungry, again, I'd stick it back on the same side. And she was still hungry, I'd stick it back on the same side. And this went on and on in these early weeks, because I thought I make loads of milk, it's fine. And actually I damaged my milk supply horrifically doing this. And ended up with a baby whose weight was never terrible, but just never quite catching up, she was always really cranky. And there was probably a lot of stuff to do with personality and temperament and the autism that we obviously didn't know about them. But also the fact that actually my milk supply just wasn't ever quite catching up. Because I'd been sticking it back on the same side again and again, which had suddenly been dropping my milk supply down without me even realising it.

Emma Pickett  11:32

That whole one side versus two side things. I still meet people today who were told in 2024, you stay on one breast because if you swap sides, they won't get the hind milk hate No, no, no, we're not gonna use that word anymore. It's still happening today, isn't it? And I think that message of your try to, they may settle into one some people do end up being one sided babies. Yeah. But we'll have a go at two first, and they're going to get the fact that they need, they're going to get what they need. If you respond. I mean, there's still so many myths flying around, you'd think we'd all have one universal place to go to get the answers. But we've still got people being told all sorts of nonsense. I mean, one of the things I love in in your book is that you say, You know what, we're not going to know all the answers. This is a bit confusing, and honestly, will probably still be all okay. So I think one myth is that there are these things called hunger cues. And if you're a good mother, and you've paid attention properly, you'll understand the hunger cues, and you'll decipher them. And you know, and if you don't understand the hunger cues, you know, sorry, perhaps you didn't pay enough attention or you don't connect with your baby, as effectively as someone else. How do you sort of describe the world of hunger cues?

Lucy Webber  12:40

Oh, it's just awful, isn't it? I mean, it's so tricky because there's this whole you know, you'll know what their cries me No, you don't you absolutely do. That's just just not a thing. You know? And pretty much in those early weeks, the answer is stick them on the boob Janeiro and Boo was like the default setting for pretty much everything other than you know, cleaning a nappy. That's one thing that breastfeeding can't do. But that's kind of most most other things Breastfeeding can do. So any, any form of wriggling rooting, whinging, crying, squirming, back arching anything is pretty much sticky on the breast, please, do you know and that, that that isn't us? We're not we're not, we shouldn't be trying to figure out, you know, is it wind? Is it hunger? Is it this is it that just sticking on the boob and if that doesn't work, it's probably something else. And it's absolutely fine to just have it's top the top of the tree, because society doesn't really let us buy into that kind of in the UK aid, you know, it's very much, you know, you should know what you're doing very quickly, we're pressured into feeling like we should know our own child know what they're doing. And I am, I am a big believer in, you are the expert in your child, you will spend more time with them and anybody and you are connected with them on a very deep hormonal level, as well as anything else. But you're still absolutely winging it and figuring it out. And it takes a while and even, you know, 17 and 15. And seven, I'm still winging stuff on the daily Do you know, because that's parenting, that's, that's life with children. And that's breastfeeding, you just taking it day by day, sometimes feed by fees, and just having a bash and seeing how you go. And one of the biggest things that people say to me about these early weeks is, when you give yourself permission to lean into, and go with whatever's happening, everything is so much easier when you stop trying to put them down and they wake up every time when you stop trying to space out a feed and just go with it and feed them again. When you start trying to get dressed and go shopping and go for a coffee and think you know what, I'm just gonna stay in my jammies and watch Netflix. That is that is just the way to go. Just relax into it. Go with it, and it will all sort itself. We've got to stop pushing ourselves and pressuring ourselves. 

Emma Pickett  14:48

Yeah, absolutely. As you know, I'm a big fan of the it doesn't matter if they last fed 40 minutes ago, it doesn't matter if they last fed 25 minutes ago, whatever your app tells you. There's normal or what you know, solve that. Every baby is different. And if you spend all day on the breast that's doesn't that's not a failure. That's not an indication of low milk supply. That can just be a normal pattern for your baby. And another thing that often happens is people think they've nailed hunger cues. And then they go, Oh, no, they're putting their hand in their mouth. Yeah. Does that mean that I sudden I've, I don't understand them anymore. I've lost it. You know, I thought I'd nailed this. And now I've lost it again. So I'm constantly saying, nobody really understands hunger cues, overstimulation over tiredness looks a lot like hunger, I've got wind looks a lot like hunger, I just fancy comfort, feeding looks a lot like hunger. 

Lucy Webber  15:34

And it's just this, thinking that feeding is hunger. Genuine, actually, feeding is feeding, not hunger. Breastfeeding is a tool, it's not just about getting milk into a baby, it's about regulating a baby. It's about calming them, comforting them, helping them sleep, helping them pass a boo album and pass when, you know, it's everything, actually, to a baby. And that's really hard for us as parents, because we're not set up for that. But actually, when we go with it, and go, No, I'm just gonna use the boob as a tool, and probably everything else will fall into place. And it does get difficult when you start to head out of that fourth trimester kind of at the other end, 10 ish weeks, or even 12 weeks. And they start to become a little bit more awake and alert and stop consciously cramming their hands in their mouths a bit, you know, before it's the sort of swiping and shoving them in. But this is a bit more of a kind of, oh, actually, this is my hand and I can move this and I can put this in my mouth, and often feeds around then can drop off quite a bit. And quite suddenly, we're suddenly they're entertaining themselves a bit more, and they might be comforting and soothing themselves a little bit more. And it's not uncommon for people to sort of reach out and go, What the heck is happening? Why are they suddenly feedings so much less? You know, it's still weighing, we're still putting, yep, you know, they still go up and down. But when they go to the restroom yet, then grant, you're fine. It's just a developmental stage, but it really throws you because you feel completely lost. Actually, you felt like you knew what you were doing. And all of a sudden things change. And that is what happens again and again, throughout parenting is just when you feel that you know what you're doing. Something switches up and changes. 

Emma Pickett  17:01

Yeah, yeah. And that sort of 1012 week mark is often a time where people get a wobble around their milk supply. So not only is baby not feeding much, but feeds are shorter, you're not leaking any more. You don't feel the letdown, maybe any more breastfeed softer. you're expressing is not brilliantly going brilliantly well, maybe because the valves need changing on your pump, but also maybe because you've adapted to your pump. So all these things seem to come together right at a time when we think we've got, you know, got more of a handle on things and yeah, absolutely. conversations about nappies, what's happening at the breast, did you last checked the weight, everything's probably likely to be okay. Another message I love in your book is that you see set a few times in different contexts. If you don't get off to a good start, don't feel like you're never going to recover. So, for example, if your birth doesn't go to plan, if you don't have that golden hour, you know, we sometimes get the message that you know, you're gonna be in trouble. If you don't get this magic golden hour, it's, you know, this is gonna be really hard, your baby's gonna be scarred your relationships gonna be damaged. I love how you say, in the book, you know, sometimes the golden hour is not possible. And you say I'm really sorry, if this has happened to you, as I know it can be really drummed into you that it's important. How do you help parents recover from a difficult first couple of days or a difficult birth? What messages do you want them to have?

Lucy Webber  18:19

Yeah, it was it was when I started writing the first sort of few chapters. And I know there's a really sort of, often standard way that in breastfeeding books we talk about, you know, these benefits of breastfeeding and the reasons to breastfeed and the sort of what we really want to happen and actually working with parents, this isn't happening always because it can't because actually we're in a bit of a culture where that you know, we we have got quite high induction rates and severity rates and you know, various things going on and so actually a lot of the time it isn't going to happen and that can be really traumatic for families. And so I want to try and try and take the pressure off a little bit and go gee, you know, look, this doesn't happen for everybody. And it's great if you can, if you can do it, fantastic. But if you can't, you can do it at a later date. You know, you can get skin to skin with your baby. Whether it is an hour after birth 10 hours, 10 days, 10 weeks, whenever it is that you can be with your baby and spend that time skin to skin snuggled up, do it then you know when whenever it's the right time, there was a picture of my ex husband skin to skin with my second baby because I had her at home she was mad she was 10 pounds. And I had her at home and afterwards I was shaking with shock because I was just like wow, it was a lot. Understandably and I just they said you want to hold him I went I just can't. I just can't. And so he did he held her and had her kind of skin skin and I had her back skin to skin when when I could and you know and that's that's when you start that over because sometimes you just can't do it and there was nothing wrong that was beautiful, straightforward standard home but there was no reason I couldn't have time straight away skin skin there but I you needed a few minutes before I could. So we also it's not just always about going to NICU and all kinds of things. When I'm working with families, and I'm having kind of consultations, either in person or online or on the phone or whatever, I talk to them about their birth and their pregnancy, because it's relevant to feeding, but also because they often need time to just talk about it. They need sort of that holding space, if you like, where you can just let them talk and let them process what's going on. There's so much focus on the baby, and breastfeeding and the healing and your stitches and your this that the other that often, you know, birth has become so medicalized actually, that it's just become normal to have, you know, an emergency caesarean. And actually, sometimes we need to think, come on, that's quite traumatic for people. A lot of people have had quite a traumatic situation. My third birth was a was a very traumatic birth, he was a home birth too. And he got stuck at the belly, which is very random, because babies, if they're going to get stuck, we usually get stuck on the shoulders. But now he has to be a bit different as everybody in my house decides they want to be different. And he got stuck at the belly. And then when he came out, he decided that breathing was for wimps. And he took, you know, nearly 10 minutes to decide to do that with sort of on my dining room table being resuscitated by two very competent, but probably incredibly scared midwives. And that was traumatic and actually, weirdly, for me, I was okay, I was bobbing around in the pool on an oxytocin Hi thinking, it's alright, this will be fine. Because I've done this 1000 times I've resuscitated babies 1000 times over this is okay. But the hard part for us was when he started to cry, and he did not stop. And he was doing this very high pitched horrible scream. And we transferred into the hospital and he was still screaming, still screaming wouldn't feed still screened. And they said that we think there might be something going on brain damage wise, that was when the world plummeted. And that birth trauma sort of kicked in. So actually, it wasn't the resuscitation. For me, it would be for lots of people, we spent a lot of time in NICU, he had to have all sorts of cooling and blood tests and tubes and wires and all sorts. So I thought I understood what birth trauma was having been a midwife and having, you know, spent a lot of time with people going through these situations. But it wasn't until I experienced my own birth trauma that I kind of really understood what that's like, and how much time that takes you to process that. And it's it, people need to talk about it. And that's about all you can do really in those early days is just hold that space for them and let them talk if they want to or not, if they're not ready, and respect that. And and then try and get them to connect with as much skin skin cuddling as they can and let them know that it's okay to feel either very attached to their baby, or not at all attached to their baby, you know, and that any of these reactions that are can be very, very normal, that you may just feel incredibly protective and not want to leave your baby even to go to the toilet. Or you may feel nothing to your baby yet. And that actually those things are okay. And that all we've got to do right now is focus on those, the three keeps, you know, which we talk about, you know, keep your milk flowing, keep the baby clothes, keep your baby fed. Just keep those things going, and the rest will come. And that's pretty much all you can do in those days. And obviously refer them on to lovely Support Services who are going to be able to support them if they need it along the way. 

Emma Pickett  23:22

Yeah, thank you for sharing that. Lucy, You're so honest about your own experiences, which I think really does help parents and I'm sure anyone who gets to talk to you about their birth has a very lucky person, because you've got so much empathy, I will not gush anymore, because you're going to be uncomfortable. But thank you for sharing that. Okay, let's talk about positioning. Yes, you call it the 4 Ts. Which, which I love. Tell us about the 4 Ts. 

Lucy Webber  23:47

Yeah. So, you know, babies have these gorgeous reflexes, don't they, you know, they're rooting and they're checking their head backs and a little picky, little birds pecking around and stuff. And actually, it's our responsibility or our role as parents to facilitate that. And there are lots of ways that people describe these things. And there's lots of sort of acronyms and various things that people come up with to try and help people remember it or understand it. And I just, I just thought, oh, I don't know why it kind of came into my head to just try and come up with some kind of something else. But it did, it came into my head and I thought well, it's not going to do any harm to have an extra thing because if it helps one person remember it, then crack it and you know, so I call it the 4 Ts, which is tuck, tuck, turn and tip just to try and help us remember how to position the baby at the breast. So tucking them in making sure that they've held in very, very, very, very tightly into body tipping, we're not tipping their head back, they are tipping their head back but you know, being able to allow them to tip their head backs in nothing on the back of their head and pillows. Do you know, breastfeeding pillows. I have a real love hate relationship.

Emma Pickett  24:52

Oh, yeah. Can I join that club? 

Lucy Webber  24:55

Yeah, absolutely. I think a lot of us are in the club because they are amazing. They're wonderful because You know, you're sitting for a lot of time feeding baby and breastfeeding pillows can be fantastic and certainly with multiples, et cetera. But so many times I have seen people, they tuck in a pillow in, then they're putting the baby on. And either the baby's you know, in the wrong height, or where their breasts naturally sits, and they're having to sort of manipulate their breasts over to the baby, which isn't a comfortable position, and then you're stuck in that position them to hold your boob and hold the baby and everything's just sort of falls apart if you let one of them go. Or they just can't tip their head back. You know, it doesn't look like they can't tip their head back when they're on a pillow. But actually, when you take that pillow away, and you're working with apparently they go, Oh, he's really, really wide and tapping his head back. And you're like, that's because that pillow is not there. Let's get them latched. And then tuck that pillow in. And it just makes the most enormous difference. Sometimes. That's all it takes. 

Emma Pickett  25:44

Yeah, chucking out the pillow. Yep, I've definitely remember those consultations walking in the room. And it's could have been a three minute consultation. Because it was like that pillow is not the right height for you. You are leaning forward, you are hunching over, we can all Picture those tall women leaning right over to meet the baby and then slightly moving back shallowing the latch of gosh, there's so many hurt pillow nightmare stories I can share. I'm sure you can do. Yeah, so you're a fan of attaching a baby. And then if you need support, tucking that in afterwards and getting that support if but you might not need to, if you're leaning back, 

Lucy Webber  26:15

if you're leaning back and your body is taking their weight, then great. I'm when you know, definitely a very big fan of making sure we can try and do this with as few hands as possible. So that your hands a cake and a remote control just I just think that's very or your phone or whatever. That's hugely important to know. So trying to make sure that the they're in a position that is going to be I think we see breastfeeding very much as a sort of doing activity that we have to do a thing to the baby. And actually, it's more of a sort of being activity than a doing activity in that we're just trying to facilitate this, you know, by really getting them in a position to help them. Do those reflexes and get them latched. And then you should be able to just be comfortable and just plop them on your you know, your tummies sticking out for a reason afterwards, you know, you've got your little shelf to stick the baby on top. And that's fabulous. But you do need to watch that as your tummy deflates down which you know might be after a week might be after three months might be after a year, whatever it is. If you find that you are starting to struggle again after a little while with position and match. Sometimes it actually is that they've either grown and they've shifted up around your body a bit or your tummy is gone. And you're looking to balance them.

Emma Pickett  27:18

Wrist is aching for the first time and week three, because you're

Lucy Webber  27:24

always going back to basics. You know the thing you hear hooves think horses, not zebras go back to basics every time. 

Emma Pickett  27:30

Yeah, so we've got tuck, we've let tip. Yeah, what comes next?

Lucy Webber  27:35

Tug now, I mean, obviously don't actually tug. But this is about moving them around further away from the breast that they're reaching up for the breasts so that the you know, when they're lined up, ready to start, that actually the nipple is further up their face, it's not just opposite their lips, it's further up their face, so that when they take that head back, you know, because they they open their mouths by hinging up that upper jaw not lowering down the lower jaw, so the nipple needs to be high up their face, so that when they open their mouths, that is going to be the right place to actually kind of come forward. So we want to make sure that they're kind of turned around towards their feet so that they're further away from the breast and turning them into that they're in that nice straight line. We don't want their heads twisted, you know, and kind of you know, coming to the breast with the chin down or their chin to the side or anything, we want them to look comfortable. And it can be really helpful to have somebody with you, who is looking at you from the outside and going actually to both of you that comfortable because if one of us twisted or scrunched your shoulders up or your arms twisted, or their arms twisted, or, you know, it's not it's not rocket science, often it is but it isn't. It's one of these really weird things isn't it is that, you know, latching is both the most natural simple thing in the world and also so extremely difficult. gerund takes a long time, and it is a learned thing. And I think that's another thing where we can feel like we're failing as if latching is taking us weeks and or months to get to grips with but it's so normal for it to take time. Don't ever hesitate to go back to basics and ask again and again and revisit it again and again. You know, so important.

Emma Pickett  29:04

Yeah, yeah, absolutely. 100% Actually, somebody messaged me on Instagram and had a question about early breastfeeding that I'm going to sneak in here, because I think this is a good place to talk about it. She said, can we talk about a normal sucking rhythm for a baby once so we've got the 40s happening. Babies latched on effectively, they're starting to get that milk flowing. What do we expect to see the baby doing in terms of their normal sucking and feeding pattern?

Lucy Webber  29:33

when they first go on they take these quite quick sucks and people talk about that being that kind of, you know, trying to encourage your body to let the milk flow and have this letdown or milk ejection reflex or this surge of milk that kind of happens. And that can happen for like three seconds or two, three minutes. You know, it varies person to person, day to day, hour to hour, all manner of things, but they will go on and they will take these kind of quite quick steps where there's not a lot suorin going on. But then as that milk surge happens, which some people will feel some people won't feel some people will see it very obviously, some babies will be noisy about it, you will notice that they will start to swallow with pretty much every one to two sucks. Usually, if things are, you know, if they're transferring milk, effectively, it will be every kind of one to two sets, maybe three for a good kind of chunk of the feed. And that will vary. You know, that might be five minutes, that might be 15 minutes, and it's going to vary again, day by day, President, President cetera, et cetera. And then once they've done this good chunk of swallowing, which they will have pauses throughout, you know, they do sort of sub songs that sort of sits on pause for a bit, and then start up again. And that will come in searches, you know, these milk letdowns, they don't just happen once at the beginning, they happen multiple times through the fee two or three times, usually during the feed. So you might notice that the swallowing slows down, and they move on to these kind of little flattery sucks at the end, where it's like, they're, they're not really, they're often asleep, and they're just doing these little kind of nibbly sucks, that aren't these big kind of jaw opening, active sucks that they were doing. And that might be the end of the feed. Or it might be that they do that for a little bit, and then another surge of milk comes and they might go back onto swallowing again. So the pattern can vary, you know, all the time. And you don't need to focus on it necessarily. This is this is one of these things where actually it can be really helpful to know if you've got any kind of difficulties going on. But actually, if things are going well, and they're filling nappies, and they're growing, and you're comfortable, and they're comfortable, and you're all right, don't worry about it, just follow their lead, give them a boob, once they've popped off, give them another boob, see how you go and give them a snuggle. That's pretty much how these first few weeks are going to go. If you're having any difficulties with weight, or milk supply or various things, then it might be a useful thing to be able to spot because we want to try and encourage as much of this active swallowing as possible. Because the more swallowing they're doing, the more milk they're taking, and the more milk they're taking, that you're making. And it goes in this lovely kind of upward spiral. But don't get fixated on it because you can get hugely focused and then you can get very worried about all the work they did for sucks then to swallow that. Is that not okay, and we really don't want to go down that path at all.

Emma Pickett  32:16

Yep, wise words. 

Emma Pickett  32:20

A little advert just to say that you can buy my four books online. You've Got It In You, a positive guide to breastfeeding is 99p as an e book, and that's aimed at expectant and new parents. The Breast Book published by Pinter Martin is a guide for nine to 14 year olds, and it's a puberty book that puts the emphasis on breasts, which I think is very much needed. And my last two books are about supporting breastfeeding beyond six months and supporting the transition from breastfeeding. For a 10% discount on the last two, go to Jessica Kingsley Press. That's uk.jkp.com and use the code MMPE10, Makes Milk Pickett Emma 10. Thanks. 

Emma Pickett  33:07

Let's say a few words about baby hands. Katherine Watson-Jenner is great on baby hands. There are people who are talking about baby hands. But yeah, we still have people with mittens, and swaddling and holding hands out the way really firmly. One of the things that I regularly see is people saying I'm battling baby's hands, I'm fighting with their hands. It's an absolute nightmare. And it turns out, they just weren't bringing the chin to the breast yesterday and their babies desperately, you know, hunting. So and you bring chin contact, bring the baby closer, do your tuck, and the hands suddenly relax. Why are two hands matter? Why do baby hands matter?

Lucy Webber  33:43

Yeah, I mean, breastfeeding is a completely multi sensory experience, isn't it for babies, and actually, it's not just about mouth on breast, it is about the whole body and those little hands. I mean, if you think about when you watch kittens and puppies, you know, their little paws are so instrumental in what's going on with their feeding and milk flow and all sorts. So it's partly that these little hands are trying to you know, get some skin and some warmth and feeling you and you know, and getting milk flow going. But they're also probably just trying to find their way and if they really scrabbling around like crazy, then there's probably something going on that's making them think I know I'm near it and I'm close to it, but I'm not quite sure where I am. And it really is about trying to just get that Shin onto the breast and you will see them going from this kind of crazy manic scrambling routine to oh, I'm here and then they might start to actually try and actually latch so if you really are struggling with the hands, make sure they're uncovered because they do need to feel and I know that's tricky with little shots can be very difficult. But try and to have them uncovered if you can because they do need to feel their way but get them so that you can get the chin on the breast or move positions you know if you are having them in a cross your body and that kind of classic, you know, cradle or cross cradle hold that we see people kind of doing sitting very upright and doing that and the hands are kind of going Mix it up, try something different. either have them in a sitting up koala hold where they're sitting on your lap facing the breast or lay back position, because that's stability for the rest of their body can also help because sometimes those hands are just kind of, not quite, I feel a bit kind of unstable and a bit unsettled. And we're so focused on mouth and breasts mouth, that we're not looking at the whole picture of, actually, this baby's little legs are going in their hands are going because they're feeling a little bit like actually, I don't feel quite secure enough. So lie back, strip them off skin to skin down to the nappy, absolutely. Keep them happy. And for goodness sake, take your top off, lie back with them and see what happens. And that can make the most enormous difference, because they are a pain in the butts baby hands. Cute. But a pain in the butt. 

Emma Pickett  35:41

Yeah, I'm always using the word anchored. That's more of a word. I've never thought I'd be saying this much in my life. But But if a baby who's scrabbling around as often saying, Help, gravity's fighting against me here, and this doesn't feel great. So just a little bit of a lean back can be super valuable. Okay, so you talk about this in the book beautifully. So I'm just going to ask you a simple question. When somebody says, is breastfeeding meant to hurt room? How do you answer that question?

Lucy Webber  36:07

I say meant to hurt. No. Can it hurt? Yes, there is a very big difference between normal and common. So pain is common. But it is not normal. And this is such a controversial one. Because, you know, if anybody says breastfeeding is not meant to hurt, you will get 100 People say, but it hurt me. And everything was fine for me, it hurt me. So it must be normal, it must be normal. And I don't want to devalue their experience or tell them that their lived experience is wrong. But we're in such a bit of a difficult way with breastfeeding support, not perhaps being as it should be all the time, sadly, that we have got very used to pain being a normal thing, and not a common thing. Because latching is such a tricky skill to master it is a learned skill, a lot of the time, pain can happen, because not every laptop is going to be fast. You know, they're learning, you're learning some of the latches, you're gonna be like a drag, that wasn't great multiples, come out, looking all pinched, and it's got blisters on the top. And actually, that was sore. And so yeah, there can be some pain. But there shouldn't be pain. And it's what's important is to know that you shouldn't just be saying, well, that's normal, you just need to cope with it, because it will get better. We should be trying to correct the issue and going there's pain. Okay, that's all right. We can, it's not the end of the world, we can cope with it, we can do things, but what we need to be doing is discovering the underlying cause of why there's pain and getting rid of it, not just waiting for it to pass.

Emma Pickett  37:34

Yeah. The Angriest people I think I've ever met are the people who who get that message that pain isn't something you just have to put up with. And and they did for six weeks. And then mum did for six weeks and their sister did for six weeks. And the implication that if they'd got support at week two, they may have been pain free, infuriates them, they are so angry because they feel understand. So one hurt and so that, you know, they just don't want to believe that that's true. And they very much believed that pain for six weeks is what you should be doing. I don't think we'd be here as a species. If pain for six weeks was the norm for breastfeeding, I don't think early humans would have been up for that. And it's really hard to give that message because if we say, Oh no, you're right pain for six weeks, you know, that was fine. No problem, of course, that's your normal, then the other person who should be who can go along at Week two is not going to get that message. And it's so it's impossible to make everyone feel comfortable and heard in this conversation. 

Lucy Webber  38:29

And it's not something I discuss very often on social media, because, frankly, I am human living my own life, and I don't need the attacking. So as much as I will take a nod to that from time to time, you will not ever find me putting out a post about this directly. Because you can't, you can't win this discussion. Because you're going to upset somebody with this. If you say pain is normal, then that's not great. Because we don't want people thinking it's normal. But if you say pain is not normal, there's going to be a lot of very hurt very upset people. And I don't want that either. I don't ever want anybody upset by something I say or I do. Do you know there's enough rubbish on social media to cut through that actually, I would rather just stay away from those controversial subjects and kind of let that exist somewhere else on the internet. And I will support people in a way that I can without fueling them. Mommy was I really feel very strongly that we just don't need these arguments existing everywhere. And I will speak to clients individually about it, generally, but not on mass. 

Emma Pickett  39:34

No, that was worse. I mean, it is ideally an individual conversation for everybody, isn't it? That's one of the pitfalls of social media is you're standing with a megaphone, and that isn't going to work for everybody in that space. Yeah, wise words. Okay, so I was chatting to the other day to Dr. Justice Riley about healing nipples and healing damaged nipples and how in this breastfeeding space this is true of several areas but particularly when it comes to healing nipples. Were so confused about the evidence. We've got all these research studies, we've got the Cochrane Review saying, if you've got sore nipples use nothing or breast milk, you know, what's a sore nipple? What about if you're cracked? What about if you've got third grade damage? And then you've got people saying, use soap and water because we've got to break down the bacterial biofilm. Someone else saying do not use soap and water or nipples because I breastfeed in network says don't use soap and water. The lecture league womanly arts of breastfeeding says use soap and water to very respected sources of information. It's super confusing. What are your sort of go twos when you're helping somebody with with damaged nipples and healing damaged nipples.

Lucy Webber  40:35

underlying issue is always the first thing, you know, we do want to heal it. But actually, if we can correct what's causing it, then that is going to be the fastest best way of healing a damaged nipple. Tiny little millimetre adjustments to the way they're positioning can make all the difference. Sorting out if there's a tongue tie getting that divided, etc. But if we do need to heal some damage, it is it does seem to be a very individual thing, actually. And people are influenced by what they've seen or what their mates used, or they've seen online or whatever. And people come to me using different things. The Lana Lin's are the most popular and obviously there's a popular tube that people like to spend a lot of money on, which is excellent for crack lips when you're out on baby walks in case you don't actually use it. Or patches of dry elbows. But I I've seen so many people with awful skin on their breasts from slathering on Landau in that, when they've stopped using it, the pain has gone away and the difficulties have gone away and slathering this stuff over. And then the baby is slipping around all over the place and can't latch because actually what he's greasy, greasy nipples. So I think sometimes London can be useful for actually, you know, what's wrong with bit Vaseline? What's wrong with coconut oil, what's gonna eat, you know, there's, there's, if you want something a bit greasy, it might be helpful. But it certainly isn't a case of slobbering on as much greasy, moist stuff as you can covering that breast up. Because actually, if you're then sitting with a very soggy nipple, that probably is gonna go the other extreme and not be happy either. And this is what's happening with the, you know, the silver shells. We've used silver in healing for a long time. So, you know, there there may well be something in it. But we obviously we don't really know. And we know but we know anecdotally that there are some people who swear blind, the best thing that ever happened in their whole life. And thank goodness these things exist. And then other people who've had their nipple sitting in a pool of milk in a silver shell getting soggy or in Saudi or in Saga and getting worse and worse and worse. But I think it is very individual. I think it's trying to think about is it working? Because if it's not working, stop using it. Stop doing it. 

Emma Pickett  42:48

Yeah. If you're doing something for two or three days, and there's no improvement, maybe that thing is not the thing you should be doing the silver cups thing. And I know this man won't mind me mentioning this because I asked him for permission to talk about on social media. I worked with a mum two weeks ago who was using silver cups and had done for weeks. She'd gone to the doctor to ask for a swab because she thought she had an infection. She wasn't healing. She had redness all over her nipple and sort of white squeegee blistery things. And I watched her sort of peel the silver shell off and those are kind of Slurpee noises she did and I thought that skin is not getting oxygen. So I said, you know, let's talk about how you're using the shells. She was wearing them 24 hours a day. She was wearing them at night as well. You know, and because she didn't want her damaged nipple, her saw nipple to rub against fabric. She wasn't putting them back on again. So I suggested she gave them a break. I saw her at 10 o'clock in the morning. By about 6pm She had messaged me to say her nipples were no longer red. And they had been red for weeks. Yeah, week later little history, things that healed. And some people love the silver cups. And they can be really useful for some people, but your nipple does need oxygen as well. And if your nipple is sitting in moisture, we're going to get that laceration we're going to get that skin breaking down. So it's all about balance. And I think your comment just then if something isn't working, and several days have gone by, it's time to look at something else. And that's a very, very wise way to summarise 

Lucy Webber  44:15

sometimes there is so much damage that we're using creams and gels and creams gels and potions, lotions and just going through all these different things and actually doesn't there is an underlying infection and that actually that you know we need to we need to get some antibiotics on there and that's very different to a fungal you know, thrush and suffering. We're talking bacterial infection, and that can sit there and can go unnoticed for a really long time. And people might be coming to me after weeks going I just cannot heal this damage. And I've tried all these things and actually once we've sent away actually what it needed was a course of antibiotics. Now, I'm not suggesting that everybody gets antibiotics for the cracked nipples. Not at all, but I think we forget sometimes I think that that's a possibility as well.

Emma Pickett  44:55

Yeah, for sure. Extended nonhealing can definitely indicate that as well. So the same mum that mess history about the suck rhythm also messaged me about phaser spasms. She said she'd been experiencing vasospasm it'd been a complete shock. She didn't even know it was a thing. You know? Can you give me your just a minute on vasospasm? More so so

Lucy Webber  45:14

Crikey. So yeah, we want your nipple to look a normal shape and colour for you. Right? It may well be a bit elongated after a feed are quite integrated, but it shouldn't be flattened or pinched or blanched or blue or purple or anything else kind of going on. If that's happening, something underlying is going on. And often that is to do with that. And if the nipple is getting compressed, it's getting pinched or squished or something that blood flow is restricted and that nipple we might come off looking really really pale really white or really blanched depending on your skin tone. And that can be hugely, even full, really, really painful. That tends to be to do with latch it can be to do with other things as well, of course, kind of tongue tie going on rabies positioning, sometimes for some people it is to do with the kind of condition Raynaud's but that tends to link with not just blanching and paleness but also kind of bluey colour in a bluey purple and various things going on. And that is a kind of a bit of another sort of sidestep from that and not your sort of standard thing, although I don't think it's quite as uncommon as perhaps maybe other things. It's probably more common than thrush, I would think actually, but that's probably a whole nother like, but yeah, I think it's heat is very helpful for this, whether it's Raynaud's or not making sure that the latches deep and asymmetrical is really important. Never latching when you are having a spasm because that is just toe curlingly Hideous. And going back and getting that support. Going back to basics over and over. 

Emma Pickett  46:40

Yeah. And then if was if your nipples coming out looking white, and then the colour returns. That's not thrush, because I've had people have gone oh, I've got white nipples thrush. So yeah, vasospasm, as you say, normally, we're going to need to start positioning attachment support. So because you have so much empathy for new parents, I think you're a great person to talk to about faltering growth, and how to help somebody when their baby is struggling with weight gain in a way that protects the sort of mental health of the parents as best as we can. What do you say to somebody who is struggling with weight gain, and maybe they've been advised to do triple feeding, for example,

Lucy Webber  47:13

I call it triple feeding torture, because it's torture. Faltering weight, is something that I work with a lot. And certainly when we went into lockdown, I saw a lot of parents with faltering weight, and it is soul destroying for them, it is so incredibly hard and upsetting. And they use words like feeling like a failure, not feeling like a good mother, you know, the one thing I should be able to do, and I can't do it, and my baby's not growing, my baby's not thriving. And it is really hard. So there was a lot of emotional stuff going on with altering weight, as well as the practical how do we actually maximise the amount of milk going into the baby? How do we boost this milk supply up? You know, and how do we get all this balance? Right? At the moment when people are told, you know, pump and top up, pump up after every feed? And that is crazy difficult? Because probably that baby's feeding loads? And when do you fit it in? And how do you fit it in and pump for how long? And how much do I give and you know, often there isn't a very clear plan. And even if there is a clear plan, they're not given an exit route, like so how long do I do this for? Do I just do this for the rest of my life? Do you know there's no time to eat or drink or go to the toilet or rest? I mean, for goodness sake, when he goes to sleep, if you're constantly pumping and feeding and washing up and desert, it is hideous. And there are definitely ways to make this more manageable. And I think you know, 10 years ago, me would have been saying you absolutely have to make sure that you're pumping and that you're doing all this currently goes Do you know, we want to try and do this as much as we can do. But this needs to be manageable for you. Because otherwise you're gonna go, I'm not doing this anymore. I cannot do this. I'm going to stop breastfeeding. And then yeah, and then actually, you've not, you know how happy and your journey you've ended your journey when you had to, you know, because you felt like you have no choice rather than through because you wanted to and that's not something I ever want to happen for anybody. So it's trying to find a way of supporting breastfeeding, protecting breastfeeding, maximising milk supply, making sure the baby's getting the milk, but also in a way that is going to be manageable and maintainable. But with an exit plan, or knowing what the next step will be to get to the exit plan, not just constant rewiring and rewriting and rewiring. It's one of the when I do a lot of debriefs with parents or if I speak to them about they're pregnant again, and they want to talk about their previous breastfeeding journey. This is one of the biggest things that comes up is is the triple feeding and how sort of traumatic that is for them. And I don't think quite getting it right all the time at the moment, unfortunately.

Emma Pickett  50:02

Yeah. Are there any sort of practical tips so I just double check people aren't sterilising the pump every time, which I think is a huge time waster. Is there anything else you tend to say just to make life a little bit easier? 

Lucy Webber  50:15

Yeah, absolutely. So, yes, not not sterilising your hot soapy water or dishwasher if the, you know, parts etc are all dishwasher friendly, making sure that you've got the best pump you can get and money does not equate to best pump it is not the more expensive your pump, the better your pump, especially this sort of very expensive wearable ones actually are not going to be great for boosting your milk supply. If we can get you know, a kind of double pump that's going to cut down time, but also flange size. Oh my goodness, we need to be talking more about flange size for pumps, pumps send out these massive franchises in actual pump part that goes over the breasts. They're massive, we use it because it's come with the pump. So we think well this is what I meant to be using. But actually they can be uncomfortable. And they're certainly not the most effective or the most efficient. And if we can get the right size flange for somebody that can really help with what they're actually managing to get off on the tire managing to get it often hands on pumping before and during pumping is really super effective. And remembering that it's not just about what's going on with the breast, it's about what's going on with your hormones as well. So in order to get a letdown happening in that milk surge, that milk rep ejection reflex, it's not just what's going on with the boob, it's about trying to get that oxytocin flowing, which is super hard when you're stressed and you're busy and your baby isn't getting away as expected. And that's all a bit difficult. trying anything you can to try and switch you into a bit more of a relaxed headspace, or a bit more of a you know, trying to get that love wave happening, I kind of talked about this love wave of when you you know just feel that kind of oh my gosh, I just love them so much. I want to just a little face, you know, that kind of feeling is what you're trying to get going on. And people don't, you don't get that when you pick up a pump, you know, you might pick up your baby. And even if you're having a difficult time feeding them, you're still like all the little ears and the little toes and a little you know, there's something really driven in you to get that oxytocin flowing. Whereas with pumping, you don't pick up the pumping out. It's so lovely. I love it. Most people pick up the pump and go oh yes times pump Do you know it's not so you want to try and make it like as an enjoyable as experienced as you can have a bit of chocolate every time you pump or put on your favourite comedy or do something that's going to feel homely and relaxing. 

Emma Pickett  52:28

I've just suddenly had a business idea and I think we should trademark this together. like cute little pumps, you know that those kind of the Korean cute thing with dinky little, we need little pumps with little eyes and little faces and little ears. And we want people to go oh my my little fairy covers that. Yeah, little teddy bear, you know, muddle medalla pump that comes with your teddy bear cover. So you have cute a cute feeling when you pick up your pump. Yeah, we're definitely missing that for sure. I sometimes say that pumping is like making love to a toaster. Instead of making love to a partner, you're not going to get that hormone or rush in the same way. Another message that I like to give is if you're triple feeding, forget measuring how many millilitres comes out when you pump because your what you do get out after a feed is going to be so much richer and fat compared to formula, if you get 20 mils of that, chances are it could have double or triple the fat content of you know, significantly larger amounts of formula. So stopping measuring millilitres and just realising you're pumping for a purpose rather than necessarily to get a vast amounts of water out of your breasts. And maybe skipping a pumping session at night. Is that something you feel comfortable? 

Lucy Webber  53:34

Yeah, yeah, I do. And maybe maybe sort of just adjusting the pattern a bit? I think we we focus a lot on three hourly stuff, three hourly must do things three hourly. And that's because that equates to eight times in 24 hours, you know, and so that's, you know, lovely if we can do eight, eight times in 24. But actually, can you do it hourly or to hourly in the day so that you can then do a for hourly structure at night? Do you know would that work a bit better for you? Like how can we adjust this around so that you're getting loads of breast stimulation and managing to fit this in, but also managing to fit some resting, because actually, if you are just going hell for leather on feeding and pumping, and feeding and pumping, defeating pumping, you're going to crash and burn. And that's not going to get you anywhere. So if you need to take a bit of one pump off and smoothes and eat, then the next pump session you will probably find that you are just so much more relaxed and comfortable and feeling mentally so much better. That things will just flow half flow, you know, literally and figuratively will be will be so much nicer for everybody. So yeah, we have to try and maximise rest.

Emma Pickett  54:32

Yep, for sure. So we do talk about those very expensive, expensive wearable pumps, I think I'd want people to know that there are wearable pumps that cost significantly less than the most popular brand and work just as effectively. And there are some hospital grade pumps that cost significantly less than the non hospital grade wearable pumps. I mean, if you've got a toddler and you're running around, no one can underestimate how wonderful a wearable pump is. But it doesn't have to be the fancy brand that everybody's buying At 200 quid plus, can I ask you for for a quick word on single silicon pieces that rhyme with packer, there's, there's more than one brand. I'm seeing them a lot of oversupply as a result of people using these. Is that something you're coming across as well?

Lucy Webber  55:18

Yeah, absolutely. Yeah. So when I had my third It was when they were just kind of starting to become a very popular thing. And it's just absolutely the you must have gadget that you just latch it, you know, suction it onto the other side whilst you're feeding, and then it will just catch what you're leaking. And so you'll have an easy way of just having some extra milk and sticking that in the freezer. And then that is very difficult, because actually, they're not just catching what you're leaking like there is suction on the rest, they are taking off more than you would be naturally leaking off. And because we are using them so much, people are putting a lot of stimulation onto their body and their bodies thinking that they need a lot more milk than they need. And oversupply is no joke. You know, it's not just oh, great. I've got loads of milk. This is excellent oversupply is not a fun thing to be battling with an absolutely. I mean, the case is I mean, if we had any research into this, which of course we don't, because if we had any research into this, we would we would find I'm sure that rates of over like, you know, proper oversupply have probably quadrupled or more do you know, because of putting all this additional stimulation on? And I'm not suggesting that they're not a valuable tool? I think they are had them myself, I've got one in my bag for clients to look at, you know, I think they definitely have a place. My other concern with them is that when we're trying to suction them on one side, with uncompromising the position and latch on the other a lot of the time, yes,

Emma Pickett  56:39

yes, I'm waving my flag, the baby too far away from the mom's body because we're making space for that device.

Lucy Webber  56:45

So I mean, if we can get the baby in a nice sort of diagonal positions, so that we have got easy access to that breast, but if you're somebody with, you know, big breasts that are sort of sitting that bit lower, it's gonna be really difficult to fit that in, and then, you know, actually, then you're finding that you've got a really sore nipple and what's going on? And actually, if we can just get rid of that, you know, sort of going public, then that can make a big difference. So, yeah, I am a fan and I'm not a fan. 

Emma Pickett  57:07

Yep, yep, me too. They definitely have a place but we need to be careful, for sure. Okay, let's do a fast round, I'm gonna throw some myths at you, and encourage you to give me your instant reaction. So pumping to test your supply pumping to measure how much milk you get?

Lucy Webber  57:21

No! Pumping will tell you what you can get on that day with that pump. At that time, after when you've lost fed, you know, if that if you've got the right flange size, and the right pump and the right mood, and even then it's very rarely going to be as effective as the baby. Some people can pump loads off. But most people, the vast majority of people are just not going to get what a baby would get pumps are not the same as babies. And so to pump to try and see what you've got is is just not appropriate at all, you know, and it worries me when I hear people being told to kind of pump and see what they're getting. Because it's just it's just nearly the same. Oh, and and it's a worry.

Emma Pickett  57:59

So the baby whisperer book used to talk about a test that you wouldn't breastfeed for 24 hours, and you would pump and that would tell you how much milk your belly baby is getting. People are still being told that. No, okay. Right. Next one. If you're worrying about milk supply, you should eat oats and lactation cookies.

Lucy Webber  58:17

Now I'm a big fan of a cookie. But not anything to do with taxation. Not in the slightest. I mean, if you if someone's going to make some cookies, and you want to eat some cookies, eat the cookies. I am definitely on board with comfort foods aren't big girl. I like eating. So I'm definitely on board with heck, you got to eat what you want to eat, try and eat well, of course, and nutritious. It's important. But yeah, cookies, go for it, but not because it's gonna do anything to milk. What's gonna make more milk actually, is removing more milk. And it doesn't matter how many fancy teas or cookies you shovel into your face, that's not actually going to make any difference. People I think that say, Well, it did make a difference to me. It may be because you had a lovely cookie, and you relaxed and it was really nice, and you felt better. And then your body went, Oh, that's nice. And then you pumped and you felt like you know, got more off because actually, you were having a lovely delicious cookie. So there are boxes of cookies that you can buy, that are more expensive than a book about breastfeeding. You know, and I just think, Whoa, just No, actually, let's tackle the underlying and also, do you really have a problem with your milk supply? Do you really need to be eating a cookie? Or is there something else going on? That you're worried that your baby is unsettled? Or that your breasts feel soft? And you're not feeling let down? Is that actually a problem with the milk supply or not? That's something that needs unpicking into.

Emma Pickett  59:41

Yeah, yeah, I'm waving my flag again. Okay, next one. Breastfed babies don't poo regularly because there's not much waste. And that's not a problem. 

Lucy Webber  59:50

No, I'm in the I'm in the breastfed babies do poop camp personally. And the reason I'm in this camp is because partly it's just makes biological sense that we all Pain is meant to sort of happen. If there was no waste from breast milk, then how come some babies are pulling 10 times a day? That doesn't equate that doesn't work. There is very little research into this. But from what I have discovered, the average is actually about three or four times, at least, you know, especially in those early weeks, the early weeks is the most important thing. And I have worked with so many families who had somebody picked up on the fact that actually that baby was not pulling and put the correct support in place and given them the right tools to change what was going on. They would not have then come to me weeks and months down the line with a baby who has dropped down and down and down that wage chart. It is a red flag doesn't always absolutely mean there is something going on. But we really need to be looking at the whole picture and not just going yeah, no personnel. Well, that's fine. No Poo might be happening for one family. And it may be that everything's all okay. But on the whole generally, we need to be going No Poo. Let's look into that. Let's see what's going on.

Emma Pickett  1:01:02

Yeah, thank you for that. You can't drink alcohol if you're breastfeeding.

Lucy Webber  1:01:07

More shucks than I did wrong. Deny I mean? Yeah, no. Yeah, this is another one of those things, isn't it that again, gosh, you will never find the talking about this on social media because you can't do right. Because one thing says one thing once it says another and there is so much conflicting information about everything breastfeeding related online, but alcohol is another one of those ones that is really tricky for people and sort of the official guidance is, you know, wants to drinks actually is usually absolutely fine. And you've got people who, you know, are very well known lactation consultants and things kind of saying, you'd actually have to drink a really huge amounts to even make the tiniest dent into your milk supply. Before it's kind of cause a problem. And I kind of I waver a bit more towards that ideal, really, I think, I think a lot of barriers are put in place for us when we're breastfeeding, and alcohol is one of those. I wish we had more research into it so that we could more confidently say to people, it's okay, I don't think anybody should be getting absolutely wasted with a new baby anyway, because frankly, you've got to look after a new baby. And you're not going to want the hangover. So yeah, drink water is great. But remember, you may not have drank for a while, it may hit you a little bit harder, and you're gonna feel pretty rough. And definitely, absolutely no bedsharing no cosleeping with alcohol that we do know for sure. 

Emma Pickett  1:02:29

Yeah. Yeah, thank you. In the book, I think one of the most powerful sections is when you're talking about postnatal anxiety and depression. And I know, in the book, you explain that that is your personal experience. And I'm really sorry, that was your personal experience. But I think it does help you talk about this subject in a really powerful way. If someone listening to this is worried that they might have postnatal depression, what would you want them to know?

Lucy Webber  1:02:52

I think the main thing is to know that you will get better and that you can get help and get support. This support may not come from the place you expect it actually. So the support may not come through the health care system. It might it absolutely might. And I would strongly encourage you to go to your doctor and get some referral for some talking therapies and some support and medications, potentially, for some people that are compatible with breastfeeding, there are lots of them, if that's the right thing for you. But often it comes from places we don't expect and finding those other parents with new babies. Getting out and going to a group, for example, going to the breastfeeding support group going to the mental health support groups where it so I'm in Bristol, and we've got mothers and mothers who are incredible, and put on all sorts of groups that aren't just about sitting around talking about mental health in his art groups, and you know, all sorts of things that you can kind of go and do. So look at the charities and the volunteer led organisations as well as just going to the GP. And I think probably what I would want most people to know is that it doesn't have to be this way. You can do something about it. You don't just have to put up with it. If you're in any doubt that it might be going on for you assume it is and go and get the help. I think I would also want all people to know about postnatal OCD, because that is not I mean, anxiety, depression, we talked about postnatal depression for a long time, anxieties then started creeping in and we're a lot more rare person. So anxiety, we often don't talk about the other perinatal mental health conditions that can happen. And OCD is actually one of the pretty common ones at two and 100 people and that is not a small amount. And that might you know, people think about OCD as hand washing and germs and things like that. But actually what it can be is obsessively checking the baby's breathing, but not just I mean, it can be very common for parents to want to check their baby's breathing because it's your brand new baby, etc. This is getting too big for you. And it's getting out of control and you're setting alarms to wake up and check your baby's breathing for example, or Joe there's anything going on and we're obsessively checking your breasts because you're worried about lumps or do There can be all sorts of things that can go on with that. And it's worth going and speaking to somebody because it's it's not always just depression, not just anxiety, there can be other stuff going on as well, that isn't as well known that you can kind of get support for intrusive thoughts is the other one. Everybody gets intrusive thoughts. 

Emma Pickett  1:05:15

You talk about that really brilliantly in the book. I really liked how you talk about that. And I particularly like you refer to the intrusive thoughts of a sexual nature, which I think people are nervous about talking about, and they don't want to mention it. And I think it's really good. I really liked that. You mentioned that the book, thank you. 

Lucy Webber  1:05:30

I think it's really important, because you're not going to sit next to somebody at the baby group and go, Hey, do you ever accidentally worry that you're going to do something inappropriate? Maybe when you're changing their nappy? And no, of course, you're not going to do you know, but that thought will ping into your head. And then you'll go, oh, my gosh, why on earth? Am I thinking that that's the difference is that intrusive thoughts pop into your head and you're disgusted by them, you're horrified by them, you can't believe you're thinking them. If those thoughts get too big for you, or you're actually worried, you're going to act on those thoughts of I could drop my baby, now I could throw them out the window, those kind of thoughts will ping into us. But if they get too much for you, or they're disturbing you too much, that's when you get help. If they're popping in from time to time, when you're particularly terribly ticularly. Hormonal, you are not alone. And it's not uncommon at all. 99% 100% of people get those we all get them. In case you're not. And nobody ever told me about that. And I think when I had my first baby, if I'd have known that these were a common thing, I would have felt a lot less worried about myself. A lot less worried. 

Emma Pickett  1:06:25

Yeah, thank you for sharing that, Lucy. So you're a lactation consultant, like me, who also cares about supporting the ending of breastfeeding. And I know you do support groups and sessions with clients on supporting the ending of breastfeeding, there are so many things we could talk about, we could do a whole podcast series, Emma and Lucy on ending breastfeeding. But I'm just going to pick your brains on one particular area, because obviously, you're a mom of neurodivergent people and you, I think this will give you particular expertise. If somebody wants to end breastfeeding, and their child is neurodivergent, maybe not even speaking, what would you want that that mum to know? Or that breastfeeding parent, chest feeding parent to know?

Lucy Webber  1:07:01

what's often very difficult with this is that parents often don't know that what's going on until later down the line. So for example, I had no idea my children were autistic or had ADHD until much later down the line. So when I was winning them, I didn't have a clue. There are some people that do know, perhaps because they know their own neuro divergence. So these are suspecting that might be what's happening in their own child, or they might have another child who is autistic, so suspect strongly that this child might be so it's not, you know, some parents do know, or, you know, their child might be 456, or whatever and may already be, you know, going through that assessment process or be diagnosed, a lot of the stuff around weaning is going to be very, very similar to a neurotypical child. But we have to take into consideration that, for autistic children, for example, routine can be hugely, hugely important. And any change to that routine can be extremely unsettling. So trying to change that can be very, very difficult, sensory issues. Breastfeeding is very sensory experience. And that suckling at the breast or being the breast or the warmth, or the soothing, or just the regulating nature of breastfeeding can be a very useful thing for any child, but especially for a child that is, you know, struggling. And so we need to try and take into account what's happening for that individual child. And we talk about, you know, spiky profiles, because not every autistic child, not every child with ADHD is going to be the same. Every child is completely different. So you might have one child who routine is the real thing for them, you might have another child who are incredibly sensory sensitive. And actually for them, you know, noise is an issue and touches and assurance, you know, those kinds of things. You might have a child whose their emotions are incredibly difficult to regulate. So you need to think a little bit about your own individual child. And it's difficult because you're still getting to know them. And you may still be getting to learning about autism or ADHD or whatever is kind of going on for them. So it is a really difficult situation. You need to come at it from a place of love and understanding, as always, with yourself not just with your child that you're learning and that it's going to be potentially difficult. I think we need to give permission to parents that it is okay to carry on if they want to, but that it is okay to stop if they want to. And that just because it's difficult, doesn't mean that they can't stop. Because a lot of these children who are neurodivergent may well carry on a lot longer because it is so regulating for them. We need to try and layer in other things that can be regulating and know that for that parent, give them that permission and work with them to kind of say look, hey, if you are ready to stop that is okay. Even though it is a difficult situation to be in. I've got a Facebook group for breastfeeding with autistic children, which really started kind of a couple of weeks ago, because I realised there was a real lack of information and support in this area. And we're still working this out. And I think that the main message, I guess is that individuality is trying to figure out your own child and what they might need and layering in, how can you build in a different routine? How can you build in other things that are regulatory for them? How can you support them with tools with that communication? Because communication may be difficult? So will there be, you know, our pictures helpful? social stories? Can you put a, you know, can you put pictures of take pictures of them actually having a breastfeed or not having a breastfeed, stick it up on the wall? And then when they have that request for a breastfeed, you might say, you know, no, we're not having a breastfeed right now. Because look, there's a picture of us having a cuddle and a drink, and a cuddle with your teddy and reading a book, not having boobie right now, do you know any way that you can try and help them with that communication? Because it's going to be that bit difficult, but knowing that it can take time, and knowing that you're going to need the support behind you as well.

Emma Pickett  1:11:06

Thank you. Yeah, I'll put the link to your new Facebook group in the show notes, because I know that's definitely going to help people. And it's important to note that that isn't for people who've had a formal diagnosis, as you say, because that makes sense. It's for anyone who anyone who's got a gut feeling and a hunch that maybe there's something going on that's that's the group where they can get that extra support from experienced people like yourself. Thank you.

Lucy Webber  1:11:26

I definitely don't claim to be an expert in the area. But certainly I feel passionate about it. And it's something that I think probably over the next few years, as I spend more and more time around people, I think I will probably end up developing more and more of a, an interest and knowledge in this area. Because I think it is a bit of a space that needs the help.

Emma Pickett  1:11:45

Yeah, for sure. What are some of your favourite resources? When you're supporting new parents? What are your tabs on your? On your phone on your iPad? Where do you often signpost people to?

Lucy Webber  1:11:55

The global health media videos, thank goodness for those. I mean, those are just fabulous. I mean, you've got your positioning and your latching ones, which are great. Also that knowing they're getting enough milk in the first week. I love that one. That is brilliant. Oh, yeah, I love that one. Yeah, we fab I use that one a lot. So those are the global health media videos. And those are in all different languages as well, which is so wonderful, because it means you really can appropriately support parents and with what they need. So those are great. I adore the breastfeeding dot support website. I mean, hallelujah for Philippa that is wonderful, isn't it? What a fantastic evidence based, it is impartial resource that I say to parents, if you feel the need to do a 3am google, don't stick your question in Google, stick it in that website. Because that's when you're gonna get a lovely answer. And also, you know, the association or breastfeeding mothers and La Leche League those are my kind of go to three websites. If you're gonna, you know, Google something, stick them in those and see what comes up because those are probably going to be your really good reliable resources.

Emma Pickett  1:12:59

Yeah, definitely a shout out for Philippa's Breastfeeding dot support such a great address, easy to remember, even when you're super sleep deprived. She's so good at just building an article with all the links all the evidence. And when when something's not straightforward. She'll say, Oh, by the way, there are different opinions about this. This is what some people think this is what some people think. She's just fantastic. I didn't just absolutely huge, huge vote for that for me as well. 

Lucy Webber  1:13:21

Yeah. Brilliant for professionals and dads too if they knew about that website, that would probably answer a lot of questions.

Emma Pickett  1:13:28

Yeah, for sure. So I'll put those in the show notes. And I will Global Health media that that little 10 minute video attaching your baby at the breast when the pandemic first hit and all these antenatal classes were closed, and everyone did a big panic. I was often saying just gonna watch the video three times. Honestly, you watch that video three times and you have a sense of how to breastfeed at the at the end of it. And yeah, big vote from me on that one too. Thank you so much for your time today, Lucy I'm incredibly grateful. As I said I would love to talk to you on at 10 million other subjects. And if you write another book I'm going to definitely bagsy for you to come back. But even if you don't, I might be cheeky and ask you to come back another time. But thank you. 

Lucy Webber  1:14:05

You're very welcome.

Emma Pickett  1:14:11

Thank you for joining me today. You can find me on Instagram at Emma Pickett IBCLC and on Twitter @MakesMilk. It would be lovely if you subscribed because that helps other people to know I exist. And leaving a review would be great as well. Get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast. This podcast is produced by the lovely Emily Crosby Media.