Q&A on natural term breastfeeding

This week it’s the return of your questions - this time on the topic of natural term breastfeeding.

Questions answered -
2:28How does self weaning happen?
8:57Is there evidence of calories needed to not affect milk supply while pursuing weight loss?
12:47My baby is 13 months old and my health visitor recently said she only needs two feeds a day at this age, so not to feel guilty if I want to impose limitations. Is this rooted in any evidence?
15:03Breastfeeding and travel - I need to go away for three to four days. This is the first time I've had more than six hours separation from my son since his birth. I'm not sure how to go about it.
22:51I would like to know what you can do if you were tandem feeding, and suddenly start to have strong nursing aversions with the older nursling but don't want to wean, especially if the older one is a Boobie Monster and demands boob for nap and multiple times in the night.
27:40I would love to know what natural term feeding looks like?
29:50I don't want to wean, but I need to be away from my 18 month old for an indeterminate amount of nights. I know breastfeeding can re-start after a break, but is there a length of time where being away could force weaning?
33:24Excuse my new mom ignorance, natural term breastfeeding - does that mean that it ends on baby's terms or when milk dries up?
38:27 How do I overcome the feelings of guilt for schedule feeding my firstborn from four months, and then he lost interest in breastfeeding around one year. And now I'm feeding and comfort feeding my now one-year-old all through the night and sometimes in the day? It seems so unfair.
42:05I'd love to know more about uni boobing, and how common this is when natural term breastfeeding? Does your supply increase on that side? Or does it cap at whatever you've been doing for so long?
45:10Something about dealing with judgement would be helpful. I do plan to carry on but I'm a bit worried about other people's judgement when I'm out and about and I'm starting to feel a bit uncomfortable at 12 months.
49:38 Can I get some information on the benefits of breastfeeding older children?
51:08Could you discuss natural term breastfeeding when feeding a younger sibling, so a four year old and a two year old, for example?
52:24It's common advice to not offer a child alternatives if they're being a picky eater, especially something they previously liked. How do I weigh this up against responsive feeding?
56:42I'm at 20 months. I'm not planning to wean anytime soon, but I'm trying to put some boundaries in place. Do I just keep trying? Or does she need more time to get used to the idea of breastfeeding not always being there on demand?
1:00:15Okay, this might be TMI, but I really want to know if my nipples are ever going to shrink back. Is there anything I can do to change my nipple shape?
1:01:25I'd love to know if using a dummy as a toddler, and if mom getting pregnant can affect natural term breastfeeding?



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 -

When Breastfeeding Sucks: What you need to know about nursing aversion and agitation (lllgbbooks.co.uk)
Instagram accounts - 
Lucy Upton @childrensdietitian
Stacey Zimmels @feedeatspeak

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  00:45

Thank you very much for joining me today. Today, it's just going to be a little old me rather than an interviewee, I'm going to be talking about natural term breastfeeding. So rather than focusing on weaning, which I'm often doing or talking about bringing in boundaries, which we might touch on a little bit, this session is very much going to be about answering some of your questions on continuing to breastfeed beyond infancy. What is that like breastfeeding an older child or chest feeding an older child? What are some of the experiences I'm coming across in the clients I work with, and just you know, life with an older breastfeeding child, essentially, that's what we're going to be focusing on today. And I'm not saying that I am the guru of this subject. Obviously, there are lots of different perspectives on this, but I'm gonna give you my perspective, as a mother who breastfed two children myself to natural term, and also as a lactation consultant who specialises in this space. So since the pandemic, a large chunk of my practice has been helping families who are breastfeeding beyond infancy, I've never lost sight of helping people to breastfeed the very teeny babies. That's what I tend to do my face to face work. But a big chunk of my private practice is zoom support and online support with people who are breastfeeding beyond infancy, whether that's bringing breastfeeding to a close, whether that's putting in boundaries, whether that's just questions about how to breastfeed an older child. So that's what we're focusing on today. And I've got your questions from Instagram, and huge apologies. If you feel like you submitted this question in the stone age, and it's taken me this long to to get to recording this episode. I will never stop talking about this. So we'll always keep coming back to this subject. And I'll keep talking about on my Instagram as well. 

Emma Pickett  02:27

Okay, first question says, and this is the sort of million dollar question here. How does self weaning happen? So when we say self weaning, we're meaning child led weaning or a child leading the end of a breastfeeding journey. And I'm just going to nail my colours to the mast here a little bit and say that if you have read my book about the transition from breastfeeding, you know, I have quite strong opinions on the use of the term self weaning, I actually think we have to be really careful about using that term. I think we have to be really careful that as breastfeeding supporters and lactation consultants, we don't kind of gatekeeper that term because it can be very distressing for a parent, if they don't feel they've kind of ticked all the boxes. If we feel that child led weaning or self weaning as some kind of idealised goal, we could be setting some parents up for a sense of failure, if they feel they do need to put some boundaries in place. And it's my experience that those who breastfeed beyond infancy beyond the preschool years, you know what I'm talking about pupil breastfeeding, 6/7/8 year olds, these people are very unlikely not to have put some boundaries in place and not to have explained to their child that they're a person with needs to. They're a person with a body. They're a person with moments where they feel uncomfortable, and it's going to be a two way relationship. It's incredibly unusual to have a breastfeeding relationship where there hasn't been a little bit of give and take. And if we sort of set self weaning up as this idealised goal, what will we do when we have a parent who's having a rough day has flu is feeling a bit overwhelmed is feeling a bit touched out, doesn't want the breastfeeding session to last 20 minutes would rather it lasts 10 minutes, and then they offer to read a book instead. I just think we have to be a little bit careful because truthfully, we're all offering food. I mean, the minute you offer your kid a stick of broccoli, are you a practising parent led weaning because you're encouraging them to reduce their breast milk intake? You know, the minute you ask someone else to do bedtimes, the minute you go back to work, or you're even doing a you know, a zoom call to work in your office with the door closed and your child with a nanny is that parent led weaning. So obviously we're going to be offering food we're going to be offering cups, we're going to be saying may I have to take the washing out the washing machine, can you just watch blue for five minutes. There's always going to be a little bit of give and take care. So I'm a little bit cautious about saying here is self weaning according to Emma Pickett, the lactation consultant, and this is what it should look like, because it's going to look different in every family. But having said that, let's assume that we're in our family, we're in a home where the parent doesn't want breastfeeding to end. They are not actively seeking the end of breastfeeding. Despite a little bit of negotiation here and there, they've essentially decided that their child can take as long as they want to bring breastfeeding to an end, what does that home look like? So we know and if you read my book, or if you're familiar with the work of Katherine Detweiler, who wrote the essay and natural age of weaning, we're looking at somewhere between two and a half and seven years old, roughly is a pretty typical age for self weaning. It's my experience that we do sometimes have children that wean earlier than that I do sometimes meet children who don't have a particular emotional connection to breastfeeding. They haven't particularly seen breastfeeding as something key to their sleep, they don't feed to sleep. So you know, pretty early on, they actually aren't that thrilled about breastfeeding, they're not that keen on it, they'll do it sometimes. But there is a bit of give and take that, you know, 14 months, they're down to just two feeds a day. And these are the guys who are probably not going to be going for another year, two years, three years. But usually, typically, we're talking about two and a half to seven years. And what will that look like? Well, you know, yourself weaning, if it's so gradual, you barely notice it. So if it's very abrupt, if a child goes from four feeds to zero, probably something else is going on, they may have hand foot and mouth disease, they may have a sore throat, they may have a nursing strike. Usually self weaning, or child led weaning is very gradual, it's very slow. Feeds are going to get gradually shorter. Requests are going to get rare and fewer and far between, there'll be longer gaps between requests, you'll be down to sort of one or two feeds a day. And the other big clue that you're self weaning, or your child's is leading the weaning relationship is that you don't actually know when your last feed is because it's so gradual that you think, Oh, hang on, haven't breastfed for three days, they haven't asked for three days, okay? I wonder if they're going to ask tomorrow. And they do us tomorrow. And you go, Okay, so I'm not weaned. Okay, let's hang on. And then another three days go by another four days go by two weeks go by and your child goes, Can I breastfeed? And then they might try and there might still be some milk there, because you probably know doesn't take just two weeks for milk to disappear. And then maybe another two weeks, or maybe they'll see a younger sibling breastfeed and decide they want to breastfeed. So quite often, you do get these big long gaps towards the end. And at the very end, you literally don't know when your last feed was. That's a pretty common pattern. I have occasionally met nurse Ling's who have taken a little bit more of a conscious decision. So they may say, it's my fourth birthday. And I have decided that I don't have baby anymore. And I don't have baby because my friends don't have baby, and I'm not going to have baby anymore because I'm full. And in those situations, it can actually be a slightly more abrupt than that. But it's still not a nursing strike, because there was a wind down there was a little bit less of an emotional connection to breastfeeding. It's not a shock when it happens. But sometimes it can be a little bit more deliberate. And it can sort of sometimes be a little bit more sudden, than necessarily the week, two weeks, three weeks go by. There's a lot of different kinds of normal goodness me I say that so many times. But generally, it's going to be something that is gradual and slow. And your child's needs are very gently and slowly met in different ways. And a breastfeeding just gets less important to them. I'm doing some writing at the moment for young people. And one of the phrases I'm using is it's like that little voice in your head that told you to have boobie or milk keys or doo doo or whatever you call it has just got quieter and quieter. And sometimes you don't even hear that voice at all. And one day, time goes by and and the voice never happened because other things are meeting those needs instead. 

Emma Pickett  08:57

Okay, question number two says weight loss and continuing to breastfeed. If a woman chooses to pursue weight loss, and she continues to breastfeed. Is there any actual evidence that she needs X amount of calories to not have a detrimental effect on her milk supply? Okay, so you will find various bits of information about this online. It is quite difficult to find information about this for people who are continuing to breastfeed beyond infancy because most of the information is assuming that you're talking to people who are breastfeeding in the first six months producing their child's entire nutritional intake need to you know, produce 700 millilitres of milk in 24 hours, you're going to be taking that full 500 calories extra in your diet to be doing that. You're not going to find a lot of information talking to people who are breastfeeding, you know, two year olds three year olds. Universally everyone agrees it's pretty much safe to lose about half a kilo a week if you want to lose weight. That's about a pound for people who speak English. Aereo one study talked about it being safe to reduce calorie intake by 500 calories a day to balance it about that half a kilo weight loss. Trouble is once you start talking about 500 calories a day, it's fairly meaningless because all our metabolisms are different people have different activity levels, it's very difficult to calorie count, really, when you are trying to lose weight, it is going to be also difficult finding research in this area because of the ethics of testing in this group. So no, ethics committee is going to say to a researcher, sure, let's test weight loss for breastfeeding families, let's find out what we can risk in terms of calorie reduction, before milk production starts to suffer, we're not going to have a study where we've got permission to potentially affect milk production and cause babies to not get enough milk. So we're gonna, it's gonna be very difficult to get research in this area, because no research is going to be approved if it's going to risk infant nutrition. So we're essentially looking at what seems logical, and what's probably safe, they'll actually have an article where they pretty much say that a breastfeeding mom should roughly consume around 1800 calories a day. And you can again, you can safely lose a pound a week, you want to make sure that the calorie intake you have is useful in terms of your nutritional intake, because if there is anything nutritionally deficient, you're probably going to be the one that suffers before your milk suffers. Evolution is not daft evolution tends to hang on to things in your milk, but you may be the one who loses energy, you may be the one who gets tired, you may be the one who's nutritionally deficient. Now, if for some, if you're consuming 1800 calories a day, that doesn't allow much room for weight loss. But you could obviously pair changing your diet with extra exercise to maybe promote weight loss at that safe pace, some children are going to be less dependent on milk, which is why again, this question is hard to answer. If you've got a two year old, who's brilliant and eating solids, and their breastfeeding relationship is probably more about comfort and settling to sleep, you probably can feel you might be able to be a bit more robust in this area. If you've got a two year old who's really not a great solids eater, they're gulping away at the breast, you know, they're taking a large amount of milk, you may be a little bit cautious before you go too fast. We're not going to get definitive answers on this. And as I said the risk could be more about minerals and vitamin B6 and you know your iron levels rather than necessarily, you know, your calorie intake. So generally, we do continue to produce milk, even when we are fairly low in calories, but we may be the ones that end up suffering from that situation. So it is sensible to aim for roughly that half a kilo a week loss.

Emma Pickett  12:47

 Okay, so, next question. My baby is 13 months old and my health visitor recently said she only needs two feeds a day at this age, so not to feel guilty if I want to impose limitations. Is this rooted in any evidence? Or is it a figure plucked out of thin air? Like I suspect it is. Okay, so I think I like this person's wording. Essentially, it is a figure plucked out of thin air. There was a recent piece of research on breastfeeding patterns of 12 month olds, and there was a vast amount of difference in the feeding patterns. 5/6/7 feeds in 24 hours was pretty typical. And certainly in the families I talked to, that's pretty ordinary 5/6/7 feeds. Having said that, if you want to go down to two feeds, if your child is a really good eater, if they're doing really well with solids, if they're really good at drinking water, if you're happy that they're well hydrated, if you have a reason why you want to go down to two feeds and 24 hours that may be possible, but it's certainly what what we wouldn't expect a 13 month old to do. And there's no harm in a breastfeeding child feeding more than that. The idea that for example, feeding more than that is going to limit their development was solid is not evidence based. I can give you the names and addresses right now of several 100 toddlers who are brilliant eating solids and breastfeeding a heck of a lot more than twice in 24 hours. And it's really difficult to answer this question without coming across as health visitor bashing. I love the health visitors I work alongside there are some absolute gems out there. But you'll also find health visitors that will absolutely put their hand up and say we don't get much training in breastfeeding beyond 12 months. And I am basing some of the recommendations I make on perhaps not the best evidence not the most up to date information. What may be culturally as seen as acceptable. What maybe you know, I happened when I was parenting myself. So we do have to be really careful about anybody that tells anybody to reduce the amount of breastfeeding sessions because it is absolutely normal to continue to breastfeed responsively alongside solids intake at this age to breastfeed multiple times and 20 For hours, and that is happy for everybody. 

Emma Pickett  15:03

Okay, next question says, breastfeeding and travel, I need to go away for three to four days. This is the first time I've had more than six hours separation from my son since his birth. I'm not sure how to go about it. He is a two year old booby monster. And he's also co sleeping. So this is something I really like to talk about, because there is a lot of misunderstanding around this concept. And I have also met people who think they have to wean in order to spend a little bit of time away from their child, I even had somebody that contacted me the other day, who was going away for one night, and thought it would be better to end their breastfeeding relationship because of that. Having time away from a young child is not a barrier to continuing to breastfeed and ending breastfeeding does not make that experience easier. When you are away from your child. And you know, a child who's two years old, doesn't fully understand where you've gone, they don't fully understand what three or four days mean, when you tell them I'm coming back on Friday, they don't really fully understand that we do have to accept that there is a rupture to our relationship with a two year old. When we do spend several days away from them. We need to be honest about that. Because if we pretend that's not the case, I think we're misleading parents, and I don't think we're being fair to children. Having said that, though, that does not mean that that extended trip away is not the right thing for a parent in terms of their work in terms of family commitments, in terms of their friendships, you are allowed to make that choice. But we want to leave that person as secure and as regulated as possible. So we don't change anything we're doing in our parenting before we go away. We don't reduce the breastfeeding, we don't stop feeding to sleep, we don't stop breastfeeding responsively, you might have heard people talking about filling their mummy cup or filling their parent cup, you want them to feel as absolutely secure and regulated as possible. The nightmare scenario for people who have heard this myth that we have to wean, before we can go away as they start restricting breastfeeding, their child emotionally reacts to it, understandably, because they're two years old, and breastfeeding is the centre of their world. And then they end up leaving their child at a really scary time for their child because the world is being shifted, breastfeeding is being removed, they're feeling a bit dysregulated they're scared about what's happening with their relationship with their moms. And then you disappear for four days. And it's very difficult to get that timing right, because you don't necessarily know how your child is going to respond to you reducing breastfeeding. So don't please think that a few days away from your child means that you have to end your breastfeeding relationship. And it's another story as to my views on how we don't use a trip away to wean. That's something I've talked about in a separate weaning episode. And I've talked about my book in more detail. But you certainly don't have to change anything. If you're going to spend a couple of nights or three or four nights away from your child. What can we do to help your child? Actually the answer is, how can we help the other adult who's going to be caring for your child? Because they're the one who's going to need to be doing the coregulation of that child. And you can't co regulate, if you are dysregulated. So if let's imagine it's your partner, for example, let's imagine it's your partner who will be doing the childcare. Let's imagine there'll be doing the childcare in the day and at night. They don't breastfeed. Your disappearing for four days. The answer is not to get them to pretend to be you, the answer is not to try and pretend to be them. So you're not both going to parent and exactly the same way, you're not both going to put children to sleep in the same way, you're not going to regulate children the same way, your partner is going to need to feel empowered to step in and do what feels right for them. So it might be wise possibly for them to have done a little bit of bedtime experience, or maybe some nighttime parenting experience. But I'd even be cautious about that. Because you can't practice not being there when you're there. And you could leave your child just spinning again a little bit confused and dysregulated just before you disappear, it can be useful to have your partner come in as well to do the bed times to come in as well at nighttime. So you're doing joint bedtimes and joint nighttime parenting. So your child accepts your partner in that space if they're not already doing nighttime parenting care. But actually, what I often say to parents, when they're going to go away is don't expect things to be exactly the same. If everybody camps in the living room for three nights if they all everyone moves to a different bedroom, and it's all a bit different. And you know, the novelty is a bit special. You know, if the kid falls asleep on the sofa every night and gets carried to bed after watching telly, it's not the end of the world. Everything's gonna be a little bit different. And we just want your partner to choose experiences and strategies that help them to feel secure. So if your partner is a massive fan of Bob Dylan, and they want To sing Bob Dylan songs to your two year old in the middle of the night, brilliant, that's going to mean that your partner is going to feel regulated. And that's more likely to co regulate your child. You don't have to practice being the same kind of parent at nighttime. One thing I would say is that when you are going away, and you're leaving a two year old, think about how you're going to communicate with them when you're away. So we live in a world where we've mostly got smartphones, I'm a big fan of parents making little mini videos. So FaceTime doesn't always work brilliantly well. And phone calls don't always work brilliantly well with two year olds, because if they're angry with you, and they're just a bit crossed, that you're not there, and they're a bit confused about where you are, you may actually find that those phone calls go a bit pear shaped. So what I sometimes suggest is if you're going to phone have a really clear focus, so I am phoning you, so I can read you a bedtime story, you know, mom or dad is going to go and get you the book, they're going to sit and read the book. And I'm going to read the words and we're going to read this bedtime story together. That's the focus of the FaceTime call, I am FaceTiming you so we can have dinner together. So we can eat together on the phone rather than a How was your day. I mean, that doesn't mean a lot to a two year old. What can also work really well is making little videos. So if let's imagine you're going on a work trip, when you get to your hotel room, make a little video of your room, show them your bed, show them your bath, show them your toothbrush, show them the video of the view out the window, send them that little video, and then your partner can choose to show it to them at a time when they feel regulated and happy. And they're ready for that conversation, make a little video of you getting on the train or getting on the plane, little videos that just connect them to you. So they have a sense that you are in the world, you're out there somewhere. And when you come back, you're going to share your experiences. And then when you do return after a little trip away, as I said it has been a rupture. With all the best preparation in the world with the most loving partner looking after your child, it's still been a rupture, your child hasn't had agency over this situation, and they may push you away a little bit. And don't be scared if that happens, because that's a really natural reaction, they might run into your arms. Or they might actually stand behind the legs of your partner and say, Where the hell have you been in the two year old version. So it's can be worth taking the next day off work the next half day off work, just really giving yourself some time to reconnect with your child. And of course, breastfeeding is such a brilliant way to reconnect with a two year old which is why it's so valuable to not win unless you really need to. As I said, the nightmare scenario is when people pick up this ancient myth of how this is how we win by leaving our children for four days. Then you come back after four days and the child is desperate to breastfeed to reconnect with you. And you thought this was going to somehow be a winning strategy. It doesn't work on so many levels. That's something I have quite strong opinions about that I'll talk about a bit more another time. 

Emma Pickett  22:51

Okay, next question. I would like to know what you can do if you were tandem feeding, and suddenly start to have strong nursing aversions with the older nursling but don't want to wean, especially if the older one is a Boobie Monster and demands boob for nap and multiple times in the night. You're breastfeeding aversion and agitation is incredibly tough and it's not unusual to only experience it with an older nursling if you are tandem feeding. So I would just signpost you to Zainab Yates book when breastfeeding sucks, and the breastfeeding aversion and agitation website and resources that she's created. You will find in that book and on that website that sometimes taking supplements can help, particularly mineral supplements, you may find that there is actually something going on with positioning attachment. So it's not unusual for an older child to have not such great positioning. And that is what's causing the aversion because you're getting for example, the nipple rubbing on the hard palate or they're having to create a stronger compensatory suck because the positioning is not great. Or because the positioning is not great in the meal transfers not so great. They're being a bit more fiddly and mucking around and that's causing more aversion. So check positioning attachment first. Make sure they've got that lovely chin contact, make sure they're not looking into the breast but looking past it. So we've got that head tilt that you know that Liam Gallagher Diet Coke thing where they're looking up at the breast and tilting their chin back, rather than crunching into the breast with their nose pushing in first. If they're very twisty and there's a lot of cheek asymmetry and only one cheek is in contact and the other one isn't. You're gonna have a shallow a latch on the side of their face where the cheek isn't in contact. So talk to them about big mouth but it's not just big mouth it's also about looking up it's also about chin touching. See if some work around improving positioning attachment can help. It could be that the issues nursing manners, quite a lot of people I work with struggle with the older child because they are getting more fiddling nipple twiddling, so it may be you have to be a little bit firmer about nursing manners. is and don't hesitate to be as authentic as you can with your child and and try and express what you're feeling in the most child appropriate way. So some people are really nervous about this. And they say, oh, no, I don't want my, I don't want my toddler to know I'm struggling. Honestly, they will pick it up. Don't underestimate a young Nerdlings ability to read your body language, and to read your micro expressions. They can sense if you are struggling, they can absolutely sense of your body's tensing or if there's a sigh of relief when they come off the breast, or there's a sigh of relief when they're willing to do something else instead of breastfeed. So don't assume that by not having this conversation, they're going to be completely protected from these emotions. And don't feel guilty for having these feelings because he's absolutely beyond your control. So sometimes it's worth saying something like when we have nurses, when we have booby, sometimes it's a bit itchy. For mummy. Sometimes it feels a bit achy for Mummy, let's try some different things. Let's try some different positions. Maybe we just have a count to 10. Boobie, and see how that feels. In the breastfeeding aversion resources. You'll also see some ideas about different strategies to maybe distract yourself. It may be for example, that tandem feeding is too overwhelming and to too much sensation. And some people start moving to just doing single feeding and not feeding both children together. It might be that you want to start listening to music or audiobooks when you're breastfeeding. It may be you do some deep breathing exercises, it may be that this is about you changing your mental approach to feeding, rather than necessarily thinking that breastfeeding has to end. But don't hesitate to reach out for support. Because there may be some ideas from local peer supporters, or people online that will also help you navigate this. And don't think you're stuck like this forever. Because a version can often go in and out. One thing I often say to people who are experiencing a version is just check your cycle. If you haven't necessarily had a full return of your menstrual period, you may not necessarily notice that you're cycling hormonally, you may be about to start a period or you might be possibly ovulating before you have your period. Do you notice for example, that there's one week in the month when you're really having a tough time or two weeks in the month when you're really having a tough time. That's not an uncommon pattern. I had one client who actually did not notice that her version was absolutely peaking around the time of ovulation. And when she became aware of that, it really helped her to understand what her body was going through. So it may be you're somebody that needs to take calcium and magnesium supplements because it's connected to your period, or connected to lower milk production during a period. So there's lots of investigation to be done around this. Don't feel that you're stuck with a version you've got to grit your teeth and put up with it. There may be some solutions out there.

Emma Pickett  27:40

Okay, next question says would love to know what natural term feeding looks like? Still feeding my two and a half year old, more or less on demand during day and night? I know she could continue to feed for a long time still. But does it typically reduce first even without the parent actively reducing it? Yes, it's a simple answer to that if the parent did nothing, it would reduce one day. Someone said to me last week, oh, I was told that boys never self Wayne. Excuse me, I can point you to many, many, many, many boys who have self waned absolute nonsense. I do not see gender patterns. It's simply nonsense that boys breastfeed a certain way. And girls breastfeed a certain way. Everybody, eventually self wanes, everybody, everybody will eventually come down to breastfeeding less frequently, it may be more challenging for some members of the population. So if your child is neurodiverse, or your child is autistic, it may take them longer to get to that place. And it may be that there's a greater challenge in that space. But generally, I would say that every child in the end is going to reduce breastfeeding, not least because at the very top end of self weaning, we've got children whose permanent teeth are coming through, palates are changing shape. And eventually, milk transfer becomes more difficult. And we do tend to find that much, much older children actually will sometimes reduce their breastfeeding because they're not getting as much milk out because of anatomical changes. We need more research in that area. But that is definitely a pattern that I'm seeing. So will you two and a half year old eventually reducing their breastfeeding? Yes. Will you actively reduce it? That's your choice. That's your decision. There may be times when you don't want to feed for as long or there may be feeds that you'd rather didn't happen. And if you choose to nudge things in certain directions, that does not mean you're not an actual term breastfeed. That does not mean you're not a passionate breastfeeding advocate. You can make a decision that feels right for you. But yes, it does typically reduce with the child reducing it by themselves before you have to do anything. 

Emma Pickett  29:50

Next question says I don't want to wean, but I need to be away from my 18 month old for an indeterminate amount of nights. I know breastfeeding can re-start after a break, but is there a length of time where being away could force weaning? Now, I don't know what's happening here. I don't want to make any assumptions. Obviously, it's quite an unusual question for someone to talk about an indeterminant amount of nights. I mean, it may be that this person is going to prison. I mean, there are lots of possibilities as to what's happening here. 18 months, how long could you leave somebody before breastfeeding ends? I wish I could give you a definite answer. But I'm afraid I really can't. I have worked with people who have left their child for two weeks and returned and breastfeeding has been absolutely fine has continued without a pause. I haven't worked with many people who've been away for more than two weeks. So I've worked with people that have had maybe a two week break back for a week away again for another couple of weeks, and their breastfeeding was still fine. But I've also had clients that were only away for five nights, and breastfeeding wasn't quite the same on return. So I think it's going to depend a little bit on what your child's relationship to the breast is right now. So if you've got an 18 month old, who is absolutely a Baby Monster loves it to pieces really sees it as a core part of the way they connect with you. And when you're away from them, they're going to continue to be really loved and well regulated and have lots of emotional support, perhaps also have someone with them who can talk about breastfeeding, or they may still see breastfeeding in the world in the world. They may be around other family members who breastfeed, I think it's really unlikely that that child's going to forget to breastfeed. But if they do have a very difficult time when you're away from them, if they don't necessarily see many other people breastfeeding, if it just leaves their mind completely. It could be more challenging when you get back. I think it probably is also going to depend on how you're feeling and how you're feeling emotionally and how emotionally regulated you are, and how confident you feel about reuniting with your child and resuming that loving, nurturing relationship. I would say if someone has to be away for their child for an extended period of time, it may be worth getting some professional advice from somebody who maybe is a parenting mentor or a therapist to help you negotiate that because it's not really the default position to be away from an 18 month old for an extended period of time. And that is going to be a challenge in your relationship. And potentially there could be a long term impact of that that gap. So I think it's important to get the right advice, not just from somebody who's a lactation consultant, but from someone who perhaps understands young people's psychology and and, you know, parenting skills and parenting relationships. 

Emma Pickett  32:37

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  33:24

Next question says excuse my new mom ignorance, natural term breastfeeding does that mean that it ends on baby's terms or when milk dries up? But it's not the parents who decide when to end it? I want to know how often this comes about. The kids often lose interest. Does it happen after a certain age? Does milk supply decrease a lot after a certain age? Do they usually just have night feeds when they're beyond infancy? Do you think there's an average age that most children naturally stop or lose interest? How do you do this? If you've got a second child? Wow. Okay. There's a lot of questions going on there. So let's try and break that down a little bit more natural term breastfeeding. Does that mean it ends on the baby's terms? No, I don't think it does. And I actually questioned breastfeeding organisation that posted this the other day that implied the term natural term breastfeeding suggested it was always child led. I don't think that's true at all. Natural term breastfeeding just means that someone is breastfeeding, to the biologically normal age to the natural age of human weaning, which is about two and a half to seven years. Who's to say that parent led weaning at that age? isn't natural turn breastfeeding. Who's to say that if a parent has breastfed for five years, and at their fifth year they decide, I think I really do need to breastfeed bring breastfeeding to an end now perhaps because they want to change their fertility or they've got something else going on. Who's to say that still isn't natural term breastfeeding? I really question that the assumption so I believe that natural term breastfeeding is a phrase that refers to any length of time. I don't don't think it necessarily says that there has to be the end to breastfeeding in a particular way. Because most breastfeeding relationships do end with a little bit of mutual give and take and a little bit of mutual discussion. Does it end when the milk dries up? Glad you asked this because a lot of people I have spoken to think that breastfeeding just naturally tapers off because parental milk disappears, that you get to two or three and your milk just gradually goes and your child goes Oh, right. Okay, we're done. Fair enough. And that's the end of the breastfeeding relationship. That is not common. Now, it may be it may happen in pregnancy, because milk dries up. So just over 50% of children wean in pregnancy, about 43% Continue through pregnancy and tantum feed at the end of pregnancy. So that's from a study in the 90s. So just over 50%, weaning pregnancy, some of that weaning is about parental discomfort and aversion and its parent lead, some of that weaning is child led, because milk production has dropped, and they don't particularly consider it valuable to have milk anymore. Some children don't mind milk production dropping, by the way, and will continue to breastfeed even if there isn't any milk. So drying up, even if that was to happen, doesn't necessarily mean the Enter breastfeeding relationship. There are quite a lot of children who will happily dry nurse for months, if not years, and they don't always lose interest, because milk supply diminishes. But usually, milk production will continue as long as milk is being removed, so that that supply and demand relationship continues throughout the duration of your breastfeeding experience. If milk has been taken out, you're going to be making milk tomorrow. Does weaning often happen at a certain age? Yes, it does usually happen. As I said, between about two and a half and seven years? Do they usually just have night feeds when they're beyond infancy? No, not at all. I work with lots of clients who are night weaned and didn't even do the night weaning the child just started to sleep through, but they're perhaps still feeding frequently in the day. So the idea that, you know, one or the other is normal is not the case at all. So quite a lot of children do continue breastfeeding through the night. And sometimes daytime feeds will reduce but it can absolutely be flipped the other way. And they may not feed at all at night to be great sleepers, maybe just have a bedtime feed, maybe feed again at 5am. But be more interested in breastfeeding in the day. Do you think there's an average age that most children naturally lose interest? Well, it's several years. So yes, there's an average age. But it's a big chunk of time. And how to support this if you have a second child. So I'm not quite sure what you mean by support this, do you mean that you want to support natural turn breastfeeding, it just happens really naturally. It just happens because that's what happens with hormones. That's what happens with our bodies, we carry on making milk and they carry on taking out and tanned and feeding and natural turn breastfeeding is the default position for humans. So yes, it absolutely continues when you have a second child, you don't need to do anything, it just happens automatically. There may be times when you do want to put boundaries in place, there may be times when you might want might want to change the pattern of the older child. But it absolutely just happens by default, if you've got any problems or if you do want to shift anything. Find a breastfeeding counsellor or a peer supporter and talk to them about it.

Emma Pickett  38:27

Next question, how do I overcome the feelings of guilt for schedule feeding my firstborn from four months, and then he lost interest in breastfeeding around one year. And now I'm feeding and comfort feeding my now one year old all through the night and sometimes in the day? It seems so unfair. But I guess life isn't always fair for lots of reasons. By the way, my firstborn is absolutely fine. More than fine. He's amazing. So this is not an unusual situation. And I absolutely know there'll be some people listening to this that are go, oh my god, this is me. So first baby, you bought the books, you followed the advice of your mom or your granny or your auntie or your sister, you thought scheduled feeding was the way to go. You scheduled your breastfeed from a surprisingly young age and your child possibly did lose interest in breastfeeding a bit sooner, because you were doing other things to meet their emotional needs. You perceived breastfeeding to be about nutrition, you perhaps weren't offering it for comfort. You were working really hard to not have asleep Association, for example, because that's what the book told you you should do. And breastfeeding did have less of a role in your child's life. So it would be really normal for them to lose interest at a younger age. By the way does that become child led weaning if someone loses interest at one year? You can see why talking about child led weaning gets you into a bit of a fuzzy space. And now you've got a one year old and you've done more reading. We do more we learn when we learn more. We do more when we know better we do better You've now spent your time on social media, you found the accounts, you've learned about responsive feeding, you've learned about natural term breastfeeding, you've learned about schedules versus being responsive, you've learned that breastfeeding is not just about milk, you know, it's about meeting emotional needs and delivering oxytocin and calluses declining. And you've, you've got all that knowledge. And that's helped you to be a more instinctive mum, not somebody governed by those external rules. And I've got I'm in my early 50s, I've got friends who've got teenagers now. And this was what they were going through, you know, 20 years ago, they were doing the scheduled thing, the gene afford thing, and then they had another baby. And it was a completely different experience for them. They parented in a very different way. And the question says, How do I overcome the feelings of guilt? I'm not sure that that's necessarily something you can ever entirely do. And what does guilt mean, guilt is a word that is difficult to define. Maybe we can replace it with regret. I think it's okay to have some regrets. But I think it's also important to be kind to yourself, and make sure that you understand that who you were during that first pregnancy and during that first baby is not who you came to be later on. And how lucky it is that you did have that learning and that reflection and that experience, and you came to parents in a different way, how lucky it is that you got to where you are. And that now means that you're probably parenting your firstborn in a different way, because you're being more emotionally responsive, and you're more tuned into your oxytocin. And they are benefiting from you breastfeeding your second child in a different way as well. So the idea that we've got to remove our guilt, and if we don't remove our guilt, we've sometimes we've somehow horribly failed, I think, is something we have to question. I think we have to be kind to ourselves about how we first parented and we also have to be kind to ourselves about the fact we may not be able to wipe off all that regret and guilt. And that may be something we come to live with. And hopefully, the noise in our head gets quieter and quieter. 

Emma Pickett  42:05

Next question says, I'd love to know more about uni boobing, and how common this is where natural term breastfeeding? Does your supply increase on that side? Or does it cap or whatever you've been doing for so long? Uni boobing is a term that means breastfeeding only on one breast. Now, some people breastfeed only on one breast from birth from the very beginning, you might have Poland syndrome and have an underdeveloped a second breast, you might have had surgery, perhaps you've got one very inverted nipple that that's completely permanently inverted. You never quite got the hang of breastfeeding on that side. You may have lots of reasons, perhaps to do with mobility or what's happening on one side of your body. You may have lots of reasons why you've ended up really significantly favouring one breast or entirely only breastfeeding on one breast. It is more common than many people might realise. So there's a Facebook group with about 60,000 members who are breastfeeding older babies and I asked them how many people are only breastfeeding from one side and 47% said they were heavily feeding only from one side so they favoured one side heavily. 23% said they only breastfed from one breast. And that is a lot of people. So that's well over 50% that are either heavily favouring one breast or only feeding from one breast. Someone by the way, use this look the lovely phrase decommissioned, I decommissioned one side, which I thought was a great phrase. So some people may have breastfed from both breasts for perhaps the first eight to nine months. That seems quite a common age for uniboob. To start. I've met some people who decommissioned a breast at eight, nine months, but then carried on breastfeeding for another whole year just on one side. It's not necessarily a barrier to long term breastfeeding, loads of people just breastfeed on one side and the long term. I was talking to Jenny who's another breastfeeding counsellor with the ABM and she said she's ended up uni booming just because of sleeping at night. And just because of sleeping positions and how people lie in bed. It's easier to offer the same side and now her child is older and any feeding at night. She's ended up uniboob. It's not unusual. Question says Does your supply increase on that side? Well, yes, is the short answer it should do. Most people will have still that supply and demand relationship with their milk production. But you will have a finite storage capacity. So you may find that you have to feed more frequently in 24 hours to meet your child's needs. But it's uniboob is not a barrier to meeting full milk production just from feeding on one breast. So let's imagine you're breastfed for the first eight, nine months. It's not like you've kept permanently at that point and you will never be able to increase your milk supply. If you only feed on that one side. Chances are You will in 24 hours, be able to increase your overall production but that will probably mean more frequent feeding if you're only feeding from one side. 

Emma Pickett  45:10

Next question says something about dealing with judgement would be helpful. Maybe ways you can explain to your youngest child that we only do booby at home and saying this in the gentlest way. I do plan to carry on but I'm a bit worried about other people's judgement when I'm out and about, I'm starting to feel a bit uncomfortable at 12 months. Okay, so it's it's really hard because it's not for me to say, Oh, come on love you can do you can do it. You know, we need you to be out there breastfeeding an 18 month old, you know, we need you to be fighting the good fight. You know, when you're out there in the cafe, breastfeeding your two year old, you're making the world a better place and other people are seeing you breastfeeding and well done. And, you know, if you don't want to do it, this you know, you're letting the side down a little bit. I think it's really important. We don't give that message because not everybody has that kind of strength. Not everyone can breastfeed a two year old in a busy restaurant. It does take an effort. I think we have to be honest, we don't live in a society where we see it a lot and to be the person that does it. Absolutely. Hats off to you. Yes, you are helping to make society a better place. You absolutely are helping the next person. You are doing that ripple effect. Which normalises breastfeeding, older children, and I cannot thank you enough. But equally if you're in that space, and you think I can't, I really don't want to feed out and about they're very fiddly. I know, they're gonna nipple twiddle, and they're gonna Bob on and off, I just don't want to that is okay. And that doesn't mean by the way, you need to end breastfeeding because someone wants came to me and said, I can't feed in public anymore, I'm going to have to when not at all, if you want to only feed at home, you absolutely can only feed at home. So I think what you need to perhaps say to your child is we have to be at home. Mommy loves doing boobie at home because we can sit on the sofa. And it's really comfy, and we can really snuggle, and I can give you my focus. When we're out and about sometimes Mommy's not very comfortable. Sometimes my mind is busy thinking about other things, and I can't relax. And I want boobie to be relaxing for both of us. And my body and my mind doesn't feel relaxed, if we're out and about. And sometimes when we're in other places, the chairs aren't very nice, and I feel a bit uncomfortable. Would I go as far as to say, I don't like people looking at me, probably not just because I think that's quite difficult to explain in a child appropriate way. But I certainly might say something about my body feels more comfortable feeding at home. But then you have to make a decision around what else you're going to do instead. So your child is asking to breastfeed outside the home, probably because they're feeling dysregulated or they're feeling neglected, or they're a bit bored. So you're gonna have to upskill yourself and provide some alternatives. If you're not going to breastfeed outside the home. You can't just say sorry, mate, we're not breastfeeding. You know, sit here quietly, while I talked to my friend about Married at First Sight Australia, you're going to have to offer them something else. So that may be that your little bag of toys needs to get a bit of a refresh. And you might need to be thinking a bit more creatively. I'm quite a fan of doing activities with your child, while you're still focusing on the conversation with your friend. So don't just have a book of toys where it's like, here you go, Bob, here's a toy. Here's another toy. Here's another toy instead have come and sit with me. Let's do the sticker thing together. Let's put these stickers on this picture together, come and sit with me. Let's do this colouring together. Come and sit with me. Let's do this fuzzy felt together. So they're doing something with you. But you can still talk to your friend at the same time. So you're trying to bring them into you you're bringing them closer to you. You're not saying sort of look at this book by yourself. You're saying Come here Come with me. I'm also I'm not going to read this book to you because I'm gonna talk to my friend. But let's do something physical together that is connecting us but my brain can also do something else at the same time. So the things like the fuzzy fell and the colouring and the sticker books, things like cats cradles things were like drawing on their hand or allowing them to draw on your hand with washable felt tips, things that can be done together, still physically connecting you. But you can also give them an alternative to breastfeeding.

Emma Pickett  49:38

Next question says, Can I get some information on the benefits of breastfeeding older children? Okay, so I'm going to signpost you to one of my earlier podcasts rather than go into massive detail in this episode. I'm going to signpost you to one of my very first podcast and it is actually the part of my little Hello, I'm going to do a podcast episode, I think it was the absolute very, very first one that basically said, Well done for breastfeeding until now. That's the title of the podcast. And it talks through some of the reasons why it's great that you're still breastfeeding, and some of the scientific research and information that might help you want to continue breastfeeding. And the one after that that talks about making the decision to wean as well. We'll also help you think about that. The information on benefits. By the way, I just want to double check. You're not asking that because you're getting pressure from an external party. I think it's really important that you know that if you want to breastfeed, that's the only reason that you need to want to breastfeed the fact that you want to breastfeed, you don't have to be able to quote research studies at your fingertips. The burden does not fall on you to justify the continuation of breastfeeding, the continuation of breastfeeding as the biological norm. It's up to somebody else to find out the research that they want to counteract that position. Yes, I do provide information on on the benefits of breastfeeding. But I'm also cautious in saying don't feel that that's your obligation to be able to justify your decision to want to still breastfeed. 

Emma Pickett  51:08

Next question says, Could you discuss natural term breastfeeding when feeding a younger sibling, so a four year old and a two year old, for example? So as I mentioned before, that is the default for humans to tandem feed. One thing I would say about feeding a four year old four year old and a two year old, is we shouldn't necessarily assume that the two year old is going to be more of the booby monster than the four year old. So if this is your story, don't feel like there's anything unusual about your family. It's not unusual to meet a four year old who's more of a booby monster than their two year old brother or sister. I have met families, where it's the four year old who's waking up at night to breastfeed, and the two year old is sleeping through and only breastfeeding at bedtime. I've met families where the four year old is breastfeeding six times in 24 hours and the two year olds just brute breastfeeding twice. There's such a massive variation of normal for any child breastfeeding at this age, whether or not they have a sibling. So I think the question is really, when you say cat, could you discuss I'd like to know what you're thinking? Are you wanting to know if your situation is normal? Are you wanting to know if you can put boundaries in place? Are you worried about something? If this was your question, come back to me, and we'll talk a bit more about this. 

Emma Pickett  52:24

Next question says it's common advice to not offer a child alternatives if they're being a picky eater, especially something they previously liked. How do I weigh this up against responsive feeding? And a baby having longer feeds after eating very little of a routine meal? How do I judge comfort versus unwanted snacking between meals? is breastfeeding less nutritionally satisfying for toddlers? Okay, so sounds like you've got some worries here about your child solids intake. And you're, you're perhaps thinking that you shouldn't be allowing them to breastfeed after a meal. Or you should be restricting breastfeeding somehow. I think we've obviously got emotional regulation coming into play here. So if there has been a meal, that's been quite stressful, if your child is feeling emotionally dysregulated, it's really normal, I think, for them to want to breastfeed. I don't think it's a problem for a child to breastfeed quite a lot at the stage of introducing solids. And throughout the first couple of years of introducing solids, it takes quite a bit of time for solids interest to increase. Obviously, we're worried about mineral intake, and we're worried about iron, and we want to make sure we're getting enough of those micronutrients, but it can take a bit of time to solids to increase and, and solace to get a bit more interest in their lives. I personally wouldn't suggest that you restrict breastfeeding after a meal hasn't gone well. In the theory that tomorrow, they'll understand they won't get to breastfeed, so they're going to eat more of their meal. I think it's quite an ask for a little person to have that sense of cause and effect and to get that lesson that they weren't breastfeed so they should eat more. I don't think that they're going to necessary hold that information for 24 hours and see that as a positive and I probably wouldn't recommend breastfeeding being something that you kind of withdraw almost as a punishment. I don't think that's the right word. But you know, it's we don't breastfeed less as a sanction for not eating, I think, if you feel like you're in that space, where oh, you can't breastfeed because you didn't do you didn't eat nicely. If you think you're in that space, I'd probably suggest that you reach out for some help. So somebody like Stacy Zimmels who's @feedeatspeak on Instagram or somebody like Lucy Upton, who's @thechildrensdietitian, find somebody who's breastfeeding supportive and can help you think a bit more about your solids so you don't feel like you're getting into this negative spiral of breastfeeding being, you know, something that you withdraw way that you punish a child whose hasn't eaten? Well, is breastfeeding nutritionally satisfying for toddlers. I mean, yes, I, it's got a really high calorie content, it's got lovely lactose, it's got a good fat and protein content, we've got lots of vitamins, I mean, you know, we're taking in not just water we're taking in something that is very bioavailable and nutritionally very rich. So it certainly hasn't turned to water it is, if a child does have a massive breastfeed just prior to a solids meal, they're probably going to be a bit less interested in solids. So if you are finding that your older toddler is not interested in solids, you might want to just look a little bit at your scheduling and maybe not bring them to a solids meal so soon after a breastfeed. But equally, if they're asking for breastfeed at four o'clock, and you want to do dinner at five, you know, why are they asking for breastfeed at four o'clock? Is there something going on about emotional regulation that you need to reflect on? Did they maybe not eat enough in the day? Do you maybe need to do a snack at three? So then they're going to get through to dinner time? You know, don't just think the answer is taking away the breastfeed. The answer is looking at the whole picture working out, you know, does dinner time need to be a different time? Do I need to work on the whole 24 hours, maybe lunch is going to be their big meal, maybe they're always too tired at dinner time because I've been dropping the nap, you want to sort of look at the whole picture. So I would suggest you carry on responsibly feeding as long as you can, until you start feeling it's a barrier to solid interest. And then maybe you might pull back a little bit just before a meal. But I wouldn't hesitate to let a child breastfeed after a meal, particularly if they're feeling emotionally dysregulated after a meal. 

Emma Pickett  56:42

Okay, next question says I'm at 20 months, I'm not planning to wean anytime soon, but I'm trying to put some boundaries in place. But at times, she gets extremely upset. And so dysregulated to the point I'm scared, she'll hurt herself. So I give in and allow the boob. Even if I initially said no, nothing helps in these moments. So do I just keep trying? Or does she need more time to get used to the idea of breastfeeding not always being there on demand? So if that's the space you're in, I think you need to have a little bit of a rethink around how you're putting in boundaries. So if you're simply saying no, not now, to a 20 month old, as I've talked about in some of my episodes, that's a that's essentially like putting a brick wall up that slamming a door in their face. That's leaving them with a vacuum. They literally don't know what to do with themselves in that space. So instead, we would say, actually, right now babies are resting babies are sleeping, but we can do X or Y. Or you might say, well, babies are a little bit tired. So we'll just do short boobies. And then we're going to play this really cool game. What you're trying to do is find a way for your child to still get that connection with you. And also to feel that agency and feel that communication bars, which I've talked about on Instagram. So a 20 month old who's asking for breastfeed isn't just saying I would like milk, please. They're also saying, I love it. When I ask for a breastfeed and it happens. And I get that connection with you. My request is met that feels amazing. Because I'm not a brilliant talker. Half the time people don't understand what I'm saying. But this always works. You know exactly what I want. And it feels brilliant. So if we say no to that, it's not just they're not getting milk. It's their whole communication buzzes squished, their sense of agency or squished, they lose a lot more than just milk. So sometimes I say to parents in this space before you take with the breastfeeding, you've got to give them other things they can ask for. You've got to give them other things that they're excited about other things where they say, Mommy, can we do x and you know exactly what they mean. And you go and do X and it's something they love. So we're looking for power reversal play opportunities. We're looking for how we communicate. So if your child's not super verbal, I talked about having little photos, they can point to little posters on the wall they can point to we want her to be excited about asking for other things. You might add in a few activities that are brand new, that are a bit fresh bit of novelty, that she can ask for instead. So when you say well, sweetie, yes, we can have boobie, but just quick boobie, and we're going to do this new new cool, exciting thing. They're really excited or you say eventually what boobies a bit tired now the next boobie will be at this time, do you want to do X or Y, X or Y things they're really excited about and the act of making that choice feels empowering. I wouldn't just plod on with saying no, and dealing with a big meltdown. If that's where you are. I think you probably need to rethink the way you're saying no. And can you say no in a way that doesn't leave a vacuum doesn't leave that emotional sense of failure doesn't squash that community. a buzz, something that leaves her empowered and excited. And quite often a first step is just a short feed. Yes, we can have baby but just a little one because the next really cool thing that I'm super excited about is where I'm placing all my emotional energy.

Emma Pickett  1:00:15

Okay, next question says, Okay, this might be TMI, but I really want to know if my nipples are ever going to shrink back. After four years of total breastfeeding, they're really prominent and noticeable through multiple layers of clothing. Is there anything I can do to change my nipple shape? So short answer is probably not. Because there have probably been a change to the shape of your nipples, that is going to be semi permanent. breast shape is a bit different, because breast shape is about fat distribution. And quite often, as your fat levels change, and your weight changes your breasts shape or change, when you end breastfeeding entirely, you're going to play some fat down with each menstrual cycle. So your breast shape is likely to shift quite a bit. But nipple shape, probably not so much. So yeah, I don't have an easy answer for that one. I'm afraid I actually read an article this week about nipple surgery to change the length of your nipples. And as I'm afraid as a lactation consultant, that's something that makes me have a sharp intake of breath. But who am I to say that's not right for some people if they're really struggling emotionally, with the shape of their nipples? 

Emma Pickett  1:01:25

Next question says, I'd love to know if using a dummy as a toddler, and if mom getting pregnant can affect natural turn breastfeeding? My daughter is 33 months. Okay. Two separate questions to this using a dummy? Well, yes, I think logically, we can probably see how using a dummy is going to change your child's relationship to the breast, it's not unlikely that they will perhaps use the dummy sometimes to help them with sleep, or to help them with their emotional regulation. So I think it's logical to assume that if a child has a very strong relationship to a dummy, they are likely to breastfeed less compared to a population who don't use a dummy. I can't tell you exactly what the impact will be. But I think we can pretty much say logically, that's likely to be the case. What about pregnancy, while pregnancy is definitely going to make a difference to the natural term breastfeeding relationship. As I said, about 43% of children will continue to breastfeed through pregnancy and come out the other end tandem feeding, which means a lot don't. And why is it that some people are ending breastfeeding while other mums are pregnant? Probably because of a change in milk supply. So about 70% of pregnant parents notice a significant decrease in milk supply, sometimes as early as the first month. For some people, that's the sign that they're pregnant because they noticed their milk production dropping. We don't exactly know why. It's probably something about progesterone and progesterone impacting on the way our body responds to prolactin, Hilary flour, who wrote adventures in tandem nursing talks about maybe milk storage areas, or alveolar, being a bit leakier, but certainly 70% notice a significant decrease in milk supply, and about 18% say that they dried up completely in pregnancy. Now, as I said to one of the previous questions, some children will continue breastfeeding despite their parents drying up. But that's not going to be universal for everyone. So that 33 month old, may get less interested in breastfeeding may not want to breastfeed as much supernormal. And then we have colostrum arriving from the second trimester, sometimes as early as 16 weeks. And again, for some children. That is something that causes them to reduce their breastfeeding, so some children would like whoo colostrum has arrived. Finally, after several weeks of dry nursing, there's something here, and some children are like, hang on colostrum is arrived. This doesn't taste the same, it tastes maybe a little bit less sweet. It has lower lactose levels. Some older nurses who are verbal describe it as tasting a bit more like crisps. Some children are not up for that. And they will stop feeding at that point. So we get a group that stopped feeding in the early weeks. And then we got another group that stopped feeding when colostrum comes along. Can you increase your supply and pregnancy? Can you preserve your supply and pregnancy? No, is the answer. And it's really important to state that because I see a lot of myths around this. I even see people being advised to take galactagogue So herbs that increase milk supply in pregnancy. No. That is not advisable because some of those herbs are actually contraindicated in pregnancy and could genuinely be risky and pregnancy. But generally, almost all the herbs that increase milk production and we can have another conversation about how evidence base that is. Do so by increasing prolactin and prolactin levels is not your problem here is how prolactin is able to be used by the body. That's your problem. So if you feed more frequently, and you get more surges of prolactin, you still got progesterone saying air sorry, know that prolactin is not going to be able to do its job. And we don't want to mess around with our progesterone because we really need that. And if anyone has been in a place where they've needed to take progesterone to protect their pregnancy, or sustain their pregnancy, you'll know How important progesterone is, we don't mess around with a hormonal balance during pregnancy. So if someone is worried about their milk supply dropping, you do not pump more and pumping in pregnancy, some people are doing it, because that's been their history, but it's not a good idea to increase it significantly. And there is possibly a risk of nipple stimulation, causing maybe potentially uterine contractions for some people, some people won't notice a problem, and it'll be absolutely fine. Feeding more frequently is not likely to increase your milk supply taking herbs, it's not like to increase your milk supply, there's very little you can do. So if you are noticing a drop during pregnancy, this is going to be about acceptance. This is going to be about supporting your child, it may be you move into a dry nursing relationship. And that's the right thing for both of you, but reach out to someone and get support. So the simple answer is, if you are 33 months, will pregnancy make a difference to natural term breastfeeding? Almost certainly yes. But it doesn't necessarily mean the end to natural term breastfeeding. We have many people out there who are happily breastfeeding through pregnancy and continuing to tan and feed after pregnancy. A lot of it comes down to how your body responds to pregnancy, and how your little person responds to how your body responds. And we can't necessarily say that's going to go one particular way. 

Emma Pickett  1:06:21

Okay. I'm going to leave it there for now, because I've been talking for more than an hour. And I will definitely do another question and answer on natural term feeding at some point because this is never going to be a subject I stopped talking about. This was the topic of my third book. It's something I believe very passionately about that people need to have these conversations around breastfeeding beyond infancy. If this is the space you are in, I just want to say very cheap, easily well done for being in this space. Because I know how bloody hard it is to breastfeed a toddler or an older child. I know how hard it is. And I know how some of you are really up against it. You don't know many people in real life, you may not necessarily have the support of your wider family, you may be doing it without your wider family even knowing that you're still breastfeeding. So if that is you, thank you for doing this for your child and well done for being in this space. And, you know, you really should feel proud of yourself because I know this is not easy. Apologies for being super cheesy. But I feel I need to end by saying that. 

Emma Pickett  1:07:24

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.