Our baby’s feeding journey feels so personal to us. It is a very positive experience in many cases, however, sometimes our baby’s first year may feel traumatic. I welcomed Victoria Facelli, an international board-certified lactation consultant and the author of Feed the Baby: An Inclusive Guide to Nursing, Bottle-Feeding, & Everything in Between.
Join us as we discuss:
Join us in this episode for a candid and compassionate exploration of the infant feeding journey.
Connect with Victoria on Instagram or TikTok
Connect with Erin:
Our baby’s feeding journey feels so personal to us. It is a very positive experience in many cases, however, sometimes our baby’s first year may feel traumatic. I welcomed Victoria Facelli, an international board-certified lactation consultant and the author of Feed the Baby: An Inclusive Guide to Nursing, Bottle-Feeding, & Everything in Between.
Join us as we discuss:
Join us in this episode for a candid and compassionate exploration of the infant feeding journey.
Connect with Victoria on Instagram or TikTok
Connect with Erin:
Did your baby's feeding journey go as planned? Mine either. Our baby's feeding journeys can bring about so many emotions, from joy to fear to shame, and all feelings are valid. Today I am talking with IBCLC Victoria Ficelli about what to do when our feeding journeys don't go as planned. Victoria is the author of Feed the Baby and feels passionate about inclusive infant feeding. Let's dig in.
Speaker 1:Welcome to the Baby Food for Busy Moms podcast, where you will get the knowledge you need and the support you deserve so you can finally feel good about feeding your baby, whether you're breastfeeding, formula feeding or offering solids. I'm your host, erin Moore, a mom of two boys, a practicing pediatric nurse practitioner and a lactation counselor with years of experience helping moms feed their babies. Tune in each week for bite-sized, judgment-free education you can trust, all with a busy mom in mind. Before we start, this podcast does not provide medical advice. Information on the podcast is for educational purposes only and no information on the podcast or my website is intended to be a substitute for professional medical advice, diagnosis or treatment. I am a pediatric nurse practitioner and a lactation counselor, but I am not your baby's NP or CLC. Please consult your pediatric provider for any questions. Victoria, thank you so much for coming on. I like to start off introducing yourself, your why, and then just any background information that you'd like to share.
Speaker 2:I'm so glad to be here. Thank you for having me. I'm Victoria Vitelli. I'm an IBCLC and author of the book Feed the Baby, an inclusive guide to nursing, bottle feeding and everything in between. And my why. I think a little different than a lot of people in my field. I think a lot of people in baby land, sort of like, had their own personal experience and then became professional and sort of like had their own personal experience and then became professional and that's really their why, and mine was sort of backwards, so my why has changed over time.
Speaker 2:Initially I just found the postpartum so magical and interesting it's like this really special, rare spate and I was really drawn to that. So I became a postpartum doula and then I love solving complicated problems and so I was really drawn to the infant feeding piece of things. That putting these two people together, these multiple systems, these different kinds of food, you know like putting all that together, understanding the research, was really interesting and where I live we have at our university we have an IBCLC program so I was able to do that and I was able to go to out-of-hospital birth centers, small rural hospitals, wic offices and work with peer counselors Rural, we have like a NICU in Eastern North Carolina that serves 29 counties, level three trauma centers. I was able to really see the gamut and just fell in love with how complex and interesting families are. And then my why shifted dramatically when I had my own daughter and had a really traumatic birth and a pretty traumatic postpartum, a NICU stay and found myself parenting outside of my decade of experience and having to really face what I now understand as good parents change their mind, sure, and really understanding that, like the depth of of informed decision making that you have to do when you're navigating the NICU Right that really serves all families, and being able to sort of take that and my experience in teaching people how to feed babies that I had brought into my career before having my kid.
Speaker 2:And then I did the incredibly cliche thing of writing a book during the pandemic. So while my kid was in the bathtub watching Daniel Tiger, I would sit on the floor and tap out my manuscript and was lucky enough that you know kind of well, I don't know if this is lucky or reality or sad or hard or true, but basically every step along the way of publishing the book I would just encounter people who were like I really struggled and I really needed this information. Yes, I want to be your agent. This was really hard for me. I really needed this information. Yes, we want to buy this book.
Speaker 2:All of the people my illustrator, my videography team is a little bit different, but so many people along the way of this had had their own experiences and were really excited to sign on to the project because of their experiences, and so I wanted a book where I could see you know, I'm queer, I'm Latina, my daughter's disabled. I wanted to build a book that spoke to families like mine that are different, but also spoke to the way that so many of us just feel different, even if you're just like, feel like. You, for instance, could absolutely be the lady on the front of most covers of breastfeeding books, right? Sure, sure, not the long brown hair and the beautiful smile. You could absolutely be just like in a field of daisies.
Speaker 1:Oh, thank you Right.
Speaker 2:But you don't feel that way.
Speaker 1:No, no In the postpartum.
Speaker 2:You don't feel that way when you're having to make hard choices, and you can often feel like like oh, everyone else is having an easy time, this and I'm having a hard time a bit, and so I really wanted a book that both honored that and spoke directly to that and gave sort of a choose your own adventure of like finding the information you need in the moment because you are having your own experience and sort of putting that together as you needed, so like if you know off the bat you're doing the formula feeding, like get the trunks about breastfeeding easy peasy, and so that you could just really tailor it to your experience and feel validated in your experience.
Speaker 1:Right, and I think that's so important in that often we prepare in one way because we have a vision of how our postpartum period is going to be, and then, when things change or shift even a little bit, it's like we feel so alone or it feels so personal. And it really is. It truly is, but I think that your message is just so important. It's like you may need this, you may need something else, but you have all of this information, which is all really important information to know, and maybe you won't need this part, but that's okay. And you might need this part, but it's all completely valid, whether it's one topic or another topic or another feeding topic, and this is where your journey is taking you. So, as an IBCLC, how do you see most families prepare for infant feeding and if you are seeing like a traditional path, do you see any kind of downfalls or something that they're missing?
Speaker 2:I think a lot of this is really cultural. So I think it really depends on your family and your culture and, like, what messaging are you getting? How close are you with your extended family? Like, all of those things are really different. Like, what are the beliefs around you? What of those feel important to you? And I think that what I see most people feel like is the thing to do like to check the box is often to take a hospital breastfeeding Right.
Speaker 2:Most of those classes are pretty heavy on the benefits of breastfeeding and don't teach you that many skills. Partially because it's really hard to teach these skills. Right, because they're really tactile. It's sort of like driver's ed, like when you start driver's ed by watching a lot of videos and maybe you're doing the simulator, but it really bears very little resemblance to actually driving right, right, and you're just gonna start driving and you're just gonna be bad at it for a little bit and then, like for most people, it ends up to where you like literally don't know how you got somewhere right.
Speaker 2:Right, because it, like the motor planning of it, becomes so second nature and that's a lot like breastfeeding. Specifically, it's this really hard, complicated motor plan thing that you really can't wrap your head around until after, and that's part of why the QR codes to the videos in the book were so important to me, because we are primates. We are primates and we do like. We have what are called mirror neurons, where we learn a lot from watching each other Right and hearing from each other, and so what I wanted was for people to be able to like actually watch actual newborns latching, which is really hard to do on the Internet because nipple Right.
Speaker 2:So by putting them in QR codes to the book, I could keep that like slightly more private, but people could still access and just like watching it and be like I don't really know what I'm watching, but I'm taking in this information.
Speaker 1:I was looking just on YouTube just to see like a good latch versus a bad latch or things like that, and I'm like, oh well, it's so subjective. But I'm like I'm seeing that and they're like, oh look, how great this latch is. And then I'm like, but is it actually good? I don't really know. So I agree that you know, being able to read it and then going to certain sections and then actually getting the visuals is so important.
Speaker 2:Yeah, and then I think a lot of lactation teaching cheats a little. I think that we often it's really hard to explain feeling full and drained. Learning a baby's hunger cues and feeding cues, like it takes a lot of time it does, and so we tend to get little shorthands, like 20 minutes per side. We have the apps with the timers, and so I also think a lot of the information that people get is actually really unhelpful and stays with them. So I think, like some people are definitely overachievers and like there's some like phenomenal classes online or read all of the books, but a lot of the books are kind of one sided and don't have really in-depth information. A lot of the time, if you are planning to breastfeed, you need a little bit of formula at some point to get there, or things don't go to plan and you want to switch completely or all of those things, and that information is pretty hard to come by, right? And so I also want to just like, in case there are folks who are not yet, who don't yet have their babies we're listening, it's like you can't learn everything beforehand.
Speaker 2:Yes, right, like I was the most prepared person in the entire universe. I was an IBCLC who had a decade of experience, the entire universe. I was an IBCLC who had a decade of experience. I thought I had seen it all. Yes, and I still got walloped. So learn all of it.
Speaker 2:What you need is people in your life who can really listen to you and support you when it's hard, ideally clinicians who are curious and listening and guiding you, and resources like my book, that really that you can go to and find information as you need it, because trying to get all of the information before you have a baby is actually a really overwhelming task. Right and that was not a baby you have yet.
Speaker 1:Absolutely. And I was wondering about that and that's my next question is a lot of families go into feeding or having a baby and then feeling like they're going to follow this path, but sometimes it doesn't go that way. But if they're really set on this path, do you have suggestions? So, whether that is exclusively breastfeeding or combo feeding or formula feeding, what are your suggestions for families when they're like I really want to accomplish X Y Z goal or get to this point, but maybe there's a little bit of a struggle there too?
Speaker 2:Yeah, I think that in most situations we have to make short-term plans and really understand the risk benefits of what we're doing in the short term and then also make sure that your clinicians are understanding what your goals are in the long term. And I think some of that is like getting into the minutia of your goals, because our goals actually, like you'll hear people be like oh, I'm obviously going to breastfeed. I don't know, and I think you assume it's a little more intuitive than I do, but what's really helpful is for me, I always have to like get under that where I'm like okay, but what about? It is important to you? For instance, like I had a client that does a lot of international work and she was going to be taking her baby to places where there's not clean water okay, and in that instance, breastfeeding was really important to her. Yes, because she wanted to be able to take that baby with her to work.
Speaker 2:Similarly, I've had clients who are surgeons who do 20-hour surgery, mm-hmm, and they needed to be able to make sure their babies can take a bottle Mm-hmm and make a plan for how they were going to stay comfortable and without mastitis, standing somewhere for 20 hours, right, and like, is there a way to pump in the middle of that? Or is it okay to choose your job over human milk feeding? Or like, do some breastfeeding and combo feed because you're prioritizing your job in that way, right? So like these are both incredibly important jobs, right, and they have different needs and goal, and actually like both of those goals are to do with like sterile, like sterility and like bacterial exposure yes, in totally different ways, right, yes, and so that's what I'm always looking for is like, what about?
Speaker 2:this feels super important to you and like for me, it was lazy, like I'm really into the idea of being able to like feed a baby while you're kind of asleep. Looks pretty great to me. That was not the kid I. The kid I had literally, because of her motor disability, couldn't laugh and like could barely do bottle. Okay, right, so like actually bottle feeding was a triumph for us over a tube feed, which now I'm like right on tube feed.
Speaker 2:So I'm like that's an amazing tool and I feel much more neutral about it, but for me, like that wasn't going to happen, and so then I had to look at my goal again and actually I think I ended up on a path that was really misaligned with my goals.
Speaker 2:Like if the thing that I was after was like that it was going to be, so that we could get enough rest and like feel present and bonded and together Right, I did not achieve that by exclusively pumping for nine months in a way that for me, lots of people exclusively pump and have a great experience For me, way that for me, lots of people exclusively pump and have a great experience for me exacerbated my very severe perinatal mood disorder.
Speaker 2:So actually, like I ended up out of sync with my goals and I really try to help people avoid that. That's my biggest thing. Like we can feed babies really healthfully lots of ways, like lots and lots of ways it's not two ways, it's like many, many, many permutations of that and so figuring out like what is really important in your family system, in your life, and starting there and then making sure that your practitioners know that so they can help you piece together, and I will often be like, hey, this was the initial goal that you set out. Isn't it still your goal, like that priority? Is that still your priority? Because I think we might be off track with that priority, or I think you need to re-examine that priority because it's doing harm in these other ways and I'm worried about you, right?
Speaker 1:So then, how do families know when it's the right time to pivot or when they need to make a different decision? And if their providers are not necessarily helping facilitate that, how can they, like, trust their intuition?
Speaker 2:I think a really good friend is the best. Like you need your really good sounding board. I mean I wish I had an easier answer for this. Like God knows, I wish I could go back in time and tell myself these things Right, right, like I don't I got really lost in it, so I don't know that. I think it's okay to say, like it's actually really hard, right, like it's actually really hard to know. Think it's okay to say like it's actually really hard, right, like it's actually really hard to know when it's time to pivot. It's actually really hard to make those choices to change. And like getting to where you trust yourself as a listening and who can reflect back what you're experiencing. That helps, yes.
Speaker 2:And like getting good at talking stuff out with your partner about like wait, what are our actual values here, and that'll serve you long term right being able to like talk it out with a friend or a partner or your community, to be like wait, why are we doing soccer four times a week? Is this what I want to be doing with my time? What is our goal here? Like? What are we doing? Like those things I think actually serve you in parenting, but practicing them for the first time when you're so sleep deprived and it's so heightened, it's just actually hard. Like I don't think I have a good answer to that, because it's just actually really hard.
Speaker 1:Right, I agree, and I'm a pediatric nurse practitioner and I've been working in pediatrics for what? 13, 14 years now, and then also doing lactation. And I had the same thing that you had, where I'm like, oh, my feeding journey is going to go this way, it's going to be, it's going to be like this because I have all this experience. And then, of course, we're thrown for a loop. I never planned on having a baby right before a pandemic, but here we are.
Speaker 1:And then when my son, when Max was not gaining weight and I was still having a lot of, like difficulty, knowing or feeling comfortable asking for help, as in feeling comfortable going to see somebody because of the risk for bringing COVID home to my baby and taking him out to any place, and and then learning to like trust my intuition and I like looking back, I am like, wow, I really should have done the pivot a lot earlier. But it's just so hard when you have your heart set on one way of feeding and can't see that maybe there's a better like, there's something else that could help you accomplish the goal of having a well-developed and growing and developing baby versus.
Speaker 2:I think that's such a good example because your risk benefit was different because of your circumstances, right, right, like we also have to acknowledge where our benefits change, right and in that moment, like I think you weren't.
Speaker 2:Like it's easy to look back and be like, oh covet, like wasn't spread on the male, like it was probably safe-ish to take the pediatrician, like babies actually usually do okay with COVID, right, like we know that now. Yes, but at the time you were having to make really really big, really really scary risk benefit decisions where, like slow growth as compared to the possibility of where we were with COVID at the time, right, like might have actually been a sound medical risk benefit. Yes, yes, thanks. Like I think that's and I think that's the thing I really want to encourage people to be able to do is acknowledge that none of these are one variable in a vacuum.
Speaker 2:Yeah, yeah like I am so bored of, like formula versus breast milk, because that's not a real comparison. Yeah, like that presumes two identical circumstances, right, that don't exist right, so like. Actually, I'm like in that bigger picture of, like all of the variables of your life. What is the helpful choice? Because help is more than a number of respiratory infection or actually, in the case of formula, dry skin. Yeah.
Speaker 1:Yeah, yeah. Well, let's talk about it. And how do you guide families to figuring out that right decision for them? And if their goal is one thing seeing the bigger picture, what's your approach?
Speaker 2:So, first of all, I am kind of a research minimalist, like my burden of proof is pretty high. Right, there are things like vaccines and seatbelts where, like, we have like, really like really solid evidence really make a huge difference. Yes, and while I find the minutiae of breast milk very interesting, it is very difficult to study, and that is where we get the like exclusive breastfeeding from is because it makes it easier to study, not because we have proof that exclusivity is an important health marker. Right, because, like, if I'm like hey, think back to like May 2020. Much formula did you use every day? Yeah, right, be able to give me that information People can do that research Let alone.
Speaker 2:Like, how much breast milk did you give them, especially if you were nursing? Sure, who knows, yeah, thumb quantity 20 minutes worth. Yeah, some quantity 20 minutes work, yeah, right, so it's so, so, so difficult to study and so, but, like, what we know is that, like, the kids are all right, yes, so like those I can like, like researcher to researcher, like clinician to clinician, like I can sit there all day with you and like bang that out. But when someone's in front of me, I'm gonna really sit in those conversations.
Speaker 2:Like to take the example of my friend who does international aid work, the risk of formula is actually really different in that case. Yes, right, the risks of formula use in, like parts of rural africa without clean water are actually meaningfully different, yes, than they are in durham, north carolina, yes, and so I always try to help people like get to where their circumstances are so that they can really make those decisions for themselves, and I try to be as neutral as I can be. Like my stance already is like there's different healthful option. But someone in front of me that has a family history of type 1 diabetes right, we don't actually understand fully what causes type 1 diabetes.
Speaker 2:There is some correlation with breast milk feeding and reduction in that we don't have causation but we have some correlation and that was really important to a client of mine. They're like she needed to feel like she had done everything in her power to prevent that for her kid right, and like I can't say with research that she's right or wrong, but right health feeling that she was having was really important to me sure. So I was going to support her in whatever she needed to follow that right. If that had been impossible for her like, say, she was something that just like doesn't make any milk, then we would have had to have like a real heart to heart about, like the research says, correlation, not causation. Mm-hmm.
Speaker 2:How accessible is donor milk for you? Mm-hmm, you also have a family history of severe food allergies. Mm-hmm. So, like, different formulas are going to have different risks, let's walk through those Right. Different donor milk might have different risks, let's walk through those Right. Like then it gets really complex, right. And I think the big thing for me is like I'm okay with that kind of complexity. Yes, because I don't think it's a binary and I don't think that people who breastfeed succeed and people who formula feed fail, right, right, and people who formula feed fail right right.
Speaker 2:I think that we are people in modern society moving through the world. You're in austin. You had your max in 2020. Did you get hit with the snowstorm?
Speaker 1:yes, it was it I still have, while I don't know. It's like, it's like post-traumatic stress, right? I I still have, while I don't know it's like post-traumatic stress, right, I still have because we were running out of food. And then also my husband my sister, was pregnant at the time. She lived at the bottom of a hill. We couldn't communicate for I think it was like 18 hours. We didn't hear from them because we couldn't get through.
Speaker 1:And it turns out that they were trying to get out of their house and she slipped on ice and she needed to go to the emergency room to make sure everything was okay with her baby, and she had no way to get out of her house around the area and they also had no electricity, so it was like 50 some degrees in her house.
Speaker 1:She had a son and and so then my husband had to go I'm like you need to go because you have to, you have to see if she's okay and then we couldn't communicate while he was out too. So it was a risk for him and a risk. And then we found all this stuff out and it's like I still feel. I still have those feelings. And then, of course, if there stuff out and it's like I still feel, I still have those feelings and then, of course, if there's any in Texas, because we're in Texas if it's like too hot or too cold or anything like that, I still have those feelings of anxiety of like not being able to like reach my sister or reach my husband in house.
Speaker 2:Harry, that was yeah, so was your son born at that point he was.
Speaker 1:He was he was 12 months or 13, 13 months and that was also eating solid foods, eating solid foods and we were running out of food because we had planned I had planned on, I had like four or four days, I think, of food but we were running out of. He had just like switched to whole milk and luckily we went back to formula and I was like thank God he was on whole milk and luckily we went back to formula and I was like thank god he was on formula so I could go back to formula and and at least I can know that he's getting xyz amount of nutrients, as we're running out of food that he can actually eat with what we can prepare yeah, so that's another example right of like you know, I say like oh well, like we're in modern society and all these things, but also like natural disasters happen.
Speaker 2:Mm hmm, right, so like, how are we making those risk benefit decisions in those moments? Right, you know, it was such an interesting experience. I have a lot of close people in Texas who called me in for support for their loved ones during that time and it was fascinating during that time and it was fascinating Many of them have a lot of financial privilege and normally would be able to access anything that they want in the whole world.
Speaker 2:Right, and it was such an interesting moment of folks, even with the most resources, like really really struggling to melt snow to flush their toilets immediately postpartum, you know like some of these folks like got home from the hospital that day.
Speaker 2:Yes yes, and worrying about low supply and weight gain and those sorts of things, and like not having water access, you know. So, like those moments are really, really intense. Right, and I do. I want to touch back on what you're saying about PTSD. This is one of the things I talk about a lot.
Speaker 2:I also have PTSD from my daughter's birth. So does my spouse, right, and we also talk about PTSD sort of flippantly like or say, or we either sort of like downplay, we're like I don't know, I have PTSD from that, or we think like it's only something that exists for people who've experienced war. Right, and I want to reiterate that PTSD is actually very common in postpartum in particular, and that's because PTSD occurs anytime you're in a life-threatening situation and your brain has to go into fight or flight mode to keep yourself and, like, your offspring, alive and safe. And so some people, like me, experience that because birth can be life or death. Yes, I think often partners experience that because they perceive birth that way. If you've never seen that much blood, sure, even a really regular birth can cause PTSD for a partner, right, right, and I want to acknowledge that, like, like, making decisions about feeding our babies is not the same Like.
Speaker 2:There's often a thing of like we're going to feed them French fries off the floor anyway later right, it is a little bit different because they can't eat all foods, yeah, true, and they are really fragile when they're little. Yes, yes, and nature intentionally puts us in an incredibly protective state where we really are still kind of one nervous system with our babies. Mm-hmm.
Speaker 2:And so making these decisions, especially when we've been told that one tool or another is dangerous or threatening in some way Right, and that can be birth or infant feeding right. If we've been told that one of the available tools is dangerous and that providers are trying to hoist it on us, which may or may not be happening right, that does happen. It's not always what's happening Absolutely. That can put us into a state of PTSD that can feel life-threatening. A baby who's your baby not gaining weight can be or can feel life-threatening.
Speaker 2:A baby, who's your baby, not gaining weight can be or can feel life-threatening and there is an element of why feeding difficulty and postpartum mood disorders are besties, right, right, right. And then also, knowing that I do also see that in partners who become really fixated on their baby's weight the charts, I've seen the graphs, the scales yes, right, like I think that is really common Mm-hmm. And one of the things about PTSD if you've experienced is like it doesn't go away unless you treat it Mm-hmm, mm-hmm. It doesn't go away unless you treat it Mm-hmm, mm-hmm.
Speaker 2:And so I just want to encourage people if you are experiencing prolonged anxiety, intrusive thoughts, inability to sleep, sort of like blings of temperament or rage, like feeling really like out of it and dissociated and like you're kind of swimming through jello, those could be signs of PTSD and they can show up years later and there are really effective, well-researched treatments and you do deserve help.
Speaker 1:Yes, I think that you had talked about it a little bit earlier and I just feel like, yeah, there's so much emotional turmoil and how, when you were trying to, when you wrote your book, there were so many people that were supportive's related to it that when you're like, hey, this is my book I'm writing, people are like, oh my gosh, yes, I want to help you because that would have been so helpful for me. So when there are parents that are sort of like, let's say, borderline, they're having these sort of negative feelings or emotional aspects that are coming about when feeding their baby or their feeding plan is not going as planned, what are your recommendations? What are your so like I'm assuming therapy and talking things out or talking to a friend, but are there avenues that you like to share with parents, when they're kind of in it, that you like to share with parents?
Speaker 2:when they're kind of in it, when they're feeling this really heavy stuff. Therapy is actually not at the top of my list. Okay, okay, sure, because one of the resources we're really struggling to navigate I'm talking like really immediate postpartum, like first month is time.
Speaker 1:Okay, right.
Speaker 2:Like if you're having feeding struggles, like you're around the clock. Yes. You're going to a lot of appointments, often adding in more appointments for talk therapy, which is an incredibly effective but slow process. Yes, may or may not be accessible to you and might add stress, so I actually my number one intervention, first foremost, always, is going to be sleep. Okay, this is why I'm like a warrior against triple feeding. Yes, yes.
Speaker 2:So triple feeding is when you're having feeding troubles, and so to protect both your baby's ability to nurse and their exposure to that motor plan and behavior and protect your supply, you like nurse and then give them a bottle and then pump.
Speaker 2:if you have a baby who's struggling to eat effectively, that nursing often can take an hour right and then pumping, and people often don't get good advice on like how and for how frequently to clean their pump parts. Milk storage, that's like actually you can do that a lot less than most people think and so they're doing a lot of over washing and spending a lot of time doing those parts. And then maybe your baby struggles to take a bottle too Right? Or like we don't have much parental leave in this country, like maybe you're home alone, so that whole process is three hours, right, and you have to do it every three hours right and so that is really anxiety producing.
Speaker 2:Yeah, does leave a lot of space for everybody to build new skills. It is impossible, which makes most people feel like they're failing Right, and the sleep deprivation is actually really dangerous. Yes, yeah. So I recommend an alternative to this that is somewhat based in research from NICUs because, again, so hard to research. So this is a little bit based on how we teach preemies to eat without a feeding tube and it's based on just like my experience. One day I'll get to study this, but for the meantime, yep, it's my experience that if we offer babies the chance to practice a skill two times per 24 hours, they tend to hold on to it. Okay, most babies like I have seen a handful in my career of babies that really struggle with nipple preference.
Speaker 2:My kid included Like usually later on we're like oh, that kid like is autistic, or that kid has CP and like has like actual difficulties with like praxis and motor Sure, but mostly it's flow preference. Mm-hmm. Or just skill and ability Right.
Speaker 2:Right. So, like a kid who's struggling to suck. Like may do better with one tool or another, but that's not really because we introduced that tool, right. So if a baby is able to be effective with a bottle, first of all I'll skip right to a bottle and ditch syringe feeding and all that Because a bottle can be used to develop those skills. Right, syringe feeding and all that because a bottle can be used to develop those skills. Right. And I'm gonna have folks do like nursing practice two times every 24 hours. Okay, pump the rest and bottle feed.
Speaker 2:Wow, we're figuring out what's going on. Yeah, is it just an issue of slow weight gain or maturity? Like, is this just a 36 weeker? Right, right, is there a tongue tie? Yes, is there a motor planning issue? Yes, is there torticollis? Right, that's like a tightness in some of the muscles that can make it difficult to eat. Like, is it your production is slowly transitioning? Yes, is it actually a physiological production issue on your end? Like, we need a little bit of time and space to figure that out. Yes, and we cannot do that if we're totally underwater.
Speaker 2:Yes yes, we cannot think straight if you're not sleeping and you're just at a monumental risk of perinatal mood disorders if you are both struggling with feeding and not sleeping Right. So in that plan, as long as the baby gets fed and you understand that the risk of skipping a feeding is is possible low supply down the road and we accept that that's a reasonable risk to keep you well in the meantime, to recover from a cesarean, to recover from a birth, then I'm going to recommend that folks, ideally, if full milk production is their goal, we're going to drop in like a random pump at some other point in the day. Yeah.
Speaker 2:And we're going to skip at least one feeding to get four to six hours of protected sleep. That means white noise on earplugs in baby. I don't care if grandma is circling the block with that baby in a carrier. Just like you know, you got a friend who really likes burn boot camp.
Speaker 2:Like great, you're doing squats yeah, maybe for four hours like I'm going to bed and if you can't sleep, right then I want you to call the 24-hour line of your birthing provider and make a plan. If you can sleep but you wake up and you still don't feel like yourself, feel anxious or having intrusive thoughts. Intrusive thoughts are the thoughts that you have that just sort of like blow through you and you're like what if I drove my car off the road? And you're like that's weird. Those feel really different when there's a baby in the car, right, those feel really scary when your brain just says to you for some reason, what if I smother my baby? You don't want to smother your baby, you don't want to smother your baby, right, but your brain just like does that blip?
Speaker 2:If those blips are showing really, you are happening really frequently we need to talk to somebody. If you're just feeling really anxious, you're not feeling like anyone else can care for the baby, you're obsessing over small details, all of those that you just like feel really down consistently, feel really disconnected, right then we, you don't need to call the 24-hour line, but I want you to get in touch with your providers. Yeah, and usually you're like birthing providers are kind of the best first step because they're most likely to know who in the area is good at these things and they can prescribe meds. So my number two intervention is actually meds. Most, most meds are safe for making milk Right. I think choosing your mood over breast milk is the right choice. A lot of the time, for some people, breastfeeding is actually really mood protective.
Speaker 1:Right, some people it's not.
Speaker 2:Right, and that's okay. Yeah, for me personally, I was in the category of could not sleep, even when given the chance. Yes, and so my provider prescribed me Klonopin Okay, so that I would sleep, and that sleep enabled me to move through everything else that I was going through, and then, for long term, I started Zoloft. It's an.
Speaker 2:SSRI that I still take. It's an SSRI that I still take and that helped me be able to have the bandwidth to get my life to a stable place and then access the therapy that I need. Right, right, sunshine, yes, talking to a friend is great, moving your body a little bit, you know, just like walking around the block one time. So those interventions are helpful to support your mate. But in terms of like, real triage, my first prescription and I often give it as a prescription to families where I'm like no, this isn't for the birthing person or the feeding person, this is for the family to orchestrate. Yes, this is for the support system to do. This is your prescription. I prescribe that.
Speaker 2:And then we use that both protectively and diagnostically. If you're able to sleep and you feel a little better after, more able to cope with the challenges you're dealing with, great, we're going to repeat it. We're going to like keep that as a system and that doesn't have to happen at night, like sometimes that's like spouse gets home at five and that's five to nine, right, you know. And like grandma and dad like take over after his work time and like you are night night and they've got the three-year-old and the baby and like goodbye, right, sometimes you actually have to go over to a friend's house to sleep because your house is too chaotic. Like, yeah, what are the creative solutions we can come with to do that protected sleep? Or they all go to the park and have a picnic every single night at five, right, yes, yes.
Speaker 1:I love that.
Speaker 2:I love that, right. So what are the ways that we can predict that and really prioritize it? And then we move from there. But my order is really sleep meds, then like getting to a stable place so that therapy can work. And I think sometimes people think of meds as the last resort Right, when often they're the tool that enables us to get access to the care that we need long term Right.
Speaker 1:Yeah, I also I felt like meds were a last resort and I had a really hard time figuring out what was what postpartum, because I did deliver max right before COVID and then being in the medical profession and testing kids for COVID and worrying about bringing COVID to my baby and everything like that and not sleeping really terrible insomnia, sleeping for like three hours a night, fear of underperforming, all of that stuff. And then I'm like, okay, now I'm desperate enough to try medication and I like really wish I didn't feel that way, but it did. Like that was my lived experience is I'm like I will do anything before I start medication. And then I started medication and I'm like, oh my gosh, I should have done this so much earlier. Like things would have been so much better.
Speaker 2:Yeah, I want to speak to that for a second. Yeah, which is the thing I talk about a lot with some good friends of mine who also have disabled kids, which is sort of this idea of like, well, my depression or anxiety is situational, mm, hmm, right, so if I wasn't in the situation of having to navigate these really complicated systems or being up with my child all night, every night, or like dealing with X Y Z, then I wouldn't need meds. So I shouldn't access, right, reality. Your situation is true to what you're living through and sometimes, like I'm an all tools are neutral person. Formula's a tool, breast milk's a tool, breast thing's a tool. Everything is a tool. Bottles are a tool. Pacifiers are a tool. Tools are neutral. Right, we need to understand tools to use them well. Yes, right, I'm not going to just be like, oh, you should take like a lot of Klonopin all day, every day. Yeah, no, but I'm not qualified to prescribe that. Yeah, that's not my job, that's not how that tool works. Right.
Speaker 2:But to be able to say to yourself the situation I'm in right now is the situation I'm in right now and, yes, it is causing this mood disorder and I should use all of the tools that I need to navigate this situation and I can change up those tools later if my situation changes right, and I think that's something that we should talk about more.
Speaker 2:Is that like it is okay to access the tool that you need for the situation you're in, instead of being like, oh, if I was different or if I was tougher, or if my situation was different, I wouldn't need this tool? Yes, like well, right now this is the reality is like you're a doctor in a pandemic or like you're a nurse practitioner in a pandemic with a young baby. That's your real life. That's your real life experience.
Speaker 2:Right, and I can't change any of those variables, except for giving you more tools to cope. Yes, that's the only variable I can change.
Speaker 1:Right, I really love this conversation and I think that it's really important, and you're bringing up so many good tidbits and I think it's going to be so helpful for families that are listening. So, as we're wrapping up, what is one piece of advice you'd like to give moms when things feel really, really hard during that first year or two?
Speaker 2:It's so hard because it's just really really hard during that first year or two. It's so hard, because it's just really such a hard time. Number one is like can you take a little break? And I think we often immediately are like no, and here's the 19 reasons why I can't, and maybe ask yourself three times but could I? Yes, you know, and that's going to look different person to person, Mm-hmm, but I think sometimes we one of the things that's so hard about that first year is you're so in it. Mm-hmm.
Speaker 2:That you can't really see the forest for the trees, mm-hmm. So if you can take a half day to go sit by your friend Cheryl's condo pool, Love it. Or whatever that looks like. Yeah Right, it doesn't need to look like a trip to Paris, right.
Speaker 1:Yes.
Speaker 2:Whatever that looks like, to take a break and zoom out when you're totally overwhelmed and underwater. And then, yeah, I think that's my biggest piece of advice. And then my other piece of it is like, use the tools. Like, if there are tools available to you, don't be scared of tools. Don't go into birth scared of tools. Don't go into parenting scared of tools. An iPad is a tool, timeout is a tool, swaddles are a tool, like a car seat's a tool. You should definitely use that one.
Speaker 3:They're all just tools and you don't have to be scared of them.
Speaker 1:This is really great, and so, Victoria. What's the best way to connect?
Speaker 2:with you. You can find me on Instagram or TikTok victoriavicelli I-B-C-L-C. And you can find the book anywhere. Books are sold in your target app and on amazon at your local bookstore. Great baby shower gift, in my opinion. Yeah, and yeah, you can get if there's an audio book, or you can get a digital book right now if that's what you need. I really want people to be able to access it at two in the morning, be like I don't know what they're talking about. I need to look this up, and not have to go to the Facebook groups and be able to be like okay, what is a temp without so much information? Just like one piece of information.
Speaker 1:Yes, so great, and I will link that in the show notes too. So thank you so much for coming on and I just really appreciate the conversation that we had and these just this like critical thinking, when when a lot of times we are on like one track when it comes to making decisions for our babies, but just presenting this information in just such a nice and neutral way to help educate and empower families.
Speaker 2:Well, I think that's yeah. I think that's a note to end on. We ended up having not the conversation we expected, but I think it comes down to health is not one thing. Right To say that feeding your baby one way or another way is healthier presumes that health is one thing. But health is really complicated, Like our emotional health, our mental health, our physical health, our genes, all of that stuff, Our bodies, like bodies, aren't perfect. They're not supposed to be Like we're supposed to be people and we're not supposed to fix our kids and make perfect kids. We're not supposed to be perfect ourselves. Health is really complicated and health gets to be more than one thing.
Speaker 1:I really love this. Thank you so much for coming on. Thank you so much for coming on. Thank you so much for having me. Hey Mama, I hope you loved this bite-sized episode. This podcast is powered by your reviews, ratings and shares. It helps other mamas find the show so they can finally feel good about feeding their baby, just like you do. Make sure to subscribe so you don't miss an episode. Need personalized feeding help for your baby's unique situation? Let's work together with a one-on-one consult. I can't wait to meet you. Until then, happy eating.