Birth, Baby!

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Welcome, this is Birth, Baby.

Your hosts are Ciarra Morgan and Samantha Kelly.

Ciarra is a birth doula, hypnobirthing educator, and pediatric sleep consultant.

Samantha is a birth doula, childbirth educator, and lactation counselor.

Join us as we guide you through your options for your pregnancy, birth, and postpartum journey.

Today, we have Erin Moore with us.

She's a pediatric nurse practitioner and certified lactation counselor living in Austin, Texas.

Hey, that's where we are too.

She has 13 years of working with moms experiencing difficult situations.

Erin believes that moms should have support throughout their entire feeding journey, even if that isn't what was expected.

Erin has you covered if you're breastfeeding, formula feeding, combining both, or feeding your baby solid foods.

She provides judgment and shame-free virtual support and has such a fun Instagram presence, we will link that in the show notes so that you can enjoy it as well.

Thank you so much for being here with us today, Erin.

Yeah, thanks for having me.

So to start us off, tell us what is a baby feeding coach and what exactly is it that you specialize in?

Right, so it is, I'm a little bit of everything.

So I'm not quite a nurse and nurse practitioner, I'm not quite a lactation counselor, but I'm kind of blending the two together.

So I focus on both things.

So I focus on infant feeding throughout the first year of life and on.

So when I was thinking, I'm like, who am I, right?

I need to figure out who am I and what do I do?

I'm like, I'm just not quite in one field and I'm not quite in the other field.

So I'm like, what do I do?

I help moms feed their babies and then I'm like cheering you on.

I'm helping you find something that feels good for your family.

I'm like, who does that?

I'm like, coaches, coaches, they cheer you on.

So even though it's a made up term, it's just, I want families to feel good and feel supported, have the tools that they need and then be able to apply it to their own unique situations because feeding's hard and there can be a lot of challenges.

I think that that is something that, it's hard because when we are sitting there, educating people throughout their pregnancy, we don't want to make it sound like it's going to be this awful thing.

And it doesn't have to be, but it can be a struggle.

And I say all the time, breastfeeding is natural and normal, but so is walking.

And you have to learn to walk and you have to learn to breastfeed.

And so does your baby.

Like both of you are learning.

We have a favorite IVCLC.

We love her.

And she always says, even with the second baby or third baby or fourth baby, she's like, yeah, it's the same dance, but a different partner.

And so you have to get reacquainted and learn again.

So that is something that we struggle with.

And when your parents come home from the hospital or wherever, and they get all sorts of advice and they don't know how to digest it all and what actually is true, what makes sense for their situation, because one size fits all is not a thing when it comes to feeding your baby.

So a lot of our family is like the biggest thing we get a complaint about or people wanting guidance about is a lot of people are recommended to triple feed right after their baby is born.

And so can you explain a little bit to people what triple feeding is and what situations it's recommended in?

Sure.

There are feeding issues that arise in the very first period and really throughout the entire year that you just can't quite anticipate.

So we never know how our feeding journeys are going to go.

So one common thing that happens in the beginning is that milk takes a little bit of time to come in.

So in this period of time between when baby is born and when your milk supply fully comes in, babies might not be getting enough to support their daily needs.

So we know this because babies are losing their birth weight, which is common.

But if they lose too much weight, it becomes a concern.

So it's monitored closely by the hospital before you leave or wherever you're giving birth before you leave.

And then also in your pediatric office.

So if milk supply is not quite where we are when a mother is breastfeeding, a mom might be asked or a parent might be asked to triple feed their baby, which means we're trying to boost the milk supply, help the milk come in a little bit faster by triggering to the brain to increase milk production.

So first mom or a parent will put the baby on the breast.

So try to attempt latching, feeding, and then mom will trigger her supply.

And by pumping and then any milk that we get from pumping, we're feeding it to the baby.

So in my opinion, babies need to be fed.

If they're hungry, we need to feed babies.

So whether that's through maternal milk supply or whether that's through donor milk or whether that's through formula, if a baby's hungry, we need to feed them.

So sometimes triple feeding is not the nicest thing to do.

So we need to find something that works for the family and works for the mental health of the parents in the picture.

Because if we are triple feeding, doing that cycle every single feeding session, eight to really up to 12 times per day, it's a lot, it's a lot.

And it's meant to be something that's temporary until milk supply increases.

I think that's something we see is that when it's recommended, people aren't really given an end time.

It's just like, go triple feed.

And then there's not really any other guidance.

Yes.

And one thing that I recommend parents to talk about, whether it's with their pediatric provider or whether it's seeing a lactation professional, well, if we have to triple feed, I definitely recommend having the family meet with a lactation professional because we need an exit plan.

And a lot of parents are concerned, well, okay, my milk supply increased with triple feeding.

Now, how do I get out of it without my milk supply decreasing?

So what's going to happen there?

Is my baby transferring enough?

Is my baby getting more from the bottle?

You know, all these different things, is there nipple confusion?

So there's just so many questions, and parents definitely need support in that.

It's not intuitive to know.

Absolutely, absolutely.

So in your professional opinion, do you think that triple feeding is over recommended and not necessarily always needed, or do you think it's used appropriately?

I know it's controversial, and I take both perspectives, because I have done all my coursework for my IBCLC.

I understand the lactation point of view, and then I also understand the provider point of view.

In my opinion, if your baby has not regained their birth weight, or they're not going up by the recommended amounts, we have to make sure a baby is fed.

And I think that there are different ways to accomplish that.

So maybe we don't need to offer formula every single feed.

We need to encourage breastfeeding and figuring out how your baby can balance the breast milk and formula, because what we don't want to do is have baby be so filled with the bottle that baby doesn't want to be on the breast or sleeping longer periods of time.

So I think that there's a delicate balance, but when it comes down to it, babies need to be fed, babies need to get their calories.

And if they don't get their calories, they're not going to be able to adequately breastfeed because they don't have enough energy to get through feeding sessions.

It's like this cycle, this catch-22 of like, or kind of a chicken or the egg sort of thing.

And it also feels like when people are recommended to triple feed, sometimes it actually sabotages breastfeeding inadvertently because they're not being given enough education around how to do it effectively and, you know, bottle feeding when someone is bottle feeding the baby and those sorts of things.

So as doulas, we're always like, oh, when someone's told to triple feed, just because they don't usually get that added support.

And a lot of times I feel like it's happening at the hospital because they're about to send these, you know, this mother and this baby home, and, you know, they aren't there to support that.

And so they need to know that baby's getting what they need.

So it's almost, it almost feels like they need to be going home with, I'd like you to be triple feeding, but you need to get in with a lactation professional so that they can create a custom plan, because that's what we do.

We create custom plans for people, and we look at the whole dyad and figure out what, you know, what's working here?

Why do we need to triple feed?

What's the problem?

And it needs to be a customized thing, right?

I totally agree.

And sometimes it's the short period of time that we need to triple feed and then milk comes in.

And even then, if milk comes in right away, parents are still like, okay, well, now what do I do?

Do I still need to keep triple feeding?

Do I want to really increase my milk supply?

Because sometimes it's nice to have that little boost, and they're like, oh, well, I see everybody's freezer stashed, but then that can come with its own problems.

Or what I see a lot is we're three weeks into triple feeding, we're four weeks into triple feeding, and the parents are both, or whoever's in the situation is just really struggling, and they don't have a plan out, and maybe milk supply is not there, maybe we're not doing it exactly how we're supposed to be doing it.

So regardless, I think every parent needs follow-up lactation, and I'm a lactation professional, and I got follow-up lactation help, and I'm still, I have a seven-month-old, and I'm still getting support.

We have a feeding therapist because he had a bunch of feeding issues at the beginning and really until like three or four months, and I'm actually touching base with them next week at seven weeks, or seven months, sorry.

Well, and that's, it's just like therapists need therapy, and doulas need doulas in their own labors.

You can't do things, you don't have a big picture view anymore.

Now you're just like very narrowly viewing the situation because it's you that's doing it.

So I love that you reached out to somebody and you're still getting that outside help, even though it might be something you already help people with.

So, you know, it's not, I'm not happy you're going through issues, but it is pretty neat to see that even if you have all the knowledge in the world, you can still have a baby that is struggling.

So what does that look like when breastfeeding doesn't go as planned?

Kind of what is the process of trying to narrow it down to what's going on?

The types of professionals that need to be seen or the things that need to be tried before it's really decided, okay, we do actually have an issue.

Right.

There's a lot.

And I can tell you from my personal experience with my seven month old, when he was born, he had a tongue tied out to the tip of his tongue.

So we ended up seeing ENT, lactation, craniosacral therapy, feeding therapy, and then we're seven months in and we're continuing to see feeding therapy and lactation.

So there's a lot.

And I must say that between my first and my second, and I learned a whole lot about all these different resources.

And my first was born in January of 2020.

So I had very few resources at all because everything was kind of closed down.

It was figuring out a lot by myself.

So sometimes feeding doesn't go as planned.

I think really the majority of the time feeding doesn't go as planned.

While it's beautiful, while breastfeeding is beautiful, sometimes there are challenges.

And just like you said before, it's a skill that needs to be learned.

And it's a skill not only that the parent needs to learn, but it's also a skill that the baby needs to learn.

So it's kind of this double whammy.

And there are things that you just can't predict.

So we can tell you all about like sore nipples and how to latch, but that might not be the issue.

It might be oversupply or undersupply, and we can't really anticipate that.

So what I recommend is, well, mom is still pregnant, I recommend finding the support team that they feel very comfortable with, and then setting up an appointment.

So what is this going to look like afterward?

Then that way you're not like spending your baby's first week being like, who do I want to see?

What do we need to do?

Because that person that you trust can help guide you in the direction.

And maybe your feeding plans are going to change completely.

Maybe you want to combo feed, you want to add formula in because of, well, there are a variety of reasons that you want to do that.

And so finding somebody who can help, even if what is happening is not what you expected to happen.

Can you explain what combo feeding in and what that looks like is and what that looks like?

Because I think that some people think of it as, you know, feeding some formula, some breast milk, but when it be a lot of different things where maybe you nurse for the first half of a feeding and then top off with formula, or maybe some feeds are breast milk and some feeds are formula, or is it all sorts of things?

There are so many ways to combo feed, and it's really finding what your intentions are.

So do you want to give as much breast milk as possible, but then have a little bit of formula just for, you know, just in case you need it or if you feel your baby's hungry, or you can use it as a part of your routine.

Now, if you have adequate milk supply, so your milk supply is meeting your baby's needs, you don't necessarily even need to use formula.

If you are feeling like your baby is still hungry after a feed, first I would get help.

I would see how much is your baby actually eating?

How much is your baby transferring?

And if there's some kind of discrepancy in the amount that your baby needs versus the amount that you're producing, then we come up with a plan to figure out how can we preserve the milk supply you have?

Can we increase the milk supply that you have to reach your goals if your goal is to exclusively breastfeed?

And if we can't, what is realistic to making sure your baby's actually getting the calories and the amount that they need?

So a family can offer just a little bit like a half an ounce of formula a couple times a day, or once a day, or sometimes you don't do it every day and it's just if your baby seems to need it, but it all depends on milk supply and baby's demand versus the supply.

So how can families find confidence in finding a feeding method that works best for their family?

I feel like finding somebody that they trust, whether it's a medical provider that is willing to support their goals.

So they have the right to choose how to feed their baby, even if it doesn't look like what they expected it to look like, and then really caring for their mental health also.

My biggest thing that I like to deal with is just maternal mental health matters.

Breastfeeding is important, but maternal mental health is as important, if not more important in my opinion, than how a baby is fed.

So finding somebody that aligns with their goals, their mission, and doesn't shame them, doesn't provide any judgment, because in the end, a parent needs to decide what's best for their family, and it might not be what the provider thinks is best for their family, but the provider really does need to take the step back and assess the family's goals, and then what is necessary to make sure a baby is fed, and then find somewhere in the middle to make sure everything is addressed.

Absolutely.

That's so, I mean, it's really just part of the informed consent conversation.

What works, I mean, we say this all the time, what works for one person isn't necessarily going to work for you.

And as an individual, you have the right to decide what is going to work for you.

So just because, as lactation professionals, we hear all the time like, breastfeeding, all the benefits of breastfeeding, how wonderful it is, how good it is for baby.

And all of that is true, but if exactly like you said, if in the long run, it's gonna be detrimental to the mother's mental health, then that's not what's going to be best for the baby.

All those benefits are not going to happen because there's going to be other downfalls that are coming from the mother's mental health concerns.

So it really, you have to figure out what works for you and your family.

And it could be different baby to baby.

We had a client who didn't have us for their first baby as a birth doula and hired us for their second.

And she was like, I do not want to breastfeed.

I want to start out formula feeding.

Breastfeeding relationship was traumatic for me the first time around.

I don't even want to try again.

It wasn't worth it for my mental health.

And I need you guys to respect that.

We're like, we absolutely do.

And she goes, well, I'm glad you do, but people in the hospital won't.

And it's funny because we went from a society who was having to fight for people to stop offering babies formula and bottles in the hospital to now where it's almost slipped a little bit the opposite way where there's almost shame if you're not wanting to breastfeed.

And so that was our job with her was just trying to kind of protect that space and make her feel supported the opposite way.

So it's just so important to find what works for each individual and be able to move forward.

And maybe they have no idea what that's going to look like, but we got to figure it out.

Right.

And it takes a lot of confidence to do something against the grain.

So if we're told this is best, this is best, this is best, yet we make an informed decision that for my family, this isn't best.

It's very hard.

It's just a very, very difficult thing to do.

And it takes a lot of confidence because you get a lot of, of kickback.

That's just negative, negative feelings and people with very strong opinions.

So just finding providers that are open to doing and supporting what's best for your family it's huge.

Yeah.

So if you, do you have any like words of wisdom, if you could just have something to pick to say to people, it could be more than one thing if you have a couple of little pieces of advice, but is there anything that you would want to leave our listeners with?

Maternal mental health matters.

I just don't think that we can stress that enough, that it is so important.

And I, everybody wants what's best for their baby.

It's just, if it's causing a lot of issues in your life, if it's causing nonstop anxiety, you need to ask for help.

So help is not just one person.

It's probably going to look like what my situation looks like, which is maybe you see lactation first, you end up seeing a psychiatrist too, you're obese.

So it's just a whole team.

And it's a little bit overwhelming because in those very beginning days, you're so exhausted.

You're waking up.

It's hard to tell what's what.

Trying to get to all these different appointments is very hard, but it's also so important that you just tend to your baby's needs.

You also tend to your mental health.

So figuring out something that works for you and either that's talking to somebody, talking to a friend, seeing a counselor or a psychiatrist or a lactation professional or your OB or pediatric provider.

These are all different options, but really just saying, this is what I need and how can I accomplish these goals?

Who do I need to see to help me?

Yeah, absolutely.

So how can people find you if they're wanting to learn more or work directly with you?

Sure.

So my website is www.babyfeedingcoach.com.

I am most social, most social.

I am most social, but I am most active on Instagram and I am babyfeedingcoach, babyfeeding.coach.

And I have consult packages, support groups for combo feeding, for starting solids, combo feeding guides.

So I have a lot of different ways that I can work with families.

I love it.

And we'll have all of that linked in-

The resources are so great.

Yeah, absolutely.

Thank you.

We'll have all that linked in the show notes for everyone to have easy access to.

Thank you so much for coming on.

This was really great.

I'm excited to share all this with our listeners.

And I'm already thinking of different times I want you to come on other things that we might have you talk about other times.

Oh, I'm happy to come on anytime.

I feel very, very passionate about what I do.

And it's like feeding in health and how it, or feeding in mental health and how it impacts the whole family.

So I am just happy to share anytime.

Thank you.

Yeah, you're welcome.

Thank you Thank you for joining us on Birth, Baby!

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