Cheryl Martin (Host): There are many advantages to breastfeeding your newborn, but it can also come with its challenges. Here to provide a realistic perspective is Corri Martella, a registered nurse and International Board Certified Lactation Consultant.

This is Hello Healthy, a Dignity Health podcast. I'm Cheryl Martin. Corri, it's great to have you on.

Corri Martella: Hi, Cheryl. Thank you so much for having me. I'm very thankful to be here.

Host: Now, with your expertise, what's the most common question you get about breastfeeding a newborn?

Corri Martella: The most common question is typically do I have enough milk or am I making enough milk? That is the most common question that I get.

Host: And what's your answer?

Corri Martella: I typically let every feeding person know that, depending on their health history, it is very uncommon to have a low milk supply. Whatever your body makes is the most optimal, and your baby will tell your body how much it should and shouldn't make. It also varies from person to person. So, that question is not necessarily, you know, cut and dry. And so, I tend to tell parents how you know you're making enough is baby is peeing and pooping enough as they should, and their weights are appropriate. It definitely delves into a lot more than that. But that, in general, is what most doctors, providers, how we look at overall health and knowing that they're getting enough.

If we see that infants are not thriving and they are struggling, then they will end up losing weight or not have enough output, just like you and I. If we're dehydrated and not eating enough, we're not going to let as much out. But for the most part, I let parents know in the beginning, we have small amounts of breast milk, but it's meant to be that way so they could absorb it. Please don't anticipate flowing and flowing. That happens once our milk comes in about day three to four or, essentially, I like to say transitions. So, we already have milk, it's colostrum, but it increases in volume around that time until we start to see more flow. That's more of an in-depth answer to that question. But a lot of times, my answers are a lot more detailed because, again, not so cut and dry. It depends on the situation.

Host: That's great. Corri, talk about some of the benefits of breastfeeding.

Corri Martella: The benefits could honestly be like a multi-day talk. But with this short amount of time we have, for a baby, benefits can include decreased risk of certain diseases, like ear infections, gastrointestinal diseases, like vomiting,and diarrhea. There are benefits to their orofacial structure. It helps develop their sinuses and mouth into adulthood. It helps protect them against, again, many diseases, but it also helps with comfort. It can help them sleep. Breast milk has over 200 components in it. It holds melatonin to help infants sleep. Just like you and I, if we were to eat some fiber to help us use the restroom, breast milk has components to help babies use the restroom. It has stem cells. It has amazing immunological properties that the benefits are honestly endless, and it's very few with any negatives.

Now, the benefits for the feeding parent, it can help decrease risk of certain cancers. It can help decrease risks developing type 2 diabetes as well as high blood pressure and the same with infants actually. It can help decrease our weight that we have gained from pregnancy. It can help us lose that weight back to pre-pregnancy state. Immediately after delivery, it can help us from bleeding after we have a child. I can definitely go on and on. Lots of benefits.

Host: No, those are definitely great. I'm glad that you shared those. How long should a mother breastfeed?

Corri Martella: Now, it depends on the aspect of the question. So for the one single feed, essentially a baby eats on demand as often as they want to, right? You and I eat when we're hungry, and we don't eat when we're not hungry. So, we like to say have baby eat on demand as often as they want to. They will demonstrate feeding cues, which one of them is like licking, smacking, eating their hands, and we like to share waiting no longer than three hours in between feeds.

Now, another part of that question is, some parents ask me, "How long is it beneficial to feed my child? Is it one year, two years?" So, the American Academy of Pediatrics as well as the World Health Organization have come to the conclusion in agreeance that they state that it is beneficial to exclusively breastfeed up to six months of age with no other complementary foods, so no supplementation with any alternate milk and no solids or even water. After six months of age, they recommend breastfeeding up to two years of age. And that is at that point with any complementary foods. So, they start eating solids, drinking water, et cetera.

Host: Now, I understand that you breastfed your two children. What was that like for you? and kind of talk about how and when the process gets started. Is it really pretty simple?

Corri Martella: Correct. I breastfed my first child for about 18 months, so about a year and a half. And my second was a little bit shorter. I think it was a year and a couple months after that. My experience had many ups and downs. And I do share my experience with other parents if they feel like it can be relatable. It's not without its challenges. It really isn't. You would even think somebody that teaches this day in and day out, I would have such an easy, breezy journey, and it's hard. It doesn't come easy to everybody. It's a skill that needs to be learned. And any new skill that we have, it takes time. It doesn't just come easy to us right away.

And so, I definitely had some of my own challenges and I had pain when I had feeding. My children had some oral issues that needed to be taken care of to help that journey continue along. And I definitely had similar parent doubts and concerns, just like every other parent does. They say, "Oh, am I giving them enough? Am I feeding them appropriately?" And I think that just comes with being a parent, making sure that we're doing the right thing.

But just like anything in life, I just took it one day at a time. I went through each challenge as it came and I seeked help when I needed it. I didn't try to just suffer through it. And I stopped when I was ready to stop.

Host: Corri, before the mother leaves the hospital with the newborn, I mean, does she get training or is there a nurse to show her how to do it properly?

Corri Martella: Absolutely. Every nurse in OB-GYN has a certain amount of training that they do receive in breastfeeding, and they help each one of the mothers with latching and feeding if they so desire. And depending on their choices, if their desire is to bottle feed, we help the parents in all aspects of feeding.

Now, when there's challenges or concerns, that's when the staff reaches out to a lactation consultant, and they ask us for more expert opinion and assistance. And that's where we also help the parents. So, when they have a baby, our lactation consultants are starting to attend births and try to be there for that very first feed. There are a lot of wonderful studies that show if we have a great, successful first feeding after what we call the golden hour, the first hour after having a baby, it can exponentially assist in their breastfeeding journey later on and help with milk supply. So, we have started to do that to help assist our mothers in a beautiful time, and then also throughout their journey during their hospital stay.

Nurses help as well as lactation consultants. We do our best to make rounds and see every patient if possible. And then also, there are resources for them to go to on their way out from discharge.

Host: Talk about some of those resources where parents can turn for resources on breastfeeding.

Corri Martella: Yes. So, at St. Joseph's Medical Center, we have a free class every Wednesday from 1:00 to 3:00. That class is at St. Joseph's in the birthing center, right when they first come into the department. And essentially, we call it a breastfeeding class, but it's almost more of like a nursing circle. And we also give advice if they're needing any help. So, our lactation consultants come and attend it. And we host it once a week. Again, every Wednesday from 1:00 to 3:00. And then, we host those to help with those resources. Because unfortunately, depending on our insurance, because of course, Dignity Health holds many different insurance providers, depending on the insurance, some patients unfortunately have a hard time seeing a lactation consultant after delivery, because If they can't get an appointment right away or sometimes, depending on the insurance, also they might not always have good resources for it.

So, that's where St. Joseph's has a beautiful, resource for that, that we host once a week. So, our parents come, and we do weights, see how feeding is going, and answer any questions they may have. Now, depending on the insurance, sometimes it is optimal for patients to see a provider within their own insurance, because it's good for them to look at their medical record and history. And sometimes It can be necessary to do that. For example, St. Joseph's takes Kaiser patients And so, Kaiser also has outpatient resources for that. But either way, no matter what insurance you have, we take our patients and it's free.

Host: That's great. And so, this is a support that St. Joseph's provide after discharge.

Corri Martella: Correct. And there are several Dignity Healths that also provide similar resources, but every hospital is different. So, for example, if you're pregnant now, it'd be great to look at those resources ahead of time. But even if a hospital does not necessarily have the resource, there are other community resources that they can turn to, like local WIC offices, as well as La Leche League. They're non-profit organizations that help support and promote breastfeeding, as well as they do parent nursing circles, to where they can come and get assistance, get any needs answered there as well. And then, there's also different parenting groups that sometimes have helpful resources that they can go to, to get that help as well.

Host: So, one of the things you highlighted though that I think is important for mothers of newborns is that if it doesn't come naturally, or if they're facing some challenges in breastfeeding, they shouldn't feel as if they failed, because they should almost expect some struggles and challenges. Is that correct?

Corri Martella: I would say so. I'll just give an example of riding a bike. Sometimes where we fell down and couldn't ride on our own. We needed those training wheels to get us started before we learned to ride on our own. Sometimes we have some days where we struggle, trip a little bit, but it's just like anything in life. You know, we push through. We look at the picture and go, "Is there something I need to improve on? Is there something that maybe I need to adjust or change? " And then, seek help. If there's any struggles or anything going on, please, you know, nursing shouldn't hurt, baby shouldn't be losing a ton of weight.

There are certain red flags that can absolutely tell us, "You know what? I think I need to seek some outside help." But I would honestly say my own motherly advice is you're doing a beautiful job. I think we doubt ourselves as parents sometimes. And not everybody has difficulties with breastfeeding. I will say not everybody. Some can be learned very well and they do a great job, but it just takes time to learn the new skill. I would say after a couple of weeks of starting to nurse their child, they start to become experts and they do a beautiful job. So, just take every day as it comes and have positive people around you and don't be afraid to seek help if you feel that it's needed. No question is a dumb question.

Host: You mentioned red flags. What would some of those red flags be that you need to reach out for support?

Corri Martella: Sometimes the red flags also include a medical provider. Sometimes they need to reach out to their OB-GYN or pediatrician. Now, some of those red flags would be if you need to seek a pediatrician, if your baby's not having enough diaper output, if they seem overly fussy and they never seem satisfied, if they are spitting up or vomiting a lot, if they are very lethargic and not waking up to feed well, those are a handful of things when we need to seek a pediatrician.

Now, with feeding in general, seeking a lactation consultant, it would be that if nursing is hurting, if they feel like their baby isn't latching on well enough or they seem to be sliding off, if they are having overall difficulties if they're not sure how their supply is going, if a person would like to pump, if they have a significant life change, or they need to make some alterations in how they're nursing their baby, or some parents like to seek a lactation consultant when they're going back to work and they like to ask us about how to use a pump.

But we also don't just help with breastfeeding, we also help with bottle feeding as well. And so, some parents have struggles with transitioning their child from breast to bottle. So, those are just a couple to name a few. Also, it's good to seek out a lactation consultant almost immediately after leaving. If you have a baby that is in the NICU, so neonatal intensive care unit, if you have some form of separation, if your child has some sort of specific medical needs, if for example, they have Down syndrome or they have some form of medical treatment that they're needing assistance with feeding with.

And then, with the mother, if the mother needs to seek an OB-GYN, sometimes they need to seek them for milk supply issues. Sometimes they need to seek them if they possibly have an infection in their breast or they have any concerning lumps or if they're having rashes on the breast, if anything that has to do with their specific body and their breast, it is advisable to seek an OB-GYN.

Host: Corri Martella, thank you for sharing your expertise on breastfeeding. I know that the mothers of newborns appreciate your insights. Thank you.

Corri Martella: You're very welcome. It was my pleasure. And I wish everyone the most successful feeding journey and you got this.

Host: Thanks, Corrie. You can learn more when you visit dignityhealth.org/stockton/maternity. If you found this podcast helpful, please share it on your social media and check out the entire podcast library for other topics of interest to you. This is Hello Healthy, a Dignity Health podcast. Thanks for listening.