Scott Webb (Host): Though breastfeeding is as natural and easy as pregnancy itself for most, some moms may have trouble breastfeeding or may just have some questions that are best addressed to an expert like my guest today. I'm joined today by Ario Pierre-Sutton. She's a Certified Lactation Counselor who's recently achieved certification as an International Board Certified Lactation Consultant, and she's the coordinator for a grant program at Jamaica Hospital Medical Center, which is focused on expanding access to lactation services for underserved community members, especially within Queens and East New York.

 This is Jamaica Hospital Med Talk, the podcast from Jamaica Hospital Medical Center. I'm Scott Webb. Ario, it's so nice to have you here today. We're going to talk about breastfeeding and essentially like the frequently asked questions, if you will. And I'm going to ask the questions and you're going to answer them today and you're the expert and this all makes sense to me. So, as we get rolling here, let's just talk about breastfeeding. Is it always easy and natural for everybody?

Ario Pierre-Sutton: Thank you for having me, Scott. And while breastfeeding is a natural process, it really can be challenging for a lot of women. There are issues such as latch, latch problems, pain. There may be concerns about their milk supply, and that's one of the most common ones. And so, we really want for persons who may be struggling with breastfeeding to really seek out support from a lactation consultant or a provider, a healthcare provider, who is knowledgeable about breastfeeding, and so that can really helpful.

Host: Yeah. Yeah. And that's why it's great to have you on. As I said, these are like the frequently asked questions, right? And you are an expert. So, is there any association between small breasts and breastfeeding? Like, as you're saying, one of the concerns is having enough milk, right? Is there any connection there between small breasts and breastfeeding?

Ario Pierre-Sutton: So, a lot of parents believe that you can't breastfeed if you have small breasts. And really and truly, breast size doesn't determine whether or not you're going to produce milk. Milk production is really more about how well and how efficient you are about removing that milk from your breast, and the body's response, the hormonal response. Breastfeeding is not really about breast size, but more so about how frequently and how efficient you are about, you know, removing that milk from the breast.

Host: Yeah, for sure. And that falls under the category of some of those myths, if you will, and I'm glad to have you here to kind of dispel some of them. I want to ask you about diet. Is there any special diet that somehow is better for breastfeeding or enhances breastfeeding or helps to produce more milk or anything like that?

Ario Pierre-Sutton: Well, you know, that is something that a lot of people ask, whether you should have a specific diet. And really and truly, we tell families it's good to keep a balanced diet, but there is no specific food that you should be eating for breastfeeding. Anything that you can eat while pregnant, you can definitely eat while breastfeeding. If, however, you notice that your baby may have a sensitivity to whatever foods that you may be eating, then you may have to try to eliminate that from your diet. But there's no specific food that a breastfeeding person should or should not eat.

Host: Yeah, right. It's not some special diet. Make some sort of magical milk or something like you still get to be a person and eat things that you want to eat and maybe even eat things that you hadn't been eating while you were pregnant, right?

Ario Pierre-Sutton: That's correct. So, a lot of people say that, you know, you want to make sure that you want to be cautious about things like caffeine and alcohol. But, of course, all of the things that you were able to consume while you were pregnant, you can certainly go on to consume while you're breastfeeding.

Host: Yeah, that sounds right. So, how about formula? You know, there's a lot of formula. My kids are older, my kids are 16 and 21, so it's been a long time since I've had to think about some of this stuff, but is formula just as good as breast milk?

Ario Pierre-Sutton: A lot of people come up with this notion that formula is just as good as breast milk. And while formula is safe, and it is an alternative for persons who may have issues with breast milk production, breast milk provides unique benefits that formula really cannot replicate, such as the antibodies, the enzyme, and specific nutrients that adapt to your baby's needs. So no, it's not as good as breast milk, but it does have a necessary place when needed.

Host: Yeah, good alternative if that's the best option for parents, for moms, but not quite as good as breast milk, right?

Ario Pierre-Sutton: Correct. So as we said before, you know, some people struggle with supply and so they may definitely have to turn to formula. It is an option. It's just not, you know, what we would say as good as breast milk.

Host: Yeah, for sure. And I don't know if this falls under the myth category or not, but wondering does breastfeeding make breasts sag? I feel like I've heard that. I feel like people believe that, but is that true?

Ario Pierre-Sutton: A lot of people believe that. But, you know, changes in your breast shape are more so related to aging, genetics, hormonal changes rather than breastfeeding itself. And so, you know, you want to continue to maintain a healthy weight, and wear supportive bras, and that's what will really help, but breastfeeding in and of itself doesn't make your breast sag.

Host: My wife insists to me that gravity is her greatest foe, as a woman now in her 50s, that in terms of what we're discussing here of sagging, that it really is gravity that is the toughest thing to defeat. Is that your sense of things?

Ario Pierre-Sutton: It is. Gravity is a woman's worst enemy. So, you know, it's not necessarily the breastfeeding, but gravity, aging, you know, all of those things really do play into it.

Host: For sure. And as you say, a healthy weight is one thing, of course, women can do to sort of combat things a little bit. And you touched on this a moment ago just to circle back around about drinking alcohol while breastfeeding. It sounds like it's okay in moderation, but from your perspective as an expert.

Ario Pierre-Sutton: So, alcohol while breastfeeding is okay in moderation. An eight ounce portion should be okay over a couple hours. So, it should be over two to three hours. But you should try to not breastfeed your baby within that time. So, what you would do is if you plan on having a glass of wine, you would breastfeed your baby, have your glass of wine, and you would have those couple of hours that would pass between your baby's next feeding. So, it should be okay.

Host: All right. And this next one, I don't know if I've ever heard this or not. I'm not sure if this is true. I'm going to get your take on this, but does breastfeeding prevent pregnancy?

Ario Pierre-Sutton: So if done right, it can be alternative contraceptive method. it's called the LAM method. And so, what would happen is if you are putting baby to the breast each and every feeding for six months, you are, well, I wouldn't say guaranteed, but you are less likely to get pregnant. So, each and every feeding, putting baby to the breast because the baby would signal to your body that, "Hey, I'm feeding at the breast, there is a baby here." And so, your body would not release that egg or ovulate. And so, for six months after giving birth, you are less likely to get pregnant. That's one of the reasons that they say breastfeeding is a pretty good contraceptive method.

Host: Yeah. I had never heard that before. Certainly not spending a lot of time thinking about this topic, of course. And I had never heard that. And I was putting together frequently asked questions and I saw this one. I was like, "Well, I'm going to need to ask Ario about this because I truly don't know the answer," and thankfully you do, of course. And you mentioned there six months in terms of preventing pregnancy. What's the duration for breastfeeding? What are the recommendations for the duration, I guess?

Ario Pierre-Sutton: The World Health Organization, they really talk about breastfeeding for up to two years. They have made their recommendation that breastfeeding should continue for at least two years or beyond as it continues to provide important nutrients and immune support. But here in the U.S. and in a lot of places, we do say at least six months because by the time you're going back to work and all of those things, people are less likely to want to breastfeed. But it can be a duration that is mutually exclusive to both parent and baby. So, you know, if you guys decide you want to go for six months, eight months, or however long that you and your baby decide, then that's really up to you.

Host: Yeah. And it does seem, even though they can't necessarily verbalize, it does seem to me, in my experience, that the babies, you know, have strong thoughts about what they're going to do and how they're going to do it and how long they're going to do it, right?

Ario Pierre-Sutton: They're the boss.

Host: They really are.

Ario Pierre-Sutton: They're literally the boss when it comes to, you know, the duration, because a lot of times, for the parent, they may want to cease breastfeeding and it's the baby that really wants to continue. So, a lot of times, you know, families continue to breastfeed well beyond their expectations because the baby decided that they wanted to continue.

Host: Right? The baby's like, "Nope, you're not off the clock yet, mom. Get back over here," right?

Ario Pierre-Sutton: Certainly, that's how it is.

Host: Yeah, it is for sure. And, you know, I'll just give you a chance here at the end.  

Ario Pierre-Sutton: One of the myths that I commonly hear is that, you know, if families are not producing enough milk that they should switch to formula immediately. And while we talked about formula, I just wanted to say that even if you're suffering from low milk supply, that can be improved with certain strategies like more frequent breastfeeding, consulting with a lactation specialist. And there's often like a range of solutions before jumping into formula, there's also now the recommendation of donor milk for people who may be able to access that. So, you know, I don't want people to feel like there are no options. There are certainly a lot of options and talking with a lactation specialist can really avail you of those options. So, that might be a good choice if you feel like you want to ask some questions.

Host: Definitely. Well, I appreciate your time today. It's always good to dispel some myths, to answer those frequently asked questions, because, you know, folks, women who may listen to this, couples even may listen to this and be like, "Yeah, I've always wanted to ask a lactation specialist these questions. And now I have." So hopefully, good for them, and good for everybody who listened, and thanks so much.

Ario Pierre-Sutton: Thank you. Thank you for having me.

Host: And if you need more information on Jamaica Hospital's breastfeeding initiatives, please visit jamaicahospital.org. And if you found this podcast helpful, please be sure to share on social media and check out the rest of our library at jamaicahospital.org/podcasts. Thanks for listening to Jamaica Hospital Med Talk, the podcast from Jamaica Hospital Medical Center. I'm Scott Webb. Stay well.

All the content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast.