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Well, I can show you my nipples if you want… I found myself saying this to complete strangers in the early postpartum days. I’m not really the nudist type, so let me explain what brought me to this point. As soon as my daughter was born, I tried to latch her to my breast. I struggled. I had just stopped nursing my son about 6 months earlier when he self weaned during my pregnancy. As a toddler, he latched himself. I didn’t have to do anything- even wake up sometimes. So latching a newborn felt clumsy and foreign to me. At the hospital we got her on but it did not feel right. I was vocal about it. Especially as a few hours and several feedings went by, I told everyone that came in the room. It hurts, it doesn’t feel right. But everyone said I was doing well. I heard several theories why it hurt- I just stopped breastfeeding my son so I don’t remember how it is to nurse a newborn. My nipples are still sensitive from pregnancy. I need to try another position. Everyone had something different to say. But from my perspective, as I latched my baby, I could see she wasn’t opening her mouth wide enough. I started to silently wonder if she had a tongue or lip tie. Two years ago when I had my son, everyone looked in his mouth at the hospital, especially the lactation consultant, who came to see me several times during my hospital stay. We had no problems nursing. He basically crawled up my chest after birth and latched himself beautifully. There wasn’t much I needed to do. With my daughter it was different. Lactation only came once. The nurses only asked how nursing was going- rather than watching how it was going. Nobody looked in her mouth. Not one person. Every shift change, when a new nurse came in and was introduced to me, they were told “she’s a veteran breast feeder, she nursed her son until he was one and a half. She’s knows what she is doing and is doing great!” My response was always the same, I would say I don’t think so- I think something is wrong. Again, I was very vocal. And very dismissed. Now here’s the thing, and this is what gets me. So many new mothers at this point, would stop talking, stop speaking up. Being dismissed and essentially ignored by professionals when you are so vulnerable, like after giving birth, is a nail in the coffin. I felt incompetent, unheard, and downright embarrassed. I’m hearing them say that I should be fine, I am fine, but I’m not fine. And these are the people I have to ask for help, over and over again. Finally, one of my nurses looked in my daughters mouth, “oh she has a lip tie, do you see it?” She showed me her mouth and tried to inform me about it. Clearly, she was educated and that came through as she explained to me that my daughter had this restriction. I honestly in that moment felt relief. It’s not me, there is an issue, and like I said, I was already thinking it. I’m a social worker, means that I am trained to look at an issue, and problem solve it. I can be tenacious about it and “stop at nothing.” It’s where I shine professionally. Using those skills, I immediately went to my trusted sources, which happen to be on Instagram. I researched lip ties and what to do about them. I looked at pictures, I watched videos, I read and read and read. But like I said, I had trusted sources. I have the background, I have the resources and support. But mostly, I had it in me to do it. After I delivered my son, a cloud of darkness and emptiness came over me. Postpartum depression hit instantly. I will tell you now, if this had happened again, or if my son had a feeding issue, that would have been the end of the road for us. There is no way I could have advocated for breastfeeding going through the trenches of depression and anxiety. By the time the hospitals pediatrician came in to discharge us, I had already reached out to schedule a consult with a pediatric dentist in my area. When he came in, they weighed her and she had lost quite a bit of weight. I told him nursing has been painful and I was concerned. I told him that I was informed that she had a lip tie. He immediately went off the rails. “Which nurse told you that?!” “I hate it when these nurses say things like that without consulting with me first!” Obviously I wouldn’t tell him which nurse told me. I wasn’t about to rat her out. And by the end of his rant, I stopped taking HIM seriously and just assumed he was an asshole. In his fury, he quickly opened my daughters mouth and said, “no, that is a normal frenulum. There is no tie in there.” Then he told me, “I know they say that nursing shouldn’t hurt, but that’s just not true. Some pain with nursing is normal and fine. My wife had horrible pain that would shoot from her breast to her back every time she nursed our son.” I looked at him and said, “well that sounds horrible. I feel bad for your wife.” And I meant that in more ways than one. I think/hope he knew. So, we went home, again dismissed and discouraged. But I wasn’t stopping. I went ahead and scheduled a virtual consult with my favorite IBCLC I found on Instagram years ago. After meeting with Aubri, I had a plan for my poor nipples. I had a plan to feed my girl. Two days later we went to my daughters regular pediatricians office. “She has a mild lip tie, you can have it looked at if you want, but it’s probably not impacting breastfeeding.” Well, by now I have had it. Within 3 days of her little life, I was no longer feeling human. My breasts were ready to explode and my nipples were absolutely shredded. “Would you like to see my nipples?” I asked. Not to mention my baby had lost more weight. She was lethargic and barely getting through feeds. I was having to wake her for every one. It was stressful and I felt so worried for her. Again, had I been struggling with my depression or anxiety, this would have been the final straw. Here is what I know. Oral ties are a place of emerging information. Pediatricians are NOT lactation consultants and their regular training on breastfeeding is minimal. Also, they were probably not taught about ties in medical school 10 or 20 years ago. As is true for any profession, especially within the medical community, as new research comes out, they need to be willing to learn about it. As a veteran mother I have learned that I need to trust my gut when it comes to parenting my babies. But also, I need to prioritize myself because no one else will. I could just give up and switch to formula or exclusively pump. But that’s not what I want to do. If I eventually have to, OK I will come to terms with it, I am a flexible person. But I felt like I had to try to fix it. Two days later when we went back to the pediatrician to have my daughters weight checked (we saw a different pedi), she dismissively said she has a mild lip tie, you can have it looked at if you want, but it’s probably not impacting breastfeeding. After two days of pumping and putting wound cream on my nipples, I again, couldn’t take it. “Do you want to see my nipples?” How can a stranger tell me, at a weight check appointment for my baby, that her lip tie is not impacting feeding? Luckily she had gained ONE ounce, but she was vomiting a lot and they were already talking about reflux. And it wasn’t just breastfeeding, she couldn’t latch on the bottle nipple either. Finally, the day of her consult with the dentist arrived. He asked me a lot of good questions before even looking in her mouth to understand what was happening. “How has it impacted breastfeeding?” Just that question made me want to cry. “It’s not going well.” My sweet girl had a grade four (not mild) lip tie and a grade two tongue tie. It was definitely impacting breastfeeding, and feeding in general. When I look back on the whole journey to get to where we are now, I see a lot. I see a tired mom, but one in a much better place emotionally than I have been in before. Without much support from medical professionals actually looking at me and my daughter, I was able to create a care plan to deal with her feeding issue that included lactation and body work. I’ll say it again, there is NO WAY I could have done this when I was struggling with depression after having my son. This was an exercise in advocating for ME. I want to breastfeed her. I don’t want to be in pain. I know that breastfeeding should be pain free, despite what a man with useless nipples tells me it should feel like. I wanted this journey for myself. Luckily, I was able to achieve it. Our Milky Moment, Annie & Tiny C

First let's look at the fridge hack. The fridge hack is a method of storing breast pump parts and pieces in the fridge between pump sessions. You can do this after pumping by pouring out the milk into another container, do not rinse simply store the pieces all connected in a wet/dry bag or gallon ziploc in the fridge until the next pumping session. Many moms want to know if the fridge hack is safe for milk storage? The CDC says it's a no go. BUT I want to tell you my thoughts on this process as an IBCLC. I think that breastmilk when handled with clean hands and on a clean surface is a VERY stable fluid. Breastmilk has TONS of antibodies, white blood cells and is even considered bacteriostatic. This means it prevents bacteria growth and when you combine that with the temperature of the fridge I think its a viable option for many moms. Some things I would warn you about if you do decide to use this method. ALWAYS wash your hands and clean the pumping surface prior to handling the pump, bottles and kit. Make sure to not touch inside the flanges or bottles when pouring out your milk. Remember that opting to not wash can place you at higher risk for infection (i.e. thrush mastitis etc) so if that happens I would go back to standard washing and cleaning methods. Additionally, if tiny is having extra gas, reflux or other tummy trouble I would steer clear of this hack. If you are needing to save time while at work but don't want to use the fridge hack there are other options: pump wipes for fast cleaning or simply buy another pump setup (or two) and use a clean one with each session. Overall the fridge hack can be a time saver but it should be used with extreme caution and care as it's not an "approved" method for storage or cleaning. As far as standard storage/cleaning goes the recommendation is washing with hot soapy water and hot water rinse in-between each pumping session. It's ideal to use a silicone bottle brush to prevent and wear/tear or breakdown on your bottles or pump parts. When storing remember the 5-5-5 general rule: 5 hours room temperature, 5 days in fridge and 5 months in the freezer. Here is the CDC guidelines on detailed storage breakdown. It's important to store milk in the center or back portion of the fridge for greatest temperature stability. Same thing with freezer storage try to keep it in the bottom of the freezer in its own gallon sized bag or Tupperware. This separate storage can keep temps stable and prevent fluctuations. If you live somewhere with inclement weather or potential power outages I would suggest investing in a freezer bluetooth alarm. If ever milk is "questionable" consider using it for a milk bath prior to just dumping down the drain. Here are a few additional tips when storing milk to keep all the nourishing properties & keep your milk fresh: Store milk in BPA free plastic or food grade glass Store in coldest location of fridge/freezer For colostrum store in 1-2oz servings For mature milk store in snack size 1-2oz or feast size 2-5+ oz servings Combine milk to even out fat content If your tiny is sick write out symptoms on the milk bags when stored (great for use later when baby has similar sickies) Lay flat to freeze (remove air and it saves tons of space) Mason jar for combining large amounts Flange as funnel to fill bags without spills Store frozen milk inside of a container bag or Tupperware for extra temp stability Use bowl, container or ziploc to thaw milk in case of spills Use a freezer thermometer to keep and eye on the temp and prevent any accidental power outage thawing Taste/smell your milk: fresh, frozen, thawed & warmed. That way you know when something is off. Then use that milk for a bath if needed. A few storage/cleaning items I LOVED: REMEMBER: Your milk & your tiny are BOTH resilient. Even if you have an oops or don’t get storage just right. It. Will. Be. Ok. Breastmilk is medicine for tiny. And just like motherhood. Your milk is what’s best for your tiny no matter the elements it’s faced. happy storing, washing and pumping Aubri

Trigger: NICU, Pumping, Breastfeeding I’m jealous of the moms who get the “Golden Hour” and have unlimited skin to skin time with their newborns. I’m jealous of the moms who have zero issues latching their babies onto their breast so they can feed. I’m jealous of the moms who don’t have to pump. I always thought breastfeeding came naturally, and that there was nothing to it. Baby would find nipple and begin to feed. Baby would continue to find nipple any time they were hungry, and mom would watch as she effortlessly nourished her child. This was not the case for me, nor is it the case for many women. My baby decided to come four weeks early, so he was considered “late premature”. His breathing was affected and because of this he was immediately taken to the NICU after birth. No Golden Hour, no skin to skin, no initial latch after we spent all that time and effort working to meet each other. Of course, breastfeeding was the last thing on my mind at this point; I was more concerned about my baby being able to breathe well enough to sustain life. When the nurse came in to show me how to pump, I was a little confused. She told me I might only get a couple of drops at first, but that that was okay, and to keep trying to pump. She recommended a pumping schedule to me, and told me I had to be very diligent about pumping on time in order for my milk to come in. So, I did as she said and I pumped every 2 hours, on the dot. I didn’t know how to use the different settings on the hospital-grade pump. I was in pain, mentally and physically. I was also determined to be the main source of nutrition for my baby, so I kept on. Our first latch was four days after my son was born. We couldn’t try any sooner because of the mask he had to wear to help him breathe, and the tube in his mouth that was feeding his belly. He latched successfully for a minute or two, then kept popping off. I later realized that because of the amount I was pumping, I had an oversupply. Because of this, my let down was so fast and overwhelming, so he couldn’t stay on my breast for long without feeling like he was drowning. We struggled for days, weeks, and months with latching. I kept pumping, not knowing at the time that I was sabotaging our breastfeeding journey. I was so concerned about having enough milk to feed him that I over pumped. I had plenty to feed him every day, and was storing anywhere between 10-20 additional ounces in the freezer. This left me with a hefty freezer stash, but still the inability to breastfeed directly. For the first couple of months of my son’s life, he struggled with excessive gas, runny stool, and obvious discomfort. At one point, his stool had blood in it and naturally, I freaked out. The pediatrician recommended I cut dairy out of my diet immediately to see if he had a “dairy intolerance”. Come to find out, he had an allergy to dairy, soy, wheat, egg, and oat. The pediatrician did not help me discover this; rather, an Instagram account and business run by a molecular biologist who specializes in infant food allergies helped me navigate our way through my son’s allergies while continuing to breastfeed. It took us six long and painful months before I was able to successfully breastfeed my baby. I drastically decreased the amount I was pumping, tried more often than not to latch him, and practiced incredible patience. I was determined to detach from the pump full time and continue to provide breastmilk to my baby. I am proud to say that we are over a year into our breastfeeding journey and we aren’t anywhere close to the end. I’ve reached one goal and I’m setting more based on my child’s wants and needs. Breastfeeding provides him with not only the nutrients he needs, but the comfort and closeness he desires. I would not have gotten this far without the help and support from my wife, who has continued to encourage me throughout this entire endeavor; through the tears, the laughter, the pain- she’s been there. In addition, the wonderful free resources I’ve found on social media are unmatched. I’ve made connections with IBCLCs, doctors, and nurses who are passionate about their work in providing education and support to mothers around the world, as well as assisting families through their breastfeeding journeys. The theme for World Breastfeeding Week 2022 is educate and support. I would not be where I am today without the education and support provided by the following Instagram pages: @free.to.feed @lutz.lactation @thebetterboob @mothermadelactation I’d like to add that pumping IS breastfeeding. Whether your journey lasted one day, one month, one year; whether you primarily pumped, primarily latched, supplemented, etc.- you breastfed. I’d also like to add that if you did NOT breastfeed your baby, whether that was a choice you had to or chose to make- you fed your baby, and that is what matters. -Brianna