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Ep. 92- 2021 Breastfeeding Year in Review! (Pt. 2)

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This is Maureen Farrell and Heather ONeal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way.

So join us for another episode. Welcome back to the Milk Minute Podcast, my friends. How are you this day? This beautiful day or evening, whatever time you’re listening to this. It’s very cloudy here, but still beautiful. I went on a nice walk today. It’s like a gorgeous spring day today and it should not be because it’s the middle of winter.

I have a, my lovely gosh, what is she? Nine months old? Nine-month-old here with me today. That’s crazy. Just for a little bit, she’s just nursing then we’re going to pass her off to dad, but I thought, you know, you can enjoy some baby sound effects again. Oh my gosh. Isn’t it crazy when you live your life in one-week blocks?

You know, like we air every Friday. It’s like her life has just zoomed on by and it’s like, oh my gosh, we didn’t realize we were only gonna have so many Fridays have cute baby noises before she was like running around doing other stuff. Before she’s literally like throwing the mic, like she just did before you pressed record.

Thank you, Lyra. Thanks, Lyra. Thank you for blowing out my eardrums because you threw your mom’s mic. Yeah. Well, I want to start out by telling you that I got my period back. Oh, welcome to the dark side. Actually, while I was traveling over Christmas, which like, feels like a really lovely time for that to happen, but you know what?

It’s a real kick in the pants. I don’t know if you know this about me Heather, but I am like always ready for lots of scenarios, including this one. Dude, I am never ready for my period and it’s very regular. I am super ready because when I was nursing Griffin, it was really irregular, which was the first time in my life that had happened.

So I use menstrual cups and I have a Lilly compact, which folds down to the size of like a very fat coin and I always have that with me. And actually, you know, since I’d been having like menstrual symptoms, like cramps and stuff for the last, like two months, every once in a while, I was just like in the store and I saw a new cup and I was like, I want to try that one.

So I bought myself a Honey Pot is what they’re called. It’s called a Honey Pot? It’s called the Honey Pot. And I just like when I was packing, I saw it still in the package on my dresser and I was like, sure, throw that. I guess I shouldn’t have done that to be totally honest because now I have my period or I had it.

And it was, it was I was just gonna say, like, it was okay. I, the first one with Griffin, I feel like really kicked me in the pants. This one, I was like, oh, that, that, blood’s kind of weird. And like how, I don’t know how long it’s been hanging out my uterus, but clearly it was time to come out. It’s like awkward browning.

Yeah. It’s like a little, like lots of weird clots, but otherwise fine. Good. Well, I’m happy for you. I’m obviating, so. Oh, congrats. Thanks. Thinking about the optional third baby now, are we? My eye is literally twitching, just thinking about it. So sorry, I won’t bring it up again. Anyway, but I feel like it’s like a milestone.

I’m like, okay, cool. Incidentally happened during the week that I think I’ve gotten like the least amount of sleep that I’ve gotten in a long time. So that doesn’t make sense to me, but Hmm. Your body’s like she’s ready. She’s been training. Clearly ready for another. Let’s do it. She’s been training for this for the past, you know, seven years.

Let’s do it. You are your mother’s daughter. That’s true. Cute little burp. Anyway, so yeah that was new. Not particularly exciting, but whatever it’s back. Well, that’s cool. Let’s see. I have been battling trying to get professional liability insurance so I can partner with the lactation network and have the lactation network bill insurance for patients just to give patients an extra option for private consults with me. But because I’m a midwife, they lumped me in with obstetricians and they’re surgeons..

Yeah. They’re like here, can you afford like $1 million a month? Right, Lyra. I know. It’s like ridiculous. So I obviously can’t afford like, you know, $20,000 a year of malpractice in order to bill, you know, $200 for lactation consulting. You’re like this is why lactation care is not accessible.

Right? Exactly. And they’re like, well, you could just give up your midwifery certification. And I was like, yeah, I could. Except then I won’t be able to prescribe for mastitis. And you know, also screw you because I worked really hard for that. Sorry. So what, that, that only took several years of my life.

Let’s just throw that down the drain. More than time, and I’m still paying for it. You know, I’ve got $115,000 in student loans and they’re like, oh, you want to make money? You need to give up the thing that you already paid for in order to make money doing this. And it’s like, you pay for the thing that you just gave up.

Right. It’s ridiculous. Like I can’t even technically get premises liability insurance without professional liability insurance. Yeah. So if you come to my office, do me a favor, don’t slip and fall when you’re here for another month until I get this sorted out. It’s just mind numbing, but I’m doing it, you know, we’re just one day at a time.

So yeah. Periods, insurance. Regular life things. Just trying to potty train still. That’s still happening. Yeah. Heidi please! Heidi refuses to poop on the potty. We tried round two of potty, really round three of body training and she held her poop for another three full days, plus, and shit between the couch cushions, not just on one, between them, shot out some like liquid stool.

Yeah. So we had some liquid shit between the couch cushions, but she didn’t finish and then refuse to finish on the potty. And so I’m like crazy searching through everything on Instagram for like the potty-training consultant and research, you know, like what do I do when it’s been this long? Because I don’t want to create a medical problem.

And pretty much they say that after like around the three-day mark, if they’re still withholding, just give them a diaper because anything beyond that is going to just mentally destroy them and put your potty training. Oh yeah. It’s going to regress them even more. So I put it on me and I said, Heidi, we’re going to go back to pooping in diapers until mommy can figure out how to help you better.

So I tried to. That’s good. That was good framing. Yeah. So I try to reframe it in that way so she didn’t feel shameful about it. And gosh, she just, I think most of the problem is she can’t take a solid poop. She’s never had a solid poop in her whole life. And I’ve had her on fiber for the past two weeks and she’s been taking a really good like refrigerated probiotic for the past three weeks.

No change, none. And she eats beans, tons of dairy and bananas and I’m like stuff that should pack your poop together. It does not. So I’m going to call the doctor. This is what you do when you get to the end of your rope and you call the pediatrician and hopefully they send a stool sample and we can figure it out.

So like, if she has liquid poops all the time, like her urges to go might not feel the same. True. They really might not. And a lot of the stuff that you’re supposed to do, like when they poop in the diaper, you then take her to the potty, dump it in the potty and say, bye-bye poop. I cannot do that because it’s like not solid.

So it’s just really unfortunate. And she’s just trying so hard to be excited about it, you know? So I’ve just. You will get there. She will not be pooping in a diaper when she’s fifteen. Yep. Unless there’s a medical issue, you know, it’s like, it’s fine. You’ll figure it out. All right. So sorry you’re going through it though.

Well, I’m sorry for the couch and we just need to figure that out. Just go back to Ikea, I guess. If Ikea had anything that I would, but they still don’t have any stock stupid. Anyway, so just mom stuff, you know, just the regular kind of thing. Yeah, well I have a good question for us today because it’s something I’m dealing with too.

So I feel like we both can answer this one well. This is from one of our patrons, Kaitlin, and she said that her son will be a year old in a few weeks. And her question is about daytime feeds. She said he’s very interested in nursing, especially when he’s tired, but during the day it’s like sip, sip, sip. Put me down.

I want to play. Up and back two minutes later, why did you put me down? I want more milk. Sip, sip. I want to play, repeat, you know, forever. Is it normal? She’s not like super worried about him since he also loves table food, but it’s the constant up and down, start and stop is making her crazy.

That’s normal developmentally and it’s normal for your milk to be fine with that. Yeah. Unfortunately like I kind of wish I could be like, no, it’s not and here’s the solution. No, it’s totally normal, but you know what? You’re at a year. If you need to set some boundaries, you can begin that process. You can be like, okay, I see you want milk, but I know that you want to play.

How about you play for five more minutes and then we’ll have milk. But if you want milk, you need to stay for, you know, two full minutes or like, let’s go in another room to nurse and you start only nursing in the other room or something. Like try, try to be creative and think about that a little bit, because this looks different for everybody, but this is absolutely a habitual thing.

It’s a developmental thing, you know? And it’s okay at this point, like you said, he’s really into table foods just to be like, nope, we’re not going to nurse right now because I know you’re going to pop off in a minute and keep playing. Not right now. You don’t have to be, you know, beholden to your kids, random whims because their brains do not work in a linear fashion.

So if you’re just trying to follow your kids’ fancies all day long, like this minute, I want to nurse. This minute I want to go look out the window. Ooh, garbage truck. Oh, look, shiny thing on the floor. You are going to be so discombobulated in your everyday life. So you decide. When are we going to sit down and eat?

Like, you kind of know when their general hungry times are. And then if it’s not that time, you can absolutely say, you know, mommy’s going to finish making lunch or dinner or whatever, and then we will sit down and we will do that. And verbally they can understand a lot more than you think at 10 months plus.

So don’t be afraid to tell them. Yeah. And let us know how it goes. Right. And, and also it’s annoying and we understand that. Yeah.

Do you know what I really need Heather? Hmm. So many things, but I’m guessing a drink of water. Yeah. Water gets a little boring. That’s true. It does. So I like to add just a little Liquid IV now. Oh, man. I love Liquid IV because it’s gluten free, soy free, dairy free, non-GMO, and made in the USA. Yeah.

And it’s a great tasting daily electrolyte drink mix that utilizes this like cool technology that delivers hydration to your bloodstream faster and more efficiently than just water. Plus it just kind of makes you a little bit happy. And I got a little bit of fizz to mine. I don’t know about you, but I actually add a little bit of Perrier to mine and I make it a little fancy sometimes when I’m feeling it.

I like this and they don’t just have a hydration multiplier. They’ve got a sleep mix too, which I love. And one for energy, which does not make you shaky and wacky and weird like coffee does. It just kind of gives you that extra edge that you needed. So if you’d like to order Liquid IV you can use promo code MILKMINUTE for 25% off your order and free shipping. That’s and enter promo code MILKMINUTE for 25% off and free shipping.

Okay, well, today we’re doing part two of our 2021 year in review, and I want to kind of jump in because I’m really excited to look at some of this. We are going to take you guys through some of the more exciting pieces of research that came out this year, do a little summary and just kind of say what it means for us.

And also just to give a little nod to the global COVID situation, although it is the worst, it did bring everybody on the same page with breastfeeding and made us ask a very important question. How much does it matter? You know. Yeah, it’s, I actually, we hate this pandemic situation. It sucks for so many reasons, but it’s one of the few times that we’ve seen such a large amount of clinical guidance and research coming out on the same topic at the same time by leading researchers.

It’s interesting. So do you want to hop right into COVID stuff? Like we, we try not to do this all the time to you guys, but this is going to be a pretty coronavirus, like heavy episode. Yeah. It is going to be because a lot of it is talking about, does COVID play with breastfeeding, like other respiratory illnesses, you know?

Should we be treating this like, we treat a head cold when it comes to breastfeeding or are we separating moms and babies at birth for, and for how long and what are the protocols, if you are going to put them together and should they be pumping? Does it cross over into breast milk? You know, so, whereas before with colds there wasn’t really an incentive to go that deep on the research. The research has been much more thorough because of the potential risk or the perceived risk. So that has been very fascinating. And we’ve learned a lot more about how breastfeeding interacts with respiratory illness because of this. So I’m kind of excited to dive into it.

Okay. So of course the biggest question of all is, “if a mother is sick with COVID-19, like active infection, should she breastfeed?” That is huge because depending on where you are in your breastfeeding journey, that can make a huge difference. I mean, if you’re one day in, you know, your COVID test came back positive and you’re 24 hours into being a mother for the first time and they don’t know if you’re supposed to breastfeed or not, you might as well just say sianora.

Like, are you pumping and dumping? For how long? You know, that’s so disruptive. Yep. And then the other thing is, what if you’re six months down the road and you’re COVID positive or should I say four months down the road and you haven’t started solids yet, you know, but your baby won’t take a bottle because you’ve been exclusively breastfeeding?

So many scenarios where this can really throw a wrench into it if we don’t have clear evidence-based clinical guidance, Right. So lucky for us, we did learn through an observational study and it is a smaller sample size, but it’s been repeated a few times, so we can be pretty certain that this is the case. That expressed breast milk can be considered safe in neonates, born to COVID-19 positive mothers, even sick mothers with COVID-19 can continue to express breast milk after ensuring proper safety measures.

They did not say what the proper safety measures were, but, well, the CDC doesn’t really tell us what those are right now anyway, right? Oh, we’re going to get into that. But so, so that’s good. That’s good to know. It’s like, you’re not, you’re not giving your baby COVID by breastfeeding if you have an active case, this is not like an HIV situation.

Right. Another study from October of 2021. So that’s fairly recent. The title is, “Does Breastfeeding Protect Children From COVID-19?” and this was done in Spain. So again, this is the pandemic. Pan, meaning the world, bringing everybody together and letting everyone know that breastfeeding is universal. So we can trust that if it’s happening in Spain, it’s probably happening here. Cause it’s all, it’s all boobs. So the conclusion of this study was that kids that have been breastfed ever, ever, so whether they’ve been breastfed for a month or 12 months or four years, if they have received.

Sorry, can I just cut in and say, I love when we add that as a statistical data point, because it anyway, it matters. Okay. It does matter. And actually the sample size for this was pretty good. 691 children. And these were all children who were under the age of 14, who were tested for COVID in the emergency room. So they came in with something, you know, some kind of funk and the conclusion was that kids that were breastfed ever were less likely to have a positive COVID-19 test than other kids who were formula fed strictly. So that’s pretty stark. And when you’re looking at a sample size that that’s a decent size like that, we can be pretty sure. It’s big enough to, to notice, you know. And they did find a higher prevalence of positive tests for the formula fed babies or children?

Yes, they did. So, you know, it’s just, it’s interesting cause like they were obviously in the emergency room because they were experiencing symptoms and so they were all tested for COVID and then the one little variable was, “were you ever breastfed?” And it’s like the kids that were breastfed a little bit were much less likely to have a positive test. Cool. Yeah. All right. That’s really good to know. And again, this is not data that we’re like, shame on you for formula feeding during a pandemic, but this is something where we can more positively say like, yes, it is safe to breastfeed during a pandemic. And if you can, you should.

It’s interesting. And it’s an observational study. So a lot of these are observational. Well, I mean, they’re not setting up double blind COVID stuff. I mean, that’s how we get a lot of our disease protocols is from observational studies. Okay, so this one was, let me just say, remember the time in the pandemic, where they were separating moms and babies after birth, when the moms had unknown COVID positive or positive? I remember because I was really, really mad.

Yeah. It was like a really shitty time to be pregnant because you, first of all, weren’t sure if you had a support person that was going to be able to be there. And also you were of course, terrified that someone was going to rip your baby out of your arms and tell you that you were a danger to them immediately after birth.

Yeah. So that’s when we saw this huge uptick in home births and you know, that just further made midwives, the anti-establishment people. But it was a wild time let’s just be clear. It was like wild west everywhere. Right? So this study was from September 2021, and this is a retrospective study. So they were looking back at these breastfeeding dyads and what we did to them.

So for COVID positive mothers in high-risk areas for coronavirus. So the results showed that babies who were not isolated from their mothers at delivery were significantly more likely to be breastfed and were at no higher risk of infection with SARS COVID.

So the conclusion of that study was that the World Health Organization recommended strict hand and mask hygiene measures but wanted to establish good breastfeeding practices and keep the babies rooming in thus promoting the mother child bond without compromising the safety of the newborn. So the World Health Organization got behind it and they were like yeah.

Remember back in the day during the HIV situation when we separated babies and moms and how many more babies died? And there are risks to not breastfeeding. Not saying if you don’t breastfeed your baby’s going to die, but when you look at it from a 30,000-foot view and make everybody a number, the numbers point towards breastfeeding being the safest best thing for mom, baby dyads.

Yeah. I mean, when we’re looking globally too, and the resources for safe formula feeding, very widely. Right. Exactly. So, you know, this study basically confirmed everything that we figured. Don’t separate moms and babies. Okay. Thanks for that. All right. What’s next? You have some vaccine info for me. Right. So then after we had all these positive cases we were like, what are we going to do with these active cases, then the vaccine rolled out.

And so now we have a whole other slew of questions about breastfeeding and the vaccine and is it safe? Should you get it? Does it pass through blah, blah, blah, blah, blah? So a study from September of 2021 titled COVID-19 Vaccine in Pregnant and Lactating Women, A Review of Existing Evidence and Practice Guidelines.

So this, this I liked, and I picked this one because it kind of shows where all the professional organizations stand as of September 2021. So just FYI currently there are over 300 clinical trials exploring new medications and vaccines for COVID-19, but pregnant women and breastfeeding women are still excluded from all of these trials.

Okay. So, you know, it’s like, so we’re all just doing the best we can to figure out how we fit into these studies and can we make these conclusions, you know, and in such a short amount of time? So, well, there are a few observational studies happening where pregnant and lactating people who are choosing to get the vaccines are then reporting information.

So hopefully that will be published at some point. I have participated in one of them. Cool. Because I chose to get vaccinated both in pregnancy and in lactation. I just got my booster in December. Whoo. Yeah. And know, just also as an aside, there is a task force on research specific to pregnant women and lactating women.

That’s what the task force is called. And they recommend inclusion of pregnant women and lactating women in clinical trials unless there is a compelling scientific reason for their exclusion. Yeah. I agree. Like, I feel like the blanket exclusion is actually really patronizing. I feel like it’s like, Hey, since you’re carrying precious tiny life forms, you’re not allowed to take risks.

And you’re also not allowed to choose, right. If you would like to participate. Right. And I feel like, guess what? Like we’re adults. And we have to do risk assessment every single day of our entire lives with our pregnancies and in raising our children. And this is just one more piece of that. Right. And, you know, we do have the database that came about during the pandemic called V Safe after the vaccine rolled out where they’re collecting data.

And so far they have over 50,000 pregnant women that have shown no serious vaccine related adverse events. Yeah. And this feeds directly into VAERS, which is like the database of all of the adverse vaccine reactions. So there’s been many experts that have suggested that vaccine- stimulated immunoglobulin may pass through breastmilk and provide additional protection to the baby against COVID-19, which is great.

Yep. And one study showed the presence of the vaccine IGA antibodies in breast milk, three to four weeks post vaccination with the mRNA COVID-19 vaccines. So that’s the vaccines that are specifically mRNA. So they were able to find that in people that were vaccinated three to four weeks later in the breast milk, which is great.

So that’s like the Pfizer, Moderna, I feel like is one more of them mRNA? Those are the two big ones. Yeah. I can’t really remember. The other big thing was they noted that the IGA antibody titers in breastmilk were similar between people that had the vaccine and people that had previously had COVID.

So that was shocking to me actually, because I would have thought common sense would tell you that if you had actual COVID that you would have more titers, higher titers. That definitely speaks to the efficacy of some of those vaccines, you know? Yeah. So that’s cool. I’m kind of into that. Like no adverse events recorded so far.

Yeah. And we have to say like, of course, lots of adverse events happen in pregnancy and lactation, whether or not they are related to vaccination is sometimes hard to establish. There’s lots of stories that go around Facebook and whatever. So we have to consider context and numbers when we look at those.

So in the larger context of all of the people who have reported it, it does not appear that any adverse events were due to vaccination. Right? So let me just give you a quick little snippet of the professional organizations and where they stand with COVID and breastfeeding. Tell me, tell me, tell me, okay.

First of all, I didn’t even know this was a thing, but apparently there’s an advisory committee on immunization practices. Oh, I knew that was a thing only from trying to get information on COVID vaccines for this podcast. Well, the people that are obsessed with immunization, ACIP. They say no data on the safety of COVID-19 vaccines and lactating mothers, or on the effects of mRNA vaccines on the breastfed infant.

So they are making a non-statement. Fun. Thank you. And they do also say that individuals who meet criteria for vaccination based on ACIP recommended priority group may choose to be vaccinated. Thank you. You’re going to let us choose to do it. I appreciate you letting us take all the risk. So then we have the American College of Obstetrics and Gynecology, also known as ACOG.

Their statement is COVID-19 vaccines should not be withheld from breastfeeding individuals who meet criteria for vaccination based on ACIP recommended priority groups. So they’re kind of bumping it back up to the ACIP. I’m just going to piggyback. Who had no statement and ACOG is like, we should not withhold it.

So if, if there is a breastfeeding woman knocking at your glass clinic door screaming, give me the vaccine, you should give it to her is what they’re saying. And they also say the theoretical risks of vaccinating lactating people do not outweigh the potential benefits of the vaccine. Okay. That’s slightly more, I don’t know.

Yeah. They’re, they’re taking a little bit more responsibility. It’s a baby step. Okay. So who is next? Now we have the Society for Maternal Fetal Medicine. SMFM. Sounds like a radio station for sexual people. You’re listening to SMFM.

You should do podcasts. Your voice is so good. Oh my God. Shut up. So the SMFM says vaccination recommended for lactating women. Kept it really short and sweet. Honestly, like I will say, SMFM is really good at bold statements. Yeah. They’re just like general. When you read their recommendations you are like, this is clear. Thank you.

And then they, of course echo the ACOG thing where they’re like the risks of vaccinating lactating people do not outweigh the benefits. So then we have the Academy of Breastfeeding Medicine, which we refer to all the time, ABM. ABM! They say that ABM does not recommend cessation of breastfeeding for individuals who are vaccinated against COVID-19.

That’s a very passive statement. It’s an interesting, I don’t like the way that’s phrased. It’s confusing. Okay. What’s what do they say next? They would like us to discuss potential benefits and unknown risks with their clinicians regarding receipt of vaccine. They do. Okay. So I want to talk to my doctor about the unknown risks while they’re unknown so you can’t know them.

Okay. But I’m, I want to discuss it. Well, this is. This is our discussion. End of discussion. Okay. And then they also say while there is little plausible risk for the child, there is a biologically plausible benefit. Okay, thanks. Now last but not least, actually they might be the least is the Food and Drug Administration.

The FDA. Oh, are you ready for this? Are you ready to mic drop? The FDA says insufficient available data on the effect of COVID-19 vaccine on the breastfed infant or on milk production slash excretion. Thank you. Thank you for that non statement. Okay I’m done with COVID. We done with COVID? Can I move on? We’re done. I just, because a lot of people have asked me in the past year, like, well, what is, what are, what are the professional organizations saying?

Now, there you go. None of them are being helpful. Okay. Right. So there we go. Now let’s move out of COVID. Okay. Well this is my turn now. I have a couple, so I like did a lot of Googling and found actually like a ton of lactation studies that were completed and published in 2021. And I chose a couple of fun tidbits just to talk about.

Okay. I love tidbits. Yeah tidbits. The first one I looked at was the CHILD cohort study and child stands for Canadian Healthy Infant Longitudinal Development. So they analyzed over 2000 children with complete data on early life feeding and blood pressure, which was interesting because you don’t hear about that a lot in relation to breast milk or formula feeding.

And they then measured that up to three years of age. And they did control for some stuff in this study. Like it was pretty well conducted and they basically found that nearly all the children who were ever breastfed, had ever had any amount of breast milk, that their blood pressure was lower than the children in the study who had never breastfed at three years of age.

And not like by a huge amount, just by like five or six points in both the systolic and diastolic. However, thus, I dunno, it’s like a kind of a cool data point to look at. I have never seen a study that compares that before. Well, and also it’s in three-year-olds so, exactly. So, you know, yeah. It’s not that big of a difference, but they’ve only been around for three years for their environment to make a difference. Exactly. In their biological processes.

Can I add that the associations were not changed by the, the children’s BMI. Oh, now blood pressure is interesting to me. I’m not an internal medicine person by any stretch. And I really hate med surge, but you know, there’s been a lot of talk about inflammation and inflammatory markers and blood pressure.

And just like when your body starts doing extra everything, cramping up, but basically just like kinking up your plumbing, like why? Blood pressure is one of our vital signs. And that means it is one of the things that we can objectively measure that tells us a lot about our health status. There’s a reason we take blood pressures for every single patient.

Yeah. Every time, because you can see trends, you know, it’s like, it’s like weighted feeds. They don’t really mean anything singled out. But when you look at a trend over a long period of time, it’s like, that’s interesting to me. Yeah. Yeah. So anyway, I, I thought that was an interesting tidbit. Just wanted to throw that out there.

But the next study I want to talk about, oh wait, wait, wait. Well, I was just going to say as usual, thanks Canada. Thanks Canada. You’re not perfect, but you’re better than us. Yeah. Okay. Anyway, I’m excited about this next study because I’ve been in contact with the author and we may be able to speak with her on this podcast.

So just put a pin in it. Okay. So this one is a study out of UCLA Health that was looking at cognitive performance in people who have lactated as they age over 50. So they found that women over the age of 50 who had breastfed their babies performed better on cognitive tests compared to women who had never breastfed. Their findings suggested that breastfeeding may have a positive impact on post-menopausal cognitive performance and could have long-term benefits for the maternal brain.

Which I love because frankly, a lot of the time we focus on the benefits for the infants and we’re like, oh, sorry, breastfeeding’s really hard, but you should do it for your baby. Guess what? Do it for you too? Well, and also doesn’t it just kind of feel like payback that we deserve for all of the brain, the mental loss that we have postpartum, where we can’t remember the name of a fork?

You know, or we’re like this, this thing that I’m eating with that has these stick, four sticky up-y things that people are like, it’s a fork, Heather. And you’re like, aha. Yeah. But don’t worry because I’m breastfeeding, I’m going to be much more cognitively sound later. Just not right now. This is, this is something that we’re calling neuroprotective.

Thank you very much. We love that. I do love that. And I’m going to say importantly, none of the participants in the study had actually been diagnosed with dementia or any psychiatric diagnosis or whatever. So this is on like theoretically all very cognitively healthy people. Cool. I can get down with that.

So we love that. I’m hoping we can speak with Dr. Fox who is the lead author on this study about this after she’s off of her maternity leave. So hopefully. Nice. Next. I want to just quickly mention something. When I was looking through like the, all the journals I saw an article titled, “The examination of factors that contribute to breastfeeding disparities and inequities for black women in the US,” and I was just like, hell yes.

Frankly, like, you know, for us, if you listened to our episode with Dr. DeVane-Johnson, this is like the stuff in the article is not particularly new information to you. But what I was really excited about is just seeing that kind of thing in a major scientific journal. I’m like, yeah. More of that because healthcare providers are the ones who need to read this. Yes, you’re right.

And it was, it was a lot of attention on provider bias and looking through the lens of critical race theory in, you know, as to explain these breastfeeding disparities, so great article. You can find it on Science Direct if you want to read it. Yeah. I had a great time with Dr. Devane-Johnson and I wish her nothing but the best in all of her career goals and all of the work that she’s doing.

Absolutely. Okay. Next up, sorry, I’m just flying through these. So this was an interesting one, just like another tiny tidbit. So this was called, “The Critical Window of Opportunity: Lactation Initiation Following Cesarean Birth.” I was really excited about this study until I noticed it seemed like an inclusion criteria was that the infants had been diagnosed with a known congenital anomaly.

So I’m like not sure why. So just like pin that, maybe not as applicable as I thought, but we know cesarean birth is a reported risk factor for delayed onset of lactation. So the study was trying to describe the timing of initiation and then like how that influences subsequent feeding and expression patterns, daily milk volumes, all of that.

And they were looking at that three-day hospital postpartum stay window for a lot of this. So the results, they basically found that the time from delivery or from birth to initiation, like that was an important factor in determining how much milk we’re going to make later. The average time, let me just say was over four hours.

Yeah, that’s awful. That’s too long. I’m understand if you have a congenital anomaly that you have to sort out and making sure everyone’s stable beforehand, but if this is, if we were talking about like medically well-baby, four hours is way too long to separate and not initiate lactation. Yeah. And basically they found, of course, the people who fell into the early group where they initiated lactation before the first hour or, or at the first hour, just did significantly better as far as how much milk they’re making and how long they breastfed and all of that.

So it’s just another thing that tells us like, Hey, this is a really important thing that we need to focus on, you know, as a determinant for long-term health, you know? Yeah. That needs to be a priority because the C-section rate is still high and I got bad news for you guys. It’s not ever going to be below 30% because they got to keep the lights on at the hospital.

Right. So, you know, as long as people are having a lot of C-sections, this matters for breastfeeding. Okay, well, I want to round this out with a study that has not been published yet but is currently being conducted. So Indiana University is conducting a lactation cookie study. They currently have somewhere around 200 participants where they’re having people for one month duration use lactation cookies and they’re giving some people a placebo and some a regular lactation cookie.

I assume they have one brand. I’m not sure, but it’s a double-blind 30-day intervention. They’re estimating that they’ll publish in 2024. So, how are they looking at it? Is it like pump exclusive pumpers? So they have this method that I actually went down a rabbit hole looking into when they were like using the so-and-so method of measuring milk or whatever.

I don’t have time to get into it right now. It’s not my favorite, but it is like a controlled method of like taking these people at the end of that time and we have a certain window where they’re going to pump at certain times and measure output. Got it. Yeah. And I think they’re, they’re looking at some other stuff too, and they’re also going to use that survey that a lot of studies have used for perceived low milk supply and put that data in there as well.

Okay but is it sponsored by Little Debbie? Not that I’m aware of. Little Debbie oatmeal cream pies. We’ll see, we’ll see. You know, I just found this on the clinical So I just have like two paragraphs to go off of. But anyway, it’s fun. I’m just like, thank you. Cause we need some research here, but yeah, that’s exciting.

Sorry. They closed enrollment so you can’t go be a part of it. You can’t eat all the cookies you want for a month. Well, I am really pumped about all of that new research. I’m very excited about the fact that lactation is getting looked at as an indicator for maternal health as well and, and what the future holds for us there.

You know, I just did a very interesting custody case for somebody who was breastfeeding. And I made sure to put in there in my expert argument that, you know, by cutting off breastfeeding of her, you’re actually increasing her risk later of breast cancer and, you know, type two diabetes and all of these other things.

And it’s like, I want judges to be thinking about this. I want people in power to be thinking about what you are robbing somebody of, if you force them to stop lactating. So. Hell yeah, let’s keep doing this 2022. All of you PhD candidates out there, start your projects on lactation. We have a whole list that we keep on a Google Drive of things that we would eventually like to study when we have time.

Yeah. Okay.

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I’m going to roll us into an award cause I have one that I’d like to give. Let’s hear it. Okay. I want to give an award to Heather Dollar. She’s a member of our Facebook group and she has been going through it, okay. Like a lot of stuff has been going on, but I would like to give her an award because she has made it nine months breastfeeding through a lot of issues with pumping and daycare and all kinds of stuff.

And recently we had some discussions around like, what is failure? And I just want to say none of what is happening is failure here. I don’t even let that word enter into my vocabulary. I want you to know Heather, not you, Heather, other Heather, that you have not failed. You are a super amazing successful parent.

You’ve breastfed your baby for nine months. You’re going to keep breastfeeding and that’s incredible. Yeah, that’s really, I mean, and unfortunately I know this girl’s name because in a group of over 16,000 people, if I know your name, it’s because you’ve been posting in there so much because you’ve been going through it.

So I like the minute you said Heather Dollar, I was like, oh, I recognize this poor thing. You deserve an award. Oh my God. Give it to her now, please. Okay. Oh my God. From one Heather to another, I’m going to give you, What’s Your Damage Award. I hope you understand the reference. Anyway, we, we love you. We think you’re doing a great job and we want to keep supporting you through all of this.

So just, just don’t forget that you’re amazing. Yeah. And in case you don’t get my reference, you can have the Nine Month Ninja Award. That’s also fine. Okay. Well, we have to wrap this up right now. Thank you so much for listening to another episode of The Milk Minute Podcast. The way we change this big system that is not set up for lactating families is to educate ourselves, our friends, and our children.

And today I want to tell you that if you want to learn more about us or support us, you can check out our brand-new website, which is Check it out. Oh my God. Okay. We have merch you can buy and drink out of and carry things in and blankets to lay on. Actually our web designer is amazing. Okay. Anyway. Thanks guys. We will see you next week. Bye-bye.


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