Ep. 94- Clogs & Blebs: Where are you getting stuck?

Transcript:

Ep 94- Clogs & Blebs

Hey, Hey. Hey. Howdy, everybody. Welcome back to another episode of the Milk Minute Podcast. We are very excited to be here today and we have a very exciting episode. Much awaited for all of you persistent cloggers out there. And I’m not talking about the ones with wooden shoes.

It’s the worst dad joke I’ve ever heard. I’m starting off this recording day very strong with a joke about Dutch clogging. Oh my God. Anyway, we are going to talk about clogged ducts. But I do want to talk about like eight other things first. Me too. Can I go first? I don’t know. Maybe. Well, I’m going to. Okay, fine.

So my friend, Julie, who, you know, did the whole meditation episode for us, love her. She just took her three-year-old daughter and her husband to the Galapagos Islands on vacation and brought me back a t-shirt that said, I heart boobies, Galapagos, Ecuador. But it has the feet of blue footed boobies on it.

And if you’re one of our patrons, you can see it on video. But I love that no matter where people go in the world, they see something boob related and they think of me. I think, I think that’s wonderful. If I had thought ahead, I would have made the mascot of my whole business, the blue footed booby. I think they are wonderful little animals.

I love how they do their little dance and they stand on one foot and then the other foot. So thank you for my t-shirt Julie. And also she told me that in the Galapagos, which is in the Eastern time zone, which is weird and I did not realize, and does not take that long to get there from here. It’s like a three-hour flight to Miami from Pittsburgh, and then like another hour flight to Ecuador. That’s nice.

Isn’t that wild? And then you’re still in the same time zone. So if you have a three-year-old, as I do, that’s ideal because you’re not going to have any jet lag and all of that. But she said in their culture, they actually like children. So the whole travel experience was really good because anybody that they came across was excellent with children, cared about their experience, wanted the adults to make sure they were having a good, easy time of it.

And she just said, I didn’t realize how little America helped you out with your kids until you go to a different country and they are like above and beyond. I mean, we definitely, we are stuck in some weird, like, I don’t know, maybe it originated in the Victorian era, but like children should be seen and not heard.

And like, if your children are inconveniencing anyone else they should be kicked out of the space. Yeah. It’s crazy. International travel, like my friend just went to Spain, she’s Spanish, took her six-year-old. And anybody who has a family member under 12 does not have to wait in security. They have a special family line and you just go right through.

This sounds like one more reason I do not want to live here anymore. I don’t dislike our country. Okay. I think, I think our country is great. I feel really privileged that I can be here. I just am not ashamed to point out some improvements. I mean, I do that with myself. I love myself. I always want to get better.

I feel the same way about America. Come on guys. We can do this. Alright sometimes I’m ready to give up. I’m going to be, I’m going to be real about it. Sometimes I’m like would learning German be that hard? I already know a little bit. Or like, like maybe I could just resurrect some Spanish from eighth grade.

Yeah, maybe. Yeah. Well that was not what I wanted to talk about today. Okay. Well, I’m done talking about my blue footed booby shirt from the Galapagos. Thank you, Julie again, and if you haven’t heard Julie’s meditation episode, please go check it out. I believe it’s Episode 68. It’s fun to remember those numbers.

Anyway, I wanted to talk a little bit about surgery. Yes. Tell us about the surgery you had. Yeah, so I recently evicted four bones from my body. I had to get my wisdom teeth removed at age 32, which like I’ve, I’ve never felt so old before. I don’t really think of myself as old at all. And I’m not, I’m 32, but apparently that is very old to get your wisdom teeth removed.

That’s really funny. And like every person I interacted with along the way was like, oh, 32. I was like, fuck y’all. Yeah. I think normally they like notice that it’s too crowded in there or something earlier on when your mouth isn’t maybe done forming and, and they’re like, we should take these out, but what, what happened?

I think that my childhood dentist may have inhaled too much nitrous to be real. Yeah. Cause also like all the fillings he did are like falling the fuck apart now. And I don’t know. I just, like, he told me it was fine. He told me it was going to be fine. And then when I got a root canal, when I was like 18 or something, they also looked and they were not fully in yet.

And they were like, oh, it looks fine. And then honestly, like I just haven’t had consistent dental care since then, because it’s really expensive and I haven’t had great dental insurance. And yeah, like I always knew it was probably not fine. Cause I was like, oh, look at that expensive orthodonture just getting smushed up front there.

And it was not super comfortable and they were a little bit out of line. So I was biting my cheeks. And anyway, I finally went to the dentist, which was kind of scary after a long time of not going to the dentist. And he was like, all of your wisdom teeth have cavities. You probably can’t brush them at all cause there’s like no room for them and we should just take them out. And I was like, cool, cool beans. How is that going to change your teeth now? Are they going to move again? Are they like set there? So the surgeon said that they might move a little bit, but it’s not going to like, they’re not all just going to magically like space out again.

But he said to expect like a little bit of movement, but nothing dramatic, but like, I think the more important thing was I have like a crown back there that he was like, ooh, this might like disrupt that so you have to keep an eye on it. Okay. But anyway, the reason I wanted to talk about surgery is not how spacious the back of my mouth is now, which kind of freaks me out a little bit, but I realized it’s just like relative to how crowded it was, but I wanted to talk about it because of breastfeeding and medications.

Yeah. You don’t just go get those shit bones ripped out of the back of your mouth without some kind of pain management. And when you’re breastfeeding, I think a lot of people are worried when they’re working with healthcare providers like dentists, or I don’t know, literally anyone, but a lactation consultant that they’re going to get pressured into pumping and dumping for an inordinate amount of time.

We’ve heard this story over and over and over again. So what was your experience? Okay. It was actually pretty good. Okay. So the nurse who was like, well, first of all, this is like not my dentist, right? It’s like an oral surgery clinic. Literally never been there. I was actually scheduled for months from now and then I called them and they were like, what about tomorrow?

We had a cancellation. What about tomorrow, you know? And they were like, does that work for you? And I was like, absolutely not, but I will be there. Yeah. So we canceled everything. It is three hours away. I literally then packed up my family immediately drove them down, got a hotel room. Cause it was seven in the morning that I had to have the surgery.

It was ridiculous. But I walk in there, never been there before. They’re like here, fill out 10 pages of paperwork and then we’ll put you under anesthesia. Okay. That felt weird. But I’m like in the room I have, they’re like prepping me with like oxygen and just like fluids for 10 minutes because my, you know, I was like super nervous and my heart rate was like 100 or something.

So the nurse is just chatting with me and turns out she is really great and used to have this like holistic health care clinic in Oak Hill and then had to shut it down because that’s what happens here. We were talking about birth and breastfeeding and the stuff I do. And she was like, oh, well, since you mentioned that you do this work, what’s your recommendation for whether or not you should pump and dump with this medication because I think usually we just tell people to do that, but do we need to? 

Oh my gosh. Yeah. And I was like, well, turns out, I don’t think there’s anything in this building that would cause me to have to pump and dump. And if you guys really want to have the best information to give to your patients, you should call the infant risk hotline or go to the LACT med website. Either one’s going to take you five minutes and then you can send people on their way with the right information. Yeah, I mean, I’m just trying to think about what they would even be using. I mean, nitrous, first of all, we use that in labor. And it’s very short acting, which is why we use it in labor. It’s like the laughing gas, you know, that’s out of your system in no time and opiates.

You use that in C-sections. I did actually get IV sedation because they were taking so many teeth out. I guess they were saying like, if it’s one or two, they do nitrous, but for all four. Especially cause I was so old and they were like, look at this, x-ray look how close your nerve is to these teeth roots.

I was like, wow, that’s scary. So yeah, I did have IV sedation. I was not under general anesthesia, but whatever they gave me fucked me right up. Let me tell you that. I was high as shit. Did you hit on your dentist like I did? No idea, Heather. Yeah, that was my, I won’t tell you the whole story, but I will tell you that I got all four of my impacted wisdom teeth taken out when I was 16 and I hit on the guy, the assistant dentist ortho.

I don’t know, orthodontic surgeon, mouth people. I just kept telling him how much I loved his tan forearms. And I was like, I mean, they’re so strong. Look at how strong your tan forearms are. And then I made him carry me to the recovery room and I like was messing with the doorknob like I can’t open the door.

And then I tried to go to lunch with him. So I’m like packed full in my cheeks with gauze wads, gauze wads. And my mom was like, all right, Heather, let’s go down the stairs. And I kick off both of my flip flops, cause I’m like, I can’t use these going down the stairs. She’s at the bottom catching them. And I looked at him and I was like, do you want to go to lunch with me?

And he was like, I think I need to go to lunch with my dad. It turns out his dad was the surgeon. And then fast forward about 10 years and I’m working at a restaurant and my friend texted me and she says, I’m coming down to Black Bear. I want you to meet the love of my life. Like I know I’m going to marry this guy. In walks forearm guy.

And I was like, no. And he looks at me and he’s like, you. And I was like, oh God, I wish you did not remember that. Why do you remember that? But great job on the teeth. And I love me some nitrous. You can give me laughing gas any day of the week. Oh man. So you did not try to. I have no idea frankly, because the other nurse came in that started my IV and she was like, okay, like, I’m going to put this in your IV now.

And you might not remember what’s going on. You might kind of know, like be aware, but it’s not really going to seem like a big deal. And I was like, sure, whatever sounds great. Give me it. I think then basically, I don’t remember what happened after that. And the first thing I remember is the nice nurse from the initial encounter being like, do you think you can walk?

And I was like, excuse me? But I tried to talk, but then I of course had like an entire mouth full of gauze and also no feeling in my whole face. And she was just like, okay, I’ll get you a wheelchair. And I was like. She’s like blink once for yes. And then she wheels me out and also because I brought my children, oh, to the hotel because I didn’t, like I knew I couldn’t drive myself back home after, you know. So I had to bring my whole family down to the hotel and I didn’t also want to interrupt breastfeeding and have to pump. So a friend of mine who lives around there, he very graciously, thank you, Ryan. But. He drove me to the appointment from the hotel, waited there for two hours and then drove me back to the hotel. Oh, that’s sweet.

But anyway, the nurse like wheels me out and basically like dumps me on the pavement next to him. And she’s like, all right, have a good day. And I’m like, wow, this anesthesia has not worn off yet. And my friend Ryan was like, all right, come on. And he like, basically picked me up and put me in his car and then proceeded to just have fun trying to talk to me all the way back to the hotel. You know, as you do, when your friends are super fucked up on anesthesia. You’re like telling me how you really felt about the first time you met me. And then he walked me into the hotel, walked me to the room. I just walked over to the bed and face planted on it.

And he was like, I think she’s good. All right, see ya. Here’s your ibuprofen and your opiates. He handed Ivan like all the aftercare instructions and whatever. I, I think I then proceeded to take a 20-minute nap and I woke up and I was like, okay, I’m alive again. Let’s do this. Right. Great. So were you, did you, you didn’t pump at all in advance of this?

No. And you were not, well, I brought one bottle with us. Just for while you were gone. And I was actually meant to bring a pump to the surgeon, but then like I had to wake up at like six, I mean, I didn’t bring a pump and I didn’t pump. And it was fine. It was fine. I mean, it was like three hours total away from baby.

So I was feeling a little engorged by the end, but like not a huge deal. And were you looking for anything in Lyra, you know, as far as symptoms go, like after you take, what were you on Percocet? So I frankly have no idea what was in that IV. And then I know I had local anesthetic and then I didn’t actually get my scripts filled till that afternoon.

So I wasn’t on anything at that point. But then I got Norco, which is hydrocodone and acetaminophen, but it’s a really small dose of hydrocodone. It’s like five milligrams to 325 of acetaminophen. So that was the only opiate or opioid that I was taking post-op. And I’ll be honest, like the whole anesthetic that I had during the operation was still like, my face was still numb and I was still feeling a little bit out of it when I nursed her but safe enough to like, hold her. 

Right. And you weren’t by yourself? No, no. My husband was there. My six-year-old was there, like poking my face. Like mommy, are you okay? It’s just so funny because in situations like that, we’re like, okay, make sure you have a partner and make sure that you are, you know, pumping and dumping.

Like if we’re not, if it’s not us as the provider, yet we will cut a baby out of somebody that is brand new, flop on your chest and hand you the baby in one arm. Why don’t you nurse while we stitch? And the opiate in the other arm to take. And then we say, by the way, the baby never leaves this room and you’re like, wait, but I don’t have a partner.

And it’s like good luck. Right. Totally. Yeah. So I just wanted to tell that story though, because like the anesthetics that were used, even the IV one, they’re not contraindicated with breastfeeding and frankly, you know, yes, it’s safest to wait until they fully worn off. But also like I have an older baby, she’s medically well, I was not really worried about it, you know, and yeah.

Like I was like, oh, I should pay attention to see if she gets drowsy or whatever, but she never did. And it’s fine. And then I did take some of the hydrocodone post-op and again, like, I, frankly, I was like, you know, she could be a little drowsier and can give me some sleep, but she was not. That’s always how it goes.

Yeah. And it was fine. And really the thing that has fucked both of us up more were the antibiotics, which again, they are safe while breastfeeding and they are not a reason to discontinue breastfeeding. Most antibiotics are safe while breastfeeding. There’s a couple that we have need to have some conversations about, but this was just amoxicillin, super commonly give to children.

Right. Directly, you could give it to the child. Did give both of us diarrhea, going to be honest. Right. Also it was okay. You’re going to live. You’re going to make it. And you’re not going to have sepsis from your mouth infection so that’s great. Right, right, right. And I ordered some new probiotics for her and for me, and we’re just going to hit that hard now. 

We’re going to hit those probiotics so hard. We’re going to be shitting for different reasons. I did take them while I was taking the antibiotics, but frankly, I’m going to be real that it feels like a little bit of a waste. I’m like, yeah, I’m eating yogurt every day. But like, is it really surviving? I don’t know. Who knows?

We’re all just doing the best we can. Anyway, so that was fine. I still have stitches in my mouth, but, and I’m taking ibuprofen, but it’s okay. It will be better eventually. And you can have most surgeries and still breastfeed. Yeah. And from the peek I just took in your mouth, your stitches do look really good.

Mouths heal a lot like vaginas. You know, when your vagina was busted after birth and you’re like, oh my gosh, it’s never going to be the same. And then three days later you’re like, oh, it’s not too bad. You know, like that, it’s amazing. I’m pretty good. The mouth is the same kind of deal. Like those mucous membranes, that tissue is like, it looks really bad on day one.

And then it heals super quick. And I will say, when you look at those wounds healing, you’re like, if you’re not familiar with it, you’re like, Ooh, is that really okay? It’s like a weird wet membrane forms. But that’s how it’s supposed to be. It is not supposed to be dry and scabby, so good. Yeah.

Gross. So anyway, now that I’ve told that story, should we probably like, actually talk about what we’re doing today? Yes. And just so you know, we are going to put on the list a specific episode to talk about surgical procedures and how to prepare for them when you’re breastfeeding and common misconceptions that we can bust straight through.

Oh wait, I wasn’t done actually. I’m so sorry. I did want to say I have them making less milk since the surgery. Not significantly. I’m still making enough for my baby, but I was pumping before to donate to the milk bank, and I haven’t been able to like, add any milk to that for this week, which is fine.

And I would not have been able to give them that milk anyway, because for preemies, the rules about medications are different. Right. So it’s fine. And I’m like putting some effort into working that back up because I want to continue donating, but also like more than that, I’m just feeding my baby. And that is literally the only job.

Okay. Okay. Let’s do a question today. We have a question from one of our lovely patrons, Destiny Brown. Destiny says, my question for you guys is, does the distracted breastfeeding get better? My son pops on and off CONSTANTLY, in all caps, anymore since about six and a half months. It doesn’t bother me too much at home where I can just hang out with my tits out, but it makes breastfeeding in public when we’re out and about really frustrating as I can’t just leave my boob hanging in the wind.

Oh, that’s great. Okay, this answer is a little bit like not straightforward, right? Because the answer is maybe. Yeah. Some babies get over it. Some don’t and it is pretty situational, right? Like if there’s more stimulation around your baby’s going to do that more. Well, and also it depends on your kid and their personality.

If you’ve got a very curious kid, who’s like, Ooh, so many different developmental things, right? Look at the colors and the smells and the, and the people. Look at the people. There’s a dog, there’s a dog over there. Babies that are super curious like that are always going to be curious. You know, my, both my kids were like that.

I did not get the kid that I ordered last time. I was like, I just want a chubby little baby who likes to sit down and read quietly, you know, after my son where I was like, never stopped moving. I put in a special request for my second one, did not get it, but she still likes books. And, you know, she just doesn’t quit moving.

She reads on the go. So, and that’s fine. It’s all good. But both my kids were very distracted eaters. Did it affect my supply? Yes, it did, but it was fine because they were still growing perfectly well. And that is the main thing. It’s like, they’re not going to eat the same as they did when they were, you know, two months old. And they get better at getting milk out faster.

Yes. They’re much more efficient. And so typically I say, if your kid is like wiling out at the boob and they are so distracted, it’s just, take a break. Put it away. Just tell them, I guess you’re not that hungry right now and you’re more interested in petting the dog. That’s fine. And then 10 minutes later, you can try again and then maybe they’ll get the message that, okay, this is eating time or she’s going to take it away. And it’s okay too, to be like, oh, if you want that, we need to go sit over in this quiet place.

I actually, I do really like bonnets and bucket hats for blocking their peripheral vision and maybe like muffling a little bit of sound just to like focus them like horse blinders, you know or carriers with hoods. But also like, I, I don’t know it, they just, oh my God. Can we please have a Milk Minute line of hats that have like baby blinders on them?

How cute would that be? Yeah. For nursing in public. So they’re not. So even if they do pop off the wide brim is still kind of covering you. Well, that’s why I always loved the bucket hats. Because my son would pop off all the time and I wouldn’t notice frankly because I’m doing other shit too. And at least that way, like his circumference was larger so it just kind of blocked more of me. 

Yeah. That’s hilarious. So I don’t know. I mean, to answer your question, does it get better? Probably not. It’s fine though. Right? Like that is the one guarantee about babies is they’re going to grow and they’re going to change. And what is true today will not be true tomorrow.

That’s a truth if I’ve ever heard one. And you know, just keep in mind, you want them to be curious. You want them to be developmentally moving onto the next stage and the next stage is being mobile. And once they’re mobile, the world has expanded beyond your chest area. They want to see other things and that’s appropriate.

So if your kid is doing that, congratulations, they’ve moved on to the next developmental stage and you have a normal kid and you can just try to keep that perspective so you don’t want to, you know, quit every day. Yeah. Yeah. Okay. Well, good luck. I’m there too. My tit is always hanging in the wind. I get it.

So we will be there in solidarity. Yep. Destiny, we’re with ya.

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Okay. Well, how about I just move us into talking about clogged ducts. Yeah, which I feel like I have to enunciate a couple of times really well. Cause I’m, I’m not talking about like quack ducks, but like D U C T S ducts. It’s a very hard word to say, actually. So, but anyway, this is, some people never experienced this problem. For others, it is a persistent issue, but most people will have one, in fact. 

It feels normal to have milk that kind of accidentally congeals at least once in your journey. And it’s good to know what to do about it. And my big question, I hope you answer in here, Maureen, is what causes it? Well, no promises. Okay.

Well anyway, let’s start from the beginning and not that big, scary question. So I’m going to just state that the way that we talk about this in, from a scientific perspective, we call it milk stasis or localized milk stasis being a clogged duct, right. But milk stasis can refer to just any time that we’re having trouble removing milk from the breast.

Stasis meaning it ain’t moving. Right? So, as I said up to about two-thirds of lactating people will have a clogged duct at some point. And the time that we see this usually is when it is caused by engorgement or what we’re terming mismanagement of breastfeeding. Wait, who termed it that? Every study that I read on it. ABM, the textbook literally says that I mean everything. This kills me. I feel like one researcher makes up some phrase. Just like that.

Mismanagement of breastfeeding. Everybody else cites them, everybody cites them. And it becomes this big, like neon sign that’s like, if you didn’t mismanage your breastfeeding, you wouldn’t be in this situation. Right. And we call that mom shaming or parent shaming or it’s BS. 

Because yes, while sometimes the way that we remove milk causes the clog. Sometimes it also just fucking happens, right? Yeah. God, the underlying current of the language we use in the birth world and the lactation world is still so freaking shame-y and patriarchal. So we’re just going to keep pointing it out every time it happens. And really, like, I don’t know a single person who was like, I’m going to mismanage my breastfeeding on purpose.

Like no, usually shit happens and you do your best. And sometimes your best means that you don’t get to remove enough milk. And also what is the standard for normal, right? What is the standard for perfect management? Right. And sometimes we just have, I mean, usually it’s that we have situations that are out of our control, like primary engorgement.

Right. Which is frankly, at this point in time, usually caused by an excess of IV fluids. That is not your fault, but it can absolutely cause a situation where you cannot remove enough milk, therefore, a clog forms. This is usually like day three or four postpartum when your milk comes in and this is usually most common in first-timers.

Yeah. We also often have say like baby’s position or latch isn’t right. Whether that’s because we don’t know what we’re doing or because baby’s oral functioning is off or, you know, there’s some other circumstance like surgical incisions or, you know, preemie with a lot of stuff on them. A lot of things can contribute to this, but again, if we have something off with that latch or position, that can cause not enough milk to be removed and a clog to form. Waiting too long between feedings or the weaning process can cause clogs. Supplementing or bottle-feeding in some way that kind of interrupts the normal feeding pattern for baby.

The big one that I think a lot of people experience around the age that our patron Destiny was talking about is infant behaviors while breastfeeding like tugging, pulling, twisting of the nipple. Yeah. Incomplete feedings, right? Distracted nursing. I honestly think that I see the most clogs around like 7, 8, 9 months.

And it happens a lot more when you travel because your kid is much more distracted and there’s family members that are trying to hold your kid and you space out the time between feedings that milk has time to separate and the fattier milk that separates congeals to itself and clog. Right. And then we have things that are of like issues, like pressure on the breast somehow.

So like from a strap from your purse or diaper bag or an ill fit bra, or, you know, wearing something else, like a chest binder that’s really tight, or even carrying your baby in a baby carrier, but not positioning it well around your breasts. How about also always feeding in the same exact nursing position. Right. I see clogs a lot with exclusive pumpers, because it is much harder to change positions, quote, you know, with your pump than it is with your baby.

You’re going to pump in the same position because you kind of have to. Yeah. And some babies are, you know, the kind of babies that only want to be in a certain position to breastfeed. I’ve seen this time and time again, especially people that come to see me. Like if you’re coming to see me, it’s because you have a problem.

And it’s like, this baby will only eat in cradle position and nothing else. I see a lot of that with football hold with the babies with oral restrictions, like, oh, they will only take left boob in football and I don’t know why and that boob has always clogged. Yep. Most common area for clogs are by the armpit.

Yep. So, you know, it could be the, my theory is, can I tell you my theory? Please. Cause I want to get past these. Because the things that are all listed they’re correlations, actually, they’re not what we would call true causes in the sense that there has been no well controlled study to see what causes these, nor has there been a large enough collection of data that we could call it like a review that actually presents a like heavy enough burden of evidence that we can say yes, these cause it.

You know, colloquially, we can say these cause it, but scientifically that’s all correlation. Yeah. I think, you know the nursing bras that clip up above the breast and when you unclip them, there is like that strip of fabric on the side, by the armpit? That is tighter than the fabric on the outside. And it tends to restrict a lot more.

And so when your baby starts sleeping through the night, this is when I see this a lot with clients. It’s when I saw it with myself, is that band right on the side, doesn’t have as much give to it and is tighter than the outside. And you’ll often wake up when baby’s been sleeping longer stretches and have this more like weird, like, why am I engorged?

Like my baby’s older now. And it’s like, oh crap. It’s cause they slept through the night. And then they end up with these weird clogs on the side. Also repetitive motions. Yep. Hold on. Wait, let me back up and say bras are not standard for how we’ve evolved. So bras have not been around that long. And really, if you look at the mechanics of the breast, the milk storage and milk production is at peak function with no, like we’re not meant to actually restrict them at all. 

Pressure is the antithesis of milk movement and physiological development of the milk itself. And not to say you cannot wear a bra, but to then say, if you’re going to wear one, make sure it fits properly, make sure it’s not too tight. And really frankly, stay away from underwire, yeah.

Underwire is a no-no. After this started happening to me and I started noticing with the strip of fabric on the side, I switched to the brand True, which is not for nursing, but it was like the loose, no wire, no cup, no nothing. It was basically just like a soft tank top bra. And it was very easy to pull down or pull up. You know what though? The people who pull up, I see that a lot too causing clogs.

Right? Cause you pull it up and then that under bust band creates extra pressure just above your chest and into the axillary, into your armpit. And that is the line that we see the most clogs on. True. Not that you can’t do that, but again, like if you’re like, wow, I keep getting clogs and I just said that sentence to you and you were like, oh, that’s how I pull my bra away to breastfeed, change that. 

Right. Also repetitive motion. So runners, you know, first of all, you’re probably lifters or weightlifters. You’re probably wearing a sports bra. So in this situation, I always recommend emptying your breasts before you put your sports bra on, because again, internal pressure from too much milk causes milk stasis as well as apoptosis of the milk making cells.

So decreasing supply there, pressure internally and then pressure externally, same thing, right? So, you know, empty your breasts before you put your sports bra on, then go for the run and then immediately take your tight bra off afterwards and check, just check around your breasts to make sure you don’t have any hard areas.

But here’s the thing about all of that. When I’m reading these studies about clogs, which are very few, let me first state that most of the research on this general topic focuses on mastitis and treatment protocols. And the vast majority of that is about cows because people make money on it. It’s estimated that in the United States, dairy farmers lose about $2 billion annually due to mastitis.

Oh, what? Right. So there’s a lot of money, so that is studied. And I’m pretty sure if men could make money off of human milk, we would have more studies on it. Okay. Off the soap box. Anyway. So this is what we’re working with here. Several of these mentioned like, basically when I was like, what is a clog? I want the real scientific research.

It doesn’t exist. It’s hypothesized, in fact, that it is congealed milk that is just like a fatty deposit. But really we don’t know if that’s true in all cases, we, you know, some people visibly pass a clog, most people do not. And we also don’t know why that happens exactly. And there is some theory that there’s some kind of separate inflammatory process that like starts this cascade.

But again, like nobody’s studying it. I want to study it except I have no free time. Okay. Gotcha. Well, when you decide to get your PhD, I will be a worker bee for you. Can we tell our anecdotal story really quick about someone that thought they had persistent clogs and then we realized it wasn’t? Please. I think that, you know, there’s a lot of discussion about clogs, especially in our breastfeeding support group on Facebook.

And I know it’s in a lot of other, you know, social media support groups. I have a clog, I have a clog, I have a clog, I have a clog. And maybe, yeah, maybe you do. And there is never any harm in going through the steps to treat a clog because they’re not going to hurt you. But if this, if you’re somebody that’s like, I am persistently feeling like I have a clog maybe there is a differential diagnose. Yeah. 

And this happened to somebody and we determined that possibly it was varicose veins in their breast. And it was, as she got fuller with her milk throughout the day, it got, it started, her breasts were heavier and it started to pull. And then when her breasts would pull, those varicose veins would hurt and they are sectioned off. They can be really painful.

Right. And they feel lumpy. Yeah. They feel lumpy. They’re tender to the touch and then they’re there and then they’re gone. So then she’d nurse and the breast would empty and then it wouldn’t pull as much sometimes. Yeah. Right. So we were like, Hmm, let’s try something. Try icing that area after a feeding, never before, after a feeding.

And if it gets better, it’s not a clog. It’s probably not a clog then. It might be a varicose vein. You know, I also had a client once where it was just her lymph nodes. Oh, she had swollen lymph nodes, which is, if you’ve ever looked at a picture of human anatomy with the lymphatic system, you will notice that the chest is fricking covered in those suckers, like all over, which is one of the reasons that we see that primary engorgement when we have excess fluids in the body.

Right. And I really realized she was like; I keep getting these clogs. She was having some immune stuff going on. Her lymph nodes kept getting swollen. And I figured that one out because I also palpated them on her neck. And I was like, oh, can you, every time you think you get a clog, can you touch this spot on your neck and tell me if you have one there too? Right. And then maybe also go for a massage and a lymphatic drainage massage in that, you know, just make sure we are drinking plenty of water to give your lymph system a chance to flush out whatever it is trying to flush. You know, not an obscene amount of water, a regular amount of water. Don’t poison yourself.

Don’t be poisoning yourself with water or body armor, side note. Yeah, just doing anything you can to keep that lymph moving such as walking, you know, get up, get your blood. Cold showers, jumping on a trampoline. A lot of people who have issues with lymphatic drainage, right? Cause the lymph system has no pump.

It is a fluid and vessel system in your body without a pump. So when things are not working well, or you have some extra inflammation, there’s some stasis there. So those little like workout trampolines are actually really good for this. And then follow it up with a full submersion of your body in an Epsom salt bath.

Okay. Anyway, sorry. I do, I do want to kind of reign us back in but that’s an interesting conversation. Okay. But let’s talk about some symptoms of clogged ducts because I think again, like we said, sometimes it’s confusing whether or not you have one. So if we are going about, you know, a consult where we’re trying to figure this out with somebody, the things I’m looking for are first and foremost, localized pain and tenderness.

One side of the chest only, typically on a small portion of a breast, often a palpable lump. But for those deeper clogs, it’s hard to feel. Some swelling and possibly some skin tone changes. If you have light skin, it’s usually red, but if you have darker skin, it is not typically going to be red. Oh. But if it is red, doesn’t everyone just assume they already have mastitis?

Right. Which may not be true. It may not be true. One of the big things for me is often a hotspot on the breast. Sometimes we also see even deeper clogs accompanied by a white bleb on the nipple pore. And we typically do not have full body symptoms, but occasionally a low-grade fever is associated with this even if you don’t have mastitis. 

What, all right, define low grade for everyone. Like, what is it? Below 101? Yeah. I always say if it’s 100.9 or below we’re in a wait and see pattern, I will often prescribe antibiotics for people to hang onto because mastitis loves to come at like 2:00 AM. It’s like let’s have a party. 2:00 AM on a Saturday when like nobody’s willing to answer the phone. Sunday night at midnight.

So I am totally cool with giving people antibiotics to hang onto while we troubleshoot this clog slash possible bleb. Which is a very painful white spot on the tip of the nipple usually. And we can talk a little bit more about that later, but yeah, I don’t start the antibiotics until that fever is creeping up and you have general body aches and malaise. General malaise, which means I feel like garbage. It’s almost like flu like symptoms. Right? 

Okay. So I want to move on to treatment a little bit, but to do that first I also want to talk a little bit more about how we categorize this medically. So we have just plain old, localized milk stasis, but we also have what we consider a non-infectious inflammation state, which is basically we’ve got some leukocytes and some bacteria that we can detect in the milk or in the bloodstream or whatever in that area, but it’s not full-blown mastitis.

And then we have infectious mastitis. It’s most likely staph. You know, all of that. So we have kind of those three categories. Now I did find one study that I was like jumping for joy about that looked at the duration and outcome of cases with and without medical interventions. And basically those without intervention were compared to those whose treatment consisted of emptying the breasts fully. And some of them got antibiotics if they were classified as infectious mastitis. 

Basically the summary of this is that any treatment beats no treatment. And in the cases with infectious mastitis, about 15% of them did resolve with no treatment. And 11% of those developed into abscesses. Oh yeah. Wait, so what she just said was, if you feel like you might have a clog, do not avoid feeding your baby on that boob. We’re going to, we’re going to start treatment immediately because we have a really positive association between resolving these clogs successfully and using treatment protocols that I will get into after this quick discussion.

Right. And also we need to define what an abscess is. Those of you listening right now who have had one need no explanation. Basically, and I’m going to put this in real layman’s terms here. When you have enough bacteria in there messing around, it kind of deteriorates the linings and the tissues and creates open holes where holes shouldn’t be and your body attempts to wall this off and create scar tissue and all kinds of weird membrane. It makes like a sack. Yeah. It makes a giant sack to try to consolidate all of the shit going on in there. And, and we have a lot of like white blood cells rushing into there and a lot of bacteria reproducing and it gets really painful. There’s pus everywhere if it’s got an outlet.

And often it, it tries to find an outlet. And it’ll find it in your duct. So sometimes the abscess will grow into the duct itself. And then we end up with a situation where we have like puss and ooze and all kinds of gross stuff coming out of your nipple and it’s real painful. And those typically have to be drained and packed.

There’s scar tissue. It is horrendous. And that scar tissue puts you more at risk for clogs later on because all of the reasons we already know. Right. So in, right, and like I said, in this study in the cases where they determined infectious mastitis by measuring leukocyte and bacteria levels for the ones that did no treatment, 15% of them were fine. 11% developed abscesses. 

I don’t know about the others. Anyway, wait, that’s a big, like, why don’t we know about the others? Like you’re either fine or you have an abscess? That’s crazy. Because it was a very short paper. And I don’t know why, but there’s more so but for the, for those who treated by emptying the breast frequently and fully that increased the rate of a good outcome by 50% and significantly decreased the duration of the symptoms.

And then the addition of antibiotic therapy resulted in a good outcome in 96% of cases with a further significant reduction in persistent symptoms. Okay. So that’s just for your mastitis, but I wanted to start there because clogs often develop into mastitis and the treatment is basically the same.

So then in cases of noninfectious inflammation, where we’ve got some bacteria stuff going on, some immune stuff going on, but it’s still under control, the symptoms persisted for several days, if there was no treatment. And about half of the patients in the no treatment group developed mastitis. Yay.

Okay. But in the treatment group, emptying of the breast resulted in a significant decrease in duration of symptoms and significantly improved outcomes. Yay. And there are more details to this study, but I just kind of wanted to give a snippet. It also is not a particularly large study because you know, like I said, money and profit and funding and cows.

But anyway that was one of the few studies that actually looked at whether these treatments work. So let’s talk about what conventional therapies are for this. Maureen, I have a hard spot on the left side of my left breast. It feels firm and a little bit warm to the touch and it hurts. What should I do?

I have some suggestions for you, Heather. Please. It’s 2:00 AM on a Saturday. I’m really afraid. So first, we are going to make sure that you are frequently feeding or pumping on the effected side. Does this mean I only pump on that side? No. Okay. But we are not avoiding it in any way. We are going to use heat and massage and or vibration prior to, and during feeds or pumps.

How am I supposed to vibrate? Well anything that vibrates work. So if you have a lactation massager, wonderful. If you have an electric toothbrush, awesome. If you have a sex toy, even better. Any of those work. Or if you have the massive back massage or called the Thumper that works, but don’t put it on full blast.

You don’t, you don’t need to be thumped. But at this point you can find an electric toothbrush in the dollar store, you know. They’re easy to find and they’re five bucks. So, well, you did a review on the LaVie versus the Lansinoh, right on Tik TOK. Yeah, I did. I did. Go check. I know it was the LaVie versus the Frida Mom.

That’s what it was. Yeah. Go check it out people. Pretty good. Yeah. But really in this case, like anything that vibrates, if you have it, use it. And what I want you to do prior to emptying the breast is kind of in a circle around the affected area, apply that vibration. And then the way that we typically recommend massage is we start from the top of the breast and massage down toward the nipple.

Do not go whole hog people. Yeah. If you already have an inflammatory process happening, you don’t want to massage, like you’re trying to win a prize because you’ll just make it worse and more inflamed. I’m going to call this firm gentle massage. Firm gentle. Yeah. If it hurts, don’t do it. Even if you can’t massage right on the lump, and I don’t want you to like, mash the shit out of that lump, but massaging the rest of the breast is going to help too.

So we’re going to start with that. If you take a hot shower or use a hot compress, that’s great too. Then we’re going to feed her empty. And then after you can apply some ice to the spot or a cold compress. And we always want to do the cold after because cold makes everything shrink up and close up.

So if you do cold before, it’s gonna make it worse. You’re not going to be able to get anything out because everything will be shrunken up and closed up. So heat first then with massage towards the nipple gently, but firmly. Point baby’s nose towards the area of the clog, because that is so they say is where the suction is the strongest.

I just tell people to switch up positions because I have read so many conflicting, like, oh, point their chin to the clog or point their nose, same thing. Yeah, whatever. I’m just going to say, like do your best to change positions throughout the day and night. And don’t feed in the same position all the time.

Do not wear a bra. You know, don’t restrict the flow in any manner. And most clogs resolve with just that within 24 hours. If we have something that is a little more stubborn, I have a couple more suggestions. So second level of care, we still don’t have mastitis, but we still have a clog. We are going to keep doing all those things.

We’re going to add sunflower lecithin supplements. Heather, what dosage do you like to start with? If somebody has an active clog, that’s pretty bad I usually do 1200 milligrams three times a day. Okay. Sounds great to me. We are going to rest. Why? Because we are experiencing an inflammatory process here.

The body is stressed. This is where if it was like 1850, you’d be like, I need to go take the air at the sea. Right. And you get in the carriage and you leave the city to go take the air and just lay around on the beautiful east coast, if only. Yeah. But we’re going to rest and we’re going to take care of this stupid body.

You know, that, that’s how I kind of think of it. Sometimes I’m like, God dammit, you have another freaking clog. Fuck you body. I have to fucking take care of you. Okay. Just drink some water and eat some good food. Take my vitamins and rest. Fine. Drink, some turmeric tea, turmeric ginger lemon tea. Turmeric is very anti-inflammatory.

And also, I don’t know how you feel about this, but I often, if people are really bad with a clog, I will have them do 600 milligrams of ibuprofen, every six hours, 24 hours. I am a hundred percent supportive of it. And so it’s the literature it’s in the Academy of Breastfeeding Medicines Protocol. I always love to know that I’m doing the right thing.

Thank you for validating me. You’re so welcome. Yes, I absolutely will tell anybody. First of all, who’s in any pain from a clog that you can take an analgesic, you can take ibuprofen or acetaminophen. However, in the case of a clog where we have inflammation, ibuprofen is also an anti-inflammatory and it’s going to be more effective.

Yep. So yes, please take that. I will max you out on that dose for three days. Sounds good. Yeah. Then, you know, if we’re still having trouble, I’m going to recommend an Epsom salt soak. It’s a little awkward to just do a boob bath, like a one boob situation, but you can totally do it. You can also just take an Epsom salt bath.

If you have a deep enough tub that your chest is going to be submerged, but not everybody has that. And you can also do the haakaa trick which is pretty fun and I will attempt to describe, but I also have a TikTok video where I show you. So you can look at that. But you fill your haakaa or off-brand similar pump with hot water, but not so hot that you scald yourself.

Do not boil this water. This is just comfortable, hot. Okay. And then I put like a heaping tablespoon of Epsom salts in there. I don’t think it particularly matters, whatever will dissolve. Get it nice and salty. But really fill it to the brim because you want the water actually touching your nipple. And then we’re gonna latch that sucker on and like swish, swish, swish, swish, squeeze it around.

And I have witnessed clogs, like evacuating themselves, just shooting out into the haakaa. And then you look and you’re like, holy cow. But the reason we recommend Epsom salts is that they are emollient, so they soften our tissue and they reduce inflammation. Did you say soft in? I did. I was enunciating. They soft in it for you. Also as an aside, if you see a clumpy clog come out, number one, send me a photo because I love that shit.

It’s like watching the pimple popper. Oh, I love it. It’s like, God, I can feel the sweet release. And also people always ask, what if my baby eats that? They do. It’s fine. It’s fine. They’re like, Ooh, little texture. It’s like eating tapioca, yogurt, yogurt. Thanks, mom. You’ll never know. They’ll just have a big gulp and you’ll never know what even happened, which is why most people don’t experience a clog shooting out of them because usually your baby just eats it and it’s fine.

It’s fine. So yeah, that’s kind of our conventional recommendations. I have a couple extras though that I like. One is acupuncture. So it is very hard to do controlled studies in acupuncture, just FYI. Like double blinded, you know, whatever. Cause anyway, it’s fine. There has been a little bit of study on whether this is effective.

It’s kind of inconclusive, but in my opinion, it is very hard to do harm with acupuncture as long as you were using like clean needles. So if that’s something that’s available to you and you want to try out you absolutely should. And we’ve a great episode on that. So that’s Episode 34, we spoke with a wonderful practitioner and it’s a great interview.

So please check that out. If that’s interesting to you. I also want to mention chiropractic adjustment both for you as the lactating person and possibly for your baby, because here’s the thing about clogs. If it’s a one-off and it goes away quickly, whatever. But if you have a persistent one or they are recurring, there’s something going on in your lactation that just isn’t emptying your breasts enough or is blocking that flow.

And maybe it’s a subluxation for you and that’s pinching some nerves that’s interrupting hormonal signals so you’re not actually letting down effectively. Maybe baby has something going on where they’re not effectively sucking. Yeah. About an interview with the acupuncturist she’s got this most wonderful accent. She says, it’s all about the flow. It’s about the flow and that’s what the clogs are all about. We don’t have flow. You need to go get some flow. Exactly. So consider that if it’s available to you which for most people that’s also covered by insurance pretty well. So think about it. And then I want to mention one more thing.

So typically when we talk about massage, right? I’m like, oh yes, massage, you know, from the outside of your breast, toward the nipple. But sometimes especially if the issue is engorgement, we actually want to do the opposite. We want to do fluid mobilization, aiming to promote drainage toward the lymph nodes.

So like, we want you to recline and massage from areola to your armpit. Even if you do this anyway, it’s not going to harm you. Like, there’s nothing wrong with massaging the quote, wrong way. Any way that you can loosen up what’s going on in there and reduce inflammation and drain fluid is fine. I think it’d be way easier for your partner to do this.

Like if you lay back and actually like get some coconut oil and have them, cause you know, definitely lube it up, I would say. Cause you don’t want to hurt the tissue and just have them gently massage back towards the armpit and towards the lymph nodes in the chest, just to kind of get any additional inflammation out of your body.

Right. And it’s not going to like extra clog it if you massage back up or forward. That’s like don’t have sex on your period or the blood will go backwards. That’s not a thing. And if it does, like if, if the clog loosens, you know, backwards a little bit in the duct, great, maybe it’ll shoot right out. You know, it’s like if you have a clogged pipe and you blow into it and then it comes back out or whatever. What we used to have a spring that we would have to like dislodge gunk from the pipe sometimes.

And your parents made you blow into it? No, not when I was a kid. At my old house. But sometimes we’d have to like blow air into the pipe to like push the clog back and then loosen it and it would actually come through. I don’t know why my brain automatically made you a child who had to orally, like blow into. I’m not a plumber you guys, I don’t know.

Anyway. It’s fine. Okay. So the last therapeutic treatment I want to talk about is frankly, for me, the most exciting. Tell me. Therapeutic ultrasound. Mm mm mm. Yeah, let’s do it. Okay. There is only one study I could find on it. That’s funny because it’s happening all over the United States. Right. And I think that it is a new way that we’re using this technology.

And frankly, just baseline study on ultrasound is lacking just for everything. Even for baby. It was not invented as a medical device, but anyway it’s an industrial imaging invention that was then like adapted to medical imaging. Cool. Yeah. I mean, it’s fine. I’m not like against appropriation of technology, but I’m just saying like, we could study this some yeah, we should. Anyway, but here we are.

And ultrasound study, 25 patients. Just background on them quickly. 24 of them were white. I do not know the race of the other person, but it is not white. 16 had no history of clogged ducts before. 9 had reported previous issues. Most patients were already using heat, analgesics. Some of them were already using sunflower lecithin.

Most of them were also using breast massage and trying to empty the breasts. They were already using these conventional therapies essentially when they came in for treatment. So out of the 25 participants, there were 34 episodes of clogged ducts, and that were reported and treated in this way. 23 of the participants reported a resolution of symptoms after the therapeutic ultrasound.

About half of the participants only needed one treatment with the other half receiving two or three. One patient out of all of these developed mastitis and one was sent on for further care, they were unsure what was going on. So when they put the ultrasound probe on the area, did they just hold it there and the ultrasonic waves jiggle it from the inside? Like what’s happening there?

Yeah. I don’t really know, but that’s kind of the theory. So like you could use your vibrator or for the low, low price of $2,000, you could jiggle it with waves from the inside. But I’m going to say like 23 out of 25 having a resolution of symptoms with this after already trying vibration and massage and all that seems really good.

That does seem really good, but like, I guess. It’s a small study. How does time factor in? Yeah, I know. Age of the baby. I don’t know. There were a lot of other details in the study. We’ll post a link in the show notes. You can read them. Again this is really small, but at the same time, there were no adverse effects reported.

This is the therapy we’re using more and more to reduce inflammation. So I would say if you have persistent clogs and this is available to you, a lot of chiropractors are offering it. It is worth a try. And also let me just circle back on the sunflower lecithin and say that for people that have consistent and persistent clogs after I do the three times a day of the 1200 milligrams, I’ll often keep people on once a day, 1200 milligrams for another week, just to make sure everything’s moving and flowing okay before we wean you off of it completely. 

Yeah. And let me state that again, the sunflower lecithin, we don’t have a lot of data behind oh my God, shocker. But it seems to work pretty well. Pretty low risk. The theory is that it emulsifies the fat within your milk. So it, instead of like making lumps, it’s kind of more well distributed. Yeah. It’s, it’s not getting rid of fat molecules, so it’s not making skim milk. It’s just making the fat more slippery.

Like soap is an emulsifier, you know, so it’s a lot like how soap works. Right. And some, I have had some people who basically have to be on a maintenance dose of this, their entire lactation journey. And I don’t know, personally how I feel about that, but if it works, we’re going to keep doing it. If, if that’s, what’s getting you to your goal.

Right. Exactly. Yeah. So I think I want to conclude here by saying these are really common. It’s good to be prepared. And if you find that this is a repetitive issue for you, then that’s a really good time to kind of put on your like Sherlock Holmes hat, you know, and be like, why? Do I have an over-supply? Am I wearing a bra that is restricting flow?

Is it a repetitive motion issue? Is this my baby being a complete jerk at the boob and headbutting me? Like, is this an issue where I’m not fully emptying my breasts for some reason? Right? So, cause usually what I find is if we can figure that part out, we can stop the cycle. I have occasionally seen this happen as a stress response.

Where, you know, sometimes when we have really traumatic or stressful things happen, it just increases the inflammation in our body. Right. And increased inflammation is going to cause stuff like this to happen. So, you know, not that you can prevent stressful things from happening, but you can also understand like, okay, I just had a really crazy thing happen.

I’m super stressed out. Maybe I’m going to break out that sunflower lecithin and pump a couple extra times and just really massage while I do it and make sure that I’m fully draining. Awesome. Yeah. I think this was great. I hope that this helps you and gives you some kind of a guideline. 

Just a friendly reminder, we do create professional transcripts of every single show that’s available on our website MilkMinutePodcast.com. So if you would like to print out just the part about the treatment, you can print it out and you can keep it in your little, wherever the heck you keep it, put it on the fridge or just read it with your mind so you can remember it when you’re postpartum. Cause you know how that works. 

Absolutely. And also, you know, I want to just add in conclusion, any like super rich people out there feeling generous who would like to fund studies on this? Like please, please. Yes. When are we going to create a running list of PhD projects to try to convince people to do? In our spare time.

Okay. Do we want to give an award? I’d love to do that. I do. It’s like my favorite part of the episode. Also side note, if you would like to be featured in an award, one, you can join our Patreon cause they get first dibs. But you can also just email us or even better, you can make a public social media post and tag us and we will absolutely share that and do that.

Yeah. And this new thing I’m doing is if you get the award and you send me a picture of you and your baby, I’ll put you in our story highlights on Instagram so we can keep track of all the hilarious awards that we give you guys. And you deserve it so much. Yes.

Heather, did you know I have an Etsy shop? Yes, I creep on there regularly. Well, listeners, if you didn’t know out there, I have an Etsy shop with my personal artwork on there. I have stickers, posters, t-shirts, but my favorite items are my surprise mugs. I have a couple of color changing mugs featuring my little illustrations of vulvas and breasts.

And boy, are they a surprise, especially when you give it to your boss that you do not like, and they pour hot coffee in it and labia’s abound. I like to give them to like my mom or dad when they visit. Pour them a cup of tea and watch their face. And really, I think everybody needs these in their home. So if you would like one for yourself or anything else that I make, you can visit etsy.com/shop/thewanderingwom6 that’s etsy.com/shop/thewanderingwom6, but with a six instead of a b. And of course that link will be in the show notes. Thanks.

Today’s award goes to Maria Elkady. I hope I’m saying your last name. Maria is in our breastfeeding support group on Facebook called Breastfeeding for Busy Moms. And she says, my son is officially one year old as of December 22nd. I’m proud to say I made it to one year of breastfeeding while working full time.

I reached my goal and I’m so thankful for this group and the support and knowledge I received along the way. It wasn’t easy, but glad I kept going, despite having mastitis three times, sick multiple times and having many clogged ducts. Photo of my son as a newborn to now and look how cute he is. Oh, okay.

Okay, Maria, I want to give you the Clogging Queen award, the Clogging Queen. Piggyback on your dad joke from earth. Everyone try really hard not to picture Maria in tiny wooden shoes. I just see, it’s impossible. But congratulations on making it a year through all of that stuff you had to deal with. And thank you so much for telling us about it so we can celebrate you.

Yes, and I empathize with having a Christmas baby. I am a Christmas baby and I made a Christmas baby. So I’m here with you throughout those holiday dramas and best of luck to you moving on after a year of breastfeeding. All right. Well, before we head out today, I want to thank some new patrons. Okay. So thank you, Destiny Brown from Batavia, Ohio.

We’re super happy to have you. And thank you also to Annie Weismeyer. She is from Cincinnati, Ohio. We’re super happy to be welcoming Ohioans here, even though we’re from West Virginia. Oh, hi. Oh, hi guys. I love that. Okay, well welcome. And if you guys are interested in our Patreon you can go to Patreon.com/MilkMinutePodcast and consider joining us.

Thank you for tuning into another episode of the Milk Minute Podcast. If you found some value in our content today, and you want to help us change this big system that is not made to support lactating parents, you can tell a friend about this podcast. Yep. Tell a friend, thank you for educating yourselves.

Educate your children. And don’t forget you can always make a small donation, which goes directly back to supporting this project and making it more sustainable. And you can find us on Patreon.com/MilkMinutePodcast. Thank you. Bye-bye bye-bye .