Medication safety while breastfeeding is an area that is often unnecessarily controversial, and rife with miscommunication. Many health practitioners, simply not understand the underlying principals of drug safety in lactation, will advise breastfeeding parents to “pump and dump”, prematurely wean before starting medications, or withhold important medications “just in case”. The main problems here are pretty clear when we consider that the majority of medications are safe to take while breastfeeding; women are either denied beneficial/necessary medications while they’re lactating, or they are ..read more

PMDD, or “pre-menstrual dysphoric syndrome”, is like PMS’s evil step-sister. Occurring in the 1-2 weeks before someone’s period, PMDD is a serious mood condition that is treatable with both medications and non-medication strategies. While pre-menstrual syndrome (PMS) causes symptoms like irritability, bloating, physical discomfort and fatigue, these symptoms are usually relatively manageable and don’t cause any issues with functioning day-to-day. PMDD ramps all of this up, leading to symptoms like Severe irritability, anger & rage Anxiety Depression Fatigue Anhedonia (low motivat ..read more

In this post, we’re continuing the discussion around the basics of milk production. Find Part One here. Labour and delivery. Phew. For those who experience it, labour involves a physical, emotional and hormonal journey, and for some, a profoundly spiritual one. Much of the hormonal changes that occur during labour help to prepare the body for breastfeeding and bonding with your pēpi. Labour can be wonderful, and terrifying, and traumatic, and blissful, and painful, and confusing. Caesarean sections can also be wonderful and terrifying and traumatic and blissful and confusing (hopefully not pa ..read more

You may have heard the term “functional lactose overload” when referring to fussy, unsettled babies. We’re used to the idea of “lactose intolerance” for adults, but how is this different from functional lactose overload in infants? Lactose is a “disaccharide”, which means that it is made up of two separate sugar molecules (glucose and galactose - “monosaccharides”) joined together. Lactose needs to be broken into these two individual sugars by the enzyme lactase (produced in the small intestine) to be absorbed and used as energy. Many adults (and older children) no longer produce adequate am ..read more

“Self-settling” is such a buzzword in the infant sleep space. But what does it even mean? What is “self-settling”? A quick google search of the term takes me to several articles written by sleep trainers that suggest that self-settling is a “cognitive skill” that needs to be taught to infants from 4 months of age and that not teaching this crucial skill leads to sleep deprivation and an “over-reliance” on “negative sleep associations”.  In fact, this is often the goal of sleep training - to teach a child not to need their parent’s help to get back to sleep. To teach them to calm themselv ..read more

Parents are often told not to breastfeed their baby to sleep because it will damage their baby's teeth - or that if they "have" to do it, to brush their baby's teeth or wipe their mouth after feeding. Many parents are left feeling guilty or struggling with the logistics of how to brush their teeth after feeding when feeding is every 1-2 hours. So, what’s going on here? “Dental caries” is a chronic condition caused by acid-producing bacteria in the mouth damaging the hard surfaces of your teeth. Child teeth should look white and sparkly - any grey/brown discolouration is abnormal. The evidence ..read more

Maybe you’ve started leaking colostrum already, your midwife has suggested collecting colostrum, or a friend has shared this article with you. Either way, lets talk about expressing milk during pregnancy. Antenatal expression of colostrum involves hand expressing small amounts of colostrum during pregnancy, usually in the late third trimester (from 36 weeks). There are two main reasons someone might want to express colostrum To get comfortable with the skill of hand expression To have some colostrum on-hand in case their baby needs topping up after delivery. Both of these can be extreme ..read more

By Nicky Cooper You've had a significant traumatic experience in your journey into motherhood. This left you feeling deeply scared to your core like you had no control over what was happening to you or your baby. You know that your partner had/has similar feelings about your experiences. And the bottom line is that this made you feel REALLY, REALLY unsafe. This is definitely not how it was supposed to be. Some time has now passed, you're through the hardest yards, and everyone has kind of moved on. Except you. You still have flashbacks of the absolute fear and terror you felt at that time. Th ..read more

From time to time I’m asked to recommend other health professionals around Aotearoa for those who prefer to see someone in person. Here is my list of colleagues who I have worked with and can happily recommend. Some do mainly breastfeeding, some do mainly sleep, and some do both so you’d need to get in touch with them individually to work out who is best for you to see. Please note that this is not an exhaustive list of all the health professionals working in lactation and/or sleep - it’s just a list of people I have personally worked with professionally and can therefore wholeheartedly recomm ..read more

The current thinking about mastitis has changed significantly in recent years, and the release of the new Academy of Breastfeeding Medicine protocol on the mastitis spectrum along with Dr Pamela Douglas’ papers on the inflammatory spectrum of the breast (one and two), has resulted in a complete shift in our understanding of the underlying causes, assessment and management of mastitis*. Once thought to be a purely bacterial entity that required antibiotics (and not much else) to treat, we now think of mastitis as a being on a spectrum, with microscopic damage to the lactocytes (breast cells) on ..read more