First Flight Lactation

10/20/2026

100%!!

“Your baby has lost more than 10%. We need to start top-ups.”

I hear this so often: a baby crosses a weight-loss threshold, a top-up protocol kicks in, and suddenly parents are questioning whether breastfeeding is working.

But for an otherwise healthy term newborn, more than 10% weight loss should trigger a thorough assessment and skilled breastfeeding support, rather than automatic supplementation.

The Academy of Breastfeeding Medicine’s Protocol #3 states:

“Ten per cent weight loss is not an automatic marker for the need for supplementation but is an indicator for infant evaluation.”

Why does this distinction matter?

Unnecessary top-ups can mean less feeding at the breast and less breast stimulation, which can reduce milk production. They can also undermine a mother’s confidence. Early formula supplementation is associated with shorter breastfeeding duration. And there is emerging evidence that it increases food allergies. (Bhasin et al. 2026)

A recommendation intended to help can therefore make breastfeeding harder, particularly when the underlying difficulty hasn’t been addressed.

And has anyone asked about IV fluids during labour or birth?

Fluids given to mum through a drip may also affect the baby’s fluid balance. Some babies may carry extra fluid when their birth weight is recorded, then pass it as urine after birth.

That temporarily higher starting weight can make the percentage lost afterwards look larger. Some early weight loss may therefore reflect fluid shifts, rather than insufficient milk intake.

Parents deserve more than a top-up instruction.

They deserve someone with breastfeeding expertise to watch a feed, assess milk transfer, consider baby’s age, nappies and overall wellbeing, and provide practical help.

When extra milk is needed, the plan should also support milk production, address feeding difficulties and include follow-up.

You can ask:

💬 “What, alongside the weight loss, suggests my baby needs extra milk?”

💬 “Have the IV fluids I received been considered?”

💬 “Can someone with breastfeeding expertise watch a full feed?”

💬 “If top-ups are needed, how will you help me protect my supply, and when will you review them?”

If you followed advice to supplement, you did what you believed was best for your baby. The responsibility sits with services to provide thorough assessment, clear explanations and skilled support.

Hospital protocols should protect babies while supporting breastfeeding. A percentage should prompt us to investigate, rather than automatically determine the top-up feeding plan.

Save this for your birth preparation, or share it with someone supporting new parents.

Reference: Academy of Breastfeeding Medicine, Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate (2017).

Bhasin M, Cooper M, Macchiaverni P, Joys RS, O'Sullivan TA, Keelan JA, Venter C, Palmer DJ, Lowe AJ, Prescott SL, Silva D, Verhasselt V. Colostrum as a Protective Factor Against Peanut Allergy: Evidence From a Birth Cohort. Allergy. 2026 Feb;81(2):552-562. doi: 10.1111/all.70043. Epub 2025 Sep 18. PMID: 40968490; PMCID: PMC12862506.

09/28/2026

Chin to breast!

09/22/2026

Take a prenatal breastfeeding class and make a plan to meet with an IBCLC the day after you’re discharged home!

08/19/2026

08/12/2026

When milk supply was good and then drops, ask WHAT CHANGED??

The biggest mistake I see when milk supply starts to drop? Trying to fix the supply before figuring out WHY it dropped in the first place

When milk production changes, it can be tempting to grab the first solution someone recommends. A supplement. More water. Lactation cookies. A new pumping schedule. Eating oatmeal. Whatever worked for your mom friend, your sister, or someone on TikTok

But milk production is a physiological process. If milk isn’t being removed effectively or frequently enough, adding random “milk boosters” doesn’t fix the reason production changed

Here are some of the most common mistakes I see:

1. Ignoring fl**ge fit

A fl**ge that is too large, too small, or simply doesn’t work well for your anatomy can cause pain, swelling, ni**le trauma, and inefficient milk removal. And no, 24 mm is not a universal fl**ge size

2. Using a pump that isn’t working well for you

Pump performance matters. A pump can be technically functioning and still not be effective for your body. Worn pump parts, damaged valves or membranes, clogged tubing, water getting into the tubing, or a pump that simply doesn’t provide effective milk removal can all matter

3. Assuming the baby is transferring milk well

A baby can nurse frequently and still not remove milk efficiently. An inefficient latch, oral-motor differences, or a tongue restriction can sometimes contribute to ineffective milk transfer. If baby isn’t removing enough milk, your body isn’t receiving the same production signal

The answer isn’t always “feed more.” Sometimes we need to figure out why feeding isn’t effective

4. Dropping night feeds or pumping sessions too early

Your breasts don’t know that you’re trying to sleep through the night. They respond to milk removal. For some mothers, eliminating a nighttime feeding or pump session can be completely compatible with maintaining supply. For others, especially earlier postpartum or when supply is already vulnerable, suddenly removing that milk removal can cause production to decrease

5. Treating a sleep-training schedule like a milk-production schedule

A schedule designed to help a baby sleep isn’t automatically a schedule that protects milk production. If longer stretches of sleep mean substantially less milk removal, your supply may respond accordingly. This doesn’t mean you can’t sleep. It means we need to look at the whole feeding picture and make sure your milk removal is adequate for your goals

6. Not allowing cluster feeding

Cluster feeding can be exhausting, but it is also a normal way babies increase milk removal. If you’re following a rigid feeding schedule that tells you to stretch feeds or prevent frequent nursing when your baby is clearly asking to eat, you may inadvertently reduce the stimulation your breasts are receiving

Your baby isn’t a robot. Neither are your breasts

7. Following someone else’s protocol instead of your baby’s physiology

Moms on Call, schedules, routines, feeding plans, and advice from friends can be helpful tools. But no protocol knows your baby’s milk transfer, your breast storage capacity, your pumping response, your supply history, or your individual goals. A schedule that worked beautifully for someone else may not be the right strategy for you

8. Not eating enough

Your body needs energy and nutrients to support lactation. If you’re chronically under-eating, especially while recovering from birth and caring for a baby, it’s worth looking at whether you’re getting enough overall calories, protein, fat, fiber, fluids, and micronutrients

You don’t need a magical lactation diet of expensive cookies, chalky oats or herby teas

You need enough food

9. Reaching for supplements before fixing the problem

This is probably my biggest pet p*eve. If your supply is dropping because your fl**ge doesn’t fit or your pump parts need to be replaced, a supplement your friend swears by probably isn’t going to fix the problem. If your supply is dropping because your baby isn’t transferring milk efficiently, chugging a gallon of water isn’t going to fix the problem either. And yes, drinking excessive amounts of water beyond thirst can actually be counterproductive. Hydration matters, but more water does not equal more milk

The same goes for lactation cookies, teas, powders, tinctures, and every other “milk booster”. Sometimes they aren’t addressing the problem because they aren’t the problem

‼️The most important question when milk supply starts to dip isn’t:‼️

“What can I take to make more milk?”

It’s:

“What changed?”

Did milk removal decrease?
Did baby start transferring less effectively?
Did you change pumps?
Are your pump parts worn?
Did your fl**ge stop working well?
Did you drop a feeding or pumping session?
Did you start sleeping longer stretches?
Are you restricting feeds because of a schedule?
Are you eating enough?
Are you experiencing pain?
Is there an underlying medical or hormonal issue?
Did your period start back?
Did you go back to work?
What is baby’s feeding schedule?

There are MANY possible reasons milk production can decrease

And the best strategy depends on the reason

So before you try the thing that worked for your mom friend, take a step back and figure out your root cause

Because you don’t fix low milk supply by throwing solutions at it

You fix it by figuring out what your body is responding to and changing the thing that needs to change

08/10/2026

The fat in your milk accounts for 50% of the calories your baby takes in each feeding. While protein and lactose remain relatively stable throughout the day, milk fat concentration can vary by 47% in a 24 hour period!

Factors that influence milk fat in breast milk:
🤱🏽 Things that influence the amount of fat in your milk include: Lifestyle, Diet, Body size, Health or disease/inflammation, Number of children, Type of birth, Overall milk volume produced daily

👶🏼 In the baby, your body will respond to make specific milk for your baby based on their Gender, Gestational age, and Birth weight!!!

🍫 Other factors that influence fat in human milk:
⏰ Time of day (highest fat is in the afternoon/evening)
👶🏼 👧🏽 Stage of lactation (colostrum has the lowest amount of fat. Extended milk for toddlers 12+ months has the highest amount of fat!)
🗓 Time postpartum (milk fat increases with time!)

Ways to help increase milk fat:
🤱🏽 Feed more frequently. The shorter you go between feedings, the higher fat and lower water concentrations are in your milk
⭐️ Shake your breasts prior to feeding. This gets the fat at the back of the breast to be activated more quickly to flow sooner in the feeding
🙌🏻 Breast compressions while feeding and pumping increases the amount of fat that is squeezed from the breast during feeding
🐠 Add in healthy fats to your diet: salmon, herring, sardines, flax and chia seeds, and walnuts are high in healthy fats that can boost those kinds of fat in your milk
🍦 Manage diabetes/blood sugars
🏋🏽‍♀️ Make sure you’re not anemic or iron deficient
♨️Reduce inflammation in the body (can often be done with diet and lifestyle changes and/or with the help of a naturopathic practitioner)

breastmilkbag breastmilkbooster breastmilkbottle

08/10/2026

How you labor matters. Having a IV placed has become a standard with hospital births. They are often set to continuously drip while in labor. These fluids don’t just hydrate you, they cross the placenta and also enter your baby. Why is this a big deal? Research suggests that these fluids can actually inflate your baby’s birth weight. They will p*e this fluid out, usually as the first day progresses. So why does that matter if they’re going to p*e it out anyway? Birth weight is the first data point used by healthcare providers to know if baby is feeding efficiently when feeding from the breast, since there are no markers on breast or baby telling us how much they get from feeding

It’s OK for babies to lose weight after birth!! Long standing research shows up to 7-8% of birth weight in the first few days after birth (while drinking the first milk, colostrum) is acceptable, and then once milk transitions they should regain back to birth weight by 10-14 days. We also expect only 1 (2 at the most) p*e diapers on their first day of life. If they are born with excessive fluids, their weight can be inflated and when they p*e this fluid off, the weight loss can be exaggerated. Once a baby loses 10%, supplementation is always recommended as the standard of care to ensure baby is getting the nutrients they need

This can lead to the assumption that baby isn’t feeding well even if they are. It also puts needless pressure for milk supply to “come in” or increase to volumes beyond what the body would typically make at that stage of lactation. Coincidentally, too much fluids can also delay colostrum transitioning to mature milk and increasing in volume as well as cause excessive swelling in the breasts which makes latch more challenging!! This also results in an increased chance of formula supplementation (with or without initiating pumping) which is often associated with a shorter duration of breastfeeding than what was initially intended by the family

How you birth matters. Knowing what happens to your body and baby’s body is so important to help you figure out your journey

📸 Lauren Archer (she/her)
Midwife pictured: the amazing Faith Free

07/31/2026

Want to make fattier milk??

“If you want fattier breast milk, just eat more avocado.”

No.

“Drink whole milk.”

Nope.

“Eat more butter.”

Yeah, no.

One of the biggest myths in breastfeeding is that you can dramatically change the fat content of your milk by changing what you eat.

You can’t. Your body isn’t making a smoothie out of your lunch. The amount of fat in breast milk changes throughout a feeding, throughout the day, and from one pumping session to the next. The biggest factor isn’t whether you had salmon or ice cream yesterday, it’s how full the breast is and how long you’re going between feedings.

When the breast is very full, fat globules tend to stick to the milk-making cells, so the milk flowing out at first is relatively lower in fat. As the breast empties, more of those fat globules are pulled into the milk, increasing the fat concentration.

That’s why milk from a fuller breast often looks thinner than milk pumped after the breast has been emptied more. Babies cluster feed for this same reason. The more often they come back to breast, the lower the overall volume, but the higher the fat content. When they cluster feed at night, they’re getting a fattier milk to help them sleep and not p*e over night.

Can your diet affect breast milk? Absolutely. The types of fats you eat influence the types of fats in your milk, but not the amount in it. For example, eating more omega-3 fatty acids increases the omega-3 content of your milk. Your diet also affects some vitamins and micronutrients. But there is very little evidence that eating specific foods will magically make your milk significantly higher in total fat or calories.

So if someone tells you your baby needs “fattier milk,” the better question is: WHY?

Is baby transferring milk well? Is baby gaining weight well? Is milk supply adequate? Is there an oral motor issue? Are feedings effective? Is there an underlying medical concern?

Those questions matter far more than adding an extra avocado to your toast. And if your baby isn’t gaining weight on your breast milk the first step is to feed more milk to the baby or breastfeed more often. This naturally gives baby more milk and a higher fat content even in lower overall volumes.

Save this for the next time someone tells you to eat a stick of butter to make “creamier” breast milk. And if your baby isn’t gaining weight well on breast milk alone, work with a local IBCLC (or me in a virtual appointment!!!) to figure out why. Go to lalactation.com to book your appointment today.

07/26/2026

Pacifier shapes and uses explained so well by LA Lactation!!

Walk into any baby store and you’ll find an entire wall of pacifiers.

Round. Orthodontic. Flat. Symmetrical. Cherry. “Breast-like”. Glow in the dark. Silicone. Natural rubber.

The packaging often promises the “best” shape for oral development. Which can make picking one so challenging.

As a SLP/IBCLC, I don’t believe there’s one perfect pacifier for every baby. The shape matters less than how, when, and how long it’s used.

🍼 First, let’s remember what breastfeeding actually looks like. During breastfeeding, we want to see the tongue create a deep cupped shape around the ni**le and areolar tissue. The sides of the tongue lift up around the ni**le while the middle of the tongue forms a groove that helps hold the breast securely. Gentle wave-like movements from front to back help remove milk while the jaw opens widely and rhythmically. A breast isn’t held in the mouth by suction alone. It’s an incredibly coordinated movement involving the tongue, jaw, lips, cheeks, palate, and nervous system. That beautiful cupping pattern is what we often work to encourage in babies who struggle with latch.

💤 Sleep is a little different. When babies are resting and not actively feeding, we want the tongue to relax up against the roof of the mouth. The tongue resting against the palate supports healthy nasal breathing and normal development of the upper jaw.

So feeding and resting actually involve two different tongue postures. One requires active cupping and peristaltic movement. The other is quiet, relaxed elevation of the tongue.

🍼 So what about pacifier shapes?

The three most common designs are:

• Round (Cherry)
The round shape (think Philips Avent Soothie, Dr Browns Happy Paci, Ninni co, Momi, Nanobebe) allows the tongue to cup around it. I often like these when we’re working on suck training because they encourage babies to organize a more rounded tongue shape. Some babies who struggle with tongue coordination respond beautifully to them. They are not all created equal and some are better than others at promoting the wide, deep latch of the breast

• Orthodontic
Usually flattened on the bottom with a rounded top. (Nuk, Ryan&Rose, Chicco all have these shapes) The idea is to reduce pressure on developing teeth and encourage the tongue upward against the palate.

• Flat
The Mam is the most common flat pacifier, but other brands like Dr Browns Advantage, Cutie Pat, etc also have them. Because the tongue doesn’t have to cup they can be easier for some babies to keep them on their mouth. I’ve also seen babies who gag easily on the round pacifiers tolerate these better for soothing. Some babies strongly prefer these while others simply won’t keep them in.

Every baby is different. Some babies immediately spit out every round pacifier but happily soothe with a flat one. Others gag easily on longer pacifiers but can do ok when it’s shorter. Some won’t take any pacifier at all. Some take anything you put in their mouth. We have to look at the unique baby to determine which pacifier could be a good option for them based on why we are using it.

There is currently no strong evidence that one pacifier shape is universally superior for every baby’s oral development. In fact, the American Academy of Pediatric Dentistry has specifically called for more research comparing pacifier designs because the evidence simply isn’t definitive yet.

🦷 What the research does show is something different. The biggest concern isn’t usually the shape. Its duration, intensity, and frequency.

A baby who sucks vigorously on any pacifier for hours every day over many months places repeated pressure on developing teeth, the palate, and the growing jaws. That prolonged force (not simply the silicone shape itself) is what has been associated with changes such as anterior open bite, posterior crossbite, and narrowing of the upper arch. The longer the habit continues, particularly beyond toddlerhood, the greater the likelihood of these changes.

Every baby’s oral anatomy is also unique. A baby with a naturally high palate, strong suck, oral tension, tongue restriction, low muscle tone, or different jaw growth may respond differently to the exact same pacifier.

That’s one reason I hesitate when lactation consultants recommend one shape as “the best for breast.”

Human development simply isn’t one-size-fits-all.

❤️ How I recommend using pacifiers

I think pacifiers are wonderful tools. Tools. Every tool has a specific job for a specific reason.

• Helping babies settle in the car.
• Transitioning to sleep during naps and bedtime.
• During “rest and digest” time when babies simply need comfort.
• During medical procedures.
• For some babies, supporting organized non-nutritive sucking to support sucking during feeds.

I don’t recommend using a pacifier to stretch feeds or convince a hungry baby to wait longer to eat. Hunger should always come first. And once the pacifier has done its job? Take it out. If your baby falls asleep and it gently falls from their mouth, you don’t need to keep replacing it throughout the nap. In fact, the AAP advises that if it falls out after the baby is asleep, there’s no need to put it back. The pacifier’s job is to help the baby soothe, not continuous suck all day long.

🗓️ When should you wean?

There isn’t one magical birthday. However, here’s what many pediatric and dental organizations recommend:

• Around 6–12 months, begin gradually limiting pacifier use to sleep and comforting situations.

• By 2 to 3 years, most children should be completely weaned to minimize the risk of lasting dental changes. The AAP recommends dental evaluation if non-nutritive sucking continues beyond age 3, while the AAPD encourages discontinuing pacifier habits by 36 months.

✨ My approach?

If I’m doing suck training or helping improve tongue organization, I often reach for a round pacifier because I like how it allows the tongue to cup around it. The Ninni Co, Dr Brown’s Happy Paci and Avent Soothie all have a place with different babies for working on different oral motor skills

If we’re simply using a pacifier occasionally for soothing or sleep? I’m much less concerned about whether it’s round, orthodontic, or flat. I’d rather choose the one your baby actually accepts, use it thoughtfully, and avoid having it in their mouth all day.

Because in the end, healthy oral development isn’t determined by one piece of silicone. It’s shaped by feeding, breathing, muscle function, genetics, growth, and the countless little experiences that help a baby’s mouth develop over time.

Pacifiers can absolutely have a place in that journey,
they just work best when they’re used intentionally, not constantly.

I’m curious… did your baby have a strong preference for one pacifier shape, or refuse them all?

Schmid KM, Kugler R, Nalabothu P, Bosch C, Verna C. The effect of pacifier sucking on orofacial structures: a systematic literature review. Prog Orthod. 2018 Mar 13;19(1):8. doi: 10.1186/s40510-018-0206-4. PMID: 29532184; PMCID: PMC5847634.