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Episode 95: Plugged Ducts & Mastitis with Victoria Rothbard, CLC

, , , , , January 25, 2023

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Jacqueline Kincer 0:38
Welcome back to the Breastfeeding Talk Podcast. I’m your host Jacqueline Kincer. And today I am joined by Victoria Rothbard. And you’re gonna get to know her today, but I’ll tell you a little bit about her first, she is a mom to a rambunctious two and a half year old and she was sat on nursing for at least one year but faced countless challenges throughout her journey, including recurrent plugged ducts and mastitis. She often received conflicting advice and quickly learned there’s a lot of misinformation out there regarding breastfeeding, determined to help others avoid her mistakes, Victoria decided to become a certified lactation counselor, and provide parents with evidence based support. With some perseverance and a lot of help Victoria managed to surpass her breastfeeding goal. And nurse her son passed the one year mark, you can actually find her on Instagram at pluged duck diaries, which is how I found her and how we’ve connected for this podcast today. And she shares up to date information on breastfeeding and all things related to plump ducks and mastitis over there. So welcome, Victoria, I’m thrilled to chat to you today. It’s gonna be an awesome conversation super helpful for our listeners.

Victoria Rothbard 1:49
Thanks so much for having me. Jacqueline, I have followed you on Instagram for a long time. I’m an avid listener of the podcast. So kind of surreal to actually be a guest on the podcast today. But really thrilled to have the chance to chat with you share a bit more about my journey. Yeah, absolutely. No, it’s always awesome to connect. And I love when people have listened to the show. And then they get to be honored or a part of it somehow. So yeah, it’s amazing. And now you’ve got your toddler. But I would love to hear how things got started with you in the very beginning in terms of breastfeeding and anything relevant there, you’d love to share if there’s anything regarding your pregnancy or birth that led up to certain things because everyone gets their own unique start to postpartum and breastfeeding. And I always feel like that helps provide some awesome context for listeners.

So I definitely want to provide like some details. And I feel like, as you mentioned, I ran into a lot of obstacles along the way, I feel like kind of every, you know, thing that could sabotage breastfeeding was thrown in my direction, unfortunately. And so I’d love to like touch on those and talk through how my journey progressed to get to the point that, you know, I really enjoyed breastfeeding. And it’s one of the things that I’m most proud of, that I’ve been able to accomplish. So I think, you know, my, my journey got, maybe not really a typical start. So I actually was pregnant and gave birth abroad while I was living in Turkey with my husband, who is Turkish. And so you know, this was during the height of COVID, there were moments that I thought maybe I would go back to the US to deliver but you know, with everything that was happening, it just made sense to stay where I was, I had a great doctor who was a family friend there. And so that made me feel really comfortable and feel like, you know, I could do this thing abroad, and I would be fine.

And, you know, my pregnancy was pretty normal. And up until the birth, you know, I got into the hospital and my water had broken. And I think I was in labor for about 18 hours did have an epidural, but that was after like 12 hours of labor. And you know, just to kind of, you know, progress things faster, the doctor did decide to vacuum out my son. So I think you know, because of that it was just, you know, very painful. I mean, all moms have recovery and stuff like that, right. But I think with the addition of that intervention, I did have, you know, a lot of pain afterwards and trouble sitting.

And I think that was a hard thing for breastfeeding too. Because when I was in the hospital, I was seeing a lactation consultant. And the first time she came in, I was nursing my son lying down. And she quickly told me that I needed to sit up and so in that moment, I was like, Okay, there’s something wrong with this, right? It was comfortable for me at the time, but the way that she responded made me think that it was unsafe for my son. And so from that kind of moment on I was always doing, you know, sitting and doing cradle holds which was not comfortable for me and you know, probably translated into it not being comfortable for my son. And so I think you know, down the line, there were a few other things that happened in the hospital, which created some some challenges for me. Another thing was when the lactation consultant came in, she told me that my nipples were flat and I needed to use the nipple shields. And so my husband quickly ran out, got me nipple shields, I think that the hard thing was I wasn’t really instructed on how to wean from those nipple shields. Later on, I didn’t really understand like how long I needed to use them and that type of thing.

And so, you know, when we were discharged from the hospital, I wasn’t there long, probably like 24 hours after I gave birth, I got home and, you know, that’s when it all kind of like set in that I really needed to figure this out. And so I had my nipple shields, and, you know, it’s just uncomfortable to carry those around to sanitize them all this stuff. And then I later found out that, you know, there might be issues like transferring milk with, with nipple shields, and it can affect milk production. I think that, you know, I was lucky, I think that my milk production was fine, but then I am a working mom. And so when I was, you know, about like, a month and a half in, I decided to get one of those suction pumps like a hookah pump, because I had convinced myself that I needed a freezer stash. And so you know, based off of that, I decided that I was going to use the hookah because I really didn’t enjoy like the regular type of pumping, I tried it like once or twice, like adding in a session to try and have a little bit of milk to store for my son, but I was just exhausted, you know, nursing every two to three hours or so it was a lot. So I decided that I was going to try this Hukka. And with that, too, I didn’t really have any instruction on like, how to use it, how often to use it.

And so what I ended up doing was basically every time I was nursing my son on one breast, I had the Hukka on the other breast and then he would switch breasts and then I would put the hook on the other breast. So I think that you know, what ended up happening was I had actually created an oversupply think I had potentially trick my body into thinking that I was nursing twins, because my breasts were being so stimulated at each session. And through this process, I started to have a lot of issues with plug docks, lots of lumps in my breasts, which are really painful. And I think this is when you know, my journey got really challenging because I just I didn’t know where to start in terms of like how to treat the plug ducts. And they seem to keep coming back. And when I looked online, which was the first place I went, I found you know, kind of a list of like 101 things that you can do to unplug and plug dots from, you know, doing a deep tissue massage, using an electric toothbrush on your breast, you know, using an Epson salt, so all of these things dangle feeding, where you’re positioned hanging over the baby. And that position also, you know, like I hurt my back doing it and all of these things.

So you know, it was just kind of this like a Olympics to try and get the plug ducked out, and I would get it out. And then you know, a few days later, it would come back again. And so I was really, you know, just kind of exhausted and upset by this point, I did start contacting different providers that I had. And so I think that, you know, I had heard of lactation consultants or I had one in the hospital before my gynecologist had someone who was working with him. But I think that I also like reached out to a pediatrician to my gynecologist himself. And so, you know, everyone was kind of giving me different advice, the pediatrician was advising some things that were not really what I had heard of before and, you know, didn’t really seem to be right. But I was like, I don’t know, I guess I can, you know, try this out. And then I think like kind of where things peaked in terms of, you know, these episodes of clogged ducts. Typically, it was just one breast that had like the lump and the swelling and redness. But there was one time that it was both breasts. And so, you know, that was just very scary, like I was reading online that it was dangerous to have both breasts like that. So I decided to call my gynecologist with the lactation consultant there and go and see them. And this basically led to you know, her doing a very, like forceful deep tissue massage on both of my breasts.

And I had told multiple people that this was actually more painful to me than labor was because it was just, you know, my breasts were so tender and sensitive, and they also tried to, like, get some milk out. And then I think I left leaving there thinking that that’s what I needed to do, you know, to be able to like treat this. So I was under the impression that I needed to do these really, frankly, painful deep tissue massage is to relieve myself from this pain, and no one can really tell me like why these kept coming back a little bit after that I did finally like see another lactation consultant quite found on Instagram, that one provide me with some ideas, but not really like anything that I hadn’t tried before and didn’t mention anything about like the pumping so I just kind of continued on continued pumping that it wasn’t until a friend of mine had mentioned that you know, maybe you should stop with the pumping because maybe you have an oversupply and maybe that’s causing some issues for you. And so I was able to cut out the the pumping session and get to the point that the plug ducts kind of just like magically went away one day it was this weird thing where I guess I always felt you know, to be very full and then It got to the point where, you know, I just felt like a normal breast. And I realized that’s actually how it should have felt the whole time.

But it was probably just engorged beforehand. So I think that that led to the point where I had a much better breastfeeding relationship with my son, I had gained the confidence again after that to do sideline again, which was great, because that was so comfortable. And that just made breastfeeding. So easy for me. And so you know, when I talked to like friends and other moms now, I just always recommend sideline because it’s just often very comfortable for moms. And it makes it easier for the baby to latch. You know, after all of this, and all of my struggles, I really wanted to, you know, learn what the evidence was saying about breastfeeding. And so I decided that I was going to study to be a certified lactation counselor, thankfully, because of COVID. You know, previously, you had to go in person and do these courses and examination, and I could actually do all of that online, which made accessible for me, and that was great. And so I went through that process, and then was actually able to find out like what the literature says about breastfeeding, what the most effective methods are things like that. And so through that I’ve really been able to, you know, be able to be a source of the right information, evidence based information for new parents, and I’ve been able to, you know, use that to spread information on social media on the the account that you had mentioned before club duck diaries, and really be able to help moms and parents who are struggling with the same kind of issue.

Jacqueline Kincer 11:30
Oh, I love that. Yes. Oh my gosh, so many things, there’s so much to unpack, too, that I feel like we’ll dissect as we’re talking. Because, you know, your experience that you just described is sadly, so incredibly common. And fill in the blank with, you know, plug duct or low milk supply or baby that won’t latch, right. Like there’s, you know, pick, pick your choose your own adventure. But you know, I think so many of us can relate to what you said. And honestly, no matter where you are in the world, this is a very common thing that happens. And, you know, it’s wonderful that you’ve taken that step to go and get that certification and put that information out there. But it also is really, really sad that you felt like that was the only way that you could get access to evidence based information or really understand breastfeeding better. And it’s just such a disservice that sort of society and the healthcare system and you know, culturally, oftentimes that plays a role that, you know, happens to moms, because you’re the one who’s breastfeeding multiple times a day, and the fact that, you know, pretty much everyone who’s doing it unless they’re pretty seasoned out or has, you know, really taken that initiative to go and learn more on their own, you don’t really have a good handle, it’s not something you have a great understanding about. It’s this mysterious thing, you know, why do the clogs keep coming back? Or why? How can I tell if my baby’s getting enough milk or like all of these questions that moms have about their bodies and breastfeeding? And they really don’t feel like there’s a definitive knowing or answer along the way. So I love that you’re out there working and provide clarity and I think clogged ducts and gorge men and mastitis, you know, they’re often really misunderstood. It’s it is one area of lactation that I feel like, has so much misinformation. And to your point, you know, if you go online, or you ask somebody, you know, there’s 101 Plus ways that you will be told to manage this, many of them incorrect or not helpful, sometimes harmful, like you mentioned about the massage. So, my goodness, I do have a question about your journey, though, before we get into some of that stuff. Which is you started out with a nipple shield, you weren’t given guidance on how to wean from it. Which, again, sadly, so common, did you ever get off of the nipple shield? And like, how far out postpartum was that? Or did you could just continue with it?

Victoria Rothbard 13:54
Yeah. So I think it was about like, six weeks postpartum, I was able to wean from it. And, you know, it was a process, right? Kind of like starting out with the nipple shields and then being able to slip it away. And, you know, just have my breasts fall into my son’s mouth. But it was, you know, this whole kind of, I think, probably even more of a mental challenge than anything, because in my head, I had, you know, this lactation consultant telling me that I had flat nipples, and I needed a nipple shield. And so, you know, it wasn’t until I started my coursework, become a Certified Lactation counselor that, you know, I realized that babies can nurse any kind of nipple, right? Well, we’re all born with different types of nipples. And babies have managed that for a long time. And so, you know, I think it was just more so affecting my confidence when I was brand new to nursing and being a mom and all this stuff. So I think that’s what was in my head that I was like, Okay, no, I need to, you know, keep using this. This is how I can continue my breastfeeding relationship. So I think once I was kind of able to get out of that headspace and had a lot of support from my husband and mother in law, who were you know, could see how uncomfortable I was having until I carry these around with me and cleaned them all the time and all of this stuff, you know, was able to finally get to that point. And then I think also, that was just one less thing that I had to worry about when I was breastfeeding. Right. Because it was like the positioning, it was his latch.

And you know that it was the nipple shields. But you know, after that, I feel like after I stuck with the nipple shields, and I also quickly switched to like sideline and, you know, it just it felt like everything was kind of coming together at that point. Yeah. Oh, yeah. No, I’m so glad that you were able to finally wean off of it. And I think like you said, it, it really is a mental game, a lot of the time, there’s a physical aspect to it as well. And babies kind of get accustomed to that. So especially if they’ve used it since birth, you know, it can be more difficult. And it’s a process, I’ve definitely seen clients or, you know, just moms in general, that will say, you know, like, it’s working for us. So I’m going to keep using it, and maybe one day, I’ll have the energy to try again, or, you know, like maybe one day, my baby will just not want it anymore. And that does happen. So, you know, it’s, I tell people, like it’s not ideal, but if that’s what works for you, and that’s the space that you’re in like, it’s fine to, you know, so. But you had mentioned some things, obviously, I know this, but just for our listeners, some of the risks of using a nipple shield, especially long term. So maybe you could just speak to that for a moment, because you didn’t know about those things when you were handed that nipple shield. So I’d love for you to just expand on that for a moment for us. So I think that this is kind of the basic idea is that right? The nipple shield is getting in the way between, you know, the the baby’s mouth and your breast. And so in this way, it could lead to some kind of issues related to milk production. So, you know, there might be some issues related to producing enough milk, you do have the nipple shield on too often.

And so this is one thing that I was worried about later, because in the beginning, my son was nursing for like long periods of time as well. And so like after then finding that out later, I was like, Oh my gosh, you know, maybe it was the nipple shield to blame. There’s also kind of this information that says that it could also cause like clogged ducts and things like that later, when I had all of these issues happening, I pointed back to the nipple shield. And I was like, oh, you know, if I didn’t have this, then maybe I wouldn’t have had these problems. But I think you know, what the latest research is saying is that oversupply is the main kind of driver of blood ducks. And so, you know, I think that, as you mentioned, like, sometimes the nipple shields work, sometimes they help moms get over a hurdle and continue that breastfeeding relationship when maybe they wouldn’t have been able to otherwise. Or maybe they would have decided to pump instead, which can be really hard on moms, what we just have to do is keep kind of our ear to the grind to understand what the the latest research is saying, and take it from there. Yes, sorry. I agree. You know, there, there’s always more that we’re learning, right, or, especially, you know, clinical experience, has taught me so much about nipple shields, obviously, it made it a point to you know, stay up to date with all of you know, the latest research and protocols and all of that, but really just kind of, you know, seeing what works.

There are so many different types of nipple shields. I was having a conversation with a colleague about that this morning. And she was like, you know, this other colleagues that I work with, she loves the cherry shaped nipple shield, and she was like, I just don’t like when do you use it? And why do you recommend it? And I was like, Well, I do think it’s over recommended. And here’s the use cases, you know, so he kind of went through it, like why you would use that versus a conical shaped one. And they come in different sizes and different cutouts and all of these things. And so for the mom who’s you know, going to like her local, local Target or something and picking up you know, her on Amazon or whatever, right, picking up a nipple shield, like there’s probably just one option, maybe two, they’re the same size, same shape. And there’s not like an instruction guide really, or, you know, maybe there’s like, how to wash it sort of thing. They’re very often clear and easily misplaced. I don’t know how many like garbage disposals, they fallen down over the years, but it’s pretty sad. I made it real about that on Instagram actually.

Jacqueline Kincer 19:16
Because they aren’t, you know, you just you get a set on the nightstand and the next thing you know, it gets knocked off, you’ll never find it again. Unless it’s dirty then you might like they’re so cumbersome and to your point because they really, you know, make the babies suckle, suckle at the breast in a way that’s more like a bottle that milk removal may not be as efficient. There may not be the same level of breast stimulation so that hormonal signaling for letdown milk production all of that may be hampered to some extent. I think as long as moms are counseled on those things and they know what to look for. Then, you know, they can really kind of decide you know, risk benefit wise like should I continue on with this? This is something I should really work to move away from, but yeah, it It adds an extra load to breastfeeding on top of positioning and you know, all of the other things that you’re trying to, you know, work with. But it can be a very handy tool, I usually tell people, honestly, it’s really best for you to use a nipple shield and consult with a lactation consultant, because then you’re gonna have specific guidance on why to use it. which one to use, how to wean off of it, all of that, yes, you can totally figure it out on your own too.

But I don’t know, why not like, save yourself the trouble. So yeah, thank you for sharing that. And then kind of on the the side of, you know, the plug ducts. So for you when you experienced a plug duct for their first time, I don’t know if you remember, but like, how did you know that you had a plug duct, I’d love to hear some of those signs and symptoms that you experienced, or that you know about, because breast tissue changes so much with lactation that I have a lot of moms that are trying to, you know, get up to speed very quickly with these rapid changes. And they’re like, my breasts are super lumpy. And I’m like, Yeah, that’s your glands in your breast and your fat has moved around and all you know, like, you don’t have clogs, or sometimes they do so there’s, it’s not always obvious. So yeah, I’d love to hear about that. Yeah,

Victoria Rothbard 21:15
I think that’s such a great point, I think that we’re just not familiar enough with the anatomy of a breast and how it should feel and what it’s naturally like before pregnancy. And after. And while you’re nursing. It wasn’t until like a few weeks, in that I experienced my first one, I think that it you know, it felt very much like a ball at the top of my breast. And so it felt different. Like, it didn’t feel like the normal kind of lumps that I felt in my breast before it was like a very kind of distinct ball or kind of like palette that I felt. And then I think, you know, the symptoms kind of like progressed from there. So there was some redness surrounding the lump. So that also seemed, you know, kind of out of the ordinary, I hadn’t experienced that before. And, you know, typically when I had plugged ducts, it did not progress into mastitis. But it did that that one time that I mentioned, when both breasts had lumps in them, there was redness, and then I did have a fever as well. So you know, I think that that’s kind of the the main things that you can look out for. And also just like you said, you know, you want to make sure that it is different than then your breast is feeling normally. And so I would look for those kind of like more distinct, you know, kind of feeling like a pebble in your breast or something like that. And, you know, it could also be in the form of other things like there’s milk gloves, right, so it’s at the actually on your nipple, and it might be like a white kind of spot or.on your nipple, which you feel like a lot of intense pain there as well.

So I think the unfortunate thing is, there are so many different variations of these kind of problems that you can run into, then when you have to think that you have to like jump through all these hoops to solve them. You know, it just doesn’t really make sense. And I think the unfortunate thing is a lot of us, you know, maybe our parents didn’t breastfeed, like my mom didn’t breastfeed. My mom’s mom wasn’t breastfed. So, you know, I think in that way, there weren’t even that many people that I could turn to for a lot of the support. And so I think like when we’ve kind of forgotten this as maybe even like a society, you know, something that kept mankind long alive for a long time. And, you know, we we’ve forgotten the basics, and then we need to turn to medical professionals. And, you know, of course, lactation consultants are so important in this because they are really the one health care professional that specializes in this and has taken curriculum in lactation specifically. So you know, I think that all of that is really important to keep in mind to to help moms when they run into struggles like this, because, you know, like you said, you can try and fix it on your own. But I think, you know, from my own experience, it took much longer on my own to try and figure this out to try and like disentangle the misinformation from you know, the true evidence. And so unfortunately, I didn’t have a lot of success with my first lactation consultant. But I did have a second lactation consultant who was also like, much more helpful and was able to provide advice that, you know, helped me down the line and encouraged me to do these positions that maybe I wasn’t comfortable doing before, like, like sideline and things like that. So I think all of that is really important for for new parents. Hmm, yeah,

Jacqueline Kincer 24:21
I think there’s so much good advice and everything that you just said, especially that, you know, it’s actually the episode before this one with Gene and agro, she talks about how, you know, if you get somebody that you first work with the lactation consultants and doesn’t feel like very helpful or like, you know, a good fit like then you know, it’s okay to go find someone else like, there is this you know, variation in clinical experience and training and personality, right. So, for some reason, I feel like our profession sometimes gets painted with this like huge, broad Paint Brush of everyone’s the same and it’s like no, no, you know, I’ve never worked in the hospital, right? Some people have done, you know, only hospital, some people have done a mix of both. Some people lived in various countries and experienced different things. So you just never know. And then to that front to, like you said about Blubs. Right. So that’s really like sort of a, you know, can be a blister on the tip of your nipple thinking about clog deeper in the breast. For people who are wanting more information on this as listeners, like you can have a clogged duct anywhere on your breast. It could be on the top underneath is very common and often overlooked, especially if you’re large breasted, it could be on the sides, it could be far from the nipple could be close to the nipple could be in your armpit. There’s mammary tissue there as well.

So you could experience it in any of those places. You could have a clogged duct and engorgement you have a clogged duct and mastitis, you know, you can have a clogged duct that turns into mastitis and turns back into a clogged duct. Again, it can feel like a little BB or a pebble like you described, it can feel like an oblong shape, you know, so if there’s like a clog in one spot, and milk is backed up behind that it can create firmness in that duct that you’re feeling. And it extends further than just around area. So there’s all these different things. You can have redness, you cannot have redness, you could have pain, you could not have pain, then if you have mastitis, you can feel those who like symptoms, like you said, a high fever, body aches, chills, usually there’s a very sudden onset to that. So there’s all of these things, that could also be a sign of something totally different as well. So it’s like, we don’t want to say that every single lump in your breast is a clogged duct. We know that’s not necessarily true. Obviously, the scariest one is cancer. But then you could have something like a GALACTA seal, which is not a clogged duct, it’s kind of a sack filled with milk, if you will, inside the breast that isn’t necessarily problematic. So it’s a lot. It’s not just a plug duct, right. It’s not like one little thing, there’s so many things we have to consider. And you know, I guess because you obviously taken all the time to learn so much about this. We’re talking about what it is, you know, kind of kind of how it how it presents, what are some of the best things that you would recommend a mom does to prevent or avoid plug ducts and mastitis? Because I feel like there’s just, you know, so much like you said, confusion out there online and what have you. And then we don’t have that, you know, wisdom of the ages that’s been passed down to us. So yeah, I’d love to give our listeners some tips and guidance on how to avoid this ever happening.

Victoria Rothbard 27:42
I think you’ve already hinted about one of those major causes maybe too. So when you have like a nipple shield, or you have a breast pump, which I actually feel like has just become like one of those things, right? That you get when you’re having your baby shower, like it just becomes a thing like, Oh, you’re breastfeeding, oh, you need a pump. And so I think that, you know, one thing that probably would have saved me, a lot of trouble is a lot of moms, you know, and many moms, you know, want to have a milk stash in their freezer, and they’re worried about going to work and things like this. But I think you know, when you tend to use these different types of like gadgets for breastfeeding, I think that that’s when you know, you might be more likely to cause some of these things down the line. So again, with me, it was the pumping, you know, I was pumping way too often I just didn’t really understand at the time, like how often I should be pumping, which, you know, if you’re just trying to have a little bit of a stash or have a little bit extra, it shouldn’t be more than like one extra session per day, I certainly shouldn’t be pumping every time that I’m nursing because that was you know, not going to lead anywhere good. Some women are able to manage their oversupply and they donate milk. But you know, I think for me this this oversupply this like frequent pumping, got me to the point that you know, I just was really not having a good time anymore with with breastfeeding and really wanted to be able to continue and hit that one year mark.

And the latest research that’s come out from the Academy of breastfeeding medicine is is also you know, finally kind of putting the pin in this before there were lots of different risk factors for plug ducts and mastitis, but now there are mainly two and that really has to do with an oversupply. That’s the leading factor and then there can also be this like imbalance of bacteria within your bras. And so previously, antibiotics were kind of the go to for mastitis and so now they’ve said that there are different types of mastitis, inflammatory mastitis and then bacterial mastitis and so we really want to reserve the antibiotics because that can mess with the the breast biome and the microbiome. And so I think that, you know, if we’re looking at those as the two primary factors, then avoiding an oversupply or kind of removing more milk than your baby may need. Again, you know, it’s It’s normal for moms to want to pump before they go back to work. But I think another good thing to know is you really only need enough milk to cover your first day away from baby, because you’re going to be pumping while while you’re at work. And so I think there’s a lot of pressure that moms put on themselves to have this big freezer stash. And, I mean, personally, I ended up just, you know, not being able to use most of it, because I also found out later that my son didn’t like the taste of the milk after it, uh, defrosted and all this stuff. And so we basically just ended up using it for milk baths and other things. So it’s good that there are other things you can do besides giving it of course, you can donate it, like I mentioned before, but I think that’s, you know, if I could go back in time, that’s the main thing that I would try to avoid, I wouldn’t be you know, kind of like, over pumping. And then I think that it can create this vicious cycle because the previous guidance was telling you to drain the breast if you had plugged ducts. And so that creates this like vicious cycle of you know, you have a plucked up because you have an oversupply, and then you keep removing more milk. And that just makes it worse, because when you remove milk, you produce more milk. So I think, you know, those are the main things that you can do to avoid that type of thing. Mm hmm.

Jacqueline Kincer 31:06
Yes. No, very, very good tips for sure. I would say, you know, I think like you so, you know, described in so much detail with the haka, right, like, people think it’s like this benign. Oh, it’s just a milk capture. Right? Isn’t it is more than a milk capture. But it’s also not quite a pump. It’s like this interesting little hybrid device. And no, they weren’t great for some mums for others, not so much. And there’s this idea of, oh, well, it’s not it’s not doing much. Well, yes, it is. And I’ve absolutely seen oversupply and engorgement created or, or, you know, prolonged by someone using the hawk after every time they nurse, like you said, so you know, those little things, right, we, we get these devices, and you’re like, Oh, this is cool, I got my shower, everybody has one or, you know, it’s inexpensive. So I definitely want to have one of these, you know, something like that, right. And it’s just potentially problematic, you know, like you said, or this culture of this idea of like, oh, we really need to pump and have this huge, you know, freezer stash, stored up and all of that. A couple other like honorable mentions, if you will, that I like to suggest to people are one, like, make sure that if you are wearing a nursing bra, which I do think can be really, really helpful, especially if you’re leaking or whatever, make sure it’s well fitted, I will give a shout out in the episode show notes. I am NOT an affiliate, I’m not associated with them in any way. But there is a company that does virtual bra fittings, you do not need to show them your bras. By the way, when I say that people instantly get like freaked out, I’m like, no, no, no, they’re not looking for any photos. Okay, you’re gonna take some measurements, you’re gonna send them to them, you’re gonna tell them what bras you’ve been wearing, what sizes they are, where the straps fall, when you wear them, what you like about them, what you don’t like about them, and they as much detail as you’re able to provide, they can give you a really good answer about what brands and what sizes would fit you. The cool thing is about this company is that they know nursing bras really, really well. So it’s not just a bra fitting, like they can really help you with nursing bra fitting.

And so make sure that you do have something that’s comfortable, that allows flexibility. I know some people will be like, you know, hey, I can just you know, wear my normal bra. And I just, you know, I just pull it down and I nurse and that and I’m like, that’s great. But keep in mind that typically the materials that are used in the fabrics that are used for nursing bras are meant to stretch and have a little bit of give, because your breast size fluctuates hour to hour, depending on how often your baby is nursing. So you want to have that flexibility built in. Sometimes moms find that underwire can create clogs, it’s just limiting that lymphatic drainage and flow and and all sorts of things like that. I know moms are doing everything right. And sometimes you know what you sleep on your boob. You’re so happy you can finally sleep on your stomach again, that baby is out and you sleep on your bed and you wake up with a plug duct and it’s like oh no. So some of these things can just be like random and positional too. I’m not saying you can’t ever sleep on your stomach. Those of you who are larger breasted or have very abundant milk supplies will no you still can’t sleep on your stomach comfortably. But yeah, that’s just something to think about a couple of other things because I know I got my first plug duct from sleeping funny. And then interestingly enough, kept getting more of those. I did have an oversupply as well. So yeah, it’s it’s tough out there. But just because you have an oversupply does not mean that you’ll necessarily get plugged up like you said some mums manage and they donate and you know, that’s wonderful, too. So you are talking about the Academy of breastfeeding medicine protocol, which was revised last year and came out. And I do I found it refreshing. I think they covered a lot of things in there. I think that they cleared up some of the things that we in the profession have been wanting some guidance on or someone else really come out and say, I don’t know if you saw this, I should have asked you earlier. Have you seen the response that was sent from some lactation consultants about that protocol? I did not no, no. Okay, we can like talk about it a little bit. Um, basically what they were saying.

And I can find the link and provide that in the show notes was really that a lot of the evidence that was cited by the Academy for their protocol was not very strong evidence, they were looking for more specificity on certain things. They just kind of had, you know, these these critical things to say about the phrasing and recommendations and, you know, really more of the evidence side of things, and I completely understand where they’re coming from. I try to give people the benefit of the doubt, I think it’s always good in terms of science and research to scrutinize and find those areas of, you know, well, maybe this isn’t the strongest, or you might be, you know, kind of leaping to a conclusion that we can’t really say, is fully evidence based, or what have you. But on the flip side, I kind of feel for the academy and all of us as a whole in the world of lactation support, because, quite frankly, there is not a heavy investment in breastfeeding and lactation research. And what we do have is kind of limited, generally not repeated very often or at all. And so we’re scrounging together what we can like somebody has to come out and say something and give some guidance somewhere along the line, otherwise, we have nothing. And so it’s like, Yes, could we do better? Absolutely. But then give us money. Like, not me personally, like just, you know, fund this research, right? You know, and it’s, it’s just tough. It’s, you know, nobody makes money off of breastfeeding. I know, people like to say, mean things about lactation consultants, I’m like, um, most lactation consultants cannot make a full time living doing what they do. But nice try. But like, just know, it’s it is, which is underfunded, you know, formula makes money, and they have lots of money, they can invest in research, the same is not true for breastfeeding, if you breastfeed, ideally, unless things are difficult, and you need a lot of things, you’re saving money long term, right? So you know, no one really profits off of that. So anyway, I just wanted to bring that up. Because I do have an appreciation for the Academy of breastfeeding medicines protocol, I can see some of the shortcomings like this statement came out and said, but at the end of the day, like we’re all trying to get to the same goal, which is, you know, help moms continue breastfeeding, even when things come up, like clogged ducts and mastitis. So I’d love to know your thoughts on the protocol, or bits and pieces or as a whole, because this is your area, you’re all about the plug ducks.

Victoria Rothbard 37:51
Yeah, so I think that, you know, I definitely hear those kinds of reservations, I think that, you know, one thing that I liked about the protocol was they were very transparent with the kind of amount of evidence that was backing up each recommendation. So, you know, there were a lot of C’s on there, which showed that, you know, there weren’t like, too many studies, you know, and they might not have been, like the the most rigorous studies that had been conducted. I think that what you just said, though, is an important thing to recognize, right? What we know is that, you know, there’s a very limited amount of research. And so because of the limited funding, if there is, you know, a study that happens and a conclusion, then, you know, it might not be replicated. And so we just have that to go on. I think that in an ideal world, there would be lots of money poured into research for breastfeeding, because we really know so little. And so I think that, you know, to me, that’s what this is showing the fact that we could go from, I think 2010 or so was the previous mastitis protocol. And so a lot of things were basically turned upside down or reversed from what was being said in 2010. And so I think, to me, that says that, you know, like, we really didn’t know that much. And now we know a little bit more. And so I think that, you know, all we can, you know, kind of hope for is, is that like transparency and so that’s what I appreciate it though I definitely echo your concerns, and I would love to have more research done like make sure that this is definitely the most valid and rigorous conclusions that we could come up with. But I think that on like a personal level and as a nursing mom, reading this, that side of me it really just made me think like, okay, yeah, like, that makes sense. I’ve always been told that, you know, removing milk causes more milk to come in. So why would I be trying to drain my breasts when you when you can’t actually drain your breasts because, you know, you’re always producing milk.

So I think that things like that and and this like focus on an oversupply as an underlying cause for me just really made me think like, Yeah, this is kind of what my gut was saying before like, this is why I had a really hard time dealing with this. And I found a lot of other moms a lot of other people who are struggling with the same problems on social media that I was able to connect with. And so, you know, to me that just made it seem like something isn’t quite right about about the previous guidance. You know, I think that a lot of things like the deep tissue massage, which was pretty common, you know, I know that I actually, like caused myself a lot of pain, and because of the deep tissue massage, and so again, to like, see that now, this isn’t being recommended anymore, there’s no need to like, you know, kind of attack yourself with an electric toothbrush and put this vibration or stand in like a hot shower, all of this stuff, if it didn’t make sense at face value, that these were the right ways to deal with this. And so I think, you know, my kind of, like, overall reaction would just be that definitely could be more evidence, I think that, you know, I hope that there will be more studies that will be commissioned to to look more into clogged ducts and mastitis moving forward. But I do feel like we’re in a better place now than we had been when I started my breastfeeding journey. And I think that it seems like less is more. And so I think in the end, when I’ve been struggling with this for about two months, I think that I just got exhausted, and so I didn’t have the energy to like, nurse, my son, and then go and pump.

And then you know, like, try to get him to nurse early. So I could like keep stimulating my bras and stuff. And so I think when I really just ended up doing less, and trying to do less of these kinds of like crazy positioning, like dangle feeding and stuff, that’s when I really, you know, started to get some relief, or at least like not cause myself more harm. And so, you know, being able to like kind of, you know, rollback those different types of treatment options, and then get to the point where I reduced my pumping. I think that those were the real things that worked for me. And so I think, you know, from a personal level, it does resonate with me, and it does seem like it makes more sense than, you know, what the previous guidance was, was encouraging moms to do. Yeah, I

Victoria Rothbard 42:04
would say Less is more is is generally a good rule of thumb when it comes to a lot of things regarding lactation, but definitely plug ducks because I think that a lot of moms are also expecting this like instant fix to like if I just put the massager on for 15 minutes, then it will clear. No, not necessarily right then and there. Like that’s not always how it works. Or if I just massage in there deep enough, I’ll push it out. Right like that can happen. I’m not with deep tissue massage. By the way, there is a proper way to massage the breast for mastitis and flub ducts. And it is not with super firm pressure it is not needing your breast with your knuckles. It is not squeezing the plug out like Please do not do that. Oh my gosh. I’m like have moms ruptured their their ducts yet? Like have that has that happened? Because I feel like I’ve seen moms I’m like, why are there bruises on your breast? Well, I have plugged up last week, oh my goodness, what are you doing? Like stuck? It makes me think of like, just, you know, some like old like, you know, grandmother or something that is like, this is the way we did it in my day. You know, like, No, it’s not kneading bread over here. Gentle, less is more, right.

That’s what we’re trying to go for. But also like, it takes time, I try to tell people like, as long as nothing’s getting worse, you know, gradually, you should notice improvement. And eventually it will fully clear it can take a few days, like just because it’s still there the next day, you know, as long as you know, you’re kind of on that on the road to recovery. Like it’s okay, let it let your body do its thing. So yeah. And also I think too, doctors tend to jump to antibiotics whenever it comes to mastitis, which can absolutely be necessary that there are there is a time and a place where you may need that, especially if you have not done things to kind of treat it early on. Or if you’ve exacerbated it by doing the wrong things, then yeah, there’s kind of like no going back. And that’s it’s time for that. But, you know, I think this new protocol did a good job of clarifying the real need for antibiotics, the role of probiotics, and overall the microbiome within the body and things of that nature. Because, yeah, just you know, at the slightest case of mastitis, it’s really inflammatory. Do we need antibiotics? Probably not. Could that do more harm than good? Yes, you know, whether it’s got issues potential allergies, antibiotic resistance, like we want to want to, you know, use those sparingly if we can. So I’m curious in your in your experience, you know, is more plugged ducts than mastitis for you? It sounds like but did your doctor ever give you antibiotics for what was going on? Yeah, yeah. Yeah, just once said last time that like both breasts and I was having the fever and things like that. So I think that was the the time that I had mastitis. I was given Um, antibiotics. And so I did feel better. I

Victoria Rothbard 45:03
think that, you know, I feel like the good thing about antibiotics is you typically start to feel better after them. But you know, I think that it’s it’s important to not jump to that, like you said, right? Because, you know, it might be messing up the the microbiome and you know, it could result in other struggles later on. So I think, yeah, that was also something that was good to see in the protocol. Yeah, absolutely.

Jacqueline Kincer 45:27
I’m curious what your thoughts are on lecithin, that is seeming to be that thing that moms jump to that they will take mega doses of? Did you try it? What have you seen in the evidence, because I feel like a, like a love hate relationship with that supplements. I just, you know, I don’t know, moms also seem to have this idea. So maybe you could speak to this about that lecithin somehow gets the fat to, you know, stay in the breast milk more than if they didn’t take it. So I’d love to hear your thoughts and knowledge on that. So I did try lecithin. I

Victoria Rothbard 46:07
think that, you know, I wanted to try that long list of different things with, you know, really just this hope that that something would help me. And so, you know, I think that when I took it, it was really hard to tell if it was making a difference, because I was doing so many different things at the same time. So you know, maybe if I wasn’t like pumping as much, then I would have seen something because, you know, there’s a few studies right now that are out there, which were in the new protocol, you know, saying that you could try lecithin, and then probiotics, and, you know, so I think that that is a potential, I think that they’re still figuring out like the dosage for lecithin, right? It’s really the choline within the lecithin that is best for club plugs, ducks, and so there’s their soy, and there’s other things, which can also cause inflammation for mom, or just like stomach troubles and stuff like that. So I think, you know, I would prefer to try other things before recommending lecithin. I think, you know, if it’s someone who’s having like, recurrent plug ducts, like I was, you know, I might be more likely to recommend that. But, you know, I think that, you know, hopefully it wouldn’t get there. And there could be some, you know, changes made to like, your pumping routine or, or something else before then. But

Jacqueline Kincer 47:23
if it’s still a problem, then I think that there are other things that you can try, like what you mentioned. Yeah, absolutely. And I love that you brought that up, because one of the things I was so excited to see in the protocol was that mention of if it’s less a thin, you know, they they gave a pretty wide range in terms of dosages that can be taken, and that it really is the choline that is within the lecithin, that is what’s really helpful. So, you know, lecithin is an emulsifier, you will find it in most like milk chocolates, or powdered protein shakes, or, you know, anything that really is meant to be mixed with water, and that you don’t want it to settle at the bottom of water, right? You want this kind of, you know, when you mix it, it stays consistency, you know, kind of nut milks that you buy commercially, that sort of thing won’t contain lecithin. And people, moms, the internet, social media have like made this I mean, there is no evidence to support this, as far as I know, maybe I’m wrong, maybe you know, but I have not seen it, that it emulsifiers the breast milk that it just mixes all all of it together in the breast, like that’s not how ingestible things work, by the way, even if you injected lecithin into the milk ducks and pretty sure it wouldn’t have that same effect, like so I always find this very interesting, right? Like, and not to, you know, not to say moms are dumb, like you just don’t know, what you don’t know, if you don’t understand the pathways and, and the ways in which breast milk is manufactured within the glands like and how what you ingest goes into the breast milk or doesn’t like, you know, I get it, right. Like, I think you’re making a logical conclusion, I totally get it. But there are risks to like, you know, consuming too much less than and consuming it, you know, chronically and very frequently can cause issues with your gut is not something that you’re supposed to be taking in large amounts. Like if you read the labels on things you’ll see it’s typically one of the last ingredients that you only need a little tiny, tiny amount, whereas like mom’s was plugged ducts are taking, you know, 5000 milligrams a day, 10,000 milligrams a day, heck, I don’t even know. So, just something to keep in mind when you know, you saw a tip somewhere. Some mom told you they did this and it worked for you. You don’t necessarily have to keep taking it for months and months and months. If it works for you great, but we’re not necessarily saying you know, every mom who’s breastfeeding should take this you’re not going to pump more fatty milk if you take it like all of those things. So will squash it will squash the rumors. So for you when you finally like I’m curious, was it scary for you when you like Go have pumping so much like, Were you worried that you wouldn’t? You would suddenly not have enough milk? Or were you? Were you like, no, I’ll just have just enough like, cuz I find sometimes moms have this fear of, you know, I don’t want to, you know, end up with low milk supply. So did you have to navigate that?

Victoria Rothbard 50:18
Yeah, um, I think I definitely was worried, like, especially since I had mentioned that my brush just kind of always felt in orange. And that was right for a few months. So when I kind of just clap back to like, a normal brass that that wasn’t engorged and didn’t really feel like, you know, too hard. I was like, what? What’s going on? Did yeah, did I lose my milk supply? So I think that and I did have, you know, like, I mentioned it to friends. And, you know, I was I was concerned about it. And so I think that, you know, there were these fears in my mind about that. But in some way, I was like, No, I think that, you know, I probably just had too much milk before. And this is a normal amount of milk to have, and this is how it should feel, you know, I shouldn’t feel that and gorged all the time at like three months postpartum. So I think that, you know, it was one of those things where I needed to trust my gut, and my gut was saying that it was fine. My son was still nursing fine, he was growing, you know, he was like, having enough diaper output and all these things. And so, you know, I think in that moment, I just had to kind of get rid of those doubts and, and move forward with with minor saying, and it worked in in that way. And so I think that, you know, something else that I learned during my journey was just the importance of like, trusting yourself, like, when you get a piece of advice from a pediatrician or, again, someone who might not be have specialized knowledge in lactation, and it doesn’t feel right to you. It’s okay to question it, you know, and so I think that when I was starting to introduce solids, at six months, my my pediatrician was telling me that I should stop nursing at night. And I was just like, that doesn’t feel right. You know, I think that it’s important to, to nurse my son at night to, you know, continue with that path. And I want to make sure he gets as much milk as he can. And, you know, he was looking for the breast at night.

So it felt strange to, you know, kind of ends that early. And, and so that was one moment where I did push back and I said, Okay, he can, you know, say that, that’s the right thing to do. But I’m going to do what, what feels right to me, and, and for me and my son, and that that was the right thing to do. There’s no reason to cut night nursing, when you’re starting to introduce solids, there’s no reason to kind of do all these crazy things where you know, you can only give, I could only give my son the breast if he had had some solid foods, you know, that’s not really exactly how it works. You know, they’re just starting to explore new tastes, try to figure out be exposed to different foods and things like that, but they’re not going to consume that much. Right at six months. So you know, I think like being able to stick to my guns and understand and then I later was able to learn that, you know, milk is the primary source of food for babies up until one year. So, you know, even though you’re introducing solids, it’s really important to still be providing them with with that milk, not like, you know, saying goodbye to tonight, nursing too early. You know, I think that I was able to continue on with that. And it was one of the things that I cut later on, like, is the first thing when I was weaning. But you know, I think that like listening to your gut is really important, especially with all the misinformation out there and things like that. And then of course, if you have additional questions that you want reassurance on, that’s when you reach out to a lactation consultant, because that’s really the best person who can help you and provide you with that evidence based information.

Jacqueline Kincer 53:49
Yes, oh, gosh, yes, pediatricians, I assume that they mean, well, but infant feeding tends to not be one of those things that they’re really up to date in. And, you know, truthfully, like, if you really ask them, I’m pretty sure they’ll admit it, you know, like, if you really pressed them, like so how much training have you had on this. And, sadly, a lot of the time, their training or their information comes from Formula companies or baby food companies, which tend to be the same. And so they you know, cannot wait to get your baby hooked on stage one and stage two and stage three in this many foods and keep you a customer for a long time. So, always, you know, if your pediatricians giving you a handout that is branded with a formula or baby food company’s name on it, I would definitely take a second glance and look at some breastfeeding friendly information if you want to keep breastfeeding. So just throwing that out there for the moms. I’ve definitely seen that many times in my practice, and personally myself, exploring options for pediatricians for my kids. So your son is now two and a half and And I would love to hear you made it past a year with breastfeeding. So how did that go? I hope things ended on a high note for you guys. And what does winning look like? How did breastfeeding? You know, go for you guys, after a year after you seem to have gotten things figured out with all of the plug ducts and all of that.

Victoria Rothbard 55:17
Yeah, I think, you know, it got to a point where it was just so much more enjoyable after all of those like bouts of plugged ducts and things like that, you know, I was doing positions that were comfortable for me like sideline. And I think that’s like, what made the difference that made me comfortable and my son comfortable, it allowed me to really continue and move forward. And I was able to nurse him until about a year and a half. And that’s when I was able to realize that at a certain point, it just wasn’t really working for me anymore. You know, I had met my goal, I really did enjoy the breastfeeding relationship that we had. But, you know, I kind of wanted my body back at that point, I wanted to, you know, not have to worry about, like, nursing him all the time, and things like that. And so that process was a little tough, just because he was so crazy about breastfeeding, like, it was such a rare thing to do, which made it, you know, hard for me to, you know, go through it and stuff, I did it very slowly started by cutting a feeding by kind of cutting, like the feeding that seemed least important to him first. And so I did it with night nursing, we were still like waking up once a night to nurse. And so, you know, I just kind of tried to get back to sleep other ways. And he would, you know, go down. And then eventually, you know, he wasn’t really like looking for the breasts anymore after like a few days. But since I had these plugged ducts. Previously, I know that weaning too quickly can also put you at risk of getting plugged ducts. So I wanted to be super careful with that. And so you know, I think that you can probably start cutting out sessions like every three to four days, see how your body reacts, and then find another session.

But with me, I really wanted to give myself more time to make sure that my body was responding. So I think, overall, it ended up taking like a month and a half until I finally had named my son completely, but I think I was so you know, worried about how he would take it this whole time. But once you know, once, it wasn’t happening anymore, he was he was okay, you know, he was fine. He never really like looked for the breasts anymore. He had other ways, you know that we would like bond. And he often like he still plays with my hair all the time. It’s his favorite thing. And even when he was nursing, he used to play with my hair. So I think that that’s still like one little, you know, comfort thing that he still does that he has after our nursing relationship came to an end. But you know, I think that having like that lactation consultant to talk to, through this process is really helpful because, you know, there’s a big change in your hormones when you’re weaning. And so I think that that’s also a really important thing for moms to know, like, you know, you’re going to have, you know, some big like, mood swings, potentially, it’s totally normal to, to be upset to feel lows of weaning and coming to an end with this type of relationship with you and your child. And so I think that, you know, it’s it’s a lot of things to process to deal with, both for you and for your child. And, and so I think just kind of, you know, going at your own pace, making sure like, you’re easing into it, you know, that you’re comfortable, your child’s comfortable, your bodies, okay, I think those are all like really important things to take into consideration. And, you know, then being able to get to the point where I was able to have my body back. And I think that that was also just like a really rewarding thing after so long you grow a baby, you birth the baby, you nurse a baby, and then you know, you’re able to kind of you know, just just be a mom and lots of other ways. After that.

Jacqueline Kincer 58:59
I’m so glad you were able to go through weaning being this thoughtfully done process. And I always try to tell bombs, like, hey, it’s not something that is going to happen super quickly, unless there’s like a medical need or what have you. And a month and a half is a very reasonable timeframe. So thank you so much for sharing not only your personal experience, and you know, all the things that you’ve learned along the way, but all of the wonderful expertise that you’ve gained with us because I think it’s so valuable. And for moms who are out there that might be you know, struggling with recurrent flood ducts or, you know, have had mastitis or are facing some similar challenges to you. What would be like if you could pick one piece of advice, whether it’s tactical or something else, more personal, what would you want to say to that mom?

Victoria Rothbard 59:49
So I think the first thing I would say is to be easy on yourself to trust your gut and and to really figure out like what works best for your body, right. So I think In all the things that I was doing, it felt like my body was just screaming No, like whether I was pumping too much, or if I was, you know, using trying to use a lot of heat to get rid of the plug or using this vibration, like none of these things felt good for my body. And so, you know, I think that now with the new protocol there are there is this new evidence that is saying that we should avoid those types of things. Also, the deep tissue massage did not feel good. So that should have been enough, but it was like, No, that’s what it says. So I think that, you know, it’s an invalidating in that way. And so I think that, you know, being able to have an understanding of evidence, but you know, also like, what, what works for you what works for your body and knowing that you’re gonna get through it, because, you know, I think that the reality of breastfeeding is not all moms get plugged ducts and mastitis, but quite a few do. And so, you know, just knowing that you’re going to get through this, like you had said, it takes a few days, I think that we all like everything to be like an instant reaction nowadays. So you know, knowing that it’s going to take some time, but it will pass. And, you know, I think that that’s really the best kind of outlook that you can have. And, you know, if you run into it again, and you know, or the first time you’re running into it, like lactation consultants are always a great resource they should be, you know, the first person that you reach out to, to get that information. And like we said before, if if you don’t really like click with the first lactation consultant, and it doesn’t go as you had planned, like, find another there’s, there’s lots of great ones out there. And so I think it’s just about, you know, finding the provider that that works for you listening to your body, and, you know, also making sure that you and your baby are able to get past that hurdle. Oh, yes.

Jacqueline Kincer 1:01:46
The best advice from Victoria here for all of you. And if anyone wants to hear more of Victoria’s wonderful insights, and all of the great advice and evidence that she’s sharing, definitely go to Instagram, check out her account at flog duck diaries, Is there anywhere else where you’d want someone to try and connect with you to follow along? Victoria.

Victoria Rothbard 1:02:10
I think that’s the main place. I’m trying to push out lots of new content based on this new protocol and, and just kind of, you know, let parents know that do things that that feel good for your body. And if there’s something some kind of treatment that you’ve heard about, or you know, just pops up on Google search, it might not actually be what you need to do. So I think that’s the best place to to follow along.

Jacqueline Kincer 1:02:32
Yeah, absolutely. Well, thank you so much for being on the show today. It’s been an absolute pleasure. I feel like this was a very educational but reassuring episode. And it’s been awesome to get to chat to you.

Victoria Rothbard 1:02:46
Thank you. I really am so glad I could be here today and really excited to follow along and continue seeing all the great content that you put out there on on social media. So thanks so much for that.

In this episode, Jacqueline is joined by Victoria Rothbard, a CLC who faced countless challenges throughout her journey, including recurrent plugged ducts and mastitis. Victoria often received conflicting advice and quickly learned that there is a lot of misleading breastfeeding information out there. Together, Jacqueline and Victoria clear up some key pieces of information around mastitis, pumping, and clogged ducts.

Victoria decided to become a Certified Lactation Counselor to help provide parents with evidence-based support. Jacqueline and Victoria discuss the Academy of Breastfeeding Protocol and its response from other lactation consultants.


In this episode, you’ll hear:

  • When nipple shields should and shouldn’t be used
  • How to navigate the weaning process
  • Signs and symptoms of clogged ducts and mastitis
  • What to do if you’re experiencing mastitis
  • ABM Protocols and the response


A glance at this episode:

  • [2:20] Victoria shares her pregnancy and delivery while living abroad in Turkey
  • [10:34] Why and how Victoria became a Certified Lactation Counselor
  • [13:40] How she weaned off of using a nipple shield
  • [16:14] Risks of using a nipple shield long term
  • [20:32] Signs and symptoms of plugged ducts that Victoria experienced firsthand
  • [25:18] Tips and guidance to avoid mastitis
  • [34:43] Academy of Breastfeeding Medicine Protocol and the response to it from lactation consultants
  • [37:42] Victoria’s thoughts on the ABM Protocol response
  • [43:50] When you might need antibiotics for mastitis
  • [45:26] Victoria’s thoughts on Lecithin
  • [49:58] How Victoria navigated her fear of low milk supply
  • [55:02] What did weaning look like for Victoria


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