IBCLC: International board certified lactation consultant
Avery is a part of a registered regulated profession that supports mums and babies with the
process of breastfeeding. She has a masters in biology and education. Her background is in
teaching children between 12-18.
She then had her own children which sparked her interest in childbirth and lactation.
She also has an interest in neurology as she has kids who are neurodivergent.

Kate is a mum of four who has had all her babies in hospital. In this time she encountered various
health professionals who gave breastfeeding advice.
She acknowledges that going through labour and having a child it’s just such a big thing and no
amount of experience makes you immune to not needing advice or support. However, sometimes
this advice isn’t the best, it can range from from flat out wrong to making you feel not heard or
validated

Not all IBCLC’s are all lactation consultants are equal. Lactation cognstulantts and have different
backgrounds some have backgrounds as doctors, nurses and other health professions with a
varying range of experience in the breast feeding diad.

• Not being heard and validated as a mother through delivery, labour and the breastfeeding process is a common experience.
• Mothers are taught not to trust their instincts and to question their instincts.
• Leads to feelings of unworthiness
• Part of the journey of motherhood is reclaiming that ability to listen to yourself and reclaiming that instinct is there and finding people who will listen. This is a difficult process.
• Being unable to breast feed can lead to feelings of not being a good mum

Lactation is a field where many professionals have personal experiences with feeding an infant so there’s many opinions of what is ‘right’ which may not be evidence based but is anecdotal based.

• Babies reflexively move to the breast when you put them on your chest after birth and continue to do this as they grow
• This is the first glimpse we have into whether or not those neurological reflexes are firing in the way they should
• Some babies don’t do this or they struggle with latching. This tells us that the connection between the brain and those muscles that move for that reflexive a pattern just aren’t as mature as they need to be yet.

Avery realised when babies are struggling with latching they have a different set of wiring and that this was an opportunity to help. Neuroplasticity means that we can help babies with oral reflex challenges to change those patterns. We have the potential to change their trajectory from day
one.

Spectrum of types of feeding from functional to compensatory

1. Functional feeding, Creating a vacuum by lifting the posterior part of the tongue and then lift
   and drop the posterior part of the tongue in the mouth so it is sealed around the breast dropping of the tongue pushes air out of the wall cavity and air can’t get in because there’s a nice grip all the way around and a vacuum is created and milk flows from the breast into the mouth. Doesn’t talk lots of effort, but takes lots of coordination.
2. Compensatory feeding, something that you use if you don’t have access to the muscles that are designed to do the right job so if a baby can’t lift and drop the tongue or can’t make a seal they create an intra oral seal its like sucking through a straw right kind of a transfer of milk that way and this is very effortful
3. Breastfeeding is not enough, we can have lots of babies that breastfeed but don’t breastfeed
   functionally
4. Just getting on the spectrum anywhere is a good starting point
5. Children may have breastfed for a long time or the whole time they needed it however they still
   could’ve been using compensatory strategies.

• Nowhere on that spectrum is good or bad because there is no such thing as a good/bad latch
• if you’re feeding your baby at the breast and that’s how you want to feed your baby then
  you’re good
• good bad terminology is problematic because it is so subjective, a spectrum helps us recognise where a baby is on the spectrum and we can think about what resources do we need to shift the needle towards functional
• We don’t have to move right across the spectrum its just about moving up a step. There is not
  one definition of success or breastfeeding.

• Breastfeeding is just the first window into oral function it helps us recognise if a baby has oral function challenges and the earlier we can get in there the better.
• This builds the foundation for all of his other skills that they need down the road for airwaves for
  speech for solids.
• Gives a picture about oral motor development for a child and it might relate to the things like
  speech difficulties, breathing, airways, saliva management

How we Bring the baby to the breast matters sets them up from a functional latch
What they do at the breast is there story (tells us how they’re functioning)

How much areola in the babies mouth (anatomy dependent)
Lips curled under (if lips can’t flange then they can’t seal and make a vacuum)
Dimples in babies cheeks (comes from intra-oral suction like a straw)
Hard suck (compensation because baby is trying to get milk from the suck action vs lift action)
Unstable, hops on and off the breast or they slide shallow often
Choke at breast, coughing
Pain at the nipple (some compensating babies don’t cause this but some do)

Important to look at the whole picture not just one sign/symptom.

Babies have reflexes its not a choice, its whether or not the reflexes are connected to the muscle and whether the muscle has enough tone and freedom to move through its full range of motion with ease

In order to suck and swallow babies need to

• bob their head up and down
• turn head side to side
• Move themselves to the breast

These moments patterns builds connections between muscles and brain that sets them to have choice and mobility down the road. (Important to let baby do this even if you don’t breastfeed)

Gaping reflex – babies come to the breast with neck in extension which enables them to open their mouth wide. When babies come to the breast in extension their chin hits the breast and this triggers the baby to open the mouth.

Some babies just need help with how you bring the baby to the breast
If we are doing step one well and they’re still not latching functionally
– In cases like babies with recessed chin then getting the chin plant can be difficult

• Babies might be struggling with breastfeeding for many reasons and tongue tie may be just one, important to consider all factors.
• You can work on oral motor skills without removing a tongue tie
• Removing a tongue tie is not a complete solution by itself