Should This Mum Keep Feeding? How We Make That Decision- E17

Should This Mum Keep Feeding? How We Make That Decision- E17

When breastfeeding is causing significant pain or nipple trauma, should a mother keep feeding through it? Or are there times when a temporary change in the feeding plan may actually protect breastfeeding long term? In this episode, Katie and Joh explore one of the most challenging clinical decisions faced by lactation consultants, midwives and breastfeeding supporters. Episode Summary Breastfeeding professionals are often taught how to support mothers to continue breastfeeding. Sometimes harder is knowing when continuing exactly as things are may be contributing to ongoing pain, tissue damage, stress, and feeding difficulties. In this episode, Katie and Joh discuss how they approach severe nipple pain and trauma in clinical practice. They explore the factors that influence decision-making, including wound healing, maternal wellbeing, feeding goals, pumping, nipple shields, and the importance of individualised care. The conversation highlights the reality that many breastfeeding situations sit firmly in the grey zone. Rather than rigid rules, the discussion focuses on clinical reasoning, transparency, and working collaboratively with mothers to develop plans that feel achievable and supportive. As always, this is an honest conversation between two experienced clinicians navigating the complexity of real-world breastfeeding support. In This Episode We Cover * Why severe nipple trauma is rarely a simple clinical decision * When continuing to breastfeed may be helping or hindering healing * The role of maternal wellbeing in feeding decisions * How pumping may fit into a temporary feeding plan * When nipple shields might be useful * Supporting wound healing while protecting milk supply * Why breastfeeding support must remain individualised * Clinical reasoning versus rigid protocols * The importance of collaborative decision-making * Helping mothers feel seen, heard and supported * The emotional impact of ongoing feeding pain * Balancing short-term challenges with long-term breastfeeding goals Want More From Katie and Joh? Check out our courses for professionals: Decoding the Suck: Gentle support for babies with sucking difficulties [https://thelatchrevolution.com] Breastfeeding & Lactation: The Fundamentals [https://katiejames.site] Pregnant or a new mum? Find more support from Katie: The Feeding Couch® – Breastfeeding SOS – for new mums [https://katiejames.site] Instagram Katie: @katiejameslactation Johanna: @milkandmotherhood YouTube: The Latch Revolution Enjoying the podcast? Leave us a 5 star review - please scroll a bit further down and do it now! ;) Support the show on Patreon: [https://www.patreon.com/posts/welcome-155495472] Medical Disclaimer The content of this podcast is for educational and informational purposes only. It is not a substitute for personalised medical advice, diagnosis, or treatment. Listeners should always seek the guidance of their own healthcare provider, midwife, or lactation consultant with any questions they may have regarding their own situation or that of their clients. Katie James and Johanna Sargeant do not accept responsibility for any decisions made based on this content. Keywords nipple trauma, nipple pain, breastfeeding pain, breastfeeding support, lactation consultant, IBCLC, breastfeeding complications, wound healing, pumping and breastfeeding, nipple shields, breastfeeding management, breastfeeding challenges, breastfeeding education, lactation support, midwife education, doula education, breastfeeding professional development, maternal wellbeing, clinical lactation skills, breastfeeding counselling

Why Some Babies Prefer Bottles Over The Breast- Ep 16

Bottle Preference vs “Nipple Confusion” | Flow, Breast Refusal & Paced Feeding Last episode, we unpacked bottle refusal in breastfed babies. This week, we’re tackling the other side of the feeding conversation: what happens when babies begin preferring the bottle over the breast — or what many people still call “nipple confusion.” Except… babies usually aren’t confused by nipples at all. In this episode, lactation consultants Katie James and Johanna Sargeant explore what’s actually happening when babies begin refusing the breast after bottles are introduced — and why flow, sucking mechanics, oral function and feeding dynamics matter far more than most people realise. We discuss: • bottle preference vs “nipple confusion”   • flow preference in breastfed babies   • why some babies begin refusing the breast   • how milk flow changes sucking behaviour   • fast flow vs slow flow feeding dynamics   • paced bottle feeding that genuinely mimics breastfeeding   • how to bottle feed without sabotaging breastfeeding   • bottle feeding positions and latch mechanics   • non-nutritive sucking and letdowns   • oral function signs that often get missed   • late-onset low milk supply linked to feeding mechanics   • teat shape, bottle flow and feeding behaviour   • mixed feeding and combination feeding support   • breastfeeding politics and fear-based messaging   • how to support families without shame or black-and-white advice This episode is for: midwives, lactation consultants, IBCLCs, speech pathologists, maternal child health nurses, doulas, infant feeding professionals, and parents trying to navigate breastfeeding and bottles without panic, guilt or confusing advice. One of the biggest themes in this episode is nuance. Because bottles are not poison.   Teats are not poison.   And one bottle does not automatically ruin breastfeeding. But feeding mechanics matter. And the way we support families around bottle feeding matters too. Mentioned in this episode: • paced bottle feeding   • flow preference   • breast refusal   • oral function assessment   • bottle feeding mechanics   • late-onset low milk supply   • mixed feeding support   • responsive feeding approaches Listen to the previous episode: Why Babies Refuse Bottles - And What Gets Missed [https://podcasts.apple.com/us/podcast/why-babies-refuse-bottles-and-what-gets-missed-e15/id1841874307?i=1000767520640] Support The Latch Revolution Podcast: If these episodes help you, leaving a 5-star review genuinely helps more parents and professionals find the podcast. You can also support the podcast and access extra content here with Patreon [https://www.patreon.com/posts/welcome-155495472?utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=postshare_creator&utm_content=join_link]: Connect with us: Instagram: @katiejamesibclc   @milkandmotherhood Courses & Education: Katie James & Johanna Sargeant - Decoding the Suck training for professionals [https://www.thelatchrevolution.com/] The Latch Revolution - Exercises for parents to support their infants suck challenges [https://www.thelatchrevolution.com/] The Feeding Couch — breastfeeding education for parents: [https://www.katiejames.site] Breastfeeding & Lactation: The Fundamentals — professional education for birth workers [https://www.katiejames.site] Disclaimer: This podcast is for education and information only and should not replace individual medical advice, diagnosis or treatment. Please seek support from your own healthcare provider, IBCLC, midwife or medical professional for individual concerns. #breastfeeding #bottlefeeding #pacedfeeding #nippleconfusion #breastrefusal #lactationconsultant #IBCLC #oralfunction #mixedfeeding #newbornfeeding #breastfeedingpodcast #postpartum #midwife #speechpathology #infantfeeding

Why Babies Refuse Bottles - And What Gets Missed -E15

Bottle refusal isn’t always behavioural.  And if you’ve tried every bottle on the market without success… there may be something else going on. In this episode, Katie and Johanna, IBCLC's, unpack bottle and teat refusal in breastfed babies — looking at both the behavioural side as well as the physiological side that often gets missed. They walk through the practical strategies many parents are already trying: changing positions, changing the caregiver, adjusting milk temperature, experimenting with teat flow and creating low-pressure experiences around bottles. But they also explore why some babies still struggle despite all of that. The conversation dives into oral function, tongue movement, high palates, gag reflexes, bottle teat design, and why some babies physically struggle to coordinate sucking on certain bottle shapes. Katie and Johanna also discuss how stress and pressure around bottle feeding can quickly escalate into bottle aversion — and why play, curiosity and responsiveness matter far more than forcing feeds. Importantly, we talk about the situations where bottles simply aren’t working before a return to work, many babies compensate by 'reverse cycle feeding' — breastfeeding much more frequently overnight. This episode is packed with practical ideas, nuanced clinical discussion, and reassurance for both mums, new parents and professionals. * Why breastfed babies may suddenly refuse bottles * Behavioural strategies that genuinely help * Why teat shape matters more than marketing suggests * Bottle flow rates and matching milk flow * The role of milk taste * Why some babies become distressed around bottles * High palates, tongue tie and oral sensitivity * The connection between bottle refusal and sucking function * Why play and curiosity reduce bottle aversion * Open cups vs straw cups vs bottles * Reverse cycling and feeding when mums return to work * Why observation matters more than rigid rules MENTIONED IN THIS EPISODE Decoding the Suck — Professional Training [https://thelatchrevolution.com] NEW Parent Sucking Support Packages [https://thelatchrevolution.com]   Susan Howard IBCLC - Reel with O Ball and bottle teat [https://www.facebook.com/reel/1244198891235071]   The Feeding Couch® — Breastfeeding Support for Parents [https://katiejames.site] Breastfeeding and Lactation: the fundamentals - Professional Training [https://katiejames.site]   SUPPORT THE PODCAST If you enjoy The Latch Revolution podcast: * Leave a 5-star review!  * Subscribe  * Share the episode  * Support the podcast on Patreon: [https://www.patreon.com/posts/welcome-155495472] MEDICAL DISCLAIMER The content of this podcast is for educational and informational purposes only and should not replace individual medical care. Mums and new parents should always seek support from their own healthcare provider, lactation consultant or medical practitioner regarding their individual circumstances. KEYWORDS bottle refusal breastfeeding, breastfed baby won’t take bottle, teat refusal baby, high palate bottle refusal, tongue tie bottle refusal, oral function breastfeeding, paced bottle feeding, reverse cycling breastfeeding, bottle aversion breastfed baby, breastfeeding and bottle refusal, lactation consultant bottle refusal

Mastitis: What’s Changed, What’s Wrong, and What Still Gets Missed - E14

Mastitis isn’t just an infection. And the way we’ve been treating it… might be making things worse. In this episode, Katie and Joh unpack mastitis through a more current lens — moving away from the idea of “blocked ducts” and towards understanding inflammation as the key driver. They explore the early signs many women miss — including the flu-like symptoms that can appear before any visible breast changes — and why recognising these early can change the entire trajectory of the condition. The conversation also challenges long-standing advice around heat, massage, and increased feeding, explaining why these approaches may worsen inflammation rather than resolve it. Instead, they introduce a more physiologically aligned approach focused on rest, anti-inflammatories, cold therapy, and maintaining normal feeding patterns. Importantly, they discuss what happens when mastitis doesn’t fully resolve — including subclinical presentations, changes in milk supply, and the impact on baby behaviour. The episode also highlights the emotional and practical realities for mothers navigating mastitis, and the need for clinicians to remain flexible, transparent, and responsive when protocols don’t fit the individual. In This Episode We Cover * Early “boob flu” symptoms and why mastitis can present before breast changes * The shift from “blocked ducts” to inflammation-based understanding * Why heat and massage may worsen symptoms * How cold therapy and anti-inflammatories may support recovery * When to manage at home vs when to seek medical review * Subclinical mastitis and recurring symptoms * Changes in milk taste and baby feeding behaviour * Maintaining milk supply when baby refuses one breast * The role of clinical judgement beyond protocol * Transparency and trust in complex lactation care   Want More From Katie and Joh? Check out our courses for professionals: Decoding the Suck: Gentle support for babies with sucking difficulties [https://thelatchrevolution.com] Breastfeeding & Lactation: The Fundamentals [https://katiejames.site] Pregnant or a new mum or parent? Find more support from Katie: The Feeding Couch® – Breastfeeding SOS – for new mums and parents [https://katiejames.site] Instagram Katie: @katiejameslactation Johanna: @milkandmotherhood YouTube The Latch Revolution Enjoying the podcast? Leave us a 5 star review Subscribe so you don’t miss future episodes Support the podcast via Patreon [https://www.patreon.com/posts/welcome-155495472]: Medical Disclaimer Disclaimer: The content of this podcast is for educational and informational purposes only. It is not a substitute for personalised medical advice, diagnosis, or treatment. Listeners should always seek the guidance of their own healthcare provider, midwife, or lactation consultant with any questions they may have regarding their own situation or that of their clients. Katie James and Johanna Sargeant do not accept responsibility for any decisions made based on this content. Keywords mastitis breastfeeding, mastitis inflammation vs infection, blocked ducts myth, mastitis treatment cold therapy, lactation mastitis protocol, breastfeeding pain inflammation, milk supply mastitis, baby refusing breast mastitis, subclinical mastitis, lactation consultant education

Breast Pumping in Clinical Practice: What We’re Still Getting Wrong - E13

Pumping should be simple. But for many mums… it becomes painful, confusing, and ineffective. In this episode, Katie and Joh unpack what’s really going on when pumping “isn’t working” — and why the answer is rarely what you think.   Episode Summary Katie and Joh take a deep dive into the reality of pumping, starting with one of the most overlooked issues in lactation support — incorrect flange/shield sizing. They explore why so many women are given the wrong size, how this affects comfort and milk output, and why going smaller, not larger, is often the key to effective stimulation. The conversation moves into pump types, including hospital-grade pumps, double pumps, and wearable devices — where, for once, Katie and Joh don’t entirely agree. They explore the tension between efficiency and flexibility, and how the “best” pump depends entirely on the individual mother, her circumstances, and her goals. They also unpack practical strategies to improve pumping outcomes, including timing, vacuum levels, switching between stimulation and expression modes, and why watching milk output can actually reduce it. Joh shares the now well-known “sock over the bottle” technique and the surprising impact of removing visual pressure. Finally, the episode broadens into the emotional and psychological experience of pumping — from stress, grief, and NICU experiences to the importance of oxytocin and creating a sense of safety. They highlight that pumping is not just mechanical — it is deeply physiological and emotional, and support must reflect that. In This Episode We Cover * Why incorrect flange size is one of the biggest barriers to effective pumping * Why smaller sizes often work better than larger ones * The difference between hospital-grade pumps and standard pumps * Wearable pumps vs traditional pumps — and where Katie and Joh differ * Why pumping should never be painful * How to set the correct vacuum level based on comfort, not numbers * Timing: why 15 minutes is often enough * Switching between stimulation and expression modes * The “sock over the bottle” method and why watching output reduces milk flow * Oxytocin and pumping — what actually helps milk release * Why pumping can carry emotional weight, stress, or grief * Why a pump session does not reflect total milk supply * Power pumping — when to use it and when to stop   Want More From Katie and Joh? Check out our courses for professionals: Decoding the Suck: Gentle support for babies with sucking difficulties https://thelatchrevolution.com Breastfeeding & Lactation: The Fundamentals https://katiejames.site Pregnant or a new mum? Find more support from Katie: The Feeding Couch® – Breastfeeding SOS https://katiejames.site   Download the FREE 5 Gentle Questions booklet: https://www.thelatchrevolution.com/gentle-questions   Instagram Katie: @katiejameslactation Johanna: @milkandmotherhood YouTube The Latch Revolution   Enjoying the podcast? * Leave a 5-star review — it helps more mums and professionals find this work   * Subscribe so you don’t miss what’s coming next   * Or Join our Patreon [https://www.patreon.com/posts/welcome-155495472?utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=postshare_creator&utm_content=join_link]   Medical Disclaimer Disclaimer: The content of this podcast is for educational and informational purposes only. It is not a substitute for personalised medical advice, diagnosis, or treatment. Listeners should always seek the guidance of their own healthcare provider, midwife, or lactation consultant with any questions they may have regarding their own situation or that of their clients. Katie James and Johanna Sargeant do not accept responsibility for any decisions made based on this content.   Keywords breast pumping, breast pump tips, flange sizing, pumping milk supply, wearable breast pumps, hospital grade pump, milk expression, lactation support, pumping problems, low milk output, oxytocin breastfeeding, power pumping, exclusive pumping, NICU pumping