October 2024

Kristin Revere and Jacque Ordner discuss finding ways to make pumping more effective, comfortable, and sustainable in the latest episode of Ask the Doulas.  Jacque is an IBCLC, BSN, RN, RLC, and Motif Medical Advisor. 

Hello, hello!  This is Kristin Revere with Ask the Doulas.  I am thrilled to chat with Jacque Ordner today.  Jacque has many titles: IBCLC, BSN, RN, RLC.  And she is an advisor to Motif Medical.

As a registered nurse and IBCLC, Jacque has worked with breastfeeding families in the clinic, hospital, and private practice settings.  As a mom of four, Jacque is intimately familiar with the struggles that breastfeeding families face, and she loves helping families create personalized feeding plans to help them reach their breastfeeding goals.  Jacque has developed much of her career to creating lactation, birth, and baby care educational programs that equip new parents for the journey ahead.  She is passionate about finding ways to make pumping more effective, comfortable, and sustainable.

Welcome, Jacque!

Thank you so much!  I’m glad to be here!

I am excited to dive into the pumping topic, especially making pumping more comfortable.  I’d love to hear your tips for our listeners.

Absolutely.  This is something I’m really passionate about, working with families in private practice and advising Motif Medical.  The goal is to make pumping more comfortable, rather than something that we just absolutely dread.  There’s always going to be parts of it that we dread; washing parts, and all those things.  But my biggest tips are to understand, first of all, that it shouldn’t hurt, and if it does, that means that we need to investigate the underlying causes of that.  Most often, it’s flange size.  We need to get the right flange fit.  Other causes could be an underlying infection, or maybe we have soreness going on with baby’s latch, and that’s sort of transferring over and being exacerbated by pumping.  But honestly, most of the time, we’re not getting that flange fit correct.  That’s usually the first place that I start.

That makes sense.  So I know that with my own pumping and breastfeeding journey, it was difficult to find the right size.  And one breast can be a different size than the other, and trying to make that comfortable, you don’t have to just grin and bear it.  There is so much more that you can do, such as find a lactation consultant like yourself to help with that journey.

Yes!  And what’s really exciting is over the last, I would say, five to eight years, maybe, we have seen more of a focus on sort of just looking at nipple sizes and saying, okay, maybe this size 24 that comes in the box as “standard” isn’t really standard.  People are surprised to find out that flange sizes that sort of just came when we started working with pumps when they were invented – that wasn’t based on science having to do with human nipple sizes.  It was really science having to do with dairy animals.  And last time I checked, most of us don’t look like dairy animals when we’re talking about our anatomy.  It makes a lot of sense that we really need to revisit that topic, and thankfully, there is a lot of new information emerging.

Something I’m really excited about with Motif is we are taking a look at all of our flange sizing guidance, and you will see it’s a big process to change everything that comes in the box and to change all of the instructions about how to get your flange size.  But that is something that Motif has been willing to take on, and we are changing all that guidance to more closely align with the newer information that’s coming out.  And that information really is that most people’s nipples are smaller than 24mm.  They need a smaller flange size.  So we’re trying to adapt to that and provide moms what they need to be comfortable without having to jump through all these hoops.

So we’ve got this new flange sizing sort of criteria that we’re working with or instructions that we’re providing to parents, and that is you want to stimulate your nipples.  You want to get them to perk up, be everted as much as possible.  Sometimes we have nipple shapes and sizes that are a little bit more difficult to measure and to size, and so that’s when you need to seek out that expert help.  We’ve got a couple of flange sizing tools.  One is like a measurement tape.  It’s actually on a card.  And it’s like a ruler, but with the millimeter measurements, so you can measure from one side to the other of the base of your nipple after you’ve got it everted.  The other one has the holes that you can slide over the nipple itself.  You want to use something like that to measure in millimeters, and you do want to measure both sides, like you mentioned.  And then after you have your measurement, we’re not adding as much as we used to.  The current information is that we only need to be adding maybe zero to three millimeters, where we used to say two or four, or some sources said two to five.  And we’re finding that just like when baby’s mouth is stimulating that nipple tissue, baby’s mouth is touching the nipple on all sides, so it’s no longer this, oh, no, you can’t have the nipple touching.  It’s the nipple can touch as long as we’re not seeing a lot of swelling and it’s not painful.  So we’re definitely expecting a shift in how moms are able to size themselves, as long as they have the correct information, which is sort of the most important starting point.

Absolutely.  I’d love to hear more about Motif Medical.

I’m so excited to work with Motif.  As somebody who loves pumping, and as a mom of four, I have nursed my babies; I have exclusively pumped.  At times, I’ve pumped for a couple of adoptions.  So pumping is something I’m passionate about personally and professionally.  And what I love about Motif is they seek the information from parents and from professionals.  They want to know what makes lives easier, but not just what products can we put out there to market and make money.  Obviously, business is business, and you have to have products that sell to make a business work, but they’re really interested in, let’s solve problems.  Let’s figure out how we can make our pumps more effective.  Let’s get this flange sizing thing figured out.  Let’s make milk storage easier.  Because the whole idea is to make pumping easier and to help families meet their breastfeeding goals.  I just love that they’re constantly seeking information from the people who are boots on the ground, in the thick of it, so they can improve their products.

My favorite product from Motif is the Motif Luna pump.  It is an absolute workhorse pump.  It’s a pump that you could exclusively pump with.  I have exclusively pumped with it.  It’s a pump that you can build supply with right out of the gate.  And it rivals hospital rentals as far as performance.

That’s amazing!

It is!  When you look at the technical features, it really does rival the hospital rentals, and it’s available through insurance.  Usually, even to get the battery option is a lesser upcharge for moms than many other pumps on the market.  So I just sing its praises all the time.

I had to rent a hospital grade pump as my daughter was in the NICU and came home, so that was challenging.  I love that there are other options like Motif’s pump that have the strength of a hospital grade pump but you don’t have – I mean, it’s pretty big and bulky.

Yeah, and the Motif Luna is – you would just be surprised at how lightweight it is and how quiet it is.  I remember the hospital rentals that you’re just like, I’m going to turn this thing on and wake my baby up in the middle of the night, and that is so frustrating.  I’m excited for the advances that are happening in this space so that families who are dealing with all these other things – we can at least make pumping a little bit easier.

Excellent.  What are your tips for our listeners who are pumping at work?

Oh, my goodness.  First of all, it’s not easy, and there are no magic formulas to just take out all of the difficulty.  But I like to remind families that I work with that just because something is hard doesn’t mean it’s bad.  So we can do really hard things and have really positive results for ourselves, and sometimes it’s just important when you’re in the thick of it to remember that it’s okay that pumping is hard at work and continuing to breastfeed while I’m at work, it’s hard.  Hard doesn’t equal bad, and there can be good things that are coming out on the other side.  The focus on those positives can really be motivating.

I think the biggest tip I have is not to get so overwhelmed with what you see on social media.  Probably three, four, five years ago, that was not my biggest tip, but it has become that way because so many families are coming to me.  Moms are saying, I’m only pumping four ounces at every pump session, and I’m shouting, going yes, that’s wonderful; that’s a great amount.  But mom is dejected because she’s seeing amounts from influencers on social media that are ten ounces, eight ounces at a pumping session, so there’s this disconnect between what real, normal output is versus oversupply.  So my first tip is to know what normal is.  25 ounces a day is the average intake for a breastfed baby from one month all the way to six months when we introduce solids.  So if you’re seeing somebody pumping eight to ten ounces at every pump session on Instagram, that’s an oversupply, and you don’t need to feel like you’re doing something wrong if you’re not getting those amounts.

I would say my second biggest tip is to know that some milk removal is better than no milk removal.  So if you’re in a situation – like especially teachers that I work with, nurses – being a nurse, I remember you couldn’t even go to the bathroom, let alone get in a pumping session sometimes.  Having this sort of mentality of, I’m going to do some milk removal, even if I can’t get in a full pumping session, can really be beneficial at protecting your supply.  So learned the skill of hand expression.  I can’t tell you the number of times I hand expressed into a sterile urine cup when I was working in the hospital because that’s what I could do.  I could steal away for five minutes, wash my hands.  I had a sterile container.  And I expressed some milk rather than skipping a full pumping session.

I had to do that as a doula, as well.  I can totally relate.  At a birth, you have just a few minutes. 

Yes!  Yeah, and you’re just like, some relief.  But also, you’re at least telling your body, I need some of this milk, and it’s more protective to your milk supply.

I think also reminding ourselves that breastfeeding doesn’t have to be all or nothing.  If you go back to work and you’re doing all the things and your mental health starts to struggle; you feel like, I just maybe need some formula.  First of all, I would highly encourage you to work with an IBCLC because sometimes there are things that maybe you’re missing.  You need somebody to look at big picture, and there are some ways to adjust things and you can meet whatever your original goals were.  And sometimes we need to adjust our goals.  And it’s okay.  You’re not unsuccessful if your goals change and you maybe aren’t producing 100% of what baby takes.  Now, it’s entirely possible to produce 100%, but sometimes we have to look at the whole big picture and decide what our priorities are.  And you’re not failing if you’re making 30%, 80%.  It doesn’t always have to be 100% of what baby is taking.

So true.  So I would love to talk a bit more about how partners can support the pumping journey. 

I’m sure that you work with partners so much as a doula, and I always champion doulas as the coach kind of mentality with partners.  But partners can really influence so much and breastfeeding in general that they just don’t realize.  Sometimes we get focused on, I’m not the one physically feeding the baby, if mom is nursing directly at breast.  If I’m not the one physically feeding the baby, somehow I’m not bonding with my baby.  And I love to tell partners that every time you meet a need for your baby, you are creating attachment.  You can work on anticipating and recognizing their needs, and then that helps foster the secure attachment.  So every time you change a diaper, every time you bring baby to mom for a nursing session, every time you wash pump bottles, every time you give the baby a bath – you are doing something that is supporting your baby’s basic needs, and that is creating secure attachment.  So try not to be so focused on, I have to directly feed my baby to have a bond, because that’s just not true.  And then basic things for mom, too: meeting her needs is also supporting her.  Filling her water cup every time she sits down to nurse or pump.  Washing those pump parts.  Oh, my goodness.  I told my husband he never looked better to me than when he was at the sink washing my pump parts.  Doing things like asking, what can I do that would be make it easier for you right now, because as moms, sometimes we’re sitting down and we have 10,000 things running through our brains.  It looks like we’re just pumping.  It looks like we’re just nursing our baby.  But mentally, we’re juggling a lot of things.  And so having a partner that says, what are you thinking about, and what can I take off your plate that maybe has nothing to do with baby care or nothing to do with pumping, but is just something else in our lives and the management of our household that can be handled?

And then research really tells us that being a cheerleader is so valuable for success when it comes to breastfeeding.  So no matter how your partner is feeding the baby, whether we’re pumping and bottle feeding, directly nursing, doing a combination of both – telling her that she is doing a great job, encouraging her when times are tough.  Maybe we’re dealing with cluster feeding or a dip in supply.  Helping to provide factual information, so learning about breastfeeding as a partner so you can then reinforce with factual information is really, really important for success overall.

Excellent.  And with partner involvement, I’m always suggesting that they attend a breastfeeding and/or pumping class to be able to understand how to put a pump together or how to be that encourager and help in other ways to optimize rest for the new mom.

Absolutely.  Even just having somebody sitting next to you in class – you’re just not going through that experience alone.  It doesn’t feel like it’s all on your shoulders.  It’s so important.

And my final question for you, Jacque, is you mentioned that insurance covers the Motif pumps and some of the differences with your pumps, but I would love to have your tips in selecting the right pump that works for the individual based on their needs and goals.  And also, how do you figure out if your insurance covers a particular pump?

Fantastic question!  First of all, the insurance piece is easiest, so we’ll start with that.  You can actually go right onto the Motif Medical website, motifmedical.com, and there is an insurance lookup tool where you can put in your insurance information and it will pop up different DMEs, durable medical equipment, providers who carry Motif pumps and work with your insurance.  Probably the most well known is Aeroflow.  Lots of people are really familiar with Aeroflow because they’ve got the whole things figured out.  We’ve had to send things to your house and all of that.  But there are tons of other DMEs as well who do the same thing and different DMEs might have different options based on your insurance provider.  So if you don’t find the pump that you’re looking for at one, check with another one.  That’s something I highly recommend.  And you can find even a brick and mortar store if that’s important to you to go touch the pump.  There are definitely still brick and mortar DMEs available, and the insurance lookup tool on the site will tell you all of that information if you want to go see and touch the pumps, which I’m somebody that would want to go do that.

As far as choosing a pump, on our website, I’ve written some recent blog content really diving into this, but we divide them into really primary and secondary pumps, and that’s not like, oh, this pump is just better and this pump is worse.  It’s really more about how we’re using them.  So the Luna, because it has a really high performing motor – it’s a double electric pump.  It has the independent cycle and vacuum, so you can adjust how fast or slow it is pulling the nipple, cycles per minute or sucks per minute, versus the vacuum.  They’re independent of each other.  So you can have it going really fast with a really high vacuum or low vacuum and vice versa.  So that is kind of the hallmark of a primary use pump.  And then the other thing is that it uses traditional flanges because we tend to see better milk removal with traditional flanges.

So then in our secondary pump category, we have things like the Motif Duo.  We have a wearable pump called the Motif Aura.  And those would be more of your secondary pumps, meaning we’re not going to rely on those for building a milk supply or exclusive pumping or maybe regularly pumping back at work.  We might have a secondary pump that we use sometimes, but we’re also going to have that primary pump like the Luna to really have those effective, efficient pumping sessions to just undergird the whole process.

So think of your primary pump like the Luna as the one that you probably want to use your insurance benefit for, and then something portable or wearable like the Duo or the Aura, these smaller, more portable pumps.  That’s something you put on your baby registry as an extra.  Really nice to have, but you want to have that primary pump as the main pump that you’re using to remove your milk.

The other thing when you’re looking at choosing a pump is battery options.  So a lot of the primary pumps out there, like Luna, you have plug-in option, and then you have the same pump, but it has a rechargeable battery, and I can tell you in all the families that I’ve worked with, no one has ever been sorry that they scraped together a $30 upgrade fee or a $40 or $50 upgrade fee for that rechargeable battery.  So any sense that you might need to be pumping in the car or where there’s no electricity or even in a power outage – if you’re exclusively pumping and the power goes out, having that charged battery is going to be really important to your pumping journey.

And then the other thing is knowing that flange sizing.  With Motif, it’s across the board once you figure out your flange size.  You can apply that to all of the pumps.  And so making sure that you can have an idea of what your flange size is and that as you’re shopping for pumps, make sure that that pump has some sort of option to size for you.  A lot of times, it’s a third party insert that is compatible, and that’s totally fine.  With Motif, we want you to use whatever size works for you, so it doesn’t have to be our product, but something that’s compatible that would size it for you.  So just making sure that is an option.  You don’t purchase a pump and then realize, oh, there’s not an insert available for this particular pump that fits me.

Makes sense.  And you mentioned your website for Motif Medical, but how can our listeners and doula clients connect?  I know you’re also on social media, for example.

We are.  Yes, you can find us on Instagram, on Facebook.  Definitely, you can even reach out.  If you go to our website and read a blog and you want to leave a comment, that’s always an option, as well.  We have great customer service.  That’s one of the things I absolutely love about Motif.  We get high marks in customer service, and those gals work so hard to make sure customers are happy.  You can always reach out to us for customer service, and that is available through the website as well, or you can call customer service directly.

Excellent.  Thank you so much for sharing all of your pumping wisdom, Jacque, and we’ll have to have you on again.

Loved it!  Thanks so much for the conversation!  Such an important topic.  I appreciate it.

IMPORTANT LINKS

Motif Medical

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Buy our book, Supported

 

Kristin Revere and Dr. Ari Brown focus on the benefits of goat milk formula on the latest episode of Ask the Doulas.  Dr. Brown is the chief medical advisor at Kabrita.

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to chat with Dr. Ari Brown.  Dr. Brown is a pediatrician, best-selling author, and chief medical advisor at Kabrita.  She has been in private practice for over 25 years.  Her passion to advocate for children and educate families extends beyond the office setting.  She is the co-author of the best-selling 411 Parenting book series, including Baby 411: Clear Answers and Smart Advice for Your Baby’s First Year; Expecting 411, and Toddler 411.  Dr. Brown has received several professional awards, including the American Academy of Pediatrics Advocacy Award and the Ralph Feigin MD Award for Professional Excellence.

Welcome, Dr. Brown!

Thank you so much for having me!

What an impressive background!  I don’t know how you have the time to author three books.  I’ve only authored one, and it took me two years!

Well, it’s been a journey.  Let’s say I didn’t get much sleep during those years, put it that way.

I can only imagine!  I’m excited to learn from you.  It is excellent timing in that we’re recording this during National Breastfeeding Awareness Month, but we are going to talk about all types of feeding today.  So I’d love to get into a bit more about your background and what led you to focus on feeding topics, especially goat milk formula.

Sure.  So I am starting my 30^th year of practice.  My gosh.  And I see a lot of newborns.  Over the years, I’ve cared for too many to count, and now those little babies – some of those are parents and bringing their babies to me now!

That’s so lovely!  The full circle!

It does.  It feels full circle, and it’s really – I have to say, I have the best job in the world because I get to be part of all of these families’ experiences and share in watching their kids grow up.  And what a great gig, right?  But I think in my experience – and also, by the way, I’m a parent too – I know what keeps parents up at night.  And the reality is that we’ve been given this very precious gift, and we don’t want to screw it up.  So the stakes feel really high, and we all want to do our best, right?  I think what I’ve learned on this journey of walking this road with parents is they feel much more empowered when they’re knowledgeable and also learning that we’re all just trying to do our best and that no one is every going to be the perfect parent, right?  So I try to give parents that knowledge base.  I feel very passionate about education, which is why I write books and do speaking engagements and do all these crazy things.  And I also want them to feel like they don’t need to be a martyr, right, and that they have to be open minded and realize that we’re not going to be able to control all the variables, as much as we would love to do that.  And so we want parents to be confident in the way that they feed their baby, and I think that when it comes to breastfeeding particularly, the struggles early on can feel insurmountable, and I don’t think people are prepared for that.  So that’s part of the education piece is preparing families for, wow, this may seem like a natural thing, but it doesn’t come naturally for everybody, and everybody has to learn.  The baby has to learn.  You have to learn.  And that takes some practice, and sometimes there’s some challenges.  And those challenges are early, right when you’ve delivered a baby and you’re exhausted and your hormones are all over the place.  All of those things can conspire to make that journey very early on very difficult.  And so teaching families where they can get help and being prepared for that is one of my missions.

And how that led to goat milk based infant formula?  Well, the interesting thing is, watching my families over the years, I’ve learned a lot of things from them and what’s important to them.  I had families that were basically buying not regulated formula from Europe – basically, being bootlegged.  It’s almost like prohibition days, and people were bootlegging this formula with a middle man that was questionable.  Like, where are you getting this product?  And these families would be saying, well, I’m buying this and I’m getting – and I’m like, why are you doing this?  I was actually pretty intrigued by this whole process, which was really kind of consumer driven.  People were looking for something better as an alternative that they could feel confident about to feed their babies.  So I kind of became goat curious, as an American pediatrician, because we didn’t have that, any goat milk based product, in the American market.  I came across Kabrita while they were going through the entire process, which by the way, the only goat milk based infant formula in the US that meets all FDA requirements, and they did this whole process and they did it right.  I kind of stumbled upon them back in 2018 as they were going through this process and was really excited that they were doing it right.  They were doing the work and doing the research and the clinical trials and getting it published and really demonstrating the efficacy – and we’ll talk more about why I’m excited about goat milk based infant formula, but they brought this product to market through the correct channels where you can actually buy it the way you’re supposed to be able to buy a product in the US, and so that’s why I’m excited about this.  It does offer a great option for families if they are combo feeding or if they ultimately formula feed their baby.

That makes complete sense.  And of course, we’ve gone through the formula shortage.  You mentioned trying to buy European formula, buying formula online and not knowing the source.  There was a lot of desperation, not only in being able to find formula, but also afford it.

Right, yeah.  I think the infant formula shortage demonstrated that the American formula supply system is kind of messed up.  And there had been kind of – not a monopoly but an oligopoly, kind of two major manufacturers.  And some of it is because we have a system where we have the WIC program, which is the Woman, Infant, and Children program where government subsidizes infant formula for families, which is fantastic, but because there are these government contracts, it kind of restricts the marketplace, right?  And then when we had a problem and we lost basically 40% of our infant formula supply in the US overnight because one manufacturing plant had a problem with a contamination event, it made us realize, wow, we probably need to have more options here in the US.  And so I think that has been an eye opener and hopefully an opportunity for us to have more options.  That did bring in other infant formulas, and it is a nice reminder that Kabrita, like I said, had been going through this entire regulatory process and meeting all of the hurdles.  Some of these other products that have kind of entered the market only have emergency discretion use because of the infant formula shortage, and for them to maintain their supply in the US, they have to go through the same FDA regulatory hurdles, which that has not happened for those products yet.  But I am thankful that it’s been a horrible situation, but it’s offered an opportunity to have more options for us and a more stable infant formula supply, hopefully, in the future.

Exactly.  So Dr. Brown, I would love for you to explain the difference between goat milk formula and the, say, cow milk based, and the pros and cons of each.  And certainly, as families are making choices, it’s good to have all of the information.  I know with a lot of my clients, their infant or baby might have skin reactions or some allergies to the milk based formulas.

Sure.  So let’s start really simple and talk about what infant formula is.  So it’s a chemical formula.  That’s why it’s called formula.  But as we have evolved, as civilization has evolved, we have created options to approximate and resemble human milk, as much as we can.  And so people have tried many different kind of formula bases over the years and then tried to modify it, which is the formula piece, to compare it as much as possible to human milk.  And to be clear, there is nothing like human milk.  Breastmilk – human milk is made for human babies, right?  And it’s living food, and it’s dynamic food.  It’s never exactly the same for every person or even on a daily basis, right?  So you’re never going to get exact comparison.  But when you’re trying to create these infant formulas, historically, what has been the most popular base has been cow milk protein.  And I think a lot of people don’t realize it, because that’s what’s so prevalent.  When you look at a can of formula, you don’t realize, oh, this is made out of cow milk or this is made out of goat milk.  In general, the leader in the marketplace, or at least in the United States for – I will say goat milk based infant formula has been around for decades worldwide.  This is not new there.  It’s just new in the US.  But cow milk has been the prevailing base for infant formula.  And most babies tolerate it and do fine with it.  And all of the what we call macronutrients and micronutrients – so your macronutrients are your fat and your protein and your carbohydrate, and your micronutrients are your vitamins and minerals, like folic acid and vitamin D and all the other ones.  So those ingredients are regulated.  So for any product to be sold in the United States – or the EU has their standards, and wouldn’t it be great if we all had one universal standard, but we don’t.  The United States has 29 ingredients that have to be regulated and meet those standards to be able to be sold in the US and meet all FDA requirements.  All of those ingredients are as close to, again, human milk as possible.  And then there are some premium ingredients that some manufacturers will add, and that kind of falls under what we call bioactives.  So they’re probiotics or prebiotics.  Other things that, again, are present in human milk and then are added to infant formula to try to resemble human milk as much as possible.  But the base, again, is kind of the protein, right?  So cow milk protein has historically been the most popular base.

Now, there are some babies who cannot tolerate that protein, and there are some babies who are actually allergic to that protein.  So for babies who struggle with tolerance issues – you may have a fussy, gassy baby; constipated baby; unhappy baby.  And then when you have a baby who has a true allergy, you may seem eczema.  The one key thing that we’re looking for as pediatricians is blood in the stool.  There is – it’s called a food protein induced proctitis, but what happens is the lining of the gut gets irritated because of this protein allergy, and then the baby may have this – what looks like slimy, mucous, snotty-looking stool, but then when you test it in the lab, there’s actually blood in it.  Some babies, you will actually see the blood visibly.

So for those kids, you can’t have them on a cow milk protein based infant formula.  You have to use something that’s considered hypoallergenic where the protein has been totally broken down or an elemental formula where it’s just amino acids floating around, like the protein is just amino acids.  It’s not even cow milk based.  And we have tried other alternatives.  In the US, there’s also a soy-based product for some babies and for families who for dietary reasons do not want a cow-based product.  So we’ve had kind of these categories of cow milk based infant formula, soy based infant formula, hypoallergenic where the protein is really, really broken down, and then elemental formulas where it’s just amino acids and there’s not even any cow milk.

But these babies that have trouble tolerating the cow milk protein, that’s when people are seeking alternatives because it’s really not fun to have a baby who’s miserable, right?  And so that’s where goat milk infant based formula has risen in popularity, but what I always try to tell people is this is not just a niche product for babies who can’t tolerate cow milk protein.  It is completely acceptable as first line nutrition.  You don’t have to wait until your baby has a problem with cow milk to try goat milk based infant formula, and in fact, that’s now been endorsed by the American Academy of Pediatrics.  They put out an endorsement in 2023 regarding that.

But here’s the difference.  So why is goat milk protein different than cow milk protein, and why is it more tolerated?  So the key is – and this is where we’re getting a little bit granular, a little nitty gritty – but if everyone remembers Little Miss Muffet, sitting on her tuffet, eating her curds and whey – milk proteins are casein, which is the curds, and whey is very liquidy.  And casein, when it gets digested in the gut – curds.  Kind of like cottage cheese, like those clumps.  And so the big difference between goat milk and cow milk, naturally, is that the goat milk protein, that casein protein, is more like human milk, which is why it’s more easily digested.  And so it’s got more beta casein and it’s got less alpha S1 casein than cow milk, and it’s got more alpha S2 casein.  So it’s a little bit granular, but at the end of the day, the casein makes the curds different.  And the goat casein curds are softer and looser, so they’re easier to digest, versus the cow milk curds.  And so when you look at the data on these clinical trials of the babies who drink the goat milk based infant formula versus the cow milk based infant formula, it’s more tolerable.  You have fewer reports of the gassiness, colicky behavior, constipation, and even there’s some data on sleep where the babies sleep a little bit more comfortably and slightly longer, which for a newborn, I don’t give anyone – I don’t tell anyone their baby is going to sleep, so this is not like the baby is going to sleep through the night.  But it does seem that it’s more tolerated.  And so that’s really the key difference between those two.  Now that Kabrita is out – it came out in January here in the US – I’ve had families who have started cow milk based infant formula, and if the babies are having trouble with it, I’m like, let’s try this!  Let’s see how it goes!  And I’ve had good success with families.  So I can say clinically that I do think I have some happier babies after trying it.  I’m very excited about that.

The other piece that’s a little bit different between the cow milk and the goat milk is something called oligosaccharides, and again, this is a little bit granular, but these are prebiotics that are in huge numbers in human milk.  Huge, like third leading ingredient in human milk.  And goat milk naturally contains five times more oligosaccharides than the cow milk.  So that makes a big difference.  Also, there’s a diversity in the population.  So what it does is it fosters the baby’s microbiome because you need the prebiotics to grow those little germs that help your gut digest.  That’s also a reason why goat milk based infant formula has an advantage over the cow milk based because it’s supporting the microbiome and the gut health.

So where can our listeners and doula clients find Kabrita?

Super easy.  It’s on Amazon now.  You can buy it directly from Kabrita if you go to Kabrita.com.  You’ll be able to order it directly online and you can even set a schedule and set it and forget it and it shows up however often you want it to.  As far as in stores, there are a variety of supermarkets that are now carrying it nationwide.  Whole Foods is now carrying it.  And stay tuned because there’s a lot of other places that are coming, probably by the end of the year.

Exciting!  I’d love to take a few minutes to chat about your books.  I’m sure that our listeners would be interested in ordering the entire series.  They’re so helpful!

That was an evolution of families coming in, really seeking information.  I’m working on my second generation of parents, right?  But I’ve watched this evolution of parents who crave information, and they want more detail and they really want to understand and make science based decisions, right?  And as the growth of the internet and opportunities to filter information on that become more and more confusing – it’s overwhelming.  You have a vast array of information.  You just don’t know if it’s accurate, right?  And so as I watched my parents in my practice struggle with wanting to learn more, but I don’t know what I can trust.  Can you help me?  It exceeded the duration of our well check time, and I was like, how can I really give you more information, what you really need, and how can I be kind of at your bedside when I’m actually not physically there?  That was the birth of Baby 411.  It was really just all the questions that parents asked.  I think people still buy books, which is exciting.  As a book author, I’m so glad people still buy books because I think it’s super important to have everything in one place.  But in the day – you know, I’ve kind of picked up all the parenting books that were on the bookshelves, and I was like, what is missing here?  Because clearly people are reading this stuff, and they still don’t know what they need to know.  And so what I realized is that most of them are not written by somebody who lives in Exam Room 1.  And that’s what I can honestly say is I spend my days in Exam Room 1, and I’ve made a career of conversations with families.  So it’s really that level of detail.  And now we have a challenge, because I’m on the tenth edition of Baby 411.  We update our books every two years.  So I’ll say to my parents, if you have a question that is not in this book, you get added to the next edition.

I love it!  Because everything changes, even in two years, with sleep, feeding, all of the things.

Exactly.  So we update it.  I’m on social media.  I’m on TikTok.  My daughter, who is an adult now, was like, you need to be on TikTok.  That’s where people are who are young parents.  And I’m like, oh, okay.  So I’m actually on TikTok, but I will say, in between every update on my books, I’m always posting new information, and when there’s something that’s buzzing, I definitely address it so that people will understand, what do I really need to be concerned about?  Is this new study important, or is it just hype and the headline and the clickbait?  So anyway, I encourage people to follow me there because I really try to keep people abreast of new and changing things and then again, we update the books every two years.  So it’s very relevant and timely and evidence-based.

So where can they find your books?

Again, go to Amazon.  Our books are sold nationwide where books are sold, so every national bookstore carries them.  Amazon, or you can go to Baby411.com and buy it direct.

Beautiful.  Dr. Brown, you mentioned TikTok.  I’ve seen your videos on Instagram, as well.  I’ll have to check out your TikTok.  But yeah, they’re very helpful and engaging.  Where else can our listeners connect with you?  You mentioned your website.  Any other social media spaces you are spending time with?  Facebook, for example?

You know, it’s interesting.  I think that when I post to Instagram, it will go directly to Facebook, and it’s a generational thing.  I think you have to be everywhere all at once, I guess.  But I will say that I’m probably a little less active on Facebook.  But yes, we have our fan page @expecting411 on Facebook, and that is the portal for all three of our books.

Wonderful.  Any final tips for our listeners, Dr. Brown?

I think one of the things I like to tell families is to give yourself permission.  I think particularly moms, but dads, too.  I think that we put our children first, and they are our highest priority.  And for good reason, but I think that you need to take a step back sometimes and go, you know what, I am a parent.  I’m a spouse.  I’m a sibling, a child.  You have so many roles and you wear so many hats, and I think at some point, a lot of parents kind of become martyrs.  So I always remind people that happy parents make happy babies.  So make sure that you take care of yourself.  Don’t forget about yourself in this equation, and I think that it makes a much more joyous parent and a much better relationship with your child.

Excellent advice!  Thank you so much for sharing your wisdom and we’ll have to chat again soon!

My pleasure!  Thank you so much for having me!

IMPORTANT LINKS

Kabrita

Baby 411

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Buy our book, Supported