Culture Apothecary with Alex Clark: Episode Summary

Episode Title: Breastfeeding Is Hard—Here’s How to Actually Make It Work
Guest: Therese Dansby, RN, IBCLC
Release Date: June 6, 2025

Introduction

In this enlightening episode of Culture Apothecary with Alex Clark, host Alex engages in a profound conversation with Therese Dansby, a former NICU nurse turned International Board Certified Lactation Consultant (IBCLC). Together, they delve into the intricate challenges of breastfeeding, offering both scientific insights and heartfelt support for mothers navigating this crucial aspect of early motherhood.

Breastfeeding Statistics and the CDC Report Card

Therese begins by highlighting the significant drop-off in breastfeeding rates from initiation to six months. “There is a huge drop between even three months,” she explains ([02:19]). While over 80% of mothers start breastfeeding, only about 26% exclusively continue for six months. This discrepancy underscores the myriad obstacles women face in meeting their breastfeeding goals.

Formula Lobbying and Policy Failures

A critical barrier to successful breastfeeding in the United States is the aggressive formula lobbying. Therese points out, “The US just blatantly doesn't [follow the WHO code],” referring to regulations that limit the promotion of breast milk substitutes ([04:34]). Unlike other countries that restrict formula advertising, American women are inundated with formula marketing, including unsolicited formula samples mailed directly to households.

Inconsistent Breastfeeding Advice

Therese emphasizes the confusion caused by conflicting advice from healthcare providers and social media influencers. “There is a lot of conflicting information,” she states ([05:50]). This inconsistency can derail even the most determined mothers, making the breastfeeding journey feel overwhelming and unsupported.

Impact of NICU Experiences

Separation of mother and baby, often necessitated by NICU admissions, can severely disrupt breastfeeding. “Pumping to remove milk ideally within three or four hours of delivery” is crucial for maintaining milk supply ([07:16]). However, hospital protocols and other priorities often impede timely milk removal, leading to supply issues.

Cultural Taboos and Public Breastfeeding

Therese discusses how cultural attitudes towards breastfeeding impact its prevalence. “It was only legal to breastfeed in public in 10 states” as recently as 2019 ([09:26]). Such restrictions contribute to the overall difficulty mothers face in breastfeeding, making it a less normalized and more stigmatized practice in the U.S.

Support Systems and Professional Help

Finding the right support is vital for breastfeeding success. Therese advises, “Taking a local breastfeeding class is a great idea. You will meet a local consultant” ([13:04]). She underscores the importance of working with knowledgeable lactation consultants who can provide personalized guidance and support.

Managing Milk Supply: Low and Oversupply

Understanding milk supply dynamics is essential. Therese clarifies misconceptions, stating, “When you pump, if you pump three hours after the last feeding, you might only get 2 to 4 ounces. If you pump after a feeding, you might only get half an ounce to 2 ounces. And that's normal” ([13:39]). She also discusses oversupply issues, which can lead to problems like clogged ducts and mastitis.

Addressing Gassy Babies

Gassiness in babies can stem from various factors. Therese explains that it may be due to poor latch causing air swallowing or reactions to certain foods in the mother's diet. “It's really painful. There is a lot of conflicting information” ([15:29]). She advocates for professional guidance over social media solutions to effectively address these issues.

Effects of Birth Interventions on Breastfeeding

Therese highlights how interventions like inductions, C-sections, and epidurals can impact a baby's ability to latch and breastfeed effectively. “They don't get to go through those cardinal movements of labor” ([37:00]), which can affect reflexes necessary for successful breastfeeding.

Health Benefits of Breastfeeding

Breastfeeding offers extensive health benefits for both mother and child. Therese cites research stating that “universal breastfeeding would prevent the deaths of 800,000 children under the age of five every year and 20,000 mothers every year” ([20:08]). Benefits include reduced risks of various illnesses for babies and decreased risks of breast and ovarian cancers for mothers.

Emotional Connection and Personal Fulfillment

Beyond the physical benefits, breastfeeding fosters a deep emotional bond between mother and child. Therese shares personal insights, “It's so empowering” ([24:27]), emphasizing the emotional connection and sense of accomplishment that comes with overcoming breastfeeding challenges.

Breastfeeding and Hormonal Impact

Breastfeeding significantly influences a mother's hormonal balance and menstrual cycle. Therese discusses how prolactin, the hormone responsible for milk production, interacts with other hormones like estrogen and progesterone, affecting fertility and menstrual patterns. “Breastfeeding is not birth control,” she clarifies ([39:39]).

Understanding Milk Composition: Foremilk vs. Hindmilk

Therese debunks the myth of foremilk and hindmilk being different in composition. “It's all the same milk. You're not making different milk,” she asserts ([44:19]). She explains that milk composition changes naturally during a feeding session due to physical dynamics, not due to a separate production of foremilk and hindmilk.

Tandem Feeding: Balancing Multiple Children

Breastfeeding while pregnant or nursing multiple children, known as tandem feeding, presents unique challenges. Therese provides practical advice, “It's pretty safe for most people, unless you have a history of preterm birth” ([45:48]), and emphasizes the need for careful monitoring and support.

Formula Choices and Safety Concerns

When breastfeeding isn't possible, Therese outlines the hierarchy for supplementation: mother's milk, donor milk, and then formula. She critiques homemade formula recipes for safety concerns, particularly with raw milk, and advocates for safer alternatives. “Any non human milk needs to be modified under one year of age,” she states ([51:07]).

Maternal Nutrition's Impact on Breast Milk

A mother's diet directly affects the quality and composition of her breast milk. Therese explains, “Some of the B vitamins fall in that category. Vitamin C. We don't think of milk really being a vitamin C rich food, but breast milk actually is” ([55:36]). She emphasizes the necessity of a nutrient-dense diet to support both mother and baby’s health.

Weaning: Proper Methods and Emotional Support

Therese discusses the ideal ways to wean, advocating for a gradual and respectful process. “The WHO and the AAP...say up to two years or as long as is mutually beneficial for mom and baby” ([32:55]). She also addresses the emotional toll of weaning, recognizing the sadness many mothers feel when their breastfeeding journey concludes unexpectedly.

Managing Mastitis: Modern Protocols

Mastitis, an inflammatory condition, can be effectively managed without overreliance on antibiotics. Therese introduces the Mastitis Protocol by the Academy of Breastfeeding Medicine, focusing on anti-inflammatory treatments. “There is a time and a place for antibiotics, but ideally breast gymnastics, ice, lymphatic massage, anti inflammatories like turmeric, ginger” ([65:18]).

Handling Nursing Strikes

When a baby suddenly refuses to breastfeed, Therese advises persistence and understanding developmental stages. “Feeding is a learned skill and not a reflexive skill anymore” ([67:53]). She suggests strategies like creating a calm feeding environment and being patient as the baby navigates new priorities.

Postpartum Support: Choosing the Right Consultant

Therese differentiates between postpartum doulas and lactation consultants, stressing the importance of credentials and rapport. “A lactation consultant is gonna be the same because like I said, there's a lot of ways to meet your breastfeeding goals and some are gonna resonate with you” ([76:16]). She encourages mothers to seek out qualified professionals who align with their personal needs and breastfeeding goals.

Healing from Unsuccessful Breastfeeding Journeys

For mothers who couldn’t achieve their breastfeeding goals, Therese offers compassion and validation. “Breastfeeding trauma and breastfeeding grief are actually very real” ([74:54]). She emphasizes the need for support systems and acknowledges the emotional struggles associated with unmet breastfeeding expectations.

Final Thoughts and Remedies to Heal a Sick Culture

In her closing remark, Therese advocates for parents to trust their intuition and advocate for their children. “This generation of parents tapping into their God-given intuition” ([77:32]). She believes that empowering parents with knowledge and support is essential for healing and nurturing a healthier cultural environment.

Connect with Therese Dansby

• Instagram: @HappyMamaHealthyBaby
• Podcast: Milk and Motherhood – Released two to three times a month
• Private Practice: Happy Mama Healthy Baby
• Patreon: Earbud IBCLC – Offering accessible lactation support

Conclusion

This episode of Culture Apothecary provides a comprehensive and compassionate exploration of the challenges surrounding breastfeeding. Therese Dansby’s expert insights and empathetic approach offer invaluable guidance for mothers striving to overcome obstacles and achieve successful breastfeeding. Whether you’re a new mother, expecting, or seeking knowledge on breastfeeding dynamics, this episode serves as a crucial resource in navigating the complexities of nurturing your child through breastfeeding.

Note: This summary excludes promotional segments and advertisements present in the original transcript to focus solely on the informative and content-rich discussions between Alex Clark and Therese Dansby.