Breastfeeding Outside the Box

We are proud to present a series of podcasts for parents Breastfeeding Outside the Box, where we aim to support the nourishing and nurturing of babies in exceptional families - families who historically have not received the help and support they need and deserve. Our exceptional families include adoptive, intended, and foster families; gender and sexual minorities; families with special needs babies; parents who have had breast surgery; mothers with IGT or low milk production for other reasons; exclusively pumping mothers; and more.
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Breastfeeding Outside the Box




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Jun 6, 2018

For as long as I've known my podcast co-host Hope Lien, she has been my go-to person for questions about at-breast/chest supplementation.  When nursing her daughter by adoption (pictured here), at-breast supplementation was a key to her success - as it is for most parents who need to provide long-term supplementation.  She understands first-hand how frustrating at-breast/chest supplementation can be at the beginning and how invaluable it can be in the long run.  Getting from frustration to long-term success is the key and Hope tells us how!


View full show notes Here:

May 9, 2018

It's a case study!  Something a little bit different in our discussion with Dr. Nice, our pharmacist expert.  Alyssa had connected with a mom-to-be Courtni who was inducing lactation with very quick and abundant milk production.  She wanted to figure out what Courtni was doing so that she could learn from Courtni's experience to help other parents.  (We at Sweet Pea are always trying to learn more about how to support the nursing success of non-birthing parents!)  ... but Alyssa could not find anything in Courtni's approach that was different than other parents she had worked with.  She did observe, however, that Courtni was taking several medications for her own health issues.  Alyssa wondered if these medications or the health conditions underlying them could be the secret to Courtni's outcomes.  She went to her friend, Dr. Nice for the answers...

View full show notes here:

Apr 18, 2018
As it turns out, breastfeeding is not just "A Womanly Art."  Steph shares an incredible story about a same-sex male couple she worked with who both nursed their baby, exclusively providing human milk for baby's first 6 months.  How does this work?  Creativity, support, milk expressed by baby's gestational carrier, and a tiny feeding tube at the father's nipple.  Steph gives us the details of this amazing nursing relationship and how to support any LGBTQIA family interested in breastfeeding/chestfeeding/nursing.

Check out the full show notes here:

Apr 4, 2018
With the FDA warning against domperidone, we have noticed an increasing number of U.S. parents who choose to induce lactation or relactate without using the pharmaceutical medication domperidone.  While we have spent many episodes discussing the safety and effectiveness of domperidone, our ultimate goal is to  meet each parent with a plan for inducing lactation or relactation that is consistent with their preferences.  In this episode Alyssa and Hope discuss alternatives to domperidone and how milk production may be impacted by a lactation plan that does not include dom.
Full Shownotes available at:
Feb 27, 2018
For breastfeeding parents, safely taking medications - whether they are for the parent's health or for increasing milk production - can be complex.  It is a delicate balance between the parent's health, the safety of the milk for the baby, and the importance of breastfeeding.  It involves communication between the parent's health care providers, the baby's health care providers, and the pharmacist who can help to put it all together.  Here our friend and pharmacist with a ton of experience with lactation, Dr. Frank Nice has more answers.

​On today's episode, we asked Dr. Nice questions such as:
  • How to understand safety of medications when a parent is taking several of them.  Can we simply look at each one individually or is there a combined impact?
  • ​What if both parent and baby are taking medications - do we need to consider the safety of how those medications interact in combination?
  • ​When a parent is making less than a full milk supply, will the amount of the parent's medication in the milk be more concentrated or will the baby get less medication because there is less milk?​
...and more!
Jan 30, 2018

In the US, it is natural that we have a lot of concerns about the safety and side effects of domperidone.  Our Food & Drug Administration has not yet approved this medication (see episode #4 for more on that) so parents are generally obtaining it without a doctor's or certified nurse midwife's prescription*.  That also means that the pharmacist is not able to oversee use of domperidone and how it plays out with other medications that the nursing parent is taking.  That is our unfortunate reality today.  With this in mind, it is essential that parents and lactation professionals understand and take responsibility for possible contraindications and side effects associated with domperidone.  We are extremely fortunate once again to bend the hear of one of the most expert resources on safety and use of pharmaceuticals while breastfeeding, Dr. Frank Nice.

Jan 12, 2018

about their co-nursing experience, and with Katie about inducing lactation!  It has been a joy-filled road for them with a few bumps along the way ... including concerns with safety of medications, not always supportive healthcare providers, ​sore nipples, middle of the night challenges, and a bout of baby preferring one mom for bedtime nursing.  With creativity, communication and resourcefulness these two moms have navigated these challenges and now that baby is 10 months old they look back (and forward) to their nursing experiences with much gratitude.  

Dec 27, 2017

Dysphoric Milk Ejection Reflex, more commonly known as D-MER, is one of the most severe breastfeeding challenges yet also one of the least known or understood.  D-MER is a feeling of dysphoria caused by the hormonal shift that occurs when the milk releases during nursing, pumping, or any other time a let-down is triggered.  So if you or anyone you know experiences significant negative feelings when milk lets-down, you may want to hear what Alia Macrina Heise has to share.  Propelled by her personal experience with D-MER, Alia has become a clinical expert in the area of dysphoric milk ejection reflex.

Dec 13, 2017

Alyssa and Hope get real!  Being a new parent isn't always the blissful joy we might see on holiday cards.  It can be really tough times, as well as wonderful times.  We suggest that the balance lies in self-care.  It can be so difficult to care for ourselves as new parents, and we haven't always done the best job of it ourselves. We hope our stories and discussion will support you and propel you into a holiday season and new year of simple joys and caring for yourself just as well as you already do for your precious little ones. 

Nov 28, 2017

While using medications is a science, using herbs for increasing milk production doesn't seem quite as straightforward.  There are so many nuances to consider: 

  • ​How do I know if a particular herb is helpful for me?
  • What form of the herb should I take?
  • ​What about using herbs in combination with domperidone?
  • ​Can taking herbs alone boost my milk production?  Should I even try this?

Alyssa discusses these tricky herb questions and more in this Ask Dr. Nice episode.

Oct 25, 2017

Cathy, like so many other non-birthing parents wanting to induce lactation or relactate, is trying to unravel all of the varying information she has received.  So she emailed us for help.  When I suggested we might share her email on the podcast so that we could help others in her shoes, Cathy agreed.  This podcast episode is devoted to addressing Cathy's questions, concerns, and confusion around the basics of how to induce lactation/relactate -- and you might find it addresses some of yours as well!  Below is the email that is the inspiration for today's episode:

I am 38 and have an almost 3-year-old son whom I nursed from birth-22 months. We are in the process of adoption.  We are in process of our homestudy and imagine we'll be bringing an infant home within 9-12 months.  I am eager to relactate for this baby.  I have spoken with two of our local IBCLC's.  One suggested the Newman-Goldfarb protocol, and the second suggested I contact you.  My GP suggested I talk to my ob/gyn for the prescriptions and my ob/gyn said the only way to relactate is via pumping.  As you can imagine, I am a bit frustrated.
Oct 11, 2017

We are thrilled to re-visit an early podcast interview with Chrissy Fleishman who induced lactation for her baby born via surrogacy.  There are a couple of reasons why we are re-releasing it now.  One, we thought Chrissy gave a great interview.  She is well-informed and enthusiastic, and her experience has followed a fairly typical pattern - if there is such a thing in inducing lactation!  Second, we want to address a particular experience Chrissy shares.  Chrissy had Depo-Provera injections as a young adult in order to help with menstrual difficulties.  She experienced lactation as a side effect. Recently, there has been some information floating around online suggesting the use of Depo-Provera for inducing lactation.  This source cites a 1994 study done in Papua, New Guinea which 11 out of 12 mothers who had induced lactation with the help of a single Depo-Provera injection were able to fully lactate within a few weeks of starting the protocol.  (Nemba, 1994)  We agreed that this study seemed promising, not only because of the high rate of full lactation but also because the protocol described in the study takes much, much less time than other approaches typically used.  Although Alyssa had looked into this study when writing Breastfeeding Without Birthing, she decided it made sense to take another closer look and to contact some other professionals for their advice.  This podcast episode is about what she discovered (and in some cases  re-discovered).

Sep 27, 2017

We can't get enough of talking with Dr. Nice about medications for increasing milk production.  Domperidone is at the forefront of our discussion, as usual.  We delve a bit deeper into dosages and side effects of dom with Dr. Nice.   But we don't leave you there:  we know that domperidone is tricky business in the United States right now (since it is not yet FDA approved) and wondered if there may be other medications for increasing milk production that are both safe and more available in the US.  Dr. Nice has the answers!

Sep 13, 2017

I first learned about Malunggay (a.k.a. Moringa) as an herb to help with milk production when I was writing Breastfeeding Without Birthing.  When Diana West, IBCLC, author of Making More Milk and internationally known expert on milk production, was reviewing a draft of my book she suggested adding this really helpful herb.  I'm so glad she did!  Since then, I've worked with countless nursing parents who have successfully used this herb  -  whether they are inducing lactation, relactating, or needing to support milk production for other reasons.  During this interview, I chatted with Angela Veloso of Sugarpod Naturals, maker of Go-Lacta malunggay.  She has a rich knowledge and appreciation for this helpful herb, and after listening to her we think you will too!  

Read our full show notes at our website

Aug 30, 2017

I had a blast talking with SonJoria Sydnor and Denecia Harrell about support for breastfeeding families of color in the St. Louis area and beyond. They talked about the needs around breastfeeding for families of color and how they provide the specific support that is needed. Whether it is through group meetings, home visits, texts, or social media I AM: Breastfeeding is there for breastfeeding families of color in St. Louis. You can read the rest of our show notes here. 

Aug 9, 2017

A little something new with Dr. Nice!  We've talked with in the past with Dr. Nice mostly about galactogogues:  medications, herbs, and foods for promoting milk production.  This time we pick his brain about medications the nursing parent may take for herself rather than her milk production.  This includes medications for the nursing parent's health and for her recreation ... such as alcohol and marijuana. See more information on our show notes at:

Jul 25, 2017

Introducing the winners of the 2017 World Breastfeeding Triathlon!  Okay, I just made that up.  But if there was one, this couple would certainly have been a top contender.  Together they have successfully relactated, co-nursed, and nursed triplets.  Add tongue-ties for all of their children and you start to get the picture!  We think you will find this lovely couple as delightful and their story as heart-warming as we did! See more information on our show notes at:

Jul 12, 2017

Dr. Nice is back, and he answers questions about the other half of the galactogogue equation:  herbs and foods that may be used to support milk production.  (Last time we interviewed Dr. Nice, we discussed pharmaceutical medications for increasing milk production.  Check out episode #32.)  We discuss whether to take herbs individually or in combination, whether to consume them in food or separately, and more.  We even get into the relationship between digestion and milk production, and how using galactagogues that support digestion can support milk production as well.  Don't miss this one! See more information on our show notes at:

Jun 28, 2017

We've talked with other adoptive mothers before, but this one is different!  Jennifer brought her daughter home as an older baby and when she finally began nursing, her daughter was 2 years old.  Bringing a toddler to the breast required determination but it was well worth it, according to both Jennifer and her daughter Helina.  (Yes, you'll hear what 8-year-old Helina has to say about her nursing experience in this extraordinary episode!) See more information on our show notes at:

Jun 14, 2017

Because it is our mission at Breastfeeding Outside the Box to support non-traditional families - growing families who have historically not received the information and support they need and deserve - we are so pleased to introduce you to Queer Birth Project.  This is an amazing organization that provides local and online education and resources to both LGBTQ parents and the family building and early parenting professionals working with them. (That includes Lactation Professionals!)  And for families in the Minneapolis area, they hold a local community for new and growing LGBTQ families.  Queer Birth Project is run by Janine, a midwife, and Cheyenne, a doula:  two birthing professionals with a passion for backing growing LGTBQ families.  If you are a prospective or current LGBTQ parent, Queer Birth Project has much to offer you.  If you are a birth or lactation professional wanting to grow a LGTBQ+ practice, Janine and Cheyenne will direct you to your next steps. See more information on our show notes at:

May 31, 2017

In this episode, Dr. Frank Nice debuts his first special episode on our podcast! He gives some updates about Domperidone as well as talks about the use of Reglan for parents who want to use these medications to increase their milk production, as well as some of the risks and possible side effects. See more information on our show notes at:

Apr 26, 2017

Ah tongue- and lip-ties!  We've heard A LOT about them from our podcast interviewees.  Hope and I both have children who've had them.  So, while not outside-the-box per se, tongue- and lip-ties affect many babies regardless of any other circumstances and so we wanted to be sure to address them. 

Dr. Catherine Sledge is a family dentist who deals a lot with tongue- and lip-tie, and we are so thrilled that she was willing to take the time to talk with us and share her expertise on this very tricky and important issue potentially impacting breastfeeding...and so much more. See more information on our show notes at:

Apr 12, 2017

What do adoption, surrogacy, partnering with a birthing parent, breast/chest surgery, and insufficient glandular tissue (IGT) have in common?  Parents who CAN and DO breastfeed.  In most of these situations, parents will need to supplement their milk production with extra milk or formula in order to meet their babies needs.  How that supplementation goes greatly impacts the long term success of breastfeeding.  So, while we can address how to make the most milk possible, it is also at least as important to address how to work with what milk is there.  In today's podcast, we discuss how to determine whether supplementation is needed, how much to supplement, and tools for delivering the supplement.  See more information on our show notes at:

Mar 31, 2017

I (Alyssa) have had a guilty conscience for a long time.  On this podcast, in my private practice, in my book, and when I speak at conferences, I share breastfeeding guidance that I myself did not take when nursing my babies.  It's not that I am a hypocrite - it is that I just don't want other parents to go through the same struggles that I did.   So why am I sharing this with you?  I want you to know that, just like you, I did not do everything perfectly.  I also want you to know that despite my many mistakes, breastfeeding still turned out well for me in the long run - and it can for you too.    See more information on our show notes at:

Feb 22, 2017

What an opportunity to hear from a medical professional who has brought in milk for her adopted baby.  Deziray's expertise as a physician's assistant gave her added confidence in using a medical approach to inducing lactation.  For her, that worked really, really wonderfully.   She actually had a surplus of milk for her baby that she was able to donate her extra ounces to a friend unable to nurse due to cancer and to several other adoptive families. This degree of milk production is not typical for parents inducing lactation or relactating, but it certainly is exciting to know it is possible! See more information on our show notes at:

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