When the Clinician Becomes the Patient

In order to stay on this journey, you have to have what me and you have, which is this unnatural— or like, just like you just want to give the breast milk. I can't explain it, I don't know what it is, but I'm gonna work like hell to make it happen.

And we do. Hi and welcome to the Untethered Podcast. Today we have Tamari Jacob joining us. Tamari is determined to change the world one pumping session at a time. Through her own experience as a pumping mom, she saw a huge gap in resources, education, and support for women who need to pump. So she set out to fill that gap as a certified lactation counselor and founder of One with the Pump. Over the last few years, she's been able to help thousands of moms by sharing pumping products that she believes in, and she's created training programs that she teaches now to help everyone pump better, helping these moms to feel empowered to advocate for themselves throughout their journey.

Welcome to the Untethered Podcast. I am your host, Hallie Bulkin. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner, and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up-to-date information in the orofacial myofunctional therapy, airway, tethered oral tissue, and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide. If you've been around since June 2019, thanks for being a loyal listener. As we jump into today's episode, remember to listen with correct oral rest posture— tongue up, Lips closed, teeth apart, breathe through your nose. Let's get started.

Mari, welcome to the podcast.

Well, thank you for having me.

I'm excited to dive in today because I know you are all about the pump. I would love for you just to share with everyone listening a little bit about who you are, who you are, and how you came to do the work that you're doing right now.

First of all, thank you for having me. I love being here and I just love connecting with other moms, other communities. I feel like you and I have a very similar story where you really needed something, it wasn't available, and you're like, I think I'm going to create it. And then so many other moms are like, oh, thank God someone finally came up with this. And the fact that it wasn't available yet is also crazy. So I had my daughter in March of 2020, if everyone remembers what was going on in the world then. I basically had— I had my first son actually in 2017. I guess we're really starting quick. But I had my first son in 2017, and I assumed that I would nurse because why wouldn't I nurse? Mom nurse, like my family nurse. I was very familiar with it. And I remember like my OB was asking like, oh, do you plan to nurse? And I was like, yeah, like I hope I'll be able to. And she was like, oh, well, like if you can't nurse, you can always just pump. And I was like so taken aback. I was like, what do you mean? Like, how do you pump? It's like, who knows what it is? Everyone just puts that in a box and they never think about it again. So I didn't really think about it. And then lo and behold, my son came out and it was one problem after the next. This child would latch onto anything besides for me. He would have a pacifier and a bottle and this. He just would not, could not latch onto me. I was a first-time mom. I had no idea what I was doing. Just nothing. I didn't know that if your baby isn't nursing well, you have to supplement. My baby to the pediatrician for the first day, no diaper bag, no bottle. He pooped when he was there. I didn't even know what to do. We had to take him home in a dirty diaper because they didn't— it was just— such a hot— was a hot mess express. I ended up trying really, really hard to nurse for 2 months. Countless, countless lactation consultants, countless money on items to see if this would work and that would work and this bottle and that pump and this flange, just a bunch of different things. At 2 months postpartum, I made the sad decision that I was like, I just— I cannot do this anymore. And I was making a decent amount of milk, which I didn't know at the time, which was amazing. I was making a decent amount of milk and I just decided I'm going to pump full time, which was apparently called exclusive pumping, which I did not know. Now, this was very much pre all the stuff. It's not like— I don't remember if Instagram was a thing yet, but it definitely wasn't a big thing yet because I wasn't on it. And I remember like I found these random blogs and I found this Facebook group for exclusively pumping moms, which definitely was— I was like, Wow, I cannot believe how many people here actually exclusively pump. I couldn't even believe it. So I ended up exclusively pumping. It was a very— I didn't know at the time, but going through it, it was a very, very just emotional journey. I didn't realize how much I was grieving the nursing journey that I didn't have. And I kind of just went through it. I went up to 10 months. I ended up giving 2 months of formula, and I just put the whole situation behind me. Great. We move on. He's very cute now. Love him. Then when I'm pregnant with my daughter, I was like, I really— that was just 2 and a half years later— I really, really, really want to nurse. Hopefully it's going to work. But then she was born March 2020. And remember, guys, that like March to April, it was that— it was that in-between. There was no Zoom yet. There was just— no one knew what was going on. So there was no option to see someone virtually, but you couldn't see anyone in person. Because the world had just shut down. So I tried enough. The first case of COVID came into the hospital I was in as I was walking out with her. So we were— everyone was just like kind of dealing with other things. I basically ended up exclusively pumping for her as well. 2 months into my journey, I'm on my way to my 3-month appointment with her, and I text one of my friends in our group chat, and I'm like, should I put all my pumping information onto an Instagram? Just for like all my friends who are interested in seeing it. They're like, of course, go ahead and do it. Like just for my friends, like just because like then like I was pumping and then like the other friends from high school were asking me questions and I was like, put this together, I have enough information. And when you have basically no other accounts, it, it went very well is basically what I'm going to say. Just it went very well, very quickly because it was a huge need. There were at the time— now there's so many, but at the time there were very few exclusively pumping accounts. There were, there were a couple of nurses who wanted, but very few focused on pumping. So I was an early childhood teacher while I was doing this as a side hustle. Did that together for about 3 years. I was doing consults at 6 AM, at 7 AM before I taught. I would teach throughout the day, go on my lunch break, do another consult, go home, deal with my 2 babies at home, and then I would do consults at night. And then eventually, thank God, I was able to retire from teaching. And do you want me to come full-time? And here we are now. I'm out of doing a podcast at 1:45 in the afternoon when normally I would be teaching little children. So here we are. Thanks for having me.

That's exciting and awesome. And how incredible, right? I mean, it's so funny because I, a lot of, I dunno if a lot of people know this, but when I started in my career, I started in business and I didn't do well in my first business class. And I was like, I'm gonna do business one day. And so I pivoted after that semester and I went and took like winter semester classes. I was at University of Maryland. And took like— I just need to get my grades up a little because I'd always been like a straight-A student. So this was like wild for me, right? So I go, I take this like history of rock and roll, which you can never get into because like the football players and everybody gets to like enroll first. And so if you're doing it on a winter semester, you can get in, but not necessarily during your normal.

Okay.

It's like the history of baseball in America or something too, which was like— and let me tell you, they were fun classes. I was like, what's that? And like, I was actually very interested in both.

That sounds fun.

Very good classes if they still exist at University of Maryland. I, I won't say how old I am. I'm 40, so it's been a while. Fast forward, I then go into like early education and my dad is like, you're never gonna be able to support your lifestyle on a teacher salary. Like, haha, joke's on you. And I was like, okay, I don't really necessarily wanna be a teacher because I'm so ADHD. Like, I don't know that being in that same classroom every day is gonna serve me well, but I wanna work with children. I couldn't figure out what it was, so I. Quickly pivoted and I was like, psychology, that's it. And then I discovered my aunt was a speech pathologist and, oh wow, fell in love with like speech pathology and then ended up pivoting to that. Didn't get to study abroad because that would have extended my college years. I went to grad school at University of Maryland and here we are. There's so many parallels whenever we talk.

Yeah, ADHD thing, right?

I'm like, I knew I wanted a business, I wanted to work with young children, I just didn't know what capacity. And I kind of finally worked my way through and figured it out. And even when I started out, I was doing like speech and early language development, and then saw these kids had feeding things going on. And again, like, nobody was really teaching how to do this. There were good courses out there, but you would leave the course and be like, I know what to do with these 3 kids on my caseload, but after I do this, what's next, right? And, and again, and then fast forward 10 years later, pandemic happens and everything. And I graduated grad school in spring of 2009, So fast forward to 2019, I'm like, I'm like, I feel like I should be sharing this information. It doesn't really exist or people aren't really talking about it that much yet. And it was funny 'cause I wanted to start with the myo course and my friend was like, you really need a pediatric feeding course, like a comprehensive pediatric feeding course. They, so my team and I were just looking these stats up. I think it's zero. Oh no, 0.04, whatever it is, 0.04%. So less than 1% of colleges and universities teach pediatric feeding to speech pathologists and OTs. I'm like, what? And they're teaching— what? Yeah, swallowing for adults, but it's very different. There's different anatomy and physiology and just everything happening with breast and bottle feeding and introducing solids and how all the anatomy is changing. And so crazy, like, it's totally different than a stroke patient or somebody who's had a traumatic brain injury or whatever.

Wow. Yeah, pediatricians and OBs do not get any lactation education, which is crazy. You know, crazy that they don't get like— and then, and then moms don't know. So they go to their OB, who's seemingly a doctor, or go to their pediatrician to ask information. Not the fault of that provider. They don't really have the information. The good ones will tell you that they don't have the information and they'll refer out. The bad ones will give you that false information. And then it really, it really has a very negative effect on your journey. And especially like in those early days where you're really going back, it can be really, it can be really big. My goal is to like get into as many offices as I can so I can like get those moms before the problems start. But I listen sometimes. Yes.

Yeah. I mean, yeah, I had similar experiences with both my babies. So my first one was born, she had a tongue tie. She— we had painful breastfeeding for 13 months. At one point I would like have to turn my head away from her because I didn't want her to see like my face while she was lactating. Latching because it hurts so bad. And like, when she was latching, my letdown happened. Like, I'm like, okay, we'd get into a groove and it wasn't like as painful. It was tolerable at that point. Yeah, I had people saying the dumbest things to me. I took her to the IBCLC at the pediatrician's office. I sought out help and nobody— like, and of course it was like, take your car into the shop, you take the baby into the lactation consultant's office, and all of a sudden they position her, they get her down naked, they position her, they put her here, she feeds well, and they're like, look, she transferred And I'm like, and it never happens ever again. That will never happen again. Yeah.

And it doesn't. And it doesn't happen again.

Yeah. And that's what happened. And I was like, oh, it's like when I take my car to the shop and it has a noise. Cool.

You got it. Okay. 100%.

I mean, it's so stressful. Like she had that colicky baby with gas and didn't have reflux but had air-induced reflux and all these symptoms that I didn't know were tongue-tie related and just like digestion and texture, at least part.

Is that especially when you are a first-time mom, if you don't know what you don't know— I literally did not know what a tongue tie was.

Neither did I. 12+ months, like in toddler feeding and like upward. And I had never worked with like the birth to 12 crowd, so I wasn't working on like, you know, breast, bottle, or transition to solids. And so that was really humbling to have a child.

I had no idea. And that's the thing, like Then once you do finally find out, you feel so stupid and you're so upset. Like, I always think, like, if I knew the information I knew now with my first, we probably wouldn't have the journey that we had. But I'm like, okay, but then I'd still be a teacher in a different life. So everything works out the way— I think we're teachers.

We love—

there's a system for me. Exactly.

That's what I think. I came back to my bio course. She was 24 months old. I flipped her over. I looked under her lip and her tongue and I was like, ah, there it is.

There you go. Found it. Found it.

It was 2 years ago. And then my next one was born 6 months later. I was like, oh, let's look into her. And I kind of was like, I'm just going to latch her the first day in the hospital. I'm not going to look. The second I latched her, I was like, oh crap. Yeah. And it was very interesting because— and I'm sure you probably have heard these dynamics and maybe you know better than I do even. But in the hospitals, there's such a gag order on nurses diagnosing tongue ties in certain hospital settings. What was very fascinating was before, like when I commented like, oh, this, her latch is shallow and she's not latching well and she's getting a little fussy and whatever. And like obviously just born, like she doesn't need to transfer that much, but like, right, right. She maybe she just wants to comfort nurse. And they were like, oh, okay. And so they sent in lactation and let me help you and this, that, and the other. And it wasn't until the next day when I said, I'm, I'm a speech pathologist, I am trained, I teach. Teach speech, like SLP, OT, PT, how to do infant/toddler feeding. I was like, she has a tongue tie and I can diagnose that with my license. So, and they were like, oh, do you want us to— okay, well, let me assess. Oh yeah, we see the tongue tie now. Do you want a hospital surgeon to release that? I was like, step away from my baby. No, I do not want you to release that and bill me. I have my oral surgeon I'm going to. Thank you very much. I will take her as soon as we leave here. Like, don't touch her.

Right. Yeah, but like literally majority of moms, I would never have known that. Like that's not something that they talk about. And it's really stressful because you don't even know. Half of them, you don't even know what the problem is. And you don't even know, like moms don't know. Like they'll go anywhere. Like the doctor says, oh, like when I was a first-time mom, if they told me that in the hospital, like, oh, you want us to release it? I would have been like, yeah, you can do that. Thank you so much. That'd be perfect. 100%, I would have said yes. Yeah, well, and listen, maybe they did it or they did a good job, but I went to an oral surgeon who did a great job and I was much happier in that situation. But it just goes to show that like there isn't enough education about what it is that— I always say majority of the people that come to me, it's not for their first, it's for their second or third. They had a tumultuous first journey. Feeding went terribly. They did not reach any of their goals or their goals in the way that they thought they were going to. They want things to be differently the next time, whether it's to be able to give breast milk full breast milk, less formula, more formula, less pumping, more pumping, whatever it is. They understood that they did not know a thing. And they understood now with their second that if they do have the information, they could potentially have a different journey. But it takes you, like when I get a first-time mom, I'm like, beautiful, let's get to business here. The majority of the time it's the second or third really trying to change their journey, which is what I did also. You just don't know what don't know at the time and it's very difficult. And you honestly, there's a lot of talks about forgiving yourself about I literally have to forgive myself for my first journey with my son. Like I didn't know anything. I really tried my best. Like I tried so hard. I probably would have tried less had I known what my life would have turned out to be because I pumped from him. I probably would have been like, it's fine, I'd rather just type. But like I didn't even know and I was, I had so much breastfeeding grief. That I didn't even understand what it was like. Yeah, I, I had babies a similar time with a lot of my friends, which a lot of people do, because when you're the same age, a lot of times that happens. And they would like pick up their shirt and they would just nurse their baby and it was going fine. Or their baby wouldn't take a bottle. And I was like, oh, what a problem. Like their baby won't take a bottle. My baby won't take a breast. It's literally, literally, if his life depended on it, he would have starved. If I didn't have a breast pump, this child would have starved. Because he would not, he could not take it. He really had to come to a lot of terms with that. And I had to forgive myself. I had to forgive him. I was very resentful, whether I wanted to admit it or not. But at the time, I was very resentful towards him. Why can't you latch? Why can't you do this? And I was upset at myself. And there was just so much feeling of not being able to get over the breastfeeding journey that you didn't have, that you wanted to have, whether it was like You ended up giving formula you didn't want to. We love formula. Formula's great, but if you don't want it, that's also okay. You're just forgiving yourself for that. And there's so much breastfeeding grief that comes to it. So those are the people that usually are able to then change their journeys for the next one. So it kind of just depends where you are at in your journey, but there's, there's so much emotional baggage and stuff, and it all stems from the fact that you have no idea what the hell you're doing. That's really where it comes from. Circling back to the beginning of our point.

100%. I mean, and I think you made— you brought up so many great points. I was basically triple feeding my child and I didn't know I was triple feeding, feeding her, bottle feeding her, pumping. Like, she was so cool.

By the way, I also call triple feeding hell on earth. That's my best whole term for it.

I'm sure you have some sense. Well, she's feeding on one side, which will take her probably a solid 40 minutes to empty that breast. So I'm going to pump on this side and then whatever I feel, if she seems unhappy, I'm going to give her bottle feed her next, or we'll bottle feed her in 25 minutes when she's fussy again. Exactly. The milk drawer was always open, constantly feeding her around the clock. And she was that kiddo who also was like never getting over the first percentile weight-wise, super tiny. Like, but the doctor's like, oh, she's on her own growth curve and staying on it. And I'm like, but we have all these other things. I'm like, I'm not worried about that. The fact that I can't keep pants on my kid is one thing, but the other, like the bigger issue is— and she didn't look malnourished or anything, but I'm like, it was literally feeding her around the clock. And I, after having my second one, realized how many emotions I had about that, right? With my first one, the second one was released. Her tongue tie was released day 5. It was a very different feeding journey. I got her in. She had like a tight neck. So little. They didn't diagnose torticollis, but then they gave me the torticollis sheet and said her neck was tight.

Oh, interesting.

Yeah.

Tell me more.

She then like her crawl was actually dragging one leg behind her as she like scooted across the room for a while. When she did that, we were probably in and out of PT for like 8 months with her. But her breastfeeding journey was fantastic and she would take a bottle and she's like, it was everything. And so it was like, oh, we got this. Like, yeah, because I was like, you said it was a shell. And I realized how much like emotional baggage there was around that. I was actually on a podcast a couple of years ago. I don't know if you know Taylor, Taylor Kulik, but I was talking to her. She was on the podcast. We were having a conversation. I was like almost in tears. I was like, all of a sudden I just had this like realization. It was like emotional release where I was like, wow, it really actually impacted. And like my daughter and I have a very close relationship. She's now 10, my oldest. But I was like, it really impacted things between us, you know, how I felt about her versus like 100% it was with my second because I knew what to do the second time around and I had the right supports. And when I when I didn't feel like it was working, I felt like there were other avenues and other people now that I could talk to because I was now deep, deep down this rabbit hole of support.

100%.

100%. And I always—

it's on me.

I was a feeding therapist, but I'm also like, jokes on me. Well, what about, like you said, all these other parents who, one, have no clue, they're not even in a related space, and so they're completely navigating this on their own, thinking this is normal, and also realizing this is probably not normal, but everybody's gaslighting me. And so—

exactly, exactly. They don't even know to stick up for themselves. Something that's really important that I always say is that when you're a first-time mom, you don't trust yourself at all, but you also don't know who to trust around you because everyone around you who all mean well, like your mom, your grandmother, your sister, your aunt, you love all of them. They all have different opinions and you love all of them, but you have no idea who to believe. So you're like, okay, my sister recently had kids, so maybe I should believe her. But this girl doesn't know anything that she's talking about. She just randomly had a good journey and she was lucky about it. So your mom's like, no, no, no, I'm telling you, if you do this, back and you're like, girl, you didn't have kids in 30 years. I don't even know what I'm listening to you for. And then your grandmother comes and God knows they didn't even make breast pumps back with her. So you have all these different people saying things. You don't trust yourself. Trust your gut. You don't even know what your gut is. Your gut is nowhere in the room with us. You have no idea who to believe. And then your pediatrician says something, your OB says something, lactation consultant, 7 lactation consultants, 7 different opinions. It is so overwhelming.

And you're about to scream like, what the heck? Like, what do I do? And you're in survival mode.

It's beyond, beyond, beyond overwhelming. Something that I say to do is that I always say, find one person that you trust and just stick with them. Because this way, at least everything is like this. Like, you're not taking this from this and this from this. So I always tell people, if you find me, trust me. I promise I know what I'm talking about. But I'm like, at least stick to what it is. Because if you're listening to 10 things of 10 different people, you're not getting a full picture of anything. So just find one person, one professional, not like your bestie who doesn't know anything and you're just like, she seems good. Pick a professional that you could stick with and just stay with them. Again, if things are going well, things are improving, you feel like you have the right information. If you're working with a provider and you're like, this man has no idea what they're talking about, then find someone else. Fine. But just kind of like, in that way, just kind of stick with someone. Don't go with 100 different opinions because it can be really hard. And there's just so much attached to that time period, which is like, oh, God, thank God it's over.

Yeah.

Thank God it's over.

It's a lot.

It is a lot. Yeah.

It's like, yeah, out of all of this, because I feel like this is breastfeeding, bottle feeding, pumping, like whatever avenue you're going or not going. And also I was really stubborn and was like, I'm not giving my baby formula. And I gave— so my, my first one, then I'll get back to the question in a second because this is fun. My first one, she lost so much weight in the hospital. They're like, oh, you have to go for weight checks when you, you know, when like the first day you're home, basically. And we stayed a little longer because I was induced. And the whole birth experience was not a good one anyways. Like, I lost a lot of blood, but I didn't hemorrhage. And so, like, the room was spinning and I couldn't even, like, really take— bring her to my body and latch her right away. Anyways, it was like a whole, like, for, like, a couple of hours. It was a whole thing. Anywho, fast forward, we take her to the pediatrician. They're like, oh, let's supplement with some formula. And every, like, part of my body was like, no, like, I don't want it. And they're like, well, maybe your milk hasn't come in yet. And it had, but like, They didn't know what they were talking about. Also, no one told me to order a pump yet. Apparently I should have done that, like, either when I went to the hospital or the week before. But here we are. So my mom is going to Target to get me a hand pump. I'm trying to learn how to hand express with a screaming baby.

And I could write a book about first-time mom situations. You and every other chapter.

Right, right. I'm like, that's why we need to talk about it, though, because people have no idea how common this is. And I tell everyone, I'm like, please, you're a good Dar— no, sorry, they gave me Similac and it was like in a ready-to-feed bottle. So I take it home and thought it would be a good idea when she was fussing in the middle of the night. So I try to give her some.

It sounds like a good idea.

Sounds like a good idea until baby is now screaming, like blood curdling, like somebody is hurting her. Clearly, clearly could not digest the milk protein. Oh my God.

Okay, that's, that's, that's, that's so bingo. Like, that's not necessarily so expected. That's special for me.

That is not as expected, right? So that happens. But the part that was like really frustrating for me, like more so because my mom was there. So I'm like, my mom, like, who lived down the street, like, moved in for a week, right? So I'm crying, the baby's crying. My mom's like, I don't know what to do with the two of you. Like, it's like 3 a.m.

and she's like, I don't know what to do. Been there, girl. Been there.

I was like, I'm never feeding her a bottle again, or I'm never feeding her like formula again. Yeah, formula. So the next morning we call a pediatrician's office and we update them and they're like, well, that has 3 milk proteins. Maybe you should try Gerber Good Start that only has 1 milk protein. And I was like, like, you're clearly not hearing me, but sure. My mom went and picked it up, picked up the formula, and I donated it. I was like, no, I'm not putting this in my kid. Like, I was so traumatized by like that first night that I was like, this has not been easy already. The baby's not even a week old yet. Like, we're 5 days old here and my baby's screaming bloody murder in the middle of the night. Hello? Nobody can help me, right? And then I was the one who figured out, like, she's not latching well, she's not pulling milk. I'm finally— the breast pump came. It was—

well, the fact that you were able to figure that out— I'm saying my first experience when I couldn't get my baby on, I opened the pump, obviously fresh from the factory, like, didn't sterilize a thing because my baby's screaming. I don't even know how to put this pump together. So we're like putting it together. This— that I'm, I'm pumping. I'm pumping and then a half an ounce is coming out and I'm giving it, unscrewing it, pouring that into my mom's bottle that she's holding to feed the baby, putting it back on, pumping more. Like, just keep— we keep refilling the bottle back and forth, back and forth. My biggest thing that I tell first-time moms— I have a first-time moms workshop that I give sometimes, and I say I give them the whole rundown of things. I go, not only do you give birth, then you have to push out the placenta. Like, things that you think people know, they do not know. They're like, you're pushing again. I'm like, pushing again? There's no baby in there.

I'm like, what the hell are you talking about? So I tell them everything.

That they never heard of. And the main thing that I say is, even if you think you're not going to use it, get yourself a pump, take out the parts, sterilize it, watch a bit, watch my video, watch a video to know how to work it. Because when it is 2 AM, like, imagine in your situation, had you had that breast pump, or my situation, ready to go, and you could be like, okay, this is the first time, so I'm nervous, but at least I know what button to freaking push, or I had to put it on so I'm not going to damage my nipples, or Or that phalanges come in sizes because you think I knew that? No, no, because the box comes in 24s and 28s and majority of moms are 17 and 19. You think they know that?

That was too big. Didn't know that until I had it for a whole year.

Yeah, of course it is. And moms, it's equivalent, guys, if you're using the wrong size flange. The flange is the plastic piece that goes on your breast when you're pumping. It's equivalent to wearing a size 10 shoe when you're a size 6. That's what you're doing. If you're wearing too big or too small phalanges, you can cause major damage. You can have no milk coming out. It's just a hot mess and you want to take it out. Just prepare. Worst case scenario, you pack that back up and you donate it to your friend who will be more than happy to have it. Do yourself a favor and have it ready because you do not want to be like either of us, even though more people will. But learn from us, guys.

Learn from us.

Don't, don't be like—

part was insurance covered 100% of my pump. Exactly. So, you know, and I— it was a great— I think it was like a Spectra, whatever the Spectra model was back in 2015. It was like top of the line. Like, it was amazing.

Options for pumps. There's no reason to be going to Target. And especially, listen, hand pumps are good for what hand pumps are good for, but you need an electric pump.

When you're a late-night mom with a screaming baby and you're like, it was hard.

I was like, thank God she got something. So you know what? Learn from us. Don't be a hot mess in the middle of the night, even though, listen, If you are, or you've been there, we've all been there. You come out on the other side better for it. But the main thing is that if you want your journey— listen, there's something like me and you have it, and a lot of people have it, this unnatural want to get breast milk. I don't know. I don't know what made me have it. We just want it. There's nothing wrong with formula, guys. Formula saves lives. Formula saves breastfeeding journeys. We love formula. But it's also— and I say this now, like, I feel like these days and age, it's actually becoming more of a thing where, like, you have to, you have to, you have to stand behind the fact that you are pumping. And like, people are like, why are you doing that? So much work. Just give formula. And I'm like, no, like, it's okay to do whatever you want to do, whatever works for you. But like, in order to stay on this journey, you have to have what me and you have, which is this unnatural or like just on— like, you just want to give the breast milk. I can't explain it. I don't know what it is, but I'm going to work like hell to make it happen.

And we do.

Thank God. Usually we make it happen. But otherwise you're just going to be like, forget it, I'm just going to give formula, which is fine if that's the option for you. But for people like me and you, I don't know, I think we have high pain tolerances or something. And just—

we just do have a high pain tolerance, actually. So that is absolutely true. And I don't remember if it was 2015 with my first one or like in 20 into 2016, or if it didn't come out till closer to 2018. But like the, you know, the breast pumps on the go where you could like charge and put it—

was actually like more closer to 2020, was closer to 2020 because they did not have it at all when I had my son in 2017 and they had just come out with the first one.

I bought one of the first ones that ever came out. It was like a They were probably demoing it whenever I was like, yeah, okay, for it.

Yeah, I got it.

Yeah. And I like went back to work like 5 months in, a couple of days a week treating patients, and I was driving down the road with those things in my bra and I am killing it.

Love it, love it, love it. And listen, if it works, that's fantastic. The thing is that you have to— when something isn't working, you got to listen, guys. It's a hard journey. Breastfeeding, nursing, pumping.

It is.

It is not for them.

Yeah. What do you think the hardest thing is about, like, exclusively pumping? Like, physical? Is it emotional, logistical, all of the above? Like, what are your thoughts?

Yeah, I think it is the time commitment because if you— I'm terrible at math, but if you would multiply how many hours you are pumping over a year's journey, I mean, like, let's see, what would you even ask? You would say, like, how many It's like 30 minutes. So it's like 4 hours or 5 hours a day times 5 hours a day times 365.

How much time is a pumping mom spend pumping in the first—

in the baby's life? 1,825 hours a year. That's if you're pumping 5 hours a day for one year. Like that. So that right there is your answer. It is the time. It is. Waking up in the morning and you have a million things to do and you have to pump. Getting ready. Yeah, it's getting ready to go to bed and you're so tired and you have to pump.

Yeah, I do think that there is 50 to 1500 hours depending on if you're combo feeding, if you're full-time exclusively pumping, definitely exclusively pumping, you'll be closer to like the 1500, like you were kind of saying, number. And then it's like, that's like 37 full 40-hour work weeks.

37. I think that's more than whatever the job is, which is crazy. It really is. And like, it really does feel like a full-time job because between the pumping and then like the milk management. So if you have a lot of milk, you have to manage all that breast milk. If you don't have a lot of milk, you're stressing about not having a lot of milk. So on both ends, you're just stressed out.

Yeah. So exclusive pumpers are working the equivalent of basically a full-time job for nearly 9 months straight without weekends, holidays, or paid time off.

People will say like, oh, you're feeling like really tired. Can you just take one day off? I can't even take one hour off. Yeah. You know, I will say though, one tip that I will say, if you do have the right equipment, it does make it a lot easier. If you have— when I was first— before I was like doing this for my full-time jobs, so I had a pump in every room that you walked into. I remember I had one pump and I remember I told my husband, I was like, we all lived in an apartment. It was a one-bedroom apartment. It wasn't that big. But I was like, I really want another pump to keep in the living room. I was like, I want one in the bedroom and one in the living room. And I was like, I just— I want it. Like, I want two of them. And he was like, OK. And I remember like that changed everything because you don't even realize how annoying it is to have to go into that room, unplug it because back then everything was really plugged in.

Carry it around with you everywhere.

Plug it in. It's like all these little things. So if you can get the pump, get the pump. How the methods of storing the milk. I get to like have the equipment. Get yourself a nice pump bag that makes you smile when you're packing it up. You deserve it. You deserve it. It makes it so much better. And no worries, guys, because if anyone says anything to you about how expensive any of those things are, it is significantly cheaper than formula. Significantly. People are spending $50 to $70 a week on formula. So that bag that you're getting one time and it lasts for the entire year. Don't worry, you deserve it. I said so.

Well, and the best part, I remember when I was traveling and there were a couple times I traveled while breastfeeding without like the kids, was you could go through TSA with a closed water bottle because you were a breastfeeding mom and you had a whole like, right? I was like, oh, this is the, this is the, this is the trick.

Milk. Like you could have it. Listen, they'll check it through.

I have the milk in the freezer bag and I was like, it's like, do I need it?

I need it.

So funny. Oh my goodness. Oh, so, okay, so now you've had— you said 2, 2 feeding journeys, 2 kids so far or more?

I have, I have 4 children.

You have 4 children. Okay.

I have 4 children.

My—

at the time that we're recording this, my baby is about 7 months old and it has been— I am combo, meaning both nursing and pumping. And it is the best journey that I've had so far. I'm actually not even nursing the most. I nursed my third the most while I was still teaching. But I think I've just— I've accepted what it is that I'm looking for. I understand what it is that I'm doing. And I realize that as long as me and my baby are happy, that's what matters. So it took me, guys, till my fourth child to really come at ease. My first, hot mess beyond. Number 2, pandemic situation, bad. Exclusively pumped also for that one. My third one, he came out with a massive mouth. He would have had a field day, like so much anatomy going on. Just, I was like, look at his lips, there's so much going on here. Latched right away and I was like, oh my God, he like healed so much of my trauma. Like he was just amazing. But I had to go back to work at 4 months. So I ended up having to then— I had to then pump and then give him a bottle and all that stuff. So like, I nursed him the most though until about, I think, like 10 months. And then at 10 months, I just went exclusively pumping because I was like, he doesn't really care for this anymore. I never had that baby. Those moms whose babies are like attached to them for nursing, like picking up their shirt, wanting it, only soothes from the breast.

Like, that was my first one. Even though she could barely take the milk out of my breast, she literally just wanted to be on me 24/7.

So like, my babies just don't— like, they're, they're so happy with silicone. Like, they love a bottle, they love a paci. Like, they're fine with the boob. I think like even for this baby, like, he would be totally fine if I never nursed him. I nurse him for me because I love it and it's just super like— and it is. I love it. He's like, and like crying, crying. Also, I stick my thing and he's like, oh, and I'm like, my whole heart, like, it's just so—

right, really?

It's just like everything, like, like the golden, like everything is just better now. Like, I love it. It's like such a special moment for us and like, it's working well, it's going well. And the breastfeeding journeys don't always look easy. I remember I wanted to nurse him exclusively 100% and I really was trying to make it work. And I went back to my lactation consultant. I had a great one this third time around— fourth time around, sorry. I finally got a good one and I went back for our third appointment and she— I was like, well, what do you want to nurse 100% of the time? And she's like, she's like, but Tamari, do you want to be with your baby 100% of the time? And I was like, what? No, no. And she was like, well, then you can't nurse 100% of the time. She's like, you have to think about what your values are because some people— I had a good friend that also had a baby at the same time, and she was— she's very crunchy and like, well, that like doesn't have a bottle, doesn't even own a pump, nothing. And I was like kind of looking to emulate that. Until I was talking it through because I take good notes. And I was like, I realized I actually don't want what she has. I want to be able to nurse, but I want to be able to leave my baby with my husband or my mom or my babysitter, say peace out and see you in a few hours. And it's OK to change what you thought or even what you fought so hard for to change that into something that works for you.

I love that.

I love that. So that's been— that's been growth. We have grown here.

That's a lot of growth. I mean, and I think it probably helps so much too, just working with other moms and babies and knowing like everyone's journey is different, everybody's goals are different. I'm always that person who's like, there's the textbook, what they teach you, and then there's real life. And I always— and I was like, I'm so glad that I never judged a parent for like their choices before I had kids, because once I had kids, I'm like, it was the most humbling experience. And I think for all of us, we're all very humbled by children and, and the world.

Nothing that we did worked. None of it. None of the above. Nothing that we did. It really just reminds you that you do not have all the answers, that you are just doing your best, and that you need to rely on people around you. We're all just a hot mess, and that's okay. Listen, hot mess express. Scrambling to clean up this room before we got on this podcast. I was like, okay. And there's still, that's some puff crumbs right there on the floor. You see that? I've been covering that the whole time. Just like, turn back right here. We'll deal with them later. No one knows anything.

Real life stuff, right? And it's so interesting too, because I think like when you're genuine and when you're here for the parent, you're here for the child, like that's what attracts those families to you who are like, I know that you're going to have my best interest in mind and you're not going to push your agenda on me. Yes, you may be the professional, you may have the knowledge, you may know best case scenario or best practice or whatever the evidence says, but then also there's humans. We're dealing with humans in real life.

I love that you just said that about pushing your agenda. That's such an important thing. I was doing an expo one time with a different lactation consultant. They had like dropped both of us in. I don't know why. I guess teamwork or whatever. And I had bottles and pumps and all this stuff on the table because I want to show parents. And she looks over, she goes, oh, good, there's no pacifiers on the table. And I'm like, it's only because I forgot it at home. Like, come on, let me get it. Like, I would have. Like, is there, like, is there? And that's the thing, like, that just makes me want to say it louder. And I was telling you before we started recording, like, I'm not like other lactation consultants. I really, like, when I get on a consult with a mom, one of the first questions I say is, besides where I'm like, how are you? But like, no, really, how are you? And I'm like, what is your goal? What's your feeding goal?

What can I help you?

I'm here because I want to help you do what you want, and then I'll make it happen for you. Because I have a mind.

That's the best practitioners. And I think so many people have gotten so far away from that. And I always— people are like that. They're like, Hallie, when— why is it that your patients, like, complete therapy with you? Why is it that they keep coming back? Why is it that you make so much progress so quickly? Why is it this? And I'm like, well, I just help them. Yeah, I reflect back what they're saying. Yeah. Today, like when you're working with children too, even though moms and babies, yes, but also children, no child is going to show up and go through steps 1, 2, and 3 on your agenda today. That is just not going to happen. Yeah. Like, where they're at right now. And keep in mind, why are they here? What's their goal? If you're constantly pushing your goal, guess what? They're going to go find somebody else who's going to hear them and listen to them. Because again, we're all human.

Or, or they won't and they'll just feel defeated. That's right. Because that's the other option that I've seen. Because I don't know, because they think that that's the only way, which is really hard. So I'll be like, they'll be like, can I actually pump less frequently and get formula? Sure, that's what you want to do. I'll help you do it. My main goal is breast milk. I don't care how it gets to the baby, whatever it is you, you want, whoever you're working with, no matter what kind of doctor it is, to be hearing what you're saying and helping you reach whatever your goal is. If you don't know what your goal is, that's also okay. You can do some exploring by talking. Like, sometimes someone will be like, I don't really know what I want. I just like, I feel very overwhelmed. And I'm like, say less, I've got you. And then I'll go over and I'll say, this is an option for you. You can nurse exclusively, but then do one pump during the day that your husband can give a bottle to, and you can go take a break. And I'll say, how does that feel when I say that? And I'll give different scenarios for them and I'll just say, which one of these feels the best? And whichever one feels the best, we'll figure out how to make that one happen for them.

Yeah. No, I love it. It's very patient-centered. We've, most people have gotten so far away from that and I feel like there is this big drive to like kind of come back to it again. I know obviously that's not, if things are dictated by health insurance in this country, that looks very different. Yeah. But for those of us who tend to own our own practices and work face-to-face with patients, we tend to have a little more wiggle room whether we're taking insurance or not. We get to choose how we spend that time. But I think it's just so, so critical that message that parents like, and we have parents who listen to the podcast, not just providers, but like parents listening. You drive the boat like you are the ones. Yes. And also we're going to help you with treatment and implementation and all the things. But at the end of the day, either you're going to do it or you're not going to do it. You're going to take the advice.

You can argue.

Yeah. Yeah.

It's okay to argue. It's okay. I mean, listen, be nice. Don't, don't be mean, but it's okay to ask questions and it's okay to push a little bit. This is your baby, your body. Like, don't tell anyone what it is that you should be doing. Like, you ask some more questions. That's what you should be doing.

Yeah, like, don't just settle for one person telling you this is how it is. Exactly. And look, we get people in our, in our practice sometimes where they do hand kids to us and they're like, here, fix my child. And we're like, that's not how it works, right? But that's not the breast bottle feeding families typically. That's usually a little bit older. Yeah, there needs to be a little more engagement here. And then that takes some education, some massaging relationship and some just understanding all around, like whether or not this is the right fit and are we going to, are we willing to all work together towards your end goal? Keeping the parent end goal in mind, this conversation of kind of bringing it back to the patient and or the dyad and letting them kind of drive the boat and keeping in mind like their goal. If you don't know what your patient's goal is and you've got a, you don't know any of your patient's goals are, you're just like, oh, I saw dysfunction and I have to fix it. And that's where you're focused, it's time to have a session where you start the session and just say, so let's revisit why you're here.

Yes, exactly. You— it's like, because I've had—

I'm sure.

Yes, 100%.

And dive in.

Yeah.

So tell everybody where they can find you.

Thank you for having me. I love chatting with you. Once you get off the podcast, we have to continue to stay friends in real life. Okay? We'll make it happen. You can find me at One with the Pump on all platforms. Instagram, TikTok. Yes, I did it. I'm on TikTok, YouTube. All of the things. If you need help, we do one-to-one consults. I have an alternate pumping course. You can use the code UNTETHERED for 10% off. I'm here to support you. Whatever your feeding goals are, as you heard, we are here. So find me @momwithapump. I would love to hang out with you, get you feeling not over— if you're feeling overwhelmed, we're going to fix that. And I want to make you just, just feel a little bit more in control. So thank you guys for hanging out with us and listening to all the goodies that we have to say today.

Quick disclaimer: all information, content, and material of this podcast are the opinions of the speakers and is for informational purposes only and not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified healthcare provider. Thanks for listening to this podcast. If you found value in this episode and want to hear more of these Myotots airway and feeding related episodes, be sure to leave a review on Apple Podcasts and share this episode on your social media platforms. You can access free resources and all I offer at halliebulkin.com or pop over to @halliebulkin on Instagram to get all the latest updates.