E 29. Going Back to Work: The Pumping Episode

It's day three. Or day four. Everyone keeps asking if your milk has come in, and you have no idea, and you are starting to panic. In this episode, Dr. Ashley Robinson, IBCLC, breaks down delayed onset of lactogenesis II, the medical term for milk that is late to arrive after birth. She explains how milk production actually switches on, what "delayed" really means, why up to one in four parents may experience it according to 2025 research, the biggest risk factors (from cesarean birth and gestational diabetes to separation from your baby and retained placenta), and exactly what to do while you wait: hand expression, frequent milk removal, how to tell if your baby is getting enough, and how to supplement without derailing breastfeeding. Evidence-based, calming, and practical for those long early days. Keywords: milk coming in, delayed lactogenesis II, delayed milk, colostrum, breastfeeding, lactation, IBCLC, newborn weight loss, low milk supply, hand expression.linktr.ee/drrobinsonibclcBook a virtual consult: ashleyrobinsonibclc.comThe Supportive Partner: available on AmazonFirstDays App: firstdaysapps.com

Can you take Ozempic, Wegovy, Mounjaro, or Zepbound while breastfeeding? It is one of the fastest-growing questions in lactation care, and most parents are getting a shrug instead of an answer. In this episode, Dr. Ashley Robinson, IBCLC, breaks down what GLP-1 medications actually are, what the newest human milk studies found about semaglutide and tirzepatide transfer into breast milk, and why the real breastfeeding concern is not the drug in your milk but the appetite it takes away from you. She covers timing, milk supply, protein and hydration, the birth control interaction nobody mentions, compounded versions, and how to talk to your provider without shame. Evidence-based, judgment-free, and very honest about what we still do not know. Keywords: GLP-1 breastfeeding, Ozempic breastfeeding, semaglutide breast milk, tirzepatide breastfeeding, Zepbound lactation, milk supply, IBCLC, lactation, breastfeeding, postpartum weight loss.linktr.ee/drrobinsonibclcBook a virtual consult: ashleyrobinsonibclc.comThe Supportive Partner: Buy HEREFirstDays App: firstdaysapps.comDiab H, Fuquay T, Datta P, Bickel U, Thompson J, Krutsch K. Subcutaneous Semaglutide during Breastfeeding: Infant Safety Regarding Drug Transfer into Human Milk. Nutrients. 2024;16(17):2886. doi:10.3390/nu16172886. (8 lactating participants; semaglutide not detected in any milk sample.)Thompson J, Diab H, Datta P, Krutsch K. Tirzepatide (Zepbound) in Human Milk During Periods of Maternal Dosing. SSRN preprint, 2025. doi:10.2139/ssrn.5387250. (5 participants on 2.5 to 5 mg weekly; tirzepatide not quantifiable in any sample up to 168 hours post-dose; calculated relative infant dose below 0.05%. Preprint, not yet peer reviewed.)Mozaffarian D et al. Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. American Journal of Clinical Nutrition. 2025;122(1):344-367.InfantRisk Center. Can You Take Zepbound While Breastfeeding? New Human Milk Study Findings. May 12, 2026.

"The Birth Control Episode: What Your OB Didn't Tell You About Hormones and Your Milk Supply"Your six-week postpartum appointment lasts approximately eleven minutes. In those eleven minutes, someone asks how you're feeding, hands you a prescription for birth control, and sends you on your way. What they often don't tell you: some hormonal contraceptives can affect your milk supply, and the timing of when you start them matters more than most providers realize. In this episode, Dr. Ashley Robinson, IBCLC, breaks down the evidence on birth control and breastfeeding: what suppresses milk supply and what doesn't, what the 2025 WHO recommendations actually say, the truth about the mini pill, Depo-Provera, the hormonal IUD, the copper IUD, and how to have a real conversation with your provider about protecting your supply while also taking care of yourself. Keywords: breastfeeding, birth control, milk supply, IBCLC, hormonal contraception, postpartum, lactation, progestin, LAM.linktr.ee/drrobinsonibclcBook a virtual consult: ashleyrobinsonibclc.comThe Supportive Partner: available on AmazonFirstDays App: firstdaysapps.com

Right when your milk lets down — right at that moment — a wave of dread, sadness, or anxiety washes over you. It lasts about sixty seconds. Then it's gone. And you have no idea why it keeps happening, and nobody has ever mentioned it to you, and you're starting to wonder if you hate breastfeeding. You don't. You might have D-MER. In this episode, Dr. Ashley Robinson, IBCLC, explains Dysphoric Milk Ejection Reflex: what it is, why it happens, the dopamine mechanism behind it, why it's so underdiagnosed, how to tell it apart from postpartum depression, and what actually helps. Recent research suggests up to one in five breastfeeding people may experience it. You are not alone. Keywords: DMER, D-MER, dysphoric milk ejection reflex, breastfeeding, lactation, IBCLC, milk letdown, postpartum mental health.Linktree: linktr.ee/drrobinsonibclcVirtual Consult & The Supportive Partner: ashleyrobinsonibclc.comFirstDays app: firstdaysapps.com

Someone in your mom group swears by lactation cookies. Your postpartum doula mentioned fenugreek. Your mother-in-law is ordering you a special tea. And you're wondering — does any of this actually work? In this episode, Dr. Ashley Robinson, IBCLC, breaks down the evidence on lactation cookies, galactagogue supplements, and herbal teas: what a 2023 randomized controlled trial actually found, why so many people swear by things that don't hold up in research, what galactagogues can and can't do, and what actually matters for your milk supply. Evidence-based, myth-busting, and not here to take your cookies — just your misconceptions. Keywords: lactation cookies, galactagogues, breastfeeding supplements, milk supply, IBCLC, lactation, fenugreek, breastfeeding.Linktree: linktr.ee/drrobinsonibclc Virtual consult & The Supportive Partner: ashleyrobinsonibclc.comFirstDays app: firstdaysapps.com

Everyone warns you about low milk supply. Nobody warns you about what happens when you have too much. In this episode, Dr. Ashley Robinson, IBCLC, covers hyperlactation — oversupply of breast milk — a common and frequently misdiagnosed condition that can make breastfeeding miserable for both parent and baby. She walks through what oversupply actually looks like (hint: it's not just leaking everywhere), why babies with hyperlactation are so often misdiagnosed with colic, reflux, or milk protein allergy, and what the evidence says about managing it — including the block feeding approach from ABM Clinical Protocol #32. If breastfeeding feels like drowning instead of flowing, or your baby comes off the breast gagging and screaming, this episode will finally give you the language for what's happening. Keywords: breastfeeding, IBCLC, lactation, oversupply, hyperlactation, block feeding, overactive letdown, breastfeeding problems.linktr.ee/drrobinsonibclcBook a virtual consult: ashleyrobinsonibclc.comFirstDays App: firstdaysapps.com

It is the most common question in every lactation consultation, every new parent support group, and every 2am internet spiral: is my breastfed baby getting enough milk? In this episode, Dr. Ashley Robinson, IBCLC, cuts through the noise and gives you the actual clinical answer — what matters, what doesn't, and why the 7% weight loss rule you've been given may be doing more harm than good. She walks through the real markers of breastfeeding adequacy, explains the Newborn Weight Tool (NEWT) and what it means for supplementation decisions, and breaks down what your baby's diapers are telling you that your scale isn't. If you've ever stared at a baby who just nursed for 45 minutes and still wondered if it was enough — this episode is for you. Keywords: breastfeeding, IBCLC, lactation, newborn weight loss, breastfeeding adequacy, supplementation, NEWT tool.Check Me Out HERE Book a virtual consult FirstDays AppNeed more podcasts? Check out Public Health in 5!

Breastfeeding and Postpartum Anxiety: What Nobody Talks About"Everyone talks about postpartum depression. Far fewer people talk about postpartum anxiety — and almost nobody talks about what happens when postpartum anxiety and breastfeeding collide.In this episode, Dr. Ashley Robinson, IBCLC, takes a deep, honest look at postpartum anxiety in breastfeeding parents — what it looks like, how it differs from typical new-parent worry, and why it is so often missed and underdiagnosed. She covers the complicated relationship between breastfeeding and anxiety, including how breastfeeding can both support and worsen mental health depending on the context. She also introduces D-MER — dysphoric milk ejection reflex — a physiological phenomenon that causes a sudden wave of negative emotions at letdown, and why it is so frequently misunderstood.Plus: the overlap between anxiety and low supply fears, and when and how to seek help.🔗 linktr.ee/drrobinsonibclcBook a virtual consult: ashleyrobinsonibclc.comThe Supportive Partner — available on AmazonFirstDays App: firstdaysapps.com

You woke up at 3am with a hard lump, a fever, and seventeen browser tabs open — and none of them agree on what you're supposed to do. In this episode, Dr. Ashley Robinson, IBCLC, breaks down the mastitis spectrum using ABM Clinical Protocol #36 (Revised 2022): what's actually happening in your breast, why aggressive massage and force-pumping can make things worse, and exactly what the evidence says to do for blocked ducts, blebs, inflammatory mastitis, bacterial mastitis, and abscess. She also covers emerging evidence on photobiomodulation (low-level laser therapy) for recurrent breast inflammation — and when to call your doctor vs. manage at home. Keywords: breastfeeding, IBCLC, lactation, mastitis, blocked duct, bleb, breast inflammation, ABM protocol.linktr.ee/drrobinsonibclcBook a virtual consult: ashleyrobinsonibclc.comFirstDays App: firstdaysapps.com

Going back to work while breastfeeding is one of the most logistically overwhelming transitions a new parent faces. And most of the advice out there? Either too vague to be useful, or so overwhelming it makes you want to cry. In this episode, Dr. Ashley Robinson, IBCLC, breasks it all down: how to build a pumping schedule that actually protects your supply, what your legal rights are at work, how to talk to your employer about pumping time and space, how to store milk safely, and how to keep your supply up when you're spending eights hours a day away from your baby. This episode is the pumping-at-work guild you wish someone had handed you at your baby shower. LinkTree: Click hereBook a virtual consult HEREThe Supportive Partner found on Amazon, Barnes & Noble or my website: www.ashleyrobinsonibclc.comFirstDays: The baby tracking app build by an IBCLC. Available NOW on the Apple App Store!! Check it out here www.firstdaysapps.com