How to Prep for Infant Feeding with Victoria Facelli: Podcast Episode #201
Kristin Revere chats with Victoria Facelli IBCLC, author of Feed the Baby: An Inclusive Guide to Nursing, Bottle-Feeding and Everything in Between about the best ways to prep for infant feeding. Victoria has so many resources to help you! You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you find your podcasts.
Welcome. You’re listening to Ask the Doulas, a podcast where we talk to experts from all over the country about topics related to pregnancy, birth, postpartum, and early parenting. Let’s chat!
Kristin: Hello, hello. This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Victoria Facelli today. Victoria is an international board certified lactation consultant and a postpartum doula and a new author of the book called Feed the Baby: An Inclusive Guide to Nursing, Bottle Feeding, and Everything in Between. Welcome, Victoria!
Victoria: Hi! Thank you so much for having me. I’m so happy to be here.
Kristin: I am so excited to chat with you, and I love your book. It is so needed. So let’s get into a bit about your personal story that, of course, you share in your book, leading you to the journey of becoming a postpartum doula and IBCLC and then of course now an author.
Victoria: Yeah, it’s been quite a journey, let me tell. So I had been a nanny forever, and I did a lot of theater, so that sort of complimented what I was doing. And I just found that I loved that space right after a baby was born. There was just something so magical about that time in the early postpartum. And so I decided to become a postpartum doula and started that work and loved it. And then we happened to have a fabulous IBCLC program at the university up the road from me up at UNC, and so I decided, okay, let’s go for it. That was really the piece of my work that was fascinating to me and really driving me because it’s such a puzzle, and I like complex puzzles. So I found myself really drawn to that work and ended up getting my IBCLC and really diving into all of that and found that I was a little bit of a black sheep at times because I asked a lot of uncomfortable questions and was always looking to push the envelope. But in general, even though when I started my practice, I started a practice that was formula positive, when I had my own kid, I found that I was still carrying a lot of that kind of, like, best health misinformation with me.
Victoria: And so I had a really uncomplicated pregnancy. I was literally working at a doula agency, surrounded by birth doulas and postpartum doulas all day every day. I had two incredible birth doulas at my birth, this amazing midwifery team. And those outcomes happen, and we had one of those bad outcomes. And so my daughter was born not breathing and spent three weeks in the NICU. And as a result of that, has cerebral palsy. And so learning the motor planning of how to eat was our biggest barrier in leaving the NICU. So we left the NICU with me pumping and her bottle feeding, and then I pursued nursing directly for a good while, and we had her tongue tie revised and I was working with really phenomenal lactation consultants and finally came to a place where I was like, this is actually not helping. Like, I – we had so many appointments. We had so much going on. I really needed sleep due to the PTSD that I was navigating at the time. I was really physically ill. And so I just – so I took that off the table, and I’m really proud of that. And one of the things I talk about in the book is that it is good parenting to change your mind with the circumstance in front of you.
Victoria: And so I was so proud of that and then continued to pump for nine months which, to some degree, I regret. It was really negative for my health. And – but it was the one place where I had control, and it was so symbolic of who I was as a professional. So walking away from all that and with this much broader understanding of ableism and bodies and the way – like, the sheer – I think I say in the book, the sheer breadth of human experience that was just blown wide open for me in having my daughter, and so when the pandemic started and we locked down, my therapist told me that I needed something that was just about me. I had spent coming up on three years with total focus on my kid’s therapies and her needs and solving the complex problem that was having a disabled kid, and she really encouraged me to walk away from motherhood as a problem to solve and find something that was just for me. And so I started writing. And so the book came out a little bit memoir, both mine and that of other families. I really wanted to tell the stories of the complexity of our families and not sort of these – you often see in parenting books these little snippets of, like, Janet’s baby slept through the night at three months, and it was wonderful.
Kristin: Right, but the real story is the hardships are not shared as often.
Victoria: Yeah, you don’t hear about the fight she was having with her mother-in-law and, like, the depth of the pain of the miscarriage that she was still carrying with her and all of those pieces. And so it was really important to me to share really diverse stories with a lot of depth throughout the book. And then also I was writing a book that we need, that I had always had in my head, that I was forging a new path where I think the part of it that is most important to me is the everything in between, that for so many people, the journey into exclusive breastfeeding actually involves a lot of bottles and formula and pumping, or the road through weaning involves those things, or the transition back to work revolves around those tools. And so one of the things that was a beautiful gain of having a disabled child and being welcomed into this world of understanding disability was understanding that all tools are neutral, that a wheelchair isn’t bad. It’s a tool. And a communication device is a tool, and medication can be a tool. And tools are all neutral. A flathead screwdriver and a Phillips head screwdriver are morally neutral. And so can we move into a place where we can say, like, okay, all things being equal, like, human milk that a parent makes for their baby is species-specific, and that’s pretty groovy. And we have made this other incredible biomedical tool that we can use, and we can use those tools in a way that really honors those individual experiences.
Kristin: Exactly. I mean, you are speaking to me 100%. My doula agency is focused on unbiased, judgment-free support, so no matter how you birth, parent, feed your baby, we just want to support families, so this book is so needed. I feel like there are people in the camp of formula is more convenient and better, or pumping is the way to go, and then there’s of course breast is best as long as you can, and there’s so much judgment in feeding and also how we parent.
Victoria: And then the other part of it with feeding in particular is even if we step outside of that judgment piece, we’re the tools. You know, like people – we actually, in my opinion, are number of ways of feeding babies, the number of variables we’re managing, be that, like, brand new pumps hitting the market every 45 minutes, the one true upside of the formula shortage being an influx of different kinds of formula. We’re starting to see a little more diversity in our formulas across the board, as well as, like, a really wide range of how we navigate work, right?
Kristin: Yeah, and I love that you cover those different types of formula in the book. The goat’s milk and European formula versus – yeah.
Victoria: Because unless you really know where to find those people on the internet, you’re not going to find that info, and the Facebook groups are so overwhelming that I wanted people to be able to get – like, I just really wanted to get all the way out of the why you should feed your baby one way or another and get way into the how. And I sort of – for me, I likened it back to birth where I had the incredible experience of my best friend is a trained midwife, an infant massage therapist, a tattoo artist, and an illustrator, so she actually illustrated the book.
Kristin: I love the illustrations! That is so wonderful.
Victoria: Aren’t they stunning? Yeah, in love. So talented. And she also taught my childbirth ed class.
Kristin: Love it! So talented.
Victoria: So unbelievably talented. And taught the class from this perspective of, instead of not learning about birth tools because you’re scared that someone will foist them upon you, learn about them so that if you need them, you can make those tools. And I happened to have a birth – I was in active labor for around 72 hours. Quite active. And so I needed all the tools. There was not a tool – I guess we didn’t use a vacuum.
Kristin: Yeah, that’s a long labor.
Victoria: It was a long labor! I used every tool that that hospital had to offer, and knowing what they were and what they did was enormously helpful in making those decisions because it’s not that those tools are good or bad. It’s that they have different impacts depending on when and how we use them.
Kristin: Exactly. 100%.
Victoria: And that’s also the case with formula, right? If we indiscriminately use formula on day two after having a baby because we have a perception of low milk supply, even though low volumes are physiologically normal at that point, it’s going to disturb production in a really different way than at six or eight months, which is not to say it’s wrong to do that at day two, but we need to understand the how of that tool. And so I really wanted to get into, like, really concrete stuff for folks at two in the morning, and that’s such a funny thing in 2023 to, like, not be an Instagram star, not be all over my Facebook group, but rather to make a book, which is so old school, but it’s so concrete. It’s just like this is one thing. It is, like, one voice that covers all of the things. And so it just cuts through a little bit of the chaos. And then the other piece of it that I love, my favorite part of the book, is that there are QR codes to videos because I can tell you that nursing a baby is like eating a taco, not drinking a Slurpee, and I can show you an illustration, but to see a video of a real newborn actually latching is just a different thing.
Kristin: Totally, and the paced bottle feeding video – all of it is so needed. Like, the different holds that you illustrate. It’s excellent. It’s a way to modernize a book.
Victoria: Exactly. And it allows me to show different bodies and it – if you’re like, I’m confused. I’m overwhelmed. It’s just right there. You don’t have to search for anything. You’re already holding your phone, and it’s just right there.
Kristin: Instead of scrolling the moms’ groups, you have actionable videos at 2:00 in the morning. I love it.
Victoria: Yeah, and there’s so much – because of the privacy stuff and, like, the nature of bodies, a lot of that stuff will get filtered and so you end up with things like dolls or not really showing people’s chests. And so it also gives me a way to not have to worry about any of those filters and instead just, like, actually really show what people need.
Kristin: So excellent. I can’t wait to share this with the students in my Becoming a Mother course and our clients. So thank you for taking the time to make such an impactful book!
Victoria: I really hope it is impactful. I hope it brings in a new generation. Some of the formula companies are starting to catch on to this messaging of neutrality, but there’s still an ulterior motive there.
Kristin: Of course, to make money. Their brand.
Victoria: Yes, and it’s still not neutral to lots of pads and everybody in, and I just really – like, I wanted a book that dads could read. I wanted a book that grandparents could read that was really going to open that up for everybody.
Hey, Alyssa here. I’m just popping in to tell you about our course called Becoming. Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between. You’ll gain the confidence and skills you need for a smooth transition to motherhood. You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more. You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most. And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls. If you’d like to learn more about the course, you can email us at firstname.lastname@example.org, or check it out at www.thebecomingcourse.com. We’d love to see you there.
Kristin: Exactly, and I love that it’s so inclusive. Adoptive families, LGBTQ+, and also even getting into the plus size category that is not often covered, and we – my doula team recently had a training on supporting plus size families both in birth and postpartum, and it was eye opening to really learn some of the biases that are faced, not only in birth, but also with feeding.
Victoria: Absolutely. I mean, the medical bias around large and fat bodies is really something you need to take a hard look at, and bodies are different. Like, that is one of my things is that the different shapes and sizes of our bodies actually impacts the ergonomics of how we feed babies. And so we have to be direct about that. You actually need different holds. They’re going to be different depending on the size of your body. And the function and recovery, depending on the kind of birth you’ve had. There’s all of these pieces to it, and I will say that is one regret in the book. While I do have beautiful illustrations of holds of larger bodies, I was not able to find the right dyad for the videos, and I really wanted to do that well and not just sort of grab whomever to do that. And so one of the things that is great about QRs, though, is that the QRs are basically just an address to a door, so I can change what’s behind that door. So once I find the perfect team to include in there, to include those larger bodies and those other positions, I will update the video and change that on the back end because that is so important to me, and I was really grateful to the folks who were gracious in allowing my illustrator to illustrate those different holds and those larger bodies in feeding and really honor fat pregnancy and fat postpartum, and I feel really grateful for that and I look forward to continuing to push that envelope because it’s not my experience. I am straight sized. But it’s something that I think about a lot. And on the other end, we don’t see a lot of images of how to nurse with a really small chest, and people with pretty flat chests, as well, so that is another thing that I want to find just the right person and include more of that. But I do, in the topography of chests, have those smaller chests represented because I think it’s important for people to be able to see the difference between small chests that make enough milk and chest shapes that tend to indicate physiological low production, because it’s a really subtle difference that I find that many practitioners don’t know, let alone parents.
Kristin: Right, so true.
Victoria: So one of the things that I really want to get across in this book and in this work is how are we preparing for feeding? We do so much preparation for birth, and then we sort of assume that feeding will fall into place. And so how are we preparing? And the classes are phenomenal. What is missing from a class is you don’t, generally speaking, take your shirt off in breastfeeding class. So having that information of, like, how do you take stock of your own anatomy before you have a baby, as well as really taking a medical history of your chest and having a conversation about that medical history with your provider if it’s relevant. So if you have had surgery on your chest or armpits, if you have had augmentation or reduction, if you have flat nipples, if you have very wide spaced chest tissue, all of those things are things that it would be helpful to talk through with your practitioner before you have a baby.
Kristin: Absolutely. And you’re right, that’s not discussed oftentimes.
Victoria: No, and it’s really hard to process that information when you have a tiny baby in front of you.
Kristin: Yes, and you’re exhausted. Again, even talking about your own labor being multiple days and just learning as a new parent, or if you have other kids at home, every baby and every birth is different. And so I found that with my own kids and their feeding journeys. I had different struggles and still had to seek lactation consultant help. My son had a tongue tie, and my daughter was in the NICU. I had preeclampsia and had an induction, and she needed about four days for glucose issues. So I was pumping and she had formula and an IV, and then had to get help to transition to breastfeeding.
Victoria: Well, and the postpartum care for preeclampsia is also often very intense, which we don’t talk about very much.
Victoria: We don’t talk about the impact of hemorrhage, both psychologically and physiologically, and we don’t talk about the impact of preeclampsia physiologically and emotionally because it’s really something for those of you who have never had the experience of being on magnesium, which I have not personally, but having worked with clients who are on a magnesium IV, it’s like watching someone try to swim through concrete. And so being in a state where, as a human, as a mammal, you just want to get to your baby and your instincts are all to care and feed, and your body feels like you’re swimming through concrete. That really is traumatizing.
Victoria: Not to mention, either someone is going to have to help you express milk in that state, or it’s going to impact production, and that’s also really challenging.
Kristin: Yes. And then getting all of the judgment on how you should feed your baby from family and friends. Oh, just stick with formula, or I breastfed, so you need to. I was hearing so many different opinions as a new mom.
Victoria: Yeah, and it’s actually just more complicated, right? Maybe your family is very well meaning and saying, oh, just take care of yourself. You need to recover. But maybe your instinct is that part of your recovery is that reconnection through nursing. So it just actually is always more complicated than that, and how do we honor both? How do we sit in that in our discomfort with that middle, and that’s what attracted me to that phase of life anyway is that it’s messy and it’s problematic, and there’s not simple answers.
Kristin: Yeah. And like you said, Victoria, I mean, preparation with a breastfeeding class, having conversations with your provider, reading a book like Feed The Baby and getting as prepared as possible, and again, I felt like I needed to prepare both times and still even with being someone who plans, there were so many unexpected twists. Like, again, the tongue tie with my second child that was causing pain that I hadn’t experienced before, and I was tandem nursing, and so I had the supply, but you just never know.
Victoria: Yep. The tongue tie piece is so complex for people. I work in a tongue tie clinic that I started with a dentist because I was looking for a dentist with really strong ethics, and she was like, oh, that’s interesting. I did a PhD in infant suck physiology. I was like, okay. Great. You want to come take this tongue tie course together? She’s amazing. And then my illustrator and body worker also was in collaboration of starting that clinic, so our patients get to see a body worker, a dentist, and an IBCLC all in one visit, which is really helpful to people because one of the things that is so difficult with tongue ties is that you really need a functional assessment. It’s not just about how it looks. It’s really much more about how a baby is able to move their mouth, and the appearance really changes a good bit in those early weeks. And so depending on when a provider looks at it and who looks at it and their level of training, you’re going to get really different answers. And that is really confusing for folks.
Kristin: Absolutely. It is, because you don’t know which individual to listen to. I have that with my birth doula clients. They get different advice from the lactation consultant at the pediatrician’s office than they got in the hospital. So it’s like, who do I listen to? And then of course if they have a postpartum doula in their home who’s trying to support feeding and give referrals, you just – it’s overwhelming.
Victoria: It’s very overwhelming.
Kristin: The information doesn’t align.
Victoria: Yeah. Once your son’s tongue tie was resolved, did nursing get better?
Kristin: Absolutely. It was a breeze after that. It was just identifying, and it got a misdiagnosis at first, and my pediatrician caught it, but it wasn’t caught in the hospital. Yes, so it – I had no issues after that.
Victoria: That’s great. And that’s another thing I remind parents, that pain is your body communicating with you. So while pain is common, it is always a sign that you need more help. So any time you’re in pain, even if one provider brushes you off and says that looks normal, if you’re still in pain, to continue to pursue the people who are trying to find the answer for why you’re in pain.
Kristin: Absolutely, Victoria.
Victoria: Parents are tough. Like, I have seen parents tough out all manner of things. And as long as their baby’s gaining weight, they’re fine.
Kristin: Right, because that’s the goal is to gain.
Victoria: But you can do real damage. You can do real nerve damage to yourself, pushing through that. And so I always want people to listen to their own pain.
Kristin: Great advice. So what are your tips for partners and family members in supporting feeding?
Victoria: Well, unfortunately, it’s the advice that’s hardest for me to listen to myself, which is to try not to fix and to listen and respond and to really ask people, like, are you wanting to vent right now? Do you want help solving this? Do you want help finding someone to help solve this problem? Because sometimes you’re just in it, and you just need to be upset about it. And our inclination to problem solve sometimes from the outside can feel undermining. And so to just sit in that question with somebody and be like, okay, let’s go find a provider to give us advice to lead to where you want to be going instead of, like, you’re in pain, this is too hard, you should switch to formula. Really sitting in that with your partner, I think, is really important, or as a grandparent or a support person, to really try to get out of our own desire to solve the problem and instead sit in it, which is probably the hardest thing for me, which is why I’ve positioned myself to be the person people go to for the solving.
Kristin: I love it, yes. That makes sense.
Victoria: And then the other thing I want folks to learn about is protected sleep. This is my big soap box is that difficulty with feeding causes or exacerbates postpartum mood disorders.
Kristin: It does, yes.
Victoria: And we have a tendency to focus only on postpartum depression. Like, we actually use the word postpartum often too stand in for depression. And that is a tiny slice of what is a much bigger picture of often anxiety, postpartum PTSD, intrusive thoughts, which is sometimes part of obsessive compulsive disorder, which we think about as, like, cleanliness or light switches going on and off, but is actually intrusive thoughts, and those intrusive thoughts are often because of the nature of that mood disorder, the scariest thing we could possibly say out loud. And so then we don’t tell anyone that it’s happening because often those thoughts are something like, what if I leave my baby in the car? What if I roll over my baby, and it makes it sound like you want to harm your baby, and you don’t. You’re having intrusive thoughts that you might. Right? And those are really hard to spot. And so if you notice that your partner or your child, if you’re a grandparent, or your bestie is off, is just, like, generally pretty off, the first line of defense is to say, hey, if they’re nursing, like, nurse and pump, and then I want you to go to bed. One bottle of formula today is not going to rock the world, or if there’s some feeding stash, and put that person to bed for ideally six hours but at least four. White noise, no phone, you are not getting that person. Like, you can take care of that baby for six hours. Nothing catastrophic is going to happen in six hours. And if they wake up from that nap and feel better, then we can make a plan involving that person getting more rest or if they’re not able to sleep or wake up and are still feeling badly, it’s time to seek help. So your first easiest place to get help is the 24 hour line that you use for your birth practitioner. It’s the same line we’re going to use if you have mastitis. And you’re going to go ahead and call them and say that you need a referral for postpartum mental health for that individual. And then start working on a plan from there. But that protected sleep can be both therapeutic and diagnostic, and I feel like people don’t know enough about that tool.
Kristin: I’m so glad you brought up sleep, Victoria. It’s essential.
Victoria: It’s so essential. I mean, as postpartum doulas, we are the facilitators of that sleep, and so we know a lot about protected sleep, but you really don’t hear about it much in the common consciousness.
Kristin: Right, exactly. And with feedings, the rest is interrupted, and so to get a solid block can make a huge difference.
Victoria: Exactly, and if it doesn’t, then we know there’s something happening chemically that we really do need to take a hard look at. And I myself was pretty aggressively, I would say, medicated for my postpartum mood disorder and needed to be. I had very severe postpartum anxiety and depression and suicidality, and my word to folks in that experience is that there is treatment. It’s safe and well-tested, and you deserve to feel better.
Kristin: Exactly. Thank you so much for sharing! I feel like we could have ten different podcasts on all of your knowledge. But I would love to have you share more info on Feed the Baby, how our listeners can purchase your book, and all of the sites that you’re on as far as purchasing options and bookstores that you’re in and so on.
Victoria: Yeah, so I’m probably at your local bookstore. Feed The Baby is on Bookshop and Amazon and your Target app and all of those things. You can have the book right now digitally or overnight it from Amazon if you’re in that situation right now, or you can go ahead and get it from your local bookstore if you’re anticipating a baby. And you can find me – I’m mostly on Instagram, @victoria.facelli.ibclc. I’m attempting to be on TikTok, but it’s a stretch for me.
Kristin: I have an issue with TikTok as well. I feel like I’m just too old for it.
Victoria: I know, yeah, exactly. I’m trying to get into it, but it’s not my comfort zone. My comfort zone is definitely Instagram, like the millennial I am. But yeah, that’s where you can find me. My website, victoriafacelli.com, where you can find some of my videos, as well as on YouTube. Paced bottle feeding bodies, SNS, some info about poop transitions and kind of what to look for in baby poop, all that stuff, is up on YouTube. So those are all the spots where you can find me.
Kristin: Excellent! And any final thoughts to share or tips for our listeners?
Victoria: My big final statement in the book and in my heart is that I hope you feel like enough, because you are enough just as you are, and you are enough as a parent beyond how you feed your baby.
Kristin: Love it. So true. Thank you, Victoria! It was so amazing to chat with you today.
Victoria: So great to talk to you! Take care.
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