Lactation Expert Amy Peterson on Balancing Breast & Bottle Feeding

October 30, 2016

Amy Peterson is a lactation and breastfeeding expert. She is the co-author of BALANCING THE BREAST AND THE BOTTLE. She spoke with CareGuide about trends in breastfeeding, provided advice for new mothers and spoke about her extensive research which shows how a mother can use bottles and formula effective. Expecting parents and mothers need to read this interview!

Interview with Amy Peterson

Amy Peterson lactation expert and co-author of Balancing the Breast and the Bottle

by Clarke Illmatical

How did you become a lactation specialist?

“I have four of my own children that I breastfed and started working to help breastfeeding moms about 20 years ago.

As I worked with moms helping them achieve their breastfeeding goals, I found that I became a specialist for really hard breastfeeding cases. Most of the babies that have worked with me have seen two or three breastfeeding specialists before they came to me and then I was even stumped on occasion and that’s when I found my co-author who’s a speech language pathologist, so we started working together. That was about 10 years ago. My first babies were babies that were having breastfeeding difficulties and we both looked at the mouth, but we approach it differently.

The speech pathologist brings in a bottle and different tools to help the oral motor weakness or bring organization to whatever is happening. So we were able to start using bottles to fix breastfeeding, which was an eye opener, because in my world if you’re breastfeeding you don’t use bottles.

Now we were using bottles frequently to fix breastfeeding and then what we found since we became the experts on this new way… helping moms resolve breastfeeding problems. We found lots of moms who were just returning to work or school or just wanted to use the bottle in addition to breastfeeding started contacting me to find out how you do it. So, we found that we were answering the same questions over and over again and decided to write it down, which is when we made our book…

A lot of what is in the lactation field is very skeptical of bottle abuse, or lots of warnings about the dangers of bottles, but we found over and over that it was a tool that could help extend breastfeeding. We love working with moms…”

So based on your research, the bottle is an assistant with breastfeeding?

“Yes. It can be a tool to correct breastfeeding difficulties.”

I spoke to a newborn care specialist and she said that some of her clients, had never held children before. I’m not trying to be judgemental but is there a disintegration within the family unit in America?

“I think part of it is, we are separated from our families. I live in Idaho, but my immediate family, my parents, and brothers are in Texas, I have family in California, New York, everyone is spread out now. I think that causes some difficulties because when you have a child, and you breastfeed or have a child in general… When you have a child it’s something intimate and it may not be something you want to share with the neighbors…

I also think in the information age, a lot of moms are looking for online resources to answer questions. There are losing the personal aspect and there is something really wonderful about having a human coming along your side during that time rather than just reading about it.

Also, there are quite a few women reading what to do, not only is there conflicting information out there, but moms want to do it right. Doing what works best for them because there is no right way, there are lots of right ways to achieve your goal…”

As a lactation specialist, what is the most typical problem associated with breastfeeding?

“I think that probably the two most difficult things I see are, it hurts, so they need specific help on how to feed your baby without it hurting and then the other how to know it’s going well.

Because if you have a bottle and you know how much a baby is supposed to get, you can calculate how much they’re getting and now your baby is doing well. With breastfeeding it’s kind of a mystery, so, just knowing how to be confident…”

Chapter 1 of your book is BREASTMILK IS BEST. Do suggest that a mother uses formula occasionally? Or are you totally against formula? Or do you have strong feelings about it? One mother told me that there are instances where she has to use it.

“My feeling is, babies need to eat. Whatever that looks like. Breastfeeding is a biological normal way. Dogs drink dog milk, horses drink horses milk, Humans drink human milk. I think, biological that’s how we’re created. I’d much rather see a baby eating than not breastfeed.

I know a lot of moms may have trouble with milk supply or working out the logistics… When I go see a mom who has been feeding her baby while waiting to get help; my first statement is always ‘Thank you for feeding your baby!’ Because babies need to eat.

We have an industry that has strived to make infant feeding safe for every baby and we need that.”

As a lactation specialist, what is your relationship with the pediatrician? When would a mother consult you or someone like you? When do you get involved?

“You have to look at what doctors do in school, they do learn normal infant feeding, then they spend a lot of their time learning how to overcome problems, how to work through these illnesses. How to deal with things that aren’t healthy… They don’t spend a lot of time on infants. In schooling, they don’t.

I’ve done some teaching at nursing colleges, they give a couple of hours on infant feeding and that’s it. It’s not their specialty. It’s a small piece of the puzzle of what we do…

in the lactation world, that’s our main focus. If you go to a doctor, at least in America, depends on what the appointment’s for, let’s say a twenty minutes appointment, maybe thirty minutes, they have to look at the whole baby. When we see a baby we can spend an hour and a half. We don’t have to measure them… we’re just going to work on feeding. We have a lot more time to focus on one area to focus on one area.

If it’s just a simple problem, sure ask your doctor, but if you feel like you need a significant time or help, working with someone who specializes in that…”

Are there instances where pediatricians have good intentions, but would it be good advice for mothers to seek out someone like you? Go the extra mile to get a lactation consultant.

“Anytime she still has unanswered questions or she doesn’t feel that the problem was resolved, that would be a good time to get help.

Also, if her goal is exclusive breastfeeding, and that’s not working or the baby is not gaining weight, so she’s doing some formula or some breast milk, it’s great to go to a lactation consultant, even if there’s gonna be formula involved.

To look at what the underlying issues, a lot of time, it’s freeing to know when your body is not cooperating and lactation consultants can help you understand what’s going on and work through that…”

In terms of healthy breast milk, when it comes to a diet, these days mothers have different lifestyles, what does mother need to have in her diet to have healthy breastmilk?

“A well rounded balanced diet. There needs to be protein, there need to be healthy fats.

Our bodies are amazing though, regardless of what the mom eats, her body is going to draw from her stores to make nutritious breast milk.

So when I work with moms who may be teenager moms, they’re worried that they don’t eat healthy enough, that they should just formula feed, but then you’re gonna suffer, your babies are going to be fine…”

How long typically is breast milk stored?

“First thing to know, as milk is stored, the way it is stored, the nutrients start to dim a little bit. So depending on how long the mom needs store milk will determine what she needs to do.

Room temperature milk would be the best choice. She can leave it on a counter, to feed the baby. If it’s gonna be a while, she’ll want to refrigerate it or freeze it. But each active refrigeration starts to interfere with the nutrients.

Not in a large way, but if you want a hierarchy room temperature would be your best choice, followed by storage in the fridge, followed by storage in the freezer.”

Mothers who are pumping, in your book you have several chapters or sections on pumping. Parenting has changed in America. A lot of mothers are going back to work in a few weeks after they’ve had their children. Pumping at work, do you have any advice? I’ve heard that some mothers don’t feel comfortable pumping at work.

“Well, I think if there’s separation and moms can pump at work that’s an attitude thing, she should feel empowered to be able to do that for her baby. Opposite of guilty. Yay, that she has the opportunity to provide for her baby during separation!

When moms go back to work so early iit so important to continue pumping to keep your milk supply up. Even in the workplace environment, moms have a hard time finding a private place, I have been seeing lately, moms with nursing covers … I have seen moms using those at the workplace for pumping. They just sit at their desk and power through. Which to me is amazing. They need a medal and we need to put them on posters. I’m not sure all moms would be comfortable…

Let’s say they’re working at a place where they just can’t pump, moms need to know even if they can’t pump during work during work hours, their body will learn to keep making milk when they are with their baby… so even if it’s not okay to pump, it’s going to happen, they can still breastfeed. They would use formula during separation and they could breastfeed when they’re together. A lot of moms don’t know that…”

Based on my research, I’ve come to find out that certain fathers go through a period of jealousy or neglect after the child is born. Is this something you’ve experienced?

“I’ve seen it a few times, I’m not sure in my experience if I’ve found it to be often. But I have seen it… It would be great if dads could remember that adults can have delayed gratification, more than a baby could. If you need to wait five minutes because she’s tending to her baby, you’re an adult. Also, there are so many ways a dad can support a mom. It is really important for mom and dads to spend time together. The baby is just one tiny snapshot of their time together…”

Postpartum depression or the Baby Blues. How does this affect breastfeeding? Does it impact it?

It usually doesn’t impact the milk supply but there’s been some great research on how babies are affected by a mom that’s depressed or isn’t present and what we find is babies do best with a mom is having good mental health. Moms need to get help and their babies will benefit from that.

Based on your research, when should a baby start and stop breastfeeding?

“For starting, they can start when they’re born. A lot of moms… the average time it takes for a baby to latch on the first time is like 56 minutes after the birth. They are born and they just kind of chill out and go through a series and movements. They don’t just get out and start nurturing right away, most babies… It’s going to take about an hour. Right now, the American Academy of Pediatrics recommends a minimum of a year. Most other health authorities in the globally recommend a minimum of two years. Then as long as mutually desired…”

Why are some mothers opposed to pacifier?

“I’m going to guess that they’re afraid it will impact the breastfeeding. Research shows that it doesn’t…. I also think it could be sanitation, they fall on the ground…. There’re lots of reasons but it’s a personal preference…”

There’s no substitution for a professional, but what was your target audience? Who needs to read the book? I looked at the comments on Amazon and mothers were saying it was an invaluable book. What can mothers or parents expect to get after reading?

“The audience is expecting parents and first-time parents or even if they have more children if they were planning to use a bottle and it didn’t go successfully before… In the beginning, it has a lot of basic information on how to get breastfeeding off to a good start. Then the rest of it goes through how to adapt to choosing and using a bottle or pacifier or milk storage. Moms who know that they’re going to introduce a bottle and know they’re going to breastfeed, this book is for them.”

For more information on Amy Peterson and to purchase her book visit:

Balancing the Breast and the Bottle Book Cover

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