Lactation Conversation with Adrienne Koznek


Adrienne Koznek on Mixed Dentition Podcast

Adrienne Koznek is an IBCLC certified Lactation Consultant. Through her company, Wy'East Lactation Support, she provides breastfeeding Moms the support they need to navigate this special and delicate bonding experience. Her special interests include oral restriction/tongue tie, the newborn period, and returning to work outside the home.


In this episode, she talks to Dr. Stafford about the importance of breastfeeding, how she provides support, red flags to watch out for, tongue and lip tie restrictions, and advice for first time Moms. You can learn more about everything she offers the community on her WEBSITE.

Listen, read, watch! You can listen right here, or with a podcast app of your choice. You can also read the complete transcript below, or scroll to the bottom of this post for the video.


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Dr. Stafford: Hi. This is Dr. Michelle Stafford here again with our podcast, Mixed Dentition, and my special guest today is Adrienne Koznek. Thank you for coming.


Adrienne Koznek: Thank you for having me.


Dr. Stafford: Your business is Wy'East Lactation Support.


Adrienne Koznek: Yes. Mm-hmm (affirmative).


Dr. Stafford: And you are a lactation consultant.


Adrienne Koznek: I am, yes. I'm a IBCLC, which means that I'm board certified to provide expert lactation care for moms and babies, and their families.


Dr. Stafford: That is so wonderful. You have such a great job.


Adrienne Koznek: It's the best.


Dr. Stafford: And so important. Ah, I just love it.


Adrienne Koznek: Yeah.


Dr. Stafford: Well I think we can start off talking about why breastfeeding is so important. I mean, I know we could probably talk hours about why it's so important.


Adrienne Koznek: Certainly, yes.


Dr. Stafford: Maybe just give me your top five reasons.


Adrienne Koznek: Well, I think for me personally, the things that I care about most when it comes to breastfeeding is, breastfeeding is a public health issue, and the amount of positive outcomes that there are from babies who are breastfed and for the breastfeeding parent as well, and how much money the community can save and just global health-wise like how much money can be saved from preventative diseases and all of that.


Adrienne Koznek: Then I also believe really strongly in breastfeeding as the foundation of secure attachment. I think it's a really, really great way to have babies be bonded to their parents in a very important way.


Dr. Stafford: That's great.


Adrienne Koznek: It's a huge part of raising a securely attached child.


Dr. Stafford: Mm-hmm (affirmative). Yep, I couldn't agree more.


Adrienne Koznek: Yeah.


Dr. Stafford: Thank you for all that you do for our families.


Adrienne Koznek: Yeah.


Dr. Stafford: Because it's so important to have lactation consultants and support.


Adrienne Koznek: I mean, it's my pleasure. It's really ... it's such a joy to get to be able to support families on such a tender time in their lives too. And there's so much going on and it's ... I mean, their worlds are just rocked when you have a baby. So it's a big honor and privilege to be chosen to support a family in that time.


Dr. Stafford: Mm-hmm (affirmative).


Dr. Stafford: Tell me exactly how you provide support to new moms? Say it's their first time baby, and she's just learning. I mean, I've been there.


Adrienne Koznek: Yeah.


Dr. Stafford: You're just learning how to nurse this tiny little human. Tell me how you provide that support to new moms.


Adrienne Koznek: I think that we spend a lot of time planning for pregnancy, and planning for childbirth, and we read all of the books about that, and we make these beautiful, amazing plans of how we want our births to go, and then we forget to read the breastfeeding books. I mean, I know I certainly did, for sure.


Adrienne Koznek: So then we're kind of thrown into it, and learning how to do it while doing it, and that's not easy. You know, breastfeeding is natural in that it's a biological imperative that babies are born to do it. But that doesn't mean that it's easy, and it doesn't mean that it comes naturally. There's definitely a learning curve, and there's a real art to it.


Adrienne Koznek: So, how I support families when learning how to breastfeed is teaching them the basics of what good breastfeeding looks like and what it should feel like, and what are the signs that they can look for to know that their baby is getting enough milk, because that's definitely like the number one thing that parents worry about. I'm sure of it. That's on everybody's mind.


Dr. Stafford: Right.


Adrienne Koznek: So providing those basics, and oftentimes my support comes by way of they're having problems. Something is not going right, breastfeeding is painful, they're worried about whatever. So then, they come to me and then I help them problem solve, and strategize, whether it ... what is the problem, I can help identify what the problem is, if there is one. And then how do we solve that?


Dr. Stafford: Right.


Adrienne Koznek: Yeah. So that's where my expertise comes in, is knowing what good breastfeeding looks like and then what are red flags in breastfeeding, and helping parents navigate kind of where they are with that.


Dr. Stafford: That's great.


Dr. Stafford: For new moms especially, can you give us a couple of what do you call red flags? Because I think there is a misperception. Moms know that breastfeeding is supposed to be natural, and a lot of people out there are saying that sometimes it hurts, and sometimes it's uncomfortable and just get used to it. Right?


Adrienne Koznek: Right.


Dr. Stafford: But maybe that's not the best advice.


Adrienne Koznek: Yeah, I think it's well intended because I think that we all hear stories about breastfeeding being painful and that you have to push through it, and you have to tough it out and all those things. Pain is a sign that something is wrong, so I really stress the importance of being able to differentiate what is normal transient tenderness, normal soreness in the first week, 10 days max, and then what is beyond the realm of normal.


Adrienne Koznek: I would say that if you're having consistent, like persistent pain and soreness, and tenderness beyond the first two weeks, then there's something that needs to be looked at for sure.


Dr. Stafford: What could some of those causes of that discomfort for moms be?


Adrienne Koznek: It's kind of Occam's razor. Generally speaking, the simplest explanation is usually what it is, which means the basics of the latch. So, ensuring that the baby is latching well from the beginning is going to be the best prevention of soreness and pain with breastfeeding.


Adrienne Koznek: So, red flags would be if you're having continued sore nipple pain that's continuing. If you're dreading feeds, that's a really common one. When parents say, "I am dreading having to feed my baby next time," that's a huge red flag.


Dr. Stafford: Right.


Adrienne Koznek: Breast pain, plugged ducts, sign of infection where it seems like you might be getting something called mastitis, which is a breast infection. Those are all red flags that ideally, when I help, when the baby is first born, we can prevent those things. But if they're happening, then I come in and I help try to fix them.


Dr. Stafford: Yes.


Adrienne Koznek: Yeah.


Dr. Stafford: That's great.


Dr. Stafford: Where does tongue tie come into play, and lip tie as well with that?


Adrienne Koznek: Yeah. With tongue and lip tie those have a lot of signs and symptoms that ... that's how I look for a tongue tie is basing on its signs and symptoms, and a lot of those signs and symptoms are things like sore nipples, nipple pain, nipple damage. Also, signs in the baby too. Do they have blisters on their lips? That's a common one that I see that I feel like gets missed a lot. And I think that's one of those things that gets out there in the world as, "Oh, that's a normal thing for babies to have blisters on their lips." And it's not.


Adrienne Koznek: That, and then, is baby nursing for three minutes, and then passing out, falling asleep? That's another sign and symptom that I look at that would be of concern as well. Then, is baby gaining weight? If they're not gaining weight, if they're not having proper output, that can also be a sign and symptom related to tongue tie, but it's also ... it can be a lot of other things too.


Dr. Stafford: Right.


Adrienne Koznek: Tongue tie is definitely on my radar. I consider it to be something that's of particular professional interest to me. I am trained in how to assess and evaluate for it. So if a parent comes to me and says they're having these symptoms, and sometimes they ... because they've talked to other parents, or they've read on the internet, or in Facebook groups and all those things, because we're talking about it a lot, they'll say, "I'm concerned that my baby might be tongue tied." And more often than not, I have a lot of the parents say, "This provider said that they weren't." Or, "This provider said that it's a slight tongue tie."


Adrienne Koznek: So then I have to kind of take all that information and look at it, and make my assessment based on my evaluation, and then refer out to the appropriate provider to then diagnose and treat it if necessary.


Dr. Stafford: And that's where we can work together.


Adrienne Koznek: Yes.


Dr. Stafford: Where we come into to give play.


Adrienne Koznek: Yeah.


Dr. Stafford: Because of course, at World Smiles, I do a lot of tongue ties for infants because I feel so strongly for nursing babies, but I also think it's so important that we look at nursing at multi-factorial.


Adrienne Koznek: Absolutely.


Dr. Stafford: Because when I have moms that come to me who have self-diagnosed the tongue tie off the internet. I'm quick to emphasize that they still need to see a lactation consultant because releasing the tongue tie in and of itself may not correct the nursing issues. You know, the baby may have habits of a shallow latch, and just so important to see someone like yourself in order to make sure that mom and baby have that wonderful diad and are able to nurse together well.


Adrienne Koznek: Because that's exactly it. It is a diad. And I say this a lot with parents who have breastfed babies in the past, and they're on their third baby, or whatever. They say, "Oh, I've breastfed before." And yes, that is great. That's not nothing to have that own knowledge for yourself on how to breastfeed, but the baby that you're carrying has never breastfed before.


Dr. Stafford: Right.


Adrienne Koznek: So, sometimes there can be some practice that needs to go into to teaching this baby how to breastfeed. Especially when it comes to tongue tied, they've been using their tongue in compensatory ways since before they were born. In utero, they're-


Dr. Stafford: In utero ... Yep.


Adrienne Koznek: Exactly. They're using their tongue in a way that is not ... that will not be conducive of proper breastfeeding. So, it doesn't end with just releasing a tie because then they have to like physically retrain their tongue to be able to remove milk appropriately and efficiently. So that's where ... You know, lactation consultants, we're the expert on the latch, so that's where we come in with that.


Dr. Stafford: Yeah. I think that's so great, and I emphasize with parents, the in utero thing is so great about ... they're tongue tied since they were created in utero.


Adrienne Koznek: Yes.


Dr. Stafford: So just releasing it, it's a muscle that needs to be strengthened, so they need to work with baby in special ways in order to strengthen that muscle, to get a better latch, in order to have a better relationship.


Adrienne Koznek: Yes. And I do all of that as well. Especially after ... if a baby has their tongue tie and/or their lip tie release, that I always recommend that they come back for a followup because I can help work through those exercises to really strengthen the tongue.


Adrienne Koznek: Then I'm also a really big fan of pediatric chiropractic care for babies too. So I refer out for that for pretty much every baby I see.


Dr. Stafford: That's wonderful.


Adrienne Koznek: Whether or not they're tongued tied.


Dr. Stafford: Yeah. I think that's great too.


Adrienne Koznek: Yeah.


Dr. Stafford: I've taken both my children to pediatric chiropractor and just to make sure they're all aligned, and I think it helped with, not just breastfeeding, but as they grew with growth and development. That's a whole nother topic.


Adrienne Koznek: Yeah. It totally is. But that's a nice little addition to our collaborative team. Absolutely.


Dr. Stafford: Definitely.


Adrienne Koznek: Yeah. I'm a big fan of it.


Dr. Stafford: I agree.


Dr. Stafford: For any pregnant moms out there with their first baby, what advice can you offer?


Adrienne Koznek: Yeah, I can ... there is some research that shows that prenatal breastfeeding education is related to breastfeeding duration rates, like longer breastfeeding duration, which is a challenge in this country. We have great initiation rates, but we really struggle with continuing to breastfeed for the recommended amount of time, which from the American Academy of Pediatrics it's a minimum of one year is what's recommended.


Adrienne Koznek: So, I think that getting that prenatal education is really important. So just kind of learning about breastfeeding, the importance of it, right? And how it's this biological process and all the ways that it can help your baby and yourself. I think being empowered in that knowledge is half the battle, right?


Dr. Stafford: Yes.


Adrienne Koznek: Just kind of knowing that, and knowing what to expect I think, and then what normal newborn nursing looks like.


Dr. Stafford: Yes.


Adrienne Koznek: Managing those expectations of what it looks like in the first two weeks. So, that's kind of where I might stop it for a pregnant parent and say, "Just kind of look at the first two weeks, because then the rest of it, that's for future us to worry about."


Dr. Stafford: Yeah.


Dr. Stafford: Do you offer any classes?


Adrienne Koznek: I do offer prenatal consults, yeah.


Dr. Stafford: Great.


Adrienne Koznek: So that can be an individualized one-on-one appointment, and I really recommend those for parents who maybe had breastfeeding problems in the past, and want to kind of figure out how they can keep that from happening again.


Adrienne Koznek: I mean, as you know, tongue tie can be ... We do often see it in subsequent babies. It is hereditary.


Dr. Stafford: It's genetic, yes.


Adrienne Koznek: So, sometimes parents say, "My baby was tongue tied before, so there's a chance this one might be, so I want to be prepared." So we talk about things like that. If you also have a history of low milk supply, I also really recommend prenatal consults for that too because then we can potentially get to possible reasons why you have low milk supply, and what we can do to prepare for that, and just kind of managing what that might look like. And just you know, in this country we go back to work very, very early after having our babies.


Dr. Stafford: So true.


Adrienne Koznek: And sometimes we have to prepare for that while we're still pregnant, and I can help. I think that's it common for parents to think that they have to stop breastfeeding once they go back to work, and I don't think that those things are [inaudible 00:13:10] exclusive. So part of my job is to help combine the working and the breastfeeding together to make it possible for it to look however that parent wants it to look.


Dr. Stafford: Right. Oh, I think that's great to talk about that too.


Adrienne Koznek: Yeah.


Dr. Stafford: It is something in this country I don't think we talk about enough.


Adrienne Koznek: No.


Dr. Stafford: I pumped for a full year for each child. And I had one of my team members, she was pumping so we set up a little pumping station for her.


Adrienne Koznek: That's awesome.


Dr. Stafford: I have a couple more women that are out with maternity leave and I hope to encourage them when they come back to continue pumping and giving that gold milk to their babies because it's so important.


Adrienne Koznek: Having a supportive employer is huge, and definitely makes a difference on breastfeeding duration rates. It's in companies' best interest to support their breastfeeding parents, which is like a whole nother topic, but it's ... So it's great to be able to offer those things and to be able to support parents when they come back to work because it's not nothing.


Dr. Stafford: Right. It's so important. I mean, it keeps the babies healthy and the parents healthy.


Adrienne Koznek: Yeah.


Dr. Stafford: And there's just so many positive aspects of nursing. And like you said, it's really society, if we can really get back to getting babies on the breast, and society will be healthier. So I love that.


Adrienne Koznek: It's taking a cultural shift. And I think that we make a lot of progress, and I think we still have a long way to go.


Dr. Stafford: Great. Great.


Adrienne Koznek: Yeah.


Dr. Stafford: Now for any families out there looking to find you, please tell us your name of your company again and the website.


Adrienne Koznek: Yes. So, it's Wy'East Lactation Support is my private practice, and my website is wyeastlactationpdx.com. I'm also across platforms on social media, so you can find me there too. I have office visits at a clinic called Mindtree Holistic Counseling and Wellness. It's over off the Sylvan exit on Highway 26, so it's pretty easy to get to.


Dr. Stafford: Right.


Adrienne Koznek: Then I also, in addition to the office visits, I also do home visits in the Portland and surrounding area. I am in network with Regents Blue Cross Blue Shield, so I'm able to take that insurance. Then I also offer sliding scale for families who are utilizing OHP.


Dr. Stafford: Aww, that's wonderful.


Adrienne Koznek: Yeah.


Dr. Stafford: Well thanks for being on the podcast Adrienne.


Adrienne Koznek: Thank you.


Dr. Stafford: I really appreciate you.


Adrienne Koznek: Yeah, thanks for having me.


Dr. Stafford: Thanks for all that you do.


Adrienne Koznek: Thank you, and you as well.


Dr. Stafford: Thanks to everybody who's out there watching, and remember, fill the world with smiles.



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