Evidence-based breastfeeding guidance
for families and the communities that support them
- 10-10-10
- Antibiotics for Mastitis
- Blebs
- Bras
- Burping
- Diaper Rash
- Dream Feeding
- “Fat Globules” In Milk
- “Flat” Nipples
- Freezer Stashes
- “High Lipase” Milk
- DMERs and Nipple Nerve Pain
- If You Feel Silly Doing It…
- Increasing Production
- Infant Allergies
- “Insufficient Glandular Tissue”
- Latch
- Letdowns
- Massage
- Milk Fistula
- Milk Stasis
- Nipple Shield
- Nipple Sizers and other Gadgets
- Nursing Strike
- Pain
- Placental Encapsulation
- “Plugs”
- Probiotics
- Pumping for Engorgement
- Pumping for 24 Hours
- Sleep Regression
- Spitting up Blood & Bloody Diapers
- Using Mom as Pacifier
- Water for Babies
- Yeast
- 10-10-10
- Alcohol or Marijuana and Breastfeeding
- Apps
- Bottle Nipples
- Breastmilk Content and Volume
- Burping
- Choking and Gasping at Breast
- Clicking
- Dream Feeding
- Environmental Toxins
- Exclusive Pumping
- Feeding Cues
- “Freezer Stash” of Milk
- Hand Expression
- Home Scales
- How to Increase Breast Milk Supply With Galactagogues
- Increasing Production (“Supply”)
- Is Baby Getting Enough?
- Latch and Position
- “Lipstick” Nipple Shape
- Long Feeds
- Low Supply
- Nipple Shields
- No Milk When Pumping
- Pulling Off Breast
- Pumping
- Refusing a Bottle
- Short Feeds
- Skin to Skin
- SNS (Supplemental Nursing System)
- Syringe Feeding
- Tandem Breastfeeding
- Breastfeeding Stools and Oversupply
- Chokes or Pulls Off Breast While Feeding
- Cleft Palate, Down Syndrome, Other Congenital Conditions
- Clicking
- Cluster Feeding
- Colic
- Complementary Foods
- Cries the Minute We Put Baby Down
- Cries While Feeding
- Developmental Leaps
- Distractible Baby
- Feeding Cues
- Flow Sensitive Baby
- Formula or Donor Milk Supplementation
- Fussy Baby
- Gassy Baby, More at Night
- General Infant Concerns
- Growth Curves
- Growth Spurts
- Infant Needing Surgery
- Iron
- Jaundice
- Likes to Be Held
- Loud Baby/Baby Noise
- Pets
- Refusing a Bottle
- Rooting/Feeding Cues
- Self-Weaning
- Sick or Hospitalized Infant
- Sleep
- Sleep Training
- Sleepy Baby
- Thrush
- Tounge Tie (ankyloglossia)
- Using Mom as Pacifier
- Weight Gain
- Weight Loss
- Wet and Poopy Diapers
- Adenoma
- Blebs
- Bloody Milk
- Colostrum
- Cysts
- Dermatitis (eczema)
- DMERS and Nipple Nerve Pain
- Extra Nipples
- Fungal Infections
- Hyperkeratosis (“Warty Nipple”)
- Inverted Nipples
- Keloid Scars
- Lactiferous Sinuses
- Leiomyoma
- Milk after weaning
- Montgomery Glands
- Nevi (Moles) and Seborrheic Keratoses
- Nipple Color Changes During Breastfeeding
- Nipple Crust
- Nipple Discharge
- Nipple Eversion
- Nipple Masses and Conditions
- Nipple Pain during Breast Feeding
- Nipple Piercing and Tattooing
- Nipple Reduction
- Nipple Shape and Size
- Nipple Wound Care
- Paget’S Disease
- Psoriasis
- Skin Tags
- Subacute Mastitis
- Vasospasm
- Viral Infections
- Breast Augmentation
- Breast Basics After 1 Year
- Breast and Nipple Pain
- Breast Growth
- Breast Lump
- Breast Reductions
- Burns on Breast
- Dermatitis/Eczema
- Ectodermal Dysplasia
- Engorgement
- Fibroadenoma
- Hamartoma
- Hidradenitis Suppurativa
- Hindmilk and Foremilk Imbalance
- Idiopathic Granulomatous Mastitis (IGM)
- IGT
- Inflammatory Breast Cancer
- Keloids
- Lactating Adenoma
- Lopsided Breasts
- Low Supply
- Lymphedema
- Lymph Nodes
- Milk Fistula
- “Milk coming in”
- Mondor’s Disease
- Periductal Mastitis
- Plastic Surgery
- Poland Syndrome
- Psoriasis
- Silicone Rupture and Silicone Injections
- Swelling Under Arm (Axillary Breast Tissue)
- They feel soft, do I have enough milk?
- Tubular Breast
- Acanthosis Nigricans
- Breastfeeding While Pregnant or Undergoing IVF
- Chronic Health Conditions
- Environmental Exposures
- Exercise, Weight Loss, and Nutrition
- Flus, Colds, COVID
- Health History and Medications
- Illness Impacting Milk Production
- Injectables and Herbs
- Lopsided Breasts
- Maternal Health and Illness
- PUPPP and HIVES
- Rashes
- Recreational Drugs
- Surrogacy
- Tattoos
- Wrist and Neck Pain
- Vaccines
- Vaginal Dryness
The Physician Guide to Breastfeeding, created by Dr. Katrina Mitchell, provides scientific lactation information for healthcare providers, breastfeeding moms, and communities.
Welcome, and thank you for visiting my website! My name is Katrina Mitchell, and I am a breast surgeon, lactation consultant, and perinatal mental health provider in Santa Barbara, California.
I created the Physician Guide to Breastfeeding during the 2020 Covid pandemic, when I was inundated by parents and children suffering from a variety of breastfeeding challenges related to isolation and restricted contact with medical professionals. “Lactastrophes” — complications resulting from women being repeatedly given incorrect advice from unreliable sources and breastfeeding folklore — abounded.
As a physician, I wanted to develop an evidence-based website free of commercial bias for parents, other healthcare providers, and lactation consultants. My goal is to address common myths that have been perpetuated for decades in the lactation world, and illuminate the science.
Many “traditional” recommendations offered to breastfeeding mothers are not only inaccurate, but harmful. “N of 1” — a personal or professional experience limited by lack of generalizability to others — is often employed in lactation care. This leads to confusion and contradictory advice. Women can feel pressured to spend significant funds on breastfeeding products, and are exhausted by countless appointments with lactation or infant care “experts.” Motherhood has become a big business, and the industry preys on women at a vulnerable time period in their lives.
Having operated on the breast for more than 15 years, I have a unique perspective on breast physiology and tissue anatomy. This impacts the way I approach lactation challenges and resolve them, putting mother-infant dyads on a path to healthy physical and mental health development.
If you are caught in a miserable tailspin of any combination of 24/7 triple feeding, power pumping, washing bottles, timing feedings at the breast, using home scales, walking around naked trying to maximize “skin to skin”, tracking it all on an app, feeling overwhelmed by social media comparisons, pumping to keep your breast “empty to prevent mastitis,” coating your nipples with complicated concoctions, and hating breastfeeding and mothering in the process, you are in the right place now.
The key is to SIMPLIFY and get back to basics. Whether it means helping a mom with too much milk become more comfortable, or supporting a mom with not enough milk, it’s necessary to establish a REASONABLE plan going forward. When you confirm the correct diagnosis and provide straightforward treatment, everything gets better. I receive daily emails from people thankful for simple advice, and one very descriptive patient gave me permission to share her story.
I encourage everyone reading this website to reach out to the Institute for the Advancement of Breastfeeding and Lactation Education (IABLE) for referral to knowledgeable breastfeeding medicine physicians and lactation providers throughout the world.