Ellen Passloff, MD, FAAP

“I am a General Pediatrician in Seattle and I have to say that our community was very sad to say goodbye to Sarah Tyack when she moved to the Bay Area.
I first discovered Sarah several years ago when a colleague of mine who is a Doula had observed Sarah working with one of her clients. She reported that Sarah was wonderful with these stressed, overwhelmed Mothers who were struggling to get their newborn to latch onto their breast.

I started referring my Mothers who were having struggles with breastfeeding to Sarah and they all returned with rave reviews and with newborns who were now successful at Breastfeeding.
I continued to refer to Sarah afterward and was never disappointed! Sarah has unlimited patience, as well as excellent technique with lactation advice.

She makes house calls, which is a huge relief to these sleep deprived Mothers. One of the most valuable qualities that I have found in Sarah and is that she notifies the referring doctor if she sees warning signs of possible post partum depression, or concerns with the baby. She recommends frenotomies when appropriate, as well as referrals to the Occupational therapists at Seattle Children’s Hospital when she feels that the newborn may have a more complex oral motor feeding abnormality.
Sarah always managed to fit struggling Mothers and newborns in to see her, regardless of how busy she already was! Sarah’s patience, expertise and kindness with my families made her my preferred lactation specialist in the entire Seattle area. I will miss her very much, as will my patients!”

Ellen Passloff, MD, FAAP

My Interview About PMAD, Breastfeeding, and More for the Perinatal Support Washington Newsletter

See below for the interview I did with Perinatal Support Washington (formerly Postpartum Support International of Washington), for their July 2016 newsletter.

Perinatal Support Washington


Sarah Tyack RN, BSW, IBCLC

Sarah Tyack is a registered nurse and internationally board certified lactation consultant in Seattle and the Eastside. She has over [25] years of experience working with new moms and their babies. We had the opportunity to interview Sarah regarding her experience and expertise.

What are the most common breastfeeding issues that come up in the population with whom you work?

The most common issues are low supply and sore nipples. The reasons for both of these issues can be complicated but it’s often from not getting the proper support in a timely manner.

What percentage of the women with whom you work are also experiencing a perinatal mood and/or anxiety disorder?

A large percentage. I’d say 75% of my clients have some sort of PMAD. I do a lot of emotional work with my clients. My clients are used to situations where B comes after A and C comes after B and if B doesn’t come after A, they know exactly what to do to make that happen. So when they have a baby and B isn’t coming after A, they think there’s a problem that needs to be fixed. So they search the internet to figure out how to fix these “problems.” The internet can be so undermining to new moms. There’s something to support any position you take about anything so therefore you’re always wrong. I really try and get my clients to learn how to read their baby’s needs and get off the internet.

In your experience, is there a connection between perinatal mood and anxiety disorders and breastfeeding? 

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4 Things Lactation Consultants Wish More Baby and Mom Providers Learned to Teach Parents During Pregnancy and the Postpartum Time

Recently I discovered a newly published blog post featured on the “What To Expect” website. Titled “5 Things Pediatricians Wish More Women Learned During Pregnancy” I was surprised to find this article to be especially demeaning to women. It assumes no responsibility for the medical team treating mom and baby, but instead, blames the lack of knowledge on the mom.

Any new parent will tell you, they depend on their baby’s provider to give them good and accurate information about feeding their baby, sleeping with their baby, and taking good care of themselves. But as an experienced lactation consultant who has seen the results of what some providers teach these new parents, I have created my very own list. Here are 4 things lactation consultants wish more baby and mom providers learned to teach parents during pregnancy and during the postpartum time.

1. Your patient might have trouble breastfeeding and if they do, there are lactation consultants who can help. Yes, there are great benefits to breastfeeding and that’s why it would be great for you to know a little bit about it. Since you most likely haven’t taken any classes on breastfeeding, it would be best for you to refer your patients to someone who has. We know you mean well, but sometimes in your effort to help, you give inaccurate advice and make things worse. So, please refer your patients to a qualified and experienced lactation consultant.

2. In direct response to the orginal article’s second point – “There are really ‘four trimesters’ in pregnancy”. Yep! Four  trimesters! I had a client tell me she didn’t realize she should have prepared herself for the marathon she’d have to run after her baby was born. The postpartum time can be tumultuous. Hormones are fluctuating, you’re sleep deprived, and you’re trying to figure out how to be a parent. The Center for Disease Control estimates that 8-19% of women will experience some kind of postpartum mood disorder . That’s why it would be great if the baby’s and the mom’s providers were knowledgable and had good resources.

3. From my direct work with new moms, I know for a fact that crying to both the baby’s and mom’s providers is common and many providers aren’t equipped with the knowledge to know what to do.  There are counselors who specialize in this postpartum time and there are groups for moms to attend. There is also the Perinatal Support of Washington website that has lots of information available on the topic. By the time a mom goes to her 6 week appointment with her doctor or midwife, a lot has happened. She may have already decided she’s a failure because she can’t feed her baby the way she wants, she may still be dealing with an emotionally and/or physically traumatic birth, she may already be having relationship problems, and she may feel like she’s in a dark tunnel with no way out. This is a key time for the baby’s and mom’s providers to have helping handouts with some good resources ready to give to moms in these sensitive times.

4. No one can prepare a new parent for the sleep deprivation. It is cumulative and seems unrelenting. It would be great if every baby provider would visit and review Dr. James McKenna’s Safe Cosleeping Guidelines. This background knowledge could help the new family find the time to get a little more sleep and feel less guilty.

There’s no question that the postpartum time is one of the most difficult and wonderful time in a parents’ life. If a parent is feeling sad and guilty and full of negative emotions past about three weeks, please refer to one of the recourses on this blog and just know there’s lots of help out there for you. You are not alone!

Should I find a Lactation Consultant when I’m pregnant? Or is that too early?

It’s definitely not too early! I love it when a pregnant mom contacts me to inquire about my services while she’s pregnant. Breastfeeding challenges are on her radar, and she’ll be on mine. This means, I know to expect her phone call and will fit her into my schedule after her baby is born.

It greatly reduces the anxiety of a new mom just knowing she has the trust that she’ll be working with someone from the get-go and won’t need to wait until she’s having breastfeeding problems. Many new parents have no idea what to expect and don’t know when they need help. If I see someone three or four days postpartum, we can just nip potential problems in the bud.

My latest interview: going back to work while breastfeeding

Once breastfeeding has been established, around four to six weeks, it’s fine for your partner or another caregiver to give the baby a bottle of expressed breast milk. “Choose a nipple labelled ‘very slow flow,’” advises Sarah Tyack, a registered nurse and IBCLC in Seattle, Washington, who works with nursing moms through her company Babe N’ You. This helps you mimic the breast as much as you can, she says, so your baby doesn’t get used to chugging an easy-flow bottle and then not want to work a bit more when it’s time for breastfeeding.

Day care providers may not be used to babies who drink breast milk. “Feeding too much at day care is the biggest ‘booby trap,’” says Tyack. “Then the baby isn’t that hungry at the end of the day and doesn’t nurse much, so mom’s milk supply goes down and it gets into a cycle. Also, a baby may want to suck but there are other ways to soothe a baby other than a bottle—using a pacifier, for example.” She recommends that the caregiver provide the last bottle two hours or more before pickup, and then you can nurse when you arrive at the day care or in your own home. When choosing a caregiver, Wright suggests asking questions like, “Will you refrigerate and reuse any leftover breast milk?” and “Do you require all parents to clearly label milk containers to avoid mix-ups?”

Click here to read the full article!

The power of donating your breastmilk

New York Times Op-Ed Contributor, Elizabeth Currid-Halkett, says it well:

We also need more public-awareness campaigns run by the milk banks and the hospitals that rely on them. Even if they have the capacity to do so, lots of women aren’t even aware that they can donate milk. Hospitals and milk banks need to spread the word on how to donate to milk banks and the tremendous help this milk can be to N.I.C.U.s and premature babies.

If you have an abundance of breastmilk, donating your milk to another mom is such a gift. Studies show that babies in the NICU (neonatal intensive care) are less sick and leave the NICU sooner when given breastmilk.

New at Postpartum Support International of WA

Sarah Tyack, International Board Certified Lactation Consultant, Registered Nurse, and PSI of WA Group Leader

Sarah Tyack, RN, BSW, IBCLC is a nurse and certified lactation consultant with a background in social work who provides gentle, supportive, family-centered lactation consultation through her private practice. Sarah specializes in helping women and new families with a wide range of breastfeeding problems and concerns via in-home consultations and through private breastfeeding classes. Some of her specialty areas include: Twins, infant weight gain, newborn care, returning to work, mom’s physical and emotional needs, and postpartum depression.

Sarah spoke with us specifically about her experience working with moms experiencing breastfeeding problems and postpartum depression:
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Stardust L.


I emailed Sarah very late one Sunday night after seeing six other lactation consultants and taking my baby to see a pediatric occupational therapist because I couldn’t get my baby to breastfeed. Every time I would get her on the breast, she would fall asleep. None of the techniques or exercises suggested were helping us to breastfeed and I was getting to the end of my rope.

Sarah responded to my email first thing the next morning and came to visit me that same day. She asked me about the issues we’d been having, then sat down with me and my daughter and had us breastfeeding within 60 seconds.


From then on, breastfeeding became so much easier […] Sarah also followed up by email and telephone to make sure everything was going okay. Plus, she offers a weekly support group – I haven’t been able to make it yet, but I plan to as soon as my schedule allows for it.

I’m really grateful to Sarah and highly recommend her!

Click here to read more on Yelp

Stardust L.

Ruiza A.

All the reviews are TRUE!!! 5 stars! She was a lifesaver! I’m a first-time mom and was having breastfeeding issues with my 4 month old […] especially accompanied by postpartum anxiety. I was hardly getting any sleep and was in a lot of pain because of it (tried everything I read online and felt like just giving up and just admitting myself to a hospital). I’m so glad I called her!

Sarah responded to my email really fast and even gave me a call right away. After talking and assessing that I did need immediate help, she made time to come to my house the next day and answered not just breastfeeding questions/concerns, but even other postpartum or health/motherhood questions I had.

She was genuinely concerned and was very caring. With her professionalism, care and experience/credentials, it was easy to see why she is definitely one of the top lactation consultants in Seattle! Highly recommend her!


The information and support you will get is priceless! She is also an expert/trained in helping mothers with postpartum depression/anxiety.

Click here to read more on Yelp

Ruiza A.