BirthWays Newsletter

Breastfeeding: 7 Strategies for Success

By: Dahlia Frydman, IBCLC & Doula

One of the most frequent questions expectant moms ask me is: “How do I prepare to breastfeed? ” We used to tell moms they had to “toughen up their nipples” but now research has shown, (thank heavens) that “nipple toughening” makes no difference. Here are some practical tips to help you prepare:

1. NO PLASTIC
Just Momma! Specify on your birth plan that no artificial nipples, pacifiers or formula be given to your baby unless medically necessary (if supplemental feedings are required you can use a syringe or SNS).  This helps both you and your baby.  It helps you because the frequent suckling will stimulate your mature milk to come in sooner and help reduce engorgement.  It helps your baby because while sucking is an inherent reflex, breastfeeding is a learned behavior and practice makes perfect.  Suckling helps them relax and feel secure, and avoiding artificial substitutes helps prevent nipple confusion.

2. NATURAL BABY
Studies show,oms whose births include multiple interventions have lower rates of prolonged breastfeeding. Research further concludes, “Having a doula or trained birth coach attend to you during labor results in no use or lower rates of anesthesia/ medication during labor and shorter births” {Childbirth Connection’s Cochrane Review of studies on continuous labor support (2003, 2007)}.  But not to worry, most babies do just fine, regardless of interventions.  If you end up having an epidural or other interventions and your baby needs a little bit more time before they can breastfeed just keep offering and provide lot’s of skin to skin cuddling.  If you are committed and patient, I promise, it will all work out.

3. SUPPORT
It’s very helpful to take a prenatal breastfeeding class. In addition to learning some hands on techniques for positioning and nursing your newborn, you will be receive valuable tips for avoiding or overcoming challenges during the early postpartum period.  Does your hospital or birth center have a lactation consultant on staff? If not call around and select one you have a good rapport with. (most insurance companies reimburse for lactation services) Find out if she can visit you within the first 24 hours if things aren’t going well. Hopefully you won’t need it, but better to be prepared. Some lactation consultants will even be willing to answer a few questions by phone  (no charge) and getting expert advice early on can make a world of difference.   (Find an IBCLC: http://www.ilca.org/i4a/pages/index.cfm?pageid=3432)

4. SUPPLIES
Two good supportive nursing bras, (your breast size at two weeks postpartum is your new “real” size during your nursing career) nursing pads, nipple cream, (LOVE Earth Mama Angel Baby)  frozen peas/gel packs and cabbage (sparingly) to ease breast soreness/engorgement.  Some moms also like having a glider/rocker, nursing pillow, breast pump (free thru your Insurance) and milk storage bags.

5. LATCH
Breastfeed your baby shortly after you deliver. Babies who are breastfed within the first hour postpartum generally have more successful breastfeeding experiences than those who aren’t.  Many medical procedures can be done while the baby is on you and breastfeeding. Weight checks and baths can wait while this critical milestone is unhurriedly taking place. Breastfeeding is so much more than nutrition—it’s brain wiring!

6. SCHEDULED OR FEED ON DEMAND
Baby led feeding is lovely! Babies know when they are hungry and know how much they need.  If we follow their cues they won’t be over or underfed. Instead, their nutrition intake will be just right.  But start this after the first 1-2 weeks.  All newborns lose weight in the first week of life and are very sleepy!  Your breasts need frequent stimulation and regular emptying to signal milk production. Thus, in order to reduce weight loss, decrease baby’s bilirubin levels, increase your milk production and relieve engorgement, it is advisable during the first 2 weeks of life; during the daytime wake your baby to feed at least every 3 hours (and sooner if they like) and every 4-5 hours during the night.  After your two week pediatrician appointment if baby’s weights have stabilized and your milk supply has regulated you can feel relaxed about following your baby’s cues for feeding.

7. MAMMA CARE
Sleep when baby sleeps; it is a necessity!  In fact, mother nature has built rest & recovery right into your chemistry.  You may notice how sleepy you get 30-45 minutes after you breastfeed?  This is due to the spike in serum prolactin levels (“the mothering hormone”) and CCK (a gut hormone signaling when you are satiated). Your only job in the early postpartum weeks is to let your body gently heal from childbirth and to keep breastfeeding. Transitioning into motherhood is the biggest adjustment of your life.  You will remember and enjoy it so much more if you are feeling peaceful & rested.

Congratulations & enjoy your new baby!
Resources:
•    “The Womanly Art of Breastfeeding” by LLL International. Or visit a La Leche League meeting.  They are located in every city and it’s a wonderful peer to peer support network.  Learn from other nursing moms and connect with new mommy friends.
•    “Ina May’s Guide to Breastfeeding”, Ina May Gaskin Midwife
•    “Nursing Mother’s Companion”,  Kathleen Huggins R.N.
•    “The Ultimate Breastfeeding Book of Answers” Dr. Jack Newman


Dahlia Frydman, IBCLC & Doula, can be contacted at www.YourIdealBirth.com

 

My Baby won’t Latch On – What do I do?  © 2015

By: Janaki Costello, Molly Brannigan,  Paula Santi, IBCLCs  East Bay Lactation Associates

Most expecting mamas in the bay area look forward to breastfeeding their babies, some with great excitement, some with some concerns about how it will go and if it will work out for them.

In most cases the baby takes to the breast as nature intended, with enthusiasm and innate ability.  Occasionally however, a new mama has trouble getting her baby to attach to the breast.  This situation is so frustrating and difficult for the new mama and her family.  Often she has no idea why her baby is not breastfeeding.  She may receive all kinds of conflicting advice about what to do.

At East Bay Lactation Associates, we have worked with many new mothers who are experiencing all sorts of breastfeeding challenges including the non-latching baby.  Our first action is to assess the situation to see if we can find out WHY the baby is not latching.  It can have to do with many complicated factors including oral anatomy issues like tongue tie, difficult birth, the “fit” between mom’s nipple and baby’s mouth, maternal medications, baby being forced onto the breast or held in such a way that he is unable to move his head or open widely, deep suctioning after birth, etc.

It is vitally important to stimulate and maintain milk supply if baby is not latching!  Many moms find that hand expression and a hospital grade rental pump works best for this early initiation and we have many suggestions for pumping and increasing milk supply.

If we find something that can be changed, such as positioning, or general management, of course we will start with that.  The following are some general guidelines that we have seen work well and will keep mama and baby close without becoming overly frustrated.

  • Start with calm baby.
  • Take some slow deep breaths, close your eyes
  • Get comfortable, leaning back, feet up
  • Place your baby Skin-on-skin on your chest. Baby should not be starving. Sometimes it’s helpful to feed baby some milk first.  Hungry babies cannot learn!
  • Hand express first and have a little milk available to spoon into baby’s mouth, put on your own nipple or a nipple shield to entice baby with instant reward
  • Learn and observe feeding cues – don’t make baby wait
  • Be available!  Offer the breast often. Try :  different positions, latching while moving (walking, rocking, swaying, bouncing on birth ball)  in a warm bath, while baby is drowsy (waking or just falling asleep) , darkened room, no distractions
  • Baby-led latching works best!
  • No forcing, especially no holding baby’s head, short sessions/limit frustration
  • Allow baby to search for breast, you can help without any forceful movements
  • Patience – Learning to breastfeed is often two steps forward, one back
  • Time and lots of “kangaroo care” skin on skin carrying, holding, bathing
  • Carry baby skin-on-skin in a sling, or other carrier in between latching attempts
  • Keep sessions short and sweet!!  Be available at any moment to offer but forcing can result in an aversion and stress so resist the temptation to be at all forceful
  • If baby latches speak softly to baby, verbal reinforcement
  • Acknowledge the emotional frustration/sadness/confusion
  • Believe! It IS possible for any baby of any age to begin breastfeeding! Be persistent
  • Your baby does not hate breastfeeding or you – when a baby is not breastfeeding
  • there always is a reason – even if we have not yet discovered what it is.

The only rules:

Feed the baby – a baby who is taking in enough calories will be better able to learn

Maintain supply – make sure your pump is adequately draining your breasts, consider renting a hospital grade pump because the higher the supply the easier it will be for baby to get the milk.

Babies cannot tell time or read a calendar.  Often enticing a baby to breast and teaching baby to breastfeed well can take quite a bit of time.  This is when the quality of patience is so important.  Having continual support from knowledgeable lactation consultants can be the difference between quitting and facilitating a smooth breastfeeding relationship.

Please do not hesitate to ask for help if you have any breastfeeding difficulties!


*  For more ideas see: http://kellymom.com/bf/concerns/child/back-to-breast/ – basics

Janaki Costello, Molly Brannigan,  Paula Santi, IBCLCs  East Bay Lactation Associates

www.eastbaylactationassociates.com  (510) 525-1155

A Doula’s Guide to Visiting New Parents

By: Haley Reen

When I became a postpartum doula, it was because I love to be with new parents, to nurture them so that they may nurture their new baby. I love to hear fresh birth stories, I love to nourish with meals, and care with chores and empathy.
It used to be that we lived among friends and family, that families already had a network of support upon the welcoming of a newborn. Modern life has parents living thousands of miles from grandparents and aunts. Urban families might have 300 friends on Facebook, but no one in their own neighborhood to come and help, and help is needed so very much in those first weeks.

Perhaps a friend, a coworker, the parents of your own children’s playmates are expecting.  … Iif you are feeling generous, perhaps you would be willing to be part of their “village” and offer your support. But, this is not etiquette covered in the books of Emily Post. How do we offer traditional forms of support to modern families?
I know how exciting new babies are. I know how much people want to see and smell them when they are brand new. I also know that being a good friend to new parents means taking the utmost care with a new and very delicate situation. If you want to be extra kind to new parents, consider these dos and don’ts, but as with all advice on the internet: you know your situation and your community best — these are just suggestions.

  1. Wait for an invitation
    In the weeks before birth, let mom and dad know that you would love to help when the baby comes, and not to hesitate to call. Then: wait for the call. A Facebook wall post or text is an appropriate way to let them know you’re available, but don’t expect a quick response, and don’t be offended if you don’t get one at all. They are likely overwhelmed and exhausted.
  2. When you get that invite, stick to it
    When they say “Wednesday at 2pm,” be there. Don’t make a new mom wait for you when she could be taking a rare moment to sleep or shower. Don’t be late and risk interrupting baby sleep. When you get there, either text to say you are there or knock ever so gently — don’t rap, don’t ring the bell. If you wake that baby, you’ll feel awful.
  3. Before you come over, be clean and prepared
    No sniffles, no diarrhea last night, no cigarette smoke on your clothes or hair. Call the parents or email them to ask if there is anything you can pick up for them at the store on your way over, or any food they would like. When you have a newborn in your arms 24-7 it’s nearly impossible to eat, let alone cook, so food gifts are king. Food in disposable casserole dishes is ideal — new parents are not going to get around to washing and returning your Pyrex dish. And for goodness sake, if you cook them a meal in their home, consider helping with dishes.
  4.  When you get there, do something
    Wash the dishes, wipe down the bathroom, fold baby laundry, empty the fridge of old food and take out the garbage. This is seriously the best thing you can do for new parents. If you need to, pack damp paper towels with cleanser sprayed on in a Ziploc in your purse/bag before you come over. When you use the restroom, just give it a wipe down on the down-low. Just do these things — the parents will likely say no if you ask them if they want you to. Not because they don’t want you to but because they’re trying to be polite.
  5. Be calm, quiet, and patient
    I know you want to scoop that baby up and smell it. Here is the bad news: you might not get to hold the new baby on your first or second visit. New moms often don’t want to let anyone hold the new baby, or baby simply won’t tolerate it. But if you are a conscientious guest, you will get other opportunities. Let mom know you would love to hold baby, but don’t push the issue.
  6. If mom WANTS to tell you her birth story, listen
    Offer to write it down for her, even. But don’t pry if she doesn’t want to, and don’t offer your own (if you have one) unless she asks. This is especially true if it was traumatic or unplanned things happened.
  7. Don’t bring young kids
    They can’t be expected to be quiet and keep to themselves. Wait until the baby is older.
  8. Leave
    Seriously, don’t stay long. Thirty minutes tops unless mom asks for more. Make up some sort of thing you have to do/go to, and let yourself out. In fact, if mom is really tired, don’t stay at all, just drop off the food and go.
  9. Don’t give advice unless asked
    I can’t say this enough. When you do give that advice, tread lightly.

More than anything, new parents need lots of help and rest.  They need someone to clean out the kitty litter, bring over a warm meal, or hold the baby while they sleep.  Be sensitive to their needs, ask them what would be most helpful, remembering that sometimes new parents just need someone to talk to, but sometimes they just need you to leave food on the porch and come back at a better time.


Haley Reen is a work-at-home mother to two spirited children. She resides in the East Bay and home schools in the Waldorf method. She writes for several parenting blogs, and does post-partum doula care on the side.

Hanging the Hooter Hider Out to Dry: The Cover Up of Public Breastfeeding

By Dr. Meghan Lewis

Fabrics of fanciful flowers, pink plaid, or purple polka dot are delicately draped over the shoulders of hundreds of nursing parents on both sides of the Bay. Worn as a cloak of concealment, the Hooter Hider, a triangular breastfeeding blanket becomes an accessory to societal setbacks.

Sadly, even in the height of the Locavore, or Farm-to-Table movement (i.e. consuming local, naturally produced food), sales of the Hooter Hider continue to soar. No doubt, Giving-Breast-to-Baby offers the best, most nourishing noshings. So why then has feeding a nurseling in public become such a taboo that so many children are made to eat under a kind of tot tarp? Who wants to dine in a tent while eating out?

It’s simple: People feed their babies from their bodies. What does hiding it imply? Could parents be subsuming either personal, regional, or cultural standards by wearing their cleavage cover-up? Might they possibly be even unconsciously perpetuating a suppressive stigma of shame and discrimination?

When we gather with friends and family to share in a meal we also co-create and celebrate togetherness. Chestfeeding, in truth, is the initiation of these food sharing rituals; a practice to be revered not reviled. When babies feast, they source their nutrition from their parents simultaneously laying the neurological pathways for a lifetime of interconnection.

In considering the broad cause of the Hooter Hider, I see that it perhaps points toward a societal longing. Are we shielding our psyches from a kind of suppressed, primal desire for familial tenderness and symbiotic awe? Perhaps the Hooter Hider keeps under wraps a need that’s hardwired into our brains for a felt, body-based connection, one that gives a kind of assurance of personal survival. Perhaps this phenomenon has developed similarly to the way we do not often see the farms from which our food comes. There’s nothing innately inappropriate or offensive about natural nursing or, for that matter, tilling the soil. Originally, it was do or die.

Bra burning of the 1960’s represented the freedom to be natural, to no longer uphold stereotypes surrounding the breast. I am not suggesting to actually go about torching the titty tablecloth. (I am, however, thinking that they could be turned into something of practical use; perhaps made into menstrual pads, diaper wipes, or burp cloths).

Just as we have the right to choose how and where to birth our babies, we have the right to choose how and where and with what we feed them. Supportive spaces in the East Bay that openly embrace natural nursing include public libraries, (because they’re smart there), farmer’s markets, (because they know that naturally harvested, raw food is good for you), and, of course, the zoo, (because non-human mammals have mammaries too).

I wonder what would happen if breastfeeders, those willing and able, shook loose their trendy yet staid suckling sheets. Let’s really consider the benefits of beholding, not blanketing, baby’s inherent and blissful bond with the breast. One does not have to be a lactivist to view that breastfeeding is not only interpersonally precious and ideally nutritious for baby in the long-run, but it is a boost to public health as well. To this end, when considering natural nursing in public the question is simply this: Is it really too intolerable to bare?

This article was first published in the East Bay Express. 


Meghan Lewis holds a PhD from the Institute of Transpersonal Psychology in perinatal and somatic psychology and received a BA from the University of Michigan. She has a private practice, Integrative Perinatal Psychotherapy in the San Francisco Bay Area, specializing in preconception, pregnancy, birth, postpartum, and early parenting.  She is also the founding member of LGBTQ Perinatal Wellness Associates, a group of LGBTQ-identified professionals dedicated to the health of the queer community’s growing families. Additionally Meghan is a monthly contributor to the East Bay Express’ parenting column, Kid You Not. www.meghanlewisphd.com

It Takes a Village

By: Simona Fino

“Nobody has ever before asked the nuclear family to live all by itself in a box the way we do. With no relatives, no support, we’ve put it in an impossible situation.” Margaret Mead

Most everyone acknowledges the importance of a village, yet our American culture places more value on the individual or nuclear family, which makes it difficult for many to truly believe our village is available. Women especially are encouraged to “do it all.” But can we do it all? Can we be expected to succeed as parents with such limited support? What would life be like if we had true village support?

The first step to building a strong community is to acknowledge that our villages are an essential component of a happy life. For many, this isn’t easy. In a “pull yourself up by your bootstraps” society, asking for help is a sign of weakness, being indebted to others is a negative thing, and asking family and friends for support is encroaching on their personal freedom.

However, quite the opposite is true in many cultures around the world. Asking for help is a sign of strength and knowing your limits and being indebted to others is a positive thing creating a symbiotic relationship with people you love. Asking for support gives your family and friends the opportunity to feel useful and experience the joy of helping others.

Maintain Connections and Offer Support

A village is important for all phases of life but especially as families are created, because that is often when community is needed most. The next step is to build strong community, maintain connections and offer support. Below are some practical ways to maintain positive and supportive connections with friends and family:

  • Call friends and family and make plans to spend quality, one-on-one time together such as sharing a meal or enjoying a walk or hike in nature. One hour of quality time is far better than several hours of Facebook check-ins.
  • Offer direct support to those in your community when you see a need or even ‘just because’. Don’t wait for others to ask for help but instead make the first move. Offer to take their children for a couple of hours; call those going through rough times and ask them what they need; offer to grocery shop or bring a meal over to an elder or parents with a new baby; offer to weed someone’s garden or help them with a project (always more fun with help!). Should you receive an offer for help say “Yes, please!” and “Thank you!”
  • Already have a baby or child? Encourage childcare trades with several nearby families and start by making the first offer. This is a great way to connect with other parents and get to know each others’ children.
  • Ask Aunties and Uncles (aka friends you really love) to watch your baby from those very first newborn days. Nearly everyone loves to spend an hour holding a newborn and if they are spending time with your little ones consistently they will develop a sweet and special bond that is wonderful to watch grow. These friends will learn how to care for your little one, you will learn to let go and trust, and your little one will learn they have many loving adults in their world whom they can count on to take care of their needs.
  • Maintain connections with friends who don’t have kids. Spend one-on-one time with them, letting them know their friendship is appreciated. Ask them to get involved with your family by spending time with your little ones – encourage them to be aunties & uncles!
  • Demonstrate that you are taking care of yourself and then offer to support others in taking care of themselves. “Would you mind watching our daughter for a few hours over the weekend so we can go out on a date? We’d be happy to reciprocate so you can also get out!”
  • Express gratitude! Everyone likes to feel appreciated and useful so let your friends and family know how much you appreciate them by telling them.
  • Friends and family live far away? Send snail mail cards offering emotional support and love. A short but thoughtful card is usually more appreciated and meaningful than an electronic message.

Ask for Help

The third step to building strong community is learning to ask for help. This is a big challenge for most of us.  But we can change our beliefs and come to understand that asking for help is a positive thing. Start by asking for small things from close friends and family and then, become brave, and ask for more. The more you practice, the easier it will become. An ask can also include an offer: “Might you be available to take my baby for a few hours so I can get some things done around the house? I’m free Saturday next week to take your little one if you’d like.”

Let Go

The final step to building strong community is learning to let go.  Allowing someone else to care for you and your child is important. Trust your friends and family can take good care of your little ones and they will. Hover over them and they will lose faith in their own abilities. They may not do things exactly the way you do and that is okay. Let go and appreciate all the wonderful things they bring to your child’s world. Personally, I like to keep in mind the simple fact I cannot teach my daughter everything. My friends and family have a wealth of knowledge and wisdom and I’m ever so grateful they are sharing it with her.

As you build your strong community and become part of giving and receiving support you will find parenting, and life in general, becomes simpler and more joyful. Remember, it really does take a village!

  • Acknowledge the need for your village
  • Build your community by maintaining connections and offering support
  • Ask for help and express gratitude
  • Let go and enjoy your village support!

If you’ve found these tips helpful, let me know! And I would certainly love to hear what has worked for you. Please share your tips by replying at http://wp.me/p5gqHr-4Q.  To learn more about caring for your family naturally and simplifying your life, sign up to receive my newsletter and blog posts at http://www.simonafino.com


 

Simona is a certified Postpartum and Birth Doula offering families support through pregnancy and beyond. She brings simplicity into family life by offering organizational and de-cluttering assistance as well as help in creating family rhythms around food, sleep and play.