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When Breast Isn't Best: 6 Tips for Making Exclusively Pumping Work January 25, 2015 15:51

Many new mothers dream of breastfeeding their babies, but sometimes despite all of our good intentions and hard work, it doesn't work out. Whether it is due to illness, latch issues, or other problems, sometimes breastfeeding just isn't a possibility. In these cases, many women turn to formula, and while this is a perfectly acceptable alternative, others choose to exclusively pump. Exclusively pumping is a major commitment and is difficult to accomplish, but by following some important tips, you can make it work for you and your baby.

Don't Beat Yourself Up

Choosing to exclusively pump is not a decision that most women take lightly, and many mothers only decide to take this path after repeated attempts at breastfeeding have failed. Although this is not the path that you would have liked for you and your baby, it is important to remember that you are not a failure. By exclusively pumping, you are ensuring that your baby is still getting the best possible nutrition even though you are not able to breastfeed. Focus your energy on your baby and developing a strong bond, and don't allow guilt to affect how you feel about the process.

Get a Great Pump

The breast pump that you choose can make or break your ability to be successful at exclusively pumping. Research double-action electric breast pumps online to find the best one for you, and choose your accessories wisely. Since your pump will likely go everywhere with you, you'll want to find one that comes with a convenient carrying case and a small cooler, if possible.

Double (or Triple) Up on Pump Accessories

One of the major drawbacks of exclusively pumping is the amount of time that you will spend washing and sterilizing your pumping supplies. In order to make this process less labor intensive, consider an investment in duplicate pump parts. Contact your pump manufacturer or look online for extra tubing connectors, silicone diaphragms, valves, and horns. By having extra supplies, you won't have to wash your parts after every pumping session. 

Freeze Excess Milk

Exclusive pumpers know that you'll have good days and bad days in terms of your milk supply. Therefore, it is important to take advantage of your good days and to freeze any excess milk that you may retrieve. Invest in freezer bags and a permanent marker so that you can properly label them, and clear out some room in your freezer. By stocking up on extra milk, you will have backup available in the event that a drop in supply doesn't leave you with enough to feed your baby.

Find a Support System

While breast and formula feeding mothers usually have a support system of people who understand their feeding decision, exclusive pumpers are often left out. Therefore, it is important to find someone that you can talk to about your experiences and struggles with exclusively pumping. Ideally, your partner and family will be supportive of your decision, but if speaking to them isn't an option, go online to search out birth boards and support groups targeting women who exclusively pump. These mothers know exactly what you are going through and can provide you with tips on how to make your life as an exclusive pumper easier.

Take Pumping One Day at a Time

Exclusively pumping is hard work, and at the beginning, you may question your ability to maintain a consistent and rigorous pumping schedule. You may have a goal in your mind to try to pump for three months, six months, or even a year, and the thought of keeping up your routine for that length of time may seem overwhelming. In this situation, the best thing that you can do for yourself is to take pumping one day at a time. Focus on the present day and completing all of your pumping sessions. By putting the future and your ability to continue pumping out of your mind, you will feel less stress about your situation. 

 As an exclusive pumper, it is important to remind yourself about the sacrifice that you are making for your baby. While your dreams of breastfeeding may not have worked out, you are continuing to sacrifice your body and time in order to ensure that your child is getting the best nutrition possible. By focusing on your baby and using helpful techniques, you can make exclusively pumping a positive experience for your family.


What Can I Do About My Low Milk Supply? May 09, 2014 13:07

Written By Michelle Roth, BA, LCCE, IBCLC

One of the top reasons women wean their babies before intending is thinking that their milk supplies are low (McCarter‐Spaulding & Kearney 2001; Gatti 2008; Kent, Prime & Garbin 2012; Kent, et. al. 2013; Neifert & Bunik 2013). While there are cases where women cannot produce enough milk for their babies, more often the problem is in expectations about breastfeeding patterns and what’s normal for a breastfed baby.

Sometimes around 10 days and then again around the 4-6 week mark, women think they have “lost their milk” because their breasts don’t feel as full or their milk is no longer leaking copiously. Changes around these times, however, are normal fluctuations in the way your body makes milk. They are likely signs that your initial engorgement has subsided and your milk supply has evened out to perfectly match your baby’s needs (Mohrbacher 2010; Kent, et. al. 2013).

Women who feel their milk supply is insufficient often base this perception on infant behavior – a baby who seems unsatisfied, who wants to nurse often, who is fussy or unsettled, etc. Though these behaviors can have many causes, women tend to blame their own bodies for not producing enough milk (Mohrbacher 2010). In addition, use of formula before hospital discharge is often wrongly instituted for “insufficient milk supply” at a time when moms aren’t yet making much milk (as nature intended!). While their bodies are, in fact, working right, they are led to believe something is wrong. And this perception sticks with them causing them to wean early (Gatti 2008). In addition, McCarter-Spaulding and Kearney (2001) found “mothers who perceive that they have the skills and competence to parent a young infant also perceive that they have an adequate breast milk supply” and vice versa. If a mom isn’t confident in her abilities, she may think her milk supply is low whether that’s truly the case or not.

So, milk supply issues – whether real or perceived - can impact how long a baby is breastfed. The solution is to help these moms feel confident in their milk supply. Working to increase milk supply will help those who are truly experiencing a dip in output, and may aid those who perceive a low supply feel more self-assured in their ability to breastfeed. Consider these tips for increasing milk supply:

  • Nurse more! The more stimulation your breasts get, the more milk you will make. And the baby is better at prompting this than any pump on the market. You need to be sure, however, that your baby is transferring milk well. Do you hear your baby swallowing after every one or two sucks early in the feeding and less frequently as the feeding progresses? This may sound like a soft “kah” sound, or may look like a pause in the middle of a suck. Do your breasts feel full before a feeding and softer when your baby has finished? These are good signs that your baby is transferring milk. Is your baby falling asleep at the breast soon after starting a feeding? These babies need to be encouraged to keep going.

Newborns will nurse every 1-2 hours, but even older babies may nurse often. Has your baby stopped nursing so often? Is he skipping feedings? Are you getting busy during the day or using a pacifier and missing some feeding cues? Has your baby started “sleeping through the night”? These can all lead to a decrease in supply. Try a “nursing vacation” – spend the weekend tucked in bed with your baby and nurse as often as possible.

  • Pump: Using a quality electric breast pump can help to stimulate supply. Keep in mind that pumps and pumping supplies can wear over time, so be sure yours is in top shape for the best results. Also, some brands are better than others at removing milk, so do some research before purchasing a pump.

Some women choose a few times a day, and consistently pump at those times. Other moms pump on one side while baby nurses on the other. Or you can try pumping for 5-10 minutes after every nursing session. The key to getting a good yield of milk when pumping is the ability to elicit milk ejections. If you have difficulty letting-down to a pump, you will get less milk. Two let-downs are sufficient, and three or four are even better. (Mohrbacher 2010). Use all of your best relaxation techniques: relax your muscles, breathe deeply, think about your baby, listen to a recording of your baby crying, smell something baby has slept in, do whatever it takes to condition yourself to let-down to the pump.

Also, doing breast massage before and during a pumping session (sometimes called “hands-on pumping”) can increase the amount of milk you are able to remove, and may give your nerves more stimulation resulting in an increase in production (Mohrbacher 2012).

  • Consider herbal galactagogues: A galactagogue is a substance that can increase production of breastmilk. Different substances have different mechanisms, but they should all be used in conjunction with increased nursing or pumping, or reserved for use until after other methods have failed to produce the desired results (Mohrbacher 2010).

Fenugreek (Trigonella foenum-graecum L.) is an herb used in many cultures to increase milk supply. The recommended dosage is 1800mg three times a day. Supply generally increases 24-72 hours of beginning the supplement; but for some women, it can take as long as one to two weeks. Use caution with this supplement if you have a history of allergies, asthma, hypoglycemia, or diabetes, and do not use if you are taking blood-thinning medications.

The effects of fenugreek are improved when combined with the herb blessed thistle (Cnicus benedictus). Adding 3 capsules of blessed thistle 3 times per day along with fenugreek improve output.

Both fenugreek and blessed thistle seem to be the most effective if used in the first few weeks after birth. Other herbs (including marshmallow root, goat’s rue, alfalfa, fennel, spirulina, raspberry leaf, brewer’s yeast, and shatavari) and some foods (for instance, oatmeal) have milk-enhancing properties, so adding them to your diet may boost your milk production. Keep in mind, though, these substances won’t do much if you aren’t nursing or pumping often.

  • Discuss medications with your healthcare provider: Prescription medications that act as galactagogues are sometimes warranted when all else has failed. Domperidone is the medication most likely to be effective in increasing milk supply, and the least likely to cause untoward effects for mom or baby. It has been used successfully in many parts of the world; however, use in the US is restricted. Reglan (metoclopramide) is another drug that helps to increase milk production. This drug should not be used by anyone with a history of depression or anxiety as it can increase the severity of these symptoms, and can even cause these symptoms in someone without a prior history. Use of Reglan should be considered with caution (Mohrbacher 2010; Zuppa 2010).


Any time you are dealing with a dip in supply, you should consider working with someone knowledgeable about breastfeeding, such as a board certified lactation consultant (IBCLC) or trained peer counselor. Sometimes just having that support is all you need to persevere through difficulties with supply. Any amount of breastmilk your baby gets is a gift – but maximizing your production so you can continue to nurse is well worth the effort, for you and for your baby.

 

References:

Gatti, L. (2008). Maternal perceptions of insufficient milk supply in breastfeeding. Journal of Nursing Scholarship, 40(4), 355-363.

Kent JC, Hepworth AR, Sherriff JL, Cox DB, Mitoulas LR, Hartmann PE. (2013). Longitudinal Changes in Breastfeeding Patterns from 1 to 6 Months of Lactation. Breastfeeding Medicine 8(4), 401-7

Kent, J. C., Prime, D. K., & Garbin, C. P. (2012). Principles for maintaining or increasing breast milk production. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41(1), 114-121.

McCarter‐Spaulding, D. E., & Kearney, M. H. (2001). Parenting Self‐Efficacy and Perception of Insufficient Breast Milk. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 30(5), 515-522.

Mohrbacher, N. (2012). To Pump More Milk, Use Hands-On Pumping. http://www.nancymohrbacher.com/blog/2012/6/27/to-pump-more-milk-use-hands-on-pumping.html [Accessed March 30, 2014].

Mohrbacher, N. (2010). Breastfeeding Answers Made Simple. Amarillo, TX: Hale.

Neifert M & Bunik M. (2013). Overcoming clinical barriers to exclusive breastfeeding. Pediatric Clinics of North America, 60(1), 115-145.

 

Zuppa, A. A., Sindico, P., Orchi, C., Carducci, C., Cardiello, V., Catenazzi, P., ... & Catenazzi, P. (2010). Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production. Journal of Pharmacy & Pharmaceutical Sciences, 13(2), 162-174.


Can a birth doula improve breastfeeding success? March 29, 2014 15:26

Written By Michelle Roth, BA, LCCE, IBCLC

Continuous labor support during childbirth has many advantages, including a decreased risk of interventions (including cesarean birth), less use of pain medication, and more positive birth memories (Hodnett 2013). But did you know a doula may also increase breastfeeding success?

From the Greek word for slave, doula has evolved to mean a woman who supports another woman during the birth process. During childbirth, she supports the laboring woman and her partner physically - helping mom change positions, providing massage or counterpressure, and giving the birth partner suggestions on how to help – as well as emotionally and intellectually. She is typically with the couple from the start of labor to the time of birth. Because of her presence and her trusted position with the new parents, she may be the ideal member of the birth team to help a mom initiate breastfeeding.


In an early study of the effect of doula care on breastfeeding success, researchers found that women in the intervention group (doula care) were more likely to be exclusively breastfeeding at one month after the birth (Langer et al, 1998). These women were also less likely to wean or supplement for perceived low milk supply. In closing, the researchers write, “These results provide grounds to consider that psychosocial support during labour and the immediate postpartum period should be part of comprehensive strategies to promote breastfeeding “ (1062).

In another study, Nommsen-Rivers and colleagues (2009) assessed the timing of the onset of lactation and the proportion of breastfeeding moms at 6 weeks postpartum for two groups – those with and without doula care for the birth. Compared to the standard care group, women in the doula care group were more likely to have their milk come in by day 3, were less likely to use a pacifier in hospital, were less likely to report concerns about milk supply, and were more likely to be breastfeeding at 6 weeks. After looking at relationships between confounding factors, the authors conclude, “Among mothers with a prenatal stressor, doula care was particularly effective in increasing the odds of continued breastfeeding” (172).

When studying the effectiveness of a hospital-based doula program, Mottl-Santiago and colleagues found that women with doula care were more likely to express an intention to breastfeeding, and were significantly more likely to breastfeed within the first hour after birth. The authors caution, however, that their results may not be a direct effect of a doula at the birth, since the doulas also provided prenatal breastfeeding education to the expectant mothers.

A recent study showed even more promising results. Of the women who had doula care during birth, nearly all initiated breastfeeding (97.9% compared to 80.8% in the general low-income population studied). When looking at a subgroup of women who are less likely to initiate breastfeeding, the researchers found 92.7% of African American women with doula support initiated breastfeeding, significantly higher than in the general population studied (Kozhimannil 2013). The authors suggest that “access to culturally appropriate doula care may facilitate higher rates of breastfeeding initiation,” with the key being suitable matching of doulas to the client population.

What more evidence do we need? Having doula support for your labor and birth may increase the chances of your breastfeeding. Choose a doula who shares your same values and birth philosophy so you feel comfortable and confident in her care. Ask friends, family, your care provider, or your childbirth educator for referrals or check the DONA International website for a doula in your community. Be sure to interview the doula you choose – even asking about her background in breastfeeding education and support. Let her know you plan to nurse your baby, and ask if she will help you get started. Her support may be essential.

 

References:

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. (2013). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, 7.

Kozhimannil KB, Attanasio LB, Hardeman RR, O'Brien M. (2013). Doula care supports near-universal breastfeeding initiation among diverse, low-income women. Journal of Midwifery & Women’s Health. E-pub ahead of print 9 JUL 2013.

Langer A, Campero L, Garcia C, Reynoso S. (1998). Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers’ wellbeing in a Mexican public hospital: a randomised clinical trial. British Journal of Obstetrics and Gynaecology (105), 1056-1063.

Mottl-Santiago J, Walker C, Ewan J, Vragovic O, Winder S, Stubblefield P. (2008). A hospital-based doula program and childbirth outcomes in an urban, multicultural setting. Matern Child Health J 12, 372–377.

Nommsen-Rivers LA, Mastergeorge AM, Hansen RL, Cullum AS, Dewey KG. (2009). Doula care, early breastfeeding outcomes, and breastfeeding status at 6 weeks postpartum among low-income primiparae. JOGNN 38, 157-173.

 


The Power of Prolactin: Reverse Cycling and Your Milk Supply February 13, 2014 15:16

Written By Michelle Roth, BA, LCCE, IBCLC

Prolactin is a hormone produced by the pituitary gland in both males and females throughout the life cycle. It’s a protein important for immune function, cell growth, and more. In females, prolactin takes a starring role in the reproductive cycle, and is especially important as the main hormone of milk production.

 

 

Often called “the mothering hormone,” prolactin creates protective behavior in a woman during the birth process, as well as throughout breastfeeding. One of the
most interesting aspects of this substance is that it has a circadian rhythm – higher levels are present at night in both males and females. This diurnal pattern may be the reason women who practice unrestricted breastfeeding – both day and night – tend to see a delay in the resumption of their menstrual cycle as well as a stronger milk supply.

Building a robust milk supply depends on frequent nursing from the start. In fact, nursing often establishes more prolactin receptors in the breast, increasing a mom’s ability to make milk over the entire cycle of lactation. And the more often you nurse, the better your supply – thanks to an intricate hormonal dance that includes prolactin, among others. A full breast will release a feedback hormone that says, “hey, stop making milk.” But a breast that is emptied often keeps filling. Prolactin levels rise whenever a baby suckles - they spike during nursing - and more prolactin equals more milk production.

For moms struggling with milk supply issues, nursing more frequently is often all that’s needed for improvement. But this increase in nursing needs to happen at night, too, in order to take full advantage of the higher nighttime prolactin levels. Sometimes babies naturally get into a pattern of more frequent night nursing, often called reverse cycling. These babies nurse more in the evening and at night, and less during the day for a variety of reasons. While moms may be losing some sleep, reverse cycling is actually a boost for their milk supplies.

Reverse cycling is most likely to happen in situations where mom and baby are apart during the day, but together at night (for instance, when a mom works outside the home). Sometimes a working mom will find that her baby drinks only enough during the day to take the edge off his hunger, but then spends the evening nursing non-stop and wakes several times throughout the night to nurse. This pattern shows a strong mother-baby attachment. Rather than a behavior in need of correction, it is, in fact, the key to keeping up a strong milk supply after returning to work. 

But reverse cycling can happen for other reasons, as well. If you are taking care of other children, or have simply had a busy day for whatever reason, it may be that you miss some of the daytime cues for breastfeeding. Your baby may try to catch up – on calories and on closeness - by reverse cycling. Or maybe your baby is at that distractible stage – every time he nurses, he starts and stops multiple times to look at the cat, listen to the noises outside, smile at his sibling, etc. Or maybe he’s busy learning to crawl or walk, and doesn’t want to slow down to nurse. These babies may use the quiet of night to get the majority of their calories.

You might think that all that night waking is a disadvantage, and others may encourage you to get your baby onto a “sleep schedule.” But, research shows moms whose babies nurse often at night actually get the rest they need. This is especially true if you choose to co-sleep with your baby. Moms and babies who sleep in close proximity – especially when sharing a bed – tend to have entrained sleep cycles. When your baby wakes, you’re in the same stage of sleep, and the waking doesn’t provide the same level of disruption to your system that sleeping apart in separate rooms would. When a mom sleeps near her baby, she often notices small sounds and movements before either she or her baby are fully awake, and can often doze as baby nurses. If you choose to share a bed with your baby, be sure that you take precautions to make your sleep space safe. Learn more here [Add hyperlink - http://cosleeping.nd.edu/safe-co-sleeping-guidelines/]. If your baby is reverse cycling and you’re feeling a little sleep deprived, try going to bed earlier or napping during the day.

Another benefit of reverse cycling for working moms is that they may not need to pump during their workday. If your caregiver tells you repeatedly that your baby isn’t taking much from his bottles, but he nurses like crazy when you’re together, you may be able to cut back on how often you pump (or maybe not even pump at all depending on your baby’s pattern). Many women find this eliminates much of the stress surrounding working and breastfeeding. You can read more about other working moms’ experiences with reverse cycling and nighttime nursing in La Leche League International’s magazine for mothers, New Beginnings here  [http://www.llli.org/nb/nbmayjun00p98.html] and here [http://www.llli.org/nb/nbiss3-09p32.html].

The biggest benefit of reverse cycling, though, is that the baby consumes more breastmilk, thus keeping your milk supply strong and your baby healthy and happy. The key is to practice unrestricted breastfeeding when you are with your baby – whether that feeding takes place day or night - to take advantage of your hormones for keeping up your supply.

 

About the author

Michelle Roth, BA, LCCE, IBCLC is a board-certified lactation consultant working in a private pediatric practice. She has been a La Leche League Leader for the past 12 years, and currently serves on the Area Council for LLL of Western PA. As a freelance writer and editor, her favorite jobs are proofreading and blog writing. With 4 active children, she doesn’t get much time to herself; when she does, she enjoys reading, crocheting and cross-stitch.

 

Resources:

Ayden, KK. (2001). Employed Mothers: Supporting Breastfeeding and Mother-Baby Attachment. Leaven 37(5), 101.

Bonyata, K. (2011) Reverse cycling. Accessed at http://kellymom.com/bf/normal/reverse-cycling/.

Buckley, S. (2010) Ecstatic Birth – Nature’s hormonal blueprint for labor. E-book. Available at www.sarahbuckley.com.

Lawrence RA & Lawrence RM. (1999). Breastfeeding: A guide for the medical professional. 5th ed. St. Louis, MO: Mosby.

Riordan J & Wambach K. (2010). Breastfeeding and Human Lactation. 4th ed. Sudbury, MA: Jones & Bartlett.

West D & Marasco L. (2009). The Breastfeeding Mother’s Guide to Making More Milk

Heard of Moringa? It's an herb that helps milk supply. June 09, 2013 00:00


For any new mother who wants to do the best for her baby, breastfeeding can easily provide many benefits. However, some women have problems producing enough milk throughout the breastfeeding years. There can be causes for low milk supply such as being under stress or having some types of hormonal imbalances. Other causes can be having duct milk damage from previous surgeries, smoking, or even getting pregnant again while nursing.  When these possible causes can be ruled out, Moringa can be an option to help increase breast milk flow.

The Moringa tree was first referenced around 2000 B.C. when it was used by people in Northern India. It was believed the tree had medicinal benefits and was able to prevent over 300 diseases. This tree was also used for various reason by the Greeks, Romans, and Egyptians as both protection from the hot sun and as a lotion. Maurian warriors of India ate the leaves believing they had the power to increase their strength and stamina. 

Although the Moringa tree is native to the Northern part of India, it is now found in many areas of the world including Central and South America, Africa and Asia in tropical and sub-tropical climates. This tree can grow up to 12 meters high and has drooping branches on which there are small leaves that contain an incredible powerhouse of vitamins and minerals. It grows best in sandy or dry soil with bright sunshine, but cannot tolerate excessive flooding or soil with little drainage. The tree needs little water, making it a valuable commodity in drier climates.    

The Moringa tree has many uses including: food for humans and forage for livestock, medicine, dye, water purification, and can also help to increase flow of breast milk in lactating women, as has been proven in studies. The leaves of the tree are full of vitamins and minerals which contain:

* 7 times the Vitamin C content of oranges

* 4 times the calcium content of milk

* 4 times the vitamin content of carrots

* 3 times the potassium content of bananas

* 2 times the protein found in yogurt

The Academy of Breastfeeding Medicine Protocol Committee did a study to find out how Moringa effects the rate of milk flow in lactating mothers. Two groups of mothers were given breast pumps and asked to pump every four hours. One group was given the supplement and the other was not. The mothers in the study were asked to write down how much milk was produced each time they pumped over a three day period. The results came back showing that the mothers who had used the Moringa supplement produced more milk overall than those mothers who didn’t use the supplement.

In another such study, the same results were found. Mothers were asked to measure their breast milk production on the third, seventh, and fourteenth day of production. Although all mothers had about the same results on the third day, the mothers taking a Moringa supplement had increased production on the seventh and fourteenth days when compared to those who didn’t take a supplement. These promising results will most likely lead to even more studies showing the efficacy of the supplement on lactating women.

For any mother who struggles with not producing enough milk, the Moringa supplement may be just what she and her baby needs. There are no ill side effects and a good variety of vitamins and minerals come from it. According to both studies done, it may be beneficial for a mother to begin taking the supplement as soon as she gives birth, enabling her milk flow to increase by the third day after birth.

  1. http://www.treesforlife.org/our-work/our-initiatives/moringa
  2. http://itsmoringa.com/1/about/history
  3. http://www.drugs.com/breastfeeding/moringa.html
  4. http://miracletrees.org/growing_moringa.html

 


5 Reasons to Co-Sleep While Breastfeeding April 13, 2013 00:00


 

 

 

 

 

 

 

 

 

 

 

 

The conventional wisdom for a couple expecting their first child is to equip a room with a crib and other furnishings, to buy baby formula, bottle, and diapers, and to prepare to lose sleep. Parents often secretly expect their lives to be changed for the worse. They may cover up these fears with false cheer. Truthfully, these fears are well-founded. This conventional approach to welcoming a new child into the home is in fact artificial and needlessly painful -- it is plainly difficult. There is a much easier approach, in which parents share their bed with the baby, and the baby nurses at will throughout the night. Parents may find this way not only easier, but simpler and more life-giving. Here are five benefits of co-sleeping with your newborn while breastfeeding.

One of the greatest discomforts parents face when they relocate the infant into her own room and crib is a lack of sleep for themselves. A child separated like this may wake at any hour of the night, and cry for food or comfort. Parents are then left with a dilemma: to climb out of bed yet again and feed or hold the child, or to remain in bed and let the child "cry it out". Arguments may occur about who arises to tend to the infant. These difficulties can also occur for parents whose infant sleeps in their bedroom, but in her own bed.

This is barely a problem at all for co-sleeping families. A co-sleeping child, next to her mother and able to nurse at will, is able to rest much more easily. The child need not cry loudly to wake the parents and to draw them near; the parents are already there. All the child need do is grunt and touch the mother, and the breast is there. The mother need not even be fully awake to nurse the child. They can both fall back asleep, naturally. And there will be no arguments between parents over who will rise and feed the baby next

There are many psychologists today who argue that the conventional removal of a newborn to its own room and bed is traumatic to the infant. The argument is that the infant physically and psychologically needs the physical warmth and touch of the mother's skin. Having just come from the total comfort of the womb, she requires a far more gradual separation from the mother, taking years, rather than hours. Moving the infant into its own room so early is traumatic, and shakes her trust in her parents -- and in the world -- deeply and irreparably. Her suffering is multiplied when she is required to "cry it out". Parents may feel guilt over this separation and the suffering of the child.

When co-sleeping while breastfeeding, all this potential trauma simply does not occur. The infant goes straight from the comfort of the womb to the comfort of the parents' embrace. Needless suffering is avoided. The parents don't sever the bond of comfort and trust, so they carry no guilt. They experience greater freedom to love and help the child, and less need to "make up" for their failings.

A mother's milk is the ideal food for an infant. The best formula cannot approach its nutritive benefits. The small body of a newborn results in a fast metabolic cycle. Because an infant gets hungry frequently, often even at night, she needs to nurse frequently -- sometimes several times an hour.

When parents nurse an infant while co-sleeping, that food is always there. Since an infant does most of its growing at night, the necessary nutrients for growth will be readily available in the easily-digestible mother's milk. And the infant need not get to the point of crying or screaming before nursing, when her growing hunger is already unbearable; when nursing while co-sleeping, she can eat as soon as she is hungry. Her nutritional needs are met as soon as they occur.

One fear of expectant parents is the financial strain a new baby will bring. Many of the usual costs don't exist when nursing and co-sleeping. Since all the food comes straight from the mother, the greatest expense there is her own food. There is no need to buy formula. No crib is necessary, either, though parents might invest in a sleeping pad to avoid urine stains in their bed. Freed of the compulsion to buy new things for the home -- things often made of unattractive plastic -- the material simplicity of co-sleeping while breastfeeding contributes to a certain peace of mind. There is less clutter from "baby stuff" in a co-sleeping home -- and more happiness.

A family does not require a new room for the baby when she simply sleeps in bed with the parents. The notion of a nursery is in fact foreign to a co-sleeping family. A co-sleeping family doesn't feel the need to expand their living space. This acceptance of things as they are invites contentment and a lack of stress. With any extra space not "swallowed up" by the baby, the family can use an existing extra room for another purpose -- perhaps for a recreational, family-building purpose. Perhaps the space can be used to develop a personal hobby, or for activities toward fulfilling one's lifelong dreams. All this adds joy and vitality to a young family, rather than the nervous oppression that infects so many young parents.

Co-sleeping while nursing provides significant benefits over the conventional approach to raising an infant. Parents get more sleep, and form a deeper bond with the child. The infant receives better nutrition. Parents save money, and don't need to scramble for more space. All of these benefits, significant in themselves, lead to the greater benefit of more peace and joy in the home. 


The Good, The Bad, and the Ugly: Here's the Skinny on Dietary Fat March 07, 2013 00:00

BAD FAT 

While a fat-free or even low-fat diet is not the healthiest choice, there are certainly some types of fat that you'll want to do your best to avoid or limit.  These are the fats that are detrimental to your health, especially when consumed in large quantities.

Saturated fat comes from animal sources.  When you eat a burger with bacon and cheese, the saturated fats from the meat and dairy raise your total and LDL blood cholesterol levels. This is not good. High LDL cholesterol dramatically increases your risk of cardiovascular disease and type 2 diabetes.

Trans fats are naturally occurring in some animal products, but most trans fats are the product of partial hydrogenation.   The process of hydrogenation takes healthy unsaturated fats and turns them into fats that are more shelf-stable and easier to cook with.  These fats are usually solid at room temperature, .like lard, butter, margarine, and shortening.  They are often referred to as synthetic fats, and are found in a lot of the processed and prepacked food that fills most American grocery stores.

Many restaurants and food manufacturers now advertise the fact that their products are trans fat free.  Be careful of tricky labeling... just because a doughnut is trans fat free doesn't mean it is good for you.  It's likely to be high in sodium, sucrose (the bad sugar), or heavy in saturated fats.  Your best bet is to read the label, including the little box that tells you all the vitamins and minerals (or lack thereof). 

Remember, food is fuel.  If you are filling up with empty calories (that's food that is basically void of any nutritional value), you won't be able to run very long before you crash.

GOOD FAT

The term “good fat” is not an oxymoron.  Fats are the building blocks of the brain and are absolutely essential for proper body function, but you must be able to differentiate between the good, the bad, and the ugly... or at least the good and the bad.

Monounsaturated fat is found primarily in oils (like olive oil), nuts, sunflower seeds, and avocados.  This type of good fat reduces the risk of cardiac disease and stroke, because it helps regulate LDL cholesterol in the bloodstream.

That's not all, though. A diet rich in monounsaturated fats verses one that is comprised of “bad fats” and carbohydrates often results in weight loss, decreased symptoms of rheumatoid arthritis, prevention of type 2 diabetes, and reduced belly fat.

Polyunsaturated fat is found in plant-based foods, oils, and some types of fatty fish.  One especially beneficial type of polyunsaturated fat is Omega-3 fatty acid, found in some types of fatty fish, nut oils, and flax seeds.  According to the University of Maryland Medical Center,  Omega-3 fatty acids are a necessary component of a healthy brain, including memory and behavioral function.  In fact, infants who have not received enough of this polyunsaturated fat in utero can suffer from vision and nerve problems.

Balanced consumption of Omega-3's is also associated with reduced risk of inflammatory diseases like cancer, heart attack, stroke, and arthritis. 

WHAT CAN GOOD FAT DO FOR ME?

According to information published by the Franklin Institute for Science Learning, fat literally builds your brain.  Fatty acids from the food you consume are the substance your body uses to build the specialized cells which allow you to think and feel.

Good Fats Build Neuron Membranes

Neurons are the specialized cells that the brain uses to communicate with the rest of the body.  The membranes of these cells are comprised of the same fatty acids that you consume in your foods.  The process of digestion breaks the dietary fat into molecules of different lengths.  These molecules become the building blocks of the fats used in the formation of brain cell membranes.

Good Fats Protect Your Brain

Myelin is the sheath that protects the neurons of your brain.  It's composed of 30% protein and 70% fatty acid.  Oleic acid, the most abundant acid in human breast milk, is one of the most common fatty acids found in the brain's myelin.  Excellent dietary sources of monounsaturated oleic acid are avocados, olive oil, and oils from peanuts, macadamias, almonds and pecans.

Good Fats Aid Digestion

Believe it or not, that slippery looking margarine is hard to digest.  Why?  The shape of a trans fat molecule is not barbed, which means lots of those molecules can clump together nice and tight.  On the other hand, a mono or poly unsaturated fat molecule is barbed, which means they are loosely packed and can be picked apart by the body and put to good use.  These fats are more readily absorbed and distributed to the cells that need them.  Whereas the bad fats, in essence, plug you up. 

WHAT CAN GOOD FAT DO FOR MY BABY?

A pregnant mama supplies two specific types of fatty acids, DHA (docosahexaenoic acid) and AA (arachidonic acid), to her growing baby.  These fatty acids are crucial to the baby's brain and vision health. Studies have shown that a deficiency in DHA and AA can lead to impairment of the baby's central nervous system and cognitive development. 

After the baby is born, the mother will continue to provide these necessary building blocks through her breast milk.  Since Omega-3 and Omega-6 fatty acids are essential nutrients, they can not be manufactured by the body.  They must be built from the foods that we consume.  A diet high in nuts and cold pressed oils will help ensure that a nursing mother produces the most nutritious breast milk for her baby's growing brain and body.

HOW MUCH GOOD FAT DO I NEED?

The United States Department of Agriculture's Dietary guidelines are based on a 2,000 calorie per day diet.  Within that framework, you should consume about 44 to 78 grams of fat per day, most of which should be unsaturated fatty acids. 

Remember, even good fats are high in calories.  For a nursing mom who needs to consume a few more calories, this is no problem.  But it's best not to go overboard.  Start by replacing a couple of beef dinners a week with fresh water fish.  Snack on nuts, or non-hydrogenated nut butters on celery, instead of chips and crackers.  Whip up a free-range egg white omelet for breakfast.  Go for a snack bar that is full of flax, almonds, or macadamia nuts instead one that is really a glorified candy bar.


By making these simple dietary changes, you can provide your beautiful baby with the most nutrient rich breast milk possible.  Not to mention that your own mental and physical health will benefit right alongside your baby's.  Healthy mama.  Healthy family.  It's a no-brainer.

RESOURCES:

Mayo Clinic.  Nutrition and Healthy Eating.  Dietary Fats:  Know Which Types to Choose.

http://www.mayoclinic.com/health/fat/nu00262/nsectiongroup=2

The Franklin Institute:  Resources for Scientific Learning.  Nourish- Fats.

http://www.fi.edu/learn/brain/fats.html

University of Maryland Medical Center, Omega-3 Fatty Acids.

http://www.umm.edu/altmed/articles/omega-3-000316.htm

United States Department of Agriculture:  Dietary Guidelines.  2010.

http://www.cnpp.usda.gov/DietaryGuidelines.htm

 

 

 


How Medications Affect Breastmilk January 20, 2013 21:26

At the pharmacy, I get a lot of questions about medications while breastfeeding.  While it is always safest to avoid medications while breastfeeding, sometimes mothers are left without a choice if their condition puts their own health at risk.  Although many medications are safe to use when you're breastfeeding, most drugs will get into your milk to some degree and may even affect your milk supply. To be safe, check with your child's doctor before taking any kind of medication, even over-the-counter drugs.  The mechanism of how drugs enter breast milk is described below in addition to some general guidelines that I follow when counseling my patients.

Transfer of drugs into breast milk is influenced by protein binding, lipid solubility and ionization

This sounds pretty scientific but basically this means that nearly all drugs transfer into breast milk to some extent.

Notable exceptions are heparin and insulin which are too large to cross biological membranes. The infant almost invariably receives no benefit from this form of exposure and is considered to be an 'innocent bystander'.

Drug transfer from maternal plasma to milk is, with rare exceptions, by passive diffusion across biological membranes. Transfer is greatest in the presence of low maternal plasma protein binding and high lipid solubility.

In addition, milk is slightly more acidic than plasma (pH of milk is approximately 7.2 and plasma is 7.4) allowing weakly basic drugs to transfer more readily into breast milk and become trapped secondary to ionization.

What you should know is that milk composition varies within and between feeds and this may also affect transfer of drugs into breast milk. For example, milk at the end of a feed (hindmilk) contains considerably more fat than foremilk and may concentrate fat-soluble drugs.

As a general rule, maternal use of topical preparations such as creams, nasal sprays or inhalers would be expected to carry less risk to a breastfed infant than systemically administered drugs.

This is due to lower maternal concentrations and therefore lower transfer into breast milk.

However, the risk to the infant must be considered in relation to the toxicity of the drug used, the dosage regimen and the area of application. For example, use of corticosteroids nasal sprays or inhalers in standard doses would be considered compatible with breastfeeding.

Infants have lower drug clearance (elimination) than adults

Drug clearance in the infant is a particularly important consideration and premature infants have a severely limited ability to clear drugs.

Within a few days of delivery, term infants have kidney filtration rates approximately one-third of adult values after adjusting for difference in body surface area, and premature infants have even more impaired clearance.

Generally, adult kidney filtration rates (adjusted for the difference in surface area) are attained by five to six months of age.

Minimize risk to the breastfed infant by reducing drug exposure

The overall risk of a drug to a breastfed infant depends on the concentration in the infant's blood and the effects of the drug in the infant. If, after assessment of the risks and benefits, the decision is made to breastfeed while the mother is using a drug, the infant should be monitored for adverse effects such as failure to thrive, irritability and sedation.

However, it is difficult to identify adverse reactions occurring in neonates. 

Feeding immediately prior to a dose may help to minimize infant exposure as concentrations in milk are likely to be lowest towards the end of a dosing interval.  Or,it may be reasonable to reduce infant exposure by alternating breast and bottle-feeding. For drugs that are not considered safe in breastfeeding, breast milk may be expressed and discarded for the treatment duration. Breastfeeding may be resumed after the drug has been eliminated from the maternal blood stream. A period of approximately four half-lives (the time it takes for half of the drug to clear the body) will reduce maternal concentrations to around 10% of steady-state (full) concentrations.

Atkinson HC, Begg EJ, Darlow BA. Drugs in human milk. Clinical pharmacokinetic considerations. Clinical Pharmacokinetics 1988;14:217-40.

Bennett PN and the WHO Working Group, editors. Drugs and human lactation. 2nd edition. Amsterdam: Elsevier, 1997.

Infantrisk.com

 


Returning to Work or School while Breastfeeding Your Baby - Some tips for Success December 28, 2012 21:23

Congratulations on your decision to provide the best possible nutrition and protection for your baby after returning to work or school! Here are some tips to help you succeed.

Combining breastfeeding with work or school is challenging, but well worth it. The health and immunity benefits your little one gets from your breast milk cannot be matched by formula. And sitting down to cuddle and nurse after a busy day is a wonderful way to de-stress and reconnect with your baby.

Two keys to success are planning and being organized. Below are tips that other mothers have found helpful, as well as information about the federal law to support breastfeeding mothers at work.

What should you do before you deliver?

Before you begin maternity leave:

 

  • Find out how much time you will be able to take off from work or school after you deliver. 
  • Take as much family leave as you can to have more time with your baby.  Research your options for returning to work or school.  Can you work/study part-time for a while?  Can you telecommute or use distance learning? Is there a more flexible work or school schedule you can try? 
  • Talk with your supervisor. Will he/she be supportive? You may want to point out the company advantages of having breastfeeding employees: 
    • »  Less time lost from work because breastfed babies tend to stay healthier than their formula fed counterparts.
    • »  Fewer health expenses for the baby and lower overall health care 
         costs. 
    • »  Higher employee satisfaction, morale and productivity and lower staff 
          turnover. 
    • »  Major recruitment incentive for new employees. 
    • »  Reputation as a company concerned for the welfare of working 
          mothers and children. 
  • When making arrangements for childcare, choose a provider that supports your wishes to provide pumped breast milk to the baby while you are away and allows you to nurse your baby as soon as you return. 
  • Be aware of the laws regarding employees who are breastfeeding. On March 23, 2010, as part of the Patient Protection and Affordable Care Act, a federal law amending Section 7 of the Fair Labor Standards Act (FLSA) (29 U.S.C. 207) was passed. This law mandates break times for breastfeeding mothers to express milk.
  • Find out where you will be expressing milk for your baby. Does the room have an electrical outlet? Is there a refrigerator nearby? If not, you may want to purchase a pump with rechargeable battery back-up and an insulated cooler with ice packs (blue ice). Is there a sink available to wash breast pump parts between pumping sessions?
  • If not, is there a microwave handy to steam clean the parts? If not, you may want to purchase wipes you can use to clean the parts.

What should you do before you return to work or school? 

  • Learn how to manually express breast milk, even if you plan to use a breast pump.
  • Become familiar with your breast pump. Practice setting up your pump and putting the parts together. Try it out. Adjust the settings so that the speed and suction are as close as possible to how your baby nurses.
  • About two or three weeks before returning to work or school, begin pumping once each morning about an hour after you have nursed your baby. (Prolactin levels are highest in the morning.) You may not get any milk during the first couple days, but you are sending a message to your body to begin increasing your milk supply.
  • Gradually add two or three more pumping sessions between feedings. Once you start to get milk, store it in the freezer for emergencies. Store expressed or pumped milk in small amounts, two to four ounces. 
  • Introduce the bottle to your baby two or three weeks before you go back to work or school. It may be easier to have someone else offer the bottle, since your baby links you with breastfeeding. Try to use the newborn-sized nipple for as long as you breastfeed, but you may have to experiment to find one your baby likes. 
  • Consider buying a “hands-free” nursing bra that allows you to use your hands while you are pumping milk.
  • It may be helpful to schedule a practice day. Set your alarm for the time you will be getting up when you’re working or attending class. Take your baby to childcare for at least part of the day. Breastfeed and pump at the times you expect to during work or school. At the end of the day, see if your baby drank as much as you pumped.
  • The evening before your first day back, pack the diaper bag and your pump bag. (See packing lists below.) Include an extra blouse or sweater that you can leave at work in case of a milk leak that soaks through breast pads.

What should you do when you return to work or school?

  • Be prepared. Your first day back at work or school may be very emotional. Try to start on a Wednesday or Thursday. Easing back into the work or academic world by starting with a shortened week will be less stressful. 
  • Breastfeed your baby when you wake up, then give him/her a “top-off” when you get to childcare.
  • Your baby will need at least two to three bottles while you are away, so you will need to pump at least two to three times during the eight or nine hours you are at work or school. (If you have a longer work day or longer commute, you will need to pump more milk.) This is the milk that will be given to your baby the next day at childcare. 
  • You may have an easier time having a let-down reflex if you look at a picture of your baby or have a piece of clothing handy that smells like your baby. Pack these in your pump bag. 
  • Clean pump parts that come into contact with you or your milk. Read the instructions that came with your breast pump. Between pumping sessions you may: 
    • »  rinse with cool water, then wash with warm soapy water and leave out to air dry, 
    • »  wipe with a sanitizing wipe sold by pump manufacturers, 
    • »  rinse parts well and store in the fridge or your cooler, and 
    • »  alternate options above throughout the day. For example, rinse and store in fridge after the morning pump session and wash in warm soapy water after the lunchtime pumping session. 
  • Some women prefer to purchase several extra sets of pump parts so they do not need to clean parts while at work or school and just put everything in the dishwasher at night. 
  • Breastfeed again as soon as you and your baby are back together. You can discuss your baby’s day with your childcare provider during this time. Let the mothering hormones that are released during breastfeeding help you relax and bond. 

1 Bridges CB, Frank DI, Curtin J. Employer attitudes toward breastfeeding in the workplace. J Hum Lact. 1997;13(3):215-219 

Resources 

Books

  • Working without Weaning: A Working Mother’s Guide to Breastfeeding (2006) by Kirsten Berggren 
  • Milk Memos: How Real Moms Learned to Mix Business with Babies-and How You Can Too (2007) by Cate Colburn-Smith and Andrea Serrette 

Websites 

  • www.workandpump.com
    Has many helpful tips for managing the transition back to work 
  • www.usbreastfeeding.org
    Has information on new legislation that relates to breastfeeding 

The information presented here is not intended to diagnose health problems or to take the place of professional medical care. If you have persistent medical problems, or if you have further questions, please consult your doctor or member of your health care team. 

 


The Top Thirteen Health Benefits of Breastfeeding Your Baby December 07, 2012 22:44

Breastfeeding is not an option for all mothers, but there is now an impressive body of evidence suggesting that those women who can breastfeed will reap substantial health benefits. Some of these apply to the development of the baby, while others influence the health of the mother. Read on to discover thirteen fascinating and profoundly important reasons why breastfeeding is a smart choice.

 

1) It reduces your risk of developing certain cancers:

Cancer research has shown that mothers who do not breastfeed or who only breastfeed for a short period of time (i.e. less than three months) are a shocking 11% more likely to suffer from breast cancer at some stage in their lives. Further studies have also connected breastfeeding to a reduced risk of developing ovarian and endometrial cancers.

 


2) It is linked to higher intelligence:

Recent studies have revealed that children who were breastfed as babies are, on average, more likely to score higher on IQ tests and more likely to get better grades in school.

 

3) It can help you become slimmer:

There are a couple of reasons why breastfeeding can help you to get in shape. Firstly, it burns around 500 extra calories each day, and this will help you to lose weight. Secondly, when you lactate this causes your uterus to shrink more rapidly, and the quicker your uterus returns to its normal size then the easier it is to cultivate a slimmer figure.

 

4) It makes your baby less likely to suffer from digestive difficulties:

Breastfeeding your baby reduces its risk of developing a range of intestinal problems, including Crohn’s disease, ulcerative colitis and diarrhea. It is not entirely clear why this correlation exists, but a large body of research has established that there is a significant connection.

 

5) It reduces your risk of developing osteoporosis:

As a result of an overwhelming number of studies, it is now almost universally agreed that women who do not breastfeed their babies are around four times more likely to develop osteoporosis (i.e. brittle bones) in older age.

 

6) It boosts your baby’s immune system:

Breast milk helps to promote a strong and healthy immune system in your body, and this means that your baby is less likely to contract serious illnesses. This is because breast milk is a source of lymphocytes and macrophages, which produce antibodies that protect us from bacteria and viruses.

 

7) It reduces your baby’s chance of developing breast cancer:

A study conducted in the mid-nineties proved that female children who were not breastfed were as much as 25% more likely to develop some form of breast cancer during their adult lives.

 

8) It makes your child less likely to develop arthritis at a young age:

According to studies aimed at discovering how we might prevent arthritis, children who are breastfed appear to be around 60% less likely to develop arthritis during their childhood or teenage years.

 

9) It reduces your baby’s risk of suffering from diabetes:

Research conducted in Finland has found that drinking dairy products (instead of breast milk) at a young age raises the risk of ending up with type one diabetes. This is because cow’s milk antibodies are linked to a greater chance of developing diabetes.

 

10) It can help with insomnia:

The chemicals in breast milk can help to encourage your baby to fall asleep. This, in turn, can also help you to feel more relaxed and able to sleep.

 

11) It makes your child less likely to develop asthma:

Studies on respiratory health show that children who were breastfed as babies are much less likely to suffer from the wheezing and chest discomfort that are experienced by sufferers of asthma.

 

12) It promotes your child’s dental health:

When babies suckle in order to breastfeed, this tones and strengthens their facial muscles. Orthodontic studies show that this toning and strengthening improves jaw alignment, which in turns makes those children less likely to need braces or other orthodontic work in later life.

 

13) It helps to create and maintain a body between you and your baby:

When you breastfeed your baby, your endocrine system responds by releasing a hormone called oxytocin. This is the same hormone that is often called the ‘cuddle hormone’ because of its ability to increase emotional intimacy between romantic partners. In the context of breastfeeding, it improves milk ejection and promotes happy and relaxed feelings during the feeding process. In addition, babies it comforting to be cuddled, and being cradled in your arms during breastfeeding helps to soothe them.

 

As is obvious from these impressive health benefits, breastfeeding can boost the health of both you and your baby. However, note that you should never breastfeed if you have a serious bacterial or viral infection, and you should always speak to your doctor to make sure whether you are taking any medications that could harm your baby if they are transferred via breast milk.


How to Evaluate the Early Signs of Postpartum Depression November 26, 2012 13:09

 

The room is dark. The clock says 3am. You relish this brief moment of rest. And then, the baby cries again. You cringe, desperately hoping she’ll stop. But the crying gets louder. Your man merely grunts and rolls away from the sound. Suddenly, a wave of emotion hits you in the gut, and your whole body begins to spasm with impending tears. Postpartum depression is real, overwhelming, and terrifying. Here is a brief guide on how to cope with the initial onset of postpartum depression.

When does postpartum depression start, and how long does it last?

Immediately after pregnancy, all women experience hormonal fluctuations. Some women (but not all) experience mood changes as a result of these hormonal shifts, and the mood changes can vary from minor “baby blues” to full postpartum depression. The onset of these symptoms can start within the week after delivery, or they could emerge any time within six weeks. For some, the symptoms might last for a few days. For others, it can last weeks or months.

So it’s important to know that every woman experiences hormonal changes. You are not alone. It’s also important to recognize that the “baby blues” are common for many women (estimates say 50-90% of women experience these minor mood changes), and they will fade away when your hormones stabilize.

It’s also important to be aware of more severe symptoms of postpartum depression, which affects 20-25% of women. Be honest with your doctor and pediatrician about the symptoms you are experiencing, and be open and willing to get help, if needed.

The Early Signs of Postpartum Depression

Women experience a wide variety of mood changes during the postpartum hormonal-adjustment period. Many women feel unhappy, weepy, anxious, and have sudden shifts from happy to sad. More often than not, these feelings come without clear or adequate reasons. Often, the smallest thing can initiate a mood swing. However, some symptoms should be viewed as red-flags, and you should get help immediately.




 How to Know if You’re in Danger

It is important to regularly do a self-check on yourself. Here are some questions to ask:

1. How long has your depression lasted? (Concern: Your depression lasts longer than a week.) 

2. How are you sleeping? (Concern: You have trouble sl

eeping when baby is sleeping.)

3. How is your appetite? (Concern: You have very little interest in food.)

4. How are your interests? (Concern: You have lost interest in yourself and your family.)

5. How is your hope? (Concern: You have very little hope; you only see a bleak future.)

6. How is your confidence? (Concern: You feel helpless, without any control.)

7. How is your desire to press on? (Concern: You have suicidal thoughts or urges.)

8. How do you see your baby? (Concern: You wish the baby had never come.)

9. How am I caring for my baby? (Concern: You are not taking care of the baby; you have thoughts of harming the baby.)

10. How is my mental state? (Concern: You are experiencing weird thoughts, extreme fears, hallucinations, etc.)

If you are experiencing any of these “concern” symptoms, call your doctor and get help immediately. Don’t hesitate. Even if you feel you might be over-exaggerating, it doesn’t hurt to talk to someone. If anything, talking out your symptoms will put your fears to rest. And the good news is that help is just around the corner. There are well trained counselors and doctors who will quickly come to your side and support you through this experience. And often, you might be encouraged to join a mother’s group with women facing the same feelings as you. This kind of support (even if it’s the last thing you thought you’d need) can drastically soothe your feelings of panic and give you the tools and encouragement needed to get through this postpartum period. Help is close at hand. You just have to ask.

 Tips and Tricks to Cope With the Initial Onset

Step One: First recognize and accept your problem. In this case, you are experiencing a form of postpartum depression. As discussed above, you first need to accept that mood changes are normal and common during the postpartum period, and it is due to hormonal changes. Do a self-evaluation (perhaps regularly) to see where you are at in the depression spectrum. If in the danger zone, the first step is to get immediate help.

Step Two: During the postpartum period, you will often think negatively. Unfortunately, negative thoughts fuel negative behaviors and moods. So when you are feeling overwhelmed, take a moment to step back and evaluate your thoughts. Write them down if you can. “I feel like I’m doing everything wrong.” This is a thought. It’s a negative thought. Take a moment to step outside yourself and evaluate this thought. Is it accurate? In most cases, negative thoughts are extreme and overly-critical. If you can, try to come up with a positive thought as a rebuttal. “I may feel like I’m doing everything wrong …BUT, I am showered and dressed, and the baby has a clean diaper. That counts for something.” It may be simple. It may seem ridiculous. It may take time to really believe the statement. But these positive thoughts can and do dampen the fire of your negative emotions.

In Conclusion

All women experience hormonal changes after pregnancy. And 50-90% of women experience a mild case of “baby blues” that can last for a few days or so after delivery. In 20-25% of cases, women experience a more intense hormonal reaction called postpartum depression, which can vary from mild to extreme. It’s important that you regularly do a self-check to see if your symptoms are warning that professional help is needed. If you see these red flags, be quick to ask for assistance. Otherwise, for the day-to-day coping of postpartum depression, you can practice evaluating your thoughts. Positive thoughts can dampen your negative thoughts. And practicing positive “rebuttal” thoughts can pave the way for a greater sense of control and self-validation as you navigate through this (sometimes brutal) postpartum period.


Living Mindfully Through Breastfeeding November 21, 2012 00:00


 

 

 

 

 

 

 

 

 

 

 

 

 

As many concepts related to parenting, green living is an ideal that often gets tossed out the window once the baby arrives. Staying sane on only an hour of sleep while taking care of a demanding infant and remembering basics like getting your teeth brushed on a daily basis can be hard enough, much less living mindfully and in an environmentally friendly manner. However, incorporating green living into your daily life as a parent can start with something as simple as how you feed your infant.

One of the most ways a new mother can live mindfully and be green at the same time is to breastfeed her baby. While of course this is not possible for all mothers, nursing can be an incredible way to foster emotional bonding between a mother and child and may offer important health benefits such as increased immunity. Breast milk is also free, which can substantially lower overall costs compared to purchasing baby bottles and formula. According to the website KidSource.com, the yearly cost of baby formula can range between $1275.00 and over $3000.00, compared to the potential cost of a yearly breastpump rental, which costs less than $500.00 a year.

The creation of baby bottles, nipples, and formula containers has an environmental cost as well as a financial one, since natural and energy resources must be used to manufacture and distribute these items. Such objects are also less likely to be recycled and may take up to 400 years to disintegrate once left in a landfill. Moreover, there may be an environmental risk to using bottles and nipples, as plastic baby bottles and some nipples may contain biphenyl-A (BPA), which a chemical commonly used in the production of plastic items. BPA is also found in the metal lining of several types of infant formula cans, including Enfamil and Similac. The U.S. Environmental Working Group (EWG) has shown that exposure to BPA, even in low doses, may result in early puberty, cancer, behavior and brain disorders. According to MomsandPOPsProject.org, infants who are bottle-fed are the highest population group to face high levels of BPA exposure, which can be reduced through the simple act of breastfeeding.

Many parents think that using filtered water to mix their baby formula is a healthier choice than tap water and in many instances that may be true. However, water is also used to manufacture the bottles, formula and nipples used to feed these babies and this water may not be filtered. This increases the potential risk for contamination of cadmium, aluminum, lead, pesticide and other hazardous chemicals. Dangers with the water used to mix baby formula often continue at home as well. The hot water that parents frequently use to make baby formula in order to warm the formula before feeding it to their baby can also dissolve potential contaminants into the water faster than cold water, which only increases the overall risk of the infant’s exposure to potential chemical contamination.

For all the environmental, health and financial reasons to breastfeed your baby, there is no denying that there is an environmental risk in breastmilk as well. Pollutants that the mother is exposed to or ingests through what she eats or drinks can pass into the breastmilk, including heavy metals, pesticides and persistent organic pollutants (POPs). POPs can include a variety of chemicals, including DDT and other bioactive substances that can pose a health risk to humans. While this may make parents despair that nothing is safe for babies, not even human milk, the U.S. National Institutes of Health concludes that there is little evidence that the chemical agents in breastmilk are strongly linked to morbidity in infants and any potential health risk is lower than any potential health benefit to breastfeeding.

Not all mothers can breastfeed and if this is true for you, consult with your pediatrician about the best type of baby formula to use. If you do use baby formula, look for baby bottles, nipples and formula marked “BPA Free” and remember to clean and recycle the items when you are done with them. Moms who can nurse should consider doing so, due in no small part to the emotional, physical and environmental benefits. But don’t forget that nursing comes with a responsibility as well and carries a risk that may be reduced by eating organic foods whenever possible, choosing meat and dairy items marked “Hormone Free” and consuming a healthy diet. Doing so is a good choice for your mind and body, not to mention your baby and the environment.