The Power of Skin to Skin April 13, 2014 18:30
Written By Michelle Roth, BA, LCCE, IBCLC
What if there were an intervention that could improve how many moms breastfeed their babies, and could help those babies nurse more months than other babies? And what if this intervention was completely FREE? It wouldn’t take any additional investment of money, time or energy on the part of the parents or the birth facility, but it can be started as soon as the baby is delivered. Would you try it?
In reading a recent journal article, I was reminded that we already have tons of research to support just such an intervention – uninterrupted mother-baby skin-to-skin contact. In their survey of 413 mothers, Augustin and colleagues found 59% of mother baby pairs were still breastfeeding at 6 months. Of these dyads, 62% had spent time skin to skin and 49% breastfed in the first hour after birth. Earlier contact means breastfeeding sooner, which may mean a stronger milk supply and a longer overall duration of breastfeeding.
Nils Bergman, one of the world’s foremost experts on skin-to-skin contact and kangaroo mother care, says that for newborns, birth is a habitat transition. I heard him speak at the 2007 La Leche League International Conference in Chicago, and his comment that “the mother is the baby’s habitat” has stuck with me ever since. On a practical level, if we can help mothers and babies stay together – in their natural habitat – we can improve the postpartum adaptation, including breastfeeding success.
Amazingly, babies come into this world hardwired to expect to stay with mom after birth, and if left undisturbed and in contact with mom, they will find the breast and begin feeding, usually within that first hour after birth. Researchers have described a distinct “behavioral sequence that begins immediately after birth and terminates with grasping the nipple, suckling and then falling asleep” if baby is placed skin to skin with mom and left undisturbed. In their study, Widström et. al. found that babies have a brief “birth cry,” then progress slowly through relaxation, awakening and active phases, each with distinct characteristics. They will then make crawling motions interspersed with rest periods, and when they reach the breast they will familiarize with it then begin suckling and finally will sleep when a feeding is completed. They key to these behaviors? Being left skin to skin with mom, without interruption for hospital routines. The authors conclude that these innate behaviors are adaptive. They help baby to self-regulate from birth, which in turn leads to better developmental outcomes.
Some birth interventions do get in the way of this natural sequence. For instance, the Augustin et. al. survey mentioned above found that 71% of women who had a cesarean birth did not have a chance to spend time skin to skin in the hour after birth, and had a longer span of time before the first breastfeeding was able to take place. On a physiologic level, pain medications for labor and delivery interfere with the baby’s innate reflexes and behaviors after the birth. Righard and Alade found that when mothers use certain pain medications in labor, their baby’s just don’t show the same behaviors at the breast. The babies who fared the worst in their study? The ones whose mothers had narcotic pain medication and who were NOT placed skin to skin with their mothers. The babies placed skin to skin and not exposed to pain medication were all able to suckle successfully within the first two hours after birth.
Another researcher, Suzanne Colson, writes that human infants, like other mammals, are abdominal feeders. Colson and colleagues describe 20 feeding-related newborn reflexes, and, more significantly describe how maternal and infant positioning can impact the expression of these reflexes. When mothers assumed full “Biological Nurturing” positions, babies were more likely to use their reflexes to feed effectively. What components make up this optimal positioning? A semi-reclining position for mom, with baby prone on her body. Colson’s book and website illustrate how laid-back nurturing - a non-structured approach to feeding and latch - can facilitate better breastfeeding. While Colson’s work doesn’t rely on skin to skin contact necessarily, it does inform how moms and babies can best work together to use baby’s inborn traits to facilitate breastfeeding success.
Anytime you are able to spend time skin-to-skin with your baby – from birth onwards - is a good thing. Bergman and Bergman recommend at least 2 hours of uninterrupted skin to skin time after birth, and then remaining skin to skin for the first 24 hours. This challenges the model we have created for hospital birth, with a swaddled baby, frequent separation for routine newborn care, and the inevitable barrage of visitors most moms receive in those first couple of days after baby’s birth.
It’s never too late for skin to skin time, especially if you missed it in the first few hours after birth. Skin to skin can be used to continue your baby’s adaptation to the outside world even after you get home from the hospital. Imagine the baby’s first three months as the 4th trimester, and continue to create a womb-like environment. Carry your baby, sleep with your baby, respond immediately to your infant’s needs, and breastfeed often.
If you’ve never seen a baby crawl to the breast, several resources can be eye-opening. The video Delivery Self-Attachment is short and sweet. Health Education Associates has developed two DVDs – one for parents and one for professionals – to illustrate the newborn breastfeeding reflexes described above. The website www.breastcrawl.org has a wonderful video and extensive resources to learn more about this important aspect of early care. (I have no financial interest in any of these resources, just a passion for helping moms and babies make the most of their nature through a nurturing approach to birth and parenting.)
Albright L. (2001). Kangaroo Mother Care: Restoring the original paradigm for infant care and breastfeeding. Leaven 37(5), 106-107.
Augustin AL, Donovan K, Lozano EA, Massucci DJ, Wohlgemuth F. (2014). Still nursing at 6 months: a survey of breastfeeding mothers. MCN AM J Matern Child Nurs 39(1), 50-5.
Bergman J, Bergman N. (2013). Whose choice? Advocating birthing practices according to baby’s biological needs. J Perinatal Edu, 22(1), 8.
Colson SD, Meek JH, Hawdon JM. (2008). Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Human Development, 84(7), 441-449.
Moore ER, Anderson GC, Bergman N, Dowswell T. (2012). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev, 5.
Righard L, Alade MO. (1990). Effect of delivery room routines on success of first breast-feed. The Lancet, 336(8723), 1105-1107.
Widström AM, Lilja G, Aaltomaa‐Michalias P, Dahllöf A, Lintula M, Nissen E. (2011). Newborn behaviour to locate the breast when skin‐to‐skin: a possible method for enabling early self‐regulation. Acta paediatrica, 100(1), 79-85.
Prenatal Yoga: How to Get Started April 28, 2013 00:00
It might be difficult to find the time and energy to exercise while pregnant, but the benefits of doing so are numerous. Properly done, it can actually increase the amount of energy you have. It can reduce back pain, constipation, and bloating, and could even make labor a lot easier.
Prenatal yoga is a great way to stay in shape while you are expecting. Prenatal yoga will make you and your baby stronger. It does not matter whether you’re a first-timer or an experienced yogi – prenatal yoga is available to everyone, regardless of experience. There are a few considerations to be made depending on what trimester you’re in, but there are a few things that apply no matter what.
Many women around the world have only thought about trying yoga. Now that they’re expecting mothers, it’s the perfect time to try. It is important to only seek classes that are specifically for expecting mothers. Yoga looks relaxing, but it is actually an incredibly stressful exercise, one that can cause trouble if not approached appropriately.
Your regular class may still do if your instructor knows how to teach prenatal yoga. In either event, it is best to inform him or her of your condition as soon as you know so the proper adjustments can be made.
Experienced and expecting practitioners need not stop just because they’re now carrying a child. Some positions will be uncomfortable if not downright dangerous as your pregnancy progresses, so feel free to back out of more intense sessions. Do not feel obligated to do more than you feel your body and baby can take. If necessary, temporarily switch out of your current class to go to a prenatal yoga class so you can stay away from questionable poses.
Dedicated Home Yogis
Home practitioners may either continue practicing at home or sign-up with an experienced prenatal yoga class to make sure that you’re doing it right. If you’re confident in your skills, simply add “Prenatal Sun Salutations” to your routine. “Prenatal Sun Salutations” start in Tadasana, with your feet set as wide as the mat. While inhaling, bring your arms up through the center, up towards the ceiling until you are into the Urdva Hastasana position.
Other positions great for Prenatal Yoga include:
- Cat-Cow Stretch: Being on all fours helps get the baby in position. To make it even more effective, you can have the relevant movements start in the pelvis.
- Utthita Trikonasana: This is an excellent pose that opens up the hamstrings, hips, and chest.
- Parighasana: Your stomach or middle can get exceptionally low on space as the pregnancy progresses, making side stretches extremely satisfying to perform.
- Pelvic Tilts: Lower back pain is common in most pregnancies. Stretching it out will offer some relief.
There are more positions. It is best to consult with an experienced prenatal yoga instructor to learn more.
Yoga after the Pregnancy
The wonderful day has come and past, but that’s no reason to stop practicing yoga. Yoga has a number of physical and mental benefits that new mothers may want to experience. Doctors, however, strongly recommend waiting for a month and a half after delivery before practicing yoga again if you gave birth vaginally. The recovery period may be significantly longer if you had a cesarean operation. Regardless of which method was used, you will have the opportunity to practice yoga again.
Protein: Essential Building Blocks for You and Your Baby April 20, 2013 00:00
Most people don’t know as much about protein as they think they do. When you were in school, or perhaps in your own kitchen as a child, you learned that protein was one of the rainbow colored sections that comprised the all-powerful Food Pyramid. The protein section of the poster was filled with pictures of beans and chicken legs, nuts and eggs. Your mother complained that the only protein she could get down you was peanut butter. Now, as an adult and a mother, you know that protein is important to growing bodies. But what, exactly, is t protein-rich food comprised of and why is it necessary for a healthy body and mind?
Proteins are the building blocks of life.
Simply stated, proteins are compounds formed from various combinations of amino acids, of which there are twenty, arranged in countless combinations.
Every single chemical reaction and every body function relies on the presence of amino acids. So you can see that proteins really are a requirement for a healthy body. They build cells, regulate fluids, rebuild tissues, and are vital to hormone, antibody, and enzyme production. In the absence of carbohydrates and fat, proteins also supply the body with energy.
Eight of those twenty amino acids that form the proteins are not produced or stored inside the body, so they absolutely must be consumed throughout the day. They are phenylalanine, tryptophan, valine, isoleucine, leucine, lysine, methionine, and threonine. These eight are called essential amino acids, as in, “It’s essential that you eat them!”
Essential amino acids are found in a variety of protein sources like fresh water fish, eggs, nuts, and some nut oils. But it’s also important that you eat a balance of various types of proteins, essential and non-essential, as your body often cannot produce enough of the non-essential amino acids to meet your needs. Let’s see if we can make it easy for you to figure out just how much and what types of proteins to include in your diet.
Healthy Protein Consumption
You may have heard proteins referred to as complete or incomplete, high-quality or lower-quality. These terms simply refer to whether or not a protein source provides you with all of your essential amino acids in the necessary proportions. Sources such as meat, dairy, poultry, eggs/egg whites, and fish provide you with the correct balance of all of your amino acids. However, you can still get all of your amino acids by combining several incomplete proteins such as nuts and oats, or beans and brown rice.
Eating large amounts of red meat and dairy can actually add too much fat to your diet, without the necessary fiber for a healthy digestive system. Instead, you should balance your protein intake by combining lean meats and fish, low-fat dairy and eggs, with combinations of nuts, legumes, and whole grains.
How much is enough?
The Food and Drug Association recommends a daily protein intake of about 50 grams, based on a 2,000 calorie diet. This might look like two poached eggs for breakfast, a yogurt cup for a snack with granola, a cup of beans and brown rice as part of your lunch, a pork chop with dinner, and a handful of almonds and seeds somewhere in between.
Contrary to what you may think, the necessary intake of protein does not changed based on physical activity. Instead, protein needs are based on your weight, and should be right around .8 – 1 gram of protein per kilogram of body weight.
Protein for Breastfeeding and Pregnancy
However, if you are a nursing or pregnant mother, you will need to increase your protein intake by about thirty additional grams per day. While still in the womb, this protein is crucial to the healthy development of his or her body and brain. Also, the amino acids that you take in will help regulate your sleep and your emotions, two very important things for your own personal well-being.
Infants use a third of their dietary protein to build new muscles and connective tissues. Since their primary, and best, source of nutrition is their mother’s breastmilk, you will need to make sure yours has all the protein necessary for your baby’s healthy body.
You can add extra protein into your diet easily by snacking on unsalted nuts, egg whites, lean meat slices and hard cheeses, or by sprinkling your cereals and yogurt with flax seeds. Skip the chips and opt for edamame or raw trail mix, and add a slice of turkey bacon to your morning omelet. Carry some prepackaged protein bars in your purse to avoid grabbing a bagel when you’re out running errands.
With just a few simple changes, you’ll be able to add the right kinds of protein to your diet… for your body and your baby’s.
- U.S. Food and Drug Administrationhttp://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/FoodLabelingGuide/ucm064928.htm
- Nutrition and Well-being A to Z
- The Nutrition Source, Harvard School of Public Health http://www.hsph.harvard.edu/nutritionsource/protein/
- USDA Dietary Guidelines for Americans 2010
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.
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.