Tag Archives: early days

Round Two: 10 Tips for Nursing Your Newborn While Chasing a Toddler

7 Jun

Tears streamed down my face

as I sat in the recliner nursing my one week old son, holding my 18 month old daughter and watching my mom drive away.   Though breastfeeding was much easier the second time around, I was unsure how I was going to manage with a toddler and a newborn.  I had visions of my busy toddler coloring on the walls or playing in the toilet while I was sitting every 2-3 hours (or more often) nursing my son.  How I wish I knew then what I know now!

“Breastfeeding the second time around was SO much easier. Probably because I had the confidence. I breastfed my first for 2 years, so I ‘knew’ I could do it again. I just felt way more comfortable, and I knew the early pain was normal and would get better in a few days. It’s been tough because my toddler still needs attention, but the baby needs to eat! So we’re working on it and figuring it out together. But overall, it has been way easier and more comfortable the second time around.”   Beth, pictured above

  1. Prepare them.  Depending on your toddler’s age, consider taking her to a sibling preparation class.  Classes vary but usually include watching a video about becoming a big brother or big sister, diaper changing and swaddling practice on dolls, a craft project and sometimes a visit from a real newborn.  Read more about preparing your child for baby’s arrival here.  This is a great list of books geared toward sibling prep, and click here for children’s books about breastfeeding.
  2. Feed them.   Have healthy finger foods available for your toddler to snack on during some of your nursing sessions.  Put together little baggies of their favorites that are easy to grab and go.
  3. Surprise them.  How many times have you remarked your toddler has too many toys?  Pack some of them away in plastic tubs for awhile then pull them back out during the times you are caring for the baby.  Designate those as the breastfeeding toys.
  4. Contain them.  As I remarked above, I was concerned what my toddler would get into while I was nursing.  Create a nursing nest in a safe space where you can keep an eye on your toddler.  Installing a gate is an easy way to create a boundary.
  5. Include them.  Encourage visitors ahead of time to make sure and pay special attention to your toddler as the baby is a magnet!  I even suggest in my sibling class that visitors bring a treat to big brother or sister.
  6. Involve them.  Making the baby off-limits to big brother or sister will only cause them to resent the newborn.  Show them how to be gentle while staying close to prevent any accidental head bops or eye pokes.  Let them “help” with diaper changes, baths, retrieving clothes or your nursing pillow.
  7. Spend quality time with them.  Your time will be divided but your love is not.  Steal lots of moments to hug and kiss on your toddler.  When your partner gets home, hand over the baby and take big brother or sister aside to read a book with them, play a game, take a walk around the block or start their bedtime routine.   Plan toddler “dates,” such as a trips to the park or library, where the whole family can get out and brother or sister understands that the baby can be fun, too.
  8. Pack for them.  Take a trip to the dollar store, and pick up a few items like stickers, notepads, colors, pens, etc, and a little bag or basket to pack them in.  Make it the special bag that only comes out at nursing times.
  9. Expect regression from them.  For reasons they don’t even really understand, your toddler may regress to more baby-like behavior after the new baby comes.  If they are potty-trained, they may even regress in that area.  Refrain from disciplining this behavior and understand it is temporary and perhaps the toddler’s way of expressing “I need an extra, extra hug so I can feel like I am still important.”
  10. Embrace flexibility.  Learning to be flexible is a requirement for motherhood as our kids don’t always fit into the neat little boxes our culture creates for them.  Anticipate the diaper blow-outs right before you walk out the door.  Be ready for the toddler melt-down in the store.  Carry an extra shirt to change into after the unexpected spit up.  And most of all, look forward to the intangible rewards being a mom brings, whether you have one, two, or five!

What other tips can you share for moms going from one to two?

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Lactation Derailment Can Begin in the Hospital: 10 Tips for Avoiding a Trainwreck

29 May

I must preface this blog by explaining that

fourteen years ago I became a mother/baby nurse, and ten years ago I became the resident childbirth educator and “breastfeeding counselor” on staff at a local hospital.  We did not have an IBCLC on staff, so I was IT until we hired another educator.  My training as a nurse, some time as a member of La Leche League and my own personal breastfeeding experience was all I had in my arsenal.  Though I wasn’t “official,”  I worked the position of a lactation consultant.  And it wasn’t easy…so many moms…so little time…so many interventions.  That being said, please read the following with the understanding that I have been “on the other side,” doing my best as a nurse to help fresh babies latch…bending over beds as an educator positioning babies and sandwiching breasts for moms who were too sleepy on pain medication post-cesarean to do it themselves.

A week ago, I had the privilege of visiting a new family in the hospital to provide assistance with breastfeeding.  She has given me permission to share my observations.

When I arrived, I had dad undress baby down to diaper and in skin to skin with mom.  The baby was only 36 hours old and very sleepy after a long labor and difficult delivery.  Mom, Dad and I chatted for a moment then got to the business of latch.  The baby would not wake up.

A nurse came in to give mom pain medication.

Though I was not surprised at the baby’s behavior, he appeared jaundiced, and I knew it was important to get colostrum into him.  So, we proceeded to hand express and collect colostrum to spoon/syringe feed him.

Then the baby photographer came in to show the picture previews.

Mom asked her to come back later.  (Reminder:  Mom is sitting in hospital bed with her breasts exposed.) We continued hand expression and then fed the colostrum back to the baby.  He began to exhibit some hunger cues, so we put him back to the breast.

The OB came in to check on mom.

Once again, latch attempt without success.  More hand expression.

Knock, knock? Have you had a chance to look at your pictures? Baby photographer again. (Are you kidding me?)

More teaching, more skin to skin….fed baby more colostrum.

A different nurse came to check on mom.

Another latch attempt…

The first nurse came back to tell mom the baby’s procedure had been delayed.

We wrapped up latch attempts (and the baby) as we knew the nursery nurse would be coming to get the baby soon.  He was happily sleeping in Grandma’s arms as we discussed a care plan.

Persistent photographer, back again, insisting on showing the pictures.

I wrote out mom’s care plan.

Nursery nurse came to retrieve baby.

I ensured mom had my number for questions, planned to follow up with a home visit, and I made my exit.  Did you count the number of interruptions?  How long do you think I was there?

Eight interruptions in one hour and fifteen minutes. 

I left there concerned about derailment and feared I would encounter a trainwreck at her home visit.  Fortunately, when I arrived, breastfeeding was going well and she needed very little assistance from me at the follow up.

Now, I realize everyone that came in just saw me as a visitor.  They weren’t aware of who I was or why I was there.  However, my presence aside, feeding her newborn was mom’s priority, but what was the priority for the people that kept interrupting?  Definitely not feeding a 36 hour old, sleepy newborn who appeared jaundiced.

How can a mom even think about getting breastfeeding established when she is being bombarded by staff from all sides?  It’s sensory overload.  As a private practice lactation consultant, I see the outcome of this all the time….the trainwrecks…the result of the cascade of interventions.

What steps can you take to avoid the trainwreck?

  1. Take a prenatal breastfeeding class so that you know what’s normal for the early days of breastfeeding.
  2. Hire a Doula to minimize birth interventions which can lead to troubles breastfeeding.
  3. Find a breastfeeding friendly pediatrician who will support your breastfeeding goals.
  4. Research local resources for breastfeeding help that are available to you once you get home such as La Leche League or private practice lactation consultant that is an IBCLC (International Board Certified Lactation Consultant).
  5. Prepare your partner to be the gatekeeper after delivery to minimize interruptions in your breastfeeding. You may also want your partner to accompany your newborn to the nursery to keep watch and ensure your feeding preference is respected.
  6. Hand express your colostrum and feed back to the baby. Doing this up to 6 times a day can increase and speed copious milk production.
  7. Reinforce your desire to breastfeed without any supplementation to every nurse that you have contact with.
  8. Room-in with you baby to keep your baby close and to learn his hunger cues.
  9. Better yet, keep your baby “on” you to facilitate skin to skin contact which has been shown to stabilize temperature,
    heart rate and oxygenation. You are your baby’s best habitat!
  10. Ask to see the lactation consultant…and keep asking….getting help early is so important!

What if you told me “I don’t like being a mom”?

22 May

If you told me you didn’t like being a mom, I wouldn’t judge you.

 If you told me you weren’t sure you liked your baby, I would believe you.

Being a mom is the hardest job in the world…add on feelings of anxiety, sadness, irritability, panic, loss of control and it becomes virtually impossible.

While many women experience some mild mood changes during or after the birth of a child,

15 to 20%

 of women experience more significant symptoms of depression or anxiety.(1)

If it is so common, then why don’t we hear more about it? 

“There is a lingering stigma associated with discussing any kind of depression, but the stigma associated with PPD [post-partum depression] is especially fierce.  These days, it’s probably easier for a man to talk about problems with his penis than it is for a new mother to admit that (in her own eyes, anyway) she is a failure at the one task for which women are supposed to have instinctive gifts.”  (2)

  • Did you know that symptoms of post-partum depression can develop any time in the first year after birth?
  • Did you know that many moms think being depressed is normal in the midst of adjusting to life with a newborn?
  • Did you know that “approximately 1 out of every 8 women experiences significant depression, anxiety, intrusive repetitive thoughts, panic, or post traumatic stress?”(1)
  • Did you know that many medications used to treat post-partum mood disorders are safe to take while breastfeeding?
  • Did you know that help is just a phone call away?
  • Did you know that

YOU ARE NOT ALONE?

One Mom’s Story:

“I dealt with depression in my early 20’s to the point of suicidal ideations.  I took medication long enough to get me through my last semester of college then took myself off of it due to outside pressures.

When I got pregnant, I don’t recall being told that I would be at greater risk for post-partum depression.  After the birth of my first baby, it took weeks for me to feel “normal,” whatever that is.  Pregnant with my second when my first was only 9 months, there was no down time.  Then, baby number three…three under three I felt I was drowning.  I didn’t know how to feel any different.  I thought, ‘My fault…what was I thinking?  Of course any mom in my situation would feel like I do.  This is my new normal, right?’

When my fourth was a newborn, I would take my other three to daycare, and on the way home I would go through a drive through, go home and try to eat my feelings away and then go to bed with the baby and stay there until it was time to pick them up.

My faith is the only thing that saved me during the six year roller coaster ride.  All along my husband, knowing something was not right, kept urging me to get help, but this was my new normal….I didn’t think there was anything ‘wrong’ with me.  I was simply the product of 4 babies and one miscarriage in 6 years.  I needed to just ‘get over it,’ pray more, go to church more, spend more time with God…

At the end of that six years,  all the ‘babies’ were weaned and potty trained.  I felt good.  Better than I had in a long time.  We had just moved into a new house and were getting settled.  Finally felt like a ‘good’ mother.  My energy level was up, the house stayed clean, life was good.

Then, surprise….baby number five.  I enjoyed my pregnancy, had a fabulous labor and birth.  Things stayed good for a long time.  This was the first baby I had while being a full time stay at home mom.  I loved it. 

Then she began to wean…slowly but surely, the sadness, anxiety, irritability, and depression started to invade.  I felt out of control….I was going crazy.  I sank to an all-time historical low.  Spent my days on the couch….such a blur I don’t even remember most of it. 

At that point, my husband insisted I get help.  I was so ashamed.  Why?!  I don’t know.  I reluctantly made an appointment and nervously and tearfully shared the past 11 years of my life.  And guess what?  There was no judgment.  Lightening did not strike, mountains did not crumble into the sea.  I left with counseling and a prescription.  The nurse told me that it could take 2-4 weeks to start feeling better.  I was a new person in two days.  I wish I could go back and tell myself that getting more help sooner would be worth it.  I feel I finally listened to what perhaps God was trying to tell me all along…”Pray, spend time with me AND let me work through the doctors to help you. It’s OK.”

Am I less of a mom?  Am I less of a wife?  Am I less of a friend? Am I less of a professional?  No, I’m not.  I know I risk judgment…but this is my story…and if it helps just one mom, it’s worth the risk.  I didn’t need post-partum depression to make me a stronger person.  I am not implying that to be a good mom you have to endure its’ clutches.  But my journey through the valley has made me the me I am today – wife, mom, friend, professional.  I can spot post-partum depression a mile away….

I am not saying that medication is the only way to feel better.   But GET HELP.  If you are a husband, partner, mother, friend, HELP HER…she doesn’t recognize it.  If you are a mom, DON’T WAIT.  Those are years of my life, my husband’s life and my children’s lives I can NEVER get back…” 

As lactation consultants with Bay Area Breastfeeding, Leah and I are in a unique position to recognize waving red flags as we see mom in the safe environment of her own home.  Our approach sets mom at ease in a very vulnerable, intimate time of her life, allowing her to lower her guard and be honest with us and herself about how she is really feeling.  If we encounter a mom who is struggling, we feel comfortable voicing our concerns and encouraging her to seek help and perhaps sharing a personal experience.  You see, the story above is my story.  I urge you, if you can answer yes to any of the following questions, seek help so you don’t lose those precious moments that you can never get back… 

Are you feeling sad or depressed?

Do you feel more irritable or angry with those around you?

Are you having difficulty bonding with your baby?

Do you feel anxious or panicky?

Are you having problems with eating or sleeping?

Are you having upsetting thoughts that you can’t get out of your mind?

Do you feel as if you are “out of control” or “going crazy”?

Do you feel like you never should have become a mother?

Are you worried that you might hurt your baby or yourself?

Please click here for a post-partum depression self-evaluation.

And Get Help Now.

References:

1Postpartum Support International

2The Ghost in the House: Motherhood, Raising Children and Struggling with Depression

Before You Breastfeed: 10 Tips for New Breastfeeding Moms

2 Apr

1. Learn about and use Laid-back breastfeeding technique. This approach taps into your baby’s feeding instincts. Your baby is capable of latching and feeding well at the breast.

2. Have a list of things others can do to help you when they come to visit. If visitors must come in the early weeks have a list posted on the refrigerator of small tasks that YOU would find helpful and reduce your stress. Usually someone else holding the baby is not as helpful as someone running a load of laundry or fixing a meal or changing the sheets on your bed. Don’t be afraid to ask for help; your job is to spend time with your baby learning about her, feeding her and resting.

3. Spend as much time as possible in skin to skin. Having skin to skin time with your baby has amazing effects on the both of you. Science has proven that skin to skin contact with mom and baby stabilizes baby’s temperature and heart rate, helps mother identify early feeding cues, and helps mother bond more deeply with her baby.  Get comfy in a recliner or bed, have baby down to diaper and lay her on your chest heart to heart. You can put a blanket over her back and just relax. Baby may rouse and search for the breast or may fall comfortably to sleep with the familiar sound of your beating heart.

4. Learn about how to know your baby is feeding well. One of the biggest concerns new mothers have is whether or not their baby is getting enough from breastfeeding. Following are some signs to look for:

  • Your baby has adequate diaper output.
  • Your baby wakes to nurse on their own.
  • Your baby is alert and active when feeding.
  • You hear or see baby swallowing as they feed.
  • Your baby is gaining weight well.
  • You may also notice your breast feel softer after a feeding and/or you may notice a let down during a feeding or milk dripping from the other breast.

5. Find or recruit a support system. One of the major reasons women quit breastfeeding before they expect to is a lack of support from family and friends, and research tells us the spouse/partner plays the biggest role. If you are struggling in the early weeks, having family members and supportive friends to lean on and who will encourage you will help you reach your breastfeeding goals.

6. Find a breastfeeding support group early on. Breastfeeding support groups, like La Leche League or hospital based groups, are a valuable resource for help and support in the early weeks of breastfeeding.

7. Don’t forget to take care of yourself. Often times moms are so exhausted they forget to eat or drink frequently. Having snacks that you can grab quickly are life savers. You will feel your best if you are also making sure you are resting often and getting plenty to eat and drink.

8. Get help early on if things are not going well. Many moms are reluctant to get help or not sure where to find help with breastfeeding issues, but getting help early is so important! Many times minor issues can turn into major problems if help is not found early on. Getting qualified help is the key when facing challenges. An International Board Certified Lactation Consultant (IBCLC) is the highest accredited breastfeeding helper and has proven skills to assist in many of the common breastfeeding challenges. But not all Lactation Consultants are IBCLC’s so be sure to ask!

9. Take a prenatal breastfeeding class. Find a class that is taught by an IBCLC, and attend early in your third trimester.  Often times, classes taught in other locations besides hospitals will focus on prevention of problems and provide more practical breastfeeding information rather than teaching “this is how we do it at XYZ Hospital.”  Consider a private class to get the most customized experience.

10. Build your portable nursing nest. Whether you decide to have a special place to nurse your baby or nurse in different locations throughout the house, having a basket of self-care items within hand’s reach is invaluable.  Here’s a list of things you may want to include in your portable nursing nest:

  • Water bottle – If you forget it, you will feel like you just trekked through the Sahara…
  • Healthy snacks – High protein, high fiber, tasty snacks to keep you satisfied…
  • Cell phone – You will get very adept at texting while nursing…
  • iPod, mp3 Player – Relaxing music…increased relaxation helps those breastfeeding hormones flow better…
  • Burp cloth – For little spits and leaking milk…
  • Breast pads – Disposable or reusable…
  • Lanolin – Your choice of nipple cream, such as Earth Mama or MotherLove, all-natural ingredients…
  • Book/Magazine – Or these days, Kindle, Nook or eReader…
This is YOUR time with YOUR baby…learning together…slow down, relax and enjoy!
*photo courtesy of www.007b.com