Tag Archives: supporting breastfeeding moms

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!
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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

A “Time” To Celebrate

16 May

Molly at 24 Months

I didn’t need to read the article featured on the cover of Time  magazine to predict the tone of the piece, and it was obvious that the intent of the photo accompanying the article was to ruffle feathers not encourage educated, non-judgemental discussion.  Fact is, how you feed your baby and for how long is a personal decision. As mothers, we should have the freedom to parent our children without fear of judgement.  Any woman who takes hold of the responsibility to ensure the health and well-being of her children is

mom enough.”

Bay Area Breastfeeding and Education supports breastfeeding as the biological norm, and we would love to see exclusive breastfeeding rates at 6 months increase (currently only 14.8%)…

  • Katherine Dettwyler’s anthropological research shows that the minimum predicted age for natural weaning is 2.5 to 7 years.
  • The World Health Organization recommends exclusive breastfeeding for the first 6 months of life, then to 2 years or beyond.
  • Here in the United States, the American Academy of Pediatrics “reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.”

…However, though our goal is more moms breastfeeding and more babies receiving breastmilk, we support moms where they are and work to help them reach their goals.  The mom is the mom…we are not; the baby is hers…not ours; the baby has to eat…it’s mom’s decision not ours.  We educate, we practice using the evidence, we encourage breastfeeding, we support with compassion, we foster empowerment.

  • The mom who breastfeeds is mom enough.
  • The mom who formula feeds is mom enough.
  • The mom who home schools is mom enough.
  • The mom who has her kids in public school is mom enough.
  • The mom with one child is mom enough.
  • The mom with five kids is mom enough.
  • The mom who wears her babies is mom enough,
  • and the mom who doesn’t is mom enough.

So, we celebrate moms of all walks of life, everyday, everywhere.  And in celebration of the 100 strong moms and 101 beautiful babies BABE has had the privilege of walking along side of, we are giving away a beautiful Moby Wrap (pictured).  Here’s how to win:

  • Click the “Follow” button and enter your information to subscribe to our blog.
  • Comment on this blog post by responding to: “We know you are mom enough….tell us how.”
  • Share our post with someone.

The winner will be selected in a random drawing out of the pool of blog followers and will be announced on June 1, 2012, in a blog post.

A BABE Mom’s Story: 6 Tips For 6 Months

14 May

  Three weeks into her breastfeeding journey

we had the privilege of meeting this sweet momma and her precious little boy.  Our first contact was November 15, 2011.  She was our fifth client but our first real challenging case.  Over the phone, she described that she was having some pain and nipple damage with latch and decided it was time to get help as she suspected what she was experiencing was not normal.  This was her third baby to breastfeed yet the first time to experience this situation.

Baby was ready to eat soon after we arrived, so we had her proceed with breastfeeding in her normal fashion.  As she readied herself and the baby for latch, she was relaxed and calm.  We then got our first look and could hardly believe what we saw.  To date, we have yet to encounter nipple damage as severe as hers!  There were actual craters in the center of each nipple.  Leah and I could not believe she had made it this far.

Our assessment revealed that the baby had

a very shallow latch.  His mouth would stay open no longer than a millisecond to achieve latch, and once he did latch, his lips stayed pursed on the breast.  Our impression was that his jaw and mouth were hypertonic (increased muscle tone).  At rest, he kept his lips tight, and we could not even properly assess for tongue-tie (which we suspected right away because of the nature of mom’s damage) because his mouth was so tight!

Over the course of the next five or six weeks

we worked with Linda in person, via email and over the phone to assist her in getting to a comfortable and enjoyable place with breastfeeding.  Using a combination of breast rest, APNO, pumping, finger feeding, bottle feeding, chiropractic, time, and a lot of patience and determination, we were thrilled to hear from her late December that healing was complete and breastfeeding was finally pain-free!

Sweet, little Sam is now six months old.  He never had one drop of formula…how did she do it?  Keep reading for his mom’s advice:

1.  Let it go:  I had a hard time accepting that my house wasn’t always tidy, the laundry and dishes piled up, and gathering my hair into a ponytail was as close to “styling” as I could manage.  It took me a while to figure out that it is OK to not be able to accomplish everything I could pre-baby.  None of those tasks are as important as being able to meet the basic needs of my family and myself.

2.  Don’t be afraid to ask for help:  Asking for help doesn’t come easy for me but I learned to not be shy about telling others what needed to be done.  My husband was great at taking over the jobs he could do while I concentrated on my needs and the needs of the baby – but I needed to be sure to ask!  Something as simple as asking someone to look after the baby (and my 2yo and 4yo!) so I could take a shower or just have a few minutes to myself to eat a big bowl of ice cream in peace made all the difference in my outlook on life.

3.  Trust your instincts:  I think everyone who knew I just had a baby had an opinion on how I should be feeding the baby.  I had to believe in myself and my ability to know what will work for me versus what doesn’t feel right for my family.  My grandmother probably meant well when she told me that babies do just fine on evaporated milk, but after thanking her for her concern, I forgot she ever mentioned it.  I also had to trust my instincts enough to know that I needed outside help.  I figured that since this was my third, I should have known what to do on my own when he had problems – I didn’t.  My only regret was not getting outside help sooner.  I could have saved myself some addition pain.

4.  Find a cheerleader:  Having immediate family members and lactation consultants to tell me that I was doing a good job was priceless.  Affirmations are important – I needed to be reminded that I am strong and I could do it and that the sacrifices I was making were for the new little person I just brought into the world.

5. Set short term goals:  Even though it was baby number three for me, I was feeling overwhelmed about surviving the whole newborn period.  So I aimed to just make it through the week, the day, the next feeding session, or past whatever other hurdles were getting me down.  Once that was behind me, I would give myself a pat on the back, consider it an accomplishment and set a new goal.

6. Believe that does get easier:  It can be so hard to see past the present, but the first few weeks really are the most difficult.  I knew that if I could just make it past the hump, things would start to get better.  I had to cling to the knowledge that one day soon I would feel human again.  Six months down the road, I am grateful I stuck it out.

What most helped you get to where you are in your breastfeeding journey?

More Than Meets the Eye: How Doulas Help Moms Breastfeed

12 May

May is International Doula Month…

Source Unknown

As lactation consultants, we are thrilled to work along side our local Houston area doulas.  It is well-supported by research that labor and birth interventions can interfere with the natural course of breastfeeding, and it is also well-supported by research that the incidence of birth complications is reduced by having a doula present at your birth.  However, a doula is more than just “present” at your birth, patting your hand through contractions.  She

  • is passionate about coming along side you during one of the most important and special times in your life,
  • meets with you throughout your pregnancy and builds a relationship with you and your partner to establish trust,
  • provides ongoing education on the labor, birth and postpartum process,
  • assists you in creating a birth plan,
  • actively networks, seeking out the best resources for you,
  • advocates for you at a time when you are most vulnerable,
  • supports you during your labor and birth,
  • acts as a gatekeeper for mom, partner and baby after the birth, and much more…

Doulas are in a unique position to recognize early on any potential breastfeeding challenges.  They understand the importance getting help early.  In our experience, moms with doula support are extremely committed to pursuing breastfeeding even through tough issues.   Cole Deelah, a South-Houston doula, childbirth educator, and midwife apprentice, describes perhaps why we have found this to be true:

“A doula can oftentimes be the mother’s first exposure to breastfeeding education. I encourage the moms that I work with to attend a La Leche League meeting, refer them to area breastfeeding workshops and classes, and offer breastfeeding books from my library, including The Womanly Art of Breastfeeding, Breastfeeding With Comfort and Joy, and others. A doula also has a lot of time during the prenatal period to educate moms on different helpful positions, what a successful latch and nursing looks like/feels like, local resources, products that might help in the journey, and what is normal/not normal when breastfeeding. And finally, in those first few moments after birth, a doula can help protect the new parenting space, help with initial latch-on, and minimize outside distractions and interference from others. In the first few days after birth, a doula is completely accessible to the new family and can oftentimes be whom the family calls when something doesn’t seem right with the breastfeeding relationship. The doula then has the opportunity to offer additional resources, like a lactation consultant, so as to ensure to the best of abilities, a successful breastfeeding relationship!” (Read more about Cole on her blog, Wonderfully Made Bellies and Babies.)

Three other doulas join Cole in the Houston Doula Cooperative, Nicole Yunker, Lourdes Resendez, and Kimberly Foster.  Read about their co-op here.

Also serving the greater Houston are are the TLC Doulas.  This group is made up of Kathleen Wilson, Dorin Jordan, Amanda Moore, Jessica Gonzales and Rowan TwoSisters.

Now hear from a mom about how her doula helped her breastfeed:

“Hi! I’m LaKendra a proud supporter of breastfeeding, midwives, doulas and all those great non intervention assets surrounding pregnancy and birth. I’m sharing my experience with you regarding Lourdes Resendez who is not just a doula but someone who has really become a special person to me and my 8 month old daughter! Growing up, I knew absolutely no one who breastfed and my family did not support me saying negative things like I’m starving my baby, I’m not producing enough milk, I need to let somebody else feed her, my milk doesn’t have everything she needs like formula, only”white” people do that, I could go on and on about the ignorance and negativity that surrounded me but you get my drift. Kennadi latched on great right after birth and Lourdes took us in for about 3 weeks as I established a great milk supply with her support, I had me a few cups of mothers milk tea on a daily basis which actually was sort of tasty to me, but she gave me that extra boost I needed to get going and staying confident in my decision!! And because of that great start, she’s still exclusively breastfed! Which as a working mom I take to heart because you really have to be dedicated pumping on lunches and breaks, but it’s been a great journey and I don’t plan on stopping anytime soon!”

…How are you celebrating your doula?

Who’s Feeding Momma? 10 Ways to Support a Breastfeeding Mom

16 Apr

1. Share your successful breastfeeding stories and experiences and leave the negative experience or breastfeeding “horror stories” for another person……a new mom is already emotionally full as she processes her birth experience and contemplates motherhood…she is full of desire to be successful at breastfeeding and bonding with her new baby.  Offering stories of challenges may not fill her with the inspiration she needs, especially if she is struggling…..certainly let her know she is not alone even if there are struggles but adding to the list of “what if” and “could that happen to me” worries is probably going to have a negative effect.

2. Bring her food!! And NO it does not have to be bland and boring just because she is breastfeeding. Most nursing babies have no problem with any foods a mother eats even spicy or bold flavors. You could ask a mother about her preferences but don’t hold back on foods she enjoys. Or make her easy-to-grab, healthy snacks that she can store in her nursing nest and can eat while she feeds the baby!

3. Pamper mom!! Bring her some flowers to brighten the room, offer a foot rub or shoulder massage or bring her some chamomile tea to relax. Fill Momma’s love tank so she can fill baby’s!!!

4. During a feeding help her relax.….if you are present for a feeding, and you see mom getting tense, some gentle relaxation reminders can be helpful! Sometimes her shoulders creep up to her ears. Reminding her to relax and encouraging a few deep breaths can even help with the milk letting down!

5. Ask her what tasks around the house would help reduce her stress.….often times offering to hold the baby or take the baby so she can rest will only stress the mom more or make her feel inadequate as a mother. What may enable her to relax and focus on the baby is clearing the kitchen sink or doing some laundry. Straightening a room or walking the dog? Ask her!!

6. Be the gate keeper…..the early days of learning to breastfeed are usually filled with fumbling and adjusting as mom and baby learn the dance of latching. Mothers may find it hard to manage and focus if there are many visitors stopping in. Help decrease visitors, and you may also want to hold off on long visits until she requests it or feels up to them!

7. Send encouraging texts and emails….let her know how proud you are of her efforts to breastfeed, her dedication to breastfeeding, her amazing mothering abilities…….a simple text like ” You are an awesome mom and every drop of breastmilk you give your baby is a precious gift!” can carry her to through a long feeding at 2 am or a round of evening cluster feedings!

8. If she needs help…help her find good help…..IBCLC’s are the gold standard for  lactation care, bring her a list of local IBCLC’s to call on if she is having any issues!

9. Look up her local chapter of La Leche League and help her get to a meeting! Mother to mother breastfeeding support is invaluable…..she needs to feel like she is not alone…..even if everything is going well, it is good to meet other like-minded moms doing all the same things she is!

10. Help educate others around the new mother about ways to help support her! If you are reading this blog, there is a strong likelihood that you have a new mom in your life…..pass this blog on to others in her life as well.  Create a “village” around this new mom to inspire and support her on the journey of breastfeeding her baby.  Each child we see breastfed in this generation will contribute to a healthier and happier world in the next!!

Meet the BABE IBCLCs…Leah Jolly

22 Nov

My journey towards Lactation consultant work started with my love for science. I grew up thrilled with anything science and nature. I explored my world with the eyes of a scientist. I was so interested in the natural course of life and as I moved through my school aged years my interest grew and I was drawn into science as a career path in college.  I began college sure I wanted to work with animals but after a year of veterinary nursing school I was not so sure, I found my self more drawn to human life and sciences. So I transferred to University of Houston Clear-Lake and acquired a degree in Biology.

In my last year of college I met and married my husband. We started our family a year later. My first breastfeeding experience came when my first son arrived and due to his oral motor hypotonia, we struggled a great deal and with a lack of support to continue through the struggles, we only had 4 weeks of breastfeeding. I was devastated and determined to have a different experience the next time. When my second arrive, in 2003, after a very traumatic birth, breastfeeding started on another difficult path. Determined to not give up, I sought the support of my local La Leche League group and this is where it all began.  Even though we still had a very difficult time breastfeeding, the support and encouragement made it all so much easier! After a year with the group, I began my work to become a leader.

We had two more children, in 2005 and 2009 and with each one my breastfeeding experiences became more and more positive and less difficult.  I continued my work with La Leche League and loved helping moms achieve their breastfeeding goals. I was so reward to give back what was given to me! In the fall of 2010 I decided I want to be able to help moms even more and made plans to sit for the 2011 IBCLC exam.  I met Misti through our La Leche League work and we decided to become study partners…..well the rest is history!! My dreams have come true beyond measure! I absolutely love working as an IBCLC. I love empowering moms to listen to their own voice and their baby. It is a joy to be part of such a special part of the mothering journey! Daily, I am amazed at the strength and perseverance of mothers. I look forward to many years of working with moms and babies!