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Breastfeeding- Yeah- It’s Not Exact or Precise

Cartoon by Neil

Cartoon by Neil

The truth of the matter is that doctors, physicians assistants, med students, interns, yes and many midwives plus many nurses working in the mother/baby environment SIMPLY DO NOT have enough education about Lactation and Lactation Management to adequately guide new mothers. It is sad and pathetic. The vast majority of these individuals would rather work with precise numbers and are actually happier if a mom is pumping and feeding her milk in a container to baby.

It is no wonder this has transferred to the vulnerable new mother. WE have done this to her. There is actually a new trend to pump and feed expressed breast milk instead of ever putting baby to breast. I can help you with that.  Please know that a large number of these infants do get some formula until milk supply is established. Make an informed choice. These breastmilk-fed babies are not usually exclusively fed expressed milk thru out the first few months. It is a hard job to pump and feed and pump and feed. It is a damn hard job to build and keep up a full supply long term exclusively pumping!! It has been done. You can do it. Mommas are very powerful and they can do it SO if that’s the choice you make then GO FOR IT!!! Give it all you have got. But CONSIDER putting baby to breast and feeding the way nature designed your body. Work with an IBCLC. We need good lactation programs at EVERY facility that provides childbirth services. We need IBCLC’s in the hospital. We need prenatal education about the benefits of breastfeeding so mothers make a true informed choice.

The more I speak with and counsel new mothers, the more I get asked for exact numbers when it comes to feeding instruction. It is no surprise that the number one question on the mind of a brand new first time breastfeeding mom is “HOW do I know my baby is getting enough milk?”

Babies were born to breastfeed

WATCH the baby, Listen to the baby. Look for feeding cues or little things the baby does which tell you he is getting hungry.

Lets make it EASY with very little “rules”. Think of these as TOOLS– not RULES

First:  Attachment to breast should be DEEP and COMFORTABLE

Second: Baby needs to do the RIGHT JOB of effective drinking

Third: Baby needs to do this OFTEN ENOUGH each 24 hours…. about 8 for most moms – more is very common- feed on cue

Fourth: By the fourth day ( give or take a day), and EACH 24 HOURS thereafter Baby should be having around 6 ”good” wet diapers and about 3 -4 poops that are starting to turn yellow.

Please KEEP your baby with you at a times!! Just.Say.NO.

 

Bottom lineWeight Gain. Baby should be at birth weight by Day 10 (or at least on a proven good upward trend) and be gaining about an ounce every day thereafter.

After the first 4-6 weeks. This little chart comes in handy:

Copyright Nancy Mohrbacher used with permission

Copyright Nancy Mohrbacher used with permission

If a doctor or  nurses first suggestion is to give formula to your breastfed baby—for whatever reason— ask to see a Lactation Consultant, an IBCLC.

These are the only numbers to remember. TRY to stop stressing out.

This blog post is not a replacement for medical advice should you or your baby have an issue. This is applicable to healthy full term infants.

Copyright 2014 StorkStories RN IBCLC RLC

Breastfeeding or Bottlefeeding–> Millennium Moms Guilty over Infant Feeding Choices?

Image

(image from National Geographic)

As a professional, educating mothers and their family’s about the importance of breastfeeding and human milk for human infants is a priority and a professional responsibility.

It is not about guilt.

It is inappropriate for any of us to imply directly or indirectly to any mother trying to make feeding choices that breastfeeding and formula feeding are equal.

They are not. Human milk is the superior species-specific food for Human infants. The recommended feeding hierarchy from the experts (AAP,CDC, WHO) is Breastfeeding, expressed milk from baby’s mother, expressed donor milk then properly prepared infant formula.

The Benefits of Breastfeeding are NOT Overstated as articles currently circling social media would like you to think……

However– There are many moms confused, afraid or unsure.

Please don’t be feeling guilty. Educate yourself and make feeding choices which are right for you.

All or most of this discussion is NOT directed at any mother who tried to breastfeed under any circumstance and wasn’t able to at all or wasn’t able to fulfill her individual goals. I applaud all your efforts for trying to give your baby the best food you could. I am so sorry that you experienced the difficulties you have. Your situation is not what this discussion is about.

I am trying to encourage moms to make informed educated feeding choices and then not feel guilt about their decisions.

It doesn’t have to be all or nothing! 

It is the recommendation for exclusive breastfeeding during an infants first 6 months. If that doesn’t seem feasible to you, then your baby can still benefit from however much or however long you can breastfeed of provide breastmilk. I think that in today’s world, we give a mother all this education about what she should do and then we don’t have all the right support systems in place to really help her!

 Here’s what I have found

  • Today’s mom is connected to the internet, information and friends by phone, Facebook, Twitter, Pinterest, Instagram or YouTube and “checks in” at least 5 or more times per day.
  • The education process to a lot of mothers needs to be in small doses (140 characters of less), sensitive to her unique learning abilities, her cultural beliefs and practices and most importantly, her choices and individual breastfeeding goals.
  • With that in mind, try to provide her with the information she needs to make her decision.
  • Never overestimate a mother’s desire to breastfeed her infant.
  • Never underestimate a mother’s desire to breastfeed her infant.
  • Listen to the mother; help her define her true desires and goals.
  • Many times, the first question she asks may not be what she really wants to ask.
  • The mother’s individual breastfeeding goals, how she defines them, how important they are to her and how she relates them to her actual breastfeeding experience all help define how she measures success.
  • Support the mother, support the mother, and support the mother.

HOWEVER SHE NEEDS OR WANTS
Stay connected

PEER Counseling is Unparalleled Breastfeeding Support–> Do You Have a Great Story?

Read more

PELVIC REST

WHAT IS PELVIC REST and why would we say to do that?
Prenatal care is designed to watch moms closely during pregnancy. Sometimes there is the need to see a perinatologist or Maternal Fetal Medicine (MFM) doctor. When a pregnant momma has obvious signs of trouble like bleeding long before her due date or has shown signs of effacing early on… or dilating early… when she has had symptoms of preterm labor or runs of preterm labor with or without cervical changes– they often will tell her to have Pelvic Rest. This isn’t bed rest—- this is PELVIC REST to avoid introducing bacteria, stimulating contractions or start labor early.

Right now as I write this–> we have a full NICU of 26 to 33 weekers. You don’t want your baby born that early– you really don’t…….. After a rash of moms who didn’t realize their activity may cause preterm labor even though they “felt OK at the time” and engaged in the activity after being placed on pelvic rest…. I felt like- WELL—>

Maybe somebody just really has to say it ALL !
This is supposed to be a little bit funny!


Sometimes there is a partner
who pushes for a little intimacy and well— maybe you feel bad for him or her and/or maybe you want t0…… We know it’s difficult. You may want the intimacy or the connection.  If this partner is not also on pelvic rest–> you could be creative to get the connection so long as you adhere to the list below.

I am so sorry to have to really spell it out but……

This Means:

  • NOTHING in the vagina……..    Not a penis, Not a finger or thumb, Not a toe, Not a tongue, Not a lip, Not a dildo, Not a sex toy, Not anything in the house you can make into a dildo or sex toy, Not anything in the house that can FIT into the vagina, Not anything you may purchase or get outside your home that can fit into the vagina EVEN if the package does say “Sterile” on the outside!
  • No Crotch/Genital Stimulation or Rubbing   with or without your partner…. (or with anyone who isn’t your partner). This includes but not limited to: No rubbing of your genitals with those of another, No rubbing with hand, No licking, No labia sucking or hickeys, No clitoral sucking, No blowing of air into the vagina
  • No Orgasm.     I’m sorry- that is not good news. I know- but an orgasm can cause powerful uterine contractions. This means no orgasm brought on intentionally by any type of activity including nipple stimulation.
  • No Anal Sex of Any Kind.    Unless you are applying hemorrhoid ointments or inserting a suppository…. everything listed for genitals above includes the anus.
  • No new Piercings.     You will need to keep your current piercings clean.
  • No Prostitution activity.  Yep- I really said that. It happens.
  • No Swimming or Tub Baths as directed by your provider. We encourage regular hygiene of course.
  • No Heavy Lifting —ask your provider for amt of weight safe for you.
  • No Exerting Exercise activity — again— ask your provider for amt of exercise safe for you… it is usually limited to gentle stretching exercise or gentle stretching yoga.

I say all those above because I have seen ALL of them and more and the momma has claimed … “but you didn’t say that“!

Sorry😦

Did I forget anything???

JUST. SAY. NO. –> You can’t take my baby……

JUST. SAY. NO.

You CAN’T Take MY Baby to the Newborn Nursery!

All too often, we~ as hospital staff in Labor and Delivery- Mother Baby units or the Newborn Nursery, want to take YOUR baby away for this test or that exam saying we’ll be right back.  Well it isn’t always that quick- in fact it is RARELY that quick. One thing leads to another and before you know it, it is 1 to 2 hours before you have your baby back.

This is beyond wrong.

We are horrible for doing this.

We need to be a better support system for you.

I am working on getting all staff involved in increasing our exclusive breastfeeding rates. This begins with the first feeding. (well- it really begins with birth interventions but of course that is a totally different post)…….

Your baby should stay with you until he latches and feeds.

Stay.

Skin to Skin is the best way for him to get accustomed to his new habitat and learn where he will be feeding.

STAY WITH YOU

We can do virtually everything~ all routine newborn exams, procedures and tests at the bedside, with you right there.

Speak up and tell us NO

Thank You

Pledge for Judgement-Free Breastfeeding Support

Support with Integrity

Check out the Pledge at the website link above.

Please pledge for Judgment Free breastfeeding Support!

Thanks to Earth Mama Angel Baby

Supporting my Non-Breastfeeding Daughter-In-Law … Part II

Why is that some of the common childhood bumps, bruises or injuries have to happen for the first time when I’M in charge of the baby?? I swear…seriously.. I was right there! Please believe me!😕

"The perfect Grandmother keeps the infant safe at all times and goes on daily outings..."


This is a continuation of Supporting my Non-Breastfeeding Daughter-In-law Part I

Let me back up a minute. I have been going down to Dave and Sadie’s regularly for help with babysitting my grandson Tommy. I was getting good at being just a grandma and not a nurse. He was growing pretty well even though we all had to put a lot of effort into getting adequate calories into the boy! He was long and lanky. A skinny lightweight. Both his parents are very tall so it may partially be just genetics. He had outgrown some of his feeding issues as he merged into toddler-hood. Then he turned into a finicky picky eater. Through out all this time, Sadie and I were feeling really comfortable with our relationship. At least I know I felt good about it and she told me she did also. We had developed a respect for one another.  She had been relying on me to come and help out from time to time.  I was always so happy to oblige so that I could see Tommy and enjoy some time with him. I remained respectful of how she wished his day should go for example, managing nap-time, playtime outside, meals and how to handle unwanted behavior. She didn’t have a lot of rules at all…just certain things she asked me if I could do to maintain consistency. No Problem. I know she appreciated it. Sometimes my son would call me to tell me that Sadie said I had done a really good job with the baby that day etc.. 🙂

Tommy started talking! He mixed some letters in the beginning and came up with my name. Instead of “Grama”… it came out “Manga”! We all loved it and it stuck. Now I am forever… Manga! It is so delightful when when you are recognized and greeted with an excited little voice! And even more delightful when that sweet little boy calls you his own special name! We played lots of different things and I was having a blast!

One day as we were march-dancing to a little song in the living room clapping toys together, I sat down on the couch, getting tired, and Tommy came running towards me, dropped his toy, immediately tripped over said toy– flying face first into the coffee table! Oouch! He hit just under his right eye! He didn’t break the skin and his eye was fine. But darn it! He got hurt :-(  This was the FIRST face bump he had! One time he had bump on the back of his head from falling over a few weeks back and I had overheard Sadie telling one of her friends about it then saying “It did NOT happen while in my care, let me assure you!” I think my son was playing with him at the time. So needless to say, I was a little anxious to let her know what had happened but of course I had to tell her right away. I called her and explained what happened, how he was and that he was letting me hold ice on it while I had a video going and he was having milk. I KNOW she was upset…. what mommy wouldn’t be when something like that happens to their baby when you are at work. She was very good about it, asked me if I could take a picture for her and send it so I did.  Everything was OK… Tommy actually got his fair share of bruises and bumps!

The next one involving me was pretty upsetting. We were at my house, Tommy was in the high chair, his parents just left for dinner. I cleaned Tommy up and got him down. He ran past the sink where my husband was making the dogs dinner (Tommy had been playing with our Chocolate Lab all day) and the dog turned and snapped at Tommy as he went by!  That sweet little angel boy just sat on the floor stunned and didn’t even cry till I picked him up~ horrified~ and left the room to examine him. He had welts of dog teeth around his tender little calf. No broken skin!    Oh.My.God. This. Did. Not. Just….Happen!! Ice, snuggles with Manga, milk, favorite video and phone call to mommy again. They were both very upset but realized it was all an accident.  It was completely gone in a few days. Still. That was beyond sucky.😕
I think part of learning as you go…as a parent helps you to de-sensitize yourself to some issues or things that you originally thought were such a big priority. You begin to accept some things as they are and not expect that you can have control over all the little things. This may have been what happened to Sadie. I saw her relax on things about which she had previously been so firm. I didn’t tell her I saw this transformation but it was there.

Sadie got pregnant again on their first month of trying!! They told me when we were out to dinner. I saw my son get up and move a lamp above my head saying the light was in his eyes, He sat back down again and said “I don’t think we’re going to make it up for Thanksgiving this year, mom.” “Why?” …I said (That was the one holiday they ALWAYS spent with my family…..) Dave says nonchalantly: “Because- it will interfere with Sadie’s due date.” I jumped up so excited!! (glad he wisely moved that lamp) then they said… “You are the first to find out Manga… we didn’t even tell Sadie’s parents yet!” I felt so honored!!  YAY!

Because I had previously been admonished for saying things in a way which I had felt was “just being  myself” and I obviously crossed the line, I wanted to be especially careful and respectful. There was always an underlying fear for me that I would screw up. I didn’t ask or talk about anything medical. I had learned how to just be a supportive Manga. Life went on, I was babysitting frequently and Sadie was already in to the second trimester.

“I want to make sure I get breastfeeding right this time.” Sadie said to me out of the blue while I was having breakfast with her one morning. “I’ve been reading about it and I want to do a lot of things differently. I don’t want all those people in the hospital. I just want it to be me and Dave and the baby.”  (I was quiet, letting her talk)    “I was really depressed after Tommy was born and I had tried to pump but not really very much so I never had much milk… I was reading you need to pump a lot” ( I felt so bad I didn’t know she had been depressed! She hid so much from me then…I should have seen it!)    Of course I was so happy to hear her say this on her own…. 😀      In order to be most supportive, I needed to find out what her wishes and goals were… so that’s what I asked.  Then Sadie replied: “I want the baby to get all breastmilk for as long as possible.. I don’t care if the baby feeds from me or if it’s pumped milk.”… she continued… “I’m kind of afraid that I might not like it….  and I might want to see how much the baby drinks every time after what we went through with Tommy. What do you think?”

I said” You are an amazing woman! Anything you’ve ever put your mind to seems to be what happens! You should be able to do things however you like. I am so sorry you were depressed last time, that must have been so very difficult! (Pause for Hug) I will help you anyway I can if you want.” Sadie said she did want some help figuring out a good book to read and some info on pumping. I was totally happy! It wasn’t so much that Sadie had expressed her interest in breastfeeding (which of course I was over the moon happy about…) but more that she wanted to talk to me about things and wanted my guidance! I felt like we had really reached a milestone!

Once I got back home I got the PERFECT book ready to send her! “Breastfeeding with Comfort and Joy” by Laura Keegan. I had met Laura online and we struck up an immediate friendship. She has the best approach to showing moms how to really have a very comfortable and enjoyable breastfeeding relationship. I have used this book as a teaching aid at work to help moms really visualize what we are discussing. I find it invaluable. Sadie got the book in the mail and read it twice through! She loved it! She started asking me questions a few times a week… referring to the book and looking past her immediate goals to future issues and asking about that! For the first time, after her mother’s negative experience, her own bad experience to the point where she just gave up even trying…. She was now seeing breastfeeding in all it’s beauty! I thank Laura Keegan for this fabulous book! Helping to gently open the eyes of a young women and empower her!

After more discussion, and checking Sadie’s wish list, I decided I would also buy her a high quality pump. She had checked with her hospital to see what they had there and it made sense to stay with the same kind. I got her an Almeda Purely Yours Ultra. We had a little breastfeeding class and pumping info class on a Sunday afternoon. She had Dave set up a little pumping station in their bedroom. All the while, I really only gave her info she asked about, the basics of milk productions and the importance of skin to skin and self attachment. I went into detail on what she wanted and highlighted things that were important for good understanding and good overall management.

Sadie went into labor again at about 38 weeks. My job was to stay at the house with Tommy. I left work early and got down there just after he went to bed. There was a babysitter there who then left and I was all alone…. waiting to hear.  Finally I got a text and a photo… Another boy!! Joseph or “Joey”. The text was from Dave and said “he’s never left Sadie except to get weighed and he’s been nursing a lot already, mom!” I was so happy for them! The next day, Sadie’s dad came to stay with Tommy so I could go over to see the new little family. The plan was for a quick little visit so I didn’t interrupt their alone time. Sadie called then and asked where I was, how far away because the baby was ready to eat and she want me to see if it looked alright. (The surprises kept coming.. I was really honored once again..) I got into the room as she was preparing to feed. She seemed so confident as she positioned herself and Joey. He opened wide and self attached beautifully with a big deep mouthful of breast! Sadie looked blissfully happy, had no pain and was experiencing the positive signs of hormonal surge. Joey began to have a rhythmic deep sucking pattern with audible swallowing. I was able to point out all these positive things to both of them. Like a well rehearsed play, it was as if the perfect script had been well acted!  I would not have believed it could have gone THIS well for them if I didn’t see it myself!! I thought I was going to leave then and she asked if I could stay and help her with the pump to make sure she knew what she was doing with that in case she needed it later… She wanted to pump anytime Joey was not feeding well. He was a great nurser but she pumped anyway so she had an excellent supply!

To get to this point has been a fabulous journey of learning more about myself and learning more about how to be the best support to other moms in my care. Sadie went on to nurse Joey or feed him pumped breast milk exclusively for the first 4 months. She continued to pump and nurse after that but had started to also use formula at times. She did a fabulous job! She is very proud of herself.  One thing she said to me a few weeks ago was that she thinks having her babies, and especially nursing Joey, has really made her feel so much closer to me. *tear**

Then she thanked me for hanging in there…… again……….

Support the mother, Support the mother, Support the mother most important of all!

And the Manga… Support the Manga! Most Manga’s want to to the best for you…

Show us how!

Supporting my Non-Breastfeeding Daughter-In-Law… Part One and a Half

This is a form of general response to some comments/ an “addendum” of more history or “back-story” type of intermission.  So I am calling it Part 1 & 1/2. Part II about the next pregnancy is in the works and coming later this week or next….

I am amazed and thrilled at the volume of interest this post has generated. I’m not a big blog by any means (usually getting on average 35 – 70) hits per day even when I don’t write anything. Now I have over 700 hits for 3 days in a row. For some of you that’s normal… not me. It makes me want to make sure I get this right. Make sure the correct points are being made. Without monkeying around…

Breastfeeding Baby Monkey

I LOVE Sadie. I love her like my daughter. She is a very smart, strong, independent, confident and outspoken young woman. She has a large group of friends to whom she is always supportive, a good listener and would do anything to try and help with all types of situations. These types of things make me respect her tremendously! My son had met her at a party once in college then re-met her a few years later when she was near graduation and he was … well….. a college drop-out party animal at age 23 recovering from knee surgery after a car accident. (** drops head with embarrassed grimace **)  Sadie.. I always say.. finished raising my son. She did NOT put up with any of his shit.  She is responsible for or part of the catalyst (besides the car accident) in encouraging my son to turn his life around. He is now a 32 yr old successful business owner.  They are very much in love. They still talk for hours every day and crack each other up all the time. Lots and lots of laughter and fun!

I am very happy that so many of you understood that I was (and still am) LEARNING the new roles of mother-in-law and grandma. This is a story of my feelings and emotions as I attempted to do the best job I could….. respecting and honoring that my son and his wife were indeed the decision makers as they became parents, helping Sadie understand that she was most certainly going to be respected and supported in her feeding choices……. and learning to let go. I’m glad many of you realized that I knew it wasn’t always appropriate to provide information and advice … but sometimes, because of the professional I am and how important I feel it is for all mother’s &  parents to make informed decisions….. I found it hard to not say something if only for their protection.  I hope you all realize that I am not pushy and try to always be supportive. But I’m human and I can screw up…  I should have asked first what they read or researched about it before talking. As a breastfeeding advocate and lactation professional, I know that it is in my grandchild’s best interest to be breastfed. I also know that it is NOT my decision. This is a story of my journey to deal with all that so close to home and on a personal level.

I wrote this post “Breastfeeding, Bottle Feeding and…. Somewhere In-between…. Why the Guilt?”  two years ago and another.. “**ROAR** on Breastfeeding Guilt “ a little while after. I have a hard time with people having guilt- thinking proper education for informed decisions will cause guilt- others making rude comments about someones choice making them have guilt- a personal guilt anyone has because they don’t feel they did “enough”…. I just have a hard time with all that. I had guilt thinking I went too far with the kids…. (Dave and Sadie). Never did I want Sadie to have guilt because of something I said, how I said it or perhaps acted. It was important to me that the guilt factor was eliminated. There are so many opinions out there and mommy wars and stupid stuff actually (IMHO). We need to be supporting each other. ALL MOTHERS AND BABIES SHOULD BE HONORED AND RESPECTED. We don’t know their story or reasons for any choices they are making.  Some of you have had painful experiences and I am sorry that happened to you. I hope you can move past the memory to be supportive to the next person you meet… even if it’s just a smile. :-)   For “Mama of 2″…. Your MIL is sounding unbalanced and in need of a psych eval IMHO. Seriously inappropriate! I hope you can throw out her comments with the dishwater (what an old fashioned saying…) which reminds me of an old favorite cartoon: (LOL)

That being said about the feeding issues. I want to talk about parenting. All the years that I have been a nurse sending new parents home with their babies, it has been important  that they are empowered to become loving parents with their own style. I have always encouraged them to discuss things among themselves and decide just what that is. I encourage them to smile and nod at “Grandma” or “Aunt Sue” and do things their own way. I had this same discussion with Dave and Sadie at the very beginning of the pregnancy. It isn’t my place to raise their child or decide what type of discipline for any situation… My role is to fill in while babysitting and try for consistency on their plans. Not to make the plan…follow it.

Consumer ALERT–> FDA Bans “SimplyThick” Breastmilk Thickener

SimplyThick

Does anyone use this product in your

NICU??

Did you use this product for your baby?

This product is used to help thicken feedings of breastmilk or formula for infants with swallowing issues or even to help with reflux.

Some Preterm Infants have become ill with a serious condition called NEC (Necrotizing Enterocolitis– where the lining of portions of the intestine become inflamed, lack adequate blood supply and subsequently, parts of the intestine can die). This particular problem is most often found early in the premature baby’s life before discharge home.

“To date, the agency is aware of 15 cases of NEC, including two deaths, involving premature infants who were fed SimplyThick mixed with mothers’ breast milk or infant formula products. “

Symptoms to watch for:

  • Bloated distended abdomen

  • Bloody stools

  • Vomiting greenish tinted milk or

  • green fluid

If you see any symptoms like this, please

contact your babies doctor and get

prompt medical attention.

Read more:  FDA ALERT

Wordless Wednesday–>Why Boys Need Parents!

Taking a study break…

I  became a mom 32 years ago today!

As the experienced mother of 2 very mischievous (now grown) boys and

a grandma to 2 boys

with that twinkle in their eye…

I can tell you this was an hysterical laugh out loud photo essay for me!

Happy 32nd Birthday to my first born son!

WHY BOYS NEED PARENTS