by Jennie Bernstein
You just went through this transformative experience. You created life! And then, as you bask in the glow, you are told the newest member of your family has jaundice.
What does it mean? How concerned should you be?
Jaundice is a very common condition in newborn babies. Newborn jaundice is caused by a pigment substance, known as bilirubin, and when it increases in the baby’s blood it makes him/her appear yellow. More than half of all newborns become jaundiced within the first week of life. This situation is usually temporary and resolves on its own within a few days without treatment. This is termed physiological jaundice. Physiological means what happens normally in the body. Physiological jaundice is not a disease but a temporary condition.
So what exactly is bilirubin? Bilirubin is formed in our bodies when red blood cells die off. This is a normal process. Red blood cells contain the substance bilirubin. Newborns are born with a surplus of red blood cells. When greater numbers of red blood cells break down, this yellow pigment, bilirubin, accumulates in the newborn’s blood and is deposited in the skin, muscles and mucous membranes, causing the skin to appear yellow. Bilirubin is fat soluble, meaning it mixes easily with fats and oils. For the body to get rid of bilirubin, it needs to be water soluble. So how is it possible for the body to get rid of bilirubin if this is the case? That’s the job of the liver. The liver processes the bilirubin, changing it from fat soluble to water soluble and is then passed into the intestines. From the intestines, the bilirubin leaves the body through the newborn’s bowel movements. Some bilirubin, however, is reabsorbed back into the body after becoming fat soluble again. This occurs if the baby is having very few or no bowel movements. The less bowel movements, the more bilirubin gets reabsorbed, resulting in higher bilirubin levels. The most common cause of increased reabsorption of bilirubin is insufficient intake of breast milk. Bilirubin levels on the third day is directly linked to the number of EFFECTIVE breastfeeds per day in the first few days of the baby’s life.
Some mothers are informed by their health care provider that they need to stop breastfeeding and start feeding their little one formula in order to lower the bilirubin levels in the blood but options are available to treat jaundice without interrupting breastfeeding. For the healthy, full term baby, breastfeeding should continue so it does not become more of a challenge for mother and baby. The solution is not to stop breastfeeding but to resolve the breastfeeding issue so the baby gets the breast milk needed to have regular bowel movements.
Colostrum, the first milk available to the newborn, is actually a laxative which causes bilirubin to pass into the meconium stools. However, when a newborn does not receive enough colostrum as a result of inadequate feeding; either too few feedings, ineffective feedings, or both during the first few days, the bilirubin levels are exaggerated by day three. All mothers and babies should be assessed for effective breastfeeding while in the hospital by the nursing staff every shift and by a Lactation Consultant if a problem has already been identified. A newborn can be at the breast frequently but not breastfeeding. They do not become jaundiced from the breast milk but from a lack of breast milk. That is why it is necessary to have the nursing staff and/or a lactation specialist evaluate baby for effective latch and nutritive breastfeeding. Milk transfer is critical. Mothers may need to be taught how to latch their baby correctly to the breast and to recognize effective breastfeeding. This action assures mothers of comfortable, efficient breastfeeding and prevention of newborn jaundice.
As the liver is responsible for converting fat soluble bilirubin to water soluble bilirubin problems can arise because a newborn’s liver is relatively immature and may be unable to convert all the bilirubin in the first few days. Premature newborns’ livers are even less mature so therefore have higher levels of bilirubin than full term babies.
There are other reasons for excessive red blood cell breakdown resulting in high bilirubin levels and jaundice. ABO blood type incompatibility can result when mother has type O blood and her baby is one of the other blood types, A, B or AB. During pregnancy, red blood cells can leak across the placenta from the baby to the mother. The mother’s immune system reacts to the baby’s cells by forming antibodies against the baby’s blood resulting in increased red blood cell breakdown after birth and jaundice. With appropriate treatment, jaundice resolves. If a baby has a difficult birth and this results in bruising or a hematoma, there will be more red cells broken down resulting in higher bilirubin levels and jaundice. These are all normal causes of newborn or physiological jaundice with some babies requiring treatment and others not. But all these babies have one thing in common; they can and should continue to breastfed a minimum of 10 times or more per day every 24 hours for the baby’s first 2 days of life. Frequent nursing should be considered the norm; rooming-in with your baby promotes more breastfeeding than if baby were kept in a separate nursery.
Some babies are often sleepy as the bilirubin levels increase, sometimes resulting in baby falling asleep soon after feeding begins or he/she won’t even wake up to feed at the breast. Try skin to skin, holding you baby between your breasts, keep baby in close proximity to enable you to observe feeding or waking cues and never watch the clock for when you should nurse next. Remember a minimum of 10 or more feeds in 24 hours is norm. If baby does not respond to various stimuli to breastfeed more effectively, then an alternative method should be used to supplement baby with expressed colostrum/breast milk, if necessary. Hand expression of the breast is a very effective means of collecting colostrum. It can be expressed into very small cups or spoons for feeding. Mom should receive instructions for using a Hospital Grade breast pump for milk expression and to breast stimulation for adequate milk production. Breast milk can be given by cup, syringe, eyedropper or small spoon. Formula supplementation, on a short term basis, may be needed if fewer effective breastfeeds in the first days has contributed to a lower milk supply. Mother can continue pumping and nursing during treatment.
Most cases of jaundice require no treatment or little more than exposure to direct sunlight each day, but if the bilirubin levels continue to rise, more action is needed. The child’s physicians will observe and monitor the baby’s jaundice and bilirubin levels which are obtained through a simple blood draw from the baby’s heel. Phototherapy is a common treatment for all types of exaggerated jaundice. Phototherapy uses fluorescent light to break down bilirubin through the skin. The bilirubin absorbs the light, changing the bilirubin to the water soluble form, which then is eliminated through the baby’s stools. The baby is placed in an Isolette or self-contained incubator unit that provides for controlled heat and humidity. The light source, called bili-lights, is placed over and/or on the side of the Isolette. The baby is naked but for his diaper. His eyes will be covered to protect his retinas and corneas from damage.
If breastfeeding is a priority talk to your doctor and nurses about options. Often, babies are taken to the nursery for this treatment but most hospitals give mothers the option of treatment in their room. Baby’s eye patches should be removed during feeding to make eye contact with his parents. The Wallaby phototherapy unit is a fiber optic blanket that is wrapped around the baby’s trunk and provides continuous treatment that does not require eye patching or separation. The blanket can be used both in the hospital and in the home after hospital discharge.
If your baby has jaundice, it doesn’t have to interrupt breastfeeding. You are your child’s number one advocate and if breastfeeding is important to you, communicating that with your child’s care providers is an important part of your child’s care. Breastmilk may be exactly what is required to help your new baby get well.
Did your baby have jaundice as a newborn? How were they treated? Were you supported in continuing to breastfeed?
Good luck and a huge thanks to all the brands that wanted to make this possible!
There is something about breastfeeding and milk-making that just kills my sex drive, friends. It goes the way of bell-bottom jeans and jello molds. They’re fun once in a while, and have definitely been more popular in previous times, but their heydays have already passed. Wearing those jeans feels like a game of dress up or something you pull out for a 70’s themed special occasion. And jello molds haven’t been pulled out AT ALL since 1987. Suffice it to say, Taylor Swift has probably never had lime jello with canned mandarin oranges and pecans while wearing her mom’s bell-bottom jeans.
Feeding our babies is miraculous. Breastfeeding, formula feeding, pumping, or any other combination those is special and keeping a human alive is an amazing feat. I remember holding my son for the first time, full of wonder, joy and terror. How in the world could I be trusted to feed him and keep him safe? I did, though, and you are keeping your little ones alive and safe, too. But that first year of their little lives takes it out of us as parents. It’s part of the journey, and they make up for it with sweet cuddles, funny moments, and lending us their perspective of wonder and newness.
But that first year can be hell on your sex drive.
Adding in a little warmth, nourishment, and some helpful nutrition can boost your energy. And let’s be honest here: it could lead to increased sex drive and possibly a milk supply boost and who doesn’t want to get in on that action?! Sign me up. Twice.
So, here’s a little bit of cure for whatever ails you: hot chocolate. Okay, hot chocolate with a little twist. Chocolate releases endorphins. Endorphins make you feel like you are made of actual magic. Maca is a natural hormone booster, and for some women, can boost milk supply. Cinnamon stabilizes your blood sugar and the cayenne pepper might just make you feel like you’re 22.
Here is an easy tutorial for you cocoa, because sometimes words are hard without music and pictures. Seriously.
You’re so hot right now,
I didn’t always know that I wanted to breastfeed. When my closest friend gave birth at 19, I was happy when she supplemented her milk for the short time she nursed so that I could feed her baby from a bottle. When she became exclusively formula fed, I had made the decision to feed a specific formula to my baby because it didn’t stain clothing or stink as much as the first formula my little goddaughter had.
A few years later, my sister had her second child and was determined to nurse her. She fought the good fight with a nipple shield for almost six months where she was informed that my niece was suffering from “failure to thrive” on her mom’s milk alone and was told to switch to formula.
Shortly after, my friend (mentioned above) had a multiple birth and her babies were sent to the NICU. She was urged to pump for them. The weeks that she transported milk to the hospital, she was a warrior mom! Her dedication to her babies and her milk left me in awe. I visited one day with her and she took me into a very special place called The Lactation Lounge. I had never heard of such a thing. There were a few hospital grade pumps for moms to use to express milk for their babies. There were encouraging signs and posters all over the room. I left the place curious, inspired, and weirded out to have seen my friend topless.
These were my experiences with black women breastfeeding until last year. I delivered a 9lb 3oz beautiful baby boy in November. When we were left for a few minutes after delivery, I tried to latch my little boy on to my breast and he did it! He was suckling like a pro, but he had been sucking his thumb on 3rd trimester ultrasounds, so it wasn’t so much of a surprised that he loved suckling on me.
Things were going well but due to his size, he was a bit of a sleepy eater. It was explained to my husband and I that we needed to wake him on schedule. We woke him, stripped him naked, plucked the soles of his feet, bounced him, turned the tv up as loud as it would go… Nothing worked to keep him awake through feeds. Our 3 day weight check bought on a 4 and a 5 day weight check. At his lowest weight, he had gotten to 8lbs even. We were sent home on Day 5 with a case of formula and ill-sized nipples, told to supplement one ounce of formula at the end of each nursing session.
I was certain I had officially failed my son. I knew that formula could lead to supply issues for me. I nursed my little one when we got home and when he dozed off, I handed him to my husband who attempted to give him a ready to feed bottle. I cried as I pumped, trying to produce an ounce of my own milk so that at the next feed, we would supplement with MY milk.
And we did.
By the next day, he had gained 7oz. I went on to meet with a lactation consultant when he was 9 days old. He had great milk transfer. We were all set to continue on our breastfeeding journey!
At 11 weeks, I returned to work full-time. I was determined to make time to pump at work for at least the first year. Between 11 weeks and 8 months, we dealt with thrush twice, washed more bottles and pump parts than I can count and used many, MANY breast milk storage bags. I am eternally grateful to my supervisor who gave me a wide berth and unyielding support for my dedication to pumping. I am also incredibly grateful to my mother, who looked after my son while my husband and I were at work. She followed proper storage and thawing protocol, as well as stored hundreds of ounces of milk in her deep freezer. At 8 months postpartum, I realized that I was dealing with an oversupply and worked to correct that by not pumping on the weekends and by dropping from 3 pump sessions to 2. This continued until my little guy was 11 months old, when I dropped to one session per work day. At 12 months, I stopped pumping all together. I felt liberated and felt like being free of the pump left me able to nurse forever! Or so I thought.
Unfortunately, we made it to nearly 21 months. There is a bit of sadness about that part of our relationship, something that was so sweet, peaceful and calming for us both being gone, but we are okay. During the 21 months we spent as nurser and nursling, we went through several colds, a stomach bug, and the eruption of 16 teeth, and donated over 300oz of milk to babies in need. I am excited that we had the time together and that I will be able to start all over again with his baby brother in December.
Breastfeeding has been one of the best things I’ve even done. I had many people try to tell me I couldn’t do it, suggest formula (which wasn’t need), that I let someone else feed him give him cereal, etc. But in the end, my instincts won out and I am proud of what we have accomplished as a family. (Special and eternal thanks to my husband who washed pump parts and packed my bag many nights, who retained information in our first hours as parents when my mind was full of mush and wonder, and who acted liked nursing a baby was the most normal and natural thing in the world.) I hope to inspire and support other moms, especially black mo, who feel like nursing isn’t a feasible option for them. Moms who feel like breastfeeding is weird, embarrassing, or unnatural.
If you’d like to share your story with a larger audience, submit your story, photos, and your bio, with #MyStoryMatters in the subject to content @ theleakyboob.com (no spaces).
There are fashion junkies, pinterest junkies, home decorating junkies, birth junkies, health food junkies, exercise junkies, you name it. Anything can become a passion and then slip over into almost addictive behavior patterns. It’s all you really think about, it’s all you want to do, it’s what you can’t wait to get back to, too long without it and it’s what causes you to break out in a cold sweat. Like most teens with their smart phones. There is a point where it crosses over from a normal interest level to practically accosting strangers with information and wearing t-shirts announcing your fan status. Breastfeeding junkies can be particularly enthusiastic and start seeing breastfeeding and boobs everywhere thanks to breastfeeding on the brain, just itching to get back to breastfeeding information, support, and advocacy.
Wondering if you’re a breastfeeding junkie? They say it takes one to know one so here are 15 signs I’ve spotted in myself that may indicate I’m a bit of a breastfeeding junkie.
1. Every outfit you encounter is assessed for Breastfeeding compatability. In stores, online, random women on the street… All clothing is assessed on how well one could get a boob out. That 50 year old stranger’s smart looking outfit you mentally dissed because “her baby would be freaking out by the time she got her boob out of that dress” even though it’s obvious she wouldn’t currently have a nursling.
2. When out by yourself you find yourself checking out where a breastfeeding mom could find a comfortable spot to sit and feed her baby even though you won’t be using it.
3. If a store or business indicates they welcome breastfeeding moms you thank the person behind the counter for their support even though you don’t have a breastfeeding baby with you.
4. Without being asked, you are ready to launch into a detailed explanation of the composition of breastmilk whenever someone mentions any kind of milk.
5. You see what should be a somewhat disturbing nature video of something eating something else that has nothing to do with breastfeeding and think: “you know, what a good latch, look at those flared lips.”
6. You know HAMLET isn’t just a Shakespeare character.
7. Without meaning to you spot tongue ties in pictures of babies or talk with someone and notice they have some restriction and mentally cringe for that baby’s mom’s nipples wondering if there is restricted movement that led to nipple damage.
8. Coffee cups, lights, signs, hubcaps, patterns, gourds, melons, a pint of ice cream, you name it, you see breasts everywhere of everything. Life through boob colored glasses.
9. Somehow, someway, you always end up talking about breastfeeding. It just works it’s way into every conversation, even conversations with young single men. It happens so often it doesn’t even surprise you any more.
10. Off the top of your head you can cite the recommendations for breastmilk storage including the temperature and duration of storage, the signs for low milk supply, and
11. It’s not uncommon for you to get texts, emails, or calls from people you know asking for breastfeeding help for themselves or someone they know. Some of these come from men asking for their partner and new baby and nobody feels awkward about it.
12. You look forward to a nurse-in just so you can spend the day with a bunch of Breastfeeding moms and their babies.
13. It’s not uncommon for you to cry over and share the breastfeeding photos of others, even strangers, on your social media.
14. There is at least one breastfeeding crush in your life, an IBCLC, doctor, or advocate that you would love to meet and hang onto every word they say… about breastfeeding.
15. For baby gifts you put together a gift basket that includes breast pads, your favorite breastfeeding book, a list of online breastfeeding resources and support groups, phone numbers for local breastfeeding group leaders (you may be one) and IBCLCs, a water bottle for mom, a jar of nipple cream, a breastfeeding pillow, and a note to call any time she needs some breastfeeding help or encouragement.
If you are a breastfeeding junkie, there’s really not much you can do about it. Spend some time with your kiddos, open pinterest to distract yourself (no looking for breastfeeding on pinterest! Look for crafts, recipes, decorating, fashion, anything but breastfeeding), take up running, and find some balance. There is hope, you don’t have to be trapped in this place forever. Unless of course you’re ok with it, in that case just head over to The Leaky Boob Facebook page and help out all those moms needing the support of a junkie like yourself.
“You look terrible!” There was concern in her voice, not malice. I did look terrible, frightening even. I could have been auditioning to be an extra in Schindler’s List. I knew I looked bad. Not wanting to explain much, I tell her I’m ok, I’m just pregnant. She looks horrified and whispers “I thought pregnant women glowed.”
No, nope, nu-uh. Ok, well, some pregnant women glow. Maybe even most. I don’t glow. Unless you count the green tinged pallor I sport in pregnancy a glow.
In my head pregnancy is going to be this serene existence of light, one with the earth, I’ll feel like a goddess, my body humming with the growing life within and a sense of wisdom and peace filling me. It radiates from me as I float along my every day life where everything suddenly has more meaning. I had expectations.
Unfortunately, that isn’t what happens.
Instead of floating, I crash to the ground in a heap of extra saliva and a stomach that rejects all food and liquid all day, every day. This causes my skin to lose elasticity, my body fat to burn off quickly, my kidneys to release toxins, my eyes to sink deeper into my skull, the tiny blood vessels in my face and neck to burst, my complexion to take on a green yellow hue, my head to spin when I shift my weight, my other organs to work harder as they dehydrate, and my veins to go into hiding so that every IV attempt results in bruises the size of plums up and down my arms. I don’t even know how to tell you. Hyperemesis Gravidarum.
Decidedly not glowing.
Every pregnancy I hoped the results would be different. There were plans, you see. Plans for how I would eat, how I would prepare for my coming baby. Plans for a level of physical activity and creativity bursts. Plans for how my baby and I would grow together, healthy and strong. Plans for how my friends and family would share in my pregnancy, how we would celebrate and enjoy the journey. Plans for how everything would go the way it was supposed to go. Plans that never came to be.
Because no glowing.
I hate being pregnant.
Pregnant mothers are supposed to glow and love pregnancy.
You can fail being a mother before your kid is even outside of your body.
All because you didn’t. feel. the. glow.
We have a romanticized version of all aspects of motherhood upheld in our society. A version that is always glowing, radiating from some isolated pedestal of unattainable idealism. While sometimes we may feel like a goddess in our mothering, for many of us those luminescent images require metaphorical if not literal special lighting, makeup, shape wear, and most elusive of all, a nap. In other words, the river goddess nursing her baby in the stream may be beautiful and remind of us some inner peace we’ve made contact with a time or two but for many of us it is heavily staged.
Most of my moments in parenting haven’t been glowing. Some of them I was barely surviving.
It can be crushing to realize that your experience with conception, pregnancy, birth, and breastfeeding aren’t a breathtaking image of serenity, that your reality isn’t naturally incandescent. When all you want is to glow, to radiate, to enjoy the path that gets you to your baby but what you get is near destruction, it can be hard to separate the journey from your own personhood. Sometimes it can be hard to separate the journey from the gift. There were times when my baby felt like my enemy, my torturer, my reminder of my failure. Those times were dark and twisted. But they were nothing compared to the times when I felt my baby suffered because I just. couldn’t. glow. The agony that my babies paid the price was by far the most painful to endure.
Whatever it is, the grief is real, the suffering is profound. And the shaping is valuable.
Even if you aren’t glowing.
Specially if you aren’t glowing.
When there is no glow, particularly when there is no glow when pure radiance is what is expected, how do you go about being honest with yourself and others? And how do you start to heal while accepting what it is?
Here’s what has helped me.
Journal. Write it all down. The reality, the struggle, the loneliness, the fear that the fact that you feel this way or have experienced these things means you’re not enough. All of it, write it down.
Cry. Yep, cry. You’re going to anyway. Give yourself permission and cry. And don’t dismiss it as hormones or being a woman or overreacting or whatever. Cry because you’re human and humans cry when something hurts. It is not weakness to cry, it is a strength to stop pretending.
Art. Whether you enjoy expressing yourself through art or not, drawing, coloring, painting, sculpting, dancing, playing music, you name it, artistic expression can be incredibly cathartic because sometimes words alone just art enough to full get those feelings out. And taking in someone else’s artistic expression can be just as powerful.
Talk. You may be afraid that people may not like hearing your journey because it isn’t warm and fuzzy but more often than not sharing your story will actually help someone processing their own glowless experience. That sharing can help you and them. Be it in person or online, opening up about our struggles builds community that values authenticity and that can actually help save lives.
Commemorate. An event, big or small, to honor the journey (but please don’t do a balloon release, it’s littering and hard on animal friends); a special purchase that holds a lot of meaning for you; a ritualistic occasion that connects deeply with you; a meaningful plant/tree/shrub planted in your yard as a hopeful yet gentle reminder; compile mementos in a book; create something unique that captures the profound nature of your journey.
The tree on my arm represents me, the birds my daughters. My tattoo turned Tekhni woven wrap, named for the nymphs of Greek mythology who nurture nature, has helped me glow. From reclaiming my body to having a beautiful woven wrap that represents so much healing, hope, and promise in nurturing that surrounds other moms and their precious children, I have found a glow I can’t contain. May we all glow with honesty and hope.
Thank you for reading my story, I would love to hear yours as well. Comment here sharing your glowing or not-so-glowing experience with parenting, how you’ve found healing, and how you commemorate that experience.
If you’d like to share your story with a larger audience, submit your story with photos, your bio, and the subject #MyStoryMatters to content @ theleakyboob.com (no spaces).