TLB Comic: A Little Bit of Force + Bonus Frame

by Jennie Bernstein

 

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Bleeding uteruses of the world unite!

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We’re talking about our bleeding uteruses again! But that’s not all, we also have information on breastfeeding and returning to work, sleep issues, bacon, and more. Read all the way through our email for a special discount from our friends at Lunapads!
-TLB Team

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Hey Leakies!

It was an amazing week talking about our menses last week. So great.

No, seriously.

It was like a breath of fresh air. We think about our periods a lot, think about them monthly, manage them for days at a time, and try to forget them frequently. Talking about them was freeing and refreshing. 

And to think, people used to douche for that feeling and all we had to do was talk.

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We learned that there is a wide range of normal, that extreme pain and bleeding through a full size pad in an hour aren’t normal and can be indicators of a more serious problem, that our cravings have meaning, with A Girl With A View we learned that there is some crazy menstrual history out there (here), that many of us wish we had been more prepared for our menarche (first period- 5 things one girl wishes she had known here), and some surprising realities we weren’t expecting about our postpartum periods here. If you’re interested in reading on, click here.

Jessica Martin-Weber
Founder, TheLeakyBoob.com

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Increasing Breastmilk Supply With Pumping For Milk Donation

by Jessica Martin-Weber and Dr. Pamela K. Murphy

This post made possible by the support of Ameda

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When my 4th baby was just a few months old, a friend of mine who had adopted a little girl from Vietnam asked me for breastmilk for her daughter. Her own milk supply was dwindling and after over a year of pumping after inducing lactation even before she had her daughter, her body was done producing milk and the effects of Domperidone had left her struggling with weight and energy issues. Initially they introduced formula but her daughter reacted with painful eczema head to toe. Convinced she needed breastmilk, my friend asked me to help her little girl.

Breastmilk truly is amazing and while many babies thrive on breastmilk substitutes, the healing nature of breastmilk is something that can’t be denied. We know it can help save lives, particularly the most fragile of our society. Giving breastmilk is giving the gift of life and health for another to thrive.

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I’ve always responded well to pumps, particularly if can hook up and get busy doing something else. But my supply was well established for my own baby and because I had a job that allowed me to bring my baby with me, I wasn’t pumping very much for her. I was more than willing to help my friend but I wasn’t sure how to get enough milk for two babies with my supply regulated for my one. I decided to see what I could do.

Having a tendency to easily develop over-supply and then have issues with mastitis, I knew I needed to be careful with this process. After talking with a couple IBCLC friends, I began to add pumping sessions to each of my existing feedings to slowly increase my supply and not interfere with my baby getting what she needed first. It worked so well that 2 years later with my 5th baby I intentionally increased my supply to donate to human milk banks and two other friends who had adopted little ones and with my 6th, as soon as my supply was established I began again for another friend’s baby and the Human Milk Bank Association of North America.

To get my supply up for those babies and to donate to a milk bank I started adding 10 minute pumping session to the end of my breastfeeding sessions. Then I started pumping one breast while feeding off the other. Two feedings a day I started increasing my pumping time to 20 minutes after my baby would finish which would be long enough to cycle through another let down. Sometimes this meant that I would pump with maybe just a few drips for 5 minutes or so or even without anything at all and then I would get another let down. The first feed of the day I always pumped one breast while my baby was on the other and in just a few days I had increased my supply so much I needed to pump into a large milk storage bottle. By 3 weeks I had added 2 full and one half pumping sessions in my day and by a month I was pumping one breast and feeding off the other 3 feedings a day (the first one in the morning was always my highest output) and then pumping 3 full sessions in between feeding my baby. By that point I was pumping enough milk in a day to completely supply another baby’s feeds and have some extra for back up. When I wanted to increase my supply again, I followed a similar pattern with extending my pumping times and adding a pumping session in the morning but it was adding an extra pumping session before bed that led to the morning pumping session to increase even more in just 3 days time.

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Here’s what I learned in increasing my breastmilk supply to donate:

Don’t focus on the output. The volume isn’t the point and it will take some time before you see it so focus on why you’re doing it, remember that babies don’t actually eat that much, and every single drop counts.

Baby helps. Your baby is your ally in increasing your supply. Skin-to-skin contact doesn’t just feel good and provide your baby with neurological stimulation that is beneficial for their development, it also tells your body to make milk. And if you can pump while they are feeding from the other breast, your body will be more willing to give up more milk.

Ask and it shall be given. Your body will give what it can when you ask it to. Unless you have some physiological barrier, if your body is asked for more milk, it will make more milk.

Hands-free. Pumping isn’t fun for most even it comes easily. Going hands-free can help free up your mind to focus on something else and help you feel more productive or at least entertained in the process.

Hands-on. It helps to be distracted but taking a little time with each pumping session to be hands on with some hand compressions at the breast (like a breast massage) can significantly increase your output and send the message to your breasts to make more milk. This video is an excellent demo of how to do so.

Be patient. The process takes time and responding to the pump may be an adjustment for your body. That’s ok. Don’t rush the process.

Wean off. When it’s time, whatever the reason (and please respect your boundaries and stop when you need to), wean off slowly. Supply increase is real and not draining the breast could lead to infection and mastitis is even worse than pumping so stop slowly.

Celebrate. This is hard work and it’s a sacrifice of love. Celebrate that. Celebrate babies getting human milk.

Not everyone is going to want to increase their supply to that amount for donate but every little bit helps. You may not be able to add so many pumping sessions to your schedule but you still want to donate. If you choose to donate, do what you can and resist the urge to compare with others. Every single drop really does count.

Dual pumping- Ameda

So you want to get started increasing your supply to donate, Dr. Pamela Murphy, PhD, CNM, IBCLC shares with us some helpful information and tips to get you started:

Will pumping to increase supply take milk away from mom’s own baby?

Not if you pump after breastfeeding or in the middle of a long period when your baby isn’t breastfeeding (like a long nap). If you are trying to stock up some extra milk for when you are apart from your baby or to donate, pump 1-2x a day after breastfeeding or in the middle of a long sleeping stretch. Your body will start to make more milk to meet your new demands, just like when your baby goes through a growth spurt and breastfeeds more. This cluster-feeding helps increase your milk supply! Just keep in mind, be patient, it can take a few days to see your milk supply increase.

How do our bodies just start making more milk when we start pumping more?

Hormones! The more often you drain your breasts of milk, the more milk they make! Breastfeeding and pumping stimulates the release of prolactin, a hormone that increases your milk supply. Isn’t is amazing how nature works! Check out this quick video to learn more.

Should moms take medication, herbs, or eat certain foods to increase their supply for donation?

Normally you do not want to take anything to increase you milk supply unless you have to. Very few moms need to take anything to increase their milk supply if they are draining their breasts often. Medications, herbs and foods that help increase milk supply are called galactogogues and work by increasing the hormone, prolactin, which helps your body make breast milk. If you decide that you want to try to increase your milk supply to donate more milk, talk to your healthcare provider or lactation consultant to figure out what galactogogue might work best for you. Keep in mind that galactogogues can cause side effects, health complications or allergic reactions for you or your baby. And most milk banks won’t accept milk from a mother on certain medications, including herbs used to boost supply. If you are donating to a family directly, be sure to disclose if you used any herbs or medications to increase your supply so they can make an informed decision. Here are some additional tips about your diet while breastfeeding.

What kind of pump should moms use? What should they avoid? 

Once you have established your milk supply use a quality double electric pump like the Ameda Purely Yours. It really depends though, every woman is different and responds differently to different pumps. Some actually prefer hand expression and get more milk that way but most will do better with a double electric. A single pump or hand pump may make it harder for you to keep up with your pumping schedule since it will take longer to drain both breasts at the same time. Here is some more info about choosing the right breast pump for your situation.

How to store milk intended for donation?

Check with your milk bank to see if they have special guidelines. Some general guidelines are to always use clean pump parts and wash your hands. Collect your milk and store in either a bottle or milk storage bag. Do not store milk from more than one pumping session in the same bag. Here is some additional information about pumping and storing your pumped milk.

Anything else to keep in mind regarding being a milk donor? Even if you cannot produce enough to donate remember that milk banks are always looking for volunteers. You can still do you part to help babies! If you are a social media user, follow non-profit milk bank accounts and share and interact with them, believe it or not this is an excellent way to raise awareness and increase the number of women who donate when they become aware of the need. Find a milk bank near you.

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Are you a breastmilk donor? How did you get your supply up? What tips would you add to our list to encourage other donors-to-be?

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Pamela K. Murphy, PhD, MS, CNM, IBCLC has worked with birthing and breastfeeding families for more than 15 years. Her lactation practice extends from the preterm/high risk infant to the healthy newborn both in the inpatient and outpatient settings. She has published research on pregnancy, nutrition and lactation in peer-reviewed journals including Breastfeeding Medicine, JAPNA, the Journal of Midwifery and Women’s Health and Advances in Neonatal Care. She is shown here with her once breastfed & beautiful daughter Audrey.
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Having Enough Milk for Your First Day Back

by Shari Criso

This post made possible by the support of EvenFlo

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As you are preparing to return to work, you’ll be wondering how much should I be storing and how far in advance do I need to prepare. As with anything, it is always best not to leave things to the last minute and pumping enough breast milk for your return to work is certainly at the top of that list!

Start several weeks prior to your first day back at work and calculate how many ounces you will need for your baby on the first day as well as your freezer stash.  

For example, if you will be away from your baby for 8 hours and will need to pump 3 times for 3-4 ounces each, that will be 9-12 ounces of milk needed for your first day back at work. If you add another 10 3oz bags for your freezer this will add an additional 30 ounces that you will ultimately need. In this scenario, in total you will need about 40 ounces of milk to be fully prepared.

Waiting to store this until the last week before you go back, will make it really difficult to achieve, and in this case I would recommend that you only focus on getting the 9-12 ounces pumped that you will need for your first day. You’ll have to catch up on the freezer stash later. Ideally, you will give yourself a minimum of 4-6 weeks to start pumping and storing.

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Pumping 1-2 ounces per day in addition to the ½ ounce of milk that you will continue to feed to your baby each evening (just to keep the bottle going) will give you more than enough over the 4-6 weeks to have all the milk you need for your first day back at work, plus your freezer stash.

For some moms this is not a problem and for others you may find it difficult to pump in between feeding your baby to get this extra milk.

One of the ways to work around this is to not try and pump between feedings, but to express a small amount, like a ¼ of an ounce from each side prior to each breastfeeding during the day. If you’re breastfeeding 8 times, and you express a ½ ounce each time, you will essentially be storing 4 ounces per day.  This is even more than I am even recommending you do, if you give yourself enough time.

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To view the whole video, click here.

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Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. See the entire library of Shari’s My Baby Experts Video Program here.
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“Let Love Flo” Infant Feeding Q&A With An IBCLC

The Leakies with Shari Criso, MSN,RN, CNM, IBCLC

This post made possible by the support of EvenFlo

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We’ve asked Shari Criso to share her answers to Leakies questions about feeding their babies. If you have any questions you’d like to ask Shari, leave a comment!

Hi Shari,

My baby is due in about a month and I’ll be returning to work full time at 6 weeks postpartum. I heard that I’ll need to introduce a bottle right away for my baby to accept one. But then I heard that if you introduce it too soon my baby will have nipple confusion. I’m confused now. When and how often should my baby be given a bottle while I’m on maternity leave? Is there anything Any clarity you can offer would be great, thank you!

Jamie, Nipple confused in California

Hi Jamie,

Congratulations on the upcoming arrival of your little angel! The question about when to introduce your breastfed baby to a bottle is one that can be confusing with the enormous difference of opinion that is out there even among lactation experts. Some will say that you should wait at least 6 weeks before introducing any artificial nipple to your breastfeeding baby due to the potential risk of “nipple confusion” or preference for the bottle over the breast…while other advice will encourage you to introduce it much earlier so to avoid rejection of the bottle. In my experience, waiting too long to introduce the bottle to your breastfed baby does increase the chance of rejection and this is really difficult on a mom who needs to return to work. By 3 weeks most babies will develop a “nipple preference” either way. The advice that I always give to my breastfeeding who want to introduce a bottle, is to wait until your milk has fully come in and when your baby is breastfeeding well and regularly without any issues. This timing can vary for different moms. Some will achieve this as early as a week or two after birth. When this happens I encourage mom to pump or hand express a small amount each day (no more than 1⁄2 ounce) and then feed it to the baby in a bottle. After that they can finish the feeding at the breast. You are not replacing the feeding, but rather you are consistently introducing the bottle to the baby early when the baby is more likely to accept it and less likely to reject it. This should be done daily until the baby is 6 weeks old. Then you can pump and replace a full feeding if you choose to. This method is very effective in supporting a breastfed baby to accept a bottle, while at the same time continuing to breastfeed without issues and interfering with your milk supply. For more information and instructions there is an entire chapter about this in my full online class “Simply Breastfeeding” on my website. I hope this helps!

 

Dear Shari,

With my first 2 babies I had horrible oversupply and developed mastitis within the first two weeks postpartum and the recurring frequently throughout the first few months. It was horrible. I’m so afraid of it happening again, is there anything I can do to avoid it? The idea of battling mastitis off and on for the next few months is enough to make me not want to breastfeed this time around even though I really want to. While I’m so grateful to have plenty of milk for my babies even though my first two had slight tongue ties, I’m really afraid of dealing with mastitis again. Please help me.

Ready to quit, again,

Lisa, in Florida

Hi Lisa,

I am sorry that you struggled so much with your prior breastfeeding experiences! It can be so difficult and stressful when you are trying so hard and encountering so many challenges! Most breastfeeding moms do not fully understand just how difficult it can be to have TOO MUCH milk and the ensuing issues like mastitis that can occur, unless they are experiencing it. In my experience, oversupply can sometimes be more difficult of an issue than under supply, although neither are easy! There are a couple of things that I would recommend. First, make sure that you are not pumping in the early days and weeks to empty the breast after the feedings. This is a BIG mistake that moms make or are encouraged to do, and this can lead to oversupply. Also, feeding your newborn on one side at a time will help to bring down your supply quicker. Lastly, one of the most common reasons for mastitis that I see is constriction or pressure on the breast tissue from improperly fit bras or the use of underwire bras, especially early on and when the breast is full and engorged. This extra pressure on the full breast can cause plugged ducts and inflammation, which can lead to mastitis. Nursing frequently, warm compresses, not pumping, and avoiding pressure on the breast, will all help to normalize your supply and hopefully prevent you from developing mastitis. See this video for further information on the issue of “oversupply” that may help. Good luck to you!!

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Hi Shari,

Is it possible to not make much milk? With my son I was looking forward to breastfeeding but it just didn’t work out. I was heartbroken, I had tried so hard, used a system to supplement at the breast, had my son’s slight tongue tie revised, ate oatmeal every day, did everything I could find to do. I saw an IBCLC and she told me I may not have enough milk making tissue. My breasts aren’t very small but they aren’t very round or close together and they never changed in pregnancy or even after giving birth. I couldn’t express any milk with a pump, well, never more than a few drops and hand expression wasn’t any better. Breastfeeding is really important to me but I can’t handle seeing my baby lose weight when they should be gaining and it was really hard to see that I was failing my baby while hearing from everywhere that breast is best and I just needed to try harder. Could I be too broken to feed my baby? Is there anything I can do this time?

Thank you for taking time to answer. Heartbroken Heather from West Virginia

Hi Heather,

First of all, you are not broken! I can feel your heartbreak in not being able to breastfeed your baby the way you wanted to. It can be very frustrating and even depressing to try everything you know and still not be able to produce enough milk for your baby. To answer your question…Yes, unfortunately it is possible for a mom to not make much milk and this can be caused by a variety of reasons. This could be caused by hormonal issues that exist and go untreated (such as PCOS or Thyroid dysfunction)…it can be caused by failure to establish an adequate milk supply after birth from improper latch, formula supplementation, or even an undiagnosed tongue tie in the baby, etc…and it can also be caused by a condition call Insufficient Glandular Tissue (IGT) where the breast does not have enough glandular tissue to produce a full milk supply. This is something that can be identified during pregnancy, but cannot be determined until after the baby is born and all attempts to produce a full supply are unsuccessful. As a mom that is experiencing this it can be so difficult to keep hearing people offering advice on the very things that you have been trying all along! There are some things to try and consider all with the support and advice of an experienced Lactation Consultant. There are medications and herbs (such as Goat’s Rue) that can sometimes help. Make sure you are addressing and treating any underlying hormonal conditions with your practitioner that may be possible. Lastly, whatever amount of breast milk you are able to produce is still going to benefit your little one. It is definitely not all or nothing! If you are producing some breast milk, you may choose use a supplemental nursing system to deliver the supplementation (donor milk, infant formula, etc…) to the baby and continue to breastfeed at the breast. This can also be done if you are not producing any breast milk but still want to maintain the physical closeness of the act of breastfeeding. Either way always remember that this is not your fault! You are a great mom regardless of HOW or WHAT you feed your baby…and the most important thing that you can ever provide to your child is your love, which is always abundant and overflowing!! For more information, see this video clip. Sending you lots of love!

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Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters.
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12 Surprising Possible Realities Of Your First Postpartum Periods

by Jessica Martin-Weber

Sorry for the Buzzfeed style title. It’s that time of the month and there wasn’t enough chocolate to get me through writing this and coming up with a clear yet titillating title too.

The last 5 days we’ve been bleeding our hearts out on The Leaky Boob, Beyond Moi, A Girl With A View, and a little bit with What Love Tastes Like, opening up and sharing all about periods. Free bleeding information and experiences, debunking myths and being honest. In that time we’ve learned a lot. Like a girl having her first period (called menarche), there were a few things that surprised us and at times we found ourselves overly-grumpy. But mostly we felt like we were in good company and that commiserating was cathartic.

Also chocolate. Or bacon. Sometimes chips. And wine.

As we all shared the activities of our uteruses together, we started noticing a pattern. Not completely regular but consistent enough to chart and make a prediction:

Most women will be surprised by their first postpartum periods.

Not all and the surprises weren’t always unpleasant in nature but many women had no idea what they experienced was possible. Like, at all. And they thought they were the only one in the world to experience it.

Since we’ve already aired all our period panties to the world, it’s time to shed some of the mystery like a uterine lining. Here it is, our list of surprising possible realities of your first postpartum periods.

  1. No matter how long your postpartum bleeding lasts (lochia, which is not a period and you can read more about here), it isn’t an indicator of what your postpartum periods will be like.period week is coming
  2. It could take months for Aunt Flo to visit after you have had a baby, even over a year and for some it could be two years. Breastfeeding exclusively makes it more likely your favorite auntie won’t be around for a while.
  3. But it is no guarantee. Because we’re talking hormones and Aunt Flo, there’s only so much you can predict. Don’t be unprepared because you could be one of those that gets it back at 6 weeks postpartum and is like clockwork every month after. Even if you’re breastfeeding and your child never sees another nipple but yours. Yes, even if you’re breastfeeding twins.postpartum period surprise meme
  4. It could take a while to really get going, there could be brown spotting for a few days a month for several months while your body is indecisive. Get your period undies ready.
  5. OR it could come back with a vengeance with a gush that will feel like a scene from Game Of Thrones playing at the most inopportune moment. You may want to have supplies with you at all times just in case.brace-yourselves-cramps
  6. Essentially, there’s no guarantee when you’re going to start riding the crimson tide again after you have a baby.
  7. There’s also no guarantee that it will be the same as what you had before you had your baby. It could be lighter, shorter, and less uncomfortable. It could be heavier, longer and more painful.* Or any combination. Or different every time.
  8. The products you used before may still be your favorites. But you may suddenly hate them. Many women find they want to try something new and don’t be surprised if you see disposables as stinky, uncomfortable, and gradually building a mountain of waste that will be around when your children are having children. Which is a disgusting thought, your period supplies slowly rotting in a landfill when your grandkids are being born. And since you’re more comfortable with the weird things your body does (childbirth can do that to a person), the idea of washing cloth pads or to put a cup in it doesn’t seem so crazy any more. Diva-Cup-Evangelist
  9. If you’re breastfeeding, shark week may mean that your nipples protest someone latching on. Nipple sensitivity AND cramps? So not fair but often so real. Thankfully it usually doesn’t last long and chocolate can help.
  10. Even more annoying, periods and/or ovulation can cause a dip in milk supply if you are breastfeeding. So not only are you annoyed, your hungry baby is too. Most of the time this indicates a magnesium deficiency and supplements may fix this problem (see more here) but only after the most emotional and sensitive time when you have a hungry kid frustrated at your boob. You know what has magnesium? Chocolate. period week chocolate
  11. Just like a girl may experience irregular periods for about a year, postpartum women may find that it takes their cycles a good year to establish a regular pattern. The upside to this is that it is completely reasonable to always eat chocolate since you never really know.
  12. Health care providers may not have a clue what’s going on either. They should and many will but some don’t. You may have to educate them.

Be prepared for anything. Postpartum menses seem to like surprises.

Keep calm and menstruate on

*It is important to note that severe or debilitating pain or extremely heavy bleeding is a sign that something is wrong and may need more than chocolate and wine to address. It is well documented that women are more easily dismissed by health care providers about their pain and discomfort when it comes to health concerns. If your concerns are repeatedly brushed off as being normal but you feel something is wrong or your normal life is disrupted, please speak to your health care provider or find another one. Be persistent until you find one that will take your concern seriously. Menstruation is a normal biological part of life for most healthy child-bearing age women, it isn’t a pathology that women just have to deal with on a monthly basis and if it is interrupting your normal activity and lowering your quality of life, something more serious may be going on.

 

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Have you survived mastitis? How did you get through?

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Jessica Martin-Weber Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.
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TLB Comic: Oh Poop! (With A Bonus Frame!)

by Jennie Bernstein

 

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Ask the Sleep Expert- Rebecca Michi- 4 month olds, 3 year olds, and Partners- Sleep In Arm’s Reach

The Leakies with Rebecca Michi

This post made possible by the generous support of Arms Reach Co-Sleeper

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We asked sleep consultant Rebecca Michi to come help us all get some more sleep and we asked the Leakiaes to share there current sleep struggles. Here are a few of the responses followed by Rebecca’s support.

Dear Rebecca,

Help! I have a 10 week old and a 3 year old. The 10 week old sleeps pretty well, considering, but it is the 3 year old that is pushing me over the edge. The baby sleeps in a cosleeper next to me and my son sleeps in his own room but usually joins us in our bed in the very early morning. I’m fine with that, I like the extra snuggles then. What is getting to be too much is our bedtime routine. It is pretty straight forward; bath, pajamas, brush teeth, read a story, go potty, lights out, sing a few songs while I rub is back… and we should be done. Except we’re not. He won’t fall asleep without someone sitting there and what he really wants is me to lay there with him. It can take him an hour and a half to go to sleep! In that time I usually need to feed the baby and he’ll come out looking for me when I go get her. My partner isn’t home most bedtimes so I’m on my own. I’m getting so overwhelmed and frustrated that the other night I yelled at him to stay in bed and he ended up falling asleep crying. I feel horrible, that is not how I want to parent. How do I get him to stay in bed without needing me right by him for 90 minutes? I’m so tired by the time I leave his room, I struggle with picking up the house and getting the dishes done. Is there anything I can do to help him settle quicker?

Sleepily yours,

Grumpy and tired mommy of 2 in Idaho

Dear Grumpy,

It should take us between 10 and 20 minutes to fall asleep, if it’s taking longer than that chances are he’s not tired enough. I’m not sure how long her is napping during the day, but it does look like he is getting ready to drop his nap. I would start by reducing the nap down a little (maybe 15 or 20 minutes), that will probably mean that you need to wake him from his nap. Give it a week and then see what impact it has on the beginning of the night. You can continue to reduce down as you need to.

It’s okay for you to be in the room at the beginning of the night as he falls asleep if it’s not taking you so long, his whole world was turned upside down with the birth of his sibling less that 3 months ago, so give him the support he needs at the beginning of the night.

 

Dear Rebecca,

My husband seems to think we’ve spoiled our 4 month old by not leaving her to cry at bedtime and when she wakes. He thinks that the night wakings (usually 3 times a night) are out of hand. I’m actually ok with it, though I am tired, but I expected to be tired with a baby. The thing is his mother is telling him that our daughter should be sleeping through the night from 7 to 7. It doesn’t help that his sister has a 6 month old that has a baby that has loved sleep from the get-go and is happily sleeping 10 hours a night according to her. He thinks we need to sleep train her and that it is ok to let her cry. I don’t and feel that her sleeping patterns are normal for her age. Is there some kind of happy middle ground I can suggest?

Thank you,

Searching for middle ground in Georgia

Dear Searching,

At 12 weeks 70% of babies are sleeping for less than a 6 hour stretch. Waking 3 times at night at 4 months old is perfectly normal. I would not advise you leave your little one to cry-it-out. She is still so tiny and new and is only just beginning to understand that she is separate from you. Her tummy is also tiny, she will wake out of hunger during the night.

It’s awesome that your sister-in-law has a little one that sleeps through the night, most don’t, she is certainly one of a few.

Hang in there, sleep will change and those stretches of sleep will get longer and longer.

Rebecca Michi normal sleep 4 month old Arms Reach 01.16

Dear Rebecca,

My wife is an excellent mother but she puts a lot of pressure on herself to do everything. I work long hours and want to take on the parenting responsibilities I can when I’m home, even if they are in the middle of the night. She’s breastfeeding our 2 month old son, which I fully support, and it is going well. However, I’d like to help more at night, in part so she can get a break and have more sleep, and in part because I selfishly want to have some time caring for our son as well. Unfortunately, with breastfeeding she says there is nothing for me to do, he just wants the boob. Are there ways I can help with sleep and nighttime routines that won’t interrupt breastfeeding? I know she doesn’t want to pump but our son does wake frequently and I want to be able to help. He is sleeping in a bassinet by our bed so she can reach him easily. I know it sounds selfish but I just want to be involved and I don’t feel very needed in caring for our son at the moment. Any ideas?

I appreciate your help,

Daddy just wants to help

Dear Daddy,

There is plenty you can do to help with sleep. How about you do the getting ready for bed routine and your wife does the feeding to sleep? The night routine can be around 30 minutes long before a feed, that can include a bath, massage, diaper, pj’s, walk around and then the hand off to Mom. Chances are at this age your little one will fall asleep whilst nursing at the beginning of the night and during the night and that isn’t something you can get too involved with. You can give him a diaper change during the night, give him a quick snuggle before you pop him into the bassinet, get your wife a fresh glass of water and of course be ready to help if she does struggle to get him back to sleep.

Sleep is going to change so much over the next few months and I’m quite sure that you will be able to help more and more during the night.

____________________

Be sure to check out Rebecca’s book Sleep And Your Child’s Temperament and don’t miss out on the opportunity to participate in her Sleep Academy here.

If you have a question you would like Rebecca to answer next time, leave a comment.

____________________

small Rebecca Michi121

 

Rebecca is a Children’s Sleep Consultant who has been working with families for over 20 years. She is a gentle sleep consultant who doesn’t believe in leaving your child to cry-it-out when teaching them to fall asleep more independently. She is passionate about helping children and their parents build healthy habits so they can finally get some sleep. By transforming drama into dreamland, her mission is to help your children—and you—get a good night’s sleep.
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On My Menarche, Menstruation, and Menstrual Misogyny

by Joni Edelman

I started my period when I was 13. This is just slightly behind the American average of 12.8 — I guess my uterus didn’t get the overachiever gene. I was the last of my friends, which was sad for me then, because periods = grown up. At 12, while the rest of my friends were talking about pads, I was skinny, breastless, and without menstruation. I might as well have been 5.

The morning I started my period was the same day I was supposed to sing in church choir with my best friend — who had already had her period for like two years by then. It wasn’t bright blood red, as I expected. I thought I was getting something along the lines of Game of Thrones, instead I got what sort of looked like a poop smear. Since I knew I hadn’t actually pooped my pants, the period was only logical deduction.

It was the best day of my life.

Well, until the cramps. No one told me about the cramps. I went to my mom and showed her my poop/period stain, and she said, “YEP! You’ve got your period.” And she handed me a Stayfree maxi-pad. I don’t know what exactly I was supposed to be free from. The maxi-pad of 1987 was not the thin, super-absorbent pad of today, friends.

Period Week- Joni's 1st image

Look I was in color guard, and we wore tiny bloomers and everyone, I mean EVERYONE, knew when you were on your period. Everyone.

Why? The pads of yesteryear looked more like this:

Period Week- Joni's 2nd image

I know that doesn’t look thick, but trust me, that sucker could have doubled for a whiplash neck brace.

Period Week- Joni's 3rd image

This guy is making neck brace/maxi-pads look hot. They are not hot once placed in your underwear — I assure you.

My mom had never even considered using tampons because “Where does all the stuff go?” I don’t even know what that means, but for me, it meant no one could tell me how to insert a tampon. Also, there was no Google. Also, the tampons of yesteryear weren’t unlike pads of yesteryear. Let’s just say “feminine hygiene” (whatever the hell that is) has come a long way.

Without Google or an experienced adult, I tried to just read the package insert, which featured an anatomical cross-section of the vagina and uterus. No one told me that your vagina doesn’t empty out into your uterus so I was basically terrified to put anything in there, certainly not cardboard.

Here’s what happened: I put one foot on the toilet edge (per package instruction), gritted my teeth, and just shoved it in — half-way.

P.S. A half-inserted tampon A. does not work, and B. hurts. Really a lot.

So, without anyone to tell me what to do, or that I could fix that, or that you weren’t supposed to have something hanging out of your vagina, I walked around miserably for three cycles with a tampon half inserted in my apparent endless tunnel of a vagina. After the half-inserted tampon became too much to bear, I went back to the neck brace and wrapping a sweatshirt around my waist. Obviously.

It never even occurred to me that there might be any alternative choices, or that maybe the choices I had weren’t even really made with me in mind.

I don’t remember when I finally figured out that tampons were meant to go inside your body — like, all the way. But eventually I did and I wore them for most of my adult life; not even considering where they came from or what they meant to me or why they were $7 a box.

They are more than $7 a box now.

Also, they are taxed, like they are some sort of luxurious item. Oh what’s that you say? You don’t open a package of 24 tampons and throw them in your bathtub to create a cushion of pillowy softness upon which you might bathe?

Well you are just missing out. Pillowy bleached chemical-laden softness.

And here’s another thing I bet you haven’t considered, while we should congratulate Science on making a maxi-pad that doesn’t make you looked like you crapped your pants, can we also ask why we ever wore those diaper-pads anyway? I appreciate that this is all better than a rag shoved in your underpants, as was the custom, prior to the advent of the wood-pulp pad in 1888. It probably beats sheep’s wool too (though maybe not, there are so really soft sheep).

The Feminine Protection Industry in the US consists primarily of Tampax, Playtex, Stayfree, and Kotex. Playtex and Stayfree are both owned by Edgewell, which is run by one Ward Klein. Tampax is under the household GIANT Proctor & Gamble, CEO, David S. Taylor. Kotex is a Kimberly Clark product, overseen by Thomas J. Falk.

HOLD ON.

I’m seeing a pattern here. Are you seeing a pattern here (besides the apparent need for a middle initial)? Dudes. All dudes.

Now, while I realize that dudes are often preoccupied with vaginas, I think this has gone too far. And it would be convenient to call me a fem-nazi here, but this is real.

When I was 13, I walked around with $7 worth of cardboard taxed tampons hanging out of my vagina — because no one ever challenged it. No one ever considered that other ways to deal with your period do exist. No one ever considered that the “feminine hygiene” product industry might not actually be designed to benefit women. No one said, own your period, know your vagina, capitalism is bullcrap. We were all just happy with our beltless neck brace maxi-pads and our cardboard miserable to insert tampons.

And then there is the maintenance.

Oh vagina, how do we deodorize thee? Let me count the ways: Powder, spray, wash (who would want their vulva to smell like an Island Splash), wipes, douche, and even extra fancy soap made for ladies. Vaginas actually do not need any accessorizing. They smell like a vagina, because they are a vagina. They have their own little ecosystem that doesn’t need vinegar or backing soda mucking things up. They actually don’t need anything. At all.
A bunch of super rich middle-aged dudes are basically robbing us, by way of our vaginas.

Did you know you can use a sea sponge instead of a tampon?

Not the tampon type? There are pads you can wash. And they are made by WOMEN. I know. It’s weird. Ladies, with jobs and making stuff.

And the menstrual product to rule them all: The Diva Cup. Created, owned and operated by Francine Chambers.

A lady person.

Someone who, ostensibly, also now (or at one time) has had a period.

There’s still a tax on the Diva but Francine isn’t in charge of that.

____________________

IMG_0670

I’m Joni. I’m lucky enough to have 5 amazing kids (19, 16, 15, 4 and 2), one fantastic husband, an awesome sister and a yarn addiction. When I’m not raising up people I’m a freelance writer, RN, and the momma behind mommabare. Love is my religion. I like cake and crafty crap. And yoga. In that order.
You can follow Joni on Instagram here and on Twitter here.

 

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Normal Postpartum Bleeding and Discharge and the Return of Your Period After Giving Birth

by Dr. Kymberlee Lake

Most women know that there may be some bleeding after giving birth but often women are surprised by how much and how long and they aren’t aware of the difference between postpartum bleeding and discharge and menstruation. The first bleeding after you give birth is called lochia.

What exactly is lochia? 

Lochia is the discharge consists of blood from the area on the uterine wall to which the placenta was attached during pregnancy, the sloughed off endometrium (uterine lining which makes a bed for the fetus) which gets considerably thickened during pregnancy, blood and mucus from the healing cervix,  and dead (necrotic) tissue. Your blood volume increases by approximately 50% in pregnancy, all that extra blood also has to go somewhere after birth. Most women will experience blood and lochia discharge for 3- 6 weeks though that time span can very from pregnancy to pregnancy and can be directly influenced by a healing mother’s activity level.

Why do we have lochia and where does it come from?
The blood in the lochia comes mainly from the large raw area left in the uterine wall after the placenta detaches from it. While bleeding from this area is controlled by contraction of the uterine muscles immediately after delivery, it takes on the average about two weeks for this area to heal. It is important to remember that this is a wound and it is possible to do too much before it has healed and reopen the wound, causing fresh bleeding. You will experience this bleeding for around four to six weeks postpartum.

For the first few days it will be a heavy flow (kind of like a heavy period) and will be  colored dark red, with some clotting.  About the end of the first week the flow should start to taper off, becoming lighter in saturation and color; as time passes, it will fade to a brown, yellowish or even almost-white discharge. 

One thing to remember is that the placental area as well as the sites of sloughing endometrium are raw and open during this time and bacteria can easily spread from the vagina. So, the use of tampons should be avoided – sanitary pads are the best options to be used during this time. 

What is normal and when should I be concerned?
You might notice a ‘gush’ of blood with clotting when you stand up – this is very normal. Also, if you’re breastfeeding, you might notice that you lose more blood after feeding baby; this is caused by your hormones doing their work to help shrink your uterus back to it’s pre pregnancy size. The lochia is sterile for the first 2-3 days but then becomes colonised by bacteria giving off a typical distinct lochial smell which is normal and should not be confused with the bad odor from lochia in postpartum infection. – 

If the discharge smells foul, you’re still noticing a lot of blood loss after the first four weeks, or the blood is bright red, these are signs of infection and you should speak to your health care provider as soon as you can. This is especially true if you also have a fever (no matter how slight)  or are generally feel ill. Likewise, if your blood loss is so heavy that you’re going through more than a pad an hour, you should get medical help immediately – this can be a sign of a hemorrhage. If in question and something feels “off” it is worth a call to your health care provider for advice.

Types of Lochia
Depending on the color and consistency, lochia can be of three types:

  • Lochia Rubra: Lochia rubra occurs in the first 3-4 days after delivery. It is reddish in color – hence the term ‘rubra’. It is made up of mainly blood, bits of fetal membranes, decidua, meconium, and cervical discharge.
  • Lochia Serosa: The lochia rubra gradually changes color to brown and then yellow over a period of about a week. It is called lochia serosa at this stage. The lochia serosa contains less red blood cells but more white blood cells, wound discharge from the placental and other sites, and mucus from the cervix.
  • Lochia Alba: The lochia alba is a whitish, turbid fluid which drains from the vagina for about another 1 – 2 weeks. It mainly consists of decidual cells, mucus, white blood cells, and epithelial cells.

The Stages of Lochia table image

Do women who give birth by c-section still have lochia?
Many women believe that the flow of lochia is less after a cesarean section since the uterine cavity is cleaned out after the birth of the baby. This is not true. The flow of lochia is not dependent on the type of delivery –  The amount and duration is the same in both cases.

Return of Menses
There’s no hard rule as to when your period will return post-baby – it can vary from woman to woman, and pregnancy to pregnancy. Here are some general guidelines

  • Women who bottle-feed can see their menstrual cycle return within six weeks of birth – and most will have menses back by ten to twelve weeks.
  • Women who exclusively breastfeed may not get their period back for some time. When you breastfeed, you body releases the milk-producing hormone prolactin, which, in turn, keeps our levels of progesterone and estrogen low. Progesterone and estrogen are the hormones responsible for signaling ovulation and menstruation. Night nursing directly effects these levels, a decrease in breastfeeding at night may lead to a return of menses.

Once your period returns, it can take even longer for it to get into a regular cycle. If you are bottle feeding it can take around six months, while exclusively breastfeeding your baby can take 12-18 months. But keep in mind that this does vary from mom to mom and pregnancy to pregnancy. Even with exclusive breastfeeding on demand and no artificial nipples, there are women who see a return of their menses as early as 6 weeks while others may not breastfeed and still experience a considerable delay. Each woman is different. Some women experience lighter flows and/or less cramping with their menses after having a baby, others experience the same, and still others may experience an increase. The range of normal variations is considerable but very heavy bleeding, soaking a full size pad in 1-2 hours, may indicate a problem and should be addressed with your health care provider. There are a variety of factors that contribute to possible changes with the return of your period but keep in mind that diet, physical activity, and your menstrual products can all contribute to cramps and duration.

____________________

Please be aware that your first egg (ovulation) will be released two weeks before your period starts, so if you have unprotected sex without realizing that you are ovulating, you could get pregnant before you have even began menses again. It’s a good idea to speak to your healthcare provider about contraception even before you start thinking about sex again, so you can be confident in your choice ahead of time.

____________________

Kymberlee Lake- headshot

Kymberlee is a Physician/midwife, Therapeutic foster/adoptive parent with 6 kids ranging in age from 31 to 3 and three grandchildren. She is living life to the full with MS in the Pacific NorthWET.  As an international travel enthusiast and fan of teleportation you can find her under the name “Dr_Kymberlee” live streaming and on social media, or on her often neglected blog, TheMamaMidwife.com
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