We’re In Public and My Breastfed Baby is Hungry, Now What?!

by Jessica Martin-Weber
This post made possible by the generous sponsorship of Bebe au Lait.

 

Breastfeeding in public, at once a basic concept (feed the baby when the baby is hungry and no, moms can’t and shouldn’t just never leave the house) and somehow a complex and controversial issue. As mammals who happen to be higher thinking and social creatures, it’s also unavoidable. Often I am asked by moms how to breastfeed in public or how I became comfortable with doing so. At the time I wasn’t really aware of my journey, I just had to feed my baby. Initially I went some place private and covered (just in case someone came in) but as time went on that not only became impractical for my life realities, the isolation I experienced with a frequently feeding baby made me decide I didn’t care what other people thought. With my second baby I ditched my cover as well and just went about my business of feeding her after a male nurse that played in the worship band I was leading told me that I should just feed my baby and stop fighting with her to keep the cover on because “it’s just boobs, we’ll all live. Just feed her.” It was a progression and with each of my children I became more comfortable and more skilled with feeding in general, feeding in public in particular. What do you do when your breastfed baby gets hungry and you’re out in public? Is there anything that can make this easier for anxious breastfeeding moms? If I had to break it down into the most important tips though, it would be something like this:

Don’t rush yourself. If you’re worried or anxious it may be best to wait until you’re really ready.  Your baby picks up on your stress and you both deserve a relaxed feeding time. 

Get familiar with what breastfeeding actually looks like. Look at images of other moms Breastfeeding.  If you’ve never seen anyone else breastfeed it can be intimidating to feel like a pioneer in your area. But you’re not alone, millions of women all around the world breastfeed in public. Check out the hashtag #BeautifulBfing on Instagram for a stream of breastfeeding photos.

A Leaky breastfeeding in public at a beach.

A Leaky breastfeeding in public at a beach.

There is no should. Whatever makes you and your baby comfortable and helps you accomplish your breastfeeding goals and not being stuck at home is what you should do.  Covered with a pretty Bébé au Lait or a lightweight baby blanket, without a cover at all, finding a private spot, using a bottles of expressed milk, or mixing up a bottle of formula; this isn’t a pass/fail in mothering, it’s just another progression in the parenting journey. Do what works for you and your baby and helps you reach the goals you’ve established for yourself.

Breastfeeding in public with a breastfeeding cover. When you're a model family at an adorable cafe. Thanks to Bebe au Lait for this image.

Breastfeeding in public with a breastfeeding cover. When you’re a model family at an adorable cafe. Thanks to Bebe au Lait for this image.


Dress for success. If you find yourself needing to practically strip to feed your baby, your breastfeeding in public experience could be greatly inhibited not to mention stressful. A form fitting dress with a high neckline, non stretchy fabric, and a zipper up the back isn’t going to work out so well when your baby is hungry. Dress how you are comfortable but make sure you can get a boob out when necessary. Breastfeeding tops or dresses specially designed to make it simple are super easy (see Amamante, A Mother’s Boutique) or try layering a tank- either a regular one with a stretchy neckline or some kind of nursing tank (I’m a fan of Undercover Mama, the Naked Nursing Tank, Rumina, The Dairy Fairy nursing tank, and Melinda G‘s nursing tank) so you can pull your top up and the bottom layer down (demo video here), and necklines that stretch enough to pull a breast out are all good options. If you’re not sure then check and try it at home before you head out the door. 

Practice makes easier.  Like everything else about parenting, there is no “perfect” in breastfeeding so practice won’t make anything perfect but it will make it easier. If you’re uneasy about breastfeeding in public but really want to, practice with a cover in front if a mirror, then without a cover in front of a mirror. See what it really looks like and how much of your body actually shows. Then branch out and take a few selfies of you breastfeeding from several different angles and don’t worry about posting them on social media unless you want to. After that, try breastfeeding while attending your local breastfeeding support group or other gathering where there will be other breastfeeding pairs. From there expand to Breastfeeding in front of trusted friends within your own home, their home, and finally in the general public.

Be informed. Know your legal rights. Find out for sure what the law is where you will be and have it written down and with you. It’s highly unlikely you will be approached but it can help you relax to know your rights and be prepared with that information. And as silly as it may seem, understand the difference between feeding a baby in public vs. taking a dump in public, urinating in public, or sex acts in public.

Be confident. Feeding your child and meeting their needs is not wrong. Even if you have to pretend to overcome nervousness, having a confident air can go a long way in developing your own confidence and could just make anyone that would think twice before messing with you. Don’t be looking for trouble, be all eyes for your baby or cheerfully smile at people you see notice you. If you seem comfortable and relaxed then it’s likely the people around you will be as well.

Get comfortable. Remember that to take care of someone else you have to be taken care of too. If you need support for your arms or your breast while breastfeeding at home, you’ll be more comfortable in public with that too. A diaper bag can double as a pillow, so can a baby blanket or baby carrier and there are some neat portable nursing pillows on the market. Have a bottle of water and a little snack for you and if possible, find a spot with some back support. If you use a nipple shield or must hold your breast as you feed your baby, the more you focus on getting you and your baby comfortable, the quicker you will be through any awkward stage of the latch so try not to worry about what others may see.

If you're comfortable like this at home, you may want to take the pillow with you for out in public.

If you’re comfortable like this at home, you may want to take the pillow with you for out in public.

Focus on what is important. Look at your baby, see how much they need and enjoy being fed. Taking a moment to remember why you’re doing this can help take the pressure of on how to do it and everyone else will think and puts it on why. Your baby is the best reason there is. 

Just do it. While you don’t need to rush and force yourself, at some point you just need to jump in and do it. You may be surprised at the confidence boost you have when you realize it’s no big deal. 

Share the experience. You’re not alone and most people want to see you reach your goals, even goals for breastfeeding and being comfortable feeding your baby while out and about. Talk about it, in person and online, maybe even with photos. You’ll end up getting cheered on, hearing support, and probably encouraging someone else who has been anxious about leaving the house with their baby too. Yes, there may be nay-sayers but they aren’t as common or as loud as it seems, specially not when you can remember all you’ve gone through to get this far for your baby.

Happy breastfeeding wherever you feed your baby!

This and other breastfeeding support and information can be found at theleakyboob.com

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The Purpose of Baby Shows and Parenting Conferences

by Jessica Martin-Weber
This post made possible by the generous sponsorship of The Baby Show.

When my first baby was born I was overwhelmed with the amount of information I needed to learn when it came to caring for my baby. Initially I thought it wouldn’t be too difficult but then I learned I had to be careful how I laid her down, that car seat installation should be checked by a professional (and that there are professionals for that!), that there was a right and wrong way to introduce foods, and that there were products that would help me parent but could potentially harm my baby so Jeremy and I agonized over picking out a bouncy seat, carrier, swing, stroller, and even crib sheets. Let alone how we were going to raise our child.

So when baby number two came along I was relieved I wouldn’t have that anxiety to deal with, I had figured everything out, right? Wrong. Recommendations had changed, even laws had been updated, and some of the products I had for my first I learned had been recalled! Not to mention the things it turns out I never knew and did “wrong” with my first. Then she was born and was such a completely different little person she hated the carrier that my first had loved, our breastfeeding journey was filled with challenges and I needed a better pump, her sleep needs completely upended what we thought we did and had us scrambling for a different solution beyond “more coffee.”

With the third I wondered what could be next and the only thing I was really confident about was that I only kind of knew what I was doing and that everything could be drastically different territory.  I needed a different way of figuring out my options depending on what was thrown my way.

Now, mom to 6 kids, I’ve learned that there are few silver bullet products out there (almost none) and lots of different favorites, nor is there one specific method that will make everything just so for parents. Every child, every parent, every situation is different. Sometimes we can’t get or do the “best” because the “best” changes depending on circumstances. The three most valuable acquisitions I’ve made for my parenting are information, community, and confidence. The last two of which can be very challenging to come by as a new parent.

For years I was uncomfortable with the idea of mom-targeted events. The idea of hanging out with a bunch of moms talking about pregnancy, birth, and parenting, just sounded kind of terrifying. I wasn’t sure how much there could possibly be to say on those matters and it sounded potentially very emotional, competitive, and expensive. But I was wrong. Though I shied away from such events for a long time, eventually I realized I needed to connect with other parents on the parenting journey and hear from those not only more experienced but also more informed as well as those just figuring things out along the way. Information within the context of community was so much easier to absorb, I discovered. Even better when that community was fun and a mix of people with different backgrounds, areas of interests, and access to various professional experts from health care to product functionality.

Which is why now I love events targeted at helping build community amongst parents with information sharing, education, and connecting with brands that prioritize education for parents to be confident in their decision making. As I’ve experienced and learned more of such events, I get excited when I see more and more parents having access to these opportunities. The online support community is incredible and needed but I can’t deny that there is something about being able to touch each other, get hands on help, hear the voices of those on a similar journey, and look into the eyes of someone that understands. Being in a room buzzing with people excited to grow for their children is a bit intoxicating, awakening the power we all already hold within ourselves as the right parents for our children.

Not all events are created equal and not all events are the right fit for every parent but venturing out into the unknown for a real live connection is worth the risk that it won’t be what you’re really looking for as part of your journey.  Even if you’re not sure, taking time to explore your options and figure out how to get to them can be energizing, the actual experience even revitalizing.

I talk often about different events happening in the States because that’s where I am but today I’m excited to share with you an event taking place in Toronto, Canada in just a week, September 27th and 28th.  The Baby Show, Toronto, brings together the parenting community, speakers and workshop teachers, and brands with products and services that support families focusing on the prenatal and baby and toddler stages of parenting.  We tried to work it out for me to be there this time but it’s just not able to happen so I’ve teamed up with The Baby Show to send SIX pairs of Toronto Leakies (value of $30 each prize) to the show to go and give me the scoop. I want to hear all about this event so grab your partner or a friend and head over there and let me know what you think. The Baby Show features workshops and seminars covering a range of topics from sleep, infant massage, prenatal yoga, starting solids, birth and beyond, breastfeeding, mommy baby dance workout, first aid basics for parents, and more as well as entertainment, contests, giveaways, and shopping.

For those that don’t win, there’s a discount code for Leakies as well for $3 off online tickets using the code: LB14

To be entered, use the widget below and for once, this giveaway is open to Canadian Leakies only! Please note that all winners will be responsible for their own transportation and the winners will be announced on Wednesday, September 24, 2014. Good luck!

The Baby Show Toronto, Canada

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Breastfeeding and Ballet, making it work- Sarah Ricard Orza and the Pacific Northwest Ballet

Sarah Orza breastfeeding mother ballerina

Sarah Ricard Orza performing Giselle with the Pacific Northwest Ballet  ©Lindsay Thomas

The first time I saw soloist Sarah Orza dance was as she performed the role of the Lilac Fairy in Sleeping Beauty at Pacific Northwest Ballet in Seattle, Washington. She was sublime and the 4 preteen/teen girls I was sitting with gasped and whispered about her extension, her feet, her artistry, and her hands. Their excitement was palpable (sorry anyone sitting near us that may have been disturbed by the energy coming from our row) but mine was more subdued. While I admired her skill and artistry and marveled at her technique and her performance was stunning, I was intrigued by her for other reasons.

Like how does she not leak all over those gorgeous costumes?

By act 2 her boobs must be so engorged.

She can dance on her toes, extend a leg past her head balanced on a piece of paper mache, leap effortless over people’s heads, AND make milk for her 10 month old?

Yes, yes she can. Perhaps even more amazing (can it get more amazing?) was the reality that she could do much of that not only because of her biology, talent, skill, and hard work, but because she is in a supportive environment.

The ballet world is known for rigorous schedules, demanding physical requirements, competitive peers, limited opportunities, body type expectations, controlling dietary habits, short careers, and breath-taking performances of athletic artistry. Nobody has ever thought of the ballet profession as being family friendly. Yet at a time when major corporations are struggling with implementing federal regulations supportive of mothers pumping their breastmilk in the work place, an organization in the nonprofit ballet profession is figuring out how to make it work. In an extremely competitive field where motherhood used to be seen as career ending situation, more and more women are finding they can start a family and continue on their professional track.

Sarah Orza Breastfeeding ballerina

Sarah Ricard Orza and William Lin-Yee ©Lindsay Thomas Pacific Northwest Ballet.

At just 4 years of age, little Sarah was enrolled in her first ballet class. She enjoyed it and was encouraged for her natural aptitude. Around 12 and 13 years of age, with the encouragement of her instructors, Sarah experienced a resurgence of interest. Her devotion and hard work paid off with the opportunity for even more devotion and hard work when she was accepted and attended the prestigious School of American Ballet in New York. At just 18 she received an apprenticeship at the New York City Ballet where she danced her way up the ranks for 7 years. Then, in an unusual move that would foreshadow what was to come in her career, Sarah stepped away from dance to listen to her heart. Burned out and unsure of what she wanted to do next, she worked in jewelry design for a year. In ballet, a year is an eternity, leaving the studio for a year often means you don’t go back.

But not for Sarah, engaged to a principal dancer, she wasn’t far from the dance world and in 2008 moved from New York to Seattle for her future husband’s career. The stage began calling and Sarah asked for an audition at PNB as well, in just 3 weeks of getting back into the studio, she had her audition and subsequently, a job offer.

From 2008-2012, Sarah and husband Seth, a principal dancer with PNB, enjoyed marriage and dance together. Then in 2012 they went into parenthood with careful planning. Looking at the season schedule, they tried to time the pregnancy, birth, and postpartum recovery just right and lucky for them, their plan worked. Sarah’s last performance with PNB before she gave birth was in the Nutcracker near the end of her first trimester. At that point, also enrolled in college classes, Sarah worked in the marketing and communications department of the company as an intern until the home birth of her daughter Lola on May 15th, 2013.

Sarah took 8 weeks to just recover and babymoon. She didn’t even think about returning to physical activity in that time, just respected her body’s need for rest and both her’s and Lola’s need for bonding. When I asked her about that time and how she approached that time and the time after she said “My body created this life, I didn’t really lose the weight at first, I wanted to hold onto it. It was important to enjoy this window of time and my body had already done so much for me as an amazing vessel, I wanted to be gentle with it. I was never going to feel the same again, I couldn’t go back to what my body was before having Lola and maybe that’s ok.”

Certainly her body was changed forever and her desire to breastfeed was one very obvious change for her body. Breastfed herself until she was 3 years old, a year before starting her what would be training for her professional career, Sarah was confident that she would breastfeed her own children. Seth was on board and willing to do what he could to support her in reaching her goals and Sarah prepared for returning from maternity leave by communicating with Peter Boal, artistic director of Pacific Northwest Ballet, that she would be breastfeeding and it was a priority. While the administrative side of PNB had provisions for breastfeeding mothers in the office, there hadn’t been many ballerinas that required accommodations for pumping. Still, willing to learn and having had some experience with a few ballerinas before, Mr. Boal and the company were ready and willing to support Sarah.

Sarah Orza Breastfeeding ballerina

Sarah Ricard Orza with husband Seth Orza and daughter Lola ©Lindsay Thomas, Pacific Northwest Ballet

When she returned to the company in the fall of 2013 arrangements had been made and flexibility was required of everyone. The community of the company was supportive and not only did Sarah get back in shape, the 2013-2014 season found her cast as a soloist in some impressive and demanding roles including the Lilac Fairy in Sleeping Beauty and one of the most demanding roles in classical ballet, Giselle in spite of hiccups along the way. Early on, as she was working on toning and becoming familiar with this new version of her body, Sarah often found herself in a nearby closet during class time pumping her milk and missing out on the grande allegro portion of the class. This impacted her jumps resulting in this strength of hers a temporary weakness. Sometimes the cast would have to wait for her for rehearsals but they would take advantage of the opportunity to work pieces without her. During performances she would pump in the dressing room as needed and the other ballerinas got used to seeing Sarah hooked up to the pump expressing her milk. “I had two full time jobs plus being a mother, pumping and dance, I worked at both of them full time.” With videos and a piece of Lola’s clothing she tucked into her dance bag, Sarah found that she responded well to the pump even with all the demands she put on her body as an athletic artist.

But between the support of her husband Seth, her mother staying with Lola close enough to the theater and studio for Sarah to run home during the day to breastfeed some of the feeds, Peter, and the rest of the PNB family, she was able to make it work, not only being able to exclusively breastfeed (with her pumping when she was away from Lola) but pumping enough to donate. It wasn’t long before Sarah’s jumps were soaring again too.

Sarah made it clear that she knew going into this that she was willing to sacrifice to make it work, her breastfeeding goals were so important to her that she would skip going back to work if necessary. With a mixture of pride and gratitude Sarah explained it didn’t come to that because of the support of Seth as a very hands on dad, support from her mother, her boss Peter as the artistic director of the company, and her coworkers understanding that her lactating didn’t impair her dancing. What kept her going she said: “I’ve kept my eye on the prize, Lola, her health and safety all along.”

Sarah Ricard Orza with daughter Lola ©Lindsay Thomas, Pacific Northwest Ballet

Sarah Ricard Orza with daughter Lola ©Lindsay Thomas, Pacific Northwest Ballet

And it’s Lola that inspires her in continuing to take leaps in her dance. Sarah isn’t done with ballet, at 33 years old she has quite a few good years still ahead of her and she’s working hard pursuing her career goals along with her family goals. “It’s not worth leaving Lola if I don’t push myself. I’m going to keep reaching, I love ballet and I love my daughter, I have to commit myself fully to both to make it worth the sacrifices required. Both Seth and I do.”

Sarah has been a leader within the company regarding maternity policy and breastfeeding. This year three other ballerinas were expecting little ones and there were open conversations about breastfeeding in the studio and dressing rooms. PNB was ready and prepared to have appropriate accommodations in place for these dancers should they need space to pump for their babies as well.

Lola and Sarah are still breastfeeding, Sarah plans to let Lola wean when she’s ready. This next season Sarah isn’t planning on pumping backstage as Lola has taken to solids just fine and is well over a year. But that breastfeeding bond is still special for them right now.

When I got to go back with my eldest to Seattle to see Sarah dance as Giselle this past spring, I was moved to tears by her performance. The grace, strength, and dedication as she played the role of a young maiden driven insane by love lost and then sacrificed herself as one of the mysterious willis dancing all night to keep the man she loved alive, I forgot during the performance that she is also the mother of a sweet little girl. Her dedication and passion for her craft made it so all I saw was the heartbroken Giselle on stage. When I got to hug Sarah following the performance, all I saw was the sweet dedicated mother with a passion for her daughter.

Sarah will be onstage again this year at Pacific Northwest Ballet and I’m certain I’ll be making the drive from Portland to Seattle to be mesmerized by her performance again. To get tickets to a performance, visit pnb.org. You can also find Sarah pictured on PNBs Facebook and Instagram as well as on her own Instagram.

 

Sarah Orza breastfeeding ballerina

Sarah Ricard Orza with daughter Lola ©Lindsay Thomas, Pacific Northwest Ballet

 

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How has your place of employment supported you in your breastfeeding journey? How did your coworkers respond? What do you think would help more women reach their breastfeeding goals while maintaining a presence in the work place?

________________________

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Why Black Breastfeeding Week Is Important To Me

by Carmen Castillo-Barrett

Carmen Black Breastfeeding Week

I am an immigrant Dominican mother, with African American roots on my father’s side. My husband is of Caribbean decent. We got pregnant with our daughter in 2006. The almost 42-week pregnancy allowed my husband and I time to explore and talk to each other about parenting. We decided we were going to do things differently than how the rest of our family did them simply because it’s what works for our family. We expected to be met with lots of questions and lack of understanding as to why we were doing things differently, but I was certainly not prepared for the ongoing negativity that was associated with our decision for me to breastfeed. I am not the only one who shares this experience. Below are just some of the reactions I got and reasons why Black Breastfeeding Week  is important.

1- “You’re going to kill your baby”
At four weeks postpartum, my mother-in-law began to express concern over the fact that all my newborn had to eat was breast milk. I’d done enough research while pregnant to know that breast milk is all an infant needs, but the research never heeded any warning about being confronted with the accusation that I was going to kill my baby by exclusively breastfeeding. My mother-in-law’s concern was real to her because she didn’t know any better. She called relentlessly, offering bad advice that wasn’t solicited, all while expressing concern that there was no way my daughter has getting the nourishment she needed. This was the most significant obstacle I’ve faced as a nursing mother and it ultimately undermined my confidence and affected my decision to discontinue nursing my daughter.

2- “You’re still breastfeeding?!?”
This question started popping up around the time both kids turned 6 weeks old. Both sides of our family saw no need to continue nursing past six weeks of age and thought that the natural progression of things was to introduce formula. My mother had no experience nursing a baby past trying it out for a couple of weeks with me, so her contribution to my growth as a breastfeeding mother was to state that the baby was now “old enough for formula” and I was now “finally free” to stop breastfeeding. There was no real reason why everyone thought I should wean, it was simply a matter of never having seen a non-white mother nursing past the immediate infancy phase.

3- “What? You can’t afford formula?”
When my daughter was two months old, we went out to lunch with my husband’s cousin and his wife, whom had two children of their own. While at the restaurant, my daughter needed to eat, so I discreetly breastfed her at the table. No one at the table batted an eye, but just as I was feeling confident that my nursing in public wasn’t a big deal, I was met with the question of “Why are you still breastfeeding? You guys can’t afford formula?”. I was so mad! Worse still is that when I called my mom about it, she felt the comment was perfectly justified and offered to send me money for formula. Somehow, my breastfeeding was seen as a reflection of our economic status rather than a conscious decision on how to feed our baby.

4- “You’re just trying to be white.”
A common way to dismiss a non-white mother’s parenting choices is to wave them off as her “trying to be white”. This comment is applied to much more than breastfeeding. If you are a non-white mom who co-sleeps, uses cloth diapers, has a home birth, employs a doula, teaches your baby to sign, or does anything outside of the “normal” things a non-white mom is “supposed” to do, then your parenting choices aren’t seen as something that simply works for your family, but a desire to leave behind your true roots to pursue one’s desire to emulate a white mother. This label is applied to non-white women of all shades as a means to shame, ignore, undermine, second guess, disrespect, and pigeonhole our choices to parent as best as we can.

5- “Your baby has teeth, that means it’s time to wean.”
By the time my daughter got her first tooth at 9 months, I was no longer nursing. My son, on the other hand, started getting teeth really early at barely four months old. I made the unfortunate mistake of posting a picture of him grinning with his new itty bitty baby teeth on Facebook. The immediate and overwhelming response from both sides of the family (and some friends) was that it was time to wean because “obviously” his incoming teeth meant it was time for “real food”. Up to this day I’m still unsure what “real food” I was supposed to feed a baby that young.

6- “You’re going to turn him gay.”
While it’s a scandalous thing to say to anyone, this last comment is particularly held as true among Caribbean families. Due to bigotry embraced by both older and younger generations and stubborn cultural superstitions, many Caribbean families believe that one can be “turned” gay and that nursing one’s son past a certain acceptable age will contribute to their sexual orientation. The lack of support and obstacles I faced when nursing my daughter were nothing compared to the outright hatred that the possibility of me nursing my son into a batty boy brought out in members of our family. This is why, after 7 months of exclusively nursing my son, I started pretending that I had weaned him. Only my husband and close friends knew that I was still breastfeeding.

Imagine if your entire breastfeeding experience was framed by the comments I listed above. How successful do you think you could be? This is why Black Breastfeeding Week is so important.

Carmen Castillo-Barrett is a wife and mom who resides in Brooklyn, NY. She is the Executive Director of the non-profit organization, Kiddie Science.

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When your older, weaned child asks to breastfeed

by Jessica Martin-Weber

Today my 4 year old Smunchie who hasn’t breastfed in quite some time, asked for bobbies.  She hadn’t been feeling well all day and though it had been a while since she had breastfed, it was obvious that she found even the idea comforting.  Her eyes wide and a seriousness about her, she implored for some mama milk.  I offered to try to express some into a cup for her and the tiny bit of hope in her face dropped as she said ok but she really wanted to try to get the milk herself.  Without missing a beat, her two year old little sister rushed over, hands out, and screamed “my bobbies!”

Yes, my children were fighting over my boobs.

I gently reminded 2 year old Sugarbaby that they were my bobbies but that I share them and decided to invite both girls to cuddle up to nurse.

IMG_8849

I expect this post will make some people uncomfortable but we need to talk about it anyway.

Sometimes, older, weaned children will ask to breastfeed.  Whether it be a new baby added to the family or just what seems a random interest, it’s not unusual for a child to see breastfeeding and want to give it a try.  They may be quite insistent or perhaps shy and act embarrassed.  It may come when you’re sitting there feeding their younger sibling or when they get a moment alone with you.  There is a possibility that they are more than a little curious and will want to re-establish a breastfeeding relationship.

Before you freak out (probably too late), keep in mind that children don’t have a developed sense of sexuality or even what makes something sexual.  Unless the child is more like a teenager, the interest in breastfeeding has more to do with curiosity than sexual confusion.  Even though adults in much of westernized society place a heavy emphasis on the sexual function of the female breasts over the nutritional and nurturing functions, children just don’t see it that way so you can take a deep breath and know that there is nothing wrong with your child, they’re just a normal child with normal curiosity.  Breasts are another body part made intriguing by the fact that children have yet to develop breasts themselves and if a child encounters breastfeeding and had it explained to them without shame, they are going to understand breasts as a food source rather than identifying breasts for sexual pleasure.  Please note: gender identity, the differences between the sexes, perceived gender roles, attachment, emotional bonds, body autonomy, and understanding appropriate touching is developing from infancy.

And no, feeding children well past infancy into early childhood is not messing them up.  You don’t have to worry about psychological damage from breastfeeding past one or two years old.  That myth has totally been debunked both through scientific research and anecdotally by many older children and adults that remember breastfeeding at such an age.  Read one such account from an outspoken 12 year old who breastfed until she was 4.

If their sexual awareness has yet to develop, they don’t yet buy into society’s emphasis on female breasts primarily as sex objects, and it’s not messing kids up to breastfeed well beyond the 1st year of life, how should we respond?

With patience.  With love.  With acceptance.  With gentleness.  Without shame.  Without fear.  Without judgment.

As is often the case, the manner with which we respond to our children is more important than what we actually do.  If your older, weaned child asks to breastfeed, saying yes or no is less important than how you say it.  Before you respond, ask yourself what your reaction could be communicating to your child.  Is it loving?  Does it communicate acceptance? Or is it expressing shock and disgust?  Could they confuse your response as a rejection of them?  That they did something wrong?  That breastfeeding is shameful?

What should you do if your older, weaned child asks to breastfeed?  I have no idea.  Whatever is right for you.  I would just encourage you not to rush your decision, take a moment and reflect on why or why not you may be comfortable with that.  With older children, a conversation is usually possible and a reasonable place to start.  Involving them in a conversation as part of your decision making could be a bonding experience for you both.

Your decision is completely up to you and your personal boundaries.  If you’re not comfortable letting your older, weaned child breastfeed then don’t.  If you think you may be ok with it, then let them.  Your boundaries and modeling bodily autonomy is important too and an older child is capable of understanding such boundaries.  If you decide you’re comfortable with it and even want to encourage them to relearn how to properly latch (yes, that is an option) and that works for both of you, that can be significant journey as well.  Whatever you decide, just do so gently and you’ll both be fine.

My two eldest children never expressed an interest in breastfeeding once they weaned, not even when siblings were born.  Curiosity and copying with their own babies (dolls), absolutely, but they were never interested in trying to breastfeed for themselves.  Since then though I’ve had each of my 4 younger ones ask to try.  It weirded me out at first and I refused but that particular child began to ask repeatedly every time I sat to feed her younger sister and eventually I decided I didn’t actually have a good reason not to.  Having such a large child at my breast (she was 4) seemed strange to me but it only took one try and then a polite thank you with a hug to make me realize that was about my issues and what I considered normal than it was about somehow being wrong.  She did enjoy having my milk in a cup for months afterward though and that was something that meant a lot to her.  The most common reaction my children have is to have no idea what to do at the breast, attempt a couple of sucks, giggle, pull away, and inform me they aren’t babies any more and “bobbies are for babies.”  Sometimes they do get milk and don’t like the taste.  Even if they are interested in trying again, once their curiosity was satisfied they were happy to move on and leave breastfeeding to babies.

But that’s not what has happened with my current 4 year old.  She returns every so often to the breast, has even figured out that if she can get her little sister to start on one breast and then switch after let down, it’s easier for her and she’ll get more milk.  It doesn’t happen often, increasingly less and less, but she does still ask from time to time.  This time, after latching and not getting any milk, she decided she was good with just a cuddle.

“I like your milk, mommy, but I like your cuddles best.”

For us, it was worth letting her try.

breastfeeding the weaned child

 

___________________________

What do you think you would do if your previously weaned child asked to breastfeed again?

___________________________

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We’re Moving!

by Jessica Martin-Weber and Amy West

Leakies, we’ve got something really special for you. We’re talking about #BFingPlaces (Oh!  The Places You Go!) for World Breastfeeding Month and we’ve taken it one step further. Literally.

We have every reason in the world to be physically active; heart health, longevity, reduced health problems, strength, endurance, lower blood pressure, stronger bones, joint health, mental clarity, better sleep, and decrease in depression and anxiety to name a few.  Several studies show that people who exercise more are just happier.  Which has always baffled me personally since exercise is kind of the opposite of happy for me.  Still, I know it’s good for me so I’ve tried to do it regularly and felt guilty when I didn’t.

With having children though, juggling family, home, and work (and yes, even when I didn’t have a job), getting exercise in is often an overwhelming challenge.  Between the media, “experts,” bloggers, friends, family, health care providers, and yes, even myself saying what is so important for children, there are just so many other aspects of a child’s development that require my attention.  There is every reason in the world to not be physically active; reading to our children, providing quality meals, addressing their social needs, researching all medications/foods/education, shopping to have the “best” deals on the highest quality (but the blanket MUST be organic, what about off-gassing?!), spending quality play time with our children, limiting screen time, grooming them, keeping house, bonding, learning and executing proper child passenger safety (installing that perfect car seat that took 3 weeks of research and a small loan to purchase) and being sure every minute of their every day is filled with only the best developmentally appropriate activities.  With all that’s on our plates, how do we find time to be physically active?

But really, how can we not?

We have perfectly legit reasons to not be moving and perfectly inspiring reasons to get moving.  It’s not easy sometimes but it’s definitely worth it.

I was born with a minor heart condition, something I’ve lived with all my life.  Doctors have told me that keeping my weight in a healthy range and staying physically active will go a long way in taking care of my health and sure enough, I can tell when I’ve put on a few too many pounds, have let inactivity sneak into my routine, or am lazy about my water intake.  I try to make it a priority but I’m just not crazy about most forms of exercise.  I’m not the type to become a health nut, I’m not likely become an exercise fanatic, and I don’t like exercise for exercise’s sake.  Something else has to motivate me to get off my butt and get moving.

Turns out I have 6 really talented motivators.  I want to be around for a long time to be with my children and eventually my grandchildren and I can’t afford to wait to get started.  They inspire me and not only for my own health, but for the health of my whole family.  And now they’ve inspired me to share that motivation with you!

Actually it was Amy West’s idea, she came to me about how regularly taking walks was helping her in her immediate postpartum time.  Her mood, emotional state, and energy levels went up as she walked with her two kids, Ava and Luke.  I agreed and we wanted to find a way to share it with the Leakies and their families.  And with that, #TLBmoves was born.

It’s time for #TLBmoves!

And I hope you’ll get moving with me for your own reasons.

Are you a runner? Walker? Cross-fit fan?  Couch potato looking to change? Or maybe you just want to be screen-free a little more often.

Whatever your goal, you can join us for #TLBmoves!  This is all about embracing an active lifestyle and making healthier choices, no matter where you’re starting from.

Us? We’re starting by walking more. Just the simple act of taking a daily stroll can do amazing things for your health–both mental and physical! Our initial goal is to log a minimum of 10 miles (about 15,000 steps) each week, or 30 very active minutes each day, but you can set virtually any goal that’s important to you and participate in any way you’d like! (Quit smoking, play with the kids more, eat more veggies, do jumping jacks at your desk, living room dance party – anything goes!)

If you’re already doing that (or more), awesome! Whatever YOUR goal is, we want to see you reach it. #TLBmoves is not a fitness campaign; yeah, we’re talking about steps and activity, but the bigger goal here is overall health and happiness. You can participate at whatever level is comfortable for you: walking, jogging, running, cross-fitting, swimming – anything. (#TLBmoves is aimed at all moms of all backgrounds and is not limited to or specifically endorsing those who breastfeed.)  And we’ll never ask what’s your excuse, we know we all have great excuses so we understand that it’s one day, one step at a time to reach your personal goals.

#TeamTLBmoves! Meet the four mamas who will be sharing their #TLBmoves journeys during the month of August:

Jessica: Founder, owner, and author of The Leaky Boob Facebook group and website; mother of six girls, ages 2, 4, 6, 11, 13, and 15.

Amy: Writer (www.amywest.co); mother of two children, a five-year-old daughter and a three-month-old son.

Kileah: Member of the TLB Reviews editorial team; mother of four children, ages 6, 4, 2 and 8 months.

Elise: Member of the TLB Reviews editorial team; mother of one two-month-old son.

Meet our partners:

#TLBmoves is a big undertaking and we are so thrilled to be working with brands we believe in to bring you this event. Our partners really want to see moms getting active and enjoying a healthy lifestyle with their families! We’ll be sharing tons of photos of #TeamTLBmoves using gear from the following brands:

Joovy

JoovyWe are all about taking small steps to a healthier lifestyle – literally! Going for a daily walk with the little ones is one of the cornerstones of what we’re doing. Joovy has partnered with us to feature four of their kick-ass strollers, which we will put to to the test over the next month. You’ll see the TooFold, Qool, Caboose VaryLight, and Zoom in action. From the big kids to the littles, Joovy is making it easy (and whine-free!) to stroll with the whole family.

tula

Tula Baby CarriersWe aren’t just pushing our little ones in the strollers – we’re going to wear them, too! Whether it’s in the uber comfortable Standard or Toddler carrier, or in one of Tula’s amazingly gorgeous woven wraps, we’ll be wearing our babies throughout the month as we get out and move! Where will the #TULAlove turn up next? Stay tuned…

thinkbaby thinksport

Thinkbaby and ThinksportIt’s August, so the weather is hot. A big part of #TLBmoves is getting active outdoors (work that natural vitamin D!). A good, safe sunscreen and water bottles are necessities. Thinkbaby and Thinksport care as much as we do when it comes to keeping our families safe from harmful chemicals. We’re staying hydrated and keeping sunburns at bay, minus the endocrine disruptors!

When?
#TLBmoves will run from August 1st-31st, 2014, but we hope you’ll keep moving long after the end of the month! (We may have something up our sleeves to that end, too!)

How?
Participation is on the honor system. Counting steps can be fun, but the point isn’t a number (on a pedometer, scale, or otherwise) – it’s making healthy choices and becoming more active in general. It’s all about feeling good! Moms can track their activity via whatever means they choose. (You can use a FitBit, another pedometer, you can time three five-minute songs for a dance party in your living room – it’s up to you!)

Where?
Anyone, anywhere can participate! We’ll be announcing some fun prizes from our brand partners, and those are limited to the United States at this time, but the world is your oyster if you want to get active with us!

JOIN OUR PRIVATE FACEBOOK GROUP (Please note: this is a co-ed community where you’ll find support as we get active and make healthy choices together. Judgement free! Come as you are, this group is your #TLBmoves tribe!)

JOIN OUR FITBIT FORUM (The four #TeamTLBmoves mamas will be using FitBits to track our steps! They’re totally optional, but if you want to use one, you can grab yours here: http://bit.ly/TLBfitbit.)

Who?
You, your friends, your kids, your partner, your boss, your mom, your dad… anyone!  Though The Leaky Boob is focused on encouraging families primarily through breastfeeding, we support breastfeeding moms and everyone that supports them.  Breastfeeding isn’t a requirement to participate with TLB and #TLBmoves.  (If you are breastfeeding and you’re wondering about exercise and breastfeeding, we have an article all about that here.

We’ll have more updates soon – in the meantime, please follow TLB on Instagram to keep up with #TLBmoves. Use the hashtag #TLBmoves on Instagram, Facebook, and Twitter to share your pics. We want to see what you’re doing to MOVE, mamas!

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Leaving the parenting island and asking for help

by Jessica Martin-Weber
Parenting Island and asking for help

Parenting Island AKA Poop Rock.

 

I was struck by the beauty of that island looking rock from afar on the shore in San Francisco.  Then my friend told me it was so pretty because it was covered in bird poop.  Poop Rock.  Reminded me a lot of parenting, pretty from afar but sometimes lonely and covered in poop when you get up close.

Don’t lecture me, I know parenting is wonderful, I love it but that doesn’t mean it’s not sometimes really hard and stinky like a rock covered in poop.

Last week, my good friend Cindy was battling pneumonia.  It was horrible and scary.  Her husband is in the military and away at the moment so she and her 4 children are on their own as she struggles to get well.  I couldn’t get to her, we’re over 8 hours from each other in different countries, but I wish I could.  Every time I saw her share something of her struggle I was moved, inspired, and ready to jump in the van (that broke down 4 days after I wrote this).  Through Facebook, I feel like I get to keep up with my friend and in some small way offer support.  I wish I could do more.  Yet even so sick and all the way in Canada, my friend reminded me of something incredibly important: we all need help from time to time.

Asking for help is one of the hardest needs to voice sometimes.  Or all the time.  People judge and are judged for even needing help and we all feel it.  There is such shame attached to needing help or even encouragement.  We’re all supposed to pull ourselves up by our bootstraps and in made for TV moments, triumph over whatever challenges we face.  Alone.  Without resources.  Without bragging. Without getting anything we don’t deserve because by our own blood, sweat, and tears we paid for it or worked for it or fought for it all on our own.  We talk about the strength of the human spirit and applaud those that figure out how to go it without help.  And anyone that is worn out, broken down, or overwhelmed must be less of a person.  Even in a safe place, like The Leaky Boob Facebook, mothers (and sometimes dads too) may take the bold step to admit they are struggling but do so with trepidation, beating themselves up for being a “horrible parent, feeling like a failure” before someone else does, all because they find parenting hard sometimes.

This cultural attitude of glorifying individualism and self-sufficiency is hard enough when children aren’t involved, but when we become parents it’s not just us any more.  Our pride can get in the way of seeking out desperately needed help.  Pregnancy and childbirth set the precedent in parenting without help and while I love doulas and highly recommend having doula support for birthing women (I have for mine), traditionally the role wasn’t a paid position but one filled by a family member, friend, or a member of the community.  There seems to be a growing sense of shame in needing help from someone who isn’t designated as a paid professional.  We see it in infant nutrition all the time, mothers struggling but too embarrassed to admit breastfeeding isn’t working as well as it “naturally” should as she struggles with pain and a frustrated baby or families not knowing where to turn when they need an alternative.  In fact, the number one reason mother’s don’t reach their personal breastfeeding goals is lack of support.  Support = help.  But it certainly isn’t isolated to the area of infant nutrition, pregnancy, and child birth.  Parenting dilemmas such as health care, child care, discipline, education, financial stress, housing, safety, you name it, are often hindered by our own pride in asking for help.  As though needing a helping hand occasionally, let alone for a long season, is an indication of inadequacies or failure.  Afraid it reflects badly on us and our abilities, many parents forgo voicing their need for support and actual help because we know people will say things like “you shouldn’t have had children if you couldn’t handle it” (what are parents supposed to do, put the kids back from where they got them?), we suffer quietly and so do our children.  Sometimes it’s major roadblocks that threaten the health and safety of the family, particularly the children, others deplete personal internal resources and reinforce feelings of failing over every day aspects of parenting that may wear us down.  Either way, while learning to deal with hardships and having the experience of overcoming them on our own once in a while can be empowering, is this isolation really what we want to be the norm?

But the truth is we all benefit when we help each other, yes, even when we admit we need help and ask for it.  Not only individually are we strengthened, our communities are too.  It can be risky though, by admitting our struggles, we’re opening ourselves up for criticizing judgment or worse, being ignored and that is more than hard, it’s down right terrifyingly heart breaking.  Most parents would do anything including swallowing their pride to care for their children, there’s not a job we wouldn’t work or begging we are above when it comes to the safety and provision of our children.  That fear though, the fear of judgment or of not mattering enough for someone to even notice, can be paralyzing and parents may, unintentionally, cause suffering for their children simply because the cultural attitudes about asking for help have effectively silenced them for issuing the call when most needed.  Yet almost no parent would say their child deserved less.

Asking for help is something I continue to grow in along with knowing how to offer help, carefully avoiding judgment.  Including learning how to have grace without judgment for myself.  The journey hasn’t been easy and I’m still learning.  How does one master admitting you can’t do something on your own?  That you don’t have it all together and need others?  I’m not sure yet but I know it has gotten easier for me simply by looking at my children, I never want them to be afraid to ask for my help when they encounter difficulties.  They have not only been my inspiration in seeking out help when I need it, but sometimes my teachers.  They have shown me the joy that comes from helping and being helped, the agony that comes from pride getting in the way.  From communicating my need for help during difficult pregnancies to admitting I don’t know how to handle certain parenting situations, to finding a mentor in understanding child development when my children were driving me crazy to even asking for financial support because we lack the funds required to help our daughter reacher her dreams, though Jeremy and I work hard for our family, admitting we can’t always do it on our own and that we’re not an island but in fact need the village, our children are the ones that have benefited the most from us humbling ourselves to say three little words: “help me please.”  Accepting our limitations is the first step in being able to strengthen each other.  I firmly believe that in strengthening, supporting, and yes helping, parents makes for a healthier community that is stronger, more creative, and more skilled.  What a gift we can give our children.

My friend Cindy, has posted on Facebook a few pleas for help with her children so she can rest.  Yes, she could keep trying to go it on her own, likely prolonging her illness and a lower level of care for her children while she tries to recover.  There are risks to her not recovering, potentially problematic for those around her.  Worse, she could end up in the hospital and her children in the custody of someone else for an indeterminate amount of time.  It is to her health benefit, the benefit of the health care system, the benefit of her children, and the benefit of her friends for her to ask for help.  Her recovery will be aided and the community circles around her will be stronger as a result.  Relationships are being fortified as her friends respond to her pleas and offer their support not only physically but emotionally and spiritually as well.  I am so incredibly proud of her asking for help.  Knowing her personally I know that she is a capable, strong, and hard working woman, talented as a journalist and an attentive and loving mother.  This moment of needing help (and the next one that comes her way) are not a reflection of her capabilities, simply a moment where her humanity is evident.  And she has already paid it forward and will do so again.  Because she gets that we need each other.  We all do.

 

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Breastfeeding, Autism, Sensory Processing Disorder, and Oral Phase Dysphagia

This guest post shares a look from the perspective of a mother with a 5 year old son with neurological disorders.  Jeanie decided to share her story after seeing a thread on The Leaky Boob Facebook page asking about breastfeeding issues as potential early signs of neurological issues in an infant.   Whether you recognize yourself and/or your child in

autism and breastfeeding

My name is Jeanie and I am the author/page admin for a blog and Facebook page called Reinventing Mommy, which is all about raising my 5 year old son with Autism and multiple neurological disorders. I want to share my story in hopes that others will learn that feeding difficulties can be an early red flag for developmental concerns…

My son Jack was born on March 23, 2009 after 28 hours of labor which resulted in an emergency c-section. I had preeclampsia during the last 4 weeks of my pregnancy, so Jack was born at exactly 37 weeks. Due to the nature of my delivery, I wasn’t given the opportunity to nurse my son in the recovery room. No one even suggested it. I didn’t know it was even an option. 

The first time I nursed Jack was in our postpartum room. One of the floor nurses tried to assist me in latching the baby on and – for all I knew – it was going great. The nurse mentioned that she would be sending lactation in to see me ASAP the following day (it was nearing 11:00 PM); her reasoning was that babies born prior to 38 weeks got an automatic referral to lactation. She suggested that I send the baby to the nursery that night so I could recover a bit further, and that the baby would be brought to me to nurse. I agreed. 

The next day a lactation consultant came in. I was planning to show her just how great I was doing nursing my baby – clearly I didn’t need her at all! – but instead I was told that not only was my son not latching on at all, he wasn’t sucking properly. This began a journey of using a nipple shield, suck training, and an every 3 hour schedule of nursing Jack for 15 minutes per side then feeding him a supplemental bottle then pumping for 15 minutes. All this while recovering from major abdominal surgery. Every day I was hospitalized, lactation consultants were in and out trying to assist me. 

When I was discharged, lactation continued with phone consults. Jack’s pediatrician was of little help. No one ever said that Jack wasn’t eating normally. I just thought that this was what everyone went through. I was constantly assured that all babies can breastfeed and that I just needed to work harder. The pressure on me was enormous. I felt like a failure. 

Then came the day that Jack refused to take to the breast at all. He simply would not open his mouth for the nipple shield at all. My milk was drying up from the lack of stimulation and Jack wasn’t gaining weight, so we finally gave up and moved to a bottle and formula. 

The problem was that Jack’s feeding issues didn’t resolve with the bottle. Now that he was actually taking in liquid, he began to vomit his entire meal about 5-6 times a day. When I mentioned how much he would “spit up”, I was told that the amount really was probably no more than a couple of tablespoons. What no one truly understood was that he could fill a bowl when he spit up. No one listened when I voiced my concerns that Jack’s eating behaviors didn’t seem typical. Again, I felt like a failure as a mother, because I couldn’t do something as simple as feed my own child. 

At the age of 24 months, Jack was only able to eat purées. He couldn’t self-feed. He was nonverbal. He couldn’t climb stairs or jump. The only sounds he produced where grunts. He spent his days pacing the room and flapping his hands. He was diagnosed with Autism and – finally – someone was willing to listen to our feeding concerns. 

Jack’s developmental pediatrician and his therapy team listened to us, and we got names for what we were seeing – Oral Phase Dysphagia, which is a neurologically-based lack of coordination of the chewing and swallowing mechanisms, and Sensory Processing Disorder. Jack literally didn’t have the muscle tone in his facial muscles to chew foods, he couldn’t manipulate foods in his mouth, he couldn’t coordinate his chewing with his swallowing, but this was all assuming that we could get the food in his mouth in the first place because he was so defensive. In many ways, it was vindication in that I was not a failure as a mother, but my heart sank at knowing that my little boy had such a long road ahead of him. 

Fast forward to now…I just gave birth to my second son 8 weeks ago. My one fear – even more than him having Autism as well – was that he would have similar feeding problems as his brother. That has not happened. My new baby Andrew nurses like a champ. 

As for my sweet Jack, he works harder than any person I’ve ever known. He is an inspiration to me each day. He now speaks, though he still has a significant speech delay. He can eat foods that are either very crisp, like crackers, or bready foods. He eats about 6 foods consistently and several others intermittently. He will continue to require feeding therapy for years, but he is making slow yet steady progress. 

If there is one thing I could pass on to others about feeding concerns, it would be this – go with your gut and trust your instincts. If you feel like you child is truly struggling with feeding, don’t let doctors or anyone deter you from looking into it further. Contact Early Intervention services in your county for an evaluation, or get your child evaluated by a feeding therapist. With therapy, many children with feeding issues can expand their food repertoires, learn to enjoy eating, and become more proficient eaters.

 

Editor’s note: Does your child have a sensory processing or neurological challenges? Do you feel that has that impacted your feeding experiences? Sometimes breastfeeding problems aren’t breastfeeding problems but actually indicators of something else. I’ve heard from several moms of the last 4 years that have tried everything in addressing their breastfeeding struggles only to discover years later that there was (seemingly unrelated) neurological issues. From somewhere on the autism spectrum to high sensitivity, they have wondered if there is a connection. Maybe baby refuses to latch or latches all the time and overwhelms mom with constant breastfeeding. While it may be something else entirely, some moms do see there is a connection later on when their child is older.

I would love to hear from you if this has been a part of your journey, please comment below, share your thoughts, and if you’d like your story to be included on the website, please email content@theleakyboob.com. Thank you all so much!

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Hyperemesis Gravidarum and Ondansetron: a critical response to media coverage

by Kari Swanson

In the interest of full disclosure: I am the survivor of two pregnancies with Hyperemesis Gravidarum during which I was given Zofran and/or ondansetron. Both of my children, currently ages 9 and 4, are developmentally normal, with no health problems attributable to my use of ondansetron.

 

Birth defects from Zofran in pregnancy

A recent headline in the Toronto Star proclaims in bold face “Birth defects blamed on unapproved morning sickness treatment.” The lengthy piece about the drug ondanestron, which is sometimes prescribed off-label to women with Hyperemesis Gravidarum (HG), is written as an exposé of drug companies and physicians gone wrong, the result of which is “vulnerable” pregnant women being prescribed a harmful drug that causes their babies to be born with extraordinary birth defects as a result. This would be horrifying if it was true, of course, but, it’s not. This article is not a scientific article. It is not a scientific literature review. It is pseudo-scientific sensationalism. One might think the goal of such an article would be to protect women and children, but like most pseudo-science involving medicine it presents very real public health risks.

According to the Hyperemesis Education & Research Foundation web site, HG is

“…a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with:

  • loss of greater than 5% of pre-pregnancy body weight (usually over 10%)
  • dehydration and production of ketones
  • nutritional deficiencies
  • metabolic imbalances
  • difficulty with daily activities”

HG is not morning sickness. HG is just plain sickness. In my first pregnancy there were many days when I vomited in excess of once an hour. I lived with constant nausea. I vomited before getting out of bed when I woke up in the morning. I vomited in the shower. I vomited on the side of the road while driving to work. I vomited in my flower garden while weeding. I believe my record was 38 times in one day. I vomited so violently and so frequently at one point that tiny blood vessels broke in my face and eyes. It certainly wasn’t the pregnancy glow I had envisioned.

I tried all of the remedies that everyone, including my obstetricians, suggested: crackers, sips of water, lemon, ginger ale, ginger tea, ginger snaps, candied ginger, extra vitamin B, extra sleep. Nothing worked. I lost weight. At 3 months pregnant I weighed about 11% less than I did before my pregnancy. I had several visits to the ER for IV hydration. More than half way through my pregnancy, after an all-night stay in the ER for IV fluids, my OB finally prescribed Zofran. For me it was a miracle drug, because it meant that I was able to keep at least one meal down every day. It didn’t completely eliminate the symptoms, but it did make them much more manageable. When I became pregnant again 5 ½ years later and started vomiting numerous times every day at 5 weeks pregnant I asked for Zofran. I still experienced nausea and vomiting throughout my second pregnancy, but nothing like I experienced the first time. I only required IV hydration in the ER once the second time around.

HG presents serious risks to a woman’s health. Complications of HG include: dehydration, malnutrition, damage to tooth enamel, renal failure, jaundice, ruptured esophagus, and deconditioning of the heart muscle, just to name some. Some of these complications can be and have been fatal. In addition, HG can cause long term health effects. Some women experience PTSD. Others, like me, develop complications of their complications: prolonged dehydration caused me to develop kidney stones.

HG also presents risks to the child. Fetal complications of HG include: premature birth, low birth weight, neural tube defects, and congenital heart defects, among others. Also, according to the Hyperemesis Education & Research Foundation, “…prolonged stress, malnutrition and dehydration in the mother can potentially put an unborn child at risk for chronic disease (e.g. diabetes, heart disease) in later life.” And, HG can also cause fetal or neonatal death.

Clearly Hyperemesis Gravidarum is a serious health condition. It is not something that can be or should be ignored or treated lightly. Women die. Babies die. When considering treatment options, women and their healthcare providers must weigh the benefits and risks of particular treatments. The decision is not about a minor inconvenience. It is very often a matter of mitigating potential harmful or life-threatening effects.

The Toronto Star article cites data recorded in the US Food & Drug Administration (FDA) Adverse Event Reporting System (FAERS). The reporters cite this data as if it presents irrefutable proof that ondanestron is a dangerous drug that caused harmful effects to babies. But, the truth of the matter is it does no such thing. The FDA states on the FAERS site:

FAERS data do have limitations. First, there is no certainty that the reported event (adverse event or medication error) was actually due to the product. FDA does not require that a causal relationship between a product and event be proven, and reports do not always contain enough detail to properly evaluate an event. Further, FDA does not receive reports for every adverse event or medication error that occurs with a product. Many factors can influence whether or not an event will be reported, such as the time a product has been marketed and publicity about an event. Therefore, FAERS data cannot be used to calculate the incidence of an adverse event or medication error in the U.S. population.

Let me reiterate: the FDA does not require that a causal relationship between a product and event be proven. This means that random, purely coincidental health conditions may be reported as side effects of a drug. FAERS data are useful for looking for trends or potential side effects that might have been caused by a drug, but they are not proof that a side effect is caused by a drug. FAERS data should be used for further study. They should not be construed as concrete evidence of a causal relationship.

The use of ondansetron in pregnancy has been studied. The Toronto Star article sites some of the research, but a news article is not a scientific literature review. The reporters do not present the totality of research on the subject, and what they do present is presented in a manner that shows bias in favor of their own assertion: that ondansetron causes birth defects. There are, however, numerous other scientific studies that indicate otherwise. Anyone can easily research the topic for herself (or himself) by utilizing the freely available medical research database PubMed.

Although it has been studied, the use ofondansetron in pregnancy is considered an off-label use. It is unfortunate that the Toronto Star article presents off-label use of medications so negatively. Off-label prescribing is common and sometimes is the best or only treatment option for certain conditions. While it is true that sometimes off-label use of a medication might later be proven (by research) to be of no therapeutic value, or worse: harmful, sometimes off-label use later becomes an FDA approved use after further research supports it. According to WebMD certain beta-blockers once only used for the treatment of high blood pressure and used off-label to treat heart failure later became approved prescription treatments for heart failure.

Despite the fact that use of ondansetron to treat HG is off-label, the prescribing information for Zofran (ondansetron from GlaxoSmithKline) states:

Pregnancy Category B. Reproduction studies have been performed in pregnant rats and rabbits at daily oral doses up to 15 and 30 mg/kg/day, respectively, and have revealed no evidence of impaired fertility or harm to the fetus due to ondansetron.

Pregnancy Category B is defined by the FDA as follows: “Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.”  The safety and categorization of drugs varies from country to country. For example, acetaminophen is US FDA Pregnancy Category C (less safe to use in pregnant women than ondansetron!), but in Australia acetaminophen is Australian Pregnancy Category A, which means Australia considers acetaminophen to be safer for pregnant women than the US FDA does.

Ondansetron is not entirely without risks or side effects.   The FDA, like Health Canada, issued warnings about potential heart risks, specifically a heart rhythm problem called QT prolongation. However, those risks very clearly apply to people with Long QT syndrome, those with underlying cardiac defects, those with low potassium or magnesium, and people taking other medications that can cause QT prolongation. They did not withdraw the drug from the market. Many thousands of people have taken ondansetron with no apparent harm to their hearts.

Furthermore, many women, including those who have not taken ondansetron or any other drug, give birth to babies with birth defects every year. According to the US Centers for Disease Control and Prevention (CDC), “Birth defects occur in about 3% of all live births.” Recent CDC data on the prevalence of birth defects in the US between the years 2004 and 2006 show an estimated prevalence of 4.71 in 10,000 babies born with atrioventricular septal defect, for example. HG is associated with an increased risk for fetal cardiac defects, but women without HG and who have not taken ondansetron also give birth to babies with heart defects. According to the National Heart, Lung and Blood Institute, “doctors often don’t know why congenital heart defects occur.” Leaping to the conclusion that the heart defect of one infant reported in FAERS was caused by ondansetron is wildly inappropriate.

I do not speak for all women who have experienced HG, but I and more than one of my “HG sisters” found the Toronto Star article disturbing. It is sensationalist journalism that has the potential to cause women or their healthcare providers to delay or avoid effective treatment at the risk of their/their patients’ own or their babies’ immediate or long-term health or even at the risk of their lives.

For another look at the safety of odansetron during pregnancy, see this Huffington Post piece breaking down a Danish study of 1,970 births where the drug was used during pregnancy.

 

kariswansonTLBKari Swanson, MLS, is a daughter, sister, wife, mother of two, member of Generation X and an admin for The Leaky B@@b Facebook page. She has been an academic librarian for 15 years. She blogs occasionally over at Thoughts from BookishMama

 

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7 Risks To Feeding Your Child- You’re Screwed No Matter What

by Jessica Martin-Weber

 

risks to feeding children

You have a kid?  Congrats!  What should you feed them?  Trying to decide?  Weighing all your options and carefully assessing the risks?  Great!  You should do that.  Also, you’re screwed no matter what you do.  In 15 years of parenting 6 kids, having both breastfed and formula fed, and gone through phases in nutrition standards (yeah, there was a period with lots of Hamburger Helper and soda pop at each dinner and then a period of only organic, homemade, but most of the time somewhere in the middle), I have found that the “right” way was not only subjective but also highly circumstantial.

That there are some actual risks associated with formula feeding and breastfeeding is undeniable, if heavily debated.  Risks such as possible lowered natural immunity and increased chance of ear infections with formula feeding or risks of mastitis and dietary sensitivities with breastfeeding.  Nothing in life comes without risks.  Yep, you’re facing being screwed or screwing up your kids no matter what you do!  As parents all we can do is try our best to mitigate the risks our children face without putting them in a bubble.  There’s risk to that too, what with BPA concerns, the possible damper on social skills development, and the need for oxygenMay as well let them live in the big bad scary world.  Carefully weighing all the possible options, doing personal research, and making the best informed decisions we can according to our personal circumstances and resources means we have to learn to live with some risks.  Regardless of how you feed your child, there are risks you face no matter how carefully you studied, planned, and executed your decision.  Be it breastmilk straight from the tap, pumped breastmilk, donor milk, or formula and then eventually, before you know it, store bought baby food (organic or not), homemade baby food (organic or not), or baby-led solids, followed by McDonald’s Happy Meals, Whole Foods shopping carts, homemade, or homegrown; there are a few unavoidable risks to feeding your child.

  1. There will likely be times you question yourself.  Is this really necessary?  Am I doing it right?  Am I doing it wrong?  Am I stressing out about nothing?  Have I ruined my child for life?  Has my child ruined me for life?  The answer to all these and more is: probably.
  2. There is little doubt that new information will come out that you have, in fact, made the wrong choice.  Those organic apples weren’t actually organic, breastmilk can have toxins in it (have you had yours tested?!), formula used an unnecessary ingredient now deemed dangerous and cancer causing, the baby food company didn’t list all the ingredients they actually used, artificial colors not only suck the actually cause two horns and a tail to grow on some kids… whatever it is, there will be something that’s bad about the choice you made.
  3. Your child will grow to like junk food.  Like moths to the flame, little kids love toxic laden junk food, the more carcinogens the better.  Try as you might, they will discover the joys of foods you’d rather they not consume thanks to a grandparent, a little friend, a mother more lazy and uninformed than you (admit it, you have been judging her and she knew it), or more likely, daddy. And they will, at some point in time, eat something disgusting off the ground or the floor of your minivan.  They will also pick their nose and eat it.  They will lick something that will make you gag.  No matter what you do to cultivate their palate to make discriminating food choices, they will be drawn to the junk and you will wonder if it ever even mattered.
  4. The growth chart will scare you.  Too big, too little, too average, whatever it is, you’ll probably have at least one appointment with your child’s doctor that will make you concerned about your child’s growth pattern.  Because if there’s anything that can be truly charted, it’s that kids are predictably unpredictable.
  5. Statistics aren’t guarantees.  All the scary stuff that isn’t supposed to happen/is supposed to happen based on how you’re feeding your child doesn’t come true.  The proverbial “they” said if you feed your child “this” way they won’t get sick, or that’s what you understood anyway, and yet you’re wiping green snot off your child’s face every day for months.  And someone is bound to point this out to you, trumpeting how their kid is never sick.  Immune systems can be such ignorant traitors clueless on the what all those studies say.
  6. You will be judged.  Pull out a breast or bottle to feed your baby and watch the judgment fly.  Too long, too brief, too-not-what-they-did.  Bad mom, exhibitionist, endangering your child, endangering other people’s children (their poor eyes may see the choice you’ve made and confuse them!), pouring toxins into your child, doing that in public, you name it, judgment will come from all directions no matter what you do.
  7. You can make yourself crazy.  Trying to do it perfectly right could be exactly what drives you over the edge of sanity.  A very real risk.

And if you think it’s bad when they’re infants, just wait until your child is begging for cheetos and refusing the organic avocado and kale chips at playdates.  No matter how you feed your children as infants, they will someday inevitably grow into toddlers eating their own boogers (and sometimes those of others), tasting dirt on the playground, sucking a sucker they found on the floor of the public bathroom, and licking the railing at a public park.  The good news is, most of the time they really are going to be just fine even though.

Which is why it’s a good thing we don’t feed our children for others.  Good luck!  Whatever you do, there are risks.  This is just one aspect of parenting, have confidence, there are even bigger risk you face in this journey.  Go on, feed your kids, take a deep breath, and take the risks as they come.  You’ve got this.

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