Lactation Consultant Licensure in the United States

By Stephanie Rodriguez-Moser, IBCLC, RLC

Breastfeeding newborn

On July 3rd of 2014, something very exciting happened in the lactation world. Rhode Island passed a bill that would allow International Board Certified Lactation Consultants (IBCLCs) to be licensed providers.   A surprising number of people have no idea that this occurred, or what it means for professionals, mothers, and babies.

Licensure is something that lactation consultants have been working towards for a long time. Breastfeeding support has many faces, and this can lead to a lot of confusion for those looking for lactation services. The Massachusetts Breastfeeding Coalition has a wonderful document that goes into all of the credentials out there and what they mean, what they stand for, and what kind of services they provide. If you click on that link and download the PDF, you will see that it is really, really long.   There are 14 types of lactation help listed, and several of them use a “L” and “C” in the name, even though they all have different standards of what they are, what they do, and what their scope of practice is.

Currently, anyone practicing breastfeeding care can call themselves a lactation consultant. It’s not a protected term. This can be a problem, because a mom who thinks she is getting help from a qualified, trained professional might actually be getting help from a lay person. While I firmly believe that there is a need for many types of lactation support and assistance, I just as passionately believe that mothers have the right and need to know the training of the people that are helping them. Generally speaking, IBCLCs are the most qualified to be engaging in clinical care of the mother/infant dyad as breastfeeding is concerned. Most of the other certificates or certifications are qualified to provide education and basic counseling.

Licensure of IBCLCs protects mothers. It provides a way for mothers to know that the person they are seeking out has met the standard of qualifications dictated by the International Board of Lactation Consultant Examiners (IBLCE). This includes lactation specific training, college coursework, clinical hours, passing a comprehensive exam, and regular recertification. A licensed body means that mothers would have a board to file a complaint with if the IBCLC damaged their breastfeeding relationship or acted in an unprofessional or unethical manner.

This would also help IBCLCs be placed in more areas. There are many “lactation deserts” out there, where help and support is difficult or impossible to come by. This isn’t due to lack of IBCLCs, but it is due to lack of job opportunities and reimbursement options. The Affordable Care Act was great for breastfeeding support, but failed to define who was a trained lactation care provider that was eligible for reimbursement. IBCLCs that are non-nurses, not advanced practice nurses, et cetera, are not seen as billable licensed providers for lactation care in many states – especially through Medicaid. Hospitals and clinics are therefore often skittish about hiring someone for lactation care alone, as reimbursement can be a problem. Private practice providers have a difficult time getting insurance companies to see them as reimbursable. WIC clinics often don’t have the budget to hire IBCLCs as stand alone IBCLCs, especially in smaller areas. This leads to women in minority and/or socioeconomically challenged areas not having available help, despite the fact that these are the women facing some of the biggest challenges with breastfeeding.

We all want mothers to be supported in their unique breastfeeding goals, be that a year (or more!) or a month or even a day. Access to qualified care is one of the best ways to make this happen – and licensure is a big part of that. I encourage you to find a way to get involved in licensure efforts in your state. As someone who is chairing a licensure effort, I can assure you – we need a lot of help! Please find your state’s information below and see what you can do.

(If your state is not listed or is listed incorrectly and you know the licensure contact information for it, please let us know. We would love to include them!)

Colorado

Florida

Georgia and More for Georgia

Massachusets

Minnesota

Pennsylvania

New York

North Carolina

Utah

Is your state missing? Please contact your state breastfeeding coalition to ask what they are doing for advocacy in your area!

 

Starbaby Star Rodriguez, IBCLC, RLC is a provider in the Central Lakes, MN area.  She provides services online at Lactastic Services and in person.  She also blogs for The Leaky B@@b and volunteers her services to loss mothers at Stillbirthday.

 

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Tips From The Leakies for Breastfeeding and Babywearing

by Jessica Martin-Weber

Breastfeeding in a Beco Baby Carrier Soliel video demonstrating how to position and adjust the carrier, baby, and breast for hands-free breastfeeding:

The Leakies on the Facebook page had some tips to share for breastfeeding and babywearing, no matter your breast size:

  • Don’t wait for baby to be super hungry and upset, it’s easier when everyone is calm.
  • If your carrier has a hood, put the hood up for privacy.
  • Use a lightweight baby blanket rolled up under your breast for support and positioning help.
  • For small breasts, be sure not to drop the waist band too low and don’t be afraid to tighten the straps for better support.
  • If you need baby higher, a rolled up baby blanket under their bum can help.
  • Practice at home before trying to do it in public.
  • Talk to your baby while you position them to help you both keep calm.
  • Stretchy necklines are your friend!
  • It’s important to get comfortable, don’t end up sore or awkward, practice positioning until it works for both of you.
  • Try to have babies head tilted a bit so nose is clear to breath safely.
  • Hip carry options can be easier for large breasts.
  • Baby’s mouth height should be just at/above nipple.
  • Hold your breast for the latch.

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What tips would you add?

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Heart to Heart Breast Talk

by Jessica Martin-Weber and Kerry Gilmartin

This post was made possible through the generous sponsorship of Bamboobies.

As breastfeeding supporters when it comes to talking about breast cancer it is easy for us to get caught up in talking about how breastfeeding can reduce a woman’s risk of breast cancer. It’s true that statistically speaking breastfeeding can lower your chance of breast cancer, but it isn’t a be all- end all type of prevention, just one piece. The reality is that breastfeeding your baby (or babies) doesn’t mean you get to dismiss the possibility of breast cancer forever, there is still a risk. The good news is that breastfeeding along with other measures can help reduce your risk and education and support can better support those that do develop breast cancer.

Related post: Reduced Risk Doesn’t Mean No Risk

My paternal grandmother is a survivor of breast cancer. A kind, giving woman with a gentle soul, early detection and aggressive treatment meant she lost her breasts but kept her life. I’m so grateful for the treatments available to fight this threatening disease, without them I wouldn’t have known my grandmother. I will never forget when I was young and she showed me her double mastectomy scars and told me her story. The impact of her experience taught me a lot but it was her gentle warning to take care of myself and to regularly check my own breasts that has continued to ring in my ears. Like my grandmother, I want to be here for my children for a long time still, I’m not about to bank on one risk reducing factor. Instead, I want to be informed and do everything I can to protect my health.

So, aside from breastfeeding, what else can you do to lower your risk of breast cancer? And how can you raise your chances of surviving should you develop breast cancer? We’ve pulled together some simple, accessible tips to get you started. Awareness alone won’t change anything, education and action steps are required to make a difference.

 breastfeeding reduces but doesn't eliminate breast cancer risk

Keep A BreastBamboobies donates a portion of all online sales to the Keep A Breast Foundation to support their efforts in promoting awareness, self-checking and prevention of breast cancer.

 

Know the facts

Breast cancer is an extremely prevalent disease and it is crucial to know the facts, learn about prevention, and perform monthly exams.

  • Besides skin cancers, breast cancer is the most common cancer diagnosed among American women. It accounts for nearly 1 in 3 cases of cancers.
  • Today, about 1 in 8 women will get breast cancer in their lifetime.
  • Only lung cancer accounts for more cancer deaths among American women.
  • The chance that a breast cancer patient will be alive five years after diagnosis is lower in women under 40. Statistics indicate that tumors diagnosed in younger women may be more aggressive and less responsive to treatment, making early detection key.

Aging, genetics, race, breast tissue, and menstrual periods are all factors that cannot be changed, however, leading a healthy lifestyle, avoiding common toxins that are linked to cancer, and making smart diet choices are all ways in which you can decrease your risk for breast cancer.

Being aware of what you put in as well as on your body are preventative tactics that you are in control of. Knowledge is key, read the labels of the products you buy and when possible avoid products containing, PARABENS, PHTHALATES, 1,4-DIOXANE, NITROSAMINES, HEAVY METALS. Also, make conscious decisions about cleaning supplies you use in your home. Avoid bleach and stick to these alternatives lemon, baking soda and vinegar when cleaning. Lastly, avoid plastic whenever possible as it can slowly leak chemicals into whatever it touches i.e plastic food storage containers, and plastic water bottles.

In young people, obesity and toxicity are the most prevalent reasons for excess estrogen making it crucial to maintain a healthy body weight. Make healthy choices when choosing the food you put into your body and learn about the fruits and vegetables that are part of the Dirty Dozen and the Clean 15 lists. Avoiding pesticides and choosing certified organic produce, when possible, will reduce the likelihood that you will be exposed to dangerous chemicals and hormones.

Getting Started

Early detection is KEY making it extremely important to perform monthly exams, know your body and your breast. Becoming familiar with your breast will help you determine what is “normal” for your body. You can check yourself in 5 easy steps, beginning with a visual exam. When performing your exam, ask yourself these questions …

  • Do my breasts look the same?
  • Are my nipples the same shape?
  • Are there any indentions, bruises or bulges?
  • Is there any discharge coming from my nipples? Are the veins more noticeable on one breast than the other?

It is necessary to note that if you notice any changes you should visit your doctor right away.

*Keep in mind that lactating breasts are usually more dense and prone to lumps from milk than an empty breast. Breast self-exams are still beneficial, try to do them when your breasts are empty.

Check Yourself AppFor more information on how to perform your exam visit Keep a Breast Foundation and download the check yourself app or print out the check yourself card.

5 easy steps

Visit the Keep a Breast Foundation online store  https://shop.keep-a-breast.org/

 

 

 

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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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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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Tattoo risk while breastfeeding

We’re giving away some tattoo aftercare balm and a tattoo.  Seriously.  Keep reading.  But if you want to skip to the giveaway part, the short version is that if you’re using a safe, reputable shop, there is almost no risk to getting a tattoo while breastfeeding.  Which is good news if you’re breastfeeding and want to get a tattoo.  Woohoo!

open line work tree and bird arm tattoo

 

From time to time we’re asked on The Leaky Boob Facebook page about the safety of getting tattoos while breastfeeding.  While there isn’t a lot of information out there regarding studies done specifically on getting tattoos while breastfeeding, most health care professionals agree that as long as you are using a reputable shop that follows all the guidelines required for safe-handling and hygiene, there is no real risk to the breastfeeding relationship for the mother to get a tattoo.

Please note: don’t tattoo babies or small children, that would just be mean.

Just a few weeks ago, following Camp MommyCon near Denver, Colorado, I had a what has been a long planned appointment for my very first tattoo.  And yes, I’m still breastfeeding 2 year old Sugarbaby.  This appointment with Colin Kolker at Chroma Collective Tattoo Co. was in the works for a long time, generously gifted to help me realize a healing dream I’ve had for over 2 years to reclaim a spot on my arm scarred along my motherhood journey.  Colin helped me express my healing, inner strength, and the beauty that I have found along the way with a symbolic and meaningful tattoo that represented all of that to me.  You can read about the story and meaning behind my tattoo here.

 

open line work delicate tree and birds tattoo

Before I even made the appointment, I answered all the questions I could on breastfeeding and getting a tattoo.  Personally I decided that the risk, while minimal, was enough for me to want to wait at least until Sugarbaby was over 12 months old simply because should something happen she would no longer be dependent on just breastmilk.  Even though I was confident nothing would happen.  Finances and opportunity pushed it back another year.  At that point I felt I was well informed on any potential risk and what I could do to all but eliminate even that.  Confident that it was safe, the only nervousness I had going into my appointment that evening was that it would hurt.

It did hurt.  I had tattoolas to help me though.  Because support makes all the difference, don’t you know.  Also, people, stop comparing tattoos to giving birth.  It’s totally different and just because I can handle pain when necessary (and I can’t actually stop it anyway) in order to push out a baby does not mean I’m not a wuss about other pain.  To be clear, I’m a total wimp.  Tattoos hurt.  About like you think it would hurt to be repeatedly stabbed and scratched with a needle.  Because that’s exactly what’s happening.  But the pain was totally worth it and in some spots it even felt good, kind of like a tens unit.  Other spots felt like torture.  Still, not like giving birth, the sensation is much less than that of giving birth.

mom tattoo Chroma Tattoo

Shout out to the MommyCon Tattoolas Laney, Xza, and Alyssa!

Here’s what I considered in making my decision to get a tattoo as a breastfeeding mother:

  1. Ink molecules are too large to get into the blood stream and milk.  Sugarbaby wouldn’t have ink flavored milk but I did love that Chroma Collective Tattoo Co. used nontoxic vegan ink they were happy to show me and explain.  This also meant I was less likely to have an allergic reaction to the ink as an immune response and made me feel more comfortable with my decision.
  2. The shop I chose meets all safety standards, sterilizing the equipment and practicing good hygiene.  Breastfeeding or not, seriously, this is a minimum.  Avoid infection by going to a clean, licensed, reputable shop.  They should have an autoclave, single-use inks, gloves, and needles.  Look them up on review sites and check with the local department of health to see if they comply with health code standards.
  3. My health was in my hands, if I followed the protocol for aftercare I would further reduce any risk of infection or possible harm to me and Sugarbaby.  I followed Colin’s directions exactly and not only did I not have any issues, using the Motherlove Tatto Care, I healed surprisingly fast and with almost no flaking or peeling.
  4. Tattoos have been a part of various cultures for a very long time and is legally supported.  Some tattoo artists may refuse to give a breastfeeding mother a tattoo but no major recognized medical body (such as the AAP or WHO) have issued warnings against the practice.  I felt history and science indicated that it was a safe choice for me.  The considerations put forth in this article were helpful.
  5. I don’t tend to have allergies so I wasn’t personally worried that I was likely to have an allergic reaction to the ink.

delicate tree and birds tattoo and breastfeeding

Tattoos aren’t for everyone and some who may want a tattoo may still feel more comfortable waiting until their nursling has weaned.  For me going through with my ink dream is something I’m incredibly glad I did knowing the risk was almost nothing.

I promised a giveaway.

nontoxic tattoo aftercare

And now… you can get a tattoo and take care of it too!  Motherlove Herbal Company is giving away their Tattoo Care to 3 lucky Leakies.  I used Motherlove Tattoo Care from the very beginning as part of my aftercare regimen.  Colin had instructed me to keep the area moist, not letting it dry out by rubbing in Motherlove Tattoo Care several times a day.  It worked like a charm.  Motherlove Tattoo Care is made with certified organic ingredients, handcrafted in Colorado using the same tried and true organic ingredients that have been trusted in other Motherlove products for over 20 years. This thoughtful formulation of herbs provides optimal moisturizing and healing properties, yet retains a consistency that is comfortable to apply. Unlike petroleum based products, Motherlove Tattoo Care allows the skin to breathe, promotes quicker healing, and allows ink to fully penetrate the skin.

Chroma Collective Tattoo Co. Giveaway

Tattoo in progress selfie!

 

We’re also giving away a 2 hour session with Colin Kolker at Chroma Collective Tattoo Co. in Parker, Colorado (outside Denver).  One lucky Leaky will win a  2-hour custom tattoo session at Chroma Collective Tattoo Co. in Parker, Colorado with artist Colin Kolker. Value: $300 but no cash value. Gift Certificate will be mailed to winner or can be picked up at the shop.  Some restrictions apply.  If the piece is more detailed/larger, the winner will be responsible to pay any remaining difference. If the tattoo takes less than 2 hours, the remaining balance cannot be rolled over into a second tattoo/session- good for one session only. Colin is booked pretty solid but has a few availabilities in Sept/Oct and on so there could be a wait time for an appointment.  Must be 18+ and the winner is responsible for their own transportation to and from the Parker, Colorado shop location.

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Traumatic Birth: Resources for Healing and Protecting Breastfeeding

by Tanya Lieberman
This post was made possible by the generous support of MotherLove Herbal Company.

Young Woman Biting Her Finger Nail

Having intrusive thoughts about your birth?  Flashbacks?  Feeling disconnected from your baby?  Do you steer clear of hospitals, or try to avoid talking about your birth?

Many women experience trauma related to childbirth, and estimates range from 18% to as high as 34%.  One third of women who experience traumatic births go on to develop Post Traumatic Stress Disorder (PTSD).

Yet despite its widespread nature, the experience of birth-related trauma can be an isolating one, as mothers are encouraged to focus on their babies and quickly “get over” their birth experience.  Trauma can affect a mother – and a partner’s – ability to connect with their baby, carry out normal activities, and can also impair breastfeeding.

In this post we’ll discuss traumatic birth – what it looks like, how it impacts breastfeeding, and where you can turn for help.

 

What’s a traumatic birth?

 

According to PATTCh, a birth trauma organization co-founded by noted childbirth author Penny Simkin, a traumatic birth is defined as one in which a woman experiences or perceives that she and/or her baby were in danger of injury or death to during childbirth.

It’s important to note that it is the mother’s experience of the events, regardless of what happened or the perceptions of other people, that determines whether she experiences trauma.

Here are some characteristic features of births that may lead to an experience of trauma, according to the Birth Trauma Association:

  • An experience involving the threat of death or serious injury to an individual or another person close to them (e.g. their baby).  [Note that it’s the mother’s perception that is important, whether or not others agree.]
  • A response of intense fear, helplessness or horror to that experience.
  • The persistent re-experiencing of the event by way of recurrent intrusive memories, flashbacks and nightmares. The individual will usually feel distressed, anxious or panicky when exposed to things which remind them of the event.
  • Avoidance of anything that reminds them of the trauma. This can include talking about it, although sometimes women may go through a stage of talking of their traumatic experience a lot so that it obsesses them at times.
  • Bad memories and the need to avoid any reminders of the trauma will often result in difficulties with sleeping and concentrating. Sufferers may also feel angry, irritable and be hyper vigilant (feel jumpy or on guard all the time).

Some common triggers, according to the Birth Trauma Association, are: lengthy labor or short and very painful labor, induction, poor pain relief, feelings of loss of control, high levels of medical intervention, traumatic or emergency deliveries (e.g. emergency cesarean section), impersonal treatment or problems with staff attitudes, not being listened to, lack of information or explanation, lack of privacy and dignity, fear for baby’s safety, stillbirth, birth injuries to the baby, NICU stay, poor postpartum care, previous trauma (such as sexual abuse, domestic violence, trauma with a previous birth).

How can traumatic birth affect breastfeeding?

Breastfeeding can be healing for many mothers after a traumatic birth, and may also repair the relationship between a mother who feels estranged from her baby.  But a traumatic birth may also cause breastfeeding problems.

A traumatic birth can delay on the onset of a mother’s mature milk (“milk coming in”), known as lactogenesis II, sometimes by several days.  This effect is well documented, and often leads to a cascade of breastfeeding problems including jaundice, poor feeding due to sleepiness, poor milk removal, and low supply.

While research on the independent effect of Pitocin on breastfeeding is not sufficient to draw direct conclusions, according to Linda Smith, author of The Impact of Birthing Practices on Breastfeeding, its effects on factors related to breastfeeding are more clear.  Pitocin increases the risk of other interventions, such as IV fluids and cesarean section, which are associated with breastfeeding problems.  Linda Smith also notes that induction of labor often causes babies to be born earlier, and “early term” babies are known to be at higher risk of breastfeeding difficulty.

 

What are some steps you can take after a traumatic birth to minimize the effects on breastfeeding?

There are many steps a mother and her provider can take to minimize the effects of a traumatic birth on breastfeeding:

Skin-to-skin.  Skin-to-skin contact lowers stress hormones, promotes the release of hormones important to lactation, and helps establish a bond between mother and baby.  Some mothers are too overwhelmed by their traumatic experience to practice skin-to-skin, but for those who can it should be encouraged.

Frequent feeding and in some cases pumping.  Frequent feeding and in some cases pumping, may help to speed the onset of mature milk.  If a baby is not feeding well, pumping can protect a mother’s milk supply and prevent or lessen the downward spiral noted above.

Find support to ensure that breastfeeding is not painful.  In research on the relationship between traumatic birth and breastfeeding, authors Beck and Watson found that mothers who had traumatic births and who didn’t have the emotional reserves to work through breastfeeding pain were less likely to meet their breastfeeding goals.  So finding someone who can help you feed without pain is important.

Focus on your motivation.  Beck and Watson also found that the mothers who were very determined, and those who were motivated by a desire to “make up” for a baby’s less than optimal arrival, were more likely to meet their breastfeeding goals.  They suggest setting short term goals and finding respectful support.

Supplementation when medically necessary.  A brief period of supplementation is sometimes necessary in order to bridge the time before your mature milk arrives.  Ideally this would be donor breastmilk, but it is not often available for these situations.  See the Academy of Breastfeeding Medicine protocol for supplementation.

Know where to get good help once home.  Since mothers are generally sent home from the hospital before their milk comes in, they should plan to seek help if their milk is not in by 72 hours (the period defined as normal for the onset of lactogenesis II).  This may head off further difficulty.

If breastfeeding doesn’t work out, connect with your baby in other ways.  As noted above, breastfeeding can be healing to many mothers after a traumatic birth.  But some mothers are truly too overwhelmed to initiate or continue breastfeeding.  In these cases, consider other ways to connect with your baby, such as infant massage, skin to skin, and babywearing.

 

What are some resources for recovery for mothers and partners experiencing birth-related PTSD?

Connecting with other moms.  Connecting with other moms helps you see that you’re not alone.  There are a number of online communities for mothers experiencing birth-related trauma, including Solace for Mothers, Birth Trauma Association’s Facebook page, and Baby Center.

Self care.  A number of forms of self care can aid in healing, including: getting adequate sleep, exercise, yoga, bodywork and massage.  Getting help with cooking, cleaning, and baby care from family, friends, or a postpartum doula may also help you heal.

EMDR (Eye Movement Desensitization and Reprocessing) therapy is considered by trauma experts, including the U.S. Departments of Veterans Affairs and Defense and the American Psychological Association, to be a front line treatment for PTSD.  EMDR involves thinking about the traumatic experience while experiencing a stimulus engaging both sides of your perception.  This might mean moving your eyes back and forth, listening to a tapping sound in alternating ears, or feeling a tapping on alternating knees.  EMDR typically reduces symptoms after just a few sessions. To find a certified EMDR professional, see the EMDR Institute or the EMDR International Association.

Cognitive Behavioral Therapy (CBT) is a form of therapy which addresses beliefs caused by trauma and helps to counter conditioned-fear responses related to the traumatic experience.  To find a CBT therapist, search the websites of the National Association of Cognitive Behavioral Therapist’s or the Association for Behavioral and Cognitive Therapies.

Medications.  You may want to discuss medication options with your healthcare provider.  A summary of medication options is provided here.

Care for partners.  Partners can experience trauma related to childbirth as well.  Encourage partners to seek help if they are experiencing trauma

For more information, listen to Motherlove Herbal Company’s podcast interview.  You may also be interested in this podcast interview on traumatic birth with Dr. Kathleen Kendall-Tackett, president-elect of the Trauma Division of the American Psychological Association.

 Tanya Lieberman is a lactation consultant (IBCLC) who has helped nursing moms  in hospital and pediatric settings.  She writes and produces podcasts for several  breastfeeding websites, including  Motherwear,  Motherlove Herbal Company, and  the Best for Babes Foundation.  Tanya recently authored Spanish for Breastfeeding Support, a guide to help lactation consultants support Spanish-  speaking moms.  Prior to becoming a lactation consultant she was senior  education policy staff to the California legislature and Governor, and served as a  UN civilian peacekeeper.  Tanya is passionate about supporting nursing moms, and especially to eliminating the barriers so many moms face in meeting their breastfeeding goals. She lives in Massachusetts with her husband, her 8 year old son and her 1 year old daughter.
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Dear Kathleen- Nursing strikes, biting, low weight gain, and painful breastfeeding in pregnancy

We receive hundreds of emails and messages daily from Leakies looking for help and information in their breastfeeding journey.  As so many seek support from us, we are so honored to have the support of Kathleen Huggins, IBCLC and author of The Nursing Mothers’ Companion.  Kathleen is jumping on board with The Leaky Boob to have a regular article answering Leaky questions every month.  The questions will be selected from the huge pool we get in every day to try and help cover the wide range of topics about which Leakies are asking.  These questions are from real moms and represent hundreds of requests for more information in the past few weeks.  Please understand that this is simply the professional opinion of one International Board Certified Lactation Consultant in an informal setting and is not intended to replace the care of a health care provider.  Kathleen is offering support and information, not diagnosing or prescribing treatment.  For your health and safety, please seek the care of a qualified physician and/or IBCLC.  Kathleen does have limited availability for phone or online consultations, see her website  for more information.

Bfing tip low supply sleep on it

Dear Kathleen,

I need help!! I struggled to breastfeed my now 10 month old. After 3 months of struggle we made it and he has been breastfeeding beautifully. I work long hours and pump at work but have had a great supply. I just returned from a 5 day trip where I pumped and dumped and during that time my milk supply went from 24 oz a day to less then 15. Now my baby latches but cries after about 5 min on each side. He calms with expressed milk in a bottle. What do I do now to increase my supply back? I wanted to make it to a year and am heartbroken that I may have to stop sooner!! Help!!

Desperately yours,

Heartbroken for Milk

 

Hi there Heartbroken for Milk,

So sorry about your difficulty.  There are several things you can do.  First of all, I would make sure that you are using the best possible pump, like a Hygeia. If you don’t have a strong pump, you might consider either getting one or renting a clinical grade pump, like a Symphony, or an Ameda Platinum.  I would be sure that between pumpings and nursings that your breasts are being drained at least 7 times each 24 hours.  Having your breasts emptied less than this will keep your supply at the level it is at now.  The other thing I would suggest is More Milk Plus from Motherlove Herbals.  If you go to their website, you may be able to find a local distributor or order it directly from Motherlove.  This herbal product contains fenugreek and three other milk stimulating herbs.  Keep in mind that teas are a weak form of any herb and may not help much.  For a a short while you may also want to nurse before offering solids and once your supply increases, you can offer solids first, but again try to keep the number of nursings remain at a minimum of seven per 24 hours.  If your baby wakes in the night, welcome those nursings for now.

Best wishes too you!

Kathleen

 

Dear Kathleen,

My 10 month old bit me and I yelped, which made her cry. That was 6 days ago and since then she’s completely refused to nurse. She was exclusively breastfed before introducing solids and has never had formula. She won’t take a bottle and will only drink water from a sippy cup. I tried offering expressed breastmilk in an open cup but she wouldn’t have it. I’ve been mixing express breastmilk into her food but that’s all she’s been having. My supply is going and I can only pump a few oz a day. I’ve tried nursing her asleep, warm baths, skin-to-skin, everything, but she still refuses. Everything I’ve read says 10 months is too early to wean and that nursing strikes are temporary, but every day I feel more hopeless. I offer every couple of hours. She has three meals a day. I’m worried she’s missing out on essential nutrition, and even if I had to give formula I don’t know how I’d get it into her. I miss breastfeeding so much, I just want it back. 

Thank you for your help,

Not Ready to Wean

 

Dear Not Ready to Wean,

Tough situation!  At this point, be sure that you are expressing milk at least 7 times each 24 hours with an excellent pump to keep your production high.  You are certainly been doing the right things with co-bathing and lots of skin to skin.  I would offer your milk with an ordinary cup rather than a sippy cup with your guidance and see if she prefers that over the sippy cup.  I would also suggests seeing if she will nurse while asleep or very sleepy maybe while you lie down together in a darkened room.  Final words, hang in there.  Nursing strikes usually end as suddenly as they begin!

Good luck!

Kathleen

 

Dear Kathleen,

My son is 8 1/2 months and exclusively breast fed, and the last couple months has a side preference when he wants to relax or fall asleep. He has 6 teeth and is still in the teething process. My problem is, he bit his preferred nipple 3 times in 24 hours, drawing blood the first couple times. Now, I am trying to give it some time to heal, but he has a total meltdown when I don’t let him nurse on that side! 

Any suggestions to help him through this while I attempt to heal would be much appreciated! 

Sincerely,

Wounded Nipple

 

Dear Wounded,

I hope that you are expressing your milk very often with an excellent pump, at least 7 times each 24 hours.  I would also suggest feeding on that side using other positions that irritate the wounded nipple less, like “football” hold or having him straddle your thigh and then come onto the breast.  If the nipple is open after 5 days, it may then be time for an antibiotic as bites can easily become infected and then not only are they slow to heal, but you can also develop mastitis.  There are other healing remedies like Motherlove’s Nipple Cream which you may be able to find if you visist Motherlove’s website.  It contains several healing herbs and can work quickly unless there is already bacteria in the wound.  Also, you may want to learn more about biting.  If you visit my website, Kathlenhggins.com, I have a blog about “biting”.  This needs to stop!

Kathleen

 

Dear Kathleen,

I still breastfeed my just 2 year old and am 15 weeks pregnant. Breastfeeding is now VERY painful contributed by a very poor latch I think (there are teeth marks left behind on my nipples). It is no longer pleasant for me and I find myself feeling anger and resentment during feeding. The problem is my toddler is not ready to stop, she feeds on waking and before sleeps so it in entrenched in those routines. No amount of distraction, food or drink offerings or cuddles can stop endless sobbing and clawing at me. I’m at a loss.  

Thank you, 

Unpleasant Breastfeeding

 

Hi Unpleasant Breastfeeding,

There are a few things you can try.  First of all it is very common for nipples to be tender during pregnancy.  They may improve as your pregnancy continues.  With that and the marks from your toddlers teeth, it is no surprise that you are suffering through nursings!  There is nothing that can be done about your pregnancy nipple soreness, but you can help the problem with your toddler’s latch. Because the baby’s mouth tends to drag down the breast tissue, it may be important to lift her upwards by using a pillow and lifting your breast upward.    Experiment with other nursing positions to see which positions are more comfortable and which  avoid letting her chin rest on her chest, trying to get her head tilted back a little more.  Try and offer your breast with the nipple pointing downward and wait for a wide open mouth before latching. Feel free to use lanolin after nursings.

With all that being said, if you are still wanting to stop nursing, you can do that too! If you are only nursing in the morning and just before sleep, you and your partner can both help out.  She really is mostly weaned at this point!

For now, I would suggest tackling just one nursing at a time.  When she wakes, start of new routine of an early breakfast and some sort of play or other activity. Without telling her  “No”, let her know you are “saving the milk” until nap time, using whatever words she understands. Think of all the things she loves to do and substitute any of those things, Once you have that morning one gone, pick another, maybe the nighttime or nap time nursing. One the week-end, or in the evening, let your partner work his magic, with you out of sight.  Go take a walk. Perhaps Dad can help her off to sleep at night by making a new routine, like reading a book and rocking him for awhile.   A bath, a story and more rocking can certainly be a new way to distract her and soon you will have weaned. On the other hand, maybe one nursing a day is pleasant for the both of you.

See how changing the latch works. Move slowly on this, taking the nursings out just one at a time over a period of time until you are feeling better and she is adjusting.

Best wishes!

Kathleen

Dear Kathleen,

I have a soon to be 5 months old infant who is breastfed since birth and the biggest challenge is his weight, he only weighs less than 13 lbs and his birth weight was 6 lbs 12 oz. I’ve fed him every 2 hours and now sometimes 3 hrs to 4. When I pump I only produced 2 oz total from both breasts which the pediatrician isn’t happy and is very concerned that he’s probably not getting enough milk.  He spit up a lot, lots of urinations and some common bowel movements but his doctor isn’t satisfied and we keep having to go back for a weekly or biweekly weight check and now the doctor wants me to start giving him rice cereal now which I’d rather wait til he is 6 months old so I dont know what to do.  I don’t want to do formula. This is my 4th child and my 3rd child to breastfeed.  With my last 2 children I breastfed and did produced good amount of milk but this time I’m not sure if I’m producing enough milk which is very discouraging for me.  I took fenugreek for 3 months but I wished I had known I should have taken blessed thistle along with fenugreek.  Any suggestion on how I can increase my milk supply? Could it be his latch?  It still hurts when he latches on and sucks on my nipples.  I’m trying to stay positive but I feet like a failure that my baby is probably not getting enough milk from me because of his very low weight for his age.  With my other two nurslings I had a wonderful lactation consultant but that was 7 years ago and we have moved, I don’t even know how to find a good consultant.  Please help!

Yours truly,

Worried but hopeful

 

Hi Worried,

It’s understandable that you are worried, when I plot out your baby on the World Health Organizations Breastfed Infant Growth Charts, which you can find on line, I see that we was born on the 15th %tile and he seems to now be on the 3rd %tile.  I think you can offer him more calories without having to resort to formula.  I don’t know when you are pumping in relation to a nursing, so that doesn’t help me much.  Your baby needs more milk which has more calories, so I agree that cereal is not the answer.

I would suggest a few things.  First of all, you need to aim for 7-8 nursings each 24 hours. I would not allow the baby to go without nursing for 3-4 hours.  Watch for early hunger cues, like finger sucking and offer your breast whenever you notice this.  If your baby uses a pacifier, I would put it away.  Welcome night time feedings as mothers produce more milk in the night time.  If he sleeps through the night, I would wake him before you go to bed, or even wake him after five hours of sleep.  During the day and evening, I would try and double pump after most of these nursings for 5-10 minutes and offer him that milk after the next nursing.  This milk will be very high in calories and help him gain more weight.  While not knowing what pump you have, be sure that it is a good one, like a Medela or Hygeia or you could even rent a clinical grade pump for awhile if you have doubts about the pump you are using.  If your nipples are larger than a penny, be sure to use a larger sized flange, like a size 27mm.

Next, I would add a strong herbal galactagogue, like More Milk Plus from Motherlove Herbals.  If you go to their website, you may be able to find a local distributor or order it directly from Motherlove.  It contains, fenugreek, Blessed Thistle, and two other milk stimulating herbs.  It usually takes 48-72 hours to kick in.  A second herb you can add is GoLacta.  Go to their website for ordering information, Using both of these together can really boost your supply.  At this point, I would like to see a daily weight gain of 1/2 ounce per day.  That is normal for this age.

If your periods have already resumed, you may see that your supply lessens between the time you ovulate and when your period resumes.  If that is the case, you can take 1000 mgms of Calcium and 500 mgms of magnesium every day until your period starts.  I am assuming that you are not on any estrogen containing birth control which definitely lessens milk supply,

If your baby is spitting up, that suggests reflux to me which can cause some babies to limit their nursings.  I would avoid any of the following the following foods and beverages; these include chocolate, all citrus fruits and their juices (including strawberry, pineapple and kiwi), the gassy veggies like onion (onion powder), garlic (garlic powder), peppers, cucumbers, cauliflower, cabbage, broccoli, and Brussels sprouts.  It may be your baby is reacting to the foods you’re eating, eliminating the most likely culprits first and then testing them by adding them back one at a time could help you figure out if one of these are the cause.  If this baby has the same Daddy as the others, and they had colic symptoms, you might also consider a trial off of all cow milk products for a short while to see if that helps with the spitting up.  Cow milk products can be an allergen which runs in certain families.

Lastly, if you want to find a lactation consultant, go to ILCA.org and scroll down to “Find a Lactation Consultant”, enter your info and some name should pop up.  If you have private insurance, they should cover the cost.

Best wishes to you and your baby!

Kathleen

Kathleen-HigginsKathleen Huggins RN IBCLC, has a Master’s Degree in Perinatal Nursing from U.C. San  Francisco, founded the Breastfeeding Warmline, opened one of the first breastfeeding clinics in  the United States, and has been helping breastfeeding mothers professionally for 33 years.  Kathleen  authored The Nursing Mother’s Companion in 1986 followed by The Nursing Mother’s Guide to Weaning.  Kathleen has also co-authored Nursing Mother, Working Mother with Gale Pryor, Twenty Five Things Every Breastfeeding Mother Should Know and The Nursing Mothers’ Breastfeeding Diary with best-friend, Jan Ellen Brown.  The Nursing Mothers’ Companion has also been translated into Spanish.  Mother of two now grown children, Kathleen retired from hospital work in 2004 and after beating breast cancer opened and currently runs Simply MaMa, her own maternity and breastfeeding boutique.  She continues to support breastfeeding mothers through her store’s “breastaurant,” online at The Leaky Boob, and in private consultations.  
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Dear Kathleen- Too much and not enough, weaning and supply during monthly cycle

We receive hundreds of emails and messages daily from Leakies looking for help and information in their breastfeeding journey.  As so many seek support from us, we are so honored to have the support of Kathleen Huggins, IBCLC and author of The Nursing Mothers’ Companion.  Kathleen is jumping on board with The Leaky Boob to have a regular article answering Leaky questions every month.  The questions will be selected from the huge pool we get in every day to try and help cover the wide range of topics about which Leakies are asking.  These questions are from real moms and represent hundreds of requests for more information in the past few weeks.  Please understand that this is simply the professional opinion of one International Board Certified Lactation Consultant in an informal setting and is not intended to replace the care of a health care provider.  Kathleen is offering support and information, not diagnosing or prescribing treatment.  For your health and safety, please seek the care of a qualified physician and/or IBCLC.  Kathleen does have limited availability for phone or online consultations, see her website  for more information.
Dear Kathleen,
 
I have weaned my nursling, it has been 7 days since his last feed and lefty still isn’t getting with the program!  I have a lumpy, very sore, left breast and am unsure what to do.  Is this normal?  What can I do to relieve the pain and discomfort?
 
Thank you!
 
Lumpy Lefty

 

Hi there Lumpy,

Yes, it can take while for both breasts to involute after weaning, even if weaning was gradual.  Your left breast will soften soon, but in the meantime you can try the following suggestions.  You will want to try and avoid any breast stimulation to either breast.  This means taking backward showers or tub baths, avoiding heat to the breast and any stimulation during lovemaking.  You can use Tylenol or ibuprofen to ease any discomfort. Some mothers use cool packs on the breasts for 10-15 minutes a few times a day and some even place chilled cabbage in their bras to help with the swelling and discomfort.  While some mothers chose to express milk from the breasts, this may provide temporary relief, but that will most likely lengthen the total time it takes to dry up completely.

To speed the softening, you can drink sage or peppermint tea.  Earth Mama Angel Baby sells their “Organic No More Tea” which contains these herbs or you can buy dried sage leaves in most health food grocery stores.  Steep a couple of teaspoons of sage in boiled water storing it in your refrigerator.  Drink 2 to 3 cups a day for up to three days.  None of these herbs should not be used if you may be pregnant.  Most mothers do nothing other than wearing a supportive bra and giving it a bit more time.  Please know that it is quite normal for mothers to be able to express drops of milk for many months after weaning.

Feel better soon!
Kathleen
Dear Kathleen,I’m on the verge of tears, disappointed in myself.  My little guy is 4 months old and I returned to work last month, we are exclusively breastfeeding and I pump when I’m at work.  This month my monthly cycle returned and I’m experiencing a drop in my milk supply with it.  Is this normal?  Why is this happening?  I feel so bad, I can’t pump nearly as much as I could before and sometimes he seems very frustrated at the breast.  Will my supply come back up when my period ends?  Is there anything I can do?  I’m having to use the milk I have stored and I’m afraid that if my supply doesn’t come back up I won’t be able to keep up with my son’s needs. Even if it does come back up after my period, if it’s going to be like this every month I’m really concerned that I won’t have enough of my milk when I’m at work and that he’s going to wean early if he’s frustrated even at the breast.  Please help!Sincerely,

Could Cry

Hello Could Cry,

I am so sorry that you are worried and upset!  Let’s see what we can do.  I am hoping that you are getting in at least 7 nursing and pumping each 24 hours and that you are using the best pump possible.  If you are not using a Hygeia or another pump with strong suction such as a rental pump, I would suggest that you try and get one.  I know that many insurance carriers that are providing pumps to nursing mothers, but many are offering mothers poor quality pumps.  For an example, the Ameda pump has very low suction unless you are using it as a single pump.Try to nurse right before leaving for work every day and be sure that you care giver doesn’t feed the baby for two hours before your expected return.  In that way you can nurse just as soon as you get home.  Some mothers find that their babies are simply being overfed while they are apart. Your baby only needs about 1 1/2 ounces per hour for a good feeding at this age.  That means that if it has been 2 hours since the last feed, he will only need 3 ounces by bottle.  If your care provider is overfeeding the baby, let her know that the doctor has recommended that amount.  Using a slower flow nipple can also help slow the feeding and leave your baby a bit more satisfied.When you are home with the baby, try to nurse more often.  Keep in mind that babies at this age do not give early hunger cues.  If your baby uses a pacifier, put it away and offer the breast when you see finger sucking and it has been 2 hours or more since the last feeding. Welcome night time feeds, as nursing in the night increases your milk making hormones the most. When at home you can also pump right after any of your morning nursings and use that milk to feed the freezer.

Milk Supply Drop with OvulationYes, when a mother begins ovulating, it is common for milk production to decline somewhat until the next period starts up again.  With that being said, you can try taking 1000 mgms of calcium and 500 mgms of magnesium every day once you have ovulated and until your period returns.  You can also use herbs to stimulate your production, so long as your breasts are being drained 7 times a day.  Fenugreek can be found in any health food store and the lactation dose is 3 capsules three times a day, not what is written on the bottle.  For a stronger herbal remedy, I recommend More Milk Plus from Mother Love Herbals.  You can visit their website and find a local distributor.  More Milk Plus contains fenugreek and three other milk stimulating herbs.I do hope this has been helpful to you and that you find ways to continue nursing for as long as you and the baby like.

Best wishes,

Kathleen

Kathleen-HigginsKathleen Huggins RN IBCLC, has a Master’s Degree in Perinatal Nursing from U.C. San  Francisco, founded the Breastfeeding Warmline, opened one of the first breastfeeding clinics in  the United States, and has been helping breastfeeding mothers professionally for 33 years.  Kathleen  authored The Nursing Mother’s Companion in 1986 followed by The Nursing Mother’s Guide to Weaning.  Kathleen has also co-authored Nursing Mother, Working Mother with Gale Pryor, Twenty Five Things Every Breastfeeding Mother Should Know and The Nursing Mothers’ Breastfeeding Diary with best-friend, Jan Ellen Brown.  The Nursing Mothers’ Companion has also been translated into Spanish.  Mother of two now grown children, Kathleen retired from hospital work in 2004 and after beating breast cancer opened and currently runs Simply MaMa, her own maternity and breastfeeding boutique.  She continues to support breastfeeding mothers through her store’s “breastaurant,” online at The Leaky Boob, and in private consultations.  
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Sibling love- respecting it, working for it, and preserving it

#BecoSiblingLove walk mayou quote

Earlier I shared here some of what our 6 children have taught us in our parenting journey about sibling bonding.  Beco Baby Carriers joined us with a giveaway to encourage the connections between parents and siblings, because they believe that supporting family bonding is important and one of their core values.  While not everyone could win (the winners have been notified), we did giveaway 6 #BecoSiblingLove carrier packs and are happy that everyone wins a little with this great collection of tips and sweet photos from the Leakies shared here, on Facebook, Instagram, and twitter encouraging sibling bonding.  This collection of tips highlights respecting, working for, and preserving sibling love from the voices of experienced moms.  If you have some to add or a story of sibling bonding and adjusting to adding a new family member, leave us a comment, we love hearing from you.  Thanks to all who contributed!

More tips from the Leakies for adding a new baby in a family and promoting sibling bonds.

I like to talk to my two year old about the baby and all the things that we did with her when she was a baby. Things like, “He’s crying a lot because he’s a baby. You used to cry a lot, too!” ~Ginni, mom of two

My children bond with him by him doing things for him. And they bond with each other by playing mostly.  ~Danielle, mom of 6

They each love when I wear them and go for walks.  ~Joanne, mom of 2 under 4

We sing songs, read books, all three of us snuggle up on the toddlers bed for naps and they both fall asleep, take baths together and big brother helps with baby, when big brother loves on little brother we praise them both and tell big brother his little brother loves him so much.  ~Hannah, mom of 2 boys under 3

We’ve encouraged their relationship since I was showing. She’d kiss my belly and pat it. And its so moving seeing her noe pat the baby’s back and give him morning kisses. She actually is so in love with “brover” she gets mad if other people hold him and wants to kiss him as soon as she’s awake.  ~Tay, mom of 2 under 2

I actually encouraged him to babywear the other day because he wants to hold the baby while standing up.  ~Raina, mom to 2 boys, 6 years old and 6 months

#BecoSiblingLove

We encourage sibling bonding by letting the older one help get things like diapers, or juice for his little sister to make him feel like such a big boy. We love playing games together as well, stacking blocks is also something fun that they both enjoy! ~Cassandra, mom to 2 toddlers

I feel like we have encouraged sibling bonding by letting each child know how much they are loved and that love is endless and independent of any one else. We make them feel special as individuals, which makes sibling rivalry nearly non-existent.  ~Heather, mom to 4 girls

We are tandum nursing right now and I love to see them looking into each others eyes. It’s so sweet. I really hope nursing them together helps foster their bond.  ~Jinny, mom to one 3 year old and one 1.5 year old

Our older two boys (7 and 6) share a room. I have heard that sharing a room helps build a stronger bond for siblings in adulthood. I hope so because they have difficulty with each other now but they both adore their younger brother.  ~Melissa, mom of 4 boys

I made sure that I included big brother in everything that happened with the baby. When it was time to eat, I let him help me burp the baby. When I had to change the baby, he handed me the clean diaper and the wipes. At nap time, big brother would lay down on the play mat with the baby and watch a movie. It made him feel important and special!  ~Christian, mom to 2 boys and one on the way

Keeping them busy is the key.  ~Jenn, mom to one 5 year old and one 8 year old

Encouraging sibling harmony is definitely challenging with a fiesty 2 year old. Diligent supervision, guidance, and modeling appropriate conflict resolution are necessary with both his older brother and his younger brother as he has yet to learn boundaries.  ~Lurissa, expecting #4

#BecoSiblingLove sibling kiss

I try not to interfere with their spontaneous, happy moments but bring them up later during quiet times with our oldest.  ~McKenna, mom of 2 boys

I think it is important to include both children in everything we do but also make some time for each to have their moments in the limelight.  ~Cassandra, stepmom of 1 and mom to 1

I have 5 children, but only 4 are living. In many ways, number 4 dying has made a huge impact on their relationships with their other sisters- especially number 5. I have learned so much about love from watching them together. I love the way they always praise each others’ efforts. And I love that they are strong for each other, and work to keep each other safe. They have the courage to speak up against something dangerous, or even do things they don’t want, to protect the baby- because they don’t want to lose their sisters.  ~Anne, mom of 5, 4 living

I find my older does better if I tell her all the good and right things she does when she interacts with her baby brother.  ~Kari, mom of 2 under 3

#BecoSiblingLove b:w newborn kiss

I encourage bonding between the older and younger children by letting them help with bath time and eating snacks together, ect. My 8 yr d daughter is very involved with my youngest and I show her trust by letting her watch her while I take a shower or cook dinner.  ~Shelby, mom of 4

This Last Pregnancy my older girls were completely involved in all of the midwife appointments helped listen to the heartbeat etc. They were there for her birth also. I think that helped them have a huge Bond from the very begining.  ~Jessica, mom of 3 girls

We have 10 kids 8 boys and 2 girls ages 23 years old to 10 months old and love the way they all interact with one and another, they are their own best friends. We use baby wearing to get out and do the things with the big kids like camping, hiking and other out door activities that we wouldn’t be able to do with a stroller. ~Kathy, mom of 10

I have found that leading by example and oftentimes just letting them work things out on their own can lead to growth in their sibling relationship. Solving problems can be a wonderful way to build character and relationships. I find that if I don’t butt in, they usually get along better.  ~Jeannette, expecting #3

#BecoSibilingLove

We foster their friendship in everything we do. We make sure to get excited for each other when something exciting happens. Now, when my little boy does something neat, his sister will get excited for him and hug him. He’s potty training and when he goes, he waits for a high 5 from his sister b/c it’s important to him. When we wake up, they hug each other right away, it’s so adorable.  ~Shannon, mom of 2

We have a “Kindness Jar.” It’s an idea a got from Pinterest about a year ago. It’s a jar we decorated, that has a bunch of slips of colored paper and each one has a “act of kindness” on it. This has worked for us and I like that it encourages redirection, rather than focusing on disciplining.  ~Alexia

The older ones love feeling like they are big helpers so I have them do little things to help with the new baby like sing to him if he is crying.  ~Alicia, 4 children under 6

I encourage sibling bonding by reminding them to hug and kiss goodnight and goodbye – and when saying sorry.  ~Mandi, expecting #3

#BecoSiblingLove matching pajamas copy

One of the big ones I find is just to be observant and not in a hurry… if I see them connecting but we have to get somewhere I try to think which is more important in the long run? Being on time to wherever (getting whatever done) or what’s going on right now. ~Cindy, mom to two boys

My 2 girls are extremely helpful and you see this when they play together. I believe in loving them like you want to be loved. They will grow up with enough love to share with everyone they wish.  ~Nicola, mom to 3

Our kids love is to hear about when they were tiny — even my oldest still like to hear how she was nursed, how much we loved to snuggle her in bed at night, how we couldnt put her down, etc. sharing all their birth stories in the weeks leading up to a new sibling’s birth has become tradition.  ~Beth, mom of 5

The best thing a parent can do is to make sure they make special time for the older sibling every day, especially when the older sibling is a younger toddler. Kids who feel that they are not being replaced by a new baby will be far more receptive to bonding and taking on the role as a “big brother/sister”.  ~Taisha, nanny to many, mom of 1

I encourage the kids to all work together as a team so they have a closer bond, which they do.  ~Sandra, mom of 8

#becosiblinglove tandem wearing

Tandem nursing and co-sleeping have helped my boys bond.  ~Anne, mom of 2

When our middle child was a newborn we let her big brother help as much as he wanted to, and hold her whenever he asked to, even if it wasn’t necessarily a good time for us. We let him help her learn to sit and stand and walk, and have always celebrated every milestone as a family. Its the same this time around with the new baby. Granted her daddy or I may not be the ones holding her hand when she takes her first steps, but that’s ok. Our son remembers helping his little sister and is still proud of it. They know empathy and trust in each other, which is priceless.  ~Lacey, mom of 3

My four year old has learned the one year old’s calming song and she sings it to him every time he gets upset. It never fails to melt my heart!  ~Ashley, mom to 2

We bought our two year old a doll & started helping him care for it while explaining that these were all things mommy & daddy would need his expert help with when his sibling arrived.  ~Jennifer, mom of 4

I always include them with what I am doing with the baby. My 3 yr will nurse her babies when I nurse her brother because her babies are hungry too.  ~Heather, mom of 4

Getting out of the way and recognizing their cues that they need space.  ~Jennifer

One of her current favorite things is to have us whisper in her ears, then she whispers in ours. She just recently expanded the game to include little brother – “can I whisper in his ear?” *arm goes around the little neck, mouth smashes up to tiny ear*, “pssshh, whisper, whisper, hsss, I love you so much, Edward.” (yes, that is exactly what she whispers – every time).  ~Sarah, mom of 2

#BecoSiblingLove Big sister reading copy

Outdoor activities are the best!  ~Brandy, mom to 3

I like to encourage them to think about what the other is thinking/feeling and how they can help out. My two older girls love to read to the younger kids, and they all love to snuggle together!  ~Sarah, mom of 4

I always remind big brother how important he is & how his brother needs his help to grow up to be a superhero just like him.  ~Kristen, mom of 2

She was most excited when he had enough head control and she was strong enough to start wearing him (again, with a lot of hair pulling).  Cami, mom to 2

One thing that has encouraged bonding is tandem nursing. I love snuggling both children while they hold hands or while my oldest pets her brother’s head. I also let her help pick out his outfits and gather diaper supplies when she’s feeling helpful.  ~Jennifer, mom of 2

They have to bond because we spend so much time together. They have no choice!  ~Nicole, mom of 3

Momma time when there was a new baby~nursing became special snuggle time for all with babe at breast and older siblings tucked in close on teach side and a good book to read aloud and then the “big kids” were my special helpers assisting me in caring for younger siblings. Even to this day (my oldest ones are college bound) my children enjoy each others company, laugh together.  ~Beth, mom to 5

We kept big bro informed the whole pregnancy and I had him read the updates with me on the pregnancy app I used, to help prepare him and keep him involved.  ~Jessi, mom of 2

Our oldest has LOVED cuddling on, holding, and trying to carry baby sister from day one. We talk often of their love for one another (when 3yo makes 1 yo laugh I’ll say, “Oh, look at her smile! She loves her sister SO much! She thinks you are great!’ or during snuggles when baby-in-belly kicks, I say it is her hand reaching out to hold her big sister and encourage the 3yo to touch the hand back or give kisses to my belly/baby). I recently started the “got your nose!” game with my 3 yo which has morphed into a giggle-fit of “got your (any body part!)”. Her new favorite is to say she got my nursies (what we call breasts used for feeding), put them on herself, and tell me how she is going to nurse the new baby! <3 ~Michel, expecting #3

#becoSiblingLove babywearing copy

The very first thing we did with each older child was call the baby theirs while pregnant. So our 2yr old walks around talking to and kissing his baby. He will tell others MY baby. It seemed to work out well so when the new baby arrives they have somewhat of a bond already. Then when the baby arrived he helped with diaper changing and getting ready for feeds. Plus we have snuggle time before bed where they all get to hold the baby and snuggle.  ~Jessie, mom to 7

Games help build their bond as well as dress up/imaginary play. Sending them outside forces them to rely on each other and not a screen (or Legos). ~Jessica, mom of a 9yo, 7yo, and toddler

Juggling personalities and making sure everyone is heard and respected can be difficult. I try and foster a want of safety in my older kids, to keep the younger ones safe and happy. Whether that means watching someone while I shower or reading stories while I use the stove for a few moments. I want them to want to protect each other.  ~Chelsea, expecting #4

Reading has always been a wonderful time for us… it was for me growing up with my 5 siblings!  ~Mechelle, expecting #4

Any time any of the other kids ask to hold him I let them without question. I want their bond with each other to be the most important to carry for their lives.  ~Sarah, mom of 4

#BecoSiblingLove circle frame copy

 

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