You, Your Baby, Breastfeeding, and COVID-19

by Jessica Martin-Weber

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Breastfeeding Coronavirus Hand Washing

 

Friends, your baby has the right to breastfeed if that is what you were planning to do, want to do, and are able to do.

Not even COVID-19 should stop that from happening.

Even if you test positive for coronavirus.

Even if a health care provider insists that you should be separated from your baby for your baby’s health.

Overwhelmingly, evidence supports that if you are well enough to hold your baby, you are well enough to breastfeed even when you test positive for COVID-19.

(If you are not well enough to hold your baby, you still deserve to be supported in breastfeeding- see here as to how that can be possible).

 

** See this collection of resources of research on breastfeeding and COVID-19, what you need to know, what health care providers need to know, how you can advocate for you and your baby and more. We will be adding to it as materials become available.**

 

We’ve heard from a number of families who are being told they have to separate from their baby at the time of birth if they test positive. Even if they are not symptomatic. Even if they are able to mask and care for their baby following the recommendations of the World Health Organization, the CDC (in the USA), and other major health organizations.

After giving birth is an incredibly vulnerable time and it can be difficult to advocate for yourself and your baby in the immediate hours and days following your baby’s birth. Having a plan and communicating that with your health care team and support person can go a long way in making that easier. Being aware of current recommendations and evidence-based practices as well as being informed on your birth facility’s protocols will allow you to better advocate for you and your baby.

The following is for those in the USA who are COVID-19 positive and physically able to provide care and breastfeed their baby. 

Communicate your wishes to breastfeed even if you are CV19+ with your health care provider BEFORE giving birth if possible and request that it be included in your chart even if you do not test positive. It may be helpful to reference the WHO and CDC recommendations (included in the document linked here) and request that they be included in your chart as well. For example ask that something like this be charted:

“Patient has communicated that breastfeeding is a priority according to the recommendations of the CDC and WHO and requests lactation support regardless of patient’s COVID-19 status at time of birth.”

Current recommendations from the World Health Organization encourage breastfeeding and skin-to-skin when the lactating parent is COVID-19 as the best available protection for the infant with the parent wearing a mask and practicing good hand hygiene (and doing so for the chest area as well).

 

Breastfeeding when COVID-19 positive

 

Current recommendations from the CDC are vague at best, conflicting and confusing at worst. Hospitals are given quite a bit of autonomy in determining their protocols and there’s a wide range of interpretations of the CDC recommendations. Key in their recommendations (updated as of May 20, 2020) is this: “…the risks and benefits of temporary separation of the mother from her baby should be discussed with the mother by the healthcare team, and decisions about temporary separation should be made in accordance with the mother’s wishes.”

So what do you do if you give birth, are COVID-19 positive, and are told that separation from your infant is mandatory?

First, remember that nobody can take your baby from you without your permission without reasonable cause. You have the right to refuse to comply with protocols and practices with which you do not agree or understand. You have the right and responsibility to understand what is being recommended for the health of your child and the evidence for those recommendations. You have the right and responsibility to ask questions until you are satisfied and have the understanding you need. You have the right and responsibility to make fully informed consent in the health care decisions of you and your child. You have the right to make decisions about your child’s health care without bullying, coercion, or threats.

If you are told that your health care facility’s protocols require separation and no direct breastfeeding (pumping only), ask to speak to your child’s doctor directly, tell them you want to work together with them for the health and well-being of your new baby, that you want to understand exactly what is being recommended and why, and inquire why the WHO recommendations are not being followed. 

Listen respectfully as they explain.

Then communicate clearly that you wish to follow current evidence-based recommendations to breastfeed directly and will practice good hand and chest hygiene and wear a mask but that it is your intent to breastfeed your baby according to the WHO recommendations on breastfeeding and COVID-19 positive status. 

If you are told that the institution does not follow the WHO recommendations, you may want to point out that the CDC clearly states “…decisions about temporary separation should be made in accordance with the mother’s wishes.”

If you are again told separation is mandatory, you may find it helpful to say that you appreciate their concern for you and your child’s well-being but that you do not consent to separation based on current evidence-based recommendations to breastfeed.

If you are told that they will call CPS, you may want to state: “I would like it charted that you, Doctor/Nurse _____________ have said that CPS would be called on me if I followed the recommendations from the WHO and CDC regarding separation of the breastfeeding pair in the case of CV19+ status and that this institution would not support me in following current evidence-based recommendations regarding breastfeeding during the coronavirus pandemic.” Asking for this to be in our chart is protective for both you and the health care team. Documentation is very important. Maintaining your own documentation is also important should things escalate. Hopefully that won’t be the case but it is wise to be prepared.

If things continue to escalate, it may be time to reach out to seek legal counsel.

As much as this is a vulnerable time and there’s a lot happening in the body postpartum, as much as possible, remaining calm and non-combative is helpful. Keep in mind that information is changing rapidly and protocols are often decided by hospital administration rather than the actual care providers. The majority of healthcare professionals are just trying to help others as best they know how and may have been given no say in the hospital policies. Attacking them rarely is beneficial and could cost you an influential ally.

 

 

You and your baby should be together and evidence supports that. Should you find yourself dealing with a situation of mandatory separation at birth due to COVID-19 status, please know that all evidence supports that you and your baby should be together, have skin-to-skin, and breastfeed. You are the best person to advocate for your baby and your baby needs to be with you.

For an ever growing list of resources and information on breastfeeding and COVID-19 including studies, health organization recommendations, and more, please see this list. We will be adding resources as they become available so check back frequently.

 

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Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of wereallhumanhere.com, freelance writer, and co-founder of Milk: An Infant Feeding Conference. Jessica lives with her family in the Pacific Northwest and co-parents her 7 daughters with her husband of 23 years.

Call for speakers- MILK: An Infant Feeding Conference, 2016

Milk Conference banner

Calling for submissions from clinicians, scholars, researchers, students, artists, mothers, fathers, and others familiar with infant feeding from clinical and social perspectives. Submissions of a wide variety are welcome, including research presentations, theoretical papers, academic papers, creative submissions including personal essays, social commentary, literature, and performance art for the 2016 Milk Conference.

Milk: An Infant Feeding Conference 2016 will be held November 11-12 in Costa Mesa, California and is open to health care providers and consumers alike aiming to a create a bridge building experience that educates and supports infant feeding by changing the conversation both systemically and sociologically.

The theme chosen for 2016  Milk: An Infant Feeding Conference is Nourish. Exploring how infant feeding provides not only physical nourishment with a look at the nutritional composition involved, we will be unpacking just how feeding our babies nourishes our minds, our families, attachment, confidence, partnerships, public health, education, and other social factors.

We are looking for presentations on topics related to infant feeding and maternal health including but not limited to: continuity of care and infant nutrition, the diagnoses and care of physiological barriers to breastfeeding, sociological barriers involved in infant feeding, anthropological perspectives of infant nutrition, analysis of marketing in the maternal baby industry, conscientious marketing, exploration of infant feeding and child nutrition controversies, policies in the workplace for family support and breastfeeding, politics of infant feeding and policy making, postpartum depression and mental health research related to infant feeding, infant feeding practices in subsequent children, sociological family support and infant and child nutrition, infant feeding education, infant nutrition in public health, feeding multiples, managing maternal health issues through breastfeeding, nonviolent communication strategies for supporting infant feeding, developing infant feeding support products, immediate postpartum infant feeding support, the impact of birth interventions on maternal breastfeeding goals, maternal and pediatric allergies and infant nutrition, premature infants and nutrition, feminism and infant feeding, natural duration breastfeeding, weaning, infant nutrition and sleep, partner support and education, breastfeeding after breast reduction, socioeconomic and racial disparities in infant feeding support, breastmilk pumping, inducing lactation and relactation, the role of infant nutrition in relation to dental care, and the future of infant nutrition support.

To submit to speak at Milk 2016, please use this form.

 

Toddlers, Breastfeeding, and Boundaries

by Adina Henry

When our babies are first born and trying to get the hang of breastfeeding and regulating Mommy’s supply, we may feel like they are attached to our breasts 23 hours a day. Every time the baby fusses we stick a boob in their mouth, because it works and please child, stop screaming at me! And then we keep nursing, because everyone is happy and it’s working!

Then one day you look at your tiny baby and she’s a tornado of a toddler, “sharing” your whole plate of lasagna before you can get a bite for yourself and talking in sentences, most of which have the word “mine!” figuring prominently. And you’re still nursing, because everyone is still happy and it’s still working, except maybe Momma isn’t always so happy anymore. (Because the nipple twiddling, for example! Gah!)

(Related: The breastfeeding toddler explains when it is an appropriate time for a toddler to breastfeed.)

It looks like it’s time for some boundaries. My training and years as a preschool teacher/director have helped me when I need to set boundaries with my own daughter, and I can tell you first-hand that boundaries can save you.

When establishing breastfeeding boundaries for your toddler, it’s good to keep in mind that it’s healthy and helpful for both Mom and toddler to have limits. You are a person and a full half of the breastfeeding dyad and your feelings and needs matter. Your child is not being punished for growing up. It’s ok to set limits as both of your needs change. Boundaries are your personal choice. The boundaries for one mom at a certain time in their breastfeeding relationship may be entirely different from those of another mom’s. Even from child to child boundaries don’t have to be the same. Maybe it’s time to only nurse before sleep. Maybe you just want to start using the bathroom alone (Crazy talk! I know!). Maybe nursing sessions need to last 10 minutes, not 45 minutes. Whatever your needs are, the approach can be the same: The key is communication, and with good communication we can set ourselves and our children up for success.

Breastfeeding boundaries for toddlers

Here’s the most important part: Talk with your child about the change that will be happening. We are so used to doing things for our babies that it’s easy to forget to fill them in on the plans. Think about how you like requests to be made of you and go from there. From a very young age, younger than most of us expect, our children can understand more of our communication than we realize.

If you think of yourself attending to your child the way we would hope a nurse would attend to us in a hospital, a new, helpful perspective may be found. Picture yourself in the hospital for whatever reason. It’s the middle of the night and you’re thirsty and so you press your call button and wait for someone to come help, but she never shows up. Or she does come, but when she arrives and you ask for a drink she announces that the new hospital policy, as of now, is that no liquids are given at night anymore. You probably wouldn’t be happy about either of these scenarios hitting you without warning. But what if you were warned ahead of time? What if, earlier in the day, when you weren’t tired and upset, but just reading a magazine and doing your thing, a nurse let you know that there was gong to be a change in the night staffing routine and let you know what was coming. And even better, if she then reminded you again later, just to make sure you heard the message. You might prepare for the night by making sure you have a little bottle of water next to your bed. Or, at least, you might not be so confused when you wake up looking for assistance, but then remember the new policy.

Giving your child a “heads up” about what’s coming is a great way to help them transition to whatever’s next. Babies and toddlers can be more receptive than you might think about being talked to about what’s happening around them. Their brains are little sponges. Remember that children are paying attention to how we talk to them and will later talk to others in the same way.

How to bring up the change in routine? Make your request positive. We all generally respond to positive ideas and solutions better than roadblocks and problems.

Think back to the nurse in the hospital scene. You’ve just had your super delicious tray of hospital food and your blood pressure and temperature have been checked for the 1200th time that day. The nurse comes in to tell you about the new “no drink refills at night” rule. She can say, “I want to let you know that we’re cutting you off for snacks at night and no matter how much you want it, you can’t have any drinks after 11pm.” Or, instead, she might say, “We’re having a change in policy later this evening and we won’t be delivering snacks and drinks throughout the night anymore. I want to make sure you’re comfortable though, so I’ve brought you an extra bottle of water you can keep by your bed in case you get thirsty. And even though the kitchen will be closed during the night, if you find yourself in pain or with a problem, I’m still here.” Personally, I would respond much better to the second option.

Now that you’ve begun to set yourself up for success, talk about it more. When it’s happening, talk about it. “Remember how we talked about how when we’re having milkies, your hands can pet me gently, but aren’t going to pinch? This is what we were talking about. I’m going to help you touch me gently by showing you that gentle touch again. Remember this? Ah, this is nice. Thank you.”

And then talk about it after, and acknowledge any efforts on the part of your child to cooperate with this new boundary. “You did better with touching me gently during nursies. Thank you! It felt better to have cuddles like that!” Or, “I know it was really hard to not have milkies right when you wanted, but you got through that frustration and are ok now. I feel much better now that I actually got to eat dinner using both of my hands and while able to reach my plate. Thank you. Next time, it will be easier, I think.”

Here’s the kicker though; toddlers will hear a really good swear word once and use it correctly everyday thereafter, but it takes 5 million repetitions of “Please wash your hands after you use the toilet” for it to become second nature. You may need to repeat this process many times before you are successful.

But it will be worth it and setting you and your child up for a beautiful future together supported by healthy, respectful boundaries.

You can do this, Mommas!

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Adina Henry
Adina Henry is a preschool/daycare director and teacher, as well as a mother. She has been teaching young children in schools, homes and playgroups since 2003. Incorporating play, music, movement and imagination into each day, Adina believes that children learn best through play and exploration. In addition to being an admin in The Leaky Boob Community of Facebook, Adina bellydances when she gets the chance, and encourages you to dance too.

Oatmeal Stout Crockpot Coffee Cake- Lactation Booster!

by Carrie Saum

Summer is here.  And maybe your new little baby is here, too.  Snuggly and warm.

Oh, so warm.

Almost suffocatingly hot.

Dear God, is that a baby or a furnace you’re holding?  The temperature outside is a stifiling 100+ degrees and holding that little fireball while also living on the approximate surface of the sun might be a bit much for you.

But you want cake.

Except it’s summer and who has the time or energy or heat capacity to use an oven?

But you still want cake.

Enter your new BFF – The CrockPot.

Yep.  Make your cake IN THE SLOWCOOKER.

CrockPotOatmealStoutCake1

There is no need to turn your house into an incinerator while taking care of  your miniature lava ball on top of the erupting volcano we call Earth just to have a tasty and relatively healthy treat.

This recipe utilizes the amazing benefits of oats (with milk-boosting powers!), lowers the glycemic index with the use of coconut palm sugar, and gives you the fun milk-boosting benefit of stout beer without actually consuming it.  Plus, after baking it for several hours in a large pot, a majority of the alcohol dissipates so you don’t have to worry about you (or your other kiddos) getting a buzz when eating it.  All of this, just by using your crockpot.

Now, to be clear, this is a dense cake.  It’s almost more of a bread. Should we call it a cake bread?  Either way, it’s satisfying and just perfectly sweet.  You can add chopped up apples or nuts if you want to give it more texture.  I prefer to top my crockpot cake with a bit of homemade whipped cream, sweetened slightly with honey.

Ingredients:

  • 3 cups oat flour (You can make your own using old fashioned oats and your food processor or blender, which is the easiest and cheapest, IMO.)
  • 1.5 cups old fashioned oats
  • 1 cup coconut palm sugar
  • 2 Tbsp tapioca flour or arrow root powder (or wheat flour but it won’t be as milk boosting)
  • 1 tsp cinnamon
  • 1/2 tsp nutmeg
  • 1/2 tsp baking powder
  • 1/2 tsp baking soda
  • 1/2 tsp salt
  • 1.5 cups stout beer (like Guiness)
  • 1/3 cup oil or melted butter
  • 2 eggs
  • 1 tsp vanilla extract
  • 1 Tbsp honey (optional)

Instructions:

  1. In a large bowl, combine all dry ingredients.
  2. In a smaller bowl, combine all wet ingredients and blend thoroughly.
  3. Add wet ingredients to dry ingredients and mix until it begins to thicken.
  4. Pour batter into very well-greased or parchment paper lined crockpot. (I recommend parchment paper if you have a dark-colored crock.)
  5. Place kitchen towel over the top of the crockpot, and pull tight and flat.  Secure towel with the lid. (This will keep moisture from gathering and dripping onto your cake!)
  6. Cook on low for 3.5 hours.
  7. Once you can stick a knife into the cake and it comes out clean, it’s done!  Remove pot from heat source, and allow to cool for 30 minutes before eating.

CrockpotOatmealStoutCake2

The best way to store this is pre-cut in storage containers.  Once completely cool, you can slice it and use parchment or wax paper to separate the layers inside the container.  It’s easy to grab on the go, and you aren’t using up that valuable crockpot or counter space to store.  It refrigerates well, and also freezes well.  You can eat it in the morning with your yummy lactation tea, or as a late-night nursing snack while you cuddle your tiny newborn/thermal nuclear reactor.

What’s in your CrockPot?

Carrie

*Note: It’s important to point out that most women aren’t going to need to eat food with the intention of upping their milk supply, if everything is working the way it is supposed to, your baby will know how to up your supply just fine themselves. Skin-to-skin and feeding on demand are the best ways to increase breastmilk supply to meet your baby’s needs. (Concerned you have low supply? Read this to help figure out if it is something you need to be concerned about.) For those women, galactalogues just happen and they don’t need to think about it. But some women, like me, do need a boost. As a mom who ended up exclusively pumping and indeed having low supply such that I ended up on medication solely to increase my milk production, I know what it’s like to look for anything, anything at all that would help my body make even just a little more milk to help feed my baby. With the support of my health care providers, we tried everything. It becomes “I will eat all the cookies, I will drink all the shakes, I will eat all the parfaits!” if it even just makes me feel like I’m doing something to address the low supply struggle, it is worth it.

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If you like this recipe, check out this Kale Waldorf Salad or Roasted Cauliflower Soup over on Our Stable Table.

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IMG_2895Carrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices and health knowledge. Carrie has extensive first-hand experience in vast array of medical and service fields. With background in paramedic medicine, Carrie spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. As an AWC, Carrie currently coaches her clients and their families about topics including nutrition, weight loss, and stress management. In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and the voice behind OurStableTable.com. She lives in Portland, Oregon with her husband and young son.

Carrot Fennel (Lactation) Slaw – Feed Your Whole Family

by Carrie Saum

What do you do when you have multiple food needs in your family?

For example: Dad wants protein.  Kids want carbs. Mom could use some milk boosting foods. And EVERYONE needs veggies. You can’t spend a fortune or the energy accommodating everyone all the time, right?  Because you are a mom and you have to feed yourself and your family and maybe the neighborhood, too.

We joined a co-op a few years ago to purchase high-quality animal protein that was raised properly, humanely, and that was affordable.  That might not be possible for you, and that’s okay.  But it felt very important to us and we made the switch, even though it meant eating slightly less meat.

As a new mom, I fell in love with my crockpot.  I love the idea of putting a few ingredients into a pot, walking away for the day, and then eating a fantastic home cooked meal that night.  It seemed to meet all of the criteria for feeding my family: inexpensive, tasty, satisfying, balanced, and full of nutrition.

My favorite crockpot recipe by far is this Pulled Pork.  It’s incredibly versatile and easy to serve, reheat, remake, and freeze.  I make this fennel slaw recipe for the family and use it in pulled pork tacos.  The sweetness of the slaw pairs perfectly with the saltiness of the pork. It has a fighting chance of pleasing the whole family, and boosting your milk production, too!

pulled pork

Ingredients:

  • 2 bulbs of fennel, thinly sliced (I recommend using a mandolin.)
  • 2-3 carrots, shaved (I use a veggie peeler.)
  • Cilantro
  • 2 Tbsp Apple cider vinegar
  • 1 tsp raw honey
  • Sea Salt and Pepper

Directions:

  1. Combine fennel, carrots and as much cilantro as you’d like in a bowl.  I like LOTS of cilantro.
  2. Add vinegar, honey, S&P and mix thoroughly.
  3. Allow to sit for 10 minutes before serving to set.

My favorite preparation is this on top of pulled pork tacos with a little goat cheese a an ice cold limeade  to wash it down with.

Enjoy your summer, enjoy your family!
Carrie

If you like this recipe, check out this recipe for brussel sprouts or Charlie Brown Bars over on Our Stable Table.

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*Note: It’s important to point out that most women aren’t going to need to eat food with the intention of upping their milk supply, if everything is working the way it is supposed to, your baby will know how to up your supply just fine themselves. Skin-to-skin and feeding on demand are the best ways to increase breastmilk supply to meet your baby’s needs. (Concerned you have low supply? Read this to help figure out if it is something you need to be concerned about.) For those women, galactalogues just happen and they don’t need to think about it. But some women, like me, do need a boost. As a mom who ended up exclusively pumping and indeed having low supply such that I ended up on medication solely to increase my milk production, I know what it’s like to look for anything, anything at all that would help my body make even just a little more milk to help feed my baby. With the support of my health care providers, we tried everything. It becomes “I will eat all the cookies, I will drink all the shakes, I will eat all the parfaits!” if it even just makes me feel like I’m doing something to address the low supply struggle, it is worth it.

___________________________

IMG_2895Carrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices and health knowledge.
Carrie has extensive first-hand experience in vast array of medical and service fields. With background in paramedic medicine, Carrie spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. As an AWC, Carrie currently coaches her clients and their families about topics including nutrition, weight loss, and stress management. In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and author. She lives in Portland, Oregon with her husband and young son and writes atOurStableTable.com.

 

 

Dark Chocolate Lactation Granola Bark

by Carrie Saum

In my house, anything I make or bake will get eaten either by family or friends.  But it is a very rare occurrence that anything I bake goes in the trash.

When my son was born, I made plenty of lactation goodies (including this lemonade and these cookies) and it was impossible to keep them to myself.  First of all, I didn’t WANT to keep them to myself because I’m a sharer by nature.  Then I couldn’t because all of the people coming in and out of our house knew about the goodies and wanted to partake.

However, that became expensive.  FAST.

I got smart about it.  I made all of the treats I could that were inexpensive.  I could buy oats in bulk for super cheap.  My mom gave me a giant jar of local honey from a farm (also very inexpensive), and the rest is history. I made little crunchy granola bars that resembled Nature’s Valley but without any added junk.

But here’s the thing. I GOT BORED. Since I needed the fuel to keep my supply up while exclusively pumping, I tried my hand at different recipes.  Because boredom is the master of invention.  I think.  No, that’s not the right quote.  But it’s the right idea.  I love trying new things, but I also have to try new things to keep the game interesting. And feeding yourself (and your baby) is always interesting.

So, when boredom struck, I struck back.  I added sunflower seed butter.  And chocolate.

Then I got a little crazy and instead of cutting them, I broke the granola into pieces that were pretty and irregular and made me feel decadent.  And every new mama needs to be made to feel decadent, right?  And maybe even a little fancy, too.  They’re also a breeze to make, and very affordable.

DarkChocolateGranolaBark

 

Ingredients for Granola Bark:

  • 1 1/4 cup rolled oats
  • 1/4 tsp salt
  • 1/4 tsp baking soda
  • 1/2 tsp  vanilla extract
  • 2 Tbsp melted butter
  • 1 Tbsp molasses (optional, but adds depth of flavor)
  • 1/4 cup sunflower seed butter or peanut butter
  • 1/4 cup honey

Ingredients for Chocolate Layer:

  1. 6 oz 90% cacao chocolate
  2. 2 Tbsp coconut oil
  3. 1 tsp vanilla extract
  4. 1 Tbsp raw honey

Directions for Granola Bark

  1. Combine all dry ingredients, and mix throughly.
  2. Combine all wet ingredients and add to dry ingredients.
  3. Spread granola mixture in a 7×12 inch parchment-lined dish.  Pack it down hard, leaving no breathing room.
  4. Bake at 350 degrees for 18-20 minutes.  Allow to cool completely in the pan.

Directions for Chocolate Layer

  1. Melt chocolate and coconut oil in your home-made double boiler
  2. Add vanilla and stevia
  3. Once melted and stirred well, pour into the pan of chilled nut butter mixture (Optional and delicious step: Spread a thin layer of peanut butter or sunbutter over the granola first, then pour your chocolate over it.)
  4. Allow to harden in the refrigerator for an hour, then break into pieces.  Store in an airtight container in the refrigerator.

For an extra milky boost you can add 2 tablespoons brewer’s yeast and/or 2 tablespoons flaxseed meal to the granola bark. Be warned that some tummies don’t respond well to the brewer’s yeast so if you or your baby tend to have sensitive stomachs, it may be best to skip it.

*Note: These do NOT keep at room temperature because of the coconut oil the chocolate layer. If you want the chocolate to keep at room temperature, consider using (sustainably and humanely harvested) palm oil instead of coconut oil.

You will be impressed with yourself when you make these.  Better yet, make these for a friend who just had a baby and she will be forever grateful.

Barking up the Lactation Tree,
Carrie

If you love this smoothie recipe, you might like this recipe for Paleo Chocolate Chip Granola or these Gluten-Free Strawberry Shortcake on Our Stable Table. 

*Note: It’s important to point out that most women aren’t going to need to eat food with the intention of upping their milk supply, if everything is working the way it is supposed to, your baby will know how to up your supply just fine themselves. Skin-to-skin and feeding on demand are the best ways to increase breastmilk supply to meet your baby’s needs. (Concerned you have low supply? Read this to help figure out if it is something you need to be concerned about.) For those women, galactalogues just happen and they don’t need to think about it. But some women, like me, do need a boost. As a mom who ended up exclusively pumping and indeed having low supply such that I ended up on medication solely to increase my milk production, I know what it’s like to look for anything, anything at all that would help my body make even just a little more milk to help feed my baby. With the support of my health care providers, we tried everything. It becomes “I will eat all the cookies, I will drink all the shakes, I will eat all the parfaits!” if it even just makes me feel like I’m doing something to address the low supply struggle, it is worth it.

_______________________

IMG_2895Carrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices and health knowledge.
Carrie has extensive first-hand experience in vast array of medical and service fields. With background in paramedic medicine, Carrie spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. As an AWC, Carrie currently coaches her clients and their families about topics including nutrition, weight loss, and stress management. In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and author. She lives in Portland, Oregon with her husband and young son and writes at OurStableTable.com.

 

 

 

Tension and Breastfeeding, How Relaxing Save Her Breastfeeding Relationship

by Vivian Muehlen
this post made possible by the generous support of KoalaKin.
Vivian & Luc KoalaKin

The author and her son.

 

I still wince when I think that I had to give up breastfeeding 5 months after my son was born, due to a myriad of issues ranging from low milk supply, tendonitis, mastitis and lower back pain. And that was almost 12 years ago!

When my second son was born, I was again 100% committed to breastfeeding, but now I also had a preschooler running around the house. Not only that, but I was again afflicted with mastitis (caused by a poor latch) and arm, neck and shoulder pain from breastfeeding my little guy 8-12 times a day. Wait! Wasn’t breastfeeding supposed to be natural? It was then that I realized that breastfeeding may be natural, but its not instinctual. I needed help ASAP!

I tried slings and wraps, but they didn’t work for me. They weren’t supportive enough and my son’s face always ended up not perfectly aligned with my breast, or his latch would slip as soon as I moved.

I was at my wits end, almost giving up, when I decided to create my own solution. As soon as I developed a halfway functioning prototype of the KoalaKin and began using it with my son, a flood of relief ran through me as I was finally able to relax a little bit. My son was supported, his latch was firm and I had not one, but two free hands. Not longer feeling any strain, I was able to give my boy all my attention. I noticed his teeny, tiny fingernails, his fine hair, and the insane cuteness of his little feet… Words cannot explain the feeling of empowerment, confidence and GRATITUDE I felt when I realized that after all these years of struggle, I was finally able to effortlessly breastfeed my child.

And best of all: I now loved just staring at him breastfeed, knowing I was giving him the absolute best. There’s no feeling like it. No pain, all gain.

One of the best pieces of advice I received in my breastfeeding journey, was that it was important to minimize stress as much as possible. When moms are stressed, their breast milk supply usually decreases dramatically. Also, some studies even show that elevated levels of stress also cause a defective let down reflex.

Paradoxically, breastfeeding in itself is actually calming. The hormone prolactin is released during breastfeeding, which gives mom a feeling of peace and tranquility. That being said, the worry ABOUT breastfeeding (is my baby getting enough, what, he’s hungry again?, when is the laundry going to get done?), causes stress amongst moms and may interfere with a mom’s ability to establish a good milk supply.

KK Jade Comp LR KoalaKin

Vivian created the KoalaKin to offer other women the kind of support she found she needed to help her relax during breastfeeding and reach her breastfeeding goals. To learn more about how the KoalaKin could support you and to determine if it is right for you, click here.

 

What I wish I had known on how to relax during this special time:

Don’t wait until your baby is crying. Nothing stresses out a mom more than hearing her baby cry. Fussiness is the first cue that a baby is hungry. This is the time a mom should calmly sit or lay down with her baby and nurse. Not waiting until the baby cries will greatly reduce feelings of stress and overwhelm.

Listen to calming music. Take a moment to pop in your favorite calming tunes. Don’t focus on what kind of music you listen to, focus on how the music makes you feel. Classical music may be relaxing to some, and annoying to others. I personally liked to listen to yoga music, which always drove my husband crazy!

Create a favorite breastfeeding spot. Be it a bright space by a window in your living room or a dimly lit corner in your child’s nursery, creating a favorite breastfeeding spot can immediately relax and calm a tired, overwhelmed mom. Again, choose a spot that makes you feel warm and fuzzy inside. That’s the feeling you want over and over again when you breastfeed.

Make sure you are seated in an ergonomic way. There is virtually no way a mom can relax if her body is feeling any level of discomfort. Back or arm strain can make a nursing session torturous, and therefore it is very important to ensure mom is comfortable, and can stay that way for the next 20-40 minutes. A chair with excellent back support and an armrest is a must. Breastfeeding pillows, slings or a KoalaKin can help support the baby’s weight, allowing mom to relax any areas of strain and enabling a more ergonomic breastfeeding position.

Prepare a light snack to eat while breastfeeding. Don’t they say “sleep when the baby sleeps”? Well, I’ll add to that and say “eat when the baby eats!” Keep a stash of healthy, convenient snacks, like trail mix, pretzels and hummus, healthy energy bars and fruits where you can just grab and go. Once the baby is latched on and contently nursing away, treat yourself to these delicious snacks. Since nursing sessions can take up to 40 minutes, moms can take their time and really enjoy nourishing themselves!

Read a good book or watch TV. After a good snack, there’s nothing better than indulging in a good book or favorite TV show. As much as breastfeeding can be bonding, it’s not practical to expect to stare into your little one’s eyes through every session any more than every meal with your romantic partner should be a candlelit dinner. Getting comfortable and enjoying something that has you looking straight ahead can also help relieve tension in the neck and shoulders when you have good support.

While breastfeeding is something we do for our babies, with a little bit of organization and practice, this can also be a time that moms can use to take care of and nourish themselves.

Thanks to the KoalaKin, I was able to bond more with my son, and most importantly, I was able to breastfeed longer than I would’ve been able to, because the KoalaKin helped ease the strain I was feeling.

I’m a big believer that a mom should use any tool she thinks might help her successfully nurse her baby. After all, breastfeeding is one of the most beautiful, healthy and natural things a mother can do with her baby. There isn’t any one tool that work for every mom or even with every baby for the same mom. Be flexible and willing to try new things and take care of yourself to better be able to take care of your baby. Relax, you’ve got this!

___________________________

The KoalaKin Hands-Free Nursing Pouch was created by Vivian in 2009 after she suffered through several very frustrating breastfeeding attempts, where a poor latch coupled with arm, neck and shoulder pain from holding her baby in the same position for 30-40 minutes several times a day, took away from the wonderful experience that breastfeeding should be.
Tired of the pain and frustration, Vivian decided she needed help fast and turned to products such as slings and wraps.  However, she quickly realized there was nothing in the market that addressed her needs … so the first prototype of the KoalaKin was born!  With the goal of becoming the product that provides the best possible breastfeeding experience, Vivian worked tirelessly with lactation consultants and other birthing professionals, and turned her early prototypes into the KoalaKin that is available today. 

Oatmeal Chocolate Chip Lactation Cookies

by Carrie Saum

This post made possible by a partnership with The Leaky Boob sister community, Our Stable Table.

Photo courtesy of Gwyneth Colleen Photography.

Photo courtesy of Gwyneth Colleen Photography.

 

Confession:

I am a cookie snob.

Lactation cookies are no different.

I found a recipe in my mom’s kitchen recipe box on a raggedy old index card. It wasn’t in her handwriting or my grandmothers’ handwriting.  I snagged the card and kept it for a few years.  But let’s face it.  I made these cookies SO OFTEN that I committed the recipe to permanent memory.

When I had my son, we were too stressed and busy to think about lactation cookies while he was in the NICU for the first week of his life.  We came home from the hospital, and I had to get serious about boosting my milk supply, especially since I was not sleeping or eating regularly, and pumping exclusively. (I know, I know.  Not a great way to start motherhood, but those days were SURVIVAL. And it got better.)

My husband, who just happens to be an amazing baker, took over making the oatmeal cookies while I was working around the clock to feed my baby.  My husband and I ate these cookies by the batch, a bright spot in a wild season, and I would wake up in the middle of the night to pump and feed my baby with a spoonful of the cookie dough in one hand and my newborn in the other.

These are ADDICTIVE.

Oh yeah.  And the cookies totally boosted my milk supply. Which, let’s face it, was a bonus.

There are three versions of this cookie.

Version 1: The Regular Version. This version is perfect for eating in any form, raw, cooked, frozen, etc.

Version 2: The Lactation Version. This version gives extra milk-boosting power with the addition of flax meal.

Version 3: The You-Will-Never-Love-Another-Cookie-As-Much-As-This-Cookie Version.  I think this one is pretty self-explanatory.  And it will still make you milky.  Is that even a phrase?  It shouldn’t be.  I immediately regret writing it.

I’ll give you the base recipe with the tweaks (which are minor) along the way.

Ingredients:

  • 2 cups unbleached flour ( 1.5 cups for V3)
  • 2.5 cups old fashioned oats, not instant (3 cups for V3)
  • 2 cups milk chocolate chips (You can use dark or semi-sweet chocolate but it’s less awesome.)
  • 2 large eggs
  • 1 cup white sugar
  • 1 cup brown sugar, packed
  • 1/2 cup butter, softened
  • 2 Tbsp whole milk (4 Tbsp for V2)
  • 1/4 cup flax seed meal (ONLY for V2)
  • 1 tsp baking soda
  • 1 tsp baking powder
  • 1 tsp sea salt

Instructions:

  1. Using an elctric mixer or a lot of elbow grease, cream butter and sugars until fluffy and light. Beat in the eggs, milk and vanilla extract.
  2. Combine flour, (flax meal if you are making V2), baking soda, baking powder and salt together in a separate bowl.
  3. Slowly add flour mixture to the sugar mixture until it’s incorporated. Be careful not to over mix. Stir in the oats and chocolate chips.
  4. On a parchment paper lined baking sheet, put dough in 1 inch rounds, making sure to leave plenty of room to expand.
  5. Bake at 325 degrees for 10-15 minutes.  I’ll let you decide what kind of doneness you like but I pull them promptly at 13 minutes.
  6. Remove from oven, and cool completely on cooling rack.  Or until you can reasonably eat them without burning the crap out of your mouth.
  7. Skip baking them altogether and just eat the dough straight.

These are also pretty awesome to make and bring to your friends who have just become parents, so just go ahead and bookmark this recipe and plan to make them.  You will be the favorite friend, possibly ever.  This is also a great way to love your newly lactating Baby Mama, too.

If you like this recipe, head over to Our Stable Table for more great recipes and some great conversation.

Happy Lactating!
Carrie

 

IMG_2895Carrie Saum brings a passion for wellness and over a decade of experience in health care to her clients. A certified Ayurvedic Wellness Counselor (AWC) from the Kerala Ayurveda Academy, she empowers individuals and families to achieve health and balance through time-honored practices and health knowledge.
Carrie has extensive first-hand experience in vast array of medical and service fields. With background in paramedic medicine, Carrie spent ten years serving in the non-profit sector managing organizations, programs, and orchestrating resources to meet health needs of people across the United States and abroad in countries such as Guatemala, Mexico, Kenya, and Zambia. As an AWC, Carrie currently coaches her clients and their families about topics including nutrition, weight loss, and stress management.In addition to her work as a wellness counselor, Carrie is a passionate “foodie” and author. She lives in Portland, Oregon with her husband and young son.

 

 

MiLK Conference Call for Speakers

breastfeeding and formula feeding conference

Call for speakers

MILK: An Infant Feeding Conference,

2015

 

Calling for submissions from clinicians, scholars, students, artists, mothers, fathers, researchers, and others familiar with infant feeding from clinical and social perspectives. Submissions of a wide variety are welcome, including research presentations, theoretical papers, academic papers, creative submissions including personal essays, social commentary, literature, and performance art.

We are looking for presentations on topics related to infant feeding and maternal health including but not limited to: continuity of care and infant nutrition, the diagnoses and care of physiological barriers to breastfeeding, sociological barriers involved in infant feeding, anthropological perspectives of infant nutrition, analysis of marketing in the maternal baby industry, conscientious marketing, exploration of infant feeding and child nutrition controversies, policies in the workplace for family support and breastfeeding, politics of infant feeding and policy making, postpartum depression and mental health research related to infant feeding, infant feeding practices in subsequent children, sociological family support and infant and child nutrition, infant feeding education, infant nutrition in public health, feeding multiples, managing maternal health issues through breastfeeding, nonviolent communication strategies for supporting infant feeding, developing infant feeding support products, immediate postpartum infant feeding support, the impact of birth interventions on maternal breastfeeding goals, maternal and pediatric allergies and infant nutrition, premature infants and nutrition, feminism and infant feeding, natural duration breastfeeding, weaning, infant nutrition and sleep, partner support and education, breastfeeding after breast reduction, socioeconomic and racial disparities in infant feeding support, breastmilk pumping, inducing lactation and relactation, the role of infant nutrition in relation to dental care, and the future of infant nutrition support.

Submissions accepted through February 28, 1015 and close March 1, 2015.

Milk: An Infant Feeding Conference, is a MommyCon conference envisioned by The Leaky Boob with the support of Ergobaby. Designed to bridge professional conferences for clinicians, health care providers, academics, and researchers, with consumer conferences for parents, Milk aims to educate, inspire, and support parents in feeding their children, as well as the people that support them including nutrition, lactation, maternal, and pediatric health care providers.

To submit to speak at Milk 2015, please use this form.

Feeding Echo, part 1- Breastfeeding Trauma, Exclusively Pumping, and FPIES

By Carrie Saum Dickson

This guest post shares the feeding journey of 16 month of Echo as told by his mother. A breastfeeding, pumping, allergy story of a little boy with a bright spirit and a mom and dad with steadfast hearts and commitment. Their story is beautiful, inspiring, challenging, humbling, educational, and so very raw. Be sure to go on to read part 2 and part 3 of their story as well.

skin to skin newborn

It’s 8:30 on a Wednesday night. My husband, Lance, is in our son Echo’s room, feeding him his bottle and reading a bedtime story. Bedtime is later than usual tonight. After working a full day building my practice as an Ayurvedic Wellness Counselor, taking Echo to an early evening doctor’s appointment and cooking dinner for the three of us, time slipped away from me. Echo ate his dinner late, too. We are all tired and cranky from a day that held too much activity and not enough down time.

I’m washing baby bottles in the kitchen when I hear Lance frantically yell through the monitor, “Carrie! Carrie! It’s happening again!”. I slip the bottle I’m washing back into the soapy water and hurry to Echo’s room. Echo, Lance, and everything within a three-foot radius is covered in vomit. I grab a towel for Lance, take our crying one-year old son, and try not to cry, too.

I draw a bath while Lance peels off his vomit-soaked clothes and climbs in the tub. I undress Echo and give him to Lance and go clean up Echo’s bedroom. I strip the double bed, break out the sanitizer and get down on my hands and knees to make sure I don’t miss anything. I study the vomit: color, consistency, quantity, and make notes to share with Echo’s doctor. The details are important.

I go back to the bathroom to get my sweet, smiley and spent little boy, put him in fresh pajamas while Lance showers. We start the bedtime routine all over again. We play peek-a-boo and pretend to eat his toes and we all feel a little better after laughing. I go back to the kitchen, finish washing Echo’s bottles, and sit down on the couch with my trusty pump as Lance kisses me goodnight and heads to bed himself. It’s 10:15. Exhausted, discouraged and hurting, I massage my right breast, which seems to constantly be clogged these days, and allow myself a good ugly cry. I leave the fresh-pumped milk out on the counter so I don’t have to waste precious minutes heating up a bottle in a couple of hours when I’m sure Echo will wake.

It’s 11:00 before I climb into bed, my right breast still hard and hurting with unexpressed milk. I know my sweet little Echo will wake up several times tonight, either from pain or hunger, and I’ll sing to him and soothe him the best I can in those long nighttime hours.

Echo has eaten green beans 10 days in a row now without any reaction, and we began to hope that maybe this would be a Pass. That his diet would expand to something other than breast milk, coconut oil and spinach.   This latest vomit episode signals the end of the green bean trial and one more food to add to the Fail column, of which there are many. And more than that, it means we have to start over from scratch with a new food, and all of the trepidation and hope that comes with it. I fall fitfully asleep worried about my baby, my boobs, and this betrayal of my son’s body called FPIES: The Mother of All Food Allergies.

Echo’s relationship with food has been fraught with difficulty from Day Two. When he was 36 hours old, he stopped breathing while nursing and continued to stop breathing every 10 minutes for the next 16 hours. In the hospital, he received his nutrition through an IV for almost three days. We didn’t know it at the time, but Echo was experiencing non-breathing seizures due to a stroke he suffered sometime shortly after birth. None of the doctors could tell us what caused it, and they chalked it up to happenstance.

Echo stroke NICU Exclusively pumping

My relationship with feeding my son has also been fraught with difficulty. Resuscitating him when he turned blue at my breast brought on PTSD and panic attacks for months. Over a year later, I still feel a faint, tiny, cold fist of fear in my chest when I remember it.

My first experience with a breast pump was sitting next to Echo’s bed in the Pediatric ER while a team of medical personnel worked furiously to keep him from crashing every 10 minutes while my eyes continuously leaked tears of terror and exhaustion. I pumped every 3 hours around the clock, even when I could not hold him for two days as my milk (miraculously) came in. I continued to pump, proud of my body for rallying to feed my baby, in spite of the circumstances and in spite of my fear. My body could do this one thing for my newborn son, and it did it well through bone-crushing exhaustion and fear.

Around four months old, Echo began making great strides in his stroke recovery. The muscle weakness on the left side of his body that affected his latch retreated. We weaned him off one of his anti-seizure meds. He woke up to the world around him, alert and happy and contagious with laughter. He also rejected the breast entirely. We had worked up to three nursing sessions a day and I was sad and frustrated when he wanted nothing to do with it. He looked terrified and scared every time I put him to breast. I told him aloud “we can do the hard things together, baby”, the phrase which I used to affirm us from pregnancy on, and resolved silently to myself as I hooked up my pump, “I can do this for ONE MORE DAY”. Grace always showed up to help me through those difficult early days of weaning and extra pumping.

 

exclusively pumping

I wondered if Echo remembered his first seizure and in my gut, I knew forcing the breast was re-traumatizing him. So, we stopped nursing. Many of the dark clouds our little family had been surviving under, lifted. We enjoyed lots of cuddles and closeness with bottle-feeding and we allowed this breast feeding-free world to be our new normal. I developed an even closer relationship with my pump. It went with me everywhere, even places my baby couldn’t. I tried hard not to resent the extra dishes, the double duty of pumping and bottle-feeding, my miniscule supply of free time, and the total loss of freedom to just take my baby and have a day away from home without first planning how much milk to bring and where I could pump in privacy.

Carrie and Echo skin to skin