You are here: Home / Archives for Relational Resource

Ask the Sleep Expert- Rebecca Michi- Night Weaning, Co-sleeping, and Crib Training- Sleep In Arm’s Reach

March 8, 2016 by Leave a Comment
The Leakies with Rebecca Michi
This post made possible by the generous support of Arms Reach Co-Sleeper

Arms Reach Banner Logo

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

 

Dear Rebecca

How do I get my almost 2 year old to sleep through the night? She wakes 2-3 times a night to comfort nurse and I’m desperately in need of a fully night’s sleep. I don’t want her to feel rejected but I’m at the end of my rope. She naps once a day for about an hour and a half and our bed time routine is pretty simple (bath, pajamas, brush teeth, story, nurse, sing a few songs, bed). What can I do to gently encourage her to sleep more at night? I’m not ready to fully wean but I have to do something.

Thank you for any help you can give me,

Red eyed and bleary in Missouri

Hi,

Do you have someone who could help during the night? Could your partner help? If so, I suggest you sleep somewhere else for a few nights (if you’re bed sharing) or have your partner go in and help during the night. They need to help the same time you would have done, we don’t want her left upset for any duration of time, and help soothing her any way they can. When night weaning (recommended after 12 months old or older, before then babies often still need nutrition at night), expect strong emotions from your child. Your daughter will be mad, quite mad I imagine, but she is just that, mad and someone is with her the whole time helping her with these emotions. Habits are broken after just 3 nights so it shouldn’t take long for her to not expect a feed during the night.

Wishing You Rest,

Rebecca

 

Dear Rebecca,

My question is about a safe sleep space. My son is 3 months and growing out of his bassinet but I’m not at all ready to put him in his crib in the nursery, I want to keep him near me. What are my options? He’s pretty big, in the 98th percentile. I don’t have space to move the crib into my room and I’d like to cosleep but I’m not sure it is safe for us to bed share as my wife is a heavy sleeper and we have a queen bed. Should we get a king sized bed? Is there a cosleeper option for bigger babies?

Deeply grateful,

Craving Cozy

HI,

Take a look at a co-sleeper Arms Reach co-sleepers, they attach your bed, and are the same height as your bed. Your child is sleeping right next to you, but in a separate sleep space, this would be the safest option for you with a smaller bed and a heavy sleeping partner.

Happy Co-Sleeping,

Rebecca

sleep article image

Dear Rebecca,

Our 1 year old sleeps for a max 15 mins in his crib. if he’s in bed with us we get an hour or 2, if we’re lucky we may get 4 hours. . Any little movement he does wakes him up and he can’t get back to sleep unless he’s nursing. I’m exhausted during the day and can barely keep up.

Something has to change.

Overly Exhausted mom of 2 + a pup.

Hi,

Make sure he has plenty of playtime in his crib each day, he needs  to be comfortable in his crib when awake to be able to sleep there comfortably.

Compare the mattresses, if they are different and I bet they are, try making the crib mattress more like yours. Some crib mattresses have a softer toddler side, you can also buy mattress toppers for crib mattresses. Some families put a quilt or blanket on top of the mattress but under the sheet to make the mattress more comfortable.

Making these changes to the crib can make the world of difference, if you are still struggling with wake ups during the night, you may want to take a look at some gentle sleep training techniques.

Best Wishes,

Rebecca

____________________

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

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

____________________

small Rebecca Michi121

 

Rebecca is a Children’s Sleep Consultant who has been working with families for over 20 years. She is a gentle sleep consultant who doesn’t believe in leaving your child to cry-it-out when teaching them to fall asleep more independently. She is passionate about helping children and their parents build healthy habits so they can finally get some sleep. By transforming drama into dreamland, her mission is to help your children—and you—get a good night’s sleep.
Filed Under: Article, baby, Featured, New article, Parenting, Sleep, sleep through the night Tagged With: , , , , , , , , ,

Babywearing: A Modern Adaptation for Parents

February 11, 2016 by Leave a Comment
by Reina Christian, Baby K’tan, LLC

This post made possible by the support of Baby K’tan

BK-Banner

 

Parenting is hard. Sure, it’s been happening for a very long time but it’s still hard. Full of challenges. For some parents, more than others.

 

While many of us feel overwhelmed with the beautiful task that is caring for and bringing up children when we aren’t dealing with mobility difficulties or chronic pain, there are parents that face challenges that amplify the everyday aspects of parenting that can seem exhausting in their own right to untold degrees. Yet every day, parents with limited physical resources love and care for their children, fighting through their own pain to be present and connected with their precious little ones. Forging their own path in their parenting journey, these are some of the bravest parents you’ll ever meet who know the meaning of sacrifice and give new meaning to ingenuity.

 

For the love of their children.

 

For parents with physical obstacles, finding and creating alternatives for navigating their parenting terrain is essential. In a world set up to work for a certain privileged group, many parents that don’t fit that mold look for ways to make it work for them. Babywearing for adaptive parents opens up connection and closeness.

 

When something comes along that helps, it is celebrated.

 

Just at the very center of the Baby K’tan story sits inventor Michal Chesal’s son Coby. Born with Down syndrome, his condition was the reason Chesal went to work exploring a babywearing option that would be crucial for offering her son the best possible development during the early stages. The result was a carrier that supported his low muscle tone contrary to the other carriers available on the market 13 years ago.

co-brand image for babykatan

 

Today, the Baby K’tan Baby Carrier has grown to be a popular option for all caregivers wanting to carry their little ones. What Michal didn’t realize at the time, was that the product she invented for her son with disabilities would soon become an important necessity and mainstay for caregivers who themselves live with disabilities. For some, the carrier doesn’t just offer a more convenient way to carry a baby, but rather the only way to carry or hold a baby.

 

Parents with disabilities bring a special gift to their parenting: they understand the need for adapting.

 

The first time Michal realized that her invention could help parents living with disabilities was when her sister Chumi used the Baby K’tan to carry one of her nieces. Chumi suffers from a neurological pain disorder that doesn’t allow her to walk or hold weight on her legs. While in a wheel chair, Chumi can use the carry her many nieces and nephews safely without putting weight on her lap which can cause intense pain. Like Chumi, for parents and other caregivers utilizing a wheelchair, babywearing may provide a safe option for connection, bonding, and to be able to accomplish the practical aspects necessary for daily life. For some, this is the only way they can hold their babies.

 

“I knew I was creating something that would benefit my son, but I never imagined that it would become essential for some parents and never in my wildest dreams would have thought it could be the only way some parents hold their babies,” says Chesal, president and co-owner of Baby K’tan, LLC.  

Adaptive Parents 

When Samantha Rawagah gave birth to her baby boy, her father was delighted to know that he would soon have a grandson to do all the things that Grandpas are supposed to do with their grandchildren. Only one thing was standing in the way. Mr. Rawagah is a paraplegic and uses a wheelchair to get around. With limited use of his arms, he feared not being able to hold his grandson. Samantha’s solution was to put a Baby K’tan on her dad. The result was a match made in heaven – the perfect way for Mr. Rawagah to hold his grandson close to his heart.

 

Cristine Pyle knows all too well how Mr. Rawagah felt. While Cristine is not confined to a wheelchair, she too is learning how to parent with physical limitations. Cristine has a right hemiparesis that affects both her right arm and leg. She has no functional use of her right arm or hand and has limited mobility, balance, and endurance due to the weakness in her right leg. On her blog, AdaptiveMom.com, Cristine reports on parenting resources for differently-abled parents. With two little ones in-tow, she often relies on babywearing as a way to adapt. Cristine shared her experience of using the Baby K’tan here.

 

When Tabitha Caldwell was just a tot of 3 years old, she was the victim of a gunshot that damaged her spine. The injury resulted in the loss of use of her leg. As an adult, even though doctors warned that she may not be able to have children, she was fortunate to have carried and birthed two children who are now 9 years old and 7 months respectively. Tabitha relies on her baby carrier to assist her with her baby’s reflux as he needs to be held upright for a period of time after eating. Tabitha’s carrier of choice for her needs is the Baby K’Tan and she says that without it, managing his needs would be much more challenging.

 

These stories are at the very center of organizations like Ruckabye Baby, a non-profit whose mission is to provide baby carriers to wounded military members of all branches who have been injured in service to our nation, thereby giving them an extra tool to comfort, bond with, and care for their small children.

 

“Our intent is to not only get the carriers out to service members and their spouses, but to teach them, whether in person or via video conference, how to use the carrier correctly,” says Chelsea Cary, President of Ruckabye Baby. “We work with their care team where appropriate to help the injured service member thrive in this new avenue of parenting.”

 

Parenting with physical challenges is difficult but not impossible and with information, support, and community, there are options. Most importantly, nobody needs to go it alone. Together, we can share adaptive parenting techniques and stories, encouraging each other along the way.

 

Baby K’tan is proud to support the mission of Ruckabye Baby and all of the parents and caregivers with physical limitations and disabilities who rely on babywearing to raise their little ones. We see first hand the value of bonding through babywearing and what it means for all families, believing that everyone benefits.

 

While Chumi, Mr. Rawagah, Cristine, Tabitha and the clients of Ruckabye Baby all use babywearing as a way to assist them with acquired disabilities, using a carrier may be beneficial for those with congenital disabilities who are raising children as well. As a company whose product was invented for a child born with disabilities, the Baby K’tan family is pleased to know that the Baby K’tan Baby Carrier has been able to help other families who learn to adapt in similar situations.

 

All parents can use a little support. Adaptive parents show time and time again they are more than equipped for the task of parenting, we celebrate their strength, creativity, persistence, and most of all their dedication and love.

____________________

To learn more about Baby K’tan, click here.

____________________

Reina Christian, a South Florida native, is the Marketing Manager at Baby K’tan, LLC. After graduating from the University of Florida with a B.S. in Event Management Specialization and a Minor in Business she went on to work in marketing for a number of local non-profits and for-profits. Reina has a strong focus in social media marketing, her interest for which stemmed from the role that social media plays in our growing internet-based society. An emerging marketing leader with a strong passion for branding, she has helped propel Baby K’tan, LLC from a small startup into one of the more prominent companies in today’s growing baby carrier industry.
Filed Under: Article, baby, Babywearing, Babywearing, Featured, Parenting, Relational Resource, special needs baby Tagged With: , , , , ,

Increasing Breastmilk Supply With Pumping For Milk Donation

February 3, 2016 by 5 Comments
by Jessica Martin-Weber and Dr. Pamela K. Murphy

This post made possible by the support of Ameda

Ameda brand

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

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

Milk donation gift ameda meme

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

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

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

Breastfeeding- Ameda

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

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

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

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

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

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

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

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

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

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

Dual pumping- Ameda

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

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

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

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

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

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

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

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

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

How to store milk intended for donation?

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

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

____________________

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

_______________________
Pam headshot- Ameda

Pamela K. Murphy, PhD, MS, CNM, IBCLC has worked with birthing and breastfeeding families for more than 15 years. Her lactation practice extends from the preterm/high risk infant to the healthy newborn both in the inpatient and outpatient settings. She has published research on pregnancy, nutrition and lactation in peer-reviewed journals including Breastfeeding Medicine, JAPNA, the Journal of Midwifery and Women’s Health and Advances in Neonatal Care. She is shown here with her once breastfed & beautiful daughter Audrey.
Filed Under: Article, Ask the expert, Ask the IBCLC, breastmilk donation, breastmilk pumping, Featured Tagged With: , , , , , ,

Having Enough Milk for Your First Day Back

February 1, 2016 by 3 Comments
by Shari Criso, RN, CNM, IBCLC

This post made possible by the support of Evenflo Feeding

Evenflo-Feeding-Brand-Ad_25AUG15

____________________

 

 

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

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

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

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

FeaturedArticle1_29JAN16

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

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

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

____________________

To view the whole video, click here.

____________________

Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. See the entire library of Shari’s My Baby Experts Video Program here.
Filed Under: Article, Articles from the professional experts, Ask the expert, Featured, Relational Resource Tagged With: , , ,

“Let Love Flo” Infant Feeding Q&A With An IBCLC

February 1, 2016 by Leave a Comment
The Leakies with Shari Criso, MSN,RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

Evenflo-Feeding-Brand-Ad_25AUG15

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

Hi Shari,

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

Jamie, Nipple confused in California

 

Hi Jamie,

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

 ____________________

Dear Shari,

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

Ready to quit, again,

Lisa, in Florida

 

Hi Lisa,

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

Shari's Q&A- image1

Hi Shari,

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

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

 

Hi Heather,

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

 ____________________

Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters.
Filed Under: Article, Ask the expert, Ask the IBCLC, Featured Tagged With: , ,

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

January 28, 2016 by 1 Comment
The Leakies with Rebecca Michi

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

Arms Reach Banner Logo

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

Dear Rebecca,

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

Sleepily yours,

Grumpy and tired mommy of 2 in Idaho

Dear Grumpy,

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

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

 

Dear Rebecca,

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

Thank you,

Searching for middle ground in Georgia

Dear Searching,

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

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

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

Rebecca Michi normal sleep 4 month old Arms Reach 01.16

Dear Rebecca,

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

I appreciate your help,

Daddy just wants to help

Dear Daddy,

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

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

____________________

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

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

____________________

small Rebecca Michi121

 

Rebecca is a Children’s Sleep Consultant who has been working with families for over 20 years. She is a gentle sleep consultant who doesn’t believe in leaving your child to cry-it-out when teaching them to fall asleep more independently. She is passionate about helping children and their parents build healthy habits so they can finally get some sleep. By transforming drama into dreamland, her mission is to help your children—and you—get a good night’s sleep.
Filed Under: Article, baby, Featured, New article, Parenting, Sleep, sleep through the night Tagged With: , , , , , , , , , , ,

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

January 26, 2016 by 3 Comments
by Dr. Kymberlee Lake

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

What exactly is lochia? 

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

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

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

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

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

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

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

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

The Stages of Lochia table image

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

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

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

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

____________________

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

____________________

Kymberlee Lake- headshot

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

Understanding, Treatment, Prevention, and the Emotional Toll of Mastitis: The Red-Eyed Steaming Pooh Pile Jerk-Monster of Breastfeeding

December 2, 2015 by Leave a Comment
by Jessica Martin-Weber
This post made possible by the generous sponsorship of Ergobaby and their Natural Curve Nursing Pillow.

Ergobaby

 

Not going to sugarcoat it: Mastitis is a jerk. A real jerk. It hurts.

Other than being a jerk though, what is mastitis?

mastitis definition

Inflammation of a boob. A boob infection. A boob infection that may turn into a boob abscess. And it can spread from there.

This jerk is no joke.

Mastitis can present as a range of severity from engorgement when milk comes in to a blocked duct, redness, swelling, pain, and a fever. Sometimes bacteria or infection isn’t always actually present.

The symptoms of mastitis can include:

  • Redness
  • Tenderness
  • Heat radiating from the area
  • Pain
  • Fever
  • Chills
  • Body aches
  • Hard area under skin indicating a blocked duct
  • Abscess
  • Feeling like someone electrified your joints when you already had the flue, punched you in the boob, and then handed you a baby and told you to feed it with the boob that was punched.
  • The desire to punch someone in retaliation.

Pretty much, you feel like a steaming hot pile of aching pooh with an infant to care for and dinner to make.

the emotional impact of mastitis

It is officially miserable. Women with mastitis have been known to compare the experience to torture and generally agree that it is worse than childbirth and dental work combined.

Oh yeah, this steaming pile of pooh just got real.

There are a range of treatment options including but not limited to:
(This is not intended to be health care advice, just information. Your health care provider can address your specific needs in care.)

  • Milk removal– get it all out! Repeatedly. (This milk is safe for baby to consume unless otherwise instructed by your health care provider)
  • Heat– this may provide relief and help with let down to empty the breast. Wet heat, such as a warm compress or soaking in a tub or shower (if you can stand it) or even a bowl of warm water is effective and provides a lubricant for massaging the effected area as well.
  • Massage– Nothing like massaging the area that hurts when you touch it but some breast massage can go a long way in relieving mastitis. This method is one to try very gently.
  • Rest– you’ll want to after that massage anyway but rest has a big role in helping the body heal itself.
  • Pain relief– such as Ibuprofen. Reducing inflammation won’t just help you tolerate the pain, it can help you heal.
  • Natural remedies– from cabbage to lecithin to arnica to garlic, there are tried and true natural options worth trying if you catch it early. If you experience recurring mastitis, lecithin supplements on a regular basis may help you avoid it again in the future if mechanical issues regarding milk removal do not appear to be the cause.
  • Pharmaceuticals– If caught early, you may be able to beat this monster on your own but it can rapidly progress to a much more serious condition if left untreated. The most effective known treatment is antibiotics.

Hopefully you’ll catch it soon enough to not have to pack up your children and monster boob to see the doctor but if you end up there most women respond quickly to antibiotics.

So how do you avoid this jerk in the first place?

There are some solid steps you can take to protect your boobs but as powerful and wonderful as they are, they’re not invincible. Still, here’s what we do know.

  • Treat damaged breast tissue ASAP. Nipple damage is pretty much an invitation for mastitis. Get that taken care of and address the underlying issue with a qualified health care professional (see an IBCLC) to prevent it from reoccurring. (Could it be tongue tie?)
  • Effective milk removal. This can be more difficult to tell but if your baby or pump isn’t removing milk well from your breast you could be set up to do the tango with Jerk-face here. Reoccurring mastitis could be a sign that your breasts aren’t getting emptied. This would be the time to see an IBCLC for some answers and hands-on support.
  • Frequent milk removal. Responding to baby’s cues for feeding rather than the clock not only helps ensure you have a consistent milk supply it also helps you frequently empty the breast (which tells your body to make more milk) which in turn helps you avoid mastitis. Feel like you’re feeding baby all the time? Yay! Hopefully baby’s helping you avoid mastitis! Listen not only to your baby but also to your boobs. When they feel full and particularly if they start to become painful when you’ve missed a feeding, be sure to empty them. This goes for pumping too!
  • Different positions for milk removal. It’s normal to have your favorite position or two but changing it up a couple of times a day will help ensure that the milk removal happening is more complete. If you’re pumping, try using breast compressions to full empty the breast. If you think you may have a plugged duct or the beginning of mastitis, try a dangle feeding position. It’s not cute or fun but it can be incredibly effective.
  • Free of restrictions. Make sure your bra, nursing tanks, and anything else that comes in contact with your breast isn’t constricting (check your seat belt placement). Red lines would be an indicator that there is pressure on your breasts that could block the flow of milk and increase your chances of infection.
  • Take care of you. Rest, eat well, hydrate even better. Giving your body the resources it needs to be healthy is the best preventative measure we can take.
  • Respond. If something is up with your breast and you notice tenderness, a hard area, a white bump (called a milk bleb) on the tip of your nipple, or anything that just seems off, take care of it by resting, massaging, and calling your health care provider.

ErgoBaby breastfeeding nursing pillow mastitis prevention tip

It is important to note that sometimes mastitis is resistant to treatment. If this happens to you, you can request your health care provider to do a culture to determine if a more targeted treatment protocol is in order and to detect possible other causes for mastitis-like symptoms that don’t respond to conventional treatment measures.

The emotional and psychological impact of mastitis can’t be ignored. It’s far more than a pathology, more than a clinical diagnosis. Anyone that has experienced mastitis can tell you that it is a soul crushing, mind altering invasive monster-jerk. Women have been known to question everything about their lives in the midst of battling mastitis.

I shared my emotional unraveling and how I ended up beating the Red-Eyed Monster of Breastfeeding here, including my detailed home treatments and a “flattering” photo demonstrating dangle feeding here. It’s not pretty. It’s war.

What is mastitis and how to care for it The Leaky Boob

If you find yourself entrenched in such a battle for your soul boobs, ask for help. Virtual help (head over to our FB page, FB group, and Instagram for a real dose of virtual help that’s chicken soup for your mom soul) and in person real life help. Trying to be super mom and super boob monster-jerk fighter isn’t going to position you well to win. Beg a friend to bring dinner, reach out to a family member to do a load of laundry, be cool with Netflix babysitting so you can get down to booty kicking the jerk and getting well.

Just turn on My Little Pony, give your kids the peanut butter jar and a spoon (as long as they aren’t allergic), and sit on the floor with a warm wet wash cloth massaging your boob and cry.

There’s no sugarcoating mastitis.

Mastitis is a jerk (I’m writing “jerk” but I’m thinking a different word) but with information, help, and some mom-moxie, most moms can kick it to the curb. Demand help from your health care provider when you need it, nobody will blame you for being a bit on edge with your breast invaded by the Red-Eyed Monster of Breastfeeding, Jerk Mastitis. Do what you need to do.

This a-hole jerk is no joke.

Sources: Academy of Breastfeeding Medicine mastitis protocol,  LLLI Mastitis Tear-off sheet, The Nursing Mother’s Companion,  The American Academy of Family Physicians Management of Mastitis in Breastfeeding Women, the CDC. 

 

_______________________

Have you survived mastitis? How did you get through?

_______________________

Jessica Martin-Weber Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and co-creator of OurStableTable.com, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book and a children’s book.
Filed Under: Article, Breastfeeding, breastfeeding difficulties, Breastfeeding Pain, breastfeeding support, Featured, Jessica, motherhood, Relational Resource Tagged With: , , , , ,

Almond Joy Lactation Bars for Leakies

December 2, 2015 by Leave a Comment
by Carrie Saum

image

Truth: I once made these beauties to woo a potential future boss.  And it totally worked. I got the job and my (now former) boss still requests these delightful bites of almond and coconut bliss when we have him over for dinner or head out to his house for a hike. I made them to share with a class a few years ago.  The professor still reminds me that the almond joy bars put me on her radar in a good way, and hounded me for the recipe until I relented.

Mamas, food can be magic.

Of course these worked to woo friends and family over during the holidays, too.  Last year, I made these because I was on a Total Elimination Diet for my nursling during the holidays.  It was not the worst thing that has ever happened to me, but it was definitely not the best, either.  On one hand, I was glad to have a very good reason to say no to all the seasonal treats. On the other hand? NOPE.

I had to adapt and change my original recipe (which you can get here) to stick to my TED.  But I ended up liking these just as much, if not more than my original ones.  Everyone else did, too. Nobody knew that they were eating a healthy treat, and nobody cared.  They almond joy bars were gone in seconds.

This veer a bit from the traditional candy route.  I love sugar as much as the next gal, but I try to limit my intake as much as possible.  So, I opt for things that pack a punch and are legitimately satisfying without being cloyingly sweet or spiking my blood sugar. There are tons of benefits in coconut, which you can read up on here. Plus, it has a natural sweetness that shines on it’s own when handled properly. Combine this with a little flax to boost milk production during a stressful and busy season, and you’re pure gold.  Well, your milk is pure gold at the very least.

Ingredients for bars:

  • 2 eggs
  • 3 cups unsweetened shredded coconut
  • 1/2 can full-fat coconut milk
  • 1/2 cup coconut oil
  • 1/2 cup sugar, (or coconut sugar if you’re looking for a low-glycemic option)
  • 1/2 cup flour, sifted (I use Bob’s Redmill gluten-free blend)
  • 1 Tbsp flax meal (optional)
  • 1 Tbsp vanilla
  • 1  tsp cardamom
  • 1/2 tsp cinnamon
  • 1/2 tsp baking powder
  • 20 drops liquid stevia, or 2 Tbsp honey (optional)
  • a handful of raw almonds

Ingredients for chocolate drizzle:

  • 3 oz 90% cacao chocolate bar
  • 2 Tbsp coconut oil or butter
  • 1/4 tsp cardamom
  • 15 drops liquid stevia, or 2 Tbsp honey (optional)
  • 1 tsp vanilla

Directions for bars:

  1. In a large bowl, combine dry ingredients and mix well.
  2. In a smaller bowl, combine wet ingredients and stir.
  3. Mix wet ingredients into dry and pour mixture into 9×13 pyrex glass dish
  4. Evenly place almonds on top of batter
  5. Bake for 350 degrees for 30-40 minutes, or until the middle is firm.
  6. Cool completely then cut into bars

Directions for chocolate drizzle:

  1. In a double boiler or microwave, melt chocolate and butter.
  2. Once chocolate and butter are melted, stir in cardamom, vanilla, and sweetener.
  3. Transfer chocolate to small ziploc bag and close.
  4. Cut a tiny piece of the corner of the bag off and drizzle over cooled bars.

Joy to you!

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.

____________________

If you love this recipe, you might like this recipe for this Paleo version of the Almond Joy Bars, or Peanut Butter Cookies on Our Stable Table.

____________________

Carrie Saum, headshotCarrie 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.
Filed Under: Article, extended breastfeeding, Featured, guest posts, Milk Supply, recipes, relactating Tagged With: , , , , ,

What You Need to Know About Jaundice, Breastfeeding, and Your Newborn Baby

November 12, 2015 by 1 Comment
by Linda Zager, RN, IBCLC
This post made possible by the generous support of Ameda, inc.

 

600x200 Banner Ameda

 

 

 

 

 

 

You just went through this transformative experience. You created life! And then, as you bask in the glow, you are told the newest member of your family has jaundice.

What does it mean? How concerned should you be?

 

guest post, jaundice article

Jaundice is a very common condition in newborn babies. Newborn jaundice is caused by a pigment substance, known as bilirubin, and when it increases in the baby’s blood it makes him/her appear yellow. More than half of all newborns become jaundiced within the first week of life. This situation is usually temporary and resolves on its own within a few days without treatment. This is termed physiological jaundice. Physiological means what happens normally in the body. Physiological jaundice is not a disease but a temporary condition.

So what exactly is bilirubin? Bilirubin is formed in our bodies when red blood cells die off. This is a normal process. Red blood cells contain the substance bilirubin. Newborns are born with a surplus of red blood cells. When greater numbers of red blood cells break down, this yellow pigment, bilirubin, accumulates in the newborn’s blood and is deposited in the skin, muscles and mucous membranes, causing the skin to appear yellow. Bilirubin is fat soluble, meaning it mixes easily with fats and oils. For the body to get rid of bilirubin, it needs to be water soluble. So how is it possible for the body to get rid of bilirubin if this is the case? That’s the job of the liver. The liver processes the bilirubin, changing it from fat soluble to water soluble and is then passed into the intestines. From the intestines, the bilirubin leaves the body through the newborn’s bowel movements. Some bilirubin, however, is reabsorbed back into the body after becoming fat soluble again. This occurs if the baby is having very few or no bowel movements. The less bowel movements, the more bilirubin gets reabsorbed, resulting in higher bilirubin levels. The most common cause of increased reabsorption of bilirubin is insufficient intake of breast milk. Bilirubin levels on the third day is directly linked to the number of EFFECTIVE breastfeeds per day in the first few days of the baby’s life.

Some mothers are informed by their health care provider that they need to stop breastfeeding and start feeding their little one formula in order to lower the bilirubin levels in the blood but options are available to treat jaundice without interrupting breastfeeding. For the healthy, full term baby, breastfeeding should continue so it does not become more of a challenge for mother and baby. The solution is not to stop breastfeeding but to resolve the breastfeeding issue so the baby gets the breast milk needed to have regular bowel movements.

Colostrum, the first milk available to the newborn, is actually a laxative which causes bilirubin to pass into the meconium stools. However, when a newborn does not receive enough colostrum as a result of inadequate feeding; either too few feedings, ineffective feedings, or both during the first few days, the bilirubin levels are exaggerated by day three. All mothers and babies should be assessed for effective breastfeeding while in the hospital by the nursing staff every shift and by a Lactation Consultant if a problem has already been identified. A newborn can be at the breast frequently but not breastfeeding. They do not become jaundiced from the breast milk but from a lack of breast milk. That is why it is necessary to have the nursing staff and/or a lactation specialist evaluate baby for effective latch and nutritive breastfeeding. Milk transfer is critical. Mothers may need to be taught how to latch their baby correctly to the breast and to recognize effective breastfeeding. This action assures mothers of comfortable, efficient breastfeeding and prevention of newborn jaundice.

As the liver is responsible for converting fat soluble bilirubin to water soluble bilirubin problems can arise because a newborn’s liver is relatively immature and may be unable to convert all the bilirubin in the first few days. Premature newborns’ livers are even less mature so therefore have higher levels of bilirubin than full term babies.

There are other reasons for excessive red blood cell breakdown resulting in high bilirubin levels and jaundice. ABO blood type incompatibility can result when mother has type O blood and her baby is one of the other blood types, A, B or AB. During pregnancy, red blood cells can leak across the placenta from the baby to the mother. The mother’s immune system reacts to the baby’s cells by forming antibodies against the baby’s blood resulting in increased red blood cell breakdown after birth and jaundice. With appropriate treatment, jaundice resolves. If a baby has a difficult birth and this results in bruising or a hematoma, there will be more red cells broken down resulting in higher bilirubin levels and jaundice. These are all normal causes of newborn or physiological jaundice with some babies requiring treatment and others not. But all these babies have one thing in common; they can and should continue to breastfed a minimum of 10 times or more per day every 24 hours for the baby’s first 2 days of life. Frequent nursing should be considered the norm; rooming-in with your baby promotes more breastfeeding than if baby were kept in a separate nursery.

Some babies are often sleepy as the bilirubin levels increase, sometimes resulting in baby falling asleep soon after feeding begins or he/she won’t even wake up to feed at the breast. Try skin to skin, holding you baby between your breasts, keep baby in close proximity to enable you to observe feeding or waking cues and never watch the clock for when you should nurse next. Remember a minimum of 10 or more feeds in 24 hours is norm. If baby does not respond to various stimuli to breastfeed more effectively, then an alternative method should be used to supplement baby with expressed colostrum/breast milk, if necessary. Hand expression of the breast is a very effective means of collecting colostrum. It can be expressed into very small cups or spoons for feeding. Mom should receive instructions for using a Hospital Grade breast pump for milk expression and to breast stimulation for adequate milk production. Breast milk can be given by cup, syringe, eyedropper or small spoon. Formula supplementation, on a short term basis, may be needed if fewer effective breastfeeds in the first days has contributed to a lower milk supply. Mother can continue pumping and nursing during treatment.

guest post, jaundice article

Most cases of jaundice require no treatment or little more than exposure to direct sunlight each day, but if the bilirubin levels continue to rise, more action is needed. The child’s physicians will observe and monitor the baby’s jaundice and bilirubin levels which are obtained through a simple blood draw from the baby’s heel. Phototherapy is a common treatment for all types of exaggerated jaundice. Phototherapy uses fluorescent light to break down bilirubin through the skin. The bilirubin absorbs the light, changing the bilirubin to the water soluble form, which then is eliminated through the baby’s stools. The baby is placed in an Isolette or self-contained incubator unit that provides for controlled heat and humidity. The light source, called bili-lights, is placed over and/or on the side of the Isolette. The baby is naked but for his diaper. His eyes will be covered to protect his retinas and corneas from damage.

If breastfeeding is a priority talk to your doctor and nurses about options. Often, babies are taken to the nursery for this treatment but most hospitals give mothers the option of treatment in their room. Baby’s eye patches should be removed during feeding to make eye contact with his parents. The Wallaby phototherapy unit is a fiber optic blanket that is wrapped around the baby’s trunk and provides continuous treatment that does not require eye patching or separation. The blanket can be used both in the hospital and in the home after hospital discharge.

If your baby has jaundice, it doesn’t have to interrupt breastfeeding. You are your child’s number one advocate and if breastfeeding is important to you, communicating that with your child’s care providers is an important part of your child’s care. Breastmilk may be exactly what is required to help your new baby get well. 

More information:

AAP Management of Hyperbilirubinemia in the Newborn Infant 35 weeks or More

AAP Clinical Practice Guidelines for Hyperbilirubinemia in the 35 week or more newborn infant

Bilirubin Screening and Management of Hyperbilirubinemia, Stanford Medicine

The Academy of Breastfeeding Medicine protocol for management of jaundice in the breastfed newborn of 35 weeks or more

___________________________

Did your baby have jaundice as a newborn? How were they treated? Were you supported in continuing to breastfeed?

___________________________

 

Linda, IBCLC2 smaller
Linda Zager, RN, IBCLC
I’ve been an RN for 37 years, working in various hospital positions from Intensive Care to Hemodialysis/Plasmapheresis, Maternal Child Care and finally Lactation Consulting, my true calling in life. I have been an IBCLC for 23 years working with moms/babies in their homes and in the hospital. I left hospital work and now work as Ameda, Inc.’s Nurse Clinician/Lactation Consultant in the ParentCare division. I speak with mothers all over the country when they require resolution to breastfeeding/pumping issues.
Filed Under: Article, Ask the expert, Ask the IBCLC, Breastfeeding, Featured, guest posts, Relational Resource Tagged With: , , , , ,
« Previous Page
Next Page »