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The Serious Injury No One is Talking About: Diastasis Recti

August 25, 2017 by 4 Comments
by Nicole Nexon, MSPT

This post made possible by the generous support of Chunkabuns

 

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Sometimes I feel like exercise has become a dirty word in the mommy sphere. I can understand that.

We get this message that we need to do everything – work, raise babies, maintain perfect households, create Pinterest worthy projects, not burn dinner… and erase any shred of evidence that our bodies have created life. Society settled on the idea that skinny = perfect and the backlash from that led to a movement of pride in our bodies. Which somehow turned in to “ real woman have curves “ and all kinds of craziness about skinny girls and curvy girls and…

It’s out of control.

And what has been missed in all of this is the truth of the matter – it’s not about skinny. It’s not about having curves or not having curves. It’s not about “mummy tummies” or thigh gap or muffin tops.

It’s about being healthy.

And not “healthy” in a way that has been co-opted by people meaning “stop eating junk food you fatty!” Healthy in way that allows people to live their lives in a manner they choose. Healthy in a way that allows you to lift babies and chase toddlers and carry laundry wherever you need to carry your laundry. Healthy in a way that makes you feel confident, that lets you sleep well and go about your life.

What happens when you’re injured…and you don’t even know it?

When I was pregnant with my second daughter, I began to feel a pretty distinct pain by my belly button. It was so specific that I was fairly certain I was developing an umbilical hernia. I brought it up with my midwife and was told it wasn’t a hernia. I was developing a diastasis recti – a split between the muscles and muscular tissue that runs down the center of the abdomen. The pressure inside from an expanding uterus/baby was just too much for the abdominal tissue to handle so the tissue and muscles were separating.

With my first pregnancy, I worked in an outpatient clinic that was less physically demanding. With this second pregnancy, my current position required a lot of physical lifting as a physical therapist in a subacute center for patients who were not sick enough for the hospital, not well enough to go home. I already had work restrictions due to the physical requirements of my job; working with those restrictions AND dealing with a developing case of Diastasis Recti made the restrictions even more difficult.

It was in this position that I recognized a growing group of people in need of support, awareness, and healing of Diastasis Recti: new moms.

Here were these women, trying to juggle new responsibilities, healing from the changes their bodies went through during pregnancy and subsequent post-partum recovery and there was little to no support or even awareness about the problems that Diastasis Recti presented.

Diastasis Recti can affect your body in some pretty drastic ways.

  • -Incontinence
  • -Irregular bowel movements,
  • -Lower back pain, spinal or hip injuries due to your abdominal muscle’s inability to support your body when you’re lifting or bending
  • -Pain during sexual intercourse
  • -Increased chance of sciatica or disc issues
  • -Increased chance of umbilical hernia
  • -Postural instability due to poor strength of the abdominal muscles

The effects are numerous.

Now it was MY body that was going to need to be supported.

My body that was going to need help carrying a car seat. A baby. My toddler. The laundry.

My body that was going to be more prone to injury- that would need me to completely rethink how I went about my day. I worked out through my pregnancy because I knew what was ahead of me. I knew my core was going to be compromised. I wanted to achieve a VBAC and I knew I would need endurance (among other things) to prevent a repeated OR experience. I went back to my books and read studies on exercise efficacy. I reviewed exercise programs for pregnant women, post partum women, and people who had just had abdominal or back surgery. I had a plan, and I HAD to be as physically strong as I could when I returned from maternity leave so I could perform my job effectively.

I ended up with a VBAC, a baby girl, and a three-finger diastasis.

*when I say “three-finger diastasis” I am describing how many fingers I can horizontally fit across the tissue separation. To find this, lay on the floor with knees bent and feet flat on the floor. Lift up your head slightly and contract your abdomen muscles gently. Find your belly button and make the “scout symbol” with your fingers…see how many you can fit in there. i.e. 1 finger, 3 fingers, etc. Check the same line down by your pelvis, and again up towards your ribs. Different points along your abdominal muscles may be different fingers of separation.

 


I feel blessed that my passion and my education allowed me to understand what my body needs to function well and heal from my condition. I am grateful for my colleagues and friends with whom I can discuss ideas or count on to help me with the hands-on techniques I can’t perform on myself. I know I am lucky to have access to the information that I have.

I want other women to have this valuable access to connections and resources that are out there for those recovering from Diastasis Recti.

I want women to know that sometimes “mummy tummy” can actually be caused by a medical condition.

I want women to know that the media are not medical professionals and there is a wide range of “normal” when it comes to our bodies.

I want other mothers to know that exercise and eating well are available to them.

I want women to know there are safe exercise routines that WON’T injure a body healing from Diastasis Recti. That recovering doesn’t need to be a series of scary, out-of-reach experiences. They don’t need to spend hours in the gym (Though you certainly can, if you enjoy it!).

Recovering means that you can take a walk, be it pushing a stroller or wearing a baby. You can do squats in your living room, jumping jacks, and eventually pushups and planks. (But until you’ve healed from your diastasis, it is best to do modified planks so that you don’t further separate your diastasis or have your abdominal muscles work against you or push on that separation while you’re healing!)

I feel sad when I hear people say “I can’t workout because…”

I feel sad because they are being taught that only the big efforts count.

That’s not true.

I work with people for whom sitting at the edge of their bed is enormous effort, and standing requires assistance of others. When you see the enormous joy on a person’s face brought by these small yet enormous victories, you begin to understand the true beauty of the movement our bodies are capable of. What may seem like a small victory may be an enormous triumph-a giant step towards hope and healing.

Misguided emphasis on skinny and perfect or the fear of never being _____ enough WILL STOP US in our tracks.

Enough.

You are enough.

It’s ok to start small.

It’s ok to fail.

It’s ok to not be perfect.

It’s ok to be YOU.

It’s not about meeting someone else’s standards.

It’s about taking care of yourself, teaching your family that our bodies are a great gift and we should treat them well. It’s about understanding that you are worthy of the time and energy it will take to begin, to HEAL, and to build healthy habits that facilitate that healing and well being.

Let’s get moving, because moving not only transforms your body, but it transforms your mind, no matter what size jeans you wear.

Some Exercises to Get You  Started:

Some Other Tips to Start Healing:

  • Sitting with the best possible posture: (Pull your belly button in towards your spine. Keep breathing while doing this. Pull your shoulder blades onto your back. Keep breathing!)
  • Kegels/pelvic floor exercises (contracting the pelvic floor muscles-the ones you use to stop your pee, if that makes sense!).
  • Standing on one foot while brushing your teeth while pulling your belly button in towards your spine.
  • Stretching before you get out of bed.
  • Taking a walk or parking further from the store.
  • You can climb your stairs.
  • Swim.
  • Dance.
  • Work out with a DVD program or take a class.
  • If pregnant, getting an abdominal/belly support band to help support your abdomen and relieve pain you may be experiencing.
  • If in post partum recovery, gently binding your belly to help pull the muscles together and support you in those first few weeks of initial birth recovery.

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Where am I now? I’m down to a one finger split at my belly button. I am confidently back to work full time with no restrictions. I’m still doing pelvic floor exercises and modifying my workouts to protect and strengthen my abdominal muscles so I don’t re-injure or reinforce the Diastasis Recti. I’m teaching my daughters that exercise and eating well are ways to treat your body with respect, to give it what it needs so when you need your body to work for you, it will. I’m teaching them that strong is beautiful, that healthy allows you to follow your dreams, that food is a tool and a pleasure and size is just another physical trait that varies from person to person.

Final thought… can we all agree to stop using the words “mummy tummy” ? Please? Your tummy is awesome, mommy. Growing a human is beautiful. A body that shows the results of growing a human is also beautiful!

For more information on Diastasis Recti click here.

*You are strong, and Chunkabuns knows it. Check out their “Mom Strong” Tee-shirts (and matching “Strong Like Mommy” shirts for baby! ♥♥♥) and other clothing options for mom and baby at www.chunkabuns.com

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nicole nexon image
Nicole Nexon is a mother of two, working full time as a physical therapist. Nicole has her master’s degree in Physical Therapy, and has been working for 9 years in both the inpatient and outpatient fields of physical therapy. She is a complete nerd when it comes to the human body and wants to encourage others to take the opportunity to treat their bodies well at whatever stage of life they are in. She is also a Beachbody coach and has found it to be a great platform to spread her mission of health and wellness. In her spare time, Nicole enjoys traveling and snowboarding. You can follow her at www.facebook.com/nicolerosenex )
Filed Under: and health concerns for mom, Article, Articles from the professional experts, Ask the expert, Featured, fitness, postpartum, Relational Resource Tagged With: , , , , , ,

Clicking Sound While Nursing

October 19, 2016 by Leave a Comment
by Shari Criso MSN, RC, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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Question:

From time to time while my baby is nursing, I hear a clicking sound. I try to take her off and re-latch her, but she gets really mad and doesn’t like to be interrupted… what could be causing this?

Answer:

I can’t blame your baby for being mad- who likes to be interrupted when they are eating?

As for the clicking issue… here is my definition of the perfect latch when breastfeeding: the one that doesn’t hurt and the baby gets milk. That’s the perfect latch. So, if your baby is clicking but the baby is not hurting you and seems satisfied, and your nipple come out looking normal and there’s no damage being done, I’d say to either try holding the baby a little closer while nursing, or don’t worry about it. Sometimes, that clicking sound comes from an oversupply, when you have a lot of milk. The baby keeps unlatching because it’s hard to latch when the nipple is so wet. So that’s probably what you’re listening to. But if you’re not in pain, and the baby’s latching, don’t disturb the baby – let her eat!

 

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Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

____________________

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. You can find her on Facebook or her own personal site.
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Ask The IBCLC- Migraines, Blebs, and Teething

October 14, 2016 by Leave a Comment
by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

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Dear Shari,

Help! I’m 8 weeks postpartum with my third child. It was also my third C-section and the third time I’m breastfeeding exclusively. I’ve been having dizzying migraines that sometimes blur my vision, make my ears ring, and make my head feel like it’s in a fog. My OB recommended an excedrin migraine or a little caffeine. That doesn’t often help and I don’t want to take an excedrin or two daily. I’ve gotten the depo shot two weeks ago, and the migraines are still unrelenting. Is it hormones like everyone says? Is there something I can do to help control them or relieve them?

Dizzy Mama

 

Hi Dizzy Mama,

I am sorry to hear that you are suffering so much at a time when your full focus should be on caring for and enjoying your new little one!  As someone who has migraines myself and cared for many women who have also experienced this debilitating condition, I truly feel your pain.  It is not an uncommon occurrence affecting up to 17% of women of childbearing age.  Migraines tend to get better during pregnancy, due to the high estrogen levels.  Although this is not always the case.  Non-pharmacological treatments should be the first choice when treating anything whether you are pregnant or breastfeeding and can be quite effective. Keeping a “headache diary” can help to identify triggers and make lifestyle changes that will work. Unfortunately, some of the things that do trigger migraines are the norm for any new mom such as not eating regular meals or getting good sleep, however knowing this you can make an effort to take care of yourself as well as your baby.  Something that we as moms can forget quickly!  Caffeine can make a big difference in the effectiveness of migraine treatments and is generally safe to use in moderation and as long as it is not affecting the baby.  Excedrin is actually NOT a drug that I would recommend since it contains Aspirin which is transferred into breastmilk.  The baby receives about 4-8% of the mother’s dose.  Breastfeeding women are advised not to use aspirin because of the risk of Reye’s Syndrome in their babies.  As for what prescription medication to take, Imitrex is generally considered safe for breastfeeding as the infant will only receive about 1% of the maternal dose and it is cleared quickly out of the milk.  No short-term problems or long-term developmental issues have been documented in breastfeeding infants exposed to these drugs.  Of course you will need to consult your doctor about this or any other medication, as well as to obtain the prescription.  If your OB is uncomfortable due to lack of experience or knowledge, maybe it is worth seeking a second opinion.  I hope this helps and that you have some relief quickly!

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Dear Shari,

My daughter is 16 months old now. Lately my nipples feel so sensitive and sore and I’m not sure why. I think she may be teething, cutting her molars now, could that be causing this pain? What can I do about it? My plan was to let her self-wean but right now I wish we were done. I don’t want to give up on my goal yet though, how can I get through this and how long will it last?

Feeding a teething baby

 

Dear Feeding,

Congratulations on your great success breastfeeding!  Yes, it is possible that her teething is causing her to clamp down while nursing and causing your nipples to feel sore. If that is what is happening, it is important to pay attention to when she is done “eating” and to remove her off your breast before she has a chance to bite down or rub against your nipple trying to soothe herself.  You can also offer her a cold or frozen washcloth or teething ring to chew on so that she is not using you!  The other thing that I was thinking as I read your question…is to take a pregnancy test   This is actually the very first sign for most pregnant moms!  Nipple pain and soreness all of a sudden after many months of pain free breastfeeding (in the absence of any infection or damage to the nipple) can be the first sign that you are expecting again and it is worth ruling that out first with a pregnancy test.  If the soreness is due to pregnancy, there is not that much that can be done about it since this is hormonal vs. mechanical or technique.  For many nursing moms who become pregnant this is the main reason that they decide to wean their older child, but for others it is not a problem and they can safely continue throughout their pregnancy and beyond to tandem nurse their children. Keep me posted!! xoxo

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Dear Shari,

I have a sort of white dot on the tip of my nipple and it is extremely painful when my baby is latched on that breast. It’s been there for a couple of weeks now, it looks sort of like a pimple. I tried squeezing it but that just hurt more and didn’t do anything. My baby is just 7 weeks old and the idea of this pain lasting until we’re done breastfeeding is so discouraging. Help!

Owie Nipple

 

Hello Owie Nipple,

I am glad you wrote in to ask this question because it is a fairly common issue that moms will encounter.  It is called a “milk bleb” or a blockage of milk inside one of the nipple pores where the milk comes out of the nipple.  That is why it is white.  A milk bleb is not serious condition, but can cause serious pain in the nipple especially when trying to nurse or pump.

The best way to approach this is to first not wait to do something about it. Left untreated it can cause your breast to become engorged which can lead to a decrease in your milk production as well as mastitis.  The first thing you can try is to soak your entire breast in a bowl of hot water.  Fill the bowl with water and then lean over it and just soak for 5-10 minutes or longer.  Immediately try to nurse your baby or pump after that.  The water will often soften and loosen the plug and it will be sucked out by the baby!  It is perfectly fine for them to swallow.  You may notice after nursing that it is starting to come out.  If you can you can pull it out, but I would not squeeze your nipple to try and “pop” it.  It is not a pimple and squeezing your nipple can cause more inflammation.  If the soaking and suction does not work you may need medical help from your doctor or midwife who can use a sterile needle to remove it.  This is not something that I would do at home (although I know women who have) due to the risk of injury or infection.  Good luck!

 

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Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

________________________

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. You can find her on Facebook or her own personal site.
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Breastfeeding and Solid Foods

August 22, 2016 by Leave a Comment
by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

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Once a baby is taking solids, how often should you offer your baby the breast, and how do you know when to initiate the weaning process?

Once the baby is taking solids, you should still offer the breast whenever they baby wants to eat. You can still breastfeed before each feeding of solids. But as the baby gets older, into the seventh or eighth month, if you wanted to cut out those feeding and substitute a meal, like breakfast, and have a meal of food and then breastfeed between those feeding, that’s totally fine. By the time my children were about 8 months old, I was feeding them three meals a day, breakfast, lunch, and dinner, and I was breastfeeding them maybe 4-5 times in a 24 hour period.

 

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How do I introduce solids and keep my supply up?

And your body will adjust to this. Your body will naturally keep its own supply. It does not need to make the same amount of milk it did in the beginning. Remember, you’re making more milk in the first 6 months of the year than you are in the second 6 months, because your baby will eat a certain amount of milk, somewhere around 3-4, sometimes 5 ounces of breastmilk per feeding, and never increase from there. What changes is that in the second half of the year, they start to eat solid foods, so the actual amount of milk you’re actually producing and feeding decreases in that second half of the year from 6 month to 12 months and beyond. So you don’t need to keep up with your supply; your supply will be adequate for what your baby is taking in. And by nursing more, you’ll just make more. 

Shari Criso MSN, RN, CMN, IBCLC

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Find more from Shari supporting your parenting journey including infant feeding on Facebook or at My Baby Experts©

Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

____________________

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. You can find her on Facebook or her own personal site.
Filed Under: Article, Ask the expert, Ask the IBCLC, Breastfeeding, Featured, Introducing Solids, Milk Supply, Relational Resource Tagged With: , , , , , , , ,

Ask the IBCLC Breastfeeding Help: Low Supply and Breastfeeding in Pregnancy

August 10, 2016 by Leave a Comment
The Leakies with Shari Criso, MSN, RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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

 

My little 4 month old is refusing to take bottles. I’ve started taking him to daycare, and he is refusing bottles, not even taking a full ounce while he’s there for 6-7 hours. When we’re together he’s still drinking well from the breast and nursing frequently at night. His weight is good and we’ve had no issues other than this. I’m worried about him becoming dehydrated during the day. What can I do and what can I tell the daycare to do?

Mama to a hungry but stubborn baby.

 

Hi Mama,

I totally feel your pain and the anxiety that comes when your breastfed baby refuses the bottle and does not eat when you are not around. I had one myself! Reading your question, my first thought is that this transition may take a little time for not only you to get used to leaving but for your little guy to get into a new routine, new people, and a NEW way of eating! This is one of the reasons that I really recommend introducing your breastfed baby to a bottle earlier than most will (like within the first 2 weeks!) which makes this transition much easier. I actually have an entire chapter dedicated to this very thing in my online breastfeeding class “Simply Breastfeeding” because I know there are so many moms that need to return to work and this issue can be so distressing. I know that is not helping you now…so my best advice is this: First, try different types of nipples to see if there is one that he will take over another. Try offering the milk cold instead of warm. Sometimes this can also make a difference (not exactly sure why, but it worked with my own and other mamas I have worked with). Try feeding him in different positions instead of cradling him. Holding him outward and distracting him by moving around, staring at a picture on the wall, etc. Try an infant feeding cup. YES…babies can be fed through a cup and don’t need to take an artificial nipple! Lastly, if all of these things fail don’t stress. This may just take a little time and a few more feedings during the time you’re home and at night. Let him co-sleep with you and try to get as many feedings in that you can while you are together. Watch wet diapers, signs of dehydration and weight loss. If all seems normal, just let it be and allow your baby to adjust at his own pace. In the meantime, you should still continue to pump on schedule as to not decrease your supply and also not get too engorged while you are away.

I hope this helps and that things start to smooth out very soon for you!

Xoxo,
Shari

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Dear Shari,

I am 7 weeks with my 3rd and my son is 8 months old today, so I am still nursing very much so for nutritional purposes. He doesn’t like solids, of course, so I’m lucky if he eats 1 additional solid meal per day. I have noticed a drop in my supply already, just now I was up to nurse him and it took a good 10 minutes before he got a let down and they definitely aren’t as strong. Please tell me it won’t drop any further than it is now, I want to tandem, I nursed my daughter until 22 months so him and I would both be devastated if it just went away!!

You’ve been so encouraging before, thank you!

Not ready to stop!

 

Dear Not Ready To Stop,

First, congratulations on your new pregnancy! Having you children close in age has many benefits and can also present certain challenges as you are experiencing, however this does NOT need to be the end of your breastfeeding relationship with your older child. Many, many mothers are able to continue breastfeeding safely during pregnancy and way beyond, going on to tandem after birth. Most moms will have a decrease in their milk supply during pregnancy. This is especially common in the second trimester but can start as early as the first. It is thought that increased levels of Progesterone during pregnancy is what causes the milk supply to drop. This typically begins to resolve towards the 3rd trimester and especially at birth when the placenta is delivered and prolactin levels rise. AS always, it is important to continue to offer the breast to your nursling frequently and not decreasing “demand.” This will only add to your decreased production. Co-sleeping and night feedings can help here. Be careful on any herbal supplements that you are considering as they may help your supply, but they are not all safe during pregnancy. Always consult your doctor, midwife, and lactation consultant. The decreased supply may actually encourage your little one to start taking mores solids, as he will naturally be hungrier. This is fine as long as your are getting in at least 3-4 feedings per 24 hours. Take this opportunity to experiment with new and yummy foods, and keep trying even if he rejects it at first. It can take 5-7 “rejections” of a certain food before a child will accept and even learn to love it. As always, monitor wet diapers, signs of dehydration, weight loss, etc. Most of all, try not to stress. This is temporary and your milk WILL come back so that you can go on to provide for both of your babies! 

All the best to you and your family.

Good luck,
Shari

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Dear Shari,

My little is almost 6 months old. My supply has taken a huge turn for the worse. I am barely producing anything. I Had a huge over-supply in the beginning. This has all started about a month ago. I know that you are supposed to adjust and pump more of what baby needs close to 3mo plus. Well I started doing that. Was pumping like 20-25 ounces a day.. Then it decreased to 10-15 and now I’m at 1-6… The past two days have been around 2 ounces the whole day. I have done pretty much everything I have read to do. I have also switched pumps. I have tried switching flanges. Replaced membranes, replaced hoses. I know stress is a horrible killer for your supply. I honestly am not stressing. I do not feel stressed, do not feel worried. I have a freezer full of milk so I know my little girl will have momma milk for a while longer even if I am done producing. I just would like to know if I am done ya know. I have tried nursing her more too. Day before yesterday I nursed her more and she didn’t seem satisfied at all. Today I nursed her more and she seemed fine. What is going on?

I appreciate any light you can shed on this!

Dwindling supply and hungry baby.

 

Hello Dwindling,

It sounds like you are trying to pump in addition to fully nursing your baby at the breast. It is completely normal for milk supply to fluctuate and for there to be times when your supply may seem lower. This will naturally happen as your child ages and also during times of growth spurts when they are eating ALL THAT YOU HAVE! That will of course leave less to be pumped. Normal growth spurts occur around 2-3 weeks, 6 weeks, 3 months, and 6 months. There is also a very common decrease that happens around 6 months postpartum for many moms. This can be due to hormonal changes, the return of you period, nursing less frequently, returning to work, introduction to solid foods, etc. I talk about this a lot in my online class “Breast Pump & Briefcases,” as it is something that so many breastfeeding and pumping mothers face. It is important to understand that while there may be times where you are able to produce way more than your baby is eating (which leads to being able to pump a lot of extra feedings for storage or donation…like your freezer full of milk), there will be other times where you may just be making exactly what your baby needs in the moment and not any more. This is not abnormal, and also not a problem as long as you feel that your baby is getting what she needs at the breast (which it sounds like she it). Your pumping and storing may have to take a back seat until the growth spurt is over. This will usually pass within a few days of concentration and baby led feedings. Small but frequent feedings whenever the baby wants to go back to the breast without supplementing, will usually have your supply back within a few days. Delaying feedings or supplementing with your freezer supply or formula during theses times will have the opposite effect, delaying the decrease or decreasing it further. This is SO important to understand. There are also foods like oatmeal and herbal supplements like Fenugreek that can help during these times, but I would always consult a Lactation Consultant before using anything. 

I hope this helps you and congrats on doing such a great job feeding your little girl!

Much love,
Shari

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Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
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Ask the IBCLC Breastfeeding Help: Relactating, Back to Breast After Bottle, Once Low Supply Always Low Supply, and More

June 16, 2016 by 1 Comment
The Leakies with Shari Criso, MSN,RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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

 

Dear Shari,

I started breastfeeding my son when he was first born but we had a lot of difficulties and ended up switching to formula. He’s 2 months old now and I don’t think I have any breastmilk left but I’m really sad about stopping. Is there any way I can get him back on the breast and get my supply up for him? Is that possible or should I just accept that I screwed up?

Sad but hopeful

I am so sorry that you had so much difficulty.  This is unfortunately not uncommon and there are so many moms that face the same challenges having them stop breastfeeding way before they want to. You DID NOT screw up!  You did the best that you could with the information and support that you had.  This is not your fault although I know how disappointing it is. There are two questions you are asking here…One, is it possible after 2 months to get your baby back on the breast from the bottle, and two, can I increase my supply to go back to exclusive or partial breastfeeding?  The answer to both of these questions is YES…but it will take some work and the right support.  If you have been pumping and feeding your baby a combination of breast milk and formula, increasing your supply back up to exclusive breast milk is very doable.  It will require frequent pumping and/or feeding (possibly with a supplemental nursing system) and also supplements that can help to increase your supply.  If you have not been pumping at all, re-establishing your supply or “relactation” is possible but will also require work with pumping, feeding and supplements for you.  Getting your bottle fed baby back on the breast after 2 months is possible although not always.  I highly recommend that you seek out an experienced IBCLC that has worked with moms in this situation before and get the proper counseling and support.  This is not something to do on your own, as time is really of the essence if you want to have the best chance at success.  Lastly, there are lots of moms that exclusively pump and are still able to feed their babies breast milk even though they are not nursing at the breast.  Of course your baby will greatly benefit from this for as long as you are able to do it and for as much or as little as you are able to provide.  This is a third option to consider.

For those moms that are trying to make that final transition back to exclusive breastfeeding, here is a great video clip from my WebTV Show on “Weaning off formula back to exclusive breastfeeding” 

 

 

Dear Shari,

I was hoping you could tell me what could be causing me to feel nauseous when I nurse? It’s really bad at night, but always there when she nurses?! Is this normal? Will it go away? It is really putting a damper on breastfeeding because I feel sick every time.

Please help!

Feeling sick to my stomach

 

Hi…I know this feeling that you are describing since I had it myself when both of my babies nursed!  It is amazing how everyone feels different when they breastfeed.  Very often moms will have some sort of sensation or reaction to their milk letting-down.  It can feel different in different moms, and if you don’t feel anything it does not mean that you are not getting a let down…don’t go there!  This can be felt as nausea, which is usually caused by the hormones that are released when your baby begins to suckle.  Moms may feel something like nausea, slight dizziness, lightheaded, tingling,  etc… at the onset of the feeding and then it will subside as the baby continues to feed.  As I said this is not the same for everyone and it sounds like you may be feeling it the whole time. There is not much that you can really do about this since it is hormonal.  You may want to try a hard candy, closing your eyes and relaxing with the feeding, or maybe some fresh air or a fan, etc… Also, make sure that you are not hungry or that your blood sugar is not low, which will also cause you to feel nauseous, just as it can during pregnancy!  I wish that I had more to offer except that this is quite normal AND it may not last.  Your body (and your baby) is changing every day.  What you are experiencing one day may be completely different the next.  Hope it resolves and you can enjoy the experience a bit more.

Here is a video about relieving nausea (or morning sickness) in pregnancy…although the hormones that are causing it are different, the conversation about hypoglycemia may be helpful and especially for all the pregnant mamas out there. 

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Dear Shari,

I am 12 weeks pregnant with my second babe. With my son I wasn’t able to breastfeed, my supply never came in. I tried oatmeal, mother’s milk tea, and lots of water. But nothing helped. I really want to breastfeed with this one. Does anyone have any advice or suggestions that could help this time around? Anything I can do beforehand to make sure my supply comes in?

Thank you so much for your help.

Concerned but hopeful in the midwest.

 

Hi…It is great that you are asking these questions NOW in preparation for your baby’s arrival.  Way too often, moms will wait until their baby is born to educate themselves or try to find the support that they need.  This can be difficult when you have just given birth, trying to breastfeed and care for a newborn!  To answer this question it is important to identify what actually happened last time, identify any underlying medical issues, and also be cautious in comparing one experience with the next.  So yes there are real situations that can cause your milk to not either be delayed in coming in, have a decrease in supply, or not come in at all.  You need to discuss this with your doctor or midwife (and also consult with an IBCLC) to make sure that underlying causes are identified and addressed if they exist such as a hypothyroid, or IGT for example.  Sometimes the birth itself can be a cause for a delayed or insufficient supply…large blood loss, retained placental fragments, etc…can cause this among other things. Lastly, it is important to remember that while it is very possible to have a real situation with insufficient milk supply, my experience is that MOST issues are either perceived or created from the concern and then the unnecessary supplementation.  It is SO important to understand that your milk will take days to come in, that the drops of colostrum that you are producing is all your baby will need, and that babies are not really supposed to eat large volumes of milk in the first few days and are supposed to lose weight!  This misinformation and misunderstanding, mostly in the medical community, is what creates fear and doubt for moms and causes unnecessary supplementation, decreased feedings at the breast, and can cause the exact issue you are trying to cure.  Most importantly, get the information you need and really understand what is happening and what is not.  Yes the teas and the supplements can be helpful, but without the knowledge it will not make much of a difference.  One of the best ways to prepare yourself for success is to watch my online breastfeeding class “Simply Breastfeeding” where I go over this discussion on milk supply in the first week as well as so much more!

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Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters.
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Breastfeeding During Pregnancy

June 9, 2016 by Leave a Comment
by Shari Criso, RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

Brand-Ad_29APR16

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Can I breastfeed throughout my pregnancy?

Breastfeeding during pregnancy is very normal. Throughout history and even today in many parts of the world, children survive because they continue to breastfeed throughout pregnancy. In MOST cases, it is extremely safe, completely normal, and very healthy to continue breastfeeding while you are pregnant with your next baby.

Where this whole concept of it being an issue came from is with people who have had recurrent miscarriages, and people who are bleeding early in pregnancy. Remember, when you breastfeed, there is a hormone called oxytocin released from your brain, and oxytocin can contract your uterus. If you’re a person with a history of early miscarriage or you’re bleeding in pregnancy, this may be a consideration. But for the vast majority of people, it’s completely fine to continue to breastfeed through pregnancy, not only at the beginning but throughout.

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What I find is that for most women, their toddlers will wean themselves during pregnancy, because as you get closer to the end, the milk is changing to more of a colostrum, getting ready for delivery. The taste changes and toddlers are like, “What’s this? This is not what it was before!” And there are others that are like, “I don’t care what this is, I want it anyway!” And that’s when you have people who are nursing two children at one time. And that’s totally fine.

One thing you do want to keep in mind if you’re tandem nursing is to make sure the newborn is always going first. That the baby is getting what they need first, and the toddler is getting more of a snack. Remember that your toddler is also eating solid foods at that point, and getting other nutrition, while your newborn needs to get the full majority of it.

I hope that answers the question, but overall, it is absolutely fine to keep nursing through pregnancy and beyond!

Shari Criso MSN, RN, CNM, IBCLC

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Find more from Shari supporting your parenting journey including infant feeding at on Facebook, My Baby Experts©

Thanks for Evenflo Feeding, Inc.‘s generous support for families in their feeding journey.

____________________

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, Articles from the professional experts, Ask the expert, Breastfeeding, breastfeeding during pregnancy, Relational Resource Tagged With: , , , ,

Exploring The Potential Emotional Impact Of The Prenatal Ultrasound

May 24, 2016 by Leave a Comment
by Elizabeth MacDonald
This post made possible by the generous support of My Baby’s Heartbeat Bear
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This article originally published on mybabysheartbeatbear.com on January 2, 2016.

 

The day has come to say hello, to see the one who’s still so small.

A heartbeat will bring many tears, but still will come all the fears.

Will she grow strong and tall? Will we lose him… and my heart will fall?

Are there two or three? Will my birth choice be mine to make free?

My arms ache to hold you. My heart aches to know you.

Above all else though, I know you are mine.

I will love you in every way, no matter what the doctor will say.

Today is the day that I will see your face, tiny and real, you will move to a place

A place in my heart I had never found…

Until today’s ultrasound.

-E.MacDonald

Ultrasound

Ultrasound Day:

Seeing a heartbeat.

Seeing multiple heartbeats.

Not seeing a heartbeat at all.

Revealing a gender.

Fighting the urge to discover the gender.

Learning devastating news.

Counting ten fingers and toes.

There is no denying that a pregnancy ultrasound will change your life.  While most women may check it off as just another day of pregnancy, even seeing a healthy little baby swim around should spark a light of life-changing emotions. The miracle of life is one our society tends to shrug off and sometimes the effects can cause us to become unaware of how we truly feel towards seeing this tiny human being on a screen.

Technology is a wonderful (and scary) tool.  We learn so much in a matter of moments, whether it is a healthy or unhealthy pregnancy, if baby is growing well, whether vaginal labor will be a safe option, if the gender we dreamt of is what exists, and if everything is okay with the mother.  Primarily a diagnostic tool, the necessity of prenatal ultrasounds may be heavily debated but there is no doubt that as routine as they have become, the prenatal ultrasound is a significant moment in the lives of parents-to-be while providing information to care-givers to help the parents make informed decisions.  Along with this education comes the anxiety and fears before the truth is learned.  And what’s worse is that after this brief moment of time, the heart and mind will create a new laundry list of emotions based off of what was discovered during the ultrasound.

Let me state this: There is no right or wrong emotion to feel – Sadness to be pregnant, panic to be pregnant with multiples, triumph to have a healthy baby past a certain date, pride that you created this being, even confusion on whether to keep or adopt.  Emotions are a very personal thing, and you have a right to not feel guilty about any of them.

It is ok to let the tears fall.

A Healthy Pregnancy:  A healthy “typical” ultrasound will have you crying tears of joy; especially if you were terrified going into it.  It can also leave a woman experiencing an unplanned pregnancy in agony, as she will be filled with choices, fears, and guilt.

Multiples: Multiple heartbeats found on the screen may lead to disbelief, panic, excitement, and many many questions. Fear of placenta(s) and sac(s) and nutrients may dance through your mind endlessly.

An Unhealthy or High Risk Pregnancy:  Knowing you will be closely monitored may either be reassuring or cause further anxiety.  When the baby or mother is at risk, the emotional rollercoaster typically picks up quite a few more passengers. Bearing the weight of your own emotions, along with your family and friends will become all encompassing. Reaching out for support and having a safe sounding board to cry to will allow you the ability to have the healthiest version of this pregnancy possible.

A Miscarriage: Expecting to see a flicker of blinking light on the screen where there is none can be devastating.  It doesn’t matter if you are 9 weeks or 15 weeks when you see that the life you thought was growing has stopped. You are no less of a mother. It does not matter that others say, “The next one will stick” or “At least it ended this way instead of a sick baby.”  There was life within you.  Mourn in the ways you need to.

A Pending Loss:  To learn that your child will not survive the pregnancy will bring forth unexpected emotions – Joy that you will still have time to grow and love this baby, but so much heartache that you will never know him earth side.  There will be anger and fear, but hope that things will change. There will be days of normalcy, but so many of confusion and pain.

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A Genetic Marker or Cause for Concern:  Sheer panic may occur; heart-racing fears and a lifetime of scary images may cross your mind.  Stress will be unavoidable, but handling it well will be needed.  Further testing will be done, causing more emotions, more tears, and more prayers.

Gender Disappointment:  Gender disappointment is real. (Ask me how I know.) No one should make you feel guilty for your feelings of desire toward a certain gender. You know that you will love the baby that is growing, and that he was meant to be.  However, the heart will mourn the fact that you will not have ribbons and bows and tutus.  Taking the time to let go of those feelings will help you welcome the baby you are growing without resentment or sadness.

Placenta Complications:  A healthy baby.  A healthy mother. But a placenta that is covering the cervix or attached to the uterine wall improperly. This is a recipe for a mess of emotions.  Knowing everyone is absolutely healthy is reason enough to yell from the roof tops, but knowing there is absolutely nothing you can do to prevent a cesarean section from occurring will bring about lots of birth emotions and fears.

Fetal Positioning:  While at a normal 20 week ultrasound, there is no need for baby to be in birth position, if your midwife or doctor suspects an awkward position later in pregnancy, an ultrasound will be done to verify.  If you are planning a natural birth, this ultrasound may send you into panic mode.  There is always time, even during labor, for baby to turn correctly, but the fears will be real.  Letting go of stress will help the body relax, chiropractic care, specific exercises, and manual manipulation are all available to help.

No matter what you learn during your ultrasound, your pregnancy journey will be changed.  Sorting the emotions will be an ongoing (and hormonal) battle that can potentially affect your labor and delivery. Taking the time to accept your feelings and live through them will benefit your mind body and soul.  Try to handle your emotions by talking through them, living a healthy lifestyle, practicing a mind-centering exercise such as yoga, seeking acupuncture or chiropractic care, and finding support.  Your pregnancy and baby will be all the stronger if you can do this.

May your ultrasound be filled with many happy emotions, but be real with yourself.  Do not hide or feel ashamed with any emotion that comes rolling out.  Find support if you feel alone in your emotions.  Share your fears and sadness right alongside of the joy and excitement.  Let sorrows be known and heartache be felt for you will not truly experience the highest level of happiness until you have worked through all of your other emotions.

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me
Elizabeth is mom to four breathtakingly-beautiful children, and wife to one lucky man. She is a research writer, blogger, and a ghost writer of books.  As a natural-minded woman, Elizabeth takes pride in spreading factual information that may benefit other mothers and future generations.  She has spent the last seven years (and counting) growing babies in the womb and/or with breastmilk.  When she is not writing, she enjoys drinking wine, running, cooking, reading, homeschooling, and loving her family and friends.
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Breastfeeding When You Are Sick

April 21, 2016 by 2 Comments
by Shari Criso, RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

Evenflo-Feeding-Brand-Ad_25AUG15

 

When it comes to breastfeeding, one of the myths that drives me absolutely crazy and could actually be dangerous for your baby, is the idea that if you as a breastfeeding mom are sick, that you should discontinue breastfeeding until you feel better.

This is advice that is often given to moms by their pediatricians or obstetricians and it’s actually the complete opposite of what you want to do!

When you breastfeed, your body passes along the antibodies of what you’ve been exposed to, directly to the baby. When you get sick, antibodies are created and immediately passed into your breastmilk. So what that means for you and your baby is that if you are breastfeeding and you have a virus or you are ill, your baby is actually immediately receiving specific antibodies for the exact illness you have at that moment. This will actually help keep your baby well, rather than make your baby sick.

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What CAN make your baby sick, is to stop breastfeeding during these times! Regardless of whether you are breastfeeding or not, your baby is going to be exposed to you, because you will be with your baby. They will have the exposure anyway, but without the protection of your milk they are much more vulnerable.

I’ll tell you a little personal story… when I had my first daughter my husband Joe and I got the flu really bad. We were sick in bed for days! We had this little 2 month old, and I was like “what am I going to do with her?” All we could do was put her in the bed between us, and just let her nurse, nurse, nurse, the whole time! Now, we were new parents at the time, and even with all the skills and knowledge that I had, we were still scared and nervous. I was so afraid she would get sick. That never happened! Here was this little one who just nursed away in this sick bed with my husband and me and never got sick herself.

This is very typical, very normal, and what you’ll usually see – and if they do get sick, the illness will be so much less than if you weren’t breastfeeding.

So whether it’s stomach flu, regular flu, or any other kind of illness, especially if you’re sick or anyone in the home is sick, make sure you continue to breastfeed, because that is going to be the best way to keep your baby healthy.

Shari Criso MSN, RN, CNM, IBCLC

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Find more from Shari supporting your parenting journey including infant feeding at on Facebook, My Baby Experts©

Thanks for Evenflo Feeding, Inc.‘s generous support for families in their feeding journey.

Filed Under: Article, Articles from the professional experts, Ask the expert, Featured, Relational Resource Tagged With: , , , ,

Weight Gain in Your Breastfed Baby

February 22, 2016 by Leave a Comment

by Shari Criso, RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

Evenflo-Feeding-Brand-Ad_25AUG15-e1453970233307

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One very common concern that comes up frequently for breastfeeding moms and dads is that their breastfed baby is not gaining weight fast enough, or as quick as other babies. This often happens when parents take the baby to the pediatrician and the pediatrician says that the baby’s just not gaining fast enough. They will use a growth chart, plot your baby’s weight on the growth chart, and then say your baby needs to be growing faster!

As you can imagine, this can be very concerning for a breastfeeding mom, because you’re thinking, ”do I need to supplement?”…”am I just not making enough?”

What I want to talk about here are normal growth patterns of breastfed babies.

Unfortunately, because we have so few exclusively breastfed babies in this country (and this really is the case, that there aren’t that many babies that are being breastfed for an entire year) their weights are being compared to formula fed infants that often grow and gain faster and weigh more, especially in the second half of the first year.

So what is a normal weight gain for a breastfed babies?

Typically breastfed babies will gain faster in the first 4 months of life. Typically somewhere around 4-8 oz or 5-7 oz a week on average, is the amount that a breastfed baby will gain.

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When I say average, what I mean is that they won’t ALWAYS gain that amount every single week or consistently, so weighing them every week will actually be a problem. They will have growth spurts, and gain more weight some weeks and less weight other weeks. Typically this is somewhere between 5-7 oz per week, for the first 4 months, on average…and then around 4-6 months you’ll start to see this weight gain drop to about 4-6 oz per week, and then from 6-12 months, 2-4 oz per week is the average norm for breastfed babies. Remember, this is just basic standard or average, it does not mean ALL babies are going to follow the same patterns.

It’s important to watch your baby’s cues and take into account other things like your size – smaller parents, smaller baby; are they reaching all their milestones, are they hydrated, are they peeing, are they pooping, are they smiling, are they doing as expected developmentally – these are all important factors to consider in making sure your baby is healthy…not just are they gaining weight! Are they gaining length, is their head circumference growing as well?

Another very important thing to keep in mind is and to understand are the growth charts themselves.  This comes up with my clients all the time! Some pediatricians are using the incorrect growth charts to measure and plot your babies weight gain. What you should be asking is, “are you using the WHO growth charts for breastfed babies?” Many of these charts being used in these offices are charts that are based on formula fed infants. The older CDC charts actually measured breastfed babies against formula fed infants, and we know that this is not accurate. So you want to be sure that your office is using the WHO charts to make sure that they are plotting it correctly.

The other thing to do is to notice that just because a baby is at the third percentile, does not mean that your baby is not within normal parameters. Your baby does not have to be at the 50th percentile or the 90th percentile!

A baby that is at the 3rd or 5th percentile for weight is just as healthy as a baby who is at the 70, 80 or 90 growth percentile. These are the normal ranges, and what you really want to keep an eye on is that your baby is staying consistent in their growth. That is really what will tell you the difference. I’m going to post some links here so you’ll have those growth charts, and if for some reason your doctor is not using them, you’ll have access to them to bring them with you and have them use that chart to help plot your baby’s growth.

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Have you been concerned about your baby’s growth? Does your child’s doctor use the correct charts?

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Shari Criso 2016

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