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The content on this website (http://sdbfc.com) is the property of Robin Kaplan, M.Ed., IBCLC, except in the case of guest blog posts, which have been posted with permission of the authors credited.

The information and opinions provided on this blog are not a substitute for medical advice or consultation with a qualified medical professional; nothing contained on this website shall be presumed or shared as medical advice at any time.

Links to other websites and blogs that may be of interest to you, the reader, are provided; this does not imply endorsement of or collaboration between Robin Kaplan and the owners/authors of those websites and blogs.

Monday
Jun222015

Meet Our New Lactation Consultant at SDBFC!

We are so thrilled to introduce you to our newest lactation consultant at SDBFC!  Stacy Clifford joined us on June 1st and will be doing home visits on office visits starting next week!  Here is my interview with Stacy.  I can't wait for you all to meet her!

 

Stacy, tell us a little about yourself.

I grew up in Tempe, Arizona and moved to San Diego in 1999 to attend Point Loma Nazarene University. I love traveling and find every excuse to study or travel abroad. Some of my favorites trips include a semester in Madrid, Spain; volunteer work in the Dominican Republic; studies in Peru; volunteer medical/research trip to Honduras; and most recently my honeymoon in Panama! I got married in March 2015 to the sweetest, smartest, and funniest guy I know. Luckily he loves to travel as much as I do, and his job as a hydrographer (ocean floor charting) takes him all over the world. When we’re not traveling we spend our time walking/biking/hiking around San Diego, attempting home improvements, going to breweries, watching soccer, and spending time with friends and family. 

 

 

What inspired you to become a lactation consultant?

As a daughter of a mother-baby Registered Nurse who breastfed her own children, I believe I internalized the stories I heard growing up of my mother’s work helping new mothers breastfeed as well as her own breastfeeding experiences and challenges. My mother’s passion and dedication to her patients and her family was extremely influential in my life. I knew I wanted a career where I could similarly give care and support to those in need. I decided to pursue a graduate degree in Public Health, where I went through extensive study and practicums of maternal, infant and child health including breastfeeding and nutrition and began to learn how health professionals could support mothers and overcome barriers. While conducting a lactation research study in Honduras, I spoke with many new mothers about their breastfeeding journeys. This was a beautiful and instrumental experience that further opened my eyes to the challenges, questions, and joys new mothers face while breastfeeding and from there began my pursuit to support mothers during this important time of life. 

 

What are you most excited about working for the San Diego Breastfeeding Center?

To work one-on-one supporting mothers and the chance to work with a team of top-notch lactation experts at SDBFC!

 

What are your top 3 tips for a brand new breastfeeding mama?

1. Be patient with yourself. Breastfeeding is a new skill and takes time to master. Know and believe that you are an awesome mama and doing the very best for your baby! 

2. Be patient with your baby. Breastfeeding is a new skill for the baby too! Babies eventually become more awake, better at latching, and more patient the older they get. 

3. Accept help, especially the kind that includes housework and cooking! And don’t be afraid to ask for breastfeeding help if needed. 

 

Welcome to the team, Stacy!

Thursday
Jun112015

Positive Breastfeeding in Public Stories - Nordstrom ROCKS!

Written by Ashley Treadwell, IBCLC

So much of what we hear about feeding our babies in public is negative - stories from women being harassed and shamed for breastfeeding in public.  While we believe that it is so important to respond to these incidents and educate people on the importance of normalizing breastfeeding, we also think that one of the best ways we can empower women is to share our positive experiences as well.  Below is one of many examples of wonderful responses women receive while feeding their babies in public - meet Margaret!

-----------------------

I took five and a half months off after my baby was born in November 2014. She is our first, and after twelve weeks maternity leave, paid at 55% of my regular pay, I had another twelve-ish weeks of personal leave upaid. It was worth the financial sacrifice!

I made it a point to go out for lunch at Nordstrom (using a generous gift card) once a week. I was breastfeeding and extra-hungry, and I enjoyed soup, a sandwich, and dessert every time.

 

Usually, I visited the Ladies Lounge to nurse before or after lunch. My most-positive experience was at the Nordstrom in Westfield North County (Escondido) just before Christmas. One of the couches faces the door, so that other women going towards the bathroom stalls pass by and see you. So many people stopped to admire the baby and say a kind word. Older women in particular stopped to admire the ability of a breastfeeder to give her baby food anywhere, anytime. They regretted bottle-feeding their babies so many years ago. I made sure to say a kind word, like "you were a new mommy when 'bottle was best' back in the day - you were doing what you were told!" and we would chuckle about how silly doctor recommendations can sometimes be, and smile with the mutual generosity of mamas who are just trying to do what's best.

It was, needless to say, a very supportive and empowering experience.

As the baby got older, her sleep-wake cycle changed and it was impossible to predict when she would be hungry. A few times I fed her from the breast while eating at Nordstrom Cafe (in Fashion Valley). The staff were nothing but kind - going the extra mile to carry my things and being so kind.

I hope other San Diego mamas can build a routine of feeding baby out of the house. If they're feeling shy at first, Nordstrom Ladies Lounge is a great place to start.

 

Do you have a positive breastfeeding in public experience to share?  Please send it to us at ashleytreadwell@sdbfc.com

 

Tuesday
May262015

Top Tips for Introducing Solids to Your Baby

Written by Rachel Rothman, MS, RD

At your baby’s four-month visit, your pediatrician may have talked to you about starting your baby on solid foods and probably recommended to start between 4-6 months.  It’s usually recommended that baby can start solids when he/she is sitting up mainly on his/her own, has a pincer grasp, seems interested in food, and opens his/her mouth when food is offered.  As a pediatric dietitian, I get asked many questions about infant nutrition and starting baby on solid foods.  

(Note - many pediatricians may suggest it’s okay to start a baby on solids as early as 4 months, but it is important to note that the American Academy of Pediatrics’ statement on breastfeeding is as follows: Exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.)

 

Here are just a few of the things to keep in mind when your baby is ready for solid foods: 

 

1.  At the beginning it’s still just for fun.  Your baby will still be getting most of his nutrients from breast milk or formula, so your goal should be to help him learn these new feeding behaviors.  Eating should be a fun experience, and not stressful.  If you begin feeding solid food and your baby has a hard time with it – she’s gagging or fussy  - wait and try again at a later time.  You will not do any damage by waiting a bit.  

2.  Consider some key nutrients and focus on variety.  Key nutrients for babies and toddlers include vitamins A, C, and D, iron, total fat and omega-3 fats, and calcium.  Each of these nutrients serves a specific purpose within the body; around 6 months of age, babies require these in other forms, above what is in breast milk or formula.  Don’t be afraid to be creative with the foods you are offering to meet baby’s needs for these nutrients.  Infant cereal may be what your grandmother recommends, and it’s no slouch – its high iron content is helpful.  However, variety is important for teaching your little one to appreciate different food tastes and textures, so try purees of spinach, beans or lentils.   To help baby intake of additional omega 3 fatty acids, try adding chia seeds, ground flax or ground walnuts to purees.

3. Some foods should be avoided at the beginning.  A few foods you will want to avoid until baby is 12 months include honey (because of the risk of botulism), cow’s milk (it contains too much protein), and small solids (small chunks of raw vegetables, grapes, sausages, whole nuts and seeds can all be choking hazards).  Allergens are another consideration.  Recommendations about the foods to avoid (in order to minimize risk from allergic reactions) have changed over the years.  A 2008 review of research by the AAP concluded that the top 8 allergenic foods (cow’s milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat) need not be avoided unless you have a family history of food allergies.  In that case, it is best to speak with your pediatrician before proceeding.

4.  Serving sizes are small.  I hear a lot from parents that their baby is not eating enough.  But how much is enough?  A typical serving size when starting solids is 1-2 tablespoons of a puree or soft food - it’s a small amount.   And you will want to start by offering one to two meals per day.  Remember, baby will still be getting a good portion of her nutrition from breastmilk or formula until age one.  As baby gets older the serving size will increase, after 12 months the amount of food per meal should be around ¾ to 1 cup.

5.  Division of Responsibility.  Renowned feeding expert, Ellyn Satter, gives parents the helpful suggestion of division of responsibility.  Parents are responsible for the “what, when, and where of feeding; children are responsible for the how much and whether of eating” (Satter).  Do not force your child to eat more or stop eating if you feel they have had too much.  Babies have the amazing ability to self regulate (many of us adults have long since lost this ability). Eating is a behavior that does need to be learned, but does not need to be rewarded.

6. Milk feedings first.  Ashley Treadwell, IBCLC at the San Diego Breastfeeding Center offers these tips for protecting your mill supply when starting solids. "When it comes to maintaining your milk supply, this can be one of the most important rules to follow when offering your baby solids.  Be sure that baby is always offered the breast first, and then solids.  If baby is filling up on solids, she may not remove as much milk from the breast as she needs.  Over time, milk left in the breast tells your body to stop producing as much which will decrease your milk supply.  If you are sure that baby is taking all the milk he/she needs from the breast prior to offering him solids, you will help to maintain your supply to meet your baby’s needs."

 

When feeding baby don’t forget about mom and dad.   All too often I see mom and dad focused so much on baby’s health and wellness that the parents’ health and wellness falls by the way side.  Remember to practice good nutrition for yourself, this will not only help you to feel better, but to set a good example for your child.  Healthy and happy mom and dad lead toward a healthy and happy baby!

 

Want to learn more about starting baby on solids?  Join me at the San Diego Breast Feeding Center on June 17th from 10-11:30 am for a class on introducing solids.  More information can be found here.

 

Wednesday
May202015

Top 6 Tips for Protecting Your Milk Supply While Traveling for Work

We had this terrific question posted on our Facebook page:

“Dear Robin,

I leave tomorrow for a four day work trip and I can't take my baby with me. She has 6 feedings a day (one of those at night) so I'll be doing a good amount of pumping while I'm gone. Do you have any tips, specifically for pumping at airports and/or on planes? I'll be on a red eye there and a direct flight on the way back.”

 

Absolutely!  Just because you have to travel for work doesn’t mean that you can’t protect your milk supply while you are gone.  

 

Here are my top 6 tips for protecting your milk supply while travelling for work:

1. Pick up a few insulated cooler bags with a zipper, like this one from Trader Joe's, with several blue ice packs, from Rubbermaid, to bring with you in your check-on luggage.  When traveling for more than a day or so, you may have a lot of pumped milk to bring home with you.  Using insulated cooler bags with ice packs will allow you to bring all of that liquid gold home with you, without having to lug it through security.

 

2. Call your hotel before you leave home to ask if there is a fridge in your room.  If not, you can request one and that is where you will place all of your pumped milk while on the trip.  Store your milk in breast milk storage bags so that you can fit a lot of them in the insulated cooler bags on the way home.  Also bring a small cooler with ice packs to store pumped milk when you are away from your hotel room.

3. Depending on the length of your flight, you could either skip the pumping session and just make sure to pump extra long when you arrive in at your destination.  Or, you could bring a nursing cover, your pump pieces, and a battery pack and pump while on the flight.  On the red eye, this should be easy, since it will be dark.  On the daytime flight you might ask the flight attendants if you could sit in the back in one of their seats so that you have a bit more privacy.  If you are going to pump on the flight, bring a small cooler with you with blue ice so you can save your pumped milk.  You could also just pump right before you get on the plane and then completely forget about pumping while on the flight.

Freemie Collection Cups4. Invest in some Freemie collection cups.  These cups are amazing!  You can pump with your shirt on and no one will know what you are doing!  They are incredibly discreet and hold up to 8oz per cup.  These are great for on the plane, in the cab, and in between meetings.  

 

5. Try to pump every few hours, and once at night if your baby is still breastfeeding in the middle of the night, to keep up your milk supply for when you get home.  If your meetings are in a conference center or hotel, ask the concierge if there is an open room that you can use (NOT A BATHROOM) to have some privacy while pumping.  Aim for pumping for about 15 minutes, which is about as long as it will take your co-workers to enjoy a coffee break.

Mamava Lactation Suite6. Do some research ahead of time to see if the airport you are spending time in has a Mother’s Room, Nursing Room, or Pumping Room.  Download the Mamava app to find publicly placed Mamava Lactation Suite in United States airports.  

 

Now it’s your turn!  What tips would you add to this list?

 

Wednesday
May062015

Support Group or IBCLC: What's the Difference?

When a mom is looking for breastfeeding assistance, it can often be difficult to know where to get this help and from whom.  There are so many options…. Facebook, breastfeeding support groups, lactation consultants… where to go can be confusing, especially if she feels like she needs to get help immediately!

So, what is the difference between the breastfeeding help you will get at a support group and at a private lactation consultant visit?

 

What you can expect at a breastfeeding support group:

Let me preface this by saying that not all groups are the same and it really depends on the level of expertise of the person running the group and how busy the group is.  There are different levels of experience and training in the field of lactation, depending on how many hours a person has spent in class and in an internship.  The level of expertise are demonstrated by the letters that follow the person’s name (IBCLC, CLC, CLE, etc), which is all explained in this fantastic article, What’s the Difference Between LC, IBCLC, CLE, etc?

At a breastfeeding support group, you will find a leader who is there to offer general breastfeeding assistance and support.  This leader can assist with positioning and latch (although often times this leader will not be able to actually touch you or the baby), basic information about normal breastfeeding/pumping strategies, normal baby feeding patterns, normal baby weight gain, breast and nipple care, and ways to maintain and protect your milk supply.  Often times there is a scale where you can weigh your baby before and after a feeding to see how much your baby is taking in (which is AWESOME!)  Attendance at the support group can range from a few moms to over 20, depending on how big the space is and how well attended the group is.  Support groups are often free, depending on where you live.  Support groups are fantastic for getting basic breastfeeding support, getting help while you wait for an appointment with an IBCLC, meeting other breastfeeding moms in your community, and practicing breastfeeding outside of your home.  

What you will not receive at most breastfeeding support groups is a personalized plan of care for difficult breastfeeding situations.  To create a personalized plan of care, a mother and baby’s medical history need to be discussed, as well as mom and baby both need to be assessed, which requires a consent form.  Therefore, most advice given at a breastfeeding support group is general, not specific for mom and baby’s personal situation.  

 

What you can expect at a private lactation consultant visit:

If you are meeting with an International Board Certified Lactation Consultant (IBCLC), you are now moving from general advice to a personalized assessment and plan of care.  The IBCLC should conduct a suck assessment on your baby, collect medical histories of both you and your baby, assess a feeding session, and offer guidance on how to improve your personal breastfeeding experience.  

 

Reasons you would want to see an IBCLC rather than just attend a support group:

  • Cracked, bleeding nipples

  • Painful latching that isn’t improved with positional changes

  • Baby not gaining weight well

  • Mom’s milk has not come in by day 3-5

  • You suspect your baby has a tongue tie and/or lip tie

  • Baby has signs of colic or reflux

  • Mom has a low milk supply/supplementing baby

  • Mom has an oversupply

  • Premature baby

  • Challenges with breastfeeding multiples

Each of these situations requires that someone provides a medical assessment and advice beyond what’s normal or typical with breastfeeding, therefore, it goes beyond what a mom can seek help for at a support group.  These private visits can take place in mom’s home, in the IBCLC’s office, at an outpatient clinic, at a medical practitioner’s office, or similar places.  Most of the time these visits have a fee associated and sometimes insurance will pay for these visits.

 

Where you can find an IBCLC in your area:

  • Ask your friends

  • Ask your baby’s pediatrician

  • Search for a local breastfeeding coalition

  • Call the breastfeeding warm line at the hospital or ask your midwife/OBGYN

  • Ask your WIC Peer Counselor

  • Search for an IBCLC in your area on the ILCA website

  • Google “IBCLC” and the name of your town or city

  • Ask for a recommendation on Facebook

  • Attend a support group led by an IBCLC

Where have you found breastfeeding support in your neighborhood?  

Was it easy to find this support?