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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
Oct062014

Ease Up on Yourself

Written by Ashley Treadwell, IBCLC

 

Picture it: You’re having coffee with a good friend and she’s confiding in you about her guilt over not knowing her son had a double ear infection when he was running a fever recently.  He wasn’t pulling at his ears or crying when she laid him down.  He ran a fever for a few days, but had no other symptoms, and when she took him into his pediatrician, they diagnosed a double ear infection and prescribed antibiotics.  Your friend is feeling awful that she waited a few days to take her baby in.  She’s calling herself a bad mom.  

 

What’s your response?  

 

You tell her that she IS a bad mom, that she should have known that more was going on with her baby, even though he wasn’t showing any signs that he was in pain.  She obviously doesn’t have the instincts it takes to be a good mom.  You’d probably even tell her that her child would be better off if he was parented by someone else.

 

Right?

 

OF COURSE NOT.  

 

We would NEVER say these words to a friend.  Why?  Because they’re aggressive, mean, and meant to tear someone down.  And most of all…. because they aren’t true.  We would never say these words to a friend for fear of hurting her.  So why are we so quick to treat ourselves this way?  Don’t we deserve the same gentleness and support our friends do?

 

From the moment my first was born, a heavy layer of guilt settled over me - and breastfeeding was the first manifestation of this new guilt.  Breastfeeding hurt.  I mean, *really* hurt.  By the time I left the hospital two days after my daughter was born, my nipples were cracked and bleeding, and I was having anxiety attacks every time she began to show hunger signs.  Because of this, I made the decision to pump my milk and feed it to her in a bottle.  I had failed.  I had failed to do the one thing I was meant to do as a new mother.  I didn’t want to take her out of the house, in fear that she’d get hungry and people would see me feed her a bottle, and know that I had failed.   

 

 

Looking back, I realize the amount of dedication and perseverance it took for me to strap myself to that pump, every 3 hours, around the clock, so that I could feed my baby my breast milk, but at the time, I could only see my shortcomings, my weakness.  Looking back, I remember the sheer and overwhelming devotion I felt for my baby - she filled up my every day.  I was an amazing mother.  Her every need was met.  I look back at myself, almost 7 years ago, and wish I had half the patience and gentleness I did then.  I hadn’t failed at all.

 

 

The thing is, almost 7 years later, I still feel like I’m failing. Every time the television goes on so that I can cook dinner (which is sometimes (often) frozen fish sticks), or I find myself screeching at my girls to ‘hurrrrry up!’ as our hectic morning rages on.  Every time I cut a chapter in half at bedtime because I’m too worn out to read the entire thing, and especially every time I hear my oldest daughter’s loud, disgusted sigh - that she learned from me.  I feed my kids non organic fruit.  I spend too much time on my iPhone.  I let them eat Otter Pops.  In my mind, I’m a complete and utter failure at the one job I was built to do.

But you know who I need to hear from?  Myself, 7 years from now, looking back.  She will remind me that every day, before my kids went to sleep, I laid in bed with each of them and snuggled them.  That my girls went to bed every night with the comfort that comes with being loved completely.  That I was totally devoted to both of them, and their every need was met.  And I have something to say to this woman - myself in 7 years.  I want to thank her for her reassurance, and then I want to tell her “Ease up on yourself.”

 

 

Monday
Sep292014

Avoiding Common Breastfeeding Pitfalls Video

A few weeks ago, Ashley and I were interviewed at the Natural Family Fair about how to avoid common breastfeeding pitfalls.  Here is our 30 minute interview that just touches the surface about how to avoid some common pitfalls, such as misinformation about breastfeeding, access to breastfeeding-friendly practitioners, and lack of community and family support.  

 

 

And, stay tuned, as we will delve much deeper into each of these pifalls and provide tips for how to prevent them from happening to you!  

What do you think are the most common breastfeeding pitfalls?

Wednesday
Sep242014

How Can I Pump Enough for my Baby When I’m at Work?

 Written by Ashley Treadwell, IBCLC

 

Going back to work can be a very stressful time for many new moms.  It’s difficult to leave your baby for the first time.  You may feel nervous about returning to a job you’ve been away from for months.  Your schedule/routine may have changed due to child-care arrangements.  Plus, if you’re anything like me, none of your work pre-pregnancy work clothes fit yet!  A concern that often adds to this stress is the fear that you may not be able to pump enough for your baby’s bottles while you’re at work. Some moms find that they are constantly playing a game of catch-up, trying to keep up with their baby’s intake while with the caregiver.  Below are some things you can do to improve your ability to keep up with your baby’s needs.

 

 

Do some research before returning to work.

Most importantly, know your rights!  There is a federal law that protects your right to express milk for your baby while at work, in a private location, that is not a bathroom.  Speak to your Human Resources Department or direct supervisor (before you return to work) to find out where you will be able to pump.  Take note of where it is, how far it is from your work-space, and what equipment you’ll need to bring with you. Check to see if there are other breastfeeding moms using the space to express milk… that way you’ll know if you need to reserve the room or if you are free to use it as you please.  Take a look at your general work hours and responsibilities and create a plan for when you will be able to pump.  

 

Be sure your caregiver isn’t over-feeding baby!

Often, the issue isn’t the amount that mom is pumping (or not pumping), but the amount that baby is taking while in the care of someone else.  Many caregivers unintentionally offer too much breastmilk to babies, therefore “sabotaging” mom’s supply.  There are a number of reasons this may happen - your caregiver may allow the baby to finish the bottle too quickly and babies will take in more than they need when they eat too fast.  It’s similar for us when we sit down to a big meal.  If we eat very quickly, we often end up eating past capacity as our brain doesn’t have the chance to catch up with our stomach and tell us to stop eating.  A baby may finish a bottle and still show hunger signs, and the caregiver, wanting to soothe baby, will offer more milk when if given just a bit of time, the baby would have calmed on his/her own.  

Sometimes a caregiver may not understand the proper handling and storage of breastmilk and will treat it like formula, throwing any left in the bottle, when the milk could be placed back into the refrigerator for the next feeding.  Be sure to talk to your caregiver before returning to work to help them understand how to best bottle feed your breastfed baby.  Nancy Mohrbacher, IBCLC, wrote a wonderful article addressed to the caregivers of breast-fed babies that you can forward to your nanny/sitter/daycare worker to help them.  

Lastly, make sure your caregiver knows what time you will pick your child up and ask him/her to not feed the baby for the hour or so prior, so that baby will want to breastfeed when you are reunited.

 

Create a calm and relaxing space/routine for yourself while you express milk at work.

Trying to pump in a stressful environment can negatively impact the amount that you are able to express.  Take a good look at where you pump milk for your baby - is it a convenient, quiet, private space?  Are you able to lock the door so that you’re not worried about a co-worker unintentionally walking in on you?  

 

 

Here are some of our top tips for expressing milk at work: 

  • Bring articles of clothing that your baby has worn, or a blanket he/she has used.  
  • Have a picture nearby of your baby, or even better, a video of him/her - perhaps of your baby showing hunger cues. These items can help to get your hormones moving which will help your milk to let down and flow more quickly and fully.  
  • Use a hands-free pumping bra so that you can do other things while you express - check your email, eat a snack, play scrabble on your smartphone!  
  • Bring a blanket or towel and cover the flanges while you pump, so that you can’t see the amount that is coming out.  Hyper-focusing on how much milk you’re expressing can inhibit your body’s response to the pump.  
  • Listen to calming music, or a podcast you enjoy.
  • Watch funny videos on YouTube - we have a few that are oxytocin inducing on our San Diego Breastfeeding Center YouTube Channel.
  • Bring water and snacks to stay hydrated and satiated.  Moms often see a dip in their milk supply when they are dehydrated or are not eating enough calories.  (Breastfeeding women need about 2000 calories a day to sustain a robust milk supply.)

Engaging in activities that bring you joy or peace can help you relax and may increase the amount that you are able to pump.  You may find that you start to look forward to your pumping sessions!

 

Techniques that can help increase your output

 


There are a number of tips/tricks that can help you maximize your output when pumping.  

  • Be sure that all of your pump parts are in working order - that there are no damaged pieces.  
  • Hands-on-pumping has been shown to help increase the amount of milk a woman expresses.  
  • Learn a combination of breast massage, hand expression, and electric pumping and practice it whenever possible.  
  • Apply a bit of organic olive oil to the inside of your flanges to help reduce any friction or discomfort.  
  • Play around with the amount of time that you pump, but remember that stronger and longer doesn’t always mean more milk!  
  • If you find that you are absolutely not able to express the amount of milk that your baby needs in a day, you can add an extra pumping session in at night before going to bed and on your days off.  

 

Here are a few more tips from our Facebook friends: Help a Mama Out: Getting the Most Milk Out while Pumping


And MOST IMPORTANTLY, feel proud of the hard work you’re doing to provide your baby breastmilk while you’re at work!  Remember that breastfeeding is never an all or nothing endeavor.  Some women are not able to pump enough, some because of work situation or how they respond to the pump, but are still able to provide their baby as much breastmilk as possible, as well as breastfeed their baby while home with them.  Know that every drop of your breastmilk that your baby gets, whether it’s 1% or 100% of their total needs, is an amazing gift that only you can provide!

 

What are your favorite tips for pumping enough milk while at work? 

Wednesday
Sep032014

Help a Mama Out: Dealing with the Biting Breastfeeder

 

Oh, that sweet infant gummy smile!  So serene.... so innocent.... so adorable.  But all toothless mouths must come to an end and teething starts another fun developmental stage for your little one.  Teething can also stir up some anxiety in the breastfeeding mama, which we are hoping to aleviate today.

Will my baby bite me?  

Do I have to stop breastfeeding?  

Most moms have felt a clamp down on their nipples from their teething babes once or twice, but it doesn’t mean that your breastfeeding relationship has to come to an end.  No need for those new teeth to be a deal-breaker!

We turned to the wise breastfeeding mamas on Facebook to offer some tips for dealing with a biting breastfeeder.  As always, your advice was amazing.  Here is what you had to say.

 

Top Tips for a Dealing with a Biting Breastfeeder

Stacy: Remember that your baby isn't malicious and isn't trying to hurt you. If baby bites at the beginning of a nursing session, try giving him/her something cold/hard to chew on beforehand. If it's at the end, pay close attention and break their latch as soon as they finish eating but before they are tempted to play with the new sensation of using their teeth.

Amber: Remember, it’s just a phase!

Michelle: I found that using a nursing necklace was really helpful.  Instead of pulling back on my nipple when he distracted, he would play with the nursing necklace while breastfeeding and focus on feeding.  I found that he mostly bit down when he was distracted.

Liz: Ugh. Cry? I do the "don't bite. That hurts." And set P on the ground for a few minutes. Then nurse again.

Katie Jo: What ultimately worked for me was to pay close attention and learn to recognize when he was finished eating. Then I would have to quickly unlatch him with my finger before he started to play/explore what he could do with his teeth. If I didn't catch that moment quickly enough, he would bite down the instant he sensed I was about to unlatch him, and my nipple turned into a rubber band chew toy for him. Sometimes he would bite my finger instead. I tried pressing him into my breast and telling him ouch in an upset voice, but he just laughed every time.

Julie: I bought my daughter an amber necklace to help relieve some of the teething pain she was feeling.  Less teething pain = less biting while breastfeeding.  I also wore one around my neck as well.

 

 

Jen: I tell P, "ouch, that hurts mommy." She stops biting/nursing and looks at me with concern. I let her know it hurts and to be gentle. Sometimes it takes a few reminders, other times she will stop.

Stephanie: If your child will take a cold teether, try offering that before or after a nursing session.

Tamara: Be patient, they may be in pain from teething and doing their best to find relief.

Jennifer: Keep your finger close by their mouth so if they go to bite, you can stick your finger in the side quickly to get them to unlatch!

Erin: I loved the Camilia teething liquid to help with teething pain.  I would use this a couple of times during the day when my baby was really teething badly and I thought it really cut down on the biting while breastfeeding.

 

 

Kat: My kids didn't start that nonsense until they were 10 and 8 months old respectively. So every time they bit, I would quickly unlatch them and set them down. I would say "no biting Mama" and ignore them for a minute or 2. My daughter figured it out after a couple of days, and my son took a week. I tried a couple of times to do that thing where you push their nose into your boob to make them open their mouth but it's so counterintuitive! The first instinct is "get it off me!"

Kim: My 9.5 month daughter got her first teeth at 4 months 1 week. She usually bit me when she was done eating or not hungry. I would tell her no biting and take her off my boob. I would make sure when she was done eating to immediately unlatch her or that's when the biting would begin. I could tell when she was about to bite. Now she is biting my shoulder.

Don't miss our article about why babies bite while breastfeeding and a few more tips and tricks to stop it from happening: Breastfeeding a Teething (or Toothy) Baby

Also, check out our Boob Group podcast episodes where we discuss biting babies and toddlers:

Breastfeeding A to Z: Sore Nipples and Biting

Breastfeeding Toddlers: Frequency, Biting, and Staying Motivated

 

What tips do YOU have for dealing with a biting breastfeeder?

 

Monday
Aug252014

Was it Something I Ate? Food Sensitivities in the Breastfed Baby: Part 3

By Lindsey Hurd, MS, RD, LDN, IBCLC and Owner, Angel Food Lactation & Nutrition, LLC

 

Last month we probed a little deeper into understanding how mom’s gut influences baby, what causes an unhappy digestive system, and what we can do about it.  From leaky gut syndrome to food sensitivities in baby, maternal dietary modifications have become the first line of defense, despite the inevitable difficulties one may face when narrowing the focus of problem foods. A mom’s diet during pregnancy and during lactation is often a hot topic among anyone close enough to ask questions about her experience… even someone in the checkout line at Target! From your Aunt Sally to your Grandpa Joe, everyone seems to have an opinion about what a mom should and shouldn’t eat.

Often times we hear myths such as spicy foods, cruciferous veggies, beans, garlic, etc. cause excessive gas and GI upset in babies therefore moms should always avoid these foods. What about allergy risks? Shouldn’t moms avoid high allergen foods to reduce the risk of their baby suffering from allergies?  Most importantly for our discussion here, once an allergy or sensitivity in baby has been detected, many foods are considered to be a cause for concern and are encouraged to be eliminated all at once. This is often with no direction into the how, why, or to what capacity… so what’s a mama to do with all of this information? As a Registered Dietitian specialized in lactation related food sensitivities, below are tips and tricks I share with each client I see, via skype or in person, on how to make an elimination diet work for you. 

 

First Things First…

How do we know when our baby is showing signs of an allergy, sensitivity, or is just ‘being a baby’? Throughout the first few years of life, we go through many phases of maturation, growth spurts, improved function of the internal organs, and cognitive development that lead to variability in bodily functions. As our little ones grow, much like a child or teenager, these phases can be fast or slow, contributing to symptoms signifying the ease or difficulty in coping with such change. When infants have variations in their digestive habits, something many parents have held under strict observance, it can lead to a lot of anxiety and concern about the normalcy of what they see. Each infant’s stool pattern and appearance have individual variations of normal, similar to that of older children and adults. This could be a series of blog posts on its own! For the sake of our discussion on allergies and gut health, the top two signs that tell us something isn’t quite right are the presence of blood and/or mucus in their diapers.  

Digestive symptoms such as these often appear around the 2-month age mark when immunity shifts from maternal based to becoming more dependent on baby. At the onset of symptoms, the presence of blood can become slightly tricky. If accompanied by other symptoms of discomfort, it can be associated with an infection, much like a stomach bug for children or adults. However, once screened negative for infection, the continuous presence of blood, dark brown in appearance, begins to direct us toward mom’s diet as a potential causative factor. Mucus often times is paired with green stools and can signify irritation in the baby’s digestive system. If found independent from blood, this sign of irritation can be associated with food sensitivities. If mucus is found in combination with blood-tinged stools, it can be an additional indicator of an allergy present in baby. As with all abnormal symptoms, it is best to check in with your baby’s doctor to rule out other causative factors, especially those medical in nature. 

 

 

 

To eat or not to eat…. That is the question. 

Corn, tomatoes, cow’s milk, OH MY! Often times the prescription for an elimination diet comes with lack of clarity in what to avoid, how to avoid it, and what to eat instead. Moms are so responsive to their baby’s needs that most are quick to do whatever they can to help their baby find a little relief. This, however, can come at the expense of their own sanity and nutritional status. Determining which foods to eliminate requires in depth knowledge in the mother’s specific dietary habits, baby’s specific symptoms, and an understanding in how the two intersect. Most often, moms come to my practice having already eliminated a handful of foods, randomly selected from a list of ‘top allergens’ or a friend’s personal experience with no regard to their intake. Unfortunately, often times this elimination is only partially complete as ‘hidden’ foods are consumed with no knowledge of the allergen’s presence. Listed below are the top 4 steps toward completing an appropriate elimination diet and getting you and your baby on your way to tip top shape! 

 

1. Recruit your support team. Find evidence based blogs, peer-to-peer support, a personal chef, cooking classes, and most importantly a registered dietitian experienced in lactation related food sensitivities to help you as you progress throughout this process. Having your toolbox full of resources will definitely be the best investment of time and energy in getting you back in control of your diet. Organizing your course and plan of attack, prior to removing potential allergenic foods, will help with efficiency and the level of control during this unpredictable process! 

2. Create a food log & symptoms log. Personalization and preservation are the two top goals for me as a professional working with moms on elimination diets. For 3-4 days, I recommend keeping a log of every food and beverage you consume, the time of consumption, and the time and type (breast or bottle) of feeding for your little one. Additionally, it is best to log the time and type of symptoms you see. Although this can be a huge undertaking, it is the gold standard in narrowing down potential causative factors in mom’s diet. 

3. Take it one food at the time. Finding purpose in each action we take can release our reactionary response of jumping in with both feet. When offering little thought into the aftermath of this technique, we find that as the allergy symptoms begin to fade, we are left with confusion and uncertainty of the true offender! This can make the road toward reintroduction very tricky and sometimes unsuccessful. To preserve your sanity and protect your preferred food selection, it is best to choose one food to eliminate at a time. It is frequently stated that 2-3 weeks are required to see a complete recovery from an eliminated food. While this statement is valid in some cases, for many, improvement appears within 24-48 hours after food elimination begins. Visualizing this change on a short-term basis allows for continued elimination until baby is well and the preservation of mom’s diet is honored… especially when meal preparation and planning are difficult enough! 

4. Reintroduce when the time is right. Unless otherwise directed by your pediatrician, do not fear the process of reintroduction! Permanently eliminating the food from your diet does not allow your baby the opportunity to build up adequate immunity toward this food prior to consuming it directly via solid foods. Before considering this step, allow time for your baby’s body to heal and demonstrate its ability to be symptom free for 2-3 weeks. This is most important prior to initiating this final step. Once successful, begin with the least offensive food and reintroduce in small amounts, eating a portion once per day, or once every other day. Give this step 3-5 days and if all is well, continue down the list until your diet is back to normal. It is important to keep great inventory of your intake and your baby’s symptoms via your food log to keep a good hold on what’s going on just in case symptoms resume. If your baby begins to show signs of intolerance, back off slightly until he/she is symptom free again, holding steady at the highest stage possible. Give your baby’s immune system a couple days to settle into this allergen load. Once ready, begin again, slowly introducing as tolerated. 

 

 

The key to success during an elimination diet is personalization, education, patience, and breastmilk! Despite having a potential allergen or sensitivity within mom’s milk, the immune boosting cells, digestive enzymes, and anti-inflammatory properties, to name a few, far surpass the effects of the sensitivity... especially when considering the potential harm from alternate sources of infant nutrition. For most, the benefit of breastmilk is crucial in the continued development of baby’s immune system and in prevention of further concern down the road. Although this process varies for each mom/baby dyad, the steps toward successful elimination hold true for each case. 

 

Want to find out more? Visit www.angelfoodlactationandnutrition.com to schedule a Skype consult with Lindsey and begin your journey toward better health and a happier baby today! Want to stay connected between posts? Find Angel Food Lactation & Nutrition on Facebook at www.facebook.com/angelfoodlactationandnutrition for current articles, events, fun discussions and more!

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