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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.

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Wednesday
Jun042014

A Resolution to the LA Fitness Nursing in Public Harassment Incident

Last month I shared a story about how a breastfeeding mother had been involved in a nursing in public harassment incident at a local LA Fitness.  During this incident, Monique Golueke was told that her only option for breastfeeding in the Oceanside LA Fitness facility was in the Kids Klub restroom.  After some media coverage, a nurse-in, and several cordial email exchanges between the San Diego Nursing in Public Task Force and Jill Greuling (Vice President of Operations for LA Fitness), I am elated to report that we have come to an incredibly positive resolution!  

Today, I received an email from Ms. Greuling, stating that the following memo will pop up for every LA Fitness employee in California when they log on June 5th, requiring an acknowledgement that they read and understand the information contained in the memo:

"According to California Civil Code, section 43.3, “Notwithstanding any other provision of law, a mother may breastfeed her child in any location, public or private, except the private home or residence of another, where the mother and the child are otherwise authorized to be present.”  To accommodate breastfeeding women in LA Fitness facilities, staff members may recommend reasonable places for her to do so, such as the foyer, the sales area or in the Kids Klub. It is not reasonable to tell a woman that the only place she can breastfeed her baby is in the Kids Klub restroom."

The San Diego Nursing in Public Task Force would like to commend Monique Golueke and Ms. Greuling for having the initiative to take tangible, practical actions that will prevent any incidences like this from happening in the future.  We are thrilled we were able to collaborate with her to bring forth such a positive resolution.

 

Monday
Jun022014

Defining my Breastfeeding Experience: Inclusive Breastfeeding

Written by Aran Tavakoli

It has been nine months and I just put away my pump. Getting it ready for storage was bitter sweet. How many hours have I spent with that machine in the past 9 months? Its usefulness outweighed the annoyance.  Once again, at this point in time, I am redefining my breastfeeding relationship with my baby. 

 

 

Breastfeeding has been an extraordinary journey. I have experienced and learned so much. I keep searching for a word that captures and defines my experience, but I can’t find one. I believe the breastfeeding community is actually missing a term for mamas that fall into their own camp. There is the exclusively breastfeed group and the formula group. Research often distinctly divides mamas and babies into these two groups. But, there is an ever-growing group of mamas that breastfeed and give formula to support their breastfeeding relationship with their baby. The current words used to describe this group include combo feeding or more commonly, low supply needing supplementation. 

From the true definition, I do not "exclusively" breastfeed my baby. However, I do exclusively give my baby all the breast milk that I have.  But he needs more to be happy and healthy, so he also receives formula and when he was really little, he received donor milk. Honestly, I am so tired of the “low supply” conversation, I wish there was a different word for how I feed my baby. A word that matches the pride of the mamas who do exclusively breastfeed their little ones all that they produce.  

 


Per Merriam-Webster, ‘exclusive’ is defined as, “not shared: available to only one person or group.” ‘Inclusive’ is defined as, “covering or including everything: open to everyone: not limited to certain people.” 

Thinking about it, I have never been an exclusive type of person, so the opposite of exclusive is inclusive. I have inclusively breastfed my baby for 9 months (way longer than I would have thought in the beginning!). This is the word that I am using to define my breastfeeding experience. 

In the inclusive camp, mamas know the best and worst of both worlds. The best of breastfeeding includes that joys of nourishing your baby with your body and making personalized milk. Then there is the best of formula: the intervention that provides life saving nutrition to support healthy growth and development. The worst of breastfeeding includes the sometime difficulties: mastitis, plugged ducts, yeast, blebs and so on! On top of breastfeeding, there might also be pumping, all the equipment and time that is required. For formula, besides the cost, the worst includes the bottles to be cleaned, sterilized and cleaned again. 

In the inclusive camp, the mamas are incredible as they work so hard to maintain their milk supply for their little ones, while also accepting help in the form of formula or donor milk. It is not one way or the other, it is all the ways: the breastfeeding, the pumping, the supplementing, the love, the dedication, the tears and the sweat (especially on hot days)! The inclusiveness of the experience. 

 

 

 

I don’t want to use a breastfeeding definition that makes mamas feel bad that their milk supplies are low (I worked through that one) or that they feel badly for needing to use formula (I worked though that one, too). Saying that, 'I inclusively breastfeed" is so much more positive and empowering than saying, "I have low supply and need to supplement." My lactation consultant, Ashley, always said to me, “He is getting your milk.” That has become my motto. He’s getting my milk, the amount doesn’t matter, and he is getting my milk.

So...Mamas who Inclusively Breastfeed, shall we adopt a new term? 

 

 

Wednesday
May212014

Witching Hour vs Colic

 

Colic is a word that is often used for a baby who cries for any length of time, but did you know that it’s normal for babies to have a fussy period every day, often called the witching hour?  While it’s distressing for any parent to hear her baby cry, sometimes understanding that the behavior is a normal part of infant development can be helpful.  However, there are times when the behavior may be caused by something else, and even though the cause isn’t always immediately understood, there are measures that can be taken to reduce the symptoms of colic.

 

What is the “Witching Hour”?

The witching hour is described as normal fussy periods that almost all babies go through.  It happens around the same time every day and most frequently occurs in the late afternoon and evening hours.  It will often begin between weeks 2 and 3, peak around week 6, and then fade around 3 months.  During this time, your baby will likely want to cluster feed, which again, is a normal behavior for babies. A baby who may go 2 hours or more between feedings will suddenly want to eat constantly.  He/she may be fussier than normal and more difficult to soothe.  Often it seems like the baby doesn’t know what he/she wants!  The baby will want to feed for a few minutes, then fall asleep, only to wake 10 minutes later wanting to feed again.  Some babies will fuss at the breast, giving hunger cues, but then pull off and cry.  All of this is normal behavior.

 

What Causes the Witching Hour?

While our babies can’t tell us why they’re so cranky during these seemingly endless hours, we have some theories on what causes it.  As it happens often towards the evening hours, it could be because mom’s milk supply is lower than it was earlier in the day.  What is so important for moms to realize is that her supply is not TOO low, but lower, which is a normal fluctuation that all women experience.  As the milk flow is slower, the baby may grow frustrated, and as the milk volume is lower, the baby may want to feed more often.  Again, this is not a sign that mom doesn’t have enough milk, but a common occurrence in breastfeeding.  Another cause could be overstimulation.  Your baby isn’t able to self soothe, or shut him/herself down at this age.  So by the end of the day he/she may feel cranky and overstimulated and have a hard time calming down.  It’s also often the busiest time of day in a lot of households, when partners are returning home from work, older siblings from school, and mom is trying to juggle activities like making dinner, or helping another child with homework.

 

What Can I Do to Help My Baby During the Witching Hour?

While you may not be able to 100% prevent the fussy period, there are lots of things you can do to help calm your baby and make your own life a little easier.  The best thing you can do is to offer your breast often.  Wearing your baby and learning to breastfeed in the carrier can be an absolute lifesaver!  Wearing your baby will also help to keep him/her soothed and your hands free, so you can attend to other children or activities that need to be done.  Another idea is to prep dinner earlier in the day so that you don’t feel the stress of having to do that during your baby’s fussy period.  Take a walk with your baby in the carrier, as the fresh air will benefit you both.  As much as you can, don’t plan events during this time.  And lastly, don’t be afraid to ask your partner for help!  A baby’s cry is incredibly stressful for mom and sometimes you may need a break.  Ask your partner to step in for a while to soothe baby while you take a bath, go for a drive or walk, or just sit in a quiet room.

 

What is Colic?

Colic is different than the normal witching hour and is defined as a baby who cries for 3 or more hours a day, 3 or more days a week, for 3 or more weeks at a time.  Colic can begin in the early weeks and often fades by month 3 or 4.  The behavior of a colickly baby is markedly different than that of a baby experiencing normal witching hour.  The crying is often more intense and the baby is unable to be soothed.  The crying may be accompanied by behavior that indicates the baby is physically uncomfortable - he/she will arch his/her back, or seem to want to change positions, or tense his/her legs up near the abdomen.  

 

What Causes Colic?

Like the witching hour, there is no hard and fast evidence about what causes colickly behavior in a baby.  There are however, some things that you can definitely rule out if you suspect your baby is colicky.  One common cause for colic is too much milk.  Mom with an oversupply of milk may find her baby exhibiting the symptoms described above.  If mom has a very forceful letdown and fast flowing milk, the baby can take in too much air while feeding which can cause lots of gas and periods of great discomfort.  Sometimes an oversupply can cause a baby to have a foremilk/hindmilk imbalance.  This also means discomfort for the baby as he/she is getting more of the diluted foremilk and not enough of the fattier hindmilk.  The foremilk doesn’t have enough fat in it to help balance the lactose, which can cause it to be difficult for the baby to digest.  

A tongue-tie or lip tie can also cause this type of behavior, even when mom doesn’t have an oversupply of milk.  A baby with a restricted tongue or upper lip may not be able to create a seal while feeding at the breast, which again, like the oversupply, causes baby to take in too much air while feeding.  

A sensitivity to something in mom’s diet can also be a culprit in causing this colicky behavior.  

 

What Can I Do to Help my Colicky Baby?

Change up your breastfeeding position.  If you feel like you may have a forceful letdown, try using the laid-back position.  This can help slow down your flow, making it more manageable for your baby.

If you suspect that something in your diet may be causing your baby discomfort, try keeping a food journal for 48 hours.  Record everything you eat, the time you ate it, along with the times your baby is exhibiting the colicky behavior.  If you start to notice a trend of discomfort following a certain type of food, you can eliminate that food from your diet for a few weeks to see if the behavior improves.  The foods most likely to cause sensitivities are dairy, soy, gluten, eggs, and nuts.  

Most importantly, seek the help of an IBCLC (International Board Certified Lactation Consultant) as she can help you identify oversupply, forceful letdown, tongue/lip tie, as well as a food intolerance/sensitivity.  Lastly, contact your pediatrician to rule out any serious conditions.  

And most of all, remind yourself that this will pass!

 

What tips do YOU have for surviving you baby's witching hour?

 

Sunday
May182014

You Know You Are a Breastfeeding Mother When...

Cyndi: You have to plan your work meetings around your pumping schedule.

Sherry: You walk around the house for a few minutes before realizing you never put your boob away.

April: All your shirts open in the front.

Amy: You go to run a 10k and pack your pump as part of your post-race routine.

Kelly: Every shirt you own had a stain from leaking over one or both breasts.

Amy: You workout and apologize to your friends for smelling like a mixture of sweat and milk due to random let downs.

Dana: You are happy to have limo tint on the back windows of your car because you spend so much time pumping in the back seat.

KC: Your husband wakes up to a ‘peep show’ and you’re passed out.


Christine: Your knit shirts are all stretched out because of your toddler reaching down and grabbing for self service.

Bethany: You feel your boobs all day to see which one needs to be nursed from next.

Angelique: You fear the mailman has had a free peep show, but you don’t even care.

Melissa: You question how much milk spillage is acceptable on a shirt before you change it.... and the answer is A LOT!

Ruthii: When sitting next to you becomes a splash zone.

Jennifer: You catch your toddler breastfeeding her dolly.


Jennifer: You walk out the front door and reflexively grab your chest to make sure your boobs aren’t hanging out!

Julie: When you cry over spilling an ounce of milk on the counter.

Suzanne: You use your milk as a cure everything from sunburns to eye and ear infections. Breast milk is the equivalent to Windex from the film "My Big Fat Greek Wedding."

Ashley: You’re excited for a date night because it means you don’t have to choose your clothes based on which are the easiest to take off in public.

Jacqueline: Your boobs are often lopsided.

Alethra: When hunger, tiredness, getting hurt, or any other dilemma is solved and smoothed over with whipping out the boob.  Problem solved!


Brittany: You’re in public and when you hear a baby start to cry, your first thought is, “Oh, man!  I hope I put on my breast pads today!”

Angela: When you bring your breast pump on your Vegas trip and plan everything around your pumping schedule.  Times have changed!

 

What would you add to this list?  Please share in the comments! 

 

Monday
May052014

Advocating When Your Baby has a Tongue or Lip Tie

To help parents understand a bit more about how tongue and lip ties can affect breastfeeding, over the next few weeks we will be featuring stories from moms whose babies experienced these challenges.  We would like to extend a HUGE thank you to the brave mamas who submitted their stories for our blog!  We know you went through a ton of challenges and we are so appreciative that you were willing to share your stories!  If you have a story you would like to share on our blog, please send it to robinkaplan@sdbfc.com.

For more information about tongue and lip ties and how they can affect breastfeeding, please see our article:Does Your Baby Have a Tongue or Lip Tie?

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

Written by Kimberly Berry

I am often referred to as a "boob nerd" by many friends. Articles, research, blogs....anything breastfeeding related always interested me. I absorb the information like a sponge. Sharing and helping moms with nursing just came naturally. I never heard of tongue or lip tie though until I was pregnant with my second. A few things I read made me wonder if some of the struggles I had with my daughter were due to a possible tongue/lip tie in her. She had self weaned recently though, so I never gave it much more thought. That reading on tongue ties proved to be invaluable to me in just a few short months however.

My handsome baby boy came flying into this world at 5:01pm on a Friday afternoon. The moment he was handed to me after his birth, I saw it glaring right back at me as he cried and took his first breaths. A tongue tie. His frenulum stretched all the way to the tip of his tongue. I kissed and nuzzled him close to calm him, warm him. Once calm, I looked at my husband and said, "He has tongue tie." My husband, confused said, "..ok?" not knowing what I knew. Not knowing how that can affect breastfeeding. Not knowing the possibility for pain and injury for me while nursing our second child. The nurse nearby heard me and chimed in to say "Oh, it's just a small one, no worries!" I told her I wanted to see a lactation consultant. She nodded her head and continued on with her work. 

I then began the process of trying to get him to latch for his first feed, although I knew that it could quite possibly be as bad, or even worse than the pain I just endured to bring him into this world. He was disinterested. So we snuggled and I tried every five minutes or so. Finally, 45 minutes after his birth, he latched. I unlatched and relatched him over two dozen times before it felt even remotely close to ok. I asked again to see the lactation consultant on staff. I did breast compressions and massage to help encourage colostrum into his little mouth that he was trying so hard to get to work correctly. Becoming annoyed, I would then ask every person that came into my room to bring me a IBCLC. I was met with "Yes, sure thing!", "You are on the waiting list", "Your nipples are just too big for his mouth"... I could go on and on with the excuses I heard the rest of that day and overnight. We struggled through each feeding. He was frustrated, and so was I. When he cried, his tongue looked like a heart. My heart broke that this was going on and help was seemingly out of reach. 

Finally, at 9am the next day, a IBCLC stopped in to "see how breastfeeding was going." I told her that I had been asking to see a lactation consultant since his birth the evening before. Shocked, she said she was not made aware we needed her. We discussed for several minutes how crucial nursing support is to new mothers and who she was going to speak with about the situation. I made my notes on who to contact as well  as who to advise of the lack of proper treatment. Then we got down to the business at hand. She agreed immediately that my son had a tongue tie, and not "just a small one" as the nurse had called it. She called right then for the ENT to work us into the schedule immediately to have it clipped. Unfortunately, we were knocked back on the list several times due to other emergency surgeries that day. While I am a patient person, I was becoming angered that the fact that my child was having trouble eating was not a concern to most of the staff. 

The next day, the day of our discharge, arrived and we were still muddling through feeds. I was starting to become very sore. Again, we were told time after time that we were next in line for his procedure, only to be knocked back again by an emergency surgery. How many emergency surgeries were there?! How many other new mothers were waiting for the same help I was??? The IBCLC I had spoken with the day before was not working. The other IBCLC couldn't get to us until that afternoon. Our nurse was sympathetic, but said this seemed to be typical of the weekend. Finally, I said enough is enough and took matters into my own hands. I looked up the ENT my daughter sees. Being a Sunday, the after hours line was activated. I left a message to see if anyone could call me back to let me know if they preformed frenulectomies on newborns. Thankfully, a sweet nurse called me back after about 5 minutes. She said that they did do the procedures, but I would have to call back in the morning for a appointment. 

We left the hospital and never looked back. I bared through the pain of the feedings until that appointment with the ENT the next afternoon. The frenulectomy was not easy to watch, but it helped so much. When he nursed when it was over, I could tell a difference, not a huge one immediately, but enough that I didn't wince up and have tears in my eyes the whole time. We only had to relatch six times instead of more than a dozen times. Each day thereafter, nursing was getting better and better. We practiced the exercises and I continued trying to heal my nipples. After several days, he started gaining weight and I was settling into being a mommy of two. Nursing became a joy again. Something I once again looked forward to. It was now my time to look in awe at my newborn and be proud of my body’s amazing ability to grow this perfect being and now continue to nourish it. 

Without a doubt, if I didn't know anything about breastfeeding or tongue ties, I would have thrown the towel in and given up. It was clear for me to see why so many new mothers do. In a mom’s group I help with, I constantly tell new mothers to check for tongue/lip ties. Even if someone says there isn't one, or if its minor and won't affect breastfeeding, know how to look yourself and find someone who will help you. You have to be your own advocate. Your babies advocate. We look to these medical professionals to guide and help us. Unfortunately, sometimes that's not always the case. It's crucial for them to receive the proper training, listen to their patients, and have resources available to help mothers and babies. It's crucial for mothers to be determined, educated, and supported. All of these things go hand in hand for successful breastfeeding. My son went on to nurse until he self weaned at 13 months.


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