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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.

Wednesday
Jun112014

Was it Something I Ate? Food Sensitivities in the Breastfed Baby: Part 2

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

Last month, we talked about the prevalence of food allergies, how a baby’s immune system is established, and how maternal immunity plays a role.  This month, we are diving a little deeper into understanding how mom’s gut influences baby, what causes an unhappy digestive system, and what we can do about it.  

 

Are You Being A Good Host?

Deep within the crevices of our gut we are hosts to billions of microorganisms, or bacteria that make up our Microbiome. These gut dwellers are such an important part of our body. They kill ‘bad’ germs that make their way into our digestive system, establish and maintain our immune system and even help digest our food. We need them to be happy, healthy, hard workers! Certain aspects of our American lifestyle cause many people to lack the hospitality necessary to keep these good bacteria alive. Behaviors such as being overweight/obese, an excessive use of antibiotics, a highly processed diet low in fiber, poor intake of fruits and vegetables, chronic stress, and poor bowel habits are a few examples. The key outcome from each of the offenders listed above is inflammation. A number of chronic health concerns have been linked to inflammation such as autoimmune diseases, arthritis, Ulcerative Colitis, IBS, chronic fatigue, and even heart disease. Some may say, “You mean if I am overweight and have symptoms of IBS,  I have inflammation... the same inflammation that could lead to other chronic conditions?” The answer is yes! 

Take a look at this image to find out how this affects our digestive system. 

 

Image found at: http://lyndabuitrago.com/stress-and-your-gut-part-2/

 

Inflammation over time damages the lining of our gut. The folds of tissue you see in the healthy intestinal lining increase the square footage of our intestines, helping to absorb all the nutrients found in food. Notice how they are virtually gone in the damaged gut, leading to poor digestion and, over time, something called leaky gut syndrome. This is where the bad news enters the scene… when our cells become leaky, they allow particles, allergens, bacteria, and other offenders to pass through into our system where it can cause many unwanted side effects.  

 

How does this relate to lactation? 

The cells that line our gut are the same types of cells that make up our milk-making factory! How does this relate to allergy and sensitivity risk, you ask? For some women with chronic inflammation or leaky gut syndrome, this inflammation is present within their milk making cells, allowing whole proteins and antigens to pass through their milk to their baby. 

Now, let’s stop here and point out that even with this undesirable process, breastfeeding your baby is still the best choice to make for your little one. Know why? Some studies are linking maternal gut health with baby gut health, meaning that mom’s gut environment develops and establishes the baby’s gut en utero, as well as throughout lactation. So even before feeding your baby, his/her gut cells may be predisposed to this inflammation. 

But wait; don’t throw in the towel just yet. We have something on our side… the most amazing food known to man, one that’s easily digestible and equipped with anti-inflammatory, antibacterial, antiviral, and antifungal properties. What am I referring too? Breast milk! There is no other source of infant nutrition that can compare to the powers of breast milk, making it the best food to aid in the growth of a healthy immune and digestive system.

Still worried? Take a deep breath because all of this can be reversed. With good nutrition, you can make your way back to being the hospitality queen… renovating your gut environment to serve your microbial ‘guests’ the best food and provide the strongest cells for their home. Strengthening your microbiome and reducing inflammation will get you and your little one on the fast track to improving your gut health and overall wellbeing.

 

I am in! Now what do I eat? 

Improving your diet can begin with 3 simple steps. 

First, begin boosting your microbiome of good bacteria by consuming probiotics in the form of fermented foods such as kefir, kombucha, sauerkraut, tempeh, kimchi, and more. If these foods do not appeal to your palate, find a probiotic supplement that contains many strains and species of bacteria and take on a daily basis. Remember to check with your doctor before using supplements. 

Second, increase the fiber rich foods in your diet via fruits, vegetables, and whole grains. Why do you ask? First, fiber, also sometimes called prebiotics, is the ‘food’ that feeds your good bacteria. Once we place them in our digestive system, we must feed them! Additionally, fiber helps to regulate our digestive system, allowing bowel habits to improve and, therefore, reducing inflammation caused by constipation. 

Lastly, monitor the fats you are consuming on a daily basis. Focus on consuming healthy fats. Omega 3 fats are known to reduce inflammation and improve the health of our cells. This can be found in foods like salmon, walnuts, rice bran or olive oil, flax seeds, etc instead of the omega 6 and saturated fats found in the abundance of processed foods we find on our grocery store shelves.  Guess what? The fats you choose to consume reflect the fats found in your milk and en utero! That’s right, if you increase the omega 3’s found in your diet, you will directly increase the amount in your baby’s diet. This special perk can increase the retinal development in your baby’s eyes, as well as increase cognitive development for your baby’s brain! 

 

Next month, don't miss Lindsey's next article about elimination diets: when they are needed and how to do them. 

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!

Does your baby react to the foods you are eating?  

Have you tried fermented foods and a high fiber diet to help heal your gut?

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! 

 

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