Breastfeeding Memoirs: Best 'Bring Your Baby to Work' Situation EVER!

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Margo Byrd.

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As a new mother, the fear of going back to work haunted me as my maternity leave days grew smaller and smaller.  Although I am one of the most fortunate mothers in the world who got to bring their child to work, I still feared that somehow it would not work out.   I worried that my company would decide my bundle of joy was not so joyous, or I would completely collapse under the pressure of feeding a 3 month old in my office. I personally struggled with postpartum.  I had irrational fears about what it would be like at work, felt completely helpless on multiple occasions, and had a very hard time letting my son out of my sight even to run to the bathroom (when my husband was home).  As those small fears subsided, coincidentally my bigger fear of breastfeeding in my new work environment grew. For the summer, my office would be shared with my boss as I am her assistant and during the school year I would have my own office (which happens to be all glass).  I work for the Boys and Girls Clubs of San Dieguito and while “Bring your child to work,” has always been a motto for our club, the fear of breastfeeding with 70-150 kids on the other side of my door was very apparent.  I envisioned curling up on a toilet wiping everything down with cleaners or hiding in dark closets on the floor while I lulled my 3 month old to sleep while comfort nursing. While I was promised a, “Safe,” environment to nurse I had no idea what to expect. The struggle of postpartum and the struggle of a new environment breastfeeding made me so nervous. I had never nursed in public, let alone nursed in front of my co-workers and peers.  Personally I was too scared and too naive to understand the support I would have at my job.

I had made up my mind when attending my first meeting with my supervisors to quit. With my hormonal self and hormonal worries I just felt that it was going to be a disaster.  Yet, as my son, Charlie, and I were greeted by each of my co-workers and supervisors, I started to see the support for my son’s health and well being would not only be my priority, but my entire leadership team’s priority.  I was greeted with warm smiles and happy faces.  To my surprise one of the first questions everyone asked was, “Are you still going to breastfeed?”  I sheepishly answered, “I am going to try,” and each person in my leadership team smiled and said, “Go girl!” The more people I talked with, the more I realized that our company fully supported my commitment to breastfeed him each and every day.  

One of the first things my company did was set up my office.  Not only did they put in a curtain to cover the glass in my office, my supervisor told me that whenever I needed to feed my son, I would have a quiet and safe place to do so.  They fashioned my office to make it more suitable for a changing table, pack and play, and a swing, as well as make sure my son had what he needed to be happy and healthy.  They removed large filing cabinets and replaced them with smaller ones so I could maneuver them so I could fit everything comfortably.  Over the summer, when I began to share an office with my boss, her commitment to making me feel comfortable was overwhelming.  My boss brought in extra items in case my son needed them, she did not put me on the schedule (so I could arrive within reasonable hours to take care of my son), and suggested making a sign for my door that said, “Feeding Charlie, Please Knock before Entering.”  I was completely overwhelmed with the support to breastfeed from the beginning.  And the most beautiful part of all of this was, even staff members who saw my sign on the door would knock and enter without hesitation.  Males, females, co-worker’s children and volunteers all felt comfortable and normal walking in.  I even held staff meetings with multiple staff at a time while feeding my son and the wonderful response to my question, “Would you mind if I fed my son,” was welcomed with an overwhelming, “Absolutely!”  

While I know I am blessed and incredibly lucky, I can only speak from my experience.  Each and every day is still challenging with our regular breastfeeding issues, but having the support of my co-workers and leadership team has been incredible.   I can contribute to my family, provide the best nutrients for my son through breastfeeding, and I can continue to watch my son grow within the walls of the Boys and Girls Clubs of San Dieguito.   

Breastfeeding Memoirs: Working as a Resident

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Amelia Sorenson.

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When I found out I was pregnant as I was about to start a surgical fellow, which can mean a seven day, sixty (sometimes eighty) hour work week with erratic long nights of call, I thought a lot about what it would be like to do the work while pregnant and how to manage maternity leave (six weeks, worked the day I delivered). What I didn't think about was how I would establish a breastfeeding relationship during those first few short weeks and how I would manage to keep breastfeeding when I went back.  

PHOTO BY ERIN AT THE THEO LOVES

Once my son was born I realized I should have been preparing for breastfeeding. I went to a breastfeeding support group three times in the first week and am so grateful to the mothers I met and the support from the lactation consultants.  (First piece of advice - figure out support groups BEFORE baby arrives and utilize them early. Every time baby latches he is learning what to do, so the quicker you can get him doing it right, the better).

The night before I started back at work my brand-new electric pump made one long whirrrr and wouldn't turn on again….necessitating a frantic trip to buy a hand pump (Second - buy a hand pump just in case). I was more than anxious that first day back with my little cooler and hand pump.  Fortunately, I work in a “baby-friendly” hospital and a NICU nurse gave me a kit to the hospital grade pump and a few days later I found the most beautiful lactation room with a view of the ocean (Third - Figure out where you will be pumping before you leave for maternity leave).   

I’ve never been able to make a schedule since surgical case length and clinic patients are too different, so I decided that food for my baby had to be on the list of priorities and that some pumping is better than no pumping and tried to pump every three to four hours. (Fourth – Feeding your baby is something important; so let yourself treat it like it is a priority).

Orthopedics is 90% men and I am the first woman in a long time to have a baby, so I’ve been straightforward about what I am doing, hoping that it will make it easier for the next resident. (Fifth – Tell people what you are doing.  You have to do it a lot and really aren’t taking a break.)     

Now that we have made it to 6 months and have enough supply to have donated milk I want to say that you can do it too! Don’t give up early or think that because you are working long hours you can’t do it.  Most of all enjoy the time with your baby before your go back to work. 

PHOTO BY ERIN AT THE THEO LOVES

Breastfeeding Memoirs: Returning to Work in the Navy

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working -- moms.  

Today’s story was written by Cinda Brown.

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I’m an active duty Navy officer and mother of two girls. My journey to becoming a working, breastfeeding mother started almost 4 years ago with the birth of my first daughter. Breastfeeding was challenging in more ways than I could have imagined. I thought that it would just be easy and natural, not knowing that those two little words can mean so many different things.

My baby had a high palate combined with tongue and lip tie. I had no idea what this was. All I knew is that my nipple was damaged and cut from her very first latch and that it hurt each time there after. Soon I was scabbed and crying each time she latched. So much pain. I didn’t know where to get help and the nurses at the hospital told me it would get better with time. When my daughter was about 5 weeks old I finally met a nurse who promptly referred me to a pediatrician who was also an IBCLC. Her issues were diagnosed and we were then set up for a revision. I learned so much from this IBCLC. He taught my husband what to look for and we both were sent home with more knowledge that helped us on our road to success. My husband knew what looked wrong and was there to help me reposition. He supported me through all of the pain and sleepless nights. He did diaper changes and baths and allowed me to keep working on breastfeeding, instead of asking to bottle feed so he could bond. He found other ways to really bond with our baby girl while ensuring that our breastfeeding relationship would be preserved. Partners play such an important role and I can’t say this enough!

Once my daughter and I finally started to get the hang of breastfeeding, it was time for me to go back to work. I struggled with a very intense oversupply and was worried about how I was going to manage it when I was back at work. It had been difficult enough to manage it when I just had to take care of my baby at home, but now I was looking at adding in daycare, going back to work full time, and still trying to keep up with everything else that needed to be done at home. While many people I’ve encountered have told me how lucky I am to have oversupply, I also know that it’s very difficult to manage. It takes an extraordinary amount of time to pump, collect, freeze, and store the milk not to mention the washing of all of the pump parts. Adding this extra needed time into an already compressed day was overwhelming to think of, much less try to put into action.

We were very lucky to find a daycare teacher who was experienced with bottle-feeding breastfed babies. That was hurdle #1. She was an amazing communicator, which helped the process so much more. The day came to go back to work and I still remember it like it was yesterday because the experience is forever imprinted in my memory. Leaving my baby girl with someone new for the first time to go back to work was just devastating to me. And her. For me I felt like it absolutely went against my innate knowing to separate us. But yet I had no choice and my leave was over so it was time to go back. In that moment I would have given anything to stay home with her. Having a caring provider and making the most of the time that I did have with my baby while at home helped to ease the separation but it definitely took time before that ache started to subside. I really had no idea about the obstacles I was about to encounter and had no one to guide me along the way.

Day one back at work, I found myself in a land of cubicles, with no place to pump breastmilk. Over the next several months I improvised wherever I could to find a place to  pump when I needed to. I pumped in bathrooms, in my car in the parking lot, in my car on the way to and from meetings, basically anywhere I could find that would provide some sense of privacy and still allow me to complete work requirements. It was far from ideal and was super stressful, and mastitis and clogged ducts became more usual than unusual. I had to wake up super early before work so that I could pump since I would be so engorged. Wash parts. Try not to forget parts, bottles, or storage bags. Or the plug for the pump! So many things to remember!

My job had been so busy and intense before I had my baby and I knew that it was going to be no different when I returned. The biggest challenge was trying to coordinate pumping between meetings that for the most part I didn’t have a lot of control over scheduling. Many times meetings would come up at the last minute, or would be rescheduled right in the middle of when I’d need to pump. I had to figure out a way to talk to my supervisors about my need to pump, the importance of keeping a regular schedule, and at the same time keep my head held high.

In the military culture, it can be intimidating to ask your supervisor for permission to do things outside of the norm or what’s expected. I wanted to be able to show that I was able to handle it all: be a successful officer and a successful mother. But the reality is that each demands 100% or more of a person, and there’s only so much effort and time that can be allotted to each. Some compromises had to be made, and it was up to me to advocate for myself and my baby. I’m not going to say that the conversations were the most comfortable that I’ve ever had or the most easy, or that they were well received. They certainly were not. But I thought of all of the other more junior women going through the same journey and realized that if I couldn’t advocate and speak up for myself, then there’s no way that my example would set other women up for success.

I asked for what I needed and over time it became more normal for everyone I worked with. I did find out something very interesting in that most of the people I worked with were male, and that their wives/partners were full time stay at home parents. None of them were mothers who had breastfed and many of their wives had not breastfed. Education and communication with my male leadership helped them to realize the importance of breastfeeding and how it could in fact make the workplace better for everyone since breastfed babies tend to get sick less often. Mothers are able to get back into fitness standards more quickly since breastfeeding can help mothers lose weight. These are only a couple of examples amongst many. I know that the Navy is keenly interested in retaining females in order to have females rise in the ranks of leadership. Advocating for breastfeeding is one step in the right direction to retain mothers in the military. Mothers who are shamed or made to feel that they can’t fit in are not likely to want to stay as a part of an organization that can’t accept them for doing something that’s good for both their baby and themselves.

After several months of making do, a fellow military breastfeeding mother and I set out on a journey to have our commands come into compliance with current Navy breastfeeding instructions and guidance. This meant that our command was required to provide a room that wasn’t a bathroom space, with privacy, a locking door, a refrigerator/freezer, outlets, and furniture. It also allowed for time to pump milk that would accommodate what the mother would need to maintain her supply. It was a long process, but with diligence and help from many people, by the time I left my command there were 5 mother’s rooms set up for breastfeeding mothers to pump milk and an instruction that provided guidance so that mothers were protected in their ability to pump breastmilk.  Each room had a multi-user pump and pump kits donated by the San Diego County Breastfeeding Coalition. The command won the SDCBC Breastfeeding Friendly Workplace Award in 2014, which was such an amazing accomplishment given where it had started from. A monthly breastfeeding support group led by Sarah Lin, IBCLC, started in 2013 and continues to this day. She selflessly stepped up to donate her time to help countless mothers who have so benefitted from her expertise when there was a definite need.

I’m now a mother of two and I honestly thought that going back to work for the 2nd time with an infant would be easier since I had done it before, but it’s been just as challenging. I’m at a new command, so I have new people to interact with. Dynamics are different and the juggling act of timing pumping around work requirements is still as alive today, if not more than it was when I went back to work with my first daughter. Mastitis and clogged ducts continue to make their presence known, which was disappointing since I thought that I had them figured out. Goes to show that just because it worked last time doesn’t mean that it will work this time. Each baby is so very different, as is each pregnancy and postpartum period. I’ve been known to excuse myself from meetings with very senior personnel so I can go pump, which hasn’t been easy. I know that I need to take care of myself so that I’ll be at work tomorrow. Sacrificing today isn’t worth getting sick tomorrow and I keep telling myself that. Because there’s a part of me that still struggles to have a voice and speak up for what I need.

I pumped for 2 years for my first daughter. She will be 4 this fall and breastfeeds right along with my infant. I’m pumping for my infant at work and will continue to do so until it’s the right time to stop. I never thought that I’d make it this far in our breastfeeding journey, but now I can’t imagine it being any other way. There have been so many that I can attribute our success to in our San Diego community. The amazing support of IBCLCs and mothers has carried me when I needed to be lifted up too many times to count. I hope that through my efforts I can help other military mothers achieve the success that they envision for breastfeeding their children, whether it be for days or years.

Breastfeeding Memoirs: Trusting my Body when Returning to Work

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Georgina.

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When I had to go back to work I knew I wanted to keep providing my son with the very best I could offer and one of them was his dear breastmilk.  I was very confused with the whole pumping at work idea. I had done some research at work before delivering as to where the lactation room was and what the process was to reserve the room.  I work at a hospital and I thought that just by going to the L&D department everyone would know where our lactation room was and it was going to be very easy to find.  Well to my surprise, no one knew exactly what I was referring to, all the nurses looked at me with puzzled faces and confused as to why an 8 month pregnant employee was asking about this room and they didn't even know where it was!  When I finally found it, it was a rather disappointing, sad room that looked like a utility closet, but at least it was clean and it had the necessities: a chair, a desk and a fridge.  

I took the longest maternity time off I could take with and without pay and in the meantime I read and read and read everything I could about breastfeeding and pumping at work.  Breastfeeding had its challenges, but we quickly adapted to one another and it started to feel like a breeze.  It was near the end of my baby bonding time that I started to become stressed about the whole logistics about pumping at work. The  more I researched, the more confused I got. How many hours can breastmilk be in the fridge? What if he didn't finish the whole bottle?  Was it safe to use it again? How many ounces to feed? How often? What if I don't make enough milk? Ugh! Sooo frustrating! So many doubts! So many mixed emotions!!  I joined several breastfeeding support groups and would often go to baby weight-ins just to make sure baby was eating enough only through my breast.  But, how would I know if we were overfeeding him when using the bottle while I was at work? What about underfeeding him,? Would he prefer the bottle over me?   I decided to attend aBreastfeeding for the Working Mom class through the SD Breastfeeding Center by Robin Kaplan.  Even though I had already read what she said, it was extremely reassuring to hear it by a someone who had gone through it before. Robin was very patient.  She sat with me and we made a "pumping at work plan."  How many times and the estimated hours that I would be pumping.  I still remember my pumping schedule as if it was yesterday. Nurse at 5am,  pump at 8:30am,  pump at 11:45am and nurse at 3pm.  Slightly adjust schedule as breasts were engorged when I would feed the baby earlier than 5am. It worked like a charm!

It was definitely a learning curve for the nanny and our family members who were taking care of our little guy while we were at work.  We had to teach everyone not to shake breast milk - only swirl.  Fat particles in breastmilk are normal.  It’s normal to have different colors.  And never ever dump any breast milk that smelled fine... we could always make breastmilk soap, lotion and even use it for rashes and cuts.  Everyone, myself included, has been amazed about the little we knew about the amazing properties of breastmilk and how powerful it is.  We learned about paced feeding and growth spurts the hard way and we succeeded.

I pumped until little dude was about 11-13 months.  That was last year when our summer in San Diego was just extreme.  During the day while I was at work he was asking for more water than breast milk and shortly after he refused to drink breastmilk from his sippy cup only from the tap :)   He is past 2 years old now and we are still nursing strong.  It has been a marvelous, unexpected experience for both of us.  

Every once in a while I still pump to make our little dude some breast milk soap and I was very happy to find a beautiful bright freshly remodeled lactation room at the hospital where I still work.

If I could go back in time I would tell myself to trust my body to do its magic.  Eat oatmeal, drink lots of water, watch pictures/videos of baby while you are pumping, relax and watch your baby being nourished by your wonderful body.  Take advice with a grain of salt.  Everyone is different, trust the relationship you have with that amazing human creature your same body nourished for 9 months in your belly.  You can do this! You are meant to do this and you can!

Breastfeeding Memoirs: My Three Bs

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Louanne Ferro.

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Prior to May 27th, 2014, the word baby meant something very different to me: my baby was my business. At the young age of 17, I entered the world of cosmetology. Knowing I wanted to strive and create greatness in my industry, I focused on building. In 13 year's time, I had nurtured my baby and created a small empire. One of the leading educators for the world's largest professional beauty company, I frequently traveled to teach my craft.  In the heart of North Park, I opened my very own salon. My baby was thriving and I was the proud mother, spending further countless hours tending to make it what it is today.  Then, May 27th, 2014 happened, changing everything I knew about babies.

The test was positive. To my shock, my work "baby" was going to be replaced with a real-life, micro-human! My pregnancy was something my husband and I had been hoping for and we were thrilled!

As the days went by and I soaked in the reality of this new chapter in our lives, I quickly realized that the acronym B.B. meant far more than a makeup product; my new "B.B." was Business and Baby! I started to prepare myself with all things human baby-related. In addition to the copious things on lists and registries, preparing for the physical exit of my child by way of my body required some serious consideration. My birth plan was short and extreme: 1. Do whatever you need to do to deliver a healthy baby, and 2. If baby and mom get separated, dad goes with baby. My preparations seemed both rational and thoughtful.

As the months crawled forward, I was asked, "Do you plan to breastfeed?" "Sure," I would state casually. I mean, doesn't everybody do it? The portrayal of happy mothers stroking their babies' heads seems the most natural and obvious choice. The commitment to breastfeeding tacked a third B on my list. Self-assured, I reiterated to myself, "Three Bs and three-step birth plan." Simple right?

As the ideas gestated, so did my little human. On February 1st, 2015 when most people seemed to be watching the Patriots win the Super Bowl after the controversial "Deflategate," I was in labor. I had no delusions of grandeur, and felt that the experience progressed well, or at least as well as it could. Literally dancing myself into labor, and thus, the hospital, I was celebrating my salon partner's thirtieth birthday only the night before.

In a lighthearted moment of somewhat inappropriate comedic relief, as I was pushing my sweet boy into the world, my husband, nurse staff, and I were laughing while Maureen, the midwife, styled my son's full head of hair mid-birth canal into a Mohawk for his grand exit. Ezra entered the world healthy and strong, with all the right parts and two healthy lungs. Things were great, that is, until they weren't.  Laying him on my naked breast, as I looked into his eyes for the first time, all I could say was, "I'm going to be sick." Those weren't the words I was expecting to first say to my baby.

Before I knew it, Ezra was being transferred to my husband chest and my birth plan, the one that everyone says won't be needed, became needed. Ripping itself from my uterus, the placenta dislodged, and I, unknowingly, quickly began to bleed out. Because the hospital staff was great, the bleeding quickly stopped and I was generally unaware of the severity my body endured. Before I fully understood what had happened, I was on the mend. So I thought...

Latching my son in the hospital, he seemed to latch well. We left the hospital feeling very supported and excited to start our new lives as parents, and I was eager to be a mother who could sustain life solely from my own body. This, too, proved that things could go well until again, they don't. Shortly after arriving to our home as a family of three, I noticed my son no longer wanted to latch. Unable to wake him for feeds, we were heading down a slippery slope at excruciatingly high speeds. With no formula in the house because it wasn't part of the "plan" and no idea what was wrong, helplessness took hold of me and rattled this new parent's head and heart. Breast feeding should be easy, right? Everyone does it! It's natural.

I held my baby through the night, the first night home, praying we'd make it until morning when I would seek professional support. There was no marveling over the beauty of childbirth or reveling in the moment that our chests rose and fell together. This was the worst night imaginable.  In the mean time, it was after midnight and my husband scoured for 24-hour stores, and finding none, finally sought out a NICU nurse at the hospital to get the formula an after-hours advice nurse suggested.  

As the sun rose, I ran into the Kaiser breastfeeding support group, crying my eyes out as I told the head lactation counselor that I was starving my baby and I didn't know why. I was failing, and failing was something I was never good at doing. Rose, this angel, this pinnacle of breastfeeding knowledge, sat with me most of the support group and promptly made me a one-on-one appointment following the support group that day. Ezra had lost over 20 percent of his birth weight and was comparable to a premature baby. She asked me to share my story leading up to that point, and as soon as I mentioned the hemorrhage, she exclaimed, "There's your road block. You're not broken, you're healing." Not fully understanding, I listened, captivated by what the angel was telling me. She explained to me that our bodies can almost always produce milk for our babies, but major blood loss was one hindrance that halts milk production in its track. My body was healing me so it then could support my baby.

A woman - a new mom, rather - on a mission, I spent 24/7 learning how to help kickstart my supply, all the while supplementing at the breast, and educating myself on how to properly feed my baby. This harrowing and hormonal journey took a couple weeks, but my milk eventually came in and I had a new routine. I referred to myself as "The Dairy Queen," and I was always open for sweet treats!

Realizing quickly, in order to be successful with breastfeeding, I also needed to be knowledgable. This, after all, was one of the most important jobs I'd ever had. My short eight-week maternity leave was filled with work, just not the type of work I was accustomed to. My 13-year-old older child, my business, was doing well, but still needed my care. Much like a regular teen, it seemed as though it could self-manage, but a true mother, I realized it needed me to continue to grow. A new balancing act had begun. My new baby and breastfeeding also needed my constant care, and as the weeks passed, I slowly figured out how to balance my three Bs.

The key to success in working and breastfeeding, I have found, is to set boundaries with myself, my clients, and colleagues. Making food for my baby was just as important as my business. My work schedule has a pump break every three hours and for no circumstance should that pump break be booked - after all, it is my most important appointment of the day. When traveling for my company, it's made known that pump breaks must be allotted in order for me to take the job. Compromising my need to feed is not an option. My hands-free pump bra and car adapter for my breast pump have become my best friends. They really do support me. The ladies at the drive through coffee shop now know me as the pumping, purple haired mom as I pull through for my iced coffee while pumping on my way to work. My friends on speaker often ask, "Is that noise I hear your pump?" I say, "Sure is" with a smile, knowing that I am finding balance.

My flanges might not be a Marc Jacobs accessory, and my black pump bag may not be Prada, but I wear them with the same sense of excitement because I'm doing something I thought I couldn't achieve. They are also symbolic reminders of a label I do wear: mother, maker of milk and master of the Three-B balance, business, baby, and breastfeeding. My journey has not been lengthy, but on August 1, the first day of World Breastfeeding Week, I will celebrate my six-month "nurse-iversary." I've always argued that you can't hold a driven woman back, and now I know another word synonymous with driven woman is "mom!"

Breastfeeding Memoirs: Persevering when Returning to Work

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Maggie.

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I had a long, stressful delivery that resulted in an emergency c-section, a tongue tie revision on day 2, followed by 48 hours in NICU. I was given a nipple shield, instructed to supplement with formula through an SNS and sent on my way. Breastfeeding was painful and difficult even with the shield, I went to many support group meetings and did weighed feeds and was able to stop supplementing. We were also dealing with a "colicky" baby until about week 8 . Then at week 10, I was able to get off the nipple shield with the help of an LC at Mary Birch. I was supposed to go back to work after 12 weeks but I was so exhausted and we were finally starting to turn a corner where we could actually enjoy our time with baby, I thankfully was able to extend my maternity leave to 16 weeks.

This prelude is to say that with all the struggles we went through in the beginning, I was very anxious about going back to work, whether I would make enough milk, whether he would get nipple confusion or a bottle preference. I worked so hard and suffered through so much literal blood, sweat, and tears to make breastfeeding work I started to really resent the fact that I had to go to work and interrupt our breastfeeding relationship.

Thankfully through my breastfeeding support group journeys I came to the San Diego Breastfeeding Center. She told me about the upcoming "going back to work" class. I was so excited! I had so many questions. I had scoured the internet, and learned a lot through websites, but still needed much more guidance and support. The information from that class helped me plan and feel prepared to go back to work.

Before I went on maternity leave, I worked out with my HR department where my lactation accommodation would be, but I didn't fully understand my needs until I returned. It was obvious that what we had planned was not going to be feasible long-term, so the first two weeks back were a challenge until they were able to give me my own office and make it private so that I could pump there. My pre-baby brain was trying to cause as little disturbance as possible to the rest of the office when planning my accommodations, but once I was back from maternity leave my only concern was making enough precious milk for my little guy! I'm grateful to have a supportive team at work that have had no issues whatsoever about giving me what I needed.

The first day back I barely pumped 9 oz. I was aiming for 12-15oz. I tried to keep calm and take it one day at a time. I still try to keep this mindset and not worry if I pump a little less some days. Gradually overtime I started consistently pumping 12 oz every day, and for a while was getting 16oz and was able to build a decent freezer stash. One of the LCs I met along my journeys suggested 5 minutes of hand expression after every pumping session, and that has worked wonders for me. It's amazing how much the pump leaves behind. The facebook group, "working moms who make breastfeeding work" has been also been an amazing resource.

We're now almost 4 months back at work and things are going smoothly. Bedsharing has been a saving grace...it helps my supply to let him nurse all night long, I don't worry about whether he is getting enough to eat or not, and I'm well rested for work each morning despite waking up every 2-3 hours all night. Plus its awesome snuggly bonding time that I miss out on while I'm working.

While I plan to breastfeed as long as baby wants to, I can't wait to break up with my pump in 4.5 months once he turns one!

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.

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!

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?

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?