All Hail Exclusively Pumping Mom!

Feeding our babies should not be part of any conflict that exists out there in mommy-land.  We all make the best and right choices for our little ones.  Often what we learn about ourselves, and the choices we make with our firstborn will guide and influence how we approach our next born.   I welcome and support all moms, and the choices we face.  A particular group I’m choosing to champion today is the exclusively pumping mom who keeps her baby in breastmilk for as long as possible. Those moms who every 2 – 4 hours hook themselves up to a machine, and/or hand expresses beautiful, beneficial breastmilk.  That mom who returns to work early with minimal maternity leave and never quite got off to a good start with latching well.  That mom who like clockwork wakes still at 5am to get that quiet pumping session in before the rest of the house wakes up.  That mom who for reasons of her own chooses to bottle feed …. working moms, SAHM, any mom – you go girl!!

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Jane and 5 ounces of her beautiful breastmilk

Today I am going to highlight and applaud my good friend and work colleague, Jane.  I’ve known Jane for many years from Dr. Zatz’ office where I work.  In this photo she is holding some of her newly pumped breastmilk which she brings home each day to her boy.  She is 11 months into exclusively pumping and, as she nears the one year mark, I want to shout out and congratulate her.

Jane had a tough time with her first born, and breastfeeding was not successful. This time around though with her little guy, she and I discussed strategies and goals to be successful early on.  We laid out choices and options, knowing ahead of time – what her maternity leave was going to be like, how to juggle an older child, a busy house, her husband who want to support her in whatever she wanted to do.  Jane knew her maternity leave was not very long, so we devoted our conversation and goal setting time to having her be a strong, exclusively pumping mom.  This allowed her to be the best mom she could be – happy, confident, healthy, working full time and meeting the needs of her family and children super successfully.  

After 10 weeks of maternity leave Jane returned to work and took it day by day, week by week and set herself up for success. She’s now a month away from the one year mark and continues to pump beautiful abundant breastmilk.

I’m so proud Jane. Keeping her boy in beautiful breastmilk for as long as she has. And the added bonus here is what a strong advocate and voice she has become for working and pumping moms.

If you’re in our area, and/or are a patient of Dr. Zatz – talk to Jane about being a pumping and working mom.  She’s such a pro now, and has so much good advice. Reach out to us here and let us help you strategize returning to work and pumping for success.  It can be done.  And congrats to all you moms out there, who, for whatever reason, are exclusively pumping moms! 

 

 

Sex, hugs and breastfeeding

I often hear new moms share stories about their sex lives. Usually it’s discussed with a sense of light humor, maybe a hand tossed up into the air as if to say “stop right there, honey” and a clear desire that there ain’t going be any nookie tonight!

Recently on a popular mommy blog the author commented on how motherhood had tanked her sex life. How she had no desire and would be perfectly happy to continue her life celibate. I had a strong reaction to reading that I realized. “Celibate?” I thought immediately, “how sad.”

I think this is a subject that many women don’t want to discuss necessarily because frankly, sex is so the last thing on our minds at the end of the day. There are many realities that make intimacy and sex a challenge for sure [fill in blank ... tired, busy, stress, messy, been spit up on, nursed on, baby/toddler body fluids and boogers on you, touched out, ownership of our bodies, hormonal imbalance, pain and tenderness, etc, etc, etc]

I don’t have an answer for you if you’re struggling with this issue. What I can say though is that it seems to me important to address this issue. Not at 2 months post partum, maybe not at 6 months post partum … but by 12 months? I think it’s important to explore what’s going on.

I’ve seen many a women shrug away the needs of her/our partners with a hand of “you’ve no idea what’s been going on with my body so don’t bother me now”. Don’t get me wrong – I TOTALLY get it and have BTDT lather, rinse, repeat with all three of my kids. My husband is an angel for putting up with my ebb and flow of desire.

I think I’m reacting to this blog piece because I’ve come around now to a place of loving and wanting to be flirty and intimate with my husband in a way that resembles our early years pre-children. I wanted to shout out to this blogger that it does evolve and find its way again – but that it does take effort and dialog.

This experience of not wanting sex post partum seems so universal, so common among our new mommy friends.  Should we just look at it as normal then? Live with it and move through our days ignoring the need for intimacy in our lives?  Ignore the fact that we used to love it?  I don’t think so.  Common, yes. Normal, it doesn’t have to be. Time to start talking.  It might be a hormonal issue (so check in with your OB or midwife). It is almost certainly a fatigue issue. You’re exhausted most of the time!  And yes, it’s very much a “if another human comes near me to slobber, touch, pat, pull, tug, suck, snot, kiss, smooch or fondle me I am GOING TO SCREAM” issue.

I get it. But a wise woman (my midwife) said to me “if you don’t use, it you lose it”.

Did you know that hugging for 20 seconds releases oxytocin? Sometimes the best way to return to intimacy with your partner is just a gentle, prolonged hug.  And this is important –  a hug without any expectations of anything *more* after it. I know for me I was resistant to hugging because I was so afraid it would trigger a glimmer of desire in my husband and he’d spring one (pardon the expression) and then I’d reject his advances.  Which would then create a feeling of guilt and unhappiness that I got him all excited when what I really just wanted was a hug. So what’s a girl to do? Avoid the initial hug seemed the right answer.

Hugging is a good place to start though. With clear expectations about any intimacy the will (or won’t) evolve.  But HUG!

I don’t mean to make light of any of your individual issues surrounding difficulty wanting to ever have sex again. I guess I just want you to know you’re not alone. And that it can get better. My experience has been that it only gets better if you don’t ignore it as an issue. It can not be the elephant in the room. Our partners have needs too. They love us still, the same as they did before the baby. Aren’t we lucky to have partners who see the beauty in us, see emerging Divine Goddess of a woman and mother we’ve become? Isn’t it great that we can take care of our children and still be an attractive & sexy woman to our partners?

We can be both if we want – mother and sexy. So, make time to hug.  Just start with hugging.  And talking.  And maybe a rose or two on Valentine’s Day.

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With Love,

Deirdre 

(as modified from a FB post)

Breastfeeding – Getting Off to a Good Start!

Congratulations!  You’re having a baby and are about to embark on one of the most beautiful experiences of motherhood – breastfeeding.  Breastfeeding is such a wonderful thing to give to your baby. And as a lactation consultant I’d like to make sure your experience is a smooth sailing one.  Getting off to a good start can make a world of difference in creating a long lasting and enjoyable experience.  I am often asked “and just how do I do that.”  Well, I’ve put together a few ideas to think about and look for early on which may help you figure out if you could use some help.
1. Proper Latch & Positioning.  Breastfeeding shouldn’t hurt. There’s no “oh just grin and bare it” in breastfeeding.  If it’s hurting something is wrong and needs adjusting.  I can help you figure out what positions work best for you and your baby by showing you different positions and good latch mechanics.  Remember, this is a learning curve for both you and baby. You’re getting to know each other.  Patience and good positioning can make a world of difference in long term comfort and success.
2. Creating an abundant milk supply.  For most women milk production is the simple economics of supply & demand. The more you nurse effectively, the more milk you’ll produce.  Your new normal is holding your baby skin to skin, nursing every 2 – 3 hours, limiting separation (this means hospital staff, well meaning grandparents, siblings, family & friends, etc), gazing at your baby and taking in all the cute goodness that is your newborn.  That together time supports a beautiful hormonal picture for building a strong milk supply and creating good mother/baby bonding.
3. Is Baby Getting Enough Milk.  It may look good on the outside but learning to trust milk is getting into baby’s belly is a huge step toward success.  Look for usual markers of a thriving baby, like the number of diapers you’re getting in a 24 hour period (around 6 wet and 4 poop ) and early weight checks.  Once let down has occurred and milk is flowing, listen for a good “suck, suck, swallow” pattern.  We even use a scale here in the office to do “before & after” weights which gives some moms peace of mind that their baby is transferring good amounts of milk each feed.  Remember too that the body language of a satisfied baby can tell you a lot about how well things are going.
4. Trust and belief - the first weeks can be overwhelming. You’re flooded with joy, elation, doubt, and a rush of hormones. Remember to trust your instincts.  If you feel something is not working right, trust that – get help, find support.  If all is going great, trust that too.  You will get into a rhythm and stride as a new mom. It gets better, easier, more familiar.  Hang in there and believe.
5. Resources - before you have your baby, know what your local resources are and where to turn for help.  Consider taking a private prenatal breastfeeding & newborn class too.  Understanding what changes lay ahead and what the first few weeks may be like can help get you through the enormous transition to motherhood.
Any questions, give me a call.  I would be happy to schedule a consult for you if you would like to sit down, discuss goals and/or go over any problems you may be experiencing.  The visit is covered under most insurances, and if I see you in the pediatric office where I work it may be a simple co-pay and perhaps a follow up visit or two is all that’s needed in solving problems early .  Early support and effort to work out problems will really help you get off to a best start.  Don’t hesitate to get help.
Warmly ~
Deirdre
(edited from a piece I wrote for the Fall 2013 Newsletter for the pediatrician’s office where I work)

Education, Social Media & Motherhood

I was just talking to a dear colleague for whom I am grateful to be friends with, the wonderful Amber McCann & Nourish Breastfeeding Support.  We were discussing the upcoming ILCA conference and the business of breastfeeding, both locally and nationally.  Part of our discussion was on the business of education and helping mamas grow their confidence and wisdom before baby arrives.  The model for education can be both face to face; through class time and instruction, or online via email and social media.  Knowledge is power, as the expression goes. So how do we, as educators, grow that knowledge base for expectant mothers, and how can we expand our reach so that your transition to new motherhood is a smooth one?

As both an IBCLC and a childbirth educator & doula, I know all too well though how few families seek out empowering childbirth & breastfeeding education.

I live in the metro area of NYC.  I love teaching with Birth Day Presence.  I love their model of normal, Lamaze based childbirth education and hands on fun while learning.  I am grateful that they are a strong conduit of knowledge in the NYC area and that their classes are consistently full with families eager to learn.

But are enough women turning to independent education? I don’t think so. What I do know, and see repeatedly, is that those women who do not seek good prenatal education have a greater likelihood of feeling overwhelmed and isolated. I know this because they call me desperate for help and support.

A solid network of education, support and resources should be cultivated prior  to baby’s arrival.  This will help mom navigate those first weeks of baby blues and part partum healing. Not all mothers, mind you, have a difficult transition.  One of the many benefits to consider however is not just the knowledge base mom will take into birthing and breastfeeding, but also the relationship she has now established!  Wise Woman to New Mother!  She has her tribe, someone she can now turn to post partum to seek answers and support.  As Amber says, “a friend in her pocket”!

Social media and online support can be a wonderful conduit for support and wisdom.  Sixteen years ago, when I was pregnant with my first, I researched something on the then pretty new internet.  I brought it to the attention of my OB, who I left for midwives.  You know why?  He scoffed and said, “are you going to trust some quack you find off the internet?” and immediately dismissed my researching things outside his care.  (That quack was Ina May Gaskin).  Well, I did trust what I had read.  Those were my instincts kicking in, my learning to trust myself, my bullshit radar (which is a whole other blog piece for another day!).

Seek out advice online from reputable IBCLC businesses and online communities!   There are many wonderful resources with excellent professionals happy to help you find your way.  As a La Leche League leader, the concept of “mother to mother” support is still, in my opinion, one of the best conduits of post partum sisterhood out there!  And now that “mother to mother” care can be found online, on many a Facebook page, blog, Twitter or Listserv. It’s not always easy getting out as a new mother.  Making a monthly meeting can be a challenge, though I highly recommend my weekly support group, The Breastfeeding Cafe (we’re on a brief break for summer, email for schedules).

It all comes back to education and support!  Whether it’s private or group prenatal classes (each has its advantages), a private lactation consult in the comfort of your home, an online consult via email or even a Twitter chat (#bfchat #bfcafe) — all are great ways to stay connected to a professional who only wants the best for you — normal, healthy birthing which leads to normal, healthy breastfeeding!

If you’re in the NYC and Hudson Valley area and need resources for birthing and breastfeeding, give us a shout and check out our Breastfeeding Arts Facebook page.  And I am sure Amber would love to be a resource for you if you’re in the Maryland, DC area, so check her out too, Nourish Breastfeeding.  Nothing beats hands on, face to face, sisterhood & support. But if that can’t be your first line of defense, Amber and I both would love to talk with you online.  So reach out and get the support your need.

Love & Blessings,

Deirdre

Breastfeeding & Returning To Work

Lenora and I frequently work with moms having to return to work.  Their concerns are universal — “how do I build a supply” “is this the right pump” “does it fit properly” “how do I store milk”  “what if my workplace is not supportive“.

The working mom transition can be incredibly stressful.  My very first tip is to not wait until just a week or two prior to your return date to start thinking about it.  Start early and plan ahead!  The best way to plan ahead is to get help early on with establishing a strong and abundant milk supply!  A strong milk supply is your golden ticket to sustaining a strong pumping routine and storing lots of milk!  And the best way to establish a strong supply is nurse often, frequently and with a great latch — let baby be your “best” pump and do the work of building a strong supply!  This way, when you start to pump – after your supply is well established — you can ease into the pumping routine with confidence.

If you have the ability, negotiate with your employer to return to work well after your milk supply has been established.  I do recommend waiting 4 – 6 weeks before you even start thinking about pumping & storing milk for a return to work.  That may seem obvious, but many women are in the difficult position of having to return to work so very soon, after only a few weeks post partum.  Negotiating maternity leave in our country is way too complicated a conversation to have here and now, but hopefully your employer is able to work with you to make your return as easy as it can be.  Part of that negotiation should be returning mid-week!  Don’t start on a Monday – pick a Wednesday or a Thursday, so you have a short work week that first week back.  Even better, see if you can negotiate working from home or part time for the first few weeks.

Consider that when you do return to work you’ll likely have to pump at least twice while you’re at work, and possibly three or four times during the day to keep up your supply.  A good rule of thumb is that the number of times you need to express milk will probably be equal to the number of feedings your baby will need while you are away.  If breastfeeding is well established, these pumping times should fall into place quite logically during the day.  You will begin to see a pattern with how and when you feel full and need to pump.  Consider way ahead of time what your schedule will be at work, what break times you may take and where you will be pumping.  A great resource for researching law and policy on breastfeeding, workplace & pumping issues is breastfeedinglaw.com.

One thing to keep in mind is that getting into a rhythm with pumping is easier said than done when you’re still home with baby!  After all, if baby appears hungry you’re going to offer your breast, so when and how are you going to squeeze in extra pumping during your regular day?   Rest assured, any pumping or hand expressing you do now will only help to get your body ready for the regular pattern of pumping you’ll be doing once you return to work.  I do recommend you invest in a good, high quality pump.  With pumping, you get what you pay for.  Quality pumps are expensive, but 100% worth it when it comes to building and maintaining a supply — when pumping day in and day out for a year or more you want a great machine!

One of the benefits many women find of pumping and bottle feeding during the day is the joy and connection that breastfeeding provides when you return home!  You *can* have the best of both worlds.  You may even find your night time nursing increases, as baby is thrilled to have you home and there to snuggle with all night long.  This is normal and a real blessing.  So embrace it!  Interesting bit of hormonal info — prolactin (the hormone that encourages milk production) levels are higher during night feedings, so if you snuggle with your baby and are readily available to nurse and cuddle at night, it will only help in maintaining your milk supply!   Night nursing is excellent, especially if you can get into a groove with sleeping and resting so you don’t feel exhausted by the night time feedings.

Similarly, weekends are for breastfeeding only if you can!  Feed “on demand”. This way you are protecting your milk supply and nurturing the time at the breast. Weekends can “re-set” your milk supply too if a long, exhausting week has left you feeling as if your supply has taken a dip.  Look at the weekend as a way to just nurse around the clock, and boost that supply.

If you have any questions about returning to work, pumps, how to use them, better brands, storing human milk, or building your supply, Lenora and I would be happy to make an appointment with you to discuss your needs.  We’ve worked with so many women returning to the work place, and each mother has different needs and different work place policy.  We’d love to help make the transition less stressful for you!

Do your Vit D Drops support your breastfeeding?

This has been bothering me for a while now.  This is Enfamil brand Vit D drops, considered “#1 Brand Recommended by Pediatricians” in the country.  A free sample is handed out in many peds office across the country.  Did I mention free?

You know what that means?  That means formula reps are in these offices providing free samples to hand out to breastfeeding mothers …. with the Enfamil brand boldly highlighted on the product.  You think maybe it being free is how they can claim #1 brand status?

Now look at this screen shot below.  This is Enfamil’s website.  Hypothetically, baby is now 2 months old and you’ve run out of the free sample and need to buy more.  You’ll likely have to buy more every month, at 10 – 15 bucks a pop, so that’s at least 100 bucks worth of D-Vi-Sol a year (I’ll come back to the economics of this in a minute).  You know where these guys are shelved in many stores?  Yup, right next to the formula.  Meanwhile, look what’s smack in the middle of their webpage.  Remember, you’re a breastfeeding mom trying find out where you can buy more Vit D in your area.  What’s that?  Why yes it is!  A nice “buy Enfamil now” button ….

And what of the ingredients?  Here they are, in order of how they appear on the box:

Glycerin

water

polysorbate 80

citric acid

vitamin D3

sodium citrate

sodium hydroxide

artificial flavor

artificial caramel color.

Hmmmmm …

Ok, now, I am NOT (really!) trying to sell you on anything.  I promise.  For around 20 bucks (depending on where you live and mark up) you can get Carlson for Kids drops where a single bottle lasts a year.

The advantages to buying these guys …

1. No formula cross marketing (yay).

2. You only need one drop (not dropper full) to babies tongue or your nipple or in a bottle of expressed milk a day.  Therefor, a single bottle will last upwards of a year.

3. I promised I’d get back to those economics.  $20 a year for Carlson versus $100 a year for Enfamil.  Kind of a no-brainer right?

4. Ingredients: Vit D3 and coconut oil.  That’s it.  Just two ingredients.

The pediatrician where I work is a distributor of Carlson.  As an IBCLC I take pride in working in an office where the MD is practicing responsibly and ethically. He buys Carlson drops and sells them to our mother/baby pairs (at the company recommended modest mark up).  He’s not making a ton of money on these.  But he is keeping mother/baby pairs in Vit D (for info on the importance of Vit D click here). And he’s doing so with a reputable brand without selling out to formula companies, handing out free samples or opening up questions on practice ethics.  Bonus: it is a very clear message in support of breastfeeding.

I don’t see why more pediatric offices can’t say no to free samples.  You don’t have to distribute Carlson brand.  You don’t have to sell anything.  Let’s just start with ending the free handouts from formula companies.  An office could easily provide families with local information on brands, so individuals can make their own choices on what to buy and where to shop.  If it’s a question of making sure they in fact go out and get Vit D, then do sell them yourself in the office.  But handing out free samples sends the wrong ethical message.  It takes very little effort to set up an account and become a distributor of a better brand like Carlson (and there are others out there).

Let’s keep Vit D supplementation cheap, with simple ingredients and free from formula Booby Traps.  I like that idea, don’t you?

Breastfeeding Good Start Top 5

Since I am often asked:  short, sweet, and to the point – my own top 5 ….

1. Resources - before you have your baby, know what your local resources are!  Consider taking a private prenatal breastfeeding class. Lenora and I are happy to come to your home while you are pregnant and help you understand what changes lay ahead for you and what the first weeks may be like.  Have info on hand for your local La Leche League group, new mother’s group and of course know the hospital or birth center breastfeeding support & policies where ever you are giving birth.

2. Understanding Latch - babies instinctively know how to open up wide to latch. But looks can be deceiving and before you know it, in those first few days you may have cracked and painful nipples.  If you suspect at all that your baby is having difficulty latching, reach out for help. I like this video that shows simple latch technique …

3. Nurse Frequently - lather, rinse, repeat. A newborn should feed every 2 -3 hours. This is normal! Even before milk comes in, when the magic of colostrum is all baby is getting – baby still needs to be at the breast frequently, or “on demand”.  This will best stimulate milk production in order to ensure an healthy and abundant milk supply.  Remember, “the economics of supply & demand” – the more baby empties the breast, the more milk you’ll produce!

4. Comfort - too often I’ll pay a visit to a mom in her home for a lactation consult and I’ll see her sitting on her couch looking like Quasimodo!  She’ll be kind of hugging her baby, knee up in the air, unsupported, back hunched, shoulders up to her ears, neck tight. Positioning is important, but so is comfort!  Set up your nursing station with everything you need at hand (water, phone, ipad, tv remote, book, glasses, snack, etc.).  Remember to let baby come to YOU, rather than you hunching over to come to baby.  Try laid back breastfeeding (BE the Diva laying on the couch) and let baby find the breast while you relax in a more reclined position.  And drop those shoulders, roll your neck a few times and remember to breathe.

5. Trust and belief - the first weeks can be so overwhelming. You’re flooded with joy, elation, doubt, panic, calm, exhaustion, pure love! Remember to trust those instincts.  If you feel something isn’t working right, trust that – get help, find support.  If all is going great, trust that too!  You will get into a rhythm and stride as a new mom. It gets better, easier, more familiar!  Hang in there and believe.