First days of Breastfeeding

Breastfeeding in the hospital can sometimes be challenging for several reasons.  Supplementation is one of the roadblocks to success.  In addition to other reasons, there is a perception by the parents, visitors, family members and even staff that the baby needs to take in a lot of fluid in the early days so they believe mom's colostrum cannot possibly do the trick and that the baby will be hungry. 

Most infants are well hydrated at birth because of the placenta (nature's way of ensuring the baby is fine while mom is recovering and breastmilk volume is established).  Urine output usually exceeds fluid intake for the first 3-4 days after birth.  Small calorie-rich colostrum feedings of less than a teaspoon to a maximum of 3 teaspoons are the appropriate amount for the newborn's stomach which can hold only about this much on day one.  Why would we expect baby to take in more than this?  Yet, many of us do just that because we are comparing this feeding to that of an older infant.  Encouraging more by bottle will result in overfeeding and practically guarantees baby will spit up.  It is also enough to prevent low blood sugar in term infants.  It is also easy to manage while the infant learns to coordinate suck, swallow and breathing.  It is enough to satisfy their hunger and thirst as well as meeting the sucking needs of the newborn which are greater than the amount of food.  This sucking is also what helps bring in the mother's more voluminous mature milk.

As you can see, it's perfect!

Frankenstorm and other emergencies...

The March of Dimes had a great article today about being prepared in an emergency.  Read the full article here. 

"The media may be a bit dramatic at times, but they are right about one thing. Now is the time to make preparations and have a plan in place for your family to follow in case you ever need it."

Also, breastfeeding is especially important as a preparation for emergencies since you don't have to worry about obtaining and mixing formula with water that may not be pure.  There have been instances where women who have stopped breastfeeding were able to re-lactate - getting the breast to remember how to make milk through frequent stimulation by a nursing infant.

Check out this article from the March of Dimes blog, Feeding a Newborn After a Disaster.

We all hope to not have to face such emergencies, but should they occur, this article will help you to be prepared.

World Breastfeeding Week

Resources...

The timing was good for the recent changes to healthcare requiring insurance to pay for breastfeeding support. Read more at News Moms Need.

Utah Breastfeeding Coalition
CDC site for Breastfeeding
Utah's 7th Annual Breastfeeding Cafe at the SLC Public Library Complex during the month of August - get involved and show your support, join with others and get help
World Health Organization - World Breastfeeding Week
Utah Breastfeeding Resource Guide
Facebook - World Breastfeeding Week
Facebook - Beautiful Breastfeeding
Facebook - Dispelling Breastfeeding Myths
PRAMS Perspective - Breastfeeding in Utah (stats/facts/surveyed mothers)
LaLeche League of Utah
Text for Baby - app
March of Dimes - How to, etc.

Breastfeeding fights obesity

WebMD reports:

A large new study shows postmenopausal women who breastfed for at least six months had a lower body mass index (BMI) than those who did not, regardless of how many children they had.

The longer women breastfed, the bigger the benefits. Read the rest here.

Exercise and breastfeeding

Breastfeeding in the News

June 20, 2012 – GMA News reports on a new study published in Pediatrics that found that breastfeeding mothers who exercise do not inhibit the growth of their babies. Researchers reviewed four clinical trials done between 1994 and 2009. In each, researchers recruited sedentary breastfeeding mothers, then randomly assigned half of them to a moderate exercise program. The other half were to remain inactive. In two of the studies, the mothers also cut calories to lose weight. A total of 170 mothers participated in the four studies. On average, babies of exercising mothers in the studies gained slightly more weight than the babies of mothers not physically active. Researchers said this could be due to chance. The researchers concluded that mothers could safely exercise while breastfeeding.

One Day Deal

Comfy nursing bras at Target - special today is two for $13. You could totally sleep in this!

State breastfeeding laws

Check this site to find out how your state rates in breastfeeding laws.

Here's what it says for Utah,
Utah Code Ann. § 17-15-25 (1995) states that city and county governing bodies may not inhibit a woman's right to breastfeed in public.
Utah Code Ann. § 76-10-1229.5 (1995) states that a breastfeeding woman is not in violation of any obscene or indecent exposure laws. (HB 262)

Breastfeeding Class Deal

Only six days for this deal, but it's worth checking out.  A three hour breastfeeding class with a doula or a two hour in-home meeting with a doula for $20.  Click here for more information on today's deal.

A Fun Event this Friday, July 22nd!

Salt Lake City was chosen to be one of only 35 cities on Latch On America's cross country tour. The Utah Breastfeeding Coalition and the La Leche League have organized an event this Friday, July 22nd from 4-7 PM to bring together breastfeeding support in our community. The location is the east side of Library Square in the grassy area. There will be booths, entertainment, games, prizes, coupons, Kids' classes demos (music, movement, art), facepainting, and more. For more information on this event and the upcoming Breastfeeding Cafe, please visit www.breastfeedingcafe.wordpress.com.

Breastfeeding Videos - 2nd time and sleepy baby

Click here to view a good British video with a lactation counselor. Many issues are addressed, including breastfeeding the second time around.

I like this one because it addresses the common problem (especially while in the hospital) of sleepy baby, but it also shows a woman with large breasts.  Sometimes these women worry they will have problems but in breastfeeding size doesn't matter and every woman is different, but her breasts are perfect for her baby.  Click here.

Deal of the Day

 These deals come along every now and again.  We advocate nursing in public without the NEED for a cover, but if you would be more comfortable, by all means.  This one has a stiffening at the top so you can see your baby and it's nicer than having a blanket right on her head, unless that's what your baby likes.

Use code EASTER to get a $40 Nursing Cover for Free!  Udder Covers

Then, you can head over and get a (MSRP) $48.00 Baby Sling for Free with code EASTER. Seven Slings

Each will cost around $10 for shipping and handling (a little pricey) but considering they are otherwise free (MSRP: $40-$50 each), that is a steal! Great to have on hand for baby showers too!

Breastfeeding equipment is a flex-eligible expense

IRS Decision a Victory for Nursing Mothers Everywhere

"Breastfeeding Equipment to be Allowed as Medical Tax Deduction and Reimbursed by Flexible Health Spending Accounts" (announced Feb. 10, 2011)

The previous ruling excluded breast pumps from coverage under flexible health spending accounts and made them non-deductible on tax returns.

Mothers returning to work and/or school need a way to continue breastfeeding their babies.  This is good news if you use flexible spending or have medical tax deductions.  More is needed but this is a good place to start, acknowledging the huge health benefits of breastfeeding.

Wake up call - preparedness

http://www.msnbc.msn.com/id/42128739/ns/world_news-asiapacific/

Recent disasters remind us how important it is to be as prepared as possible.  Read here for tips on preparedness for child care and feeding of infants and young children in emergencies.  Breastfeeding is one thing you can easily do.  Once you have established your milk supply, your baby will be able to get safe food, regardless of the water supply contamination and inability to get artificial infant food.  Tsunami, earthquake, hurricanes, floods, etc. have shown us that baby formula is always hard to come by.  If you have chosen to breastfeed your baby, and you stay with it, you have one important element of your preparedness already taken care of.  Women have even been able to establish relactation of weaned infants in such emergency situations with determination and effort.  Even in times of privation, mothers have been able to successfully feed their babies.

US Breastfeeding Committee
American Academy of Pediatrics
Survival Blog

Please get a 72 hour kit for emergency evacuation purposes and survival for a few days if necessary! Here is a PDF checklist from about.com

Summary

1. Know that  a disaster could occur in your area.  Learn evacuation routes and meeting places.  Check out http://www.ready.gov
2. Plan (on paper) the steps you should take in an emergency and share with family members.  Not talking about them can be critical.  If you never talk for fear of scaring them, you won't be in the best possible place for safety and reunion.  Know where you would go if you can't go home and have an "emergency check-in" contact person.  It's good to have someone local and someone out of state in case local lines are jammed but you can get outside.  This happened in hurricane Katrina.
3. Pack emergency supplies to meet your basic needs for three days in case you have to "grab and go" in an evacuation.  Include water (plastic soda bottles rinsed and stored with water work well and can be toted in backpacks), food, baby care items, flashlight/batteries, first-aid kit.

A few more helpful things in a kit might include:

• ID for yourself and children (birth certificates, SS cards, immigration papers, school records)
• Funds that are accessible - cash (not in huge bills), traveler's checks, credit cards and checkbook.
• Keys to house, car, safety deposit box, etc.
• Calling card, cell phone and battery (may or may not be usable).  Don't forget the number of the emergency contact person.
• Medications needed regularly

http://www.womenshealth.gov says "breastfeeding protects babies from the risks of a contaminated water supply and helps protect against respiratory illnesses and diarrhea which can be fatal in a disaster.  You can step up mother's milk even if you have been giving formula.  see http://www.llli.org

More safety information about food and water can be found here:  http://www.bt.cdc.gov/disasters/foodwater

Breastfeeding Confidence

In Utah we have excellent rates of breastfeeding initiation.  In fact, we lead the nation.  The challenge comes in sustaining those levels.  We analyze data collected from new moms throughout the state.  The results indicate that the number one reason women stop breastfeeding before the recommended six months (exclusive), 12 months (with solid foods, but still as the primary food) or 24 months (as recommended globally) is lack of confidence. 

They don't believe they have enough milk.  Usually it's a perception; not a fact.  The baby seems to want to continue to suck after a feeding (this is the baby's normal reflex that encourages her to feed and survive)  Or the baby is fussy (there are other reasons for fussiness besides hunger), or the breasts don't feel full like they did at the beginning (also normal since swelling is reduced and milk supply and demand kicks in).

If there truly is a supply issue, it most often is caused by giving early supplements to the baby.  Breasts will not make more milk than is determined by the baby's feedings.  If the baby is getting nutrition elsewhere, the message will not go to the brain to make more milk.  So, it's a downward spiral.  The less your baby nurses, the less milk you have; the less milk you have, the more likely you are to supplement with artificial foods.

Read here for some good insight about this (Opposing Views article by Pinky McKay, an Internationally Certified Lactation Consultant)

Here closing comment is oh, so true: 

"Above all, rather than worrying about how much milk your baby is getting, try to relax and enjoy each feed as a time of loving interaction between you and your baby. By watching, listening and getting to know your baby’s nonverbal cues that say, I am hungry, tired, I want to play or please give me some quiet space, you will realise [sic] that you are the expert about your baby and you will be able to turn a deaf ear to negative voices. This is self- confidence!" 

Marketing strategies - Warning!

Babies are big business.  
BlogHer shared this newest marketing strategy by the makers of Similac artificial feeding products.  They want moms to buy Similac (formula for MOMS) as though breastfeeding moms need their products and if they aren't getting what they think is their share of your money for infant feeding, they'll market to you and further brand you.  It's showing up in Canada so it's just a matter of time.  Don't fall for it! 

One of the many advantages of breastfeeding is that it's free and something only you can give.  It doesn't require a special diet or "formula."   "As if this weren’t all bad enough, the second listed ingredient in Similac Mom is sugar.  And there’s no fiber in it to boot."  Just so you know....

Another marketing technique is by the makers of Enfamil - Expecta. This is simply an omega 3 supplement. Marketing to pregnant moms is important to the industry as breastfeeding becomes ever more the norm. Use the product if you like but be aware of the marketing and branding that's going on here.  They want their name to be synonymous with healthy baby in your mind and their ultimate goal is to sell infant formula (artificial baby milk) which is inferior to what you can give naturally.  There's nothing special about it.

Another first for Utah

Human milk for human babies has long been realized to be the best but sometimes the mother cannot provide it.  Donated milk is the next best thing to mother's own.  Until now, women in Utah who donated their frozen milk had to ship it to the Denver human milk bank at their own expense.

Now they can donate locally and the University Redwood Clinic will store and ship it. Read the story in the Salt Lake Tribune. 

The University of Utah has opened the state’s first human-milk donation site, where women will be able to provide breast milk to infants in need.  This is a wonderful development to help insure the best milk for babies who cannot get it from their own mothers.  Hopefully we will soon get our own milk bank here in Utah.

Valentine Special

Jenny at UdderCovers has extended this special  Valentine's Promo Code.   1.  Go to UdderCovers.com . 2.  Click on "Shop Now" and select any nursing cover. 3.  Once you have made your selection, you'll be  directed to the shopping bag. Enter the promo code  " VALENTINE " and we'll deduct 100% of the cost  of the cover - all you pay is shipping! Remember: the promo code is " VALENTINE "  and it can be used more than once - just open a new  browser window each time you do.   Don't delay as selections dwindle.

Surgeon General Call to Action

News Release

FOR IMMEDIATE RELEASE Thursday, January 20, 2011

Contact: OASH Press Office (202) 205-0143

Everyone Can Help Make Breastfeeding Easier, Surgeon General Says in “Call to Action”

Benjamin cites health benefits, offers steps for families, clinicians and employers

WASHINGTON, DC, Jan. 20, 2011 - Surgeon General Regina M. Benjamin today issued a “Call to Action to Support Breastfeeding,” outlining steps that can be taken to remove some of the obstacles faced by women who want to breastfeed their babies.

“Many barriers exist for mothers who want to breastfeed,” Dr. Benjamin said. “They shouldn’t have to go it alone. Whether you’re a clinician, a family member, a friend, or an employer, you can play an important part in helping mothers who want to breastfeed.”

“Of course, the decision to breastfeed is a personal one,” she added, “no mother should be made to feel guilty if she cannot or chooses not to breastfeed.”

While 75 percent of U.S. babies start out breastfeeding, the Centers for Disease Control and Prevention says, only 13 percent are exclusively breastfed at the end of six months.  The rates are particularly low among African-American infants.

Many mothers who attempt to breastfeed say several factors impede their efforts, such as a lack of support at home; absence of family members who have experience with breastfeeding; a lack of breastfeeding information from health care clinicians; a lack of time and privacy to breastfeed or express milk at the workplace; and an inability to connect with other breastfeeding mothers in their communities.
Dr. Benjamin’s “Call to Action” identifies ways that families, communities, employers and health care professionals can improve breastfeeding rates and increase support for breastfeeding:

• Communities should expand and improve programs that provide mother-to-mother support and peer counseling. 
• Health care systems should ensure that maternity care practices provide education and counseling on breastfeeding.  Hospitals should become more “baby-friendly,” by taking steps like those recommended by the UNICEF/WHO’s Baby-Friendly Hospital Initiative.
• Clinicians should ensure that they are trained to properly care for breastfeeding mothers and babies.  They should promote breastfeeding to their pregnant patients and make sure that mothers receive the best advice on how to breastfeed.
• Employers should work toward establishing paid maternity leave and high-quality lactation support programs.  Employers should expand the use of programs that allow nursing mothers to have their babies close by so they can feed them during the day.  They should also provide women with break time and private space to express breast milk.
• Families should give mothers the support and encouragement they need to breastfeed.

Family members can help mothers prepare for breastfeeding and support their continued breastfeeding, including after her return to work or school.

According to the “Call to Action,” breastfeeding protects babies from infections and illnesses that include diarrhea, ear infections, and pneumonia. Breastfed babies are also less likely to develop asthma, and those who are breastfed for six months are less likely to become obese.  Mothers themselves who breastfeed have a decreased risk of breast and ovarian cancers.

A study published last year in the journal Pediatrics estimated that the nation would save $13 billion per year in health care and other costs if 90 percent of U.S. babies were exclusively breastfed for six months. Dr. Benjamin added that, by providing accommodations for nursing mothers, employers can reduce their company’s health care costs and lower their absenteeism and turnover rates.

“I believe that we as a nation are beginning to see a shift in how we think and talk about breastfeeding,” said Dr. Benjamin.  “With this ‘Call to Action,’ I am urging everyone to help make breastfeeding easier.”
To order printed copies of the Surgeon General’s “Call to Action to Support Breastfeeding” and other materials, please call 1-800-CDC-INFO or email cdcinfo@cdc.gov and reference the publication title.

For more information on breastfeeding, go to www.cdc.gov/breastfeeding or www.womenshealth.gov/breastfeeding/.  To speak with a breastfeeding counselor call 1-800-994-9662 Monday through Friday, 9:00 AM to 6:00 PM ET.

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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Last revised: January 20, 2011

New Guidelines on Food Allergies

We have had question about whether or not a breastfeeding or pregnant woman should avoid certain foods that tend to be high on the allergy list. 

The first food allergy guidelines were issued today by the National Institutes of Health's National Institute of Allergy and Infectious Diseases (NIAID).  These guidelines include the following information as it relates to pregnancy and breastfeeding.

The panel defines food allergy as "an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food."

Delaying of Foods Not Warranted
The guidelines do not recommend restricting maternal diet during pregnancy or lactation to prevent the development or clinical course of food allergies, but they do recommend exclusive breast-feeding of all infants until age 4 to 6 months, unless medical reasons contraindicate breast-feeding. 

According to Dr. Sampson, the guidelines concur with current American Academy of Pediatrics guidelines. "There is no evidence that delaying certain foods, even foods that are considered allergenic, (is) going to have any significant effect on the development of allergy," he said.

 Once more, exclusive breastfeeding is supported and allergies can be avoided by doing that.  It is worth investing in lactation services to be sure a new mom is successful in this effort and supplements should be avoided whenever possible.

Medical reasons not to breastfeed include a very few diseases, taking certain medications (also very few).  Unfortunately some mothers and babies miss out on this amazing opportunity without thoroughly checking this out.  The Pregnancy Risk Line is the best resource to learn what is likely safe or unsafe since testing by the FDA of drugs does not include pregnant and nursing mothers.  Therefore the Physician Desk Reference and package inserts routinely say, "not to be taken by pregnant or breastfeeding women without physician recommendation" or "inadequate information available to determine the safety in pregnant or breastfeeding mothers."  The PRL joins forces throughout the nation to gather evidence after thousands of women have used the drug and are able to give a more helpful recommendation for or against breastfeeding.  More often than not, the drug is safe.  Your physician may be very busy or not committed to successful breastfeeding and may not get this more updated info, relying only on the manufacturer's statement so a pro-active mom is a more informed mom.  Call them at (800) 822-2229 or (801) 328-2229.

Babywearing

Safe babywearing - read here (CPSC)