Holidays and Plugged Ducts

The winter season is upon us, and one thing I always like to talk about is plugged ducts. No, really...we see them so much more around holidays! Often it's because well-meaning friends and family want to hold and enjoy your baby and then feedings are delayed. Moms can also get run down, with too much activity and not enough rest. If you feel yourself getting a plugged duct (hard, sore area that may be reddened), do these three things: rest, use warm compresses (or a hot shower w/ massage), and feed very, very frequently. The secret to heading off a plugged duct before it moves to mastitis is to keep emptying the breast. In my old La Leche League days, we used to say, "Go to bed with the baby and don't stop nursing!" Now of course, co-sleeping is discouraged by the AAP, but you can still rest and feed all day long if you are able. If you begin to develop a fever, chills, or generally feel like you have the flu, call your doctor (OB or your primary care doc). You may need antibiotics, but DO NOT stop breastfeeding! If your doctor tells you your antibiotics are incompatible with nursing, DO call you lactation consultant  - many docs are not up on the latest research around medications and breastfeeding and we can give mothers information to take back to their doctor. If it is simply too painful to feed at the breast, you can pump, but try not to use bottles in the first month (there are other feeding methods). Finally, a plugged duct and/or mastitis should serve as a sign to slow down, take care of yourself, and maybe dial back the holiday frenzy a bit. I always say to moms - "It just has to be good enough" and it's true. Use the packaged pie, the ready-made cranberry sauce (who doesn't love that anyway??), and if people are coming over - just make sure the bathroom is presentable. You are doing something no one else can do for your baby and that's pretty damn important!

Breastfeeding Uncovered

I am loving this new video out of the UK!

Making a Plan

Childbirth is one of those things that you can plan for, take classes about, talk over with your friends and prepare for but in the end, nothing may go as planned. Breastfeeding can also be this way and in fact, some parents tell me they are preparing for pain and difficulty in the beginning (it shouldn't be painful!). Does this mean you shouldn't prepare? Absolutely not. A breastfeeding plan, like a birth plan can help to make your wishes known to the staff at a time when you may be tired and overwhelmed. A colleague sent this one  and the  information is simple and straightforward. Just to recap: you can plan, prepare and pack a cute bag, but things may change in the moment, particularly if you or your baby need special care.

Podcast Love

I am in love with podcasts. If that sounds like a bit of hyperbole, let me explain that I have a 45 minute commute to work and, as my co-worker Shelly says' "That song you like gets old pretty quick". I listen to things about breastfeeding, maternal health, science, and more. There is so much to choose from but here are a few of my favorites: Born to be Breastfed , Breastfeeding Medicine, Hidden Brain, Only Human and Terrible, Thanks for Asking (all on NPR). Yesterday, I was listening to Marie Biancuzzo's podcast about infant crying (from 4/24 - listen here). Marie feels that infants cry for two reasons: to meet an immediate need and to relieve stress. I tend to think that every infant need is immediate, in that newborns are not trying to manipulate you into feeding them sooner, or changing them on a whim. The needs and the wants are the same! However, the thought that a baby may be crying to just blow off steam is very intriguing..and much like our experience as adults. Remember how cathartic it can feel to have a good cry? Not when you are in physical or emotional pain, but when you've had a bad day, or the stress of life is just getting to you. Do infants feel this way? Is it frustrating to be out in the world after spending 9 months inside mom (a snug, carefully controlled, dim environment filled with white noise)? What Marie proposes is to let babies have

these moments, but hold them at the same time. We can't always meet our babies' needs, but we can hold them through it. Think of coming home at the end of a long, somewhat frustrating day at work. Maybe you were stuck in some traffic, and maybe the dog woke you in the early morning (yeah..I get that one!). You arrive home, have trouble finding your key, and start to cry. Your partner comes to you and, without trying to make you stop crying or distract you, he/she just holds you. Can you imagine how nice that might feel? How much better you'd feel afterward?

This is Your Baby

I teach a newborn care class and one of things I always say is, "This is your baby." I want parents to know that they can and should advocate for themselves and their child. This starts in the hospital: Do you want rooming-in? Are you wondering why your baby is being given a bottle? Would you like to help give your baby her first bath? Parents often tell me they feel like they have no control over what is happening to their baby (and to Mom) in the hospital, and that this is scary and confusing. The hospital staff has mother and baby's best interests in mind, but they do this every day, and may not be thinking about the  bewilderment of new parents. Feel free to ask questions, get involved in your baby's newborn care, and express any concerns you might have. Nurses and doctors appreciate direct communication and everyone will be happier if expectations are understood. Most of all, know that this is your baby and you are her parent, advocate, and caregiver - you can do this!

Breastfeeding and Breast Cancer

  I love reading clinical studies and analyses (I really do!) and this one, from the Breastfeeding Medicine journal, is very exciting. The meta-analysis looked at studies between 2008 and 2014 that examined the effect of breastfeeding on the risk of maternal breast cancer. The analysis found that not only is breastfeeding correlated with a reduce risk of breast cancer, but longer duration of breast feeding is even better. This sums it up: "Findings from this meta-analysis suggest that breastfeeding, particularly a longer duration of breastfeeding, was inversely associated with risk of breast cancer."

Sadly, this doesn’t mean that if you breastfeed, you will not get breast cancer. So, PLEASE Moms - do breast self-exams, talk with your doctor about when it’s right for you to have a mammogram, and reduce risk factors such as smoking. Most of all, remember to consider your own health (emotional and physical) as intertwined with your baby’s. Breastfeeding is just another way to take care of both of you.

New Year, New Thoughts

Well, we made it. 2017 is finally here. Over the last year I moved, bought a house, and took several trainings in maternal mental health. It became apparent to me that mothers need a lot more support than they are getting. What does this have to do with breastfeeding? A lot. I often tell mothers, "Healthy mom for a healthy baby", while encouraging them to rest, seek outside support, and even take carefully prescribed medication if needed. A mother who is breastfeeding often feels unable to do any of these things. How can I rest when the baby is cluster feeding? How can I go to an appointment if I can't leave the baby with anyone? Am I harming my baby if I take medication while nursing? These are all questions that may not get answered (at least correctly) for the mother. The OB may say, "You'll feel much better in six weeks" and the pediatrician may say, "The baby gained weight - good job!" A lactation consultant is in the unique position to see both mother and baby and assess their needs, while working to preserve the breastfeeding relationship. She can say, "Let's think of some ways to simplify feedings so you can get the most rest right now" or” Why don't we make up a pumping plan for the next week so it feels a little more manageable?"