Enough Said

A recent article from The New York Times

 "A Free Miracle Food"

If at First

   Many, many times a pregnant mom will come to me and say, “I want to breastfeed, but don’t know if I can – it didn’t work the first time”. I can think of a lot of success stories, but I feel really blessed when a mom that I have worked with has been able to nurse when she couldn’t before. Every baby is different and every birth is a new chance to breastfeed.

   What happened last time? It’s important to think about why breastfeeding was unsuccessful and see if those issues can be avoided this time. Often, early supplementation with formula is the culprit and it often happens in the hospital. This is such a set-up for problems! I tell moms to nurse early and often and to resist offers of formula (“so mom can rest”, e.g.). Babies don’t need to eat so much in the first 24-48 hours, nor do they automatically require supplementation if they have greater than 7-10% weight loss. An immediate assessment of breastfeeding, by an IBCLC, can help to turn things around.What about anatomical issues like tongue tie (baby) or inverted nipples (mom)? Inverted nipples can be easier to evert with later pregnancies and, a sibling of tongue-tie means that the baby should definitely be evaluated, both for tongue tie and labial or lip ties as well.Some situations cannot be resolved, such as glandular insufficiency or galactosemia, but these are not very common. Most important is to support the mother to have a new and better experience and hopefully, to successfully breastfeed.

Pay Me Now

       I haven't blogged for awhile, but recent events have led me to write again.

At the end of November our church was burned to the ground by an arsonist and, of course, the massacre in Newtown has been shocking and unbelievably sad. I was reminded this week of something I heard in a La Leche League meeting years ago: "Pay me now or pay me later". What does this have to do with tragedy? Breastfeeding? Kids? I think of the phrase as meaning, "Meet your kid’s needs now or they will go looking to meet them in other (potentially unhealthy) ways." I have to clarify that I am in no way suggesting that all mental illness stems from poor parenting or that people who do bad things must have been neglected as children. However, why not invest heavily in your most precious "product" - your kids?! 

        Ok - back to breastfeeding. Nursing your child gives them not only the healthiest start in life, but also the experience of being skin-to-skin with mom, being fed both emotionally and nutritionally. Breastfed babies tend to be fed more frequently (breastmilk is digested much faster than formula), are put to breast for both nourishment and non-nutritive sucking, and often spend more time with their moms. In fact, it is said that breastfed babies can smell the difference between their mother and another nursing mom in the first few days of life. Finally, human milk is for human babies (and ideally, breasts are for nursing). The first few years of life involve incredible brain development and doesn't your child deserve the best brain food? I can't guarantee that every breastfed baby will grow up to be a nice, kind, law abiding citizen, but I am willing to bet that there is a better chance for a good outcome if you begin with the best (or the breast!).

        

The "Frankenstorm"

 

    Here on the east coast, we are familiar with high winds, flooding, and power outages. The local stores have displays filled with flashlights, batteries, and bottled water; locals are out in their yards, putting away deck furniture and potential projectiles. However, as a lactation consultant, my thoughts go to those moms who are pumping and storing breast milk. This article, from the Florida Keys, has great tips on safely using and storing breastmilk during a power outage. If your baby is hospitalized, ask the hospital staff for their preferred guidelines.

      Now, a story: In 2005, I was pumping exclusively for my preemie who was in a hospital NICU two hours away. A high wind came through the area (the "Rogue Storm of 2005") without warning and winds gusted up to 100 miles an hour. We lost power for a few days and I was desperate to find a way to use my hospital grade electric pump. I asked around, and found a neighbor who had a generator. I went over to her house and found many neighbors (male and female) sitting around her kitchen table enjoying coffee. They pointed to the one outlet in the middle of the kitchen and said - "There you go!". I put aside modesty, and started to set up. I don't think they really realized what I was going to do because as soon as those flanges came out the husband jumped up and said, "I think there's another outlet in the garage". I would have pumped in the kitchen, but the garage was fine and most importantly, I was able to save that "liquid gold" (in a cooler) for my baby.

From the Archives

The subject of donor milk came up on a listserve for lactation professionals and it prompted me to dig out this old post, from 2011.

           Got Breast Milk?

        A recent discussion about donor milk got me pretty fired up this week. I applaud BWH for their use of donor milk, but I have some reservations about informal milk sharing. I wish the Globe article had mentioned the concerns around milk sharing and sites such as Eats on Feets (an online “bulletin board” for breast milk). Now, don’t get me wrong, I am a fierce proponent of breastfeeding - perhaps even a (gasp!) “Lactivist”, but trading breast milk via Craigslist is a little creepy. How do you know what that Mom is doing in her spare time? A couple of gin and tonics before dinner? A few tokes to relax? There are also viruses that can be transmitted via breast milk. HIV is the most obvious, but there is also CMV, a potentially lethal illness that can have few if any, symptoms. Proponents of human milk sharing say that human milk is best for babies, no matter where it comes from. There have been numerous formula recalls and I have yet to hear about a breast milk recall. However, there is a better solution: banked donor milk. I have volunteered with the Mother’s Milk Bank of New England and I can tell you that these folks are working tirelessly to provide a safe and viable alternative to formula for babies who cannot get their mother’s own milk.  I’m afraid that these informal milk sharers are sending the message that donor milk is too difficult and/or expensive to obtain. This is just not the truth. Most milk banks will not turn a mother away for inability to pay and in some cases, insurance will cover the cost.  Lactation professionals and breastfeeding allies need to educate and support mothers to nurse. When that is not possible, we can confidently encourage the next best option, banked donor milk.

Mommy's Milk is the Best

This email came via my stepmother's friend Bill:

I just returned from Laos where I led a workshop teaching Laotian filmmakers to make PSAs. In this workshop, we concentrated on messages about nutrition, primarily infant and mother nutrition. I am very proud of the work these filmmakers did during the 9 day workshop co-sponsored by the US Embassy in Vientiane and the Luang Prabang Film Festival. I'm excited to share their 11 short films with you at these sites.

http://www.youtube.com/playlist?list=PL1F6F9BFE04EF51F9

I particularly like video number 4 :)

Skin –So –Soft

 I have an idea for a research study: “The effects of skin-to-skin contact on withdrawal symptoms in drug- addicted newborns”. Sound good? I think so.  This article makes a good case too. Unfortunately, many pediatric workers do not agree. Drug-addicted babies are often isolated from the rest of the NICU, caregivers are advised that minimal stimulation is best for their fragile nervous systems, and the poor little guys are pretty miserable. We know that skin-to-skin helps to establish early breastfeeding (and increases duration) and also helps regulate temperature, oxygen sats, and heart rate.  These things are likely out of sorts in babies in withdrawal, so why not encourage skin-to -skin? Is it because parents are not to be trusted? They abused drugs, so they shouldn't hold their newborns? There are obvious cases in which the parents are MIA, but volunteers can take off their shirts for a good cause, right?

Gabrielle Hathaway, MS, IBCLC